Shifei Song, Hongzhen Du, C. Bian, Xuecai Lv, Hongyuan Xue, Huanyu Hu, Zengning Li
Abstract: Objective We analysed the impact of home nutritional interventions on the nutritional risk and the incidence and severity of malnutrition in patients with malignancy. Methods In this prospective interventional study, we recruited 60 patients with malignancy who were at nutritional risk (NRS 2002 ≥ 3 scores). These patients were given home enteral nutritional supplementation (HES) for 3 months. The HES included nutritional counselling, oral nutritional supplements (ONS) and tube feeding. The incidence and severity of nutritional risk and malnutrition, as well as the body composition and results of routine blood tests, were compared before and after the intervention. Results A total of 58 patients completed the study. After three months of home enteral nutritional intervention, the incidence and severity of nutritional risk and malnutrition were significantly reduced (the NRS 2002 score was reduced from 3 to 1, the PG-SGA score was reduced from 8.00 to 3.00, P < 0.05). The patients’ body mass index (BMI) and upper arm circumference increased (P < 0.05), the muscle mass, appendicular skeletal muscle mass index (ASMI) and phase angle (PA) increased (P < 0.05). The serum albumin, pre-albumin and haemoglobin levels increased significantly, while the neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) decreased significantly (P < 0.05). The incidence of hypoproteinaemia and anaemia also decreased significantly (P < 0.05). Conclusion HES can effectively improve the nutritional status of patients and reduce the risk and severity of malnutrition.
{"title":"Impact of Three-month Home Enteral Nutritional Supplementation on the Nutritional Status of Patients with Malignancy","authors":"Shifei Song, Hongzhen Du, C. Bian, Xuecai Lv, Hongyuan Xue, Huanyu Hu, Zengning Li","doi":"10.34175/jno202203003","DOIUrl":"https://doi.org/10.34175/jno202203003","url":null,"abstract":"Abstract: Objective We analysed the impact of home nutritional interventions on the nutritional risk and the incidence and severity of malnutrition in patients with malignancy. Methods In this prospective interventional study, we recruited 60 patients with malignancy who were at nutritional risk (NRS 2002 ≥ 3 scores). These patients were given home enteral nutritional supplementation (HES) for 3 months. The HES included nutritional counselling, oral nutritional supplements (ONS) and tube feeding. The incidence and severity of nutritional risk and malnutrition, as well as the body composition and results of routine blood tests, were compared before and after the intervention. Results A total of 58 patients completed the study. After three months of home enteral nutritional intervention, the incidence and severity of nutritional risk and malnutrition were significantly reduced (the NRS 2002 score was reduced from 3 to 1, the PG-SGA score was reduced from 8.00 to 3.00, P < 0.05). The patients’ body mass index (BMI) and upper arm circumference increased (P < 0.05), the muscle mass, appendicular skeletal muscle mass index (ASMI) and phase angle (PA) increased (P < 0.05). The serum albumin, pre-albumin and haemoglobin levels increased significantly, while the neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) decreased significantly (P < 0.05). The incidence of hypoproteinaemia and anaemia also decreased significantly (P < 0.05). Conclusion HES can effectively improve the nutritional status of patients and reduce the risk and severity of malnutrition.","PeriodicalId":64349,"journal":{"name":"Journal of Nutritional Oncology","volume":"7 1","pages":"128 - 135"},"PeriodicalIF":0.0,"publicationDate":"2022-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45122076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jin-Yu Shi, Guang Yang, Bojun Liu, Xiao Shang, Guozhen Cui, Jia Xin Huang, W. Wang, Kehua Chen, Nan-Ya Wang
Abstract: Background The phase angle (PA) is an indicator of nutritional status derived from bioelectrical impedance analysis (BIA). Studies have shown that the PA is one of several factors related to the survival of cancer patients. However, the correlation between the PA and prognosis in patients with hepatocellular carcinoma (HCC) has not been reported. This study aimed to explore the relationship between the PA, nutrition-related indicators, and patient prognosis. Methods The data from 248 HCC patients who underwent BIA between January 2015 and December 2019 at the First Hospital of Jilin University were retrospectively analyzed. Patients were divided into two groups according to the median PA value, then the nutrition-related indicators and overall survival (OS) were compared between the two groups. The correlations between the PA and laboratory test nutrition-related indicators and the results of a body composition analysis were determined using Pearson correlation analysis. Independent predictors of the patient prognosis were identified using univariate and multivariate analyses. Results The median OS in the high and low PA groups were 70 and 54.6 months, respectively (P = 0.004). The Pearson correlation analysis revealed that the PA was associated with both laboratory test nutrition-related indicators and the results of a body composition analysis. The multivariable Cox regression analysis identified the PA as an independent risk factor affecting the prognosis of patients with Barcelona Clinic Liver Cancer stage A or B. Conclusion The PA is a good biomarker for the nutritional status. We found that the PA was associated with the prognosis in patients with HCC, with a low PA indicating a poor nutritional status and worse prognosis.
