Objective To investigate the clinical effect of the compound flaps of foot with joint transplantation bridging severed segmental damage type finger.Methods Eleven cases with segmental composite tissue damaged fingers,emergency free with plantar metatarsal or metatarsophalangeal,interphalangeal joint of the foot com posite tissue flap transplantation and bridging replanted finger form February,2006 to September,2011 were retrospective reviewed in our study.The therapeutic effect was evaluated according to the assessment standard of Chinese Medical Association of Hand Surgery.Results All patients were followed-up for 6 to 48 months.The composite flap and amputated fingers in the 11 cases were survived after surgery,with satisfactory appearance.Range of motion of interphalangeal joints from 40° to 90°,and metacarpophalangeal joints from 45° to 65°.There was no nonunion or refracture.Two-point discrimination of finger pulp was 5-8 mm.According to the Chinese Medical Society of Hand Surgery Trial upper part of the standard evaluation function assessment,the results were excellent in 3 cases,good in 6 cases,may in 2 case.Conclusion Compound flaps of foot with joint transplantation bridging severed segmental damage type finger could recover the appearance and functions of amputated fingers to satisfy the daily need of patients in a maximum degree.

Objective To investigate the relationship between carotid atherosclerotic plaque and multiple risk factors of angiocardiopathy,and to evaluate the injuries caused by different risk factors to subclinical target organ to control the general risk factors of angiocardiopathy.Methods Four hundred and twenty six outpatients and impatients,treated in our hospital from May 2007 to May 2009 with the results of color ultrasonic examination,were divided into carotid atherosclerotic plaque group(284 cases) and no carotid atherosclerotic plaque group( 142 cases).The clinical information including their age,body mass index,smoking condition,past medical history such as hypertension,diabetes mellitus and hyperlipoidemia were recorded,and the levels of total cholesterol(T C),high density lipoprotein cholesterol( HDL-C),low density lipoprotein cholesterol(LDL-C),triglyceride (TG),lipoprotein ( a ) ( LP (a) ),apolipoprotein A - 1 ( Apo A 1 ),apolipoprotein B ( Apo B ),highsensitivity C-reactive protein( hs-CRP),homocysteine ( HCY),microalbuminuria( MAU ) and uricacid(UA) were determined by lab tests.The independent variable and univariable data were processed and analyzed statistically to find out the risk factors of carotid atherosclerotic plaque.Results Age and drinking were significantly correlated with the carotid intima-media wall thickening(IMT) (P ＜ 0.001 ).Overweight,diabetes mellitus,increased LP (a),hyperlipoidemia,age,increased MAU and HCY could independently predict carotid atherosclerosis and plaque formation ( x2 =71.35,38.45,t =3.26,x2 =37.23,t =118.51,6.723 and 3.17respectively,Ps ＜ 0.05 ).The aggregated number of the risk factors was correlated to IMT and carotid atherosclerotic plaque ( P =0.0001 ).Conclusion Age,drinking,overweight,diabetes mellitus,increased LP (a),hyperlipoidemia,MAU and HCY are risk factors of carotid atherosclerosis and plaque formation,and the contribution of each factor can multiply and overlap,more risk factors means greater risk.

Objective The purpose of study was to evaluate the safety and effectiveness of theblood-letting and herbal-cupping therapy for lumbar spinal stenosis.Methods A multi-center prospective case series was performed.The LSS patients meeting the inclusion criteria received 8 treatments as a course and 4 courses in total.The primary outcomes were the symptom severity and physical function scale ofthe Swiss Spinal Stenosis Measurement (SSM,total score 0-5 for each domain).The secondary outcomes were thethe 12-item short form health survey (SF-12,total score 0-100),and Oswestry disability index (ODI,total score 0-100) at time of baseline,completion of last treatment of each course.The minimal clinically important differences (MCIDs) were calculated for estimating the percentage of improvement in the population.The adverse events were reported at any time of the intra-and post-operation.This was a phrase analysis of the studyat seven months.Results Forty-eight patientswere included,with 64.6％ (31/48) of LSS showing neurogenic claudication (walking distance ≤200 m).The average age was 63.1 ± 11.7 years,19 (39.6％) female,and the average BMI was 25.3 ± 3.3 kg/m2.The scores of symptom severity scale of SSM were 2.8 ± 0.6,2.6 ± 0.7,2.3 ± 0.6,1.9 ± 0.2 at baseline,1st,2nd,3rd course,and the scores of physical function scale were 2.5 ± 0.8,2.4 ± 0.7,2.1 ± 0.5,1.8 ± 0.3,and all the changes between baseline and each course showed significant improvement.The patient satisfaction of SSM,ODI and SF-12 showed significantimprovements after the 1st,2nd,3rd course (P＜0.05).The SF-12 subgroup physical composite scores after 3rd course and mental composite score after 1st showed no significant improvement.The minimal clinically important difference for the “SymptomSeverity scale” in the SSM was achieved withimprovement of 18.8％,40.6％,83.3％ in the LSS patient population after 1st,2nd,3rd course;and the "physical function scale" in SSM was achieved withimprovement of 22.9％,31.3％,50.0％.A total of 15 patients felt pain when they were micro-punctured with little blood at first time,but the symptom wereimmediately relieved without any treatment.Conelusions The Blood-letting and herbal-cupping therapy could benefit patients with lumbar spinal stenosis after third course of treatment in the fields of symptom relief and quality of life with no severe adverse event.However,this was a phrase analysis,so more evidence of this study and large comparative researches should be warranted in future.

