1.Root causes of quality changes in cultivated Chinese materia medica and countermeasures for high-quality production.
Chao-Geng LYU ; Chuan-Zhi KANG ; Ya-Li HE ; Zhi-Lai ZHAN ; Sheng WANG ; Xiu-Fu WAN ; Lan-Ping GUO
China Journal of Chinese Materia Medica 2025;50(13):3529-3535
In order to support the implementation of the Opinions on Improving the Quality of Traditional Chinese Medicine and Promoting the High-Quality Development of the Traditional Chinese Medicine Industry and fundamentally promote the high-quality development of Chinese materia medica(CMM) industry, this article analyzed the quality and safety issues arising during the transition of CMM from wild harvesting to cultivation. Root causes of these issues were identified, including changes in the habitats of medicinal plants caused by inappropriate field cultivation patterns, excessive use of chemical inputs such as fertilizers and pesticides, and shortened cultivation periods due to rising economic costs. To address the above issues, the following countermeasures and suggestions were proposed to advance the high-quality development of CMM:(1) comprehensively adjust the cultivation patterns, vigorously promote ecological cultivation of CMM, and ensure production quality and safety of CMM from the source;(2) strengthen the breeding of high-quality, stress-resistant CMM varieties, improve cultivation techniques to reduce the use of fertilizers and pesticides, and improve the quality and efficiency of ecological cultivation of CMM;(3) systematically design the production, operation, and supervision models for ecological cultivation of CMM, carry out demonstrations of "high quality with fair price", and ensure the sustainable development of ecological cultivation of CMM.
Drugs, Chinese Herbal/standards*
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Quality Control
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Plants, Medicinal/chemistry*
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Plant Roots/chemistry*
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China
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Fertilizers/analysis*
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Materia Medica/standards*
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Medicine, Chinese Traditional/standards*
2.Chemical constituents of Sophorae Flavescentis Radix and its residue based on UPLC-Q-TOF-MS.
Qian-Wen LIU ; Rong-Qing ZHU ; Qian-Nan HU ; Xiang LI ; Guang YANG ; Zi-Dong QIU ; Zhi-Lai ZHAN ; Tie-Gui NAN ; Mei-Lan CHEN ; Li-Ping KANG
China Journal of Chinese Materia Medica 2025;50(3):708-718
Sophorae Flavescentis Radix is one of the commonly used traditional Chinese medicine in China, and a large amount of pharmaceutical residue generated during its processing and production is discarded as waste, which not only wastes resources but also pollutes the environment. Therefore, elucidating the chemical composition of the residue of Sophorae Flavescentis Radix and the differences between the residue and Sophorae Flavescentis Radix itself is of great significance for the comprehensive utilization of the residue. This study, based on ultra-performance liquid chromatography-quadrupole time-of-flight mass spectrometry(UPLC-Q-TOF-MS) technology combined with multivariate statistical methods, provides a thorough characterization, identification, and differential analysis of the overall components of Sophorae Flavescentis Radix and its residue. Firstly, 61 compounds in Sophorae Flavescentis Radix were rapidly identified based on their precise molecular weight, fragment ions, and compound abundance, using a self-constructed compound database. Among them, 41 compounds were found in the residue, mainly alkaloids and flavonoids. Secondly, through principal component analysis(PCA) and orthogonal partial least squares discriminant analysis(OPLS-DA), 15 key compounds differentiating Sophorae Flavescentis Radix from its residue were identified. These included highly polar alkaloids, such as oxymatrine and oxysophocarpine, which showed significantly reduced content in the residue, and less polar flavonoids, such as kurarinone and kuraridin, which were more abundant in the residue. In summary, this paper clarifies the overall composition, structure, and content differences between Sophorae Flavescentis Radix and its residue, suggesting that the residue of Sophorae Flavescentis Radix can be used as a raw material for the extraction of its high-activity components, with promising potential for development and application in cosmetics and daily care. This research provides a scientific basis for the future comprehensive utilization of Sophorae Flavescentis Radix and its residue.
