Xiao Chaihutang， originating from the Treatise on Typhoid and Miscellaneous Diseases， is a classic formula for harmonizing the Shaoyang. It excels in regulating the pivotal mechanism and unblocking the triple energizer， corresponding to the pathogenesis of digestive system tumors characterized by the interlocking of deficiency， stasis， phlegm， and toxicity， as well as disharmony between Yin and Yang. This paper systematically reviews research findings from China and abroad over the past decade， exploring the anti-tumor effects of Xiao Chaihutang on digestive system tumors from three dimensions： theoretical rationale， clinical efficacy， and molecular mechanisms. At the level of principle and method， Xiao Chaihutang takes "harmonization" as its core therapeutic guideline. By reconciling the exterior and interior to restore the Shaoyang pivot， harmonizing Yin and Yang to improve the tumor microenvironment， and regulating the liver and spleen to consolidate and protect the foundation of postnatal essence， it promotes the restoration of the body's dynamic balance of Yin and Yang. Clinical studies have demonstrated that Xiao Chaihutang， used alone or in combination with modern medical therapies， shows definite efficacy against digestive system tumors such as hepatocellular carcinoma， pancreatic carcinoma， and gastrointestinal carcinoma. It can significantly improve patients' quality of life， inhibit tumor progression， effectively relieve concomitant symptoms such a s cancer-related fever， anxiety， depression， and insomnia， and alleviate postoperative embolic syndromes as well as adverse reactions to radiotherapy and chemotherapy. Experimental studies have revealed that Xiao Chaihutang can inhibit tumor cell proliferation， induce apoptosis， arrest the cell cycle， suppress tumor cell invasion and metastasis， and improve the tumor microenvironment. Through the above analysis， this study elucidates the current clinical and experimental research status of Xiao Chaihutang in the treatment of digestive system tumors， aiming to provide theoretical support for its precise clinical application. On this basis， it further explores key issues in the identification of pharmacodynamic substances and the accumulation of evidence in evidence-based medicine， thereby offering a new perspective for the innovative development of integrative Chinese and Western medicine in synergistic cancer therapy.

Objective To evaluate the performance of large language models in answering questions about childhood asthma, comprehensively understand the quality of their provision of information on children's health, and identify their limitations to facilitate model improvement. Methods Sixty common questions related to childhood asthma were formulated and put to two large language models known as Wenxin Yiyan and Zhipu Qingyan, which were publicly available in China. Three pediatric asthma specialists assessed the quality of the large language models'responses by using a blind method. Results Wenxin Yiyan scored higher in terms of accuracy, understanding, reliability, and logicality; Zhipu Qingyan scored higher in term of safety. Comparing the scores of the five different dimensions, it was found that large language models scored higher in terms of understanding, reliability and logicality, but relatively insufficient in terms of accuracy and safety. Conclusion Application of large language models in the education of children with asthma can provide useful references for asthma children and their parents. However, the current large language model technology still has certain limitations in terms of accuracy and safety, which requires further improvement and optimization.

Objective:To evaluate the predictive value of stair climbing test combined with arterial blood gas analysis on postoperative complications in lung cancer patients with limited pulmonary function.Methods:A total of 1 231 hospitalized lung cancer patients with limited pulmonary function dating from August 2012 to August 2020 were retrospectively reviewed. Included in the cohort were 766 of patients who underwent stair climbing test(SCT) preoperatively and completed data collection. Patients were grouped according to their general condition, past medical history, surgical approach, pulmonary function test(PFT) and SCT results. Comparison of the postoperative cardiopulmonary complication rates were made between different groups, and independent risk factors were identified.Results:A total of 182 cardiopulmonary-related complications occurred in 144 cases, accounting for 18.8% of the entire cohort. Perioperative mortality rate was 0.9%(7/766). The rate of postoperative cardiopulmonary complications was significantly different between the groups stratified by gender, age, smoking index, PFT index(FEV1%, DLCO%), SCT results(height achieved, speed, changes in heart rate and oxygen saturation of the arteries before and after the test), ASA score, surgical approach(VATS/Open), resection range(Lobectomy/Sublobectomy), anesthetic duration, blood loss volume, etc. Logistic regression analysis showed that only height achieved( P<0.001), changes in heart rate( P<0.001), changes in oxygen saturation of the arteries( P=0.001), resection range( P=0.006) and anesthetic duration( P=0.025) were independent risk factors for cardiopulmonary-related complications in lung cancer patients with limited pulmonary function. Conclusion:The stair climbing test combined with arterial blood gas analysis could be used as a preoperative screening method for lung cancer patients with limited lung function and may have a predictive value for postoperative cardiopulmonary-related complications.

