Objective: To observe the effect of strengthening qi and nourishing yin recipe (SQNY recipe) on the expressions of estrogen receptor ? (ER?) and CyclinD1 of Lewis lung cancer in C57BL/6 mice with immunohistochemistry, and discuss the mechanism of its anti-proliferation and anti-metastasis effects, and analyse the correlation between ER? and CyclinD1. Methods: Twenty-four C57BL/6 mice were randomly divided into three groups. They were all transplanted with Lewis lung cancer cells, and received the interventions the next day as follows: tumor-bearing control group was fed with 0.9% NaCl, and TCM group was treated with SQNY recipe, and DDP group was given intraperitoneal DDP injection. All of mice were killed on the 20th day, weighed the tumor and counted lung metastases to calculate the inhibition rates of tumor growth and metastasis. The expressions of ER?, CyclinD1 in tumor tissues were detected by immunohistochemistry. Results: The inhibition rates of tumor growth and metastasis were 35.02% and 54.20% in TCM group, and were 41.18% and 39.02% in DDP group, respectively (all P

Objective To analyze the differences in the correlation of tongue image indicators among patients with benign lung nodules and lung cancer. Methods From July 1,2020 to March 31,2022,clinical information of lung cancer patients and benign lung nodules patients was collected at the Oncology Department of Longhua Hos-pital Affiliated to Shanghai University of Traditional Chinese Medicine and the Physical Ex-amination Center of Shuguang Hospital Affiliated to Shanghai University of Traditional Chi-nese Medicine,respectively.We obtained tongue images from patients with benign lung nod-ules and lung cancer using the TFDA-1 digital tongue diagnosis instrument,and analyzed these images with the TDAS V2.0 software.The extracted indicators included color space pa-rameters in the Lab system for both the tongue body(TB)and tongue coating(TC)(TB/TC-L,TB/TC-a,and TB/TC-b),textural parameters[TB/TC-contrast(CON),TB/TC-angular second moment(ASM),TB/TC-entropy(ENT),and TB/TC-MEAN],as well as TC parameters(perAll and perPart).The bivariate correlation of TB and TC features was analyzed using Pearson's or Spearman's correlation analysis,and the overall correlation was analyzed using canonical correlation analysis(CCA). Results Samples from 307 patients with benign lung nodules and 276 lung cancer patients were included after excluding outliers and extreme values.Simple correlation analysis indi-cated that the correlation of TB-L with TC-L,TB-b with TC-b,and TB-b with perAll in lung cancer group was higher than that in benign nodules group.Moreover,the correlation of TB-a with TC-a,TB-a with perAll,and the texture parameters of the TB(TB-CON,TB-ASM,TB-ENT,and TB-MEAN)with the texture parameters of the TC(TC-CON,TC-ASM,TC-ENT,and TC-MEAN)in benign nodules group was higher than lung cancer group.CCA further demon-strated a strong correlation between the TB and TC parameters in lung cancer group,with the first and second pairs of typical variables in benign nodules and lung cancer groups indicat-ing correlation coefficients of 0.918 and 0.817(P<0.05),and 0.940 and 0.822(P<0.05),re-spectively. Conclusion Benign lung nodules and lung cancer patients exhibited differences in correla-tion in the L,a,and b values of the TB and TC,as well as the perAll value of the TC,and the texture parameters(TB/TC-CON,TB/TC-ASM,TB/TC-ENT,and TB/TC-MEAN)between the TB and TC.Additionally,there were differences in the overall correlation of the TB and TC be-tween the two groups.Objective tongue diagnosis indicators can effectively assist in the diag-nosis of benign lung nodules and lung cancer,thereby providing a scientific basis for the ear-ly detection,diagnosis,and treatment of lung cancer.

