目的 调查结直肠癌患者癌因性疲乏状况,研究其动态变化趋势,为临床护理提供理论依据。方法 选用癌症疲乏量表(CFS)对96例结直肠患癌患者于术前一周、术后3~4天、出院前1~2天进行调查分析。结果 三次调查患者的癌因性疲乏水平有差异(P＜0.01),术后3~4天疲乏程度最重,出院前1~2天次之,术前一周最轻;三次调查结肠癌患者的疲乏水平均高于直肠癌患者,两组疲乏水平有差异(P＜0.05)。结论 结直肠癌患者于住院不同时期存在不同程度的疲乏,应针对疾病各时期特点为患者量身裁定护理干预措施,改善其疲乏症状。

Objective To investigate the dynamic changes of cancer-related fatigue (CRF) in patients with colorectal cancer. Methods Totally 96 patients with colorectal cancer were investigated by Cancer Fatigue Scale in three times: a week before patients' surgery, 3~4 days after patients' surgery and 1~2 days before discharge, respectively. Results Scores of fatigue of colorectal cancer patients were significantly different among three measurement points(P＜0.01). The scores of fatigue in the second survey were the highest. The third survey took second place and the first survey was the lowest. The score of fatigue in colon cancer patients were higher than rectal cancer patients in survey, with significant difference(P＜0.05). Conclusion There were obvious differences of fatigue in different periods for colorectal cancer patients in hospital. Inventions should tailor for patients according to characteristics of different periods to improve fatigue.

目的 调查I-IIa期宫颈鳞状细胞癌患者术后随诊和复发情况,并探索随诊和复发的相关因素。方法 分析2011年1月—2012年6月中山市妇幼保健院收治的128例宫颈鳞状细胞癌患者的临床资料,分析他们的术后随诊情况及其影响因素。将有液基薄层细胞学(TCT)及盆腔检查者视为有效随诊的患者,分析肿瘤复发情况及其影响因素。结果 128例患者中,有效随诊104例(占总人数的81.25%)。年龄组越小,随诊率越高(P=0.034);城市患者较农村患者,随诊率高(P=0.028);文化程度越高,随诊率越高(P=0.028);职业为公务员、教师、公司职员或自由职业、个体,随诊率比职业为家庭妇女和工人更高(P=0.030)。在104例随诊者中,2年复发8例(占7.7%)。临床分期较晚,肿瘤直径>4cm,病理类型,脉管内瘤栓阳性,淋巴结转移阳性是影响患者2年复发的危险因素(P<0.05)。结论 临床分期,肿瘤直径,脉管内瘤栓阳性,淋巴结转移等临床病理特征与患者复发密切相关。应针对宫颈癌患者社会人口学特点制定措施,提高随诊率。

Objective To investigate the follow-up rate after surgical treatment and the recurrence rate among patients with cervical squamous cell carcinoma in I-IIa stage, and identify associated factors. Methods The clinical data of 128 cases of cervical squamous cell carcinoma from January 2011 to June 2012 in Zhongshan maternal and child health hospital was collected. Follow up record of these cases was analyzed and factors associated with follow up were identified. Patients having taken thinprep liquid-based cytology test (TCT) and pelvioscopy were treated as cases being followed effectively, and their recurrence and associated factors were analyzed. Results Among the 128 patients, 104(81.25%) were effectively followed. Patients with younger age(P=0.034), living in city (P=0.028), with higher education level(P=0.028) had higher follow-up rate. Civil servants, teachers and freelancers had higher follow-up rate than housewives and workers (P=0.030).Eight of the 104 effectively followed cases recurred within two years after surgery, accounting for 7.7%. The associated factors of recurrence included clinical stage, tumor diameter, larger than 4cm, the depth of myometrial invasion, deeper than 2/3, vascular tumor thrombus positive, and lymph node metastasis positive (P<0.05). Conclusion Clinical stage, tumor size, vascular tumor thrombus positive, lymph node metastasis positive were associated with recurrence. Tailored strategies should be developed to improve the follow up rate based on the social and demographic characteristics of patients.

