Manual Muscle Testing is a widely used muscle power testing method in rehabilitation practice. Although it's a key content in rehabilitation medicine and rehabilitation therapy, there are some disagreements in lots of books introducing the development and rating system of it. This article reviewed the development of Manual Muscle Testing and different rating systems.

Objective To explore effects of different doses of fluvastatin on serum hs -CRP,NT -proBNP in patients with coronary heart disease (CHD)and chronic heart failure (CHF)and its clinical efficacy.Methods 120 CHD patients with CHF were randomly divided into three groups,each group included 50 cases.Each group received the therapy of 20mg/d(20mg group),40mg/d(40mg group),and 80mg/d(80mg group),respectively,three groups were treated for 12 weeks.The related indicators were compared among the three groups before and after treat-ment,and the incidence of major cardiovascular events (MACE )and adverse reactions were recorded.Results There was no statistically significant difference between groups before treatment (P >0.05).The serum hs -CRP and BNP of three groups were significantly different after treatment(F =185.956,16.824,all P <0.05).The hs -CRP and NT -proBNP of 80mg group were lower than those of group 20mg and 40mg group (hs -CRP:LSD -t value =3.143,4.113,all P <0.05;NT -proBNP:LSD -t value =2.986,3.765,all P <0.05).The △hs -CRP,△NT -proBNP of C group were higher than those of 20mg group and 40mg group(LSD -t value =4.783,5.819,all P <0.05).The TC,TG,LDL -C of three groups were significantly different after treatment (F =14.402,10.929, 121.968,all P <0.05).The TC,TG,LDL -C of 80mg group were lower than those of 20mg group and 40mg group (LSD -t value =3.538,4.765,4.387,all P <0.05).The ALT,CPK of three groups had no significant differences before and after treatment (P >0.05).The incidence of MACE in 80mg group was lower than that in 20mg group and 40mg group.However,the incidence of three groups had no significant difference after treatment (P >0.05 ). Conclusion The treatment of high -dose fluvastatin can significantly decrease inflammatory of CHD patients with CHF,and also decreases the NT -proBNP level,effectively control lipid levels,the treatment is safe and worthy of clinical recommendations.

Long non-coding RNAs are important regulators of gene expression.ANRIL which was coded on the Chr9p21.3 loci participates in the pathogenesis of tumor, coronary artery disease, type 2 diabetes mellitus and oth-er diseases.Multiple ANRIL isoforms are tissue-specific.ANRIL mainly functions through Polycomb proteins, while there are also other downstream targets.The mechanism of each isoform and the downstream pathways are hotspots incurrent researches.

In patients with chronic myeloid leukemia (CML) in chronic phase who have achieved complete molecular remission on imatinib therapy,whether and when to discontinue the drug become a hot topic.The famous clinical trials of discontinue tyrosine kinase inhibitor (TKI) from France and Australia have demonstrated that long-term monotherapy with TKI is not curative in the majority of patients with CML.This has focused attention on strategies to eradicate residual disease in CML patients,which should result in cure and long-term treatment-free remission and leukemia-free survival.This review provides a brife summary of the 55th ASH annual meeting,focusing on the potential combination therapeutics in the era of TKI.

Objective To analyze the occurrence rate,positive rate,and other related factors influencing interpectoral lymph nodes in breast cancer patients,and to explore the significance and indications of the surgical dissection of interpectoral lympy nodes.Methods Clinical and pathological data from 148 breast cancer patients were retrospectively analyzed.All patients were subjected to modified radical mastectomy,and interpectoral lympy nodes were pathologically examined.The occurrence rate and metastasis of interpectoral lympy nodes were recorded,and the relationship between the interpectoral lympy nodes positive rate and tumor size,axillary nodes,clinical stages,neo-adjuvant chemotherapy,hormone receptors,human epidermal growth factor receptor-2 (Her-2) expression,and molecular subtypes of breast cancer were determined.Results The occurrence rate,overall metastasis rate,and the positive rate of interpectoral lympy nodes in patients with axillary lymph node metastasis were 13.5％(20/148),4.7％(7/148),and 10.9％ (7/64),respectively.I nterpectoral lympy nodes metastasis was significantly correlated with axillary node metastasis and clinical stages (P＜ 0.05).However,interpectoral lympy nodes metastasis was not significantly related with hormone receptor and Her-2 expressions(P ＞ 0.05).Interpectoral lympy nodes metastasis rate was not affected by neo-adjuvant chemotherapy.Patients with interpectoral lympy nodes metastasis were characterized by larger tumors,more positive axillary lymph nodes,and later chnical stages.Conclusions Interpectoral lympy nodes metastasis usually occurs in patients with larger tumors,more positive axillary lymph nodes,later clinical stages,as well as those with locally advanced cancer that meets the standard of neo-adjuvant chemotherapy.These indications suggest that the surgical dissection and pathological examination of interpectoral lymph nodes should be routinely performed.

