目的:探讨复方苦参注射液对乙型肝炎病毒(HBV)相关肝细胞癌(HCC)患者化疗效果及T细胞免疫功能的影响.方法:选取2019年1月～2021年12月期间于某院确诊的106例HBV相关HCC患者作为研究对象,采用随机数字表法分为对照组与观察组,每组53例.对照组给予经导管动脉化疗栓塞(TACE)术治疗,观察组在对照组基础上加用复方苦参注射液,比较两组患者的近期疗效[客观缓解率(ORR)、疾病控制率(DCR)]、Child-Pugh肝功能分级、肝癌标志物[α-L-岩藻糖苷酶(AFU)、甲胎蛋白(AFP)]水平、T细胞亚群(CD3+、CD4+、CD8+)水平以及不良反应发生情况.结果:治疗后,两组患者ORR比较无统计学差异(P>0.05);观察组患者DCR(86.79%)高于对照组(69.81%,P<0.05);观察组Child-Pugh肝功能分级优于对照组(P<0.05);两组AFU、AFP水平均降低(P<0.05),且观察组低于对照组(P<0.05);观察组CD3+、CD4+水平及CD4+/CD8+比值高于对照组(P<0.05),CD8+水平低于对照组(P<0.05).观察组不良反应发生率低于对照组(χ2=3.944,P=0.047).结论:复方苦参注射液辅助TACE治疗HBV相关HCC,可提高化疗效果,调节患者T细胞免疫功能,降低肿瘤标记物水平及不良反应发生率.

目的 探讨不同手术方式治疗肝门部胆管癌患者的近期及远期疗效.方法 根据手术治疗方式的不同将149例肝门部胆管癌患者分为根治性切除术组(n=49)、经皮肝穿刺胆道引流组(n=49)、内镜下金属支架引流组(n=51).比较3组患者的肝功能指标[丙氨酸转氨酶(ALT)、碱性磷酸酶(ALP)、总胆红素(TBIL)]、术后并发症发生率及生存率.结果 术后1周,3组患者的ALT、ALP、TBIL水平均低于本组术前,根治性切除术组患者的ALT、ALP、TBIL水平均低于经皮肝穿刺胆道引流组和内镜下金属支架引流组,差异均有统计学意义(P﹤0.05).根治性切除术组患者的并发症总发生率为30.61%,高于经皮肝穿刺胆道引流组患者的12.24%和内镜下金属支架引流组患者的11.76%,差异均有统计学意义(P﹤0.05).根治性切除术组患者的1、3、5年生存率均高于经皮肝穿刺胆道引流组,内镜下金属支架引流组患者的1、3年生存率均高于经皮肝穿刺胆道引流组,差异均有统计学意义(P﹤0.05).结论 肝门部胆管癌患者的近期及远期疗效与手术方式有关,根治性切除术仍是患者获得长期生存最重要的措施.

目的 探讨利胆排石颗粒联合熊去氧胆酸片治疗肝内胆管结石的临床疗效.方法 选取2020年1月—2021年9月在南阳市中心医院就诊的100例肝内胆管结石患者,根据随机数字表法将所有患者分为对照组和治疗组,每组各50例.对照组患者口服熊去氧胆酸片,10 mg/kg,2次/d.治疗组在对照组基础上温水冲服利胆排石颗粒,2袋/次,2次/d.两组患者连续治疗6个月.观察两组的临床疗效,比较两组的症状改善情况、结石和血清中总胆红素(TBIL)、直接胆红素(DBIL)、天门冬氨酸氨基转氨酶(AST)、丙氨酸氨基转移酶(ALT)水平.结果 治疗后,治疗组的总有效率为96.00％,明显比对照组总有效率84.00％高,组间比较差异有统计学意义(P<0.05).治疗后,两组的发热、黄疸、腹痛发生率显著降低(P<0.05),且治疗组发热、黄疸、腹痛发生率较对照组降低更明显(P<0.05).治疗后,两组的最大结石直径显著减小(P<0.05),且治疗组最大结石直径明显小于对照组(P<0.05).治疗后,两组的血清TBIL、DBIL、AST、ALT水平均显著降低(P<0.05),且治疗组血清TBIL、DBIL、AST、ALT水平明显低于对照组(P<0.05).结论 利胆排石颗粒联合熊去氧胆酸片可提高肝内胆管结石的疗效,改善临床症状,促进结石缩小,改善肝胆功能,且安全性良好.