目的 探索复发性卵巢癌放射治疗临床的效果和副作用。方法 采用回顾性分析中山大学肿瘤防治中心放射治疗中心2002年1月—2014年9月收治的复发性卵巢癌采用放射治疗的临床资料和治疗结果。结果 23例患者5年生存率为48.6%,中位生存期为54,局部无瘤生存期中位数为11.9。结论 对于局限性复发性卵巢癌放射治疗有较好的疗效和较少的副作用。

Objective To explore the clinical efficacy and side effects of radiation therapy for recurrent ovarian cancer. Methods We performed a retrospective analysis of clinical data and treatment outcomes from recurrent ovarian cancer patients who received radiation therapy from January 1999 to December 2012 at radiation treatment center of Sun Yat-sen university Cancer Center. Results Among 23 patients, the five-year survival rate was 48.6%, the median survival time was 54, and the local median disease-free survival was 11.9. Conclusion Radiation therapy has better efficacy and less side effects for non-metastatic recurrent ovarian cancer.

神经元特异性烯醇化酶(neuron-specific enolase, NSE)是糖酵解途径中一种重要的同工酶;特异性位于神经元和神经内分泌细胞中。小细胞肺癌(small cell lung cancer,SCLC)细胞浆内含有神经内分泌颗粒,具有神经内分泌分化的特征,为恶性程度高的神经内分泌系统肿瘤。因此,NSE是SCLC诊断中最敏感的肿瘤标志物,在SCLC的临床诊断、治疗、预后均有重要应用价值,科学合理联合检测肿瘤标记物,将能为临床诊疗工作提供有力的帮助。

目的 动态观察乳腺癌患者辅助内分泌治疗5年后的血脂及肝功能水平的变化,探求辅助内分泌治疗与高脂血症及脂肪肝发病率的关系。方法 56例乳腺癌患者实行辅助内分泌治疗,术后随访5年动态抽血测定其总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL)、高密度脂蛋白胆固醇(HDL)及谷草转氨酶(AST)、谷丙转氨酶(ALT)、直接胆红素(DBIL)、总胆红素(TBIL)等参数的变化,B超监测其肝脏变化。结果 经过2年内分泌治疗TG由(1.203±0.723)mmol/L上升至(1.701±1.271)mmol/L,5年内分泌治疗后TG降至(1.389±0.706)mmol/L。经过2年内分泌治疗LDL由(2.497±0.990)mmol/L上升至(2.950±0.984)mmol/L,5年内分泌治疗后LDL为(2.867±0.886)mmol/L。结论 辅助内分泌治疗2年会导致其TG和LDL的升高,5年随访仅发现LDL升高,辅助内分泌治疗会增加乳腺癌患者诱发心血管疾病的风险。

目的 探讨连续护理在提高乳腺癌保乳患者生存质量中的应用效果,号召我院为病人提供持续性、连续性护理开展APN排班。方法 随机抽取2011年1月—2014年1月我院收治的117例乳腺癌患者的临床资料。观察两组患者术后生存质量、焦虑情况、抑郁情况、术后上肢水肿情况。结果 两组患者术后1周生存质量比较,差异无统计学意义(P＞0.05);观察组术后1个月、3个月、6个月、1年生存质量高于对照组,差异有统计学意义(P＜0.05)。两组患者术后1周焦虑情况比较,差异无统计学意义(P＞0.05);观察组术后1个月、3个月、6个月、1年忧郁情况优于对照组,差异有统计学意义(P＜0.05)。观察组患者术后上肢水肿情况优于对照组,差异有统计学意义(P＜0.05)。结论 连续护理在提高乳腺癌保乳患者生存质量中的应用效果较好,能够改善患者术后生存质量、焦虑抑郁情况、术后上肢水肿情况,值得临床推广。

Objective To explore the effects of continuous nursing intervention on the quality of life for breast cancer patients after breast conserving therapy. Methods 117 cases of patients with breast cancer were randomly divided into observation group(59 cases) and control group(58 cases). The control group were cared by routine postoperative care, including health education. On the basis of the control group, the observation group were cared by continuous nursing intervention, including cognitive intervention, psychological intervention, social support, life care, functional exercise, the prevention of complications and discharge instruction. The quality of life, anxiety situation, depression amd upper limb edema were compared in the two groups. Results There has no significant difference on the quality of life after 1 week in the two groups(P＞0.05); The quality of life after 1 month, 3 months, 6 months, 1 year for the observation group were higher than the control group(P＜0.05). There has no significant difference on the anxiety situation after 1 week in the two groups(P＞0.05); The anxiety situation after 1 month, 3 months, 6 months, 1 year for the observation group were higher than the control group(P＜0.05). The depression situation after 1 week, 1 month, 3 months, 6 months, 1 year for the observation group were higher than the control group(P＜0.05). The upper limb edema situation for the observation group were better than the control group(P＜0.05). Conclusion The effects of continuous nursing intervention on the quality of life for breast cancer patients after breast conserving therapy is good. It can improve the quality of life, situations of anxiety, depression and upper limb edema. It is worthy of clinical promotion.

