To systematically synthesize evidence on multiple KRAS G12C inhibitors(KRAS G12C inhibitors, KRAS G12Ci) as monotherapy within a unified population and recommended-dose framework, establish a comparable benchmark range of efficacy and safety for previously treated patients with advanced or metastatic KRAS G12C-mutant non-small cell lung cancer(NSCLC), and explore potential effect modifiers.

Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.
Humans ; Dental Cementum/injuries* ; Consensus ; Diagnosis, Differential ; Cone-Beam Computed Tomography ; Tooth Fractures/therapy*

Radiation therapy is an essential component of comprehensive treatment for breast cancer. In comparison to photons, proton beam, with its unique Bragg peak, limits the dose distribution to normal tissues around the tumor while improving dose coverage within the target area. Therefore, it could be an appealing therapeutic option for breast cancer treatment. Current researches indicate that proton therapy for breast cancer treatment has a distinct dosimetric advantage in protecting the heart and lungs. However, there are potentially increased risks of side-effects such as skin reactions and rib fractures, etc. Future Subsequent studies should seek a better understanding of the relative biological effectiveness changes along the proton beam range to improve the proton plan evaluation. Additionally, efforts should be directed towards identifying patients who would derive maximum benefit from proton therapy, addressing concerns related to its limited accessibility and high cost. This review provides an overview of the current clinical experiences, research progress and controversies in proton therapy for breast cancer.

Objective:To produce 161Tb from enriched 160Gd 2O 3 isotope-enriched target material and realize domestic production of the novel medical isotope 161Tb. Methods:The 160Gd 2O 3 isotope-enriched target material was irradiated with neutrons by the China Mianyang Research Reactor (CMRR). The no-carrier-added 161Tb product was obtained after the processes of target broken, sample dissolution, separation and purification with lanthanide (LN) resin and solution replacement with diglycolamide (DGA) column. Various key indicators such as γ spectral purity, metal impurity content, specific activity, radiochemical purity, and radioactive concentration were used to conduct the quality inspection and the control of 161Tb products. Results:161TbCl 3 of 33.4 GBq was obtained in a single time with the radioactive concentration of 16.8 GBq/ml, nuclear purity more than 99.9%, and radiochemical purity of 99.2%. Metal impurity content was met the established standards, with the specific activity of 6.02×10 17 Bq/mol. The radiochemical purities of 161Tb labeling with 1, 4, 7, 10-tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid- D-Phe1-Tyr3-Thr8-octreotide (DOTATATE) after 0 and 72 h were 100% and 95.8% respectively. Conclusion:The preparation of no-carrier-added 161Tb by using LN resin has the advantages of high separation performance and high sample loading, which has great significance in the field of medical isotope preparation and lays a good nuclide guarantee for the research and development of domestic 161Tb-labeled drugs.

Objective:To understand the reliability and validity of quality of life instruments for cancer patients-brain neoplasm [QLICP-BN (V1.0)], a self-developed quality of life scale for cancer patients.Methods:The quality of life of 112 patients with brain neoplasms in Yunnan Cancer Hospital from March 2012 to November 2013 was measured. The general data questionnaire and QLICP-BN (V1.0) were used for data collection. The reliability, validity and responsiveness of the scale were tested, and then the metric characteristics of the scale were evaluated.Results:The split-half reliability of the total score of the scale was 0.95, the Cronbach αcoefficient was 0.92, and the test-retest correlation coefficient rwas 0.78. After extracting common factors by the principal component method and rotating with the maximum variance, the specific module obtained three principal components, and the cumulative variance contribution rate was 64.18%. The score of specific module was 75.30±17.44 before treatment and 78.91±12.20 after treatment ( t=-2.481, P=0.015). The total score of scale before treatment was 65.26±12.29, and that after treatment was 69.62±10.41, with a statistically significant difference ( t=-4.492, P<0.001). The total responsiveness of the scale was 0.456, showing moderate responsiveness. Conclusion:QLICP-BN (V1.0) has good reliability, validity and a certain degree of responsiveness. It can be used as a measurement tool for the quality of life of patients with brain neoplasms in China.

