Objective To explore the strategy of surgical therapy for breast carcinoma . Methods The clinical data of 258 patients with breast carcinoma were analysed retrospectively. Results (1)136 patients with stage Ⅰ～Ⅱ breast carcinoma were subjected to modified radical mastectomy, overall survival(OS) was 100%, and relapse free survival(RFS)92.6%.(2)Partial mastectomy and axillary dissection were performed on two patients with stage Ⅱbreast carcinoma,one relapsed in 5 months after operation. (3)In patients with stage Ⅲ breast carcinoma,there was no statistical difference in OS and RFS between 88 patients subjected to modified radical mastectomy and 20 radical mastectomy.(4)The radical operation showed a better efficacy in 5 patients with stage Ⅳ breast carcinoma.(5)Using special breast cutter and electrotome,the rate of surgical blood transfusion was 3.5%,postoperative hematocele 2.7%,flap necrosis 7.4%, effusion under skin 18.6%,and edema of affected limb 4.3%. Conclusions (1)The modified radical mastectomy is the major operation for stage Ⅰ～Ⅲ breast carcinoma patients. (2)Using special breast cutter and electrotome could cut down surgical blood transfusion and operation time.(3)Rational axillary lymph node dissective could reduce postoperative complications.

Objective To investigate the prevalence of toxoplasma gondii (Tox),rubella virus (RV),cytomegalovirus (CMV) and herpes simplex virus (HSV) infections (TORCH infections) among childbearing-age population in Henan province.Methods Enzyme-linked immunosorbent assay (ELISA) was applied to detect plasma TORCH IgM and IgG among 3084 childbearing-age men and women from theFirst Affiliated Hospital of Zhengzhou University during July and September,2011.The positive rates of anti-TORCH antibodies were compared among the various age and gender groups by x2 test.Results The total positive rate of anti-TORCH IgM was 5.5％ (170/3084),in which the positive rate of anti-RV IgM was the highest (2.9％),followed by anti-HSV IgM (1.0％).Within positive rate of anti-TORCH IgG,anti-HSV IgG was the highest (90.4％),followed by anti-CMV IgG (89.7％),RV IgG (48.1％) and Tox IgG (0.7％).The positive rate of anti-TORCH IgM was the lowest in individuals aged ＞ 30-40 year old.With the age increasing,the positive rates of anti-Tox IgG,anti-CMV IgG and anti-HSV IgG increased,but the positive rate of anti-RV IgG decreased.Women had higher positive rates of anti-CMV IgG and antiHSV IgG than men (x2 =83.470 and 7.026,P ＜ 0.O1).Conclusions Current infection of TORCH exists in childbearing-age population of Henan province,and the positive rate of anti-RV IgG is low.It is recommended to screen for TORCH infection in childbearing-age men and women.

Objective To discuss the common nature of live depression and spleen qi deficiency and liver disease and the changes after the intervention ofXiaoyaopower by the metabonomics method. Methods A total of 40 rats were randomly devided into the normal control group, the liver depression and spleen qi deficiency model group, the liver depression and spleen qi deficiency treatment group, the liver disease group, the liver disease treatment group, 8 in each group. The liver depression and spleen qi deficiency model rat was established by tail-clamping infuriation and Senna gavage method, and the liver disease model rat was established by the CCl4-induced liver injury method. The rats of the liver depression and spleen qi deficiency treatment group and the liver disease treatment group were given 2 g/mlXiaoyao powder, and other groups were given the equal-volume saline. All the treatment lasted 28 days. Twelve hours after the last administration, rat metabolite profiling and contents in the serum were detected by GC-MS, the change of rat liver tissue was observed through HE staining.Results The rats of liver depression and spleen deficiency pattern and liver disease model group appeared liver cell nuclei atrophy, dissolution, degeneration necrosis and lymphocyte infiltration, and at the same time the contents of Glycine, Butanediodic acid, Propanoic acid, Methionine, Glutamine, Phenylalanine in serum were all higher than the normal control group (P<0.05). AndXiaoyao powder could reduce the content of the contents of Glycine, Butanediodic acid, Propanoic acid, Methionine,Glutamine, Phenylalanine in serum (P<0.05).ConclusionXiaoyao powder may play the role of protecting liver by the regulation of one carbon unit, sulfur containing amino acids, aromatic amino acids and amino acid of special metabolism and three tricarboxylic acid cycle.

