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.

A new method for the preparation of oligonucleotide microarray for gene expression detection was found. The key techniques and standards of quality controlling for preparation of oligonucleotide microarray was explored using gene of human 23 kD highly protein and Luciferase and mouse cytokine-associated genes. By the using of a software system MProbe, oligonucleotide probes were designed and BLAST. All the probes have a very high specificity, i.e. except target sequence, the similarity between the probe and non-target sequences is less than 70% and the hairpin structure are not exist in all probes. All the probes have the same length 40. GC contents in all probes are in a narrow scope (from 45% to 55%). All the probes are modified with amino at 5' or 3' terminal. The satisfied images with good sensitivity and very high specificity were obtained by the using of the methods above and also using of positive and negative controls and some internal controls(house keeping gene) to quantitate and balance expression of genes. High specificity, good sensitivity and stability have been verified by three continuous experiments using the oligonucleotide microarray to study gene expression profile of normal mouse breast grand tissue. The oligonucleotide microarray for expression detection prepared using our method have high specificity, good sensitivity and stability et al. It may be a more advanced method for analysis of gene expression profile.
Animals ; Cytokines ; genetics ; DNA, Complementary ; genetics ; Gene Expression Profiling ; Granulocyte-Macrophage Colony-Stimulating Factor ; genetics ; Interleukin-10 ; genetics ; Mammary Glands, Animal ; metabolism ; Mice ; Nerve Growth Factor ; genetics ; Oligonucleotide Array Sequence Analysis ; methods ; Polymerase Chain Reaction

Studies concerning the association between arsenic exposure and hepatitis B virus (HBV) infection have been lacking.The present study aimed to examine the association between total urinary arsenic (TUA) and infection of HBV.A total of 5186 participants from National Health and Nutrition Examination Survey (NHANES) 2003-2014 were included in the analysis.We used logistic regression to evaluate the association.We defined two measures of TUA.TUA1 was the sum of arsenous acid,arsenicacid,monomethylarsonic acid and dimethylarsenic acid.TUA2 was defined as TUA minus arsenobetaine and arsenocholine.The results showed that the weighted overall prevalence of HBV infection was 6.08％.For NHANES 2003-2014,the medians (interquartile range) of TUA1 and TUA2 were 5.60 μg/L (3.97-8.09 μg/L) and 4.91 μg/L (2.36-9.11 μg/L),respectively.Comparing the highest quartile to the lowest quartile after multivariable adjustment showed that the odds ratios (ORs) and 95％ confidence intervals (CIs) for TUA1 and TUA2 were 2.44 (1.40-4.27) and 2.84 (1.60-5.05),respectively.In conclusion,elevated urinary arsenic was associated with the risk of HBV infection.Further studies,especially prospective studies,are needed to confirm the causal relationship between arsenic exposure and HBV infection.

OBJECTIVETo study the clinical features of hyperparathyroidism due to parathyroid tumors, and evaluate the efficiency of surgical management.

METHODSTwenty-two patients with hyperparathyroidism resulted from parathyroid tumors were reviewed. The age ranged from 32 to 79 years, 9 males and 13 females. Recurrent laryngeal nerve was routinely exposed, and procedures were performed in normal tissue in initial surgery. Additional selective neck dissection of levels II, III, IV, and VI was taken in the cases with recurrent cancer. Local flaps were used to repair the esophageal defects after resecting tumors. The recurrent laryngeal nerves of 4 cases had to be sacrificed because they were embedded in the tumor tissues despite the nerves had normal function before operation. Prophylactic tracheostomy was performed in 5 cases.

RESULTSEight cases were identified pathologically as parathyroid carcinoma, of them four with neck metastasis, and 14 cases as parathyroid adenoma after surgery. Their PTH dropped to normal level within two hours after surgery and hypercalcemia disappeared in two days postoperatively. The PTH and serum calcium were in normal range during the follow-up of 12 to 40 months. Recurrence occurred again in two cases in 6 and 8 months after the removal of the recurrent tumor tissues respectively. Esophageal fistula, chylous fistula and dehiscence of sternotomy developed in three cases separately. The tracheostomy was removed in four cases two weeks after operation and in one case six weeks after operation. One patient with parathyroid adenoma died of hypocalcemia about two weeks after operation and another one with recurrent parathyroid carcinoma also died of hypercalcemia 52 months after revised surgery.

CONCLUSIONExtended resection of tumor and intraoperative PTH assay were strongly suggested for the managements of both benign and malignant parathyroid tumors.

Adult ; Aged ; Calcium ; blood ; Female ; Humans ; Hyperparathyroidism ; etiology ; surgery ; Male ; Middle Aged ; Neck Dissection ; Neoplasm Recurrence, Local ; Parathyroid Hormone ; blood ; Parathyroid Neoplasms ; complications ; surgery ; Retrospective Studies ; Tracheostomy

OBJECTIVETo study the interaction between polymorphisms of estrogen receptor (ER) gene and puberty on bone mineral density (BMD).

