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.

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

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

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.

OBJECTIVESTo study the contribution of the genes and environment to variation of serum levels of lipids and lipoprotein.

METHODSOne hundred and forty-three healthy monozygotic (MZ) twin pairs and 93 dizygotic (DZ) ones aged 5 to 19 [with a mean of (11.2 +/- 3.4) years]. Microsatellite polymorphism (STR) was used to diagnose zygosity of twins, and intraclass correlation coefficient method and Falconer formula were performed to investigate heritability of serum lipids and lipoproteins unadjusted or adjusted for age and sex. Logarithmic transformation was used for data with skewed distribution. Influence of relevant physical and biochemical indicators on serum lipids and other components was analyzed with partial coefficients of correlation adjusted for age and sex.

RESULTSIn the twin samples, difference in serum level of triglycerides (TG) between MZ and DZ was not statistically significant with intraclass variation and intraclass correlation. There was significant difference in serum levels of total cholesterol (TC), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), and lipoprotein [Lp(a)] between MZ and DZ, with their heritability estimates of 0.56, 0.55, 0.49 and 0.58 unadjusted, respectively, and 0.63, 0.63, 0.55 and 0.64 adjusted for age and sex, respectively. Serum levels of TC, HDL-C, LDL-C and Lp(a) correlated reversely with age. Serum levels of TC, HDL-C and LDL-C in girls were slightly higher than those in boys. Most indicators for serum levels of lipids and lipoprotein, except for serum level of Lp(a) correlated with body mass index (BMI), body fat ratio, Pelidisi index, and other indexes such as blood pressure, blood sugar, serum level of calcium, adjusted for age and sex.

CONCLUSIONSSerum levels of TC, HDL-C and Lp(a) were influenced more greatly by genetic factors, and serum level of TG was mainly influenced by environmental ones. Levels of blood lipids in children were influenced by age and sex, and correlated with indicators that reflect their body fat and nutritional status.

Adolescent ; Adult ; Age Factors ; Child ; Cholesterol, HDL ; blood ; genetics ; Cholesterol, LDL ; blood ; genetics ; Female ; Humans ; Lipids ; blood ; genetics ; Lipoproteins ; blood ; genetics ; Male ; Sex Factors ; Triglycerides ; blood ; genetics ; Twin Studies as Topic ; Twins, Dizygotic ; Twins, Monozygotic

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

OBJECTIVEThe aim of this study was to investigate how to model an accuracy 3-dimension Finite Element Analysis (3D-FEA) model.

METHODSBased on computed tomography (CT) scan data of a woman, a 3D finite element model of the first molar on the left was rebuilt by computer imagines process and computer aided design (CAD). Analysis of the stress distribution on a cylinder dental implant and in the bone around it was conducted.

RESULTSThe stress distribution showed extremely asymmetry in bucco-lingual section: stress concentrated on the lingual side of the mandible; stress mainly was tensile in buccal side, and on the contrary compressive in lingual side.

CONCLUSIONThe results were more reliable because this model more really displayed the mandible.

Computer Simulation ; Computer-Aided Design ; Dental Implants ; Dental Stress Analysis ; Female ; Finite Element Analysis ; Humans ; Mandible ; Molar ; Stress, Mechanical

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

OBJECTIVETo compare the difference of anterior knee pain after total knee arthroplasty (TKA) between the ways using periosteal dissector and electric scalpel to release medial collateral ligament and pes anserinus.

METHODSFrom September 2009 to September 2012, 220 patients with unilateral osteoarthritis were treated with primary TKA in hospital 301. All the patients were randomly divided into periosteal dissector group (110 cases) or electric scalpel group (110 cases). In the periosteal dissector group, there were 47 males and 63 females,with an average age of (58.8 +/- 17.2) years old; the degree of genuavarus was (14.0 +/- 3.5) degrees; the weight was (65.6 +/- 12.8) kg; the body mass index (BMI) was (26.6 +/- 3.6) kg/m2. In the electric scalpel group,there were 49 males and 61 females,with an average age of (59.6 +/- 16.7) years old;the degree of genuavarus was (15.0 +/- 4.7) degrees; the weight was (66.4 +/- 13.4) kg; the BMI was (27.4 +/- 4.1) kg/m2. The mean follow-up period was 24.6 months. The AKS, VAS and HSS were used to evaluate clinical results.

RESULTSAll incisions healed at the first stage;no deep vein thrombosis of lower limbs or pulmonary embolism occurred. Knee infection occurred in 3 cases (1 in the periosteal dissector group and 2 in the electric scalpel group), and the 3 patients received stage 2 total knee revision using antibiotic bone cement and TC3 prosthesis. No recurrence of infection occurred during follow-up. Among the 20 patients who had anterior knee pain, 16 patients were in the periosteal dissector group and 4 patients were in the electric scalpel group. The occurrence rate of anterior knee pain in the electric scalpel group was lower than that in the periosteal dissector group. The AKS knee score and HSS score after total knee arthroplasty in the electric scalpel group were all higher than those in the periosteal dissector group, and the VAS in electric scalpel group was lower than that of periosteal dossector group.

CONCLUSIONCompared with using electric scalpel,using periosteal dissector used to release medial collateral ligament and pes anserinus may cause more anterior knee pain after total knee arthroplasty.

Adult ; Aged ; Arthroplasty, Replacement, Knee ; adverse effects ; Case-Control Studies ; Female ; Humans ; Knee Joint ; surgery ; Male ; Middle Aged ; Pain, Postoperative ; etiology ; Tibia ; pathology ; Treatment Outcome ; Young Adult