Objective To evaluate the value of interstitial magnetic resonance lymphography (MRL) to identify the sentinel lymph node (SLN) of breast cancer.Methods Totally 58 patients with invasive breast cancer were consecutive collected.15 mL of Gd-DTPA and 2 mL of mepivacain hydrochloride 2% were mixed and 0.5 mL of them was injected into the outside of the subareolar breast tissue.MRI was performed with Siemens 3.0 T Magnetom Trio MRI instrument using volumetric interpolated breath-hold examination sequence.Axillary lymph flow was tracked on maximum intensity projection (MIP) and sentinel lymph nodes were identified by interstitial MRL as M-SLN.All M-SLN were marked by a method of surface capsule localization.During surgery, methylene blue was used as tracer and SLNs stained by it were detected and excised by following the blue lymphatic vessels,these were designated as D-SLN.The numbers of SLNs detected by interstitial MRL and stained by methylene blue during operation were compared by paired samples rank-sum test and the correlation was analyzed by Spearman rank correlation test.Assessing the sensitivity, specificity and accuracy of interstitial MRL for diagnosing M-SLN.Results A total of 75 M-SLNs (average 1.60 ± 0.52) were identified by interstitial MRL.During operation, all M-SLNs were easily resected under the guidance of skin marker.91 D-SLNs (average 1.94±0.63) were stained by methylene blue, which was significant more than those of the M-SLNs.There was a strong correlation (Spearman's rank correlation coefficient 0.69,P<0.001) between the SLNs identified by these two methods.Interstitial MRL in diagnosing D-SLN metastasis of breast cancer had a sensitivity of 95.8%,specificity of 88.9%,and accuracy of 93.3%.Conclusion Interstitial MRL can accurately identify the axillary sentinel lymph node and guide the biopsy.It may have great clinical value in the future.

Olympic volunteer spirit is a valuable spiritual treasure of Beijing Olympics.It is of great significance for enhancing the devotion consciousness of current college students and stimulating their innovative competence to take full advantage of the social educating function of Olympic volunteer spirit.Meanwhile,the Olympic volunteer spirit is also a major carrier of CPC construction and the cultivation of Party members among college students.

OBJECTIVEThere is no safer way to transport a child than a school bus. Fatal crashes involving occupants are extremely rare events in the US. In recent years, school bus transportation began to develop in China. We want to bring advanced experience on school bus safety in Western countries such as the US to developing countries.

METHODSWe searched the papers related to school bus safety from Medline, Chinese Scientific Journals Database and the Web of the National Highway Traffic Safety Administration (NHTSA).

RESULTSThere were only 9 papers related to school bus safety, which showed that higher levels of safety standards on school buses, school bus-related transportation and environmental laws and injury prevention were the primary reasons for the desired outcome. Few school bus is related to deaths and injuries in the developed countries.

CONCLUSIONSThe developing countries should make strict environmental laws and standards on school bus safety to prevent children's injury and death.

Accident Prevention ; Accidents, Traffic ; Child ; China ; Humans ; Motor Vehicles ; Safety Management ; legislation & jurisprudence ; methods ; Schools

BACKGROUNDAtrial tachycardia or flutter is common in patients after orthotopic heart transplantation. Radiofrequency catheter ablation to treat this arrhythmia has not been well defined in this setting. This study was conducted to assess the incidence of various symptomatic atrial arrhythmias and the efficacy and safety of radiofrequency catheter ablation in these patients.

METHODSElectrophysiological study and catheter ablation were performed in patients with symptomatic tachyarrhythmia. One Halo catheter with 20 poles was positioned around the tricuspid annulus of the donor right atrium, or positioned around the surgical anastomosis when it is necessary. Three quadripolar electrode catheters were inserted via the right or left femoral vein and positioned in the recipient atrium, the bundle of His position, the coronary sinus. Programmed atrial stimulation and burst pacing were performed to prove electrical conduction between the recipient and the donor atria and to induce atrial arrhythmias.

RESULTSOut of 55 consecutive heart transplantation patients, 6 males [(58 +/- 12) years] developed symptomatic tachycardias at a mean of (5 +/- 4) years after heart transplantation. Electrical propagation through the suture line between the recipient and the donor atrium was demonstrated during atrial flutter or during recipient atrium and donor atrium pacing in 2 patients. By mapping around the suture line, the earliest fragmented electrogram of donor atrium was assessed. This electrical connection was successfully ablated in the anterior lateral atrium in both patients. There was no electrical propagation through the suture line in the other 4 patients. Two had typical atrial flutter in the donor atrium which was successfully ablated by completing a linear ablation between the tricuspid annulus and the inferior vena cava. Two patients had atrial tachycardia which was ablated in the anterior septal and lateral donor atrium. There were no procedure-related complications. Patients were free of recurrent atrial tachyarrhythmias after a follow-up of (8 +/- 7) months.

CONCLUSIONSFour electrophysiological mechanisms have been found to contribute to the occurrence of symptomatic supraventricular arrhythmias following heart transplantation. Radiofrequency catheter ablation in patients with atrial flutter/tachycardia is feasible and safe after heart transplantation.

