Nipple-areola complex (NAC)-sparing mastectomies (NSM) have gained acceptance in the ifeld of breast oncology. The superior aesthetic outcomes of NSM explain their increased use and rising popularity. Technical considerations and challenges of this procedure are centered on nipple ischemia and necrosis. Patient selection, reconstructive strategies and incision placement have lowered ischemic complication rates. An understanding of the NAC vascular anatomy is, therefore, clinically relevant beyond NSM. In this paper, the relevant clinical anatomy is described, mainly focusing on the anatomy of the NAC. This article also covers how to identify and classify the in vivo blood supply to the NAC using breast MRI exams which provide valuable information for assessing vascular anatomy of the NAC. This includes the arterial iflling phase, venous drainage phase and 3-dimensional reconstructed maximum intensity projection (MIP) images. Finally, the indocyanine green (ICG) and a specialized infrared camera-computer system provide surgeons with a practical tool to assess real-time breast skin and NAC perfusion. Intraoperative evaluation of skin perfusion allows surgeons to detect ischemia and modify the operative approach to reduce the risk of nipple ischemia and necrosis.

Acetabulum ; injuries ; surgery ; Fractures, Bone ; surgery ; Humans

The effect of the trace elements on retinopathy of prematurity (ROP) were studied. Thirty preterm infants who had potential high risk factors of ROP were selected as observation group and 18 normal infants as control groups. By using atom spectrophotometer, the contents of serum trace elements (Mg, Cu, Zn, Mn, Se) were measured and analyzed statistically. The contents of serum Zn, Cu and Se in observation group were 0.75+/-0.22, 0.41+/-0.20 and (134.07+/-71.57)x10(-3) mg/L respectively, and 0.55+/-0.12, 0.65+/-0.194 and (202.92+/-44.71)x10(-3) mg/L in control group respectively (P<0.01). The contents of Cu and Se were obviously lower and that of Zn higher in observation group than those in control group. The same results were obtained between the infants with ROP and controls (P<0.01). However, there was no significant difference in the contents of serum Mg and Mn between two groups (P>0.05). It was concluded that the contents of serum Cu and Se in preterm infants who had high risk factors of ROP were obviously lower than in the controls. The contents of serum Cu and Se in the ROP infants were also much lower while contents of Zn much higher. Attention should be paid to the detection of the trace elements in preterm infants in order to prevent the deficiencies of Cu and Se. Only in this way can we prevent the deficiencies of Cu and Se, so as to decrease the ROP risk factors and prevent the disease.
Copper/blood ; Infant, Premature/*blood ; Retinopathy of Prematurity/*blood ; Retinopathy of Prematurity/*prevention & control ; Risk Factors ; Selenium/blood ; Spectrophotometry, Atomic ; Trace Elements/*blood ; Zinc/blood

Objective To observe the clinical effect by using insulin detemir therapy in children and adolescents with type 1 diabetes mellitus(T1DM).Methods Thirty children and adolescents with T1DM were divided into 2 groups to receive Humulin R and Determir(observation group,n =15) or Humulin R and neutral protamine hagedorn (NPH) (control group,n =15)insulin therapy.Daily insulin dose,glycemic variability,incidence of non-severe and severe hypoglycemia events after the institution of insulin therapy were collected.Results The daily doses of insulin were (1.16 ± 0.30) U/kg in the observation group and(1.21 ± 0.35) U/kg in the control group,respectively.There was no clinically important change between 2 groups(t =0.526,P ＞ 0.05).Within-subject variation in fasting plasma glucose was significantly lower in observation group(29％)than that in control group(65％) (t =5.296,P ＜0.01).One case of severe hypoglycemia event occurred in the observation group,but 5 cases occurred in the control group(t =4.863,P ＜ 0.0l).Two cases of nocturnal hypoglycaemia(22:00-7:00) events occurred in the observation group,7 cases occurred in the control group(t =4.506,P ＜ 0.01).Conclusions Institution of insulin detemir therapy is associated with low within-subject variation in fasting plasma glucose and decreased rates of severe and nocturnal hypoglycemia while dose of insulin did not increase.This makes insulin detemir a valuable new tool for the treatment of children and adolescents with T1 DM.

