Utilizing complementary therapy to enhance quality of life and reduce stress and fatigue in pediatric cancer patients

The international scientific literature presents still incipient results regarding the management of cancer symptom clusters by oncology nursing,especially in pediatric oncology.This is a promising field of investigation for clinical nurses and researchers,and when it is subsidized by medium-range theories,they co-rroborate the diagnoses and interventions of nursing in oncology,enhancing the science of nursing care.This minireview article aims to discuss the utilizing the hospital clowns as a complementary therapy,to enhance quality of life and reduce stress and fatigue in pediatric cancer patients.Overall,the evidence presented so far pointed out that complementary therapy might help improve the quality of life of pediatric cancer patients,and that complementary therapy usage should be part of a health comprehensive care model,delivering therapeutic approaches that might enhance the mind-body during a pediatric cancer patients’life span.The results of scientific investigations by nurses,particularly those linked to the basic sciences,play a critical role in advancing personalized care in pediatric integrative oncology.

Effects of Tongluo Jiedu prescription on immune function and oxidative stress in patients with oral cancer

BACKGROUND Oral cancer,which is caused by mucous membrane variation,represents a prevalent malignant tumor in the oral and maxillofacial region,posing a significant threat to patients’lives and safety.While surgical intervention stands as a cornerstone treatment for oral cancer patients,it carries the risk of incomplete treatment or high rates of postoperative recurrence.Hence,a multifaceted approach incorporating diverse treatment modalities is essential to enhance patient prognosis.AIM To analyze the application effect of Tongluo Jiedu prescription as adjuvant therapy and its influence on patient prognosis in patients with oral cancer.METHODS Eighty oral cancer patients in our hospital were selected and divided into the observation group and control group by a random number table.The control group was treated with continuous arterial infusion chemotherapy of cisplatin and 5-fluorouracil.The observation group was additionally given Tongluo Jiadu prescription.The inflammatory stress level,peripheral blood T-cell subsets,and immune function of the two groups were subsequently observed.SPSS 21.0 was used for data analysis.RESULTS The observation group demonstrated lower levels of interleukin-6 and C-reactive protein,and a higher level of tumor necrosis factor in comparison to the control group.After treatment,the immune function in the observation group was significantly better than in the control group.CONCLUSION Tongluo Jiedu prescription can improve the immune function and oxidative stress level of patients with oral cancer and accelerate the recovery process.

Depression and anxiety among cancer patients visiting a tertiary care cancer hospital

BACKGROUND Cancer patients frequently experience psychological problems related to reactions to cancer diagnosis,cancer type and stage,treatment effects,recurrence,fear of end-of-life,survivorship,and financial burden.Depression and anxiety are both psychological and physiological disturbances among cancer patients.AIM To assess the prevalence of depression and anxiety among cancer patients attending a tertiary care cancer hospital.METHODS A cross-sectional study was conducted at Bhaktapur Cancer Hospital in Kathmandu Valley among 220 cancer patients aged from 18 years to 70 years.Ethical approval was taken from the Institutional Review Committee of CiST College.Convenient sampling was used to interview patients with the standardized Patient-Health Questionnaire(PHQ-9)for Depression and Hospital Anxiety and Depression sub-scale(HADS-A)for anxiety.Epi-Data was used for data entry and transferred to SPSS Version 25 for analysis.RESULTS The study revealed that of 220 patients,most of the respondents belonged to the age group 51-60 years.More than half 131(59.6%)of the respondents were female,most of them had depression,and one-third had anxiety.Among the respondents,124(56.4%)had mild depression,70(31.8%)had moderate depression,and 3(1.3%)had severe depression;79(35.9%)had mild anxiety,64(29.1%)had moderate anxiety,and 4(1.8%)had severe anxiety.CONCLUSION Most respondents were depressed and one-third had anxiety.More than half and nearly one-third had mild and moderate depression,respectively,and nearly one-third had mild and moderate anxiety,which is higher than other studies.

