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In the 42 nd and 44 th workshops of CSPEN-nutritional risk-undernutrition-support-outcome-cost effectiveness ratio (NUSOC) multi-center database collaboration group, Jens Kondrup and Henrik Rasmussen described again the application of NRS 2002, the evidence-based basis of NRS 2002 development and the methodology for prospective validation of clinical effectiveness. There is no gold standard for validation. They both considered that malnutrition could be identified as a score of 3 or more for impaired nutritional status in NRS 2002. Although NRS 2002 is simple and easy to be applied, it is not comprehensive enough for malnutrition diagnosis. ASPEN and ESPEN on-line published the Global Leadership (nutritional) Initiative on Malnutrition(GLIM)diagnosis criteria in September 2018. With the gradual implementation of medicare payment based on diagnosis related groups(DRG)in China, the nutritional risk and the malnutrition diagnosis with Chinese version of ICD-10 (2016) code should be recorded in the first page of the medical records. In this terminology interpretations, the terms of nutritional risk screening(NRS 2002.01.016)and malnutrition diagnosis (GLIM-phenotypic criteria 01.028, etiologic criteria 01.029) published in Parenteral and Enteral Nutrition Terminology 2019 are discussed based on the reports given by Kondrup and Rasmussen in Beijing and Zhengzhou.
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OBJECTIVE:To explore optimization method and effect of clinical pharmacists on anticoagulants therapy plan for cancer patient with venous thromboembolism(VTE). METHODS:Clinical pharmacists participated in the whole process of antico-agulant therapy for one case of breast cancer complicated with VTE. Clinical pharmacists suggested patient to initially take low mo-lecular weight heparin sodium 0.6 ml,sc,qd;and then take Warfarin sodium tablet 3 mg,po,qd;initial plan and oral dosage form plan superimposed and alternated,and pharmaceutical care and medication education were also provided for the patient. RESULTS:Physicians adopted clinical pharmacist's suggestions,and the patient received anticoagulant therapy for 27 days and paclitaxel che-motherapy once. Coagulation function INR was 2.71;the patient didn't felt discomfort and then discharged from hospital. CON-CLUSIONS:The participation of clinical pharmacists in the optimization of individualized anticoagulant therapy and pharmaceutical care is able to promote rational drug use,prevent severe ADR in the clinic,guarantee the safety of drug use and improve medica-tion compliance.
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Objective To evaluate the influence of diabetes on cancer stage,treatment,and overall survival rate among newly diagnosed cancer patients,and the correlation between diabetes mellitus and cancer.Methods Total 16 890 newly diagnosed cancer patients were analyzed retrospectively.Morbidity rate of diabetes mellitus,stage of cancer,cancer treatment,survival rate,and comorbidities were collected and compared.Results 9.57% of those 16 890 cancer patients were suffering from diabetes by the time of cancer diagnosis.The prevalence of diabetes was high among patients with pancreas cancer (18.76%),renal cancer (16.76%),colorectal cancer (12.34%),and uterine cancer (10.97%).Colorectal cancer was often diagnosed at an advanced tumor stage.Compared with those without diabetes,diabetic patients with colorectal cancer,gastric cancer,and endometrial carcinoma were more likely to receive surgical treatment.Unadjusted analyses showed that the median survival time and percent alive at 3 years in cancer patients with diabetes were significantly reduced in all types of cancers,except for prostate cancer,as compared with those cases without diabetes.After adjustment for occurrence of cardiovascular disease,diabetic patients with colorectal,breast,endometrial,ovary,prostate,kidney,and lung cancers still had a 8%-55% increased risk of mortality compared to cancer patients without diabetes mellitus (P＜0.05).Conclusion The prevalane of cancer in diabetes is higher than non-diabetics.Diabetic cancer patients are frequently treated less aggressively and have a worse prognosis compared to those without diabetes.
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Objective: To observe the analgesic effect and adverse effects of Controlled-Release Oxyco-done tablets(oxycontin) on moderate and severe chronic cancer pain, and the improvement of quality of life(QOL) in the cancer patients after the treatment. Methods: A total of 72 patients with moderate and se-vere chronic cancer pain were selected .The analgesic effects,adverse effects and quality of life (QOL) were observed and evaluated. Controlled-Release Oxycodone tablets were administered at an initial dose of 5 mg or 10 mg every 12 hours according to the degree of pain. The next analgesic dose should be adjust-ed if breakthrough pain occurs more than twice in 24 hours. If the initial dose is 5 mg, it may be increased to greater than or equal to 10 mg. If the initial dose is greater than or equal to 10 mg, the dosage may increased by 25%～50%. Short-acting morphine tablets are used to control the breakthrough pain. Results: The doses ranged between 10～100mg/d .Among the 72 patients with moderate and severe chronic cancer pain, 12 (16.7%)achieved complete remission ,52(72.2%)achieved partial remission,6(8.3%) achieved minor remis-sion.The overall rate of pain relief 88.9%. The mainly adverse reactions were including, nausea and vomiting, dizziness, drowsiness and dysuria. Followed the reduced of the pain intensity ,the QOL of most cancer pa-tients was improved. The KPS of 12 patients had been obviously improved, 20 patients had mildly improved, and 40 patients were stabilized. Conclusion: Oxycodone hydrochloride controlled-release tablets are effective and safe for the management of chronic cancer patients with moderate and severe pain, with less adverse reactions, and the QOL of cancer patients were significantly improved.
