Axillary reverse mapping (ARM) is anatomic theoretical foundation based on breast and upper limb lymph axillary lymph injected into different lymphatic populations, ARM can display upper limb lymphatic channels through different tracers during the periods of axillary lymph node dissection and sentinel lymph node dissection, to reduce the rate of postoperative upper extremity edem.Although ARM has a positive effect, it exists a controversy in safety and the relationship between its node and sentinel lymph node.

Objective To investigate Shuxuening injection combined with deproteinized extract of calf blood on serum IGF-1, IL-1 and ICAM-1 level in patients with cerebral infarction recovery stage.Methods 120 patients with cerebral infarction were collected.According to the different drug treatment, 60 cases in each group were given corresponding drug treatment, on the basis of control group, the calf blood extract injection was given in experimental group.After the end of treatment, all patients blood rheology, IGF-1, IL-1 and ICAM-1 levels were tested.Results Compared with control group, the indexes of the patients in experimental group improved more significantly, whole blood viscosity, red blood cell pressure volume, platelet aggregation rate decreased significantly(P<0.05); serum IGF-1 levels in experimental group decreased significantly(P<0.05).The levels of serum IL-1, ICAM-1 in experimental group decreased significantly(P<0.05).Conclusion Shuxuening injection combined with deproteinized extract of calf blood can significantly reduce serum IGF-1, IL-1 and ICAM-1 levels in patients with cerebral infarction recovery stage, improve blood flow, reduce blood viscosity.

Objective To observe the clinical efficacy of acupuncture plus rehabilitation training in treating post-stroke depression.Method Forty-one patients with post-stroke depression were randomized into a treatment group of 22 cases and a control group of 19 cases. In addition to the basic internal medicine treatment, the treatment group received acupuncture plus rehabilitation training, while the control group was intervened by rehabilitation training alone. The Hamilton Depression Scale (HAMD) and National Institutes of Health Stroke Scale (NIHSS) were observed and compared before and after treatment.Result The HAMD and NIHSS scores in the two groups were significantly changed respectively after 4-week and 8-week treatment (P<0.05,P<0.01). Respectively after 4-week and 8-week treatment, the HAMD and NIHSS scores in the treatment group were significantly different from that in the control group (P<0.05,P<0.01).Conclusion Acupuncture plus rehabilitation training is an effective approach in treating post-stroke depression.

Objective To explore the feasibility and efficacy of the selective portal vein embolization (SPVE) before radiofrequency ablation(RFA) for liver tumor large than 3 cm.Methods 63 patients with 63 liver tumor (＞3 cm) located in single liver segment completely or mostly underwent RFA.21 patients (21 lesions) were randomly assigned to receive SPVE before ablation (SPVE + RFA group),other 42 patients were treated with RFA only (RFA group).The complications and treat results of two groups were collected and compared.Results SPVE were achieved in 20 of 21 patients,and no critical complication were happened in both group.During a observation period of median 14.2 months,local tumor progression were observed in 17 of 42 patients (40.5％) in RFA group and in 3 of 20 patients (15.0％) in SPVE+ RFA group,there were significant difference between two groups(P =0.043).Conclusions SPVE can safely and effectively improve the efficacy of RFA for the liver tumors which large than 3 cm and located in single liver segment.

Objective To explore the relationship of vertebral artery hypoplasia (VAH) with acute posterior circulation cerebral infarction (APCCI).Methods One hundred and eighty-nine consecutive patients diagnosed as having acute cerebral infarction admitted to our hospital from March 2015 to March 2016 were enrolled in our study;retrospective analysis was performed on their clinical and radiographic data to compare the general clinical characteristics of patients with posterior circulation infarction (PCI) and anterior circulation infarction (ACI).VAH was conformed by cranial magnetic resonance angiography (MRA),vertebral artery ultrasound or cranial MRA+vertebral artery Ultrasound.The infarction lesions in VAH patients with APCCI were typed;the correlation between vertebral artery diameter's differences and National Institute of Health stroke scale (NIHSS) scores in VAH patients with APCCI was illuminated.Results In 189 consecutive patients with acute cerebral infarction,32 (16.93％) were with VAH;after exclusion of 8 with infarction in both anterior and posterior circulation,90 (49.72％) were in PCI group while 91 (50.28％) in the ACI group.Univariate analysis showed that statistical differences were noted between the two groups in triglyceride (TG) and VAH levels (P＜0.05).In 23 patients with APCCI with VAH,brain stem infarction consisted of 9 patients (5 VAHs were ipsilateral to the infarction,3 VAHs contralateral and one bi-VAH),cerebellum infarction consisted of one patient (ipsilateral side),thalamus infarction 10 patients (4 VAHs were ipsilateral to the infarction,and 6 VAHs contralateral),occipital lobe infarction 2 patients (one ipsilateral and one contralateral) and cerebellum with thalamus infarction one patient (the side of VAH was ipsilateral to the cerebellum and contralateral to the thalamus).After excluding one patient with bi-VAH,in 22 patients with APCCI combined with VAH,significantly positive correlation between vertebral artery diameter's differences and NIHSS scores was noted (r=0.560,P=0.000).Conclusions It might be the best assessment standard of VAH measured by combination of transcranial MRA and vertebral ultrasound.TG and VAH may be risk factors of APCCI,and VAH could be one independent risk factor of APCCI.The side of VAH is usually ipsilateral to the brain stem and cerebellum infarction,while contralateral to the thalamus infarction in APCCI patients with VAH.Also,vertebral artery diameter's differences are positively correlated with NIHSS scores.