Progress in Research on the Impact of Religious Psychological Coping on the Holistic Well-Being of Cancer Patients and Relevant Factors

This study reviews the historical development,current applications,and multifaceted impacts of religious psychological coping on the physical and mental health of cancer patients.As a method for coping with life’s pressures through religious beliefs or activities,religious psychological coping has been proven to alleviate the negative emotions of cancer patients and enhance their spiritual well-being and quality of life(QOL).Research indicates that religious faith can alleviate the physical symptoms of cancer patients,extend survival time,reduce the fear of death,assist in coping with treatment side effects,and improve self-efficacy and overall quality of life.Additionally,this study explores factors influencing religious psychological coping,including demographic and sociological characteristics,the faith status of caregivers,types of religion,the relationship between the course of the disease and the duration of belief,and psychological factors.Considering the cultural differences between China and other countries,this study calls for further research into the real experiences of cancer patients with religious beliefs and provides theoretical guidance for clinical nursing practices to achieve holistic care for the body,mind,and spirit of cancer patients.

Assessment of Cancer-Related Fatigue Expression:Comparing the Expression of Fatigue in Patients with a History of Cancer,Patients with Other Chronic Diseases,and Healthy Individuals

Aims:We aimed to compare cancer survivors’fatigue expression with that of the general population and examine psychobiological factors associated with fatigue.Procedure:In this quantitative,transversal study,we analyzed clinical and sociodemographic indicators of 389 participants(68.38%females):148 cancer survivors on active treatment,55 disease-free survivors,75 patients with another chronic disease,and 111 healthy individuals.Results:Fatigue was expressed dissimilarly in patients with a previous history of cancer and participants without a history of cancer.Survivors on active treatment reported significantly higher levels of fatigue than the other clinical status groups.Nonetheless,some level of cancer-related fatigue persisted,in a similar pattern,after active treatment into the survivorship phase.Disease-free survivors showed significantly lower vigor levels when compared to patients with other chronic diseases.Psychological distress and daytime sleepiness emerged as transdiagnostic factors associated with fatigue.Conclusion:Cancer-related fatigue may have a unique pattern,characterized by reduced endurance and muscle weakness.In the present study,psychological distress and daytime sleepiness are associated with cancer-related fatigue.These findings suggest the pertinence of future studies examining whether interventions targeting those factors may help manage this burdensome complaint.

Perspectives and Challenges of Family Members in Providing Mental Support to Cancer Patients:A Qualitative Study in Beijing,China

This study explores the perspectives and challenges faced by family members providing mental support to cancer patients in Beijing,China.The primary objective is to understand the emotional and practical roles family members undertake and the difficulties they encounter.Utilizing a qualitative research design,data were collected through semi-structured interviews with family caregivers of cancer patients.Thematic analysis revealed several key themes:the dual burden of emotional support and caregiving responsibilities,the impact on daily life and personal well-being,the role and effectiveness of external support systems,perceptions of medical staff support,and the common challenges and conflicts faced in caregiving.The findings highlight the critical need for comprehensive support systems that address both the emotional and practical needs of family caregivers.Recommendations for enhancing family-centered support programs in oncology settings are discussed.

Preoperative malnutrition in elderly gastric cancer patients and adverse postoperative outcomes of radical gastrectomy

Malnutrition is not only a prevalent condition among the elderly but also a common comorbidity in elderly people with gastric cancer(GC).Malnutrition is closely linked to high rates of postoperative complications and poor wound healing in elderly GC patients,which may lead to a higher incidence and mor-tality rate of GC.Malnutrition decreases the physical function of elderly GC patients after surgery,severely affecting their postoperative life quality and hindering subsequent treatments.This retrospective study was conducted by Zhao et al,focusing on the clinical baseline data,postoperative complications,and hospitalization times of elderly GC patients who underwent curative gastrectomy.Additionally,the underlying causes of poor outcomes for patients were discussed.This study may provide a solid basis for the clinical treatment of elderly GC patients in the future.Therefore,malnutrition can serve as a negative prognostic factor for curative surgery in GC patients.Addressing malnutrition and its adverse effects can benefit elderly GC patients from surgical treatment.

