专家述评

肠道支架治疗梗阻性结直肠癌的治疗现状

Current status of intestinal stent therapy for obstructive colorectal cancer

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       约10%~30%的新发结直肠癌患者会出现急性肠梗阻,传统急诊手术治疗存在术后并发症高、死亡率高、生存质量低等不足。肠道支架置入联合限期手术作为一种新型治疗策略,展现出显著优势。肠道支架可迅速解除梗阻,改善患者症状,降低手术风险,为肿瘤微创切除创造条件,同时为新辅助化疗提供可能,但其潜在并发症如出血、移位、再梗阻及肠穿孔等也不容忽视,且长期安全性及对肿瘤结局的影响尚不明确。文章综述了肠道支架治疗梗阻性结直肠癌的治疗现状、争议及研究进展,旨在为临床研究和实践提供参考依据。
    Approximately 10% to 30% of patients with newly diagnosed colorectal cancer present with acute intestinal obstruction.Traditional emergency surgical intervention is characterized by high rates of postoperative complications,elevated mortality,and diminished quality of life.Combined stent and curative elective surgery(CSCES)has emerged as a novel therapeutic strategy,exhibiting significant clinical benefits.Intestinal stenting can rapidly alleviate obstruction,thereby improving patient symptoms,reducing surgical risks,and facilitating minimally invasive tumor resection.Additionally,it provides an opportunity for neoadjuvant chemotherapy.However,potential complications,including bleeding,stent migration,recurrent obstruction,and intestinal perforation,must be carefully considered.Moreover,the long-term safety and impact on oncologic outcomes remain to be elucidated.This review aims to provide a comprehensive overview of the current status,controversies,and recent advancements in the use of intestinal stents for the treatment of obstructive colorectal cancer,with the goalof informing clinical research and practice.
论著

腹腔镜结直肠癌根治术患者术前静脉注射艾司氯胺酮的临床效果观察

Clinical observation of preoperative intravenous injection of esketamine in patients undergoing laparoscopic radical resection for colorectal cancer

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      目的 探讨术前静注艾司氯胺酮在腹腔镜结直肠癌根治术患者中的应用效果。方法 前瞻性分析2024年1月—2025年4月在厦门市中医院行腹腔镜结直肠癌根治术患者的临床资料,根据随机数字表法将患者分为两组:对照组40例,术前5 min予5 mL生理盐水;观察组40例,术前5 min予以0.25 mg/kg艾司氯胺酮(以生理盐水配置成5 mL)。比较围术期指标、炎症因子、负性情绪、疼痛情况、不良反应。结果 观察组的手术时间、麻醉时间、术中出血量分别为(213.54±64.22)min、(240.67±81.26)min、(141.31±45.03)mL,与对照组的(210.43±65.71)min、(244.25±81.33)min、(137.64±42.75)mL比较,差异均无统计学意义(t=0.214、0.197、0.374,P均>0.05),而观察组丙泊酚、瑞芬太尼用量分别为(1 075.52±134.37)mg、(1 267.18±242.26)μg,虽然低于对照组的(1?126.64±150.21)mg、(1 352.50±295.14)μg,但差异也无统计学意义(t=1.604、1.413,P均>0.05);观察组在术后24 h的肿瘤坏死因子-α、白介素-6、C反应蛋白水平分别为(54.52±9.64)pg/mL、(40.08±7.75)pg/mL、(30.38±6.93)mg/L,均低于对照组的(77.31±10.86)pg/mL、(56.35±9.47)pg/mL、(43.73±7.61)mg/L(t=9.926、8.409、8.203,P均<0.05);术后1 d的焦虑、抑郁自评量表评分及术后1 h、6 h、12 h、24 h咳嗽时的疼痛视觉模拟量表评分分别为(51.92±4.41)分、(53.96±4.47)分、(3.59±1.14)分、(3.06±1.01)分、(2.89±0.91)分、(2.57±0.76)分,均低于对照组的(55.06±5.12)分、(57.21±5.19)分、(4.27±1.36)分、(3.68±1.18)分、(3.41±1.06)分、(2.96±0.92)分(t=2.939、3.001、2.423、2.525、2.329、2.067,P均<0.05),但两组术后48 h咳嗽时疼痛视觉模拟量表评分比较差异无统计学意义(P>0.05);两组术后不良反应发生率也无显著差异(P<0.05)。结论 在腹腔镜结直肠癌根治术术前静注艾司氯胺酮可有效降低术后炎症反应水平,减轻术后疼痛,缓解术后负性情绪,且不会增加患者术后不良反应发生率。

