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By reviewing the materia medica， medical books and scripture history， combining modern and contemporary literature and field investigation， this paper systematically reviewed the name， origin， scientific name， producing area， quality， harvesting and processing of Scorpio in famous classical formulas to clarify the relationship between ancient and modern times and provide a reference basis for the development of related famous classical formulas. After the textual research， it can be seen that there are many names of Scorpio， and most of the materia medica use Xie or Quanxie as the official name. The origin of Scorpio used in the past dynasties is Buthus martensii， which is the same in ancient and modern times. B. martensii is mainly distributed in the central and eastern parts of China， as well as Mongolia， Korea and other places， located in East Asia. Therefore， pharmaceutical workers in China mostly continue to use the early Chinese name， that is， Dongya Qianxie， while modern Scorpiones taxonomists set its Chinese name as Mashi Zhengqianxie. In order to maintain the stability and continuity of the origin of Scorpio， the previous editions of Chinese Pharmacopoeia have always used the name of B. martensii. The geo-authentic producing area of Scorpio， which has been respected in the past dynasties， was Qingzhou， Shandong. Until the Republic of China， due to the different processing methods in the production area， the geo-authentic producing area expanded to Yu county， Henan， with Yu county as the distribution center， the best quality of Scorpio is produced by boiling in clear water and drying after boiling. The origin processing of Scorpio is mainly divided into clean water and salt water boiling and then drying， where the method of boiling with salt water was first described in Bencao Yuanshi， the purpose is antiseptic and suitable for storage， and the salt should be washed away when used clinically. There are few processing methods of Scorpio， in ancient times， it was used for roasting or frying after removing the feet， in modern times， it is mostly to remove impurities， wash and dry. Scorpio is not only used for medicinal purposes， but also has the habit of eating in many areas， so the consumption of resources is relatively large， and it is still mainly harvested from the wild， resulting in the decrease of wild resources year by year. Based on the research conclusion， it is recommended that B. martensii， which is produced in Qingzhou， Luyi or Yuzhou， should be used in the the development of famous classical formulas containing Scorpio， and the origin processing is preferable to be dried after boiling with water， and the processing specification should be selected as raw products. And B. martensii in geo-authentic producing areas was used as the seed source to establish a standardized breeding base to ensure the sustainable development of the resources of Scorpio.
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Objective:To investigate the relationship between tumor volume changes, squamous cell carcinoma antigen (SCC-Ag), carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125) and the prognosis of cervical cancer patients with concurrent radiotherapy and chemotherapy and their combined prediction of prognosis.Methods:One hundred and twenty-eight patients in Shanxi Cancer Hospital from February 2018 to February 2020, with cervical cancer undergoing radical concurrent radiotherapy and chemotherapy were selected for a prospective study. According to different prognostic effects, the patients were divided into poor prognosis group (44 cases) and good prognosis group (84 cases). The general data, tumor reduction rate (TVRR), SCC-Ag, CEA, and CA125 levels were compared between the two groups, and the Logistic regression equation was used to analyze the prognostic factors of patients with concurrent radiotherapy and chemotherapy for cervical cancer. The receiver operating characteristic (ROC) curve and the area under the curve (AUC) were used to analyze the performance of each index and the joint prediction of prognosis. Kaplan-Meier survival curve analysis and log-rank (Mantel-Cox) were used to test the survival curves of TVRR, SCC-Ag, CEA, CA125 high-risk individuals and low-risk individuals.Results:The TVRR in the poor prognosis group was significantly lower than that in the good prognosis group: (76.63 ± 7.52)% vs. (85.54 ± 6.71)%, the SCC-Ag, CEA, CA125 were significantly higher than those in the good prognosis group: (6.98 ± 2.15) μg/L vs. (4.61 ± 1.37) μg/L, (9.34 ± 2.23) μg/L vs. (5.76 ± 1.87) μg/L, (68.79 ± 12.01) kU/L vs. (49.97 ± 15.22) kU/L, and there were statistical differences ( P<0.05). Logistic regression showed that TVRR, SCC-Ag, CEA and CA125 were significant factors influencing the prognosis of patients with concurrent chemoradiotherapy for cervical cancer ( P<0.05). Among the single indicators, TVRR predicted the highest prognosis AUC, and the combined prognostic AUC of all indicators (0.837, 95% CI 0.761 to 0.920) was higher than any single indicator, with a sensitivity of 81.82% and specificity of 84.52%. The survival curves of TVRR, SCC-Ag, CEA, CA125 between high-risk and low-risk patients showed statistically significant differences ( P<0.05). Conclusions:The changes in tumor volume, SCC-Ag, CEA, CA125 and the prognosis of patients with concurrent radiotherapy and chemotherapy for cervical cancer have a certain correlation. The combined examination of the four in the early stage is expected to become a new approach to clinically predict the prognosis of cervical cancer and make appropriate treatment plans.
