Objective To study the role of ERK1/2 signaling pathways on the process of ACA positive abortion and explore the effect of Anziheji on ERK1/2 signaling pathways from cell proliferation.Methods Levels of ERK1/2 on maternal-fetal interface of every mice in ACA positive abortion model group,blank control group,Anziheji low,mediate,high dose group,aspirin group were detected by immunohistochemical. Results The average optical density value of ERK1 in Anziheji low dose group(0.678 ±0.097)was close to normal group(0.727 ±0.047),there was no significant difference between them.Compared with blank control group,the ERK1 average optical density value in model group(0.434 ±0.066),Anziheji dose group(0.613 ±0.041),high dose group(0.487 ±0.061)and aspirin group(0.551 ±0.056)were significantly lower,and the differences were all statistically significant(P<0.01).Compared with blank control group(0.708 ±0.038),the ERK2 average optical density values in model group(0.430 ±0.058), Anziheji low dose group(0.621 ±0.041),mediate dose group(0.562 ±0.047),high dose group(0.449 ±0.062)and aspirin group(0.515 ±0.045) were significantly lower,and the differences were all statistically significant (P <0.01 ).Conclusion Anziheji can improve the activity of cell proliferation,improve the function of the placenta and change the outcome of pregnancy through ERK signal pathway.

OBJECTIVE:To study the effects of Anzi mixture on Toll like receptor 4(TLR4)/myeloid differentiation factor 88 (MyD88)/nuclear facter-κB(NF-κB)signaling pathway of antiphospholipid antibodies(APA)positive abortive mice,and to inves-tigate the mechanism of anti-APA positive abortion. METHODS:BALB/c mice(female)were randomly divided into blank control group,model group,aspirin group (positive control,0.0195 g/kg) and Anzi mixture low-dose,medium-dose and high-dose groups (37.7,75.4,150.8 g/kg,calculated by crude drug),with 10 mice in each group. Except for blank control group,other groups were given human β2-glycoprotein Ⅰ as derivant to establish APA positive abortion model. From the first day of pregnancy, treatment groups were given relevant medicine intragastrically,and blank control group and model group were given constant vol-ume of normal saline intragastrically,once a day,for consecutive 9 d. mRNA and protein levels of TLR4,myeloid differentiation 2 (MD2),MyD88 and NF-κB in placental tissue of mice were determined by RT-PCR and immunohistochemical method. RE-SULTS:Compared with blank control group,mRNA and protein expression of TLR4,MD2,MyD88 and NF-κB in placental tis-sue were increased markedly in the model group(P<0.01). Compared with model group,mRNA and protein expression of TLR4, MD2 and MyD88 in aspirin group and Anzi mixture low-dose and medium-dose groups were decreased significantly as well as the protein expression of TLR4 in Anzi mixture high-dose group and the protein expression of NF-κB in all medicine groups(P<0.05 or P<0.01). mRNA expression of TLR4 and MD2 and the protein expression of MD2 and MyD88 in Anzi mixture low-dose groups were lower than those in aspirin group (P<0.05 or P<0.01). CONCLUSIONS:Anzi mixture can inhibit TLR4/MyD88/NF-κB signaling pathway of APA positive abortive mice,which may be one of anti-APA positive abortion mechanisms.

[Objective]This paper mainly introduces the academic thoughts and clinical experience of professor LU Qibin in diagnosing and treating gynecological tumor. [Methods]To elaborate Professor LU 's experience in the diagnosis and treatment of gynecological tumor, the author analyses the etiology, pathogenesis, syndrome differentiation as well as the rule of choosing the medical herbs and formulas.A clinical case was reported for better demonstration. [Results]In the perspective of Professor LU, the basic pathogenesis of gynecological tumor is"vital Qi deficiency while pathogenic Qi prevailing ,blood stasis induce tumor"and the pathological factors include blood stasis, phlegm wet, and Qi stagnation that deposit in the lower abdomen, stay in Chong Meridian, Ren Meridian and uterus, result in gynecological tumor gradually. The therapeutic princ for a period of timele is"strengthening health, dispersing blood stasis and eliminating lump".Professor LU uses"Xiaozheng Tang"to treat gynecological tumor such as uterine leiomyomas. As the case reported,the uterine leiomyomas decreased when patient was treated by "Xiaozheng Tang".[Conclusion]It has obtained satisfactory therapeatic result in the treatment of gynecological tumor with "Xiaozheng Tang" according to the rule of "strengthening the body resistance, dispersing blood stasis and eliminating lump".

[Objective]In this paper, valuable experience would be shared and the culture of Chinese medicine will be inherited through introducing the clinical experience of Professor LU Qibin in the diagnosis and treatment of RSA. [Methods]From the point of cause and pathology as well as therapeutic method of the disease, the author discussed the special treatment of Professor LU Qibin. At the same time, the author focuses on introducing the dialectics and characteristics of professor LU Qibin's treatment of complicated recurrent spontaneous abortion. In order to elaborate clearly, some clinical cases were reported. [Results]Professor LU Qibin has summarized that spleen-kidney deficiency is the foundation of recurrent spontaneous abortion. In consequence, invigorating the spleen and kidney is the basic treatment. For the complicated recurrent spontaneous abortion, Professor LU Qibin has many assistant methods on the basis of invigorating spleen and kidney. Such as clearing heat and activating blood, warming and invigorating the spleen and kidney and so on. Furthermore, Professor LU Qibin insists the treatment of traditional Chinese medicine coordinate with western medical therapies. In the reported cases, patients were successfully cured. [Conclusion]Professor LU Qibin is experienced and the clinical curative effect is remarkable. Hence, the clinical experience of Professor LU Qibin in the diagnosis and treatment of recurrent spontaneous abortion was worth of learning and wide application.

