Objective:To provide microsurgical anatomy data in the course, branch, distribution, arterial network profile of the submental artery and the range of the flap excision in submental flap transplantation.Methods:From March, 2015 to March, 2020, a total of 36 head and neck cast specimens were studied. Acrylic-butadience-styrene plastic (ABS) filler were perfused into the external carotid artery to make cast specimens. The course, branching, distribution and the arterial framework of the submental artery under a surgical microscope were investigated.Results:The submental artery originated from the facial artery before reaching the lower edge of the mandible (1.50±0.50) cm, with a diameter of (1.50±0.85) (0.6-2.3) mm. The main trunk of submental artery was (5.5±0.5) cm in length, which ran forward along the lower edge of the mandible and branched out (9.0±3.0) (7-13) branches with diameters between 0.1-0.5 mm, and mainly distributed to skin and superficial fascia of the submental area. The main trunk of submental artery divided into ascending, horizontal and descending branches about 3.0 cm of the midline of the mandible. The ascending branch went upwards over the lower edge of the mandible and joined up with the lower labial arch or participated in the formation of the lower labial arch; the horizontal branch divided into several branches and joined up with the branches from the opposite side; the descending branch branched posteriorly and inferiorly, joined up with branches of lingual artery and superior thyroid artery. The branches of the submental artery and the branches of the peripheral arteries were joined up in the submental area to form the submental artery network. The diameter of the vessels in the network ranged 0.1-0.2 mm. The arterial network was built in the form of 1 to 3 layers, and the area of main network was about 7.0 cm×5.0 cm.Conclusion:The submental artery has a long trunk, many branches and abundant anastomoses between the branches, forming a dense submental artery network, which provides sufficient pedicle length, rich blood supply and cutting area for submental flap. The flap can be transplanted free or transposed. The best location of submental flap is near the midline of arterial network, and the appropriate area is 7.0 cm×5.0 cm.

Objective: To investigate the mechanism underlying the effects exerted by the Qizhu prescription (QZP) in breast cancer (BC), and the respective targets. Methods: Expression data from the ArrayExpress and The Cancer Genome Atlas (TCGA) were used to identify differentially expressed genes (DEGs) in BC. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed on the DEGs to identify genes involved in protein–protein interactions. Molecular docking was used to explore the dynamic relationship between active molecules and targets. Cell function experiments and animal studies were conducted to evaluate the effects of hub genes and active QZP compounds on BC cell behavior. Results: Among the 25 evaluated BC-related targets of QZP, matrix metalloproteinase-1 (MMP1) and epidermal growth factor receptor (EGFR) exhibited the highest degrees of dysregulation. GO and KEGG enrichment analyses revealed that the anti-BC targets of QZP primarily affected drug responses and pathways in cancer cells. Molecular docking analysis suggested potential interactions between EGFR and quercetin/luteolin, as well as between MMP1 and luteolin/kaempferol/quercetin. Quercetin significantly reduced BC cell proliferation, migration, invasion, and tumor development in vivo. Treatment of BC cells with quercetin decreased the expression or activation of several associated proteins. Conclusion The findings of our study provide new insights into the therapeutic potential of traditional Chinese medicine against BC, with particular reference to QZP.

Objective: Reveal the global expression profile of serum exosomal proteins of Crouzon syndrome patients. Methods: We isolated microvesicles from serum of Crouzon children with a C342Y mutation in FGFR2 by ultracentrifugation, which were further characterized by electron microscopy and immunoblotting. The protein profiling in normal subjects and Crouzon patients was systematically compared by iTRAQ proteomic analysis. Results: The result demonstrated that microvesicles were between 30—100 nm in diameter, round shape with cup-like concavity and expressed exosomal marker tumor susceptibility gene (TSG) 101 and flotillin (Flot) 1. We identified a total number of 62 proteins, among which 22 proteins overlap with ExoCarta database and were different between the Crouzon patient and the normal subject. The Ingenuity Pathway Analysis showed that the functions of these proteins are mostly involved in Developmental Disorder, Hereditary Disorder, Skeletal and Muscular Disorders, which are all related to the clinical manifestations of Crouzon syndrome. In addition, the proteins were focused on the network of "Organismal Injury and Abnormalities, Hematological System Development and Function, Cell-To-Cell Signaling and Interaction" . The central protein FN1 was presented as the key protein in the network. Conclusions Our data demonstrated that serum exosomes harbor informative proteins and FN1 was selected as a potential candidate for its role in promoting osteoblast adhesion, proliferation and mineralization.