目的 探讨胰胆舒胶囊联合亚胺培南西司他丁钠治疗急性重症胰腺炎的临床疗效.方法 选取2019年3月—2020年4月在南阳市中心医院进行治疗的86例急性重症胰腺炎患者,根据就诊顺序分为对照组(43例)和治疗组(43例).对照组静脉滴注注射用亚胺培南西司他丁钠,1.0 g/次,同0.9％氯化钠注射液100 mL配伍,每8小时1次;治疗组在对照组基础上口服胰胆舒胶囊,2 g/次,3次/d.两组均经2周治疗后进行效果对比.观察两组的临床疗效,比较两组临床症状消失时间、血清学指标、肠道屏障功能指标.结果 经治疗,对照组总有效率为81.40％,显著低于治疗组(97.67％,P<0.05).经治疗,治疗组在口干、腹痛、恶心呕吐、痞满燥实、小便短赤等症状消失时间上均短于对照组(P<0.05).经治疗,两组血清超敏C反应蛋白(hs-CRP)、微管相关蛋白1轻链3(MAP1-LC3)、可溶性髓系细胞触发受体-1(sTREM-1)、肿瘤坏死因子-α(TNF-α)、P物质、降钙素原(PCT)水平均较治疗前显著降低(P<0.05);治疗后,治疗组患者血清学指标低于对照组(P<0.05).经治疗,两组血清淀粉酶(AMS)、二胺氧化酶(DAO)、D-乳酸水平均较治疗前显著降低(P<0.05),并以治疗组降低更显著(P<0.05).结论 胰胆舒胶囊联合注射用亚胺培南西司他丁钠治疗急性重症胰腺炎患者具有较好的疗效,可有效改善患者临床症状,降低机体炎症反应,有利于机体肠道功能的恢复,有着良好临床应用价值.

探讨内镜下针状刀括约肌切口术治疗急性重型胆管炎(ACST)的效果.选取2017年1月—2019年3月在河南省南阳市中心医院治疗的ACST患者88例,根据治疗方案分为A组(=50)和B组(=38),A组给予内镜下针状刀括约肌切开术,B组给予内镜下乳头括约肌切开术,观察两组手术时间、胆道引流时间等.A组与B组手术时间、胆道引流时间和住院时间差异比较无统计学意义(>0.05);A组取石成功率为98.00％,明显高于B组(<0.05);而肝外胆管结石清除时间为(17.10±3.20)min,明显少于B组(<0.05);A组术后血清高迁移率族蛋白B1为(7.22±1.80)μg/L,明显低于B组(<0.05);两组并发症发生率差异比较无统计学意义(>0.05).内镜下针状刀括约肌切开术治疗ACST有较好的效果,值得临床使用.

目的 比较腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)后同期行内镜下逆行胰胆管造影(endoscopic retrograde cholangiopancreatography,ERCP)与ERCP术后二期行LC治疗胆囊结石合并胆总管结石的疗效,探讨同期LC+ERCP治疗胆囊结石合并胆总管结石的临床价值.方法 62例胆囊结石合并胆总管结石患者,根据手术方式分为观察组28例和对照组34例,观察组行同期LC+ERCP治疗,对照组于ERCP术后二期行LC治疗,比较2组患者临床资料及术后住院时间、并发症发生率、术前及术后1个月血清前白蛋白和白蛋白水平.术后第3天行经鼻胆管造影,观察2组结石清除情况.结果 2组体质量指数、胆总管结石数量和直径、胆总管直径及谷丙转氨酶、总胆红素水平比较差异无统计学意义(P＞0.05).观察组术后住院时间[(7.0±1.5)d]短于对照组[(8.8±1.5)d](P＜0.05),术后并发症发生率(7.1％)与对照组(8.8％)比较差异无统计学意义(P＞0.05).观察组术前及术后1个月血清前白蛋白[(238.2士19.5)、(285.7±21.5)g/L]和白蛋白[(31.7±3.4)、(37.5士3.0)g/L]水平与对照组[(243.1±20.8)、(285.1士22.8)g/L,(32.5±3.4)、(37.2±2.7)g/L]比较差异均无统计学意义(P＞0.05);2组术后1个月血清前白蛋白及白蛋白水平均高于术前(P＜0.05).2组术后第3天经鼻胆管造影显示结石清除率均为100％.结论 同期LC+ERCP治疗胆囊结石合并胆总管结石安全、有效,住院时间短.