Objective To study the effect of Schisandra chinensis on the treatment of glomerular nephritis in rats by gas chromatography mass spectrometry (GC-MS).Methods The rats were randomly divided into normal group, model group, and the treatment group, 10 rats in each group. We employed the C-BSA injuction to induce situ immune complexes nephritis rate model. Then 24 hour urinary protein was detected after 12 days and a urine metabonomic technology combined with pattern recognition method was used to identify the network analysis, which focuses on the key metablites and enzmys with glomerulonephritis disease.Results After 12 days, compared with the control group, the 24 h urinary protein content (9.24 ± 2.69 mg vs. 76.04 ± 18.88 mg) significantly decreased (P<0.01). Urine metabonomicsi dentified 15 endogenous biomarkers, which included unsaturated fatty acid biosynthesis, pyruvate metabolism and glycolysis metabolism. These metabolic pathways are associated with kidney diseases.Conclusion The effect of Schisandra chinensis on glomerular nephritis may treated by regulating the metabolism of arachidonic acid and fatty acid in four.

Objective The aims of this study were to determine the expression of Ki-67 and PTEN in oral adenoid cystic carcinoma( OACC) and its relationship with clinicopathological features,and to explore the re-lationship between the expression of Ki-67 and PTEN. Methods Forty cases of oral adenoid cystic carcinoma were collected from the pathological laboratory in our hospital. Another 15 cases of normal gland in patients with oral adenoid cystic carcinoma were selected as the control group. The expression of Ki-67 protein and PTEN in adenoid cystic carcinoma was detected by immunohistochemistry. Results The positive rate of Ki-67 protein in oral adenoid cystic carcinoma was 70%(28/40),which was significantly higher than that in the control group(2/15)(P<0. 05). The positive rate of PTEN in oral adenoid cystic carcinoma was 63%(25/40),which was signif-icantly higher than that in the control group 20%(3/15)(P <0. 05). They were associated with histological types,metastasis,lymph node metastasis and neural invasion,and not correlated with age,gender and tumor loca-tion. The expression of Ki-67 and PTEN in oral adenoid cystic carcinoma may have a significant correlation. Conclusion The expression of Ki-67 and PTEN in adenoid cystic carcinoma is high,and their occurrence and development in adenoid cystic carcinoma play an important role in the process of evolution and metastasis. Ki-67 and PTEN proteins may be markers of oral adenoid cystic carcinoma.

Objective:To evaluate the efficacy and safety of non-osteotomy total hip arthroplasty (THA) in the treatment of Crowe IV developmental dysplasia of the hip (DDH).Methods:From Jan 2013 to Sep 2021, 46 patients (46 hips) in our department who underwent total hip arthroplasty without osteotomy for unilateral Crowe IV DDH were retrospectively analyzed, including 6 males and 40 females, with an average age of 41.2±7.2 years (25-61 years). The reduction of the femoral head was achieved successfully through moderate upward-posterior displacement of the movement center, gradual osteotomy of the calcar femorale, proper sinking of the femoral prosthesis and sufficient soft tissue release. The evaluation indexes included the basic condition of the operation (operation time, blood loss, blood transfusion, volume), clinical evaluation (Harris score of hip joint function, patient satisfaction, Trendelenburg sign), imaging evaluation (measurement of limb length and pelvic inclination) and incidence of complications.Results:The mean follow-up time was 72.2±8.8 months (8-101 months). The operation time was 97.2±12 min (84-112 min). The average intraoperative bleeding volume was 550±60 ml (350-850 ml). No patient had periprosthetic infection or fracture, no periprosthetic osteolysis or prosthesis loosening, and no patient needed revision surgery at the last follow-up of all cases. The average HHS score of patients increased from 42.5±12.3 points before surgery to 89.2±10.8 points at the last follow-up, and the difference was statistically significant ( t=19.35, P<0.001). Patient self-rated satisfaction: none was very dissatisfied, 1 patient were less satisfied (2%, 1/46), 4 patients were average (9%, 4/46), 19 patients were relatively satisfied (41%, 19/46), and 22 patients were very satisfied (48%, 22/46). The Trendelenburg sign of 46 cases was positive before operation, and all were negative at the last follow-up. The patients' true leg length discrepancy (LLD) measurement was -2.5±0.6 mm before surgery and 11.5±3.2 mm at the last follow-up ( t=29.17, P<0.05). Patients' perceived LLD was 28.2±5.1 mm before surgery and 3.4±1.4 mm at the last follow-up ( t=32.18, P<0.05). The length of the residual calcar femorale was 3.2±0.4 mm after THA. The limb extended distance of affected limb was 45.2±4.6 mm. The preoperative iliolumbar angle was -6.5°±2.3°, which returned to -0.5°±1.3° at the last follow-up ( F=651.97, P<0.05). Conclusion:For patients with unilateral type IV DDH, non-osteotomy THA is a safe and effective surgical method with simple operation and few complications. It can quickly correct pelvic tilt and lumbar compensatory scoliosis postoperatively.

