Examining patterns of traditional Chinese medicine use in pediatric oncology: A systematic review,meta-analysis and data-mining study

BackgroundTraditional Chinese medicine (TCM) is becoming a popular complementary approach in pediatric oncology. However, few or no meta-analyses have focused on clinical studies of the use of TCM in pediatric oncology.ObjectiveWe explored the patterns of TCM use and its efficacy in children with cancer, using a systematic review, meta-analysis and data mining study.Search strategyWe conducted a search of five English (Allied and Complementary Medicine Database, Embase, PubMed, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov) and four Chinese databases (Wanfang Data, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, and VIP Chinese Science and Technology Periodicals Database) for clinical studies published before October 2021, using keywords related to “pediatric,” “cancer,” and “TCM.”Inclusion criteriaWe included studies which were randomized controlled trials (RCTs) or observational clinical studies, focused on patients aged < 19 years old who had been diagnosed with cancer, and included at least one group of subjects receiving TCM treatment.Data extraction and analysisThe methodological quality of RCTs and observational studies was assessed using the six-item Jadad scale and the Effective Public Healthcare Panacea Project Quality Assessment Tool, respectively. Meta-analysis was used to evaluate the efficacy of combining TCM with chemotherapy. Study outcomes included the treatment response rate and occurrence of cancer-related symptoms. Association rule mining (ARM) was used to investigate the associations among medicinal herbs and patient symptoms.ResultsThe 54 studies included in this analysis were comprised of RCTs (63.0%) and observational studies (37.0%). Most RCTs focused on hematological malignancies (41.2%). The study outcomes included chemotherapy-induced toxicities (76.5%), infection rate (35.3%), and response, survival or relapse rate (23.5%). The methodological quality of most of the RCTs (82.4%) and observational studies (80.0%) was rated as “moderate.” In studies of leukemia patients, adding TCM to conventional treatment significantly improved the clinical response rate (odds ratio [OR] = 2.55; 95% confidence interval [CI] = 1.49–4.36), lowered infection rate (OR = 0.23; 95% CI = 0.13–0.40), and reduced nausea and vomiting (OR = 0.13; 95% CI = 0.08–0.23). ARM showed that Radix Astragali, the most commonly used medicinal herb (58.0%), was associated with treating myelosuppression, gastrointestinal complications, and infection.ConclusionThere is growing evidence that TCM is an effective adjuvant therapy for children with cancer. We proposed a checklist to improve the quality of TCM trials in pediatric oncology. Future work will examine the use of ARM techniques on real-world data to evaluate the efficacy of medicinal herbs and drug-herb interactions in children receiving TCM as a part of integrated cancer therapy.     

Patient and Family Caregivers’ Experiences of Living With a Jejunostomy Feeding Tube After Surgery for Esophagogastric Cancer

Background:Jejunostomy feeding tubes (JFTs) can be used to provide nutrition support to patients who have had surgery for esophagogastric cancer. Although previous research reports how patients cope with a gastrostomy tube, little is known about the impact of having a JFT. The aim of this qualitative study was to explore how patients and their informal caregivers experience living with a JFT in the first months following surgery. Methods: Participants were purposively sampled from a cohort of patients recruited to a trial investigating home enteral nutrition vs standard care after esophagogastric surgery for cancer. The sampling framework considered age, sex, and marital status. Informal caregivers were also invited to participate. Interviews were audio recorded, transcribed verbatim, and anonymized. Inductive thematic analysis was used to identify key themes related to living with a JFT. Results: Fifteen patient interviews were conducted; 8 also included a family caregiver. Analysis of the data resulted in 2 main themes: “challenges” and “facilitators” when living with a JFT. While “physical effects,” “worries” and “impact on routine” were the main challenges, “support,” “adaptation” and “perceived benefit” were what motivated continuation of the intervention. Conclusion: Findings suggest that participants coped well with a JFT, describing high levels of compliance with stoma care and the feeding regimen. Nonetheless, disturbed sleep patterns and stoma‐related problems proved troublesome. A better understanding of these practical challenges, from the patient and family caregiver perspective, should guide healthcare teams in providing proactive support to avoid preventable problems.     

肿节风颗粒对小型猪腮腺急性放射损伤防护作用的实验研究

目的 探讨小型猪腮腺放射损伤后肿节风颗粒对其外周血和腮腺ROS含量的影响.方法 15只雄性小型猪随机分成空白组、单照组、药照组.药照组在照射前一周开始给药至腮腺标本的取出,空白组和单照组给予等量的生理盐水.在麻醉条件下单照组和药照组均给予15Gy γ射线照射双侧腮腺,空白组给予0 Gy照射.在照射前1天和照射后第10天前腔静脉抽血进行血常规检测;照射后第10天取双侧腮腺,称取重量后分装,以猪活性氧(ROS)酶联免疫分析试剂盒检测其ROS的含量.结果 肿节风能促进白细胞的恢复、减缓红细胞的下降、提高血小板的含量;空白组、单照组、药照组ROS的浓度分别为12.50,88.16,13.57 U/ml,药照组和空白组的差异无统计学意义(P>0.01).结论 肿节风对小型猪腮腺放射损伤后外周血的恢复有促进作用,对ROS的清除作用比较明显,对小型猪急性腮腺放射损伤有一定程度的辐射防护作用.     

