Comparing with free perforator flap, pedicled flap is a relatively simpler and safer technique, with lesser donor site morbidity. In recent years, the application of pedicled perforator flaps has emerged as a new option for breast reconstruction. Those pedicled perforator flaps include thoracodorsal artery perforator flap, intercostal artery perforator flap (lateral intercostal artery perforator flap, anterior intercostal perforator flap) etc. Serratus anterior artery perforator flap, superior epigastric artery perforator flap, and lateral thoracic artery perforator flap can also be raised technically. To enhance surgical accuracy, it is necessary to evaluate the location and quality of perforator vessels preoperatively. Proper flap design is of more importance for pedicled flap when compared with it's free flap counterpart. Although free flap approach remains the golden standard in breast reconstruction when considering autologous tissue transplantation, pedicled perforator flap has the apparent merits of minimized surgical trauma, less time-consuming and less stress for reconstructive surgeons.

Objective To discuss the relevance between vitreopapillary traction (VPT) and anterior ischemic optic neu?ropathy (AION). Methods Two patients suffering from AION were underwent routine ophthalmic examination, and visual field (VF), fundus fluorescence angiography (FFA) and optical coherence tomography (OCT) examination. The images were analyzed. Results VPT syndrome was observed by OCT in both cases. In addition, the affected parts of VPT were consis?tent to that of AION. Conclusion Vitreopapillary traction is a possible reason of anterior ischemic optic neuropathy.

Objective:To examine the changes of matrix metalloprotein as e-2 (MMP-2) and tissue inhibitors of matrix metalloproteinase-2(TIMP-2) in g ingival crevicular fluid(GCF) after periodontal initial treatment of adult perio dontitis pateins. Methods:42 teeth of 42 adult periodontitis pat eins and 42 teeth of 42 periodontal healthy subjects were included.GCF was samp led with filter paper strips by intra-pocket methed. Assays for MMP-2 and TIM P-2 in GCF were performd by ELISA.Results:Levels of MMP-2 and TIMP-2 were higher in patients than that in the controls(P

Objective To evaluate the prognostic significance of lymph node ratio (LNR) in axillary lymph node positive breast cancer.Methods Eight hundred and three cases axillary lymph node positive breast cancer patients without distant metastasis were systematically treated in the Obstetrics and Gynecology Hospital of Fudan University from 2006 to 2014,at least 10 lymph node removed in each case.Clinicopathological data including 5-year disease-free survival rate (5y-DFSR) and 5-year overall survival rate (5y-OSR) were described.Factors related with prognosis were analyzed by univariate analysis.Prognostic difference was compared among different LNR stage in each axillary lymph node pathological stage(pN).Prognostic significance of pN and LNR was compared by multivariate analysis.Results Mean lymph nodes removed were 15.47±4.70 lymph,and median positive lymph nodes were 4 lymph in 803 cases axillary lymph node positive breast cancer patients.Altogether 159 cases of local recurrence and distant metastasis and 99 cases of breast cancer-related death occurred during median follow-up of 61 months.Five-year DFSR was 77％ and 5y-OSR was 83％.Log-rank univariate analysis showen that pT,pN,LNR,lymphovascular invasion and ER status were related to DFS and OS.Five-year DFSR and OSR for pN1,pN2,pN3 were 89％,68％,59％ and 93％,78％,63％,respectively,whereas 5y-DFSR and 5y-OSR for LNR1,LNR2,LNR3 were 90％,69％,56％ and 94％,80％,57％,respectively.There was statistically significant difference among different LNR in pN1 and pN2 (pN1:DFS:P=0.005,0S:P=0.024;pN2:DFS:P=0.017,0S:P=0.000),but not in pN3,inspite of difference tendency (DFS:P =0.165,OS:P =0.075).In multivariate analysis,when pN or LNR were entered into the Cox regression mode respectively,both were the independent prognostic factors of DFS(P＜0.001) and OS(P＜0.001).When pN and LNR were entered into the Cox hazard regression model at the same time,LNR remained as the independent prognostic factor of DFS and OS (P ＜ 0.001),but pN lost significance (DFS:P =0.461,OS:P=0.162).Conclusion LNR is independent prognostic factor for positive axillary lymph node breast cancer.

