Objective To analyze the application effect of personalized psychological nursing in the perioperative period of patients with lung cancer. Methods The research subjects were 88 patients with lung cancer who underwent surgical treatment in our hospital from October 2020 to October 2021. They were divided into an experimental group and a control group by random number method, with 44 cases in each group. The experimental group was given individualized psychological care, and the control group was given routine care. The two groups were compared in terms of self-rating anxiety scale (SAS) score, self-rating depression scale (SDS) score, postoperative recovery, incidence of complications and nursing satisfaction. The t test was used for normal measurement data, and the x2 test was used for count data. Results Before nursing, there was no significant difference in SAS and SDS scores between the two groups (P＞0.05); after nursing, the SAS and SDS scores in the experimental group were significantly lower than those in the control group (P＜0.05). The drainage time, exhaust time, out-of-bed activity time and hospital stay in the experimental group were significantly shorter than those in the control group (P＜0.05). The incidence of complications in the experimental group was significantly lower than that in the control group (P＜0.05). The nursing satisfaction of the experimental group was significantly higher than that of the control group (P＜0.05). Conclusion Perioperative personalized psychological nursing for lung cancer patients has outstanding effect, can effectively improve the negative emotions of patients, play a role in promoting postoperative recovery, help to establish a good nurse-patient relationship, and reduce the incidence of complications.

目的:评估安罗替尼对非小细胞肺癌(NSCLC)三线及三线以后治疗的有效性及安全性.方法:采用meta分析对随机对照试验进行系统评价.结果:疾病控制率(OR=0.14,95％CI 0.11～0.17,P<0.00001),客观缓解率(OR=0.08,95％CI 0.03～0.21,P<0.00001),总生存期(OR=0.71,95％Cl 0.55～0.89,P<0.00001),无进展生存期(OR=0.26,95％Cl 0.22～0.30,P<0.00001).不良反应,如高血压(OR=11.95,95％CI 8.44～16.92,P<0.00001),高血压超过3级(OR=21.92,95％CI 6.09～78.97,P<0.00001),疲劳(OR=2.32,95％CI 1.5～3.58,P=0.0001),呕吐(OR=1.64,95％CI 1.09～2.45,P=0.02),腹泻(OR=3.12,95％CI 2.16～4.51,P<0.00001).结论:在非小细胞肺癌第三和第三阶段后用安罗替尼治疗可显著提高疗效,但也明显提高高血压等不良反应的发生.

目的 探讨动态评估压力性损伤结合精细化护理在食管癌患者术后压力性损伤防治中的应用效果.方法 选取2019年8月至2020年8月于江南大学附属医院行食管癌手术的102例患者展开研究,遵循计算机分组法将其分为观察组(51例)与对照组(51例).对照组患者术后采用常规护理,观察组患者术后采用动态评估压力性损伤结合精细化护理干预,对比不同方式干预后2组患者的压力性损伤发生率、营养状况、护理满意度及并发症发生情况.结果 观察组的压力性损伤发生率明显低于对照组(P<0.05).观察组的胃排空障碍、心律失常等并发症总发生率为3.92％,明显低于对照组的17.65％(P<0.05).干预7 d后,2组的转铁蛋白、前白蛋白、视黄醇结合蛋白均高于同组干预前,且观察组的营养指标均明显高于对照组,差异均有统计学意义(P均<0.05).观察组的护理满意度总分明显高于对照组(P<0.05).结论 将动态评估压力性损伤与精细化护理联合应用于食管癌患者的术后护理干预中,可明显减少压力性损伤及并发症发生情况,改善其营养状况,并提升其护理满意度.

目的 探讨益气温阳方联合化疗对晚期(ⅢⅣ期)结直肠癌患者外周血Treg细胞比率的影响及益气温阳方的抗癌机制.方法 方便收集2017年01月—2018年06月收治的56例晚期结直肠癌患者,分为研究组及照组.对照组患者进行化疗,研究组患者在化疗基础上口服益气温阳方,两组患者均以21 d为一周期.利用流式细胞技术检测治疗前及治疗2周期后外周血CD4+CD25+CD127low/-Treg细胞表达水平.结果 对照组治疗后的外周血CD4+CD25+CD127low/-Treg细胞比率较治疗前下降不明显[(5.51±0.87)％vs(5.03±1.21％],治疗前后差异无统计学意义(t=1.76,P>0.05),研究组治疗后的外周血CD4+CD25+CD127low/-Treg细胞比率较治疗前下降明显[(5.59±1.45)％vs(4.28±1.23)％],差异有统计学意义(t=3.51,P<0.01),且研究组治疗后CD4+CD25+CD127low/-Treg细胞比率明显低于对照组[(4.28±1.23)vs(5.03±1.21)],两组治疗后的组间比较,差异有统计学意义(t=2.29,P=0.02).另研究组Treg细胞的抑制率明显高于对照组[(0.22±0.17)vs(0.09±0.13)],差异有统计学意义(t=3.18,P<0.01).结论 益气温阳方联合化疗能明显降低ⅢⅣ期结直肠癌患者外周血Treg细胞比率.通过降低Treg细胞水平,调节肿瘤免疫逃逸微环境来抑制肿瘤生长转移可能是益气温阳方扶正以抗癌的机制之一.

