OBJECTIVE: To observe the effects of thumbtack-needle embedding therapy of auricular acupuncture on gastrointestinal function and intestinal microflora in the patients with gastric cancer after operation, and to explore its mechanism. METHODS: A total of 80 patients with gastric cancer after radical operation were randomly divided into an observation group (40 cases, 3 cases discontinued) and a control group (40 cases, 3 cases discontinued). The patients of both groups received the perioperative care for accelerating recovery. Additionally, in the observation group, the thumbtack-needle embedding therapy of auricular acupuncture was delivered at the auricular points of unilateral side, including Wei (CO₄), Pi (CO₁₃), Dachang (CO₇), Xiaochang (CO₆), Yuanzhong (AT_2,3,4i), Erzhong (HX₁), Sanjiao (CO₁₇) and Jiaowozhong (TF₃), and the needles were embedded and retained for 72 h. The postoperative recovery time of gastrointestinal function (the postoperative bowel sound recovery time, the first exhaust time, the first defecation time), the postoperative hospital stay and pain visual analogue scale (VAS) score were observed in the two groups. Before operation and on day 5 after operation, the serum gastrin level was detected in the two groups. The third-generation 16S rRNA sequencing technology was used to detect the composition and relative abundance of intestinal flora in the two groups before and after operation. RESULTS: Compared with the control group, the postoperative bowel sound recovery time, the first exhaust time and the first defecation time were shortened in the observation group (P<0.05). In the observation group, the VAS scores at 24 h, 48 h, and 72 h after surgery were lower than those of the control group, respectively (P<0.05). There was no significant differences in postoperative hospital stay and serum gastrin level between the two groups (P>0.05). The alpha diversity analysis showed that the differences in Shannon index, Simpson index, Pielou_J index and Pd_fath index were not significant statistically after intervention between the two groups (P>0.05). After intervention, the community structure of the fecal sample was similar at each taxonomic level between the two groups, and although the proportion between species was various, the difference was not significant (P>0.05). After intervention, there were 55 species with the differences between the two groups, 17 species of them presented significant difference in relative abundance in the observation group and 38 species in the control group. Regarding the level of genus, the levels of Klebsiell and Enterobacter increased (P<0.05) and the level of Streptococcus decreased (P<0.05) in the observation group. The main microbial groups that played an important role were Coprobacillaceae, Sutterellaceae and Yersiniaceae in the observation group. KEGG function prediction indicated that the function of intestinal microflora was mainly associated with the cofactor and vitamin metabolism, carbohydrate metabolism, and amino acid metabolism. CONCLUSION The thumbtack-needle embedding therapy of auricular acupuncture improves the postoperative gastrointestinal function of the patients with gastric cancer probably through regulating the structure and relative abundance of intestinal microflora and affecting the energy metabolism.
Humans ; Male ; Female ; Middle Aged ; Acupuncture, Ear/instrumentation* ; Gastrointestinal Microbiome ; Aged ; Stomach Neoplasms/therapy* ; Adult ; Acupuncture Points ; Gastrointestinal Tract/microbiology* ; Intestines/physiopathology* ; Postoperative Period ; Acupuncture Therapy

Numerous research conducted in recent years has revealed that gut microbial dysbiosis, such as modifications in composition and activity, might influence lung tissue homeostasis through specific pathways, thereby promoting susceptibility to lung diseases. The development and progression of lung cancer, as well as the effectiveness of immunotherapy are closely associated with gut flora and metabolites, which influence immunological and inflammatory responses. During abnormal proliferation, non-small cell lung cancer cells acquire more substances and energy by altering their own metabolic pathways. Glucose and amino acid metabolism reprogramming provide tumor cells with abundant ATP, carbon, and nitrogen sources, respectively, providing optimal conditions for tumor cell proliferation, invasion, and immune escape. This article reviews the relationship of immune response with gut flora and metabolic reprogramming in non-small cell lung cancer, and discusses the potential mechanisms by which gut flora and metabolic reprogramming affect the occurrence, development, and immunotherapy of non-small cell lung cancer, in order to provide new ideas for precision treatment of lung cancer patients.
Humans ; Gastrointestinal Microbiome/immunology* ; Carcinoma, Non-Small-Cell Lung/therapy* ; Lung Neoplasms/therapy* ; Immunotherapy ; Metabolic Reprogramming

