Ten percent ethyl acetate oil red dye was injected into the axillary artery of 30adult cadavers.After careful dissection under surgical microscope,the cutaneousarteries in the lateral thoracic region were demonstrated.The skin and subcutaneoustissue in this region is nourished mainly by four axial arteries.In the anterior part,the anterolateral area,accessory lateral thoracic artery is almost always present.It isa direct cutaneous branch of axillary or brachial artery.In the posterior part,thepectoral latissimus dorsi area,direct cutaneous branches,arise from the lateral thoracicartery,subscapulo-dorsal thoracic artery and axillary artery.The distribution of thecutaneous arteries may be monopolized by either one,or one to be the main theother accessory.The diameters of the arteries and accompanying veins,can satisfythe requirment of a cutaneous flap in microvascular surgery.These arteries all possessrich anastomosis between each other and with neighboring arteries.The architactureof the destribution of blood vessels of lateral thoracic region,possibly set up amorphological basis,which may be helpful in cutaneous flap designation.

Acute Disease ; Aged, 80 and over ; Fibrin Fibrinogen Degradation Products ; analysis ; Humans ; Male ; Pulmonary Embolism

Objective To compare the accuracy of full field digital mammography (FFDM) and digital breast tomosynthesis (DBT) in predicting size of ductal carcinoma in situ (DCIS).Methods Totally 30 women pateints with DCIS confirmed by histology were analyzed retrospectively.Two radiologists measured the size of the lesions on FFDM,DBT images respectively,and compared with pathological results.Two kinds of inspection methods correlation with pathology were compared with Pearson correlation analysis.Results Size of DCIS measured by doctor 1 and doctor 2 between FFDM and histology had correlation (r=0.857,0.818,both P＜0.01),and those between DBT and histology also had correlation (r=0.924,0.885,both P＜0.01).Intraclass correlation coefficient (ICC) of two doctors was 0.947 on FFDM,and 0.908 on DBT.Conclusion DBT provides a better estimation of the size of DCIS.Two physicians had high consistency for lesion size evaluation.For DCIS with microcalcifications,both FFDM and DBT provide smaller estimations compared with pathology,thus a bigger surgical resection of lesion is needed.

Objective In this study,we measured the levels of urinary monocyte chemoattractant (MCP)-1 and interferon-γ-inducible protein (IP-10) and further analyzed their associations with clinical and pathological data in lupus nephritis patients in order to find the non-invasive biomarkers which canpredict disease activity.Methods MCP-1,IP-10,VEGF levels were measured in urine samples from 64 lupus nephritis patients and 20 healthy volunteers.Clinical disease activity was determined by SLEDAI and BILAG scores.The lupus nephritis patients were divided into two groups:active disease group (SLEDAI scores ≥ 10points,n=36) and non-active group (SLEDAI score＜10 points,n=28).Of all patients enrolled,37 patients had a concomitant kidney biopsy performed at the time of urine collection.The predictive performance of uri-nary MCP-1 and IP-10 for renal flare,the Student's t test,Mann-Whitney U test,Chi-square test,and re-ceiver operating characteristic (ROC) curves were constructed for analysis.Results The urinary MCP-1 and urinary IP-10 levels of the active group was significantly higher than that of the non-active group [MCP-1672.39(318.05,2 554.23)pg/ml vs 152.52,(55.61,330.44)pg/ml,Z=-4.717,P＜0.01; IP-10 (38±19) pg/ml vs (22±16) pg/ml,t=3.576 P＜0.01].The level of urinary MCP-1 was positively correlated with the levels of hematuria and 24 hours protein quan-tification,as well as the scores of SLEDAI and BILAG (rbemahuria=0.570,P=0.000; r24hpro=0.569,P=0.000; rSLEDAI=0.600,P=0.000; rBILAG=0.606,P=0.000),and it was also positively correlated with the scores of cellular crescent,wire loop,and AI (rCC=0.405,P=0.015; rwire loop=0.430,P=0.014; rAI=0.352,P=0.003),while nega-tively correlated with the level of C3 and plasma albumin (rc3=-0.564,P=0.000; ralb=-0.587,P=0.000).It had no correlation with the scores of wire loop and CI (P＞ 0.05).The level of uIP-10 was positively correlated with the protein quantification in 24 hours and the scores of SLEDAI and BILAG (r24hpro=0.305,P=0.018; rSLEDAI=0.334,P=0.009; rSILAG=0.496,P=0.000),while negatively correlated with the level of C4 (rC4=-0.301,P=0.016).The R0C curve of uMCP-1 to predict the activity of SLE showed that its specificity was 75.0％,sensitivity was 83.3％,and the area under the ROC curve was 0.85±0.05.The ROC curve of urinary IP-10 to predict the activity of SLE showed that its specificity was 50.0％,sensitivity was 97.2％,its area under the ROC curve was 0.74±0.06.The ROC curve of urinary MCP-1 to predict renal flare shows that its specificity was 45.5％,its sensitivity was 100％,and the area under the ROC curve was 0.74±0.80.The ROC curve of urinary IP-10 to predict renal flare showed that its specificitywas 36.4％,its sensitivity was 73.3％,and its area under the ROC curve was 0.49 ±0.10.Conclusion Urinary MCP-1 and urinary IP-10 predict renal flare in patients with lupus nephritis.Furthermore,urinary MCP-1 is a more specific and sensitive forecaster of renal flare in patients with a history of lupus nephritis than urinary IP-10.