Drugs, Chinese Herbal/chemistry*
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Chromatography, High Pressure Liquid/methods*
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Mass Spectrometry/methods*
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Sophora/chemistry*
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Flavonoids/chemistry*
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Alkaloids/chemistry*
3.Hepatitis C virus infection:surveillance report from China Healthcare-as-sociated Infection Surveillance System in 2020
Xi-Mao WEN ; Nan REN ; Fu-Qin LI ; Rong ZHAN ; Xu FANG ; Qing-Lan MENG ; Huai YANG ; Wei-Guang LI ; Ding LIU ; Feng-Ling GUO ; Shu-Ming XIANYU ; Xiao-Quan LAI ; Chong-Jie PANG ; Xun HUANG ; An-Hua WU
Chinese Journal of Infection Control 2024;23(1):1-8
Objective To investigate the infection status and changing trend of hepatitis C virus(HCV)infection in hospitalized patients in medical institutions,and provide reference for formulating HCV infection prevention and control strategies.Methods HCV infection surveillance results from cross-sectional survey data reported to China Healthcare-associated Infection(HAI)Surveillance System in 2020 were summarized and analyzed,HCV positive was serum anti-HCV positive or HCV RNA positive,survey result was compared with the survey results from 2003.Results In 2020,1 071 368 inpatients in 1 573 hospitals were surveyed,738 535 of whom underwent HCV test,4 014 patients were infected with HCV,with a detection rate of 68.93%and a HCV positive rate of 0.54%.The positive rate of HCV in male and female patients were 0.60%and 0.48%,respectively,with a statistically sig-nificant difference(x2=47.18,P<0.001).The HCV positive rate in the 50-<60 age group was the highest(0.76%),followed by the 40-<50 age group(0.71%).Difference among all age groups was statistically signifi-cant(x2=696.74,P<0.001).In 2003,91 113 inpatients were surveyed.35 145 of whom underwent HCV test,resulting in a detection rate of 38.57%;775 patients were infected with HCV,with a positive rate of 2.21%.In 2020,HCV positive rates in hospitals of different scales were 0.46%-0.63%,with the highest in hospital with bed numbers ranging 600-899.Patients'HCV positive rates in hospitals of different scales was statistically signifi-cant(X2=35.34,P<0.001).In 2020,12 provinces/municipalities had over 10 000 patients underwent HCV-rela-ted test,and HCV positive rates ranged 0.19%-0.81%,with the highest rate from Hainan Province.HCV posi-tive rates in different departments were 0.06%-0.82%,with the lowest positive rate in the department of pedia-trics and the highest in the department of internal medicine.In 2003 and 2020,HCV positive rates in the depart-ment of infectious diseases were the highest,being 7.95%and 3.48%,respectively.Followed by departments of orthopedics(7.72%),gastroenterology(3.77%),nephrology(3.57%)and general intensive care unit(ICU,3.10%)in 2003,as well as departments of gastroenterology(1.35%),nephrology(1.18%),endocrinology(0.91%),and general intensive care unit(ICU,0.79%)in 2020.Conclusion Compared with 2003,HCV positive rate decreased significantly in 2020.HCV infected patients were mainly from the department of infectious diseases,followed by departments of gastroenterology,nephrology and general ICU.HCV infection positive rate varies with gender,age,and region.
4.Advances in the construction of models and applications of Alzheimer's disease based on microfluidic chips
Piao-xue YOU ; Lan CHEN ; Shu-qi SHEN ; Liang CHAO ; Hui WANG ; Zhan-ying HONG
Acta Pharmaceutica Sinica 2024;59(6):1569-1581
Alzheimer's disease (AD) is a progressive neurodegenerative disease associated with dysfunctions related to thinking, learning, and memory of the brain. AD has multiple pathological characteristics with complicated causes, constructing a suitable pathological model is crucial for the research of AD. Microfluidic chip technology integrates multiple functional units on a chip, which can realize microenvironmental control similar to the physiological environment. It is well applied in the construction of pathological model, early diagnosis as well as drug screening of AD. This paper focuses on the construction of AD microfluidic chips model from the perspective of cell type, culture formats and the chips structure as well as the research progress of microfluidic chips in AD application based on the pathological characteristics of AD, which will provide a reference for further elucidation of AD mechanism and drug development.
