Objective To explore the effect of Periplaneta americana reversing multiple drug resistance (MDR) of hepatocellular carcinoma in vitro. Methods Drug resistance of Hepatocellular carcinoma cell line HepG2/ADM was established by Adriamycin ( ADM ) increasing concentration gradient method;determined cell growth curve, doubling time change using Trypan blue staining method;detected sensitivity of 4 kinds of chemotherapeutic drugs of HepG2 and HepG2/ADM by methyl thiazolyl tetrazolium method; detected the non toxic dose of Periplaneta americana CⅡ-3 and the skim cream of HepG2/ADM by MTT method; detected the inhibition rate differences of CⅡ-3, skim cream, ADM, CⅡ-3 and ADM, skim cream and ADM of hepatocellular carcinoma drug resistance cell line HepG2/ADM by MTT method.Results Drug-resistant cell line doubling time was extended obviously compared with parent cells,HepG2/ADM showed resistance to variety of chemotherapeutic drugs, ADM resistant index was especially high,that was 15.25 times.When the concentration of CⅡ-3 and skim cream were 28.76 and 45.08μg/mL respectively, the growth inhibition rate of HepG2 and HepG2/ADM two cell lines were<10%,no obvious toxic effect.The inhibition rate of the drug-resistant cell of 7.5,15,30μg/mL concentration CⅡ-3 joint with ADM concentration (1/2 IC50 ) were (24.52 ±2.05)%,( 34.78 ±3.08)%,( 45.09 ±3.56)% respectively; The inhibition rate of the drug-resistant cell of 12.5,25,50μg/mL concentration skimmed cream joint with ADM concentration (1/2 IC50 ) were (19.28 ±2.56)%,(35.08 ±2.13)%,(43.85 ±3.05)%respectively.Conclusion The cell line HepG2/ADM established has basic multidrug-resistant biological characteristics.Periplaneta americana extract can inhibit the growth of HepG2/ADM,and has good effect to reverse drug resistance at the same time.

Objective To evaluate the results and side effects in three dimensional conformal radiation therapy (3DCRT) for esophageal carcinoma. Methods From December 1996 to December 1998,67 patients with esophageal carcinoma were treated with 3DCRT(3DCRT group),in which all were treated once every other day to a total dose of 40 42 ?Gy in 13 15 days at 5 6?Gy per fraction totally 7 8 fractions, and during the same interval, another 112 patients treated by conventional fractionation radiotherapy(CF group) to a total dose of 64 68?Gy over 44 48 days at 2.0?Gy per fraction 5 days per week were analyzed and compared. Results The 1 ,2 ,3 and 4 year local control rates in 3DCRT group were 71.6% ,62.7%,49.3% and 43.3% ,compared to 53.6%, 43.8% ,33.9% and 25.9% in CF group (P = 0.011). And the survival rates in 1 ,2 ,3 and 4 years in 3DCRT group were 62.7%,52.2%,43.3% and 38.8%, as compared with 49.1%, 41.1% ,30.4% and 22.3% in CF group (P = 0.027). However, in the 3DCRT group, the incidence of acute radiation esophagitis was higher (P=0.003) and those of hematogenous side effects and B symptom were lower(P=0.007,0.021). Conclusion Compared with conventional fractionation radiotherapy,3DCRT is able to improve the local control rate of esophageal carcinoma, with tolerable acute and late radiation side effects.

The aim of this study is to determine the accuracy of RSI and RFS in the diagnosis of hypopharyngeal reflux （LPR）, the scores of RSI and RFS were compared in different age groups. To explore the RSI and RFS scoring thresholds for diagnosis of LPR in different age groups. From January 2017 to March 2019, 258 patients with suspected LPR in our hospital outpatient clinic completed the RSI and RFS scales. According to their age, 258 patients with RSI>13 and RFS>7 were selected. They were divided into group A （18-<40 years, =86）, group B （40-<60 years, =107） and group C （≥60 years, =65）. The diagnosis was confirmed by 24 h pH-metry. The diagnostic rate, RSI and RFS scores were compared among the three groups. ROC curve was used to analyze the optimal thresholds for the diagnosis of LPR by RSI and RFS scores. Among the three groups, group C had the highest diagnostic rate（93.85%）. There was no significant difference in RFS score among the three groups （>0.05）, RSI score was significantly different （<0.05）, RSI score of group A and group B was higher than that of group C （<0.05）. According to ROC analysis, the best RSI cutoffs for diagnosing LPR in group C was 11, and the area under the ROC curve was 0.866. The RSI score is a good criterion for the diagnosis of LPR. The diagnostic threshold of RSI in elderly patients is different from that in young patients. For elderly patients, the diagnostic threshold for the recommended RSI score is 11.

Objective: The aim of this study is to determine the accuracy of RSI and RFS in the diagnosis of hypopharyngeal reflux （LPR）, the scores of RSI and RFS were compared in different age groups. To explore the RSI and RFS scoring thresholds for diagnosis of LPR in different age groups. Method: From January 2017 to March 2019, 258 patients with suspected LPR in our hospital outpatient clinic completed the RSI and RFS scales. According to their age, 258 patients with RSI>13 and RFS>7 were selected. They were divided into group A （18-<40 years, n=86）, group B （40-<60 years, n=107） and group C （≥60 years, n=65）. The diagnosis was confirmed by 24 h pH-metry. The diagnostic rate, RSI and RFS scores were compared among the three groups. ROC curve was used to analyze the optimal thresholds for the diagnosis of LPR by RSI and RFS scores. Result: Among the three groups, group C had the highest diagnostic rate（93.85%）. There was no significant difference in RFS score among the three groups （P>0.05）, RSI score was significantly different （P<0.05）, RSI score of group A and group B was higher than that of group C （P<0.05）. According to ROC analysis, the best RSI cutoffs for diagnosing LPR in group C was 11, and the area under the ROC curve was 0.866. Conclusion The RSI score is a good criterion for the diagnosis of LPR. The diagnostic threshold of RSI in elderly patients is different from that in young patients. For elderly patients, the diagnostic threshold for the recommended RSI score is 11.

Artificial intelligence (AI) for science (AI4S) technology, the AI technology for scientific research, has shown tremendous potential and influence in the field of healthcare, redefining the research paradigm of medical science under the guidance of computational medicine. We reviewed the main technological trends of AI4S in reshaping healthcare paradigm: knowledge-driven AI, leveraging extensive literature mining and data integration, emerges an important tool for understanding disease mechanisms and facilitating novel drug development; data-driven AI, delving into clinical and human-related omics data, unveils individual variances and disease mechanisms, and further establishes patient-centric digital twins to guide drug development and personalized medicine. Meanwhile, based on authentic patient digital twin models, adaptable strategies are employed to further propel the development of "e-drugs" that mimic the authentic mechanisms. These digital twins of drugs are evaluated for drug efficacy and safety through large-scale cloud-based virtual clinical trials, and followed by rationally designed real-world clinical trials, thus notably reducing drug development costs and enhancing success rates. Despite encountering challenges such as data scale, quality control, model interpretability, the transition from science insights to engineering solutions, and regulatory hurdles, we anticipate the integration of AI4S technology to revolutionize drug development and clinical practices. This transformation brings revolutionary changes to the medical field, offering novel opportunities and challenges for the development of medical science, and more importantly, providing necessary but personalized healthcare solutions for humankind.