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"Yu, Jia-Yi"
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Summary of Evidence on Nutritional Management for Patients Undergoing Chemotherapy
Objective This paper aims to consolidate the most robust evidence on nutritional strategies for patients undergoing chemotherapy, offering evidence‐based guidance for clinical practice. The review highlights critical evidence gaps in nutritional therapy for advanced gastric cancer (AGC) patients undergoing systemic therapy, integrating findings from both prospective and retrospective studies. Method According to the “6S” evidence resource pyramid model, clinical decision‐making tools, guidelines, expert consensus, and systematic reviews on nutritional management for chemotherapy patients were systematically retrieved from national and international databases. The methodological quality of the selected literature was evaluated using AGREE II for guidelines, the JBI Evidence‐Based Healthcare Center's standards for systematic reviews, and expert consensus developed by evidence‐based practice experts. Results A total of 47 articles were analyzed, consisting of 12 guidelines, 12 expert consensus statements, and 23 systematic reviews. The findings were categorized into five dimensions: interdisciplinary collaboration, nutritional screening and assessment, nutritional requirements, nutritional therapy, and discharge and follow‐up, resulting in the identification of 62 pieces of relevant evidence. Conclusions The study provides comprehensive, evidence‐based recommendations for nutritional management in chemotherapy patients. Application of the evidence should be adapted to specific clinical scenarios, patient conditions, preferences, and expert judgment to ensure both feasibility and relevance in clinical practice. Contributions This review consolidates diverse nutritional management strategies into a unified framework, addressing evidence gaps in AGC under systemic therapy. Integrating prospective and retrospective studies with interdisciplinary insights provides evidence‐based recommendations to enhance patient care through personalized and standardized approaches.
Journal Article
An experimental study of huff-and-puff oil recovery for tight-tuff heavy oil reservoirs by synergistic with viscosity reducer and CO2 utilizing online NMR technology
The tight-tuff heavy oil reservoir exhibits severe heterogeneity and is characterized by high density, high viscosity, and a high wax content, posing significant challenges for its development. While CO2 huff-and-puff (H-n-P) enhances oil recovery, these reservoirs struggle with low displacement efficiency. This study proposes a method that combines CO2 with an oil-soluble viscosity reducer to improve displacement efficiency in the H-n-P process for tight-tuff heavy oil reservoirs. It also focuses on evaluating pore utilization limits and optimizing the injection strategy. Core samples and crude oil from the TH oilfield (a tight-tuff heavy oil reservoir) were used to conduct online NMR core flooding experiments, including depletion development, water, CO2, and HDC (CO2 combined with an oil-soluble viscosity reducer) H-n-P injection processes. A single-porosity model accurately reflecting its geological characteristics was developed using the GEM component simulator within the CMG numerical simulation software to investigate the optimized schemes and the enhanced oil recovery potential for a tight-tuff heavy oil reservoir in the TH oilfield. This model was utilized to evaluate the impact of various injection strategies on oilfield recovery efficiency. The study was designed and implemented with five distinct injection schemes.
Results showed that oil was produced primarily from large and medium pores during the depletion stage, while water H-n-P, with CO2 H-n-P, first targeted macropores, then mesopores, and micropores. The lower pore utilization limit was 0.0267 μm. In the HDC H-n-P process, most oil was recovered from water-flooded pores. Still, HDC's lower injection capacity increased the pore utilization limit to 0.03 μm, making micropore recovery difficult. Experimental and modeling results suggest that the optimal development plan for the TH oilfield is one cycle of HDC H-n-P followed by two cycles of CO2 H-n-P. This strategy leverages HDC's ability to promote water and oil recovery in the early stage and mass transfer and extraction capacity of CO2 in later cycles.
Additionally, the characteristics of CO2 and HDC H-n-P processes, pore utilization, and recoverable oil (at the pore scale) were evaluated. The results of this study are crucial for refining the reservoir development plan.
Journal Article
Comparative analysis of work-related factors associated with burnout and its dimensions among nursing faculty in Canada and the United States
This study aimed to investigate and compare burnout and its dimensions—exhaustion, cynicism and professional efficacy—across workplace and socio-demographic characteristics among nursing faculty in Canada and the United States (U.S.).
Burnout among nursing faculty affects the availability and retention of educators, crucial for producing qualified nurses to meet healthcare demands. Despite its significance, research in this area remains limited.
A correlational cross-sectional survey was used.
An online survey was administered to 640 nursing faculty in Canada and 111 in the U.S. Burnout was measured using the Maslach Burnout Inventory and multivariate linear regression identified predictors of burnout.
Overall, 62.4 % of participants reported moderate to high burnout. Canadian faculty were primarily involved in undergraduate and graduate education, whereas U.S. faculty devoted more time to service activities. Predictors of burnout and its dimensions varied by country. In Canada, older faculty (≥60 years) and those with a nursing diploma reported lower burnout, while those with a Doctor of Nursing Practice reported higher levels. In the U.S., burnout was higher among younger faculty (≤39 years), those with more teaching hours and lower among non-tenured faculty.
