BackgroundThe triglyceride-glucose (TyG) index has emerged as a validated and cost-effective indicator of insulin resistance (IR). Given the significant association between visceral obesity and IR, this study aimed to investigate the utility of the TyG index in estimating visceral obesity in patients with gastric cancer (GC).MethodsThe visceral fat area (VFA), subcutaneous fat area (SFA), and VFA-to-SFA ratio (VSR) were determined through the analysis of CT images at the lumbar 3 level. The definition of visceral obesity was established as VFA ≥ 100 cm2. The association between the TyG index and visceral obesity was assessed using logistic regression analysis and restricted cubic splines. The diagnostic performance for identifying visceral obesity was evaluated by calculating the area under the Receiver Operating Characteristics curve (AUC).ResultsThe cross-sectional study enrolled a total of 314 patients with GC, among whom 159 (50.64%) were identified as having visceral obesity. The TyG index was positively correlated with VFA (r = 0.45, p < 0.001), SFA (r = 0.23, p < 0.001), and VSR (r = 0.35, p < 0.001). However, subsequent multivariate linear regression analysis demonstrated that the TyG index was significantly associated with VFA and VSR, but not SFA. After adjusting for potential confounding factors, the TyG index remained independently associated with visceral obesity (OR = 2.54, 95% CI: 1.32–4.89, p = 0.005) and demonstrated a significantly positive linear correlation with visceral obesity in patients with GC (p-value for non-linearity = 0.116). TyG-BMI, the combination index of TyG and BMI, showed the highest predictive power in identifying visceral obesity in GC patients (AUC = 0.849, 95% CI: 0.807–0.890, p < 0.001). The subgroup analysis revealed a significantly stronger positive association between the TyG index and visceral obesity in patients with BMI ≥ 25 kg/m2 (p for interaction = 0.049).ConclusionThe TyG index exhibited a significant association with visceral obesity and proved to be a valuable predictor for visceral obesity when combined with BMI in patients with GC.

Background:The Asian Working Group for Cachexia (AWGC) has released consensus criteria for diagnosing cachexia in Asians. Nevertheless, there is limited data regarding the application of these criteria in cancer patients. This study aimed to assess the changes in body composition and quality of life in gastric cancer (GC) patients with cachexia defined by the AWGC criteria. Methods:Body composition parameters were analyzed using CT images at the level of the third lumbar vertebra. The European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire-Core 30 (EORTC QLQ-C30) was used to evaluate health-related quality of life (HRQoL). The diagnosis of cachexia was according to the AWGC criteria and Fearon's criteria. Results:A total of 431 patients with GC was included in this study. Among them, 160 patients (37.1%) were diagnosed with cachexia according to the AWGC criteria and 166 patients (38.5%) were diagnosed with cachexia based on the Fearon's criteria. The agreement between the two criteria for diagnosing cachexia was moderate (k = 0.477, p < 0.001). Patients with AWGC-cachexia had significantly lower skeletal muscle index (SMI), visceral fat index (VFI), and subcutaneous fat index (SFI) compared to those without (p < 0.001). The prevalence of poor HRQoL was notably higher in patients with AWGC-defined cachexia (78.12% vs. 33.21%, p < 0.001). Furthermore, AWGC-defined cachexia was independently associated with poor HRQoL (OR = 5.92, 95% CI: 3.27-10.73; p < 0.001), while Fearon-defined cachexia did not show such an association (OR = 1.51, 95% CI: 0.86-2.65; p = 0.154). Conclusion:Patients with AWGC-defined cachexia showed significant changes in body composition and was independently associated with poor HRQoL.

Impaired nutritional status is closely related to the development of sarcopenia and poor quality of life (QoL) in cancer patients. This study aimed to investigate the association of Geriatric Nutritional Risk Index (GNRI) with sarcopenia and QoL in patients with gastric cancer (GC). Sarcopenia was diagnosed based on the Asian Working Group for Sarcopenia 2019 criteria. This cross-sectional study included a total of 311 patients with GC. Among them, 57 (18.3%) patients were diagnosed with sarcopenia. GNRI showed significant correlations with sarcopenia-related indicators including skeletal muscle index, handgrip strength, gait speed, and 5-time chair stand time (p < 0.001). A significant association was observed between GNRI and sarcopenia [odds ratio (OR) = 0.815, 95% confidence interval (CI): 0.760-0.874, p < 0.001] in the multivariate analysis. The optimal cutoff value of GNRI for predicting sarcopenia was 94.98, with a sensitivity of 75.4% and specificity of 73.2%. Patients with low GNRI exhibited significantly lower scores in terms of global health status and most functional scales. Furthermore, the majority of symptoms exhibited greater severity in patients with low GNRI. In conclusion, the present study revealed that GNRI was closely associated with sarcopenia and QoL, and could effectively predict sarcopenia in patients with GC.

