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

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.

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

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.

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 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 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 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 whether the pulmanary fibrosis formed after a single PFIB exposure.METHODS A total of 70 male mice were exposed to PFIB 130 mg·m-3 for 5 min.Pulmonary edema of 10 mice was evaluated by lung indices at 24 h after PFIB exposure.Pathological changes and collagen deposition were detected by hematoxylin and eosin (HE) and Sirius red stainings in the other mice,changes in collagen content in lungs and plasma by measuring the respective hydroxyproline content at 2,4,6,8,12 and 16 weeks after PFIB exposure.RESULTS Severe pulmonary edema was observed at 24 h after PFIB exposure.At day 14 after PFIB exposure,inflammatory cell infiltration,alveolar septum thickening,interstitial and alveolar edema and protein leakage were noticed.Collagens types Ⅰ and Ⅲ on the wall of vessel and bronchi were severely damaged,but considerable amount of collagen type Ⅲ deposited on the alveolar wall.The content of hydroxyproline considerably decreased in the lungs but increased significantly in the plasma up to six weeks.Hydroxyproline in lungs and plasma began to recover at the end of 8 weeks,and then returned to normal.At 16 weeks,they recovered to normal level.At the end of 4 weeks,the lung lesions and the collagens at the wall of vessel and bronchi began to recover gradually; collagen typeⅢ at the alveolar wall was gradually absorbed,too.At 16 weeks,the lungs almost recovered to normal level.CONCLUSION At earlier phase after PFIB exposure,the excessive collagens destruction in lungs is observed,but no pulmonary fibrosis forms at the later phase.