Objective To investigate the seasonal variability of the onset of acute deep vein thrombosis(DVT).Methods The clinical manifestations in 774 DVT patients during January 2008 to December 2012 were collected and circular distribution statistics was used to identify seasonal variability.Results The total sample had the significant seasonal variability (P ＜ 0.01):DVT was most frequent in winter while less frequent in summer and the peak day was January 1.Female subgroup has significant seasonal variability (P ＜0.01):on peak in winter and at trough in summer while male subgroup has no significant seasonal variability (P ＜ 0.01).Different age subgroups (＜ 40 years,40-69 years,＜70 years)have significant seasonal variability(P ＜ 0.05,P ＜ 0.01,P ＜ 0.01).DVT was most common in December and less frequent in August.Left lower limb subgroup and both lower limb subgroup has significant seasonal variability (P ＜ 0.01,P ＜ 0.01),on peak in December-January.Immobilization subgroup also has significant seasonal variability (P ＜ 0.001):frequent in winter,January 1 is on the peak.Conclusions DVT has significant seasonal variability in onset:it is most frequently seen in winter while less frequent in summer.Some subgroups (female,＜70 years and immobilization) have the most significant seasonal variability in onset.

Objective To observe the efficacy of psychological intervention on treatment compliance rate, clinical effect and quality of life in patients with advanced cancer pain.Methods Using a sealed envelope method, 80 patients with advanced cancer pain were randomly divided into two groups: the experimental group (EG) (40 cases) and the control group (CG) (40 cases).All patients were treated with standardized cancer pain treatment, and the patients of EG were treated with positive psychological intervention.The treatment compliance rate, clinical effect and quality of life after intervention by 14 days between two groups were compared.Results In EG and CG, the clinical efficiencies of cancer pain were 95.0 ％ (38/40) and 80.0 ％ (32/40), respectively (P ＜ 0.05).The treatment compliance rates were 87.5 ％ (35/40) and 62.5 ％ (25/40), respectively (P ＜ 0.01), and the improvement rates of quality of life were 80.0 ％ (32/40) and 57.5 ％ (23/40), respectively (P ＜ 0.05).Conclusion Psychological intervention is effective to improve the treatment compliance, clinical effect and quality of life for the patients with advanced cancer pain.

Objective To investigate the change of serum nitric oxide ( NO ) in premature rupture of membrane (PROM) and its clinical significance, so as to assess the role of NO in the mechanism of PROM . Method The serum NO in 40 advanced stage pregnant women,28 premature delivery PROM,40 unknown reason term pregnancy PROM ,40 term pregnancy ,40 term labor were detected and compared. Results The serum NO was higher in unknown reason term pregnancy PROM [(95.364±3.562) (u)ol/L] than that in term pregnancy [(75.020±3.416)(u)ol/L] and term labor [(31.457±3.859)(u)ol/L](P<0.01). The serum NO was higher in premature delivery PROM [(101.256±3.124)(u)ol/L] than that in advanced stage pregnant women [(80.363±5.112)(u)ol/L] (P<0.0l),but similar with unknown reason term pregnancy PROM (P = 0.086). Conclusions The serum NO in PROM of term pregnancy significantly is higher than that of advanced stage and term labor women,indicates PROM relating to the increase of NO level. Because the increase of NO links to infection,it suggests that PROM relate closely to the amniotic infection.

Objective To explore the main factors affecting medical expenses of patients with colorectal cancer(CRC)and reduce such expenses by optimizing the clinical pathway of CRC according to the influencing factors.Methods Data of 467 discharged and medical insured CRC patients at Shanghai Cancer Center,Fudan University,were collected from 2009 to 2010.A multiple linear regression model was applied to analyze the influencing factors of medical expenses.The clinical pathway of CRC was optimized,and medical expenses before and after optimization were compared.Results Our data found days of stay and complications had impact on the medical expenses.Also,medical expenses were decreased accordingly with optimization of clinical pathway of CRC.Conclusion This study provides evidence for decision-making on single disease payment and medical insurance compensation on CRC.It is also meaningful to reduce the economic burden of patients with CRC.

