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Analysis of nutritional risk,skeletal muscle depletion,and lipid metabolism phenotype in acute radiation enteritis

World Journal of Gastrointestinal Surgery 2023年第12期15卷 2831-2843页

作者： Chen-Ying Ma Jing Zhao Ke-Yan Qian Zhe Xu Xiao-Ting Xu Ju-Ying Zhou Department of Radiation Oncology the First Affiliated Hospital of Soochow UniversitySuzhou 215006China

BACKGROUND Radiation enteritis,which often occurs during radiation-induced acute intestinal symptoms(RIAIS),is the most common and important complication during radiotherapy for cervical cancer.RIAIS caused by abdominal and pelvic radiotherapy will affect nutrient intake,digestion,absorption,and metabolism,leading to malnutrition or poorer nutritional status.In patients with malignant tumors,malnutrition can adversely affect the curative effect and response of radiotherapy by reducing radiosensitivity,affecting the precision of radiotherapy placement and increasing the incidence of radiotherapy-related adverse reactions.AIM To analyze nutritional risk,skeletal muscle depletion,and lipid metabolism phenotype in acute radiation enteritis.METHODS Fifty patients with cervical cancer received external beam radiotherapy,and 15 patients received brachytherapy after external beam radiotherapy.Body weight,body composition parameters,nutritional risk screening(NRS)2002 score,and blood biochemical indices of patients with cervical cancer during periradiation were tested by a one-way repeated measures analysis of variance.Metabolomics analysis was used to identify characteristic lipid metabolism pathways.Clinical factors that affect linoleic acid changes were screened using the generalized evaluation equation.RESULTS Among the 50 patients,37 had RIAIS,including 34 patients with grade 1-2 RIAIS and 3 patients with grade 3 RIAIS.The NRS 2002 score of patients who underwent cervical cancer radiotherapy continued to increase during the periradiation period,and 42 patients who underwent cancer radiotherapy had nutritional deficits(NRS 2002 score≥3 points)at the end of radiotherapy.Correlation analyses revealed that body weight and body mass index changes were closely associated with body fat content(R2=0.64/0.51).The results of the univariate analysis showed that radiotherapy time,percentage reduction of serum albumin,and percentage reduction of serum prealbumin were the key factors affecting skeletal muscle exhaustion(P<0.05).Me

关键词： Cervical cancer Metabolomics Radiation-induced acute intestinal symptoms Linoleic acid nutritional risk

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nutritional status and prognostic factors for mortality in patients admitted to emergency department observation units:a national multi-center study in China

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世界急诊医学杂志(英文) 2023年第1期14卷 17-24页

作者： Hai-jiang Zhou Dong-jing Zuo Da Zhang Xin-hua He Shu-bin Guo Nutrition School of Education College of Chinese Emergency Medicine Beijing Key Laboratory of Cardio-pulmonary Cerebral ResuscitationEmergency Medicine Clinical Research CenterBeijing Chao-yang HospitalCapital Medical UniversityBeijing 100020China

BACKGROUND:nutritional risk is common among patients admitted to the emergency department and is associated with adverse clinical outcomes.Despite its large population,few comprehensive studies have been conducted in China concerning the nutritional status of patients admitted to emergency department observation units(EDOUs).METHODS:Patients admitted to EDOUs of 90 tertiary hospitals in China between June 2020 and December 2020 were enrolled.Demographic information,laboratory parameters,nutritional support therapies,and 28-day mortality were recorded.risk factors for mortality were examined using multi-variateadjusted logistic regression analysis.Receiver operating characteristic(ROC)curves for each predictor of mortality were plotted,and the area under the ROC(AUROC)curves was compared.RESULTS:A total of 2,005 eligible patients were finally enrolled.At the 28-day follow-up,1,911 patients survived,and 94 died.The group with a nutritional risk Screening 2002(NRS 2002)score of 3-4 points was the largest(52.01%).The number of patients receiving oral nutritional supplements,enteral nutrition(EN),parenteral nutrition(PN),and the combination of EN and PN was 425,314,853,and 413,respectively.Among the total,77.55%of patients had nutritional risk(NRS 2002≥3).The proportion of patients with high nutritional risk(NRS2002≥5)in the age group>80 years was significantly higher than that in the age group 66-80 years(29.00%vs.23.93%,P=0.032),but not significantly higher than that in the age group 18-65 years(29.00%vs.26.54%,P=0.449).Logistic regression analysis revealed that heart failure(odds ratio[OR]1.856,95%confidence interval[CI]1.087-3.167,P=0.023),consciousness(OR 2.967,95%CI 1.894-4.648,Pnutritional Assessment-Short Form score(OR 0.946,95%CI 0.898-0.997,P=0.039)were all independent risk factors for 28-day mortality.APACHE II and NRS 2002 scores were supe