Lung cancer is the deadliest form of cancer globally, with millions of new cases diagnosed each year. Although rapid advancements in surgical techniques, targeted therapies, and immunotherapy have significantly improved patient outcomes, the overall 5-year survival rate remains disappointingly low. Recent studies have highlighted the vital role of gut microbiota in maintaining host health and its close association with the onset and progression of lung cancer through various mechanisms. This article provides a systematic analysis of the role of gut microbiota in lung cancer, focusing on its immunomodulatory and metabolic functions, as well as its potential applications in treatment, while also exploring its prospects for clinical use.
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Humans ; Lung Neoplasms/therapy* ; Gastrointestinal Microbiome ; Animals

OBJECTIVE: To preliminarily investigate the effect of buccal acupuncture therapy on ameliorating postoperative pain and enhancing recovery quality among patients undergoing radical resection of gastrointestinal cancers. METHODS: Fifty-two participants were randomized at a 1:1 ratio to either the buccal acupuncture or the control group. The acupuncture protocol entailed targeting 5 predetermined acupoints [CA-2 (Upper jiao), CA-3 (Middle jiao), CA-4 (Lower jiao), CA-6 (back), and CA-7 (waist) and two adjustable acupoints [CA-1 (head) and CA-8 (sacrum)] on each side of the face. The outcomes included the Numeric Rating Scale (NRS) scores for each day within 7 days postoperatively, 15-Item Quality of Recovery Scale (QoR-15) scores, analgesics consumption during and after surgery, incidences of postoperative nausea and vomiting, and perioperative levels of interleukin-6 and glucose. Adverse events related to acupuncture were recorded. RESULTS: Of the initial 52 participants, 46 completed the study and were included in the analysis. Findings indicated that the buccal acupuncture group experienced significantly reduced resting NRS scores in post-anesthesia care unit and throughout the postoperative phase (P=0.001 and P=0.003, respectively), along with enhanced QoR-15 scores on the 3rd postoperative day (P=0.008), compared to the control group. No notable differences were identified in the remaining indicators (P>0.05). CONCLUSION Buccal acupuncture therapy demonstrated significant effectiveness in reducing postoperative pain and improving recovery quality for patients undergoing radical resection of gastrointestinal cancers, presenting a viable intervention without associated adverse outcomes. (Trial registration No. ChiCTR2200060441).
Humans ; Male ; Pilot Projects ; Female ; Acupuncture Therapy/methods* ; Pain, Postoperative/therapy* ; Middle Aged ; Gastrointestinal Neoplasms/surgery* ; Aged ; Acupuncture Points ; Adult