Objective To understand the infection of ureaplasma urealyticum in genitourinary of secondary infertility of male and ex-plore the relationship between the genotype of individual ureaplasma species and genitourinary infection of them . Methods Based on the multiple-banded antigen genes (MBA) of ureaplasma urealyticum, 10 pairs of oligonueleotide primers targeting the 5'ends of the MBA genes were designed to identify the MBA genes of U. parvum and U. ureaplasma by PCR-based genotyping system. The 10 pairs of oligonucleotide primers could distinguish the two biovars and 14 serovars of U. ureaplasma. Results A total of 278 (48.6%) positive ureaplasma culture were obtained from 572 patients attending our clinic of reproductive medical eenter. These methods were used to identify and genotype U. ureaplasma in 311 (54.4%) of 572 patients with genitourinary infection among them U. parvum (biovar 1) was detected in 37.1% and U. ureaplasma (biovar 2) in 17.8%. serovar 1 was in 12.4%, serovars3/14 in 17.1% serovar 6 in 7.5%; subtype 1 of biovar 2 was in 5.6%, subtype 2 in 8.9% and subtype 3 in 2.8%, respectively. Conclusion The PCR-based genotyping system will facilitate future stud-ies of relationship between individual Ureaplasma species or subtypes in genitourinary of secondary infertility of male. The methods described here are relatively rapid, practicable, and specific for the detection species identification and subtyping of Ureaplasma species.

Objective To compare the clinical efficacy of catheter directed thrombolysis(CDT ) ,thrombectomy(ST ) and system‐atic anticoagulant(SA) in treating acute iliofemoral deep vein thrombosis(AIFDVT ) of lower limb using Meta analysis method . Methods The systematic review was initialted by electronic literature searches (PUBMED ,MEDLINE ,ELSEVIER ,etc .) for stud‐ies comparing catheter directed thrombolysis ,thrombectomy and systematic anticoagulant clinical effects published from January 1984 to January 2014 based on the keyword such as iliofemoral deep vein thrombosis;thrombolysis;anticoagulant therapy ;throm‐bectomy ;RCTs;Meta analysis.A Meta analysis was conducted to estimate early vein patency ,post thrombotic syndrome(PTS) , venous reflux(VR) rate ,venous obstruction(VO) rate ,etc .Results Ten RCTs were included in this analysis ,including 626 pa‐tients .The early vein patency rate was higher in the CDT group and the difference was statistically significant(OR=4 .61 ,95% CI 1 .93-10 .98 ,P<0 .05);there was no statistically difference between ST and SA group(OR= 2 .54 ,95% CI 0 .49 -13 .24 ,P>0 .05) .The post thrombotic syndrome rate was less both in the CDT group(OR=0 .18 ,95% CI 0 .07 -0 .43 ,P< 0 .05) and ST group(OR=0 .50 ,95% CI 0 .28 -0 .87 ,P< 0 .05);the difference was statistically significant .The difference of the venous reflux rate was not statistically significant in both two groups .The venous obstruction rate was less in the CDT group(OR=0 .19 ,95% CI 0 .11-0 .34 ,P<0 .05) and the difference was statistically significant ;while the difference was not statistically significant between ST and SA group (OR=1 .53 ,95% CI 0 .72-3 .26 ,P>0 .05) .Conclusion For acute iliofemoral deep vein thrombosis(AIFDVT) , short term (< 7 d) outcomes of catheter directed thrombolysis was better than anticoagulant therapy ,but thrombolysis brought more bleeding .In long term(>6 m) outcomes ,the post thrombotic syndrome rate was less both in the thrombolysis group and the thrombectomy ,and catheter directed thrombolysis could diminish the vein obstruction rate .

