Objective:To evaluate the impact of change in the hormone receptor (HR) status on the long-term outcomes of breast cancer patients treated with neoadjuvant chemotherapy (NAC).Methods:There were 215 patients for the HR status of their lesions before and after NAC.After surgery,59 cases were confirmed to have achieved complete remission of pathology,The expression of hormo ne receptors was not consistent in 63 patients before and after neoadjuvant chemotherapy.63 patients were divided into two groups,Group A:39 patients received standard endocrine therapy for 5 years after surgery and chemotherapy;Group B:24 patients were not treated with standard endocrine therapy after surgery and chemotherapy.Conclusions:The 3-year DFS rates were 77.4％ and 54.2％ in Group A and Group B patients,respectively,There was not statistical significancebetween the two groups.The 5-year overall survival rate for Group A patients was higher than that of Group B patients(74.3％ vs 45.8％,P=0.028),The difference was statistically significant.Conclusions:This study revealed that breast cancer patients with HR altered after NAC still benefit from standard endocrine therapy.

Objective To review multi-center experience on rescue use of extracorporeal membrane oxygenation(ECMO) in pediatric patients with acute fulminant myocarditis and to investigate its short-term outcome in China.Methods The survey was conducted in 28 tertiary hospitals in China mainland.All children<18 years who had been supported with non-open chest ECMO to rescue acute fulminant myocarditis in PICU were reviewed.Results Twenty-three of 63 patients with ECMO support were diagnosed acute fulminant myocarditis.Their mean age was(86.3±48.8)months,mean weight was(25.8±12.1)kg,and mean left ventricular ejection fraction was(39.5±15.6)%.Eighteen patients(78.3%) survived to discharge and 5 cases(21.7%) died.The average length of ECMO was(119.1±57.3)h,(110.6±42.7)h for survival,(150.0±93.8)h for nonsurvival.There was no statistically difference between survival and death in ECMO support time(P=0.41).The mean arterial pressure increased from(60.7±23.7)mmHg(1mmHg=0.113kPa) of the beginning to(72.1±9.8)mmHg at 24h after ECMO treatment,and increase of mean arterial pressure was higher in the survival compared with the nonsurvival(P=0.04).The mean serum lactate decreased from(6.8±5.1)mmol/L at ECMO initiation to(2.9±2.6)mmol/L at 24h after ECMO treatment,and decrease of serum lactate was higher in survival group compared to nonsurvival group(P<0.001).Twenty-one patients(91.3%) were decanulated from ECMO successfully.Three patients died within 30 days after ECMO support,and eighteen patients survived to hospital discharge.The overall survival rate was 78.3%.There were no significant difference between the death and the survival in ECMO support time(P=0.41) and medical cost(P=0.24).The most common complications during ECMO were bleeding and disfunction of oxygenator.Of the 18 survivors,15 were followed up,4 experienced obvious sequelae,and 2 had neurologic issues.Conclusion ECMO is an effective hemodynamic support treatment that confers better clinical outcome for pediatric patients with acute fulminant myocarditis.

Objective To evaluate the influence of Danhong injection on endothelial progenitor cells ,inflammatory factor and neural function in patients with acute cerebral infarction .Methods 116 cases of patients with acute cerebral infarction in our hospi-tal from April 2016 to November 2016 were chosen for the research ,and were divided into research group (Danhong injection with routine treatment) and control group (routine treatment) ,the changes of endothelial progenitor cells ,neural function and inflamma-tory factors between two group were compared 30 d after treatment .Results Endothelial progenitor cells in peripheral blood be-tween two group had no statistically significant difference before treatment (P>0 .05) .After treatment ,endothelial progenitor cells of two group all increased ,and had a statistically significant difference compared with before (P< 0 .05) .Endothelial progenitor cells at 7 d ,14 d and 30 d after treatment of research group were higher than those of control group ,and the difference was statisti-cally significant (P< 0 .05) .NIHSS score before treatment between two group had no statistically significant difference (P>0 .05) .After treatment ,NIHSS score of two group all decreased ,and had statistically significant difference compared with before (P<0 .05) .NIHSS score at 7 d ,14 d and 30 d after treatment of research group were higher than those of control group ,and the difference was statistically significant (P<0 .05) .IL-6 and IL-10 levels before treatment between two group had no statistically sig-nificant difference (P>0 .05) .After treatment ,IL-6 and IL-10 levels of two group all decreased ,and had a statistically significant difference compared with before (P<0 .05) .IL-6 and IL-10 levels at 7 d and 14 d after treatment of research group were higher than those of control group ,and the difference was statistically significant (P<0 .05) .Conclusion Danhong injection could effec-tively improve the level of endothelial progenitor cells and inflammatory ,and promote the recovery of neural function .

