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Beijing Journal of
Traditional Chinese Medicine

Announcement
 
Current Issue Just Accepted Archive Most Read Most Download
2018 Vol. 10, No. 5  Published: 20 October 2018
 
 
 
 
 
The development trend of precision treatment for colorectal cancer
2018, 10(5): 273-277,282  
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Abstract
 Precise treatment of colorectal cancer is the convergence and application of many cuttingedge technologies such as biotechnology and information technology in the clinical practice. With the development of evidencebased medicine and the discovery of more and more reliable molecular markers, the precise treatment of colorectal cancer will gradually penetrate into various fields such as surgical treatment, chemotherapy, radiotherapy, targeted therapy, immunotherapy, and etc. It will guide individualized and accurate treatment for patients with different characteristics. This article will describe precise treatment of colorectal cancer in combination with clinical practices.
 
Related questions and research improvements of apical lymph node dissection in rectal and sigmoid cancer surgery
2018, 10(5): 278-282  
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Abstract
The necessity of D3 dissection is one of the most controversial research spot in rectal and sigmoid cancer surgery. As the key point of D3 dissection, the apical lymph node by the root of inferior mesenteric artery has important clinical significance. In this article, we discussed about several hottest questions about apical lymph node dissection, including surgery characteristics, high or low ligation, and clinical significance of metastatic apical lymph nodes. We also introduced the latest studies regarding to these questions. With the improvement of precision medicine and evidencebased medicine, it is becoming more valuable to make better evaluation of the pathological status and make better decision on whether or not to dissect the inferior mesenteric artery root lymph node. More highquality clinical research is still required to get better knowledge of it.
Observational study of protective effects of cluster intervention on postoperative surgical site infection of rectal cancer
2018, 10(5): 283-286  
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Abstract
ObjectiveTo explore the risk factors of postoperative surgical site infection of rectal cancer and the clinical effects of cluster intervention on preventing infection.
MethodsTotally 105 patients who underwent radical resection of rectal cancer at Jiangsu Province Hospital of TCM from January 2014 to December 2016 were enrolled in this study. After March 2015, all patients received cluster intervention during surgery. These patients were then divided into cluster intervention group (55) and control group (50), according to whether the cluster intervention measures were applied during the operations, then we analyzed the rate of SSI between the two groups. Furthermore, the clinical factors were compared between the infection group and noninfection group.
ResultsThe rate of SSI was 91% (5/55) in the cluster intervention group and 34% (17/50) in the control group; the difference between the two groups was statistically significant (P=0002). Compared to the noninfection group, the proportions of concomitant diabetes, intraoperative blood transfusion, invasive depth beyond muscularis (T3+T4), later TNM stage (Ⅲ+Ⅳ) and unused cluster intervention were significantly increased in the infection group (P<005 for all). The result of multivariate logistic analysis revealed that unused cluster intervention, concomitant diabetes, intraoperative blood transfusion and later TNM stage (Ⅲ螅?Ⅳ? were the independent risk factors for SSI (P=0002, 0007, 0007 and 001, respectively).
ConclusionsThe cluster intervention could decrease the rate of SSI for rectal cancer operation. Unused cluster intervention, concomitant diabetes, intraoperative blood transfusion and later TNM stage (Ⅲ+Ⅳ) were the independent risk factors for SSI. The application of cluster intervention intraoperatively was the effective measure to decrease SSI rate for rectal cancer operation.
Neoadjuvant chemotherapy combined with nutritional support reduces postoperative abdominal complications in colorectal cancer patients with incomplete obstruction
2018, 10(5): 287-290,295  
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Abstract
ObjectiveTo investigate the feasibility of neoadjuvant chemotherapy (NACT) for nutritional support of colorectal cancer patients with incomplete obstruction, and to observe the effect of NACT and nutritional support on the incidence of postoperative abdominal complications.
MethodsClinical date of 139 colorectal cancer patients with incomplete obstruction treated in the Affiliated Hospital of Nanjing University of Traditional Chinese Medicine from August 2011 to January 2016 were retrospectively analyzed, 87 cases received NACT, otherwise 52 cases refused to NACT. Differences in the incidence of postoperative abdominal complications were compared between the NACT group and the nonNACT groups.
