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Objective:To investigate the nutritional status of patients with locally advanced nasopharyngeal carcinoma (NPC) and its relationship with prognosis. Methods: From August 2015 to March 2018, 53 patients with locally advanced NPC hospitalized for treatment at the Department of Radiotherapy at Hubei Cancer Hospital, Wuhan, China, were enrolled in this study. The patient-generated subjective global assessment (PG-SGA), anthropometry measurements, hematological indexes, and side-effects of radiation and chemotherapy were used to evaluate the nutritional status. Survival and its influencing factors were further analyzed using the Kaplan-Meier estimator and a Cox proportional hazards regression model. Results: 94.3% of the locally advanced NPC patients lost weight. The average weight loss was 6.89 ± 0.54 kg. Of those NPC patients who lost weight, 50.94 % had more than 10% weight loss. According to the PG-SGA score, 84.9% of the NPC patients had severe malnutrition (PG-SGA≥9). A highly negative correlation was observed among lymphocyte count (TLC), red blood cell (RBC), hemoglobin (Hb) level, albumin (ALB) level, and PG-SGA scores (all P<0.05). A highly positive correlation was observed among oral mucositis, difficulty swallowing or pain, anorexia, rate of weight loss, and PG-SGA scores (all P<0.05). Univariate and multivariate analyses showed that a high TNM stage and more than 10% weight loss during treatment were associated with an unfavorable prognosis. A high level of white blood cells (WBC), within the normal range, was associated with a better survival rate (All P<0.05). Conclusions: Patients with locally advanced NPC had a high incidence of malnutrition in this study. PG-SGA combined with anthropometry measurements, hematological indexes, and side-effects of radiation and chemotherapy can help evaluate the nutritional status of patients with NPC more comprehensively. A high TNM stage, more than 10% weight loss during treatment, and high WBC counts were independently associated with prognosis and survival among patients with locally advanced NPC.
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Objective To evaluate the dietary quality of children aged 3 to 6 years during the kindergarten period in Lanzhou City using the Dietary Balance Index (DBI). Methods Based on kindergarten grades and geographical locations, 304 recipes for different semesters from 2014 to 2017 in 40 kindergartens in Lanzhou City were randomly selected with a sampling ratio of 5％(291 recipes with no recipes 13 copies) as the research object. Adjusted DBI indicators for children aged 3 to 6 years were used to evaluate the dietary quality of the recipes during the kindergarten period in the sample. Using the Kruskal-Wallis H rank-sum test, the food consumption rates and DBI evaluation results of the kindergartens in Lanzhou City were analyzed. Results Results of the sub-group diet scores that were close to the recommended intake (DBI scores between-2 to 2) showed that cereals, fresh vegetables, nuts and beans, fish, shrimp, eggs, and snacks accounted for the ideal intake of more than 80％of all the recipes. The diet scores of fruits, meat, and processed products ranged from 50％to 80％, and that for milk accounted for only 26.8％. Analyzing the type of food intake showed that the proportion of recipes that included eating more than six types of food per day was 98.3％. Analyzing by kindergarten level and year showed that the overall dietary quality problems with the studied recipes were mainly caused by insufficient intake and dietary imbalance, and the difference was statistically significant. Among them, the lack of intake in 2017 and the degree of dietary imbalance were greater compared to the other years. The level of insufficiency and dietary imbalance in the third-grade kindergartens were higher than those in the first- and second-grade kindergartens. Dietary pattern A recipes accounted for 63.6％ of the kindergarten recipes, and there were no recipes for dietary patterns C, F, G, H, and I. Conclusion The dietary quality problems of kindergartens in Lanzhou City were mainly reflected in the inadequate dietary intake and dietary imbalance. The supervision of dietary quality by kindergartens should be strengthened and the concept of a balanced diet should be promoted. The dietary management of third-grade kindergartens should be simultaneously strengthened.
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BACKGROUND@#The epidermal growth factor receptor (EFGR) mutation was closely related to the invasion and metastasis of lung adenocarcinoma and the biological axis of CXCR4/CXCL12 (chemokine receptor 4/chemokine ligand 12) played an important role in the organ-specific metastasis of the tumor. It was a question surrounding whether there is interaction between them in the process of lung adenocarcinoma metastasis. To investigate the potential molecular mechanisms of EGFR over-expression and EFGR-mutations effects on cell proliferation, migration and invasion, we constructed EGFR over-expression and three EFGR-mutant human lung adenocarcinoma H1299 cell sublines.@*METHODS@#EGFR over-expression and three EFGR-mutant (EGFR-E746-A750del, EGFR-T790M and EGFR-L858R) plasmid were designed and transfected H1299 cells with Lipofectamine 2000. H1299 cells transfected with empty vector were negative control (NC), and H1299 cells without transfection were set as blank control (BC). The effects of EGFR over-expression and mutations on the proliferation, migration and invasion of H1299 cells were detected by cell cloning assay, wound healing assay and Transwell assay. The mRNA and protein expression levels of MMP-2, MMP-9, CXCR4 and CXCL12 were detected by RT-PCR and Western blot.@*RESULTS@#Compared with negative control group and blank control group, EGFR over-expression and EGFR-E746-A750 deletion have significantly higher colony formation (28±2, 28.33±4.16; respectively) (P<0.05) and the cell migration and invasion ability were significantly increased (P<0.05). RT-PCR and Western blot assay showed that the mRNA and protein expression of MMP-2, MMP-9, CXCR4 and CXCL12 in EGFR over-expression and EGFR-E746-A750 deletion group were remarkably higher than that in negative control and blank control group (P<0.05).@*CONCLUSIONS@#EGFR over-expression and 19 exon deletion can promote the expression of MMP-2 and MMP-9 by up-regulating CXCR4/CXCL12 signaling pathway, leading to the change of tumor biological characteristics such as higher proliferation, migration and invasion ability.