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Objective:To investigate the correlations of squamous cell carcinoma antigen (SCC), peripheral blood lymphocyte-to-monocyte ratio (LMR) and platelet-to-lymphocyte ratio (PLR) before concurrent chemoradiotherapy with recurrence of cervical cancer after concurrent chemoradiotherapy, and to explore the predictive value of the three above indicators for recurrence.Methods:The data of 90 cervical cancer patients who received concurrent chemoradiotherapy in Shanxi Provincial Cancer Hospital from January to December 2018 were retrospectively analyzed, and the patients were divided into recurrence group and non-recurrence group according to whether they relapsed. The patients' basic information and the levels of SCC, LMR and PLR before concurrent chemoradiotherapy were recorded, and the median follow-up was 17 months (5-24 months). Logistic regression was used to analyze the risk factors affecting the recurrence of cervical cancer after concurrent chemoradiotherapy, the obtained risk factors were used to construct a recurrence prediction model, and the receiver operating characteristic (ROC) curve was used to analyze the predictive value of different indicators for recurrence.Results:Among 90 patients, 26 patients (28.9%) relapsed and 64 patients (71.1%) did not relapse during follow-up. The proportions of patients with tumor maximum diameter ≥ 4 cm [57.7% (15/26) vs. 34.4% (22/64)], lymph node metastasis [53.8% (14/26) vs. 31.2% (20/64)], Karnofsky score 70-75 points [30.8% (8/26) vs. 21.9% (14/64)], Karnofsky score 76-80 points [42.3% (11/26) vs. 17.2% (11/64)], International Federation of Gynecology and Obstetrics (FIGO) stage Ⅳ [42.3% (11/26) vs. 17.2% (11/64)] in the recurrence group were higher than those in the non-recurrence group, and the differences were statistically significant (all P < 0.05). The SCC and PLR in the recurrence group before concurrent chemoradiotherapy were (4.26±0.53) ng/ml and 144.02±11.16, which were higher than those in the non-recurrence group [(2.91± 0.48) ng/ml and 125.18±12.32], and the LMR in the recurrence group before concurrent chemoradiotherapy was 3.93±0.61, which was lower than that in the non-recurrence group (4.68±0.55), and the differences in SCC, PLR and LMR between the two groups were statistically significant (all P < 0.05). The area under the ROC curve of SCC, LMR and PLR before concurrent chemoradiotherapy alone for predicting the recurrence of cervical cancer after concurrent chemoradiotherapy was 0.819 (95% CI 0.708-0.948), 0.763 (95% CI 0.677-0.860) and 0.735 (95% CI 0.590-0.916), and the best cut-off values were 2.13 ng/ml, 4.08 and 133.65. Multivariate logistic regression analysis showed that the tumor maximum diameter ≥4 cm ( OR = 2.116, 95% CI 1.204-3.718), lymph node metastasis ( OR = 2.669, 95% CI 1.022-6.970), FIGO stage Ⅳ ( OR = 2.699, 95% CI 1.359-5.362) and SCC≥2.13 ng/ml ( OR = 4.256, 95% CI 1.194-15.170), LMR≤4.08 ( OR = 5.216, 95% CI 2.987-9.108) and PLR≥133.65 ( OR = 3.256, 95% CI 1.456-7.281) before concurrent chemoradiotherapy were the risk factors for recurrence of cervical cancer after concurrent chemoradiotherapy (all P < 0.05). The area under the ROC curve of the recurrence prediction model constructed by the above risk factors for cervical cancer after concurrent chemoradiotherapy was 0.857 (95% CI 0.744-0.987), the best cut-off value was 157.24, the sensitivity was 0.873, the specificity was 0.845, and the Youden index was 0.718. Conclusions:The recurrence of cervical cancer after concurrent chemoradiotherapy is associated with many factors. The patients with higher SCC, higher PLR and lower LMR before concurrent radiotherapy have higher risk of recurrence. The combined detection of multiple indicators has high value for predicting recurrence.
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Objective To compare the efficacy and adverse reactions of intensity-modulated radiation therapy (IMRT) and conventional pelvic field radiation therapy for middle and advanced cervical cancer. Methods A total of 144 patients with stageⅡB-ⅢB cervical cancer from October 2007 to September 2012 were divided into IMRT group (72 cases), and routine radiotherapy group (72 cases) by using random number table method. The IMRT group was exposed to the 6 MV-X line 7 field, a dose of 46-50 Gy for planning target volume (PTV), 54-60 Gy for gross tumor volume (GTVnd) simultaneously integrated boosted, in 25-28 fractions. The central block of lead 4 cm was changed to 4 fields irradiation, adding to 46-54 Gy for the conventional group after 30-40 Gy of the whole pelvic field. The total dose for the two groups of patients was 30-45 Gy, after completed 30 Gy in vitro exposure, to the cavity irradiation, 5-7 Gy/fraction, and synchronous cisplatin (DDP) sensitization chemotherapy was done synchronously. Results The recent complete remission, partial remission, overall survival ratio of two groups were compared respectively, and the difference was not statistically significant (P > 0.05). The difference in 1 year survival rate of IMRT group and routine radiotherapy group was not statistically significant (χ2= 1.455, P> 0.05). The difference in 3 and 5 year survival rate was statistically significant [76.4 % (55/72) vs. 59.7 % (43/72); 72.2 % (52/72) vs. 55.6 %(40/72), P< 0.05]. Acute radiotherapy major adverse reactions included the digestive system, urinary system, skin response and haematological toxicity (bone marrow suppression). The incidence and degree of skin response in IMRT group was lower than that in routine radiotherapy group (P<0.05). The adverse effects of late radiotherapy were mainly rectal, bladder, skin response and hematological toxicity (bone marrow suppression). The incidence rectal and skin response in IMRT group was lower than that in routine radiotherapy group (P< 0.05). Conclusion The IMRT can improve the survival rate of advanced cervical cancer patients for 3-5 years, reduce the adverse effects of acute and terminal radiotherapy, and improve the quality of life.