Objective: To optimize the formula of bromhexine hydrochloride dry powder inhalations (BH DPIs). Methods: BH DPIs were prepared by freezing-drying combined with an air-jet milling method. Three factors, including the weights of mannitol (X1), leucine (X2) and poloxamer 188 (X3) in the formula were known to be associated with the quality of BH DPIs. A central composite design was used to investigate the effects of the three factors on the response angle (Y1), fine particle fraction (FPF, Y3) and aerody-namic diameter (Y4). Response surface and overlay contour plot were delineated according to the best-fit mathematic models. Opti-mum formula was selected by overlay contour plot. Results: The quantitative relationships between the three factors and the three re-sponses were obtained. The optimal formula was mannitol﹕leucine﹕poloxamer 188 (2. 4: 2. 22: 0. 05) in the excipients. The pre-dicted and observed values of the optimum formula were similar. Conclusion: The multi-objective simultaneous optimization of the for-mula of BH DPIs is achieved by central composite design-response surface methodology.

Objective To evaluate effects of flush fluid of different temperatures on pain, comfort and adverse reactions in patients receiving choledochoscopy via T tube for residual bile duct stones. Methods Patients who underwent choledochoscopy were divided into the experimental group ( 36℃ saline was used as flush fluid) and control group ( room temperature saline was used as flush fluid) randomly. Pain degree, comfort degree, procedure time, the total amount of flush fluid, infusion speed and adverse reactions were recorded and analyzed. Results A total of 100 cases were included, 50 cases in each group. There was no significant difference between the two groups in their education level, working condition, operation methods, T-tube size, necessity for lithotripsy, procedure time, total amount of flush fluid and infusion speed (all P>0. 05). The pain scores were 1. 0(1. 00, 2. 00) and 2. 0(1. 00, 3. 25) (Z=-2. 158,P=0. 031) and the comfort scores were 6. 0(5. 00, 7. 25) and 5. 0(2. 00, 6. 00) (Z=-3. 384,P=0. 001) in the experimental group and the control group, respectively. There was significant difference in the change rate of heart rate during and before procedure between the two groups (-4. 07％± 10. 76％ VS 0. 30％± 10. 23％, P=0. 046) . The incidence of postoperative diarrhea in the experimental group and the control group was 6％( 3/50) and 22％ ( 11/50 ) , respectively (χ2=5. 316, P=0. 021 ) . Conclusion 36℃ saline flush can reduce pain scores, improve comfort degree and reduce the incidence of postoperative diarrhea after procedure in patients undergoing choledochoscopy via T tube.

Chronic Urticaria(CU)is a common skin disease involving autoimmunity and allergies,which brings a heavy burden to patients and society.The theory of traditional Chinese medicine"the Lung is combined with the Large Intestine,and the symptoms of large intestine can be reflected from the skin"has long shown that there is a close physiological and pathological relationship between the function of the Large Intestine and the skin.With the modern advancement of the"gut-skin axis"theory,the correlation between gut microbiome and CU has gradually become an emerging focus of research.Adjusting the imbalance of gut microbiome would be a new trend in the clinical treatment of CU.Acupuncture has a beneficial effect of regulating the gut microbiome,and the definite curative effect on CU.Therefore,this article summarized the research progress between the gut microbiome and CU in recent years,in order to discuss the feasibility of acupuncture to treat CU by regulating the gut microbiome,and provide a new idea for the mechanism research of acupuncture in the treatment of CU from the perspective of"treating skin from intestine".

Objective To investigate the pattern of nodal recurrence after curative resection in adenocarcinoma of the gastroesophageal junction ( AGE ) , and to provide a basis for delineation of the radiation range in the high-risk lymphatic drainage area.Methods A retrospective analysis was performed in 78 patients with locally advanced AGE who were newly treated in our hospital from January 2009 to December 2013 and had complete clinical data.All patients received curative resection and were pathologically diagnosed with stage T3/T4 or N (+) AGE.Those patients were also diagnosed with SiewertⅡor Ⅲ AGE by endoscopy, upper gastroenterography, macroscopic examination during operation, and pathological specimens.None of the patients received preoperative or postoperative radiotherapy.All patients were diagnosed by imaging with postoperative nodal recurrence.The computed tomography images of those
patients were accessible and had all the recurrence sites clearly and fully displayed.Results The median time to recurrence was 10 months ( 1-48 months) , and 90%of the recurrence occurred within 2 years after surgery.The lymph nodes with the highest risk of recurrence were No.16b1( 39%) , No.16a2( 37%) , No.9 (30%), and No.11p (26%), respectively.There was no significant difference in the recurrence rate within each lymphatic drainage area between patients with SiewertⅡandⅢAGE ( P=0.090-1.000) .The lymph nodes with the most frequent recurrence were No.16b1, No.16a2, No.9, No.16b2, No.11p, and No.7 in patients with stage N3 AGE and No.11p, No.16b1, No.16a2, No.9, No.8, and No.7 in patients with stage non-N3 AGE.Patients with stage N3 AGE had a significantly higher recurrence rate in the para-aortic regions (No.16a2-b2) than those with stage non-N3 AGE (67%vs.33%, P=0.004, OR=4.00, 95% CI=1.54-10.37) .Conclusions The lymph nodes with the highest risk of recurrence are located in the celiac artery, proximal splenic artery, and retroperitoneal areas ( No.16a2 and No.16b1) in patients with SiewertⅡorⅢlocally advanced AEG.Moreover, patients with stage N3 AGE have a higher risk of retroperitoneal recurrence.The above areas should be involved in target volume delineation for postoperative radiotherapy.