Objective To explore the application effect of preoperative intravenous injection of esketamine in patients undergoing laproscopic radical resection of colorectal cancer.Methods The clinical data of patient who underwent laparoscopic radical resection of colorectal cancer in Xiamen Hospital of Traditional Chinese Medicine from January 2024 to April 2025 were retrospectively analyzed.The patients were divided into two groups according to the random number table method:40 cases in the control group were given 5 mL saline,five minutes before operation,40 cases in the observation group were treated with 0.25 mg / kg esketamine(in 5 mL saline)five minutes before operation.The perioperative indicators,inflammatory factors,negative emotions,pain and adverse reactions were compared between two groups.Results The operation time,anesthesia time and intraoperative blood loss of the observation group were(213.54±64.22)min,(240.67±81.26)min and(141.31±45.03)mL,respectively,which were not significantly different from those of the control group(210.43±65.71)min,(244.25±81.33)min and(137.64±42.75)mL(t=0.214,0.197,0.374,all P>0.05).The dosage of propofol and remifentanil in the observation group were(1 075.52±134.37)mg and(1 267.18±242.26)μg,respectively,which were lower than those in the control group of (1126.64±150.21)mg and(1352.50±295.14)μg,but the difference was not statistically significant(t=1.604,1.413,P>0.05).The levels of tumor necrosis factor-α,interleukin-6 and C-reactive protein in the observation group at 24 h after operation were(54.52±9.64)pg / mL,(40.08±7.75)pg / mL and(30.38±6.93)mg / L,respectively,which were lower than those in the control group of (77.31±10.86)pg / ml,(56.35±9.47)pg / mL and 43.73±7.61)mg / L(t=9.926,8.409,8.203,all P<0.05).The scores of Anxiety and Depression Self-Rating Scale at 1 day after operation and the scores of pain visual analogue scale at 1 h,6 h,12 h and 24 h after operation were(51.92±4.41),(53.96±4.47),(3.59±1.14),(3.06±1.01),(2.89±0.91) and(2.57±0.76),respectively,which were lower than those of the control group(55.06±5.12),(57.21±5.19),(4.27±1.36),(3.68±1.18),(3.41±1.06) and(2.96±0.92)(t=2.939,3.001,2.423,2.525,2.329,2.067,P<0.05).However,no significant difference was observed in cough-related VAS scores between the groups at 48 h postoperatively(P>0.05).Adverse event rates showed no significance in two groups(P>0.05).Conclusions Preoperative administration of esketamine in laparoscopic colorectal cancer surgery can attenuate postoperative inflammation,decrease pain,mitigate negative emotions,without increasing the incidence of postoperative adverse reactions.

肺癌患者联合药物治疗间歇期症状评估问卷的修订及信效度评价

Revision of the Symptom Assessment Questionnaire for Lung Cancer Patients During Combined Drug Therapy Intervals and Testing of Its Reliability and Validity

