BACKGROUND: During plasty of breast, innervation in nipple and areola of breast should be comprehended particularly in order to avoid sensory and motor disorder induced by nerve injury. OBJECTIVE: To observe the courser and distribution of nerve in nipple and areola of breast and provide anatomic data for plasty of breast. DESIGN: Single sampling study. SETTING: Department of Human Anatomy, Medical College of Qingdao University; Department of Pathology, Affiliated Hospital of Medical College of Qingdao University. PARTICIPANTS: The experiment was carried out in the Department of Human Anatomy, Medical College of Qingdao University and Department of Pathology, Affiliated Hospital of Medical College of Qingdao University from September 1999 to April 2001. Sixteen breasts of 8 adult female corpses aged 20-40 years and 10 breasts (5 right and 5 left) of 10 adult females with cancer of the breast aged 43-58 years were selected in this study. All patients or relations were consent. METHODS: ① Breast samples of 16 adult female corpses were scanned layers by layers with stereo anatomic micro scope to chase courser and distribution of nerve in subcutaneous fascia of mammary cancer. ② Ten fresh breast sam pies were frozen, cut into sections and stained with haematine-eosin. The typical transects were selected to observe dis tributed density of nerve fiber in 4 quadrants at various layers with stereology. MAIN OUTCOME MEASURES: ① Innervation in nipple and areola of breast,, ② numbers of nerve fiber of the same sample in various transects. RESULTS: ① Nerve which was distributed in nipple and areola of breast was derived from the lateral cutaneous branch and anterior cutaneous branch of the 3rd, 4th and 5th intercostal nerves and deep branch of mammary cancer. ② The lat eral cutaneous branch of the 4th intercostal nerves went into nipple and areola of breast with the directions like 4 o'clock in the left and 8 o'clock in the right, and nerves dominated nipple were derived from the lateral cutaneous branch of the 4th intercostal nerves. ③ Numbers of nerve fiber in extra-inferior quadrant of nipple and areola of breast were more than those in intra-superior, intra-inferior and extra-superior quadrants (8.06±0.18, 4.63±0.14, 4.43±0.16, 2.13±0.11, P ＜ 0.01). ④ Density of innervation in nipple and areola of breast was decreased centripetally. CONCLUSION: Operation of chest, especially plasty of breast, had better not damage lateral cutaneous branch and ante rior cutaneous branch of the 3rd, 4th and 5th intercostal nerves. Extraordinarily, the lateral cutaneous branch of the 4th inter costal nerves and nerve in extra-inferior quadrant of nipple and areola of breast should be protected carefully in order to avoid sensory disorder.

ObjectiveTo study the relationship between the incidence of cervical osteophytosis and the age.MethodsThree hundred X-ray films (male 159, female 141) on lateral cervical position were observed. The patients were divided as group A (age <30), group B (age 30～39), group C (age 40～49), group D (age 50～59), group E (age 60～69) and group F (age 70～90). The osteophytosis on superior or inferior cervical vertebral body were marked.ResultsThe incidences of osteophytosis were group A 0%, group B 4.0%～4.7%, group C 20.0%～23.3%, group D 38.7%～39.2%, group E 56.7%～60.0%, group F 72.7%～80.9%. There was significant differences between the group B and group C, group C and group D, group D and group E, group E and group F (P<0.05～0.01). The common places of the osteophytosis were C5 and C6, while often on C6 in male and on C5 in female.ConclusionThe incidence of cervical osteophytosis increases following age increasing. The most place of the osteophytosis is on C5 and C6.

Objective To provide credible anatomic data and information for clinical diagnosis and surgery of hand by measuring the length of metacarpal bone and phalanges of hands on X-ray films and to study their mathematical relations.Methods The X-ray films of hands on posteroanterior position were taken in 186 healthy college students (M90,F96).The length of each metacarpal and phalange were measured.All the data were calculated by SPSS software.Results The mathematical relations of each metacarpal and phalange bone were obtained .It was found that there were sexual differences in the ratio of first to second,second to fourth,second to fifth and third to fourth metacarpal length,the ratio of first to second,first to fourth and second to fifth proximal phalangeal length,the ratio of second to fifth,third to fifth and fourth to fifth middle phalangeal length and the ratio of first to second and first to third distal phalangeal length.Conclusion The results of this mathematical relations are of great significant in orthopaedic surgery of hand.

