Objective To determine the value of the apparent diffusion coefficient (ADC) of magnetic resonance diffusion-weighted imaging (MRDWI) combined with squamous cell carcinoma antigen (SCC) and carcinoembryonic antigen (CEA) in the evaluation of the efficacy and prognosis of concurrent chemoradiotherapy for cervical carcinoma.Methods A total of 80 patients with cervical squamous cell carcinoma confirmed by histology or cytology in our hospital from 2013 to 2016 were included in this study.Of the 80 patients, 39 were FIGO stage ⅡB, 7 were stage ⅢA, 26 were stage ⅢB, and 8 were stage ⅠVA.MRDWI examination and SCC and CEA measurements were first performed for the patients following group assignment, and the patients were then given extrapelvic radiotherapy (45-50 Gy)+platinum-based chemotherapy plus brachytherapy (20-25 Gy) based on their conditions.MRDWI, SCC, and CEA examinations were performed again after treatment to determine the changes in ADC, SCC, and CEA.In addition, ADC, SCC, and CEA were examined in the middle stage of treatment for 40 patients.Data were analyzed using the paired t-test or ANOVA.Results The overall response rate of the 80 patients after concurrent chemoradiotherapy was 100%.No disease progression was identified in any of the patients until the end of treatment, and the overall survival time of the patients was all above 6 months.Serum SCC and CEA were reduced after treatment (P=0.000,0.000), whereas the ADC value was increased after treatment (P=0.000).The increase in ACD following the decreases in SCC and CEA after treatment (P=0.000, 0.000) was indicative of increased efficacy of the concurrent chemotherapy and radiotherapy.Conclusions MRDWI combined with SCC and CEA is highly reliable for the evaluation of efficacy and prognosis of concurrent chemoradiotherapy for cervical cancer.

Objective To investigate the circulation and use of Akebiae Caulis and Clematidis Armandii Caulis;To provide references for clinical safe medication. Methods Literature review, field survey and telephone interview were used to conduct the investigation. Results ① The market currency of the Akebiae Caulis and Clematidis Armandii Caulis was very confused, and the mainly medicinal materials on the market were Clematidis Armandii Caulis. ② The majority used medicinal materials were Clematidis Armandii Caulis, and Akebiae Caulis was rarely used. ③ The Chinese Pharmacopoeia collected Akebiae Caulis and Clematidis Armandii Caulis separately, but there was phenomenon of using Clematidis Armandii Caulis replacing of Akebiae Caulis. Conclusion Market of Akebiae Caulis is shrinking; the phenomenon of using Clematidis Armandii Caulis to replace Akebiae Caulis widespread in clinic. There are differences in the efficacy of Akebiae Caulis and Clematidis Armandii Caulis, so they should be distinguished and cannot be used to mix or substitute.

Through detailed investigation of the market circulation of Ligustici Rhizoma et Radix, at the same time, this article collected relevant articles, conducted comparative study on genuine and conventionally used Ligustici Rhizoma et Radix from the aspects of textual research, functions, chemical composition and pharmacological effect, and discussed the results of the study.

Objective:To investigate the pathological characteristics in chronic HBV infection patients with different upper limits of alanine aminotransferase (ALT) normal values and the influencing factors of liver tissue injury.Methods:The clinical data of 667 chronic HBV infection patients with ALT<40 U/L and HBV DNA loads >30 IU/mL who received liver biopsy in Zhenhai District Hospital of Traditional Chinese Medicine and Hwa Mei Hospital from January 2014 to December 2020 were retrospectively analyzed. The enrolled patients were divided into ALTⅠ group (<30 U/L for males, <19 U/L for females), ALTⅡ group (≥30 U/L and <35 U/L for males, ≥19 U/L and <25 U/L for females) and ALT Ⅲ group (≥35 U/L and <40 U/L for males, ≥25 U/L and <40 U/L for females). According to the degree of liver inflammation (G) and fibrosis stage (S), the enrolled patients were divided into non-significant damage group (G<2 and S<2) and significant damage group (≥G2 or/and ≥S2). Ridit analysis was used to compare the G/S composition ratio among three ALT groups, Logistic regression was used to analyze the risk factors of liver injury, the receiver operating characteristic curve (ROC) and the area under the curve (AUC) were used to analyze the optimal diagnostic threshold of ALT.Results:There were significant differences in the composition ratio of G and S among the three ALT groups( χ2=13.926 and 14.702, both P<0.001). The constituent ratios of significant liver pathological damage in the three groups of ALT levels were 26.05% (99/380), 32.03% (41/128) and 46.54% (74/159), respectively( χ2=21.596, P<0.001). Multivariate logistic regression analysis showed that high white/globulin ratio and PLT counts( OR=0.246 and 0.986, both P<0.001)were the protective factors for liver tissue injury; while negative HBcAg staining and elevated ALT and GGT levels ( OR=3.797, 1.053 and 1.013, P<0.001 or <0.05) were the risk factors of liver injury. ROC curve demonstrated the ALT threshold of liver tissue damage in male and female patients were 25.6 U/L and 25.5 U/L. Conclusions:In chronic HBV infection patients with normal ALT, with the increase of ALT level, the degree of liver tissue pathological damage may become more severe. The study demonstrates that it is necessary to lower the ALT threshold for protecting patients from liver tissue pathological damage.