Objective:To explore the feasibility of predicting axillary lymph node metastasis of breast cancer using radiomics analysis based on dynamic contrast-enhanced (DCE) MRI.Methods:The retrospective study enrolled 163 patients (163 lesions) with breast cancer diagnosed by core needle biopsy from January 2013 to December 2013 in Peking University First Hospital. The status of axillary lymph nodes in all patients was pathologically confirmed, and they had complete preoperative breast MRI images. Among the 163 patients, 94 patients were confirmed with axillary lymph node metastasis, and 69 patients without axillary lymph node metastasis. They were randomly divided into the training dataset ( n=115) and testing dataset ( n=48) in a 7∶3 ratio. The radiomics analysis was performed in the training dataset, including image preprocessing and labeling, radiomics feature extraction, radiomics model establishment and model predictive performance inspection. Model performance was tested in the testing dataset. Receiver operating characteristic curve and area under curve (AUC) was used to analyze the model prediction performance. Results:Of the 1 075 features extracted from the training dataset, principal component analyses (PCA) features 8, 41 and 67 were selected by random forest classifier. The radiomics model including 3 PCA features reached an AUC of 0.956 (95%CI 0.907-0.988), with sensitivity of 91.2%, specificity of 100% and accuracy of 94.8%. In the testing dataset, the radiomics model including 3 PCA features reached an AUC of 0.767 (95%CI 0.652-0.890), with sensitivity of 80.8%, specificity of 72.7% and accuracy of 77.1%.Conclusion:It is feasible to predict axillary lymph node metastasis using radiomics features based on DCE-MRI of breast cancer.

Objective To preliminarily verify the effectiveness and safety of bloodletting combined with drug bamboo cups in intervention of degenerative lumbar spinal stenosis,and to explore the prognostic factors that affect the efficacy of TCM regimens in the treatment of DLSS.Methods 64 consecutive patients with degenerative lumbar spinal stenosis were enrolled.Bloodletting combined with drug bamboo cup intervention was used.Acupoints were selected and treated with the same length of the governor channel of the lumbar spine,the first and second side lines of the bladder meridian and Ashi point,weekly 2 times,8 times per course,2 consecutive courses of treatment.Before treatment,after treatment,and 1 month follow-up,the changes of the patient's lumbar spinal stenosis specific scale(SSM),modified Oswestry dysfunction index(ODI),and 12 health survey summary scores(SF-12)were observed.Using SSM symptom or function score≥0.5,the criteria for grouping were first single-factor analysis,and then logistic regression was used to analyze the prognostic factors of the treatment.Results After 2 courses of treatment,the patient's SSM symptom score(2.25±0.56),SSM function score(2.06±0.67),ODI index(15.49±8.72),and SF-12 physiological score(36.31±7.35)were more significant than before treatment Improved,the difference was statistically significant(P<0.05),the SF-12 psychological score(49.70±9.47),the difference was not statistically significant compared with before treatment(P>0.05);the patient's SSM symptom score(2.22±0.54)was followed up for one month,SSM function score(2.09±0.66),ODI index(15.53±8.23),SF-12 physiological score(36.55±7.25),SF-12 psychological score(50.62±9.17),which are significantly better than before treatment,and the difference is statistically significant(P<0.05),the difference was not statistically significant(P>0.05)after 2 courses of treatment.The univariate logistic regression analysis of each influencing factor showed that:BMI,baseline symptom dimension,baseline functional dimension,foraminal stenosis,lateral recess stenosis,and two-stage stenosis had statistically significant differences between the effective and ineffective groups(P<0.05).Conclusion Bloodletting combined with drug bamboo cups has a certain clinical effect on degenerative lumbar spinal stenosis.