Objective To explore the effects and mechanism of Shentao Ruangan Prescription on hepatocellular carcinoma.Methods MTT assay was used to detect the activity of Shentao Ruangan Prescription against HepG2 cells and the effects of PI3K/Akt/MAPK inhibitors(LY294002,Akti,MEKi,JNKi),apoptosis inhibitor(Z-VAD)and autophagy inhibitor(Wortmanin)in human hepatoma cells.),ferroptosis inhibitor(Ferrostatin-1)and cell necrosis inhibitor(Necrostatin-1)on the inhibition of HepG2 activity of human hepatoma cells by Shentao Ruangan Prescription.LDH method was used to detect the toxicity of Shentao Ruangan Prescription on HepG2 cells;Real-time PCR experiment tested the effect of Shentao Ruangan Prescription on the pyroptosis marker IL-1β in human hepatoma cells HepG2;Western blot experiment explored the effect of Shentao Ruangan Prescription on the Akt/ERK signaling pathway in human hepatoma HepG2 cells and the expression of Akt,ERK,P-ERK,the key proteins of apoptosis signaling pathway Caspase 3,PARP,Bcl2,Bax,and the expression of pyroptosis marker Cleavaged Caspase-1.Results Shentao Ruangan Prescription Can effectively inhibit the activity of human hepatoma HepG2 cells.LY294002,Wortmanin,Akti,MEKi,JNKi,Z-Vad,Ferrostatin-1,Necrostatin-1 had no significant effect on the inhibition of HepG2 activity by total extract(water extract),supernatant and precipitation.Shentao Ruangan Prescription promoted the release of LDH in human hepatoma HepG2 cells,causing cytotoxicity.It inhibited HepG2 pyroptosis markers in human hepatoma cells and the expression of IL-1β and Cleavaged Caspase-1 and decreased the protein expression of Akt in human hepatoma cells HepG2 but inversely increased Caspase3 protein expression.Conclusion Shentao Ruangan Prescription has the effect of inhibiting the activity of hepatocellular carcinoma cells and anti-hepatocellular carcinoma,and its mechanism may be related to inhibiting the expression of Akt and promoting the expression of Caspase3.At the same time,Shentao Ruangan Prescription reduces the expressions of IL-1β and Cleavaged Caspase-1,which may inhibit cell pyroptosis.The inhibitory effect of Shentao Ruangan Prescription on the activity of liver cancer cells is likely to be independent of programmed death modes such as autophagy and necrotizing apoptosis,and PI3K/Akt/MAPK signal transduction.The total extract of Shentao Ruangan Prescription has better anti-hepatoma activity than its water-soluble and alcohol-soluble components,and its water-soluble and alcohol-soluble components may have synergistic effect.

Objective:To investigate the epidemiological and clinicopathological characteristics of thyroid cancer.Methods:Data of 13 673 thyroid cancer patients admitted to the First Medical Center of PLA General Hospital from Jan. 2014 to Dec. 2019 were retrospectively analyzed. According to the admission criteria, 9 662 patients were screened out, including 2 768 males and 6 894 females, with an average age of 43.98±11.28 years. According to the year of diagnosis and treatment, the incidence of thyroid cancer, the changing trend of age of new cases, the average length of hospitalization, the pathological classification of the tumor, the size of the primary tumor, multifocal tumor, and the rate of lymph node metastasis were statistically analyzed. The surgical methods were summarized and discussed.Results:① Characteristics of population economics: the ratio of males to females were 1.00:2.49, the number of cases increased year by year, and the rate of increase of female was higher than that of male. The average age of onset of the patients was (43.98±11.28) years old, and the incidence rate of the young population increased by 6.0%, showing a younger trend. The mean length of hospital stay was (7.21±2.85) d, and the length of hospital stay decreased. ② Clinicopathological features: There were 9 513 cases of papillary thyroid carcinoma (PTC) (98.46%) , 45 cases of follicular thyroid carcinoma (FTC) (0.47%) , 58 cases of medullary carcinoma (MTC) (0.60%) and 18 cases of poorly differentiated thyroid carcinoma (PDTC) (0.19%) . There were 2 cases (0.02%) of undifferentiated thyroid carcinoma (ATC) and 26 cases (0.26%) of a particular type. The tumor size was (1.10±0.85) cm, among which the microcarcinoma (D ≤1 cm) accounted for 64.5% and showed an increasing trend year by year, with the fastest growth rate. There were 3 809 cases of multifocal carcinoma (39.4%) , and the proportion of multifocal carcinoma increased year by year in recent 3 years. The central region and lateral region lymph node metastasis rates were 33.0% and 13.0%, respectively. Correlation analysis showed that the differences were statistically significant except for pathological types ( P<0.05) . ③ Surgical methods: in the first 3 years, 2 224 patients (84.2%) underwent normative primary resection, which increased to 94.9% in the last 3 years. In the first 3 years, 2 033 patients (77.0%) underwent central lymph node dissection, which increased to 91.8% in the last 3 years. In the first 3 years, 188 cases (50.5%) underwent normative lateral cervical dissection, which increased to 71.6% in the last 3 years. Conclusions:The incidence of thyroid cancer is increasing year by year, showing a younger trend; Papillary carcinoma accounts for 98.5% of thyroid cancer. The proportion of microcarcinoma and multifocal carcinoma is increasing. The rate of lymph node metastasis in the central region and lateral region is increasing; surgery is gradually standardized, and it is necessary to standardize the diagnosis and treatment of thyroid cancer and postoperative follow-up.

Objective:To study the diagnostic value of the artificial intelligence (AI) diagnostic system, ACR TI-RADS classification and AI+ ACR TI-RADS combined diagnostic performance in benign and malignant thyroid nodules and its guiding significance for surgical treatment.Methods:From Nov. 1, 2021, to Feb. 26, 2022, 349 patients with 605 thyroid nodules who received surgical treatment in Department of Thyroid (Hernia) Surgery, Department of General Surgery, the First Medical Center of the PLA General Hospital, were selected. There were 95 males and 254 females, male: female=1:2.67, aged 16-78 years, and the nodule diameter was 0.2-5.6 cm. SPSS 26.0 and R studio software were used for data processing. AI diagnostic system, ACR TI-RADS grading and AI+ ACR TI-RADS combined diagnostic efficacy were statistically analyzed, respectively. ROC curve analysis was performed in parallel.Results:The AUC value of AI+ ACR TI-RADS combined diagnosis was 0.900, greater than 0.857 of AI diagnostic system and 0.788 of ACR TI-RADS, and the difference was statistically significant ( Z= 7.631, both P<0.001) . The sensitivity of the combined diagnosis was 95.32%, the specificity was 84.61%, the accuracy was 92.56%, the positive predictive value was 94.69%, the negative predictive value was 86.27%, the missed diagnosis rate was 4.68%, and the misdiagnosis rate was 15.38%, which were better than the other two diagnostic methods. With an excellent coincidence rate with postoperative pathological results ( Kappa=0.804, P<0.001) . The accuracy of combined diagnosis in identifying the maximum diameter of different tumors was 89.58% for d≤0.5 cm, 96.09% for 0.54.0 cm, better than the other two diagnostic methods. Conclusions:The combined application of AI+ACR TI-RADS has a certain primary screening value in evaluating thyroid nodule properties. The combined diagnosis of the two can more effectively determine the benign and malignant thyroid nodules.