Application of Onodera prognostic nutrition index in prognostic evaluation of elderly patients with colorectal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To study the applied valuation of Onodera prognostic nutrition index (Onodera index) in elderly patients with colorectal cancer.</p><p><b>METHODS</b>Onodera indexes of 163 elderly patients with colorectal cancer were calculated and these patients were divided into better-nourished group (Onodera index ≥45) and under-nourished group (Onodera index <45). Correlations of Onodera index with general data, operation type, postoperative complication, recovery of gastrointestinal function, clinicopathological feature and prognosis were analyzed. Cox proportional hazards model was also established to identify the independent prognostic factors for prognosis of elderly patients with colorectal cancer.</p><p><b>RESULTS</b>Patients in better-nourished group had significantly higher radical resection rate [90.9% (70/77) vs. 62.8% (54/86), P<0.01], lower postoperative complication rate [17.1% (12/70) vs. 53.7% (29/54), P<0.01] and earlier postoperative defecation [(3.09±1.14) d vs. (3.43±1.98) d, P<0.05] than those in under-nourished group. Onodera index was found to be related to age, tumor location, tumor size, and operation type (all P<0.05). Better-nourished group had significantly better survival than worse-nourished group (5-year survival rate: 64% vs. 24%, P<0.01). Onodera index was identified as an independent prognostic factor for elderly patients with colorectal cancer (RR=0.888, 95%CI:0.800-0.985, P=0.025).</p><p><b>CONCLUSION</b>Onodera index is a valuable clinical marker in preoperative estimation as well as prognosis prediction for elderly patients with colorectal cancer.</p>

Effect of branched-chain amino acid-rich parenteral nutrition on protein metabolism after partial hepatectomy in rats with liver cirrhosis / 南方医科大学学报

<p><b>OBJECTIVE</b>To observe the effect of parenteral nutrition (PN) with branched-chain amino acid supplementation on protein metabolism after partial hepatectomy in rats with liver cirrhosis.</p><p><b>METHODS</b>Eighteen rats with liver cirrhosis were randomly divided into pre-operation group (n=6), post-operation 8.5% Novamin PN group (n=6) and post-operation 10% Hepa PN group (n=6), with 6 normal rats severing as the normal control group. Five days after the operation, serum albumin (ALB), insulin-like growth factor I (IGF-1) and plasma amino acid spectrum were measured, and ALB mRNA level in the liver was assayed using RT-PCR.</p><p><b>RESULTS</b>Postoperative serum ALB was similar between 10% Hepa PN and 8.5% Novamine PN groups, but the rats in the latter group showed significantly increased serum IGF-1 level, Fischer ratio and hepatic ALB mRNA expression (P<0.05).</p><p><b>CONCLUSION</b>Administration of PN with branched-chain amino acid supplementation can ameliorate plasma amino acid spectrum and increase protein synthesis in rats with liver cirrhosis after partial hepatectomy.</p>

Effects of amino acid solution and recombinant human growth hormone on growth hormone/insulin like growth factor-1 axis in rats with liver cirrhosis / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the effects of amino acid solution and recombinant human growth hormone on growth hormone/insulin like growth factor-1 (GH/IGF-1) axis after partial hepatectomy in rats with liver cirrhosis.</p><p><b>METHODS</b>Six normal rats severed as normal group, while 30 rats with liver cirrhosis were randomly divided into preoperation group, 1 day postoperative group, 8.5% Novamin PN for 5 days postoperative group, 10% Hepa PN for 5 days postoperative group and rhGH + 10% Hepa PN for 5 days postoperative group. Liver function, blood glucose and serum GH, IGF-1, IGFBP-3 were determined. ALB mRNA, IGF-1 mRNA and IGFBP-3 mRNA levels in liver tissues were detected by RT-PCR. Liver Ki67 immunohistochemistry staining was studied.</p><p><b>RESULTS</b>Compared with the 8.5% Novamine PN group, serum ALT [(103 +/- 23) IU/L vs (154 +/- 45) IU/L], ALP [(571 +/- 92) IU/L vs (972 +/- 252) IU/L], GH [(1.55 +/- 0.12) ng/ml vs (1.81 +/- 0.11) ng/ml] level were lower (P < 0.05), serum IGF-1 [(966 +/- 55) ng/ml vs (813 +/- 43) ng/ml] and IGFBP-3 [(8.1 +/- 0.3) ng/ml vs (6.9 +/- 0.2) ng/ml] level and the expression of hepatic ALB mRNA (1.24 +/- 0.06 vs 1.02 +/- 0.09), IGF-1 mRNA (0.85 +/- 0.00 vs 0.60 +/- 0.03), IGFBP-3 mRNA (0.69 +/- 0.02 vs 0.58 +/- 0.09) were higher in the 10% Hepa PN group (P < 0.05), but there was no difference in liver Ki67 labeling index [(4.8 +/- 0.3)% vs (4.4 +/- 0.4%)] (P > 0.05). Compared with the 10% Hepa PN group, serum ALP [(434 +/- 41) IU/L vs (571 +/- 92) IU/L] was much lower (P < 0.05), serum ALB [(37.0 +/- 1.8) g/L vs (32.8 +/- 1.2) g/L], blood glucose [(7.6 +/- 1.3) mmol/L vs (4.9 +/- 0.7) mmol/L], GH [(3.00 +/- 0.61) ng/ml vs (1.55 +/- 0.12) ng/ml], IGF-1 [(1100 +/- 32) ng/ml vs (966 +/- 55) ng/ml], IGFBP-3 [(9.3 +/- 0.2) ng/ml vs (8.1 +/- 0.3) ng/ml] level, the expression of hepatic ALB mRNA (1.35 +/- 0.04 vs 1.24 +/- 0.06), IGF-1 mRNA (0.97 +/- 0.00 vs 0.85 +/- 0.00) and liver Ki67 labeling index [(5.4 +/- 0.3)% vs (4.8 +/- 0.3%)] were higher (P < 0.05) in the rhGH + 10% Hepa PN group.</p><p><b>CONCLUSIONS</b>Amino acid solution and recombinant human growth hormone can influence the GH/IGF-1 axis in rats with liver cirrhosis. It may be helpful in selecting and evaluating nutrient by measuring the serum IGF-1 and IGFBP-3 level.</p>