The Impact of Social Support on the Mental Health of Cancer Patients:Evidence from China

Exploring the relationship between social support and the mental health of cancer patients is a vital endeavor for enhancing mental well-being.The objective of this study was to explore the relationship between social support and psychological well-being in cancer patients and to provide new empirical evidence for psychological improvement in cancer patients.This research holds significant practical implications for optimizing China’s public health system and strengthening the development of a healthy China.Using data from the 2018 China Health and Retirement Longitudinal Study(CHARLS)database,we empirically examined the influence of social support on the mental health of cancer patients.Models such as Ordered Probit and OLogit were used to provide empirical evidence and theoretical insights for enhancing the mental health of cancer patients in a context marked by a high prevalence of cancer.The findings indicated that both formal and informal social support mechanisms were effective in improving the mental health of cancer patients.Furthermore,we utilized the propensity score matching(PSM)model to eliminate the endogeneity issue associated with sample selectivity bias.The results obtained through PSM demonstrated robustness,underscoring the importance of addressing sample selectivity bias when assessing the impact of social support on the mental health of cancer patients.Therefore,the Chinese government is recommended to prioritize the use of social support as a means to proactively enhance the mental health of cancer patients,thereby continuously elevating their overall quality of life.

Navigating emotional challenges:A journey with patients undergoing chemotherapy

A recent article reported that cancer patients with subthreshold depression are more likely to develop major depression within a year.Multivariate regression analysis revealed that regular exercise was a protective factor against cancerrelated fatigue,whereas advanced age,radiotherapy,pain,and low hemoglobin were risk factors for cancer-related fatigue.A limitation of this study was the lack of methodological details about leukemia patients receiving depressive treatment at a specific hospital.Professional assessment,behavioral modification plans,communication,destressing techniques,and educational plans may help chemotherapy patients manage emotional issues and reduce anxiety.Furthermore,these strategies can inspire patients to create,facilitate their treatment,and help them to remain healthy.

Family resilience of cancer patients:a concept analysis

Objective:The concept of family resilience of cancer patients was discussed through literature review,which provided reference for nursing of cancer patients.Methods:China National Knowledge Infrastructure(CNKI),Wanfang Database,SinoMed,PubMed,Web of Science,and Embase were systematically searched,and the concept analysis method proposed by Walker and Avant was adopted.Results:In this study,we defined the concept of family resilience,identified attributes,and analyzed the antecedents and consequences.The proposed operational definition of family resilience was:After a family member is diagnosed with cancer,the whole family can actively explore its own unique internal and external resources and advantages,strengthen self-regulation,jointly cope with the crisis by establishing close family relationships,providing mutual support to family members,and interacting with the outside world.Conclusions:The definition of family resilience of cancer patients is conducive to the development of measurement tools and the improvement of family outcomes of adult cancer patients by intervening family resilience factors.

Correlation between psychological,family social support,and home nursing quality for an implanted venous access port

BACKGROUND Cancer patients with an implanted venous access port(IVAP)often manage their care at home during chemotherapy intervals,including maintaining the device,monitoring complications,and following medication instructions.Home care ensures continued support after discharge.However,due to factors such as age,gender,culture,psychological status,and family support,the quality of home care varies significantly.Understanding these factors can help provide targeted guidance to improve the care of cancer patients.AIM To explore IVAP chemotherapy on home care quality and its association with mental health and family support for cancer patients.METHODS This investigative study was based on a medical records system.It investigated the relationship between psychological status,family support,and home care quality in 180 patients with cancer undergoing IVAP chemotherapy.Psychological status was assessed using the State Anxiety Inventory(S-AI);family support was assessed using the Perceived Social Support Scale(PSSS),and home care quality was evaluated using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire(EORTC QLQ-C30).Pearson’s correlation and Structural Equation Modeling were used to analyze the interplay between these factors.RESULTS The average S-AI score was 47.52±14.47,PSSS was 52.48±12.64,and EORTC QLQ-C30 was 70.09±17.32.A substantial inverse relationship was observed between the EORTC QLQ-C30 and S-AI scores(r=-0.712).A significant positive correlation was found between the EORTC QLQ-C30 and the PSSS,with a correlation coefficient of(r=0.744).The multiple linear regression analysis indicated that family social support,psychological status,and average monthly family income were the main factors influencing the variation in the quality of home care,explaining 71.9%of the variation.The Structural Equation Modeling results indicated that psychological status acted as a partial mediator in the association between family social support and home care quality of life,explaining 32.78%of the mediation effect.CONCLUSION Psychological status and family social support positively impacted cancer patients’home care quality,with psychology partially mediating this effect.

