Objective To evaluate the significance of IgM treponema pallidum specific antibody in the diagnosis of syphilis in various periods.Methods By using Western bloting(WB),tolulized red unheated serum test(TRUST),treponema pallidum particle agglutination(TPPA) and treponema pallidum (TP),we examined and analyzed 21 cases of first-stage syphilis, 8 cases of second-stage syphilis, 4 cases of latent syphilis, 3 cases of new born infants suspected with congenital syphilis, 7 cases of syphilis formally treated for 18 months and 5 cases of healthy control groups.Results The positive rates of IgM, TRUST, TPPA and TP in first-stage syphilis cases were 100.0%, 42.9%, 57.1% and 66.7% respectively. The positive rates of IgM, TRUST and TPPA in second-stage syphilis, latent syphilis and congenital syphilis were all 100.0%.The positive rates in syphilis cases received 18 months treatment were 0%(IgM), 28.6%(TRUST) and 100.0%(TPPA). The IgM,TRUST and TPPA in control groups were all negative.Conclusion The specific antibody of IgM treponema pallidum has high sensitivity and specificity,and hence can be applied in the diagnosis of syphilis in various periods.

Objective To assess the performance capability of syphilis serology among STI laborato-ries in Guangdong Province. Methods Positive and negative sera samples were prepared and delivered toSTI laboratories. Non-treponemal and treponemal quantitative and qualitative tests were performed with these samples based on standardized procedures. Quality and proficiency of syphilis serology among these labora-tories were evaluated. Results A total of 225 STI laboratories in Guangdong Province participated in this survey, 3696 serological tests for syphilis were performed from 2004-2006. The outcomes showed that the total reproducibility among participating laboratories increased from 82.5% in 2004 to 90.0% in 2006 (x2 =16.8, P ＜ 0.05), and the percentage of laboratories with a performance level higher than the provincial average level rose from 64.7% in 2004 to 76.8% in 2006. The total reproducibility was 95.5% for non-treponemal qualitative tests,95.0% for treponemal qualitative tests, 82.1% for non-treponemal quantitative tests, and 81.1% for treponemal quantitative tests. The false-negativity and false-positivity rates were 4.7% and 4.0%,respectively, for non-treponemal qualitative tests, and 7.2% and 0.4%, respectively, for treponemal qualitative tests. Conclusions It is important to do capability building and improve the performance of STI laborato-ries, in order to prevent and control syphilis.

BACKGROUND: Posterior antebrachial skin is beneficial for repairing injury of dorsum of hand; however, according to lacking operative researches on distal pedicel arterial perforators of posterior antebrachial cutaneous nerve nutrient vessel flap, it is still a confusing problem in clinic.OBJECTIVE: To investigate the features of distal antebrachial arterial perforators of dorsal forearm and provide anatomical theories for suitable designing pedicle flap and compound flap at distal flap pedicled with nutrient vessels of posterior antebrachial cutaneous nerve.DESIGN: Single sample observation.SETTING: Researching Center of Clinical Anatomy, Military Institute of Orthopaedics, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA.MATERIAL5: The experiment was carried out at the Researching Center of Clinical Anatomy, Military Institute of Orthopaedics, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA from May to October, 2004. Thirty-three upper limbs of adult cadavers perfused with red latex through arteries were provided by Researching Center of Clinical Anatomy, Military Institute of Orthopaedics, Fuzhou General Hospital of Nanjing Military Area Command of PLA.METHODS: Thirty-three adults upper limbs were dissected and observed with microscope with taking rhe styloid process of ulna and radius as pivot point.MAIN OUTCOME MEASURES: ① Distal antebrachial arterial perforators of dorsal forearm; ② nutrient vessels of distal posterior antebrachial cutaneous nerve; ③ their blood supply relationship with nearby muscle, bone and skin.RESULTS: ① Along extensor digitorum communis muscle, distal antebrachial arterial perforators of dorsal forearm were perforated along bilateral muscular interspace and tendon interspace to form lateral and interior inosculated vascular plexuses of fascia. The axis of lateral muscle interspace, dorsal antebrachial lateral vascular plexuses consisted of lateral branch of dorsal carpal branch of anterior interosseous artery, radial interosseous cutaneous perforators, radial interosseous cutaneous perforators of posterior interosseous artery, carpal dorsal branch of radial artery and its perforators. The axis of medial muscle interspace, dorsal antebrachial medial vascular plexuses was consisted of medial branch of dorsal carpal branch of anterior interosseous artery, ulnaris interosseous cutaneous perforators, ulnaris interosseous cutaneous perforators of posterior interosseous artery, carpal dorsal branch of ulnaris artery and its perforators. ②Above mentioned arterial perforators sent out cutaneous branches, fascia branches and posterior antebrachial cutaneous nerve nutrient vessel to form vascular chain of cutaneous nerve stem and vascular nets of deep and superficial fascia.Muscle-periosteum branches of posterior interosseous artery had some ulnar periostea whose radial interosseous cutaneous perforators were anastoimosed with periosteum vessels in the middle and inferior segments of radius; therefore,there was an anatomic basis for distal pedicele compound flap.CONCLUSION: Blood supply of distal antebrachial arterial perforators of dorsal forearm is characterized by multiple sources, obviously longitudinal distribution and homologous nutrient vessel; therefore, there are three blood-supplied distal pedicled flap or compound flap of posterior antebrachial cutaneous nerve nutrient vessel. Rotation point of distal pediclde flap can reach wrist joint, and the compound flap can be applied in repairing the injury of distal tissue of hand.

