With the emergence of new endocrine drugs and the development of research in resistance mechanisms,significant progress has been achieved in the endocrine treatment of breast cancer in recent years. Fulvestrant,the combination of endocrine drugs and the combination of targeted therapy with endocrine therapy will be effective treatments for postmenopausal women with hormone receptor positive in advanced breast cancer.

Background:Cytapheresis has been used gradually in the treatment of ulcerative colitis( UC),however,its efficacy is still controversial. Aims:To systematically evaluate the efficacy and safety of cytapheresis on UC. Methods:PubMed, Embase,Web of Science,Cochrane Library,CNKI,Wanfang and VIP database were retrieved to collect the randomized controlled trials( RCTs)using cytapheresis for UC. Article selection,data extraction and quality evaluation were conducted independently by two reviewers. Meta-analysis was conducted by using RevMan 5. 3 software. Results:A total of 20 RCTs involving 1 354 UC patients were included. The results of the meta-analysis showed that cytapheresis was superior to conventional therapy or sham procedure in inducing clinical response(RR=1. 36,95% CI:1. 20-1. 55,P﹤0. 000 01), clinical remission(RR=1. 38,95% CI:1. 15-1. 66,P=0. 000 5)and maintenance of remission(RR=2. 92,95% CI:1. 40-6. 08,P=0. 004 ),and no differences in adverse events were found( RR =0. 37,95% CI:0. 11-1. 24,P =0. 110). Conclusions:Cytapheresis has porfound effect on induction of clinical response, clinical remission and maintenance of remission,and is safe as well. However,the conclusion should be verified by more large-scale and multi-center RCTs.

Objective To estimate relationship between the brain atrophy rate and percent corpus callosum area change in patients with cerebral vascular disease.Methods Forty-six patients with cerebral vascular disease underwent MR scanning twice,at the baseline and at the end of the follow-up period.T1W images at both time points were processed automatically with structural image evaluation using normalization of atrophy(SIENA) software to determine the percent brain volume change(PBVC).In addition,the corpus callosum and the inner table of the skull on the mid-sagittal images of two scans were outlined manually to measure their areas.The percent of corpus callosum area change(PCCAC) was calculated.Then,the relationship between PBVC,PCCAC and age was statistically analyzed.Results Significant correlation was found among the three variables: spearman rank correlation coefficient was-0.295 for PBVC and age(P=0.047),while it was-0.4 for PCCAC and age(P=0.006),and 0.538 for PBVC and PCCAC(P=0.000).Conclusion SIENA software identifies brain atrophy quantitatively in patients with cerebral vascular disease,which correlated with area reduction of the corpus callosum.

Objective To evaluate the diagnostic value of 2D-FIESTA sequence of MRI in the detection of the biliary tract lesions in infant and young children patients(less than 3 years).Methods 8 infant and young children patients were examined by MRI to evaluatetheir biliary tract.Images were obtained with a 1.5T whole body MRI system(GE Medical System,Milwakee,Wis,USA),using theCARDIAC coil.The patients were sedated by chloral hydrate orally or by pentobarbital sodium intravenously.No contrast agents wererequired.All of the axial,coronal and sagittal images were reviewed on an independent workstation and maximum intensity projection(MIP) and multiplanar reformations(MPR) techniques were applied.Results The 2D-FIESTA pulse sequence results in images in which the hepatic vascular structures and the biliary tract were highlighted.In this way,a clear visualization of the hepatic vessels and biliarytract could be obtained in all 8 cases.MRI could demonstrate the anatomy and pathology of post-transplantation changes in 3 patients,choledochal cysts in 2 patients,anomalous connection between the bile and pancreatic ducts in 1 patient.All the abnormalities were proved by operation.2 examinees were diagnosed normal by MRI and were confirmed by follow-up.Conclusion 2D-FIESTA is a fast sequence that allows the high quality images to be generated without breath-hold and without administration of contrast material.It has a potential wide application in the evaluation of biliary tract in the infant patients.

