RESUMO
As one of notable works of HUANG Yuanyu， a renowned physician from the Qing Dynasty， The Indications of Classics by Four Medical Sage emphasize the theoretical paradigm of “one qi circulation” with a particular focus on the middle qi. Building upon disease differentiation and treatment， HUANG Yuanyu attaches great importance to understanding the underlying cause of the disease. It is believed that the imbalance of the six climatic factors is the fundamental cause of diseases. The concept of mutual interaction between the physiological and pathological aspects of the six climatic factors is proposed to grasp the basic pathogenesis. Based on the individual's specific condition of six climatic factors， excess or deficiency， specific prescriptions are formulated. The diagnosis and treatment system can be summarized as a “differentiation of diseases → disease etiology → differentiation of the condition of six climatic factors → individualized pathogenesis of traditional Chinese medicine （TCM） → prescription of TCM” model based on the holistic view. HUANG Yuanyu' s diagnosis and treatment system is highly practical and can provide reference for clinical diagnosis and treatment of diseases in TCM.
RESUMO
Objective@#To compare the outcome of postoperative adjuvant chemotherapy and surgery alone for stage pT1b-3N0M0 squamous cell carcinoma (SCC) of the thoracic esophagus.@*Methods@#Two hundred and thirty-eight patients who underwent esophagectomy for stage pT1b-3N0M0 SCC of the thoracic esophagus in Department of Thoracic Surgery, Fourth Hospital, Hebei Medical University between January 2008 and February 2011 were analyzed retrospectively. These included postoperative adjuvant chemotherapy for 118 patients and surgery alone for 120 patients. In postoperative adjuvant chemotherapy arm, 3 or 4 cycles of taxol+ cisplatin (TP, n=33) or fluorouracil+ cisplatin (FP, n=85) regimens were given commencing from 4 to 6 weeks after surgery. Survival analysis was performed using Kaplan-Meier method. Univariate analysis for prognostic factors was performed by Log-rank test and multivariate by Cox regression model.@*Results@#The 3- and 5-year disease-free survival (DFS) rates were 57.9% and 53.8%, respectively for postoperative adjuvant chemotherapy patients, compared to 40.4% and 32.5% for patients who underwent surgery alone (χ2=11.973, P=0.001). The 3- and 5-year overall survival (OS) rates were 64.4% and 55.9% in postoperative adjuvant chemotherapy patients, and 46.7% and 33.5% in surgery alone patients (χ2=13.110, P=0.000). Stratification analysis showed that there was significant difference in stage T3 patients (χ2=7.895, P=0.006), but not in stage T1b (χ2=0.762, P=0.383) and T2 (χ2=1.259, P=0.262) patients between adjuvant chemotherapy and surgery alone. Both DFS rate (χ2=1.748, P=0.186) and OS rate (χ2=2.200, P=0.138) of TP group were similar with FP group.@*Conclusion@#In lymph node negative esophageal SCC patients, postoperative adjuvant chemotherapy shows survival benefits in stage T3 patients.