Objective To investigate the imaging characteristics of lymphoscintigraphy in postoperative breast cancer patients and evaluate its diagnostic value in breast cancer-related lymphedema (BCRL).Methods Seventy-nine breast cancer patients who underwent mastectomy and axillary lymph node dissection were studied. Patients ( n = 158 ) were divided into the study ( affected arms, n = 79 ) and control groups ( contralateral arms, n = 79). After subcutaneous injection of 99Tcm-dextran via the first interphalangeal space, lymphoscintigraphy was performed at 10 min, 1,3, 6 h respectively. Sensitivity and specificity of lymphoscintigraphy for detection of BCRL were calculated. Results There were significant differences in the amount of visualized lymph nodes, lymphatic integrity and backflow pattern between the two groups.Lymphatic drainage was preserved in 96.2% (76/79) of the contralateral arms and only 5.1% (4/79) of affected arms. 87.3% (69/79) and 74.7% (59/79) of control arms had ≥2 lymph nodes in axilla and supraclavicular regions, respectively; while none ( 0/79 ) and 5.1% (4/79) of the affected arms had ≥ 2lymph nodes in both regions, respectively. Four backflow patterns of radiotracer in subcutis were observed in the affected arms: normal (2.5% , 2/79), dilatated (55.7%, 44/79), diffused (36.7%, 29/79) and without backflow (5.1%, 4/79 ). The sensitivity and specificity of "lymphatic integrity" and "backflow pattern" on lymphoscintigraphy for detecting BCRL were 97.5% (77/79) and 96.2% (76/79), 94.8%(73/77) and 100.0% (81/81), respectively. Conclusion Lymphoscintigraphy is a noninvasive, accurate and effective imaging modality for the evaluation of BCRL.

Objective To evaluate the lymphoscintigraphic imaging characteristics for the patients with lower limb lymphedema and to establish a novel grading system for the injury to lower limb lymphatic system. Methods One hundred and sixty six consecutive patients (332 lower limbs) with lower limb lymphedema after surgical and(or) radiotherapy treatment for gynecological cancer were recruited into this retrospective study. The lymphoscintigraphy studies were performed after subcutaneous injection of 111～185 MBq (0. 1～0. 15 ml) of 99Tcm-DX into the webbed space between the first and second toes of both feet. Based on the integrity of lymphatic vessel and the extension of dermal diffusion on lymphoscintigram,the lymphatic injury to the lower limb was graded as 0, 1,2 and 3 respectively. The lymphedema of the limb was staged as 0, Ⅰ , Ⅱ a, Ⅱ b, Ⅲ by the standard of Consensus Document of the International Society of Lymphology (ISL). Chi square test was carried out to validate the established grading system for the assessment of the injury to the lower limb lymphatic system. Results The lymphoscintigraphic imaging characteristics included lymphatic blockage, dermal backflow, no visualization of lymphatic or lymph node, lymphocele and lymph fistula in the lower limb, pelvis and abdomen. There were 65 (19.6%), 71 (21.4%),131 (39.5%), 62 (18.7%) and 3 (0.9%) limbs staged as 0, Ⅰ , Ⅱa, Ⅱb, and Ⅲ for lymphedema while 36(10.8%), 79(23.8%), 116(34.9%) and 101 (30.4%) limbs graded as 0, 1, 2, and 3 for lymphatic injury. There was a statistically significant correlation between the grading methods (χ2 =313.483, P <0.001). The patients who underwent radiotherapy had a higher incidence rate of grade 2 and 3 (70.5%, 158/224) than those who underwent surgery (53.6%, 59/108) (χ2 = 9.662, P = 0.022).The patients with erysipelas had a higher incidence rate of grade 3(73.1%, 38/52) than those without erysipelas (43.9%, 50/114) (χ2= 12.238, P<0.001). The incidence rate of grade 3 increased with the duration of lymphedema after treatment: 36.6% (34/93) for less than 1.5 years, 72.3% (34/47) for between 1.5 to 5 years, and 76.9% (20/26) for more than 5 years (χ2 = 23.123, P<0.001). The grade of lymphatic injury showed no significant difference among 3 types of gynecological cancers (χ2 = 4.000, P =0.676), or between the patients with and without chemotherapy (χ2 =0.411, P=0.938). Conclusions Lymphoscintigraphy is a reliable modality to diagnose lower limb lymphedema after treatment for gynecological cancer. The injury grading system could provide objective assessment of the lymphatic damage.