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Colorectal cancer has the propensity to develop liver-dominant metastases.In some of these patients,the liver is the only site of metastatic disease.Thus,surgical resection is the mainstay of treatment for liver-only colorectal cancer metastases,which can produce long-term survival in selected patients,but only 10%-20% of patients are suitable for a surgical approach.In this paper we introduced how to transfer the inoperable colorectal liver metastases to operable colorectal liver metastases through improved chemotherapy with /without molecular target therapy and multidisciplinary treatment approaches,and the results of radiofrequency ablation(RFA),which can also produce long-term survival in a subset of patients with colorectal liver metastasis or prolong survival duration.
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Objective: To evaluate effect of combination of PA and RES on human gastric carcinoma cell MGC803 in vitro.Methods :The effects of PA and RES were measured by MTT assay.Morphous of cell was observed by light microscope.Flow cytometry was used for MGC803 cell cycle analysis.Results: PA significantly inhibited the growth of MGC803 cell in a dose and time dependent way(P
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AIM: To investigate the role of nuclear factor ?B (NF-?B) in the induction of IL-8 gene by TNF-? in colon cancer cells and the effect of antioxidant on the induction of IL-8. METHODS: ELISA was used to detect the concentrations of IL-8. IL-8 mRNA was analyzed by using RT-PCR. NF-?B in the cell nuclei was detected with electrophoretic mobility shift assay. RESULTS: (1) IL-8 production and IL-8 mRNA expression induced by TNF-? was blocked by pyrrolidine dithiocarbamate (PDTC). (2) TNF-? triggered the activation and translocation of NF-?B and PDTC inhibited the activation of NF-?B induced by TNF-?. CONCLUSION: The induction of IL-8 gene and protein by TNF-? is dependent on the activation of NF-?B. Antioxidants may inhibit the induction of IL-8 gene and protein through inhibiting NF-?B activation.
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AIM: To evaluate the influence of radiofrequency (RF) hyperthermia on immunity function in mice. METHODS: The expression pattern of T helper type 1 (Th1) and T helper type 2 (Th2) cytokines in splenocyte culture supernatants, mainly the expression levels of IFN-?, IL-2, IL-4 and IL-10 in splenocyte culture supernatants of mice in tumor-bearing group, surgical resection group, RF therapy group and normal control group were detected by enzyme-linked immunoadsordent assay (ELISA). RESULTS: IL-2 concentration in two weeks after RF therapy group was higher than that in two weeks after surgical resection and normal control groups (P0.05). CONCLUSION: RF hyperthermia may activate the transformation from Th2 to Th1 and facilitate the excretion of Th1 type cytokines that play an important role in the anti-tumor immunity.
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AIM:To investigate the changes of apoptosis and activation of I??-? induced by vinblastine via the blockage of caspase-3 signal transduction pathway, and to explore the possible mechanism of signal transduction pathway involving in the vinblastine-induced apoptosis. METHODS: The breast cancer cell lines Bcap37 were treated with different concentrations of vinblatine dissolved in dimethyl sulphoxide (DMSO) or caspase-3 inhibitor (DEVD-CHO, 100 ?mol/L) for 3 h. The changes of the proliferation were detected by MTT methods. The apoptosis was determined by observing the internucleosomal DNA cleavage and PI staining, and the proteins of pro-caspase-3 and I??-? were detected by Western blotting methods. RESULTS: The results showed that vinblastine induced the pro-caspase-3 degradation. The significantly attenuation of vinblastine-induced apoptosis in breast cancer cell line by caspase-3 inhibitor DEVD-CHO was verified by MTT assay, internucleosomal DNA cleavage and flow cytometry PI staining analysis. The IC50 was 56.8 ?mol/L and 87.4 ?mol/L respectively for two groups. The inhibition of vinblastine-induced phosphorylated degradation of I??-? was also observed by DEVD-CHO. CONCLUSION: Based on these finding, vinblastine induces apoptosis in breast cancer cells via NF-??/I?? signal transduction pathway, which is co-operated by caspase signal pathway. Through the blockage of caspase pathway with caspase-3 inhibitor, vinblastine-induced apoptosis and the phosphorylated degradation of I??-? in breast cancer cells are suppressed greatly.