目的:通过对Lewis肺癌原位移植小鼠肿瘤组织长链非编码RNA (long noncoding RNA,lncRNA)和mRNA表达谱的检测,探讨麦门冬汤合千金苇茎汤(金方)抗肺癌的作用机制.方法:C57BL/6小鼠随机分为正常组、模型组、金方组(20 g·kg-1 ·d-1),构建小鼠Lewis原位肺癌模型成功后,次日用金方灌胃开始治疗.应用基因芯片技术,检测与金方抗肺癌作用密切相关的差异lncRNA,mRNA,进行聚类分析,并利用t检验和差异表达的倍数变化,筛选出关键lncRNA,mRNA.运用生物信息学方法预测差异lncRNA调控的靶基因,并对其进行功能和通路分析.应用病理组织学技术,检测各组小鼠肿瘤组织光镜下的差异表现.结果:lncRNA,mRNA芯片杂交结果显示,金方调控了887个lncRNA差异表达,其中上调442个,下调445个(P＜0.05).差异表达的mRNA共610个,其中上调376个,下调234个(P＜0.05).使用GO分析方法,发现下调或上调的靶基因主要参与了细胞代谢调控、信号通路调控等生物学过程(biological process,BP).靶基因分子功能(molecularfunction,MF)分析显示,下调或上调的靶基因主要具有DNA结合、蛋白质结合、受体结合和转录因子活性等功能.信号通路预测显示金方可调控Janus激酶/信号转导与转录激活因子(JAK/STAT)等与肺癌的发生发展密切相关的信号通路.病理组织学检查结果证实,与模型组比较,金方能明显改善小鼠肺组织的病理改变.结论:金方可能通过调控多种lncRNA和mRNA的表达及下游相关信号通路来发挥其抗肺癌的作用.

Objective:To analyze the clinical effect of Modified Shengmai Yin combination with chemotherapy treatment of elderly ad-vanced non-small cell lung cancer. Methods:136 cases of patients with elderly advanced non-small cell lung cancer were randomly di-vided into the experimental group and the control group. The control group received gemcitabine combined with cisplain,while the ex-perimental group based on the control group,received extra modified Shengmai Yin. The peripheral T cell subsets and cytokine levels of two groups were compared before and after treatment. The incidence of adverse reactions were compared during treatment. The clinical efficacy of two groups were compared 3 months after treatment. Results:CD3 + in both groups 3 months after treatment were significantly higher than before. CD3 + CD8 + ,NK,NKT and Treg levels in the experimental group 3 months after treatment were significantly higher than those before treatment,and CD3 + CD4 + was significantly lower than those before treatment. CD3 + CD4 + ,CD3 + CD8 + ,NK,NKT and Treg were significantly lower in the control group 3 months after treatment than those before treatment and the experimental group (P < 0. 01). IFN-γ,TNF-α,IL-2 levels in the experimental group were significantly increased 3 months after treatment;IFN-γ,TNF-α, IL-2 levels were significantly lower in the control group were significantly decreased 3 months after treatment,and the difference was sta-tistically significant(P < 0. 01). The effective rate of experimental group was 48. 53% and 38. 23% in the control group,and there was no significant difference. during Treatment,overall incidence of adverse reactions in the experimental group was 47. 06% ,less than 72. 05% of the control group,and the difference was statistically significant(P < 0. 01). Conclusion:Modified Shengmai Yin combined with chemotherapy in the treatment of advanced non-small cell lung cancer can not only improve the patients' level of immunity,but also reduce the incidence of adverse reactions.

目的：观察附子理中汤加减联合化疗治疗晚期脾胃虚寒型胃癌的临床疗效。方法：选取晚期脾胃虚寒型胃癌患者共106例，采取随机数字表法，对照组采用EC F方案进行化疗，治疗组在对照组基础上，加用附子理中汤加减（炮附子、干姜、党参、白术等），治疗2个化疗周期后，对比两组患者治疗前后的外周血 T 细胞水平、不良反应发生率、生存质量和临床疗效。结果：两组患者治疗2周期后的C T L、CD4＋和CD4＋ CD8＋均较治疗前显著上升，且治疗组治疗2周期后的CTL、CD4＋和CD4＋ ／CD8＋ TCM细胞水平均显著高于对照组。两组患者治疗2周期后的身体功能、情绪功能和社会功能评分均较治疗前显著提高；治疗组治疗2周期后的身体功能、情绪功能和社会功能评分均显著高于对照组。治疗组治疗2周期后的总有效率和对照组无显著差异。治疗组治疗期间总不良反应率显著低于对照组。结论：本法可提高晚期脾胃虚寒型胃癌患者的免疫功能，降低其不良反应发生率，改善患者的生活质量。

原发性肝癌是我国最常见的恶性肿瘤之一,死亡率居高不下.故预防和阻断肝细胞癌变的发生,显得尤为重要.近年来,对肝癌癌前病变的研究显示西医仍缺乏理想的阻断或逆转这种病变的手段,而中医药的治疗作用日益受到重视,以致成为目前肝癌防治学研究的重点.笔者就近几年的有关文献,综述如下: