Objective:To investigate the clinical efficacy of strengthening the spleen to nourish the lung in treating stable chronic obstructive pulmonary disease (COPD) with lung and spleen qi deficiency complicated by sarcopenia. Methods:This study was designed as a prospective study. A total of 65 patients with stable COPD and sarcopenia who received treatment at Kunshan Hospital of Chinese Medicine from January 2021 to December 2021 were included in the study. They were randomly divided into a control group and an observation group using the random number table method. The control group ( n = 34) was treated with conventional therapy, while the observation group ( n = 31) was treated with Shenling Baizhu Powder, a traditional Chinese medication based on the principle of strengthening the spleen to nourish the lung, in addition to the conventional therapy given to the control group. Both groups were treated for 1 month. Traditional Chinese medicine syndrome score, pulmonary function, grip strength, walking speed, albumin and prealbumin levels were compared between the two groups. Results:After treatment, the scores of all traditional Chinese medicine syndromes in the observation group were significantly lower than those in the control group (all P < 0.05). Compared with the control group, the levels of forced expiratory volume in the first second (FEV 1)[(1.51 ± 0.27) L vs. (1.32 ± 0.20) L, t = 3.11, P < 0.001 ] and FEV 1/forced vital capacity (FVC) [(57.20 ± 8.41)% vs. (52.89 ± 5.66)%, t = 2.30, P = 0.025] were significantly higher in the observation group. Compared with before treatment, gait speed [(1.07 ± 0.27) m/s vs. (0.90 ± 0.30) m/s, t = 7.66, P < 0.001], grip strength [(20.62 ± 5.07) kg vs. (19.42 ± 5.78) kg, t = 3.55, P < 0.001], albumin [(231.38 ± 49.40) g/L vs. (200.26 ± 65.87) g/L, t = 3.70, P < 0.001] and prealbumin [(39.53 ± 3.45) g/L vs. (35.81 ± 4.46) g/L, t = 4.08, P < 0.001] levels in the observation group were significantly increased after treatment. There were no significant differences in gait speed, grip strength, albumin, and prealbumin levels in the control group before and after treatment (all P > 0.05). Conclusions:The method of strengthening the spleen to nourish the lung shows good clinical efficacy in treating stable COPD with lung and spleen deficiency complicated by sarcopenia, and it has great potential for broader application.

Objective:To investigate the clinical efficacy of strengthening the spleen to nourish the lung in treating stable chronic obstructive pulmonary disease (COPD) with lung and spleen qi deficiency complicated by sarcopenia. Methods:This study was designed as a prospective study. A total of 65 patients with stable COPD and sarcopenia who received treatment at Kunshan Hospital of Chinese Medicine from January 2021 to December 2021 were included in the study. They were randomly divided into a control group and an observation group using the random number table method. The control group ( n = 34) was treated with conventional therapy, while the observation group ( n = 31) was treated with Shenling Baizhu Powder, a traditional Chinese medication based on the principle of strengthening the spleen to nourish the lung, in addition to the conventional therapy given to the control group. Both groups were treated for 1 month. Traditional Chinese medicine syndrome score, pulmonary function, grip strength, walking speed, albumin and prealbumin levels were compared between the two groups. Results:After treatment, the scores of all traditional Chinese medicine syndromes in the observation group were significantly lower than those in the control group (all P < 0.05). Compared with the control group, the levels of forced expiratory volume in the first second (FEV 1)[(1.51 ± 0.27) L vs. (1.32 ± 0.20) L, t = 3.11, P < 0.001 ] and FEV 1/forced vital capacity (FVC) [(57.20 ± 8.41)% vs. (52.89 ± 5.66)%, t = 2.30, P = 0.025] were significantly higher in the observation group. Compared with before treatment, gait speed [(1.07 ± 0.27) m/s vs. (0.90 ± 0.30) m/s, t = 7.66, P < 0.001], grip strength [(20.62 ± 5.07) kg vs. (19.42 ± 5.78) kg, t = 3.55, P < 0.001], albumin [(231.38 ± 49.40) g/L vs. (200.26 ± 65.87) g/L, t = 3.70, P < 0.001] and prealbumin [(39.53 ± 3.45) g/L vs. (35.81 ± 4.46) g/L, t = 4.08, P < 0.001] levels in the observation group were significantly increased after treatment. There were no significant differences in gait speed, grip strength, albumin, and prealbumin levels in the control group before and after treatment (all P > 0.05). Conclusions:The method of strengthening the spleen to nourish the lung shows good clinical efficacy in treating stable COPD with lung and spleen deficiency complicated by sarcopenia, and it has great potential for broader application.