关键词： nutritional risk Malnutrition nutritional risk Screening 2002 Mini nutritional Assessment-Short Form

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Impact of Three-month Home Enteral nutritional Supplementation on the nutritional Status of Patients with Malignancy

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Journal of nutritional Oncology 2022年第3期7卷 128-135页

作者： Shi Ming Song Hong Zhen Du Chun Hua Bian Xue Bing Lv Hong Mei Xue Huan Yu Hu Zeng Ning Li Department of Nutrition The First Hospital of Hebei Medical UniversityShijiazhuangHebei 050031China Hebei Province Key Laboratory of Nutrition and Health ShijiazhuangHebei 050031China Hebei Medical University School of Public Health ShijiazhuangHebei 050031China

Objective We analysed the impact of home nutritional interventions on the nutritional risk and the incidence and severity of malnutrition in patients with malignancy.Methods In this prospective interventional study,we recruited 60 patients with malignancy who were at nutritional risk(NRS 2002≥3 scores).These patients were given home enteral nutritional supplementation(HES)for 3 months.The HES included nutritional counselling,oral nutritional supplements(ONS)and tube feeding.The incidence and severity of nutritional risk and malnutrition,as well as the body composition and results of routine blood tests,were compared before and after the intervention.Results A total of 58 patients completed the study.After three months of home enteral nutritional intervention,the incidence and severity of nutritional risk and malnutrition were significantly reduced(the NRS 2002 score was reduced from 3 to 1,the PG-SGA score was reduced from 8.00 to 3.00,Pnutritional status of patients and reduce the risk and severity of malnutrition.

关键词： Home enteral nutritional supplementation nutritional risk Malnutrition Malignant tumour Phase angle

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Correlation of dietary mineral intake and malnutrition in cancer patients:A multicenter cross-sectional study

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Journal of nutritional Oncology 2023年第4期8卷 159-167页

作者： Ying Wang Hong-Mei Xue Jun-Jie Miao Hong-Zhen Du Bin Luo Zeng-Ning Li School of Public Health Hebei Medical UniversityShijiazhuang 050000HebeiChina Department of Clinical Nutrition The First Hospital of Hebei Medical UniversityShijiazhuang 050000HebeiChina Hebei Key Laboratory of Nutrition and Health Shijiazhuang 050000HebeiChina

Background:To examine the correlation between the dietary mineral intake and the nutritional status of patients suffering from malignan-cies.Methods:This multi-center cross-sectional study included a total of 866 patients with malignant tumors recruited from seven hospitals throughout China.The information of socio-demographic characteristics and biochemical indicators were obtained from electronic medical records of inpatients.Dietary data were collected using a 3-day 24-hour dietary recall questionnaire.The intake of energy,dietary calcium(Ca),phosphorus(P),potassium(K),sodium(Na),magnesium(Mg),iron(Fe),zinc(Zn),selenium(Se),copper(Cu)and manganese(Mn)were estimated according to the Chinese Food Composition Tables standard edition.The weight and height of patients were measured,and the body mass index(BMI)was calculated.nutritional risk and malnutrition were assessed by the nutritional Screening 2002(NRS 2002)and Global Leadership Initiative on Malnutrition(GLIM)diagnostic criteria.We used a multivariable logistic regression model to estimate the asso-ciations between dietary minerals and malnutrition.Results:The patients had an average age of 61.98(±15.49)years,and 40.6%(n=352)were female.Slightly less than half(44.5%)of the patients were at nutritional risk(NRS 2002≥3),and 32.7%were diagnosed with malnutrition(using the GUM criteria).Univariate analy-ses revealed that there was a statistically significant relationship between dietary mineral intake and the occurrence of nutritional risk(Pnutritional risk as-sessed by the NRS 2002 score.Moderate intake of Ca and high intake of Zn might also decrease the nutritional risk(Ca:OR,0.53,95%CI,0.32-0.88;Zn:OR,0.36,95%CI,0.19-0.68).However,no significant relationships were observed between any dietary mineral intake and malnutrition identified by the GUM criteria.Conclusions:Dietary minerals,especially P,Se,and Mn,may have a protective effect on t