OBJECTIVE: To investigate the effect of electroacupuncture pretreatment on the quality of recovery in the patients undergoing laparoscopic gastrointestinal surgery. METHODS: Sixty patients for elective laparoscopic resection of gastrointestinal tumors under general anesthesia were randomly assigned to either an observation group or a control group, with 30 patients in each group. In the control group, the routine inhalation-intravenous combined general anesthesia was adopted. On the basis of the control group, in the observation group, 30 min before anesthesia induction, electroacupuncture was applied to bilateral Neiguan (PC 6) and Neimadian (Extra) for 30 min, using disperse-dense wave and at 2 Hz/100 Hz. The recovery time of spontaneous breathing, awakening time, extubation time, and the post-anesthesia care unit (PACU) stay time were compared between the two groups. Mean arterial pressure (MAP), heart rate (HR), and oxygen saturation (SpO₂) were recorded at multiple time points: before electroacupuncture (T0), before extubation (T1), immediately after extubation (T2), 5 minutes (T3) and 10 minutes (T4) after extubation, and upon discharge from PACU (T5). The visual analogue scale (VAS) score for pain and Ramsay sedation score at T3, T4 and T5 were observed; and the incidence of agitation, nausea and vomiting at T5 was evaluated in the two groups. At T0 and T5, the serum levels of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and cortisol were determined in the two groups. RESULTS: In the observation group, the recovery time of spontaneous breathing, awakening time, extubation time, and PACU stay time were shorter (P<0.001), MAP and HR at T2 were lower (P<0.01, P<0.05), the VAS scores for pain at T3, T4, and T5 dropped (P<0.001, P<0.01), and the Ramsay sedation score at T3 reduced (P<0.05) compared with those in the control group. The incidence of nausea and vomiting was lower in the observation group when compared with that in the control group (P<0.05). In comparison with the indexes at T0, the serum levels of TNF-α, IL-6, and cortisol increased at T5 in both groups (P<0.01); and these indexes at T5 in the observation group were lower than those in the control group (P<0.01, P<0.05). CONCLUSION Electroacupuncture pretreatment can enhance the quality of recovery in the patients undergoing laparoscopic gastrointestinal tumor surgery, shorten the time for spontaneous breathing recovery, awakening, extubation and PACU stay, and attenuate postoperative pain and stress response.
Humans ; Electroacupuncture ; Female ; Male ; Middle Aged ; Laparoscopy ; Adult ; Aged ; Anesthesia Recovery Period ; Interleukin-6/blood* ; Pain, Postoperative/therapy* ; Tumor Necrosis Factor-alpha/blood* ; Young Adult ; Gastrointestinal Neoplasms/therapy* ; Acupuncture Analgesia

OBJECTIVES: To investigate the predictive value of myocardial strain for cardiotoxicity associated with fluorouracil-based chemotherapies in gastrointestinal cancer patients. METHODS: Patients with diagnosis of gastrointestinal cancers, who were hospitalized for chemotherapy involving antimetabolic drugs, were eligible in this prospective study. Echocardiography was performed before and after each chemotherapy cycle during hospitalization until the completion of chemotherapy. Cancer therapy-related cardiac dysfunction (CTRCD) was identified if there was a decrease in left ventricular ejection fraction (LVEF) by at least 5% to an absolute value of < 53% from the baseline, accompanied by symptoms or signs of heart failure; or a decrease in LVEF of at least 10% to an absolute value of < 53% from the baseline, without symptoms or signs of heart failure. Subclinical cardiac impairment is defined as a decrease in the left ventricular global longitudinal strain (GLS) of at least 15% from baseline.Clinical data and myocardial strain variables were collected. Changes of echocardiographic indexes after chemotherapy at each cycle were observed and compared to those of pre-chemotherapy. Cox regression analysis was used to determine the associated indexes to CTRCD, and receiver operating characteristic (ROC) curves were plotted for evaluation of their predicting efficacy. RESULTS: Fifty-one patients completed 4 cycles of chemotherapy and were enrolled in the study analysis. LVEF, GLS, GLS epicardium (GLS-epi), and GLS endocardium (GLS-endo) were decreased after the 4 cycles of chemotherapy. Throughout the chemotherapy period, 6 patients (11.8%) progressed to CTRCD. The Cox regression analysis revealed that the change in left atrial ejection fraction (LAEF) and LAS during the reservoir (LASr) phase after the first cycle of chemotherapy (C1v-LAEF and C1v-LASr, respectively) were significantly associated with the development of CTRCD [C1v-LAEF (HR=1.040; 95%CI: 1.000-1.082; P=0.047); C1v-LASr (HR=1.024; 95%CI: 1.000-1.048; P=0.048)]. The sensitivity and specificity were 50.0% and 93.3%, respectively, for C1v-LAEF predicting CTRCD when C1v-LAEF > 19.68% was used as the cut-off value, and were 66.7% and 75.6%, respectively, for C1v-LASr predicting CTRCD when C1v-LASr > 14.73% was used as the cut-off value. The areas under the ROC curve (AUC) for C1v-LAEF and C1v-LASr predicting CTRCD were 0.694 and 0.707, respectively. CONCLUSIONS GLS changes among patients with subclinical impairment of cardiac function who were treated with fluorouracil-based chemotherapies, and C1v-LAEF and C1v-LASr of the left atrium are early predictors of cardiac function deterioration.
Humans ; Fluorouracil/adverse effects* ; Male ; Female ; Middle Aged ; Gastrointestinal Neoplasms/drug therapy* ; Aged ; Echocardiography ; Prospective Studies ; Adult ; Heart/diagnostic imaging*

