[Objective]To explore the medication patterns of WU's tumor school for anti-metastasis through"enhancing health and promoting detoxification"based on data mining.[Methods]Systematically review the literature related to the prescription and medication patterns of WU Liangcun in the treatment of tumor metastasis,and summarize his clinical experience in the use of the"enhancing health and promoting detoxification"method.Complete case records of lung cancer,gastric cancer and colorectal cancer metastasis treated by SHEN Minhe,WANG Binbin and RUAN Shanming from January 1,2020 to August 31,2023 were collected.Data mining analysis was performed on the effective prescriptions by using the Traditional Chinese Medicine Inheritance Computer System(V3.5).[Results]A total of 3 023 prescriptions from SHEN Minhe were included,involving 344 types of Chinese herbs.Codonopsis Radix was frequently used,and common herb pairs included Codonopsis Radix,Poria cocos-Atractylodis Macrocephalae Rhizoma.WANG Binbin's 2 654 prescriptions involved 370 types of Chinese herbs.Paeoniae Radix Alba was frequently used,and common pairs included Coicis Semen,Fagopyri Dibotryis Rhizoma-Hedyotis diffusa Willd.RUAN Shanming's 1 182 prescriptions included 257 types of herbs.Astragali Radix was frequently used,and common pairs included Astragali Radix,Alismatis Rhizoma-Scutellariae Radix.WU's tumor school prefers to use herbs with sweet,bitter and acrid flavors,as well as neutral,cold and warm properties,avoiding excessive purgation or tonification and extreme cold or heat.They advocated for gentle tonification and gradual adjustment,as well as a balanced combination of cold and heat.In terms of meridian tropism,they focused on using herbs that entered the spleen and lung meridians,targeting the pathogenesis of spleen and stomach deficiency,which led to the accumulation of dampness and phlegm,emphasized the simultaneous regulation of the spleen and lung,to strengthen the spleen and stomach,eliminate dampness and phlegm,regulate the flow of Qi and clear cancerous toxins.[Conclusion]WU's tumor school has been passed down for three generations,following the principle of"enhancing health and promoting detoxification".The overall medication is balanced and tailored to different types of malignant tumors,demonstrating significant clinical efficacy.

[Objective]To explore the medication patterns of WU's tumor school for anti-metastasis through"enhancing health and promoting detoxification"based on data mining.[Methods]Systematically review the literature related to the prescription and medication patterns of WU Liangcun in the treatment of tumor metastasis,and summarize his clinical experience in the use of the"enhancing health and promoting detoxification"method.Complete case records of lung cancer,gastric cancer and colorectal cancer metastasis treated by SHEN Minhe,WANG Binbin and RUAN Shanming from January 1,2020 to August 31,2023 were collected.Data mining analysis was performed on the effective prescriptions by using the Traditional Chinese Medicine Inheritance Computer System(V3.5).[Results]A total of 3 023 prescriptions from SHEN Minhe were included,involving 344 types of Chinese herbs.Codonopsis Radix was frequently used,and common herb pairs included Codonopsis Radix,Poria cocos-Atractylodis Macrocephalae Rhizoma.WANG Binbin's 2 654 prescriptions involved 370 types of Chinese herbs.Paeoniae Radix Alba was frequently used,and common pairs included Coicis Semen,Fagopyri Dibotryis Rhizoma-Hedyotis diffusa Willd.RUAN Shanming's 1 182 prescriptions included 257 types of herbs.Astragali Radix was frequently used,and common pairs included Astragali Radix,Alismatis Rhizoma-Scutellariae Radix.WU's tumor school prefers to use herbs with sweet,bitter and acrid flavors,as well as neutral,cold and warm properties,avoiding excessive purgation or tonification and extreme cold or heat.They advocated for gentle tonification and gradual adjustment,as well as a balanced combination of cold and heat.In terms of meridian tropism,they focused on using herbs that entered the spleen and lung meridians,targeting the pathogenesis of spleen and stomach deficiency,which led to the accumulation of dampness and phlegm,emphasized the simultaneous regulation of the spleen and lung,to strengthen the spleen and stomach,eliminate dampness and phlegm,regulate the flow of Qi and clear cancerous toxins.[Conclusion]WU's tumor school has been passed down for three generations,following the principle of"enhancing health and promoting detoxification".The overall medication is balanced and tailored to different types of malignant tumors,demonstrating significant clinical efficacy.

