Objective To analyze the index of relative apparent diffusion coefficient (rADC)of magnetic resonance diffusion weighted imaging (DWI)for nasopharyngeal carcinoma with cervical metastatic lymph node before and after treatment,assess the application value of rADC in the recent curative effect after radiotherapy and chemotherapy.Methods 45 cases of nasopharyngeal carcinoma with cervical metastatic lymph nodes proved pathologically were selected as the research objects,which was including 107 pieces of metastatic lymph nodes and underwent DWI.The rADC index of cervical metastatic lymph nodes before and after radiotherapy and chemotherapy was measured and calculated.The cervical metastatic lymph nodes were divided into effective group (CR+PR,n=84)and ineffective group(SD+PD,n=23),and the difference of the rADC index between the two groups was compared.Results For the target volume disappeared or reduced more than 30% in the effective group after treatment,the rADC index was significantly higher than that before treatment(t=4.981, P<0.05).The rADC difference between effective group and ineffective group was statistically significance (t=3.471,P<0.05).Conclusion rADC can be used as the auxiliary marker for the evaluation of short-term curative effect of nasopharyngeal carcinoma with cervical metastatic lymph nodes.

Objective To develop the Chinese version of depression stigma scale ( DSS) and examine its reliability and validity .Methods The Chinese version of DSS was formed using the standard translation /retroversion method , and its reliability , content validity index ( CVI ) , construct validity , criterion-related validity ( CRV) and discriminant validity were examined subsequently .Results The Cronbach′s αcoefficient for Chinese version of DSS was 0.78 and the test-retest reliability of the scale was 0.74, which was correlated with perceived devaluation-discrimination scale(PDD) significantly (r=0.37,P<0.01).Conclusions The Chinese version of DSS has a good reliability and validity in general population , and can be used to evaluate public′s belief, cognition and behavior toward depression and patients with depression .

Objective:To summarize the clinical diagnosis and therapeutic method in chronic hepatitis B (CHB) combined with autoimmune hepatitis (AIH).Methods:Clinical manifestations, laboratory examination, imaging, histopathological characteristics, treatment and prognosis of 19 cases diagnosed with CHB combined with AIH followed at the outpatient Department of Gastroenterology of Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine during December 2013 to June 2018 were retrospectively analyzed. Paired sample t-test was used before and after treatment for the measurement of normal distribution data. Measurement data of non-normal distribution were expressed as a median (quartile spacing) and Wilcoxon matched-pairs signed rank test was used before and after treatment.Results:Among the 19 cases, 5 were male and 14 were female. The age of onset was 35 to 63 years, and the average age was 47.10 ± 8.76 years. There were 12 cases diagnosed with CHB before AIH, 5 cases diagnosed with AIH before CHB, and 2 cases diagnosed with AIH and CHB at the same time. After the definite diagnosis of CHB combined with AIH, nucleoside (acid) analogues (antiviral against hepatitis B virus) combined glucocorticoid therapy were given, and azathioprine or mycophenolate mofetil (immunosuppressant) was added according to the intrahepatic inflammation (inflammation graded at G3 and above) and leukocyte conditions. The duration of treatment varied between 2 weeks to 16 (median treatment duration of 6 weeks), except for one case who was just diagnosed and followed up. Biochemical indicators and immunoglobulin of the remaining 18 cases before and after treatment was significantly decreased, and the differences were statistically significant ( P < 0.05), with HBV DNA < 20 copies/ml. Conclusion:CHB combined with AIH diagnosis can be easily missed. Therefore, it requires comprehensive diagnosis combined with clinical characteristics, autoantibodies, and immunoglobulin levels with special emphasis on pathological characteristics of liver tissue. Anti-HBc-positive patients using immunosuppressant should be carefully monitored for HBV DNA and anti-HBV treatment should be given if necessary.