Objective To provide the anatomic base of the breast n erves for the regional surgery. Methods A total of 15 ca daveric specimens (30 sides) were dissected to observe the distribution of T 2~ T 6 laterial cutaneous branch of the anterior branch of intercostal nerves (LCA IN) and anterior cutaneous branch of the anterior branch of intercostal nerves ( ACAIN).Results The distances from the site of LCAIN perfo rating to the anterior middle one were gradually increased from T 2 to T 6, wh ile the diameters of the nerves were decreased. The sites of T 2~T 6 ACAIN wer e consistedt and situated 2.5 cm on the anterior middle line, which gradually de creased in diameter at the perforation sites. The skin and cutaneous tissues of the breast were segmentally overlapped by anterior branches of intercostal nerve s.Conclusions The nerve to breast includes superclavicula r nerve, breast branches of ACAIN and LCAIN. It is possible to block ACAIN and L CAIN to obtain analgetic effect.

Objective To observe the therapeutic efficacy of Ganshuang granules in the treatment of hepatic fibrosis.Methods Sixty-eight patients with cirrhosis due to chronic hepatitis B (CHB)were divided into experimental group (n=34)and control group (n=34).Both groups received adefovir dipivoxil for 6 months,and the experimental group received Ganshuang granules additionally for 24 weeks.After treat-ment,the changes in hepatic fibrosis indices including hyaluronic acid (HA),laminin (LN),collagenⅣ(CⅣ),and precollagenⅢ(PCⅢ),as well as liver stiffness value were evaluated by paired t test.Results In the experimental group,the serum levels of HA,LN,CⅣ, and PCⅢwere significantly decreased by 37.5%,34.2%,35.4%,and 39.9%,respectively (t=2.238,2.151,2.148,and 2.198,P<0.05 for all),and the liver stiffness value was significantly cut by 40.6%(t=2.189,P<0.05).However,the control group showed no sig-nificant changes in these indices.Conclusion For patients with cirrhosis due to CHB,Ganshuang granules can effectively reduce serum mark-ers of hepatic fibrosis and liver stiffness value and have a good therapeutic efficacy in the treatment of hepatic fibrosis.

OBJECTIVE:To study the effects of ritonavir on the pharmacokinetics of sufentanil in rabbits. METHODS:24 rab-bits were randomly divided into 2 groups,with 12 rabbits in each group. Trial group was given ritonavir 10 mg/kg by gavage and then injected sufentanil 2 μg/kg intravenously after 5 min. Control group was given equal volume of normal saline by gavage and then injected sufentanil 2 μg/kg intravenously. Arterial blood samples 0.3 ml were taken before gavage and 0,0.25,0.5,1,2,3, 4,6,8,10,12,14,24 h after intravenous administration. The plasma concentrations of sufentanil were determined by LC-MS/MS,and DAS 2.0 software was adopted to calculate pharmacokinetic parameters. RESULTS:The pharmacokinetic change of sufen-tanil conformed to two-compartment model in 2 groups. The pharmacokinetic parameters of sufentanil in control group vs. trial group were that t1/2 were(22.0±6.59)and(26.4±1.41)h;MRT0-24 h were(8.6±2.08)and(12.1±3.70)h;AUC0-∞ were(16.1± 5.17)and(38.1±12.95)mg·h/L,respectively. There was statistical significance in MRT0-24 h and AUC0-∞ between 2 groups(P<0.05). CONCLUSIONS:Ritonavir can elevate distribution of sufentanil in rabbits,and prolong retention time of sufentanil.

Objective To determine the efficacy of side-to-side anastomosis in the treatment o f peripheral nerve injury.Methods Ten cases of peripheral nerve injury which could not be repaired by the routine methods were selected in thi s study by using the side-to-side anastomosis.The average time between injury to operation was 4months(1to 10months).The injured nerve trunk was kept abr east of neighbor donor nerve at suitable segment,the opposite epineurium and fascicle of two nerve were cut open 1-2cm until nerve fiber was seen.Two segments were clo sed together tightly and the side-to-side anastomosis was performed wit h9/0-11/0threads.Clinical and EMG e xamination were carried on in each case.Results Nine of ten cases were followed-up for 3months t o 3years,with an average of 16months.M3S3or b etter of their main nerve control area were found in 6/9c ases,and M2S3 - in 3/9.No obvious motion or sensory f unction loss was seen after the surgery,or the dec rease from M5S5down to M4S4of the don or nerve postoperatively re-covered in 3weeks to 3months.Conclusion Side-to-side anastomosis of peripheral nerve is a new remedy measure to treat those peripheral nerve injury which can not be treated by routine procedures.[

Acupuncture Points ; Acupuncture Therapy ; Burning Mouth Syndrome ; therapy ; Female ; Humans ; Middle Aged

