Objective To compare the efficacy and safety of different cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) combined with endocrine therapy (ET) for the treatment of hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2−) advanced or metastatic breast cancer. Methods Randomized controlled trials (RCTs) on CDK4/6i for the treatment of HR+/HER2− metastatic or advanced breast cancer were retrieved from databases including PubMed, EMbase, Web of Science, The Cochrane Library, CNKI, Wanfang, VIP, and SinoMed, with the search period ranging from database inception to August 2023. Bayesian network meta-analysis was conducted using R 4.2.0 software. Results A total of 18 RCTs from 25 articles, involving 8 031 patients and 11 treatment regimens, were included. There was no significant difference in progression-free survival (PFS) or overall survival (OS) among different CDK4/6i+ET combinations. The highest cumulative probability for PFS was observed with dalpiciclib (DAL)+fulvestrant (FUL), while ribociclib (RIB)+FUL ranked first for OS. In terms of efficacy, abemaciclib (ABE)+aromatase inhibitors (AI) and ABE+FUL ranked first in objective response rate and clinical benefit rate, respectively. Regarding safety, statistically significant difference in grade 3-4 adverse events was observed among certain types of CDK4/6i (P<0.05). Conclusion Current evidence suggests that CDK4/6i+ET is superior to ET alone for the treatment of HR+/HER2− advanced/metastatic breast cancer. Different CDK4/6i+ET combinations demonstrate comparable or similar efficacy; however, the incidence of adverse reactions is higher with combination therapy. Treatment regimens should be selected based on individual conditions.

3-iodothyronamine（T1AM）is an endog enous derivative of thyroid hormone. It can also be used as exogenous drug. It can play pharmacological effects such as reducing cardiac output and coronary flow ，slowing heart rate ，promoting lipolysis ， reducing basic metabolism and improving learning and memory ability. Its regulatory effect on metabolism is similar to that of thyroxine，but regulatory effect on heart and thermogenic function is opposite to that of thyroxine. As a new chemical messenger ， T1AM can exert different pharmacological effects through a variety of receptors and signal pathways. This review summarizes the research progress of various pharmacological effects and mechanisms of exogenous T 1AM，in order to provide new therapeutic drugs of cardiovascular ，metabolic diseases and nervous system diseases.

Objective To analyze the status, trends and issues of professionals in rehabilitation institutions in China, and provide policy recommendations on rehabilitation professional development.Methods The data from database and statistical bulletin of CDPF has been analyzed using descriptive analysis and deviation analysis.Results The quantity of professionals of rehabilitation institutions increased 24,900 (12.62%) in 2016. Average professionals per institution had been decreased from 33.89 in 2012 to 28.33 in 2016. In regard to the structure of distribution, the rehabilitation professionals at provincial level had been decreased 21.95% in 2015 than that of in 2012. Both training programs and the number of trainees from rehabilitation institutions had decreased.Conclusion There were big gap between services provision and needs of professionals. The distribution of professionals at provincial, city and county level was under optimization. The on-job training for rehabilitation professionals should be improved. It is recommendated to develop national plan for professionals development to meet the needs of rehabilitation services, advance the on-job training for professionals, develop the higher education of rehabilitation and improve attractiveness of rehabilitation to retain and recruit more professionals.

Objective To investigate the feasibility of labeling mice spleen lymphocytes with superparamagnetic iron oxide(SPIO)and in vitro MR imaging of the labeled cells.Methods Spleen lymphocytes of 5 mice were isolated and then labeled with SPIO of 100,50,25,15,10,5 μg/ml,which was previously prepared with PLL.Prussian blue staining was performed to show the intracellular iron.Cell viability was compared among fresh,labeled and unlabeled cells.Different concentrations of mice spleen lymphocytes were screened using 3.0 T MR on T2WI,T2 * WI and SWI sequences in vitro.Cell viability was compared using independent-sample t test between groups.The MRI values among different groups were compared using one-way ANOVA.Results SPIO prepared with PLL could successfully label mice spleen lymphocytes,the optimum concentration of SPIO was 5 μg/ml.The Prussian blue staining showed intracellular blue spots and a labeling efficiency of(93.6 ± 2.1)％.Three groups of fresh,labeled and unlabeled cells showed a Trypan blue staining result of(94.8 ± 3.1)％,(88.7 ± 2.7)％,and(88.9 ±3.2)％,respectively; no statistically significant difference was found in cell viability between labeled and unlabeled lymphocytes(t =0.281,P ＞ 0.05); however,the cell viability of fresh cells were statistically significant higher than the labeled and unlabeled lymphocytes(t =8.125 and 7.253 respectively,P ＜0.05for all).Among the T2 WI,T2 * WI and SWI sequences under the same concentrations of cells,the SWI sequence was the most sensitive.Conclusions The mice spleen lymphocytes can be effectively labeled with SPIO with no impact on cell viability,and MR can be used to track these labeled cells in vitro.The SWI sequence is the most sensitive.