Background: Patients with gastric cancer (GC) are more likely to experience malnutrition and muscle wasting. This study aims to investigate the potential of phase angle (PhA) as a screening tool for identifying malnutrition and sarcopenia in GC patients, as well as its association with short-term outcomes after radical gastrectomy. Methods: This cross-sectional study enrolled patients diagnosed with GC at The Affiliated People's Hospital of Jiangsu University from October 2021 to September 2022. PhA was measured using bioelectrical impedance analysis. Computed tomography scan images were analyzed for body composition at the level of the third lumbar vertebra. Malnutrition was diagnosed using Global Leadership Initiative on Malnutrition (GLIM) criteria. Sarcopenia diagnosis was based on the Asian Working Group for Sarcopenia (AWGS) 2019 criteria. Results: A total of 248 patients with GC were analyzed, including 188 patients who underwent radical gastrectomy. Of these, 71.4 % (n = 177) were male and 28.6 % (n = 71) were female and the median overall age was 68 years (IQR: 61-72 years). According to GLIM criteria, 49.2 % (n = 122) of patients were malnourished and 19.8 % (n = 49) had sarcopenia based on AWGS criteria. A one-degree decrease in PhA was significantly associated with GLIM malnutrition (Odds Ratio [OR] = 8.108, 95 % CI:3.181-20.665) and sarcopenia (OR = 2.903, 95 % CI:1.170-7.206). PhA exhibited fair to good diagnostic accuracy in identifying GLIM malnutrition (male: AUC = 0.797; female: AUC = 0.816) and sarcopenia (male: AUC = 0.814; female: AUC = 0.710). Low PhA (OR = 3.632, 95 % CI: 1.686-7.824) and operation time (OR = 2.434, 95 % CI:1.120-5.293) were independently associated with the risk of postoperative complications. Conclusions: PhA can serve as a reliable screening tool for identifying patients at risk of malnutrition, sarcopenia, and postoperative complications in GC. (c) 2023 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

Background: STAD ranked 5th most common in the incidence of malignant tumors and 3rd most common in the death rate of cancer worldwide. CXC chemokines affect the biological progress of various tumors, resulting in therapeutic failure. The role of CXCL2 in STAD was still a mystery. Methods: The expression, prognostic value, and clinical function of CXCL2 were analyzed using several online bioinformatics tools and clinical tissues. Results: CXCL2 level was significantly upregulated in STAD tissues. Strong correlation was obtained between CXCL2 level and immune cells as well as immune biomarkers. High CXCL2 expression in STAD was correlated with a favorable prognosis. Further analysis revealed that CXCL2, pTNM stage and age were independent factors affecting the prognosis of STAD patients. A predictive nomogram indicated that the calibration plots for the 1-year, 3-year and 5-year OS rates were predicted relatively well compared with an ideal model in the entire cohort. Validation analysis revealed that CXCL2 expression was upregulated in STAD and high CXCL2 level had a better overall survival. CXCL2 was associated with resistance to numerous drugs or small molecules in STAD. Conclusions: We identified CXCL2 as a novel therapeutic target and associated with immune infiltration in STAD.

Primary hepatic neuroendocrine tumor (PHNET) is rare liver cancer and related prognostic factors are unclear. The aim of this study was to analyze the prognostic risk factors of patients with PHNETs and establish an assessment model for prognosis. The clinical information of 539 patients with PHNETs who met the criteria for inclusion was extracted from the Surveillance, Epidemiology, and End Results (SEER) database. These patients were randomly assigned to the training (269 cases) and validation sets (270 cases). Prognostic factors in patients with PHNETs were screened using the Cox proportional regression model and Fine-Gray competing risk model. Based on the training set analysis using the Fine-Gray competing risk model, a nomogram was constructed to predict cumulative probabilities for PHNET-specific death. The performance of the nomogram was measured by using receiver operating characteristic curves, the concordance index (C-index), calibration curves, and decision curve analysis (DCA). No differences in clinical baseline characteristics between the training and validation sets were observed, and the Fine-Gray analysis showed that surgery and more than one primary malignancy were associated with a low cumulative probability of PHNET-specific death. The training set nomograms were well-calibrated and had good discriminative ability, and good agreement between predicted and observed survival was observed. Patients with PHNETs with a high-risk score had a significantly increased risk of PHNET-specific death and non-PHNET death. Surgical treatment and the number of primary malignancies were found to be independent protective factors for PHNETs. The competing risk nomogram has high accuracy in predicting disease-specific survival (DSS) for patients with PHNETs, which may help clinicians to develop individualized treatment strategies.

In this article, a mode converter based on irregularly distributed long period fiber gratings(LPGs) is proposed. The mode conversion characteristics of LP01 mode to LP02 mode are analyzed by beam propagation method. The effects of the cross-section shape and diameter of the gratings on the mode conversion efficiency and bandwidth are analyzed. Mode conversion bandwidth between the LP01 mode and the LP02 mode is found strongly dependent on the interaction between the mode fields and the LPG section.

目的 探讨研究双水平式呼吸道正压通气治疗慢性阻塞性肺疾病急性加重期患者的护理效果.方法 选取我院2017年1月～2018年6月收治的行双水平式呼吸道正压通气治疗的慢性阻塞性肺疾病急性加重期患者80例,随机分成观察组(40例)实施全面护理,对照组(40例)实施常规护理,观察比较两组的呼吸频率、心率、pH值、二氧化碳分压、氧分压及血氧饱和度.结果 观察组的呼吸频率、心率、pH值、二氧化碳分压、氧分压及血氧饱和度均优于对照组,差异具有统计学意义(P<0.05).结论 对行双水平式呼吸道正压通气治疗的慢性阻塞性肺疾病急性加重期患者实施全面护理可以有效改善患者的相关体征.

目的 探讨护理干预在俯卧位通气对改善急性呼吸窘迫综合征中的临床疗效.方法 选取2017年1月～2017年12月期间的50例急性呼吸窘迫综合征患者当作研究对象.所有患者均采取俯卧位通气治疗,接受护理干预.观察并比较治疗前后患者动脉血氧分压、脉搏血氧饱和度、吸入氧浓度、氧合指数、气道痰液引流量的情况.结果 治疗后患者的动脉血氧分压、脉搏血氧饱和度、氧合指数、气道痰液引流量均明显高于治疗前,差异有统计学意义(P<0.05);治疗前后的吸入氧浓度比较,差异无统计学意义(P>0.05).结论 在俯卧位通气治疗中加强护理干预,有利于改善急性呼吸窘迫综合征患者的氧合,提高气道痰液引流量,值得推广.