OBJECTIVE： To study improvement effect and mechanism of Shuangshen yin on liver function and the degree of liver fibrosis in liver fibrosis model rats. METHODS： Healthy SD rats were collected and given 40％ CCl4 olive oil solution intraperitoneally for consecutive 7 weeks to induce liver fibrosis model. 47 model rats were randomly divided into model group， positive control group and Shuangshen yin low-dose， medium-dose and high-dose groups， with 9， 9， 9， 10， 10 rats respectively； another 10 healthy SD rats were included in normal group. From the next week after model induction， model group and normal group were given water intragastrically； positive control group [colchicines 0.2 mg/（kg·d）] and Shuangshenyin groups [Shuangshen yin water decoction 3， 6， 12 g/（kg·d）， by crude drug] were given corresponding medicines respectively for consecutive 28 d. The serum levels of liver function indicators （ALT， AST， TBIL， ALB， GLB） were determined by Rye’s analysis method. The serum levels of liver fibrosis indexes （HA， LN， Ⅲ-PC， Ⅳ-C） were determined by ELISA. The pathological changes of liver tissues were observed by HE staining and VG staining. The levels of SOD， MDA and HYP in liver tissues were determined by spectrophotometry. The expression of α-SMA was detected by immunohistochemistry. RESULTS： Compared with normal group， the serum levels of ALT， AST， TBIL， HA， LN， PC-Ⅲ and Ⅳ-C in model group were increased significantly， and the level of ALB was decreased significantly （P＜0.05）. There were some pathological phenomena such as vacuolar degeneration and fibrous tissue proliferation in rat liver. The levels of SOD in liver tissue were decreased significantly， while the levels of MDA and HYP were increased significantly （P＜0.05）. A large number of positive staining granules of α-SMA protein were observed in liver tissue， and the expression level of α-SMA protein was significantly increased （P＜0.05）. Comparison of model group， the serum levels of ALT， AST and liver fibrosis indexes were significantly decreased and ALB level was significantly increased in Shuangshen yin groups， while the TBIL levels in Shuangshen yin medium-dose， high-dose groups were significantly decreased （P＜0.05）； the phenomena of hepatocyte degeneration and fibrosis tissue proliferation were significantly improved； the levels of SOD in liver tissue were significantly increased， and the levels of MDA and HYP were significantly decreased （P＜0.05）； the positive staining of α-SMA protein decreased significantly， and the expression level of α-SMA protein was decreased significantly （P＜0.05）. CONCLUSIONS： Shuangshen yin has protective and anti-fibrotic effects on liver in rats with hepatic fibrosis， the mechanism of which may be associated with enhancing antioxidant capacity， down-regulating the expression of α-SMA， inhibiting the activation of hepatic stellate cells， reducing extracellular matrix synthesis so as to reverse liver fibrosis.

Pancreatic cancer is a highly malignant tumor of the digestive system, also known as "the king of cancer" . Its incidence is increasing year by year worldwide. At present, there is still a lack of effective screening methods for pancreatic cancer, and the early symptoms are not obvious. Most pancreatic cancer is diagnosed in the late stage, and the best time for surgery has been lost, and patients often have poor response to radiotherapy, chemotherapy and targeted therapy, so the prognosis is very poor. The occurrence and development of pancreatic cancer are closely related to genetic background, environmental factors, basic diseases and living habits. So far, although certain risk factors have been identified, such as smoking, obesity, alcohol, chronic pancreatitis, type 2 diabetes mellitus, and family history, the cause of pancreatic cancer is still not very clear. In recent years, more and more studies have shown that in addition to the already recognized risk factors for pancreatic cancer, there is a certain relationship between digestive microecological disorders and the progression of pancreatic cancer. The authors review the research status of digestive system microecology and pancreatic cancer, in order to understand the role of digestive system microecology disorders in the occurrence and development of pancreatic cancer, thus providing a new way to effectively improve the prognosis of pancreatic cancer.