Objective:To explore the clinical features of immunocompetent primary central nervous system lymphoma (PCNSL) and influencing factors for prognosis of immunocompetent patients with PCNSL.Methods:A retrospective analysis was performed; 69 immunocompetent patients with PCNSL confirmed by pathology in First Medical Center of PLA General Hospital from January 2016 to January 2024 were enrolled; initial symptoms, Eastern Cooperative Oncology Group (ECOG) score, and results of laboratory and pathological examinations in these patients were collected. Patients were divided into biopsy confirmed group ( n=43) and lesion resection confirmed group ( n=26) according to different diagnostic methods; patients were also divided into chemotherapy group ( n=48), chemotherapy+radiotherapy group ( n=9) and surgical resection group ( n=12) according to different treatment methods. Clinical outcomes of these patients in different groups at the end of follow-up were compared, and the influencing factors for short-term prognosis (6 months after treatment) were identified. All patients were followed up for 12.80 (6.00, 36.40) months. The short-term prognosis was evaluated by modified Rankin scale (mRS) 6 months after treatment (mRS scores of 0-2: good prognosis; mRS scores of 3-6: poor prognosis). Overall survival (OS) was recorded at the end of follow-up. Results:Among the 69 immunocompetent patients with PCNSL, 37 were males and 32 were females; median onset age was 59 years, ranged 24-83 years. Focal neurologic deficits of different degrees (34/69, limb weakness, sensory disturbances, ataxia, or eye involvement) were the most common initial symptoms, followed by headache (14/69), dizziness (10/69), cognitive dysfunction (9/69), epilepsy (1/69) and psychiatric disorders (1/69). Forty-five patients underwent cerebrospinal fluid examination: 17 had cerebrospinal fluid pressure≥200 mmH 2O (1 mmH 2O=9.8 Pa); 10 had increased white blood cell count (>10×10 6/L), reaching to (16.5[11.0, 20.0])×10 6/L; 32 had increased protein level, reaching to 758.10 (547.83, 948.13) mg/L. Cerebrospinal fluid cytology was performed in 15 patients, and tumor cells were found in only 1 patient. Cranial MRI showed that intracranial solitary lesions were more common (60.87%, 42/69), and most lesions were at the basal ganglia region (40.58%, 28/69). PET/CT showed a obviously higher metabolism of the lesions (97.06, 33/34), with maximum standardized uptake of 22.9 (13.9, 30.55) g/mL. All patients had diffuse large B-cell lymphoma (DLBCL). By the end of follow-up, 28 patients died. Logistic regression analysis showed that ECOG score≥2 ( OR=9.210, 95% CI: 2.558-32.896, P=0.001) and positive MYC ( OR=0.088, 95% CI: 0.008-0.973, P=0.047) were independent risk factors for poor short-term prognosis. Cox proportional hazard regression model analysis showed that ECOG score≥2 ( HR=5.135, 95% CI: 2.230-11.827, P<0.001), positive B-cell lymphoma 6 (BCL-6, HR=0.226, 95% CI: 0.079-0.649, P=0.006) and chemotherapy or chemotherapy+radiotherapy ( HR=0.392, 95% CI: 0.157-0.980, P=0.045) were independent prognostic factors for OS. Conclusions:In immunocompetent patients with PCNSL, focal neurological deficits are more common at the onset, and fever is rare. Patients with ECOG score≥2 are more likely to have poor short-term prognosis and short OS. MYC-positive patients will have a better short-term prognosis; BCL-6 positive patients and patients treated with chemotherapy or chemotherapy+radiotherapy will have longer OS.