Objective:To investigate the clinical efficacy of histone deacetylase(HDAC)inhibitor chidamide combined with CHOP in the treatment of preliminarily diagnosed peripheral T-cell lymphoma(PTCL)and to analyze the factors influencing its prognosis.Methods:Clinical data were collected from patients who were preliminarily diagnosed with PTCL,but had not received radiotherapy or chemotherapy at the Affiliated Hospital of Nantong University between April 2012 and August 2022.The patients were divided into two groups,based on the frontline treatment regimen:the chidamide+CHOP group(n=20)and the CHOP group(n=24).The differences in clinicopathological characteristics between the two groups were compared by chi-square test or Fisher's exact test.Survival curves were generated by Kaplan-Meier method,and univariate survival analysis was conducted by Log-Rank test.Subgroup analysis was performed to assess the survival outcomes of patients in the chidamide+CHOP group,and interaction tests were conducted to assess the factors that might influence the difference in survival prognosis between the two groups.Results:The baseline levels of the two groups were comparable in age,gender,and tumor stage,but there were more AITL patients(70.8%vs 15%)and fewer PTCL-NOS patients(16.7%vs 30%)in the chidamide+CHOP group.Efficacy analysis revealed that the median PFS was significantly longer in patients treated with chidamide+CHOP(7 months vs 3 months,P=0.032),and their median OS was also significantly longer(20 months vs 6 months,P=0.004).Univariate prognostic analysis revealed that PTCL patients with B symptoms had significantly poorer PFS(P=0.053)and OS(P=0.065)than PTCL patients without B symptoms;and patients with elevated baseline LDH levels had a worse OS(P=0.056).Further subgroup analysis of efficacy revealed that,among patients with normal baseline serum ferritin levels,those in the chidamide+CHOP group had significantly better PFS compared with those in the CHOP group(95%CI[1.14,43.58]).The interaction test between serum ferritin levels and treatment regimens demonstrated statistical significance(P=0.042).Conclusion:The combination of chidamide and CHOP has survival benefits for patients preliminarily diagnosed with PTCL,and baseline serum ferritin levels may serve as a potential predictor for combination therapy.

OBJECTIVETo investigate the knowledge and willingness of breast cancers patients from Shanghai for genetic counseling and gene testing.

METHODSA total of 428 patients filled out the questionnaire and the data was statistically analyzed.

RESULTSMost of the patients were unaware of genetic counseling and gene testing. But after a brief introduction, a majority of them were willing to accept genetic counseling and recommend their family members to participate. The willingness was education- and age-related. When told that gene testing may benefit themselves, 92.1% of the patients were willing to be tested. However, when told that gene testing may only benefit their family, only 33.9% of the patients were willing to join the testing. The acceptance was also age-, education- and family income-related. The difference was statistically significant. Moreover, the willingness ratio to participate the gene testing was lower than expected. Overall, 74.1% of the patients were willing to accept cheaper preliminary gene screening, whilst only 19.2% were willing to accept genetic testing of higher price. Despite of being told that testing results will be maintained as confidential, still 43.2% worried about adverse effects. Such patients tended to younger, from low-income families, with a family history of associated cancers, or personal history of other cancers. The difference was statistically significant.

CONCLUSIONThe majorities of patients do not know but are willing to accept genetic counseling and gene testing and recommend their family to participate. Lack of genetic knowledge, cost for the testing and concerns about discrimination are the obstacles for patients to participate in genetic counseling and gene testing. To spread the knowledge about breast cancer and establish a follow-up screening system for high-risk population may improve the tertiary prevention for breast cancer.

Adult ; Aged ; Asian Continental Ancestry Group ; genetics ; statistics & numerical data ; BRCA1 Protein ; genetics ; BRCA2 Protein ; genetics ; Breast Neoplasms ; diagnosis ; ethnology ; genetics ; Chi-Square Distribution ; China ; Educational Status ; Female ; Genetic Counseling ; Genetic Predisposition to Disease ; genetics ; Genetic Testing ; Health Knowledge, Attitudes, Practice ; Humans ; Middle Aged ; Social Class

Objective To study the quality of life (QOL) of patients with ductal carcinoma in situ (DCIS) and to analyze the relevant factors affecting their QOL.Methods A total of 84 patients with DCIS and 125 patients with invasive breast cancer were surveyed.Researchers used SF-36 to assess the QOL of participants at one year after operation.The relationships between some information of patients and SF-36 score were analyzed,such as age,the type of surgery,endocrine therapy,education,marital status,working status and health insurance.Results Compared to normal women,patients with DCIS had lower QOL in physical function (t =2.468,P =0.029),bodily pain (t =2.076,P =0.039),general health (t =2.153,P =0.033) and mental health (t =3.396,P =0.003).Patients with invasive breast cancer also had poorer QOL in physical function (t =5.638,P =0.002),bodily pain (t =5.417,P =0.002),vitality (t =4.438,P =0.002),general health (t =3.960,P =0.002) and mental health (t =6.020,P =0.001).QOL of DCIS patients was similar to that of invasive breast cancer patients,except that scores of physical function (t =2.714,P =0.032) and vitality (t =2.134,P =0.040) were better in DCIS patients.Endocrine therapy significantly affected the score of QOL of DCIS patients.DCIS patients with endocrine therapy had poorer score in physical function (t =2.082,P ＜ 0.05),bodily pain (t =2.003,P ＜ 0.05),general health (t =2.751,P ＜0.05),vitality (t =2.048,P ＜ 0.05) and mental health (t =4.162,P ＜ 0.05).Conclusion Patients with DCIS have poor QOL at one year after operation.Endocrine therapy significantly reduces their QOL.

Recent preclinical data have demonstrated that antidiabetic drug metformin can act as an anticancer agent for breast cancer.Epidemiologic evidences show that metformin decreases the incidence of breast cancer and cancer-related mortality in diabetic patients.The metformin treatment also increases complete pathological tumor response rates following neoadjuvant chemotherapy for breast cancer patients.Metformin also displays significant growth inhibitory effects in most types of breast cancer cell lines and tumor xenogra-fts in mice.Preclinical data also shows metformin combined with chemotherapy drugs or HER2-targeted drugs or new anticancer drugs has synergic anti-cancer effect.Reduction of the insulin/insulin-like growth factor signaling pathway in body and activation of LKB1/AMPK and inhibition of downstream mTOR pathway in tumor cells have been found to play the most important role in anti-cancer effect of metformin.Currently,a number of clinical trials are underway in breast cancer patients to evaluate the effective use value of metformin as a cancer therapy