Background and Aims:Radical resection is the only potentially curative treatment for intrahepatic cholangiocarcinoma(ICC),yet the high recurrence rate results in poor prognosis.In recent years,"textbook outcome"(TO)has been proposed as a comprehensive quality metric,but its association with prognosis remains unclear.This study aimed to analyze the risk factors influencing the achievement of TO after radical resection of ICC and to explore the relationship between TO and survival.Methods:A retrospective analysis was conducted on the clinical data of 180 ICC patients who underwent radical resection at the 904th Hospital of the Joint Logistic Support Force of the PLA between February 2018 and February 2023.Univariate and multivariate Logistic regression analyses were performed to identify risk factors associated with TO,and survival analysis was carried out using the Kaplan-Meier method and Log-rank test.Results:Of the 180 patients,66 achieved TO.Multivariate Logistic regression analysis indicated that preoperative total bilirubin＞22 μmol/L,preoperative CA19-9＞35 U/mL,maximum tumor diameter＞5 cm,poor tumor differentiation,microvascular invasion(MVI),and lymph node metastasis were independent risk factors for failing to achieve TO(all P＜0.05).Survival analysis demonstrated that patients who achieved TO had a significantly longer median survival compared with those who did not(36 months vs.16 months,P＜0.001).Conclusion:Preoperative total bilirubin＞22 μmol/L,preoperative CA19-9＞35 U/mL,maximum tumor diameter＞5 cm,poor tumor differentiation,MVI,and lymph node metastasis are independent risk factors for not achieving TO after radical resection of ICC.Patients who achieved TO exhibited markedly longer survival,suggesting that TO not only reflects perioperative treatment quality but also serves as an important prognostic indicator.Greater attention to these risk factors and optimization of perioperative management may improve the likelihood of achieving TO and enhance long-term outcomes.

Background and Aims:Radical resection is the only potentially curative treatment for intrahepatic cholangiocarcinoma(ICC),yet the high recurrence rate results in poor prognosis.In recent years,"textbook outcome"(TO)has been proposed as a comprehensive quality metric,but its association with prognosis remains unclear.This study aimed to analyze the risk factors influencing the achievement of TO after radical resection of ICC and to explore the relationship between TO and survival.Methods:A retrospective analysis was conducted on the clinical data of 180 ICC patients who underwent radical resection at the 904th Hospital of the Joint Logistic Support Force of the PLA between February 2018 and February 2023.Univariate and multivariate Logistic regression analyses were performed to identify risk factors associated with TO,and survival analysis was carried out using the Kaplan-Meier method and Log-rank test.Results:Of the 180 patients,66 achieved TO.Multivariate Logistic regression analysis indicated that preoperative total bilirubin＞22 μmol/L,preoperative CA19-9＞35 U/mL,maximum tumor diameter＞5 cm,poor tumor differentiation,microvascular invasion(MVI),and lymph node metastasis were independent risk factors for failing to achieve TO(all P＜0.05).Survival analysis demonstrated that patients who achieved TO had a significantly longer median survival compared with those who did not(36 months vs.16 months,P＜0.001).Conclusion:Preoperative total bilirubin＞22 μmol/L,preoperative CA19-9＞35 U/mL,maximum tumor diameter＞5 cm,poor tumor differentiation,MVI,and lymph node metastasis are independent risk factors for not achieving TO after radical resection of ICC.Patients who achieved TO exhibited markedly longer survival,suggesting that TO not only reflects perioperative treatment quality but also serves as an important prognostic indicator.Greater attention to these risk factors and optimization of perioperative management may improve the likelihood of achieving TO and enhance long-term outcomes.

