Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2023-04-28 Cooperative journals: 《中国全科医学》
Abstract： Background Breast cancer is the most prevalent malignancy in the world. Endocrine therapy reduces the level of estrogen in vivo，thus affecting the blood lipid level，which reduces the quality of life and the treatment compliance of patients. Objective To analyze the clinical characteristics and traditional Chinese medicine（TCM）prescription of hyperlipidemia in estrogen receptor（ER）positive breast cancer patients during endocrine therapy in real world. MethodsBased on method of retrospective study，a total of 238 patients with ER positive breast cancer who received endocrine therapy in Shandong Province Hospital of Traditional Chinese Medicine from 2012 to March 2022 were selected as the study subjects. The data including age，triglyceride，total cholesterol，low density lipoprotein，endocrine therapy drugs，TCM prescriptions of the patients were exported through the search platform of scientific research big data to establish a clinical data table of the patients. ER positive breast cancer patients with normal baseline blood lipid levels were divided into the normal group and dyslipidemia group according to the blood lipid levels during endocrine therapy，and hyperlipidemia was classified into hypercholesterolemia，hypertriglyceridemia and mixed hyperlipidemia. The exported prescriptions were analyzed for frequency，four properties，five flavors，channel tropism and medication regularity by using the 〝prescription analysis"，an auxiliary platform for TCM inheritance，to obtain new prescriptions. Results Among 238 ER positive breast cancer patients，97 patients（41.00%）had normal baseline blood lipid levels，of whom 42 patients developed dyslipidemia during standardized endocrine therapy. Among the patients with dyslipidemia，77 person-time（37.6%）occurred in the age group of 51 to 60 years as the highest number；86 person-time with dyslipidemia received exemestane treatment，accounting for the highest proportion of 41.9%. Among the 42 patients with dyslipidemia（205 person-time in total），hyperlipidemia occurred in 99 person-time，and hypercholesterolemia occurred in 49 person-time（54.13%）. There was no statistically significance difference in the age of patients with three types of hyperlipidemia（P>0.05）. There were statistically significance differences in the proportion of endocrine therapy types among patients with three types of hyperlipidemia（P<0.05）. There were 189 kinds of TCM prescriptions for hyperlipidemia in ER positive breast cancer patients during endocrine treatment，licorice was the most frequently used medicine，the highest frequency of use was tonifying qi drug. The channels of TCM collected by the big data platform were mainly distributed in the spleen，lung and liver channels. The properties of TCM were mainly cold，flat and warm，and the flavors were mainly sweet，bitter and pungent. The combination of 〝Astragalus and Licorice" had the highest frequency. Six core drug combinations and three new prescriptions were obtained through complex system entropy clustering analysis. Conclusion Based on analysis of clinical characteristics and prescription medication，the position of hyperlipidemia in ER positive breast cancer patients during endocrine therapy is in the spleen，with pathogenesis of dysfunction of spleen in transportation and phlegm turbidity stagnation. The medication are maily used for invigorating spleen to remove dampness，tonifying qi and regulating stomach.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2023-12-19 Cooperative journals: 《中国全科医学》
Abstract： Background With the continuous development of the training program of rural order-oriented medical students（referred to as publicly-funded medical students）in China，the talent team of general practice is constantly enriched， and the professional identity status and its influencing factors in rural order-oriented medical students have become the focus of current attention. Objective To analyze the influencing factors of professional identity in rural order-oriented medical students. Methods Purposive sampling method was used to interview the 30 rural order-oriented medical students from 2018 to 2022 grade of Traditional Chinese Medicine（five-year system）Beneficiary Class of Shandong University of Traditional Chinese Medicine by semi-structured interviews from December 2022 to March 2023. The interview data were coded and analyzed by using open coding，axial coding，and selective coding，following the Anselm Strauss and Juliet Corbin programmatic grounded theory approach. Results A total of 482 initial concepts and 47 basic categories were extracted by open coding，9 main categories obtained by axial coding. A typical relationship structure was formed by selective coding，and it showed that the influencing factors of professional identity in rural order-oriented medical students were consisted with six dimensions of career cognition，career behavior，career choice，career will，career emotion，and career belief. Conclusion The influencing factors of professional identity in rural order-oriented medical students are composed of six dimensions，including career cognition，career behavior， career choice，career will，career emotion，and career belief，of which career cognition，career behavior，and career choice belong to the exogenous factors，while career will，career belief，and career emotion belong to the implicit factors.
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