The fresh cadavers were injected with A. B. S into the popliteal arteries. We have studied the micro-vascular structure of this skin area under scanning electron microscope. There are 5 layers of the vascular network in this skin area. They were formed by the small branches coming from either the direct or indirect cutaneous arteries. The 5 layers are as follows: The capillary network of the papillary layer. The vascular network of the subpapillary layer. The deep dermal network. The network in the subcutaneous tissue. The network in the deep fascia tissue. It is clear that each layer of the vascular network has it's -own special character.

OBJECTIVE: To provide reference for the management of central pharmacy in our hospital. METHODS: In daily work, performance score of a job was related with quality evaluation using grouping work model and management method of allocating a specific responsibility to a specific person. RESULT & CONCLUSION: The work process of central pharmacy is clear and plays a great role in economizing on resources relatively.

Objective To study the hemoprotective effects of a rotary magnetic field(RMF)with radiation- injured mice.Methods C57 BL6/J mice were randomly divided into a control group and a magnetic treatment group.The mice received total body irradiation with 7.0 Gy and 6.5 Gy ~(137)Cs?rays.The treatment group was trea- ted with a RMF for one hour at a time,twice a day.The intensity of the RMF was 0.6T.The survival rate was ob- served for 30 days.On day 7,10,14,21,28 after irradiation,the subjects' peripheral blood cells were counted.On day 12 and 16,the number of bone marrow mononuelear cells(BMNCs)was measured and their ability to form granu- locyte-macruphage colony-forming unit(CFU-GM)was assessed.The pathological sectioning of the femur was per- formed and the expression level of bone morphogenetic proteins(BMPs)in the bone marrow were evaluated.Re- sults The RMF treatment increased the survival rate and duration among the irradiated mice and the number of blood cells in their peripheral blood.Also,RMF treatment could increase the number of BMNCs and improve their ability to form CFU-GM on days 12-16.Furthermore,RMF could improve angiogenesis and the expression level of BMPs. Conclusion The RMF treatment had an obvious protective effect against the effects of irradiation,and it accelerated the recovery of hematopoiesis and the hematopoietic microenviroment in mouse bone marrow.

Objective To investigate the relationships between Cyclooxygenase(COX-2) and angiogenesis and expressions of COX-2 and vascular endothelial growth factor(VEGF) in thyroid cancer and its clinical significance.Methods Immunohistochemistry was used to detect the expressions of COX-2 and VEGF in 60 thyroid cancer,(15 thyroid)adenomas and 10 normal thyroid tissues.Results The expression rates of COX-2 and VEGF in thyroid cancer were higher than those in thyroid adenomas and normal tissues(P

ObjectiveTo study the hemoprotective effects of rotating and stationary magnetic field(RSMF) in mice treated with 5-Fluorouracil(5-FU).MethodsThe BalB/C mice were randomly divided into control group and RSMF-treated group.The mice were injected with 5-FU,the dose were 150,180,210,250 mg/kg respectively. RSMF-treated group was exposed to RSMF for 1 h a time,twice a day during 30 consecutive days,and the magnetic intensity was 0.6 T.The survival rate and survival days during the 30 days were observed.7,10,14,21,28 days after injection,the peripheral blood cells were counted.On day 8,10 and 14,the number of bone marrow mononuclear cells(BMNC) and the forming ability of colony-forming unit-granulocyte/macrophage(CFU-GM) were measured.The pathological section of femur and the expression level of bone morphogenic proteins(BMPs) in bone marrow were evaluated.ResultsRSMF could increase the survival rate and survival days of mice treated with 5-FU,and induce an increase in hemoglobin concentration,white blood cell count(WBC),red blood cell count(RBC) and platelet number.Also,RSMF could increase the number of BMNC and improve the forming ability of CFU-GM on days 8～14.Furthermore,RSMF could improve the bone marrow angiogenesis and the expression level of BMPs.ConclusionRSMF have an obvious protective effect against chemotherapeutic injury,and it can accelerate the recovery of hematopoiesis and hematopoietic microenvironment in mouse bone marrow.