Objective: To survey the conduction and evaluate the effectiveness of extracorporeal membrane oxygenation (ECMO) therapy in pediatric intensive care unit (PICU) in China mainland. Methods: In a questionnaire-based survey, we retrospectively reviewed the application of ECMO in children's hospital and general hospital in China mainland to summarize and analyze the categories of diseases and prognosis of children treated with ECMO therapy. Results: By December 31, 2017, a total of 23 hospitals using ECMO, including 22 tertiary referral hospitals and 1 secondary hospital, among which 16 were children′s hospitals and 7 were general hospitals. Thirty-seven ECMO equipment was available. A total of 518 patients treated with ECMO, within whom 323 (62.4%) successfully weaned from ECMO and 262 (50.6%) survived to discharge. Among 375 pediatric patients, 233 (62.1%) were successfully weaned from ECMO and 186 (49.6%) survived to discharge. Among 143 newborn patients, 90 (62.9%) successfully weaned from ECMO, 76 (53.1%) survived to discharge. ECMO was applied in veno-arterial (VA) mode to 501 (96.7%) patients, veno-venous (VV) mode to 14 (2.7%) patients, and VV-VA conversion mode to 3 (0.6%) patients. Sixty-nine patients required extracorporeal cardiopulmonary resuscitation (ECPR), including 20 newborn patients (29.0%) and 38 pediatric patients (71.0%), who were all with cardiovascular disease. Neonatal respiratory distress syndrome (26/61), persistent pulmonary hypertension of the newborn (PPHN) (12/61), and meconium aspiration syndrome (MAS) (11/61) are the most common pulmonary diseases in newborn patients; among whom, infants with PPHN had highest survival rate (10/12), followed by MAS (9/11). Among newborn patients with cardiovascular diseases, those who admitted were after surgery for congenital cardiac disease were the most common (54/82), while those with septic shock had the highest survival rate (2/3). In pediatric pulmonary diseases, acute respiratory distress syndrome was the most common (42/93), while plastic bronchitis was with the highest survival rate (4/4), followed by viral pneumonia (13/16). Among pediatric cardiovascular diseases, congenital cardiac defect was the most common (124/282), while fulminant myocarditis had the highest survival rate (54/77). Conclusion The application of ECMO as a rescue therapy for children with severe cardiopulmonary failure has dramatically developed in China mainland.

ObjectiveTo summarize the modeling methods, test indicators, and evaluation methods of the animal models of urticaria and provide a basis for the subsequent research on urticaria models. MethodWith the keywords of "urticaria" and "animal model" and the time interval from inception to July 13, 2022, relevant articles were retrieved from CNKI, Wanfang Data, VIP, CBM, Web of Science, Embase, and PubMed. Two evaluators independently screened the articles and extracted the publishing time, sources, animal conditions, modeling methods, modeling time, and test indicators from the articles meeting the inclusion criteria to establish a data library for quantitative statistics and analysis. ResultA total of 116 articles were included, involving 129 animal experiments (102 in Chinese and 27 in English) of urticaria. In the last three years, the studies about the animal models of urticaria presented an obvious upward trend, and the articles were dominated by dissertations. KM mice and SD rats of both females and males were mainly used for the modeling of urticaria, and the models were mainly established by passive sensitization of skin for 14-16 days. The models were mainly evaluated based on apparent indicators such as blue-stained lesion area and ear swelling, supplemented by the pathological indicators of the skin and serum. ConclusionAlthough the experimental studies of urticaria are increasing, the modeling methods lack unified modeling standards and have low coincidence with clinical symptoms. Therefore, this paper analyzed the modeling elements and evaluation criteria of urticaria animal models, and proposed that both male and female KM mice (6-8 weeks old) or SD rats (8-10 weeks old) of SPF grade should be preferentially selected for modeling. Active and passive sensitization can be combined for the modeling, and the specific modeling elements such as modeling time and sensitization times need to be further explored. The model evaluation should include four aspects of behavior, appearance, pathology, and immunity.