This article systematically analyzes the historical evolution of the name， medicinal parts， origin， harvesting， processing and other aspects of Houttuyniae Herba（HH） by referring to the medical books， prescription books and other documents of the past dynasties， combined with the research materials related to modern and contemporary times， in order to provide a basis for the development of famous classical formulas containing this herb. In ancient literature， HH was often referred to as "Ji" and "Jicai"， the name of "Ji" was first recorded in Mingyi Bielu during the Han and Wei dynasties， and the name of Yuxingcao was first seen in Lyuchanyan Bencao during the southern Song dynasty and has continued to this day. The origin of HH used throughout history is consistent， all of which are the whole herb or aboveground parts of Houttuynia cordata in Saururaceae family. HH recorded throughout history has a wide range of production areas， mostly self-produced self-marketing. In ancient times， fresh HH was often used as medicine by pounding its juice without involving any processing steps. Both fresh and dried products can be used as medicine， the fresh products uses the whole plant， while the dried products uses the aboveground parts， which are cleaned， selected and processed before use. Fresh products are harvested regardless of season， while dried products are harvested in both summer and autumn， with summer as the best. In ancient times， there were no specific requirements for the quality of HH， while in modern times， "intact stems and leaves with a strong fishy smell" are preferred. In addition， the medicinal properties of HH have undergone significant changes from ancient to modern times. In the early period， it was believed that its medicinal property was slightly warm， until the 1977 edition of Chinese Pharmacopoeia officially changed it to slightly cold. Both ancient and modern literature states that HH can be used for the treatment of carbuncle and malignant sores， Lyuchanyan Bencao for the first time introduced HH fresh juice can relieve summer heat， since Diannan Bencao recorded that it can be used for lung carbuncle， and gradually developed into the first choice for the treatment of lung carbuncle. Based on the research results， it is suggested that fresh herb or dried aboveground parts of H. cordata are used as medicine when developing famous classical formulas.

In order to provide basic information for the utilization and development of famous classical formulas containing Bletillae Rhizoma， this article systematically analyzes the historical evolution of the name， origin， harvesting and processing of Bletillae Rhizoma by reviewing the ancient materia medica， prescription books， medical books and modern literature. The research results showed that Baiji（白及） was the main name， some scholars took Baiji（白芨） as its main name， and there were many other names such as Baiji（白给）， Baigen（白根）， Baiji（白苙）. The mainstream source of Bletillae Rhizoma was the tubers of Bletilla striata， and drying， large， white， solid， root-free and skin removed completely were the good quality standards. With the promotion of wild to cultivated medicinal materials， there were certain differences between their traits， and the quality evaluation indexes should be adjusted accordingly. The origin of records in the past dynasties was widely distributed， with Guizhou and Sichuan having high production and good quality in modern times. The harvesting period is mostly in spring and autumn， and harvested in autumn was better. The processing and processing technology is relatively simple， and it was used fresh or powdered in past dynasties， while it is mainly sliced for raw use in modern times. Based on the results， it is suggested that the tubers of Bletilla striata of Orchidaceae should be used in the famous classical formulas， and it should be uniformly written as Baiji（白及）. And if the original formula indicates the requirement of processing， it should be operated according to the requirement， if the requirement of processing is not indicated， it can be used in raw form as medicine.

Immune checkpoint inhibitors (ICIs) have revolutionized the approach to advanced and locally advanced non-small-cell lung cancer (NSCLC). Antibodies blocking inhibitory immune checkpoints, such as programmed death 1 (PD-1) and its ligand (PD-L1), have remarkable antitumor efficacy and have been approved as a standard first- or second-line treatment in non-oncogene-addicted advanced NSCLC. The successful application of immunotherapy in advanced lung cancer has motivated researchers to further evaluate its clinical role as a neoadjuvant setting for resectable NSCLC and for improved long-term overall survival and curative rates. In this review, we discuss the efforts that incorporate ICIs into the treatment paradigm for surgically resectable lung cancer. We reviewed the early-phase results from neoadjuvant clinical trials, the landscape of the majority of ongoing phase III trials, and discuss the prospects of ICIs as a curative therapy for resectable lung cancer. We also summarized the potential biomarkers and beneficiaries involved in the current study, as well as the remaining unresolved challenges for neoadjuvant immunotherapy.

