1.The application value of radiomics in the nutritional therapy of surgical patients
Chinese Journal of General Surgery 2024;39(3):166-171
The incidence of malnutrition in surgical patients is high and affects the clinical outcome of patients. Through the extraction and analysis of image data, radiomics can assess changes in the composition of the body, such as skeletal muscle and fat, and it demonstrates tremendous potential in nutritional screening, assessment, diagnosis, and evaluation of treatment effects, emerging as a crucial evaluation tool in nutritional therapy for surgical patients. Furthermore, radiomics can predict patients' clinical outcomes, providing more precise treatment plans. Therefore, the application of radiomics should be fully emphasized in nutritional therapy for surgical patients to promote their enhanced recovery. With the continuous development and improvement of radiomics technology in the future, its application in nutritional therapy for surgical patients is expected to become more extensive and profound, bringing better treatment outcomes and quality of life to patients.
2.Clinical value of"four longitudinal,two transverse planes"method of membrane anatomy in laparoscopic radical cystectomy
Dongping BAO ; Peifeng ZHONG ; Guohao WU ; Haomin LI ; Dongjiang CHEN ; Xianguo HU ; Bingquan WU ; Zheng CHEN ; Zexiong GUO ; Dongming YE ; Caiyong LAI
Journal of Modern Urology 2024;29(5):399-405
Objective To explore the clinical value of laparoscopic radical cystectomy based on fascia anatomy for bladder cancer treatment.Methods The clinical data of 51 patients with bladder cancer who underwent 3D laparoscopic radical cystectomy during Jan.2015 and Jun.2022 were retrospectively analyzed.The surgery was performed based on membrane anatomy technology along four longitudinal and two transverse planes to complete the radical cystectomy.The pelvic plexus was preserved for patients with normal preoperative sexual function.Results All surgeries were completed without conversion to open operation.The mean operation time was(502.52±108.99)min,mean intraoperative blood loss was(275.96±155.18)mL,mean postoperative drainage time was(4.14±2.41)d,and the mean postoperative hospital stay was(16.37±4.85)d.The mean number of lymph nodes removed was(17.98±11.48).The mean postoperative follow-up was(30.27±19.39)months.At the last follow-up,no Clavien ≥grade 3 complications were observed.The estimated overall survival(OS),tumor-specific survival(TSS),and recurrence-free survival(RFS)were 82.4%,92.2%,and 88.2%,respectively.The lymph node positive patients had shorter OS and RFS(60.0%,60.0%)than the lymph node negative patients(84.8%,91.3%).Among the 19 male patients who underwent radical cystectomy with pre-exposure and preservation of pelvic plexus,daytime and nocturnal continence rate were 83.3%and 72.2%,respectively,and 17 patients recovered potency within 6 months postoperatively.Conclusion Laparoscopic radical cystectomy based on fascia anatomy is safe and effective in laparoscopic radical cystectomy,with standardized surgical procedure,satisfactory oncological outcomes,little hemorrhage,few complications and fast recovery.
3.Interpretation of 2024 ESPEN practical short micronutrient guideline
Zhige ZHANG ; Shanjun TAN ; Qiulei XI ; Mingyue YAN ; Guohao WU
Chinese Journal of Clinical Medicine 2024;31(4):668-686
Trace elements and vitamins are essential micronutrients for metabolism.Micronutrients deficiency results in adverse effects on human body,and brings huge challenge to clinical nutrition therapy.To normalize micronutrients application in clinical practice,European Society for Clinical Nutrition and Metabolism(ESPEN)published ESPENpractical short micronutrient guideline on January 2024.Based on previous version published in 2022,current guideline shortens the interpretation of biochemical and physical mechanisms,focuses on micronutrients deficiency and inflammation,recommends the methods of micronutrients assessment and supplementation in different statuses during clinical practices.This paper summarizes specific recommendations and comments for domestic peers to communicate,and provides reference for the management of micronutrient therapy in China.
4.Malnutrition in advanced gastrointestinal cancer patients and nutritional support therapy
Chinese Journal of Gastrointestinal Surgery 2024;27(3):215-220
The advancement of comprehensive treatment has allowed an increasing number of patients with gastrointestinal tumor to achieve long-term survival. In current clinical practice, there is a growing population of patients with advanced gastrointestinal tumor. Due to various factors, such as tumor burden, treatments including chemotherapy and radiation therapy, as well as underlying diseases, patients with advanced gastrointestinal tumor often experience malnutrition, which negatively impacts their clinical outcomes. The mechanism of malnutrition in patients with advanced gastrointestinal tumor is complex, and conventional nutritional support therapy has shown limited effectiveness. With the continuous progress in the concept and technique of nutritional support therapy, the diversification of treatment strategies, and the strengthening of multidisciplinary collaboration, the nutritional management for patients with advanced gastrointestinal tumor tends to be standardized and rational, leading to effective improvement in patients' nutritional status and clinical outcomes. Based on the latest evidence-based medicine, combined with the author's practical experience and insights, this article aims to explore nutritional support therapy for patients with advanced gastrointestinal tumor.
