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 analyze the objective tongue diagnosis data characteristics of benign and malignant pulmonary nodules and to establish a lung cancer risk warning model based on the logistic regression method.Methods From July 2020 to March 2022,263 lung cancer patients(lung cancer group)from the Oncology Department of Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,292 benign pulmonary nodules patients(benign pulmonary nodules group)from the Physical Examination Center of Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,and 307 healthy individuals(healthy control group)were selected.TFDA-1 digital tongue diagnostic instrument was used to collect tongue images.Objective diagnostic features of the tongue were obtained through feature extraction technology.The distribution characteristics of the tongue indicators of the three groups of subjects were analyzed.A lung cancer warning model was established based on logistic regression method after feature screening,and the performance of the model was evaluated using sensitivity,specificity,accuracy,and AUC.Results The tongue features of patients in benign pulmonary nodules group were similar to those of the healthy control group,while the tongue features of the lung cancer group differed greatly from those of the healthy control group and benign pulmonary nodules group.The tongue features of lung cancer patients were dark and opaque,the tongue body was reddish,and the tongue coating is thin and yellowish with a greasy texture.The accuracy,sensitivity,specificity and AUC of the lung cancer warning model based on tongue image data were 70.09%,69.94%,70.29%and 0.769,respectively.After adding baseline information to the tongue image data set,the models'performance was improved.The accuracy,sensitivity,specificity and AUC of the new model based on tongue and baseline were 77.30%,75.94%,79.15%and 0.812,respectively.Conclusion The statistical characteristics of objective tongue image data between benign pulmonary nodules and lung cancer patients show significant differences.The lung cancer classification model based on objective tongue data performs well,and the objective tongue diagnosis data in TCM can provide reference for the differential diagnosis of benign pulmonary nodules and 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 evaluate the effect of traditional Chinese medicine ( TCM) treatment as maintenance therapy on regulating the serum concentration of soluble cytotoxic T lymphocyte associated antigen?4 ( sCTLA?4) in patients with advanced non?small?cell lung cancer ( NSCLC) and the relationship between sCTLA?4 and time to progression ( TTP ) . Methods This study was conducted as a prospective, randomized, controlled trial. 64 non?progressive patients who responded to initial therapy were randomized 1 ∶ 1 to the TCM arm ( treated with cinobufacini injection, herbal decoction and Chinese acupoint application, n=32) or to the chemotherapy arm (n=32). Each cycle was 21 days. Cycles were repeated until disease progression, unacceptable toxicity, or until the patient requested therapy discontinuation. The serum concentration of sCTLA?4 was detected by enzyme linked immunosorbent assay ( ELISA ) in the 64 patients with advanced NSCLC before and after two cycles of maintenance treatment. Cox regression was used to analyze the relative ratio for the risk of disease progression. Results After 2 cycles of maintenance TCM treatment, the serum concentration of sCTLA?4 in patients with advanced NSCLC was (12.77±2.37 pg/ml), significantly lower than that before treatment (40.30±10.75)(P=0.013). After 2 cycles of maintenance chemotherapy, the serum concentration of sCTLA?4 was higher than that before treatment, but was not significantly different (44.48±10.12 vs. 46.64±11.21 pg/ml, P=0.612). After 2 cycles of maintenance treatment, TCM treatment can significantly bring down the serum concentration of sCTLA?4 compared to chemotherapy (12.77±2.37 vs. 46.64±11.21 pg/ml, P=0.004). The multivariate analysis indicated that sCTLA?4 levels and treatment regimen were independent prognostic factors for TTP ( P<0. 05 for both ) . Conclusions Regulating the serum concentration of sCTLA?4 may be one of the mechanisms of TCM maintenance treatment of NSCLC. Trial registration Chinese Clinical Trial Register, ChiCTR?TRC?10001017.

Objective To evaluate the effect of traditional Chinese medicine ( TCM) treatment as maintenance therapy on regulating the serum concentration of soluble cytotoxic T lymphocyte associated antigen?4 ( sCTLA?4) in patients with advanced non?small?cell lung cancer ( NSCLC) and the relationship between sCTLA?4 and time to progression ( TTP ) . Methods This study was conducted as a prospective, randomized, controlled trial. 64 non?progressive patients who responded to initial therapy were randomized 1 ∶ 1 to the TCM arm ( treated with cinobufacini injection, herbal decoction and Chinese acupoint application, n=32) or to the chemotherapy arm (n=32). Each cycle was 21 days. Cycles were repeated until disease progression, unacceptable toxicity, or until the patient requested therapy discontinuation. The serum concentration of sCTLA?4 was detected by enzyme linked immunosorbent assay ( ELISA ) in the 64 patients with advanced NSCLC before and after two cycles of maintenance treatment. Cox regression was used to analyze the relative ratio for the risk of disease progression. Results After 2 cycles of maintenance TCM treatment, the serum concentration of sCTLA?4 in patients with advanced NSCLC was (12.77±2.37 pg/ml), significantly lower than that before treatment (40.30±10.75)(P=0.013). After 2 cycles of maintenance chemotherapy, the serum concentration of sCTLA?4 was higher than that before treatment, but was not significantly different (44.48±10.12 vs. 46.64±11.21 pg/ml, P=0.612). After 2 cycles of maintenance treatment, TCM treatment can significantly bring down the serum concentration of sCTLA?4 compared to chemotherapy (12.77±2.37 vs. 46.64±11.21 pg/ml, P=0.004). The multivariate analysis indicated that sCTLA?4 levels and treatment regimen were independent prognostic factors for TTP ( P<0. 05 for both ) . Conclusions Regulating the serum concentration of sCTLA?4 may be one of the mechanisms of TCM maintenance treatment of NSCLC. Trial registration Chinese Clinical Trial Register, ChiCTR?TRC?10001017.

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。