Multidisciplinary diagnosis and treatment nutritional support intervention for gastrointestinal tumor radiotherapy:Impact on nutrition and quality of life

BACKGROUND Gastrointestinal tumors are a major cause of cancer-related deaths and have become a major public health problem.This study aims to provide a scientific basis for improving clinical treatment effects,quality of life,and prognosis of patients with gastrointestinal tumors.AIM To explore the clinical effect of the multidisciplinary diagnosis and treatment(MDT)nutrition intervention model on patients with gastrointestinal tumors.METHODS This was a case control study which included patients with gastrointestinal tumors who received radiotherapy at the Department of Oncology between January 2021 and January 2023.Using a random number table,120 patients were randomly divided into MDT and control groups with 60 patients in each group.To analyze the effect of MDT on the nutritional status and quality of life of the patients,the nutritional status and quality of life scores of the patients were measured before and after the treatment.RESULTS Albumin(ALB),transferrin(TRF),hemoglobin(Hb),and total protein(TP)levels significantly decreased after the treatment.The control group had significantly lower ALB,TRF,Hb,and TP levels than the MDT group,and the differences in these levels between the two groups were statistically significant(P<0.05).After the treatment,the MDT group had significantly more wellnourished patients than the control group(P<0.05).The quality of life total score,somatic functioning,role functioning,and emotional functioning were higher in the MDT group than in the control group.By contrast,pain,fatigue,nausea,and vomiting scores were lower in the MDT group than in the control group(P<0.05).CONCLUSION MDT nutritional intervention model effectively improves the nutritional status and quality of life of the patients.The study provides a rigorous theoretical basis for improving the prognosis of cancer patients.In the future,we intend to provide additional treatment methods for improving the quality of life of patients with cancer.

Application of nanoparticles in the early diagnosis and treatment of tumors:current status and progress

Objective:Malignant tumors pose a serious threat to human life and health.Despite recent developments in modern medical techniques,the early diagnosis and treatment of tumors remain difficult due to their asymptomatic nature in the early stages of disease and the limitations in current clinical diagnostic methods.Advancements in nanotechnology,particularly in the area of multi-functional diagnostic nanomaterials,can help effectively resolve present inadequacies via concurrently achieving early diagnosis,image-guided intervention,and real-time monitoring and treatment of tumors.The development of nanomaterials and nanotechnology may also aid in the area of anti-cancer drug development by improving the safety and side-effect profile,as well as by enhancing the targeted specificity of the drugs,which are two of the long-standing challenges in Western medicine.The progress in the field of nanomaterials has also uncovered novel approaches for the clinical application of traditional Chinese medicine because the combination of traditional Chinese medicine components with nanoparticles overcomes various drawbacks,including poor water solubility,low bioavailability,and short half-life,of the former.Moreover,nanoparticles also enhance the biological effectiveness and targeted specificity of these medicines.In this review,we discuss the application of nanoparticles in the early diagnosis and treatment of tumors,through modern and traditional medicine.

Diagnosis and treatment of spinal primitive neuroectodermal tumor

Objective To sum up the clinical experience in diagnosis and treatment of spinal primitive neuroectodermal tumor(PNET). Methods Thirteen patients with spinal PNET were included in the study from 1999 to 2009.There were 8 males and 5

