1.Malnutrition status of elderly patients undergoing surgery for gastric and colorectal tumors and the impact of nutritional support therapy on clinical outcomes
Liru CHEN ; Zijian LI ; Lijuan WANG ; Hongyuan CUI ; Bo CHENG ; Danian TANG ; Anqi ZHANG ; Lili DING ; Mingwei ZHU
Chinese Journal of Geriatrics 2025;44(6):782-787
Objective:To examine the prevalence of malnutrition and evaluate the impact of nutritional support on clinical outcomes in elderly patients diagnosed with gastric and colorectal cancer.Methods:A retrospective cohort study was conducted, analyzing elderly patients with gastrointestinal tumors who underwent surgical treatment in the general surgery department from January 2019 to June 2020.The Global Leadership Initiative on Malnutrition(GLIM)criteria were utilized to diagnose malnutrition, and the effects of malnutrition and nutritional support on clinical prognosis were investigated.Results:A total of 426 elderly hospitalized patients with gastric and colorectal tumors who underwent surgical treatment were included in this study.This cohort comprised 199 cases of gastric cancer and 227 cases of colorectal cancer, with ages ranging from 65 to 91 years(mean age: 72.05±5.99).According to the GLIM criteria, 43.7%(186/426)of the patients were diagnosed with malnutrition, of which 25.6%(109/426)were moderately malnourished and 18.1%(77/426)were severely malnourished.Among the gastric cancer patients, 73.4%(146/199)were identified as having nutritional risk, with 48.7%(97/199)being malnourished and 22.6%(45/199)experiencing severe malnutrition.In the colorectal cancer group, 63.9%(145/227)were at nutritional risk, 39.2%(89/227)were malnourished, and 14.1%(32/227)had severe malnutrition.Additionally, 60.3%(257/426)of the patients received nutritional support therapy: 25.4%(108/426)received parenteral nutrition(PN), 11.3%(48/426)received enteral nutrition(EN), 23.7%(101/426)received a combination of EN and PN, while 39.7%(169/426)did not receive any nutritional support.Regardless of the presence or degree of malnutrition, patients who received nutritional support had significantly shorter total hospital stays compared to those who did not receive nutritional support, and this difference was statistically significant( t=5.58, 3.69, 2.21, 3.03, all P<0.05). Conclusions:Providing nutritional support to malnourished patients can reduce the length of hospital stay and improve clinical outcomes.
2.Malnutrition status of elderly patients undergoing surgery for gastric and colorectal tumors and the impact of nutritional support therapy on clinical outcomes
Liru CHEN ; Zijian LI ; Lijuan WANG ; Hongyuan CUI ; Bo CHENG ; Danian TANG ; Anqi ZHANG ; Lili DING ; Mingwei ZHU
Chinese Journal of Geriatrics 2025;44(6):782-787
Objective:To examine the prevalence of malnutrition and evaluate the impact of nutritional support on clinical outcomes in elderly patients diagnosed with gastric and colorectal cancer.Methods:A retrospective cohort study was conducted, analyzing elderly patients with gastrointestinal tumors who underwent surgical treatment in the general surgery department from January 2019 to June 2020.The Global Leadership Initiative on Malnutrition(GLIM)criteria were utilized to diagnose malnutrition, and the effects of malnutrition and nutritional support on clinical prognosis were investigated.Results:A total of 426 elderly hospitalized patients with gastric and colorectal tumors who underwent surgical treatment were included in this study.This cohort comprised 199 cases of gastric cancer and 227 cases of colorectal cancer, with ages ranging from 65 to 91 years(mean age: 72.05±5.99).According to the GLIM criteria, 43.7%(186/426)of the patients were diagnosed with malnutrition, of which 25.6%(109/426)were moderately malnourished and 18.1%(77/426)were severely malnourished.Among the gastric cancer patients, 73.4%(146/199)were identified as having nutritional risk, with 48.7%(97/199)being malnourished and 22.6%(45/199)experiencing severe malnutrition.In the colorectal cancer group, 63.9%(145/227)were at nutritional risk, 39.2%(89/227)were malnourished, and 14.1%(32/227)had severe malnutrition.Additionally, 60.3%(257/426)of the patients received nutritional support therapy: 25.4%(108/426)received parenteral nutrition(PN), 11.3%(48/426)received enteral nutrition(EN), 23.7%(101/426)received a combination of EN and PN, while 39.7%(169/426)did not receive any nutritional support.Regardless of the presence or degree of malnutrition, patients who received nutritional support had significantly shorter total hospital stays compared to those who did not receive nutritional support, and this difference was statistically significant( t=5.58, 3.69, 2.21, 3.03, all P<0.05). Conclusions:Providing nutritional support to malnourished patients can reduce the length of hospital stay and improve clinical outcomes.