The end stage of chronic renal diseases is characterized by glomerular sclerosis and interstitial fibrosis. Studies have revealed that effective amelioration of renal fibrosis can significantly delay the progression of chronic renal diseases. Peroxisome proliferator activated receptors (PPARs) are ligand-activated nuclear transcriptional factors of the nuclear hormone receptor superfamily, and PPAR-γ is one of the phenotypes of PPARs. The effect of PPAR-γ on inhibiting renal fibrosis has become a hot spot. In this article the research advances of PPAR-γ in amelioration of renal fibrosis are reviewed.

Objective To describe the Reverdin technique for treatment of hallux valgus (HV) based on correction of proximal articular set angle (PASA). Methods Thirty-one Reverdin osteotomies (in 31 feet of 17 female patients)were performed between 1992 and 1998. Reverdin operation is unique among the surgical procedures for its ability to correct large PASA with a medial wedge-type osteotomy of the metatarsal head. Results On the follow-up of 1 to 8 years, patients rated outcomes as excellent or good in 96％ (30 feet). There was no complication of delayed union or avascular necrosis of the metatarsal head. Radiographical follow-up: PASA averaged 19 degrees(range 30-12 degrees), had a postoperative averaged value of 1.95 degrees, HV angles averaged 30 degrees(range 41-23 degrees), had a postoperative value of 14.3 degrees. Intermetatarsal angles averaged 10.9 degrees (range 16-4 degrees), had a postoperative value of 5.8 degrees. Conclusion The preoperative PASA value is the most important factor in hallux valgus evaluation, as well as the selection of operative techniques. The normalization of PASA safegurds more successes and less recurrences.

Objective To investigate the effect of lead aVR on recent prognosis in patients with non -ST -elevation acutecoronary syndrome(NSTE -ACS).Methods 195 patients with NSTE -ACS were divided into ST segment elevation in lead aVR group(n =54 cases)and non -ST segment elevation in lead aVR group(n =141 ) according to ST segment elevation in lead on admission;clinical data,laboratory index and coronary artery lesion were recorded,and major adverse cardiac (MACE)in hospitalization time were also recorded.Results Compared with non -ST segment elevation in the lead aVR group,the heart rate of ST segment elevation in the lead aVR group was faster[(85.4 ±12.0)beats per minute vs.(79.3 ±13.2)beats per minute,t =2.959,P <0.05],systolic blood pressure and diastolic blood pressure were higher[(145.0 ±20.3)mmHg vs.(136.0 ±19.4)mmHg,t =2.874,P <0.05];NT -proBNP[(743.9 ±125.8)pg/mL vs.(416.4 ±95.3)pg/mL,t =19.625,P <0.05],cTnI[(3.4 ± 1.0)ng/mL vs.(1.2 ±0.4)ng/mL,t =21.994,P <0.05],CK -MB[(31.5 ±9.8)ng/mL vs.(19.8 ±6.5)ng/mL, t =9.682,P <0.05]were higher (P <0.05);LVEF were lower[(50.1 ±5.2)% vs.(53.8 ±5.7)%,t =4.153, P <0.05];the rate and amplitude of low ST segment in outside lead aVR also was higher[(9.5 ±3.8)mm vs. (7.4 ±2.8)mm,t =4.224,P <0.05];the rate of left main and three -vessel disease in ST segment elevation in lead aVR group were higher (P <0.05).Compared with non -MECE group,proportion of ST segment elevation in lead AVR on admission was higher (P <0.05).Logistic regression analysis showed that heart rate(OR =1.472),NT -proBNP(OR =1.732),cTnI(OR =1.893),left main coronary artery(OR =2.478)and three -vessel disease (OR =2.310)were risk for ST segment elevation in lead AVR(P <0.05).Logistic regression analysis also showed that ST segment elevation in lead AVR were risk for MACE(OR =1.474).Conclusion ST segment elevation in lead AVR has close relationship with large area of myocardial ischemia,and patients prognosis is poorer,which may be independ-ent risk factor for the recent outcomes of patients with NSTE -ACS.Early record of the change in the case of aVR lead ECG ST segment NSTE -ACS patients is of important value in evaluation of the condition and prognosis.

Eosinophilic gastroenteritis (EGE) is a rare disorder characterized by eosinophilic infiltration of the bowel wall with various gastrointestinal manifestations.The etiology of the disease is not clear.EGE can affect the growth and development in children,and can cause a variety of complications.Through the elaborate discussion to the pathogenesis,clinical manifestations,diagnostic criteria and treatment principles of EGE,can strengthen identification to EGE,and improve the level of diagnosis and treatment.

To investigate the correlation between traditional Chinese medicine (TCM) syndrome and short-term prognosis of ischemic stroke.

Based on the related theories of physician behavior analysis, summarize and discuss the incentives mechanism of supplier payment on physician behavior and its inner mechanism, provide theoretical supports and political suggestions for further analysis on payment reform.