Objective To evaluate the accuracy and feasibility of time-resolved immunofluorometric assay (TRI FA) for detection of HBsAg based on Abbott automated chemiluminescence immunoassay(CMIA),so as to carry out this project in primary hospitals,and provide reference for individual antiviral strategy and prediction of therapeutic effect.Methods Serum of 157 patients infected with hepatitis B virus were detected with CMIA and TRIFA,specimens with HBsAg titers exceeding the detection limit were firstly diluted,then performed quantitative analysis.HBsAg levels were divided into 4 groups:≤100 IU/mL,101-1 000 IU/mL,1 001-20 000 IU/mL,and ＞ 20 000 IU/mL,quantitative correlation between two methods was analyzed.Results The linear regression equation of two methods was Y=2.323X-896.3,correlation coefficent r=0.943,P＜0.001.CMIA was as a reference,4 groups were divided for analysis,results showed that when detected specimens was at low concentration of HBsAg,TRIFA value was low compared with CMIA method,while detected specimens was at high concentration of HB sAg,CMIA value was high,two reagents had good consistency in the detection of different concentrations of HBsAg(both P＜0.05),when concentration was at 1 001-20 000 IU/mL,consistency was the best.Conclusion The accuracy of two reagents in the quantitative detection of HBsAg is similar,and the best correlation of detection value is 1 000-20 000 IU/mL.TRIFA assay has wide application for its low-cost and easy to be operated,which is especially suitable for primary hospitals.

Objective To observe the curative effect of clinically equivalent doses of Xuesaitong and ginaton injections on cerebral ischemia reperfusion (I/R) injury of rats.Methods Male rats were randomly divided into five groups:normal control group,sham-operation group,model control group,Xuesaitong group and ginaton group.The cerebral ischemia rat model was established by middle cerebral artery occlusion (MCAO).Rats in the Xuesaitong group were given 20 mg·kg-1 of Xuesaitong injection,and rats in the ginaton group were intravenously injected with 7.5 mg· kg-1of ginaton immediately after I/R injury and once daily for 7 days.Rats in the sham-operation group and model control group were given the same volume of 0.9％ sodium chloride solution.The score of ethology,volume of cerebral infarction,mortality,superoxide dismutase (SOD),malondialdehyde (MDA),xanthine oxidase (XOD),nitrogen oxide (NO) and NO synthase (NOS) in seruu were examined.Results Compared with model control group,Xuesaitong and ginaton effectively reduced behavioral score 96 h (P ＜ 0.05),120 h (P＜0.01),144 h (P＜0.01) and 168 h (P＜0.01) after I/R injury,the volume of cerebral infarction 168 h after I/R injury and NO content (P ＜ 0.05).But they had no effects on NOS,SOD,MDA,and XOD contents.Conclusion Curatively injecting Xuesaitong and ginaton can effectively reduce cerebral I/R injury,but no significant difference in curative efficacy is observed between Xuesaitong and ginaton at clinically equivalent doses.

OBJECTIVE: To determine whether time-resolved immunofluorescence assay (TRIFA) shares the similar accuracy and specificity with automatic chemiluminescence immunoassay (CMIA) in analyzing HBeAg levels in hepatitis B.
 METHODS: A total of 157 serum samples were collected from outpatients with infection of HBV in Xiangya Hospital, Central South University. CMIA and TRIFA were used to analyze HBeAg quantitation and HBeAg/HBeAb qualitative detection, respectively.
 RESULTS: The linear regression equation for the two methods was Y=0.72779X-4.0551 (r=0.712, P<0.001). Compared with the CMIA, the sensitivity and specificity in detection of HBeAg by TRIFA were 89.89% and 100%, respectively, and the coincidence rate of HBeAg was 94.27% by two assays. Similarly, the sensitivity and specificity in detection of HBeAb by TRIFA were 100% and 95.45%, respectively. The coincidence rate was 97.45% by two assays.
 CONCLUSION TRIFA has similar accuracy, sensitivity, and specificity with CMIA in quantitative detection of HBeAg, and their coincidence rate in detection of HBeAg/HBeAb is high.
Feasibility Studies ; Fluorescent Antibody Technique ; Hepatitis B ; Hepatitis B Antibodies ; Hepatitis B e Antigens ; Hepatitis B virus ; Humans