Objective:To explore the impact of a modified blood management strategy on blood loss and transfusion rates during outpatient total hip arthroplasty(THA).Methods:The retrospective research was performed in a total of 125 patients (125 hips) who underwent outpatient primary THA from January 2019 to December 2021 at a medical center. According to whether a modified blood management protocol was used or not, all patients were divided into two groups. Group A was used the original perioperative blood management strategies (1 g tranexamic acid, intravenously, 10 minutes before skin incision), and group B was used the modified perioperative blood management strategy (on the basis of the original protocol, 2 g tranexamic acid was sprayed locally in the joint cavity before the incision was closed, 1 g tranexamic acid was injected intravenously 3 hours after surgery, and 1 g tranexamic acid was injected intravenously again on the first day after surgery). There were 52 cases in group A, including 32 males and 20 females, aged 58.5±9.8 years (range, 39-69 years), 13 cases were developmental hip dysplasia (Crowe I°-II°), 24 cases were avascular necrosis of the femoral head, 10 cases were hip osteoarthritis, 3 cases were ankylosing spondylitis involving hip joint, and 2 cases were femoral neck fracture. Among the 73 patients in group B, there were 43 males and 30 females, aged 55.8±10.4 years (range, 42-67 years), including 17 cases of developmental hip dysplasia (Crowe I°-II°), 32 cases of avascular necrosis of the femoral head, 16 cases of hip osteoarthritis, 7 cases of ankylosing spondylitis involving hip joint, and 1 case of femoral neck fracture. Intraoperative blood loss, transfusion, deep vein thrombosis (DVT) events (vascular ultrasound, 2w Postop.), the hemoglobin (Hb) drop, the hematocrit (Hct) drop and other complications were recorded.Results:After using the modified strategy, the intraoperative blood loss was significantly reduced (305.6±38.6 ml vs. 416.2±88.3 ml, t=9.51, P<0.001), and the drop of hemoglobin was significantly decreased (18.1±4.0 g/L vs. 22.3±5.8 g/L, t=4.97, P<0.001). The drop of Hct also decreased significantly (7.3%±0.7% vs. 9.6%±1.3%, t=10.21, P<0.001), and total blood loss decreased significantly (720.6±57.4 ml vs. 919.6±86.3 ml, t=15.49, P<0.001). The hidden blood loss was also significantly lower than that in group A (414.9±71.1 ml vs. 503.5±96.4 ml, t=5.91, P<0.001). One patient (in group A) developed intra-articular hemorrhage 2 h after surgery and was transferred back to the inpatient ward for treatment after transfusion. Three patients (2.4%, 1 in group A and 2 in group B) developed symptomatic anemia and were discharged successfully after conservative treatment. Calf muscular venous thrombosis occurred in 3 patients (2.4%), but no symptomatic deep vein thrombosis occurred in all patients. Conclusion:According to this retrospective research, the use of modified blood management strategy during outpatient THA can further reduce intraoperative blood loss, hidden blood loss and postoperative hematocrit drop, and does not increase the occurrence of perioperative thrombosis-related complications.

Objective:To provide insight into the clinical characteristics, therapy and prognosis of patients with radiation-induced brainstem injury after radiotherapy.Methods:From August 2013 to September 2021, 13 patients with radiation-induced brainstem injury were included in this study at Sun Yat-sen Memorial Hospital, and the general information and strategy of radiotherapy were collected. A retrospective analysis was adopted to investigate the clinical and radiological characteristics, treatment and clinical outcomes.Results:There were 13 cases in total, including 4 females and 9 males. The onset age of enrolled patients ranged from 29 to 66 years with an average of (48.15±10.23) years. The median dose targeted at tumor area was 70 Gy with in 33 fractions. The median interval between radiotherapy and the diagnosis of radiation-induced brainstem injury was 24 months. The common clinical manifestations included dysphagia, bucking dysarthria, dizziness and problem with balance. The MRI radiological features were hypointense on T1WI, hyperintense on T2WI, and irregularly enhanced with contrast. The median follow-up was 45 months. Seven cases got improvements, while 3 had no obvious efficacy and 3 cases died. No significant differences in prognosis were observed between those received traditional glucocorticoid and those received bevacizumab treatment( P=0.079). Conclusions:The common symptoms of radiation-induced brainstem injury were symptoms of posterior cranial nerves injury and ataxia. Lesions mostly happened in pons and medulla, with hypointense on T1WI and hyperintense on T2WI. Half of the patients have improved after treatment. There was no significant difference in prognosis between glucocorticoid and bevacizumab treatment.