{"title":"Low Phase Angle Predicts Poor Survival in Patients with Hepatocellular Carcinoma: A Retrospective Study","authors":"Jin-Yu Shi, Guang Yang, Bojun Liu, Xiao Shang, Guozhen Cui, Jia Xin Huang, W. Wang, Kehua Chen, Nan-Ya Wang","doi":"10.34175/jno202202003","DOIUrl":"https://doi.org/10.34175/jno202202003","url":null,"abstract":"Abstract: Background The phase angle (PA) is an indicator of nutritional status derived from bioelectrical impedance analysis (BIA). Studies have shown that the PA is one of several factors related to the survival of cancer patients. However, the correlation between the PA and prognosis in patients with hepatocellular carcinoma (HCC) has not been reported. This study aimed to explore the relationship between the PA, nutrition-related indicators, and patient prognosis. Methods The data from 248 HCC patients who underwent BIA between January 2015 and December 2019 at the First Hospital of Jilin University were retrospectively analyzed. Patients were divided into two groups according to the median PA value, then the nutrition-related indicators and overall survival (OS) were compared between the two groups. The correlations between the PA and laboratory test nutrition-related indicators and the results of a body composition analysis were determined using Pearson correlation analysis. Independent predictors of the patient prognosis were identified using univariate and multivariate analyses. Results The median OS in the high and low PA groups were 70 and 54.6 months, respectively (P = 0.004). The Pearson correlation analysis revealed that the PA was associated with both laboratory test nutrition-related indicators and the results of a body composition analysis. The multivariable Cox regression analysis identified the PA as an independent risk factor affecting the prognosis of patients with Barcelona Clinic Liver Cancer stage A or B. Conclusion The PA is a good biomarker for the nutritional status. We found that the PA was associated with the prognosis in patients with HCC, with a low PA indicating a poor nutritional status and worse prognosis.","PeriodicalId":64349,"journal":{"name":"Journal of Nutritional Oncology","volume":"7 1","pages":"75 - 84"},"PeriodicalIF":0.0,"publicationDate":"2022-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44914003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Feng-Min Zhang, Zhen Yu, Hanping Shi, M. Cong, Hong-xia Xu, Zhuang Le Cheng
Abstract: The number of new cancer cases in China is increasing rapidly, and China now ranks first in the world for the number of cancer patients. Traditional oncology treatment is based on surgery, radiotherapy and chemotherapy, but all three treatments are often accompanied by a poor quality of life, impaired physical function, and significant anxiety and depression. Exercise therapy can provide both prognostic improvement and a better quality of life for cancer patients, and can be adapted to serve patients at all stages from perioperative recovery to hospice. Although the impact of exercise alone is difficult to assess given the influence of lifestyle and other factors, data suggest that consistent exercise can improve the prognosis of cancer patients. Exercise enhances cardiopulmonary function, induces protein synthesis, improves physiological performance and increases physiological reserves; it also helps to improve the metabolic and immune functions, creating an anti-cancer environment in the body. An appropriate exercise plan can reduce adverse effects associated with cancer treatment, improve patients’ physiological function, reduce fatigue and improve quality of life. Of note, exercise may also reduce the risk of cancer recurrence and metastasis. In recent years, exercise oncology has received increasing attention, thus, this article reviews the progress made in the clinical application of exercise therapy in oncology patients.
{"title":"Exercise for Cancer Therapy","authors":"Feng-Min Zhang, Zhen Yu, Hanping Shi, M. Cong, Hong-xia Xu, Zhuang Le Cheng","doi":"10.34175/jno202202001","DOIUrl":"https://doi.org/10.34175/jno202202001","url":null,"abstract":"Abstract: The number of new cancer cases in China is increasing rapidly, and China now ranks first in the world for the number of cancer patients. Traditional oncology treatment is based on surgery, radiotherapy and chemotherapy, but all three treatments are often accompanied by a poor quality of life, impaired physical function, and significant anxiety and depression. Exercise therapy can provide both prognostic improvement and a better quality of life for cancer patients, and can be adapted to serve patients at all stages from perioperative recovery to hospice. Although the impact of exercise alone is difficult to assess given the influence of lifestyle and other factors, data suggest that consistent exercise can improve the prognosis of cancer patients. Exercise enhances cardiopulmonary function, induces protein synthesis, improves physiological performance and increases physiological reserves; it also helps to improve the metabolic and immune functions, creating an anti-cancer environment in the body. An appropriate exercise plan can reduce adverse effects associated with cancer treatment, improve patients’ physiological function, reduce fatigue and improve quality of life. Of note, exercise may also reduce the risk of cancer recurrence and metastasis. In recent years, exercise oncology has received increasing attention, thus, this article reviews the progress made in the clinical application of exercise therapy in oncology patients.","PeriodicalId":64349,"journal":{"name":"Journal of Nutritional Oncology","volume":"7 1","pages":"58 - 63"},"PeriodicalIF":0.0,"publicationDate":"2022-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45360086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mingming Zhou, Tiantian Wu, Yu Wang, Y. Zou, K. Xu, J. Cui, Zengning Li, Junqiang Chen, Ming-Eng Liu, Zengqing Guo, Hong-xia Xu, Hanping Shi, Chunhua Song
Abstract: Objective The Nutritional Risk Screening 2002 (NRS 2002) was used to assess the nutritional risk of hospitalized oncology patients in China. This study explored the factors affecting the risk of nutrition to provide a scientific basis for the assessment and treatment of malnutrition in oncology patients. Methods We used the NRS 2002 to evaluate the nutritional risk in 48,831 hospitalized cancer patients. Descriptive statistical methods were used to describe the general patient information. A Chi-squared test was applied to analyze the relationship between NRS 2002 scores and different demographic characteristics, and the NRS 2002 scores of cancer patients with different characteristics were compared by one-way ANOVA. Results Among 48,831 patients, 43.3% were women and 57.7% were men, and 36.5% (17,802) of patients were at risk of nutrition (score ≥ 3). The NRS 2002 score was the highest in leukemia patients (2.93 ± 1.28). A one-way ANOVA revealed that the differences in NRS 2002 scores among patients of different gender, ages, TNM stages, education levels, occupations and areas of residence were statistically significant (P < 0.001). Male patients had slightly higher NRS 2002 scores than females (2.33 vs. 2.17). The lowest NRS 2002 scores were in patients aged 45-59 (2.00 ± 1.26) years and the highest scores were in patients aged ≥ 70 (2.76 ± 1.43) years. The NRS 2002 score of patients receiving surgery was the highest (2.45 ± 1.41), and patients receiving surgery plus radiotherapy/chemotherapy was the lowest (2.00 ± 1.26). The risk of nutrition was highest in patients who were farmers (2.34 ± 1.37 scores) and lowest in office staff (2.15 ± 1.32 scores). Patients living in rural areas had the highest risk of nutrition (2.32 ± 1.37 scores). There were significant differences in the NRS 2002 scores for different cancer sub-types for different ethnic groups (P < 0.05), except for Zhuang individuals (P = 0.124). The risk of nutrition was highest in Uyghur patients (3.35 ± 1.33 scores) and lowest in Mongolians (2.04 ± 1.37 scores). Conclusion More attention should be paid to people at high risk of nutrition, such as elderly patients, patients with a high TNM stage, patients receiving surgical treatment, and patients living in rural areas. Active nutritional interventions should be carried out to improve the nutritional status of malnourished patients.
