Breast cancer is the most common malignant tumor among women, and early diagnosis, coupled with optimized treatment strategies is crucial for improving the prognosis. In recent years, with the advancement of nanotechnology, manganese-based nanomaterials have shown potential in various aspects of early breast cancer diagnosis, drug delivery, and tumor treatment. Compared to other nanomaterials, manganese-based nanomaterials exhibit excellent biocompatibility and have become a significant focus in the research of breast cancer diagnosis and treatment.

OBJECTIVE To investigate the efficacy and safety of clobazam in the additional treatment of refractory epilepsy in children， and provide reference for clinically safe and rational drug use. METHODS The literatures about additional clobazam treatment for refractory epilepsy in children were searched from PubMed， The Cochrane Library， Embase， CNKI， VIP and Wanfang database during the inception to November 2023. After literature screening and data extraction， the quality of included literature was evaluated according to quality evaluation tool for methodological evaluation indicators of non-randomized controlled trial， and then meta-analysis of single-group rate and sensitivity analysis were performed by using RevMan 5.3 software. RESULTS Finally， 18 one-arm studies were included， with a total of 1 424 children. The results showed that compared with before additional treatment， the proportion of patients with seizures-free （proportion of patients with seizure reduction of 100%） was 24%[95%CI （0.18，0.32）， P＜0.000 01] after conversion； the proportion of patients with seizure reduction ≥75% was 32%[95%CI（0.25，0.40）， P＜0.000 1] after conversion； the proportion of patients with seizure reduction ≥50% was 53%[95%CI（0.44，0.61），P＜0.000 01]； the proportion of patients with seizure reduction ＜50% or no change was 35%[95%CI（0.24，0.49），P＝0.04] after conversion； the proportion of patients with seizure increase was 9%[95%CI（0.05，0.18），P＜0.000 01] after conversion. The proportion of patients with adverse reactions was 31%[95%CI（0.23，0.40），P＜0.000 1] after conversion； the proportion of patients with discontinuation due to adverse reactions was 10%[95%CI（0.07， 0.15）， P＜0.000 01] after conversion. The common adverse drug reactions were drowsiness， fatigue and behavior change， etc. The results of the sensitivity analysis showed that the study was robust. CONCLUSIONS Clobazam is an effective additional therapy for refractory epilepsy in children， but its adverse effects should be vigilant.

Objective To investigate the clinical efficacy and safety of 1 565 nm non-ablative fractional laser combined with topical minoxidil and oral finasteride in the treatment of patients with androgenetic alopecia(AGA).Methods Seventy-five male AGA patients with Norwood-Hamilton classification grade Ⅱ-Ⅲ,were randomly assigned into three groups:the control group 1,the control group 2 and the experimental group,with 25 cases in each group.Patients in the control group 1 received topical 5%minoxidil(1 mL,twice daily).Patients in the control group 2 were treated with both topical 5%minoxidil and oral finasteride(1 mg,once daily).Patients in the experimental group received a combined therapy of 1 565 nm non-ablative fractional laser in addition to topical 5%minoxidil and oral finasteride.Hair overall efficacy was evaluated using a 7-point rating scale after 24 weeks of treatment.Hair diameter and density were measured using a dermoscope.Patient satisfaction was assessed post-treatment,and adverse reactions were recorded.Results The overall efficacy of hair in the experimental group was superior to the control group 1 and the control group 2.There were no significant differences in hair density and hair diameter before treatment between the three groups(P＞0.05).After treatment,hair diameter and density increased in all three groups compared to baseline values(P＜0.05),and the hair diameter and hair density of the experimental group were higher than those of the control group 1 and the control group 2(P＜0.05).Patient satisfaction in the experimental group was higher than that in the control group 1 and the control group 2(P＜0.05).Patients in the experimental group experienced tolerable pain and burning sensations during laser treatment,and the symptoms were self-alleviated within a few hours.There were no serious adverse reactions reported in any group.Conclusion The combination therapy of 1 565 nm non-ablative fractional laser,5%minoxidil,and finasteride demonstrates significantly better efficacy in the treatment of AGA than minoxidil and finasteride alone drug therapy.