4,4′,4″-三氨基三苯胺合成工艺的改进

以对氯硝基苯与对硝基苯胺为原料,经过两步反应合成三偶氮类医药中间体4,4′,4″-三氨基三苯胺,第一步以氟化钾/季铵盐为催化剂,进行常规的加热合成方法以及微波辐射合成方法进行收率比较,收率分别为45.3%、46.8%,且微波辐射合成使反应时间从常规的加热合成所需的10h缩短到3h;第二步反应用锌粉/盐酸+冰醋酸进行还原,收率为87.9%。     

出生前暴露1800MHz电磁场大鼠Morris迷宫测试

目的探讨出生前1800 MHz微波辐射对大鼠学习和空间记忆行为的影响.方法用功率为1800MHz密度为0.5 mW/cm2的微波于大鼠孕期0～20 d全身连续照射,同时设置对照组.用Morris水迷宫对10周龄F1代仔鼠进行学习和空间记忆功能的测定.结果暴露组与对照组在学习记忆功能上差异无显著性(P＞0.05),但暴露组在空间定位上有性别差异,雌鼠能力较雄鼠差,P＜0.05.结论该次实验没有发现1800MHz射频场暴露对10周龄F1代仔鼠的学习和空间记忆有影响.     

妊娠期患者腹部CT检查所致胎儿辐射风险分析

目的：对妊娠患者进行常规腹部螺旋CT扫描所致胎儿辐射风险进行评估。方法：曝光条件由临床CT检查选择病例的统计数据确定。CT扫描仪包括3个生产厂商的双排、16排和64排CT。胎儿受照剂量由患者子宫的器官剂量代替。子宫器官剂量由SR250软件估算。结果：对于所有机型的常规腹部螺旋CT扫描,胎儿受照剂量范围为14～26mGy,平均值和方差为（18.5±4.7）mGy。结论：根据ICRP建议书,分别从3个角度评价胎儿辐射效应：①常规腹部螺旋CT扫描不会引起胎儿组织损伤及功能障碍;②不会造成胎儿智力发育障碍;③胎儿时期的X射线照射会提高幼儿时期癌症的发生率。然而,由于实际情况的复杂性,很难确定这个癌症发生率提高的程度有多大。因此,根据本次实验所估计的胎儿受照剂量,妊娠患者进行常规腹部螺旋CT扫描导致胎儿发生辐射效应的概率极低。     

三维适形放疗同步TP方案治疗中晚期宫颈癌的临床观察

目的观察三维适形放疗同步TP方案治疗中晚期宫颈癌的的临床疗效。方法将75例中晚期宫颈癌患者随机分为治疗组和对照组,治疗组38例,接受三维适形放疗同步TP(多西紫杉醇+顺铂)方案化疗;对照组37例,接受放疗。结果治疗组的有效率为94.7%,明显高于对照组的70.3%,差异有统计学意义(P﹤0.05)。随访2年,治疗组和对照组的局部复发率分别为7.9%和29.7%,远处转移率分别为10.5%和35.1%,差异均有统计学意义(P﹤0.05)。两组的1、2年生存率分别为92.1%和70.3%,84.2%和62.2%,差异有统计学意义(P﹤0.05)。治疗组的胃肠道副反应、骨髓抑制、放射性直肠炎及放射性膀胱炎的发生率略高于对照组,但差异无统计学意义(P﹥0.05)。结论对于中晚期宫颈癌患者,同步放化疗与单纯放疗相比可降低局部复发率和远处转移率,提高1、2年生存率,是一种安全有效的辅助治疗方法。     

中药肺纤方防治放射性肺损伤的临床研究

目的:观察肺纤方治疗放射性肺损伤的临床疗效.方法:选择符合放射性肺损伤诊断患者63例,随机分为两组.接受直线加速器治疗后,对照组采取西医对症治疗;治疗组采取口服以中药肺纤方为主方治疗.30 d为1个疗程,2个疗程后观察放射性肺损伤的评定及分级、毒副反应、生活质量等情况.结果:治疗组客观疗效和放射性肺损伤的评定疗效分级优...     

γ射线诱发培养淋巴细胞TCR基因突变的剂量-效应关系

目的　探讨γ射线诱发培养淋巴细胞T细胞受体 (TCR)基因突变的剂量 效应关系。方法　以不同剂量 (0～ 4 0Gy)的γ射线照射新鲜分离的健康成人外周血淋巴细胞 ,植物血凝素脉冲式刺激 2h后 ,用白细胞介素- 2培养 7d ,用单克隆抗体直接免疫荧光标记流式细胞术检测TCR基因突变频率 (TCRMF)。应用SAS统计软件包编写的程序进行辐射剂量 效应曲线的拟合和筛选。结果　培养 7d后 ,TCRMF (10 -4)随照射剂量D (Gy)的增加而增高 ,最佳拟合曲线为二次多项式模型 ,其方程式可描述为 :TCRMF =2 . 74+ 6. 0 5D + 7 60D2 (F =3 62. 3 7 16,P <0 . 0 1,经校正的R2 =0 . 9999)。结论　TCR基因突变作为一种有潜力的生物剂量计可能用于近期辐射照射生物剂量的估算。     

两种数字化X线影像系统在冠状动脉造影中的辐射剂量对比研究

目的:评价平板探测器(FPD)和基于电荷耦合器成像的影像增强器(II-CCD)在冠状动脉造影时对患者辐射剂量的影响。方法:采用FPD和II-CCD分别在拟人模体上进行冠状动脉造影操作,并采用射线剂量仪测量辐射剂量和剂量率,每台造影机测量3次,取算数平均值。结果:在透视模式下,FPD较II-CCD辐射剂量减少5.6%,在摄影模式下则增加7.8%,完成冠状动脉造影FPD较II-CCD总射线剂量增加2.3%。结论:在冠状动脉造影时采用FPD较II-CCD于透视模式下可减少对人体的辐射剂量,摄影模式下则增加辐射剂量,完成冠状动脉造影所需总射线剂量也稍增加。