With the aging of the population,the proportion of older patients with cancer is increasing.The treatment of older patients with cancer is challenging owing to frailty,comorbidities,and the exclusion from most clinical studies.Green therapy,using low-injury,sustainable,repeatable,and individualized treatment methods—such as minimally invasive surgery and traditional Chinese medicine—provides a new option for patients with cancer who are intolerant or have failed in conventional treatment.This article summarizes the safety and effectiveness of minimally invasive surgery,such as radiofrequency ablation,microwave ablation,cryoablation,and vascular interventional therapy,in older patients with tumors,as well as external treatment of traditional Chinese medicine in clinical practice to provide a basis for green treatment of tumors.Prospective clinical trials should be performed on older patients with cancer to provide high-level evidence-based medical evidence for the treatment of these patients.Furthermore,a clinical prediction model of green treatment based on real-world data should be constructed for older patients with cancer to provide a foundation for clinical medical decision-making.Basic researches should be conducted to explore the mechanism of green tumor treatment.

Traditional Chinese Medicine (TCM), as a treasure of the Chinese nation, plays a significant role in maintaining public health. In 2019, the Central Committee of the Communist Party of China and the State Council proposed for the first time the establishment of a TCM registration and evaluation evidence system that integrates TCM theory, "personal experience" and clinical trials (referred to as the "Three-in-One" System) to promote the inheritance and innovation of TCM. Subsequently, the National Medical Products Administration issued several guiding principles to advance the improvement and implementation of this system. Owing to the complexity of its implementation, there are still differing understandings within the TCM industry regarding the positioning of the "Three-in-One" Registration and Evaluation Evidence System, as well as the connotation and value orientation of the "personal experience." To address this, Academician WANG Qi, President of the TCM Association, China International Exchange and Promotion Association for Medical and Healthcare and TCM master, led a group of academicians, TCM masters, TCM pharmacology experts and clinical TCM experts to convene a "Seminar on Promoting the Implementation of the ′Three-in-One′ Registration and Evaluation Evidence System for Chinese Medicinals." Through extensive discussions, an expert consensus was formed, clarifying the different roles of the TCM theory, "personal experience" and clinical trials within the system. It was further emphasized that the "personal experience" is the core of this system, and its data should be derived from clinical practice scenarios. In the future, the improvement of this system will require collaborative efforts across multiple fields to promote the high-quality development of the Chinese medicinal industry.

Objective To comprehensively evaluate the quality difference of Huaihua powder obtained by the hospital's electromagnetic furnace decoction method and automatic decoction machine decoction method.Methods Five methods(induction cooker decoction(once decoction,twice decoction),normal pressure decoction(once decoction,twice decoction),and pressure decoction)were used to prepare the decoction.The HPLC method used a Shiseido CAPCELL PAK-C18(250 mm×4.6 mm,5 μm)column,with a UV detection wavelength of 254 nm,mobile phase of acetonitrile 0.1%phosphoric acid water,column temperature of 30℃,flow rate of 1.0 mL/min,and detection of index components including rutin,naringin,quercitrin,neohesperidin,quercetin,and menthone.The extraction rate of the index components was calculated and the cream yield of each decoction was detected.The evaluation of quality differences is based on the comprehensive score of cream yield(40%)and indicator components(60%).Results The HPLC fingerprint similarity of Huaihua powder prepared by 5 decoction methods was greater than 99%.There was no significant difference(P>0.05)in the yield of ointment and the content of indicator components between the induction cooker one decoction and the induction cooker twice decoction methods.The yield of ointment and the extraction rate of indicator components were significantly higher in twice normal pressure decoction using a decoction machine than once normal pressure decoction using a decoction machine(P<0.05).The index component score of machine under pressure decoction once was the highest,but the comprehensive score of twice normal pressure decoction was the highest,with a combined score of 92.13 and 89.58,respectively,far higher than the 36.01,18.79,and 15.60 of the other three decoction methods.Classify the decoction into three categories through cluster analysis.Orthogonal partial least squares-discriminant analysis was used to screen for rutin,naringin and neohesperidin as differential biomarkers.Conclusion The quality of Huaihua powder decocted by a decoction machine is significantly better than that by an induction cooker,and the twice decocted at normal pressure by the decoction machine are significantly better than those decocted at normal pressure once.Decoction under pressure once may be a better choice.

