Objective To investigate the effect of two chemotherapeutic regimens suitable for elderly ad -vanced non-small cell lung cancer(NSCLC).Methods A total of 58 elderly advance nonsmall cell lung cancer pa-tients randomized into two group:single-agent group and combined group .Single-agent group received gemcitabine 1 000mg/m2 at Days 1 and 8 for a 21 day cycle.Combined group received gemcitabine 1 000mg/m2 at Days 1 and 8 in combination earboplatin AUC 5 at Day 2 for a 21 day cycle .All patients in the two groups received 3 cycles of chemotherapeutic regimens.Results Of the single-agent group,complete remission (CR) in 1 cases,partial remis-sion (PR) in 12 cases, the effective rate was 46.4%,and of the combined group,CR in 1 cases,PR in 13 cases,the effective rate was 50.0%,there was no statistically significant difference between the two groups (P>0.05).Of the single-agent group,the median survival time was 9.7 months,1-and 2-year survival rates were 31.3%,12.5%,re-spectively,and of the combined group ,the median survival time was 10.1 months,1-and 2-year survival rates were 33.8%,15.6%,respectively,there were no statistically significant difference between the two groups (χ2 =1.743, 1.529,1.739,all P>0.05).The leutropenia and thrombocytopenia incidence of 3 to 4 grade in the combined group was 50.0%,46.4%,respectively,which were significantly higher than 28.6%and 18.0%in the single-agent group (χ2 =4.41,4.69,all P<0.05).Lung Cancer Symptom Scale scores showed:after the treatment,the anorexia,fatigue and pain scores of the single-agent group improved significantly compared with pre-treatment ( t =2.687,2.789, 2.603,all P<0.05),whereas no significant improvement in the combined group;After the treatment,three symptom scores of the single-agent group were significantly higher than those of the combined group (t=2.986,3.569,2.764, all P<0.05).Conclusion Single-agent gemeitabine regimen efficacy is comparable with that of combined regimen for elderly advanced NSCLC with less adverse effects .

0bjective To explore the effects of narrative nursing on posttraumatic growth for patients with amputation. Methods From December 2016 to March 2018,a total of 62 hospitalized patients with amputation were randomly assigned into the control group and the intervention group by random number table.The control group received routine nursing,the intervention group received narrative nursing on the basis of control group.Two groups were evaluated by Posttraumatic Growth Inventory(PTGI) before and after intervention. Results Before intervention,the scores of reflections on life, personal strengths, new possibilities, relating to others, self-transformation and posttraumatic growth in the the control group were (19.87 ± 5.22), (7.90 ± 2.53), (8.83 ± 3.62), (9.73 ± 3.13), (10.63 ± 3.01), (56.97 ± 17.21) points, respectively. After intervention,the scores were (20.80±5.89), (8.80±2.17), (8.90±3.39), (10.27± 2.75), (11.07 ± 3.12), (59.83 ± 16.91) points, respectively, except new possibilities, the scores of each dimension and total scores of posttraumatic growth in the the control group were higher than before,the differences were statistically significant(t=3.00- 5.34, P＜0.05).Before intervention,the scores of reflections on life, personal strengths, new possibilities, relating to others, self-transformation and posttraumatic growth in the the intervention group were (20.28±4.94), (8.17±2.58), (8.59±3.48), (9.55± 2.90), (11.07±2.83), (57.66±16.42) points, respectively. After intervention, the scores were (23.79±4.70), (10.10±2.17), (10.72±3.34), (11.69±2.22), (12.79±3.28),(69.10±14.92) points, respectively, the scores of each dimension and total scores of posttraumatic growth in the intervention group were statistically higher than those in the control group and before intervention,the differences were statistically significant (t=10.61-16.75, P＜0.05). Conclusion Narrative nursing can effectively improve the level of posttraumatic growth and psychological state for patients with amputation.

Objective:To explore the application of psychological resilience intervention combined with prospective nursing in patients with free skin flap transplantation to repair skin and soft tissue defects of extremities.Methods:Using the convenient sampling method, a total of 65 patients with soft tissue injury in the skin of extremities after undergoing free skin flap transplantation who were admitted to Henan Provincial People's Hospital from October 2019 to October 2020 were selected. According to the admission time, they were divided into the observation group (34 cases) and the control group (31 cases) . Patients in the observation group received psychological resilience intervention combined with prospective nursing, while patients in the control group only received prospective nursing. The surgical success rate, flap necrosis rate, incidence of vascular crisis and complications were compared between the two groups. Symptom Checklist-90 (SCL-90) was used to evaluate treatment effects of patients in two groups before and after the intervention.Results:There was no statistically significant difference in the surgical success rate, flap necrosis rate and incidence of vascular crisis between the observation group (100.00%, 2.94%, 2.94%) and the control group (96.77%, 12.90%, 16.13%) ( P>0.05) . The observation group had 1 case of deep venous thrombosis (DVT) and 2 cases of other complications, and the control group had 3 cases of pressure injury, 1 case of infection, 2 cases of DVT and 3 cases of other complications. The complication rate in the observation group was 8.82%, which was lower than 29.03% in the control group, and the difference was statistically significant ( P<0.05) . After intervention, the scores of anxiety and paranoia in the observation group were lower than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Psychological resilience intervention combined with prospective nursing has a good application effect on patients with free skin flap transplantation to repair skin and soft tissue defects of extremities. The complication rate is reduced, and mental health of patients is good.