妇科恶性肿瘤化疗的护理体会

女性生殖器官各部位均可发生肿瘤，目前已有多种恶性肿瘤经化疗获得治愈机会，如侵蚀性葡萄胎及绒毛膜癌经单一的化疗可基本达到根治。恶性肿瘤的化疗已成为主要治疗方法之一，并受到重视。抗癌化学药物能抑制肿瘤生长．也可影响正常的细胞代谢，大多数药物在杀伤癌细胞的同时．对造血系统及上皮组织具有明显的毒性作用，一些药物对肝、肾等器官亦有损害。

PICC导管与浅静脉留置针在化疗中的疗效对比

目的PICC导管在化疗中的疗效。方法85例患者分为两组，A组为接受PICC途径输注者。B组为接受浅静脉留置针途径者。结果A组在静脉保护方面和患者自我感受方面明显优于B组。结论PICC置管简单安全，留置时间长，患者痛苦少，值得临床推广。

护理干预减轻妇科恶性肿瘤化疗患者恶心呕吐的效果观察

目的:探讨护理干预减轻妇科恶性肿瘤化疗患者恶心呕吐的效果。方法:以66例妇科恶性肿瘤化疗患者为对象,就诊时间段为2018年10月到2019年6月期间,将患者按照1:1比例进行平分,其中33例患者纳入对照组并实施普通护理干预,剩余33例患者纳入观察组实施优质护理干预,对比两组患者恶心及呕吐缓解情况,焦虑及抑郁的情绪变化情况。结果:评分量表结果显示,护理后两组患者SAS及SDS情绪均得以改善,且观察组评分下降幅度明显大于对照组(P<0.05);观察组患者Ⅲ度及Ⅳ度恶心及呕吐发生率明显低于对照组(p<0.05);对照组0度及Ⅰ度恶心及呕吐发生率明显低于观察组(p<0.05),说明对照组恶心及呕吐情况较观察组严重。结论:针对妇科恶性肿瘤化疗患者,采用优质护理干预能减轻患者恶心及呕吐症状,缓解焦虑及抑郁的不良情绪,缓解患者痛苦,促进疾病预后。

Current endoscopic approach to indeterminate biliary strictures

Biliary strictures are considered indeterminate when basic work-up, including transabdominal imaging and endoscopic retrograde cholangiopancreatography with routine cytologic brushing, are non-diagnostic. Indeterminate biliary strictures can easily be mischaracterized which may dramatically affect patient's outcome. Early and accurate diagnosis of malignancy impacts not only a patient's candidacy for surgery, but also potential timely targeted chemotherapies. A significant portion of patients with indeterminate biliary strictures have benign disease and accurate diagnosis is, thus, paramount to avoid unnecessary surgery. Current sampling strategies have suboptimal accuracy for the diagnosis of malignancy. Emerging data on other diagnostic modalities, such as ancillary cytology techniques, single operator cholangioscopy, and endoscopic ultrasonography-guided fine needle aspiration, revealed promising results with much improved sensitivity.

117 cases of advanced malignancies treated with recombinant human endostatin plus chemotherapy

Objective: The aim of this study was to evaluate the recent efficacy and adverse reactions of recombinant human endostatin (Endostar) plus chemotherapy in the treatment of advanced malignancies. Methods: One hundred and seventeen cases of advanced malignancies were diagnosed and confirmed by histopathological examination, patients were treated with Endostar combined with chemotherapeutic drugs with no cross-resistance. Evaluate the efficacy and adverse reactions after finished two cycles of combination therapy. Results: All the 117 cases of patients were evaluated according to relevant standards, and there were 12 cases of complete remission (CR), 30 cases of partial remission (PR), 58 cases of stable disease (SD), 17 cases of progressive disease (PD). The response rate (RR) was 35.8%, disease control rate (DCR) was 85.4%. Conclusion: The protocol of Endostar combined with chemotherapy could improve the quality of life of patients with malignances, it also has the advantage of low toxicity. Considering the time span of the study, the long-term efficacy remains to be observed.

Treatment of Interstitial Peumopathy by Fei Tong Oral Liquid in the Malignant Tumor Patients after Radio-and/or Chemotherapy

Fei Tong Kou Fu Ye (肺通口服液 Fei Tong Oral Liquid) was used to treat 30 cases of interstitial pneumopathy after radio- and/or chemotherapy.In comparison with the control group (15 cases) treated with hormones,the therapeutic effects in improving dyspnea,cough,respiratory rate,cyanosis,findings in X-films and CT examination,partial pressure of oxygen in artery,FVC and VC were found significantly better (P<0.05).The total effective rate obtained was 83.33%.

Chemoradiotherapy for a patient with a giant esophageal fistula

We describe our experience of treatment for a giant esophageal malignant fistula, which has not been reported previously. A 36-year-old woman who was diagnosed as having massive esophageal small cell carcinoma with metastases was treated with chemoradiotherapy. However, a giant esophagomediastinal fistula appeared due to shrinkage of the massive tumor, and all anti-cancer treatment was suspended. However, chemoradiotherapy was restarted at the request of the patient despite the presence of the fistula. After restarting treatment, the giant esophageal fistula was naturally closed despite intensive chemoradiotherapy, and the patient became able to eat and drink. Although the patient finally died, her QOL and prognosis seemed to be improved by the chemoradiotherapy. Anti-cancer treatment could be safely performed despite the presence of a giant fistula. The giant fistula closed while intensive chemotherapy was administered to the patient. Therefore, the presence of a fistula may not be a contraindication for curative chemoradiotherapy. Completion of treatment with proper management and maintenance of patients would be of benefit to patients with fistula.