Objective To study the clinical efficacy of lateral collateral ligament reconstruction surgery com-bined with arthroscopy in treatment of chronic lateral ankle instability.Methods 60 cases with chronic lateral ankle instability were selected,the patients were divided into the study group and the control group according to a random number table,which has 30 cases in each group.The control group was received conservative treatment, the study group was underwent exploratory arthroscopic ankle cleanup combined with peroneus brevis tendon lateral ligament reconstruction surgery.Scores before and after treatment of the two groups were detected in American bare foot and ankle surgery-hindfoot score system( AOFAS) .And excellent rate,the recurrence rate and complication rate between the two groups were compared.Results AOFAS score before treatment of the two groups had no significant difference (P>0.05),AOFAS score after treatment of two groups were significantly higher,and that of the study group was sig-nificantly higher than the control group,the difference was statistically significant (t=9.837,10.873,8.789,all P<0.05);Excellent rate of the study group was 96.7% (29/30) significantly higher than the 73.3% (22/30) in the control group,recurrence rate of the study group was 0.0% (0/30),significantly lower than the 13.3% (4/30) in the control group,the complication rate of the study group was 3.3%(1/30),significantly lower than the 20.0%(6/30)in the control group,the difference was statistically significant (χ2 =13.982,15.037,13.298,all P<0.05). Conclusion Lateral collateral ligament reconstruction surgery combined with arthroscopy in treatment of chronic lat-eral ankle instability has better clinical efficacy,the recurrence rate is low,and has less complications.

Ageing of population is now a phenomenon of the world and has considerable consequences for public services.Ageing is always accompanied with dysfunction of multiple organs,including hypothalamic-pituitaryadrenal axis.Here,we summarized alterations of hormone secretion of adrenal glands in the elderly and their relationships with Alzheimer' s disease.Moreover,we discussed characteristics of pheochromocytoma,primary aldosteronism,and Cushing's syndrome in the elderly.Lack of typical manifestations usually makes difficulty in diagnosis.

Gastrointestinal neuroendocrine tumor is a group of heterogeneous tumors and was considered as a rare tumor.According to the data of recent years,its incidence has been increased significantly.The clinical manifestations of gastrointestinal neuroendocrine tumors are varied,and serum chromogranin-A is considered the most important biomarker of both non-functioning and functioning neuroendocrine tumors.The traditional imaging examination and somatostatin receptor scintigraphy are helpful to diagnosis.Its treatments include surgery,biological treatment,radionuclide therapy and chemical therapy.The aim of this paper is to summarize briefly the clinical symptoms,diagnostic methods and treatment options of gastrointestinal neuroendocrine tumors.

Objective To explore the basic method and clinical application of spatio-temporal image correlation (STIC) in the routine scanning of normal fetal heart. Methods Totally 120 volume datasets of normal fetal heart were acquired with 2D and STIC, respectively. The difference in time between the two methods were compared and the basic imaging method was explored and analyzed.Results Satisfactory gray-scale volume acquisitions were accomplished in all 120 cases. The quality of the images derived from volume datasets were comparable to that directly obtained from 2D echocardiography. No significant difference of visualization rate was found between the two methods (P>0.05). Some views that could not be showed with 2D were acquired with STIC. In fetal heart screening, STIC (n=104) and routine ultrasonography (n=85) took (4.47±2.32) min and (5.26±2.01) min per case, respectively.Conclusion STIC provides more views and information than 2D, simplifies the picture-gathering process, decreases the dependence of examiner, increases the efficiency, and decreases the exposure upon fetal heart obviously.

Lead compound optimization plays an important role in new drug discovery and development. The strategies for changing metabolic pathways can modulate pharmacokinetic properties, prolong the half life, improve metabolism stability and bioavailability of lead compounds. The strategies for changing metabolic pathways and improving metabolism stability are reviewed. These methods include blocking metabolic site, reduing lipophilicity, changing ring size, bioisosterism, and prodrug.