Validation And Reliability of Distress Thermometer in Chinese Cancer Patients

Objective：To examine the validation and reliability of the distress thermometer（DT） recommended by National Comprehensive Cancer Network（NCCN） in Chinese cancer patients.Methods：A total of 574 Chinese cancer patients from Beijing Cancer Hospital completed the detection of DT,the Hospital Anxiety and Depression Scale（HADS） and Symptom Checklist 90（SCL-90）,Receiver Operating Characteristic（ROC） curve and Area Under the Curve（AUC） were used to analyze the validation relative to HADS and SCL-90.The patients with DT≥4 and whose distress caused by emotional problems were interviewed with the MiNi International Neuro-psychiatric Interview（MINI）（Chinese Version 5.0）.This version was used to analyze cancer patients＇ psychological and Psychiatric symptoms during the cancer process;3.Another 106 cancer patients in rehabilitation stage and stable condition were asked to fill in DT two times,at the base time and after 7-10 days.Results：Data of ROC indicates that a DT cutoff score of 4 yielded AUC of 0.80 with a optimal sensitivity（0.80） and specificity（0.70） relative to HADS,and AUC of 0.83 with the greatest sensitivity（0.87） and specificity（0.72） against SCL-90.The DT also has acceptable test-retest reliability（r=0.800,P=0.000）;According to the interview results,the most common psychiatric problems cancer patients have adjustment disorder,depression,and anxiety.Conclusion：The data suggest that DT has acceptable overall accuracy and reliability as a screening tool for testing distress severity and specific problems causing distress in Chinese cancer patients.It is worth being used in oncology clinic,the rapid screening and interview could help caregivers to identify psychological and psychiatric problems of cancer patients and provide useful information for further treatment.

Analysis of risk factors for central venous port failure in cancer patients

AIM: To analyze the risk factors for central port failure in cancer patients administered chemotherapy, using univariate and multivariate analyses. METHODS: A total of 1348 totally implantable venous access devices (TIVADs) were implanted into 1280 cancer patients in this cohort study. A Cox proportional hazard model was applied to analyze risk factors for failure of TIVADs. Log-rank test was used to compare actuarial survival rates. Infection, thrombosis, and surgical complication rates (χ2 test or Fisher's exact test) were compared in relation to the risk factors. RESULTS: Increasing age, male gender and openended catheter use were signifi cant risk factors reducing survival of TIVADs as determined by univariate and multivariate analyses. Hematogenous malignancy decreased the survival time of TIVADs; this reduction was not statistically signifi cant by univariate analysis [hazard ratio (HR) = 1.336, 95% CI: 0.966-1.849, P = 0.080)]. However, it became a signifi cant risk factor by multivariate analysis (HR = 1.499, 95% CI: 1.079-2.083, P = 0.016) when correlated with variables of age, sex and catheter type. Close-ended (Groshong) catheters had a lower thrombosis rate than open-ended catheters (2.5% vs 5%, P = 0.015). Hematogenous malignancy had higher infection rates than solid malignancy (10.5% vs 2.5%, P < 0.001). CONCLUSION: Increasing age, male gender, openended catheters and hematogenous malignancy were risk factors for TIVAD failure. Close-ended catheters had lower thrombosis rates and hematogenous malignancy had higher infection rates.

Validation of nutritional risk index method against patientgenerated subjective global assessment in screening malnutrition in colorectal cancer patients

Objective：To validate malnutrition screening tool of nutrition risk index （NRI） against patent-generated subjective global assessment （PG-SGA） as a gold standard tool in colorectal cancer patients before radiotherapy.Methods：Nutritional status of 52 volunteer colorectal cancer patients with a mean age of 54.1±16.8 years who referred to radiotherapy center were assessed by PG-SGA （gold standard method） and NRI.Serum albumin levels of patients were determined by colorimetric method.A contingency table was used to determine the sensitivity,specificity,and predictive value of the NRI in screening patients at risk of malnutrition,in comparison with the PG-SGA in patients before radiotherapy.Results：The findings of PG-SGA and NRI showed that 52％ and 45％ of patients in our study were moderately or severely malnourished respectively.The NRI had a sensitivity of 66％ and a specificity of 60％ against PG-SGA.The positive predictive value was 64％ and the negative predicative value was 62％.The agreement between NRI and PG-SGA was statistically insignificant （kappa =0.267; P＞0.05）.Conclusions：The findings of present study showed that the prevalence of malnutrition was high in patients with colorectal cancer.Moreover,NRI method had low sensitivity and specificity in assessing nutritional status of patients with cancer.It seems that the combination of anthropometric,laboratory parameters and a subjective scoring system may be helpful tools in screening of malnutrition in cancer patients.

