Objective To systematically evaluate the effects of the different postoperative exercise programs on the rehabilitation (such as shoulder range of motion,the incidence of the lymphedema and postoperative complications) of breast cancer patients.Methods The relevant randomized controlled trials which were retrieved from January 2008 to October 2013 were searched in the databases of the Pubmed,Embase,Ovid,Cochrane Library,China Biomedical Literature Database (CBM),China National Knowledge Infrastructure (CNKI),Wanfang Data,VIP.Two reviewers independently screened the literature according to the inclusive and exclusive criteria,extracted the data,and assessed the quality.The RevMan 5.2 software was used for Meta-analysis.Results Finally 10 randomized controlled trial involving 1 110 patients were included.The Metaanalysis showed that progressive exercise program compared to usual exercise obviously modified the shoulder anteflexion [MD =33.04 (26.85-39.23) and 28.05 (21.81-34.30)],abduction [MD =31.06 (8.17-53.95) and 31.39(24.96-37.82)],extorsion [MD=18.47(13.44-23.50) and 16.02(8.35-23.68)] 1 month and 3 months after surgery (P＜ 0.05),extension 1 month after surgery,adduction 3 months after surgery.It also decreased the incidence of the lymphedema.Conclusions It gives us some evidence that the progressive exercise program can promote the rehabilitation of the postoperative breast cancer patients.

Objective To explore the role and mechanisms of ω-3 polyunsaturated fatty acids (ω-3PUFA) alone or in combination with dexamethasone ( DEX) in inducing cell apoptosis and anti -proliferation in multiple myeloma(MM).Methods DEX resistance MM cell line MM1R were treated with different concentra-tions of Eicosapentaenoic acid(EPA)or Docosahexaenoic acid(DHA)alone or in combination with DEX for 24hrs or 48hrs.Cell proliferation was detected by MTT .Cell cycle and apoptosis were measured by flow cytometry .The levels of apoptosis related proteins were analyzed by Western blot .Results The proliferation of MM1R was in-hibited by different concentrations (10,20,50,100μM)of EPA or DHA alone or in combination with 10μM DEX in a dose-and time-dependent manner .Inhibition effect was significantly higher in combinative groups than in single agent groups(P<0.05).The percentage of G0/G1 phase and cell apoptosis rate in MM1R treated with dif-ferent concentrations of EPA or DHA alone was increased in a dose -dependent manner ,and being significantly higher in combinative groups than in single agent groups (P<0.05).The expressive levels of cleaved caspase -3 and Bax were up-regulated ,while pro-caspase-3 and BCL-2 were down-regulated in a dose-dependent manner.Conclusion ω-3PUFA can inhibit DEX resistant MM cell proliferation ,arrest cell cycle and induce cell apoptosis ,and has a synergistic anti -resistant effect in combination with DEX ,may serve as a new ,effective MM drugs.

Objective To investigate the effect of Celecoxib on human brain microvascular endothelial cells release6-keto-PGF1α,TXB2 and apotosis after irradiation.Methods The logarithmic growth phase cells were divided into control groups (Con),simple irradiation (IR) groups and combination groups (IR+C).CCK-8 and clone formation experiment were used to evaluate the effects of radiosensitivity and toxicity of celecoxib.The results were observed atthe time point of 6 h,12 h,24 h,48 h after irradiation.ELISA was used to test the contents of 6-keto-PGF1α and TXB2,which metabolized by PGI2 and TXA2 from culture medium after irradiation at different time points in different groups.TXB2/6-keto-PGF1αratios were calculated.Annexin V-FITC/PI double staining method was used to measure the apoptosis rates at different time points in different groups.Western blot was used to measure the protein expression.Paired t test difference.Results Compared with simple irradiation group,there were no significant radiosensitivity (SER=0.96) in combination groups incubated with30 μmol/L of celecoxib.Compared with the control group,the ratio of TXB2/6-keto-PGF1αincreased at each time point in IR and IR+C (P<0.05),and the apoptosis rates increased (P<0.05).Cox-2,P-JNK and Cleaved caspase-3 increased.Compared with IR,the ratio of TXB2/6-keto-PGF1αdecreased at each time point in IR+C (P<0.05),and the apoptosis rates decreased (t=3.34~6.38,P< 0.05).The protein expression of Cox-2,P-JNK and Cleaved caspase-3 decreased.Conclusions Celecoxib may help to protect HBMECs from releasing TXA2 and decreasing the ratio of TXB2/6-keto-PGF1α,and inhibitting apoptosis after irradiation.The mechanisms of apoptosis inhibition may be related to the inhibition of Cox-2 and P-JNK,caspase-3 Cleaved proteinexpressions.

