目的 对晚期非小细胞肺癌(NSCLC)患者进行回顾性分析,探讨参一胶囊维持治疗对患者炎症因子的影响。方法 经参一胶囊联合化疗一线治疗后取得缓解或稳定的37名晚期NSCLC患者意向性分为治疗组(A组,21人)和对照组(B组,16人)。A组继续服用参一胶囊每天2次,每次20 mg,服药至疾病进展或无法耐受;B组未予特殊治疗。分别于第1 d、90 d采血,检测白细胞计数、中性粒细胞计数、C反应蛋白、肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)、白细胞介素1α(IL-1α)、白细胞介素6(IL-6)和白细胞介素10(IL-10)。结果 治疗前后比较,治疗组各项炎症指标均未发生明显变化(P>0.05);而对照组的TNF-α、IL-1β、IL-6上升(P值分别为<0.001、0.032、0.001),IL-10下降(P=0.035);治疗后两组间比较,对照组TNF-α、IL-1β、IL-6上升(P值分别为<0.001、0.001、0.004),IL-10则下降(P=0.002)。两组间IL-1α及白细胞计数、中性粒细胞计数、C反应蛋白无变化(P>0.05)。结论 参一胶囊维持治疗可使晚期NSCLC患者TNF-α、IL-1β及IL-6的低表达,提示调节炎症反应可能是参一胶囊维持治疗抑制NSCLC进展的机制之一。

Objective To retrospectively investigate the influence of Shenyi Capsule maintenance therapy on inflammatory factors in patients with advanced NSCLC. Methods Thirty seven patients with advanced NSCLC, who had become palliative or stable after first-line treatment with combined Shenyi capsule chemotherapy, were intentionally assigned to treatment group (group A, 21 patients) and control group (group B, 16 patients). Shenyi capsule was given to group A (20mg p.o., bid) until appearance of deterioration or intolerance, while no special treatment was given to group B. Leukocytes, neutrophils, C-reactive protein, tumor necrosis factor α (TNF-α), interleukin-1β(IL-1β), interleukin-1α (IL-1α),interleukin-6(IL-6) and interleukin-10(IL-10) were tested by blood specimens taken respectively on 1st day and 90th day. Results There were no statistical differences (P>0.05) between the level of inflammatory factors on 1th day and 90th day in treatment group. In control group, however, TNF-α、IL-1β and IL-6 increased (P<0.001, P=0.032、P=0.001 respectively) and IL-10 decreased significantly (P=0.035). Furthermore, the level of TNF-α、IL-1β and IL-6 in treatment group were also higher (P<0.001, P=0.001, P=0.004 respectively), while IL-10 was lower (P=0.002)than control group on 90th day. There were no statistical differences(P>0.05)between the two groups in the level of IL-1α, leukocyte, neutrophils or C reactive protein on 1th day and 90th day. Conclusion Shenyicapsule maintenance therapy could lower the expression of TNF-α、IL-1β and IL-6 in patients with advanced NSCLC, which indicates that the regulation of inflammatory reaction may be one of the mechanisms of inhibition from NSCLC progression in Shenyi capsule maintenance therapy.

目的 探讨ε-3多不饱和脂肪酸在胃肠道肿瘤患者化疗后的胃肠道毒性及生活质量的作用。方法 在研究前经过化疗筛选,按照WHO化疗副反应在2级或者以上的50名住院的胃癌或者直结肠癌患者,随机分为对照组(单纯化疗)(n=25)和研究组(化疗加ε-3多不饱和脂肪酸)(n=25),两组的化疗方案均为化疗筛选的方案。预防性每天静脉使用ε-3多不饱和脂肪酸 200 mg,连续5天,记录评估胃肠道并发症,如恶心、呕吐和腹泻,以及KPS评分、血清白蛋白、IL-2、IFN-γ和CRP。结果 与对照组比较,恶心、呕吐和腹泻评分、IL-2、IFN-γ和CRP低于于对照组,相反,生活质量评分研究组高于对照组,差异有统计学意义(P<0.05)。结论 预防性使用ε-3多不饱和脂肪酸能够减轻胃肠道肿瘤患者化疗后的胃肠道毒性症状、降低全身炎症因子反应并改善生活质量。

