One hundred branched cadavers were dissected in order to observe the morphological character of the beginning part of the vertebral artery. There are 193 cases (96.5?1.3％) out of 200 sides in which the vertebral artery takes its origin from the subclavian artery. According to the position of the origin, they may be classified into three groups: 1) in the first group it takes its origin just on the arch of the subclavian artery, out of 193 sides, 159 belong to this group, 2) in the second group, the vertebral artery originates immediately before the subclavian artery going over to form the arch; out of 193 sides, 28 belong to this group, 3) The remaining 6 belong to the third group in which the vertebral artery takes its origins from the medial wall of subclavian artery, which already lies in the cavum thorax. The verteral arteries with abnormal origins were 7 (3.5?1.3％) in number, being 1 case on the right and 6 cases on the left. Owing to the difference of the origin of the vertebral artery, the angle formed by the vertebral artery and the subclavian artery is not the same. In our specimens, the angle on the right side is usually greater than that on the left side. The most mommon foramen for the entrance of the vertebral artery is found to be the 6th foramen transversarium. The 5th, 4th and 7th came next in order. Their percentages are 93.5?1.7, 3.5?1.3, 2.0?0.9 and 1?0.7 respectively. This article has also dealt with the calibre and the surface anatomy of the origin of the vertebral artery.

Fifty systems of dural venous sinuses of the Chinese people were investigated with the purpose to clarify their anatomical patterns of confluence. Four types of patterns were classified.In the first type,“simple confluence” (22%),the superior longitudinal and rectal sinuses met in the mid-line to form a typical sinus confluence,from which the two transverse sinuses arose.In the second type,“double bifurcation”(26%),both the superior longitudinal and rectal sinuses bifurcated with the union of the right and left branches to form the corres- ponding transverse sinuses.In the third type,“rectal sinus deviation”(20%), the rectal sinus deviated to one side of the transverse sinus,while the superior longitudinal sinus bifurcated.In the fourth type,“superior longitudinal sinus deviation”(32%),the superior longitudinal sinus turned to one side of the trans- verse sinus,while the rectal sinus bifurcated or opened in one side of the trans- verse sinus. The third and fourth types were subdivided into 2 subtypes respectively,i.e., the rectal sinus turned to left(18%)and the rectal turned to right(2%)for the third;the superior longitudinal sinus turned to right(30%)and the superior longitudinal sinus turned to left(2%)transverse sinus for the fourth. The cross-sectional areas of superior longitudinal,rectal,right and left trans- verse sinuses were measured in 50 systems in order to find out the capacity of these sinuses.The capacities of both transverse sinuses of each system were com- pared.In 22%,the size of the right transverse sinuses was larger than that of the left one,while in 14%,the reverse obtained.Twenty per cent showed that the size of the right transverse sinuses,was three times larger than that of the left one,while 20% showed the contrary pattern only. The occipital sinus was studied in 44 specimens.It was noted that the occi- pital sinus was present as a single vessel or in the form of 2-4 branches.In 21 specimens occipital sinuses were measured more than 1mm,of these,3 sinus were 4-6mm in cross-section.The latter might play the role of collateral branches of the transverse sinus.

Objective:Evaluate the role of video-assisted thoracic surgery (VATS) in the treatment of bilateral synchronous multiple primary lung cancers.Methods and Results:Two paitents diagnosised as bilateral synchronous multiple primary lung cancers received one-stage treatment combined conventional thoracotomy with video-assisted thoracic surgery,performing open lobectomy to remove the larger tumor,performing wedge resection using thoracoscopy to excise the smaller one.The surgery time is short.Patients all recover smoothly without complications.To date,these two patients all alive without any sign of recurrence or metastasis of tumor,median follow-up time is 5 months (2 months+8 months).Conclusions:It is feasible to carry out one-stage treatment combined conventional thoracotomy with video-assisted thoracic surgery on patients with bilateral synchronous multiple prima-ry lung cancers,when one of the tumors of bilateral synchronous multiple primary lung cancers is classificated as T1N0M0.

Objective To investigate the clinical value of laparoscopic resection of gastric stromal tumors.Methods Thirty-two cases received this new type of operation.The tumors ranged in size from 1.5 to 5.5cm with a mean diameter of 2.6 cm.The operative methods included the full laparoscopic resection of(gastric) tumor and the hand-assisted laparoscopic resection of gastric tumor.Results All cases were(successfully) resected and no complications were observed.The mean operative time was 75min.The mean(intraoperative) blood loss was 50ml.Postoperative pain was slight.Postoperative flatus and feces were passed at a mean of 34 hours,and average postoperational hospital stay was 7.5days.Postoperative pathologic(examination) confirmed that 25 cases were benign GIST and 7 cases were of low-grade malignancy.No(recurrences) were observed at follow up of 8 to 30 months.Conclusions Laparoscopic resection of gastric(stromal) tumor is a technically simple,safe and effective procedure that could be widely used.

An expression of ras oncogene protein (p21) was assessed with immunohistochemistry in normal, dysplasia, benign hyperplasia, chronic prostatitis and prostatic carcinomatous tissues. The results showed that the positivity rate of p21 was higher in prostatic carcinoma than that in other prostatic lesions and was markedly correlated to histologic tumor grade. The expression level of p21 was more intentive in prostatic dysplasia surrounding carcinoma than that in simple prostatic dysplasia. It is suggested that overexpression of ras oncogene p21 product may play an important role in progressing from dysplasia to cancer and may be used as a new tumor marker for assessment of biological behavior of prostatic carcinoma.