Objective To analyze the clinical effect of a bifurcated ball frame designed for undergraduate research to assist hand-knee position,avoid physical exertion and increase comfort.Methods Randomized controlled trials consisted of 260 occipital (posterior) primiparous women born during labor,and were randomly divided into the observation group and the control group with 130 cases each.The observing group's mothers were on the yoga ball on the device.The angle and height of the frame and the ball plate were adjusted according to the maternal body type,so that the yoga ball at the chest and the cross could effectively support the maternal weight loss knee burden,and both sides of the small abdominal yoga ball could be effectively posted.After the adjustment was completed,the maternal relaxes and gently shakes the body in one direction so that the small yoga ball on the ventral side forms a continuous soothing push.The control group leaned forward on both knees (with protective gear) and supported themselves with both hands or both fists,swaying the pelvis or crawling forward.Comparing the two groups of vaginal delivery rate,maternal postural maintenance time,maternal dehvery experience,and effective correction rate of occipital position.Results The time of postoperative maintenance in the observation group was (49.51 ±10.62) minutes,and that of the control group was (18.31 ± 9.72) minutes.The difference between the two groups was statistically significant (t=6.69,P ＜0.05).The effective correction of abnormal fetal position rate,spontaneous delivery rate and comfort rate were 82.30％ (107/130),77.69％ (101/130),and 99.23％ (129/130),respectively in the observation group,and 27.69％ (36/130),33.85％ (44/130),3.84％ (5/130),respectively in the control group,the differences between the two groups were statistically significant (x2 =4.06,4.15,5.61,all P ＜0.05).Conclusions The undergraduate design of this sort of ball delivery group has a significant effect on the extraversion of the assisted position to the fetal position.

Objective: To analyze the infection characteristics of patients in acute gastroenteritis outbreaks caused by noroviruses. Methods: Between April 2014 and March 2016, the clinical data and samples were collected from the patients in acute gastroenteritis outbreaks caused by noroviruses in Beijing. Noroviruses were detected and genotyped using real time RT-PCR, and the infection characteristics of norovirus gastroenteritis were analyzed using the descriptive epidemiological method. Results: A total of 1743 clinical diagnosed cases of norovirus gastroenteritis were collected, and children under 12 years old accounted for 77.68% (1354/1743). The detection rate of noroviruses was 73.98% (509/688). The detection rates of noroviruses in fecal, swab and vomitus samples were gradually decreased (χ²=67.798, P<0.001). Among these clinical diagnosed cases, vomiting was the most common symptom (93.98%), followed by abdominal pain (40.34%), diarrhea (30.35%) and fever (27.94%). The most common symptom of patients under 6 years old was vomiting(98.14%), whereas diarrhea was most common among over 18 years old patients (68.12%). With the increase of age of the patients, the incidence of vomiting was gradually decreased (χ²=100.913, P<0.001), whereas the incidence of diarrhea was gradually increased (χ²=261.164, P<0.001). There was no statistical difference in vomiting, diarrhea and abdominal pain symptoms between patients infected with genogroup Ⅰ and Ⅱ noroviruses, and patients infected with genogroup Ⅱ (34.49%, 149/432) had the higher incidence rate of fever than that of genogroup Ⅰ (18.18%, 14/77) (χ²=7.985, P<0.01). Conclusions Noroviruses mainly infected children under 12 years old in acute gastroentertis outbreaks. The most common symptom of patients with acute gastroenteritis caused by noroviruses was vomiting, and the incidences of vomiting and diarrhea were significantly correlated with age of the patients. Patients infected with genogroup Ⅱ had the higher incidence rate of fever than genogroup Ⅰ infection.