ResultsAll 87 patients completed 2 courses of NACT, whose nutritional status were significantly improved, and whose scores of obstruction were increased in different degrees. The incidence of postoperative abdominal complications was 115% (10/87) in patients who underwent NACT, whereas the incidence of postoperative abdominal complications was 308% (16/52) who refused NACT. Single factor analysis indicated that ASA (American Anesthesiologists Association) classification, NRS2002 (Nutrition Screening 2002) score, preoperative obstruction score, NACT, combined organ resection were related to the incidence of postoperative abdominal complications; Multivariate analysis revealed that NRS2002 and combined organ resection were independent risk factors for postoperative abdominal complications. Preoperative obstruction score and NACT were protective factors of postoperative abdominal complications.
ConclusionsThe stage of tumor in all colorectal cancer patients with incomplete obstruction is advanced. NACT combined with nutritional support can improve nutritional status, reduce the degree of obstruction, and then reduce the incidence of postoperative abdominal complications of these patients.
Epidemiology and clinicopathological features of secondary lung cancer after breast cancer
2018, 10(5): 291-295  
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Abstract
ObjectiveTo explore epidemiology and clinicopathological features of secondary lung cancer after breast cancer.
MethodsData excavating from pubmed and CNKI database and data of 32 paired breast cancer patients from Jiangsu Province Hospital were retrospectively analyzed.
ResultsThe median age is 50 to 59 years old, with a median time interval, generally between 435 to 60 months. The pathological types of infiltrating ductal carcinoma of breast cancer patients account for a higher proportion. T1, T2, N0, stage Ⅱ breast cancer patients account for a higher proportion. Luminal type breast cancer has a higher proportion. All lung cancers are single lung masses, most in ipsilateral side of breast cancer and most are adenocarcinoma.
ConclusionsThis study reveals a series of epidemiological and clinicopathological features of lung cancer secondary to breast cancer.
Comparison of curative effect of different laparoscopic and open surgery in the treatment of adrenal tumors >6 cm
2018, 10(5): 296-299  
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Abstract
ObjectiveTo investigate the clinical efficacy and safety of different methods of laparoscopy and open surgery for the treatment of adrenal tumors >6 cm.
MethodsBetween January 2008 and December 2017, 88 cases of patients with adrenal tumors>6 cm underwent surgery in our hospital. Afterward, their clinical and pathological data were extracted and analyzed. The operations were divided into laparoscopic group (65 cases) and open surgery group (23 cases), and the laparoscopic groups were divided into transperitoneal group (39 cases) and retroperitoneal group (26 cases) according to different surgical approaches. The operative time, intraoperative blood loss, intraoperative blood transfusion volume, postoperative analgesia time, postoperative hospitalization time, postoperative drainage tube retention time and postoperative complications were compared between the three groups.
ResultsThe complications, intraoperative blood transfusion cases, postoperative analgesia, postoperative hospitalization time and postoperative bleeding of the transperitoneal and retroperitoneal groups were significantly less than those of the open surgery group in operation (P<005), but there was no significant difference between the transperitoneal group and the retroperitoneal group (P>005). There was no significant difference between the three groups in the operation time and the retention time of postoperative drainage tube (P>005).
ConclusionsLaparoscopic operation through abdominal or retroperitoneal approach is safe and effective in the treatment of adrenal tumors>6 cm, and its curative effect is much better than open surgery. It is worthy of clinical promotion.
Clinical and cerebrospinal fluid cytology features of 31 cases of adult meningeal carcinomatosis
2018, 10(5): 300-303  
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Abstract
ObjectiveTo investigate the clinical and cerebrospinal fluid (CSF) cytology characteristics of meningeal carcinomatosis (MC).
MethodsThirty one patients with MC were retrospectively analyzed in the authors affiliated hospital from June 2014 to June 2018, diagnosed by CSF cytology.
ResultsIn 31 patients, 13 were male and 18 were female, the average age was (595±88) years old. Eighteen cases had a history of tumor, and the main clinic manifestation was subacute headache, accompanied intracranial hypertension. Tumor marker raised in 917% patients, enhanced magnetic resonance imaging (MRI) showed leptomeningeal enhancement in 474% individuals. CSF cytology demonstrated mild inflammatory reaction, and all of 31 patients were found suspicious heterocyst. The immunohistochemical staining was positive which ascertained metastatic cancer cell.
ConclusionsMiddleaged and elder patients without a history of tumor, subacute headache within 6 months, MC should be exclude. Tumor marker, enhanced MRI were helpful to improve the diagnosis of MC Noninvasively, definite diagnosis depended on CSF cytology. Immunohistochemical staining should be check while suspicious heterocyst was found.
 