目的 比较腹腔镜下规则性肝段或肝叶切除治疗复杂性肝内胆管结石患者血浆皮质醇(COR)和外周血T淋巴细胞亚群的变化.方法 2017年11月～2018年11月我院收治的85例复杂性肝内胆管结石患者,其中52例对照组患者接受开腹肝切除术,33例观察组患者接受腹腔镜下规则性肝段或肝叶切除术.结果 观察组手术时间为198.9±15.2 min,显著长于对照组(172.4±18.1 min,P＜0.05),术中出血量、术后肛门排气时间和术后住院时间分别为211.1±17.9 mL、18.3±3.1 h和7.8±1.5 d,显著少于或短于对照组[分别为(245.9±23.6 mL、27.5±4.3 h和10.0±2.2 d),P＜0.05];术后3d,观察组血清COR、C反应蛋白(CRP)、肾上腺素(EP)和白介素-6(IL-6)水平分别为232.5±27.9 nmol/L、15.8±1.6 m g/L、204.3±19.2 ng/mL和72.7±6.9 μg/L,均显著低于对照组[分别为(327.0±35.6 nmol/L、31.2±2.8 mg/L、352.8±31.5 ng/mL和111.6±10.3 μg/L),P＜0.05];观察组外周血CD3+、CD4+和CD8+细胞百分比分别为58.1±5.2％、37.1±4.1％和28.2±1.7％,与对照组比,差异显著(分别为53.2±4.9％、33.6±4.0％和37.6±3.4％,P＜0.05).结论 腹腔镜下规则性肝段或肝叶切除术较开腹肝切除术对患者的创伤更小,能够抑制应激反应,提高机体免疫力,可能更有利于患者术后恢复.

目的 通过对吲哚菁绿(ICG)清除率的测定来预测肝切除术患者肝功能的状态.方法 纳入2016年9月至2019年9月入院收治施行解剖性肝切除术患者68例.所有患者均接受ICG清除试验并且术后病理诊断为原发性肝细胞癌.比较采用t检验;Pearson相关性分析探讨ICG15min潴留率(ICG-R15)与观察资料的相关性;采用Logistic回归分析引起肝功能不全的独立危险因素.结果 68例患者中肝功能正常52例,肝功能不全16例.两组患者的年龄、血小板、总胆红素、ALT、AST、前白蛋白、凝血酶原国际标准化比率、手术时间、术前ICG-R15比较差异均无统计学意义(P>0.05),而术中出血量、术中ICG-R15及肝切除量之间差异有统计学意义(P<0.05).患者术中ICG-R15为(14.5±7.0)％,较术前的(6.8±5.5)％,显著上升(P<0.05);Pearson相关性分析提示术中ICG-R15与术前ICG-R15、术中出血量及肝切除量之间均存在显著相关(相关性系数分别为0.49、0.72和0.60,均P<0.05).将术中ICG-R15、术前ICG-R15、术中出血量及肝切除量纳入Logistic回归模型,结果提示术中ICG-R15肝切除量是解剖性肝切除术患者发生肝功能不全的独立危险因素(均P<0.05).结论 ICG清除率的测定有助于为解剖性肝切除术患者肝功能状态提供参考,术中ICG-R15是患者发生肝功能不全的独立危险因素.