Immune checkpoint inhibitors (ICIs) have revolutionized the approach to advanced and locally advanced non-small-cell lung cancer (NSCLC). Antibodies blocking inhibitory immune checkpoints, such as programmed death 1 (PD-1) and its ligand (PD-L1), have remarkable antitumor efficacy and have been approved as a standard first- or second-line treatment in non-oncogene-addicted advanced NSCLC. The successful application of immunotherapy in advanced lung cancer has motivated researchers to further evaluate its clinical role as a neoadjuvant setting for resectable NSCLC and for improved long-term overall survival and curative rates. In this review, we discuss the efforts that incorporate ICIs into the treatment paradigm for surgically resectable lung cancer. We reviewed the early-phase results from neoadjuvant clinical trials, the landscape of the majority of ongoing phase III trials, and discuss the prospects of ICIs as a curative therapy for resectable lung cancer. We also summarized the potential biomarkers and beneficiaries involved in the current study, as well as the remaining unresolved challenges for neoadjuvant immunotherapy.

Objective:To observe the epidemiology, clinical manifestations, laboratory tests, imaging findings, treatment and prognosis of patients with corona virus disease 2019.Methods:Clinical data of 109 patients with suspected and definite corona virus disease 2019 admitted to the Sixth Hospital of Wuhan from December 24, 2019 to January 28, 2020 were retrospectively analyzed. Statistical analysis was performed by using t test or chi-square test. Results:Among the 109 patients, 54(49.5%) patients had definite contact history. Among the 109 patients, 104(95.4%) presented with fever, 37(33.9%) with headache, 78(71.6%) with general pain, 88(80.7%) with fatigue and poor appetite, 23(21.1%) with diarrhea, 94(86.2%) with coughing, 23(21.1%) with shortness of breath, 57(52.3%) with palpitation, 45(41.3%) with chest distress, 4(3.7%) with chest pain, 40(36.7%) with lung rales. Forty-two cases (38.5%) had leukocyte count <4×10 9/L, 58 cases (53.2%) had lymphocyte count <1.5×10 9/L, 27 cases (24.8%) had hemoglobin <120 g/L, 37 cases (33.9%) had lactic dehydrogenase (LDH) >230 mmol/L, 29 cases (26.6%) had pro-brain natriuretic peptide>300 ng/mL, 87 cases (79.8%) had hypersensitive C reactive protein>10 mg/L, 26 cases (23.9%) had D-dimer>0.5 mg/L, 35 cases (32.1%) had coagulation disorder. On admission, chest computed tomography showed that 27 cases (24.8%) of pneumonia were unilateral, 82 cases (75.2%) were bilateral, and most of them were ground glass. The leukocyte counts, LDH, pro-brain natriuretic peptide and D-dimer of severe/critical cases ((11.33±4.87)×10 9/L, (527.51±260.87) mmol/L, (722.88±189.56) μg/L, (4.24±1.89) mg/L, respectively) were all higher than those of common cases ((4.02±1.49)×10 9/L, (159.75±30.31) mmol/L, (428.22±124.76) μg/L and (0.41±0.22) mg/L, respectively), while the lymphocyte count of severe/critical cases ((0.60±0.17)×10 9/L) was lower than common cases ((1.13±0.43)×10 9/L) ( t=11.36, 11.33, 9.81, 2.81 and 7.77, respectively, all P<0.05). The comprehensive treatment included antiviral drugs, prevention of bacterial infection and supportive treatment, and glucocorticoid and respiratory support treatment were administrated when necessary. Conclusions:The corona virus disease 2019 is characterized by highly infectious, rapid progression, and diverse clinical and imaging features. Early diagnosis and active comprehensive treatment could improve the prognosis and reduce the mortality.

