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<p><b>OBJECTIVE</b>To analyze the relationship between Chinese medical constitutions and chemotherapy-induced leucopenia (CIL) of primary breast cancer patients.</p><p><b>METHODS</b>Totally 306 breast cancer patients undergoing adjunctive chemotherapy for the 1st time, and effective 291 breast cancer patients were recruited in this study.Nine Basic Constitutional Scale was used before first chemotherapy. Chinese medical constitutions were classified and quantitatively scored. The highest grading for any item of adverse reactions in each case during the whole chemotherapy course was recorded after chemotherapy. Data were statistically analyzed using SPSS16.0.</p><p><b>RESULTS</b>There was no significant difference in CIL between different chemotherapy regimens and various Chinese medical constitutions of breast cancer patients (P > 0.05). Yang deficiency constitution is one risk factor for CIL. The higher the score of yang deficiency constitution, the more severe the CIL.</p><p><b>CONCLUSIONS</b>Yang deficiency constitution was correlated with the degree of CIL. The higher the score of yang deficiency constitution, the greater the risk of III-IV grade CIL in breast cancer patients.</p>
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Female , Humans , Breast Neoplasms , Drug Therapy , Drugs, Chinese Herbal , Therapeutic Uses , Leukopenia , Medicine, Chinese Traditional , Yang DeficiencyABSTRACT
<p><b>BACKGROUND</b>Noninvasive cardiac imaging is now central to the diagnosis and management of patients with moderate probability for coronary artery disease. The aim of this study was to assess the impact of stress myocardial perfusion single photon emission computerized tomography (SPECT) on in-hospital coronary angiography and revascularization for such patients.</p><p><b>METHODS</b>Between January 2005 and June 2007, 1053 consecutive in-hospital patients (423 women, the average age of (57.2 ± 11.2) years) with suspected coronary artery disease but without any prior interventional treatment were retrospectively analyzed. All patients underwent a 2-day stress/rest (99m)Tc-methoxyisobutylisonitrile (MIBI) myocardial perfusion SPECT, including 984 exercise test and 69 adenosine test.</p><p><b>RESULTS</b>Overall, stress/rest myocardial perfusion SPECT was normal in 973 patients (92.4%) and abnormal in 80 patients (7.6%). A total of 190 patients underwent coronary angiography, 46 underwent percutaneous coronary intervention and 10 coronary artery bypass grafting during hospitalization. From the whole perspective, only 14.7% of patients with normal SPECT underwent coronary angiography, so did 58.8% of patients with abnormal SPECT (χ(2) = 97.0, P < 0.001); furthermore, the rates of revascularization in patients with normal and abnormal SPECT were 2.8% and 36.3%, respectively (27 out of 973 vs. 29 out of 80, χ(2) = 157.9, P < 0.001). The extent and severity of ischemia did not add more predictive value for subsequent coronary angiography, but did have impact on revascularization. Multivariate analysis showed that reversible perfusion defect was the most predictive variable for referral rate to coronary angiography (odds ratio = 7.5, P < 0.001).</p><p><b>CONCLUSIONS</b>Abnormal myocardial perfusion SPECT is a powerful referral for in-hospital coronary angiography and revascularization during the same hospitalization. Thus, stress/rest SPECT is an effective gatekeeper for early coronary angiography and invasive treatment for patients with suspected coronary artery disease.</p>
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Coronary Angiography , Methods , Coronary Artery Disease , Diagnostic Imaging , Pathology , Hospitalization , Retrospective Studies , Tomography, Emission-Computed, Single-Photon , MethodsABSTRACT
Objective To evaluate the clinical application of stress/rest MPI in the patients with 50％-75％ coronary artery stenosis.Methods The criteria for patient selection were that the patients should have at least one main coronary artery with stenosis more than 50％,and the maximal stenosis should be less than 75％ according to CAG.The stress/rest MPI was performed in 2 weeks before or after CAG.A total of 244 patients (178 males,66 females) with mean age (57 ± 10) years were included in this study.Symptom restriction stress test was used and stress MPI was performed 1 - 1.5 h after 99Tcm-MIBI (925 MBq)injection at the exercise peak.Rest MPI was performed within 48 - 72 h after stress MPI.Myocardial ischemia was diagnosed when there was a reduced uptake or even a defect in 2 different tomographic sections or in the same part of a myocardium in the continuous 2 slices.When there was an irreversible reduced uptake or defect,myocardial infarction was given as the final diagnosis.No reduced uptake or defect in all slices was shown as normal.The impact of MPI images on the selection for optimal clinical therapy plans was also discussed.X2 test was used for statistical analysis.Results A total of 340 coronary arteries with stenosis 50％ - 75％ were found by CAG.According to stress/rest MPI results,207 patients (84.8％)presented normal,33 had myocardial ischemia,3 had myocardial infarction,and 1 had both myocardial infarction and ischemia.In abnormal MPI images,there were 61 ischemic segments and 9 infarct segments,which were associated with 43 stenotic arteries (23 LAD,10 LCX,and 10 RCA).Patients were divided into 2 groups according to the results of MPI:Group 1 with normal MPI (207/244,84.8％ ) and Group 2 with abnormal MPI (37/244,15.2％ ).In Group 1,9 patients underwent coronary artery revascularization (PTCA or CABG),and the others had medical treatment.Eight patients had PTCA and 29 patients had medical treatment in Group 2.There was a statistically significant difference between the two groups ( X 2 =11.9,P =0.001 ).Conclusion Stress-rest MPI may be an effective method to evaluate ischemia degree for patients with 50％ -75％ coronary artery stenosis and a useful indicator for the individual treatment.
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Objective To evaluate the use of gated SPECT in patients with hypertrophic obstructive cardiomyopathy (HOCM) and the effects of percutaneous transluminal septal myocardial ablation (PTSMA) on myocardial perfusion.Methods 99 Tcm-methoxyisobutylisonitrile (MIBI) and 18F-fluorodeoxyglucose (FDG) images were performed in 31 HOCM patients before PFSMA and in 15 patients 3-7 d after PTSMA.The images in different left ventricular segments were analysed by using scores.Results In 99Tcm-MIBI images, uptake decreased at the septal regions in 12 HOCM patients (80.0%, 12/15) after PTSMA, 18F-FDG images also showed decreased uptake at the septal regions in 5 HOCM patients (33.3%, 5/15) after PTSMA.Conclusion 99Tcm-MIBI images might be an important method to evaluate PTSMA results, and 18 F-FDG images showed important value as reference.
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OBJECTIVE To explore the value of the continuous quality improvement(CQI) in the quality control of disinfection supply center.METHODS The CQI was applied to every aspect of disinfection supply center.We analyzed and identified the reason of the existence of quality problems,and took CQI measures and the implementaion of quality improvement.RESULTS After 5 years CQI,quality control of disinfection supply center had been remarkably improved.The harmony had increased among staff year by year.The professional knowledge rose from 60% to 100%,the rate of monitoring raised from 70% to 100%,the pass rate of sterilized package raised from 55% to 95%,the satisfaction rate of the relevant sections raised from 85% to 100%.The errors and accidents were eliminated or reduced owing to pay attention to quality control.CONCLUSIONS CQI plays an important role on medical service safety and can effectively improve the medical safety,medical quality and service quality.