In open heart surgery,perioperative arterial pressure is an important index for Circulatory monitoring.Pressure sensor,an invasive arterial pressure monitor,can provide accurate,reliable and continuous arterial pressure value,and determine the status of the blood volume or the heart through wave analysis.It is necessary to grasp the components,principle and technical requirements of biosensor applied to clinical practice.

OBJECTIVETo explore the venous angio-architecture of deep inferior epigastric artery perforator ( DIEP) flap with computed tomography angiography( CTA) and the application of venous angio-architecture in flap thinning of DIEP flap.

METHODSFrom February 2012 to August 2014, preoperative CTA examination of venous system of DIEP flap was performed in 11 patients to study the course, the branch and the anastomosis of the deep inferior epigastric veins, the superficial inferior epigastric veins and the perforator veins. The flap thinning of DIEP flap was based on the finding of the abdominal venous system.

RESULTSThe CTA images were obtained including 22 deep inferior epigastric veins, 22 superficial inferior epigastric veins and 22 perforator veins. The distance between the superficial inferior epigastric vein and abdominal midline was 3.30 cm to 5.77 cm in the zone 3 cm above umbilicus and in the zone 15 cm below umbilicus. The superficial inferior epigastric vein was 0.29 to 0.39 in depth ratio. The superficial inferior epigastric veins were the main drainage vessels of superficial abdominal wall according to the CTA images. They were anastomosed with the deep inferior epigastric veins through perforator veins. The 11 DIEP flaps were thinned based on the structure of the superficial inferior epigastric veins and all flaps had no drainage disturbance.

CONCLUSIONSPreoperative CTA images can display the venous angio-architecture of deep inferior epigastric artery perforator flap. The superficial inferior epigastric vein can be utilized as reference architecture to guide flap thinning of DIEP flap.

Abdomen ; blood supply ; Abdominal Wall ; blood supply ; Angiography ; methods ; Epigastric Arteries ; anatomy & histology ; diagnostic imaging ; Humans ; Perforator Flap ; blood supply ; Phlebography ; methods ; Tomography, X-Ray Computed ; Veins ; anatomy & histology

OBJECTIVE:To compare the dissolubility of ambroxol hydrochloride tablets from four different manufacturers METHODS:To determine the dissolubility of ambroxol hydrochloride tablets according to Chinese WS-430(X-370)-2000 RESULTS:The accumulative dissolving quantity of all preparations exceeded 80% in 45 minutes The comparison of Weibull parameters,m,T50 and Td,showed significant differences(P

The Chinese clinical medical national licensing examination is the profession ad-mittance exam, which is undertake the responsibility of selecting qualified physicians. It also promotes the medical education in China. The standard for examination, the examination content, methods for measuring the Chinese clinical medical national licensing examination as well as the reform and de-velopment, has a certaln guiding role to China's medical education and medical education reform. While reviewing the medical students' performance in the examination, we can discover the weakness in medical education, which is then conducive to the promotion of teaching reform and innovation. The competence based medical licensing examination reform in China, advocating the cultivation of clinical comprehensive ability as the core content to tralning and evaluating, is conducive to continuously im-proving the quality of medical education in China, and to tralning more qualified physicians in the country.

The osmotic pressure of ammonium sulfate solutions has been measured by the well-established freezing point osmometry in dilute solutions and we recently reported air humidity osmometry in a much wider range of concentration. Air humidity osmometry cross-validated the theoretical calculations of osmotic pressure based on the Pitzer model at high concentrations by two one-sided test (TOST) of equivalence with multiple testing corrections, where no other experimental method could serve as a reference for comparison. Although more strict equivalence criteria were established between the measurements of freezing point osmometry and the calculations based on the Pitzer model at low concentration, air humidity osmometry is the only currently available osmometry applicable to high concentration, serves as an economic addition to standard osmometry.

Objective To evaluate the efficacy of pressure bladder indicator in guiding epidural puncture.Methods Test Ⅰ Thirty-two patients scheduled for epidural puncture were studied. After successful epidural puncture, the end of the epidural needle was connected to a pressure sensor to measure the epidural space pressure. Test Ⅱ Seventy patients scheduled for epidural puncture were studied. The epidural puncture was performed using the pressure bladder indicator. The successful condition of the pressure bladder indicator in guiding epidural puncture was recorded. Results The epidural space pressure was ( 10 ± 4) cm H2O. Seventy patients completed epidural pucture under the guidance of the pressure bladder indicator. The success rate was 100%.Conclusion The pressure bladder indicator can serve as an assistance for epidural puncture and has clinical application value.

Objective To study the relationship between X-linked inhibitor of apoptosis protein (XIAP) expression and transitional cell carcinoma(TCC) development. Methods Forty-three TCC tissues and 12 normal transitional epithelial tissues were applied to detect XIAP expression by semi-quantitative RT-PCR, immunohistochemistry and western blot. The data were statistically analyzed by using SPSS11.5 according to the 2 groups (TCC and normal transitional epithelial) as well as the dif-ferent subgroups (tumor stage, grade, single or multiple tumor, primary or recurrence tumor). Results XIAP expression in TCC tissues was higher than in normal transitional epithelial tissues(im-munohistochemistry: 22±5 and 16±2, Western blot:1.21±0. 15 and 0. 61±0.24, mRNA: 1.17± 0. 30 and 0. 75±0. 17, P<0. 05). In the bladder tumors group, XIAP expression in recurrence tumors was higher than in primary tumors(immunohistochemistry: 24±3 and 20±3, Western blot: 1.66±0.28 and 1.10±0. 23, mRNA: 1.44±0. 27 and 1.05±0. 23, P<0. 05). However, there were no significant differences according to the tumor stage and tumor grade as well as tumor multi-plicity or not. Conclusion XIAP expression might serve as a biomarker in TCC diagnosis and recur-rence prediction.

