Objective Tostudyrecentclinicalefficacyandadversereactionsofpemetrexedincombi-nationwithcisplatininthetreatmentofadvancedbreastcancer.Methods Usingenvelopesandrandomlythe patients were dividing into treatment group and control group.The treatment group with 1 8 cases of advanced breast cancer were treated with pemetrexed and cisplatin while in the control group ,23 cases advanced breast cancer patients were treated with gemcitabine and cisplatin with 21 days as a cycle.The efficacy and adverse re-actions were determined according to the WHO on Response Evaluation Criteria in Solid Tumors therapy and chemotherapytoxicityevaluationcriteria.Results Tumorcontrolrateinthetreatmentgroupwas83.3%(1 5/1 8),while in the control group was 78.3%(1 8/23 ),and the difference was not statistically significant (χ2 =0.000 94,P>0.05);while the adverse reactions differenced between the treatment group and the con-trol group were statistically significant(bone marrow suppression χ2 =9.23;fatigue χ2 =4.96;nausea and vomi-tingχ2=4.98;diarrheaχ2=4.45;skinrashχ2=5.03,P<0.05).Conclusion Pemetrexedcombinedwith cisplatin in patients with advanced breast cancer has a good effect,and the adverse reaction is low.

Objective To establish a simple scoring system for the diagnosis of liver fibrosis in chronic hepatitis B (CHB), and to observe its sensitivity and specificity. Methods Two hundred and thirty-three patients diagnosed as CHB by liver biopsy were divided into model group (N = 154) and validation group (N = 79). The general information, biochemical parameters and imaging data of all patients were observed. With hepatic fibrosis being obvious or not as the end point of primary study in the model group, we established a simple scoring system for the diagnosis. The cut-off, sensitivity and specificity of the system were tested in the model group by ROC curve, and its diagnostic efficacy was tested in the validation group. Results(1) A simple scoring system for the diagnosis of liver fibrosis called MDFS was established in the model group, and the dimensions of the system included sex, HBV-DNA, Fibroscan (FS) value and splenomegaly. In MDFS, male, HBV-DNA≥ 107 U/mL,FS value≥7.3 kPa, and splenomegaly were assigned 1 point, -2 points, 3 points, and 2 points respectively. (2) The best cut-off value in MDFS was 2 points.(3) ROC curve of the model group indicated that the specificity and sensitivity were 92.86% and 54.76% respectively, the area under curve(AUC) was 0.790, and the Youden index was 0.4762. In the validation group, the diagnostic cut-off value was over 2 points, and the sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio were 52.17%, 82.35%, 2.96, and 0.58 respectively. (4) The scoring results of MDFS for different traditional Chinese medical syndromes of CHB showed that the scores of blood stasis blocking collaterals > damp-heat accumulation > deficiency of spleen and kidney yang> liver depression and spleen deficiency = stagnation of liver Qi. Conclusion The MDFS diagnostic scoring system has medium efficiency. The specificity of MDFS is relatively high and MDFs has a relatively low misdiagnosis rate for the diagnosis of obvious hepatic fibrosis in CHB. The MDFS is expected to be a noninvasive and simple diagnosing way for hepatic fibrosis in CHB.