5.The development and innovation of clinical nutrition
Chinese Journal of Surgery 2024;62(6):525-531
The strategy of nutrition therapy in the treatment of diseases is constantly optimized with the development and innovation of the concept and technology in the field of clinical nutrition, especially the rise of multi-disciplines such as imaging omics and artificial intelligence and the latest discoveries of clinical trials. Precise nutrition assessment, diversified products, multimodal nutrition therapy throughout the process and intelligent compliance management have efficiently improved the effect of nutrition therapy. The implementation of personalized and precise nutrition therapy still needs further investigation.
6.LncRNA MAGI2-AS3 enhances cisplatin sensitivity of non-small cell lung cancer cells by regulating the miR-1269a/PTEN/AKT pathway
Xirui FAN ; Zhilin QI ; Yuanjie DENG ; Zihan YANG ; Li SUN ; Guohao LI ; Juanjuan LIANG ; Fei WU ; Liwen YUAN
Journal of Southern Medical University 2024;44(10):2033-2043
Objective To investigate the mechanism mediating the regulatory effect of lncRNA MAGI2-AS3 on cisplatin(DDP)resistance in non-small cell lung cancer(NSCLC).Methods MAGI2-AS3 and miR-1269a expression levels were detected by qRT-PCR in DDP-sensitive lung cancer cell lines(A549 and H1299)and their resistant counterparts(A549/DDP and H1299/DDP).In A549 and H1299 cells with MAGI2-AS3 silencing and A549/DDP and H1299/DDP cells overexpressing MAGI2-AS3,the effects of 20 μmol/L DDP on cell viability and apoptosis were examined with CCK-8 assay,colony formation assay,flow cytometry and Western blotting,and the changes in epithelial-mesenchymal transition(EMT)were assessed with wound healing and Transwell assays.The interaction between MAGI2-AS3,miR-1269a and PTEN was predicted using GEPIA,StarBase and miRDB and verified with luciferase reporter gene assay and radioimmunoprecipitation(RIP)assay.A miR-1269a mimic and pcDNA3.1-PTEN plasmid were used to perform the rescue assay.Results MAGI2-AS3 expression was significantly downregulated in lung cancer tissues(P<0.05)in association with a poor prognosis(P<0.05).In the two DDP-resistant lung cancer cell lines,MAGI2-AS3 expression was significantly lowered as compared with the sensitive cells.Silencing MAGI2-AS3 significantly enhanced cell viability and promoted EMT of A549 and H1299 cells irrespective of DDP treatment,and also decreased DDP-induced apoptosis of the cells.In A549/DDP and H1299/DDP cells,MAGI2-AS3 overexpression strongly repressed cell viability and EMT irrespective of DDP treatment and promoted DDP-induced cell apoptosis.Luciferase reporter gene and RIP assays confirmed the binding of MAGI2-AS3 with miR-1269a and the binding of miR-1269a with 3'-UTR domain of PTEN.The rescue assay demonstrated that MAGI2-AS3 acted as a sponge for miR-1269a to promote PTEN expression and downregulate AKT phosphorylation,thus inhibiting EMT and promoting DDP-induced apoptosis of A549/DDP cells.Conclusion MAGI2-AS3 enhances DDP sensitivity of NSCLC by targeted regulation of the miR-1269a/PTEN/AKT signaling axis.