To investigate the association between red blood cell volume distribution width (RDW) and osteophytes.
 Methods: This cross-sectional study was conducted in the Department of Health Examination Center of Xiangya Hospital, Central South University in Changsha, Hunan Province, China. A total of 8 334 subjects were included in this study. The severity of osteophytes was graded using the criteria of the Osteoarthritis Research Society International (OARSI). Osteophytes incident was defined as at least one side of the knee had a osteophytes grade ≥1. According to the quartiles of the RDW level, the subjects were divided into 4 groups. Multivariate logistic regression analysis was used to calculate the odds ratio (OR) and the 95% confidence interval (CI) of the knee osteophytes incidence between each RDW group and the lowest level group. Tests for linear trends were conducted based on logistic regression using a median variable of RDW level in each category.
 Results: Quartile 1 (Q1), RDW≤9.78; Q2, 9.7813.10. The multivariable adjusted ORs (95%CI) of the prevalence of osteophytes were 1.38 (1.06 to 1.79) in the second percentile interval, and 1.27 (0.97 to 1.66) and 1.50 (1.15 to 1.94) in the third and fourth percentile interval, respectively. Test for linear trends suggested that there was a positive association between the RDW level and the risk of knee osteophytes incidence (P=0.019).
 Conclusion: The risk of osteophytes incidence increases with the increasing RDW levels.
China ; Confidence Intervals ; Cross-Sectional Studies ; Erythrocyte Volume ; Humans ; Incidence ; Odds Ratio ; Osteophyte ; blood ; epidemiology ; Risk Factors ; Severity of Illness Index

Objective:To evaluate the left ventricular diastolic dyssynchrony (LVDD) and its influencing factors early after acute myocardial infarction (AMI) using phase analysis of SPECT gated myocardial perfusion imaging (GMPI).Methods:Bama miniature swines ( n=16) were subjected to establish AMI models. GMPI was performed before and 1 d after AMI to obtain the extent of myocardial perfusion defect (Extent, %) and left ventricular systolic dyssynchrony (LVSD)/LVDD parameters, namely the phase histogram bandwidth (PBW) and phase standard deviation (PSD). Meanwhile, left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular ejection fraction (LVEF), and the ratio of early to late peak mitral diastolic flow (E/A) were obtained by echocardiography. Independent-sample t test, paired t test and Pearson correlation analysis were used to analyze the data. Results:Sixteen AMI swines were successfully created. Compared to baseline, Extent, LVEDV and LVESV significantly increased on 1 d after AMI ( t values: -11.14, -4.55, -6.12, all P<0.001), while LVEF and E/A significantly decreased ( t values: 10.16, 2.18, P<0.001, P=0.046). GMPI showed that the LVDD parameters PBW and PSD increased significantly on 1 d after AMI when compared to those at baseline((142.25±72.06)° vs (33.06±8.98)°, (56.15±26.71)° vs (12.51±5.13)°; t values: -6.11, -6.60, both P<0.001). There were significant differences between LVSD parameters and LVDD parameters (PBW: (109.06±62.40)° vs (142.25±72.06)°, PSD: (44.40±25.61)° vs (56.15±26.71)°; t values: -2.73, -2.20, P values: 0.016, 0.044). LVDD parameters PBW, PSD were negatively correlated with E/A after AMI ( r values: -0.569, -0.566, P values: 0.021, 0.022), and positively correlated with the Extent ( r values: 0.717, 0.634, P values: 0.002, 0.008). The phase analysis of SPECT GMPI to evaluate LVDD showed good intra-observer and inter-observe reproducibility (intraclass correlation coefficient (ICC): 0.953-0.984, all P<0.001). Conclusions:LVDD occurs early on 1 d after AMI, and can reflect left ventricular diastolic dysfunction. The Extent is correlated with LVDD significantly. Phase analysis of SPECT GMPI is an accurate method to evaluate LVDD and left ventricular diastolic function.