Objective：This study was designed to evaluate the efficacy of breast conserving operation plus radiotherapy. Methods： From January 1989 to march 1994, 63 cases with early breast cancer, among them, 22 cases were in StageⅠ , 41 cases in Stage Ⅱ were treated using breast conserving surgery plus radiotherapy. Tangential field irradiation was used with dose of 45 Gy－ 50 Gy. Tumor bed was irradiated additional 15 gray－ 20 gray with electron beam. Results： The 5 and 10 years survival rates were 92.1％ and 87.3％ respectively. In all of 63 patients, only 1 cases developed radiation induced pneumonitis. The cosmetic effects were satisfactory for all patients. Conclusion： In early stage of breast cancer, the effects of breast conserving operation plus radiotherapy were simitar to that of radical mastectomy. Thus for legible early stage breast cancer breast conserving therapy could be the first choice.

OBJECTIVETo evaluate the efficacy and safety of percutaneous coronary intervention (PCI) combined cardiac resynchronization therapy (CRT) for refractory heart failure secondary to ischemic cardiomyopathy (ICM).

METHODSPCI and CRT were performed in 7 ICM patients confirmed by angiography with NYHA class IV, QRS duration >/= 130 ms in 6 of them, III degrees AVB in 1 patient, fast ventricular heart rate Af in 1 patient, ventricular fibrillation history in 2 patient. All of them had their LVEDD >/= 55 mm, and LVEF

RESULTSThe procedures of PCI and CRT were performed successfully in all patients. Five patients received right atrial and biventricular pacing, one patient with Af received biventricular pacing and atrial-ventricular node radiofrequency ablation at the same procedure, and the another one patient received CRTD. One out of seven patients died of re-AMI 4 months after the combination therapy, and the other 6 patients had been alive 5 - 41 (23.2 +/- 13.8) months during the follow-up period. The heart function of the 7 patients had further improved after PCI and CRT combined therapy compared to that of PCI or CRT only. Their NYHA class decreased from IV to II, 6-minute walking distance increased steadily, and mitral regurgitation reduced and QRS duration shortened significantly. The LVEDD decreased and LVEF increased significantly in 2 patients without ventricular aneurysm, and slight improvement or no change were in the other 5 patients.

CONCLUSIONFor patients with refractory heart failure secondary to ICM, the combination of PCI and CRT could obviously improve their heart function, quality of life and prognosis, which also very safe in perforation.

Adult ; Aged ; Angioplasty, Balloon, Coronary ; Cardiac Pacing, Artificial ; methods ; Combined Modality Therapy ; Female ; Heart Failure ; etiology ; therapy ; Humans ; Male ; Middle Aged ; Myocardial Ischemia ; complications ; therapy ; Treatment Outcome

OBJECTIVETo distinguish female and male plants of Gynostemma pentaphyllum quickly and accurately in the stage of seedling and to understand the relation between sex differentiation and endogenous plant hormone.

METHODStained methods of BTB and enzyme linked immuno-sorbent Assay were used.

RESULT10 Hours after being dyed, the liquid extract of female plants turned into yellow, while extract of male ones turned green. There were obvious differences on iPAs and GA(1 + 3) contents but no differences on IAA and ABA contents between male and female plants during the stages of seedling and vegetative growth.

CONCLUSIONBTB can be used for distinguishing female and male plants and there were a certain relation between sex and endogenous plant hormones.

Gibberellins ; metabolism ; Gynostemma ; growth & development ; metabolism ; Plant Growth Regulators ; metabolism ; Plant Leaves ; growth & development ; metabolism ; Plants, Medicinal ; growth & development ; metabolism ; Sex Factors