Application value of human epididymis secretory protein 4 and carbohydrate antigen 125 in fallopian tube cancer
2018, 10(5): 304-307  
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Abstract
ObjectiveTo investigate the value of serum human epididymis secretory protein 4(HE4)and carbohydrate antigen 125(CA125)in the diagnosis of fallopian tube cancer.
MethodsA retrospective analysis was carried out on the levels of serum HE4 and CA125 in 574 patients who were admitted to the authors affiliated hospital from January 2016 to January 2018 by plotting the ROC curve of HE4 and CA125, their diagnostic value was evaluated.
The postoperative pathological diagnosis was divided into 8 groups including the tubal carcinoma group (48 cases), the ovarian cancer group (157 cases), the endometrial carcinoma group (72 cases), the cervical cancer group (70 cases), the fallopian tube benign tumor group 67 cases (including oviduct inflammation, stagnant water, cyst, etc.), the ovarian benign tumor group (80 cases, including ovarian cyst, cystic adenoma, fibroma, etc.), benign uterine tumor (80 cases, including Hysteromyoma, polyp, adenomyosis, etc.). Sixty healthy female samples were selected as the control group in the same period.
ResultsThe expression of serum HE4 and CA125 in ovarian cancer was significantly higher than the other 7 groups, and the difference was statistically significant(P<001), The expression of HE4 in the pelvis was higher than that of the pelvic benign tumor group, and the expression in the benign group was higher than the control group, and the difference was statistically significant.(P<005),and the levels of HE4 in each group of benign tumor were higher than those in control group(P<005).The levels of HE4 in fallopian tube cancer were higher than those in cervical cancer(P<005). There were no statistical significances of CA125 among fallopian tube cancer, cervical cancer, endometrial cancer and ovarian benign 4 groups(P>005)where as CA125 in the benign 4 groups were all higher than the uterus benign group and the oviduct benign group(P<005). The area under ROC curves of HE4 and CA125 for diagnosing fallopian tube cancer was 0966 and 0731 respectively, the diagnostic accuracy of HE4 was better than CA125(P<005). The sensitivity(7500%)and negative predictive value(8286%)of HE4+CA125 in the diagnostic efficiency of fallopian tube cancer were significantly higher than those of two indicators(P<005),the specificity(9851%)and positive predictive value(9630%)of HE4 alone were higher than those of CA125 and HE4+CA125(P<005). The levels of serum HE4 and CA125 in stage Ⅲ to Ⅳ of fallopian tube carcinoma were higher than those in stage Ⅰ to Ⅱ(P<005). The serum HE4 and CA125 levels in patients with Lymphatic metastasis were higher than those who without lymphatic metastasis.
ConclusionsSerum HE4 and CA125 levels have important clinical value in the diagnosis of fallopian tube cancer.
 