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目的 修订肺癌患者联合药物治疗间歇期症状评估问卷,并评价其信效度。方法 以中文版安德森症状评估量表及肺癌特异性模块为基础,经文献分析、专家会议和认知性访谈形成测试版问卷。于2023年10-12月便利选取福州、莆田2所三级甲等医院278例肺癌患者进行调查,评价其信效度及偏倚风险。结果 修订后问卷含7个症状系统、60个条目,跳转式作答后实际作答21个条目。总问卷Cronbach's α系数为0.856,各维度为0.639~0.747;内容效度指数为0.81。验证性因子分析显示模型拟合尚可(χ2/df=2.366,RMSEA=0.070,CFI=0.858),各维度因子载荷、组合信度及平均方差提取量均达到可接受标准,区分效度良好。COSMIN-RoB评价结果为良好。结论 该问卷信效度良好,可用于评估肺癌患者联合药物治疗间歇期症状严重程度。
Objective To revise the Symptom Assessment Questionnaire for Lung Cancer Patients During Combined Drug Therapy Intervals and evaluate its reliability and validity. Methods Based on the Chinese version of the M. D. Anderson Symptom Inventory and its lung cancer-specific module, a preliminary questionnaire was developed through literature review, expert panel discussions, and cognitive interviews. From October to December 2023, a convenience sample of 278 lung cancer patients was recruited from two tertiary hospitals in Fuzhou and Putian, China. Reliability, validity, and risk of bias were evaluated. Results The revised questionnaire comprised seven symptom-system domains and 60 items, with 21 items completed through a skip-logic design. The overall Cronbach's α coefficient was 0.856, and the coefficients for each domain ranged from 0.639 to 0.747. The content validity index of the questionnaire was 0.81. Confirmatory factor analysis demonstrated an acceptable model fit (χ2/df = 2.366, RMSEA = 0.070, CFI = 0.858). Factor loadings, composite reliability, and average variance extracted of all domains met acceptable standards, indicating good discriminant validity. The overall risk of bias was rated as good according to the COSMIN Risk of Bias checklist. Conclusion The revised questionnaire demonstrated satisfactory reliability and validity and can be used to assess symptom severity in lung cancer patients during combined drug therapy intervals.

基于E-Coach健康管理模式的营养管理联合主动循环呼吸训练应用于非小细胞肺癌化疗患者的效果分析

Effect Analysis of Nutrition Management Based on E-Coach Health Management Model Combined with Active Cycle of Breathing Technique in Patients Undergoing Chemotherapy for Non-Small Cell Lung Cancer

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摘要目的 探讨基于E-Coach健康管理模式的营养管理联合主动循环呼吸训练(ACBT)在非小细胞肺癌(NSCLC)化疗患者中的应用效果。方法 选取2023年6月至2025年8月我院收治的98例NSCLC化疗患者,采用随机数字表法将所有研究对象分为联合组和常规组,每组49例。常规组给予常规干预,联合组在常规组基础上予以E-Coach健康管理模式的营养管理联合ACBT干预。比较两组干预前后营养状况、肺功能、运动耐力、生活质量以及营养不良发生率。结果 干预12周后,两组BMI、ALB、PA、Hb均较干预前上升且联合组高于常规组(P<0.05);联合组FVC、FEV1、MVV及6MWT均显著高于常规组(P<0.05);干预前两组6MWT组间对比差异无统计学意义(P>0.05),干预4周、6周、8周、12周后,两组6MWT均较干预前增加,且联合组远于常规组(P<0.05);干预12周后,两组身体功能、社会或家庭功能、情感功能、功能性状况得分均较干预前上升,且联合组高于常规组(P<0.05)。结论基于E-Coach健康管理模式的营养管理联合ACBT能够有效改善NSCLC化疗患者的营养状况和肺功能,提高生活质量和运动耐力。
Abstract Objective To investigate the application effect of nutrition management based on the E-Coach health management model combined with active cycle of breathing technique (ACBT) in patients undergoing chemotherapy for non-small cell lung cancer (NSCLC). Methods A total of 98 NSCLC patients receiving chemotherapy in our hospital from June 2023 to August 2025 were selected and randomly divided into a combination group and a conventional group using a random number table method, with 49 cases in each group. The conventional group received routine intervention, while the combination group received nutrition management based on the E-Coach health management model combined with ACBT in addition to the routine intervention. The nutritional status, lung function, exercise endurance, quality of life, and incidence of malnutrition were compared between the two groups before and after the intervention. Results After 12 weeks of intervention, BMI, ALB, PA, and Hb in both groups increased compared with baseline, and the levels in the combination group were higher than those in the conventional group (P<0.05). The FVC, FEV1, MVV, and 6MWT in the combination group were significantly higher than those in the conventional group (P<0.05). There was no statistically significant difference in 6MWT between the two groups before intervention (P>0.05); after 4, 6, 8, and 12 weeks of intervention, the 6MWT in both groups increased compared with baseline, and the walking distance in the combination group was significantly longer than that in the conventional group (P<0.05). After 12 weeks of intervention, the scores of physical function, social/family function, emotional function, and functional well-being in both groups increased compared with baseline, and the scores in the combination group were higher than those in the conventional group (P<0.05). Conclusion Nutrition management based on the E-Coach health management model combined with ACBT can effectively improve the nutritional status and lung function of NSCLC patients undergoing chemotherapy, and enhance their quality of life and exercise endurance.

