Objective A comparative study of clinical factors and dose-volume histogram (DVH)parameters on the impact of radiation pneumonitis occurred in the three-dimensional conformal radiotherapy of lung cancer (lung target)and mediastinal tumors and esophageal (mediastinal target).Methods Review 83cases lung cancer,mediastinal tumors and esophageal patients,and analyzed with chi-square tests on the correlation of the clinical factors (gender,age,tumor location,stage,chemotherapy) with radiation pneumonitis;have relevance analysis between the DVH parameters of two targets and radiation pneumonitis; lung target and mediastinal target volume DVH parameters compared to the t-test.Results ≥2 radiation pneumonitis was 36.5 ％.≥2 radiation pneumonitis occurred in various clinical factors had no significant effect.DVH parameters of the two targets,V5,V10,V20,V30,whole lung dose (MLD) were significantly related to RP.Two targets of RP patients V5 [(50.9±17.8) ％,(69.9±20.4) ％],V10 [(38.6±15.2) ％,(53.5±18.8) ％] were statistically significant by t-test (t =2.434,P ＜ 0.05),while V20 (t =0.388,P ＞ 0.05),V30 (t =0.005,P ＞ 0.05) and MLD (t =0.138,P ＞0.05) were no significant difference (P ＞ 0.05),so the same results with the two targets of patients without RP obtained.Conclusion In the lung target and mediastinal target of radiotherapy radiation pneumonitis is related with DVH parameters,especially V20,V30 and MLD impact on the occurrence of RP.

Objective To evaluate the changes of serum tumor markers of carbohydrate antigen 125 (CA125),carbohydrate antigen 199 (CA199),carcinoembryonic antigen (CEA) and squamous cell carcinoma antigen (SCC) during anti-tuberculosis treatment in patients with active pulmonary tuberculosis and tuberculous pleurisy.Methods This research was a prospective study.Sixty-three patients with active pulmonary tuberculosis and 24 patients with tuberculous pleurisy underwent blood samplings before treatment,2 and 6 months after treatment.Centaur XP chemiluminescent immunoassay was used to test serum levels of CA125,CA199,CEA and SCC.Thirty healthy subjects were included as controls.Student t-test was used to compare continuous variables,and chi-square test or Fisher exact test was used to compare categorical variables.Serial changes of serum tumor markers levels pre-and post-treatment were analyzed by repeated measures analysis of variance.Binary Logistic regression model was used for multivariate analysis.Results The mean serum CA125 level of the 63 patients with active pulmonary tuberculosis pre-treatment was (64.4± 30.4) U/mL,which was significantly higher than that of healthy controls ([12.7±5.5] U/mL,t=11.98,P＜0.01).The mean serum CA125 level decreased to (16.9±6.1) U/mL after 6 months standardized treatment,which was significantly lower than that before treatment (t=12.74,P＜0.01).While compared with healthy controls,the serum level of CA125 in patients who had completed the standardized treatment was not significantly different (t =0.94,P =0.348).When compared with the healthy controls,serum CA199,CEA,SCC levels in patients with active pulmonary tuberculosis before and after treatment showed no statistically significant difference (P＞ 0.05).Univariate analysis and multivariate analysis by Logistic regression analysis showed that bilateral pulmonary tuberculosis (x2 =7.746,P=0.006; OR=6.99,95％CI:1.73-28.22) and cavity pulmonary tuberculosis (x2 =6.254,P=0.012; OR=7.64,95％CI:1.64-35.35) were associated with increased serum CA125 level.The mean serum CA125 level of 24 cases of tuberculous pleurisy pre-treatment was (81.2 ± 37.6) U/mL,which was both significantly higher than that of patients with active pulmonary tuberculosis (t=2.153,P=0.034) and that of healthy controls (t=12.05,P＜0.01).Similarly,CA125 levels sharply decreased to (15.5 ± 7.3) U/mL after 6 months standardized treatment,which was not statistically significant compared with the control group (t=0.450,P=0.652).However,CA199,CEA and SCC levels in tuberculous pleurisy pre-and post-treatment were all not statistically different from those of healthy controls (all P＞0.05).Conclusion Serum CA125 can be used as a marker for assessing the disease progression and therapeutic efficacy for patients with active pulmonary tuberculosis and tuberculous pleurisy.

Coronavirus disease 2019 (COVID-19) is a kind of viral pneumonia which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The emergence of SARS-CoV-2 has been marked as the third introduction of a highly pathogenic coronavirus into the human population after the severe acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome coro-navirus (MERS-CoV) in the twenty-first century. In this minireview, we provide a brief introduction of the general features of SARS-CoV-2 and discuss current knowledge of molecular immune pathogenesis, diagnosis and treatment of COVID-19 on the base of the present understanding of SARS-CoV and MERS-CoV infections, which may be helpful in offering novel insights and potential therapeutic targets for combating the SARS-CoV-2 infection.

Acute－on－chronic liver failure （ACLF） is a serious form of acute decompensation of liver cirrhosis， which is characterized by multiple organ failure， systemic inflammatory response， and a high short－term mortality rate. In 2023， the European Association for the Study of the Liver gave recommendations to clinicians， aiming to help them with the diagnosis of ACLF， the decision of triage （whether it is necessary to transfer a patient to the ICU for treatment）， the identification and management of acute predisposing factors， the identification of organs that need support or replacement therapy， the definition of potential criteria for ineffective ICU treatment， and the determination of potential indications for liver transplantation. This article gives an excerpt of the above main contents in the guidelines.