The evaluation systems for chronic venous insufficiency of lower extremities play a very important role in standardizing the diagnosis and evaluating the curative effect in patients with the disease. This paper gives an introduction to the CEAP classification system, VSS evaluation system and chronic venous insufficiency questionnaire.

OBJECTIVETo investigate the value of MRI follow-up in pediatric patients with spinal tuberculosis.

METHODSFrom February 2004 to April 2013, MRI imaging data in 21 children with spinal tuberculosis by pathologically and clinically proven were retrospectively analysed. There were 11 males and 10 males, with an average age of 9.4 years old ranging from 2 to 14 years old. Eighteen patients were received conservative treatment, 3 patients were treated by surgical operation. The course of disease ranged from 2 months to 3 years. All cases underwent two or more MRI examinations for follow-up. MRI findings of the first and second examination were comparatively analyzed,including signal changes of vertebral body and intervertebral, paraspinal abscess and the change of kyphosis angle.

RESULTSIn the 21 cases with tuberculosis, 85 vertebral bodies were affected in total, including 10.6%(9/85), 49.4%(42/85) and 40%(34/85) vertebral bodies separately in the cervical,thoracic, lumbosacral spine. Follow-up MRI showed vertebral body shape and signal had no obvious change during or after treatment, 15 cases with vertebral bodies changed flat or cuneate, 10 cases with disc involvement,and intervertebral space became narrowing at different level. Among 13 patients with kyphosis angle greater than 0°, 7 were located on thoracic, 2, 3, 1 were on thoracolumbar, lumbar and cervical spine, respectively. Among 18 cases with conservative treatment,kyphosis angle were 0° on the first and the follow up MRI of 8 patients. One case of mild (<10°) kyphosis,follow-up MRI during therapy showed the angle slightly increased; 5 cases with moderate (10° to 30°), follow-up MRI during therapy showed no obvious change; 4 cases with severe (>30°), follow-up MRI during and after therapy showed kyphosis increased in varying degrees.

CONCLUSIONFollow-up MRI can make a big difference in the spinal tuberculosis of children; it can clearly show the change of the vertebral body and intervertebral space, paraspinal abscess and the kyphosis angle after the treatment,which can provide reference for clinical treatment and estimating prognosis.

Adolescent ; Anti-Bacterial Agents ; therapeutic use ; Child ; Child, Preschool ; Drug Monitoring ; Female ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Male ; Radiography ; Retrospective Studies ; Spine ; diagnostic imaging ; Tuberculosis, Spinal ; diagnostic imaging ; drug therapy ; surgery

Colorectal Neoplasms ; complications ; Humans ; Male ; Middle Aged ; Neck ; pathology ; Rectal Neoplasms ; complications ; Skin Neoplasms ; diagnosis ; pathology ; secondary ; Thorax ; pathology

OBJECTIVETo investigate the effect of c-kit mutation on the prognosis of gastrointestinal stromal tumors.

METHODSA search of studies in PubMed and MedLine (from 1999 to 2008) was performed to assess the effect of c-kit mutation on the prognosis of gastrointestinal stromal tumors. The articles were retrieved with the entries of "gastrointestinal stromal tumors", "imatinib", "c-kit" and "mutation". A meta-analysis was performed to assess the data included.

RESULTSA total of 15 articles were collected in this analysis. No significant differences was found in incidence of mitoses (> 5/50 HPF) between the patients with wild type c-kit (wild type group) and the ones with mutated c-kit (mutation group) (P = 0.710); tumor recurrence and metastasis rate after surgery was significant higher in the mutation group than that in wild type group (P = 0.010); as for imatinib response with different c-kit mutation types, the results showed the incidence of clinical response (complete response + partial response) was significantly higher in mutation group than that in wild type group (P = 0.009), but the imatinib resistance rate was lower in mutation group (P = 0.000); three studies provided data for imatinib resistance with c-kit second mutations, the results showed the second mutations mainly focus on exon 13, 14, 17.

CONCLUSIONSC-kit mutation is related closely with the incidence of recurrence and metastasis in GIST after surgery. The mutations of c-kit influences the therapeutic effects of imatinib.

Antineoplastic Agents ; therapeutic use ; Benzamides ; Case-Control Studies ; Gastrointestinal Stromal Tumors ; drug therapy ; genetics ; Humans ; Imatinib Mesylate ; Mutation ; Piperazines ; therapeutic use ; Prognosis ; Proto-Oncogene Proteins c-kit ; genetics ; Pyrimidines ; therapeutic use

OBJECTIVE: To compare the echocardiography parameters during different pregnancy trimesters and to determine the reference range of echocardiography for pregnant women.METHODS: Normal pregnant women were recruited from Renji Hospital,Shanghai Jiao Tong University School of Medicine from February 2017 to December 2017.Women were randomly assigned into 4 groups,cardiac ultrasonography was performed in any one of the three trimesters or 42 days postpartum,and the reference ranges of indicators were determined in each group.Non-pregnant women of childbearing age were recruited as controls.Make a comparison of the measurement values of echocardiography at different trimesters of pregnancy.RESULTS: A total of 733 normal pregnant and non-pregnant women were enrolled,and reference values of echocardiography indexes were determined.The reference range of echocardiograph parameters for pregnant women was established for the first time.Compared with non-pregnant women,there were significant differences in echocardiography parameters among these groups. With the increase of gestational age,the radial lines of left and right atria and ventricles enlarged;the aortic root diameter and pulmonary artery diameter increased,and left and right heart systolic function declined. Most of the above changes reached a peak in the third trimester and did not return to the nonpregnancy level at 42 days postpartum. The diastolic function did not change significantly throughout pregnancy or 42 days postpartum.CONCLUSION: The current normal reference range of echocardiography is not fully applicable to pregnant women,so it is of great importance to establish a normal reference range of echocardiography for pregnant women.

