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Objective:To investigate the changes of circulating tumor DNA (ctDNA), circulating B cell-specific Moloney leukemia virus insertion site 1 mRNA (Bmi-1 mRNA) and microRNA-21 (miR-21) before and after treatment with epidermal growth factor receptor (EGFR) monoclonal antibody in advanced colorectal cancer, and analyze their association with treatment response.Methods:The clinical data of 98 patients with advanced colorectal cancer from March 2019 to March 2021 in Yantai Yuhuangding Hospital were retrospectively analyzed. After treatment with cetuximab, complete remission was in 4 cases, partial remission in 26 cases, stable disease in 39 cases, and progressive disease in 29 cases. The patients with complete remission and partial remission were classified as remission group (30 cases), the stable disease and progressive disease were classified as non-remission group (68 cases). Before treatment and after 2 cycles of treatment, the plasma level of ctDNA was detected by high-throughput sequencing; the levels of Bmi-1mRNA and miR-21 were detected by real-time fluorescence quantitative polymerase chain reaction. Spearman correlation was used to analyze the relationship between ctDNA, Bmi-1mRNA, miR-21 and treatment responsiveness after 2 cycles of treatment; multivariate Logistic regression was used to analyze the independent risk factors affecting treatment responsiveness; receiver operating characteristic (ROC) curve was drawn to evaluate the value of ctDNA, Bmi-1mRNA and miR-21 in predicting remission after 2 cycles of treatment.Results:There were no significant differences in ctDNA, Bmi-1mRNA and miR-21 before treatment between 2 groups ( P>0.05); the ctDNA, Bmi-1mRNA and miR-21 after 2 cycles of treatment in remission group were significantly lower than those in non-remission group: (10.03 ± 3.32) μg/L vs. (15.33 ± 5.14) μg/L, 0.13 ± 0.04 vs. 0.19 ± 0.05 and 0.81 ± 0.26 vs. 1.08 ± 0.24, and there were statistical differences ( P<0.01). Spearman correlation analysis result showed that ctDNA, Bmi-1mRNA and miR-21 were negatively correlated with treatment response ( r = -0.500, -0.506 and -0.531; P<0.01). Multivariate Logistic regression analysis result showed that, after controlling for the number of distant metastatic organs and clinical stage, ctDNA, Bmi-1mRNA and miR-21 were still independent risk factors for treatment response in patients with advanced colorectal cancer ( OR = 3.342, 2.725 and 1.838; 95% CI 3.116 to 3.584, 2.647 to 2.805 and 1.768 to 1.911; P<0.01). ROC curve analysis result showed that the area under the curve (AUC) of ctDNA, Bmi-1mRNA combined with miR-21 after 2 cycles of treatment to predict the treatment response was the largest with 0.922. Conclusions:The changes of ctDNA, Bmi-1mRNA and miR-21 in patients with advanced colorectal cancer before and after treatment with EGFR monoclonal antibody are related to the treatment response. Combined detection is helpful for screening patients sensitive to EGFR-targeted therapy, and can provide reference for new targets of molecular intervention.
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OBJECTIVE：To prov ide effective improvement paths and policy suggestions for improving the innovation efficiency of TCM industrial enterprises. METHODS ：Based on the input and output data of innovation resources of 38 listed TCM industrial enterprises from 2014 to 2020，an evaluation index system was constructed from the perspective of all factors. First ，the deta envelopment analysis （DEA）model was used to measure the static efficiency of the sample enterprises ，and at the same time ， four patterns of innovative resource utilization were provided ；then the total factor Malmquist index method was used to analyze the decomposition of the changes in utilization efficiency of innovative resources according to different periods and micro-individuals. RESULTS & CONCLUSIONS ：The overall efficiency of innovative resource utilization of listed TCM industrial enterprises was too low，and the average overall efficiency was only 0.293. The input and output of innovation resources of 33 enterprises were unreasonable，and the reasons for the inefficiency are mostly due to insufficient pure technical efficiency. The average value of the all-factor Malmquist index was 0.818 for 38 sample enterprises ，and the overall efficiency was declining. The obstacles to technological progress were a more important reason for the decline in efficiency. It is recommended to improve TCM industrial enterprise’s ability to allocate innovation resources and adjust the proportion of R&D investment in conjunction with the return to scale；clarify the development principles with scientific and technological innovation as the core driving force ，and actively carry out basic research work ；implement the production and research platform of “TCM industrial enterprise-TCM research institution ” to promote the overall technological progress of the industry.