目的 构建抑癌基因SEMA3B真核表达载体pcDNA3.1-SEMA3B,并检测其对肺癌A549细胞恶性生物学行为的影响。方法 应用PCR扩增SEMA3B全长cDNA片段,构建真核表达载体pcDNA3.1-SEMA3B。克隆PCR、双酶切法、基因测序验证过表达载体构建成功。将pcDNA3.1-SEMA3B真核表达载体和空载体pcDNA3.1分别转染入A549细胞中,应用qRT-PCR、Western blot检测SEMA3B mRNA、蛋白表达水平的变化;MTS法检测细胞增殖;流式细胞仪检测细胞凋亡、细胞周期;克隆形成实验检测细胞集落形成能力。结果 SEMA3B基因扩增片段与预测片段一致,克隆成功,且测序鉴定证实真核表达载体构建成功。转染pcDNA3.1-SEMA3B真核表达载体可上调SEMA3B mRNA、蛋白表达水平,且可抑制A549细胞的增殖,诱导凋细胞亡,细胞被阻滞在G1期,抑制细胞集落形成能力。结论 成功构建了SEMA3B基因真核表达载体,抑癌基因SEMA3B在肺癌恶性生物学进程中可能发挥重要作用。

Objective To construct the eukaryotic expression vector of the cancer suppressor gene, SEMA3B, and research the effects on malignant biological behavior of lung cancer A549 cells. Methods By reverse transcriptase-polymerase chain reaction (RT-PCR), the full length SEMA3B gene was amplified and then was inserted into pcDNA3.1. The recombinant plasmid pcDNA3.1-SEMA3B was confirmed correctly through double enzyme digestion and PCR identification, which was transfected into lung cancer A549 cells by lipid media transfection. The untransfected A549 and A549 transfected with pcDNA3.1 were used as controls. SMEA3B gene was detected by qRT-PCR and western blot. MTS assay, flow cytometry, and colony formation test were performed to evaluate the effect of overexpression of SEMA3B gene on A549 cell proliferation, apoptosis, cell cycle, and colony forming ability. Results The amplied fragment of SEMA3B gene by PCR was consistent with the anticipated result, the SEMA3B gene was cloned successfully. And the recombinant plasmid pcDNA3.1-SMEA3B was constructed successfully through gene sequence identification. After transfection of pcDNA3.1-SEMA3B, SEMA3B mRNA and protein expression levels were raised, and overexpression of SEMA3B gene in A549 cells significantly inhibited the proliferation of A549 cells, induced apoptotic cell death, blocked cell cycle in the G1 phase, and suppressed cell colony-forming ability. Conclusion The recombinant pcDNA3.1-SEMA3B is constructed successfully. SEMA3B gene can significantly inhibit the malignant biological behavior of lung cancer A549 cells.

目的 分析乳腺癌细胞中Snail与MTDH基因的作用,明确Snail是否通过结合于MTDH的启动子区域促进乳腺癌转移。方法 克隆、转染Snail基因至乳腺癌细胞,观察过表达Snail的乳腺癌细胞中MTDHmRNA及蛋白表达的变化;再使用免疫共沉淀法检测Snail与MTDH基因的共作用。结果 转染Snail基因进入乳腺癌MDA-MB-435细胞后,转染组、空白组和对照组中MTDHmRNA的表达水平分别为1.61±0.22、1.02±0.18、0.99±0.20,转染组高于空白组和对照组,差异有统计学意义(P<0.05),而后两组表达无差异(P>0.05);Westren blot检测结果显示,Snail可促进MTDH蛋白的表达;免疫共沉淀显示,Snail与MTDH在细胞内存在相互结合作用。结论 Snail在乳腺癌细胞中可通过结合于MTDH基因的启动子区域,促进MTDHmRNA转录及相关蛋白的表达,从而导致乳腺癌转移。