Objective To explore the effect omega-3polyunsaturated fatty acid omega-3 FA on clinical manifestations of gastrointestinal toxicity and quality of life (QOL) induced by chemotherapy for patients with gastric or colorectal cancer. Methods After screening chemotherapy, Fifty patients with gastric or colorectal cancer, according to developing WHO side-effect grading system of grade 2 or higher were randomly divided into either control group (n=25) or omega-3 FAs group (n=25) during next cycle of chemotherapy. In the control group, the patients received the same chemotherapy regimens as screening cycle and in the omega-3 FA group, received chemotherapy and omega-3 FAs. Prophylactic intravenous 200 mL /d was given for 5 days. The gastrointestinal complications such as nausea,vomiting or diarrhoea and Karnofsky performance status(KPS ),IL-2,IFN-γandCRP,ect, were evaluated respectively. Results Compared with the control group, the scores of nausea vomiting and diarrhea and IL-2,IFN-γor CRP levels decreased , significantly,on the contrary, the score of QOL increased. There was significantly statistical difference (P<0.05). Conclusion Prophylactic intravenous omega-3 FA can ameliorate clinical manifestations of gastrointestinal toxicity and systemic inflammatory response syndrome(SIRS) induced by chemotherapy and improve QOL for patients with gastric or colorectal cancer.

       目的   对比分析双极半髋关节置换术（BHA）与全髋关节置换术（THR）治疗股骨颈骨折（FNF）的效果。方法   回顾性收集北京中医药大学东直门医院洛阳医院2019年6月—2023年4月90例FNF患者临床资料，依照手术治疗方案差异分为两组，BHA组（45例）行BHA治疗，THR组（45例）行THR治疗，比较两组围术期指标、术前及术后3 d炎症因子水平、术后6个月髋关节活动度、术前及术后6个月生活质量［欧洲生活质量评分（EQ-5D评分）］。结果  THR组手术时间（108.76±15.33）min、下床活动时间（40.37±10.24）h、住院时间（19.02±5.11）d均较BHA组［（53.49±10.12）min、（25.92±7.15）h、（15.16±4.87）d］长（t分别为20.184、7.761、3.668，均P＜0.05），术中失血量（318.69±35.14）mL、术后引流量（129.74±21.03）mL均较BHA组［（224.07±29.35）mL、（90.35±17.48）mL］多（t分别为13.863、9.663，均P＜0.001）；组间并发症发生率比较差异无统计学意义（P＞0.05）；术后3 d，BHA组血清白细胞介素-1为（17.35±3.06）pg/L、白细胞介素-6为（24.82±4.31）pg/L、C-反应蛋白为（26.17±4.59）pg/L，低于THR组的（20.16±3.48）pg/L、（27.04±5.06）pg/L、（28.90±5.12）pg/L（t分别为4.068、2.241、2.663，均P＜0.05）；两组术后6个月髋关节内旋、屈曲、外旋、外展、内收活动度及EQ-5D评分对比差异均无统计学意义（均P＞0.05）。结论   与THR相比，BHA能减少FNF患者围术期失血量，降低术后炎症因子表达水平，缩短手术及下床活动时间，促进恢复。

      Objective  To compare and analyze the effects of bipolar hemihip replacement（BHA）and total  hip replacement（THR）in the treatment of femoral neck fracture（FNF）．Methods  The clinical data of 90 patients with FNF in the Luoyang Hospital，Dongzhimen Hospital，Beijing University of Chinese Medicine，from June 2019 to April 2023 were retrospectively collected．The patients were divided into two groups according to the difference in surgical treatment plan．The BHA group（45 cases）received BHA treatment，and the THR group（45 cases）received THR treatment．The perioperative indicators，preoperative and postoperative inflammatory factor levels，postoperative hip joint mobility at six months，preoperative and postoperative quality of life ［European Quality of Life Scale（EQ-5D score）］were compared between the two groups．Results  The operation time（108.76±15.33）min，ambulation time（40.37±10.24）h，and hospitalization time（19.02±5.11）d in the  THR  group were longer than those in the BHA group ［（53.49±10.12）min，（25.92±7.15）h，（15.16±4.87）d］（t=20.184，8.630，3.668，respectively，all P＜0.05）．The intraoperative blood loss（318.69±35.14）mL and  postoperative  drainage volume（129.74±21.03）mL were both higher than those in the BHA group ［（224.07±29.35）mL，（90.35±17.48）mL］（t=13.863，9.663，respectively，all P＜0.001）．There was no significant difference in the incidence of complications between the groups（P＞0.05）．Three days after surgery，the serum levels of interleukin-1，interleukin-6，and C-reactive protein in the BHA group were（17.35±3.06）pg/L，（24.82±4.31）pg/L，and（26.17±4.59）pg/L，respectively，which were lower than those in the THR group（20.16±3.48）pg/L，（27.04±5.06）pg/L，and（28.90±5.12）pg/L（t=4.068，2.241，2.663，respectively，all P＜0.05）．There was no significant difference in the range of motion of internal rotation，flexion，external rotation，abduction，and adduction of the hip joint and EQ-5D scores between the two groups at six months after surgery（all P＞0.05）．Conclusions  Compared with THR，BHA can reduce perioperative blood loss in FNF patients，reduce postoperative inflammatory factor expression level，shorten operation and ambulation time，and promote recovery．