Objective To investigate the factors influencing the disease-free survival (DFS) and prognosis of patients with non small cell lung cancer after Ⅲa stage resection, and to evaluate the effect of traditional Chinese medicine intervention.Methods A total of 148 cases met the inclusion criteria were enrolled in the study. The DFS, 1-, 2- and 3-year disease-free survival rates were analyzed. Univariate and multivariate survival analysis were used to investigate the prognostic factors.Results In the analysis of 148 cases, the DFS was 17.49 months, 1 years, 2 years, 3 years disease-free survival rates were 62％, 40％, 29％. Single factor analysis showed that the duration of DFS was 21.03 months, and the difference was statistically significant (P<0.001) for 8.26 months without the intervention of Chinese medicine (TCM). Open chest surgery, syndrome differentiation, oral medicine, oral medicine dialectical decoction continuous time, vein used traditional Chinese medicine preparation course, traditional Chinese medicine to the route of administration, multidisciplinary intervention methods for prognosis related factors(P<0.05). Multivariate analysis showed that vein used traditional Chinese medicine preparation course (≥4 courses) and traditional Chinese medicine intervention (≥six months time), syndrome differentiation, oral administration of traditional Chinese medicine combined with intravenous preparations continued administration were the non-independent protective factors for disease-free survival and prognosis (P<0.05). Postoperative application of intravenous formulation more than or equal to four courses showed 57.1％ risks of recurrence and metastasis than the those fewer than 4 courses. After operation is Postoperative continued intervention of traditional Chinese medicine more than or equal to 6 months showed 50.4％ risks of recurrence and metastasis than the those fewer than 6 months. Postoperative adminstration of intravenous and oral traditional Chinese medicine showed 27.7％ risks of recurrence and metastasis than the those fewer than only TCM syndromes differentiation of traditional Chinese medicine.Conclusions The combination of syndrome differentiation with oral and intravenous application of traditional Chinese medicine helps to delay the recurrence and metastasis of postoperative stage Ⅲa NSCLC.

Narrative medicine,as an emerging discipline,has rapidly developed in the context of the current era of emphasis on medical humanities.The parallel chart is an essential tool for implementing humanistic practice in narrative medicine,while medical records and medical conversations are the carriers of traditional Chinese medicine(TCM)academic viewpoints and humanistic thoughts.Although there are differences in the textual content between them,the concept of"people-oriented"in TCM aligns with the spirit of narrative medicine.Medical records teaching is an important link for cultivating TCM clinical thinking and medical humanistic thought.Therefore,examining TCM medical records and humanistic education from the perspective of narrative medicine,sorting out the connections and differences between TCM medical records and parallel charts,and emphasizing the educational and guiding value of narrative medicine in the modern TCM diagnosis and treatment process,are of great significance for establishing and promoting TCM-featured parallel charts,thereby guiding the education and teaching of TCM,and cultivating new-era TCM talents with empathy and reflective capabilities.

As a malignancy with the highest morbidity and mortality in the world， lung cancer poses a huge threat to the health and life safety of all human beings. Most lung cancer patients are already in the advanced stage when they are diagnosed， and the treatment of advanced lung cancer often brings heavy mental pressure and economic burden to patients but has little effect. Therefore， the early diagnosis and treatment of lung cancer has become a major problem for medical researchers. At present， chemotherapy， immunotherapy， targeted therapy， and other treatment methods still have problems such as intolerance of patients and drug resistance， so there is an urgent need for human beings to seek new methods to treat lung cancer. Currently， the relationship between gut microbiota and disease occurrence， development， and prognosis， and the treatment of diseases by regulating gut microbiota have become a hot field of medical research. There are significant differences in gut microbiota between lung cancer patients and healthy people. Intestinal microorganisms can act on the respiratory system through the gut-lung axis， thereby affecting the occurrence， development， and prognosis of lung cancer and other respiratory diseases. As a peculiar means of treatment in China， Chinese medicine can effectively delay tumor progression， prevent postoperative recurrence and metastasis， reduce complications in the course of treatment， improve the quality of life， and prolong the survival of patients. Therefore， Chinese medicine is widely involved in the treatment of malignancies. Some Chinese medicine monomers， compounds， and active components have been found to regulate the gut microbiota. They can regulate the metabolism of the body， control the inflammatory response， build an immune barrier， or play a synergistic effect with various lung cancer treatments by affecting gut microbiota， so as to achieve the anti-tumor purpose. This article systematically reviewed the research on Chinese medicine and effective components in regulating gut microbiota， creating tumor-suppressing microenvironment， and intervening in the treatment of lung cancer， in order to provide new research ideas for the treatment of lung cancer.