目的 研究腹腔镜联合腔镜胆囊切除术(LC)联合内镜Oddi括约肌切开取石术(EST)治疗胆囊结石合并胆总管结石(CCWC)的疗效.方法 回顾性分析2016.10 ～2018.10于我院就诊的CCWC患者的临床资料,按照治疗方式法分为对照组53例(LC+胆道探查取石(LCBDE)治疗)与研究组53例(EST+ LC治疗),术后随访半年.对比两组患者围术期指标、T细胞亚群、并发症、追访半年后患者的生活质量.结果 所有患者均未发生中转开腹手术情况.研究组患者的手术时间、下床活动时间、止痛药使用率、住院时间均显著低于对照组而住院费用显著高于对照组(P＜0.05),而两组患者的术中出血量、结石清除率及肛门排气时间对比,差异不显著(P＞0.05);术后,研究组患者的总并发症率为9.43％,对照组为18.87％,两组对比差异不显著(P＞0.05);术后,研究组和对照组患者的GGT和ALP较治疗前均显著降低(P＜0.05),且研究组术后与对照组对比差异显著(P＜0.05);随访半年后,两组患者的生活质量评分较治疗前均显著上升(P＜0.05),且研究组治疗后与对照组对比差异显著(P＜0.05);两组患者的结石残留率和结石复发率对比差异不显著(P＞0.05).结论 应用腹腔镜联合内镜Oddi括约肌切开取石术治疗CCWC患者,可减短手术及住院时间,术后并发症较少,结石复发率较小,提升术后生活质量,可作为治疗CCWC患者的一种安全方法,但住院费用高.

Objective To investigate the clinical features and prognostic factors of extrahepatic biliary neuroendocrine neoplasms(EB-NENs).Methods The clinical data and survival of 21 patients with EB-NENs admitted from May 2014 to May 2018 were analyzed retrospectively.Results These 21 EB-NENs patients accounted for 1.6％ (21/1313) of all biliary tract neoplasms treated during the study period.Seven (33.3％) cases had lymph node metastasis.Five (23.8％) suffered from distant metastasis.The follow up time was (4 ～ 46.5) months with median survival time of (23.23 ± 4.17) months.Univariate analysis showed that the risk factors for survival were tumor TNM stage (x2 =9.066,P =0.003),lymph node metastasis(x2 =6.399,P=0.011) and distant metastasis (x2 =9.808,P=0.002).By multivariate analysis,independent risk factors were tumor TNM stage (P =0.008,RR =3.003,95％ CI:1.332 ～ 6.774),lyraph node metastasis (P =0.023,RR =5.382,95 ％ CI:1.261 ～ 22.971) and distant metastasis or not(P =0.007,RR =7.423,95％ CI:1.730 ～ 31.851).Conclusion EB-NENs was a rare malignant tumor with poor prognosis.Tumor TNM stage,lymph node metastasis and distant metastasis were independent prognostic factors for EB-NENs patients.

目的 探究硬膜外麻醉复合全身麻醉应用于肝叶切除术的临床效果.方法 选取60例择期行肝叶切除术患者为受试对象,随机数表法分为观察组与对照组各30例.观察组予以硬膜外麻醉复合全身麻醉,对照组则单纯采取全身麻醉.比较麻醉前(T0)、切皮前(T1)、腹腔探查后(T2)、术毕前(T3)、拔管后(T4),两组血流动力学指标[平均动脉压(MAP)、心率(HR)、外周血管阻力(SVR)]、血浆应激状态指标[内皮素(ET)、皮质醇(Cor)、肾上腺素]水平变化,分析两组全麻药物用量、苏醒质量指标差异.结果 T1、T2时,两组MAP、HR、SVR水平均较T0时有显著下降(P＜0.05),但组间同期比较均无统计学意义(P＞0.05).T3、T4时,两组MAP、HR、SVR水平均较T0时无明显变化,且组间同期比较均无统计学意义(P＞0.05).T1时,两组血浆ET、Cor、肾上腺素水平较T0时无明显变化,且组间同期比较均无统计学意义(P＞0.05).T2、T3、T4时,两组血浆ET、Cor、肾上腺素水平均较T0时有显著提升,且观察组明显低于同期对照组(P＜0.05).观察组术中全麻药物用量及术后苏醒质量指标均明显少于对照组(P＜0.05).结论 硬膜外麻醉复合全身麻醉能维持肝叶切除术患者围术期血流动力学处于适宜手术操作的水平,并有效改善术后苏醒质量,对改善其麻醉满意度有利.