Objective To investigate the dynamic changes of VEGF mRNA and protein in the injured brain of rats irradiated by 20 Gy of electron beams.Methods A total of 114 Sprague-Dawley rats were randomly divided into two groups,42 rats in sham group with sham-irradiation,and the other 72 rats in irradiation group that the whole brains of rats were administered with a single dose of 20 Gy electron beam (6 MeV) to establish an animal model of radiation-induced brain injury.All rats were terminated at 1,3,7,14,28,42,56 d post-irradiation respectively.The pathological changes were observed with light microscopies.Real-time quantitative reverse transcriptase-PCR was used to measure the level of VEGF mRNA in the brain tissue.The expression of VEGF protein in whole brain tissue was detected with Western blot.The VEGF protein expression in brain endothelium,gliacyte and neuron were measured via immunohistoehemistry with computerized image processing.Results The pathological process of radiationinduced brain injury (RBI) included brain endothelial cell damage,brain edema,thrombosis formation and ablation,revascularization and angiogenesis.In the irradiation group,the expression of VEGF mRNA was declined significantly at 1,3,7,2g,42 d post-irradiation (t =16.275-46.118,P ＜ 0.05).The VEGF protein expression in whole brain tissue was up-regulated at 1 and 7 d after irradiation,but downregulated at 3,14,28,42,56 d post-irradiation.There were VEGF positive cells in the brain endothelium,gliacyte and neuron at 1 d after irradiation.The expression of VEGF protein in gliacyte and neuron significantly was increased at 1,14,42,56 d post-irradiation (t =-8.394--4.697,P ＜ 0.05),and increased significantly in brain endothelial cells at 1,14,and 42 d after irradiation (t =-5.554--4.159,P ＜ 0.05).Conclusions The expression of VEGF mRNA was relatively suppressed in RBI rats.The expression of VEGF protein in whole brain tissue was up-regulated only at the early stage of RBI.The expressions of VEGF protein in brain endothelium,gliacyte and neuron were increased in the observation period,which induced brain edema and the formation of thrombosis at the acute RBI stage,and participated in the progression of angiogenesis and thrombosis ablation at the early-delayed RBI stage.

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Objective To describe the clinical characteristics,outcome and prognostic factors of primary intraspinal tumor treated with postoperative radiotherapy.Methods Thirty-three patients diagnosed as suffering from intraspinal tumor treated with postoperative radiotherapy were analyzed.There were eighteen male and fifteen female,with a median age of 37 years(range 7-64 years).Two patients were treated with grossly total resection,25 subtotal resection,2 biopsy only.These patients were treated either with(~(60)Co)(n =18,before 1998) or 6?MV-X ray(n =15,after 1998) to the total dose of 45-68?Gy.The overall response and survival rates were calculated by Kaplan-Meier method and the difference between groups was tested by the log-rank method.The prognostic factors related to the characteristics of patient,tumor,and treatment were determined.Results The overall response,five-year and disease-free survival rate was 81.3%,59.4% and 56.3%,respectively.By multivariate analysis,the histological type(P= 0.039) and gender(P= 0.049) had independent impact on the 5-year survival rate.Ependymoma had a better prognosis compared to other histological subsets and female gained more survival advantage over male.There was no close relationship between survival and other factors,such as age,extent of surgery,initial site,irradiation dose,or the interval between surgery and radiotherapy.Conclusions Postoperative radiotherapy is safe and effective for primary intraspinal tumor.The histological type and gender are important prognostic factors of survival in primary intraspinal tumors.

Objective To investigate the relationship between interleukin (IL)-28B gene polymorphisms (rs12979860 and rs8099917) and treatment response in patients with chronic hepatitis C in China.Methods Taqman probes single nucleotide polymorphism genotyping methods were used to detect the genotypes of rs12979860 (C/T) and rs8099917 (T/G) located at IL-28B gene in 105 included patients.The patients were treated with standard doses of pegylated interferon plus ribavirin and were followed up regularly for therapeutic response and adverse reaction.The relationship between IL-28B gene polymorphism and antiviral treatment response of patients were analyzed.Categorical data were analyzed using Pearson chi-square test or Fisher exact test.Results Totally 105 cases were included in our study and 2 cases lost to follow-up because of moving away.Eight-one cases (78.6%) of the remaining 103 patients were CC/TT genotype (CC/TT group) at rs12979860 and rs8099917, 19 cases (18.4%) were CT/TG (CT/TG group) and 3 cases (2.9%)were TT/TG (TT/TG group).No other genotypes were detected and linkage disequilibrium was discovered at the two polymorphism loci (r2=0.11).After 4 weeks of treatment, 35 cases (43.2%) in CC/TT group, 3 cases (15.8%) in CT/TG group and non in TT/TG group achieved rapid virological response (RVR).There were statistically significant differences among three groups (P=0.033).After 12 weeks of treatment, 45 cases (55.6%) in CC/TT group, 6 cases (31.6%) in CT/TG group and none in TT/TG group achieved early virological response (EVR).There were statistically significant differences among three groups (P=0.025).At the end of the treatment, 68 cases (83.9%) in CC/TT group, 10 cases (52.6%) in CT/TG group and only 1 case (33.3%) in TT/TG group achieved end-of-treatment response (ETR).There were significant statistical differences among the three groups (P=0.003).After 24 weeks of follow-up, 62 cases (76.5%) in CC/TT group, 9 cases (47.4%) in CT/TG group and 1 case (33.3%) in TT/TG group achieved sustained virological response (SVR).There were statistically significant differences among the three groups (P=0.014).One hundred and one cases in CC/TT group developed adverse events, among them 19 cases needed clinical treatment.There were 43 cases in CT/TG group developed adverse events and 9 cases needed treatment.Seven cases in TT/TG group developed adverse events and only 1 case needed treatment.There were no statistically significant difference among three groups (χ2=0.139,P>0.05).Conclusions The genotype of rs12979860 (C/T) and rs8099917 (T/G) at IL-28B gene could affect the treatment response in patients with chronic hepatitis C.RVR and SVR are higher in patients with genotype CC/TT, which might help to guide HCV treatment.