With the aging of the population,the proportion of older patients with cancer is increasing.The treatment of older patients with cancer is challenging owing to frailty,comorbidities,and the exclusion from most clinical studies.Green therapy,using low-injury,sustainable,repeatable,and individualized treatment methods—such as minimally invasive surgery and traditional Chinese medicine—provides a new option for patients with cancer who are intolerant or have failed in conventional treatment.This article summarizes the safety and effectiveness of minimally invasive surgery,such as radiofrequency ablation,microwave ablation,cryoablation,and vascular interventional therapy,in older patients with tumors,as well as external treatment of traditional Chinese medicine in clinical practice to provide a basis for green treatment of tumors.Prospective clinical trials should be performed on older patients with cancer to provide high-level evidence-based medical evidence for the treatment of these patients.Furthermore,a clinical prediction model of green treatment based on real-world data should be constructed for older patients with cancer to provide a foundation for clinical medical decision-making.Basic researches should be conducted to explore the mechanism of green tumor treatment.

Objective To comprehensively evaluate the quality difference of Huaihua powder obtained by the hospital's electromagnetic furnace decoction method and automatic decoction machine decoction method.Methods Five methods(induction cooker decoction(once decoction,twice decoction),normal pressure decoction(once decoction,twice decoction),and pressure decoction)were used to prepare the decoction.The HPLC method used a Shiseido CAPCELL PAK-C18(250 mm×4.6 mm,5 μm)column,with a UV detection wavelength of 254 nm,mobile phase of acetonitrile 0.1%phosphoric acid water,column temperature of 30℃,flow rate of 1.0 mL/min,and detection of index components including rutin,naringin,quercitrin,neohesperidin,quercetin,and menthone.The extraction rate of the index components was calculated and the cream yield of each decoction was detected.The evaluation of quality differences is based on the comprehensive score of cream yield(40%)and indicator components(60%).Results The HPLC fingerprint similarity of Huaihua powder prepared by 5 decoction methods was greater than 99%.There was no significant difference(P>0.05)in the yield of ointment and the content of indicator components between the induction cooker one decoction and the induction cooker twice decoction methods.The yield of ointment and the extraction rate of indicator components were significantly higher in twice normal pressure decoction using a decoction machine than once normal pressure decoction using a decoction machine(P<0.05).The index component score of machine under pressure decoction once was the highest,but the comprehensive score of twice normal pressure decoction was the highest,with a combined score of 92.13 and 89.58,respectively,far higher than the 36.01,18.79,and 15.60 of the other three decoction methods.Classify the decoction into three categories through cluster analysis.Orthogonal partial least squares-discriminant analysis was used to screen for rutin,naringin and neohesperidin as differential biomarkers.Conclusion The quality of Huaihua powder decocted by a decoction machine is significantly better than that by an induction cooker,and the twice decocted at normal pressure by the decoction machine are significantly better than those decocted at normal pressure once.Decoction under pressure once may be a better choice.

Non-small cell lung cancer is one of the cancers with the highest incidence and mortality rate in the world, and precise prognostic models can guide clinical treatment plans. With the continuous upgrading of computer technology, deep learning as a breakthrough technology of artificial intelligence has shown good performance and great potential in the application of non-small cell lung cancer prognosis model. The research on the application of deep learning in survival and recurrence prediction, efficacy prediction, distant metastasis prediction, and complication prediction of non-small cell lung cancer has made some progress, and it shows a trend of multi-omics and multi-modal joint, but there are still shortcomings, which should be further explored in the future to strengthen model verification and solve practical problems in clinical practice.

Objective Network Meta-analysis was conducted to evaluate the differences in the efficacy of different traditional Chinese medicine injections(TCMI)in patients with cancer-related fatigue.Methods The database was systematically searched and included in Cochrane Library,PubMed,Web of Science,CNKI,Wan Fang,China Biomedical Literature Database and Database of Chinese sci-tech periodicals until September,2022.These relevant randomized controlled trial literatures were evaluated the methodological quality by using of Cochrane risk of bias assessment tool.Results 18 articles involving 1404 patients and 6 traditional Chinese medicine injections(TCMI)were included.The results showed that Kangai injection[MD=-2.30,95％CI(-3.09,-1.52)]and Aidi injection[MD=-1.31,95％CI(-1.99,-0.62)]combined with chemotherapy were better than chemotherapy alone in improving CRF in cancer patients during chemotherapy,among which Kangai injection is more effective[MD=-1.05,95％CI(-1.89,-0.21)];Shenmai injection[MD=-1.24,95％CI(-1.91,-0.57)],Kangai injection[MD=-1.02,95％CI(-1.65,-0.39)],and Shenqifuzheng injection[MD=-0.54,95％CI(-0.90,-0.19)]were superior to palliative care alone in improving CRF in palliative care of cancer patients,among which Shenmai injection[MD=-1.26,95％CI(-2.15,-0.37)]is more effective.Conclusions The results demonstrated that TCMI can improve the degree of cancer-related fatigue in tumor patients at different stages.When combined with chemotherapy,Kangai injection was superior to other TCMI,while when combined with palliative treatment,Shenmai injection was superior to other TCMI.