{"title":"Nutritional Risk Screening with NRS2002 among Hospitalized Cancer Patients in China","authors":"Mingming Zhou, Tiantian Wu, Yu Wang, Y. Zou, K. Xu, J. Cui, Zengning Li, Junqiang Chen, Ming-Eng Liu, Zengqing Guo, Hong-xia Xu, Hanping Shi, Chunhua Song","doi":"10.34175/jno202202005","DOIUrl":"https://doi.org/10.34175/jno202202005","url":null,"abstract":"Abstract: Objective The Nutritional Risk Screening 2002 (NRS 2002) was used to assess the nutritional risk of hospitalized oncology patients in China. This study explored the factors affecting the risk of nutrition to provide a scientific basis for the assessment and treatment of malnutrition in oncology patients. Methods We used the NRS 2002 to evaluate the nutritional risk in 48,831 hospitalized cancer patients. Descriptive statistical methods were used to describe the general patient information. A Chi-squared test was applied to analyze the relationship between NRS 2002 scores and different demographic characteristics, and the NRS 2002 scores of cancer patients with different characteristics were compared by one-way ANOVA. Results Among 48,831 patients, 43.3% were women and 57.7% were men, and 36.5% (17,802) of patients were at risk of nutrition (score ≥ 3). The NRS 2002 score was the highest in leukemia patients (2.93 ± 1.28). A one-way ANOVA revealed that the differences in NRS 2002 scores among patients of different gender, ages, TNM stages, education levels, occupations and areas of residence were statistically significant (P < 0.001). Male patients had slightly higher NRS 2002 scores than females (2.33 vs. 2.17). The lowest NRS 2002 scores were in patients aged 45-59 (2.00 ± 1.26) years and the highest scores were in patients aged ≥ 70 (2.76 ± 1.43) years. The NRS 2002 score of patients receiving surgery was the highest (2.45 ± 1.41), and patients receiving surgery plus radiotherapy/chemotherapy was the lowest (2.00 ± 1.26). The risk of nutrition was highest in patients who were farmers (2.34 ± 1.37 scores) and lowest in office staff (2.15 ± 1.32 scores). Patients living in rural areas had the highest risk of nutrition (2.32 ± 1.37 scores). There were significant differences in the NRS 2002 scores for different cancer sub-types for different ethnic groups (P < 0.05), except for Zhuang individuals (P = 0.124). The risk of nutrition was highest in Uyghur patients (3.35 ± 1.33 scores) and lowest in Mongolians (2.04 ± 1.37 scores). Conclusion More attention should be paid to people at high risk of nutrition, such as elderly patients, patients with a high TNM stage, patients receiving surgical treatment, and patients living in rural areas. Active nutritional interventions should be carried out to improve the nutritional status of malnourished patients.","PeriodicalId":64349,"journal":{"name":"Journal of Nutritional Oncology","volume":"7 1","pages":"94 - 108"},"PeriodicalIF":0.0,"publicationDate":"2022-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41672643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Na Li, Yu Zhang, Chuan Chen, Wei Li, Chunhua Song, Han-ping Shi, Hong-xia Xu, L. Yin
Abstract: Background Metastatic lung cancer (LC) is a threat to human health. We previously proposed a fatage-inflammation (FAIN) index which showed prognostic value in patients with certain cancers. However, whether a similar association exists in patients with metastatic LC remains unknown. Methods We performed a cohort study including 1360 patients with metastatic LC from January 2013 to April 2019. The FAIN index was defined as: (triceps skinfold thickness + albumin) / [age + 5 × (neutrophil count/lymphocyte count)] × 100%. Sex-specific cutoffs of the FAIN were determined using an optimal stratification approach. The associations of the FAIN index with the nutritionrelated factors, short-term outcomes and overall survival (OS) of patients were comprehensively assessed. Results The study enrolled 865 males and 495 females with a median age of 59.9 years. The continuous FAIN was significantly associated with the OS in both genders (both P < 0.05). The optimal stratification-defined FAIN cutoffs were 82 for women and 60 for men. A total of 623 patients (45.8%) were categorized as having a low FAIN. A low FAIN was associated with poorer nutrition-related factors and impaired short-term outcomes including the thirty-day mortality, length of hospital stay, intensive care unit stay and cost (all P < 0.05). Multivariate Cox regression analysis revealed that a lower FAIN was also associated with an increased death hazard (HR = 1.428, 95%CI = 1.209-1.686). Conclusion This study assessed the FAIN index, which might act as a feasible tool to monitor nutrition-related factors and help develop management strategies to optimize the clinical outcomes of patients with metastatic LC.