呼吸性肌肉力量减低对I-IIIA期非小细胞肺癌术后预后的影响

Impact of Reduced Respiratory Muscle Strength on Postoperative Outcomes in Stage I–IIIA Non-Small Cell Lung Cancer

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【摘要】 目的 探讨基于峰值呼气流速(peak expiratory flow rate,PEFR)的呼吸性肌肉力量减低对I-IIIA期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者术后预后的影响。方法 回顾性分析我院2020年1月-2025年11月接受根治性手术切除的I-IIIA期NSCLC患者临床及影像资料,包括基于肺功能的PEFR(呼吸性肌肉力量指标)及胸部CT的胸肌质量指数(pectoralis muscle index, PMI)。分别采用Jonckheere-Terpstra检验、Spearman’s相关分析比较PEFR与PMI随年龄的变化规律及二者的相关性。低PEFR定义为小于PEFR的性别特异性下四分位数,进一步采用单、多因素Cox回归分析探讨PEFR及PMI对NSCLC患者术后结局的影响。结果 共纳入102例患者,中位年龄62岁(53-67岁),男性65例(63.7%),低低PEFR组24例(23.5%)。低PEFR组在年龄、FEVI、DLCO、FEV1/FVC、FVC、血清白蛋白及随访时间等方面均与正常组间存在显著差异(P<0.05)。在男、女性患者中,PEFR均表现为随年龄增长逐渐下降的趋势;且与PMI具有较好的相关性(r=0.25,P=0.001)。单因素及多因素Cox回归分析显示,低PEFR是影响NSCLC患者术后无进展生存期(progression free survival, PFS)的独立危险因素(HR=1.57,95%CI:1.03-2.39;P=0.036)结论 呼吸性肌肉力量减低是NSCLC患者术后PFS的独立危险因素,有望成为NSCLC术后复发的早期生物学标志物。
【Abstract】 Objective To investigate the impact of reduced respiratory muscle strength, assessed by peak expiratory flow rate (PEFR), on postoperative outcomes in patients with stage I-IIIA non-small cell lung cancer (NSCLC). Methods Clinical and imaging data of patients with stage I-IIIA NSCLC who underwent radical resection at our hospital from January 2020 to November 2025 were retrospectively analyzed, including PEFR (an indicator of respiratory muscle strength) based on pulmonary function tests and the pectoralis muscle index (PMI) derived from chest CT. The Jonckheere-Terpstra test and Spearman’s correlation analysis were used to evaluate age-related changes in PEFR and PMI and their correlation, respectively. Low PEFR was defined as values below the sex-specific lower quartile of PEFR. Univariate and multivariate Cox regression analyses were performed to assess the impact of PEFR and PMI on postoperative prognosis in NSCLC patients.Results A total of 102 patients were enrolled, with a median age of 62 years (range 53-67 years); 65 patients (63.7%) were male, and 24 (23.5%) were classified into the low PEFR group. The low PEFR group showed significant differences from the normal PEFR group in age, FEV1, DLCO, FEV1/FVC, FVC, serum albumin, and follow-up duration (all P < 0.05). In both male and female patients, PEFR progressively decreased with age and was positively correlated with PMI (r = 0.25, P = 0.001). Univariate and multivariate Cox regression analyses identified low PEFR as an independent risk factor for postoperative progression-free survival (PFS) in NSCLC patients (HR = 1.57, 95% CI: 1.03–2.39; P = 0.036).Conclusion Reduced respiratory muscle strength is an independent risk factor for postoperative PFS in NSCLC patients and may serve as an early biomarker for postoperative recurrence.