5.Bacterial community diversity in human Demodex mites
Renren HAN ; Dacun ZHANG ; Lan WANG ; Feifan TANG ; Jiacheng CAO ; Jingxuan WANG ; Xiaodong ZHAN ; Shengli GU
Chinese Journal of Schistosomiasis Control 2024;36(2):174-178
Objective To investigate the bacterial community diversity in human Demodex mites, so as to provide insights into unraveling the role of human Demodex mites in them caused infectious diseases. Methods From June to July 2023, Demodex mites were collected from the faces of college students in a university in Wuhu City using the adhesive tape method, and the V4 region of 16S ribosomal RNA (16S rRNA) gene and the internal transcribed spacer (ITS) gene of nuclear ribosomal DNA were amplified on an Illumina PE250 high-throughput sequencing platform. Sequencing data were spliced according to the overlapping relations and filtered to yield effective sequences, and operational taxonomic units (OTUs) was clustered. The diversity index of obtained OUTs was analyzed, and the structure of the bacterial community was analyzed at various taxonomic levels. Results A total of 57 483 valid sequences were obtained using 16S rRNA gene sequencing, and 159 OUTs were classified according to similarity. Then, OUTs at a 97% similarity were included for taxonomic analyses, and the bacteria in Demodex mites belonged to 14 phyla, 20 classes, 51 orders, 72 families, and 94 genera. Proteobacteria was the dominant phylum, and Vibrio, Bradyrhizobium and Variovorax were dominant genera. A total of 56 362 valid sequences were obtained using ITS gene sequencing, and 147 OTUs were obtained, which belonged to 5 phyla, 17 classes, 34 orders, 68 families, and 93 genera and were annotated to Ascomycota, Basidiomycota and Chytridiomycota, with Ascomycota as the dominant phylum, and Alternaria alternata, Epicoccum, Penicillium, and Sarocladium as dominant genera. Conclusions There is a high diversity in the composition of bacterial communities in human Demodex mites, with multiple types of microorganisms and high species abundance.
6.Analysis of active components of Acorus tatarinowii extracts and its activity against dust mites
Huiyong WANG ; Meiqing WANG ; Feifan TANG ; Lan WANG ; Renren HAN ; Feng JIANG ; Xiaodong ZHAN
Chinese Journal of Schistosomiasis Control 2024;36(2):179-183
Objective To investigate the activity of Acorus tatarinowii extracts against dust mites, and to isolate and characterize active ingredient of A. tatarinowii extracts. Methods The essential oil components were extracted from A. tatarinowii rhizome powder by rotary evaporation with methanol as solvents, followed by petroleum ether extraction and rotary evaporation. The essential oil was mixed with Tween-80 at a ratio of 1:1 and diluted into concentrations of 1.000 00%, 0.500 00%, 0.250 00%, 0.125 00%, 0.062 50% and 0.031 25%, while diluted Tween-80 served as controls. A. tatarinowii essential oil at each concentration (200 μL) was transferred evenly to filter papers containing 100 adult mites, with each test repeated in triplicate, and controls were assigned for each concentration. Following treatment at 25 °C and 75% relative humidity for 24 h, the mean corrected mortality of mites was calculated. The essential oil components were separated by silica gel column chromatography, and the essential oil was prepared in the positive column of medium pressure; and then, each component was collected. Silica gel column chromatography was run with the mobile phase that consisted of petroleum ether solution containing 10% ethyl acetate and pure ethyl acetate, detection wavelength of 254 nm, positive silica gel column as the chromatography column, and room temperature as the column temperature. Each component of the purified A. tatarinowii essential oil was diluted into 1.000 00% for acaricidal tests. The components with less than 100% acaricidal activity were discarded, and the remaining components were diluted into 50% of the previous-round tests for subsequent acaricidal tests. The components with acaricidal activity were subjected to high-performance liquid chromatography, liquid chromatography-mass spectrometry and pulsed-Fourier transform nuclear magnetic resonance spectroscopy. The structure of active monomer compounds was determined by standard spectral library retrieval and literature review. Results A. tatarinowii essential oil at concentrations of 1.000 00%, 0.500 00%, 0.250 00% and 0.125 00% killed all dust mites, and the corrected mortality was all 100%. Exposure to A. tatarinowii extracts at an effective concentration of 0.062 50% for 24 hours resulted in 94.33% mortality of dust mites. Six components (A to F) were separated using gel column chromatography, and components D and E both showed a 100% acaricidal activity against dust mites at a concentration of 0.50000%. In addition, Component D was identified as isoeugenol methyl ether, and Component E as β-asarinol. Conclusion The extract of A. tatarinowii essential oil has acaricidal activity, and the isoeugenol methyl ether shows a remarkable acaricidal activity against dust mites.