3.Reduced macular thickness and vascular density in abnormal glucose metabolism patients: A meta-analysis of optical coherence tomography (OCT) and OCT angiography studies
Xiangyu FU ; Xiang REN ; Wenyue CHEN ; Danian CHEN
Chinese Medical Journal 2024;137(9):1054-1068
Background::Alterations in macular thickness and vascular density before clinically visible diabetic retinopathy (DR) remain inconclusive. This study aimed to determine whether retinal manifestations in abnormal glucose metabolism (AGM) patients differ from those in the healthy individuals.Methods::PubMed, Embase, and Web of Science were searched between 2000 and 2021. The eligibility criteria were AGM patients without DR. Primary and secondary outcomes measured by optical coherence tomography (OCT) and OCT angiography (OCTA) were analyzed and expressed as standardized mean differences (SMDs) with 95% confidence intervals (CIs). A random-effects model was used in the data synthesis. The potential publication bias for the variables was evaluated using Egger’s test.Results::A total of 86 observational studies involving 13,773 participants and 15,416 eyes were included. OCT revealed that compared to healthy controls, the total macular thickness of AGM patients was thinner, including the thickness of fovea (–0.24, 95% CI [–0.39, –0.08]; P = 0.002, I2 = 87.7%), all regions of parafovea (–0.32, 95% CI [–0.54, –0.11]; P = 0.003; I2 = 71.7%) and the four quadrants of perifovea; the thickness of peripapillary retinal nerve fiber layer (pRNFL), macular retinal nerve fiber layer (mRNFL), and ganglion cell layer (GCL) also decreased. OCTA indicated that the superficial and deep vascular density decreased, the foveal avascular zone (FAZ) area enlarged, and the acircularity index (AI) reduced in AGM individuals. Conclusions::Retinal thinning and microvascular lesions have occurred before the advent of clinically detectable DR; OCT and OCTA may have the potential to detect these preclinical changes.Registration::PROSPERO; http://www.crd.york.ac.uk/prospero/; No. CRD42021269885.
4.Controversy of vitrectomy in the treatment of intraocular malignancy
Chinese Journal of Experimental Ophthalmology 2021;39(3):249-253
Retinoblastoma (RB) and choroidal malignant melanoma are the most common primary intraocular malignancy in children and adults, respectively.Due to the advance in the diagnosis and treatment of intraocular tumors, the survival rate and survival time of the patients are significantly improved.The goal of the therapy for the patients of intraocular malignant tumors has gradually changed from simply saving life to trying to preserve eyeball on the basis of saving life.Although there are various treatment options for intraocular malignant tumors, eye salvage is still an great challenge for the patients with refractory tumors.In recent years, vitrectomy has been used again by some doctors to the treatment of refractory RB and choroidal malignant melanoma, which undoubtedly gives the hope of eye salvage to the patients with intraocular malignant tumors.However, this therapy arouse controversy because serious intraoperative or postoperative complications occurred in some patients.Ophthalmologists should select suitable indications for this surgery cautiously, perform the operation carefully, combine other chemotherapy and/or radiotherapy and local treatment and close follow-up if necessary.
5.Microglia-Derived NLRP3 Activation Mediates the Pressor Effect of Prorenin in the Rostral Ventrolateral Medulla of Stress-Induced Hypertensive Rats.
Li HU ; Shutian ZHANG ; Kokwin OOI ; Xuehai WU ; Jiaxiang WU ; Jian CAI ; Yinggang SUN ; Jijiang WANG ; Danian ZHU ; Fuxue CHEN ; Chunmei XIA
Neuroscience Bulletin 2020;36(5):475-492
Increased microglial activation and neuroinflammation within autonomic brain regions such as the rostral ventrolateral medulla (RVLM) have been implicated in stress-induced hypertension (SIH). Prorenin, a member of the brain renin-angiotensin system (RAS), can directly activate microglia. The present study aimed to investigate the effects of prorenin on microglial activation in the RVLM of SIH rats. Rats were subjected to intermittent electric foot-shocks plus noise, this stress was administered for 2 h twice daily for 15 consecutive days, and mean arterial pressure (MAP) and renal sympathetic nerve activity (RSNA) were monitored. The results showed that MAP and RSNA were augmented, and this paralleled increased pro-inflammatory phenotype (M1) switching. Prorenin and its receptor (PRR) expression and the NLR family pyrin domain containing 3 (NLRP3) activation were increased in RVLM of SIH rats. In addition, PLX5622 (a microglial depletion agent), MCC950 (a NLRP3 inhibitor), and/or PRO20 (a (Pro)renin receptor antagonist) had antihypertensive effects in the rats. The NLRP3 expression in the RVLM was decreased in SIH rats treated with PLX5622. Mito-tracker staining showed translocation of NLRP3 from mitochondria to the cytoplasm in prorenin-stimulated microglia. Prorenin increased the ROS-triggering M1 phenotype-switching and NLRP3 activation, while MCC950 decreased the M1 polarization. In conclusion, upregulated prorenin in the RVLM may be involved in the pathogenesis of SIH, mediated by activation of the microglia-derived NLRP3 inflammasome. The link between prorenin and NLRP3 in microglia provides insights for the treatment of stress-related hypertension.