Objective To study the clinical efficacy and safety of icotinib hydrochloride tablets combined with whole brain radiotherapy (WBRT) in non-small cell lung cancer (NSCLC) brain metastasis.Methods Fifty-three patients with NSCLC brain metastasis who were unable to tolerate chemotherapy or chemotherapy failed were selected in Baotou Central Hospital from October 2010 to April 2015.The patients were divided into the observation group (n =27) and the control group (n =26) using random number table method.Two patients were dropped out,one in the control group and one in the observation group.The patients in the control group were given WBRT (30 Gy/15 Fx).On this basis,the patients in the observation group were given icotinib hydrochloride tablets 125 mg,3 times a day.The patients were followed up for 18 months after the end of WBRT.The adverse reactions,clinical efficacy and the median survival times of the two groups were compared.Results The objective response rate of the observation group was 88.5％,which was higher than that of the control group (64.0％),and the difference was statistically significant (x2 =4.238,P =0.040).The incidence rates of skin rash and liver function damage in the observation group were 76.9％ and 15.4％,which were higher than those in the control group (0,x2=31.638,P ＜ 0.001;x2 =4.173,P =0.041).However,most of them were degree Ⅰ-Ⅱ,and they were tolerable.There were no significant differences in the incidence of myelosuppression and gastrointestinal reactions between the two groups (26.9％ vs.20.0％,x2 =0.339,P=0.560;34.6％ vs.28.0％,x2 =0.259,P=0.611).The median survival time in the observation group (9.0 months) was longer than that in the control group (7.0 months).The one year survival rate of the observation group was 33.3％,which was higher than that of the control group (23.1％),but the difference was not significant (x2 =0.676,P =0.411).Conclusion Icotinib hydrochloride tablets combined with WBRT in the treatment of brain metastasis with NSCLC can significantly improve the curative effects of brain metastasis,and it has a survival advantage,with tolerable adverse reactions.

Objective:To analyze the liver pathology, clinical characteristics and influence factors in patients with chronic hepatitis B virus (HBV) infection in immune tolerant phase (IT).Methods:The clinical data of 273 patients in IT phase who underwent liver biopsy from January 2015 to December 2019 were included in this study. The correlation between liver pathological changes and clinical features was analyzed.Results:There were 43 cases (15.75%) with liver histologic activity ≥ G2, 30 cases (10.99%) with liver fibrosis ≥ S2, and 55 cases (20.15%) with liver pathology ≥ G2 and/or ≥ S2. A total of 17.95% patients had liver steatosis. The majority (98.17%) of tissue samples were positive for HBsAg staining, while only 79.49% were positive for HBcAg. The characteristics of liver pathology were comparable in men from women patients. The differences of G and S were not statistically significant according to different HBsAg positivity, while those were statistically significant according to different HBcAg positivity. By univariate and multivariate analysis, the independent risk factors of pathological severity were HBcAg intensity, HBeAg level, and age. However, the differences of liver histologic activity and fibrosis were not statistically significant between those younger than 30 years old group from those older than 30 years old, neither between those younger or older than 40. Although the diagnostic value of liver inflammation and fibrosis 5 (LIF-5) was better than that of aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis 4 score (FIB-4), three diagnostic models for predicting the pathological severity were not strong enough (all area under the curves<0.8). Only the specificity of LIF-5 for predicting≥ G2, ≥ G2 and/or ≥ S2 was over 80%.Conclusions:Approximately 20% patients with chronic HBV infection in IT phase have progressive liver inflammation or fibrosis. The intensity of liver HBcAg and HBeAg level are negatively correlated with the severity of disease. The diagnostic models or most clinical indicators have low predictive effect for chronic HBV infections in IT phase.

Objective:To establish and evaluate a new diagnostic model for significant liver tissue damage in patients with chronic hepatitis B virus (HBV) infection in the immune tolerance phase.Methods:The clinical data of 275 chronic HBV infection patients in the immune tolerance phase who underwent liver biopsy from January 2015 to November 2020 in the Hwa Mei Hospital, University of Chinese Academy of Sciences were included. According to the liver pathological changes, patients were divided into