How to use traditional medicine to play the role of primary health care to achieve strategic objectives of universal health coverage and health for all is an important issue for traditional medical development. World Health Organization (WHO) called out that the health system should return to primary health system which was officially launched 30 years ago. "Universal Health Coverage" was list as one of the overall objectives of WHO overall program in 2014-2019. WHO advocated incorporating traditional medicine into primary health care system to promote universal health coverage. At the same time, under the new situation of returning to the "basic health care", China has accumulated rich experience in incorporating TCM into basic health care system. Chinese medicine service has been successfully incorporated into the national basic public health services in grassroots medical institutions, and Chinese medicine service capacity has also been significantly improved under the guidance of good policy.

OBJECTIVETo study the effect of beta3 adrenergic receptor (beta3AR) Trp64Arg and peroxisome proliferator activated receptor gamma 2 (PPARgamma2) Prol2Ala polymorphisms on insulin resistance.

METHODSOne hundred and eight dizygotic twin pairs were enrolled in this study. Microsatellite polymorphism was used to diagnose zygosity of twins. Insulin sensitivity was estimated with logarithm transformed homeostasis model assessment (HOMA). PCR-RFLP analysis was performed to detect the variants. As a supplement to the sib-pair method, identity by state (IBS) was used to analyze the association of polymorphisms with insulin sensitivity.

RESULTSThe genotype frequencies of Trp64Trg, Trp64Arg, and Arg64Arg were 72.3%, 23.8%, and 3.9%, respectively, while the genotype frequencies of Prol2Pro, Prol2Ala, and Alal2Ala were 89.9%, 9.6%, and 0.5%, respectively. For beta3AR Trp64Arg the interclass co-twin correlations of Waist-to-hip ratio (WHR), blood glucose (GLU), and insulin (INS), homeostasis model assessment insulin resistance index (HOMA-IR) of the twin pairs sharing 2 alleles of IBS were greater than those sharing 0-1 allele of IBS, and HOMA-IR had statistic significance. For PPARgamma2 Pro12Ala most traits of twin pairs sharing 2 alleles of IBS had greater correlations and statistic significance in body mass index (BMI), WHR, percent of body fat (PBF) and GLU, but there were low correlations of either insulin or HOMA-IR of twin pairs sharing 1 or 2 alleles of IBS. The combined effects of the two variations showed less squared significant twin-pair differences of INS and HOMA-IR among twins sharing 4 alleles of IBS.

CONCLUSIONSBeta3AR Trp64Arg and PPARgamma2 Pro12Ala polymorphisms might be associated with insulin resistance and obesity, and there might be slight synergistic effects between this two gene loci, and further studies are necessary to confirm this finding.

Adolescent ; Child ; Child, Preschool ; Genotype ; Humans ; Insulin Resistance ; genetics ; Obesity ; genetics ; PPAR gamma ; genetics ; Polymorphism, Genetic ; Receptors, Adrenergic, beta-3 ; genetics ; Twins, Dizygotic ; genetics ; metabolism

Chinese Pharmacopoeia I (2010 edition) covers dosage and usage of traditional Chinese medicinal herbs and decoction pieces, and provides dosage ranges of most of decoction pieces. By using the descriptive statistical method, the article discusses the distribution of maximum dosage, minimum dosage and dosage range of decoction pieces set forth in Chinese Pharmacopoeia, and compares toxic drugs and non-toxic drugs. Altogether 617 drugs are included into the study. Except for 16 decoction pieces whose dosages are not clear, all of the remaining decoction pieces are covered by Chinese Pharmacopoeia, with the maximum common dosage, minimum common dosage and dosage range of 3, 10 and 6 g. Upon comparison, we discovered that Chinese Pharmacopoeia sets stricter standards for toxic drugs than non-toxic drugs. Compared with dosages in classical prescriptions and actual clinical usages, dosage ranges described in Chinese Pharmacopoeia are much narrower. There is no significant difference between drugs that can be used as foods or healthcare foods and other drugs according to Chinese Pharmacopoeia.
Drug Dosage Calculations ; Drug Therapy ; standards ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; toxicity ; Humans ; Prescriptions ; standards

Female ; Humans ; Middle Aged ; Neuralgia ; therapy ; Transcutaneous Electric Nerve Stimulation ; methods ; Treatment Outcome

Adult ; Appendiceal Neoplasms ; immunology ; pathology ; Dendritic Cell Sarcoma, Follicular ; immunology ; pathology ; Humans ; Immunohistochemistry ; Male ; Proto-Oncogene Proteins c-kit ; analysis ; Receptors, Complement 3b ; analysis