Objective To investigate the effects of Weidiao-3(WD-3)Mixture on the clinical efficacy of immunotherapy for advanced gastric cancer and the intestinal flora.Methods Fifty-one patients with advanced gastric cancer treated in Wuxi Traditional Chinese Medicine Hospital from January 2020 to December 2021 were randomized into a WD-3 group(immunotherapy + WD-3 Mixture,one dose per day)(n=25)and a gastric cancer(GC) group(only immunotherapy)(n=26)according to the admission time.Ten healthy volunteers were included as the healthy control group.The Karnofsky score and the Quality of Life Questionnare-Core score were evaluated before and after treatment,and the clinical efficacy was compared after treatment.After treatment,the stool samples were collected for 16SrRNA gene high-throughput sequencing and targeted metabolomics.The α and β diversity and structure of the intestinal flora and the content of short-chain fatty acids were compared between groups.Results The quality of life in both groups improved after treatment and was better in the WD-3 group than in the GC group(P=0.035).The dry mouth(P=0.038)and altered taste(P=0.008)were mitigated in the WD-3 group after treatment,and the reflux(P=0.001)and dry mouth(P=0.022)were mitigated in the GC group after treatment.After treatment,the WD-3 group outperformed the GC group in terms of dysphagia(P=0.047)and dry mouth(P=0.045).The WD-3 group was superior to the GC group in terms of objective remission rate and disease control rate,with prolonged median progression-free survival and median overall survival(P=0.039,P=0.043).The α and β diversity indexes of the intestinal flora showed no significant differences between WD-3 and GC groups(all P>0.05).At the phylum level,WD-3 and GC groups had lower relative abundance of Firmicutes(P=0.038,P=0.042)and higher relative abundance of Proteobacteria(P=0.016,P=0.015)than the healthy control group.The relative abundance of Actinomycetes in the GC group was lower than that in the healthy control group(P=0.035)and the WD-3 group(P=0.046).At the genus level,the GC group had lower relative abundance of Bifidobacteria and Coprococcus than the healthy control group and the WD-3 group(all P<0.001).LEfSe revealed the differences in the relative abundance of 6 intestinal bacterial taxa between the WD-3 group and the GC group.At the genus level,Saccharopolyspora had higher relative abundance in the WD-3 group than in the healthy control group and only existed in the WD-3 group.The content of isobutyric acid and isovaleric acid in the WD-3 group was higher than that in the healthy control group(P=0.037,P=0.004).Conclusion WD-3 Mixture may increase the relative abundance of Bifidobacteria and Coprococcus and the content of isobutyric acid and isovaleric acid to alter the intestinal microecology,thereby improving the efficacy of immunotherapy for gastric cancer.
Humans ; Isobutyrates ; Gastrointestinal Microbiome ; Quality of Life ; Stomach Neoplasms/therapy* ; Immunotherapy ; Treatment Outcome