Objective To investigate the diagnostic efficacy of MRI and bone scintigraphy in the detection of bone metastasis from prostate cancer.Methods One hundred and eighty-three patients suspected of prostate cancer were recruited in this study.All the patients were examined by pelvic MRI and bone scintigraphy.According to the integragted clinical diagnosis,the patients were categorized as metastastic group and non-metastatic group.SPSS 11.0 was used to analyze the data.Results Bone metastasis were identified in 37 of the 183 patients.In the 24 patients whose MRI results demonstrated bone metastasis,all of them were convinced of bone metastasis(24/24,100%).In the 159 patients whose MRI results revealed no bone metastasis,only 4 of them(4/159,2.52%)were detected bone metastasis by bone scintigraphy.The sensitivity,specificity and accuracy of MRI in the detection of bone metastasis was 78.38%,87.0% and 85.25%,respectively.The sensitivity,specificity and accuracy of bone scintigrapy in the detection of bone metastasis was 94.59%,62.33% and 68.85%,respectively.The specificity and accuracy of MRI in the prediction of bone metastasis were higher than that of bone scintigraphy(? 2=23.458,P=0.000;? 2=13.906,P=0.000),whereas the sensitivity of bone scintigraphy in the detection of bone metastasis was higher than that of MRI(? 2=4.163,P=0.041).Conclusion With the negative findings of the pelvic MRI,the probability of bone metastasis diagnosed by bone scintigraphy was fairly low.So even with the limitation range of the pelvic MRI examination,it is useful in the prediction of bone metastasis from prostate cancer.

Objective To evaluate the efficacy and safety of efavirenz-based therapy in patients with human immunodeficiency virus (HIV)/hepatitis C virus (HCV) co-infection. Methods Fiftythree HIV/HCV co-infected patients received efavirenz-based therapy were followed up for 7 years.The changes of CD4+ T lymphocyte count, HIV virus load, hepatic function, hepatic fibrosis index,blood lipid, blood glucose, blood uric acid and blood routine were observed. The comparison of means before and after treatment was performed by t-test. Results The HIV RNA levels at baseline and endpoint were (4. 56±0. 88) lg copy/mL and (1.70±1.10) lg copy/mL, respectively (t=14. 781, P＜0.01). The peripheral blood CD4+ T lymphocyte counts were ( 188.37±151.14)×106/L and (445.18±314.25)×106/L, respectively (t=5.362, P＜0.01).The alanine aminotransferase (ALT) levels were (36.6±16.3) U/L and (57.2±9.9) U/L, respectively (t=7.864, P＜0. 01).The glycocholic acid levels were (444.22±476.74) mg/L and (556.88±733.05) mg/L, respectively (t=0.938, P＜0.05). The Ⅳ-collagen(Ⅳ-C) levels were (45.13±8.25) ng/mL and (47.88±4.51) ng/mL, respectively (t= 2.129, P＜0.05). The riacylglycerol levels were (1.57±0.65)mmol/L and (2.51±1.29) mmol/L, respectively (t=4.737, P＜0.01). The blood uric acid levels were (298.5±48.2) mmol/L and (495.1±89.4) mmol/L, respectively (t= 14.092, P＜0.01).Conclusions The efavirenz-based therapy is efficacious in HIV/HCV co-infected patients, but it could cause liver injury and metabolic disorder.

Objective To evaluate collateral flows using vessel encoded arterial spin labeling (VE-ASL) perfusion imaging. MethodsVE-ASL was achieved to assess the presence and function of collateral flow on patients with internal carotid artery (ICA) stenosis. The presence of the anterior and posterior collateral flow was demonstrated by flow patterns of the A1 segment and posterior communicating artery (PCoA).Distal function of collateral flow of stenotic hemisphere was categorized as adequate ( cerebral blood flow ≥10 ml · min-1·100 g-1 ) or deficient (cerebral blood flow < 10 ml · min-1· 100 g-1 ). The results were compared with magnetic resonance angiography (MRA) and intraarterial digital subtraction angiography (DSA) in crosstable by using Kappa values. The VE-ASL before and after ICA stent therapy were compared. ResultsThe Kappa values of the flow patterns of AI segment and PCoA between VE-ASL and MRA were 0. 746 and 0. 700. The Kappa value of the function of collaterals using VE-ASL and DSA was914. VE-ASL showed collateral flow via leptomeningeal anastomoses. VE-ASL changed significantly after ICA steat therapy. ConclusionVE-ASL reveals the presence and distal function of collateral flow, which helps to evaluate the efficacy of ICA steat therapy.