Attitudes towards pain management in hospitalized cancer patients and their influencing factors

Objective： To investigate patients＇ attitudes towards cancer pain management and analyze the factors influencing these attitudes.Methods： The self-developed Demographic and Disease-Related Information Questionnaires, Pain Management Barriers Questionnaire-Taiwan form（BQT）, and Pain Knowledge Questionnaire were administered to 363 pairs of hospitalized cancer patients and their caregivers from the oncology departments of 7 hospitals in Beijing, China.Results： The average patient score for attitudes towards pain management was 2.96±0.49. The dimension scores indicated good attitudes in three areas（scores 〈2.5）, ＂Desire to be good＂（2.22±1.04）, ＂Fatalism＂（2.08±0.81） and＂Religious fatalism＂（1.86±1.00）, and poor attitudes in six areas（scores ≥2.5）, ＂Tolerance＂（3.83±0.96）, ＂Use of analgesics as needed（p.r.n.）＂（3.73±1.01）, ＂Addiction＂（3.44±1.05）, ＂Disease progression＂（3.28±1.26）, ＂Distraction of physicians＂（3.16±1.07） and ＂Side effects＂（2.99±0.68）. Two factors were entered into the regression equation：the caregivers＇ attitudes towards cancer pain management and the patients＇ pain knowledge. These two factors explained 23.2% of the total variance in the patients＇ average scores for their attitudes towards cancer pain management.Conclusions： The patients＇ attitudes towards cancer pain management were poor and could be influenced by the caregivers＇ attitudes and the patients＇ pain knowledge, and thus need to be improved.

Quality of Life in Cancer Patients with Pain in Beijing

Objective： To investigate the quality of life （QOL） of cancer pain patients in Beijing, and explore the effect of cancer pain control on patients＇ QOL. Methods： Self-developed demographic questionnaire, numeric rating scale and SF-36 questionnaire were used together among 643 cancer pain patients in 28 Grade 2nd to 3rd general hospitals and 2 Grade 3rd cancer hospitals. Results： The SF-36 eight dimensions scores ranged from 31.75 to 57.22 in these cancer pain patients. The t test and Wilcoxon rank sum test were used to compare the QOL between pain controlled （PC） group and pain uncontrolled （PUC） group, and the results showed that patients in PC group had the higher O, OL scores in 6 areas of SF-36 （P〈0.05）. Binary logistic regression results found that pain management satisfaction scores （P〈0.001）, family average personal monthly income （P=0.029）, current receiving chemotherapy （P=0.009） and cancer stage （P〈0.001） were the predictors to cancer pain controlled results. Conclusion： Cancer patients with pain in Beijing had poor QOL. Pain control will improve the QOL of cancer pain patients.

Determination of PDCD5 in Peripheral Blood Serum of Cancer Patients

Objective：Programmed cell death 5 （PDCD5） is an apoptosis related gene and plays an important role in the pathogenesis and development of cancer.Whether PDCD5 is present in peripheral blood serum has not been reported.The aim of this study is to determine the contents of PDCD5 protein in peripheral blood serum of cancer patients,as well as normal subjects.Methods：ELISA was used to detect the serum PDCD5 concentrations in 100 normal persons,83 patients with breast cancer,74 patients with gastrointestinal tract cancer and 41 patients with lung cancer.The results were statistically analyzed and discussed.Results：PDCD5 could be detected in peripheral blood serum in both normal subjects and cancer patients.The serum PDCD5 contents in normal persons ranged from 3.8 to 6.1 ng/ml with a median of 4.70±0.68 ng/ml.For cancer patients the PDCD5 levels were 4.59±0.90,4.79±1.14 and 10.43±22.34 ng/ml for breast cancer,gastrointestinal cancer and lung cancer patients respectively.There was no statistically significant difference between the serum PDCD5 concentrations of normal persons and cancer patients.Conclusion：PDCD5 is present in peripheral blood.The PDCD5 levels in cancer patients are not statistically different from that of normal persons,though decreased expression of PDCD5 in malignant tissues has been found.

