Objective To probe the effect of transareolar or mastoscopy assisted breast-conserving surgery combined with open axillary lymph node dissection in the treatment of breast cancer. Methods Nineteen patients, with breast cancer of a diameter cm from the nipple, were treated by transareolar or mastoscopy assisted breast-conserving surgery from August 2001 to November 2003.After the lipolysis and suction of axillary fat,open axillary lymph node dissection was performed. Results Intraoperative frozen pathological examination had showed positive margin in 1 case, in which an enlarged excision was required to obtain a negative result. Postoperative subcutaneous edema underlying the operated site occurred in 2 cases and was cured by needle aspiration and pressure dressing. Excellent cosmetic outcomes were obtained with symmetrical breast development and all the patients were satisfied with the treatment. Postoperative follow-up for 2～19 months (mean, 10.6 months) found no recurrence in the breast or the axillary fossa. Conclusions Breast-conserving surgery can be expediently carried out by means of transareolar incision or with the help of mastoscopy. The combination with open axillary lymph node dissection may give favorable effect.

Objective To explore the clinical therapeutic effects in arterial interventional therapy in early osteosarcoma patients.Methods Thirty-eight early osteosarcoma patients received arterial chemoembolization therapies and performed operations.94.7% patients received limb salvage surgeries.Levels of alkaline phosphatase were tested in preoperative and postoperative phases.Results Levels of postoperativealkaline phosphatase[average(191.7±107.0)U/L]were significantly decreased compared with that before interventional therapy[average(1129.1±572.3)U/J.The survival rate in follow-up at 1,3 and 5 years Was97%,79%,50% respectively.The rate of recurrence and metastasis WAg 24%.Conclusions Arterialchemoembolization therapies in patients with early osteosarcoma could improve clinical symptoms effectively,enhance survival rate,relieve recurrence and metastasis,remain affected extremity.The clinical thempeutic effects of iodinated oil were the best among the three embolism materials.

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.

This article was aimed to study constructive standards for the database of traditional Chinese medicine (TCM) documentation. Refer to relevant national standards, specifications and other fields of universal standards such as metadata specification of health information dataset, medical science data sharing, metadata standard, data of pop-ulation health sciences shared metadata standard, basic scientific data sharing network project standard, Chinese A-cademy of Sciences data application environment construction and service standards, combined with the specification for TCM literature resources, Chinese medicine literature database was constructed. The results showed that 6 major categories and 17 specifications were established to standardize the construction of TCM literature database. It was concluded that the standardization of TCM literature database was able to realize TCM literature database construc-tion standard and process, and to facilitate the sharing of TCM data resources.

Animals ; Cardiomegaly ; Constriction ; Heart ; Mice

Objective To summarize the sonographic features and differential diagnosis points of mass-type cornual pregnancy. Methods The sonographic ifndings of 23 pathological proven mass-type cornual pregnancy cases enrolled in PUMCH from 2011 January to 2013 January were retrospectively analyzed. Results All pathological proven mass-type cornual pregnancy were located at one corner of the uterus presenting as a heterogenous outward mass. Well-deifned margins were found in 20 cases, and interstitial-line signs were found in 15 cases. The surrounding muscle thickness is 0.1-0.3 cm. Typical hyperechoic villi were found on sonography in cases with bloodβ-hCG>20 000 IU/L. On Doppler, the lesion showed abundant peripheral vascularity with low resistance in 22 cases, 9 lesions also showed abundant internal vascularity. Among 23 mass-type cornual pregnancy cases, 7 cases were misdiagnosed as gestational trophoblastic neoplasia (GTN) due to the similar sonographic characteristics including mixed-echo and abundant vascularity with low resistance. Sixteen cases were diagnosed by ultrasound preoperatively, with featured sonographic signs including mass located in the endometrial extension line;clear margin;peripheral vascularity;or detection of interstitial-line sign and typical villus. Conclusions Mass-type cornual pregnancy may be correctly diagnosed according to the location, boundary of the mass and the distribution of blood flow combining with clinical manifestation and bloodβ-hCG level. Transvaginal sonography could play an important role in diagnosis of cornual pregnancy.