关键词： Cancer Dietary minerals Malnutrition nutritional risk Cross-sectional study

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Gut,metabolism and nutritional Support for COVID-19:Experiences from China

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Burns & Trauma 2020年第1期8卷 14-23页

作者： Ting Yuanand Wei Chen Hua Jiang Jian-Cheng Zhang Jun Zeng Lu Wang Yu Wang Charles Damien Lu Lei Deng Hongfei Deng Kai Wang Ming-Wei Sun Ping Zhou Ting Yuan Wei Chen Institute for Emergency Medicine and Disaster Medicine Sichuan Provincial People’s HospitalUniversity of Electronic Science and Technology of ChinaNo.32 Yi Huan Lu Xi Er DuanChengdu610072Sichuan ProvinceChina Emergency Intensive Care Unit Emergency Medicine CenterSichuan Provincial People’s HospitalUniversity of Electronic Science and Technology of ChinaNo.32 Yi Huan Lu Xi Er DuanChengdu610072Sichuan ProvinceChina Department of Acute Care Surgery Emergency Medicine CenterSichuan Provincial People’s HospitalUniversity of Electronic Science and Technology of ChinaNo.32Yi Huan Lu Xi Er DuanChengdu610072Sichuan ProvinceChina Medical Task Force of Sichuan Provincial People’s Hospital to Union Red Cross Hospital of Wuhan Wuhan430015China Department of Clinical Nutrition Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeNo.1 Shuai fu yuan Wang fu jing Dong cheng DistrictBeijing100730China

There is little research that focuses on the relationship between the gut,metabolism,nutritional support and COVID-19.As a group of Chinese physicians,nutritionists and scientists working on the frontline treating COVID-19 patients,we aim to integrate our experiences and the current clinical evidence to address this pressing issue in this article.Based on our clinical observations and available evidence,we recommend the following practice.Firstly,the nutritional risk Screening 2002 tool should be used routinely and periodically;for patients with a score≥3,oral nutritional supplements should be given immediately.Secondly,for patients receiving the antiviral agents lopinavir/ritonavir,gastrointestinal side effects should be monitored for and timely intervention provided.Thirdly,for feeding,the enteral route should be the first choice.In patients undergoing mechanical ventilation,establishing a jejunal route as early as possible can guarantee the feeding target being achieved if gastric dilatation occurs.Fourthly,we suggest a permissive underfeeding strategy for severe/critical patients admitted to the intensive care unit during the first week of admission,with the energy target no more than 20 kcal/kg/day(for those on mechanical ventilation,this target may be lowered to 10–15 kcal/kg/day)and the protein target around 1.0–1.2 g/kg/day.If the inflammatory condition is significantly alleviated,the energy target may be gradually increased to 25–30 kcal/kg/day and the protein target to 1.2–1.5 g/kg/day.Fifthly,supplemental parenteral nutrition should be used with caution.Lastly,omega-3 fatty acids may be used as immunoregulators,intravenous administration of omega-3 fatty emulsion(10 g/day)at an early stage may help to reduce the inflammatory reaction.

关键词： COVID-19 Intensive care nutritional risk nutritional support Energy Protein Omega-3 fatty acids China Gut Metabolism

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Current situation,consensus and controversy of perioperative nutrition management in pancreatic surgery:A narrative review

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Journal of Pancreatology 2021年第1期4卷 37-44页

作者： Jingyong Xu Junmin Wei Department of General Surgery Beijing HospitalNational Center of GerontologyInstitute of Geriatric MedicineChinese Academy of Medical SciencesBeijingChina

Pancreatic surgery contains several major procedures of pancreatectomy.Surgical trauma,severe complications and preoperative nutritional disorders will affect postoperative recovery and clinical outcomes of patients.Perioperative whole-course nutrition management focus on rational nutritional care from admission to discharge even post-hospital follow-up,including preoperative nutritional screening,perioperative nutrition assessment and intervention.The whole-course strategy has been validated in some other fields by RCTs and is also seemed to be suitable for pancreatic surgery.However,few high-grade evidences have been published and controversy still exists.This review aims to reflect the current situation,consensus and controversy of perioperative nutrition management in pancreatic surgery,expecting to provide necessary guidance for clinical research and practice.

关键词： Complication Malnutrition nutritional risk Pancreatic surgery Perioperative nutrition management Review

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