Objective To explore the anatomic characteristics of the bronchi,arteries,and veins of pulmonary segments on the coronal section.Methods Using serial coronal sections of thorax of 20 adult cadavers,multislice spiral CT images of 4 healthy volunteers,the segmental and subsegmental bronchi,arteries,and veins were traced and observed.Results There are 6 key sections for recognition of the segmental and subsegmental bronchovascular structures of the lungs on the coronal section:1.On the section through ascending aorta,the apical,lateral,apicoposterior,anterior,and superior lingular segmental veins appeared.2.On the section through pulmonary bifurcation,the left and right superior pulmonary veins can be seen under the pulmonary bifurcation.It appears on the coronal sections of 11 cadavers(55%) that apicoposterior segmental vein,anterior segmental vein,and lingular venous trunk drained into left superior pulmonary vein simultaneously.3.On the section through bifurcation of trachea,left and right superior lobar bronchi and their branches are demonstrated clearly.Under the bifurcation of trachea,it can be seen that left and right inferior pulmonary veins empty them into left atrium.4.On the section through intermediate bronchus,the origins of segmental bronchi,arteries,and veins of inferior lobes of bilateral lungs can be found.5.On the section through thoracic aorta,superior segmental and lateroposterior basal segmental bronchovasclature appeared mainly.6.On the section through spinal column,the inferior lobes of bilateral lungs shows the bronchi,arteries,and veins of superior,lateral basal,and posterior basal segments mainly.Conclusions The pulmonary segmental arteries and veins can be recognized exactly by tracing bronchi carefully on the coronal section.

Primary hepatocellular carcinoma (HCC) is one of the most common malignant tumors worldwide.MicroRNAs (miRNAs) are a kind of endogenous non coding singlestranded RNAs,which can function as a tumor promoter or suppressor in the development and progression of human malignant tumors.Studies have shown that miRNAs play an important role in the occurrence and development of HCC.Numerous studies have found that the expression of miR-34a in various tumors is reduced and it participates in the carcinogenesis.Currently,the role of miR-34a in the tumorigenesis and development of HCC has attracted widespread attentions.Studies have confirmed that miR-34a can regulate the expression of its target genes and thus affect some key biological processes such as cell proliferation,apoptosis,invasion and metastasis of HCC.In this paper,we mainly reviewed the recent research progress on the role of miR34a in HCC.

Objective To localize precisely cerebral central sulcus on the coronal MR imaging. Methods The serieses of 4 mm thickness coronal sections and coronal MR images of brain were prepared on 30 cadaver heads. The preparation of the brain slices in correspondence with MR scan took the line perpendicular to the midpoint of intercommissural line as base one. The important cerebral gyri of cadaver were painted different colors. The coronal MR images of 6 volunteers were also prepared. The localization of central sulcus on the coronal sections was studied by the comparison of MR images with serial coronal sections of the brains. Results On the section of the central sulcus appearing for the first time, the appearing rate of dorsal thalamus was: left side 93%, right side 97%; the appearing rate of pyramidal tract was: left side 20%, right side 13%. The central sulcus almost disappeared on the section through the posterior border of splenium of corpus callosum, the appearing rate of the central sulcus on the superolateral surface was 33% on the both sides. Conclusion The central sulcus appears for the first time on the 1-2 sections which the dorsal thalamus appears on but the pyramidal tract doesn′t appear. On the section through pyramidal tract, the superior frontal, precentral and postcentral gyri can be identified according to the three medullary branches on superolateral surface of cerebral hemispheres. The central sulcus has almost disappeared on the section through the posterior border of splenium of corpus callosum.

OBJECTIVE: To assess the effect for local sensory to preserve great auricular nerve in the parotidectomy. METHOD: It was a prospective study. Eighy-one patients who underwent parotidectomy were randomly divided into 2 groups, preserving the great auricular nerve group and no preserving the great auricular nerve group. They were tested with the subjective and objective sensory function testing in 3, 6, 9, 12 months after operation. We assessed the result. RESULT: In the subjective sensory function testing, the result of the preserving the great auricular nerve group was better than no preserving the great auricular nerve group. In the objective sensory function testing, the result of the preserving the great auricular nerve group was obviously better than no preserving the great auricular nerve group. There was significant difference between the 2 groups (P<0.05). CONCLUSION It was effective for recovering the sensory function that we preserved the great auricular nerve in the parotidectomy.
Ear, External ; innervation ; Humans ; Organ Sparing Treatments ; Otolaryngology ; methods ; Parotid Gland ; innervation ; surgery ; Parotid Neoplasms ; surgery ; Prospective Studies ; Sensation Disorders ; prevention & control