目的 研究多排螺旋CT成像(MSCT)及引导穿刺鉴别肝脏局灶性结节增生(FNH)的应用价值.方法 选择经常规CT平扫或肝脏超声筛选的FNH患者共126例,经CT或超声引导穿刺活检结合病理最终确诊肝癌35例(27.8％),良性结节91例;采用MSCT多期增强扫描和后处理,记录结节直径、形状、周围病灶、强化、静脉期和动脉期增强.结果 MSCT平扫诊断良恶性结节的最大直径、形状和密度比较差异均无统计学意义(P＞0.05).MSCT增强扫描恶性结节以“快进快出”征象为主,良性结节以“快进慢出”征象为主.MSCT增强扫描共诊断肝癌30例,良性结节96例,诊断肝癌的敏感性为80.0％(28/35),特异性为97.8％(89/91),阳性预测值为93.3％(28/30),阴性预测值为92.7％(89/96).结论 MSCT增强扫描鉴别FNH良恶性具有较高的诊断价值.

Objective:To investigate the correlation of preoperative platelet/lymphocyte ratio (PLR)with clinical pathological characteristics and survival time in pancreatic cancer patients with radical resection.Methods:The clini-copathological data of 86 patients who underwent radical resection of pancreatic cancer in our hospital from May 2010 to May 2014 were retrospectively analyzed.According to preoperative PLR of ROC,patients were divided into with high PLR and with low PLR.The clinicopathological features and 1 -year survival rate were compared between the two groups.Univariate analysis and Cox proportional hazards regression model were used to analyze the prognostic sur-vival factors of pancreatic cancer patients.Results:The ROC curve showed that the best critical value of PLR to pre-dict the survival time of the patients with radical pancreatic cancer was 250.2,according to the critical value,the high PLR group (PLR＞250.2,40 cases)and the low PLR group (PLR＜250.2,46 cases).The age,tumor T stage,and tumor N stage in the high PLR group were significantly higher than those in the low PLR group (P＜0.05).The me-dian survival time and 1-year survival rate in the high-PLR group were significantly lower than those in the low-PLR group (P＜0.05).Univariate analysis showed that age,tumor T staging and tumor N staging,preoperative PLR were correlated with prognosis survival after pancreatic cancer (P＜0.05).Multivariate Cox stepwise regression anal-ysis revealed that advanced T stage lesions (T3-4),advanced N stage metastasis (N1),and PLR≥250.2 preopera-tively were all independent risk factors for prognosis survival after pancreatic cancer (P＜0.05).Conclusion:Preop-erative PLR is closely related to age,tumor T stage,and tumor N stage in patients with pancreatic cancer,and preoper-ative high PLR level is an independent risk factor influencing prognosis survival of pancreatic cancer patients.There-fore,it can be used as one of the effective indicators of prognosis.

Objective To investigate the surgical time and improvement of postoperative indexes for the treatment of upper stomach cancer with laparoscopic total gastrodin D2 radical resection. Methods 96 patients with upper stomach cancer were selected and divided into observation group (n = 47) and control group (n = 49) combined with surgical indications and personal wishes. The patients in the observation group underwent laparoscopic total gastrectomy with D2, while the control group underwent open surgery. The operative time, intraoperative blood loss, lymphatic clearance, first feeding time, first exhaust time, hospitalization time, and complications were compared between the two groups. Results The operating time for the patients in observation group was (229. 53 ± 24. 47) min, significantly longer than (210. 96 ± 22. 85) min in the control group, the intraoperative blood loss in the patients of observation group was (71. 61 ± 18. 90) m L, which significantly lower than (127. 63 ± 24. 07) m L in the control group, the differences was statistically significant (P ＜ 0. 05). The difference of the number of lymph nodes for the patients in two groups compared was no statistical significance (P＞ 0. 05). Compared with the control group, the first meal time, the first exhaust time, hospitalization time in the patients in observation group were significant shorter (P ＜ 0. 05). The rate of complications in the patients in observation group was 6. 39％, the control group was 20. 41％, the complication rate in observation group was much lower than that in the control group (P ＜ 0. 05). Conclusion To use the laparoscopic gastric D2 radical treat the patients with upper stomach cancer based on the basic of strictly grasp the operation indication, although with longer operation time but less blood loss, fewer complications, and postoperative indicators are rapidly improved after surgery, it is worthy to popularize and apply in clinical use.