Objective: To explore the safety, feasibility and advantages of Da Vinci robot "3+ 2" mode in radical gastrectomy. Methods: Clinical data of 30 patients received radical gastrectomy at our department under the "3+ 2" mode of Da Vinci robot from Jan. 2018 to Oct. 2018 were retrospectively analyzed. 30 patients who received classical robot mode in the same period were randomly selected as control group. Results: Compared with the control group, the observation group had a shorter operative time (174±16)min vs.(197±19)min, t=-3.275, P<0.01) , a lower operation costs[(22 794±3 660)yuan vs.(29 307±3 220)yuan, t=-3.316, P<0.01; and inhospital costs (70 910±6 399)yuan vs.(78 180±6 636)yuan), t=-7.316, P<0.01]. Conclusion The "3+ 2" mode of Da Vinci robot in radical gastrectomy is beneficial to enhance the exposure of the surgical field, improve the cooperation of assistants, reduce the costs of surgery, shorten the operative time and the learning curves. In addition, it has similar clinical efficacy to radical gastrectomy under the classical robot mode.

Objective To analyze copy number variance (CNV) in whole genome by using gene chip technology, and to screen the radiosensitivity associated genes on esophageal squamous cell carcinoma (ESCC). Methods The patients with ESCC who received radiotherapy alone in Anyang Tumor Hospital from December 2013 to August 2016 were selected, and biopsy paraffin samples were preserved in the center of pathology. The patients were divided into radiosensitivity group (group S) and radio-resistance group (group R). DNA was extracted from these paraffin samples in both groups. Whole human genome CNV was detected by using genechip from OncoScan Array platform designed by Affymetrix company, and the differences of gene segments were screened in the two groups. Results Nineteen samples of ESCC patients were collected to extract DNA in this study. To balance pair analysis in the two groups, 10 samples were selected from the qualified patients, including 5 cases in group S and 5 cases in group R respectively. There were no statistical differences in gender, age, lesion site, lesion length, radiation dose of the two groups (all P> 0.05). Loss of heterozygosity (LOH) was the main type of CNV. The analysis results showed that LOH in q24.32-q24.33 of chromosome 10 and LOH in q21.2-q21.31 of chromosome 18 had high frequencies (100 ％) in group R, however, none were detected in group S. LOH in q27-q28.1 of chromosome 4 had a high frequency (80％) in group S , however, none were detected in group R. Conclusion LOH in 10q/18q is related to radio-resistance in ESCC, and LOH in 4p is associated with radiosensitivity in ESCC.

