Although surgical resection is currently recognized as the only effective treatment for intrahepatic cholangiocarcinoma (ICC),it is extremely difficult to diagnose because there are no obvious clinical symptoms at the early stage.Patients are often diagnosed at the advanced stage and the lesion cannot be resected which leads to limited systemic chemotherapy.So the mortality is still high.Accurate treatment is a hot topic in the medical field,and more and more attentions have been paid to enhance the treatments of patients.This article reviewed the issues related to surgical treatment,chemotherapy,molecular targeted therapy,and immunotherapy in patients with ICC,and focuses on the latest progress of molecular targeted therapy.

Objective:To investigate the efficacy of Guanqiao Zhengqi holistic therapy in the treatment of chronic rhinosinusitis. Methods:A total of 200 patients with chronic rhinosinusitis who received treatment in the Department of Otolaryngology, Shanxi Provincial Integrated Traditional Chinese Medicine and Western Medicine Hospital ( n = 72) and Shanxi Yishengtang Traditional Chinese Medicine Center ( n = 128) from January 2021 to January 2022 were included in this study. These patients were randomly assigned to undergo treatment either with mometasone furoate nasal spray and levocetirizine hydrochloride tablets (control group, n = 100) or Guanqiao Zhengqi holistic therapy combined with mometasone furoate nasal spray and levocetirizine hydrochloride tablets (observation group). All patients were treated for 4 weeks and followed up for 3 months. Clinical efficacy, modified Visual Analogue Scale score, Lund-Kennedy endoscopy scoring system score, and duration of glucocorticoid and anti-leukotriene use were compared between the two groups. Results:The total response rate in the observation group was significantly higher than that in the control group [92.00% (92/100) vs. 73.00% (73/100), χ2 = 18.45, P < 0.001). There was no significant difference in the modified Visual Analogue Scale score between the two groups before treatment ( Z = 1.37, P = 0.170). There was a significant difference in the modified Visual Analogue Scale score between the two groups after treatment ( Z = -5.27, P < 0.001). Before treatment, there was no significant difference in the Lund-Kennedy endoscopy scoring system score between the two groups ( Z = -1.65, P = 0.098) and the Lund-Kennedy endoscopy scoring system score differed significantly between the two groups after treatment ( Z = -6.03, P < 0.001). The duration of glucocorticoid and anti-leukotriene use in the observation group was significantly shorter than that in the control group [10.00 (10.00, 14.00) days vs. 42.00 (28.00, 70.00) days, 7.00 (7.00, 7.00) days vs. 21.00 (14.00, 26.25) days, Z = -11.27, P < 0.001, Z = -12.31, P < 0.001). Conclusion:Based on the conventional treatment with western medicine, Guanqiao Zhengqi holistic therapy for the treatment of chronic rhinosinusitis can effectively reduce clinical symptoms, reduce the dose of hormones and anti-leukotriene used, shorten the use cycle, and improve the therapeutic efficacy.

Purpose: The aim of this meta-analysis was to evaluate the efficacy and safety of imidafenacin for overactive bladder (OAB) induced by benign prostatic hyperplasia (BPH) in men receiving alpha-blocker monotherapy. Methods: We performed a systematic research of the PubMed, Embase, and Cochrane Library databases, and searched for studies about alpha-blocker with or without imidafenacin treatment for OAB in patients with BPH. We also investigated the original references of the included texts. Results: Four randomized controlled trials including 779 participants with BPH (389 in the alpha-blocker+imidafenacin group and 390 in the alpha-blocker only group) were studied. The main efficacy endpoint was the Overactive Bladder Symptom Score, which showed a mean difference of -1.88 (95% confidence interval, -2.32 to -1.44; P<0.00001), suggesting that alpha-blocker and imidafenacin treatment was effective in treating men with OAB. As other primary efficacy end points, the International Prostate Symptom Score (IPSS) total score (P=0.47), the IPSS storage symptom score (P=0.07), the IPSS voiding symptom score (P=0.60), and the IPSS quality of life score (P=0.18) indicated that 2 methods had no significant differences in treating men with OAB. In terms of safety, which was assessed using postvoid residual volume (P=0.05) and maximum flow rate (P=0.53), the analysis suggested that combination treatment was very well tolerated. Conclusions This study suggested that imidafenacin plus alpha-blocker was an efficacious and safe treatment for OAB symptoms in BPH patients.