Objective: To investigate routine blood test results and secular changes among Tibetan children and adolescents aged from 3 to 19 in the plateau, and to provide the basis for reference range of routine blood test for this population. Methods: A total of 1 568 Tibetan children and adolescents aged from 3 to 19 living in Shigatse, Tibet were selected by cluster random sampling method. Routine blood test results and its secular trends were compared by age and gender. Results: Significantly differences were found in red blood cell(RBC), hemoglobin(HGB), hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin(MCH), white blood cell(WBC), neutrophil(NEU), neutrophil percentage (NEU%), lymphocyte(LYM), lymphocyte percentage(LYM%)，monocyte percentage(MON%)，eosinophil percentage(EOS%),basophil percentage(BAS%) and platelet(PLT) among the four age groups of 3-5, 6-12, 13-15, and 16-19 years ( F/H =60.22, 179.41, 249.45, 115.03, 74.90, 14.33 , 33.46, 78.90, 49.20, 97.29, 24.45,24.28,42.65,20.10, P <0.05). Among red blood cell indexes, RBC, HGB, HCT,MCH increased with age in boys( F =148.77, 493.04, 623.14, 249.92, P <0.05), but there was no similar trend in girls( F =1.37, 0.15, 2.94, 0.11, P >0.05). HCT showed significant sex differences among the four age groups of 3-5 years, 6-12 years, 13-15 years, and 16-19 years [(41.33±2.31)% vs (41.98±2.40)%; (43.28±2.60)% vs ( 43.75 ±2.36)%; (46.20±3.11)% vs (44.83±2.67)%; (51.10±4.15)% vs (43.61±4.70)%, t =-2.10, -2.88, 3.50, 10.82, P <0.05]. WBC, NEU, NEU%, LYM, LYM%, monocyte(MON), and MON% increased significantly with age in both boys and girls ( P <0.05). From the age of 12 to 13, RBC, HGB and HCT in Tibetan male and female adolescents showed an opposite trend and widened gradually. Conclusion Red blood cell index shows significantly different trends among Tibetan adolescents and children of different ages and genders. Regional nationality, age, gender, and other factors should be considered when developing the reference value range of blood routine index.

Objective To analyze the dosimetric effect of the optimization tool, normal tissue objective (NTO), in Eclipse on the intensity modulated radiation therapy (IMRT) for postoperative patients with rectal cancer. Methods Twenty postoperative patients with rectal cancer were randomly selected. Based on the Eclipse treatment planning system, three IMRT plans were formulated for each patient, with manual NTO as the control group, and automatic NTO and no NTO as the other two groups. The dosimetric parameters of the target volume and organs at risk (OAR) and the monitor units (MU) were compared between the automatic NTO and no NTO groups and the control group under the same optimization conditions. Results Compared with the control group, the automatic NTO group showed a worse conformity index (CI) (t = 3.248, P < 0.05), a 0.6% higher D_mean of normal tissues (t = -3.678, P < 0.05), and no significant difference in the dose to OAR and the MU (P > 0.05); the no NTO group showed a worse CI (t = 16.716, P < 0.05), a better homogeneity index (t = 6.594, P < 0.05), a 3.19% higher D_mean of normal tissues (t = -8.560, P < 0.05), no significant difference in the dose to OAR except the small intestine with higher D_max (P > 0.05), and a 3.95% increase in the MU. Conclusion From the dosimetry results of the target volume and OAR, the plans with manual NTO and automatic NTO, and without NTO can meet clinical needs, but the plan without NTO increases the hot spots outside the target volume and the MU as well as the D_mean of normal tissues. Manual NTO has no obvious advantages over automatic NTO which is recommended for the fixed-field IMRT of rectal cancer.