Objective: To investigate the effect of hypertensive disorder complicating pregnancy (HDCP) on the mortality and early complications of premature infants. Methods: The general clinical data of preterm infants with gestational age 24-36^{+ 6} weeks were collected from the cooperative units in the task group from January 1, 2013 to December 31, 2014.According to the severity of HDCP, the infants were divided into 4 groups: HDCP group, preeclampsia group, eclampsia group and non HDCP group, the mortality and major complications of preterm infants were compared, and the influencing factors were analyzed. Results: The mortality rate of preterm in the HDCP group was significantly higher than that of non HDCP group, and there was statistical significance (χ²=9.970, P=0.019). Eclampsia had a highest fatality rate (4.8%) in the early stage, compared with non HDCP group (2.2%), and the difference was statistically significant.Comparison of HDCP group (1.8%) and eclampsia group (3.2%) suggested that there was no statistically significant difference.The incidence of respiratory distress syndrome (RDS) in preterm in HDCP group was significantly higher than that of non HDCP group, and there was statistical significance (χ²=13.241, P=0.004). Eclampsia group showed the highest incidence (35.4%), compared with non HDCP group (16.2%), the difference was statistically significant, but compared with HDCP group (19.9%), preeclampsia group (17.1%), there was no significant diffe-rence.The incidence of bronchopulmonary dysplasia (BPD) in preterm in HDCP group was significantly higher than that of non HDCP group (χ²=9.592, P=0.022), the highest incidence showed up in eclampsia group (9.7%), compared with non HDCP group (2.0%) and HDCP group (1.7%), the difference was statistically significant.But there was no statistically significant difference, compared with preeclampsia group.As the degree of HDCP aggravated, the incidence of BPD gradually rose.There was no significant impact on necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), intraventricular hemorrhage (IVH) and sepsis of HDCP (χ²=7.054, 7.214, 0.358, 3.852; P=0.070, 0.065, 0.949, 0.278). Considering the overall outcome of the child, that was, whether the child died or survived, he had at least one complication, and HDCP had an effect on it (χ²=15.697, P=0.001), so the incidence increased while the degree of HDCP rose gradually.After adjusting gestational age, birth weight, sex, way of delivery, placental abruption and front placenta, prenatal hormonal, gestational diabetes, neonatal asphyxia and other factors, the results displayed that HDCP was the factor leading to the death of premature baby (OR=2.159, 95%CI: 1.093-4.266), and comparison between preeclampsia and eclampsia showed no statistical difference (P=0.714, 0.389); HDCP had no significant influence on RDS, BDP, ICH, NEC, ROP and sepsis. Conclusions HDCP leads to increased risk of premature death, but also leads to the increased incidence of RDS and BPD, but it had no obvious effect on NEC, ROP, IVH, sepsis and other complications.

OBJECTIVETo evaluate the value of D2+ lymph node dissection for patients with distal advanced gastric cancer.

METHODSClinicopathological data of 305 cases with distal advanced gastric cancer receiving D2+(n=68) or D2(n=237) lymph node dissection in the Tianjin Cancer Hospital from January 2003 to December 2007 were analyzed retrospectively. The overall 5-year survival rate between the 2 groups.

RESULTSThe median survival was 36 months and the 5-year overall survival rate was 40.3% in all patients. The 5-year overall survival rates in the D2+ and D2 groups were 50.4% and 37.4% respectively, and the difference was statistically significant(P=0.049). In multivariate prognostic analysis however, the extent of lymph node dissection was not identified as an independent prognostic factor(P=0.174). Subgroup analysis showed that 5-year survival rate of D2+ group was significantly higher as compared to D2 group for the following subgroups: maximum diameter of tumor larger than 4 cm(43.9% vs. 27.0%), Borrmann type III(-IIII((55.5% vs. 30.1%), poorly differentiated and undifferentiated tumor (49.8% vs. 37.0%), T4 stage (47.8% vs. 31.0%), N2 stage (53.3% vs. 13.9%), N3 stage (20.0% vs. 9.6%) and positive No.6 lymph nodes (33.1% vs. 16.0%).

CONCLUSIONCompared with D2 lymph node dissection, D2+ lymph node dissection may benefit some patients with large, poorly differentiated, or late-stage tumor.