Objective:To explore the clinical features of immunocompetent primary central nervous system lymphoma (PCNSL) and influencing factors for prognosis of immunocompetent patients with PCNSL.Methods:A retrospective analysis was performed; 69 immunocompetent patients with PCNSL confirmed by pathology in First Medical Center of PLA General Hospital from January 2016 to January 2024 were enrolled; initial symptoms, Eastern Cooperative Oncology Group (ECOG) score, and results of laboratory and pathological examinations in these patients were collected. Patients were divided into biopsy confirmed group ( n=43) and lesion resection confirmed group ( n=26) according to different diagnostic methods; patients were also divided into chemotherapy group ( n=48), chemotherapy+radiotherapy group ( n=9) and surgical resection group ( n=12) according to different treatment methods. Clinical outcomes of these patients in different groups at the end of follow-up were compared, and the influencing factors for short-term prognosis (6 months after treatment) were identified. All patients were followed up for 12.80 (6.00, 36.40) months. The short-term prognosis was evaluated by modified Rankin scale (mRS) 6 months after treatment (mRS scores of 0-2: good prognosis; mRS scores of 3-6: poor prognosis). Overall survival (OS) was recorded at the end of follow-up. Results:Among the 69 immunocompetent patients with PCNSL, 37 were males and 32 were females; median onset age was 59 years, ranged 24-83 years. Focal neurologic deficits of different degrees (34/69, limb weakness, sensory disturbances, ataxia, or eye involvement) were the most common initial symptoms, followed by headache (14/69), dizziness (10/69), cognitive dysfunction (9/69), epilepsy (1/69) and psychiatric disorders (1/69). Forty-five patients underwent cerebrospinal fluid examination: 17 had cerebrospinal fluid pressure≥200 mmH 2O (1 mmH 2O=9.8 Pa); 10 had increased white blood cell count (>10×10 6/L), reaching to (16.5[11.0, 20.0])×10 6/L; 32 had increased protein level, reaching to 758.10 (547.83, 948.13) mg/L. Cerebrospinal fluid cytology was performed in 15 patients, and tumor cells were found in only 1 patient. Cranial MRI showed that intracranial solitary lesions were more common (60.87%, 42/69), and most lesions were at the basal ganglia region (40.58%, 28/69). PET/CT showed a obviously higher metabolism of the lesions (97.06, 33/34), with maximum standardized uptake of 22.9 (13.9, 30.55) g/mL. All patients had diffuse large B-cell lymphoma (DLBCL). By the end of follow-up, 28 patients died. Logistic regression analysis showed that ECOG score≥2 ( OR=9.210, 95% CI: 2.558-32.896, P=0.001) and positive MYC ( OR=0.088, 95% CI: 0.008-0.973, P=0.047) were independent risk factors for poor short-term prognosis. Cox proportional hazard regression model analysis showed that ECOG score≥2 ( HR=5.135, 95% CI: 2.230-11.827, P<0.001), positive B-cell lymphoma 6 (BCL-6, HR=0.226, 95% CI: 0.079-0.649, P=0.006) and chemotherapy or chemotherapy+radiotherapy ( HR=0.392, 95% CI: 0.157-0.980, P=0.045) were independent prognostic factors for OS. Conclusions:In immunocompetent patients with PCNSL, focal neurological deficits are more common at the onset, and fever is rare. Patients with ECOG score≥2 are more likely to have poor short-term prognosis and short OS. MYC-positive patients will have a better short-term prognosis; BCL-6 positive patients and patients treated with chemotherapy or chemotherapy+radiotherapy will have longer OS.