A clinical trial of cytokine induced killer cells treating patients with malignant tumor after radiochemotherapy

Objective: Our study investigated the immunity changes and life quality changes after the treatment of cytokine induced killer (CIK) cells for patients with malignant tumor after radiochemotherapy, and explored the therapeutic effects of CIK cells on these patients. Methods: Thirty-one patients with malignant tumor after radiochemotherapy were treated with CIK cells. Before and after CIK cells being transfused back, the immunity indexes of the peripheral blood of these cases were detected and the changes of life quality of these cases were compared. Results: After radiochemotherapy, the percentage of CD3+, CD4+ cells declined, the percentage of CD8+ cells rose; the ratio of CD4+/CD8+ declined, and the percentage of CD16+, CD56+ cells declined. As all the above indexes compared with that of normal people, the difference was significant (P < 0.05). After CIK cells therapy, the above indexes improved (P < 0.05). Life quality improved significantly after CIK cells therapy (P < 0.05). Conclusion: Radiochemotherapy can inhibit the immunity in patients with malignant tumor. CIK cells therapy is safe and effective. It may improve the recent immunity and life quality of the patients, which suggesting that it may be an alternative maintenance treatment for patients with malignant tumor after radiochemotherapy.

Biliary tract tumors: past, present and future

Tumors ofthe biliary tract （gallbladder tumors, cholangiocarcinomas and ampullary carcinomas） are low incidence tumors with poor prognosis. The five-year overall survival is 50% for stage I, 30% stage II, 10% stage III and 0% stage IV. Treatment is based on surgery for potentially resectable tumors. Chemotherapy and chemo-radiotherapy is the treatment of choice when surgery is not amenable, however it has not achieved encouraging results. These patients use to have very few symptoms, which is the reason for the delay in diagnosis and the poor prognosis. They frequently develop biliary obstruction： obstructive jaundice, right upper quadrant pain and weight loss. Ampullary carcinomas are frequently related to steatorrhea due to malabsorption. The most effective chemotherapy drugs used in monotherapy are 5FU （response rate 20%） and gemcitabine （response rate of 13%-60%）, so they have been selected for further development in multiple phase II clinical trials to explore their efficacy and safety in combination with other agents. In a phase III clinical trial, combination of gemcitabine and cisplatin has been selected as the schedule of choice. Target therapies are also being developed in this malignancy. The present work reviews the most current knowledge of the pathogenesis, diagnosis and natural history of biliary tract tumors. Further, review of surgery, current adjuvant treatment and therapies for unresectable and advanced disease is provided. The most recent understanding for target therapies and molecular biology is also summarized.

Ovulation induction in the gynecological cancer patient

Malignancy is a serious disease that can lead to serious morbidity and mortality. However, the survival rates for women with cancers have increased significantly during the past decades, reflecting improved diagnosis and treatment. With the increased survival in young women with cancer, more attention is being paid to preservation of fertility, which is potentially jeopardized by chemotherapy and radiation therapy, aiming to limit the devastating sequelae of this serious illness by providing these young women with a hope for motherhood. In vitro fertilization with oocyte or embryo cryopreservation has emerged as an astounding method to preserve fertility. It entails induction of ovulation to produce oocytes, the number and quality of which are imperative factors predicting the potential efficacy of the fertility preservation procedure. The aim of this review is to discuss ovarian stimulation for fertility preservation in women with gynecological cancer.

Squamous cell carcinoma of hypopharynx in a patient with history of celiac disease

Celiac disease is a gluten-related malabsorption in small intestine occurring in genetically susceptible patients. In this disease the risk of many malignancies is increased the most important of which being non-Hodgkin lymphoma of small intestine. Other malignancies include adenocarcinoma of small intestine and squamous cell carcinoma of esophagus and melanoma. As to our knowledge so far only one case of ceJiac disease associated with hypopharyngeaJ squamous ceil car- cinoma has been reported. In this article we presented a patient suffering from celiac disease with squamous cell carcinoma of hypopharynx. She underwent chemotherapy and radiation therapy, unfortunately however she died because of progress of disease. So, in patients with celiac disease we should pay attention to various malignancies and when cases of cancers are accompanied by malabsorption we must think of celiac disease involvement.

Effect of grain-shaped moxibustion on the expression of IL-12 in peripheral blood in malignant tumor patients with both qi and blood deficiency undergoing chemotherapy

Objective To observe the clinical efficacy of grain-shaped moxibustion in reinforcing healthy qi and dispelling pathogen and to explore the possible mechanisms of grain-shaped moxibustion in improving immune function of patients through determining the expression level of IL-12 in peripheral blood of patients. Methods Seventy patients undergoing chemotherapy due to deficiency of both qi and blood type of malignant tumor in the departments of traditional Chinese medicine and oncology in Nanjing Drum Tower Hospital Affiliated to Nanjing University Medical School from January 2014 to January 2015 were randomly divided into a chemotherapy group（group A） and a chemotherapy combined with grain-shaped moxibustion group（group B） by sortition, 35 cases in each one. Patients in both groups received chemotherapy, while patients in group B also received grain-shaped moxibustionat on bilateral Zúsānl（足三里 ST 36）, which was performed once daily, 7 cones every time, for a total of continuous 20 days. Before and after treatment, the expression level of IL-12 in peripheral blood of patients was determined using ELISA method. Results After chemotherapy, the expression level of IL-12 in patients was significantly lower than that before treatment. After two courses of adjuvant therapy of grain-shaped moxibustion, the expression level of IL-12 in chemotherapy patients slightly increased and the difference was statistically significant（P〈0.05）. Conclusion Grain-shaped moxibustion can increase the expression of IL-12 in peripheral blood of patients, promote the T cellmediated immune response and achieve immunoregulation and anti-tumor effects.