Objective To investigate the function of Snail to MTDH gene in breast cancer cells. Methods We observed the changement of MTDHmRNA and protein expression in breast cancer cell line MDA-MB-435 after transfected with Snail gene. Then, we used co-immunoprecipitation to determine the domain of Snail and MTDH binding in vitro. Results After transfected with Snail gene into MDA-MB-435 cell, the expression levels of MTDHmRNA in transfection group, blank group and control group were 1.61±0.22,1.02±0.18,0.99±0.20. The level of transfection group was significantly higher than the other groups(P< 0.05). Western blot showed that the expression of MTDH protein can be promoted by Snail. Co-immunoprecipitation showed that Snail and MTDH are binding interactions in breast cancer cell line MDA-MB-43. Conclusion Snail can promote transcription and expression of MTDH in breast cancer cells by binding to the promoter region of the MTDH gene resulting in metastasis of breast cancer.

目的 探讨肝癌根治术后恶心呕吐现状及影响因素。方法 选取2022年5月—2024年5月天津市第二人民医院收治的70例肝癌患者进行回顾性分析,所有患者均行肝癌根治术,分析其术后恶心呕吐情况。并依照恶心呕吐发生情况进行分组,将30例术后发生恶心呕吐的患者分为观察组,其余40例患者为对照组。对比两组患者临床病理特征及围术期指标。并建立Logistic回归模型以术后恶心呕吐为因变量分析肝癌患者手术切除术后恶心呕吐的影响因素。结果 肝癌患者手术切除术后恶心呕吐发生率为42.86%（30/70）,其中Ⅰ度14例（20.00%）、Ⅱ度10例（14.29%）、Ⅲ度4例（5.71%）、Ⅳ度2例（2.86%）;观察组与对照组性别、体质量指数（BMI）、病理类型、临床分期、术前禁食时间对比差异无统计学意义（P>0.05）,观察组与对照组年龄及是否化疗情况对比差异有统计学意义（P<0.05）;观察组与对照组手术时间、术后VAS评分、麻醉方式、术后合并其他并发症情况对比差异无统计学意义（P>0.05）,观察组与对照组肝门阻断时间、术中失血量及术后腹胀情况对比差异有统计学意义（P<0.05）;年龄、是否化学治疗、术中失血量、术后腹胀情况为肝癌患者手术切除术后恶心呕吐的影响因素（P<0.05）。结论 肝癌患者手术切除术后恶心呕吐发生率较高,且年龄、是否化疗、术中失血量及术后腹胀情况可能为恶心呕吐发生的影响因素,针对此类患者高风险患者需及时采取相关措施进行干预,预防患者术后恶心呕吐情况及减轻严重程度。

Objective To explore the status and influencing factors of nausea and vomiting after radical resection of liver cancer. Methods A retrospective analysis was conducted on 70 liver cancer patients admitted to the Second People’s Hospital of Tianjin from May 2022 to May 2024. All patients underwent radical surgery for liver cancer,and their postoperative nausea and vomiting conditions were analyzed. According to the occurrence of nausea and vomiting, 30 patients who experienced nausea and vomiting after surgery were divided into an observation group, and the remaining 40 patients were divided into a control group. The clinical and pathological characteristics as well as perioperative indicators between two groups of patients were compared. A logistic regression model was established to analyze the influencing factors of postoperative nausea and vomiting in liver cancer patients after surgical resection,with postoperative nausea and vomiting as the dependent variable. Results The incidence of postoperative nausea and vomiting in liver cancer patients was 42. 86%（30/70）, including 14 cases of grade I, accounting for 20. 00%, 10 cases of grade II, accounting for 14. 29%, four cases of grade III,accounting for 5. 71%, and two cases of grade IV,accounting for 2. 86%. There were no significant differences in gender,body mass index（BMI）, pathological type,clinical stage,and preoperative fasting time between the observation group and the control group（P>0. 05）. However, there were significant differences in age and chemotherapy status between the observation group and the control group（P<0. 05）. There were no significant differences in the operation time,postoperative VAS score,anesthesia method and postoperative complications between the observation group and the control group（P>0. 05）, but with differences in the portal block time,intraoperative blood loss and postoperative abdominal distension between the observation group and the control group（P<0. 05）. Age, chemotherapy, intraoperative blood loss, and postoperative abdominal distension were independent influencing factors for postoperative nausea and vomiting in liver cancer patients undergoing surgical resection（P<0. 05）. Conclusions The incidence of nausea and vomiting after surgical resection in liver cancer patients is relatively high, with age, chemotherapy, intraoperative blood loss, and postoperative abdominal distension may be influencing factors for nausea and vomiting. Therefore, relevant measures should be taken in a timely manner to intervene in high-risk patients to prevent postoperative nausea and vomiting and reduce its severity.