Diagnosis and treatment of solid-pseudopapillary tumor of the pancreas

BACKGROUND: Solid-pseudopapillary tumor (SPT) of the pancreas is a rare exocrine pancreatic tumor. Despite the increasing recognition of the tumor in recent years, its pathogenesis and apparent therapeutic algorithm remain unclear. This study was designed to define the clinical, imaging, and pathologic features and to improve the diagnosis and treatment of this rare disease. METHOD: The clinical, imaging, and pathologic findings of 9 SPT patients managed in our hospital between 2001 and 2005 were retrospectively analyzed, and related literatures were reviewed. RESULTS: In the 9 patients aged from 14 to 68 years, 8 were female and 1 male. The mean age of these patients at diagnosis was 30 years. Initially, 8 patients complained of vague abdominal pain and one patient had pancreatic mass detected incidentally by abdominal CT. The levels of blood and urine amylase and tumor markers were all within the normal range. B-US, CT and MRI demonstrated that tumors were well encapsulated and contained some degree of internal hemorrhage or cystic degeneration. The mean transverse diameter of these tumors was 5.4 cm (range, 2-10.5 cm). The tumors were located at the head (2 patients), body (2), body and tail junction (4), and tail (1) of the pancreas. Surgical procedures included pancreaticoduodenectomy, distal pancreatectomy, distal pancreatectomy with splenectomy, and enucleation. Histological examination showed solidified cystic areas and papillary protrusions. Two malignant tumors demonstrated retroperitoneal metastases and vascular invasion. Follow-up for 2.5 years on average showed that one patient died of tumor recurrence at 10 months and the rest were alive. CONCLUSIONS: SPT exhibits unique clinical and pathologic features and is readily diagnosed by its characteristic imaging and histological appearance. Surgical resection of the primary tumor and metastases is the treatment of choice.

Diagnosis and treatment of Wilms tumor

We collected a medical record of“Wilms’tumor”in the Department of Urology at the Third Affiliated Hospital of Inner Mongolia Medical University,and discussed the diagnosis,auxiliary examination and treatment of the disease.We hope to expand clinical thinking,improve our diagnosis and treatment of the disease through data analysis.

REFLECTIONS ON SURGICAL TREATMENT OF 214 CASES OF PRIMARY MEDIASTINAL TUMOR

Our hospital documented 214 cases of primary mediastinal tumor from May 1957 to July 1995. They were treated surgically, There were 184 benign cases (85. 98% ), and 30 malignant cases (14.02 % ). Among them, there were 63 cases of neurogenic tumor (29.43 % ), 48 cases of thymic tumor (22. 4% ), 41 cases of teratoid tumor (19. 16% ), 12 cases of bronchial cyst (5. 61% ), and 9cases of intrathoracic adenoma of thyroid (4. 21%). The authors mainiy discuss the early diagnosis,tumor variety, operating incisions, and operating essentials.

Comprehensive treatment for primary right renal diffuse large B-cell lymphoma with a renal vein tumor thrombus:A case report

BACKGROUND Renal involvement in lymphoma is commonly associated with widespread nodal or extranodal lymphoma.Primary renal diffuse large B-cell lymphoma is an extremely rare extranodal lymphoma,accounting for fewer than 1%of all renal masses.Interestingly,the patient in this study had a renal vein tumor thrombus that was observed after laparoscopic radical nephrectomy.CASE SUMMARY We report the case of a 56-year-old female patient with primary renal lymphoma and a renal vein tumor thrombus whose first symptom was right pain in the back and gross hematuria.Histopathology revealed primary renal diffuse large B-cell lymphoma.The patient received 8 standard cycles of rituximab with cyclophosphamide,doxorubicin,vincristine,and prednisone chemotherapy after surgery,and no obvious signs of recurrence were observed during the one-year follow-up.CONCLUSION We evaluated comprehensive treatment of primary renal diffuse large B-cell lymphoma and multidisciplinary management of this malignancy.

Analysis of clinical characteristics and treatment of pancreatic cystic tumors

Objective： To summarize experience in the diagnosis and treatment of pancreatic cystic neoplasms.Methods： This is a retrospective study of 207 patients who were diagnosed with pancreatic cystic tumors at Peking Union Medical College Hospital between Jan 2009 and Mar 2014. Clinical data, such as clinical manifestations, radiologieal and pathological images and surgical recordings, were collected. Results： Of the 207 included patients, females accounted for 76.81%, and the mean patient age was 52.04 years. Malignancy was more common in older patients who presented with marasmus and jaundice. Other risk factors included solid components in the tumor, a large tumor size, and elevated levels of tumor markers. Surgical treatment was required when a malignant tumor was suspected. The operation approach was selected based on the location, size and characteristics of the tumor. The position of the tumor relative to the pancreatic duct also played a significant role.