Adult ; Aged ; Atrial Flutter ; physiopathology ; surgery ; Catheter Ablation ; Female ; Heart Transplantation ; adverse effects ; Humans ; Male ; Middle Aged ; Tachycardia, Ectopic Atrial ; physiopathology ; surgery

OBJECTIVETo investigate the effects of small interfering RNA targeting connective tissue growth factor (CTGF) on rat transforming growth factor beta (TGF beta)/Smads signal pathway.

METHODSChemically synthetic siRNA targeting CTGF was transfected into HSC T6 and then they were injected into rat livers through their intraportal veins. At the same time these rats also received CCl4 subcutaneously every three days for 6 consecutive weeks. Untreated HSC T6 or/and rats with random siRNA treatment served as controls. Total RNA or/and protein in HSC T6 and rat hepatic tissues were extracted. The expressions of CTGF and TGF beta 1, Smad2, 3 and 7 genes were detected by reverse transcription-polymerase chain reaction (RT-PCR) and/or Western blot.

RESULTSCTGF siRNA significantly reduced the expression of CTGF protein in HSC T6. At 48 h after CTGF siRNA treatment, the down-regulation of CTGF protein was the most significant, up to 94%+/-4% (t=46.196, P less than 0.01), but the expressions of TGF beta 1, Smad2, 3 and 7 mRNA showed no differences in HSC T6 compared with the blank controls. Six weeks after CCl4 injections, prominent up-regulations were observed in the gene expressions of CTGF and TGF beta 1 in saline control or siRNA-treated rat livers. Administering CTGF siRNA for six weeks markedly attenuated the induction of CTGF and TGF beta 1 genes; the expressions of CTGF and TGF beta 1 protein decreased by 95%+/-2% (F=21.234, P less than 0.01) and 74%+/-8% (F=13.464, P less than 0.05), respectively, whereas Smad2, 7 protein expressions were not affected.

CONCLUSIONSilencing the CTGF gene can suppress the TGF beta /Smads signal pathway in rat livers.

Animals ; Connective Tissue Growth Factor ; metabolism ; Gene Silencing ; Male ; RNA, Messenger ; genetics ; RNA, Small Interfering ; Rats ; Rats, Sprague-Dawley ; Signal Transduction ; Smad Proteins ; metabolism ; Transfection ; Transforming Growth Factor beta ; metabolism

OBJECTIVETo investigate whether photochemical smog emitted during the process of electric arc welding might cause oxidative stress and potential oxidative damage in the bodies of welding operators.

METHODSSeventy electric arc welding operators (WOs) and 70 healthy volunteers (HVs) were enrolled in a randomized controlled study design, in which the levels of vitamin C (VC) and vitamin E (VE) in plasma as well as the activities of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPX), and the level of lipoperoxide (LPO) in erythrocytes were determined by spectrophotometry.

RESULTSCompared with the average values of the above experimental parameters in the HVs group, the average values of VC and VE in plasma as well as those of SOD, CAT and GPX in erythrocytes in the WOs group were significantly decreased (P < 0.005-0.0001), while the average value of LPO in erythrocytes in the WOs group was significantly increased (P < 0.0001). The findings from the partial correlation analysis on the controlling of age suggested that with a prolonged duration of exposure to photochemical smog the values of VC, VE, SOD, and GPX, except for CAT, in the WOs were decreased gradually (P < 0.05-0.005), the value of LPO in the WOs was increased gradually (P < 0.001), and that with the ozone dose increased in the air in each worksite VC, VE, SOD, CAT and GPX decreased (P < 0.005-0.001), but LPO increased (P < 0.001). The findings from the reliability analysis for the VC, VE, SOD, CAT, GPX, and LPO values which were used to reflect oxidative stress and potential oxidative damage in the WOs showed that the reliability coefficients' alpha (6 items) was 0.8021, P < 0.0001, and that the standardized item alpha was 0.9577, P < 0.0001.

CONCLUSIONFindings in the present study suggest that there exists an oxidative stress induced by long-term exposure to photochemical smog in the bodies of WOs, thereby causing potential oxidative and lipoperoxidative damages in their bodies.

Adult ; Antioxidants ; metabolism ; Ascorbic Acid ; blood ; Catalase ; blood ; Erythrocytes ; metabolism ; Glutathione Peroxidase ; blood ; Humans ; Lipid Peroxides ; blood ; Middle Aged ; Nitric Oxide ; blood ; Oxidants, Photochemical ; adverse effects ; analysis ; Oxidative Stress ; Ozone ; analysis ; toxicity ; Risk Assessment ; Smog ; Superoxide Dismutase ; blood ; Vitamin E ; blood ; Welding