Livedoid vasculopathy is a rare chronic relapsing disorder characterised by recurrent painful thrombotic and vasculitic ulcers on the legs. We present the cases of two Indian women with livedoid vasculopathy that were found to be associated with an underlying factor V Leiden heterozygous mutation. There were no other thrombotic manifestations, and livedoid vasculopathy was the sole presenting feature of the factor V Leiden mutation, although this could also be coincidental. Initial treatment with high-dose immunosuppressive therapy was suboptimal, and the addition of pentoxifylline and antiplatelet therapy was crucial in achieving disease control and remission. These cases highlight the possible association with an underlying prothrombotic disorder, such as factor V Leiden mutation, in patients with livedoid vasculopathy. Although this association is relatively uncommon, it is more relevant to Indian patients, as the presence of factor V Leiden mutation is highest in this ethnicity as compared to the local Malay and Chinese populations.
Adult ; Blood Vessels ; pathology ; DNA ; genetics ; Factor V ; genetics ; metabolism ; Female ; Humans ; Leg Ulcer ; blood ; genetics ; pathology ; Livedo Reticularis ; blood ; diagnosis ; genetics ; Point Mutation ; Polymerase Chain Reaction ; Skin ; blood supply ; Skin Diseases, Vascular ; blood ; genetics ; pathology

Seventy two patients with tension type headache (TTH) were divided randomly into two groups: massage group was treated with massage on the trigger points of neck muscles, and control group was treated with drugs.The frequency, duration, severity of TTH, use of painkiller and electromyography of pericranial muscle (temporalis muscle and masseter muscle ) were recorded before and after treatment.The frequency, duration and severity of TTH, the frequency of painkiller use, and amplitude and frequency on electromyography of pericranial muscles in massage groups after treatment were reduced significantly (P ＜0.05 ) .In summary, massage on the trigger points in neck muscles has significant therapeutic effects for TTH.

Objective To observe the pathologic changes of the rabbit sciatic nerves after the exposure of high intensity ultrasound(HIU) (7.1 MHz,45.86 W/cm2)and to establish the experimental base for protection of the nerves near the organs and tissues treated with HIU. Methods The rabbit sciatic nerves were exposed to HIU of different doses as defined by the action time of the ultrsound(0, 15, 25 and 50 seconds, respectively); The Pathological changes of the nerves were observed at different times after exposed to HIU(1 week,2 weeks,1 month,3 months and 6 months). Results In 0 s (45.86 W/cm2?0 s)group, no significant pathological changes were observed. In 15 s(45.86 W/cm2?15 s) group, slight deformation of the myelin sheath were observed and recovery took place at 2 weeks. In 25 s (45.86 W /cm2?25 s) group, the nerves became broken partly and recovered at 3 months. In 50 s(45.86 W/cm2?50 s) group, great part of the nerves got coagulation necrosis and had not recovered at 6 months. Conclusion The larger the dosage of HIU, the higher degree the injury of the sciatic nerve, the more difficult the nerves to get repaired.