Objective To detect the expression of epidermal growth factor receptor (EGFR) and cyclooxygenase-2(COX-2 ) in laryngeal squamous cell carcinoma and to investigate their clinical significance.Methods Resected tissue of laryngeal squamous cell carcinoma (observation group)and adjacent normal laryngeal mucosa ( control group) from 54 patients were collectod.Accooding to histological differentiation degreo,cervical lymph node metastasis,clinical TNM staging,EGFR and COX-2 were compared.Results The expression rate of EGFR in observation group [63.0％ (34/54)] was higher than that in control group [42.6％ (23/54)] (P ＜ 0.05 ).And COX-2 in observation group [68.5％(37/54)] was higher than that in control group [35.2％ (19/54)] (P ＜0.01).The expression of EGFR and COX-2 in observation group (0.584 ±0.136,0.561 ±0.134) were significantly higher than those in control group (0.161 ±0.045,0.114 ±0.027),respectively (P ＜0.01).The expression of EGFR and COX-2 had significant difference among histological differentiation degree,with or without cervical lymph node metastasis,different clinical TNM staging (P ＜ 0.05 or ＜ 0.01 ).Correlation analysis showed that the expression of EGFR and COX-2 in laryngeal squamous cell carcinoma had positive correlation (r =0.602,P ＜ 0.01 ).Conclusions The expression of EGFR and COX-2 have some contribution to the incidence and development of laryngeal squamots cell carcinoma.They can be used for the different diagnosis of benign and malignant carcinoma,clinical staging and prognosis estimating.They have significant clinical values.

Objective To investigate the effect of different treatment on ST-elevation myocardial infarction (STEMI) by evaluating the changes of myocardial collagen metabolism. Methods Forty-one patients with STEMI were divided into drug treatment group (22 cases) and selective percutaneous coronary intervention (PCI) group (19 cases). Meanwhile,47 healthy controls were included in control group. The levels of serum carboxy terminal propeptide of type Ⅰ procollagen (PⅠCP), precollagen Ⅲ ( PC Ⅲ ), matrix metalloproteinase-1 (MMP-1) and tissue inhibitor of metalloproteinase-1 (TIMP-1) were measured by enzyme-linked immunosorbent assay at the 3rd ,6th, 12th, 18th month after STEMI,and compared with those in control group. Results The level of P Ⅰ CP in selective PCI group was significantly lower than that in drug treatment group at the 3rd, 6th month [( 15.08 ± 3.37 ) μ g/L vs. ( 19.78 ± 2.22 ) μ g/L, (23.88 ± 3.33 ) μg/Lvs. ( 30.00 ± 3.14) μ g/L, P ＜ 0.05], but there was no significant difference at the 12th and 18th month (P ＞0.05 ). The level of serum PC Ⅲ in selective PCI group was significantly lower than that in drug treatment group at the 3rd month [(50.70 ±4.83) ng/L vs. (59.91 ±4.64) ng/L,P ＜0.05],and there was no significant difference at others times between drug treatment group and selective PCI group. There was no significant difference in P Ⅰ CP/PC Ⅲ between drug treatment group and selective PCI group in all times(P ＞0.05). Compared with those in control group,the levels of serum MMP-1 in all times were significantly decreased in drug treatment group and selective PCI group(P ＜ 0.05 ), but there was no significant difference between drug treatment group and selective PCI group at same times (P ＞ 0.05). The level of serum TIMP-1was significantly higher in selective PCI group than that in drug treatment group at the 3rd and 6th month [(61.89 ± 11.44) μg/L vs. (52.23 ±4.97)μg/L, (62.85 ±6.31) μg/L vs. (52.97 ±6.43)μg/L,P＜0.05] ,and there was no significant difference in TIMP-1 between drug treatment group and selective PCI group in other times (P＞ 0.05). MMP-1/TIMP-1 in selective PCI group was significantly lower than that in drug treatment group at the 6th month [( 1.53 ± 0.25 )% vs. ( 1.95 ± 0.04)% ,P ＜ 0.05] ,and there was no significant difference in MMP-1/TIMP-1 between drug treatment group and selective PCI group in other times (P ＞0.05). Conclusions Selective PCI can improve myocardial collagen metabolism in patients with STEMI in short term ( ＜ 6 months), but it doesn't appear to be superior to drug treatment in long term (6 - 18 months). Patients with STEMI should enforce drug treatment if they have not been treated with PCI.

liver fire exuberant syndrome. Conclusion Hs-CRP and IMT can be used as important indexes of TCM syndrome differentiation of MS.

Objective To review the clinical characteristics of idiopathic portal hypertension (IPH).Methods The clinical and pathological data of 10 patients with idiopathic portal hypertension admitted from December 2008 to December 2014 were retrospectively analyzed.Results Among 10 patients 5 were males and 5 females with averaged age of (38.6 ± 16.1) years.There were splenomegaly and esophageal varices in all 10 cases,upper gastrointestinal bleeding in 3 cases,thrombocytopenia in 9 cases and anemia in 6 cases.Liver function was normal in 7 cases,mild abnormality in 3 cases.Ten cases underwent ultrasound examination and 7 cases had CT scan,cirrhosis was suggested with ultrasound/CT scan in 6 cases.Liver histology showed lobular architecture in existence,no false flocculus to form,variable degree of portal fibrosis appeared.Eight cases were misdiagnosed as liver cirrhosis,the duration of misdiagnosis varied from 1 month to 15 years.Conclusions The clinical manifestation of IPH is similar as cirrhosis caused portal hypertension.Liver histopathological examination can exclude liver cirrhosis,and portal fibrosis and liver terminal portal branch occlusion in histopathology is helpful to the diagnosis of IPH.