Gallbladder neuroendocrine carcinoma diagnosis, treatment and prognosis based on the SEER database: A literature review

BACKGROUND Gallbladder neuroendocrine carcinoma(GB-NEC)has a low incidence rate;therefore,its clinical characteristics,diagnosis,treatment and prognosis are not well explored.AIM To review recent research and analyze corresponding data in the Surveillance Epidemiology and End Results(SEER)database.METHODS Data of GB-NEC(n=287)and gallbladder adenocarcinoma(GB-ADC)(n=19484)patients from 1975 to 2016 were extracted from the SEER database.Survival analysis was performed using Kaplan–Meier and Cox proportional hazards regression.P<0.05 was considered statistically significant.We also reviewed 108 studies retrieved from PubMed and Reference Citation Analysis(https://www.referencecitationanalysis.com/).The keywords used for the search were:"(Carcinoma,Neuroendocrine)AND(Gallbladder Neoplasms)".RESULTS The GB-NEC incidence rate was 1.6%(of all gallbladder carcinomas),male to female ratio was 1:2 and the median survival time was 7 mo.The 1-,2-,3-and 5-year overall survival(OS)was 36.6%,17.8%,13.2%and 7.3%respectively.Serum chromogranin A levels may be a specific tumor marker for the diagnosis of GBNEC.Elevated carcinoembryonic antigen,carbohydrate antigen(CA)-19-9 and CA-125 levels were associated with poor prognosis.Age[hazard ratio(HR)=1.027,95%confidence interval(CI):1.006–1.047,P=0.01]and liver metastasis(HR=3.055,95%CI:1.839–5.075,P<0.001)are independent prognostic risk factors for OS.Patients with advanced GB-NEC treated with surgical resection combined with radiotherapy and/or chemotherapy may have a better prognosis than those treated with surgical resection alone.There was no significant difference in OS between GB-NEC and GB-ADC.CONCLUSION The clinical manifestations and prognosis of GB-NEC are similar to GB-ADC,but the treatment is completely different.Early diagnosis and treatment are the top priorities.

CURRENT MEANS IN THE DIAGNOSIS AND TREATMENT OF ORAL AND MAXILLOFACIAL TUMORS IN CHINA

Oral and maxillofacial tumors (OMT) constitute a great number in tumors of head and neck as a whole. The incidence of OMT in China is rather low. but. owing to our big population, the absolute number of the patients is high. The diagnosis and treatment of OMT in China with special emphasis on malignancies are briefly introduced below.

Application of Multimodality Imaging Fusion Technology in Diagnosis and Treatment of Malignant Tumors under the Precision Medicine Plan

Objective： The arrival of precision medicine plan brings new opportunities and challenges for patients undergoing precision diagnosis and treatment of malignant tumors. With the development of medical imaging, information on different modality imaging can be integrated and comprehensively analyzed by imaging fusion system. This review aimed to update the application of multimodality imaging fusion technology in the precise diagnosis and treatment of malignant tumors under the precision medicine plan. We introduced several multimodality imaging fusion technologies and their application to the diagnosis and treatment of malignant tumors in clinical practice. Date Sources： The data cited in this review were obtained mainly from the PubMed database from 1996 to 2016, using the keywords of ＂precision medicine＂, ＂fusion imaging＂, ＂multimodality＂, and ＂tumor diagnosis and treatment＂. Study Selection： Original articles, clinical practice, reviews, and other relevant literatures published in English were reviewed. Papers focusing on precision medicine, fusion imaging, multimodality, and tumor diagnosis and treatment were selected. Duplicated papers were excluded. Results： Multimodality imaging fusion technology plays an important role in tumor diagnosis and treatment under the precision medicine plan, such as accurate location, qualitative diagnosis, tumor staging, treatment plan design, and real-time intraoperative monitoring. Multimodality imaging fusion systems could provide more imaging information of tumors from different dimensions and angles, thereby offing strong technical support for the implementation of precision oncology. Conclusion： Under the precision medicine plan, personalized treatment of tumors is a distinct possibility. We believe that multimodality imaging fusion technology will find an increasingly wide application in clinical practice.

