[ABSTRACT]OBJECTIVETo investigate the safety of the head and neck muscle pedicle flap or flaps with single vascular pedicle.METHODSThe characteristics of thoracoacromial artery were investigated in 20 autopsy cases. Farthest point into the muscle were checked by preoperative ultrasonography and intraoperative localization with perspective observation, the muscles 1-2 cm above the farthest point were cut off from the donor site, forming a simple arteriovenous island flap pedicled pectoralis major muscle. Using the same technology and methods, sternocleidomastoid island and lower trapezius island flap were harvested.RESULTSAnatomical observation revealed thoracoacromial artery single type accounts for 12.5% (5/40), double vessel type 67.5% (27/40), multiple vessel type 20% (8/40). The rate of furthest point localization with preoperative ultrasound was 29.1% (14/48), the DSA successfully developed breast artery perforator in 66.7% (12/18) of the cases. Forty eight pectoralis major island muscle flaps, 12 internal mammary artery flaps, 18 chin flaps, 4 lower trapezius island myocutaneous flaps, 4 sternocleidomastoid island myocutaneous flaps, 3 transverse cervical artery island shaped flaps, 3 thoracoacromial artery perforator island flaps were harvested. Two flaps were failure. Partial necrosis occurred in 3 pectoralis major myocutaneous flaps.CONCLUSIONThe design of single vascular pedicle island flap for the head and neck defects is feasible and safe, and patients benefite not only for easily shaped the island flap, but also for the region appearance and function preservation in both the donor site and recipient site.

Based on modern management theories and in light of the realities of China and leadership practice, the paper analyzesd the characteristics of deputy leaders in a hospital and discussesd the specific ideas, qualities and capabilities that they must possess. It was put forward that in order to make accomplishments in strategic management and implementations, deputy leaders in the hospital should position themselves appropriately, improve their qualities, persist in learning, enhance their capabilities, attach importance to investigations and enhance their communicative ability. At the same time, they should have such qualities the as strict self-discipline, dedication, exploration, responsibility, and self-restraint as well as good communication skills. They should also have the capabilities for strategic implementations, detail management, grasp of the overall situation, harmonious teamwork, complex thinking and accomplishments in accordance with the circumstances.

The paper gives a comprehensive account of the current situation of SARS treatment and analyzes the features of the disease and its prevention and treatment, viz. SARS treatment has been conducted without RCT studies; the life quality of cured SARS patients has lowered; there is the possibility of repeated SARS outbreaks and spread; and the effectiveness of some therapeutic regimes needs to be ascertained. For this reason, it is suggested that evidence-based medicine be used in screening therapeutic regimes for SARS and that systematic assessments and standardizations be conducted so as to work out favorable regimes for SARS treatment and make efficient use of limited health resources.

Writing is a general course in universities.In writing,critical thinking can also be taught.Writing makes critical thinking visible.In teaching,teachers should change teaching methods and to emphasize on process and on students' learning.

Objective To examine the effect of resveratrol on the expression of monocyte chemoattractant protein-1(MCP-1)and brain natriuretic peptide(BNP)in myocardial cells of rats with acute pulmonary embolism.Methods Ninety-six SD rats were randomly divided into 2 groups:thromboembolism group (group T)and resveratrol + thromboembolism group (group TR),each group having 3 subgroups(n=1 6 each)in terms of different time points(1 h,4 h,8 h).The model of acute pulmonary embolism was established by infusion of autologous thrombi via the catheter inserted from the right jugular vein to the pulmo-nary artery.In group TR,resveratrol at 10 mg/kg (dissolved in 1%DMSO solution)was injected to the rats via the tail vein.Animals were sacrificed at 1,4 and 8 h after the model establishment.The rat hearts were harvested,fixed in 10%paraformaldehyde and paraffin-embedded.The expression levels of MCP-1 and BNP were detected by immunohistochemistry (SP method).Results Both MCP-1 and BNP were expressed in myocardial cells in group T and TR and gradually increased with time.The expression levels of MCP-1 and BNP were much lower in group TR than in group T at 4 and 8 h,with difference being statistically significant(P<0.05).Conclusion The expression of MCP-1 and BNP tended to increase with time in both groups.Resveratrol may protect the heart tissues by suppressing the expression of MCP-1 in myocardial tissues of rats with a-cute pulmonary embolism.

Prader-Willi syndrome is a rare genetic disorder characterized by hypotonia,poor feeding in infancy,hyperphagia with evolving obesity,hypogonadism,decreased adult height,and cognitive and behavioral disabilities.Recombinant human growth hormone (rhGH) has been used in treating Prader-Willi syndrome,and it has achieved good results.Several aspects still need to be concerned,including evaluation before rhGH treatment,age at treatment initiation,dosing,monitoring of potential side effects,tolerability,endpoint,response evaluation,use of adjunct therapies,and issues of consent.

Objective To observe the adsorption of fentanyl by different materials of the analgesic pump reservoir. Methods The concentrations of fentanyl in pump reservoirs,which were made by different materials （glass,silica gel,polyvinyl chloride,non polyvinyl chloride） were detected with the time by high-performance liquid chromatography. The measurement was repeated three times.Results Fentanyl concentration in these reservoirs decreased with time,which decreased 6.3% in silica gel reservoir （P0.05）,2.7% in non polyvinyl chloride（P0.05）,1.5% in PVC and 1.2% in glass bottles.Conclusion Fentanyl citrate will be adsorbed by different materials of analgesia pump reservoir within 72 h,and the adsorption sequence was silica capsule,non polyvinyl chloride,polyvinyl chloride,and glass bottles.

Objective To explore the clinical application of determination of troponin I(cTnI) by enzyme linked fluorescent(EL-FA) method .Methods The concentration of cTnI in serum was detected by chemiluminescence immunoassay(CLIA) method and ELFA method .The precision test ,linear test ,recovery test and interference test were done on ELFA method .The correlation analy-sis was done on the results of cTnI detected by ELFA method and CLIA method .Results Determination of the concentration of cTnI by ELFA method ,the intraassay coefficient of variation(CV) of high(30 .00 μg/L cTnI) and low (0 .12 μg/L cTnI) values were 2 .81% and 1 .62% ,the interassay CV were 5 .67% and 3 .52% .Reliable detection range detection of ELFA method was 0 .00-30 .00 μg/L .When the total bilirubin concentration less than 450μmol/L ,hemoglobin concentration less than 1 .5 g/L ,three glycerol concentration less than 7 .0 mmol/L ,the ELFA method for the determination of cTnI was without interference .Determina-tion of the concentration of cTnI had a good correlation between ELFA method and CLIA method(r=0 .971) .Conclusion The EL-FA method has good precision ,recovery and linear range ,and has a good correlation with the CLIA method ,and the ELFA method is rapid and convenient ,suitable for the emergency inspection ,can satisfy the clinical requirements .

The principal role of neutrophils in tissue repair has long been thought to be confined to killing bacteria and clearing necrotic tissue. However, recent studies have shown that neutrophils are also one of the sources of pro inflammatory cytokines and growth factors, such as IL 1, TNF ?, bFGF, VEGF,TGF ? 1 that probably serve as the earliest signals to activate local fibroblasts, epidermal cells and vascular endothelial cells and initiate tissue repair. It was also reported that neutrophils improved the proliferation removal of injured epithelial cells in airway and corneal epithelial cells. It is very important for the successful tissue repair that the function of neutrophils is normal.