ObjectiveTo discuss dosimetric characteristics of an intensity-modulated radiotherapy (IMRT) technique for treating the chest wall and regional nodes as an integrated volume after modified radical mastectomy ( MRM ),and observe acute side-effects following irradiation.Methods From June 2009 to August 2010,75 patients were randomly enrolled.Of these,41 had left-sided breast cancer.Each eligible patient had a planning CT in treatment position,on which the chest wall,supraclavicular,and infraclavicular nodes,+/-internal mammary region,were contoured as an integrated volume.A muhi-beam IMRT plan was designed with the target either as a whole or two segments divided at below the clavicle head.A dose of 50 Gy in 25 fractions was prescribed to cover at least 90％ of the PTV.Internal mammary region was included in 31 cases.Dose volume histograms were used to evaluate the IMRT plans.The acute side effects were followed up regularly during and after irradiation.The independent two-sample t-test was used to compare the dosimetric parameters between integrated and segmented plans.ResultsPlanning design was completed for all patients,including 55 integrated and 20 segmented plans,with median number of beams of 8.The conformity index and homogeneity index was 1.43 ± 0.15 and 0.14 ± 0.02,respectively.Patients with internal mammary region included in PTV had higher homogeneity index PT.The percent volume of PTV receiving ＞ 110％ prescription dose was ＜ 5％.None of the dose constraints to normal structures was violated.There were statistically significant differences in the means of dosimetric parameters of PTV,such as Dmax,DmeanV107％,and V110％,between integrated and segmented plans (t=2.19 -2.53,P=0.013-0.031 ).≥ grade 2 radiation dermatitis was identified in 3 2 patients ( grade 2 in 2 2 patients,grade 3 in 10 patients ),mostly occurred within 1 - 2 weeks after treatment.The sites of moist desquamation were anterior axillary fold (27/37) and chest wall (10/37).Only 2 patients developed grade 2 radiation pneumonitis.Conclusions The IMRT technique applied after MRM with integrated locoregional target volume is dosimetrically feasible,and the treatment was proved to be well-tolerated by most patients.

OBJECTIVE: To investigate the prognostic value of metabolic tumor volume (MTV) and total lesion glycolysis (TLG), measured by preoperative ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT), in risk stratification of patients with endometrial carcinoma (EC). METHODS: The patients with pathological diagnosis of EC who underwent preoperative ¹⁸F-FDG PET/CT imaging were retrospectively selected for analysis of the prognostic values of PET parameters in risk classification and lymph node metastases (LNMs). Receiver-operating-characteristic analysis was used to analyze the correlation of PET parameters cutoff values with deep myometrial invasion (MI), lymphovascular space involvement and LNM for prognostic values in risk stratification. RESULTS: The sensitivity, specificity, positive predictive value, negative predictive value and accuracy for detection of LNM are 83.3%, 99.7%, 90.9%, 99.5% and 99.2%, respectively. The MTV and TLG of primary lesion of EC in the patients with LNM are notably higher than those in patients without LNM, p<0.010. The MTV and TLG of the EC primary lesions in high-risk patients are significantly higher than those in low-risk patients (p<0.010), but the maximum standardized uptake value (SUVmax) is not. The MTV and TLG of primary lesions were superior to SUVmax for predicting of deep MI, LNM and high-risk of EC (p<0.005). CONCLUSION: MTV and TLG of primary lesions are more valuable in predicting risk stratification of EC patients. Preoperative ¹⁸F-FDG PET/CT imaging is useful in predicting the LNM of EC and may help guide pelvic lymphadenectomy to avoid unnecessary pelvic lymphadenectomy in EC patients with low-risk stratification.
Classification ; Diagnosis ; Electrons ; Endometrial Neoplasms ; Female ; Glycolysis ; Humans ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Metastasis ; Metabolism ; Neoplasm Metastasis ; Positron-Emission Tomography and Computed Tomography ; Retrospective Studies ; Risk Assessment ; Sensitivity and Specificity ; Tumor Burden