Objective To compare the effects of intrasphincteric injection of botulinum toxin or pneumatic dilation on the treatment of achalasia. Methods One hundred and eighteen patients with esopha-geal achalasia were randomly assigned into 2 groups. (1) Injection group; botulinum toxin 100iu was injected into the muscular layer around LES under endoscopies with each site 20iu. (2) Dilation group; Dilating the cardiac sphincter with Rigiflex dilation balloon under endoscopies. Esophageal manometry was performed before and one week after treatment. And clinical symptoms were observed. Results Before therapy the 3 kinetic parameters of both groups revealed no significant statistical difference, but after therapy in dilation group LESP decreased to (6.03?3.45) mm Hg, LESRP ( -0. 11 ?2. 34) mm Hg, LESRR increased to 92. 50% ? 13. 86% , with significant statistical difference as compared to the data before treatment. In injection group LESP decreased to (23. 16 ? 16. 17) mm Hg, LESRP and LESRR after therapy showed no statistical difference as compared to the corresponding data before therapy. The improvement of clinical symptoms in dilatation and injection groups graded as prominent effective, improved and failed were 45 ( 80. 36% ) , 11 (19.64% ) ,0 and 15(24.19% ) , 38(61.29% ) , 9( 14.52% ) respectively. Conclusion In the treatment of esophageal achalasia the short term effect of pneumatic dilatation is superior to intrasphincteric injection method, the improvement of clinical symptoms is closely related to the decrease of LESP and LESRP especially the later.

Objective To attempt using the synthetic poly-peptides in the carboxyl terminal of gp210 antigen as the substrate for anti-gp210 antibody detection and search for a simple assay method of detecting anti-gp210 antibody. Methods The enzyme linked immunosorbent assay (ELISA) method for anti-gp210 antibody detection was set-up by chessboard test. Anti-gp210 antibody was tested in the serum of both patients with primary biliary cirrhosis (PBC) and the control group by ELISA and immuno-blotting. Results The working concentration of gp210's antigen was 5 μg/ml. The optical density higher than 0.61 (x+3s) was designated as the positive cutoff of anti-gp210 antibody. There was no statistical difference between the two assays (P=0.617). And there was very strongly positive correlation between them (P=0.000, r=0.868). Conclusion The sensitivity and specificity are basically consistent between the assays using synthetic poly-peptides of gp210 antigen and native antigen as the detecting substrates. The former substrate is preferred to be used for the testing of anti-gp210 antibody in clinical laboratories.

Objective To study clinical manifestations, risk factors and prognosis of patients with systemic lupus erythematosus (SLE) complicated with digital gangrene. Methods Data of 2684 inpatients with SLE admired to Peking Union Medical College Hospital during December 1997 to August 2007, including demographic information, clinical features, laboratory findings, as well as therapeutic regimens, were retrospectively analyzed, and 18 of those complicated with digital gangrene were identified and followed up. Results Average age at onset in patients of SLE complicated with digital gangrene was(33±12)years, with an average duration of disease course of (99±60 ) months.Longer course duration ( ≥ 4 yrs), Raynaud's phenomenon, elevated serum C-reactive protein (CRP) and positive anti-SSA antibody all were associated with occurrence of digital gangrene in patients of SLE, with P values of 0.012, 0.004, 0.037 and 0.087 respectively, and odds ratios of 1.03 (95% CI 1.01～1.05 ), 39.05 (95% CI 3.31～460.13 ), 17.99 (95%(CI 1.19～271.29) and 7.01 (95% CI 0.75～65.12), respectively. Fifteen of 18 SLE patients complicated with digital gangrene started treatment with predisone ≥1 mg˙kg-1 ˙d-1, and eighteen all were treated with cyclophosphamide, though eight cases failed and ultimately received digital amputation. Prompt corticosteroid treatment (predisone ≥ 1 mg˙kg-1˙d-1 within three weeks after occurrence) could decrease risk for amputation, with P =0.081 and OR =0.135 (95% CI 0.01～1.28). Conclusions Longer duration of disease course, Raynaud's phenomenon, elevated serum CRP and positive anti-SSA antibody all are independent predictors of SLE complicated with digital gangrene. Early and aggressive treatment can prevent occurrence of gangrene from its progression and improve its prognosis.