槐花散合桃花汤联合FP化疗方案治疗寒热错杂型晚期食管癌患者的多维度疗效评价

Multidimensional efficacy evaluation of Huaihua San and Taohua Decoction combined with FP chemotherapy regimen in the treatment of patients with advanced esophageal cancer of intermingled cold-heat syndrome

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目的 分析槐花散合桃花汤联合FP(顺铂、5-氟尿嘧啶)化疗方案治疗寒热错杂型晚期食管癌患者的效果。方法 选取我院2023年1月~2024年8月寒热错杂型晚期食管癌患者98例,依照随机数字表法分为两组,各49例。对照组接受FP化疗方案治疗,观察组接受槐花散合桃花汤联合FP化疗方案治疗。比较两组多维度疗效[西医疗效(疾病控制率)、中医疗效]、治疗前后中医证候积分(TCMSS)、肿瘤标志物[鳞状细胞癌抗原(SCC-Ag)、癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)]、生活质量[食管癌生命质量测定量表(QLICP-ES)]、毒副反应、1年生存率。结果 观察组中医疗效(89.80%)较对照组(65.31%)高(P<0.05),而两组疾病控制率比较无明显差异(P>0.05);观察组TCMSS低于对照组(P<0.05);治疗后,观察组CEA、CYFRA21-1、SCC-Ag水平低于对照组(P<0.05);治疗后,观察组QLICP-ES评分低于对照组(P<0.05);观察组恶心呕吐、消化系出血、脱发发生率较对照组低(P<0.05);两组1年生存率对比无明显差异(P>0.05)。结论 槐花散合桃花汤联合FP化疗方案治疗寒热错杂型晚期食管癌,能提高中医疗效,降低患者肿瘤标志物水平,减轻毒副反应,改善中医症状,并有助于减轻化疗对生活质量的负面影响。
Objective To analyze the efficacy of Huaihua San and Taohua Decoction combined with FP (cisplatin, 5-fluorouracil) chemotherapy regimen in the treatment of patients with advanced esophageal cancer of intermingled cold-heat syndrome type. Methods A total of 98 patients with advanced esophageal cancer complicated with intermingled cold-heat syndrome admitted to our hospital from January 2023 to August 2024 were enrolled and divided into two groups by the random number table method, with 49 cases in each group. The control group was treated with FP chemotherapy regimen, and the observation group was treated with Huaihua San and Taohua Decoction combined with FP chemotherapy. Multi-dimensional efficacy indicators [western medicine efficacy (disease control rate) and traditional Chinese medicine (TCM) efficacy], as well as the TCM syndrome score (TCMSS), tumor markers [squamous cell carcinoma antigen (SCC-Ag), carcinoembryonic antigen (CEA), cytokeratin 19 fragment (CYFRA21-1)], quality of life [quality of life instrument for cancer patients-esophageal cancer scale (QLICP-ES)] before and after treatment, adverse reactions and 1-year survival rate were compared between the two groups. Results The TCM efficacy rate of the observation group was 89.80%, which was significantly higher than 65.31% of the control group (P<0.05), no significant difference was found in disease control rate between the two groups (P>0.05). The TCMSS of the observation group was lower than that of the control group (P<0.05). After treatment, the levels of CEA, CYFRA21-1 and SCC-Ag in the observation group were lower than those in the control group (P<0.05). The QLICP-ES score of the observation group was superior to the control group after treatment (P<0.05). The incidences of nausea and vomiting, digestive tract hemorrhage and alopecia in the observation group were markedly lower (P<0.05). There was no statistical difference in 1-year survival rate between the two groups (P>0.05). Conclusion The regimen of Huaihua San and Taohua Decoction combined with FP chemotherapy for advanced esophageal cancer of intermingled cold-heat syndrome can improve TCM therapeutic efficacy, reduce the levels of tumor markers, alleviate toxic and side effects, ameliorate TCM symptoms, and lessen the negative impact of chemotherapy on patients quality of life.
论著