OBJECTIVE To investigate the efficacy and safety of different doses of zinc in the treatment of diarrhea in children， and to provide a reference for clinical safe and rational drug use. METHODS Retrieved from PubMed， Cochrane Library， Embase database， randomized controlled trials about zinc （zinc group） versus placebo or conventional treatment （control group） in the treatment of diarrhea in children were collected from the inception to October 2022. Then， the quality of the included literature was evaluated by the Cochrane Handbook 6.0， and meta-analysis and sensitivity analysis were performed by RevMan 5.3 software. RESULTS Finally， 25 RCTs were included， with a total of 8 618 children. The results of meta-analysis showed that in terms of duration of diarrhea， in zinc ＜20 mg group， the zinc group was significantly shorter than the control group [SMD＝ －0.39， 95%CI（－0.71， －0.08）， P＝0.01]， but in subgroups of ＜6 months old， there was no significant difference between the two groups [SMD＝0.01， 95%CI（－0.10， 0.11）， P＝0.88]. In zinc 20 mg group， the zinc group was significantly shorter than the control group [SMD＝－0.52， 95%CI（－0.80， －0.23）， P＝0.000 3]. In zinc ＞20 mg group， the zinc group was significantly shorter than the control group [SMD＝－0.83， 95%CI（－1.39， －0.27）， P＝0.004]. In zinc ＞10 mg （age ≤12 months） or zinc ＞ 20 mg （age ＞12 months） group （short for “constant dose group”）， the zinc group was significantly shorter than the control group [SMD＝－0.16， 95%CI（－0.27， －0.06）， P＝ 0.003]. In the aspect of diarrhea rate after 7 days of treatment，there was no significant difference in the diarrhea rate after 7 E-mail：lihuiying@etyy.cn days of treatment between the zinc group and the control group： in zinc ＜20 mg group[OR＝1.28，95%CI （0.96，1.70），P＝0.09]， in zinc 20 mg group [OR＝0.40， 95%CI （0.15，1.01），P＝ 0.05]， in constant dose group [OR＝0.64， 95%CI （0.28， 1.44）， P＝0.28]. In terms of vomiting rate， in zinc ＜20 mg group， the vomiting rate of zinc group was significantly higher than that of the control group [OR＝2.13， 95%CI （1.68， 2.70）， P＜0.001]； in constant dose group， vomiting rate of zinc group was significantly higher than that of the control group [OR＝1.84， 95%CI （1.44， 2.34）， P＜0.001]. CONCLUSIONS Zinc can significantly shorten the duration of diarrhea in children（6 months and above）， but low doses can increase the risk of vomiting， which should be taken attention in clinical.

Nonalcoholic steatohepatitis (NASH) is a spectrum of chronic liver disease characterized by hepatic lipid metabolism disorder. Recent reports emphasized the contribution of triglyceride and diglyceride accumulation to NASH, while the other lipids associated with the NASH pathogenesis remained unexplored. The specific purpose of our study was to explore a novel pathogenesis and treatment strategy of NASH via profiling the metabolic characteristics of lipids. Herein, multi-omics techniques based on LC-Q-TOF/MS, LC-MS/MS and MS imaging were developed and used to screen the action targets related to NASH progress and treatment. A methionine and choline deficient (MCD) diet-induced mouse model of NASH was then constructed, and Schisandra lignans extract (SLE) was applied to alleviate hepatic damage by regulating the lipid metabolism-related enzymes CES2A and CYP4A14. Hepatic lipidomics indicated that MCD-diet led to aberrant accumulation of phosphatidylethanolamines (PEs), and SLE could significantly reduce the accumulation of intrahepatic PEs. Notably, exogenous PE (18:0/18:1) was proved to significantly aggravate the mitochondrial damage and hepatocyte apoptosis. Supplementing PE (18:0/18:1) also deteriorated the NASH progress by up regulating intrahepatic proinflammatory and fibrotic factors, while PE synthase inhibitor exerted a prominent hepatoprotective role. The current work provides new insights into the relationship between PE metabolism and the pathogenesis of NASH.