Classification,clinicopathologic features and treatment of gastric neuroendocrine tumors

Gastric neuroendocrine tumors(GNETs)are rare lesions characterized by hypergastrinemia that arise from enterochromaffin-like cells of the stomach.GNETs consist of a heterogeneous group of neoplasms comprising tumor types of varying pathogenesis,histomorphologic characteristics,and biological behavior.A classification system has been proposed that distinguishes four types of GNETs;the clinicopathological features of the tumor,its prognosis,and the patient’s survival strictly depend on this classification.Thus,correct management of patients with GNETs can only be proposed when the tumor has been classified by an accurate pathological and clinical evaluation of the patient.Recently developed cancer therapies such as inhibition of angiogenesis or molecular targeting of growth factor receptors have been used to treat GNETs,but the only definitive therapy is the complete resection of the tumor.Here we review the literature on GNETs,and summarize the classification,clinicopathological features(especially prognosis),clinical presentations and current practice of management of GNETs.We also present the latest findings on new gene markers for GNETs,and discuss the effective drugs developed for the diagnosis,prognosis and treatment of GNETs.

CLINICOPATHOLOGIC FEATURES AND SURGICAL TREATMENT OF NONFUNCTIONING ISLET CELL TUMORS

Objective.To in vestigate clinicopathologic characteristics and surgical results of nonfunctiona l islet cell tumors.Methods.We performed retrospective analysis of50patient s with nonfunctional islet cell tumor treat-ed at Peking Union Medical College Hospital from July1968to July1999,and summarized clinical symptoms and signs,primary diagnosis before surgery,surgical treatments,pathologic and im munohisto-logical characteristics.Results.Of the50cases examined from July 1968to July1999,12were found during physical examinations. The most common symptoms were upper abdominal pain and upper abdominal dis-com fort,which appeared in20casesand17casesrespectively,an d the most common sign was abdominal masses.B-ultrasound and CT are the most commonly used means for preoperative examination,with posit ive rates of97.8%and100%respectively.Op-e rative mortality was2%.Five-year survival rate of radical surgery of maligna nt cases was75%.Immuno-histological examinations showed that tumors rich i n multi-peptide linked hormones,neuron-specific eno-lase and chromaffin were in65%cases,90.6%and73.3% respectively.The positive rates of insulin,glucagons,somatostatin,pancreat ic polypeptide,gastrin and vasoactive intestinal peptide were68.2% ,51.2%,42.9%,40% ,25%and15.8%respectively.Conclusion.Nonfuncti onal islet cell tumors lack diagnostic specificity.Ultrasound and CT are primar y examination methods.Immunohistological analysis indicates different hormones ,but lacks the presence of related clinical symptoms.Surgery is an effective treatment for nonfunctional islet cell tumors,and even for those with distal m etastasis,immediate surgical removal and treatment can improve prognosis.

Advances in the diagnosis and treatment of patients with cancer cachexia

Cachexia is a common complication with an incidence rate of 50%–80% in cancer patients. It is also responsible for 20% of mortality among these patients. Cachexia can significantly reduce the efficacy of antitumor therapies and increase treatment-related toxicity and adverse effects in cancer patients. This increases the symptom burden in patients, affects their quality of life, and ultimately shortens their survival time. The mechanism underlying the development of cachexia is complex and diverse and involves various factors and pathways, each playing an important role. Treatment approaches for cachexia are multimodal, including nutrition support therapy, appetite stimulants, and therapeutic drugs that specifically target the mechanism behind the disease. In recent years, we have gradually gained a better understanding of cachexia, and significant progress has been made in delineating molecular mechanisms, staging and diagnosis, and therapeutic drug treatment of cancer cachexia. This article reviews the research progress of cancer cachexia based on these contexts.

