1.Application of Nutritional Risk Screening 2002 and nutrition support in critically ill patients in a Beijing-based hospital
Sanli JIN ; Xiaoguang LI ; Qian LU
Chinese Journal of Clinical Nutrition 2012;(6):351-354
Objective TO investigate the application of Nutritional Risk Screening 2002 (NRS 2002) and nutrition support in critically ill patients.Methods Totally 172 adult critically ill patients with a hospital stay equal to or above 3 days were consecutively enrolled from a Beijing-hospital from September 2011 to December 2011.Nutrition support was evaluated on a daily basis.NRS 2002,body mass index (BMI),and Acute Physiology and Chronic Health Evalnation Ⅱ (APACHE Ⅱ) were applied to assess the nutritional risks and nutrition status within 24 hours after admission.Results Among all the patients,the rates of nutrition support were 39.5% and 67.9% on the 1st and 7th day respectively.The rate of parenteral nutrition (33.6% ~ 39.5%) was higher than that of enteral nutrition (4.1% ~ 16.0%).NRS 2002,APACHE Ⅱ score,and BMI showed that 160 patients (93.0%) required nutrition support,but only 103 patients (64.4%) actually received nutrition support,among whom 92 (89.3%) were supplied with nutrition support within 3 days after admission.Conclusions The application of nutrition support in critically ill patients is insufficient in this hospital.Nutrition support is typically provided within 3 days after admission.Parenteral nutrition remains the most common type of nutrition support.
2.Longitudinal observations of the prevalence of nutritional risk and undernutrition in patients with head and neck cancer during radiotherapy
Sanli JIN ; Qian LU ; Dong PANG ; Ping YANG ; Shuang SHI
Chinese Journal of Clinical Nutrition 2017;25(1):22-28
Objective To investigate the changes in prevalence of nutritional risk and undemutrition in patients with head and neck cancer during radiotherapy.Methods In this longitudinal observational study,a convenience sampling method was used to recruit patients with head and neck cancer who were receiving radiotherapy in Beijing Cancer Hospital.Nutritional Risk Screening 2002 (NRS 2002) was applied to assess the prevalence of nutritional risk in the patients,and Patient-Generated Subjective Global Assessment (PG-SGA) and body composition test to determine the prevalence of malnutrition (undernutrition) before,during and after radiotherapy.Results 56 patients finished the three follow-up exams.Along with the progress of radiotherapy,the scores of NRS 2002 increased gradually (1.64±1.09 vs.2.30 ±1.06 vs.3.14 ±1.07,x2 =46.639,P<0.001),and the prevalence of nutritional risk also increased gradually (21.43% vs.37.50% vs.71.43%,x2 =29.700,P <0.001);the total scores of PG-SGA [1 (1-13) vs.6 (1-15) vs.12 (1-18),x2 =63.206,P<0.001] and dimensions of weight [0 (0-4) vs.1 (0-4) vs.3 (0-6),x2 =40.798,P<0.001],intake [0 (0-2) vs.1 (0-2) vs.2 (0-4),x2=64.707,P<0.001] and symptoms [0 (0-7) vs.2 (0-10) vs.6 (0-11),x2 =61.562,P < 0.001] all increased gradually with statistical significance.The prevalence of malnutrition in different stage of radiotherapy were significantly different (x2 =64.999,P < 0.001).The body composition analysis in 40 patients showed that all the indicators of body composition decreased significantly along with the progress of radiotherapy.There was a great loss in patients' body weight during radiotherapy,especially the fat-free mass.Conclusions The prevalence of nutritional risk and undernutrition may increase in patients with head and neck cancer during radiotherapy.Lean body mass accounted for most of the weight loss.We should pay more attention to those patients' nutritional status during radiotherapy.
