ABSTRACT
Objective:To assess the ability of axillary reverse mapping (ARM) to identify and preserve the arm lymphatics drainage as well as determine its ability to reduce lymphedema. Methods:A total of 300 breast cancer patients who underwent axillary lymph node dissection (ALND) from June 2009 to May 2011 were enrolled in this study. Methylene blue dye (2 mL to 3 mL) was injected into the ipsilateral upper inner arm along the medial intramuscular groove to map the upper extremity lymphatic drainage system prior to ALND. The blue lymphatic and lymph nodes were identified and preserved during the operation. The change in the arm circumference was the selected method of measurement. The difference in the bilateral upper arm circumference was recorded after 2 months (difference≥2 cm is defined as lymphedema). Results:The ARM was performed successfully in 195 (65%) of 300 patients. The incidence of lymphedema was significantly lower in the successfully mapped patients than in the failing mapping patients, with statistically significant difference during follow-up at 6, 12, 18, and 24 months post operation. Conclusion:The ARM technique can identify and preserve the arm lymphatics drainage and prevent upper extremity lymphedema after breast cancer axillary lymphadenectomy.
ABSTRACT
Objective:To make clear the present situation of treating chronic renal failure(CRF) by TCM in our hospital. Methods: Adopting a retrospective survey of medical records in a row. Results: In total of 76 cases of patients,74 cases took herbal decoction. 19 prescriptions were used which focused on Shenqidihuang Decoction 37 cases (50.00%), Huanglianwendan Decoction 9 cases (12.16%) and Dangguishaoyao Powder 7 cases (9.46%). Herbs such as Radix Salviae Miltiorrhizae,Radix et Rhizoma Rhei,Radix Achyranthis Bidentatae and Rhizoma Coptidis were the main medicines. Herbal medicine accompanied with Shenqidihuang Decoction were Cortex Eucommiae, Radix Acanthopanacis Bidentatae(62.16%), Pericarpium Citri Reticulatae, Fructrs Amomi,Radix Aucklandiae, folium perillae, caulis perillae (59.46%) and Rhizoma Coptidis, Caulis Bambusae in Taeniam, fortune eupatorium herb (48.57%) respectively. With the main methods of tonifying qi and enriching yin, activating blood and detoxifing and regulating the middle energizer. The herbal decoction had a good effect on CRF patients in the near future. Conlusion: The prescriptions used in our hospital had the characteristics of giving consideration to deficiency and excess, takes both deficiency and excess, tonification and discharge, and paying attention to spleen. The prescriptions had some effect on CRF in the near future, but the long-term effect need further observation.