The arterial source of the flap,the anastomoses of cutaneous arteries in theskin and subcutaneous tissue and nervous distribution in the flap were observed andsurveyed in 42 upper limbs of adult cadavers.1.The arterial source of the flap comes mainly from the cutaneous branches ofprofund brachial artery,radial collateral artery,lateral humeral cutaneous artery andcutaneous branches of the posterior circumflex humeral artery.In most cases theprofund brachial artery and radial collateral artery may be served as the vascularpedicle of the flap of lateral brachium in transplantation.2.The cutaneous arteries in this flap anastomose each other to from a networkin the skin and subcutaneous tissue.Cutaneous arteries arising from the medial brac-hial region and the upper part of forearm also participate in the formation of thisvascular network.3.The veins of the flap contain both superficial and deep groups:The superfi-cial group is the cephalic vein of brachium which goes upward along the lateralsulcus of m.biceps brachii and its outer caliber is somewhat wider;the deep groupfollows the profund brachial artery or radial collateral artery as their venae comit-antes.Both groups may be sutured together or separately with veins of the recipientin skin grafting.4.The lateral brachial cutaneous nerve and posterior antebrachial cutaneousnerve pierce through the lateral intermuscular septum at various levels,and innervateover the skin in lateral brachial and posterior forearm regions.Since the posteriorbrachial cutaneous nerve is accompanied closely by the radial collateral artery,muchattention should be paid to it in cutting skin flap.5.The extent of cutting a skin flap in lateral brachial region can be enlargeddue to free anastomoses with arteries of adjacent regions which was demonstrated byperfusing red ink into profund brachial artery.The flap of lateral brachium maybe subdivided into following three parts:the upper,middle and lower,the vascularpedicle of which are the cutaneous branch of posterior circumflex humeral artery,lateral humeral cutaneous artery and profund brachial artery(or radial collateralartery)respectively.

OBJECTIVETo investigate whether patients, who are at risk of major acute coronary events, are safe to undergo and benefit from early intervention after using simvastatin.

METHODSThe study was a randomized, open, two-dosage-controlled trial to evaluate the safety and benefits of simvastatin administered to 197 patients (10 mg group, n = 98 and 20 mg group, n = 99), within 48 hours of hospitalization for a diagnosis of unstable angina or acute myocardial infarction (MI), with total cholesterol (TC) >/= 180 mg/dL or low-density lipoprotein cholesterol (LDL-C) >/= 100 mg/dL. Lipid levels were measured immediately, followed by the 3rd, 6th and 12th month after admission and all adverse events were recorded during follow-up.

RESULTSTC levels fell by 10.15% and 14.52% in the 10 mg and 20 mg groups (P < 0.05), and LDL-C levels fell 13.87% and 19.38% in the 10 mg and 20 mg groups, respectively (P < 0.01), 12 months after using simvastatin. The rates of achieving target TC reached 26.3% and 36.5% in the 10 mg and 20 mg groups (P < 0.01), and that of LDL-C reached 28.2% and 40.3% in the 10 mg and 20 mg groups, respectively (P < 0.01). There were higher rates of MI and re-hospitalization resulting from angina pectoris and revascularization in the 10 mg group compared with the 20 mg group.

CONCLUSIONSThe results suggest that early intervention with the HMG-CoA reductase inhibitor, simvastatin, in acute coronary syndromes is possible and safe. It also indicates that the clinical dosage of simvastatin are relatively smaller than that for satisfactory lipid control in patients with acute coronary syndromes.

Acute Disease ; Aged ; Cholesterol ; blood ; Cholesterol, LDL ; blood ; Coronary Disease ; blood ; drug therapy ; Female ; Follow-Up Studies ; Humans ; Hypolipidemic Agents ; therapeutic use ; Male ; Middle Aged ; Simvastatin ; therapeutic use

The incidence of colorectal cancer is rising year by year, thus screening of neoplastic colorectal polyps is very important for the prevention and treatment of colorectal cancer. In recent years, endoscopic techniques have advanced dramatically, such as high definition endoscopy, magnified endoscopy, conventional or virtual chromoendoscopy. Some of these technologies not only can improve the adenoma detection rate, but also may help to enable real-time endoscopic diagnosis and thereby guide decisions about endoscopic resection. The second generation colon capsule endoscopy provides a new and relative reliable noninvasive tool for colorectal diseases screening and diagnosis. This article aims to provide a comprehensive review of advanced imaging techniques available for the detection and differentiation of colorectal polyps.
Adenoma ; diagnosis ; Colonoscopy ; Colorectal Neoplasms ; diagnosis ; Humans ; Polyps ; diagnosis

In recent years,cancer immunotherapy has attracted considerable attention in the field of biotherapy for the development of chimeric antigen receptor T (CAR-T) cell.CAR-T cells are capable of recognizing tumor cell surface antigens leading to kill tumor cells.Anti-CD19 CAR-T has achieved remarkable success in the treatment of hematopoietic malignancies.Whether it can benefit solid tumor patients to the same extent still faces great challenges,and it has been a focus of attention in immunotherapy for tumors.Compared with hematological malignancies,the microenvironment of solid tumor is more complex,and the screening of tumor specific antigen is more difficult.The infiltration of CAR-T cells from the blood system to the tumor site needs to overcome the tumor stromal barrier.Although part of CAR-T cells can infiltrate into tumor site,its function may be quickly inhibited by multiple factors in microenvironment.In this paper,authors discussed the challenges that CAR-T is facing for solid tumor treatment,including the specificity of the tumor antigen,the heterogeneity of the solid tumor antigen and the inhibitory effect of the tumor microenvironment,and proposed potential strategies to possibly overcome these hurdles.Authors believe that with the development of biotechnology,it will provide more abundant technical means to optimize the structure and function of CAR-T,and CAR-T will make breakthrough progress in the treatment of solid tumor.

In order to better evaluate the transport effect of nanoparticles through the nasal mucosa, an nasal cavity-mimic model was designed based on M cells. The differentiation of M cells was induced by co-culture of Calu-3 and Raji cells in invert model. The ZO-1 protein staining and the transport of fluorescein sodium and dexamethasone showed that the inverted co-culture model formed a dense monolayer and possessed the transport ability. The differentiation of M cells was observed by up-regulated expression of Sialyl Lewis A antigen (SLAA) and integrin 1, and down-regulated activity of alkaline phosphatase. After targeting M cells with iRGD peptide (cRGDKGPDC), the transport of nanoparticles increased. , the co-administration of iRGD could result in the increase of nanoparticles transported to the brain through the nasal cavity after intranasal administration. In the evaluation of immune effect , the nasal administration of OVA-PLGA/iRGD led to more release of IgG, IFN-, IL-2 and secretory IgA (sIgA) compared with OVA@PLGA group. Collectively, the study constructed M cell model, and proved the enhanced effect of targeting towards M cell with iRGD on improving nasal immunity.