Objective To study the relationship between clinicopathological features and central lymph nodes metastasis in patients with papillary thyroid microcarcinoma(PTMC).Methods From Jan.2013 to Jun.2013,400 cases with PTMC in cN0 stage undergoing thyroidectomy and central neck dissection were collected.Results Univariate analysis showed that the rate of central lymph node metastasis in PTMC was 28.0％,nevertheless,the rate of central lymph node metastasis was 32.5％,42.6％,44.1％,33.3％,and 37.4％ respectively in patients aging below 45 years old,in male patients,in patients with extrathyroidal extension,in patients with tumor diameter larger than 5 mm and in patients with multifocality.Gender,age,extrathyroidal extension,tumor diameter,multifocality of patients had correlation with central lymph node metastasis.Multivariate binary logistic regression analysis revealed that the rate of lymph node metastasis significantly increased in cases of male,ageing below 45 years old,with extrathyroidal extension and multifocality(P ＜ 0.05).Conclusions The treatment for central lymph node metastasis of PTMC should be different considering elements including gender,age,multifocality of the tumor,and extrathyroidal extension.Prophylactic central lymphadenectomy should be performed when the primary lesion was resected.

Objective:To explore the chain mediating effect of escape motivation and flow experience between frustration and online game addiction.Methods:Stratified cluster sampling method was used to randomly select 740 students from 5 universities in Beijing.Frustrate mental state scale (FMSS), escape subscale of online game motivation scale (OGMS), game flow scale (GFS), and the game addiction subscale of different types of internet addiction scale (DTIAS) were used for investigation. SPSS 25.0 software and PROCESS macro program model 6 were used to analyze the data and test the mediation effect.Results:Frustration (62.94±15.84) was positively correlated with escape motivation(6.89±2.34), flow experience(20.36±7.38), and online game addiction(16.05±6.62) ( r=0.30, 0.19, 0.39, all P<0.01). Escape motivation was positively correlated with flow experience and online game addiction ( r=0.51, 0.50, both P<0.01), while flow experience was positively correlated with online game addiction ( r=0.51, all P<0.01). The direct effect of frustration on game addiction was 0.23 (95% CI=0.17-0.30). Frustration indirectly affects game addiction through two paths. The single mediating effect of escape motivation was 0.07 (95% CI=0.05-0.11), and the chain mediating effect of escape motivation and flow experience was 0.05 (95% CI=0.04-0.08). Conclusion:Frustration not only directly affects online game addiction, but also indirectly affects online game addiction through escape motivation and flow experience.

Objective To investigate the aging features of pure leukoaraiosis (LA) in nondemented outpatients. Methods The outpatients with age older than 40 years, without taking cholesterol lowering and B vitamin medications and with mini-mental state examination more than 24 scores were selected from July 2008 to December. 2009 in Beijing Tiantan Hospital. LA was defined with MRI. Patients were classified into two groups i. e. LA group consisting of 138 patients with leukoaraiosis but without lacunar lesions and cortical infarcts and a control group consisting of 124 patients without any lesion in brain. Age and other vascular risk factors were also investigated. Results Age of the patients in the LA group was significantly higher than that in the control group (P< 0.001). Multivariable logistic regression analysis showed that age was independently associated with pure LA ( OR 1.080, 95% CI 1.042-1.120), after adjusting sex, vascular risk factors and presence of atherosclerosis in cervical arteries. If age-stratification was further considered, logistic regression analysis showed that OR (95% CI) for LA was 2.693 (95% CI 1.103-6.575) in a 60-69 year group and 13. 527(95%CI 3.319-55.131) in a≥70 year group as compared with a 40-49 year group. Conclusion Age is a determining risk factor for pure LA and patients with age older than 60 years are at high risk of LA.