Objective To observe the protective effects of carnosic acid on retinal ganglion cells (RGCs) in acute ocular hypertension rats model.Methods Sixty male SPF SD rats (8-12 weeks) were randomly assigned to normal control group,carnosic-acid treated group and model control group with 20 rats for each group.The acute ocular hypertension animal model was induced by the perfusion of normal saline solution into anterior chamber of eyes to elevate the intraocular pressure (IOP) to 110 mmHg for 60 minutes in the rats of the carnosic-acid treated group and model control group,and then the carnosic-acid (dissolving in DMSO) was intraperitoneally injected for consecutive 7 days in the carnosic-acid treated group,and only DMSO was injected in the same way in the model control group.The rates were sacrificed 2 weeks after experiment and retinal sections were prepared for histopathological and apoptotic retinal ganglion cells (RGCs) examination by hemotoxylin & eosin staining and TUNEL staining,and immunofluorescence was employed to examine the survival cell number of RGCs.This study protocol was approved by the Ethic Committee for Experimental Animal of Three Gorges University.Results The retinal morphology and structure were clear in the normal control group.The edema of retinal tissue,loosely arranged RGCs and swollen nucleus were seen in the model control group.In the carnosic-acid treated group,the retinal morphology and structure were regular.The retinal nerve fiber layer (RNFL) thickness was (32.96±1.63),(58.96± 1.57) and (50.11±2.37)μm,and the apoptotic cell number was (6.92±2.96),(29.85±6.40) and (14.69± 2.98)/field,and the survived cell number was (2 363.17± 148.45),(1 308.67 ±106.02) and (1 614.17 ±96.39) / 0.235 mm2 in the normal control group,model control group and carnosic-acid treated group,respectively,with significant differences among the groups (F =339.284,81.583,122.68,all at P＜0.01).Compared with the normal control group,the RNFL thickness was thickened,the number of apoptotic RGCs was much more and the number of survived RGCs was decreased in the model control group,with significant differences (all at P＜0.01).In the carnosic-acid treated group,the RNFL thickness was thinner,the number of apoptotic RGCs was reduced and the number of survived RGCs was increased in comparison with the normal control group,with significant differences (all at P＜0.01).Conclusions Carnosic-acid plays a protective effect on RGCs by inhibiting the cell apoptosis in acute ocular hypertension rats.

Objective:To establish the quality evaluation method of Prunellae spica dispensing granules based on three quality indexes of standard decoction. Methods:Fourteen batches of Prunellae spica were collected from different habitats. According to technical requirements, fourteen batches of Prunellae spica standard decoction and three batches of formula granules were prepared and the paste-forming rates were calculated. The fingerprints of Prunellae spica standard decoction and formula granules were established by Ultra High Performance Liquid Chromatography (UPLC). The similarity values of fingerprints between dispensing granules and standard decoction were calculated. The content and transferring rate of Rosmarinic acid were determined and calculated. Results:The average paste-forming rate of Prunellae spica was (12.59±2.32)%. The paste-forming rates of the three batches were 11.14%, 10.78% and 10.39% respectively. The average content of Rosmarinic acid in standard decoction was (18.99±9.74)mg/g. The average transferring rate was (60.58±7.87)%. The contents of three batches were 7.40 mg/g, 7.49 mg/g and 7.09 mg/g. The transferring rates were 52.06%, 50.10% and 50.40% respectively. Nine common fingerprint peaks were identified in the fingerprints of standard decoction and formula granules, two of which were identified as Rosmarinic acid and Caffeic acid by comparison of reference substance. The fingerprints similarity of Prunellae spica dispensing granules and standard decoction were 0.954, 0.973 and 0.952, respectively. Conclusions:The quality indexes of three batches of formulation granules are consistent with standard decoction. This method could provide reference for the establishment of quality standard of Prunellae spica dispensing granules.