Objective The purpose of this study was to analyze the anatomy variation of coronary vein system in patients with ischemic heart disease (IHD) and non-ischemic heart disease (NIHD).Method Forty-one patients with IHD and 87 patients with NIHD [101 men, mean age (63.5 ± 10. 6)years] were included in this study. Results Coronary sinuses were successfully cannulated and venographies were obtained in 127 cases. Transvenous LV pacing leads were successfully placed in optimal coronary vein in 123 cases (96. 09% ). The majority (76. 38% ) patients had at least one or more vessel abnormalities (thinness, stenosis, tortuousity, lack of lateral marginal vein or postero-lateral vein). The incidence of thin and tortuousity was significantly higher in lateral marginal vein than that in postero-lateral vein (P <0. 05 -0. 01 ). The incidence of lack of postern-lateral marginal vein was more frequent than the lack of lateral vein (P < 0. 05 ). The rate of abnormality in both vessels was 25. 2%. Incidence of vein lack in male was more frequent than in female ( P < 0. 05 ). The thin and tortuousity of vessels in female were more frequent than in male ( P < 0. 05 ) . The incidence of thin and tortuousity of postero-lateral and abnormality of both vessels was significantly higher in IHD than in NIHD patients ( P < 0. 05 ). All coronary sinus myocardial bridges occurred in NIHD. Stenoses of left anterior descending (LAD) and left circumflex (LCX) were mostly associated with abnormality of lateral vessels. Conclusions The anatomic variations of lateral and postern-lateral coronary vein were more frequent in this patient cohort. Vein lack in male was more frequent and the thin and tortuousity of vessels were less in male than in female patients. The ratio of vessel abnormality is higher in patients with IHD. Coronary arteries stenosis and position of infarction are associated with anatomic variations of coronary vein system.

This paper summarizes the Chinese medicine diagnosis and treatment experience of Professor Wang Shuchuan,the first session national famous Chinese medicine practitioner,on paediatric Mycoplasma pneumoniae pneumonia.It concludes that the main e-tiology and mechanism of paediatric Mycoplasma pneumoniae pneumonia is wind-warmth attacking the lungs,phlegm-heat stagnation,and injury of both qi and yin.During the initial phase,there is an invasion of the lung by dryness and warm winds,with lung depres-sion and loss of dispersion being the priority;the progression phase is mainly characterized by heat stagnation and phlegm coagulation,with phlegm heat blocking the lungs;the recovery phase is characterized by qi depletion and damage to the yin,along with yin deficien-cy and the pathogenic qi lingering internally.Accordingly,the treatment of Mycoplasma pneumoniae pneumonia is divided into three stages according to its main symptom of cough.The initial cough phase focuses on dispersing the lung and moistening the dryness with pungent-cool;the phlegm cough stage pays attention to clear the heat and purge the phlegm;the deficiency cough stage focuses on benefiting the qi and nourishing the yin and reinforcing the healthy qi,which has achieved satisfactory clinical efficacy.

BACKGROUNDMyocardial bridging with systolic compression of the left anterior descending coronary artery (LAD) may be associated with myocardial ischaemia. The clinical outcome in patients with surgical treatment for symptomatic myocardial bridging remains undetermined. This study assessed the middle- and long-term results of surgical treatment for symptomatic myocardial bridging.

METHODSFrom 1997 to 2006, 37,463 patients received selective coronary angiography in the Fuwai Cardiovascular Hospital, Beijing, China. Of these, 484 patients had angiographic diagnosis of myocardial bridging. Of the 484 patients, 35 underwent surgery for treatment of myocardial bridging with significant systolic arterial compression. Among the surgical treatment patients, 24 presented with other cardiac disorders, and the remaining 11 symptomatic patients with isolated myocardial bridging were included in the follow-up study.

RESULTSThe angiographic prevalence of myocardial bridging was 1.3% in this study. The coronary angiographies of the 11 patients revealed myocardial bridging in the middle segment of LAD causing systolic compression > or = 75% (ranging from 75% to 90%). The mean age of patients was 48.4 years. Surgical myotomy was performed in 3 patients and coronary artery bypass grafting (CABG) in 8 patients. Eight patients were operated on with an off-pump approach and 3 with a cardiopulmonary bypass technique after median sternotomy. Conversion to on-pump CABG surgery was necessary in 1 patient because of perforation of the right ventricle. The left internal mammary artery was used in all patients with CABG. The acute clinical success rate was 100% with respect to the absence of myocardial infarction, death or other major in-hospital complications. All of the patients were followed up clinically. The median follow-up was 35.3 months (range: 6 to 120 months). Nine patients were free from symptoms and one of them continued taking beta blockers. The remaining 2 patients with myotomy had atypical chest pain. One received coronary angiography again and no stenosis was found two years after operation; while exercise testing was performed in the other patient and revealed no evidence of myocardial ischaemia. None of the patients sustained a myocardial infarction or other major adverse cardiac events (death or vessel revascularization) during follow-up.