个性化营养干预联合分级步行运动方案对肺癌化疗患者癌因性疲乏及生活质量的影响

Effects of personalized nutritional intervention combined with graded walking exercise treatment on cancer-related fatigue and quality of life in lung cancer patients during chemotherapy

:367-372
 
       目的  分析对肺癌化学治疗(化疗)患者采取个性化营养干预联合分级步行运动方案的应用价值。   将郑州大学附属郑州中心医院2023年7月—2024年7月符合标准的198例肺癌化疗患者作为研究对象,通过随机数字表法分为观察组和对照组各99例。对照组仅采用个性化营养干预方案,观察组则联合分级步行运动方案,两组患者均在同一时间内入组并接受持续干预3个月。对两组干预前后癌因性疲乏[Piper疲乏修订量表(PFS-R)]、营养状况、睡眠质量[匹茨堡睡眠质量指数(PSQI)]、生活质量[生活质量评估量表(SF-36)]水平予以比较。结果  相较于对照组,干预后观察组PFS-R、PSQI评分较低,白蛋白、前白蛋白、血红蛋白、铁转蛋白水平和SF-36评分较高(P<0.05)。结论  对肺癌化疗患者采取个性化营养干预联合分级步行运动方案,有利于促进其癌因性疲乏的减轻和营养状态、睡眠质量及生活质量水平的提高。
       Objective  To analyze the effects of personalized nutritional intervention combined with graded walking exercise treatment on cancer-related fatigue and quality of life in lung cancer patients during chemotherapy.Methods  A total of 198 lung cancer patients undergoing chemotherapy who met the criteria in our hospital from July 2023 to July 2024 were selected as the research subjects.They were divided into an observation group and a control group,with 99 cases in each group,by the random number table method.The control group only received individualized nutritional intervention,while the observation group received graded walking exercise additionally.Both groups of patients were enrolled at the same time and received continuous intervention for three months.Cancer-related fatigue(Piper’s Fatigue Scale-Revised[PFS-R]),nutritional status,sleep quality(Pittsburgh Sleep Quality Index[PSQI]),and quality of life(Quality of Life Scale[SF-36]) before and after the intervention were compared between the two groups.Results  Compared with the control group,the observation group had lower PFS-R and PSQI scores and higher albumin,prealbumin,hemoglobin,transferrin levels and SF-36 scores after the intervention(P<0.05).Conclusions  Adopting personalized nutritional intervention combined with graded walking exercise for lung cancer patients during chemotherapy is beneficial to promote the reduction of cancer-caused fatigue and the improvement of their nutritional status,sleep quality and quality of life.
论著

TAP 水平与乳腺癌分子分型、临床病理特征的相关性分析

Relationship between TAP level and molecular typing and clinicopathological features of breast cancer