Objective:To investigate the clinical effect on ultrasound-guided vascular access-interventional therapy of hemodialysis in day surgery mode.Methods:Hemodialysis patients with vascular access dysfunction who underwent ultrasound-guided interventional therapy in the First Affiliated Hospital of Xi'an Jiaotong University from September 1, 2018 to October 31, 2020 were retrospectively analyzed. Demographic and clinical data were collected by electronic medical record system and telephone follow-up. Kaplan-Meier method was used to analyze the patency rate of vascular access.Results:A total of 421 cases of ultrasound-guided vascular access intervention were performed in 269 patients. The technical success rates of stenosis, chronic occlusion and acute occlusion lesion were 98.8%, 90.6% and 86.4%, respectively, and 406 cases (96.4%) of 246 patients were clinically successful. The postoperative brachial artery blood flow was 821(627, 1 029) ml/min, which was significantly higher than 309(202, 453) ml/min before the operation ( Z=-13.547, P<0.001). No serious complications occurred during and after the operation. At 6, 12, 18 and 24 months after operation, the primary patency rate was 74%, 59%, 48% and 45%, respectively, the assisted primary patency rate was 94%, 91%, 88% and 82%, and the secondary patency rate was 96%, 93%, 91% and 86%. Compared with the conventional inpatient surgery mode, the total cost of the day surgery mode was significantly reduced [12 067(10 051, 13 198) yuan vs 14 986(12 411, 20 643) yuan, Z=-13.185, P<0.001], and the hospital stay was significantly shortened [5.1(3.5, 6.9) h vs 73.4(31.6, 146.6) h, Z=-13.348, P<0.001]. Conclusion:It is safe and effective to perform interventional therapy for vascular access malfunction under ultrasound in day surgery mode, which can save cost and time of hospitalization, and can be carried out in hospitals with relevant conditions.

[摘 要] 目的：观察扶正方药对晚期三线非小细胞肺癌（NSCLC）患者外周血中12种可溶性免疫检查点分子水平的影响，并分析可溶性免疫检查点基线水平与NSCLC患者无进展生存期（PFS）的关系。方法：纳入2020年10月至2023年4月在龙华医院肿瘤科接受三线治疗（扶正方药联合标准西医方案治疗）的72例晚期NSCLC患者，采用LEGENDplex™多因子试剂盒检测患者治疗前及治疗4疗程后可溶性免疫检查点分子的表达水平，分析基线水平与PFS预后的相关性。结果：治疗4个疗程后，sCD137、sTGF-β1、sPD-L1、sPD-L2等指标均明显下降（P<0.05或P<0.01），Kaplan-Meier生存分析表明sPD-L2高水平患者的PFS短于sPD-L2低水平患者的PFS（P<0.05），COX多因素分析表明sPD-L2水平是晚期三线NSCLC患者PFS的独立影响因子（P<0.05）。结论：扶正方药对外周血可溶性免疫检查点蛋白表达具有一定的调节作用，高水平的sPD-L2预示晚期NSCLC患者较短的PFS，sPD-L2可能是晚期三线治疗NSCLC患者PFS的独立影响因子。