Objective To investigate the sore-throat-relieving, anti-inflammation and antitussive actions of Qingyan mixture on the animal models. Methods Sore-throat-relieving action of Qingyan mixture was observed in SD rats with acute pharyngitis induced by spray of ammonia water at volume fraction of 15%. Anti-inflammation action of Qingyan mixture was observed on mice model of xylene-induced ear edema, and antitussive action of Qingyan mixture was carried out in mice with cough induced by concentrated ammonia spray. Results (1) The results of sore-throat-relieving action of Qingyan mixture showed that the infiltration of inflammatory cells did not happen in the blank control group, but moderate/severe inflammatory cell infiltration was shown in the model group. In the positive group, 4 rats had slight inflammatory cell infiltration while the left 6 rats had no inflammatory cell infiltration. Low-dose Qingyan mixture group had no inflammatory cell infiltration in one rat, and had slight infiltration in 9 rats. In middle-and high-dose Qingyan mixture groups, 4 rats had no infiltration and 6 had slight infiltration, inflammatory cell infiltration was markedly relieved ( P<0.01) and the sore-throat-relieving action in both groups was similar to the positive medicine of Guilin mirabilitum praeparatum (P>0.05). ( 2) The anti-inflammation rate was 69.8% in the positive control group, and was 27.3%, 60.4%, 60.0% in low-, middle- and high-dose Qingyan mixture groups respectively. The inhibitory effect of middle-and high-dose Qingyan mixture on xylene-induced mice ear edema was similar to that of the positive control group ( P>0.05) . ( 3) The cough-relieving rate was 42.6%, 139.0%, 64.3%, 104.0% in positive control group, and low-, middle-and high-dose Qingyan mixture groups respectively. Mice cough latent was obviously prolonged and cough frequency was decreased in the three Qingyan mixture groups, the differences being significant compared with the model group ( P<0.05 or P<0.01) . Conclusion Qingyan mixture has certain sore-throat-relieving, anti-inflammation and antitussive actions, which can be used for the treatment of patients with actue/chironic laryngitis and the complication of cough.

Objective To investigate the therapeutic effect of Qingyan Mixture for laryngeal cough patients with lung dryness due to yin deficiency. Methods Sixty laryngeal cough patients with lung dryness due to yin deficiency were evenly randomized into treatment group and control group. The treatment group was given oral use of Qingyan Mixture, and the control group was given oral use of Ketotifen and Carbetapentane. The course of treatment for both groups lasted for 10 days. The overall therapeutic effect, and the effect on individual symptom or sign were evaluated after treatment. Results ( 1) In the treatment group, six patients were cured, 14 were markedly effective, 8 were improved, 2 were ineffective and the total effective rate was 93.3%. In the control group, one case was cured, 7 were markedly effective, 17 were improved, 5 were ineffective and the total effective rate was 83.3%. The overall clinical effect in the treatment group was significantly higher than that in the control group (P<0.01) . (2) As for the effect on individual symptom or sign, the treatment group showed stronger effect on dry cough than the control group ( P<0.01) , while differences of dry pharynx, throat itching, foreign body sensation in the throat, and pharyngeal signs were insignificant between the two groups (P>0.05) . (3) After treatment, the total scores of main symptoms were decreased in both groups (P<0.05 or P<0.01) compared with those before treatment. Conclusion Qingyan Mixture shows certain effect on relieving symptoms and signs of laryngeal cough patients with lung dryness due to yin deficiency.

Objective To explore the effect of Chinese medicine liquid to gargle on the oral mucosa reaction in nasopharyngeal carcinoma patients with radiotherapy .Methods One hundred nasopharyngeal carcinoma patients with radiotherapy were divided into the control group and the observation group according to the random number table , each with 50 cases.The control group received anti-inflammatory mouthwash to gargle, which included gentamicin 4 ml, dexamethasone 5 mg, lidocaine 20 ml, NS 250 ml, 5% sodium bicarbonate 250 ml.The observation group received the Chinese medicine liquid to gargle , which included AMUR CORK TREE BARK 25 g, SCUTELLARIA 25 g, DANDELION 25 g, MINT 5 g and were gargled before and after three meals a day, before radiotherapy, before bedtime.The microbiology in oropharyngeal was monitored during the treatment and after radiotherapy according to WHO oral mucosa radiation damage grading criteria . Results The oral mucosa reactions in the observation group were all lighter than those in the control group at the third weekend, the seventh weekend , and one week after radiotherapy , and the differences were statistically significant (Z=37.645,22.880,10.874, respectively;P <0.05).The positive rate of throat swab bacterial culture was 16.0%(8/50) in the observation group , and was 34.0%(17/50) in the control group at the seventh weekend, and the difference was statistically significant (χ2 =4.320,P<0.05).Conclusions Chinese medicine liquid to gargle can effectively prevent and relieve the oral mucosa reaction induced by the radiotherapy for the treatment of nasopharyngeal carcinoma , and reduce oral infection .