Factors influencing burnout differ between Canada and the U.S., reflecting variations in academic environments. Tailored interventions, such as workload balancing and targeted support, are essential for addressing burnout and improving faculty retention.
Journal Article
Lactate dehydrogenase as promising marker for prognosis of brain metastasis
Background
Lactate dehydrogenase (LDH) is a biomarker for cancer. However, the relationship between serum LDH levels and the survival of patients with brain metastasis has been fully revealed. We aimed to evaluate the serum LDH levels and assess its prognostic value in patients with BM.
Methods
The serum LDH levels were collected from 2507 patients with BM. Patients were categorized into four groups according to the quartile of serum LDH levels. The association between serum LDH levels and overall survival (OS) was evaluated using Cox regression models and Kaplan–Meier curves. Three predictive models were used to evaluate patients.
Results
The Kaplan–Meier curve for survival by the serum LDH group demonstrates clear separation between four groups (P < 0.001). The participants in the lower group had longer OS than those in the higher group. After adjusting in multivariate Cox regression models remained significant for patients in the Q4 compared with patients in the Q1 (Q4:Q1 OR 1.58, 95% CI 1.38–1.80). Furthermore, the GPA-LDH model generates a pooled area under the curve of 0.630 (95% CI 0.600, 0.660).
Conclusions
Serum LDH levels and OS in patients with brain metastasis is an inverse association. Moreover, Serum LDH levels can improve the prognosis of the GPA model.
Journal Article
Detection of D2-40 monoclonal antibody-labeled lymphatic vessel invasion in esophageal squamous cell carcinoma and its clinicopathologic significance
Objective： This study aims to investigate the clinicopathologic significance of lymphatic vessel invasion （LVI） labeled by D2-40 monoclonal antibody in esophageal squamous cell carcinoma （ESCC）. Methods： Immunohistochemical assay was used to detect the expression of D2-40 and LVI in 107 ESCC patients. Then, the correlation between the clinicopathologic feature and the overall survival time of the patients was analyzed. Results： The lymph node metastasis rates were 70% and 21% in the LVI-positive and LVI-negative groups, respectively. The nodal metastasis rate was higher in the LVI-positive group than in the LVI-negative group. Multivariate regression analysis showed that LVI was related to nodal metastasis （P〈0.001）. The median survival time of the patients was 26 and 43 months in the LVI-positive and LVI-negative groups, respectively. Mthough univariate regression analysis showed significant difference between the two groups （P=0.014）, multivariate regression analysis revealed that LVI was not an independent prognostic factor for overall survival in the ESCC patients （P=0.062）. Lymphatic node metastasis （P=0.031）, clinical stage （P=0.019）, and residual tumor （P=0.026） were the independent prognostic factors. Conclusion： LVI labeled by D2-40 monoclonal antibody is a risk factor predictive of lymph node metastasis in ESCC patients.
Journal Article
Promoting effects of isobavachin on neurogenesis of mouse embryonic stem cells were associated with protein prenylation
Aim： Some small molecules can induce mouse embryonic stem （ES） cells to differentiate into neuronal cells. Here, we explored the effect of isobavachin （IBA）, a compound with a prenyl group at position 8 of ring A, on promoting neuronal differentiation and the potential role of its protein prenylation. Methods： The hanging drop method was employed for embryonic body （EB） formation to mimic embryo development in vivo. The EBs were treated with IBA at a final concentration of 10.7 mol/L from EB stage （d 4） to d 8＋10. Geranylgeranyltransferase I inhibitor GGTI- 298 was subsequently used to disrupt protein prenylation. Neuronal subtypes, including neurons and astrocytes, were observed by fluorescence microscopy. Gene and protein expression levels were detected using RT-PCR and Western blot analysis, respectively. Results： With IBA treatment, nestin was highly expressed in the neural progenitors generated from EBs （d 4, d 8＋0）. EBs then further differentiated into neurons （marked by ~-tubulin III） and astrocytes （marked by GFAP）, which were both up-regulated in a time- dependent manner on d 8＋5 and d 8＋10. Co-treatment with GGTI-298 selectively abolished the IBA-induced neuronal differentiation. Moreover, in the MAPK pathway, p38 and JNK phosphorylation were down-regulated, while ERK phosphorylation was up-regulated after IBA treatment at different neuronal differentiation passages. Conclusion： IBA can facilitate mouse ES cells differentiating into neuronal cells. The mechanism involved protein prenylation and, subsequently, phos-ERK activation and the phos-p38 off pathway.