ObjectiveTo observe the prognosis effect of soluble programmed death ligand-1（sPD-L1） in treating patients with advanced lung adenocarcinoma treated with epidermal growth factor receptor-tyrosine kinase inhibitors（EGFR-TKIs） and the influence of Yiqi Yangyin Jiedu prescription. MethodA prospective cohort-controlled study was conducted to enroll patients treated with EGFR-TKIs in the first line of treatment，who were admitted to the Oncology Department of Longhua Hospital and Shanghai Chest Hospital from May 1^st， 2021 to June 30^th， 2023， and they were evaluated as non-progressive and identified with deficiency of Qi and Yin after one month of treatment. The patients were divided into an exposed group （EGFR-TKIs combined with Yiqi Yangyin Jiedu prescription） and a non-exposed group （EGFR-TKIs alone）according to whether or not they were treated with Yiqi Yangyin Jiedu prescription and were treated until disease progression， or death and intolerable adverse reactions occurred. The enzyme-linked immunosorbent assay （ELISA） was applied to detect the level of sPD-L1 in patients at the time of enrollment and disease progression，and Cox risk proportionality model was used to analyze the independent prognostic factors affecting disease progression of patients treated with EGFR-TKIs. ResultA total of 90 patients （39 in the exposed group and 51 in the non-exposed group） undergoing disease progression after EGFR-TKI treatment were enrolled. At the time of enrolment and after disease progression，the levels of serum sPD-L1 in the 90 patients were 12.06 （27.54） ng·L^-1 and 41.99 （62.93） ng·L^-1，respectively. Compared with that at the time of enrollment， the serum sPD-L1 level in the 90 patients was significantly increased after disease progression （P<0.01）. The serum sPD-L1 level in patients in the exposed group was 12.27 （24.78） ng·L^-1 and 29.57 （61.12）ng·L^-1 respectively at the time of enrolment and after disease progression. In the non-exposed group， patients had serum sPD-L1 levels of 11.81 （28.46） ng·L^-1 and 49.54 （74.12） ng·L^-1 respectively at the time of enrolment and after disease progression. Compared with that at the time of enrollment， the serum sPD-L1 level in the two groups of patients was significantly increased after disease progression （P<0.01）. In addition， compared with that in the non-exposed group， the sPD-L1 level in the exposed group was greatly reduced after disease progression（P<0.01）. Cox multifactorial analysis showed that sPD-L1 level and age at the time of enrolment were associated with patients' progression-free survival（PFS），and that low levels of sPD-L1 （<12.06 ng·L^-1） prolonged the PFS and reduced the risk of disease progression in patients treated with EGFR-TKIs compared with high levels of sPD-L1. ConclusionElevated sPD-L1 level is a poor prognostic factor for the long-term efficacy of EGFR-TKIs，and treatment with Yiqi Yangiin Jiedu prescription can down-regulate sPD-L1 level of patients treated with EGFR-TKIs.

Lung cancer tops the disease list in the world due to the high incidence and mortality， and about 85% of lung cancer cases is non-small cell lung cancer （NSCLC）. Most NSCLC patients are in the advanced stage at the time of diagnosis， with a low 5-year survival. Traditional Chinese medicine （TCM） plays a role in the comprehensive treatment of malignant tumors. Oral Chinese patent medicines， as an important part of TCM， have the advantages of stable preparations， mild taste， simple package， and accurate effective ingredients， which are different from decoctions. They have been widely used in the adjuvant treatment of NSCLC. In clinical practice， the combination of oral Chinese patent medicines with chemotherapy， targeted therapy， or radiotherapy， as well as the application of the oral Chinese patent medicines alone， can increase efficiency， reduce toxicity， prolong the survival time of patients， and improve the quality of life. The mechanisms of oral Chinese patent medicines in the treatment of NSCLC mainly include inhibiting the proliferation， invasion， and metastasis of lung cancer cells， promoting the apoptosis of lung cancer cells， inhibiting tumor neovascularization， reversing multidrug resistance， and regulating the immune functions， which reflects the multi-pathway and multi-target manner of TCM. The oral Chinese patent medicines commonly used in the clinical treatment of NSCLC include Jinfukang oral liquid， Shenyi capsules， Pingxiao capsules， Xiao'aiping tablets， Kanglaite capsules， compound Cantharis capsules， Huisheng oral liquid， Yangzheng Xiaoji capsules， Xihuang pills， Zilongjin tablets， and Cinobufagin capsules. There are many clinical and basic studies about the treatment of NSCLC with these medicines， while a systematic review remains to be carried out. Therefore， we systematically reviewed the mechanisms and clinical application of commonly used oral Chinese patent medicines in the adjuvant treatment of NSCLC， aiming to provide reference for follow-up research and clinical treatment.