Glioblastoma (GBM) is the most common and aggressive malignant brain tumor in adults and is poorly controlled. Previous studies have shown that both macrophages and angiogenesis play significant roles in GBM progression, and co-targeting of CSF1R and VEGFR is likely to be an effective strategy for GBM treatment. Therefore, this study developed a novel and selective inhibitor of CSF1R and VEGFR, SYHA1813, possessing potent antitumor activity against GBM. SYHA1813 inhibited VEGFR and CSF1R kinase activities with high potency and selectivity and thus blocked the cell viability of HUVECs and macrophages and exhibited anti-angiogenetic effects both in vitro and in vivo. SYHA1813 also displayed potent in vivo antitumor activity against GBM in immune-competent and immune-deficient mouse models, including temozolomide (TMZ) insensitive tumors. Notably, SYHA1813 could penetrate the blood-brain barrier (BBB) and prolong the survival time of mice bearing intracranial GBM xenografts. Moreover, SYHA1813 treatment resulted in a synergistic antitumor efficacy in combination with the PD-1 antibody. As a clinical proof of concept, SYHA1813 achieved confirmed responses in patients with recurrent GBM in an ongoing first-in-human phase I trial. The data of this study support the rationale for an ongoing phase I clinical study (ChiCTR2100045380).

Humans ; East Asian People ; Surveys and Questionnaires ; Vitiligo/epidemiology*

Objective To observe the effect of muscone in regulating fatty acid synthase(Fas)/fatty acid synthase ligand(FasL)signaling pathway on cardiomyocyte apoptosis in rats with diabetic car-diomyopathy(DCM),and explore the mechanism of Chen Shuquan's theory of"warming and clear-ing collaterals"in treating DCM.Methods SD rats were divided into blank group,DCM group,low-dose muscone group(0.68 mg/kg muscone),high-dose muscone group(2.72 mg/kg muscone),met-formin group(140 mg/kg metformin),and high-dose muscone+recombinant human FasL protein(rh-FasL)group(2.72 mg/kg muscone+0.017 mg/kg rh-FasL),with 12 rats in each group.Except for the blank group,rats in all other groups were fed with high-fat feed combined with intraperitoneal injection of streptozotocin to construct a DCM rat model.After successful modeling,the rats were administered once a day for 6 weeks.After the last treatment,the changes in fasting blood glucose,left ventricular ejection fraction(LVEF),and left ventricular short axis shortening rate(LVFS)in rats were detected;Hematoxylin-eosin(HE)staining and Masson staining were applied to detect pathological damage and fibrosis degree of myocardial tissue,respectively.Spectrophotometry was applied to detect the activity of superoxide dismutase(SOD)and the content of malondialdehyde(MDA)in myocardial tissue;TUNEL staining was applied to observe myocardial cell apoptosis;and Western blot was applied to detect the expression of cleaved aspartate specific cysteine protease-3(cleaved-caspase-3),Bcl-2 associated X protein(Bax),Fas,and FasL proteins in myocardial tis-sue.Results Compared with the blank group,the pathological damage to the myocardial tissue of rats in the DCM group was severe,the fasting blood glucose,MDA content,myocardial collagen ar-ea fraction and apoptosis rate of myocardial cell,and expression of cleaved-caspase-3,Bax,Fas,and FasL proteins increased,while the LVEF,LVFS,and activity of SOD decreased(P＜0.05);compared with DCM group,pathological damage of myocardial tissue was reduced in the low-dose muscone group,the high-dose muscone group and the metformin group,and fasting blood glucose,MDA content,myocardial collagen area fraction,myocardial apoptosis rate and cleaved-caspase-3,Bax,Fas and FasL protein expression were decreased,and the activities of LVEF,LVFS and SOD were increased(P＜0.05).Compared with low-dose muscone group,pathological damage of myocar-dial tissue was relieved in the high-dose muscone group and the metformin group,fasting blood glu-cose,MDA content,myocardial collagen area fraction,myocardial apoptosis rate,cleaved-caspase-3,Bax,Fas and FasL protein expression were decreased,and LVEF,LVFS and SOD activities were in-creased(P＜0.05).Compared with the high-dose muscone group,the pathological damage to the myocardial tissue of rats in the high-dose muscone+rh-FasL group was intensified,the fasting blood glucose,MDA content,and expression of cleaved-caspase-3,Bax,Fas,and FasL proteins increased,the LVEF,LVFS,and activity of SOD decreased(P＜0.05).Conclusion Muscone may inhibit oxidative stress and cardiomyocyte apoptosis in DCM rats by inhibiting the Fas/FasL pathway.