Journal Article
In vitro assessment of the glucose-lowering effects of berberrubine-9-O-β-D-glucuronide, an active metabolite of berberrubine
Berberrubine （BRB） is the primary metabolite of berberine （BBR） that has shown a stronger glucose-lowering effect than BBR in vivo. On the other hand, BRB is quickly and extensively metabolized into berberrubine-9-O-β-D-glucuronide （BRBG） in rats after oral administration. In this study we compared the pharmacokinetic properties of BRB and BRBG in rats, and explored the mechanisms underlying their glucose-lowering activities. C57BL/6 mice with HFD-induced hyperglycemia were administered BRB （50 mg·kg^-1·d^-1, ig） for 6 weeks, which caused greater reduction in the plasma glucose levels than those caused by BBR （120 mg·kg^-1·d^-1） or BRB （25 mg·kg^-1·d^-1）. In addition, BRB dose-dependently decreased the activity of α-glucosidase in gut of the mice. After oral administration of BRB in rats, the exposures of BRBG in plasma at 3 different dosages （10, 40, 80 mg/kg） and in urine at different time intervals （0-4, 4-10, 10-24 h） were dramatically greater than those of BRB. In order to determine the effectiveness of BRBG in reducing glucose levels, we prepared BRBG from the urine pool of rats, and identified and confirmed it through LC-MS-IT-TOF and NMR spectra. In human normal liver cell line 1_-02 in vitro, treatment with BRB or BRBG （5, 20, 50 pmol/L） increased glucose consumption, enhanced glycogenesis, stimulated the uptake of the glucose analog 2-NBDG, and modulated the mRNA levels of glucose-6-phosphatase and hexokinase. However, both BBR and BRB improved 2-NBDG uptake in insulin-resistant L-02 cells, while BRBG has no effect. In conclusion, BRB exerts a stronger glucose-lowering effect than BBR in HFD-induced hyperglycemia mice. Although BRB significantly stimulated the insulin sensitivity and glycolysis in vitro, BRBG may have a greater contribution to the glucose-lowering effect because it has much greater system exposure than BRB after oral administration of BRB. The results suggest that BRBG is a potential agent for reducing glucose levels.
Journal Article
Associations of CYP3A4, NR1I2, CYP2C19 and P2RY12 polymorphisms with clopidogrel resistance in Chinese patients with ischemic stroke
Aim： There is a high incidence of the antiplatelet drug clopidogrel resistance （OR） in Asian populations. Because clopidogrel is a prodrug, polymorphisms of genes encoding the enzymes involved in its biotransformation may be the primary influential factors. The goal of this study was to investigate the associations of polymorphisms of CYP3A4, NRll2, CYP2C19 and P2RY12 genes with CR in Chinese patients with ischemic stroke. Methods： A total of 191 patients with ischemic stroke were enrolled. The patients were treated with clopidogrel for at least 5 days. Platelet function was measured by light transmission aggregometry. The SNPs NRll2 （rs13059232）, CYP3A4＊IG （rs2242480）, CYP2C19＊2 （rs4244285） and P2RY12 （rs2046934） were genotyped. Results： The CR rate in this population was 36%. The CYP2C19＊2 variant was a risk factor for CR （＊2/＊2＋wt/＊2 vs wt/wt, OR： 2.366 95% CI： 1.180-4.741, P=0.014）, whereas the CYP3A4＊IG variant had a protective effect on CR （＊1/＊1 vs ＊1G/＊IG＋＊1/＊IG, OR： 2.360, 95% CI： 1.247-4.468, P=0.008）. The NRll2 （rs13059232） polymorphism was moderately associated with CR （CC vs TT＋TC, OR： 0.533, 95% CI： 0.286-0.991, P=0.046）. The C allele in P2RY12 （rs2046934） was predicted to be a protective factor for CR （CC＋TC vs TT, OR： 0.407, 95% CI： 0.191-0.867, P=O.O18）. In addition, an association was found between hypertension and CR （P=0.022）. Conclusion： The individuals with both the CYP2C19＊2 allele and hypertension are at high risk of CR during anti-thrombosis therapy. The CYP3A4＊IG allele, P2RY12 （rs2046934） C allele and NRll2 （rs13059232） CC genotype may be protective factors for CR. The associated SNPs studied may be useful to predict clopidogrel resistance in Chinese patients with ischemic stroke.
Journal Article
Insulin-sensitizing effects of a novel a-methyl-a-phenoxylpropionate derivative in vitro
Aim： To examine the insulin sensitizing effects of a novel α-methyl-α- phenoxylpropionate derivative YY20 in insulin-sensitive cell lines. Methods： The peroxisome proliferator-activated receptor ）, （PPART） agonist bioactivities of YY20 were detected by a preadipocyte differentiation assay. RT-PCR and Western blotting analysis were used to detect the expression of the target gene or protein. The effects of YY20 on insulin-mediated glucose consumption were determined in the HepG2 human hepatocellular carcinoma line. Results： YY20 could enhance the differentiation of preadipocytes to adipocytes and upregulate the gene expression of PPART2, as well as the protein expression of insulin receptor sub- strate-1 （IRS-1）, glucose transporter-4 （GLUT4）, and adiponectin （ACRP30）. The effects on GLUT4 and ACRP30 could be reversed by the PPARγinhibitor SR-202. Furthermore, YY20 efficiently reduced glucose consumptions in HepG2 cells after 24 h culture, and the effects were related to insulin and YY20 concentrations. Conclusion： YY20, a potential insulin-sensitizing agent like rosiglitazone, could enhance glucose consumption in HepG2 cells in a concentration- and insulindependent manner. It may improve the insulin resistance associated with type 2 diabetes.
Journal Article