To investigate the impact of respiratory movement to determine the target volume on cone beam CT (CBCT) for lung tumor, we used CIRS dynamic thorax phantom (Model-CIRS008) to simulate the sinusoidal motion of lung tumor. With a constant amplitude, the ratio of the time of near-end-expiratory and near-end-inspiratory (E/I) changed when it was scanned with CBCT. We analyzed the contrast changes of target by extracting the CT value of each pixel on the center line of the target movement direction. The targets were contoured with region growing method and compared with the motion volume generated by the tumor trajectory method. The result showed that the contrast of near-end-expiratory increased and the contrast of near-end-inspiratory decreased with increasing E/I. The contoured volume generated by region growing method decreased with increasing E/I. When E/I = 4, the amplitude A = 1 cm, diameter of 1 cm and 3 cm target volumes were reduced by 48.2% and 22.7%. The study showed that CBCT was not suitable to be used to accurately determine the range of lung tumor movement. The internal target volume (ITV) may be underestimated in CBCT images.
Cone-Beam Computed Tomography ; Humans ; Lung Neoplasms ; diagnostic imaging ; Movement ; Phantoms, Imaging ; Respiration

Objective To evaluate the characteristics and clinical suitability of the ArcCHECK diode array for volumetric-modulated arc therapy (VMAT) verification.Methods The intrinsic sensitivity,short and long term reproducibility,dose and dose rate dependence,dose per pulsed dependence,field sizes dependence and directional response of the diodes were measured.The results of the diodes were compared with the measurement results of an ionization chamber and calculated results of treatment planning system.Gamma index was used to analyze the dose difference between the calculation and measurement for random selected 211 verified VMAT plans.Results The ArcCHECK performed well for all tests except directional dependence,which varies from a minimum of-3.9％ (seen only when the beam was incident on the diode at 180°) to a maximum of 7.7％ (approximately at 255°).Average gamma analysis passing rates with 3 mm/3％ for 113 nasopharyngeal cancer,48 cervical cancer and 50 rectal cancer patients VMAT plans were 93.5％,95.7％ and 97.5％,respectively,statistical significance has been found between either two of the groups (t=-12.69-4.88,all P＜ 0.01).Conclusions With proposed calibration method,the ArcCHECK diode array is very suitable for VMAT pretreatment verification,the complexity of VMAT plan is the main factor affecting the passing rate.

ObjectiveTo establish the reference value of inhibin-A in the serum of pregnant women with gestational age from 15 to 20+6 weeks in Guangdong province,and assess the efficiency of inhibin-A and quadruple test in Down syndrome screening.Methods A total of 2802 singleton pregnancies receiving triple test screening in Guangzhou Women and Children's Medical Center from March 2008 to December 2010 were included in this study.Inhibin-A was measured by automatic enzyme-linked immunosorbent chemiluminescence assay. The concentration of inhibin-A was expressed as multiples of the median (MoM),and adjusted with maternal weight and gestational age.Parameters of SURUSS were used to recalculate the risk of Down syndrome.The efficacy of single marker and combination were evaluated by receiver operating characteristic curve and the area under the curve. Results(1) In normal singleton pregnancies,the median concentration of inhibin-A was 286.60,267.10,249.10,243.40,242.30 and 256.60 pg/ml respectively for each week of gestational age from 15 to 20+6 weeks.The distribution of inhibin-A in each gestational week was relatively stable.The mean concentration [(852.83±370.04) pg/ml] and MoM (2.82) of inhibin-A in twelve pregnant mothers with Down syndrome fetuses were significantly higher than those without [(293.28±149.46) pg/ml (t=5.37,P＜0.05) and 1,respectively].(2) The detection rate was 83.3％ (10/12) by using the quadruple test including free human chorionic gonadotropin-β,alphafetoprotein,unconjugated estriol and inhibin-A at false positive rate of 5.8％; while when the detection rate of triple test including alpha-fetoprotein,free human chorionic gonadotropin-β and unconjugated estriol was 83.3％,the false positive rate was 7.7％.When the false positive rate was set to 5.0％,the area under the curve of inhibin-A,alpha-fetoprotein,free human chorionic gonadotropin-β and unconjugated estriol was 63.7％,20.5％,46.1％ and 4.8％,respectively,and the relative area under the curve of routine triple test and quadruple test was 45.5％ and 63.1％,respectively.ConclusionsInhibin-A is suggested to be the most effective marker used for secondtrimester screening,which could be used for second trimester Down syndrome screening in Chinese population combined with existing three markers.