Objective To explore the relative factors on delayed encephalopathy after acute carbon monoxide poisoning(DEACMP)and the signifiance of P 300 for judging the severity and prognosis of DEACMP.Methods Thirteen aspects such as contact time with carbon monoxide (CO)?coma time et al were analysed between 44 patients with DEACMP (DEACMP group)and 42 patients with acute CO poisoning but without DEACMP (ACMP group). P 300 s were studied in the patients with P 300 as compared with the patients had just caught acute CO poisoning (DEACMP group).and 44 normal controls (NC group).Results There was extremely significant difference in contact time with CO,coma lasting time,treatment time with hyperbaric oxygen,age,complication ( P

Objective The investitgation of vascularized periosteal flap with dorsal branch of anterior interossea vessel was performed to provide anatomical basis for periosteal flap transposition. Methods The courses, branches, distribution and anastomosis of the dorsal branch of anterior interossea vessel were observed on 30 sides of adult cadavers' upper extremities and stimulated operation were perfomed. Results The dorsal branch penetrate out of interosseous membrane of forearm at (6. 6? 1. 4) cm upper the styloid process of the radius. It also sent off branches to the dorsal of ulna and radius that consist the periosteal flap. The dorsal branch send off lateral and medial branch about (2. 6?0. 8) cm upper the styloid process of the radius. The end of the branch anastomoses with dorsal carpal branch of the ulnar and radial vessel' Conclusion The pedicled osteoperiosteal flap can be transferred for repairing the fracture nonunion of ulna and radius and transpose reversely to repair scaphoid and innate bone disease'

Objective To provide the anetomic base for the transposition of spine of scapular flap pedicled with thoracoacromial artery Methods The course, branches and distribution of thoracoacromial artery were observed on 40 adult cadaver specimens Results The main branch of thoracoacromial artery was the acromial branch Its length was (5 1?0 1) cm, the originated diameter was (1 2?0 2) mm The deltoid muscular branch went outward intermuscular ditch between deltoid muscle anspectoralis major muscle, and anastomosed with anterior humeral circumflex artery constantly besides distributing to deltoid muscle and pectoralis major muscle, its diameter was (1 9?0 2) mm, the length form the originated dot to the entrancing muscular dot of deltoid muscle or pectoralis major muscle was (4 8?0 5) cm or (3,2?0 4) cm respectively Conclusion The transposition of lateral segment spine of scapular flap pedicled with the acromial branch of thoracoacromial artery or deltoid muscular branch acromial branch may be designed for repairing proximal humerus