Clinicopathologic feature analysis of 1 166 cases with colorectal cancer
2018, 10(5): 308-311  
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Abstract
ObjectiveTo study the clinicopathological characteristics of colorectal cancer in Yanji City of Jilin Province.
MethodsStatistical analysis was conducted in the 1 166 cases of colorectal malignancy treated in Yanbian University Hospital from January 2011 to December 2016.
ResultsMost cases were histologically identified as adenocarcinoma and mucinous adenocarcinoma (1 166 cases). The patient cohort consisted of 719 males (617%) and 447 females (383%), with a male to female ratio of 161∶1. The highrisk age range for colorectal cancer was over 51 years (making up 887% of the total patients). The best predilection site of colorectal cancer was still rectum (449%). Compared with their seniors, young patients (age≤40) were prone to be affected by colorectal cancer. Histological type was mainly moderately differentiated adenocarcinoma (866%). Lymph node metastasis was closely related to the depth of tumor invasion and differentiation.
ConclusionsColorectal cancer is increasing in this area, and most of the patients are in the middle and late stage. Colorectal cancer should be early detection, early diagnosis, and early treatment, so as to improve the survival rate of patients.
 
Establishing an in situ implantation tumor model of FaDu laryngopharyngeal carcinoma in nude mice and its CT and pathological study
2018, 10(5): 311-314  
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Abstract
ObjectiveTo establish an in situ implantation tumor model of FaDu laryngopharyngeal carcinoma, then to observe the growth characteristics of tumor in the animal models, according to the performance of imagination and the results of the pathology.
MethodsWe established tumorbearing nude mouse after FaDu tumor cell lines recovery in culture and passages and made the cell suspension. Cell suspension was injected into the nude mouses laryngopharynx, then, passage nude mouse were formed.
ResultsAt 2 weeks after injection of FaDu tumor cell suspension, the FaDu tumor models of the head and neck were made successfully in nude mouse, and the tumor formation rate was 100% (30/30) at the laryngopharynx. The micro CT scan detected the tumor at laryngopharynx. Hematoxylineosin staining showed that FaDu tumor tissues were confirmed as moderately to highly differentiated squamous cell carcinoma.
ConclusionsThese findings indicate that tumorbearing nude mouse models of the laryngopharynx established by FaDu cell suspension are characterized by short modeling cycle, good stability, easy to repeat, high tumor formation rate and simple operation.
The expression and clinical significance of androgen receptor in different molecular types of breast cancer
2018, 10(5): 315-318  
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Abstract
ObjectiveTo analyze the relationship between the expression of androgen receptor (androgen receptor AR) in different molecular types of breast cancer and its clinical and pathological features.
Methods585 breast cancer specimens were obtained from October 2012 to 2017, 2 cases of pathologically confirmed expression, and without any treatment of breast cancer by routine immunohistochemical method combined with androgen receptor, molecular classification of breast cancer, menstruation, lymph node metastasis, tumor size, TNM stage and other clinicopathological parameters statistical analysis was performed using SPSS130.
Results(1) The positive expression of AR in breast cancer was higher (60%), in three negative breast cancer expression rate was 37%, the positive expression of estrogen receptor AR (estrogen receptor ER), progesterone receptor (progesterone receptor PR) was positively correlated (P<005); The expression difference of Luminal A, Luminal B and HER2 over expression and three negative type was statistically significant (P<005), Luminal B group AR positive expression was higher than that of three negative type (P<005).AR expression in Luminal B group was higer than TNBC group (P<005). AR positive expression in Ⅰ and Ⅱ stage of TNM staging was higer than in Ⅲ and Ⅳ stage (P<005). (2) Patients were in Ⅰ, Ⅱ stage of the TNM staging, whose serum testosterone levels were lower than the patients in Ⅲ and Ⅳ stage (P<005).
ConclusionsAR can be used as an indicator to predict breast cancer and predict the malignancy and prognosis of breast cancer. It can also be a target for comprehensive treatment of breast cancer or targeted therapy.
Efficacy of DCF regimen and FOLFOX4 regimen in the treatment of late gastric cancer and its effect on phenotypic changes of peripheral blood lymphocytes: a comparative study