Cerebral cysticercosis is the most common worldwide parasitic infection of the central nervous system. Intraventricular involvement is apparent in 15% to 28.8% of cases with neural compartment infestation.' Although different forms of the disease (parenchymatous, subarachnoid, and mixed form ) have been treated successfully with chemotherapy, direct surgical excision of simple cystic lesions appears to be an adequate primary therapeutic strategy in the majority of intraventricular forms. In recent years, however, some authors have advocated the use of anthelmintic treatment in all cases of intraventricular cysts so that surgical procedures of the posterior fossa and their potential complications can be avoided. The strict definition for managing the spectrum of intraventricular infestation remains controversial. We present our experience in the treatment of a patient with primary isolated intraventricular cysticercosis.
Albendazole ; therapeutic use ; Anthelmintics ; therapeutic use ; Child ; Female ; Humans ; Neurocysticercosis ; therapy ; Ventriculoperitoneal Shunt

Objective: To assess the feasibility of coronary lfow reserve (CFR) detection by SPECT myocardial perfusion imaging using a self developed software with preliminary clinical veriifcation. Methods: CFR calculation software was developed according to Mat lab guide. A total of 16 patients were enrolled including 13 male and 3 female at the mean age of (58±11) years . CAG conifrmed that 25 coronary branches were with stenosis>50% and 23 branches were without stenosis. 2-day ATP/rest99mTc-sestamibi dynamic SPECT myocardial perfusion imaging was conducted to detect CFR. First transit counts were used to sketch the interested pulmonary artery segments and to obtain the arterial input curve of contrast agent as total PAC reached to heart. Reconstructed short-axis images were divided into 3 sections to sketch interested territories (ROI) and to obtain RMC at each territory. Estimated CFR was expressed by the ratio of MBF=RMC/PAC followed by calculating the ratio of MFR=MBFstress/MBFrest. Results: The difference between simulated value and true value could be ignored which conifrmed that our program may accurately measure CFR. The reproducibility by different operators (r=0.986) and the same operator (r=0.983) was good. CFR value in non-stenosis branches were higher than stenosis branches (1.28 ± 0.19) vs (1.10 ± 0.27),P=0.008 and CFR value in stenosis branches was negatively related to stenosis degree (r=-0.5,P=0.02). Conclusion: Our self developed software is reliable for CFR detection by SPECT myocardial perfusion imaging; preliminary study showed good application prospect in clinical practice.

Objective: We aimed to explore the feasibility and perioperative safety of performing catheter ablation and left atrial appendage closure (LAAC) in a single (one-stop) session in patients with atrial fibrillation (AF). Methods: This study is an observational study. Consecutive AF patients who underwent the combined procedure of catheter ablation and LAAC with Watchman device of Xinhua Hospital in Shanghai between March 2017 and May 2019 were prospectively enrolled. Baseline, intra-and peri-procedural parameters were evaluated. Results: A total of 358 AF patients (189 males, (69.0±8.0) years) underwent the one-stop procedure. The CHA₂DS₂-VASc score was 3.2±1.5 and HAS-BLED score was 2.4±1.1, respectively in this patient cohort. Pulmonary vein isolation was achieved in all patients, while additional linear ablation was applied in 180 (50.3%) patients, yielding immediate success rate of 99.7%. Successful Watchman implantation was achieved in all patients. The perioperative serious adverse event occurred in 14 cases (3.9%). including 6 pericardial effusions (1.7%), 1 stroke (0.3%) and 5 vascular complications (1.4%), yielding procedure-related complication rate of 3.4%. In addition, 2 (0.6%) new-onset heart failures occurred postoperatively. There was no major bleeding or death during the perioperative period. Conclusions: Combined catheter ablation and LAAC can be successfully and safely performed in AF patients with high stroke risk. Follow-up data are needed to evaluate the outcome of this one-stop procedure.
Aged ; Atrial Appendage/surgery* ; Catheter Ablation ; China ; Feasibility Studies ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome

Objective:To study the efficacy of integrative medicine on congenital muscular torticollis. Methods:From October, 2017 to September, 2019, 80 children with congenital muscular torticollis were divided into group 1 (n = 40) and group 2 (n = 40) according to different treatment schemes. Group 1 received comprehensive physiotherapy, including passive stretching, head control training, posture correction and family rehabilitation. Group 2 received Tuina in addition. Before and six months after treatment, the root mean square (RMS) of surface electromyography of bilateral sternocleidomastoid muscles in supine neutral position, neck rotation and stretch, and the range of motion of passive neck rotation and lateral flexion, and the angle of head deviation from the midline to the affected side were compared. Results:Before treatment, the RMS of sternocleidomastoid muscle in each position was lower in the affected side than in the healthy side (P < 0.01), and the range of motion of neck when lateral flexion to the healthy side and rotation to the affected side was less than that of the other side (P < 0.01) in both groups; however, no significant difference was found between two groups (P > 0.05). After treatment, the RMS of EMG of sternocleidomastoid muscle in each position, and the range of motion of neck when lateral flexion to the healthy side and rotation to the affected side improved (|t| > 3.290, P < 0.01) in both groups, and were better in group 2 than in group 1 (t > 2.401, P < 0.05); the angle of head deviation from the midline to the affected side significantly decreaed (t > 15.075, P < 0.001) in both groups, and was significantly less in group 2 than in group 1 (t = -4.971, P < 0.001). Conclusion:Integrative medicine is effective on infant with congenital muscular torticollis, which is superior to comprehensive physiotherapy only.