{"title":"Associations of the Fat-age-inflammation Index with Overall Survival in Patients with Metastatic Lung Cancer","authors":"Na Li, Yu Zhang, Chuan Chen, Wei Li, Chunhua Song, Han-ping Shi, Hong-xia Xu, L. Yin","doi":"10.34175/jno202202004","DOIUrl":"https://doi.org/10.34175/jno202202004","url":null,"abstract":"Abstract: Background Metastatic lung cancer (LC) is a threat to human health. We previously proposed a fatage-inflammation (FAIN) index which showed prognostic value in patients with certain cancers. However, whether a similar association exists in patients with metastatic LC remains unknown. Methods We performed a cohort study including 1360 patients with metastatic LC from January 2013 to April 2019. The FAIN index was defined as: (triceps skinfold thickness + albumin) / [age + 5 × (neutrophil count/lymphocyte count)] × 100%. Sex-specific cutoffs of the FAIN were determined using an optimal stratification approach. The associations of the FAIN index with the nutritionrelated factors, short-term outcomes and overall survival (OS) of patients were comprehensively assessed. Results The study enrolled 865 males and 495 females with a median age of 59.9 years. The continuous FAIN was significantly associated with the OS in both genders (both P < 0.05). The optimal stratification-defined FAIN cutoffs were 82 for women and 60 for men. A total of 623 patients (45.8%) were categorized as having a low FAIN. A low FAIN was associated with poorer nutrition-related factors and impaired short-term outcomes including the thirty-day mortality, length of hospital stay, intensive care unit stay and cost (all P < 0.05). Multivariate Cox regression analysis revealed that a lower FAIN was also associated with an increased death hazard (HR = 1.428, 95%CI = 1.209-1.686). Conclusion This study assessed the FAIN index, which might act as a feasible tool to monitor nutrition-related factors and help develop management strategies to optimize the clinical outcomes of patients with metastatic LC.","PeriodicalId":64349,"journal":{"name":"Journal of Nutritional Oncology","volume":"7 1","pages":"85 - 93"},"PeriodicalIF":0.0,"publicationDate":"2022-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49174900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Y. Zou, Rui Peng, Ke Di Xu, Xiaoru Jiang, Qiuyu Sun, Chunhua Song
Abstract: Aim We herein provide an umbrella review of systematic reviews (SR) and meta-analyses (MAs) of studies of the association of oral contraceptives (OCs) with the risks of multiple health outcomes in women and their descendants. Methods Two investigators retrieved publications from four electronic databases, including PubMed, Embase, Web of Science, and the Cochrane Database of Systematic Reviews up to March 15, 2021. For each association, random/fixed-effects summary effect size and 95% CIs were estimated. Heterogeneity and publication bias were also assessed. The method quality and evidence level for each publication were respectively assessed utilizing the AMSTAR and GRADE checklists. Results A total of 68 articles with 82 unique outcomes were included based on the eligibility criteria. Numerous lines of evidence indicated that OCs had effects on nearly all cardiovascular disease-related outcomes, especially for cerebral venous sinus thrombosis (OR = 7.59, 95% CI: 3.82-15.09). Harmful associations were also found for vulvar vestibulitis (OR = 2.31, 95%CI: 1.03-5.16), preterm birth (OR = 1.17, 95% CI: 1.07-1.27), miscarriage (OR = 1.13, 95% CI: 1.02-1.72), ulcerative colitis (OR = 1.22, 95% CI: 1.06-1.41), Crohn’s disease (OR = 1.24, 95% CI: 1.09-1.40), alveolar osteitis (RR = 1.86, 95% CI: 1.66-2.08), dry socket (RR = 1.8, 95% CI: 1.33-2.43), and interstitial cystitis (OR = 2.1, 95% CI: 1.26-3.49). However, oral contraceptives did not increase the risk of cancer except breast and cervical cancer. Maternal exposure to OCs was linked to an increased risk for the development of respiratory atopic disorders such as asthma (OR = 1.1, 95% CI: 1.02-1.19) and rhinitis (OR = 1.34, 95% CI: 1.07-1.68). Conclusion In summary, although their use obviously reduces the risk of pregnancy- and parturition-related morbidity and mortality for women, OCs were frequently related to more harm than benefit in terms of other health outcomes. This was true for both women and their descendants in this umbrella review. More large-scale prospective studies analysing different doses, structures, and durations of treatment with estrogen and progestin are needed to confirm these effects.