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OBJECTIVE:To provide reference for exploring the strategy of promoting TCM formula granules.METHODS:The questionnaire was designed to investigate the cognition and attitude of TCM practitioners from different grades to TCM formula granules in our university,and the investigation data were analyzed statistically.RESULTS:A total of 312 questionnaires were collected and 306 questionnaires were collected with recovery rate of 98.08％.Among them,305 questionnaires were effective with effective rate of 99.67％.46.89％ of interviewed practitioners were found to know and understand about TCM formula granule,52.46％ knew but did not understand;the higher the grade,the higher the proportion of the known and the better understanding (P＜0.05);the cognitive channels included diagnosis and treatment course (69.64％),took by others (65.02％),took by oneself (51.49％).TCM formula granules were easy to take without decoction (95.71％) and easy to carry (87.13％),the advantage of which had high popularity,but there was not much knowledge about other advantages.7.54％ of interviewed practitioners fully appreciated TCM formula granules and 69.18％ recognized them;the higher the grade,the higher the degree of recognition (P＜ 0.05).89.51％ were willing to learn more about TCM formula granules.60.98％ said they would prescribed TCM formula granules in the furure.Among the influential factors for the attitude of the practitioners to TCM formula granules,the three factors with the highest influence were the influence of the teachers,the influence of the patients and their own practice.CONCLUSIONS:The practice of TCM practitioners in our university in Beijing is not ideal for the cognition of TCM formula granules.There is still a great room for improvement in the attitude to TCM formula granules.The teachers and patients are key influential factors for the attitude to TCM formula granules.
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OBJECTIVE:To explore drug quality dynamic evaluation mechanism based on analysis of drug quality announce-ment data. METHODS:The sorts and types of drugs,places of origin,quantity of production enterprises and frequency distribu-tion of being mentioned were analyzed on the basis of drug quality announcement issued by CFDA and provincial administration in 2013. RESULTS & CONCLUSIONS:Frequency of TCM being mentioned (0.75%) was higher than that of chemical drug (0.30%). Among drugs mentioned more than 10 times,the most chemical drugs were injection (70%) and the most TCM were tablet(66.7%). Among all types,drug types produced by more than 100 enterprises accounted for 62.5%,and those produced by more than 50 enterprises accounted for 93.75%,which indicated the frequency of problems was in relatively direct proportion to the quantity of drug manufacturing enterprises. Top 10 provinces in the list of the number of drug quality announcements showed different characteristics of problem type distribution. In compassion,the quality problems of TCM in Jilin,Guangxi,Mongolia,Si-chuan were prominent,and reference number proportion of involved TCM were 85%,80%,97% and 69%,respectively;the quality problems of chemical drugs in Henan,Shanxi,Jiangsu,Guangdong,Anhui,Shandong should be paid attention,and refer-ence number proportion of involved chemical drugs were 62%,61%,95%,57%,86% and 65%,respectively. It is suggested that the government should carry out the dynamic risk assessment system based on data of drug quality announcement,and strength-en standard management of data collection of local drug quality announcement.
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Objective To make clear of the mechanism of metastasis and recurrence of primary liver cancer, and to make sure of the preventive value of transeatheter arterial immun- ehemoembolization (ICE) in treatment of liver cancer. Methods The study is a double-blinded, controlled, prospective, randomized trial. 146 patients were randomly divided into 3 groups. Group A: regular surgery of primary liver cancer;group B: TACE 1month after surgery, treatment proposal was: ADM + DDP + 5-Fu + LP; group C:transeatheter arterial immun-chemoembolization 1 month after surgery, treatment proposal : ADM + DDP +5-Fu+LP+Octreotide+IFN. Results CD3+, CD4+, CD4+/CD8+ increased 1 month after surgery in group A; In group B: CD3+, CD4+, CD4+/CD8+ decreased but CD8+ increased 1 week after TACE; CD3+, CD4+, CD4+ /CD8+ increased but CD8+ decreased 4 weeks after TACE(P<0.05); In group C: CD3+ , CD4+, CD4+/CD8+ increased slightly 1 week after TACE, but increased significantly 4 weeks later(P<0.05). In group A, the level of VEGF was high before surgery but decreased 1 month after surgery; In group B, the level of VEGF decreased 1 week after TACE, decreased more significantly 4 weeks after TACE than that in group B(P <0.05). 1 year survival rate, 2 year survival rate and 3 year survival rate in group C ware higher than those in group A; 1 year survival rate was higher in group B than that in group A, however, 2 year survival had and 3 year survival rate had no differ-ences between group B and group A. Conclusion Transcatheter arterial ICE can prevent metastasis and recurrence after surgery of primary liver cancer increase the 1,2,3 year survival rate. It not only has the role of TACE,but can increase the immunefunction,and inhibit tumor angiogenesis, then increase the therapeutic effect.