7.Comparison of Wild and Cultivated Codonopsis pilosula Based onTraditional Quality Evaluation
Xiaoyan LAN ; Chunfang TIAN ; Zhilai ZHAN ; Li ZHOU ; Xiang LI ; Zidong QIU ; Tiegui NAN ; Qili YUAN ; Xiaoliang LIN ; Congkui TIAN ; Meilan CHEN ; Liping KANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(14):156-164
ObjectiveTo conduct a systematic comparative study on wild and cultivated Codonopsis pilosula(CP) from three aspects, including characters, microscopy, and contents of primary and secondary metabolites. MethodWild and cultivated CP samples were collected, their characters were measured using vernier caliper, tape measure and balance, the paraffin sections were stained with safranin-fixed green dyeing, and their microstructure were observed under the optical microscope. The content of alcohol-soluble extracts in wild and cultivated CP was determined according to the method for determination of extract under CP in the 2020 edition of Chinese Pharmacopoeia, the starch content was determined by anthrone colorimetry, the content of total polysaccharides was determined by kit method, Fiber analyzer was used to determine the content of fiber components, and ultra performance liquid chromatography(UPLC) was used to determine the content of monosaccharides, disaccharides and some secondary metabolites. Multivariate statistical analysis methods such as principal component analysis(PCA) and orthogonal partial least squares-discriminant analysis(OPLS-DA) were employed to screen key differential components between wild and cultivated CP on the basis of variable importance in the projection(VIP) value>1 and P<0.05. ResultIn terms of morphological characteristics, the "lion's head-like" shape, longitudinal wrinkles, and circumferential wrinkles below the root cap of wild CP were more pronounced in wild CP compared to the cultivated ones. Regarding transverse sectional features, wild CP had more fissures on the outer side of the cortex and a larger duramen. Under microscopic examination, wild CP had more stone cells, a larger proportion of xylem, and the presence of cork cells arranged in rings in the xylem, while cultivated CP has a larger proportion of phloem, smaller vessel diameters, and a more loosely arranged vascular system. In terms of primary metabolites, the contents of 45% ethanol-soluble extract and total polysaccharides in cultivated CP were significantly higher than those in the wild ones(P<0.05), the contents of lignin, hemicellulose, cellulose, fructose and glucose in wild CP were significantly higher than those in the cultivated ones(P<0.05), while sucrose content in the cultivated CP was significantly higher than that in the wild ones(P<0.05). Concerning secondary metabolites, the contents of tryptophan and tangshenoside Ⅰ in cultivated CP were significantly higher than those in the wild ones(P<0.05), whereas the contents of lobetyolinin, lobetyol and atractylenolide Ⅲ in wild CP were significantly higher than those in the cultivated ones(P<0.05). ConclusionThere are significant differences between wild and cultivated CP in terms of morphological characteristics, microscopic features and chemical composition. Glucose, fructose, sucrose, tangshenoside Ⅰ, tryptophan and cellulose components are the key differential components between wild and cultivated CP. Wild CP contains more polyacetylenes and fructose, whereas cultivated CP has higher levels of tangshenoside Ⅰ and sucrose, with noticeably lower cellulose content. These distinctions may be related to their growth conditions, growth years and cultivation techniques. Based on the results of this study, it is recommended to increase polyacetylenes and the content ratio of fructose to sucrose as an indicators to characterize different production methods of CP, in order to guide the high-quality production of CP.