BACKGROUND:As an oral anticoagulant drug, many experiments have proved that rivaroxaban can prevent the deep venous thromboembolism after the hip arthroplasty. The foreign literatures indicate that it can significantly reduce the incidence of deep venous thromboembolism after extending the treatment course to 35 days. But there is no significant conclusion at home, and the safety of drugs after extentding the course has not been confirmed. OBJECTIVE:To analyze the efficacy and safety of rivaroxaban versus low-molecular-weight heparin for the prevention of deep venous thrombosis after the hip arthroplasty. METHODS:106 patients with primary unilateral hip arthroplasty in the Second Clinical Medical College of Shanxi Medical University between March 2011 and September 2012 were selected. The patients were randomly divided into rivaroxaban group and low-molecular-weight heparin group. The patients in two groups were given drugs at 6 hours after replacement, the patients in the rivaroxaban group were given rivaroxaban 10 mg/d with the course of 5 weeks;the patients in the low-molecular-weight heparin group were given low-molecular-weight heparin 4 100 U/d with the course of 2 weeks. RESULTS AND CONCLUSION:The review and fol ow-up results showed there was no deep vein thrombosis or symptoms of deep vein thrombosis in patients of the rivaroxaban group after replacement, while seven cases (13%) of deep vein thrombosis were observed in the low-molecular-weight heparin group, and there was significant difference in the incidence rate of deep vein thrombosis between two groups (P<0.05). There were no significant differences in venous blood hemoglobin level, platelet level and coagulation function before and after replacement, as wel as the drainage volume and subcutaneous ecchymosis area after replacement of the patients received unilateral hip arthroplasty between two groups (P>0.05). The results indicate that ful course of rivaroxaban has clear effect and reliable security in the prevention of deep venous thrombosis after hip arthroplasty.

Objective To observe the major adverse reaction of irinotecan in combination with fluorouracil for advanced colorectal cancer,and sum up the nursing experience of acetylcholine syndrome and acute delayed diarrhea.Methods Pathologically confirmed 45 cases of patients with advanced colorectal cancer were treated with modified FOLFIRI regimen for total of 190 cycles.Results Acetylcholine syndrome rate was 28.9%,the incidence of acute delayed diarrhea was 40.0% ,more than 3 grade diarrhea was 6.7%.Conclusion The incidence of acute delayed diarrhea in Chinese patients is lower than in caucasians,and reasonable care measures can reduce the occurrence of adverse reactions,irinotecan in combination with fluorouracil is a safe and effective regimen for Chinese patients.

Objective To compare the clinical outcomes of bone transport technique versus induced membrane technique for treatment of infected bone nonunion.Methods A retrospective study was made on 46 cases of infected bone nonunion admitted from April 2011 to December 2014.They were 33 males and 13 females,aged from 12 to 68 years (mean,45.3 years),involving 40 tibial and 6 femoral fractures.Bone transport technique was used in 37 cases while 9 cases were treated with induced membrane technique.Fracture union and complications were recorded.The function of the affected limb was evaluated at the final follow-up using Johner-Wruhs criteria.Results The 46 cases were followed up for 9 to 18 months (mean,14 months).In the bone transport group,bone union was achieved after a mean duration of 6.5 months (range,from 4 to 11 months) without complications like wound infection or neurovascular lesions.In the induced membrane group,bone union was achieved after a mean duration of 5.8 months (range,from 4 to 11 months) and there was one case of re-infection.According to the Johner-Wruhs score system,34 cases were rated as excellent,9 as good and 3 as fair,with a total excellent and good rate of 93.5％.Bone transport technique led to 28 excellent,4 good and one fair cases in the patients with tibial nonunion,and one excellent,2 good and one fair cases in the patients with femoral nonunion.Induced membrane technique led to 3 excellent,3 good and one fair cases in the patients with tibial nonunion,and 2 excellent cases in the patients with femoral nonunion.Conclusions Both bone transport technique and induced membrane technique are effective for infected bone nonunion.Bone transport technique may be preferred for tibial infected nonunion while induced membrane technique preferred for femoral infected nonunion.