Humans ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Metastasis ; Multivariate Analysis ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; Survival Rate

Objective:The characteristics of lymph node metastasis were investigated to guide the range of lymph node dissection during the radical operation of distal gastric cancer. Methods:The clinical data of 773 patients with distal gastric cancer who under-went radical distal subtotal gastrectomy at the Tianjin Medical University Cancer Institute and Hospital between February 2010 and September 2014 were reviewed and analyzed to infer the potential clinical mechanisms of lymph node metastasis. Results:Among the included patients, 423 (54.72%) had lymph node metastasis. The proportion of metastasis in the patients from the highest to the lowest rate was observed in group NO. 6, 3, 4sb, and 5 lymph nodes. The metastasis rates of the N1 lymph nodes from the highest to the low-est were observed in group NO. 3, 6, 5, and 4d lymph nodes, whereas those of the N2 lymph nodes occurred in group NO. 8a, 7, and 1 lymph nodes. Group NO. 8a lymph node with skipped metastasis was observed in 50.68%of the patients. Conclusion:During radical distal gastric cancer surgery, attention should be given to the possibility of metastasis in group NO. 8a lymph node. Appropriate exten-sion of the lymph node dissection should be conducted when necessary.

Objective To evaluate the value of D2+ lymph node dissection for patients with distal advanced gastric cancer. Methods Clinicopathological data of 305 cases with distal advanced gastric cancer receiving D2+(n=68) or D2 (n=237) lymph node dissection in the Tianjin Cancer Hospital from January 2003 to December 2007 were analyzed retrospectively. The overall 5-year survival rate between the 2 groups. Results The median survival was 36 months and the 5-year overall survival rate was 40.3% in all patients. The 5-year overall survival rates in the D2+ and D2 groups were 50.4% and 37.4% respectively, and the difference was statistically significant (P =0.049). In multivariate prognostic analysis however, the extent of lymph node dissection was not identified as an independent prognostic factor(P=0.174). Subgroup analysis showed that 5-year survival rate of D2+group was significantly higher as compared to D2 group for the following subgroups: maximum diameter of tumor larger than 4 cm (43.9% vs. 27.0%), Borrmann type Ⅲ-Ⅳ (55.5% vs. 30.1%), poorly differentiated and undifferentiated tumor (49.8% vs. 37.0%), T4 stage (47.8% vs. 31.0%), N2 stage (53.3% vs. 13.9%), N3 stage (20.0% vs. 9.6%) and positive No.6 lymph nodes (33.1% vs. 16.0%). Conclusion Compared with D2 lymph node dissection, D2+ lymph node dissection may benefit some patients with large, poorly differentiated, or late-stage tumor.

Objective To evaluate the value of D2+ lymph node dissection for patients with distal advanced gastric cancer. Methods Clinicopathological data of 305 cases with distal advanced gastric cancer receiving D2+(n=68) or D2 (n=237) lymph node dissection in the Tianjin Cancer Hospital from January 2003 to December 2007 were analyzed retrospectively. The overall 5-year survival rate between the 2 groups. Results The median survival was 36 months and the 5-year overall survival rate was 40.3% in all patients. The 5-year overall survival rates in the D2+ and D2 groups were 50.4% and 37.4% respectively, and the difference was statistically significant (P =0.049). In multivariate prognostic analysis however, the extent of lymph node dissection was not identified as an independent prognostic factor(P=0.174). Subgroup analysis showed that 5-year survival rate of D2+group was significantly higher as compared to D2 group for the following subgroups: maximum diameter of tumor larger than 4 cm (43.9% vs. 27.0%), Borrmann type Ⅲ-Ⅳ (55.5% vs. 30.1%), poorly differentiated and undifferentiated tumor (49.8% vs. 37.0%), T4 stage (47.8% vs. 31.0%), N2 stage (53.3% vs. 13.9%), N3 stage (20.0% vs. 9.6%) and positive No.6 lymph nodes (33.1% vs. 16.0%). Conclusion Compared with D2 lymph node dissection, D2+ lymph node dissection may benefit some patients with large, poorly differentiated, or late-stage tumor.