OBJECTIVE: To determine whether the introducer curving technique is useful in decreasing the degree of tilting of transfemoral Tulip filters. MATERIALS AND METHODS: The study sample group consisted of 108 patients with deep vein thrombosis who were enrolled and planned to undergo thrombolysis, and who accepted transfemoral Tulip filter insertion procedure. The patients were randomly divided into Group C and Group T. The introducer curving technique was Adopted in Group T. The post-implantation filter tilting angle (ACF) was measured in an anteroposterior projection. The retrieval hook adhering to the vascular wall was measured via tangential cavogram during retrieval. RESULTS: The overall average ACF was 5.8 +/- 4.14 degrees. In Group C, the average ACF was 7.1 +/- 4.52 degrees. In Group T, the average ACF was 4.4 +/- 3.20 degrees. The groups displayed a statistically significant difference (t = 3.573, p = 0.001) in ACF. Additionally, the difference of ACF between the left and right approaches turned out to be statistically significant (7.1 +/- 4.59 vs. 5.1 +/- 3.82, t = 2.301, p = 0.023). The proportion of severe tilt (ACF > or = 10degrees) in Group T was significantly lower than that in Group C (9.3% vs. 24.1%, chi2 = 4.267, p = 0.039). Between the groups, the difference in the rate of the retrieval hook adhering to the vascular wall was also statistically significant (2.9% vs. 24.2%, chi2 = 5.030, p = 0.025). CONCLUSION: The introducer curving technique appears to minimize the incidence and extent of transfemoral Tulip filter tilting.
Blood Vessel Prosthesis Implantation/instrumentation/*methods ; Chi-Square Distribution ; Device Removal ; Double-Blind Method ; Female ; Femoral Vein ; Humans ; Male ; Middle Aged ; Prosthesis Design ; Pulmonary Embolism/*prevention & control ; Statistics, Nonparametric ; Thrombolytic Therapy ; Treatment Outcome ; *Vena Cava Filters ; Venous Thrombosis/*complications

OBJECTIVEIn order to understand the normal physical growth of Chinese children, data of children aged from 0 to 7 years from urban and rural areas of nine Chinese cities in 2005 were analyzed.

METHODSThe original data of height and weight were drawn into growth curves charts by Graphpad Prism 5.0 software according to the different age groups. The children were classified into five age groups: 0-3 months, 4-6 months, 7-12 months, 13-24 months, and 2-7 years.

RESULTSThe average birth weight was 3.3 kg and the height averaged 50 cm. The average monthly weight gain was 1.0-1.2 kg and the average monthly increase of height was 4 cm in the 0-3 months group. By 3 months of age, the weight and height averaged 6.6 kg and 62 cm, respectively. In the 4-6 months group, the growth rate was reduced to a half of the 0-3 months group, with an average monthly weight and height gain was 0.5-0.6 kg and 2 cm respectively. The growth rate in the 7-2 months group was a half of the 4-6 months group. By 12 months of age, the weight and height average 9.9 kg and 75 cm, respectively. The average monthly weight and height gain in the 13-24 months group was 0.2 kg and 1 cm respectively, with an average weight and height of 12 kg and 87 cm respectively by 24 months of age. A steady growth was found in the 2-7 years group, with a yearly average weight and height increment of about 2 kg and 7 cm respectively. The formulas for approximate average weight and height in children between 2 and 7 years were as follows: age (yr)*2+8 (kg) (weight); age (yr)*7+75 (cm) (height).

CONCLUSIONSThe approximate weight and height of normal Chinese children under 7 years of age can be evaluated by the key parameters and formulas above mentioned.

Body Height ; Body Weight ; Child ; Child, Preschool ; China ; Humans ; Infant ; Infant, Newborn ; Mathematics

OBJECTIVETo evaluate therapeutic efficacy of minimally invasive rotary varicotomy (TriVex) for superficial varicosities of low limbs and summarize our therapeutic experiences.

METHODSOne hundred and eighty-two cases (totally 216 lower limbs) were applied minimally invasive rotary varicotomy (TriVex) and relative clinical data was analyzed.

RESULTSThe average operation time for each limb was 48 min. Discomfort and pain of lower limbs disappeared in all of patients after operation. There was no residual of superficial varicosities. There was no severe complication and recurrence of varicosities. The postoperative complication rate was 21.3%.

CONCLUSIONSFor treatment of superficial varicosities of low limbs, minimally invasive rotary varicotomy (TriVex) have many advantages including minimal invasion, quick recovery, safety and cosmetic effect. In addition, it has extensive indications and satisfactory therapeutic efficacy. It would be beneficial to master the operative techniques of key procedures. It could decrease complications and get better curative effects.

Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Lower Extremity ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Postoperative Complications ; etiology ; prevention & control ; Varicose Veins ; surgery ; Vascular Surgical Procedures ; methods

OBJECTIVETo investigate the effect of endovascular therapy and artery bypass for subclavian artery occlusion disease and to explore a suitable therapeutic procedure.

METHODSThirty-nine patients with subclavian artery occlusive disease received endovascular therapy or arterial bypass from June 1997 to May 2004. Twenty-seven endovascular stenting were performed on 26 patients through the femoral artery (n = 14) or combined brachial artery (n = 12). Retrograde endovascular balloon angioplasty and stent placement were performed on 12 patients. Eight subclavian arteries were punctured with ultrasound localization. On account of unsuccessful stenting, 13 cases received arterial bypass. In addition, endovascular stenting were performed on 9 cases with carotid or vertebrarterial stenoses.

RESULTSThe blood pressure difference was less than 10 mm Hg between the treated and the healthy arms in all 39 patients. The ratio of healthy/diseased side of the mean blood pressure index increased from 0.62 +/- 0.11 preoperatively to 0.98 +/- 0.04 postoperatively (P < 0.01). The mean patency time for endovascular therapy and arterial bypass was (57.6 +/- 3.7) and (60.2 +/- 7.2) months, respectively.

CONCLUSIONSBoth endovascular therapy and arterial bypass have good curative effect for subclavian artery occlusion. Endovascular therapy is the preferred treatment for subclavian artery occlusion with mini-trauma and safety.

Adult ; Aged ; Aged, 80 and over ; Angioplasty, Balloon ; methods ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Stents ; Subclavian Steal Syndrome ; surgery ; therapy ; Treatment Outcome

OBJECTIVETo analyze clinical characteristics of children with 45, X/46, XY mosaicism and explore effective managements for them.

METHODFive children with 45, X/46, XY mosaicism were all in puberty period, of whom, three were female and two male. The standing height, weight and sexual development were measured. The levels of sex hormones, other endocrine parameters were also determined, and imaging examinations were performed.

RESULTAll the patients had disorders of sex development, of whom, 4 had short stature, and the HtSDs was -2.8 ± 1.1. The results of laboratory indexes suggested that 4 had hypergonadotropic hypogonadism, with the average level of LH (13.5 ± 5.8) IU/L and FSH (56.8 ± 37.4) IU/L. Imaging examinations revealed that 2 cases had cryptorchidism, 1 had immature uterus, 1 had testicular dysgenesis and 1 had normal testis. Three patients received rhGH treatment and 1 took gender assignment into account.

CONCLUSIONPatients with mosaic 45, X/46, XY karyotypes had a wide range of phenotypic manifestations, and disorders of sex development and short stature were the main clinical features. However, the disorders of sex development varied among these patients. And the management for them depends upon many factors and needs to be individualized based on the cooperation with different clinical departments.

Adolescent ; Child ; Chimerism ; Developmental Disabilities ; complications ; Female ; Gonadal Dysgenesis, 46,XY ; complications ; Humans ; Male ; Sex Chromosome Aberrations ; Sexual Development ; Turner Syndrome ; complications

OBJECTIVETo analyze the clinical and laboratory features of chronic lymphocytic leukemia (CLL).

METHODSRetrospective investigation of 263 patients with CLL in our hospital between Feb. 2000 and Jan. 2007.

RESULTSThe median age was 60 years with male/female ratio of 2.17 : 1. Patients who were asymptomatic at diagnosis (35.4%) had low Rai grades. Fatigue and lymphadenopathy (54.8%) were the most common features at presentation. Infections, connective tissue diseases and secondary tumors frequently occurred in CLL. WBC counts were between (10 - 100) x 10(9)/L, with lymphocytes percentages more than 0.50 in 97.1% patients. Bone marrow was normal- to hyper-cellularity with lymphocytes percentages more than 0.300 in 99.4% patients. Diffuse infiltrations in bone marrow section were found in 72.2% patients. There were lower CD5 (85.1%) and higher CD25 (78.9%) positivities in the present series as compared with that in other reports. Hypogammaglobulinemia, especially hypo-IgM, usually occurred. Chromosome abnormality were rarely found by routine chromosome examination.

CONCLUSIONSThere were some clinical and laboratory characteristics different from that of abroad data. Further exploration of new markers is required for prognosis prediction and treatment choice.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Leukemia, Lymphocytic, Chronic, B-Cell ; genetics ; pathology ; Male ; Middle Aged ; Retrospective Studies

OBJECTIVETo study the effects of Wuzi Yanzong Pills (WYP) on sperm mitochondrial membrane potential (MMP) and its ultrastructure in oligo-asthenozoospermia model rats.