Objective:To investigate the correlation between anthropometric indices and arteriosclerosis detection indicators in the middle-aged and the elderly .Methods: A cross-sectional descriptive study was made of 1 626 individuals ( diabetics patients 23.37%, hypertensive subjects 39.48% and healthy individuals 37.15%), aged 45 to 90 years [mean age:(61.60 ±10.22) years)] in Shijingshan Dis-trict, Beijing.Their measurements:body mass index (BMI), waist circumference (WC), and waist to height ratio ( WHtR ) .Arterial stiffness was assessed according to brachial-ankle pulse wave velocity (baPWV), intima-media thickness (IMT), augmentation index (AI) and ankle-brachial index (ABI), which were measured by noninvasive detectors and equipment .The correlations between the various indi-cators were analyzed .Results:The percentages of the hypertensive and diabetic groups of central obesity ( male WC>85 cm, female WC >80 cm or WHtR>0.5 ) and of general obesity ( BMI>28 kg/m2 ) were significantly higher than those of the healthy group ( P<0 .01 ) .The difference between the two disease groups was not significant ( P>0 .05 ) .There was a moderate positive correlation between the measures of abdominal obesity (WHtR and WC) and the general obesity indicators (BMI) (r=0.710 and 0.716) .In the healthy group , WC and WHtR showed positive correlation with baPWV , IMT and ABI, and negative correlation with AI 75 .BMI showed positive correlation with IMT and negative correla-tion with AI75 , and no correlation with baPWV and ABI .There was negative correlation between BMI and baPWV in the diabetic group .In the hypertension group , we found negative correlation between BMI and baPWV, maximum IMT, AI75 , and also between WC and AI 75 .The simple regression straight line of baPWV versus the anthropometric parameters showed that the regression equations were y =0 .949 +1.379 x (baPWV vs.WHtR, R2 =0.046, P<0.001) and y=1.133+0.006x (baPWV vs.WC, R2 =0.027, P<0.001), respectively.baPWV and BMI did not have a linear relationship (P =0.62). Conclusion:WHtR and WC are superior to BMI indices in predicting arteriosclerosis .Anthropometric measurements for central obesity are good predictors of cardiovascular risk .

Objective To assess the effect of combined hypertension (HT) and aging on left atrial (LA) size and phasic function.Methods This evaluation was based on the data from a cross-sectional study including 738 subjects with high risk for cardiovascular disease from an urban community in Beijing.Subjects were divided into 3 groups according to age (41-59,60-69 and ≥70 years) and further into HT and non-HT sub-groups.LA volume index were calculated and LA global longitudinal strain in late diastole (Sa),early diastole (Se),and total strain (Stot =Sa + Se),and strain rate in late diastole (SRa),systole (SRs),and early diastole (SRe) were measured using off-line speckle-tracking echocardiography.Results LA volume index increased significantly in HT groups with aging,whereas no changes could be viewed in non-HT subjects among all age groups.LA conduit index (Se and SRe) decreased with aging in both HT and non-HT subjects with more sever in HT subjects than in non-HT subjects in all age groups.The LA conduit index in 41-59 year-HT,and in 60-69 year-HT subjects were comparable with that in 60-69 year-non-HT subjects [Se (11.0 ±4.4)％ vs (11.6 ±4.7)％,SRe (1.0 ±0.4) s-1 vs (1.0 ±-0.3) s-1],and in ≥70 year-non-HT subjects [Se(10.1 ±4.0)％ vs (9.5 ±5.4)％,SRe (0.9 ±0.3)s-1 vs (0.8 ± 0.4) s-1],respectively.LA reservoir (Stot and SRs) and contraction (Sa and SRa) index also decreased with aging in HT but not in non-HT subjects.Conclusions Aging along does not lead to LA enlargement in subjctes,but it does when combined HT.There is synergistic effect of HT and aging on LA volume and phasic function.

Various teaching methods were used in occupational health and occupational medicine teaching,including problem based learning,multimedia teaching,bilingual teaching,case based learning and practice teaching methods when being confronted with new situation of occupational health and occupational safety.These methods are mean to encourage students' enthusiasm,cultivate students' comprehensive ability and enhance their sense of social responsibility and mission.Results showed that these methods improved the quality of teaching and achieved good teaching results.

Objective To explore the prevalence and clinical and echocardiography features of the basal septal hypertrophy(BSH).Methods Clinical and echocardiography data of 1 056 elderly population in an urban community of Beijing were analyzed.BSH was defined as the thickness of basal interventricular septum ≥1.4 cm and basal septal/mid septal ≥1.3.Data were compared between BSH and non-BSH,and the risk factors of BSH were evaluated.Results The prevalence of BSH in this population was 7.39%(95%CI:5.8%-9.0%).BSH was not associated with current cardiovascular diseases (P >0.05).Its correlates in logistic analysis included male,diabetes mellitus,small end diastolic left ventricular dimension and abnormal left ventricular diastolic function (P <0.05),with OR 0.49(0.29,0.83),1.99(1.18,3.37),2.24 (1.35,3.72),0.39(0.26,0.59),and 1.96(1.01,3.81),respectively.Conclusions BSH is common in elderly community population and not associated with cardiovascular diseases.Its risk factors included male, obesity,diabetes mellitus,small end diastolic left ventricular dimension and abnormal left ventricular diastolic function.