摘要：目的本文对口服避孕药（OCs）与妇女及其后代多种健康结果风险的相关性研究的系统综述（SR）和荟萃分析（MA）进行了全面综述。方法两名研究人员检索了截至2021年3月15日的四个电子数据库中的出版物，包括PubMed、Embase、Web of Science和Cochrane系统评价数据库。对于每个关联，估计随机/固定效应汇总效应大小和95%CI。还评估了异质性和发表偏倚。使用AMSTAR和GRADE检查表分别评估了每份出版物的方法质量和证据水平。结果根据资格标准，共纳入68篇文章，82篇独特的结果。大量证据表明，强迫症对几乎所有心血管疾病相关的结果都有影响，尤其是对脑静脉窦血栓形成（OR=7.59，95%CI:3.82-15.09）。外阴前庭炎（OR=2.31，95%CI:1.03-5.16）、早产（OR=1.17，95%CI:1.07-12.7）、流产（OR=1.13，95%CI:1.02-1.72），溃疡性结肠炎（OR=1.22，95%CI:1.06-1.41）、克罗恩病（OR=1.24，95%CI:1.09-1.40）、牙槽骨炎（RR=1.86，95%CI:1.66-2.08）、干插座（RR=1.8，95%CI:1.33-2.43）和间质性膀胱炎（OR=2.1，95%CI:1.26-3.49）。母体接触OCs与哮喘（OR=1.1，95%CI:1.02-1.19）和鼻炎（OR=1.34，95%CI:1.07-1.68）等呼吸道特应性疾病的发病风险增加有关，就其他健康结果而言，强迫症往往弊大于利。在这篇总括性评论中，妇女及其后代都是如此。需要更大规模的前瞻性研究来分析雌激素和孕激素治疗的不同剂量、结构和持续时间，以证实这些效果。
{"title":"Oral Contraceptives and Health Outcomes: an Umbrella Review of Systematic Reviews and Meta-analyses in Women and Offspring","authors":"Y. Zou, Rui Peng, Ke Di Xu, Xiaoru Jiang, Qiuyu Sun, Chunhua Song","doi":"10.34175/jno202201003","DOIUrl":"https://doi.org/10.34175/jno202201003","url":null,"abstract":"Abstract: Aim We herein provide an umbrella review of systematic reviews (SR) and meta-analyses (MAs) of studies of the association of oral contraceptives (OCs) with the risks of multiple health outcomes in women and their descendants. Methods Two investigators retrieved publications from four electronic databases, including PubMed, Embase, Web of Science, and the Cochrane Database of Systematic Reviews up to March 15, 2021. For each association, random/fixed-effects summary effect size and 95% CIs were estimated. Heterogeneity and publication bias were also assessed. The method quality and evidence level for each publication were respectively assessed utilizing the AMSTAR and GRADE checklists. Results A total of 68 articles with 82 unique outcomes were included based on the eligibility criteria. Numerous lines of evidence indicated that OCs had effects on nearly all cardiovascular disease-related outcomes, especially for cerebral venous sinus thrombosis (OR = 7.59, 95% CI: 3.82-15.09). Harmful associations were also found for vulvar vestibulitis (OR = 2.31, 95%CI: 1.03-5.16), preterm birth (OR = 1.17, 95% CI: 1.07-1.27), miscarriage (OR = 1.13, 95% CI: 1.02-1.72), ulcerative colitis (OR = 1.22, 95% CI: 1.06-1.41), Crohn’s disease (OR = 1.24, 95% CI: 1.09-1.40), alveolar osteitis (RR = 1.86, 95% CI: 1.66-2.08), dry socket (RR = 1.8, 95% CI: 1.33-2.43), and interstitial cystitis (OR = 2.1, 95% CI: 1.26-3.49). However, oral contraceptives did not increase the risk of cancer except breast and cervical cancer. Maternal exposure to OCs was linked to an increased risk for the development of respiratory atopic disorders such as asthma (OR = 1.1, 95% CI: 1.02-1.19) and rhinitis (OR = 1.34, 95% CI: 1.07-1.68). Conclusion In summary, although their use obviously reduces the risk of pregnancy- and parturition-related morbidity and mortality for women, OCs were frequently related to more harm than benefit in terms of other health outcomes. This was true for both women and their descendants in this umbrella review. More large-scale prospective studies analysing different doses, structures, and durations of treatment with estrogen and progestin are needed to confirm these effects.","PeriodicalId":64349,"journal":{"name":"Journal of Nutritional Oncology","volume":"7 1","pages":"9 - 37"},"PeriodicalIF":0.0,"publicationDate":"2022-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42160097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract: Benign gastrointestinal stricture significantly restricts enteral nutrition, which directly affects the quality of life of patients. Advances in endoscopic techniques have provided a minimally invasive means of reconstructing the enteral nutrition pathway in patients with gastrointestinal strictures. Endoscopic stricturotomy is a safe and effective way to open the nutritional pathway, especially for those with anatomic stricture length < 1 cm, and can be used either as the primary choice of treatment for patients with gastrointestinal stricture or as rescue therapy for refractory cases. Endoscopic stricturotomy can be executed with radial incision and cutting or circular incision and cutting. After the stricturotomy, other endoscopic treatments, such as endoscopic balloon dilation, stent implantation, and intra-lesional injection of steroids, can be used to prevent the development of re-stricture. This article reviews the clinical experiences with endoscopic stricturotomy for opening strictures along the enteral nutrition pathway in patients with gastrointestinal strictures.
