Objective This article systematically reviews the interaction between autophagy and herb-induced liver injury,and it elucidates the mechanism of liver injury.Also,it summarizes the control strategies of herb-induced liver injury.Methods Based on the retrieval of CNKI,Wanfang,PubMed and Web-of-Science databases,the literature on autophagy and herb-induced liver injury in the past decade was reviewed to clarify the relationship between autophagy and disease occurrence.Then we summarize common drugs and the mechanism of herb-induced liver injury caused by autophagy.The control strategies of herb-induced liver injury were summarized,too.Results Autophagy plays a dual role in the herb-induced liver injury.Autophagy pathway and autophagy-related molecules can be changed in the case of excessive activation or excessive inhibition to cause herb-induced liver injury.Conclusion The regulation of autophagy pathway is expected to be a new method for the prevention and treatment of herb-induced liver injury.Targeted control strategies are important measures to realize the safety risk monitoring of Chinese herbal medicine.

Objective This article systematically reviews the interaction between autophagy and herb-induced liver injury,and it elucidates the mechanism of liver injury.Also,it summarizes the control strategies of herb-induced liver injury.Methods Based on the retrieval of CNKI,Wanfang,PubMed and Web-of-Science databases,the literature on autophagy and herb-induced liver injury in the past decade was reviewed to clarify the relationship between autophagy and disease occurrence.Then we summarize common drugs and the mechanism of herb-induced liver injury caused by autophagy.The control strategies of herb-induced liver injury were summarized,too.Results Autophagy plays a dual role in the herb-induced liver injury.Autophagy pathway and autophagy-related molecules can be changed in the case of excessive activation or excessive inhibition to cause herb-induced liver injury.Conclusion The regulation of autophagy pathway is expected to be a new method for the prevention and treatment of herb-induced liver injury.Targeted control strategies are important measures to realize the safety risk monitoring of Chinese herbal medicine.

Objective:To compare surgical methods and clinical efficacy among different types of cesarean scar pregnancy (CSP).Methods:A total of 158 patients with CSP who received treatment in Yuncheng Central Hospital from January 2016 to June 2019 were included in this study. According to Expert Consensus on Diagnosis and Treatment of Cesarean Scar Pregnancy (2016 version), type I CSP was found in 55 patients, type II in 86 patients and type III in 17 patients. These patients were divided into groups A (ultrasound-guided suction curettage), B (uterine artery chemoembolization + ultrasound-guided suction curettage) and C (laparoscopic scar pregnancy lesion resection + scar repair) according to different surgical methods. The amount of intraoperative blood loss, the difference in human chorionic gonadotropin (HCG) level between before and after surgery, the time to postoperative HCG level returning to normal level, menstruation recovery, and re-pregnancy were compared between groups.Results:The amount of intraoperative blood loss in the groups A, B and C was (43.33 ± 72.31) mL, (34.41 ± 17.16) mL, (65.71 ± 70.52) mL, respectively. There was significant difference between groups ( F = 8.51, P = 0.014]. The difference in HCG level between before and after surgery in groups A, B and C was (0.64 ± 0.18), (0.79 ± 0.10), (0.76 ± 0.19), respectively. There was significant difference in the difference in HCG level between groups ( F = 19.21, P < 0.001). There was significant difference in the incidence of postoperative menstrual volume reduction between group B and the other two groups ( χ2 = 6.73, P = 0.003). After surgery, intrauterine pregnancy occurred in 12 patients, including 8 patients in group A (type I CSP in 2 patients, type II CSP in 3 patients, type III CSP in 3 patients), 4 patients in group B (type I CSP in 3 patients, type II CSP in 1 patient). Finally, full-term fetus delivery by cesarean section was performed in 6 patients (4 patients in group A and 2 patients in group B). Conclusion:Uterine artery chemoembolization combined with uterine curettage had less blood loss, during surgery and leads to an obvious decrease in HCG level, but it can result in reduction of menstrual volume. Ultrasound-guided suction curettage is preferred for type I and type II CSP. Balloon compression can be used to stop bleeding if massive bleeding occurs. Laparoscopic scar pregnancy lesion resection plus scar repair is recommended for type III CSP.

Objective To explore the value of histopathologic diagnosis after colposcopy for high-risk HPV16/18 positive patients with negative cytology or atypical squamous cells of undetermined significance (ASCUS) for early screening of cervical lesions. Methods A retrospective study of cervical histopathologic diagnosis in the HPV16/18 positive patients received colposcopy evaluation before got the histology was carried out between January 2014 and January 2016. The cytology of the patients should be negative or ASCUS. A total of 337 patients with age from 21 to 65 years old were enrolled, including 214 patients with negative cytology, and 123 patients with ASCUS. Results (1) The results of pathology were as follows: 63 (18.7%) cases inflammation, 89 (26.4%) cases cervical intraepithelial neoplasia (CIN)Ⅰ, 182 (54.0%) cases CINⅡ-Ⅲ and adenocarcinoma in situ (AIS), and 3 (0.9%) cases minimal invasive cancer (stage Ⅰa1). The incidence of CIN Ⅱ and above cervical lesions was higher in the patients with ASCUS (71.5%, 88/123) than that in the patients with negative cytology (45.3%, 97/214; χ2=24.876, P<0.01),and it was higher in the patients with HPV16 positive (64.4% , 150/233) than that in the patients with HPV18 positive (30.3% , 27/89; χ2=31.388, P<0.01). There was statistically significant difference among the different age group in which the patients of 20- 29 years old was 69.3% (52/75), 30- 39 years old was 55.1% (75/136), 40-49 years old was 44.8% (30/67) and 50 years old and above was 47.5% (28/59; χ2=16.512, P=0.032). (2) Among the patients with negative cytology, the incidence of CINⅡ and above cervical lesions in the patients with HPV16 positive was higher than that in the patients with HPV18 positive [54.8%(80/146)vs 26.0%(20/77);χ2=16.930, P<0.01]. The incidence was also higher in the patients with HPV16 positive than that in the patients with HPV18 positive [76.5%(78/102)vs 55.6%(15/27);χ2=4.642, P=0.031] among the patients with ASCUS. (3) Compared to the patients diagnosed inflammation or CINⅠ, the patients diagnosed CINⅡ and above cervical lesions had higher infection rate of HPV16, lower infection rate of HPV18, higher incidence of ASCUS, and smaller parities (all P<0.05). A multifactor analysis was carried out, the results showed that HPV16 positive and ASCUS might be independent risk factors to predict the incidence of CIN Ⅱ and above cervical lesions(P<0.01). Conclusions The incidence of cervical precancerous lesions is high in the women with HPV16/18 infection. Patients with HPV16 infection are more likely to have the CIN Ⅱ and above cervical lesions than patients with HPV18 infection. Patients with HPV16/18 infection are suggested to be directly transferred to clinic of colposcopy, and then getting the histology selectively, which would be help to early detection of the cervical precancerous lesions.