Objective To evaluate the clinicopathological characteristics of mucinous breast carcinoma (MBC) and its prognosis.Methods 112 cases of MBC treated in Obstetrics and Gynecology Hospital of Fudan University between Jan 2005 and Dec 2014 were enrolled retrospectively together with 1 157cases of invasive ductal carcinoma (IDC) for comparison.There were 71 cases of pure MBC (PMBC) and 41cases of mixed MBC (MMBC).PMBC and MMBC were compared with each other,and were also compared with IDC respectively.Results PMBC had smaller tumor mass,higher expression rate of hormone receptors (all P＜0.05),lower rate of lymph node metastasis (7.0％ vs.40.6％,x2 =32.663,P ＜0.001) when compared with IDC.The 5 year disease free survival (DFS) and overall survival (OS) of PMBC were both better than those of IDC (DFS:94.6％ ±3.0％ vs.81.3％ ± 1.1％,x2 =7.265,P =0.007;OS:92.4％ ±5.3％ vs.88.5％ ± 1.0％,x2 =4.059,P =0.044).MMBC had relatively larger tumor mass,higher expression rate of hormone receptor,but had no difference in the rate of lymph node metastasis (48.8％ vs.40.6％,x2 =3.417,P =0.332) when compared with IDC.There was no statistically significant difference in 5 yearDFSandOSbetweenMMBCandIDC (DFS:79.1％ ±7.1％ vs.81.3％±1.1％,x2 =0.167,P=0.683;OS:84.5％ ±7.2％ vs.88.5％ ± 1.0％,x2 =0.123,P =0.726).PMBC had relatively smaller tumor mass,lower rate of lymph node metastasis,but had no difference in the expression rate of hormone receptors.The 5 year DFS and OS of MMBC were both better than those of MMBC (DFS:94.6％ ± 3.0％ vs.79.1％±7.1％,x2 =6.772,P =0.009;OS:92.4％ ±5.3％ vs.84.5％ ±7.2％,x2 =6.401,P=0.036).Lymph node status was the only statistically significant prognostic factor of MBC by COX multivariate analysis.Conclusions PMBC has better prognosis than MMBC and IDC owing to its lower rate of lymph node metastasis.MMBC has higher rate of node metastasis than PMBC,hence similar prognosis with IDC.

Objective To explore the distribution of age,reasons for treatment,risk factors,and causes of vulvovaginitis in prepubertal girls.Methods A total of 4 214 prepubertal girls with vulvovaginitis who were admitted to the Girl's Sub-department,Zhongshan Boai Hospital from January 2010 to June 2013 was reviewed retrospectively.All clinical data were from medical records with files.Results Atotalof1 587 patients (37.7％) was0to1 years old,954 (22.6％) ＞ 1 to3 years old,1 289 (30.6％) ＞ 3 to 7 years old,and 384 (9.1％) ＞ 7 years old.Many risk factors were associated with vaginitis,including poor hygiene (2 924 girls; 69.4％),allergies and exposure to allergens (875 girls; 20.8％).Most common reason for treatment was a referral from physical examination accounting for 919 girls (21.8％),followed by vaginal secretions 812 girls (19.3％).The causes of vulvovaginitis of all patients were evaluated,1 771 of which (42.0％) were nonspecific vulvovaginitis,1 309 (31.1％) labial adhesions,375 (8.9％) bacterial vulvovaginitis,266 (6.3％) allergic vulvovaginitis,and 266 (6.3％) affective leg rubbing action.Conclusions Prepubertal vulvovaginitis occurred mainly in infancy and preschool.Floating population was common.They were caused by many risk factors including poor hygiene,allergies,poor urination habits,etc.The most common causes of vulvovaginitis were nonspecific vulvovaginitis and labia adhesion,yet allergies and affective leg rubbing action were the more common causes of recurrent vulvovaginitis.We propose that focusing on girls' reproductive health,timely treating allergic and crossing rub legs and other diseases would help reduce the prevalence of vulvovaginitis in the prepubertal girls.

Objective To evaluate the effect of rapamycin on proliferation and cell cycle of human bladder cancer cell line 5637. Methods Total?ly 5637 cells were maintained in RPMI 1640 containing 10%fetal bovine serum,100 U/mL penicillin and 100μg/mL streptomycin for adherent cul?ture. Cells were grown at 37℃in a 5%CO2 incubator. The 5637 cells were treated with various concentrations of rapamycin solution(50 nmol/L, 100 nmol/L,200 nmol/L,and 400 nmol/L). The control group was daily treated with single RPMI 1640 without medication. The growth repression rate for 5637 cells was evaluated by MTT. Flow cytometry was used to investigate the effect of rapamycin of different concentrations on cell cycle of 5637 cells. Results Compared to the control group,rapamycin can inhibit the proliferation of 5637 cells in a concentration and time dependent manner. Rapamycin inhibited 5637 cells at G0/G1 thus inhibiting cell proliferation but not inducing apoptosis. Conclusion Rapamycin inhibited growth of 5637 bladder carcinoma cells and arrested cell cycle at G0/G1,indicating that mammalian target of rapamycin may play an important role in proliferation of 5637 cells and act as a new tumor therapeutic target in patients with bladder cancer.

Objective To examine the changes of matrix metalloproteinase-2,9 (MMP-2,9) in gingival crevicular fluid(GCF) after phase 1 periodontal treatment of adult patients with periodontitis. Methods GCF was sampled with filter paper strips by intra-pocket method to determine MMP-2,9 levels. Forty teeth of forty adult patients with periodontitis and forty teeth of forty periodontally healthy persons were included in this study. Assays for MMP-2,9 in GCF were performd by ELISA. Results Contents of MMP-2,9 were higher in AT group than those in controls(P

[Summary] Lifestyle intervention is one of the important strategies for the prevention of type 2 diabetes. Recently, caloric restriction regimen has become a hot topic as one of the cornerstone of lifestyle intervention. The alternate day fasting regimen is simple, and increases the patient compliance. Both daily calorie restriction and alternate day fasting regimen can reduce body-weight significantly in pre-diabetes subjects, and reduce the visceral fat mass and the fasting insulin levels, and improve the insulin sensitivity, as well as maintain the lean mass, though the effect on fasting blood glucose was not significant. Nevertheless, the most recent studies have demonstrated that daily calorie restriction,in particular, alternate day fasting regimens can be effective in individuals with pre-diebates in order to prevent type 2 diabetes.