ABSTRACT
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.
ABSTRACT
ObjectiveTo observe the prepulse inhibition(PPI) ot the startle reflex of pure cerebral concussion (PCC) suffered from one concussion and multiple cerebral concussion (MCC) suffered from three concussions in rats,and to explore accumulate effect upon cognitive dysfunction of MCC.MethodsA metallic pendulum striker device for closed head injury was employed to duplicate PCC and MCC models in Stragu-Dawley rats.The MCC rats were hit three times on rats'head and it is interval 24 hours for every hit.According to the criteria of cerebral concussion,the investigated animals were divided into PCC group and MCC group at freedom.One control group was used.Each group included 10 animals.Each experience mental animal was tested from 3 days pre-injury to 28 days post-concussion.Startle reflex amplitude (for P values),pre-stimulation induced reflex amplitude on three standard stimulations,that was,67dB,69dB and 73dB (for PP67,PP69 and PP73 values) and prepulse inhibition of the startle reflex (PPI) were collected.ResultsThe P values and three PP values in the first three days of pre-replication experiment,there was no statistical significance in each group.However the P values and PP67,PP69 and PP73 values declined until to the 16th day after injury (P＜0.05),then recovered in PCC group.The P value and PP67,PP69 and PP73 values changes of MCC group declined and not recovered until to test end (P＜0.05 ) and they were more lower than PCC.The three PPI values were a little bit increase in both groups,there were statistics significance at some test points (P＜0.05) compared with control.ConclusionThe startle reflex amplitude and pre-stimulation induced reflex amplitude weaken after cerebral concussion and there is damaging accumulate effect to injury times,the PPI is enlanced by cerebral concussion.
ABSTRACT
Objective To observe learning and memory behavior changes of one time cerebral concussion called pure cerebral concussion(PCC)and three times cerebral concussion called multiple cerebral concussion (MCC)after injured 24 days in rats.Methods A metallic pendulum striker device was deployed to duplicate PCC and MCC model in SD rata which were the complete closed head injury model.The animals were divided into PCC and MCC groups at random.One control group was used,each group has eight animals(n=8).One 8-arms radial maze was used to assessed each animal's capabilities,that is,spatial reference memory,working memory,spirited activity and take in food.Results Compared with control group,there were some significance(P＜0.05)in both experiment groups post injury,that was,(1)The food intake decreased,PCC group from the 1st to the 11th day(from 0.00±0.00 to 2.62±1.76)after injury,MCC group from the 1st day to the 24th day(from 0.00±0.00 to 0.75±1.48)after injury.(2)Spirited activity depressed,PCC group on the 1st to the 7th,13rd day(from 4.87±1.24 to 10.0±2.39)after injury,MCC group on the 1st to 8th,22nd day(from 4.25±5.03 to 9.37±4.20)after injury.(3)The spatial reference memory was lower in early then gradually increased,PCC group on the 1 st to 7th day(from 0.50±0.75 to 3.O0±1.06)after injury,MCC group from the 1st to 19th day(from 1.88±2.10 to 2.50±2.44)after injury.(4)The working memory was delaying damaged,PCC group from the 1st to the 6th day and the 10th to the 23rd day(from 0.00±0.00 to 4.25±3.05)after injury,MCC group on the 1～4th,6th,9～13th,15th,16th,19th～22nd day(from 0.25±0.46 to 3.12±2.87)after injury.Conclusion The injured rata'capability of spatial reference memory,working memory,spirited activity and food intake were obviously damaged after CC,and the MCC group's capability of spatial reference memory,spirited activity and food intake was worse than PCC group.