Effect of modified ShengYangYiwei decoction on painless gastroscopy and gastrointestinal and immune function in gastric cancer patients

BACKGROUND Painless gastroenteroscopy is a widely developed diagnostic and treatment technology in clinical practice.It is of great significance in the clinical diagnosis,treatment,follow-up review and other aspects of gastric cancer patients.The application of anesthesia techniques during manipulation can be effective in reducing patient fear and discomfort.In clinical work,the adverse drug reactions of anesthesia regimens and the risk of serious adverse drug reactions are increased with the increase in propofol application dose application dose;the application of opioid drugs often causes gastrointestinal reactions,such as nausea,vomiting and delayed gastrointestinal function recovery,after examination.These adverse effects can seriously affect the quality of life of patients.AIM To observe the effect of modified ShengYangYiwei decoction on gastrointestinal function,related complications and immune function in patients with gastric cancer during and after painless gastroscopy.METHODS A total of 106 patients with gastric cancer,who were selected from January 2022 to September 2022 in Xiamen Traditional Chinese Medicine Hospital for painless gastroscopy,were randomly divided into a treatment group(n=56)and a control group(n=50).Before the examination,all patients fasted for 8 h,provided their health education,and confirmed if there were contraindications to anesthesia and gastroscopy.During the examination,the patients were placed in the left decubitus position,the patients were given oxygen through a nasal catheter(6 L/min),the welling needle was opened for the venous channel,and a multifunction detector was connected for monitoring electrocardiogram,oxygen saturation,blood pressure,etc.Naporphl and propofol propofol protocols were used for routine anesthesia.Before anesthesia administration,the patients underwent several deep breathing exercises,received intravenous nalbuphine[0.nalbuphine(0.025 mg/kg)],followed by intravenous propofol[1.propofol(1.5 mg/kg)]until the palpebral reflex disappeared,and after no response,gastroscopy was performed.If palpebral reflex disappeared,and after no response,gastroscopy was performed.If any patient developed movement,frowning,or hemodynamic changes during the operation(heart rate changes during the operation(heart rate increased to>20 beats/min,systolic blood pressure increased to>20%of the base value),additional propofol[0.propofol(0.5 mg/kg)]was added until the patient was sedated again.The patients in the treatment group began to take the preventive intervention of Modified ShengYangYiwei decoction one week before the examination,while the patients in the control group received routine gastrointestinal endoscopy.The patients in the two groups were examined by conventional painless gastroscopy,and the characteristics of the painless gastroscopies of the patients in the two groups were recorded and compared.These characteristics included the total dosage of propofol during the examination,the incidence of complications during the operation,the time of patients'awakening,the time of independent activities,and the gastrointestinal function of the patients after examination,such as the incidence of reactions such as malignant vomiting,abdominal distension and abdominal pain,as well as the differences in the levels of various immunological indicators and inflammatory factors before anesthesia induction(T0),after conscious extubation(T1)and 24 h after surgery(T2).RESULTS There was no difference in the patients’general information,American Society of Anesthesiologist classification or operation time between the two groups before treatment.In terms of painless gastroscopy,the total dosage of propofol in the treatment group was lower than that in the control group(P<0.05),and the time of awakening and autonomous activity was significantly faster than that in the control group(P<0.05).During the examination,the incidence of hypoxemia,hypotension and hiccups in the treatment group was significantly lower than that in the control group(P<0.01).In terms of gastrointestinal function,the incidences of nausea,vomiting,abdominal distension and abdominal pain in the treatment group after examination were significantly lower than those in the control group(P<0.01).In terms of immune function,in both groups,the number of CD4+and CD8+cells decreased significantly(P<0.05),and the number of natural killer cells increased significantly(P<0.05)at T1 and T2,compared with T0.The number of CD4+and CD8+cells in the treatment group at the T1 and T2 time points was higher than that in the control group(P<0.05),while the number of natural killer cells was lower than that in the control group(P<0.05).In terms of inflammatory factors,compared with T0,the levels of interleukin(IL)-6 and tumor necrosis factor-alpha in patients in the two groups at T1 and T2 increased significantly and then decreased(P<0.05).The level of IL-6 at T1 and T2 in the treatment group was lower than that in the control group(P<0.05).CONCLUSION The preoperative use of modified ShengYangYiwei decoction can optimize the anesthesia program during painless gastroscopy,improve the gastrointestinal function of patients after the operation,reduce the occurrence of examination-related complications.