:359-366
 
       目的  探讨TAP水平与乳腺癌分子亚型及临床病理参数之间的相关性。方法  以2021年3月—2025年1月期间收治的150例乳腺癌病例为样本,采用静脉采血方式测定TAP凝聚物表面积指标,通过免疫组织化学EnVision双步染色技术,对雌激素受体(ER)、雄激素受体(AR)、孕激素受体(PR)、Ki-67及p53等表达水平进行分析,采用荧光原位杂交(FISH)对人表皮生长因子受体2(HER2)基因扩增状态进行检测。结果  150例患者中,TAP强阳性131例,TAP弱阳性15例,TAP阴性4例,TAP阳性率97.33%。免疫表型:ER阴性43例,ER阳性107例;AR阳性133例,AR阴性17例;PR阴性60例,PR阳性90例;p53阳性73例,p53阴性77例;HER2强阳性41例,HER2弱阳性89例,HER2阴性20例;Ki-67增殖指数≥20% 116例,Ki-67增殖指数<20% 34例。FISH对65例免疫组织化学检测结果为HER2(2+ )的乳腺癌病例进行基因扩增状态分析,其中阳性7例,阴性58例。Ki-67高增殖组TAP表达水平显著高于低增殖组(P<0.05);不同临床分期患者TAP表达水平存在差异(P<0.05);三阴型、HER2阳性型、Luminal A型和Luminal B型的患者之间的TAP表达水平存在差异(P<0.05),各分子分型(HER2阳性型、三阴型、Luminal A型和Luminal B型)与其对应非分型组的TAP表达均无统计学差异(均P>0.05)。结论  TAP在乳腺癌中广泛表达,且与Ki-67增殖指数、临床分期呈正相关。虽然不同分子分型间TAP表达存在总体差异,但具体亚型对比未显示显著性,后期需扩大样本量验证。
       Objective  To explore the relationship between tumor abnormal protein(TAP)level and molecular typing and clinicopathological features of breast cancer.Methods  A total of 150 breast cancer cases admitted from March 2021 to January 2025 were enrolled in this study.The surface area of TAP condensates was measured using venous blood samples.The expression levels of estrogen receptor(ER),androgen receptor(AR),progesterone receptor(PR),Ki-67,and P53 were analyzed via immunohistochemistry(IHC)using the EnVision two-step staining technique.The amplification status of the human epidermal growth factor receptor 2(HER2+)gene was determined using fluorescence in situ hybridization(FISH).Results  Among 150 patients,131 cases were strongly positive,15 cases were weakly positive and 4 cases were negative,with a positive rate of 97.33%.Immunophenotype:ER positive in 107 cases and ER negative in 43 cases,133 cases were  positive for AR and  17 cases were negative,PR was positive in 90 cases and negative in 60 cases,73 cases were positive for p53 and 77 cases were negative.HER2 is strongly positive in 41 cases,weakly positive in 89 cases and negative in 20 cases.There were 116 cases with Ki-67 proliferation index ≥ 20% and 34 cases with Ki-67 proliferation index < 20%.Sixty-five cases of breast cancer HER2(2 )were detected in the later stage.by FISH,of which 7 cases were positive and 58 cases were negative.The expression level of TAP in patients with high Ki-67 proliferation index was higher than that in patients with low Ki-67 proliferation index(P<0.05).The expression level of TAP in patients with different clinical stages was different(P<0.05).There were differences in TAP expression levels among patients with triple negative type,HER2 positive type,Luminal A type and Luminal B type(P<0.05).There was no statistical difference in TAP expression between each molecular type(triple negative type,HER2 positive type,Luminal A type and Luminal B type)and its corresponding non-typing group(all P>0.05).Conclusions  TAP is widely expressed in breast cancer,and it is positively correlated with Ki-67 proliferation index and clinical stage.Although there is a general difference in TAP expression among different molecular typing,the comparison of specific subtypes shows no significance,and it needs to be verified by expanding the sample size 
论著

补肾益气方肾俞膏摩治疗结直肠癌康复期癌因性疲乏的临床观察及疗效评价:一项随机对照试验

Clinical observation and curative effect evaluation of Shenshu Tuina combined with Bushen Yiqi herbal ointment on cancer-induced fatigue in convalescent stage of colorectal cancer