{"title":"Endoscopic Stricturotomy for Enteral Nutrition Access in Patients with Benign Gastrointestinal Strictures: a Review","authors":"Y. Wang, Z. Zhuang","doi":"10.34175/jno202201002","DOIUrl":"https://doi.org/10.34175/jno202201002","url":null,"abstract":"Abstract: Benign gastrointestinal stricture significantly restricts enteral nutrition, which directly affects the quality of life of patients. Advances in endoscopic techniques have provided a minimally invasive means of reconstructing the enteral nutrition pathway in patients with gastrointestinal strictures. Endoscopic stricturotomy is a safe and effective way to open the nutritional pathway, especially for those with anatomic stricture length < 1 cm, and can be used either as the primary choice of treatment for patients with gastrointestinal stricture or as rescue therapy for refractory cases. Endoscopic stricturotomy can be executed with radial incision and cutting or circular incision and cutting. After the stricturotomy, other endoscopic treatments, such as endoscopic balloon dilation, stent implantation, and intra-lesional injection of steroids, can be used to prevent the development of re-stricture. This article reviews the clinical experiences with endoscopic stricturotomy for opening strictures along the enteral nutrition pathway in patients with gastrointestinal strictures.","PeriodicalId":64349,"journal":{"name":"Journal of Nutritional Oncology","volume":"7 1","pages":"3 - 8"},"PeriodicalIF":0.0,"publicationDate":"2022-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46266344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Feifei Chong, L. Yin, Jie Liu, Na Li, Jing Guo, Yang Fan, Mengyuan Zhang, Ling Zhang, Xiumei He, Hong Zhang, M. Shi, Wei Li, Hong-xia Xu
Abstract: Background The Global Leadership Initiative on Malnutrition (GLIM) recently developed a new set of diagnostic criteria for identifying patients with malnutrition. Because the GLIM criteria were only introduced a little over 3 years ago, additional validation and reliability testing are needed in a variety of populations. Methods We performed an observational, multicenter cohort study. From July 2013 to October 2018, lung cancer patients were recruited from the Daping Hospital of Army Medical University and the First Hospital of Jilin University as part of the INSCOC project. Previously-established cut-off values for the calf circumference (CC, male < 30 cm, female < 29.5 cm) were applied as the reduced muscal mass of phenotypic criteria to establish the GLIM diagnosis. Multivariate Cox regression analyses were performed to analyze the association between the GLIM criteria and survival. Results A total of 1219 patients with lung cancer were studied as subjects. Their age was 58.81 ± 9.92 years old, and 820 were male and 399 were female. According to the GLIM diagnostic criteria using the CC as a muscle mass measurement, 303 patients (24.9%) were categorized as malnourished, 142 patients (23.1%) in the adult group (18 ≤ age < 60) and 161 patients (26.7%) in the older group (age ≥ 60 years). The patients with malnutrition had a higher incidence of anemia than the nourished patients (P = 0.012). The QLQ-C30 score and KPS score indicating that the malnourished patients had a consistently worse quality of life compared to the nourished group (all P < 0.001). The median survival of the malnutrition group was 42 (95% CI: 34-50) months, which was much shorter than the 62 (95% CI: 57-66) months in the nourished group (P < 0.001). In the adult group, the median survival decreased from 65 (95% CI: 55-72) months in nourished group to 34 (95% CI: 25-48) months in the patients with malnutrition (P < 0.001). In the older group, it decreased from 61 (95% CI: 55-67) months to 48 (95% CI: 39-59) months (P = 0.001). A Cox regression analysis showed that GLIM-diagnosed malnutrition was associated with an increased risk of death among adult group (HR = 1.670, 95% CI: 1.29-2.16), older group (HR = 1.332, 95% CI: 1.05-1.69) and overall (HR = 1.453, 95% CI: 1.22-1.72). Conclusion All of these results demonstrate that GLIM-diagnosed malnutrition is associated with a poorer survival for all lung cancer patients, independent of age.
{"title":"Malnutrition Increases the Risk of Mortality in Hospitalized Lung Cancer Patients","authors":"Feifei Chong, L. Yin, Jie Liu, Na Li, Jing Guo, Yang Fan, Mengyuan Zhang, Ling Zhang, Xiumei He, Hong Zhang, M. Shi, Wei Li, Hong-xia Xu","doi":"10.34175/jno202201005","DOIUrl":"https://doi.org/10.34175/jno202201005","url":null,"abstract":"Abstract: Background The Global Leadership Initiative on Malnutrition (GLIM) recently developed a new set of diagnostic criteria for identifying patients with malnutrition. Because the GLIM criteria were only introduced a little over 3 years ago, additional validation and reliability testing are needed in a variety of populations. Methods We performed an observational, multicenter cohort study. From July 2013 to October 2018, lung cancer patients were recruited from the Daping Hospital of Army Medical University and the First Hospital of Jilin University as part of the INSCOC project. Previously-established cut-off values for the calf circumference (CC, male < 30 cm, female < 29.5 cm) were applied as the reduced muscal mass of phenotypic criteria to establish the GLIM diagnosis. Multivariate Cox regression analyses were performed to analyze the association between the GLIM criteria and survival. Results A total of 1219 patients with lung cancer were studied as subjects. Their age was 58.81 ± 9.92 years old, and 820 were male and 399 were female. According to the GLIM diagnostic criteria using the CC as a muscle mass measurement, 303 patients (24.9%) were categorized as malnourished, 142 patients (23.1%) in the adult group (18 ≤ age < 60) and 161 patients (26.7%) in the older group (age ≥ 60 years). The patients with malnutrition had a higher incidence of anemia than the nourished patients (P = 0.012). The QLQ-C30 score and KPS score indicating that the malnourished patients had a consistently worse quality of life compared to the nourished group (all P < 0.001). The median survival of the malnutrition group was 42 (95% CI: 34-50) months, which was much shorter than the 62 (95% CI: 57-66) months in the nourished group (P < 0.001). In the adult group, the median survival decreased from 65 (95% CI: 55-72) months in nourished group to 34 (95% CI: 25-48) months in the patients with malnutrition (P < 0.001). In the older group, it decreased from 61 (95% CI: 55-67) months to 48 (95% CI: 39-59) months (P = 0.001). A Cox regression analysis showed that GLIM-diagnosed malnutrition was associated with an increased risk of death among adult group (HR = 1.670, 95% CI: 1.29-2.16), older group (HR = 1.332, 95% CI: 1.05-1.69) and overall (HR = 1.453, 95% CI: 1.22-1.72). Conclusion All of these results demonstrate that GLIM-diagnosed malnutrition is associated with a poorer survival for all lung cancer patients, independent of age.","PeriodicalId":64349,"journal":{"name":"Journal of Nutritional Oncology","volume":"7 1","pages":"49 - 57"},"PeriodicalIF":0.0,"publicationDate":"2022-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42307710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jing Guo, Feifei Chong, L. Yin, Xin Lin, Mengyuan Zhang, M. Shi, H. Zhang, Jie Liu, Hong-xia Xu, Jun Kang
Abstract: Objective Bioelectrical impedance analysis (BIA) is used to measure a patient’s body composition. The phase angle (PA), the major parameter in BIA, is one of the most sensitive indicators of malnutrition. The aim of the current study was to investigate whether the PA can be used to predict survival in lung cancer patients. Methods One hundred sixty-six lung cancer patients were prospectively included from January 2014 to August 2016 in Daping Hospital. Anthropometric measurements, hematological values, the nutritional risk screening (NRS 2002) score, patient generated-subjective global assessment (PG-SGA) score, Karnofsky performance status (KPS) scale, European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ C-30) score, and BIA were investigated within 48 hours after admission to the hospital. A Spearman correlation analysis was applied to test the correlations between the study characteristics and PA. A Kaplan-Meier analysis and log-rank test were conducted to analyze the association between the overall survival (OS) and PA. Results The mean age for all patients was 63 years old (42 females and 124 males). The median PA was 5.5°(4.70°, 6.23°). The PA was positively associated with the body mass index, hand grip strength, mid-arm circumference, mid-arm muscle circumference, albumin, prealbumin, C-reactive protein, red blood cells, hemoglobin and KPS score. The PG-SGA scores, QLQ-C30 score, and NRS2002 score showed a significant negative association with the PA. According to a multivariate analysis, the PA (HR = 0.47; 95% CI: 0.27-0.81) was independent predictor of the lung cancer patients’ long-term OS. Patients with a higher PA (≥ 5°) had better overall survival (median = 426 days) compared to those with a lower PA (< 5°) (median = 96 days) based on the one-year follow-up data (P < 0.0001). Conclusions These studies indicate that the PA is a sensitive and early indicator to predict survival in lung cancer patients.