目的:探讨左结肠动脉保留与腹腔镜直肠癌根治术后远期疗效的关系.方法:收集2010年1月至2013年1月南阳市中心医院普通外科收治的行腹腔镜治疗的78例直肠癌患者的临床资料.其中,40例患者术中保留左结肠动脉,38例不保留.分析对比两组患者远期疗效的差异.结果:两组患者在性别、年龄、ASA评分、大体类型、组织学类型、TNM分期、肠系膜下动脉(IMA)根部淋巴结情况、体质指数、肿瘤距肛缘距离等方面的差异均无统计学意义(P>0.05).两组患者均手术顺利,无术中止血困难或粘连松解困难而中转开腹病例,无术中及围术期院内死亡病例.实验组患者手术时间、出血量、排气时间、住院天数与对照组相比,差异均无统计学意义(P>0.05).在预防性造口方面两组比较差异显著(P<0.05),两组吻合口瘘情况相比,差异无统计学意义(P>0.05).实验组40例患者死亡10例,5年生存率为75.0％(30/40).对照组38例患者死亡11例,5年生存率为71.1％(27/38),Log-rank统计检验显示,两组患者的总体生存率差异无统计学意义(P=0.659).结论:腹腔镜直肠癌根治术中保留左结肠动脉可在改善近端肠管血运和减少吻合口瘘的基础上,取得与肠系膜下动脉根部结扎切断相同的远期疗效,值得临床推广.

目的 分析腹腔镜贲门周围血管离断术联合脾脏切除术治疗门静脉高压症的临床疗效.方法 门静脉高压症病人48例,根据手术方式分为开腹组(开腹贲门周围血管离断术)和腔镜组(腹腔镜贲门周围血管离断术),每组24例,观察比较两组的临床疗效.结果 腹腔镜组术后丙氨酸氨基转氨酶(alanine aminotransferase,ALT)、门冬氨酸氨基转移酶(aspartate aminotrans-ferase,AST)、总胆红素(total bilirubin,TBIL)下降幅度分别为45.00、35.59和25.79,开腹组分别为49.34、43.17和27.88,两组比较差异有统计学意义(P<0.05);腔镜组术后并发症总发生率为16.67％(4例),开腹组为58.33％(16例);腔镜组术后随访1年并发症总发生率为4.17％(1例),开腹组为29.17％(7例),两组比较差异有统计学意义(P<0.05).结论 腹腔镜贲门周围血管离断术治疗门静脉高压症,术后ALT、AST、TBIL恢复更快,术后并发症降低.

目的 研究大鼠肝癌组织中微小RNA-21(microRNA-21)含量与外周血单个核细胞Toll样受体-核转录因子NF-κB(T LRs-NF-κB)信号通路的关系.方法 选取SD大鼠按照数字表法随机分为观察组和对照组,观察组大鼠腹腔注射二乙基亚硝胺(20 mg/kg)建立肝癌模型,对照组大鼠给予相同剂量的生理盐水,每周3次,持续12周,并以健康大鼠作为空白组,每组大鼠均为30只;12周后取大鼠肝癌组织测定癌组织中microRNA-21的含量,并检测外周血单个核细胞TLRs-NF-κB信号及表达水平,探讨microRNA-21表达与TLRs信号通路之间的关系.结果 观察组大鼠microRNA-21表达为(5.32 ± 0.97)mg/L,TLR2、LR4、NF-κB分别为(4.78 ± 1.69)mg/L、(5.45 ± 2.37)mg/L、(4.99 ± 1.73)mg/L,高于对照组和空白组,差异有统计学意义(P<0.05).Pearson相关性分析显示肝癌组织中microRNA-21表达水平与 TLR2、TLR4、NF-κB水平成正相关(P<0.05).结论 肝癌大鼠组织中microRNA-21表达水平与TLRs信号通路密切相关.

Objective? To explore the effects of strengthening out-of-hospital health beliefs on perceived well-being and behavioral change in elderly patients with colon cancer. Methods? Totally 112 elderly patients with colon cancer admitted in Nanyang City Center Hospital from August 2015 to August 2017 were selected by convenient sampling and divided into two groups (n=56) based on the time of admission. Patients in the control group received conventional nursing care, while patients in the observation group received out-of-hospital health beliefs. Both interventions lasted for 6 months. The knowledge needs scale for cancer patients and the Health Promoting Lifestyle Profile-Ⅱ (HPLPⅡ) were used to evaluate the perceived well-being and healthy behaviors in the two groups before and after intervention. Results? The scores of psychological needs, technical needs, medication needs and rehabilitation needs and the total score of the knowledge needs scale for cancer patients in the observation group were higher than those before intervention and those of the control group after intervention. The scores of self-fulfillments, exercise, health responsibility, nutrition, pressure handling and interpersonal support and the total score of HPLP Ⅱ of the observation group were higher than those before intervention and those of the control group after intervention (P＜ 0.05). Conclusions? Strengthening out-of-hospital health beliefs can effectively improve the perceived well-being of elderly patients with colon cancer and enable them to develop healthy behaviors.

