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Objective To investigate the risk factors of lymphedema in patients with breast cancer after operation.Methods From January 2012 to May 2016,the clinical data of 350 patients with breast cancer who underwent surgical treatment in First People's Hospital of Foshan were collected.According to the occurrence of postoperative lymphedema,the patients were divided into lymphedema group (87 cases) and non lymphedema group (263 cases).The possible risk factors were evaluated from general demographic indicators,pathological data of breast cancer,perioperative related data and preventive action implementation.Results General demographic data:there was no correlation between the incidence of lymphedema and age,preoperative body mass index (BMI),postoperative BMI,educational level,marital status,residence,family income,menopause,hypertension history (P ＞ 0.05).Pathological data of breast cancer:the occurrence of lymphedema was related with tumor quadrant (x2 =20.039,P ＜ 0.001) and axillary lymph node metastasis (Z =4.713,P ＜ 0.001),but not related with clinical stage and pathological type of tumor (both P≥0.05).Perioperative data:the occurrence of lymphedema was related with the type of incision (x2 =16.921,P ＜ 0.001),axillary lymph node dissection level (x2 =4.433,P ＜ 0.001),the number of axillary lymph node dissection (Z =3.620,P ＜0.001),radiotherapy (x2 =33.290,P ＜ 0.001),endocrine therapy (x2 =10.428,P =0.001),but not related with surgical methods,postoperative complications (subcutaneous fluid,upper limbedema,infection,serum swelling),chemotherapy and neoadjuvant chemotherapy (all P ＞0.05).Comparison of preventive behaviors:avoiding injuries such as cuts and bites (x2 =15.754,P ＜0.001),trimming nails (x2 =9.018,P =0.003),avoiding grasping heavy objects (x2 =11.828,P =0.001) were related with postoperative lymphedema,but other preventive behaviors did not show significant correlation (all P ＞ 0.05).Lymphedema as the dependent variable,multivariate logistic regression analysis results showed that tumor located in the upper outer quadrant (OR =3.943,P ＜ 0.001),surgical incision for longitudinal incision (OR =3.767,P ＜0.001) or oblique incision (OR =2.492,P ＜ 0.001),Ⅱ (OR =1.707,P =0.003) or Ⅲ (OR =4.211,P ＜ 0.001) axillary lymph node dissection,breast/chest wall radiotherapy (OR =2.869,P ＜0.001) or lymph node radiotherapy (OR =4.829,P ＜ 0.001),grabing heavy objects or not (OR =3.264,P ＜ 0.001),avoiding injuries such as cuts and bites (OR =2.602,P ＜ 0.001) were independent risk influence factors of postoperative lymphedema.Conclusion A variety of factors affect the occurrence of postoperative lymphedema in breast cancer patients.Tumors located in the upper outer quadrant,longitudinal or oblique incision,high level of axillary lymph node dissection,radiotherapy,having injuries such as cuts and bites,grabing heavy objects are independent risk influence factors of postoperative lymphedema in breast cancer patients.More attention should be paid to the high risk of lymphedema,and the preventive measures should be taken actively.
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Objective To explore the morphological characteristics and change rule of thoracic joint angles in children aged from 10 to 12 years through thinner CT scanning and 3D reconstruction,and to provide theoretical basis for early diagnosis,treatment and prevention.Methods Totally 30 normal cases aged from 10 to 12 years were admitted into this study.There was no bone destruction,deformity,fractures,tumors and spine surgery involved.DICOM 3.0 data of multi-slice spiral CT (0.625 ～ 1.25 mm),ranging from T1 to T12,were used for 3D reconstruction,measurement and statistical analysis.Results The difference between left and right sagittal section angle of zygopophysis was less than 10°.There was no significant differences between T1,T11,and T12for sagittal section angle of upper zygopophysis (P ＞ 0.05).So was it between T3,T4,T9,T10 and T11 for sagittal section angle of lower zygopophysis (P ＞ 0.05).While there were significant differences between others(P ＜ 0.05).The was no significant difference between left and right coronal plane angle of zygopophysis (P ＞ 0.05).Coronal plane angle of lower and upper zygopophysis tended to be ‘ spike-like’,and the maximum points were at T7 to T9.For horizontal plane angle,left and right upper zygopophysis made significant differences between T2,T4,T8,T10 and T12 only,so did T7 lower zygopophysis (P ＜ 0.05).Horizontal angle of upper zygopophysis tended to be stable in the upper thoracic both in the left and right side,while a decreasing trend was shown in lower thoracic.Horizontal angle of lower zygopophysis showed a decreasing trend generally except individual vertebrae.Both upper and lower zygopophysis showed negative angle at T11 and T12 levels.Conclusion Thoracic joint angles(coronal,sagittal and horizontal angle) in children aged from 10 to 12 years can directly reflect the developmental regularity with growth,and it verified the tendency that horizontal facet joints of the cervical spine gradually changes to coronal facet joints thoracic spine and then changes to sagittal facet joints of lumbar spine.And the left and right side facet joints are basically symmetrical with the angle difference less than 10°.
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BACKGROUND:Articular process of joint is an important bony structure to maintain the spinal stability and normal physiological activities. Clinical study found that bilateral articular process asymmetry is also one of the causes of vertebral degeneration, but the existing research mainly focuses on the adult, and give priority to with cervical vertebra and lumbar vertebra. OBJECTIVE:To explore the morphological and developmental characteristics of thoracic facet joints and bony structures of 10 to 12-year-old children and compare with data of adults. METHODS:A total of 30 normal cases aging from 10 to 12 years were admitted into this study. No cases experienced bone destruction, deformity, fractures, or tumors, and spine surgery was not involved in. DICOM 3.0 data of multi-slice spiral CT (0.625-1.25 mm), ranging from T1 to T12, were used for three-dimensional reconstruction, measurement and statistical analysis. RESULTS AND CONCLUSION:(1) Joint width overal trends in“V”. Joint surface height from T1 to T12 increased gradual y with the increase of the operation sequence. (2) The joint thickness from T1 to T12 showed a gradual y increasing trend with the increase of the job sequence;articular process under the joint thickness was gentle. In the left and right sides of the upper and lower joints, joint surface width, height, and thickness did not show significant difference in addition to the significant difference between the individual vertebral body. Joints spacing on the side and there was no significant difference between upper and lower, articular process spacing between sides showed an increasing trend with the increase of operation sequence;upper and lower joints spacing increased with the job sequence, and showed wide“U”shape. (3) These results confirmed that the application of three-dimensional reconstruction techniques can display shape and characteristics of each vertebral body clearly and intuitively and improve measurement accuracy. Width and height of facet joints in 10-12-year-old school children were overal smal er than those of adults. The distance between upper and lower facet joints changed a little. Distance between left and right facet joints increased from T1 to T12, which complies with the growth and development of children.
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Objective To evaluate the method and resultassess the effect of intravesical instillation of high dose mitomycin at high dose combined with transurethral Holmium laser therapy in the treatment of on cystitis glandularis. Methods Fifty-eight patients with cystitis glandularis diagnosed through cystoscope biopsy were treated with intravesical instillation of mitomycin at high dose after transurethral Holmium laser therapy. Results All patients were all followed up in 6 - 36 months. The clinical symptom of Thirty-seven patients disappeared were cured, and 16 patients were alleviated, and 5 patients recurred. Conclusion Combining the transurethral Holmium laser therapy with high dose mitomycin intravesical instillation is effective and safe against local recurrence of cystitis glandularis.