{"title":"Bioelectrical Impedance Phase Angle as a Predictors of Mortality in Patients with Lung Cancer: a Prospective Study","authors":"Jing Guo, Feifei Chong, L. Yin, Xin Lin, Mengyuan Zhang, M. Shi, H. Zhang, Jie Liu, Hong-xia Xu, Jun Kang","doi":"10.34175/jno202201004","DOIUrl":"https://doi.org/10.34175/jno202201004","url":null,"abstract":"Abstract: Objective Bioelectrical impedance analysis (BIA) is used to measure a patient’s body composition. The phase angle (PA), the major parameter in BIA, is one of the most sensitive indicators of malnutrition. The aim of the current study was to investigate whether the PA can be used to predict survival in lung cancer patients. Methods One hundred sixty-six lung cancer patients were prospectively included from January 2014 to August 2016 in Daping Hospital. Anthropometric measurements, hematological values, the nutritional risk screening (NRS 2002) score, patient generated-subjective global assessment (PG-SGA) score, Karnofsky performance status (KPS) scale, European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ C-30) score, and BIA were investigated within 48 hours after admission to the hospital. A Spearman correlation analysis was applied to test the correlations between the study characteristics and PA. A Kaplan-Meier analysis and log-rank test were conducted to analyze the association between the overall survival (OS) and PA. Results The mean age for all patients was 63 years old (42 females and 124 males). The median PA was 5.5°(4.70°, 6.23°). The PA was positively associated with the body mass index, hand grip strength, mid-arm circumference, mid-arm muscle circumference, albumin, prealbumin, C-reactive protein, red blood cells, hemoglobin and KPS score. The PG-SGA scores, QLQ-C30 score, and NRS2002 score showed a significant negative association with the PA. According to a multivariate analysis, the PA (HR = 0.47; 95% CI: 0.27-0.81) was independent predictor of the lung cancer patients’ long-term OS. Patients with a higher PA (≥ 5°) had better overall survival (median = 426 days) compared to those with a lower PA (< 5°) (median = 96 days) based on the one-year follow-up data (P < 0.0001). Conclusions These studies indicate that the PA is a sensitive and early indicator to predict survival in lung cancer patients.","PeriodicalId":64349,"journal":{"name":"Journal of Nutritional Oncology","volume":"7 1","pages":"38 - 48"},"PeriodicalIF":0.0,"publicationDate":"2022-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43539900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract: Background Patients with advanced cancer often present with malnutrition. Globally, minority populations frequently suffer from higher rates of malnutrition than the majority group. It was unknown whether the nutritional status of cancer patients is different between ethicality groups (i.e. Uyghur and Han) in China. Methods A total of 251 Uyghur cancer patients were enrolled from the Xinjiang Kashgar First People's Hospital in the INSCOC Program. The Han patients were 1: 1 matched to Uyghur patients by age, gender and type of cancer from 72 hospitals around China in INSCOC Program. The nutritional risk and nutritional status were assessed using the Nutrition Risk Screening 2002 (NRS 2002) and Patient-Generated Subjective Global Assessment (PG-SGA), respectively. Then, the functional status of cancer patients was determined based on the Karnofsky Performance Status (KPS). Results The incidence of an abnormal NRS-2002 (≥ 3), PG-SGA (≥ 4), and KPS (≤ 70) was significantly different (86.1% vs 59.0%, 70.5% vs 27.5%, and 18.7% vs 4.0%, respectively P < 0.05). The abnormal rate of laboratory indicators in Uyghur cancer patients was significantly higher than that in Han cancer patients, including total protein, albumin, serum total bilirubin, direct bilirubin, HDL-C, white blood cell, lymphocyte, red blood cell, and platelet (all P < 0.05). The abnormal rates of TSF, HGS and CC were significantly higher than that of Han nationality patients (17.5% vs 9.7%, 39.6% vs 19.6%, 29.1% vs 15.2%, P < 0.001). The nutritional support rate of Uyghur patients was lower than that of Han patients (0% vs 16.3%). After adjusting for potential risk factors, malnutrition was associated with gender (female, OR = 0.35, 95% CI = 0.13-0.92, P = 0.034), age (> 60 years, OR = 5.32, 95% CI = 1.46-19.41, P = 0.011), cancer type (gastroesophageal tumor, OR = 33.62, 95% CI = 3.42-330.67, P = 0.003), and treatment methods (received radical tumor resection, OR = 5.78, 95% CI = 1.45-23.08, P = 0.008; received radiotherapy or chemotherapy: OR = 7.69, 95% CI = 2.27-26.04, P < 0.001). Conclusions The nutritional status of Uyghur cancer patients is worse than that of Han patients and the Uyghur patients with poor nutritional status lack the necessary nutritional support.