BACKGROUND: The distally based skin flap pedicled with nutrient vessels of saphenous nerve has provided a method with higher achievement ratio to repair the tissue defect of ankle and foot, due to its high rotation point, lacking of distributive characteristics of distally pedicled vessels description for the specific operations, so it is still difficult in clinical application.OBJECTIVE: To investigate the distal artery perforators of medial leg, so as to suggest an anatomical theory for the reasonable design of the distally based compound flap pedicled with nutrient vessels of saphenous nerve-great saphenous vein.DESIGN: A single sample experiment.SETTING: Researching Center of Clinical Anatomy, Military Institute of Orthopaedics, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA.MATERIALS: The experiment was carried out in the Researching Center of Clinical Anatomy, Military Institute of Orthopaedics, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA from May to October, 2004.Thirty-four adult specimens perfused with red emulsion at lateral arteries of upper lower limbs were provided by the Researching Center of Clinical Anatomy, Military Institute of Orthopaedics, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA.METHODS: Specimens of the distal medial legs were dissected with microscope taking the most prominent point of medial malleolus as the pivot point.MAIN OUTCOME MEASURES: ① Distal artery perforators of medial leg; ② Distal nutrient vessels of saphenous nerve-great saphenous vein; ③ Blood supply correlation of nutrient vessel with neighboring muscle, bone and skin.RESULTS: ① The distal artery perforators of medial leg derived from 9 main blood supplying sources were as follows:Intermuscular perforator of posterior tibial artery, superior malleolar branches of anterior tibial artery, osteocutaneous perforators of peroneal artery or posterior tibial artery, medial malleolar branch of medial anterior malleolar artery, tarsal tunnel branch of posterior tibial artery, medial malleolar branch of medial plantar artery, medial malleolar branch of lateral plantar artery, medial malleolar branch of the superficial branch of medial plantar artery and medial maleolar branch of medial tarsal artery. ② The above-mentioned artery perforators sent out cutaneous branches, fascial branches, periosteal branches, nutrient vessels of saphenous nerve and great saphenous vein, thus formed a superior and inferior vascular net of deep fascia, vascular chain of superficial fascia and neurocutaneous superficial vein, and periosteal vascular network. Artery perforators constituted 3 distal longitudinally distributed fascial vascular plexus in medial leg (anterior, middle and posterior), including anterior longitudinally distributed fascial vascular plexus of medial anterior malleolar artery and superior malleolar branch of anterior tibial artery; middle longitudinally distributed fascial vascular plexus of osteocutaneous perforators; posterior longitudinally distributed fascial vascular plexus of malleolar canal artery perforators and intermuscular perforators of posterior tibial arteries.CONCLUSION: The blood supply of distal medial leg, which makes the anatomical basis for distally pedicled compound flaps, has the anatomical characteristics of multiple-sources, longitudinal distribution and homogeneity of nutrient vessels.Three kinds of distally pedicled skin flap supplied by nutrient vessels of saphenous nerve-great saphenous vein can be designed by taking the intermuscular perforator of posterior tibial artery, fascial perforators of medial anterior malleolar artery and artery perforators of tarsal tunnel perforators as pedicle, and the point of rotation is on the plane of medial malleolus, which are suitable for repairing the defects of distal leg, ankle and foot.

Objective To provide anatomic basis for sensation restoratiou of distally based island flap pedicled with nutrient vessels of superficial peroneal nerve by use of lateral sural cutaneous nerve. Methods The origin, course and distribution rule of lateral part sensory nerve of leg were dissected and observed in 40 antisepticized adult cadaveric limbs. Results ①Lateral sural cutaneous nerve originated from common peroneal nerve 7cm above apex of fibular head, descended short distance along common peroneal nerve, then passed through pepliteal fascia to facies lateralis cruris,along the way it sent out 1-3 terminal branches, which distributed over the skin of Ⅰ , Ⅱ area in the posterior lateral leg. ②Superficial peroneal nerve originated from common peroneal nerve 1.9cm below apex of fibular head, descended forward between peroneus longus and fibula, then descended between peroneus longus and peroneus brevis, and sent out branches to the two muscles. The nerve bole (pure sensory nerve branch) descended straight between peroneus brevis and anterior cmral intermuscular septum, at the juncture between Ⅱ、Ⅲ area in facies lateralis eruris, passed through deep fascia to subcutaneous tissue, then sent out medial dorsal cutaneous nerve of foot and intermediate dorsal cutaneous nerve of foot, which distributed over the skin of dorsum of foot and Ⅲ area in facies lateralis cmris. Conclusion It may be available in sensation restoration of distally based island flap pedicled with nutrient vessels of superficial peroneal nerve through anastomosis of lateral sural cutaneous nerve bole with sensory nervous ramification of recipient site.

Objective To investigate the clinical application of subaxillary curved mini-incision thoracotomy in thoracic operations. Methods Through a subaxillary curved mini-incision between the latissimus dorsi muscle and the serratus anterior muscle (length of incision, 8~14 cm), thoracic operations were performed in 65 patients with thoracic diseases, including pneumothorax or hemopneumothorax (13 patients), pulmonary benign tumor (23 patients), mediastinal tumor (4 patients), and esophageal benign or malignant tumor and cardiac cancer (25 patients). Results All the patients were successfully operated on. No surgery-related deaths occurred. The incidence of complications was 6.2% (4/65), including pleural effusion in 1 patient, pulmonary infection in 2 patients, and anastomotic leakage of esophagogastrostomy in 1 patient.Conclusions Subaxillary curved mini- incision thoracotomy, characterized by minimal invasion, little blood loss, mild influence on cardiopulmonary functions, quick recovery, and good cosmetic outcomes, is an ideal option for the treatment of thoracic diseases.

Objective To explore the clinical application of perforating branch flap of medial vastus muscle. Methods Perforating branch flap (muscle branch) of medial vastus muscle was designed by using the surface projection of the medial vastus muscle artery as flap anxial line and the given point of direct cutaneous artery as flap center to repair skin and soft tissue defects of the knee in seven patients.Results All flaps survived well with primary healing in all patients, with one stage healing. After a follow-up for 1-18 months, all flaps turned out to be with good texture and satisfactory appearance and function of the flaps. Conclusion The surgery of perforating branch flap of medial vastus muscle is simple,safe and easy handling and provides a new feasible surgical procedure to repair skin and soft tissue defects of medial femur and around the knee.