Use of Chinese Herbal Medicine Therapies in Comprehensive Hospitals in Central China: A Parallel Survey in Cancer Patients and Clinicians

Summary： Chinese herbal medicine （CHM）, as the largest application category of traditional Chinese medicine （TCM）, is widely accepted among cancer patients in China. Herbal slice （HS） and Chinese patent drug （CPD） are commonly used CHM in China. This study aimed to investigate the utilization of CHM among clinicians and cancer patients in central China. Five hundred and twenty-five patients and 165 clinicians in 35 comprehensive hospitals in central China were asked to complete an anonymous questionnaire that was designed to evaluate the use of CHM. The results showed that 90.74% clinicians and 72.24% cancer patients used CHM during cancer treatment. The educational backgrounds of the clinicians and the age, education level, annual income, and cancer stage of the cancer patients were re- lated to use of CHM. More than 90% clinicians and cancer patients had used CPD. Comparatively, the percentage of HS use was 10% lower than that of CPD use among clinicians and cancer patients. More clinicians preferred to use CHM after surgery than cancer patients did （20.41% vs. 5.37%）. Enhancing physical fitness and improving performance status were regarded as the most potential effect of CHM on cancer treatment （85.71% among clinicians and 94.07% among cancer patients）, in comparison with directly killing tumor cells （24.49% among clinicians and 31.36% among patients）. As for refusal rea- sons, imprecise efficacy was the unanimous （100%） reason for clinicians＇ rejection of CHM, and 95.58% patients objected to using CHM also for this reason. Furthermore, the side effects of CHM were more concerned by clinicians than by patients （33.33% vs. 15.81%）. In conclusion, our survey revealed that CHM was popularly accepted by clinicians and cancer patients in central China. The reasons of use and rejection of CHM were different between clinicians and cancer patients.

Cancer risk in relatives of BRCA1/2 pathogenic variant carriers in a large series of unselected patients with breast cancer

Objective:The spectrum and risk of cancer in relatives of BRCA1/2 pathogenic variant carriers in the Chinese population have not been established.Methods:A family history of cancer in 9903 unselected breast cancer patients was retrospectively analyzed.BRCA1/2 status was determined for all patients and relative risks(RRs)were calculated to evaluate cancer risk in relatives of the patients.Results:The incidences of breast cancer in female relatives of BRCA1 carriers,BRCA2 carriers,and non-carriers were 33.0%,32.2%,and 7.7%,respectively.The corresponding incidences of ovarian cancer were 11.5%,2.4%,and 0.5%,respectively.The incidences of pancreatic cancer in male relatives of BRCA1 carriers,BRCA2 carriers,and non-carriers were 1.4%,2.7%,and 0.6%,respectively.The corresponding incidences of prostate cancer were 1.0%,2.1%,and 0.4%,respectively.The risks of breast and ovarian cancers in female relatives of BRCA1 and BRCA2 carriers were significantly higher than female relatives of non-carriers(BRCA1:RR=4.29,P<0.001 and RR=21.95,P<0.001;BRCA2:RR=4.19,P<0.001 and RR=4.65,P<0.001,respectively).Additionally,higher risks of pancreatic and prostate cancers were noted in male relatives of BRCA2 carriers than non-carriers(RR=4.34,P=0.001 and RR=4.86,P=0.001,respectively).Conclusions:Female relatives of BRCA1 and BRCA2 carriers are at increased risk for breast and ovarian cancers,and male relatives of BRCA2 carriers are at increased risk for pancreatic and prostate cancers.