Objective To explore the clinical efficacy of locking plate in the treatment of postoperative nonunion of limb long bone fracture.Methods We treated 53 patients whose limb long bone fracture failed to unite after operation with locking plate between April 2011 and November 2014.They were 38 men and 15 women,aged from 20 to 69 (average,39.7).There were 18 humeral fractures,5 radioulnar ones,9 femoral ones,and 21 tibial ones.On average,each patient had undergone 1.2 previous operations (from 1 to 2 times),including plating in 29 cases,intramedullary nailing in 15,and external fixation in 9.In the 15 patients whose intramedullary nails were reserved because of slightly loosening only under axial stress,lateral force and rotation,the nonunion was treated with bone autograft + unicortical or full-thickness locking plate.In the other 38 patients whose original implants were removed,the nonunion was treated by re-reaming of the medullary cavity + bone autograft + locking plate internal fixation.Regular radiological follow-ups were conducted for the patients.The functional recovery of upper limbs was evaluated by the Neer system while that of the lower limbs by the Johner-Wruhs system.Results One patient was lost to the follow-up.The rest 52 were followed up for 4 to 15 months (average,12.7 months).Nonunion was found in 2 patients whose internal fixation was broken and loosened.Bone healing was achieved in 50 cases after 4 to 6 months(average,5 months).Removal of implants was conducted in 36 patients at 12 to 24 months after operation (average,13.3 months).At the final follow-ups,the Neer score of upper limb was excellent in 15 cases,good in 5,fair in one and poor in one,giving an excellent to good rate of 90.9％;the Johner-Wruhs score of lower limb was excellent in 24 cases,good in 3,fair in 2 and poor in one,giving an excellent to good rate of 90.0％.Conclusion Locking plate can have good curative efficacy in the treatment of postoperative nonunion of long bone fracture.

Objective To compare the efficacy between the treatment courses of 4 weeks and 8 weeks of lansoprazole in the treatment of endoscopic mucosal stripping ( ESD ) induced iatrogenic gastric ulcer.Methods 84 gastric adenoma or early gastric cancer patients were randomly divided into two groups after lansoprazole(30 mg/day) treatment for 4 weeks and 8 weeks.After 8 weeks of ESD, the efficacy between two groups were compared.Results 69 patients from the total 84 patients were included into the final analysis, 34 patents in 4 week-treatment group and 35 patients in 8 week-treatment group.There was no significant difference between the two groups of the ulcer stage(68% in the scar stage of 4 week-treatment group and 69% in the scar stage of 8 week-treatment group, P=0.93 ).There was no significant difference between the two groups of ulcer reduction radio (0.0081 ±0.015 in 4 week-treatment group and 0.0037 ±0.008 in 8 week-treatment group, P=0.15) 8 weeks after ESD.There was no difference in scar stage and ulcer reduction radio between 4 week-treatment group and 8 week-treatment group of patients with large ulcers ( >30 mm ) . Conclusion For ESD-induced gastric ulcer, there was no significant difference in efficacy of lansoprazole between 4 week-treatment and 8 week-treatment.It may be sufficient for proton pump inhibitors only 4 weeks’ treatment in ESD-induced gastric ulcers.

Objective To explore the mechanism of β-catenin/Akt signaling pathway in the apoptosis of gastric cancer cells induced by selenite sodium.Methods Gastric cancer cell line SGC-7901 was cultured, and 0 mol/L, 5 mol/L, 10 mol/L and 20 mol/L selenite sodium treated cells; flow cytometry was used to detect the cell apoptosis rate after 24 h;10 mol/L sodium selenite treated cells, flow cytometry was used to detect the cell cycle changes after 24 h;10 mol/L sodium selenite treated cells,protein expression ofβ-catenin,cyclin D1 and protein kinase B ( Akt) activity were detected by Western blot after 0,6,12,24 h.Results Cells apoptosis rate was significantly higher than 0 mol/L after cells was treated by 5 mol/L, 10 mol/L and 20 mol/L sodium selenite, due to cells apoptosis rate was higher by 10 mol/L sodium selenite treated than 5 mol/L and 20 mol/L, 10 mol/L sodium selenite treated cells for follow-up study;gastric cancer cells was treated by 10 mol/L sodium selenite for 24 h, compared with the control group, G0/G1 phase cells decreased, cells in S phase and G2/M phase significantly increased(P<0.05);gastric cancer cells was treated by 10 mol/L sodium selenite for 0 h, 6 h, 12 h and 24 h,protein expression of β-catenin and cyclin D1 and Survivin in 6 h, 12 h and 24 h was significantly lower than that in 0 hour (P<0.01),and with the extension of time, protein expression gradually decreased;gastric cancer cells was treated by 10 mol/L sodium selenite could significantly decrease the phosphorylation of p-Akt in 6,12,24 h, while there was no significant difference of Akt among difference time points( P <0.01).Conclusion Sodium selenite could induce apoptosis of gastric cancer cells, and the cells were arrested in S phase.The mechanism may be associated with beta-catenin/Akt signaling pathway.