Objective To investigate the clinical efficacy of sequential nasal flow ventilation after extubation in patients with acute respiratory failure (referred to as respiratory failure).First of all,before and after extubation in HFNCO group,the respiratory parameters (PaO2,PaCO2,pH,lactic acid value,oxygenation index,HR,RR and LVEF) were compared with each other.The circulatory parameters (PaO2,PaCO2,pH,lactate,oxygenation index,HR,RR),clinical outcomes at the end of treatment / comorbidities (delirium,diarrhea,reintubation,ICU stay after extubation).Methods PaO2,PaCO2,pH value,lactate value at 1 h,6 h,12 h and 24 h after extubation in HFNCO group were not significantly different from those before extubation (all P＞ 0.05) (P ＜0.05).The LVEF of patients after extubation was slightly higher than that before extubation (0.59 ± 0.09 vs.0.60 ± 0.09),and the difference was not statistically significant Significance (P＞ 0.05).PaO2,PaCO2,pH and lactate value in HFNCO group and NIV group at 1 h,6 h,12 h and 24 h after extubation showed no significant difference (all P＞ 0.05).The effect of HFNCO on improving the oxygenation index after extubation was better than that of NPV group (P ＜0.05).HR and RR before extubation were higher or higher in HFNCO group than those in NPV group lower HR,RR better (P ＜0.05).The incidence of diarrhea (33.33％ vs.38.89％) and reintubation rate (6.1％ vs 13.9％) in HFNCO group were lower than those in NIV group (38.89％),but the difference was not statistically significant (all P＞ 0.05).The incidence of delirium in HFNCO group (18.18％ vs.41.67％) and ICU stay time after extubation (2.00 to 3.50) were statistically significant (all P ＜0.05).Results There were no significant differences in the arterial blood gas analysis (PaO2,PaCO2,pH,lactate value),PaO2,PaCO2,pH value,lactate value and LVEF at 1 h,6 h,12 h and 24 h before and after extubation in HFNCO group (all P＞ 0.05) Slightly higher than before extubation (0.59 ± 0.09 vs.0.60 ± 0.09),the difference was not statistically significant (P＞ 0.05).PaO2,PaCO2,pH and lactate value in HFNCO group and NIV group at 1 h,6 h,12 h and 24 h after extubation showed no significant difference (all P＞ 0.05).The incidence of diarrhea (33.33％ vs.38.89％) and reintubation rate (6.1％ vs.13.9％) in HFNCO group were lower than those in NIV group (38.89％),but the difference was not statistically significant (all P＞ 0.05).The incidence of delirium (18.18％ vs.41.67％),and ICU stay time (2.00 to 3.50) in HFNCO group were significantly lower than those in NIV group (all P＜0.05).Conclusions For acute respiratory failure patients after mechanical ventilation extubation,sequential administration of HFNCO and NIV can provide stable and effective oxygen therapy support;relative to the NIV,HFNCO can effectively improve patients oxygenation index,improve patient comfort and reduce the incidence of delirium And ICU stay time.

Non-small cell lung cancer (NSCLC) is the most common pathological type of lung cancer, most NSCLC patients are at advanced stage at the time of diagnosis. For patients without sensitive driven-oncogene mutations, chemotherapy is still the main treatment at present, the overall prognosis is poor. Improving outcomes and obtaining long-term survival are the most urgent needs of patients with advanced NSCLC. In recent years, immunotherapy has developed rapidly. Immune checkpoint inhibitors (ICIs), especially targeting programmed death-1 (PD-1)/programmed death-ligand 1 (PD-L1), have made a breakthrough in the treatment of NSCLC, beneficial to patients' survival and changed the treatment pattern for NSCLC. It shows more and more important role in the treatment of NSCLC. Led by NSCLC expert committee of Chinese society of clinical oncology (CSCO), relevant experts in this field were organized. On the basis of referring to domestic and foreign literature, systematically evaluating the results of Chinese and foreign clinical trials, and combining the experiences of the experts, the experts group reached an agreement to develop this consensus. It will guide domestic counterparts for better application of ICIs to treat NSCLC.

Non-small cell lung cancer (NSCLC) is the most common pathological type of lung cancer. The systemic antitumor therapy of advanced NSCLC has undergone renovations of chemotherapy, targeted therapy and immunotherapy, which results in greatly improved survival for patients with advanced NSCLC. Immune checkpoint inhibitors (ICIs), especially targeting programmed cell death protein 1 (PD-1)/programmed death-ligand 1 (PD-L1), has changed the treatment paradigm of NSCLC. ICIs have become the standard treatment for advanced NSCLC without epidermal growth factor receptor(EGFR) mutation or anaplastic lymphomakinase(ALK) translocation in the first- or second-line setting, and for locally advanced NSCLC following concurrent radiotherapy and chemotherapy. ICIs are also promising in adjuvant/neoadjuvant therapy. More and more ICIs have been approved domestically for the treatment of NSCLC. Led by the NSCLC expert committee of Chinese Society of Clinical Oncology (CSCO), this consensus was developed and updated based on thoroughly reviewing domestic and foreign literatures, clinical trial data, systematic reviews, experts' discussion and the consensus(2019 version). This consensus will aid domestic clinicians in the treatment of NSCLC with ICIs.
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