8.Comparison of Wild and Cultivated Paeoniae Radix Rubra Based on Traditional Quality Evaluation
Chunfang TIAN ; Qiannan HU ; Zhilai ZHAN ; Xiaoyan LAN ; Xiang LI ; Li ZHOU ; Tiegui NAN ; Zidong QIU ; Liping KANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(14):165-174
ObjectiveTo compare wild and cultivated Paeoniae Radix Rubra(PRR) in three aspects, including character, microscope, determination of primary and secondary metabolites. MethodSeventeen batches of wild and nine batches of cultivated PRR were collected,their character data were measured by vernier caliper and scales, and their paraffin sections were made by safranin-fixed green dyeing for the observation of microscopic features. The content of ethanol-soluble extracts and total tannin from wild and cultivated PRR was determined by the method of general principle 2201 and 2202 in the 2020 edition of Chinese Pharmacopoeia, the content of polysaccharides was determined by phenol-sulfuric acid method. Anthrone colorimetry was used to determine the content of starch, and Van Soest method of washing fiber was used to determine the content of fiber. The contents of fructose, glucose and sucrose in wild and cultivated PRR were determined by ultra-high performance liquid chromatography evaporative light scattering detection(UPLC-ELSD), and the secondary metabolites(gallic acid, methyl gallate, catechin, oxypaeoniflorin, albiflorin, paeoniflorin, ellagic acid, 1,3,4,6-tetragalloylglucose, galloylpaeoniflorin, 1,2,3,4,6-O-pentagalloylglucose, naringenin, benzoylpaeoniflorin and benzoylalbiflorin) were determined by UPLC. Principal component analysis(PCA) and orthogonal partial least squares-discriminant analysis(OPLS-DA) were used to analyze the data of wild and cultivated PRR, the contribution of different factors to the difference was determined according to the variable importance in the projection(VIP) value>1 and P<0.05. ResultIn term of characters, wild PRR showed the traditional characteristic of Zaopi Fencha, its outer skin was loose and easy to fall off, its surface had longitudinal furrow and wrinkle, but the outer skin of cultivated PRR was not easy to fall off, and its surface was relatively smooth. The radial texture of xylem of wild PRR cross-section was more obvious, showing radial striations, vacuoles and more cracks, while the radial texture of xylem of cultivated PRR cross-section was not obvious, dense and some had cracks. Microscopically, the number of radial vessels arranged in the xylem of wild PRR was more than that of cultivated PRR, the number of calcium oxalate clusters in the phloem and xylem of wild PRR was more than that of cultivated PRR, while the number of starch grains was significantly higher in cultivated PRR. In terms of the content of primary chemical constituents, the contents of polysaccharides and starch of cultivated PRR were significantly higher than those of wild PRR(P<0.05), while the contents of cellulose, lignin, fructose and glucose of wild PRR were significantly higher than those of cultivated PRR(P<0.05). The results of determination of 13 secondary metabolites showed that the contents of paeoniflorin, methyl gallate, catechin and oxypaeoniflorin in wild PRR were significantly higher than those in cultivated PRR(P<0.05), while the contents of albiflorin, gallic acid, ellagic acid, naringenin, benzoylpaeoniflorin and benzoylalbiflorin were significantly lower than those of cultivated PRR(P<0.05). A total of 10 variables contributing to the differentiation between wild and cultivated PRR were screened, including albiflorin, cellulose, benzoylpaeoniflorin, oxypaeoniflorin, naringenin, ellagic acid, starch, lignin, paeoniflorin and total tannins. ConclusionThere are significant differences between wild and cultivated PRR in characters, microscopic characteristics, contents of primary and secondary metabolites. It is suggested that the content ratio of paeoniflorin and albiflorin, the contents of oxypaeoniflorin and cellulose can be used as indicators to characterize production methods of PRR so as to improve the quality standard of PRR. This study can provide reference for the improvement of quality standard of PRR and the guidance of high quality production of PRR.