CONCLUSIONSMyocardial bridging is a relatively common angiographic finding. Surgical myotomy or CABG should be limited to patients who are refractory to oral medication. Surgical relief of myocardial ischaemia due to systolic compression of intramyocardial coronary arteries can be accomplished with low operative risk and excellent middle- and long-term results.

Coronary Angiography ; Coronary Artery Bypass ; Coronary Vessel Anomalies ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Treatment Outcome

OBJECTIVETo summarize the recent experience of surgical management of the active infective endocarditis (IE) disease in Fuwai Hospital.

METHODSFrom October 1, 1996 to December 31, 2003, 54 patients with active IE underwent heart operation in Fuwai Hospital. There were 41 males, 13 females, with an average age of 35 years old and an average weight 58 kg. Of the cases, 23 had congenital anomalies of the heart, and 1 had rheumatic valvulitis. Streptococci were found in 20 patients, staphylococci in 3, enterococci in 1, enterococcus in 2 and G(+) cocci in 1. Pre-operative cardiac classification (NYHA): class I was in 6 cases, class II in 12 cases, class III in 7 cases and class IV in 29 cases. Systemic embolization occurred in 23 cases and pulmonary infarction in 2 cases. Emergent operations were performed in 27 cases because of heart failure (8 cases), embolism (4 cases), aggressive infection (3 cases), heart failure plus embolism (2 cases), heart failure with aggressive infection (4 cases), aggressive infection with embolism (2 cases) and all the three factors (4 cases). The operations included aortic valve replacement (25 cases), aortic and mitral valves replacement (15 cases), mitral valve replacement (6 cases), mitral valve repair (3 cases), pulmonic valve replacement (1 case) and intracardiac shunt repair (4 cases).

RESULTSThe operative mortality was 17% (5 operative death and 4 lost in following-up after being discharged). All of operative deaths were due to infection. Fourteen patients had operative complications. The morbidity included peri-prosthetic leakage (8 cases), prosthetic IE (5 cases), residual intracardiac shunt (2 cases), complete heart block (2 cases), myocardial infarction, ventricular fibrillation, pulmonary trunk stenosis, and mitral regurgitation (1 case in each). Post-operative cardiac classification (NYHA): class I was in 41 cases, class II in 3 cases, class III in 1 case. Two patients were re-operated because of peri-prosthetic leakage, and then they were cured. Re-operation was also performed in other 3 patients. Unrelated late sudden death occurred in 1 patient and hemiplegia caused by anticoagulant intracranial hemorrhage in another patient.

CONCLUSIONAcceptable results can be achieved with active surgical intervention in active patients with IE.

Adolescent ; Adult ; Aged ; Cardiac Surgical Procedures ; methods ; Child ; Endocarditis, Bacterial ; etiology ; surgery ; Female ; Heart Valve Prosthesis Implantation ; Humans ; Male ; Middle Aged ; Mitral Valve ; surgery ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo investigate the experience of patients in acute cardiogenic shock required insertion of mechanical circulation support devices (MCS) before undergoing standard pretransplant evaluations.

METHODSFrom February 2005 to August 2007, 10 patients including 7 male and 3 female required emergency bridging placement of MCS. Average age was (40 +/- 16.2) years old. Mean body weight was (70.8 +/- 18.1) kg. There were 5 patients of dilated cardiomyopathy, 2 patients of arrhythmic right ventricular cardiomyopathy, 2 patients of ischemic cardiomyopathy and 1 patient of end-stage valvular heart disease. All patients were accompanied with acute decompensation of congestive heart failure. Before implantation of MCS, all patients received treatment of three or more inotropic drugs at maximal dosages, 6 patients suffered from ventricular tachycardia, 4 patients required cardio-pulmonary resuscitation treatment and 3 patients suffered from definite function defect of liver and kidney. MCS included ECMO for 8 patients, BVS5000 and MEDOS for 1 patient respectively.