Objective: To investigate the effect of peripheral nerve block combined with venous fast track anesthesia on elderly patients undergoing lower extremity orthopedic surgery. Methods: From September 2015 to December 2017, 64 senile patients with lower extremity orthopedic surgery in the Fifth Hospital of Ningbo were selected in the research.According to the different methods of anesthesia, the patients were divided into observation group (30 cases, application of combined intravenous peripheral nerve block and fast track anaesthesia), and the control group (34 cases, application of simple intravenous general anesthesia). The heart rate, average arterial pressure, spontaneous breathing recovery time, extubation time, complication rate and cognitive function scores of the two groups were compared. Results: The heart rate and average arterial pressure of T1 and T3 in the observation group were significantly lower than those in the control group (P<0.05). The spontaneous breathing recovery time[(8.32±3.26)min] and extubation time[(9.69±4.29)min] in the observation group were significantly shorter than those in the control group[(18.24±5.23)min and (27.24±4.58)min](t=8.961, 15.756, all P<0.05). The incidence rate of postoperative complications in the observation group (3.33%) was significantly lower than that in the control group (20.59%)(χ²=4.338, P<0.05). The cognitive function score of the observation group was significantly higher at 4 h and 8 h after surgery than that of the control group (t=6.745, 8.494, all P<0.05). Conclusion Peripheral nerve block combined with intravenous fast-track anesthesia is very feasible for elderly patients undergoing lower limb orthopedic surgery.The time for patients to recover from spontaneous breathing and extubation is shorter, and the risk of complications such as delirium, restlessness, nausea and vomiting is lower.

Objective To evaluate the value of cardiac MRI in the diagnosis of Ebstein anomaly (EA). Methods Twenty patients from February 2014 to April 2017 with EA confirmed by surgery were enrolled into this study. The analysis in all patients was made according to preoperative cardiac MRI, 2D TTE and surgical data, including the changes of tricuspid valve leaflets, Carpentier classification, the size and function of atrioventricle, late Gadolinium enhancement, the total right/left-volume index and cardiopulmonary bypass time,etc.The numbers of apicaldisplaced leaflets and development condition of all the leaflets were compared using the R×C χ2among the three groups.With surgical results as the reference standard, the diagnostic accuracy of the two groups for the development condition of all the leaflets were evaluated. One-way ANOVA was performed to compare the differences of the apicaldisplaced distance of septal leaflet, using these three methods. Comparisons of the total right/left-volume index, surgery-related data between patients with or without late gadolinium enhancement were performed by independent t test.Results (1) The results in anatomicalstructures, such as distance of apicaldisplacedseptal leaflet,displacement of each leaflet and the Carpentier classification, showed nostatistical difference among MRI,2D TTE and operational findings. The leaflet dysplasia defined by MRI and 2D TTE areequivalent to surgically defined severe dysplasia, and surgically defined mild to moderate dysplasia can't be identified by the former two methods. The overall diagnostic accuracy of MRI and 2D TTE to identify leaflet dysplasia were 41.3%(19/46) and 34.7%(16/46), respectively.(2) Functional right ventricular volume index decreased in 1 case, normal in 8 cases, increased in 11 cases;functional right ventricula rejection fraction decreased in 15 cases. Six patients' left ventricular volume index decreased, 13 remained in normal range, 1 showed increased;left ventricula rejection fraction decreased in 14 cases. (3)LGE was identified in 8 patients and non-LGE in 12. Difference of the total right/left-volume index [(7.12 ± 4.06) vs. (3.84 ± 2.10), P=0.029] between two groups was statistically significant. However, there was no statistical difference in extracorporeal circulation time, aorticcross-clamping time, intubation time, ICU residence time and postoperative hospital staybetween the LGE and non-LGE groups.Conclusions Cardiac MRI can relatively accurately evaluate the apicaldisplacement of leaflets and the morphological changes of the atria and ventricles, as well as quantitatively evaluate the ventricular function, which can rovide references for clinical diagnosis and severity evaluation of EA.

Objective To probe into the clinical value of the whole pelvis internal organs joint excision in locally advanced cervical carcinoma. Methods Four cases of local cervical carcinoma patients who have been implemented the peculiar operation from April 1997 to April 2001 were analyzed. Results The operation progressed well and the time of surviving was 4-41 months, 16.3 months in life cycle on average. 4 patients died of intestinal obstruction, vagina-small intestine atrophy and the pain of pelvis which resulted in a hunger strike and lung metastasis. Conclusion Implement the operation to those patients whose rectum and bladder were invaded simultaneously can lengthen a patient's life cycle and improve the quality of surviving. To grasp the operation target, standardize the step and improve the treatment method before and after operation were necessary.