Objective: To investigate the value of short tandem repeat (STR) genotyping in the diagnostic workup of molar and non-molar gestations with correlation of histological characteristics. Methods: Six hundred and fifty-six cases were selected based on clinically suspected hydropic abortion and/or molar pregnancy from July 2015 to September 2017 at Beijing Obstetrics and Gynecology Hospital. DNA was extracted from dissected chorionic villi and paired maternal endometrial FFPE tissue samples by Simplex OUP™ FFPE DNA Tissue Kit. STR genotyping was performed by PowerPlex 16 HS system. Results: DNA genotyping was informative in 649 of 656 cases, leading to identification of 215 hydatidiform mole gestations and 434 non-molar gestations. Most of non-molar gestations (375 cases, 86.4%) were diploid hydropic abortion. Various trisomy syndromes were found (53 cases, 12.2%), including trisomy 2, 3, 4, 7, 8, 13, 16 and 21. Only 2(0.5%) digynic triploid gestations were detected. Moreover, 4 cases (0.9%) of uniparental disomies (homologous or heterologous) were found. There were 196 cases with histologic diagnostic suspicious of hydatidiform moles were accurate sub-classified. Among them, 59 cases hydatidiform moles were under-diagnosed as diploid hydropic abortions, and 28 cases diploid hydropic abortions were over-diagnosed as hydatidiform moles.Compared with partial moles(PHM), there were no specific histomorphological features between the various types of non-molar gestations and partial moles for definitive diagnostic separation. There was no significant difference in the expression of p57^kip2 among PHM, trisomy and diploid hydropic abortions group (P=0.247). Conclusions STR genotyping can distinguish non-molar gestations from early hydatidiform moles, and efficiently avoid misdiagnosis based only on histological evaluation. Therefore, using STR genotyping, not only can the overdiagnosis of non-molar pregnancy be avoided, but also individualized management can be offered to patients including monitoring of serum hCG.

Objective To investigate the natural changes of high-risk HPV (HR-HPV) in women with negative for intraepithelial lesion or malignancy (NILM) for regulating HR-HPV screening.Methods Four hundred and thirty-three newly-diagnosed women were enrolled from January 1st,2015 to December 31,2015 in Beijing Obstetrics and Gynecology Hospital.The ages of these patients were between 22 and 74 years,the average age was (45±21) years old.Two hundred and sixty-three cases were less than 50 years old,170 cases were more and equal to 50 years old.One hundred and fifty-six cases were HR-HPV positive,277 cases were HR-HPV negative.Follow up tests were conducted for all 433 patients,who were screened by ThinPrep cytologic test (TCT) combined with HR-HPV and were diagnosed with NILM,for a period of 1 year (at the 3,6,9 and 12 months intervals respectively),if the TCT results are abnormal and the HR-HPV test results are positive,will follow up colposcopy directed cervical biopsy.Results (1) HR-HPV natural changes:of 156 NILM cases with HR-HPV infection,42 cases (26.9％,42/156) turned negative within 3 months,88 cases (56.4％,88/156) turned negative within 6 months,99 cases (63.5％,99/156) turned negative within 9 months,and 100 cases (64.1％,100/156) turned negative within 12 months.The negative conversion ratio at 3,6,9 and 12 months for women at childbearing age (＜50 years) were significantly higher than those at non-childbearing age (≥50 years old;all P＜0.05).Of 277 NILM cases without HR-HPV infection,35 cases (12.6％,35/277) had new HR-HPV positive infections within 3 months,70 cases (25.3％,70/277) had new infections within 6 months,80 cases (28.9％,80/277) had new infections within 9 months,and 83 cases (30.0％,83/277) had new infections within 12 months.The new infections rate at 3,6,9 and 12 months for women at childbearing age (＜50 years old) were slightly higher than those at non-childbearing age (≥50 years old;all P＞0.05).(2) The progress of cervical leision:of 156 NILM cases with HR-HPV positive,no case progressed during 12 months follow-up.Of 277 NILM cases with HR-HPV negative,4 cases progressed to cervical intraepithelial neoplaisa (CIN) with HR-HPV infection and TCT abnormal during 12 months follow-up,including 2 cases pathology diagnosed with CIN Ⅰ,1 case with CIN Ⅱ,and 1 case with CIN Ⅲ.The progression rate was 1.4％ (4/277),which accounts for 4.8％ (4/83) of new HR-HPV infections cases in women.Conclusions The results of cytology combined with HR-HPV screenings suggest every 6 months for simple HR-HPV positive women,colposcopy directed cervical biopsy is recommended to assess cervical lesions if necessary.Cytology combined with HR-HPV screenings suggest every 12 months for simple HR-HPV negative women to early detection of cervical leision.