3.Taste alteration of head and neck cancer patients treated with radiotherapy: A longitudinal study
Hongmei LI ; Shuai JIN ; Lichuan ZHANG ; Sanli JIN ; Hangjing CUI ; Qian LU
Chinese Journal of Clinical Nutrition 2018;26(4):207-213
Objective To investigate the taste alteration caused by radiotherapy and its relationship with nutritional status in head and neck cancer patients during and after radiotherapy.Methods From March to November 2017,172 patients with head and neck cancer receiving radiotherapy were recruited from Beijing Cancer Hospital including 86 patients completing all follow up visits.Chemotherapy-induced Taste Alteration scale was used to evaluate radiotherapy-induced taste alteration and the Patient-generated subjective global assessment (PGSGA) was used for nutrition evaluation at baseline,mid-treatment,post-treatment and 1-2 months after radiotherapy (follow-up).Generalized estimating equations was applied to analyze the influencing factors of taste alteration and its relationship with nutritional status.Results The incidence of taste alteration were 9.3%,84.9%,94.2% and 77.9% respectively at baseline,mid-treatment,post-treatment and 1-2 months after radiotherapy (follow-up).Taste alteration score increased with the increase of radiation dose,reached the highest at the posttreatment and decreased at follow-up visit which was still higher than the score at baseline.PG-SGA score increased with the increase of radiation dose.The incidence of severe malnutrition after radiotherapy was 95.3%,decreased to 45.3% at follow up visit.Nutritional status was closely related to taste alteration.Total radiation dose and concurrent chemotherapy were the influencing factors of taste alteration.Conclusions The taste of patients with head and neck cancer is affected by radiotherapy.As radiotherapy continues,the taste alteration aggravates and PG-SGA score increases gradually,thus malnutrition becomes a prominent problem.Such effect will persist for a period of time after radiotherapy,which should be paid attention and interventions should be conducted to prevent or reduce this effect,in order that the lasting of malnutrition induced by taste alteration can be avoided.
4.Relationship between nutrition impact symptoms and fat-free mass in patients with head and neck cancer during radiotherapy
Bing ZHUANG ; Dan ZHAO ; Lichuan ZHANG ; Yujie WANG ; Tong ZHANG ; Sanli JIN ; Liqing GONG ; Yanli WANG ; Yu FANG ; Shaowen XIAO ; Baomin ZHENG ; Yaru ZHANG ; Qian LU ; Yan SUN
Chinese Journal of Clinical Nutrition 2021;29(1):1-7
Objective:To observe the changes of nutrition impact symptoms (NIS) and fat-free mass and analyze the relationship between them in patients with head and neck cancer (HNC) during radiotherapy.Methods:A convenient sampling method was adopted to select HNC patients who received radiotherapy in the outpatient clinic of department of radiotherapy for head and neck cancer in a cancer hospital in Beijing from March 2017 to January 2020. The nutrition impact symptoms (NIS) were assessed by a nutrition impact symptoms checklist and the fat free mass was assessed by bioelectrical impedance analysis at three time points: before radiotherapy (T1), during radiotherapy (T2) and at the end of radiotherapy (T3). The Generalized Estimating Equations (GEE) was used to analyze the relationship between them.Results:A total of 542 HNC patients were included in the analysis. During radiotherapy, the patients' NIS number and score presented an increasing trend, reaching the highest level and peaked at the end of radiotherapy. The change of fat-free mass showed a decreasing trend and reached the minimum at the end of radiotherapy. Patients with higher NIS scores had more percentage loss of fat-free mass.Conclusions:During radiotherapy, patients with HNC showed an increase in NIS score and lost fat-free mass. Patients with higher NIS score lost more percentage of fat-free mass, which suggested that clinical medical staff should pay attention to NIS management and take comprehensive intervention measures in time to reduce the loss of fat-free mass.
5. A randomized controlled study of erlotinib versus pemetrexed combined with cisplatin in neoadjuvant therapy of stage ⅢA EGFR-mutant lung adenocarcinoma
Wenqing CHEN ; Pei LI ; Qiang WANG ; Yijun ZHANG ; Hongyu LI ; Xintian JIN ; Song YAN ; Guofeng KOU ; Sanli CAI ; Gang LIU
Chinese Journal of Oncology 2018;40(2):133-137
Objective:
To evaluate the feasibility, efficacy and safety of epidermal growth factor receptor-tyrosine kinase inhibitors(EGFR-TKIs) for neoadjuvant therapy.
Methods:
Eighty-six patients with stage ⅢA EGFR-mutant lung adenocarcinoma were assigned to 2 groups (