METHODSOne hundred and forty-six boys aged 13-17 years were divided into two groups according to their first spermorrhea. DNA was analyzed for Xba I and Pvu II genotypes by PCR-RFLP. BMD of the total body, forearm and lumbar spine was measured by dual-energy X-ray absorptiometry (DXA). The relationship between polymorphisms of ER gene and BMD in these two groups was analyzed.

RESULTSThe BMD at all sites in the spermorrhea group was significantly higher than that in the un-spermorrhea group. The independent contribution of ER genotypes to BMD at two pubertal stages was analyzed after adjusting co-variables. In the un-spermorrhea group, the BMD at distal 1/10 and 1/3 forearm of those carrying pp genotype was significantly higher than that of the non-carries, whereas in the spermorrhea group BMD in those carrying the same genotype was significantly lower than that in the non-carriers. Similar results were obtained by haplotype analysis. Multiple stepwise regression analysis showed that body weight, age and the first spermorrehea were the dominant determinants for BMD. BMD at forearm might be influenced by interaction between ER genotype and the first spermorrehea.

CONCLUSIONThe polymorphisms of ER gene play a different role in BMD influenced by the first spermorrhea. Chinese boys carrying p or x allele should pay more attention to their bone mass.

Absorptiometry, Photon ; Adolescent ; Base Sequence ; Bone Density ; DNA Primers ; Humans ; Male ; Polymorphism, Genetic ; Puberty ; Receptors, Estrogen ; genetics ; Spermatozoa

OBJECTIVESTo investigate the effects of calcium and vitamin D supplementation in fortified milk on physical development in Chinese school girls aged 10 - 12 years.

METHODSA non-randomized, double-blind intervention trial was carried out at nine primary schools of Beijing for two years. Seven hundred and fifty-seven girls (with an average age of 10.1 years) were recruited from nine primary schools in Beijing, China. They were divided into three trial groups, a control group (n = 259) having regular diet without milk supplementation, Group 1 (n = 238) having regular diet supplemented with 144 ml/d of calcium-fortified milk, and Group 2 (n = 260) having regular diet supplemented with 144 ml/d of calcium and vitamin D-fortified milk. Data of dietary intake and physical activities were collected by questionnaire, and height, weight, sitting height and knee height were measured before, during and after intervention.

RESULTSTwo years after intervention, the percentage increases in height and weight were significantly greater in Groups 1 and 2 than those in control group (9.52%, 9.26% and 8.59% in height, and 34.53%, 35.38% and 30.91% in weight, respectively). The percentage increase of sitting height was greater in Group 1 than those in Group 2, and then than that in control group (9.21%, 8.58% and 7.87%, respectively). The percentage increase of knee height was significantly greater in Group 1 than that in Group 2 and control group (9.00%, 8.37% and 8.44%, respectively).

CONCLUSIONCalcium and vitamin D-fortified milk supplementation could promote their physical development in girls aged 10 - 12 years.

Animals ; Body Height ; drug effects ; Body Weight ; drug effects ; Calcium, Dietary ; pharmacology ; Child ; Dietary Supplements ; Female ; Food, Fortified ; Human Development ; Humans ; Milk ; metabolism ; Vitamin D ; pharmacology

BACKGROUNDPrevious studies have indicated that thrombin (TM) may play a major role in brain edema after intracerebral hemorrhages (ICHs). However, the mechanism of TM-induced brain edema is poorly understood. In this study, we explored the effect of TM on the permeability of the blood brain barrier (BBB) and investigated its possible mechanism, aiming at providing a potential target for brain edema therapy after ICHs.

METHODSTM or TM + cathepsin G (CATG) was stereotaxically injected into the right caudate nucleus of Sprague-Dawley rats in vivo. BBB permeability was measured by Evans-Blue extravasation. Brain water content was determined by the dry-wet weight method. Brain microvascular endothelial cells were then cultured in vitro. After TM or TM + CATG was added to the endothelial cell medium, changes in the morphology of cells were dynamically observed by phase-contrast light microscopy, and the expression of matrix metalloproteinase-2 (MMP-2) protein was measured by immunohistochemical method.

RESULTSBBB permeability increased at 6 hours after a TM injection into the ipsilateral caudate nucleus (P < 0.05), peaked between 24 hours (P < 0.01) and 48 hours (P < 0.05) after the injection, and then declined. Brain water content changed in parallel with the changes in BBB permeability. However, at all time points, BBB permeability and brain water content after a TM + CATG injection were not significantly different from the respective parameters in the control group (P > 0.05). TM induced endothelial cell contraction in vitro in a time-dependent manner and enhanced the expression of MMP-2 protein. After incubation with TM + CATG, cell morphology and MMP-2 expression did not change significantly as compared to the control group (P > 0.05).