摘要:背景晚期癌症患者常表现为营养不良。在全球范围内，少数群体的营养不良率往往高于多数群体。目前尚不清楚中国不同民族(即维吾尔族和汉族)癌症患者的营养状况是否存在差异。方法入选INSCOC项目新疆喀什第一人民医院维吾尔族肿瘤患者251例。在INSCOC项目中，汉族患者与维吾尔族患者在年龄、性别和癌症类型上的比例为1:1。分别采用营养风险筛查2002 (NRS 2002)和患者主观整体评估(PG-SGA)对营养风险和营养状况进行评估。然后，根据Karnofsky Performance status (KPS)来确定癌症患者的功能状态。结果NRS-2002异常(≥3)、PG-SGA异常(≥4)、KPS异常(≤70)的发生率分别为86.1% vs 59.0%、70.5% vs 27.5%、18.7% vs 4.0%，差异有统计学意义(P < 0.05)。维吾尔族肿瘤患者总蛋白、白蛋白、血清总胆红素、直接胆红素、HDL-C、白细胞、淋巴细胞、红细胞、血小板等实验室指标异常率显著高于汉族肿瘤患者(P < 0.05)。TSF、HGS、CC异常率显著高于汉族(17.5% vs 9.7%， 39.6% vs 19.6%， 29.1% vs 15.2%， P < 0.001)。维族患者的营养支持率低于汉族患者(0% vs 16.3%)。校正潜在危险因素后，营养不良与性别(女性，OR = 0.35, 95% CI = 0.13-0.92, P = 0.034)、年龄(50 - 60岁，OR = 5.32, 95% CI = 1.46-19.41, P = 0.011)、肿瘤类型(胃食管肿瘤，OR = 33.62, 95% CI = 3.42-330.67, P = 0.003)、治疗方法(接受根治性肿瘤切除术，OR = 5.78, 95% CI = 1.45-23.08, P = 0.008;接受放疗或化疗:or = 7.69, 95% CI = 2.27-26.04, P < 0.001)。结论维吾尔族癌症患者的营养状况较汉族患者差，营养状况差的维吾尔族患者缺乏必要的营养支持。
{"title":"High Risk of Malnutrition in Uyghur Patients with Cancer in China","authors":"Xiaoru Jiang, Chunhua Song, Hong-xia Xu, Jiu Wei Cui, Yuan Lin, Junqiang Chen, Qingqing Zhao, Zengqing Guo, Kunlun Wang, Ying He, Suyi Li, Hu-sai Ma, Hanping Shi, Jing Wu","doi":"10.34175/jno202104004","DOIUrl":"https://doi.org/10.34175/jno202104004","url":null,"abstract":"Abstract: Background Patients with advanced cancer often present with malnutrition. Globally, minority populations frequently suffer from higher rates of malnutrition than the majority group. It was unknown whether the nutritional status of cancer patients is different between ethicality groups (i.e. Uyghur and Han) in China. Methods A total of 251 Uyghur cancer patients were enrolled from the Xinjiang Kashgar First People's Hospital in the INSCOC Program. The Han patients were 1: 1 matched to Uyghur patients by age, gender and type of cancer from 72 hospitals around China in INSCOC Program. The nutritional risk and nutritional status were assessed using the Nutrition Risk Screening 2002 (NRS 2002) and Patient-Generated Subjective Global Assessment (PG-SGA), respectively. Then, the functional status of cancer patients was determined based on the Karnofsky Performance Status (KPS). Results The incidence of an abnormal NRS-2002 (≥ 3), PG-SGA (≥ 4), and KPS (≤ 70) was significantly different (86.1% vs 59.0%, 70.5% vs 27.5%, and 18.7% vs 4.0%, respectively P < 0.05). The abnormal rate of laboratory indicators in Uyghur cancer patients was significantly higher than that in Han cancer patients, including total protein, albumin, serum total bilirubin, direct bilirubin, HDL-C, white blood cell, lymphocyte, red blood cell, and platelet (all P < 0.05). The abnormal rates of TSF, HGS and CC were significantly higher than that of Han nationality patients (17.5% vs 9.7%, 39.6% vs 19.6%, 29.1% vs 15.2%, P < 0.001). The nutritional support rate of Uyghur patients was lower than that of Han patients (0% vs 16.3%). After adjusting for potential risk factors, malnutrition was associated with gender (female, OR = 0.35, 95% CI = 0.13-0.92, P = 0.034), age (> 60 years, OR = 5.32, 95% CI = 1.46-19.41, P = 0.011), cancer type (gastroesophageal tumor, OR = 33.62, 95% CI = 3.42-330.67, P = 0.003), and treatment methods (received radical tumor resection, OR = 5.78, 95% CI = 1.45-23.08, P = 0.008; received radiotherapy or chemotherapy: OR = 7.69, 95% CI = 2.27-26.04, P < 0.001). Conclusions The nutritional status of Uyghur cancer patients is worse than that of Han patients and the Uyghur patients with poor nutritional status lack the necessary nutritional support.","PeriodicalId":64349,"journal":{"name":"Journal of Nutritional Oncology","volume":"6 1","pages":"176 - 185"},"PeriodicalIF":0.0,"publicationDate":"2021-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47801528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：