The arteries of the spinal cord on surface have been observed in 62 Chinese adults and 39 children.Anteriorly, the spinal cord was divided into 3 areas, according to the arterial supply.The superior cervical area(segments of C_(1～3) or C_(1～4))was mainly supplied by the anterior spinal arteries; the cervical enlargement area (segments of C_4 or C_5 to T_5 or T_6) was mainly supplied by the arteria intumescentia cervicalis and the lumbar enlargement area (below the segments of T_6 or T_7) was mainly supplied by the arteria intumescentia lumbalis. In the intermediate places between these areas (segments of C_(3～4) and T_(5～6)), the anterior median artery was often narrow or interrupted. Usually the anterior spinal artery united with its fellow of the opposite side to form a single trunk (46.53%). The anterior radicular arteries averaged 5.2 (2～10) in number. The arteria intumescentia cervicalis frequently existed at C_7 and C_8 (C_5～T_3). The arteria intumescentia lumbalis mostly located at T_9 (T_6～L_2), and 72.28% of them being on the left side.Posteriorly, the arteries developed well on the two enlargements. The posterior spinal arteries arised frequently from the vertebral artery (76.41%). The posterior radicular arteries averaged 9.3 (5～21) in number.The authors have raised an objection to the view that the segments of T_4 and L_1 of spinal cord are poor supplied with blood.

Objective To evaluate the changes of platelet-derived growth factor(PDGF) and vascular endo-thelial growth factor(VEGF) in infectious and autoimmunity diseaases. Methods The growth factors were measured by ELISA in 149 patients for seven times in different periods,and the levels and duration were compared. Results PDGF was (6.32±2.54) μg/ml and (2.57±1.65) μg/ml (P<0.05), and VEGF was (179.5±53.30) ng/ml and (221.4±70.04) ng/ml(P<0.05) in the two groups before treatment;There was statistical significance in dif-ferent time points between groups and within groups for PDGF(P<0.05) and significant difference for time chan-ging to the peak and changed duration between two groups for VEGF(P<0.05). For the two groups,the peak time of PDGF were (2.6±1.1) and (5.4±3.3) days;The peak time of VEGF were (2.4±0.7) and (7.2±3.3) days respectively(P<0.05 for each). However in the two groups, the change duration were (6.7±3.1) and (15.4±6.1) days for PDGF and (8.1±3.4) and (16.7±7.2) days for VEGF (P<0.05 for each). Conclu-sions There is significant difference for serum levels of PDGF and VEGF and the level change duration as well in the two groups, which maybe correlated with inflammatory nature and outcome.

Objective To investigate the therapeutic effect of the fourth ventricle tumors through lateral wall type of the transcerebellomedullary fissure approach under endoscope.Methods Clinical data of 14 cases with the fourth ventricle lesions were analyzed retrospectively.All the patients were treated by lateral wall type of the transcerebellomedullary fissure approach surgery.The endoscope was used if the lesions develop to the aqueduct and hard to be exposed.Both neurophysiological monitoring and intraoperative ultrasound were used regularly.Results Tumors were totally removed in 12 cases,subtotally in 1,and partially in 1.All the patients were diagnosed in postoperative histopathology,including 4 medulloblastoma,three epidermoid cyst,two ependymoma,two hemangioblastoma,one meningioma,one cavernous hemangioma and 1 astrocytoma.Hypopnea occurred immediate after operation in 1 patient.Ventilatory support was performed by Ventilator,and the respiration was restored 1 day later.Normal cerebrospinal fluid circulation was return in all cases.Neither aggravation of preoperative symptoms nor nuclei injury related complication had been found.The follow-up interval between 3 months to 28 months,one patient was dead with unexplained,and 1 medulloblastoma patient was relapse.Conclusion Lateral wall type of the transeerebellomedullary fissure approach,under endoscope,combined with the usage of neurophysiological monitoring and intraoperative ultrasound,can degrade the surgical related complications such as facial palsy and amblyacousia.

Objective To study safety and efficacy of transurethral Thulium laser resection of high-risk stage bladder tumor in anticoagulant state.Methods A total of 26 non-muscle invasive bladder cancer patients receiving long-term anticoagulant therapy,including 16 cases with cerebral infarction,7 cases with coronary heart disease,3 patients with coronary stenting,were retrospectively analyzed in our hospital from July 2012 to July 2014.In condition not stopping anticoagulants,Thulium laser transurethral resection of bladder tumor was performed,and hemoglobin,thrombin time,the operative time,intraoperative blood loss,postoperative bladder irrigation duration,postoperative hospital stay,bladder tumor recurrence within two years,the postoperative complications were recorded before and after surgery.Results All patients were successfully treated.The operative time was(29.1 ± 12.8) min,int raoperative blood loss was (29.4 ± 16.9) ml portions,postoperative bladder irrigation time was (1.25 ± 0.55) d,postoperative hospital stay was(5.51 ± 1.06) d.Hemoglobin before and after operation were (131.35 ± 6.57) g/L and (129.75 ± 11.05) g/L respectively,there was no statistically significant differences (t =1.014,P ＞ 0.05) between them.Prothrombin time before and after operation were (12.50 ± 0.25) s and(12.44 ± 0.27) s,with no statistically significant difference (t =0.908,P＞0.05)between them.During the followed-up of 48 months,tumor recurred at heterotopia in 2 patients.Conclusions Thulium laser transurethral resection of bladder tumor is safe and effective for patients undergoing long-term oral anticoagulation drugs,without a needto stop taking anticoagulant drugs.

Objective:To investigate the predictive value of the changes of platelet-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR) in the therapeutic efficacy of the neoadjuvant treatment for breast cancer.Methods:The clinical data of 72 breast cancer patients who received neoadjuvant therapy in Nantong Tumor Hospital between February 2020 and January 2022 were retrospectively analyzed and the changes of PLR and NLR before and after neoadjuvant therapy were also analyzed. The receiver operating characteristic (ROC) curves were used to assess the predictive value of PLR, NLR and their changes in pathological complete remission (pCR) after neoadjuvant therapy.Results:The area under the ROC curve of PLR and NLR before the treatment, the difference in PLR before and after the treatment (ΔPLR), the difference in NLR before and after the treatment (ΔNLR) in predicting pCR was 0.520, 0.505,0.724 and 0.686,and the corresponding cut-off value was 269.231, 2.559, -2.840 and -1.457; the patients were divided into high and low groups according to the cut-off values. NLR before the treatment was not correlated with clinicopathological characteristics (all P > 0.05),while PLR before the treatment was correlated with tumor size ( P = 0.029), and ΔPLR was correlated with progesterone receptor expression ( P = 0.025), human epidermal growth factor receptor 2 (HER2) expression ( P < 0.001), molecular subtype ( P < 0.001), N stage ( P = 0.002), clinical stage ( P = 0.002) and treatment modality ( P < 0.001). ΔNLR was associated with HER2 expression ( P = 0.002), molecular subtype ( P = 0.024), tumor size ( P = 0.007), neural invasion ( P = 0.006), N stage ( P = 0.006), clinical stage ( P = 0.016) and treatment modality ( P = 0.014). ΔPLR and ΔNLR were influencing factors for patients achieving pCR after neoadjuvant therapy (all P < 0.05). Conclusions:Stage Ⅲ invasive breast cancer patients with higher ΔPLR and ΔNLR after neoadjuvant therapy have better prognosis.