Breast cancer survivors often suffer from a variety of complications post operation, such as upper limb dysfunction, limb lymphedema, brachial plexus nerve injury, and so on. This article reviewed the pathogenesis and rehabilitation of these complications.

ObjectiveTo investigate the exercise capability and the cardiovascular response at the rate of work on ergometry cycle at 70% maximal heart rate(MHR),in healthy middle-aged people(45-60 years old) and the elder people(≥60 years old ),and to offer the information of physical exercise for cardiopulmonary disease patients and formulate exercise prescription for healthy middle-aged and old people.Methods36 objects were sitting on a bicycle ergometer and exercised with a gradual increase of workload to maintain their heart rate at 70%MHR for 3 minutes. The electrocardiogram, blood pressure, rate of work, and metabolic equivalents(METs) were recorded.ResultsAll objects finished this test,without angina pectoris, shortness of breath and fatigue. Heart rate came back to the level before the test in all objects and blood pressure reduced to some extent in most objects,at the 8 minutes after cool down.The rate of work on ergometry cycle at 70%MHR were (98±10.23)W for male,(64±11.13)W for female in middle-aged people,while that was(75±8.25)W for male and(50±9.23) for female in old people﹙P<0.01).METs at 70%MHR were(5.82±0.83) for male and(4.25±0.63) for female in middle-aged people, while that was(5.75±1.25) for male and(4.05±0.93) for female in old people(P>0.20).ConclusionsThe cardiovascular response is safe for healthy middle-aged and older people exercising at 70%Hrmax. It maybe the reference for them to do the physical fitness exercise.

Objective To observe the changes of magnetoencephalography (MEG) during stretching and flexing forefinger in one hemiplegic patient before and after rehabilitation training.MethodsThe cerebral electromagnetic wave of one hemiplegic patient during stretching and flexing both forefingers was recorded by MEG and superposed with magnetic resonance imaging (MRI) to form magnetic source imaging (MSI). The changes of MEG before and after rehabilitation training were analyzed.ResultsThere was no movement evoking magnetic fields in right hemisphere motor cortex at two MSI detections, but detected in left hemisphere motor cortex. The latent period of the first and the second detection was -34.2 ms and -61.7 ms respectively. The exiting motor cortex was located in precentral gyrus. The exiting motor cortex at the second detection was located more front medial and low than at the first detection. The volume of the exiting motor cortex (9569.6 m3) at the second detection was more larger than the first detection (2309.7 m3). There was no movement evoking somatosensory magnetic fields in right hemisphere motor cortex at first MSI detection, but found at the second detection, the latent period was 91.1 ms, and the exiting cortex was located in postcentral gyrus.ConclusionThe cortex somatosensory function of patient with stroke recovers early than the motor function and the uninjured hemisphere function can improve obviously after rehabilitation training.

Objective To investigate the effects of low dose of gamma knife irradiation on the expression of N-methyl-D-aspartate (NMDA) receptor subunits in cortex and hippocampus of epileptic rats. Methods The rats were randomly divided into 4 groups: control group, GK group, pentylenetetrazole (PTZ) group and GK+ PTZ group. The rats were injected intraperitoneally with PTZ to establish the epileptic models. Gamma knife irradiation was performed on bilateral frontal cortex of rats at a peripheral dose of 15Gy. After irradiation, the changes of the seizure and behaviors were observed and recorded. The rats were killed on the 12th week after irradiation, Immunohistochemstry and western blotting were used to detect the relative expression levels of NMDAR subunits (NR1, NR2A, and NR2B) in the cortex and hippocampus. Results There were no epileptic seizures in the control group and the GK group. Compared with the PTZ group, the epileptic seizures of rats in the GK+PTZ group were significantly reduced after low dose gamma knife irradiation (P<0.05). Compared with control group, the protein expression levels of NR1, NR2A and NR2B in the PTZ group increased significantly in the cortex and hippocampus, and so were the positive neurons and their average absorbance value (P<0.05). Compared with PTZ group, the protein expression levels of NR1, NR2A and NR2B of the GK+PTZ group decreased remarkably in the cortex and hippocampus (P<0.05). Protein expression levels of NR1, NR2A and NR2B were not significantly different between control group and GK group (P＞0.05). Conclusion Epileptic rats exhibited an increase in the protein expression levels of NR1, NR2A and NR2B in the cortex and hippocampus while low dose of gamma knife irradiation can decrease expression levels of NMDA receptor subunits in the cortex and hippocampus of epileptic rats, which might represent a possible mechanism underlying the therapeutic effects of gamma knife irradiation on epileptic seizure.

Objective:To investigate the correlation between total MRI burden and serum uric acid level in patients with cerebral small vessel disease(CSVD) and its gender differences.Methods:A total of 217 patients with CSVD were retrospectively included as the research objects, and the clinical data such as serum uric acid value were collected.The imaging findings of patients with CSVD were evaluated by MRI, and the total MRI burden score of CSVD was calculated.According to the total MRI burden score of CSVD, patients with CSVD were divided into mild-to-moderate burden group ( n=133) and severe burden group ( n=84). SPSS 20.0 software was used for data analysis and processing.Logistic regression was used to analyze the relationship between uric acid and the total MRI burden score of CSVD. Results:The serum uric acid of severe burden group was higher than that of mild-to-moderate burden group((326.94±70.95)μmol/L, (293.42±80.52)μmol/L, P=0.002). The multivariate logistic regression analysis showed that the elevated level of serum uric acid was an independent risk factors for total MRI burden of CSVD ( β=0.005, OR=1.005, 95% CI=1.001-1.009, P=0.019). The patients with CSVD were equally divided into four group based on the serum uric acid concentration.After controlling the confounding factors, with the increase of uric acid level, the risk of aggravating total MRI burden score of CSVD increased, and the difference was statistically significant( P=0.001). Serum uric acid(for each quartile increase)was an independent risk factor for total MRI burden in male patients with CSVD( β=0.482, OR=1.619, 95% CI=1.125-2.330, P=0.010), while there was no significant difference in female patients( P=0.070). Conclusion:Serum uric acid level is a risk factor for increasing the total MRI burden in male patients with CSVD, but this effect is not found in female patients with CSVD.

Primary biliary cholangitis is a chronic autoimmune cholestatic disease with a progressive course. This disease is not rare in China, but standardized diagnosis and treatment for primary biliary cholangitis are insufficient. Based on the evidence and guidelines from China and other countries, Rheumatology Branch of Chinese Medical Association developed the recommendations of diagnosis and treatment for primary biliary cholangitis in China. The aim is to help clinicians recognize clinical characters, therapeutic selection and prognosis judgement of primary biliary cholangitis, which will contribute to make diagnosis in time, to select treatment properly and to manage follow-up scientifically.