7.LncRNA MAGI2-AS3 enhances cisplatin sensitivity of non-small cell lung cancer cells by regulating the miR-1269a/PTEN/AKT pathway
Xirui FAN ; Zhilin QI ; Yuanjie DENG ; Zihan YANG ; Li SUN ; Guohao LI ; Juanjuan LIANG ; Fei WU ; Liwen YUAN
Journal of Southern Medical University 2024;44(10):2033-2043
Objective To investigate the mechanism mediating the regulatory effect of lncRNA MAGI2-AS3 on cisplatin(DDP)resistance in non-small cell lung cancer(NSCLC).Methods MAGI2-AS3 and miR-1269a expression levels were detected by qRT-PCR in DDP-sensitive lung cancer cell lines(A549 and H1299)and their resistant counterparts(A549/DDP and H1299/DDP).In A549 and H1299 cells with MAGI2-AS3 silencing and A549/DDP and H1299/DDP cells overexpressing MAGI2-AS3,the effects of 20 μmol/L DDP on cell viability and apoptosis were examined with CCK-8 assay,colony formation assay,flow cytometry and Western blotting,and the changes in epithelial-mesenchymal transition(EMT)were assessed with wound healing and Transwell assays.The interaction between MAGI2-AS3,miR-1269a and PTEN was predicted using GEPIA,StarBase and miRDB and verified with luciferase reporter gene assay and radioimmunoprecipitation(RIP)assay.A miR-1269a mimic and pcDNA3.1-PTEN plasmid were used to perform the rescue assay.Results MAGI2-AS3 expression was significantly downregulated in lung cancer tissues(P<0.05)in association with a poor prognosis(P<0.05).In the two DDP-resistant lung cancer cell lines,MAGI2-AS3 expression was significantly lowered as compared with the sensitive cells.Silencing MAGI2-AS3 significantly enhanced cell viability and promoted EMT of A549 and H1299 cells irrespective of DDP treatment,and also decreased DDP-induced apoptosis of the cells.In A549/DDP and H1299/DDP cells,MAGI2-AS3 overexpression strongly repressed cell viability and EMT irrespective of DDP treatment and promoted DDP-induced cell apoptosis.Luciferase reporter gene and RIP assays confirmed the binding of MAGI2-AS3 with miR-1269a and the binding of miR-1269a with 3'-UTR domain of PTEN.The rescue assay demonstrated that MAGI2-AS3 acted as a sponge for miR-1269a to promote PTEN expression and downregulate AKT phosphorylation,thus inhibiting EMT and promoting DDP-induced apoptosis of A549/DDP cells.Conclusion MAGI2-AS3 enhances DDP sensitivity of NSCLC by targeted regulation of the miR-1269a/PTEN/AKT signaling axis.
8.Malnutrition in advanced gastrointestinal cancer patients and nutritional support therapy
Chinese Journal of Gastrointestinal Surgery 2024;27(3):215-220
The advancement of comprehensive treatment has allowed an increasing number of patients with gastrointestinal tumor to achieve long-term survival. In current clinical practice, there is a growing population of patients with advanced gastrointestinal tumor. Due to various factors, such as tumor burden, treatments including chemotherapy and radiation therapy, as well as underlying diseases, patients with advanced gastrointestinal tumor often experience malnutrition, which negatively impacts their clinical outcomes. The mechanism of malnutrition in patients with advanced gastrointestinal tumor is complex, and conventional nutritional support therapy has shown limited effectiveness. With the continuous progress in the concept and technique of nutritional support therapy, the diversification of treatment strategies, and the strengthening of multidisciplinary collaboration, the nutritional management for patients with advanced gastrointestinal tumor tends to be standardized and rational, leading to effective improvement in patients' nutritional status and clinical outcomes. Based on the latest evidence-based medicine, combined with the author's practical experience and insights, this article aims to explore nutritional support therapy for patients with advanced gastrointestinal tumor.
9.The development and innovation of clinical nutrition
Chinese Journal of Surgery 2024;62(6):525-531
The strategy of nutrition therapy in the treatment of diseases is constantly optimized with the development and innovation of the concept and technology in the field of clinical nutrition, especially the rise of multi-disciplines such as imaging omics and artificial intelligence and the latest discoveries of clinical trials. Precise nutrition assessment, diversified products, multimodal nutrition therapy throughout the process and intelligent compliance management have efficiently improved the effect of nutrition therapy. The implementation of personalized and precise nutrition therapy still needs further investigation.
10.Comprehensively promoting the application of whole-course nutritional management in surgery
Chinese Journal of Digestive Surgery 2023;22(11):1291-1294
Surgery is the main approach for treating surgical diseases, but it can bring traumatic stress to the body, causing metabolic changes and nutritional deficiencies. In addition to the primary surgical disease, the underlying health condition can also have an impact, and thus, at different stages, including preoperative, intraoperative, postoperative, and post-discharge, surgical patients often experience varying degrees of metabolic changes and malnutrition. These metabolic changes and nutritional deficiencies at any stage can mutually influence each other, ultimately reducing the therapeutic effect of surgical treatment and affecting both short-term and long-term clinical outcomes. The concept and techniques of nutritional therapy have undergone rapid deve-lopment in recent decades, greatly improving the success rate of disease treatment. It is recommen-ded to promote the application of whole-course nutritional management in surgery, which integrates nutritional screening, assessment, and intervention throughout the entire process of preoperative, intraoperative, postoperative, and post-discharge care during the disease treatment and recovery process. This approach can maximize the therapeutic benefits of nutritional therapy, accelerate postoperative recovery, and improve patient′s prognosis. Based on clinical practices and literatures, the author explores the importance and necessity, primary tasks, key measures, and final guarantees of whole-course nutritional management.

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