Objective To investigate the risk factors of pancreatic fistula after pancreaticoduodenectomy.Methods The clinical data of 310 patients who received pancreaticoduodenectomy at the Ruijin Hospital of Shanghai Jiaotong University from January 2005 to May 2013 were retrospectively analyzed.The risk factors associated with the interoperative pancreatic fistula were analyzed.The univariate and multivariate analysis were done using the Pearson chi-square test and non-conditional Logistic regression model.Results A total of 134 patients had postoperative complications,including 103 (33.23％) with pancreatic fistula,among them 40 patients developed additional complications.The results of univariate analysis showed that preoperative levels of hemoglobin,total bilirubin,diameter of the pancreatic duct and postoperative level of albumin were risk factors of pancreatic fistula after pancreaticoduodenectomy (x2 ＝ 4.543,6.087,6.265,5.311,P ＜ 0.05).The results of multivariate analysis showed that preoperative level of total bilirubin equal to or above 34.2 μmol/L,the diameter of the pancreatic duct under 3 mm and the level of postoperative albumin under 28 g/L were the independent risk factors of pancreatic fistula (OR =1.806,1.936,1.780; 95％ confidence interval:1.107-2.948,1.170-3.206,1.002-3.165,P ＜ 0.05).Conclusion Preoperative jaundice (the level of total bilirubin ≥ 34.2 umol/L),pancreatic duct diameter ＜ 3 mm and postoperative malnutrition (albumin ＜ 28 g/L) indicate a higher incidence of postoperative pancreatic fistula.

ObjectiveTo investigate the clinical application value of pancreaticoduodenectomy with the assistance of robotic operation system for pancreatic head cancer.MethodsClinical data of 38 patients with pancreatic head cancer undergoing pancreaticoduodenectomy using Da Vinci Si robotic system in Shanghai Ruijin Hospital from May 2010 to April 2014 were analyzed retrospectively. There were 25 males and 13 females with the mean age of (59±10) years old. The informed consents of all patients were obtained and the ethical committee approval was received. Three robotic exclusive Trocars, 1 camera Trocar and 1 assistant Trocar were inserted using 5-port approach and the robotic arms were inserted. Pancreaticoduodenectomy was performed under the assistance of robotic system. The perioperative situation including operation time, intraoperative blood loss, operation, postoperative complication and survive were observed.ResultsAll the operations of 38 cases were finished successfully with radical (R0) resection rate 97% (37/38), R1 resection rate 3% (1/38) and the median operation time 413(210-520)min, intraoperative blood loss 320(50-1 100)ml, lymphnode clearance number 15(2-24), postoperative hospital stay 20(7-36)d. The incidence of postoperative complication was 42% (16/38) including pancreatic ifstula (n=8), biliary ifstula (n=2), postoperative infection (n=6). The postoperative survival time was 25(3-42) months and disease-free survival time was 14(5-28) months.ConclusionPancreaticoduodenectomy with the assistance of robotic operation system is safe and feasible for resecting pancreatic head cancer.