6.Paying attention to the differences and applications of animal models of diabetic retinopathy
Chinese Journal of Experimental Ophthalmology 2018;36(6):404-409
Diabetic retinopathy (DR) is a common complication of diabetes,and remains the leading cause of blindness among working-age individuals all over the world.Current treatments for DR mainly focus on the advanced stages of the disease and are associated with significant adverse effects.As the pathogenesis of DR is not thoroughly revealed,the development of more effective therapy of DR is challenging,in which a good DR animal model is essential.At present,these animal models involve mammals,non-mammals and other species.The modeling methods also include chemical injection,high glucose diet,genetic engineering and ex vivo retinal explant cultures.Although most of the models discussed,especially the rodent models,have demonstrated the basic features of NPDR,the key feature of human PDR (pre-retinal neovascularization secondary to diabetes per se) is not recapitulated in any diabetic animal models.Therefore,choosing the appropriate DR animal model according to the purpose of research will be very important in understanding development of the disease and new approaches that prevent or delay the onset of DR.
7.Emphasizing on the importance of RB1 genetic testing in diagnosis/treatment and genetic counseling of retinoblastoma
Chinese Journal of Experimental Ophthalmology 2018;36(10):742-747
Retinoblastoma (RB) is the prototype of hereditary neoplasms in humans.It is the most common intraocular malignancy in children,which is mainly caused by RB1 gene mutation.RB1 genetic testing and genetic counseling supports optimal care and follow-up plan for RB patients and their families.RB is the first cancer to officially acknowledge the seminal role of genetics in cancer,by incorporating "H" into the eighth edition of cancer staging (2017);those who carry the RB1 cancer-predisposing gene are H1;those proven to not carry the familial RB1 mutation are H0;and those at unknown risk are HX.However,due to the complexity of RB1 gene mutation,the limitation of current genetic test,the lack of genetic counseling specialty,there is limited application of genetic testing and counseling in China.In the era of precision medicine,we need to advocate the application of RB1 genetic testing in the management of RB patients in China.
8.Are you ready? The new era of targeted local chemotherapy for retinoblastoma is coming
Chinese Journal of Experimental Ophthalmology 2015;33(11):961-964
Retinoblastoma (RB) therapy has evolved over decades.In the 1970s, enucleation was important for improving life prognosis.In the 1980s, external beam radiotherapy (EBRT) was popular.In the 1990s, systemic intravenous chemotherapy (IVC) was introduced and currently remains prevalent worldwide for intraocular RB control as well as prevention of systemic metastasis.However, RB seeds in vitreous and subretinal space are still the major obstacles for successful treatments.Advanced ophthalmic imaging technology promotes thorough and detailed description and observation of RB seeds.In the 2000s, interests in periocular chemotherapy (POC), intra-arterial chemotherapy (IAC) and intravitreous chemotherapy (IVitC) have been explored to overcome the low drug concentration around the seeds and to reduce the systemic side effects.This leads us into a new era of target local chemotherapy of RB.How to make the treatment decision based on biological behavior of RB seeds is a major task for us now.
9.An important subject in stem cells research: the regulatory of retinoblastoma pathway for stem cells
Yi ZHOU ; Yilin WANG ; Danian CHEN
Chinese Journal of Ocular Fundus Diseases 2012;(6):549-551
Stem cells are crucial for embryonic development and in the maintenance of adult cellular homeostasis.Understanding the regulatory network of stem cells,including embryonic and adult stem cells,will allow us to learn the pathogenesis and possibly design novel approaches to treat many diseases (such as cancer and degeneration).The retinoblastoma (Rb) pathway controls cellular proliferation,differentiation and death.More and more evidences support an important role of Rb activity in the biology of stem and progenitor cells.Transiently inactivating Rb pathway might favor the expanding of functional stem cell populations,thus have values in the future stem cell applications.
10.Invasion and metastasis of human retinoblastoma
Chinese Journal of Ocular Fundus Diseases 2011;27(1):1-5
Children with retinoblastoma (RB) typically survive their cancer due to advances in early diagnosis and treatment. Extraocular invasion and metastasis, and secondary malignant tumor carry a very high mortality rate. Prerequisites for metastasis include tumor initiating capacity, altered cellular adhesion and cell motility, resistance to extracellular death signals and disruption of the basement membrane and extracellular matrix. All those changes can be determined by the cell of origin and the genetic instability of the tumor, responding to the multiple layers of pressure such as hypoxia, from the tumor microenvironment or niche. The interaction between tumor cells and the tumor stroma is regulated by several metastasissuppressor proteins and microRNA. This knowledge has important implications for our understanding and the treatment of extraocular spreading of RB.

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