To explore the discrimination model of subhealth with statistical method of partial least squares (PLS).

Objective To investigate the association between albuminuria incidence and blood pressure (BP) level or body weight index (BMI) in patients with essential hypertension from five regions in China. Methods A total of 5021 non-diabetic patients with clearly diagnosed essential hypertension were enrolled in our study. The participants came from five cities in China.Urinary albumin/creatinine ratio was measured in these patients for two times. The associations of albuminuria with BP level and BMI were analyzed. Results (1)There was no significant difference of albuminuria incidence between ＜60-year-old and ≥60-year-old patients. The longer the hypertension exited, the higher the albuminuria incidence was. (2) The albuminuria incidence was associated with blood pressure level significantly. The urinary protein excretion increased with the level of blood pressure. The albuminuria incidences in patients with normal BP, upper range of normal BP, Ⅰ , Ⅱ or Ⅲ stage hypertension were 26.3%, 27.3%, 28.7%, 31.5% and 40.3% respectively. (3) The albuminuria incidence was significantly different in patients with uncontrolled BP (≥ 140/90 mm Hg) compared with those with well controlled BP (＜ 140/90 mm Hg) (27.1% vs 30.2%, P＜0.05 ). (4) The albuminuria incidence was higher in obese patients compared with those with normal BMI at same BP level, but the difference was not statistically significant. (5) Patients with albuminuria had more cardiocerebral or renal events as compared to those without proteinuria. Conclusions The albuminuria incidence of non-diabetic hypertensive patients from 5 cities in China is 28.8%, of which the microalbuminuria incidence is 18.6% and the clinical albuminuria incidence is 10.2%. Uncontrolled BP is an important risk factor of proteinuria.

ObjectiveTo investigate the clinical characteristics,epidemiology of patients with severe fever with thrombocytopenia syndrome bunyavirus (SFTSV) infection and genetic sequences of SFTSV.MethodsClinical data of five cases of severe fever with thrombocytopenia syndrome (SFTS)from Zhoushan Hospital during May 2011 to July 2011 were retrospectively analyzed.SFTSV gene was amplified by polymerase chain reaction (PCR).CD3+ CD4+ and CD3+ CD8+T lymphocytes were detected by flow cytometry (FCM).The sequences of isolated SFTSV strains were compared with those in GenBank. ResultsThe symptoms of continuous high fever,sore muscles,enlarged superficial lymph nodes,abdominal pain,diarrhea with gastrointestinal hemorrhage were observed.The white blood cells,platelets and CD3+ CD4+ T lymphocytes were progressive decreased in acute phase with the minimum of (0.97-2.00) × 109/L,(12-42) × 109/L and 7.52％-20.39％,respectively.The SFTSV was isolated from the sera of two patients.The sequences were compared with SFTSV sequences in GenBank.The homology of RNA-dependent RNA polymerase gene was 96％ compared with BX-2010,L-WWG,LN3,JS4,SD4,HN6 and AH12; the glycoprotein gene was 94％ ; N protein gene was 95％ compared with JS4,SD4 and LN4.The homology of the above three genes between two isolates was 99％.ConclusionsOur results suggest that SFTSV is sporadic in Zhejiang Province which is probably from native epidemic focus.SFTS is progressive and severe with acute onset.Multiple organ dysfunction is common in severe eases.

In recent years, Internet plus medical care has developed rapidly, and many aspects including quality control need to be further standardized. The authors summarized the current situation of quality control in Internet plus medical care, analyzed the difficulties of quality control in Internet plus medical care, and constructed the quality control system and evaluation focus of the Internet plus medical care system from the following aspects: management system framework, personnel management, quality control in the process, post evaluation and continuous improvement.

Objective To evaluate the opening level and optimal time window of the blood-brain barrier induced by adenosine A2 receptor agonist ( Lexiscan) via dynamic enhanced MRI. Methods Twen-ty New Zealand white rabbits were divided into experiment group ( group A, n=10) and control group ( group B, n=10) . Rabbits in group A were injected with Lexiscan and rabbits in group B were injected with physiological salt via ear vein, then the coronary scanning was performed. Contrast enhanced MRI was performed at different time points ( 5, 10, 15, 20 min, and then every 10 min, until 2 h) following the in-fusion of Gd-diethylene triamine pentaacetic acid (DTPA). The signal intensity (SI) of region of interest ( ROI) was measured and the percent enhancement of SI was calculated. Evens blue staining results in brain tissues were observed. Pair t test was used to analyze the data. Results The percent enhancement of SI in group A significantly increased to (40. 93±3.70)％ at 5 min, reached the maximum of (43.03±3.62)％ at 30 min, slowly decreased until 50 min, and got to a stable level at almost 80 min. At each time point, the per-cent enhancement of SI in group A was significantly higher than that in group B ( t values:6.88-20.28, all P<0. 05) . The staining was evident in group A. Conclusions Lexiscan can open blood-brain barrier tem-porarily and reversibly, and the optimal opening time window is 10-50 min post-injection.