       目的   分析早期结直肠癌内镜下治疗前行窄带成像结合放大内镜 （ME-NBI）和超声内镜技术的评估价值。方法   采用回顾性分析方法，以2021年1月— 2023 年 12月中山市第五人民医院收治的102例早期结直肠癌患者为观察对象，所有患者均接受内镜下黏膜切除术（EMR）或内镜黏膜下剥离术（ESD）治疗，根据内镜下治疗前是否进行ME-NBI和超声内镜检查分为研究组与对照组各51例。比较两组年龄、性别、肿瘤大小、直乙结肠占比及组织病理特征；比较两组治疗时间、ESD治疗后非治愈性切除发生率、治愈性切除率、并发症发生情况及再次ESD或外科手术治疗率。结果   两组年龄、性别、肿瘤大小、直乙结肠占比及组织病理比较差异均无统计学意义（P＞0.05）。研究组中37例行ESD治疗，治疗时间为（120.6±140.3）min，12例行EMR治疗，治疗时间为（11.6±9.3）min，有2例不符合内镜下治疗指征，转外科手术治疗。对照组有38例行ESD治疗，治疗时间为（128.8±144.5）min，13例行EMR治疗，治疗时间为（12.5±9.5）min，两者治疗时间比较差异均无统计学意义（P＞0.05）。研究组非治愈性切除率为7.84，低于对照组27.45；治愈性切除率为88.24，高于对照组72.55；研究组ESD手术并发症为8.11%，低于对照组31.58；ESD或外科手术率为6.12，低于对照组25.49（P＜0.05），结论  ME-NBI和超声内镜对早期结直肠癌患者行内镜下治疗指征评估更准确，可提高治愈性切除率。

       Objective  To  study the application value of magnifying endoscopy combined with  narrow  band imaging （ME-NBI）and ultrasonic endoscopy system before endoscopic treatment in patients with early colorectal cancer．Methods  A retrospective analysis was carried out on  102  patients with early-stage colorectal cancer who were admitted to Zhongshan Fifth People’s Hospital from January 2021 to December 2023．All patients were treated with endoscopic mucosal resection（EMR）or endoscopic submucosal dissection（ESO）．The patients were divided into study group（51 cases）and control group（51 cases）according to whether ME-NBI and ultrasonic endoscopy was performed before endoscopic treatment or not．The patient age，sex，volume of tumor，location of tumor and pathological result of the tumor were compared between two groups．Time for treatment，curative resection rate，non-curative resection rate and the complication incidence of ESD，incidences of second ESD or surgery were compared between the two groups．Results  There were no statistical differences in age，sex，volume of tumor，location of tumor and pathological result of the tumor（P＞0.05）．In the study group，37 patients received ESD treatment，operation time was（120.6±140.3）minutes，and 12 patients received EMR treatment，operation time was（11.6±9.3）minutes，two cases were transferred to surgery due to endoscopic ultrasonography combined with magnifying endoscopy showed that they did not meet the indications for ESD treatment．In the control group，38 patients received ESD treatment，operation time was（128.8±144.5）minutes，13 patients received EMR treatment，operation time was（12.5±9.5）minutes．There was no significant difference in treatment duration between the two groups．The non-curative resection rate of the study group was 7.84%，which was significantly lower than that in the control group（27.45%），and the curative resection rate（88.24%）was significantly higher than that in the control group（72.55%）．The complications of ESD surgery in the study group were 8.11%，lower than 31.58% in the control group．The rate of second ESD or surgery was 6.12%，lower than 25.49% in the control group（P＜0.05）．Conclusions  ME-NBI and endoscopic ultrasound are more accurate in the evaluation of endoscopic indications for early colorectal cancer patients，and can improve the curative resection rate．