Peritoneal tumours have a large population and a poor prognosis with limited therapeutic options available, and are common originated from gastric, colorectal, appendix and other cancers. Traditionally, peritoneal tumours have long been considered to be a terminal condition with a median survival of 3-6 months, and the palliative symptomatic treatment is recommended. Recently, the multimodal therapeutic strategy of cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) has resulted in more effective on the prevention and treatment of peritoneal metastasis, which can significantly improve the survival and quality of life. Under the guidance of the China Anti-Cancer Association (CACA), the "CACA Guidelines for Holistic Integrative Management of Cancer-Peritoneal Tumours" was jointly completed by experts in related fields organized by the Chinese Society of Peritoneal Oncology. This guideline is guided by the concept of integrative medicine and focuses on the domestic epidemiology, genetic background and original studies. It emphasizes the multidisciplinary team to holistic integrative medicine (MDT to HIM), and pays attention to the whole-course management of "prevention, screening, diagnosis, treatment, and rehabilitation". This guideline mainly focuses on peritoneal metastasis from gastrointestinal tumours, aiming to standardize the clinical diagnosis and treatment process, and jointly promote the management of peritoneal metastasis in China.
Humans ; Peritoneal Neoplasms/secondary* ; Combined Modality Therapy ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Quality of Life ; Prognosis ; Hyperthermia, Induced/methods* ; Gastrointestinal Tract ; Colorectal Neoplasms/pathology* ; Cytoreduction Surgical Procedures/methods* ; Survival Rate

Peritoneal metastasis is one of the common metastasis of gastrointestinal malignancy. Intraperitoneal chemotherapy (including hyperthermic intraperitoneal chemotherapy and intraoperative intraperitoneal chemotherapy) not only can effectively increase the peritoneal drug concentration, but also can reduce side effects of systemic chemotherapy. It can significantly prolong the long term survival of patients with peritoneal metastasis and improve the quality of life. In order to standardize the popularization and application of intraperitoneal chemotherapy, relevant professional committees have formulated expert consensus on intraperitoneal chemotherapy. However, there is no systematic guidance on the prevention and treatment of related complications of intraperitoneal chemotherapy. Under the guidance of the Complications Management Committee of the Colorectal Cancer Professional Committee of the Chinese Medical Association and the Colorectal Cancer Professional Committee of the Chinese Anti-cancer Association, we organized domestic experts in relevant fields to formulate this consensus according to the procedural specifications and relevant literature reports. This consensus aims to summarize the causes of common complications of intraperitoneal chemotherapy such as pneumonia, intraperitoneal hemorrhage, fever, peritonitis, ileus, intestinal dysfunction, anastomotic bleeding, anastomotic leakage, leakage or infection of perfusion tube, nausea and vomiting, myelosuppression, hepatic or nephritic dysfunction. After repeatedly soliciting the opinions of domestic authoritative experts and their discussion and modification, a consensus was formed to provide effective reference for the prevention and treatment of complications.
Humans ; Peritoneal Neoplasms/secondary* ; Hyperthermia, Induced ; Consensus ; Quality of Life ; Combined Modality Therapy ; Gastrointestinal Neoplasms/therapy* ; Perfusion ; Colorectal Neoplasms/surgery* ; China

Objective: To investigate the clinical features of patients with cardiac metastases from digestive system tumors. Methods: This retrospective study collected and analyzed the medical records of patients with cardiac metastases from digestive system tumors who received treatments in the Cancer Hospital, Chinese Academy of Medical Sciences between January 1999 and January 2021. Kaplan-Meier method was used for survival analysis. Results: A total of 19 patients were identified. The primary tumors were esophageal squamous cell carcinoma (n=7), gastric or gastroesophageal junction adenocarcinoma (n=6), hepatobiliary cancers (n=3) and colorectal cancers (n=3). 16 patients had pericardial metastases, 2 patients had right atrium metastases, and 1 patient had left ventricle metastasis. The most common symptom was dyspnea, which was present in 8 cases. 7 patients received locoregional treatment, while 11 patients underwent systemic therapies. The median overall survival from diagnosis of primary cancer was 31.4 months, and the median overall survival time from diagnosis of cardiac metastasis was 4.7 months. Conclusion: Cardiac metastasis from digestive system tumors is associated with low incidence and a poor prognosis. Systemic treatment remains the cornerstone of management, while novel anti-tumor drugs may improve therapeutic efficacy.
Humans ; Esophageal Neoplasms/pathology* ; Retrospective Studies ; Prognosis ; Esophageal Squamous Cell Carcinoma ; Digestive System Neoplasms/drug therapy* ; Gastrointestinal Neoplasms