:333-340
 
       目的  观察补肾益气方肾俞膏摩治疗结直肠癌康复期癌因性疲乏的临床疗效。方法  收集2023年6月—2024年6月结直肠癌康复期的80例住院及门诊患者,随机平均分为两组。行常规对症支持治疗的为对照组;在常规对症支持治疗上加用补肾益气方肾俞膏摩的为干预组;两组均连续治疗14天。于开始治疗前1天和治疗结束后1天分别进行疗效评估相关指标检测。于治疗前1天、治疗第7天和第14天进行不良反应检测。结果 干预组治疗后Piper评分、中医证候总积分、PSQI评分、KPS评分及免疫功能指标(CD3+  、CD4+、CD8+  、CD4+ /CD8+ )较治疗前均有明显改善;干预组发生不良反应少于对照组。结论  补肾益气方肾俞膏摩治疗能够有效改善结直肠癌患者的癌因性疲乏的治疗效果,提高生活质量和免疫功能,减少不良反应。
       Objective  To observe the clinical observation of Shenshu Tuina combined with Bushen Yiqi herbal ointment in the treatment of cancer-induced fatigue in the convalescent stage of colorectal cancer and evaluate the efficacy.Methods  From June 2023 to June 2025,80 inpatients and outpatients of colorectal cancer in the  recovery period were collected and  randomly divided into two groups.The patients who received routine symptomatic supportive treatment were enrolled as the control group.The intervention group was given Shenshu Tuina combined with Bushen Yiqi herbal ointment on the basis of control group.The relevant indicators for efficacy evaluation were tested one day before treatment and one day after the end of treatment.Adverse reactions were detected on the day before treatment,theseventh day and 14th day during treatment.Results  The efficacy evaluation indexes of the intervention group after treatment were obviously improved compared with those before treatment.Adverse  reactions occurred less in the intervention group than in the control group.Conclusions  Shenshu Tuina combined with Bushen Yiqi herbal ointment can effectively improve the treatment effect of cancer-induced fatigue in patients with colorectal cancer,improve the quality of life and immune function,reduce adverse reactions.
论著

肺癌根治术后患者康复期症状体验及心理感受的质性研究

Qualitative study on the symptom experience and psychological feelings of patients after radical resection of lung cancer during the rehabilitation period

:159-164
 
      目的 探讨肺癌根治术后患者康复期的症状体验与心理感受, 为完善症状管理和制定个性化康复干预方案提供依据。方法 采用现象学研究法,对15例肺癌根治术后康复期患者进行半结构式访谈, 运用Colaizzi 7步分析法进行归纳和提炼主题。结果 归纳出5个主题, 12个亚主题:多重躯体症状负担持续存在(术后疼痛综合征、顽固性刺激性咳嗽、劳力性呼吸困难、持续性疲劳感); 负性心理情绪困扰(病耻感、疾病不确定感与复发恐惧); 心理调适过程(诊断冲击与认知失调、角色适应与主动应对); 创伤后成长与健康行为转变(生命意义感提升、健康促进行为强化); 强烈的康复信息支持需求(自我保健知识需求、结构化康复锻炼指导需求)。结论 医护人员应关注肺癌根治术后患者康复期的症状体验, 动态评估患者的身心状况, 制定精准、有效的个性化干预方案, 帮助患者树立康复信心, 改善术后康复体验和提高生活质量。
       Objective  To explore the symptom experience and psychological feelings of patients during the rehabilitation period after radical resection of lung cancer, aiming to provide a basis for improving symptom management and formulating personalized rehabilitation interventions.Methods The phenomenological research method was used to conduct semi-structured interviews with 15 patients in the rehabilitation period after radical surgery for lung cancer.Colaizzi's 7-step analysis method was used to summarize and extract themes.Results Five themes and 12 sub-themes were summarized:Persistent burden of multiple physical symptoms(postoperative pain syndrome, refractory irritative cough, exertional dyspnea, persistent fatigue); negative emotional experiences(stigma of illness, illness uncertainty and fear of recurrence); psychological adjustment processes(diagnostic shock and denial, role acceptance and active coping); post-traumatic growth and health behavior transformation(enhanced sense of meaning in life, strengthened health-promoting behaviors); strong demand for rehabilitation information support(self-care knowledge, rehabilitation exercise knowledge).Conclusions Medical staff should pay attention to the symptom experience of patients during the recovery period after radical lung cancer surgery, dynamically assess their physical and mental conditions, develop precise and effective personalized intervention plans, help patients build confidence in recovery, and thereby improve their postoperative rehabilitation experience and quality of life.
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