Primary liver cancer is one of the common tumors in China， which seriously endangers human health. With the advancement in medical science and technology， some achievements have been made in the clinical treatment of liver cancer， but there is an urgent need to find a safe and effective solution for patients with advanced liver cancer. As a unique therapy in China， traditional Chinese medicine （TCM） has the characteristics of multiple targets and multiple pathways and plays a certain role in the treatment of malignancies. The present study aimed to clarify the mechanism of action of "dispelling pathogens" in the treatment of liver cancer through literature research. In TCM etiology and pathogenesis， deficient healthy Qi and exuberance of pathogenic Qi， such as phlegm， blood stasis， and toxins， lead to the development of liver cancer. The treatment should follow the principles of reinforcing healthy Qi and eliminating pathogens. It has been generally believed that tumor cell is the "pathogenic factor" and the immune function serves as the "healthy Qi". In the treatment of malignancies and the regulation of the immune function of patients， it is often advocated to reinforce healthy Qi to eliminate the accumulation. With the continuous updating of knowledge on tumors and tumor microenvironment， it is also recognized that there are "healthy Qi" and "pathogenic Qi" in the immune microenvironment of tumors. For example， the immune cells and immune factors that inhibit tumor growth can be classified as "healthy Qi" with TCM attributes， while those promoting tumor growth can be classified as "pathogenic Qi". Additionally， as proved by clinical data and experimental research， the elimination methods represented by "activating blood， resolving phlegm， and removing toxins" in the treatment of liver cancer can combat tumor cells and also regulate the "healthy Qi" and "pathogenic Qi" in the immune microenvironment of liver cancer to achieve the balance of Yin and Yang. Based on this， the present study reviewed from the TCM theory and the mechanisms of western medicine to provide theoretical support for the TCM treatment of malignancies by elimination methods and some ideas for TCM in tumor resistance.

Objective: To explore the effect of cryoablation on apoptosis of lung adenocarcinoma cells. Methods: According to the district in the tumor following cryoablation, human lung adenocarcinoma H1299 cells were divided into four groups to construct the freezing model of lung cancer in cell level: group A, untreated cells, as the control group. In group B, the necrotic solution was added to the untreated cell culture medium(the cell suspension was frozen in a liquid nitrogen tank for 5 min, and centrifuged to obtain the supernatant after rewarming at 37 ℃).Group C, sublethal cells(cells were frozen at-80 ℃ for 7 min to mimic sublethal state). In group D, necrotic solution was added into sublethal cell culture medium. Cell apoptosis was observed by flow cytometry analysis 24 h later. The expression of apoptosis related molecules Bax and Bcl-2 was detected by qRT-PCR and Western blot. Lewis lung adenocarcinoma cell line was used to establish subcutaneous transplanted tumor model of C57 BL/6 mice. The successful model mice were randomly divided into two groups: sham operation group and argon-helium cryoablation group, with 4 mice in each group. After argon-helium cryoablation for 14 days, the tumor tissues were taken. The expression of apoptosis-related molecules Bax and Bcl-2 was detected by qRT-PCR and Western blot. Results: In the cell freezing model, compared with group A in the control group B,C and D groups could promote cell apoptosis(P<0.05), and group D had the highest apoptosis rate, which was significantly higher than other groups(P<0.05). Bothin vitroandin vivoexperiments showed that cryoablation could increase the expression of Bax mRNA and protein(P<0.05). Bcl-2 mRNA and protein expression decreasedin vivo(P<0.05). There was no significant change in the in cell freezing model. Conclusion Cryoablation can achieve effective ablation through cell apoptosis mechanism, which may be related to the reduction of Bcl-2/Bax.

"The Expert Group on Tumor Ablation Therapy of Chinese Medical Doctor Association, The Tumor Ablation Committee of Chinese College of Interventionalists, The Society of Tumor Ablation Therapy of Chinese Anti-Cancer Association and The Ablation Expert Committee of the Chinese Society of Clinical Oncology" have organized multidisciplinary experts to formulate the consensus for thermal ablation of pulmonary subsolid nodules or ground-glass nodule (GGN). The expert consensus reviews current literatures and provides clinical practices for thermal ablation of GGN. The main contents include: (1) clinical evaluation of GGN, (2) procedures, indications, contraindications, outcomes evaluation and related complications of thermal ablation for GGN and (3) future development directions.
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