ObjectiveTo discuss the benefits of nipple-areola complex(NAC) preseving radical modified mastectomy and immediate reconstruction with latissimus dorsi fat flap for early breast cancer. MethodsFrom Jan 2006 to Dec 2008, 16 patients underwent NAC preseving modified radical mastectomy and immediate breast reconstruction with latissimus dorsi fat flap.ResultsAll patients recovered smoothly.No fat flap or back skin necrosis happened.The reconstructed breasts had good apperance with 93.8％ satisfaction rate.During the follow-up of 44 months (ranging from 36 to 60 months), all patients were disease-free.ConclusionsThe operation of NAC preseving modified radical mastectomy and immediate reconstruction with latissimus dorsi fat flap is safe and effective.It can improve the life quality of patients by satisfing the needs of both beauty and tumor resection.

Objective To investigate the clinical values of heparinase-modified thromboelastography(hmTEG)in heparin monitoring during continuous renal replacement therapy.Methods A total of 97 cases who were undergoing continuous renal replacement therapy(CRRT)in the intensive care unit of the 94th People's Liberation Army Hospital from Jan 2014 to Jun 2019 were enrolled in this stud-y.The patients were divided into TEG group and APTT group according to different means of heparin monitoring during continuous renal replacement therapy.In total,278 hemofilters were used in all the blood purification therapies.Complication of bleeding,CRRT time,total heparin dose and SOFA(sequential organ failure assessment)score of the patients were compared between the TEG and APTT groups.The filter life span and survival time in hospital were also compared using Kaplan-Meier analysis.Rusults Compared with APTT group,the total heparin dose in TEG group were significantly higher(P＜0.05).The CRRT time of patients and the average filter life span in TEG group were significantly longer than those of APTT group(P＜0.05).Compared to APTT group,the 28-day SOFA in TEG group was significantly lower(P＜0.05).Survival analysis showed that the 28-day risk of death in the patients of APTT group was 2.01 times higher than that in TEG group(P＜0.05).The 72-hour filter life of TEG group was significantly longer than that of APTT group(P＜0.05).Conclusion The use of hmTEG for monitoring heparin in blood purification should be superior in terms of safety and efficacy with longer filter life span and higher survival rate of patients.