CONCLUSIONSIncreased BBB permeability may be one of the mechanisms behind TM-induced cerebral edema. TM induces endothelial cell contraction and promotes MMP-2 expression by activating protease activated receptor-1 (PAR-1), possibly leading to the opening of the BBB.

Animals ; Blood-Brain Barrier ; drug effects ; Body Water ; metabolism ; Brain Edema ; etiology ; Cathepsin G ; Cathepsins ; pharmacology ; Cerebral Hemorrhage ; complications ; Matrix Metalloproteinase 2 ; analysis ; Permeability ; Rats ; Rats, Sprague-Dawley ; Receptor, PAR-1 ; physiology ; Serine Endopeptidases ; Thrombin ; toxicity

Objective To evaluate the effects of socioeconomic status on the distribution of cardiovascular risk factors and clinicaltreatments of patients with acute myocardial infarction in Beijing.Methods In Beijing, a prospective, muhi-center, registration study was carried out which including 800 patients who were consecutively hospitalized for ST-segment elevation acute myocardial infarction within 24 hours after event attack in 19 different hospitals in Beijing between November, 2005 and December, 2006.Indicators of socioeconomic status included self-reported personal income (＜500, 500-2000,＞2000 RMB/month), educational attainment (≤ 12 and ＞ 12 years) and status of medical insurance (yes/no).According to categories of education, patients were categorized into two groups of lower socioeconomic status and higher socioeconomic status. Differences of cardiovascular risk factors and clinical treatments were compared across the two groups respectively. Results Proportion of diabetes and hyperlipidemia in patients with higher socioeconomic status was much higher than that of patients with lower socioeconomic status (P＜0.05, P＜0.01 respectively). Patients with lower socioeconomic status were more likely to be smokers (P ＜0.05). The rates of receiving coronary angiography and PTCA were much lower in patients with lower socioeconomic status. Medical insurance and income were the most important two socioeconomic factors determining the use of PTCA. Conclusion Compared to patients with lowersocioeconomic status,patients with higher socioeconomic status had higher rates of hyperlipidemia and diabetes but lower smoking rate among cardiovascular risk factors. The rates of receiving interventional therapies were much lower in patients with lower socioeconomic status.

BACKGROUNDThree randomised trials have demonstrated that combining bevacizumab with first-line chemotherapy significantly improves progression-free survival versus chemotherapy alone in HER2-negative locally recurrent/metastatic breast cancer (LR/mBC). However, data from Chinese populations are limited and possible differences between ethnic and geographic populations are unknown. This study was conducted to determine whether there are differences in safety and efficacy in patients with HER2-negative LR/mRC between Chinese and Western populations after they receive first-line bevacizumab combined with taxane-based therapy.

METHODSIn the single-arm, open-label, Avastin Therapy for Advanced Breast Cancer (ATHENA) study (NCT00448591), patients with HER2-negative LR/mBC received first-line bevacizumab (investigator's choice of 10 mg/kg every 2 weeks or 15 mg/kg every 3 weeks) combined with taxane-based therapy. The primary endpoint was safety profile and the secondary is time to progression (TTP). A subpopulation analysis was conducted to assess safety and efficacy in Chinese patients.

RESULTSOf 2264 patients treated in ATHENA, 202 were enrolled in China. Bevacizumab was combined with docetaxel in 90% of Chinese patients and paclitaxel in 10%. The most common grade 3/4 adverse events were diarrhoea (in 5.0% of patients) and hypertension (in 2.5% of patients). Grade 3/4 proteinuria occurred in 0.5%. After median follow-up of 17.6 months and events in 56% of patients, median TTP was 9.0 months (95%CI, 8.4-11.1). Overall survival data were immature.

CONCLUSIONSWe found no evidence of increased bevacizumab-related toxicity or reduced efficacy in Chinese LR/mBC patients receiving first-line bevacizumab-taxane therapy compared with predominantly Western populations. The safety profile was generally similar to previously reported LR/mBC trials. Subtle differences may be attributable to different lifestyle and cardiovascular risk factors in Chinese patients compared with the overall population. It appears reasonable to extrapolate findings from bevacizumab-based randomised trials to Chinese populations.

Adult ; Aged ; Aged, 80 and over ; Antibodies, Monoclonal, Humanized ; adverse effects ; therapeutic use ; Antineoplastic Agents ; adverse effects ; therapeutic use ; Bevacizumab ; Breast Neoplasms ; drug therapy ; genetics ; metabolism ; Bridged-Ring Compounds ; adverse effects ; therapeutic use ; Female ; Humans ; Middle Aged ; Receptor, ErbB-2 ; genetics ; metabolism ; Taxoids ; adverse effects ; therapeutic use ; Young Adult