Objective To analyse clinical application of reversed anterolateral thigh adipefascial flap in repair of defects around the knee. Methods Reversed anterolateral thigh adipofascial flap was employed to repair defects of knee and upper shank in five patients from July 2006 to April 2007. The perforator arteries were detected and labelled with a hand held Doppler flowmeter before operation. The size of flaps containing perforator artery ranged from 6 cmx 8 cm to 12 cm×13 cm. After the descending branch was severed at the bifurcation of the lateral circumflex femoral artery, the flaps were elevated distal-ly to cover the defects of the knee and upper part of the shank. A split thickness graft was harvested to cover the flap. Results All the reversed anterolateral thigh adipofascial flaps survived well, with no complications occurred in donor site. Partial graft necrosis occurred in one patient and healed after conser-vative wound dressing change. Conclusion The reversed anterolateral thigh adipofascial flap is a good choice for repair of defects around the knee, for it can provide long thin vascular pedicle and maintain contour of the donor cite.

Objective: To explore the measurement of Hunan Han young female nasal shape and its application for short nose rhinoplasty. Methods: From June to December 2015, 162 Han young females in Hunan Xiangtan were chosen. Their photographs were used by the photogrammetry for measuremnet of nasal length, nasal height, nasal breadth, nasal depth, nasolabial angle, nasofrontal angel, nasorostral angel, columellar-facial angle, nose width-nose height index, nasal depth-nose width index, nasion to tip-defining point. The measurementresult were collected to create nasal shape database. During the period of January to June 2016, the database was applied to thirty-nine cases with short nose, to serve as guidelines for preoperative design and postoperative evaluation. Independent sample t-test was used to evaluate theresult of the operations by comparing the postoperative data with the nasal shape database of Hunan female nose assessment system. Results: The measurementresult of Hunan Han young female nasal shape were as follow: nasal length (4.4±0.2) cm, nasal height(4.8±0.2) cm, nasal width (3.3±0.2) cm, nasal depth (1.8±0.2) cm, nasolabial angle (88.6±7.0)°, nasofrontal angle (136.0±5.5)°, columellar-facial angle (33.3±3.0)°, nasal tip angle (82.4±5.4)°, nose width-nose height index 70.4±4.8, nasal depth-nose width index 55.1±5.7, nasion to tip-defining point (47.4±11.4)%.The short noses deformity was corrected greatly. The measurement data of nasolabial angle, nasofrontal angel, nasorostral angel, columellar-facial angle, nose width-nose height index, nasal depth-nose width index and nasion to tip-defining point had no statistical significance between postoperative patient and Hunan female, but nasal length, nasal height, nasal width and nasal depth difference have statistical significance. Conclusions The Hunan Han young female nasal shape database could provide quantitative reference for preoperative design, performance and post-operative aesthetics evaluation.

Objective To investigate the features of PET-CT manifestation of pancreatic metastasis,and to improve its detection rate.Methods The PET-CT images of 31 cases of clinically diagnosed pancreatic metastases and 26 cases of primary pancreatic cancer were retrospectively evaluated.Two experienced specialists identified the lesion location in fused images.After frame by frame image analysis,the lesions with significantly increased radioactivity uptake were seen as positive,when compared with surrounding normal pancreatic tissue.The outline of regions of interest was drawn along the edge of the lesion shown in PET,and based on a semi-quantitative evaluation,the maximum standard uptake value (SUVmax) was calculated.If SUVmax ＞ 2.5,it was considered as positive.Results Among the 31 cases with pancreatic metastasis,22 cases of lung cancer,2 cases of gastric cancer 2 cases of colon carcinoma,1 case of maxillary sinus carcinoma,thyroid carcinoma,melanoma,renal cell carcinoma or gallbladder carcinoma were identified.Twenty-one cases (67.7％) were single,10 cases (32.3％) were multiple or diffuse lesions.Among the single lesions,7 (33.3％) were located in the pancreatic head and neck,14 in pancreatic body and tail.Among the 26 cases of primary pancreatic carcinoma,18 cases (69.2％) were located in the pancreatic head,8(30.8％) in the pancreatic body and tail.The sites of primary and metastatic pancreatic cancer were significantly different (x2 =6.012,P =0.014).CT scan showed only 17 nodular lesions with relatively low density and less clear boundary.PET images showed lesions in 31 cases of metastatic pancreatic cancer,and the mean SUVmax was 7.42 ± 3.48,which was significantly higher than that in primary pancreatic cancer group (5.39 ± 1.71,F =4.87,P =0.032).In addition,PET-CT identified 30 cases of other organs or lymph node metastasis.Conclusions PET-CT plays an important role in the diagnosis of metastatic pancreatic cancer.