Objective:To investigate the perioperative efficacy of robot surgical system assisted anatomic and non-anatomic hepatectomy.Methods:The propensity score matching and retrospective cohort study was conducted. The clinical data of 103 patients who underwent robot surgical system assisted hepatectomy in Sir Run Run Shaw Hospital, Affiliated with the Zhejiang University School of Medicine from March 2016 to December 2021 were collected. There were 54 males and 49 females, aged 56(range, 44?64)years. Of the 103 patients, 55 cases undergoing robot surgical system assisted anatomic hepatectomy were divided into the anatomic group, and 48 cases undergoing robot surgical system assisted non-anatomic hepatectomy were divided into the non-anatomic group. Observation indicators: (1) propensity score matching and comparison of general data of patients between the two groups after matching; (2) intraoperative conditions; (3) perioperative complications. Propensity score matching was done by the 1:1 nearest neighbor matching method. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were expressed as M(range), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Comparison of ordinal data was conducted using the rank sum test. Results:(1) Propensity score matching and compari-son of general data of patients between the two groups after matching. Of the 103 patients, 94 cases were successfully matched, including 47 cases in the anatomic group and 47 cases in the non-anatomic group. The elimination of preoperative body mass index, preoperative platelet and preoperative albumin confounding bias ensured comparability between the two groups after propensity score matching. (2) Intraoperative conditions. After propensity score matching, the operation time and volume of intraoperative blood loss were 175(range, 120?240)minutes and 50(range, 50?100)mL in patients of the anatomic group, versus 155(range, 105?190)minutes and 100(range, 50?200)mL in patients of the non-anatomic group, showing significant differences in the above indicators between the two groups ( Z=1.97, 2.49, P<0.05). (3) Perioperative complications. After propensity score matching, cases with pleural fluid and/or ascites, case with biliary fistula, case with thrombosis, case with peritoneal infection, case with incision infection were 11, 1, 2, 4, 1 in patients of the anatomic group, versus 12, 0, 4, 1, 0 in patients of the non-anatomic group, showing no significant difference in the above indicators between the two groups ( P>0.05). Cases with complications classified as grade Ⅰ, grade Ⅱ, grade Ⅲ, grade Ⅳ of the Clavien-Dindo classification were 33, 14, 0, 0 in patients of the anatomic group, versus 28, 14, 3, 2 in patients of the non-anatomic group, showing no significant difference in the above indicators between the two groups ( Z=?1.38, P>0.05). Conclusions:Robotic surgical system assisted anatomic and non-anatomic hepatectomy are safe and feasible for clinical application. Compared with robot surgical system assisted non-anatomic hepatectomy, patients under-going robot surgical system assisted anatomic hepatectomy have long operation time and less volume of intraoperative blood loss.

OBJECTIVE：To establish UPLC fingerpri nt of Ligusticum sinense ，Ligusticum jeholense and Conioselinum vaginatium，and to conduct their chemometrics analysis so as to provide reference for the identification of Rhizoma Ligustici from different origins. METHODS ：UPLC method combined with Similarity Evaluation System of TCM Chromatographic Fingerprints （2012 edition） were used to establish the fingerprints of Rhizoma Ligustici from different origins. Chromatographic peak identification and similarity evaluation were carried out. Cluster analysis （CA），principal component analysis （PCA） and orthogonal partial least squares discriminant analysis （OPLS-DA）were performed to analyze Rhizoma Ligustici from different origins，and screen differential components. RESULTS ：Totally 13，11，11 characteristic peaks were identified in UPLC fingerprints of L. sinense ，L. jeholense and C. vaginatium ，respectively. Similarity evaluation showed that the similarity between C. vaginatium and L. jeholense were 0.312-0.541；that between C. vaginatium and L. sinense were 0.324-0.682；that between L. sinense and L. jeholense were 0.312-0.671，indicating there was great difference among Rhizoma Ligustici from different origins. CA，PCA and OPLS-DA showed that Rhizoma Ligustici from different origins were clustered into each category respectively ； chemical components represented by peak 10，peak 13，peak 12，peak 7 and peak 6 were differential components for Rhizoma Ligustici from 3 origins. CONCLUSIONS ：The study establishes UPLC fingerprint of Rhizoma Ligustici from different origins ， and screens 5 differential components ，which can be used to identify Rhizoma Ligustici from different origins.