Inflammatory bowel disease (IBD)is a non-specific,chronic intestinal inflammatory disease,and the pathogenesis of IBD is not completely clear. Mesenchymal stem cell (MSC)is a kind of pluripotent stem cell and has been widely used in the treatment of blood system diseases. Recent studies have shown that MSC has a unique advantage in the treatment of IBD. This article reviewed the advances in study on MSC in the treatment of severe IBD.

Objective: This study aims to evaluate the efficacy of specific exercise therapy for the treatment of skeletally immature idiopathic scoliosis (IS). Methods: A total of 51 mild IS patients receiving specific exercise therapy in Guangdong Xinmiao Scoliosis Prevention Center from October 2017 to September 2021 were recruited in this study. Treatment outcome were evaluated at 1 year follow up. All the participants were divided into two groups: open ( n =32) and closed triradiate cartilage group ( n =19), and outcome of treatment were compared within the two groups. Results: After (26.5±9.8) months of treatment, the Cobb angle of the major curve was corrected from an average of (15.5±4.2)° to (11.3±6.7)°, with an average correction of (4.5±5.7)°. Among them, 58.9% patients achieved improvement in the major curve Cobb angle, 33.3% achieved stabilization, and 7.8% progressed. There was no significant difference in the major curve Cobb angle between the closed and open triradiate cartilage groups before treatment( t =-0.73, P =0.47), whereas there was a significant difference in the correction of the major curve after treatment( t =-2.73 , P <0.05). Conclusion Specific exercise therapy effectively prevents the progression or corrects the scoliosis in patients with skeletally immature idiopathic scoliosis. It s more effective in patients with open triradiate cartilage than in those with closed triradiate cartilage.

Objective: To investigate the clinical value of combined detection of serum miR-378 and miR-21 in gastric cancer (GC). Methods: Eighty-seven patients with GC and 78 patients with colorectal cancer(CRC) from National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences were selected, 83 individuals undergoing healthy physical examination were selected as the healthy controls. The levels of serum miR-378 and miR-21 were detected by quantitative real-time PCR (RT-qPCR) (result data were transformed as log2 for analysis). Results: Relative expression levels of miR-378 in the serum were -1.24, -3.25 and -2.73 in healthy controls, GC and CRC patients, respectively. Compared with the healthy controls, the levels of serum miR-378 were significantly decreased in GC and CRC patients (both P<0.05). Relative expression levels of miR-21 in the serum were 0.11, 2.34 and 2.47 in healthy controls, GC and CRC patients, respectively. Compared with the healthy controls, the levels of serum miR-21 were significantly up-regulated in GC and CRC patients (both P<0.05). Moreover, the serum level of miR-378 in GC patients was inversely associated with tumor clinical stage (P<0.05). However, the level of miR-21 showed no significant differences among patients with different clinical and pathological characteristics (all P>0.05). The area under the receiver operating characteristic curve (AUC), sensitivity and specificity of miRNA-378 to diagnose GC was 0.770, 82.0% and 66.0%, respectively, and were 0.900, 85.0%, and 88.0% of miR-21, respectively. The AUC, sensitivity and specificity of combined detection of serum miR-378 and miR-21 to diagnose GC were 0.930, 92.0% and 87.0%, respectively, while the AUC of combined detection of serum CEA and CA-199 was 0.767, the AUC of combined all of the four factors was 0.946. Conclusion The combined detection of serum miR-378 and miR-21 have a certain effect on diagnosis of GC.