Objective To investigate the treatment efficacy of capecitabine combined with TACE for hepatic metastases after colorectal carcinoma resection.Methods The clinical data of 94 patients who were treated for hepatic metastases after colorectal carcinoma resection from June 2012 to December 2014 were retrospectively analyzed.The patients were divided into the combined group (48 patients) who underwent combined treatment of transcatheter arterial chemoembolization (TACE) and capecitabine,and the control group (46 patients) who were treated with TACE alone.The drug toxicities induced by chemotherapy in patients of the two groups were noted.The short-term outcomes and serum tumor markers were compared at 3-months after completion of TACE.All the patients were followed up and their overall survival was recorded.Results There was no significant difference in the frequency of TACE between the two groups (P ＞ 0.05).There were significant differences in the short-term outcomes at 3-month after completion of TACE (Z =2.000,P ＜ 0.05).The RR (complete response + partial response) and CBR (complete response + partial response + stable disease) were higher in the combined group than those in the control group [(52.1％ vs.32.0％) and (95.8％ vs.87.0％),respectively],although the differences were not statistically significant (both P ＞0.05).There were greater declines in CEA and CA19-9 levels at 3-month after completion of TACE in the combined group than the control group [(47.1 ± 10.3 vs.35.1 ±8.4) μg/L,(78.7 ± 19.6 vs.65.3 ± 17.0) kU/L],but the differences were not significant (t1 =5.776,t2 =7.849,both P ＜ 0.05).Toxic reactions were more common in the combined group than those in the control group,which included bone marrow suppression (39.6％ vs.30.4％) and peripheral neuritis (47.9％ vs.34.8％).Again,the differences were not significant (P ＞ 0.05).The median survivals were 17.3 months and 13.5 months,and 1-year survival rates were 72.9％ and 52.1％ in the combined group and the control group,respectively (x2 =4.325,P ＜ 0.05).There were significant differences in the survival between the two groups (x2 =4.097,P ＜ 0.05).Conclusions Capecitabine combined with TACE produced better treatment results for hepatic metastases after colorectal carcinoma resection.The short-term outcomes of the combined treatment was suDerior to TACE alone,and the treatment toxicities could be tolerated.

Objective To investigate the effect of GSN on the apoptosis and the level of ROS in gastric cancer cells.Methods The expression of GSN in gastric cancer cell lines SGC7901,AGS,BGC823 and gastric epithelial cells GES-1 were detected by Western blot.Cells were transfected with GSN siRNA (the GSN siRNA group),siRNA control (the siRNA control group) and transfection vehicle (the vehicle control group),respectively.Cell proliferation was determined by MTT assay.Cell apoptosis was determined by flow cytometry.ROS level was measured by laser scanning confocal microscopy.The levels of GSN,NICD1,NICD2,HES1,and cleaved Caspase-3 were detected by Western blot.Results Expression level of GSN in gastric cancer cell lines including SGC7901,AGS and BGC823 was significantly higher than that in gastric epithelial cells GES-1 (P ＜ 0.05).Given that AGS witnessed the highest expression of GSN,following experiments were performed on it.There was no significant difference in cell proliferation,apoptosis,ROS,GSN,NICD1,NICD2,HES1 or cleaved Caspase-3 level between the siRNA control group and the vehicle control group (P＞ 0.05).Cell proliferation and the levels of GSN,NICD1,NICD2,and HES1 in the GSN siRNA group were dramatically lower than those in the control group (P＜ 0.05),while cell apoptosis and the levels of ROS and cleaved Caspase-3 were notably higher than those in the vehicle control group (P ＜ 0.05).Conclusions GSN decreases proliferation ability while increases apoptosis of gastric cancer cells through manipulation on ROS level and NOTCH signaling pathway.