Objective To evaluate the value of serologic teats in patients with primary biliary cirrhosis by conducting a seroprevalence survey for anti-gp210 and anti-sp100 antibodies.Methods A total of 72 consecutive primary biliary cirrhosis (PBC) patients with or without Sj(o)gren's syndrome (SS) and 50 patho logic controls were studied.Antibodies were tested by ELISA assays with recombinant spl00 and purified gp210.Results The positive rates of anti-gp210 detected by ELISA was 31.1% and 45.5% in PBC patients with and without SS respectively.Among SS and virus hepatitis patients,none had anti-gp210 antibody (P＜0.01).The prevalence of anti-gp210 was similar in PBC patients with and without SS.The positive rates of an ti-sp100 detected by ELISA was 14.8% and 18.2% in PBC patients with and without SS respectively.Among the patients with SS,only 3.3% was positive for anti-sp100,but none had anti-sp100 reactivity in virus hep atitis patients.The prevalence of anti-sp100 was not significantly different between PBC and SS groups. Conclusion Anti-gp210 and anti-sp100 are highly specific for PBC.The sensitivity of anti-gp210 and anti sp100 is 31.1% and 14.8% respectively.They may be helpful in the diagnosis of PBC.

Objective To investigate the effects on catgut embedding therapy combined with traditional Chinese medicine on the patients with insomnia and TCM pattern of no connection of heart and kidney.Methods One hundred and ten patients with insomnia and TCM pattern of no connection of heart and kidney were were divided into the catgut embedding therapy group and traditional Chinese medicine group (n=55, repectively). Traditional Chinese medicine group was treated by theLiuwei-Dihuang pills andJiaotaipills, while the catgut embedding therapy group was treated with catgut embedding therapy based on the treatement of TCM groups. Pittsburgh Sleep Index (PSQI) was the outcome for analysis.Results The total effect rate (89.09%vs. 67.27%,χ2=7.674,P<0.01) in catgut embedding therapy group was significantly higher than that in traditional Chinese medicine group. The catgut embedding therapy group were significantly better than the traditional Chinese medicine group in the total score of PSQI (6.71 ± 3.55vs.8.32 ± 2.48,t=2.757,P<0.05), sleep time (0.86 ± 1.11vs. 1.29 ± 0.88,t=2.251,P<0.05), sleep efficiency (0.13 ± 0.7vs. 0.43 ± 0.55,t=2.477,P<0.05), hypnotic drugs (0.93 ± 0.77vs. 1.41 ± 0.81,t=3.185,P<0.05) and daytime dysfunction(1.14 ± 0.61vs. 1.59 ± 0.60,t=3.900,P<0.05). Conclusion Catgut embedding combining traditional Chinese medicine showed better effect than the TCM alone on the patients with insomnia and TCM pattern of no connection of heart and kidney.

From November 1997 to August 2002, a total of 165 achalasia patients were treated with endoscopic injection of botulinum toxin A into the gastric cardia. The results showed that the lower esophageal sphincter (LES) pressure (41.76?22.00 vs 19.14?11.40 mmHg) and LES relax pressure (14.74?9.41 vs 8.51?7.85mmHg) were decreased significantly (both P

Objective To investigate the effect of Yiqi Huoxue prescriptions on prevention of neointima hyperplasia after carotid artery vascular injury in rats.Methods Ninty male SD rats were randomly divided into 6 groups:the model group,the aspirin group,the low-dose Yiqi Huoxue group,the mid-dose Yiqi Huoxue group and the high-dose Yiqi Huoxue group.All of the rats were fed with hypercholesterolemic diet for 30 days,then the 2.0F balloon catheter injury was perfomed through the right femoral artery into the left common carotid artery of rats,the balloon was inflated and deflated 3 times.The rats was given drugs from 1 d before injury and to 5 d,14 d,28 d after injury.Around 6 rats from each group were euthanized by exsanguination at appropriate time point.The injuried left common carotid arteries were carefully removed and harvested for HE staining.Results The neointima hyperplasia was faint at 5 d after the operation.Morphological analysis demonstrated that there were markedly differences in the area of neointima hyperplasia at 14 d or 28 d,the average thickness of neointima hyperplasia,the surplus area of lumen/the total area of lumen between the high-dose Yiqi Huoxue group and the model group(P