9.A community-based serological cohort study on incidence of seasonal influenza virus infection in Macheng city from winter 2019 to spring 2020
Jinsong FAN ; Jianbo ZHAN ; Yue CHEN ; Shaobo DONG ; Jian LU ; Junfeng GUO ; Xiaojing LIN ; Yu LAN ; Kun QIN ; Jianfang ZHOU ; Bing HU ; Cuiling XU
Chinese Journal of Experimental and Clinical Virology 2024;38(3):311-318
Objective:To determine incidence of seasonal influenza virus infection in the community and to analyze the factors influencing seasonal influenza virus infection.Methods:This study recruited residents aged 6-59 years to build a cohort in 15 villages/streets in Macheng city in November 2019. Meanwhile, a cross-sectional baseline survey was conducted immediately to collect sera, information on demographics and child protection knowledge, behaviors, as well as attitudes using a questionnaire from the participants enrolled in the cohort (i.e., before the influenza epidemic season). In July 2020, a cross-sectional follow-up survey was conducted to collect sera once again (i.e., after the influenza season). Paired sera from the two cross-sectional surveys were tested for influenza virus-specific antibodies by hemagglutination inhibition (HI) test or micro-neutralization (MN) test using a circulating representative strain of each subtype/lineage of influenza virus as the test antigen. The infections with influenza virus subtype/lineage was confirmed if there was a four-fold or more increase in titers of antibodies against circulating representative strain of the subtype/lineage of influenza virus. Factors influencing infection with influenza A (H3N2) and B/Victoria viruses were analyzed using univariable and multivariable logistic regression.Results:In November 2019, 800 study participants were enrolled in the cohort, including 340 children aged 6-17 years and 460 adults aged 18-59 years; 605 study participants (including 224 children and 381 adults) were followed up in July 2020 and their paired sera were obtained before and after the influenza season. 25.3% (153/605) of the participants were confirmed to be infected with at least one subtype/lineage of seasonal influenza virus by HI and MN tests. The overall incidence of influenza viruses of all subtypes/lineages in children was 44.2% (95% CI: 37.6%-50.8%) which was significantly higher than the incidence of 14.1% in adults (95% CI: 10.7%-17.7%). Children had the highest incidence of influenza A (H3N2) virus infection, followed by B/Victoria. MN or HI antibody titers in A (H3N2)[ OR=0.88 (95% CI: 0.84-0.93)] and B/Victoria[ OR=0.97 (95% CI: 0.95-0.99)] before the influenza season were significantly associated with whether children were infected with that subtype/lineage of influenza virus. Conclusions:The residents aged 6-59 years in Macheng city had a substantial incidence of seasonal influenza virus infection during the influenza season from winter 2019 to spring 2020. Notably, almost half of children aged 6-17 years have been infected with seasonal influenza virus. Higher titers of HI/MN antibodies against seasonal influenza virus before the influenza season would be likely to reduce the risk of infection with influenza A (H3N2) and B/Victoria.
10.Value of multiparametric ultrasonography combined with inflammatory cell ratio in predicting the efficacy of neoadjuvant chemotherapy for breast cancer
Lan GAO ; Yunyun ZHAN ; Jiajia WANG ; Yu BI ; Xiabi WU ; Mei PENG
Chinese Journal of Ultrasonography 2024;33(11):983-991
Objective:To investigate the value of multimodal ultrasound features combined with peripheral blood inflammatory cell ratios in evaluating the efficacy of neoadjuvant chemotherapy (NAC) in breast cancer.Methods:A total of 106 breast cancer patients diagnosed and treated with NAC at the Second Affiliated Hospital of Anhui Medical University from May 2021 to April 2024 were retrospectively collected, resulting in the conclusion of 61 patients (61 masses) in the study. All patients underwent multimodal ultrasound and peripheral blood routine examinations before NAC and after two cycles of NAC treatment. The patients were divided into a major histological response (MHR) group and a non-major histological response (NMHR) group as indicators for evaluating NAC efficacy. The differences in multimodal ultrasound features and inflammatory cell ratios before NAC and after two cycles of NAC treatment between the MHR and NMHR groups were compared. Binary logistic multivariate regression analysis was performed to determine the independent predictors of NAC efficacy in breast cancer. ROC curves were plotted to evaluate the diagnostic efficacy of predicting NAC efficacy.Results:Among the 61 breast masses, 25 (40.98%) were in the MHR group, and 36 (59.02%) were in the NMHR group.Multivariate binary logistic regression analysis showed that the change rate of maximum tumor diameter after the second cycle (ΔD 2), change rate of vascular index after the second cycle (ΔVI 2), change rate of elastic strain ratio after the second cycle (ΔE-Strain 2), change rate of reverse imaging score after the second cycle (ΔI-imaging score 2), and platelet-to-lymphocyte ratio (PLR) before NAC were independent predictors of NAC efficacy ( OR=1.145, P=0.019; OR=1.055, P=0.016; OR=1.036, P=0.033; OR=1.276, P=0.016; OR=1.054, P=0.047). The area under the ROC curve (AUC) for the combined diagnosis of the above parameters was 0.928 (95% CI=0.866~0.990), with a sensitivity of 80.0% and a specificity of 91.7%. Conclusions:The combination of ΔD 2, ΔVI 2, ΔE-Strain 2, ΔI-imaging score 2 and PLR before NAC has high clinical application value for early prediction of NAC efficacy in breast cancer.

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