Objective To observe the effect of muscone in regulating fatty acid synthase(Fas)/fatty acid synthase ligand(FasL)signaling pathway on cardiomyocyte apoptosis in rats with diabetic car-diomyopathy(DCM),and explore the mechanism of Chen Shuquan's theory of"warming and clear-ing collaterals"in treating DCM.Methods SD rats were divided into blank group,DCM group,low-dose muscone group(0.68 mg/kg muscone),high-dose muscone group(2.72 mg/kg muscone),met-formin group(140 mg/kg metformin),and high-dose muscone+recombinant human FasL protein(rh-FasL)group(2.72 mg/kg muscone+0.017 mg/kg rh-FasL),with 12 rats in each group.Except for the blank group,rats in all other groups were fed with high-fat feed combined with intraperitoneal injection of streptozotocin to construct a DCM rat model.After successful modeling,the rats were administered once a day for 6 weeks.After the last treatment,the changes in fasting blood glucose,left ventricular ejection fraction(LVEF),and left ventricular short axis shortening rate(LVFS)in rats were detected;Hematoxylin-eosin(HE)staining and Masson staining were applied to detect pathological damage and fibrosis degree of myocardial tissue,respectively.Spectrophotometry was applied to detect the activity of superoxide dismutase(SOD)and the content of malondialdehyde(MDA)in myocardial tissue;TUNEL staining was applied to observe myocardial cell apoptosis;and Western blot was applied to detect the expression of cleaved aspartate specific cysteine protease-3(cleaved-caspase-3),Bcl-2 associated X protein(Bax),Fas,and FasL proteins in myocardial tis-sue.Results Compared with the blank group,the pathological damage to the myocardial tissue of rats in the DCM group was severe,the fasting blood glucose,MDA content,myocardial collagen ar-ea fraction and apoptosis rate of myocardial cell,and expression of cleaved-caspase-3,Bax,Fas,and FasL proteins increased,while the LVEF,LVFS,and activity of SOD decreased(P＜0.05);compared with DCM group,pathological damage of myocardial tissue was reduced in the low-dose muscone group,the high-dose muscone group and the metformin group,and fasting blood glucose,MDA content,myocardial collagen area fraction,myocardial apoptosis rate and cleaved-caspase-3,Bax,Fas and FasL protein expression were decreased,and the activities of LVEF,LVFS and SOD were increased(P＜0.05).Compared with low-dose muscone group,pathological damage of myocar-dial tissue was relieved in the high-dose muscone group and the metformin group,fasting blood glu-cose,MDA content,myocardial collagen area fraction,myocardial apoptosis rate,cleaved-caspase-3,Bax,Fas and FasL protein expression were decreased,and LVEF,LVFS and SOD activities were in-creased(P＜0.05).Compared with the high-dose muscone group,the pathological damage to the myocardial tissue of rats in the high-dose muscone+rh-FasL group was intensified,the fasting blood glucose,MDA content,and expression of cleaved-caspase-3,Bax,Fas,and FasL proteins increased,the LVEF,LVFS,and activity of SOD decreased(P＜0.05).Conclusion Muscone may inhibit oxidative stress and cardiomyocyte apoptosis in DCM rats by inhibiting the Fas/FasL pathway.

Objective:To analyze the burden and benefit finding of illness among home caregivers of patients with cognitive impairment after stroke, so as to provide references for formulating targeted intervention strategies.Methods:Using the intentional sampling method, 15 home caregivers of patients with cognitive impairment after stroke treated in the First Affiliated Hospital of Air Force Medical University from July 2019 to December 2019 were selected as research objects. The semi-structured interview was conducted by phenomenological method, and the interview data were analyzed by Colaizzi analysis method.Results:The burden of home caregivers of patients with cognitive impairment after stroke was mainly manifested as excessive psychological pressure, impaired health, heavy financial burden, and separation from social life. The benefit finding of illness was mainly manifested in the respect for life, the improvement of health behavior ability, and the enhancement of family and social responsibility.Conclusions:Home caregivers of patients with cognitive impairment after stroke have both a negative sense of burden and a positive sense of benefit finding of illness. Medical workers should make a dialectical analysis to help resolve the burden of negative feelings, actively cultivate a sense of benefit finding of illness, and improve their behavioral ability of care.