Objective To explore the clinical efficacy of paclitaxel(taxol,TAX)and capecitabine scheme(capecitabine,CAPE)in treatment ofⅣperiod lung adenocarcinoma.Methods 90 patients with Ⅳ period lung adenocarcinoma from March 2011 to August 2013 were collected and randomly divided into two groups,control group(n =45 )were given CAPE treatment and experimental group (n =45 )were given CAPE +TAX combination therapy.After treatment,the clinical efficacy and side effects in two groups were observed and compared. Results Evaluation of recent efficacy:the efficacy(response rate,RR)of experimental group was 46.67%,the disease control rates(DCR)was 77.78%,while RR of control group was 48.89%and DCR was 73.33%,there was no statistical significance between two groups.Evaluation of long-term efficacy:progression-free survival (PFS )in experimental group was(6.18 ±3.12)months,while in control group was(3.09 ±2.29)months,the difference was statistically significant(P<0.05). Overall survival(OS)in experimental group was(9.19 ±2.04)months,while in control group was(8.63 ±3.93)months,there was no statistical significance between two groups.Evaluation of adverse reaction:in terms of hematology change,white blood cell count(WBC),neutrophil counts(NE)in experimental group were decreased significantly than control group,the difference were statistically significant(P<0.05 ),but not the PLT.In terms of the hematology change,alopecia in experimental group was more than in control group,the difference was statistically significant(P<0.05 ),but there were no changes in nausea and vomiting,the brotherhood of syndrome,liver damage,oral cavity mucous membrane inflammation.Conclusion CAPE and TAX has good clinical efficacy in treatment of stage Ⅳ lung adenocarcinoma.It can increase the progression-free surial,and side effects is in hematology change.

Objective To observe the clinical effects of Shenqifuzheng injections combined with PTX and DDP on advanced non small cell lung cancers. Methods Fifty cases of advanced non small cell lung cancers were randomly divided into pure chemotherapy and chemotherapy combined with traditional Chinese medicine groups. The former was treated with 30 mg/m2 DDP from day 1 to day 3, 135 mg/m2 PTX only at the first day. The latter was treated with 250 ml Shenqifuzheng injections every day until the twentieth-first one, three days before the beginning of chemotherapy. After two periods of treatments, the therapeutic effects were evaluated, respectively. Results The recent effective ratios of chemotherapy combined with traditional Chinese medicine and pure chemotherapy groups were 48 % and 40 %, respectively. The former could ameliorate the physical status, the numbers of peripheral leucocytes, the decreases of blood platelet, the gastrointestinal reactions of subjects. Conclusion The Shenqifuzheng injections could increase the recent treatment effect of PTX combined with DDP on advanced non small cell lung cancers, effectively meliorate the clinical symptoms and alleviate the side effects of chemotherapy leading to improve the life qualities of subjects.

Objective To evaluate the scientificity,transparency and applicability of Chinese guidelines and expert consensuses on nursing published in 2022,in order to improve the quality of guidelines and consensuses.Methods Databases including Medline,Embase,Web of Science,CBM,CNKI,WanFang database,Chinese Medical Journal,and related websites were electronically searched,as well as China Hong Kong,Macao and Taiwan medical journals,to collect Chinese guidelines and expert consensuses on nursing from January to December 2022.STAR tool was used to evaluate the quality of each guidelines and consensuses by 3 assessors independently.Total score,scoring rate of each domain and item were adopted to analyze the outcomes.Results A total of 3 guidelines and 33 expert consensuses were included.The total guidelines and expert consensuses STAR score(33.5±14.3).The quality of guidelines and consensuses was low.The quality of guidelines was moderate with average score of 55.1,and the quality of consensuses was low with average score of 31.5.The included guidelines and consensuses had a highest score rate(52.4％)in the domain of recommendation.Among 39 items of STAR tool,the top 4 items including listing participants and institutions,explaining additional instructions for implementation,describing consensus method,and listing references for recommendations had a high score rate of 100％,83.3％,77.8％,75.0％respectively.However,the items of registration,providing registration information,protocols being searched on public platforms and explaining the role of funding had a low score rate,urgent need for attention and upgrading.Conclusion The overall quality of the Chinese guidelines and expert consensuses on nursing published in 2022 was low.As a medical and nursing practice guidance document,the quality of guidelines and expert consensuses should be improved by encouraging registration,strengthening management of interest conflict,enhancing the rigor of guideline developing process,and expanding the dissemination.

Objective:To investigate the clinical characteristics of E. coli peritoneal dialysis-associated peritonitis (PDAP) and the risk factors for its occurrence and treatment failure.Methods:The clinical data of patients with episodes of PDAP in four general hospitals in Jilin Province from 2013 to 2019 were retrospectively reviewed. According to the pathogenic bacteria, the patients were divided into E. coli and non- E. coli groups. The incidence of E. coli PDAP in the last seven years was calculated and the clinical characteristics were compared between two PDAP groups. Logistic regression was used to analyze the risk factors for the occurrence and treatment failure of E. coli PDAP. Results:A total of 693 PDAP episodes/cases were enrolled in this study, including 100 episodes/cases in the E. coli group and 593 episodes/cases in the non- E. coli group. The incidence rate of E. coli PDAP in the four hospitals showed a decreasing trend during 2013 to 2019. Compared with the non-E.coli group, the proportion of diabetic patients and the average blood albumin levels in the E. coli group were lower ( χ2=5.006, Z=-2.992, P<0.05), while the proportion of refractory peritonitis was higher, and the duration of antibiotic therapy was longer ( χ2=6.350, Z=-2.779, P<0.05). Multivariate Logistic regression analysis showed that history of PDAP ( OR=1.577, 95% CI: 1.015-2.448) and low baseline serum albumin level ( OR=0.958, 95% CI: 0.923-0.995) were independent risk factors for the development of E. coli PDAP, while concomitant diabetes was an independent protective factor for E. coli PDAP ( OR=0.538, 95% CI: 0.330-0.876). Moreover, long-term dialysis was an independent risk factor for treatment failure of E. coli PDAP ( OR=1.047, 95% CI: 1.018-1.076). Conclusion:The incidence rate of E. coli PDAP in study institutions has declined in the past 7 years, but the rate of refractory PDAP is still high. The history of PDAP and low blood albumin level are independent risk factors for the occurrence of E. coli PDAP, while concomitant diabetes is an independent protective factor for the occurrence of E. coli PDAP. Long-term dialysis is an independent risk factor for treatment failure of E. coli PDAP.