2018, 10(5): 319-322  
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Abstract
ObjectiveComparethe the effect of Docetaxel+Cisplatin+Fluorouracil regimen and Oxaliplatin+Fluorouracil+Calcium folate regimen in the treatment of late gastric cancer and its effect on phenotypic changes of peripheral blood lymphocytes.
MethodsIn this study,84 patients with late gastric cancer treated in our hospital from June 2014 to June 2017 were enrolled and divided into groups according to the chemotherapy regimen. FortyFour patients who underwent DCF regimen were included into the DCF group, and 40 patients underwent FOLFOX4 regimen were included into the FOLFOX4 group, both treated for two courses. Then the shortterm clinical efficacy, changes in peripheral blood lymphocyte phenotypes, incidence of adverse reactions, KPS score and NRS score of the two groups were compared.
ResultsThe effective rate of the DCF group was 5909%, which was significantly higher than that of the FOLFOX4 group(4500%), the difference was statistically significant (P<005). The levels of CD4+and CD4+/CD8+in the two groups were significantly increased after treatment, and the mentioned levels in the DCF group were significantly higher than those of the FOLFOX4 group (P<005); The levels of CD3+and CD8+within group or between groups before and after treatment had no significant difference (P>005). The DCF groups digestive tract reaction and peripheral neuritis were lighter in the DCF group than in the FOLFOX4 group, the difference was statistically significant (P<005). No significant difference was found in alopecia, leucocyte reduction and thrombocytopenia (P>005). There was a significant difference between the KPS score and the NRS score before and after the treatment, and the scores of the DCFgroup were better than those of the FOLFOX4 group, with statistic difference (P<005).
ConclusionsCompared with the FOLFOX4 regimen, DCF regimenhas a better shorttermefficacy in the treatment oflategastric cancer, which can improve the anti tumor immune function, reduce the adverse reaction, alleviate the cancer pain and improve the patient‘s quality of life.
Comparison of the effect of different bone graft materials in the reconstruction of bone graft in patients with benign bone tumor
2018, 10(5): 323-326  
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Abstract
ObjectiveTo investigate the effects of different bone graft materials on the reconstruction of bone graft in patients with benign bone tumor.
MethodsFrom January 2011 to January 2016, 120 patients with benign bone tumor were treated in our hospital, considered as the research object. According to the difference of the bone graft materials, 120 cases were divided into the allogeneic bone group (n=40), the hydroxyapatite group(n=40) and the calcium sulfate group. The healing speed, healing rate and economic cost after bone graft operation in three groups were compared. Followedup for 25 years, the prognosis of three groups was analyzed.
ResultsThe healing rates of the allogeneic bone group, the hydroxyapatite group and the calcium sulfate group were 975%, 925% and 875%, respectively. There was no significant difference between three groups (P>005). The initial healing time of the allogeneic bone group was significantly shorter than that of the calcium sulfate group and the hydroxyapatite group (P<005), but there was no significant difference between the calcium sulfate group and the hydroxyapatite group(P>005). After operation 18 months, the excellent and good rates of limb function in the allogeneic bone group, the hydroxyapatite group and the calcium sulfate group were 925%, 850% and 825%, respectively. The difference was not statistically significant (P>005). 
The scores of KPS in the three groups were significantly increased (P<005). The 6month and 12month KPS scores of the allogeneic bone group were higher than those of the hydroxyapatite group and the calcium sulfate group (P<005). The 3month and 18month postoperative KPS scores among the three groups were not statistically significant (P>005).
The total cost in the allogeneic bone group was 9,50015,300 RMB, with an average of (12,100±5,700)RMB. The treatment cost in the calcium sulfate group was 8,40011700 RMB (average of 10,300±3,400 RMB), and the hydroxyapatite group was 9,300~13,600RMB [average of (11,800 ±3,400)RMB]. There was no significant difference in the cost among the three groups (P>005).
ConclusionsThe healing rates of calcium sulfate and hydroxyapatite artificial bone implants were similar to allogeneic bone implants. It is beneficial to the recovery of limb function and the improvement of postoperative quality of life.
 