Objective To summarize the experience in surgical management of hilar cholangiocarcinoma.Methods The clinical data of 88 patients with hilar cholangiocarcinoma who received surgical treatment at the First Affiliated Hospital of Harbin Medical University from January 2007 to December 2011 were retrospectively analyzed.All the patients were diagnosed by imaging examination.According to the severity of jaundice and predictive remnant liver volume,19 patients received percutaneous transhepatic cholangial drainage (PTCD) and 4 received portal vein embolization.The fundamental operation consisted of hilar cholangiocarcinoma resection,skeletonization of hepatoduodenum ligament and Roux-en-Y cholangiojejunostomy,and the transanastomotic stent was placed for 6 months.The count data were analyzed using the chi-square test; the survival rate was analysed using the Kaplan-Meier method; the survival was analyzed using the Log-rank test.Results Of the 88 patients,58 patients (including 11 patients who received PTCD) received hilar cholangiocarcinoma resection.Of the 58 patients,43 (including 4 patients who received portal vein embolization preoperatively) received R0 resection,and 15 received palliative resection.Thirty patients received internal and (or) external drainage.Commitant partial hepatectomy was performed on 22 patients (including 9 received left hemihepatectomy,2 received extended left hemihepatectomy,7 received left hemihepatectomy + caudate lobectomy,4 received right hemihepatectomy).Commitant pancreatico-duodenectomy was performed on 7 patients,commitant hepatic artery resection on 3 patients,and commitant portal vein resection on 2 patients.According to the modified Bismuth-Corlette classification,there were 17 patients with type Ⅰ,19 with type Ⅱ,21 with type Ⅲa,20 with type Ⅲb,and 11 with type Ⅳ.Of the 58 patients who received hilar cholangiocarcinoma resection,19 had postoperative complications,and 2 patients died within 30 days after operation.Seventy-three patients were followed up,and the overall 1-,3-,5-year survival rates were 68.5％,28.8％,11.0％,respectively.The 1-,3-,5-year survival rates of patients who received R0 resection were 94.6％,43.2％,18.9％,respectively,which were significantly higher than 78.6％,35.7％ and 7.1％ of patients who received palliative resection (x2=4.77,P ＜0.05).The 1-,3-,5-year survival rates of patients who received palliative resection were significantly higher than 18.2％,0,0 of patients who received biliary drainage (x2 =13.26,P ＜ 0.05).Conclusions R0 resection is the best choice for patients with hilar cholangiocarcinoma,and biliary drainage with no resection is the last choice.Sufficient preoperative treatment,optimized choice of surgical procedure and exquisite surgical techniques are important for the improvement of the prognosis.

ObjectiveTo evaluate the effectiveness at anterior lumbar interbody fusion (ALIF) with a single cage alone in treatment of lumbar degenerative disc disease(DDD).MethodsThirty-four patients aged from 26 to 67 years (mean,52) were enrolled in this study,including 10 males and 24 females.Preoperative diagnosis included:degenerative spondylolithesis in 11 cases,discogenic low back pain in 21,and revision for failed posterior surgery in 2.Objective level located in L4.5 in 12 cases,L5S1 in 20,and double discs(L4.5,L5S1) in 2.All the patients received extraperitoneal approach ALIF.Surgical time,blood loss,perioperative complications and postoperative ambulation were noted.Postoperative function status was evaluated by 100 mm Visual Analog Scale (VAS) and Oswestry Disability Index (ODI50).AP,lateral and dynamic X-rays were routinely taken during follow up,according to which disc height,migration of implant and bony fusion were measured.ResultsAll the surgeries were performed successfully with a mean surgical time of 90 min and blood loss of 200 ml.An injury to the bifurcation of vena cave was encountered in an early case,after meticulous repairing of the vessel,the surgery was finished successfully.Peritoneum rupture was noticed in one case.One case of postoperative cage migration was revised and reinforced with additional fixation system.All the patients were followed up for an average of 36 months(range,12-60).All the patients were satisfied with the pain relief and returned to normal social life and working.VAS decreased from preoperative 70 to postoperative 5,and ODI decreased from 41％ to 6％.All but one migration case reached sound fusion with a fusion rate of 97％.ConclusionOwing to multiple advantages,complete removal of degenerative disc,compressive bone graft,sufficient graft area,early ambulation,less complication,extrapefitoneal approach for ALIF comes up with satisfying clinical outcomes.This mini_invasive technique provides a valuable alternative to treatment of lumbar DDD when appropriate indication is selected.