Objective:To explore the feasibility and stability of using oleic acid to establish acute respiratory distress syndrome(ARDS) model in Beagle dogs.Methods:A total of 25 Beagle dogs were injected oleic acid with a speed of 0.25?0.03ml/Kg through jugular vein after being anesthetized.The gas ventilation index,oxygen metabolism,histopathological changes,chest-ray scan and stability of each index after establishing the ARDS situation were continuously monitored and evaluated.Results:All 25 dogs were reached the diagnosis criteria of ARDS in 4.16?0.92 hours after injection of oleic acid,The arterial PaCO2 of the animals was 27.98?8.25mmHg,PaO2 was 65.40?11.48mmHg,and PaO2/FiO2 was 182.3?29.6.After mechanical ventilation treatment,PaO2/FiO2≤200.Pulmonary mesenchyme,and alveolus edema,bleeding,shrinkage and transparent formation were seen under microscope.There was darkness or coarse shadow in the lung by the X-ray scan.Conclusions:Through injection of oleic acid via jugular vein,a Beagle dog ARDS model may be quickly established with stable changes of hemodynamics,pulmonary mechanics and histology.

Objective To determine the changes in action potential peak value and maximal nerve conduction velocity of rabbit sciatic nerve after being exposed to different doses of high intensity ultrasound (HIU) and establish the experimental basis for the use of HIU in patients with refractory pain. Methods Eighty New Zealand white rabbits of either sex weighing 2.0-2.5 kg, aged 5-10 months were randomly divided into four groups with 20 rabbits in each group :group Ⅰ 0 second;group Ⅱ 15 seconds;group Ⅲ 25 seconds and group Ⅳ 50 seconds. The animals were anesthetized and placed in the prone position. Sciatic nerves were exposed to 4 different doses of HIU (7.1 MHz, 40 W/cm2 f55 0 s, 15 s, 25 s, 50 s) in the four groups. The animals were allowed to recover. At 5 intervals (1 and 2 weeks, 1, 3 and 6 months) after exposure to HIU, 4 animals in each group were anesthetized and recording electrodes were placed on sciatic nerves at 2 cm distal to the site of HIU radiation, tibial and sural cutaneous nerves. The amplitude (peak value) and latency of action potential and maximal conduction velocity of the nerves were recorded. Sciatic nerves were obtained from one of the four animals for light and electron microscopic examination. Results The larger was the dose of HIU, the more time was needed for the injuried nerve to recover. In group Ⅰ (0 s) there were no significant changes in action potential peak value and maximal nerve conduction velocity at any interval after exposure to HIU;in group Ⅱ (15 s) there were slight changes in the electrophysiological parameters and the changes recorded on tibial nerve returned to normal soon while those recorded on sural cutaneous nerve returned to normal one month later; in group Ⅲ (25 s) there were significant changes in the electrophysiological parameters and it took 3 months for tibial nerve but 6 months for sural cutaneous nerve to recover;in group Ⅳ (50s) the nerves were completely blocked, no action potential was recorded and no recovery was observed after 6 months. Light and electron microscopic examination showed that in group 1 no significant changes of nerves were observed; in group Ⅱ there was slight deformation of myelin sheath which returned to normal 2 weeks later; in group Ⅲ sheath was broken or lost, and axon degeneration was observed at 1 week after exposure to HIU and the changes disappeared 1 month later; in group Ⅳ necrosis of the nerve was observed and no recovery was observed 6 months later. Conclusion HIU can be used for the treatment of refractory pain. Analgesia can be achieved with loss of only part of motor function. The nerve can be permanently blocked by HIU if necessary.

Objective To investigate the ablative effect of high intensity focused ultrasound (HIFU) on the celiac ganglion (CG) and the subsequent change in gastro-intestinal (GI) function. Methods Thirty-three New Zealand white rabbits of both sexes aged 5-10 months weighing 1.6-2.7 kg were randomly divided into 3 groups (n=11 each) according to the dose of HIFU (intensity?time) : group A 50 W?cm-2?10 sec; group B 10 W?cm-2 ?10 sec and group C no HIFU. Upper abdomen was opened through median incision under general anesthesia. CG was exposed to HIFU. One animal was killed in each group at 4h after operation and CG was obtained for microscopic examination. The GI function was observed for 3 days in the rest 10 animals in each group. The motor function of the hind limbs and the appearance of skin were observed for 30 days after operation. One animal in each group was killed 30 days after HIFU and CG was obtained for microscopic examination. Results Stroma edema was observed in group A and B 4 hours after HIFU. The neurons became smaller and the nuclei condensed, and fiber hyperplasia and satellite cells were observed in CG 30 days after HIFU in group A and B. The incidence of diarrhea was significantly increased in group A as compared with group B and C (P