Two cases of lymphatic tumors in the extranodal marginal zone of the eyelid mucosaassociated lymphoid tissues
2018, 10(5): 327-329  
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Abstract
ObjectiveTo explore the clinicopathological features of extranodal marginal zone Bcell lymphoma of eyelid mucosaassociated lymphoid tissues.
MethodsThe clinical manifestations, histological features and immunophenotyping of two cases of extranodal marginal zone lymphoma of eyelid mucosaassociated lymphoid tissues were analyzed, and related literatures were reviewed.
ResultsMicroscopically, two cases presented nodular or diffuse infiltration of small round tumor cells, tumor cells infiltrated into the striated muscle tissues and around the meibomian gland, and lymphoid epithelial lesions were observed, and follicular implantation was observed in some areas. At high magnification, the cell size varies, the nucleus is round and nearly round, the nucleus is hollow or distorted and the nucleus is deeply stained, the chromatin is unevenly distributed, the nucleolus is not obvious, the cytoplasm is less, lightly stained or part is transparent. Immunohistochemical expression of tumor tissues: CD20 diffuseness (+), CD79a diffuseness (+), Bcl2, 1 case was weakly positive, another case was positive and ki6710%~20% (+).
ConclusionsThe extranodal marginal zone lymphoma of eyelid mucosaassociated lymphoid tissue are rare and familiarity with its clinical and pathological features also immunophenotype is helpful for correct diagnosis.
 
The progress in neoadjuvant chemotherapy for triple negative breast cancer
2018, 10(5): 330-332  
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Abstract
Triple negative breast cancer (TNBC) refers to human breast cancer with negative epidermal growth factor receptor2 (HER2), estrogen receptor (ER) and progesterone receptor (PR), and has poor prognosis and recurrence. The rate is high and the treatment effect is poor. In recent years, neoadjuvant chemotherapy has also been used more and more clinically. Neoadjuvant chemotherapy (neoadjuvant chemotherapy, NCT) refers to systemic chemotherapy that is applied before surgery or radiotherapy on a malignant tumor. On the one hand, it can reduce the primary tumor lesion, reduce the stage, eliminate micrometastases, and detect the sensitivity of chemotherapy drugs, to create more opportunities for breastconserving and surgical treatment. With the development of a large number of clinical trials, more and more studies have shown that TNBC patients have certain sensitivity to neoadjuvant chemotherapy, and the treatment effect is significant.
A case report of malignant transformation of recurrent borderline phyllodes tumor of the breast
2018, 10(5): 333-335  
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Abstract
2018, 10(5): 335-336  
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Abstract
Correlation analysis of mental resilience status, anxiety and depression status and coping style of spouses of young and middleaged breast cancer patients
2018, 10(5): 337-340  
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Abstract
ObjectiveTo investigate the correlation between the levels of mental resilience and the state of anxiety and depression in spouses of young and middleaged breast cancer patients.
MethodsThe spouses of 93 young and middleaged women with breast cancer admitted to our hospital from October 2016 to February 2018 were selected as study objects, and questionnaires were conducted using the selfcompiled general data questionnaire, the ConnorDavidson resilience scale (CDRISC), the hospital anxiety and depression scale (HADS), and the simplified coping style questionnaire (SCSQ).
ResultsIn our study, the total CDRISC score was 5774±1544, including the tenacity dimension (3018±786), selfstrengthening dimension (1834±550), and optimistic dimension (922±249). The proportion of anxiety and depression in the high CDRISC score group was lower than that in the low CDRISC score group (4800% vs. 7200%, P<005) and (3200% vs. 6800%, P<005). On the score of positive coping, the group with high mental resilience scored higher than the group with low mental resilience [(186+025) vs. (107+022), P<001], while the score of negative coping was lower [(116+035) vs. (202+023), P<001]. The total score and dimensions of mental resilience were positively correlated with active coping (r=0785, 0800, 0747, 0691) and negatively correlated with negative coping (r=-0667,-0696,-0622,-0566) (P<001).
ConclusionsThe overall level of CDRISC score of the spouses of young and middleaged breast cancer patients is low, and those with higher scores of mental resilience have more obvious state of anxiety and depression. Those with higher mental resilience were more active in coping with adverse life events. Low mental resilience tends to be negative. Therefore, patients should be concerned about their psychological state, reduce their anxiety, depression and other negative emotions, and encourage them to adopt positive coping methods to help improve the quality of life of breast cancer patients.
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