ObjectiveTo investigate the mechanism of modified Si Junzitang and Shashen Maidong Tang ［Yiqi Yangyin Jiedu prescription （YQYYJD）］ in enhancing the sensitivity of cisplatin in epidermal growth factor receptor tyrosine kinase inhibitor （EGFR-TKI）-resistant lung adenocarcinoma cells based on aerobic glycolysis. MethodsThe effects of different concentrations of YQYYJD （0， 2， 3， 4， 5， 6， 7， 8 g·L^-1） and cisplatin （0， 3， 6， 9， 12， 15， 18， 21， 24， 27 mg·L^-1） on the proliferation and activity of PC9/GR cells were detected by the cell counting kit-8 （CCK-8） assay after 24 hours of intervention. The half-maximal inhibitory concentration （IC₅₀） for PC9/GR cells was calculated to determine the concentrations used in subsequent experiments. PC9/GR cells were divided into blank group （complete medium）， YQYYJD group （5 g·L^-1）， cisplatin group （12 mg·L^-1）， and combined group （YQYYJD 5 g·L^-1 + cisplatin 12 mg·L^-1）. After 24 hours of intervention， cell viability was measured using CCK-8 assay. Cell proliferation was assessed by colony formation assay， and cell migration was evaluated by scratch and Transwell assays. Glucose consumption， lactate production， and adenosine triphosphate （ATP） levels were measured by colorimetric assays. The expression levels of glycolysis-related proteins， including hexokinase 2 （HK2）， phosphofructokinase P （PFKP）， pyruvate kinase M2 （PKM2）， lactate dehydrogenase A （LDHA）， glucose transporter 1 （GLUT1）， and monocarboxylate transporter 4 （MCT4）， were determined by Western blot. ResultsBoth YQYYJD and cisplatin inhibited the viability of PC9/GR cells in a concentration-dependent manner. The IC₅₀ of PC9/GR cells for YQYYJD and cisplatin were 5.15 g·L^-1 and 12.91 mg·L^-1， respectively. In terms of cell proliferation， compared with the blank group， the cell survival rate and the number of colonies formed in the YQYYJD group， cisplatin group， and combined group were significantly decreased （P<0.01）. Compared with the YQYYJD and cisplatin groups， the combined group showed a further significant reduction in cell survival rate and colony formation （P<0.01）. In terms of cell migration， compared with the blank group， the cell migration rate and the number of cells passing through the Transwell membrane in the YQYYJD group， cisplatin group， and combined group were significantly decreased （P<0.01）. Compared with the YQYYJD and cisplatin groups， the combined group exhibited a further significant reduction in cell migration rate and the number of cells passing through the Transwell membrane （P<0.01）. In terms of glycolysis， compared with the blank group， glucose consumption， lactate production， and ATP levels in the YQYYJD group， cisplatin group， and combined group were significantly decreased （P<0.01）. Compared with the YQYYJD and cisplatin groups， the combined group showed a further significant reduction in glucose consumption， lactate production， and ATP levels （P<0.05）. Compared with the blank group， the protein expression levels of HK2， PFKP， PKM2， and LDHA in the YQYYJD， cisplatin， and combined groups were significantly decreased （P<0.01）. The combined group showed a further significant reduction in the expression levels of these proteins compared with the YQYYJD and cisplatin groups （P<0.01）. No significant differences were observed in the protein expression levels of GLUT1 and MCT4 among the groups. ConclusionYQYYJD can synergistically inhibit the proliferation and migration of PC9/GR cells and enhance their sensitivity to cisplatin. The mechanism may be related to the downregulation of the expression of glycolysis-related rate-limiting enzymes， including HK2， PFKP， PKM2， and LDHA， thereby inhibiting glycolysis.