RESULTSThe duration of MCS supporting was 3 to 44 d with a mean of (11.5 +/- 13.9) d. Four patients were successfully supported for getting heart transplantation, 1 patient received kidney transplantation simultaneously. Two patients recovered from acute heart failure, discharged and remained on regular heart transplantation list. One patient died from cerebral embolism after 44 days' support and 1 died from multiple organ failure after 3 days' support. Because of severe infection, MCS treatment of 2 patients was terminated ahead of schedule by their family and the patients were lost finally.

CONCLUSIONSThe use of MCS devices for acute catastrophic situation appears warranted despite the abbreviated transplant evaluations. It is important for improving the outcomes with beginning MCS support before multiple organ system failure occurs, and accurately identifying individuals who can benefit from MCS.

Adolescent ; Adult ; Aged ; Emergencies ; Female ; Heart Failure ; surgery ; Heart Transplantation ; Heart-Assist Devices ; Humans ; Male ; Middle Aged ; Preoperative Care ; Retrospective Studies

OBJECTIVETo investigate the eGFR as a risk factor for long-term (4-year) outcome in Chinese renal insufficiency patients after isolated coronary artery bypass grafting (CABG) at our institution.

METHODSFrom January 1999 to September 2003, 3371 consecutive patients who underwent isolated CABG were retrospectively reviewed. Of these patients, 549 (16.29%) patients were female, 1979 (58.71%) patients with hypertension, 866 (25.69%) patients with diabetes, 1130 (33.52%) patients with hyperlipidemia, 1011 (29.99%) patients with left main stenosis > 50%, and 1150 (34.11%) patients undergoing off-pump procedures. The mean age was (60 +/- 9) years old. Estimated GFR was calculated using the Cockcroft-Gault formula. The main outcomes were in-hospital mortality, in-hospital morbidity and long-term mortality. COX analysis was used in this study.

RESULTSThere were 649 patients with glomerular filtration rate estimates < 60 ml/(min.1.73 m(2)) and 2722 patients with glomerular filtration rate estimates > 60 ml/(min.1.73 m(2)). The in-hospital mortality and follow-up mortality was higher in the estimated glomerular filtration rate < 60 ml/(min.1.73 m(2)) group (2.77% vs. 0.77%, P < 0.01), (6.81% vs. 2.63%, P < 0.01). The COX analysis result confirmed eGFR < 60 ml/(min.1.73 m(2)), derived using the Cockcroft-Gault formula (HR: 1.948, 95%CI: 1.357 to 2.797, P < 0.01) was an independent risk factor for long-term mortality in patients after coronary artery bypass grafting surgery.

CONCLUSIONSThe estimated glomerular filtration rate < 60 ml/(min.1.73 m(2)) derived using the Cockcroft-Gault formula is an independent risk factor for long-term mortality in patients after coronary artery bypass grafting surgery.

Adult ; Aged ; Coronary Artery Bypass ; mortality ; Female ; Follow-Up Studies ; Glomerular Filtration Rate ; Humans ; Male ; Middle Aged ; Renal Insufficiency ; mortality ; physiopathology ; Retrospective Studies ; Risk Factors

Castleman's disease is a slowly progressive and rare lymphoproliferative disorder. Here, we report a 55-year-old woman with superior mediastinal Castleman's disease being misdiagnosed for a long term. We found a 4.3 cm mass localized in the superior mediastinum accompanied with severe clinical symptoms. The patient underwent an exploratory laparotomy, but the mass failed to be totally excised. Pathologic examination revealed a mediastinal mass of Castleman's disease. After radiotherapy of 30 Gy by 15 fractions, the patient no longer presented previous symptoms. At 3 months after radiotherapy of 60 Gy by 30 fractions, Computed tomography of the chest showed significantly smaller mass, indicating partial remission. Upon a 10-month follow-up, the patient was alive and free of symptoms.
Antigens, CD20 ; metabolism ; Castleman Disease ; diagnosis ; immunology ; pathology ; radiotherapy ; surgery ; Female ; Follow-Up Studies ; Humans ; Mediastinal Diseases ; diagnosis ; immunology ; pathology ; radiotherapy ; surgery ; Mediastinum ; diagnostic imaging ; pathology ; Middle Aged ; Multimodal Imaging ; Positron-Emission Tomography ; Radiotherapy, Intensity-Modulated ; Tomography, X-Ray Computed