Isolated Mediastinal Lymphangioma: Prenatal Diagnosis and Thoracoscopic Treatment

Isolated mediastinal lymphangiomas are uncommon. We report a case of a 14 &#215;8 mm right paracardiac cyst diagnosed at 20 weeks’ gestation. The prenatal evolution was uneventful and a magnetic resonance imaging at 31 weeks showed the limited extension of the cyst into the anterior mediastinum. At birth, the baby was asymptomatic, but the size of the lesion increased steadily (48 &#215;29 mm). At 7 months of life, he underwent a thoracoscopic resection of the cyst without intra or postoperative complications. Histological examination showed a lymphangioma. This case is remarkable for its prenatal diagnosis, the thoracoscopic treatment and the 8 years of followup without recurrence.

Two-dimensional layered nanomaterials fortumor diagnosis and treatment

With the evolution of nanomedicine,the past decades witnessed diversified nanomaterials as marvelous antitumor tools ushering in a new era of tumor diagnosis and treatment.Among them,two-dimensional layered nano-material as an emerging class of nanomaterials has one dimension less than 100 nm,showing a high specific area and the thinnest sheet-like structure(Liu S,Pan X,Liu H.Twodimensional nanomaterials for photothermal therapy.Angew Chem Int Ed 2020;59:5890–900).The discovery of graphene drove the exploration of various new two-dimensional layered nanomaterials for tumor diagnosis and treatment including graphene-based nanomaterials,black phosphorus(BP),transition metal dichalcogenides(TMDs),layered double hydroxides(LDHs),and bismuth oxyhalides(BiOX,X=F,Cl,Br,I)(Ma H,Xue MQ.Recent advances in the photothermal applications of two-dimensional nanomaterial:photothermal therapy and beyond.J Mater Chem 2021;9:17569).On the one hand,they exhibit strong near-infrared(NIR)absorption and the capacity of optimizing corresponding properties by adjusting the crystal structure.On the other hand,they own unique strengths such as fantastic physicochemical properties(graphene-based nanomaterials),high loading capacity(BP),distinct phase-dependent optical properties(TMDs),a specific chemical response to the tumor microenvironment(LDHs),and large X-ray attenuation coefficient(BiOX).Herein,we briefly introduce three typical two-dimensional layered nanomaterials,their prospects and future research priorities in tumor diagnosis and treatment are concluded.

New roles of tumor-derived exosomes in tumor microenvironment

Throughout tumorigenesis, the co-evolution of tumor cells and their surrounding microenvironment leads to the development of malignant phenotypes. Cellular communication within the tumor microenvironment(TME) plays a critical role in influencing various aspects of tumor progression, including invasion and metastasis. The release of exosomes, a type of extracellular vesicle, by most cell types in the body, is an essential mediator of intercellular communication. A growing body of research indicates that tumor-derived exosomes(TDEs) significantly expedite tumor progression through multiple mechanisms, inducing epithelial-mesenchymal transition and macrophage polarization, enhancing angiogenesis, and aiding in the immune evasion of tumor cells. Herein, we describe the formation and characteristics of the TME, and summarize the contents of TDEs and their diverse functions in modulating tumor development. Furthermore, we explore potential applications of TDEs in tumor diagnosis and treatment.

Circulating tumor DNA:Where are we now?A mini review of the literature

For many years tissue biopsy has been the primary procedure to establish cancer diagnosis and determine further treatment and prognosis.However,this method has multiple drawbacks,including,to mention some,being an invasive procedure carrying significant risk for fragile patients and allowing only for a“snapshot”of the tumor biology in time.The process of liquid biopsy allows for a minimally invasive procedure that provides molecular information about underlying cancer by analyzing circulating tumor DNA(ctDNA)via next-generation sequencing technology and circulating tumor cells.This paper focuses on describing the basis of ctDNA and its current utilities.

Diagnosis and treatment of mixed glioma

The authors present 83 patients with mixed glioma with experiences in clinical diagnosis and treatment.In all these cases.there were 44 tumors as grade 1 or 2,and 39 as grade 3 or 4.In 39 tumors.two glial components(oligodendrocytes and astrocytes) occurr