METHODSOligo-asthenozoospermia models were made in 50 male rats weighing 200 - 220 g by intragastric administration of Tripterygium Glucosides at 30 mg per kg per d for 8 weeks, and then equally allocated to a model control, a Huangjing Zanyu Capsule (HZC) control, a low-dose WYP, a medium-dose WYP, and a high-dose WYP group. Another 10 age-matched normal male rats were included as normal controls. The rats in the model and normal control groups were given intragastrically distilled water at 10 ml/kg, those in the HZC group administered HZC at 3.01 g/kg, and those in the low-, medium- and high-dose WYP groups medicated with WYP at 2.30, 4.60 and 9.20 g/kg, respectively, once daily for 30 days. At 30 minutes after the last administration, we detected the sperm MMP by JC-1 fluorescent staining and flow cytometry, and examined the sperm ultrastructure under the JEM-1230 transmission electron microscope.

RESULTSJC-1 + % and its fluorescence intensity were (33.77 +/- 6.19)% and 1 468 +/- 496 in the model control, (56.34 +/- 10.35)% and 3 277 +/- 895 in the HZC control, (40.80 +/- 10.40)% and 2 016 +/- 767 in the low-dose WYP, (59.40 +/- 6.51)% and 3 897 +/- 643 in the medium-dose WYP, and (60.71 +/- 7.81)% and 3 371 +/- 647 in the high-dose WYP group, significantly reduced in comparison with (70.80 +/- 4.92)% and 4 360 +/- 945 in the normal control group (P < 0.05), but remarkably higher in the medium- and high-dose WYP groups than in the model controls (P < 0. 05). After modeling, the sperm membrane was loose and degenerated, the mitochondria swelling, variously sized and with incomplete membrane, and the axonemal structure unclear or ruptured. After 30 days of WYP administration, compared with the model control group, the rats exhibited integrated sperm membrane and mitochondrial membrane, reduced mitochondrial swelling and basically normal axonemal and microtubular structures.

CONCLUSIONTripterygium Glucosides could decrease the sperm mitochondrial membrane potential and damage the mitochondrial structure, while WYP could significantly increase the sperm mitochondrial membrane potential and reduce the sperm mitochondrial structure damage. The protection of the integrity of sperm mitochondrial structure and function is one of the mechanisms of WYP acting on oligo-asthenozoospermia.

Animals ; Asthenozoospermia ; pathology ; physiopathology ; Drugs, Chinese Herbal ; pharmacology ; Male ; Membrane Potential, Mitochondrial ; drug effects ; Oligospermia ; pathology ; physiopathology ; Rats ; Rats, Sprague-Dawley ; Spermatozoa ; drug effects ; physiology ; ultrastructure

OBJECTIVETo investigate the protective effects of selenium on rat hippocampal neurons against ischemia-reperfusion (IR) injury.

METHODSThirty-two rats were randomly divided into sham-operated group, IR group and selenium-treated group, and in the latter two groups, cerebral IR injury was induced by middle cerebral artery occlusion; Na2SeO3 treatment was administer in selenium-treated group. At 14 days after reperfusion, the brain tissues were harvested from the rats and hippocampal neuron injuries were observed by TUNEL and Methylene Blue staining. The levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and nerve growth factor (NGF) in the hippocampal tissues were measured by ELISA.

RESULTSCompared with IR group, the rats in selenium-treated group showed no significant increase in the expression of m-NGF (P>0.05), but pro-NGF expression was significantly increased (P<0.05) in the hippocampal tissue. Na2SeO3 treatment significantly inhibited the expressions of TNF-α and IL-1β and decreased the apoptosis of hippocampal neurons following cerebral IR injury (P<0.05).

CONCLUSIONSelenium produces antiapoptotic effect to protect the hippocampal neurons following cerebral IR injury possibly not by increasing the level of m-NGF but by decreasing the expressions of the inflammatory factors.

Animals ; Apoptosis ; Brain Ischemia ; metabolism ; pathology ; Hippocampus ; cytology ; metabolism ; pathology ; Interleukin-1beta ; metabolism ; Male ; Nerve Growth Factor ; metabolism ; Neurons ; drug effects ; metabolism ; pathology ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; metabolism ; pathology ; Sodium Selenite ; pharmacology ; Tumor Necrosis Factor-alpha ; metabolism