Objective To investigate the effects of mediastinal block(MB)on coronary atherogenesis and hemodynamics in rabbits with hyperlipoidemia.Methods Forty-eight male New Zealand white rabbits were randomly divided into 4 groups(n=12 each):control group received normal diet 150 g/d for 16 weeks,hypercholesterol group received hypercholesterol diet 150 g/d for 16 weeks,thoracic epidurial block(TEB)group received hypercholesterol diet 150 g/d for 16 weeks and TEB was performed from 13th to 16th week with 2% lidocaine 2 mg/kg twice a day,and MB group received hypercholesterol diet 150 g/d for 16 weeks and MB was performed from 13th to 16th week with 2% lidocaine 2 mg/kg twice a day.MAP was measured before and after 1st block was performed.The serum levels of total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C)and low density lipoprotein cholesterol(LDL-C)were measured on 1st day,and on4th,6th,8th and 16th week during the experiment.At the end of 16 th week,all rabbits were killed by air embolism.Heart was removed and kept in 10% formalin for a week.The ventricles were transversely sectioned at the level of papillary muscle and slices from the cross section of the ventricles were obtained for determination of the degree of atherosclerosis by microscopy.Results MAP was decreased significandy after TEB in TEB group,while there was no significant changes in MAP after MB in MB group(P＜0.05).The serum levels of TC,TG and LDL-C were significandy higher in hypercholesterol.TEB and MB groups than in control group(P＜0.05 or 0.01).The ratios of atherogenesis and intimal thickening were significantly lower in TEB and MB groups than in hyperoholesterol group(P＜0.01),there was no significant difference between TEB and MB groups.Conclusion Mediastinal block can inhibit the development of coronary atherogenesis in rabbits with hyperlipoidemia to a great degree similar to that of thoracic epidural block,but has no effect on hemodynamics.

Objective To observe the effect applicated of endoscopic sinus joint laryngoscope in laryngeal microsurgery.Methods 68 patients with laryngeal lesions were randomly divided into the multi-mirror combination group (34 cases) and the single laryngoscope group (34 cases).The multi-mirror combination group was taken with laryngeal microsurgery under endoscopic Joint laryngoscope.The single laryngoscope group was only taken with laryngeal microsurgery under laryngoscope.The efficacy and surgical situation of the two groups were compared.Results The total effective rate of the multi-mirror combination group was 97.06％,which was significantly higher than that of the single-laryngoscope group (85.30％) (x2 =4.031,P ＜ 0.05).Compared with the case of surgery and complications and recurrence rate,the multi-mirror combination group was superior to the single laryngoscope group (all P ＜ 0.05).Conclusion The endoscopic joint laryngoscope has the function of expanding the scope of the operative field and increasing the focus and clarity,and also has the advantages of small traumatic for patients,fewer complications,low recurrence rate,easy operation and high accuracy.

Objective To study the relationship between the mRNA degradation in the retinal cells of rat after death and postmortem interval(PMI) in order to provide a new methods of inferring PMI.Methods The level of ?-actin,Pgk1 and Rpl 4 mRNA in the retinal cell of rat were measured at different time(0,2,4,6,8,10, 12,14,16,18,20,22,24,26,28h)after death by compound fluorescence RT-PCR.The rats executed immediately were used as controls.Results Within 28h after death,the absorbance value of total RNA and the level of ?-actin,Pgk1 and Rpl 4 mRNA in the retinal cells decreased along with the prolongation of PMI.The equations of linear regression fitting the relationship between mRNA degradation and PMI were as follows:Y?-actin=-4436.205X?-actin+127581.7(r2=0.976),Ypgk1=-1993.884Xpgk1+57651.54(r2=0.973),YRpl 4=-1189.791XRpl 4+34533.46(r2=0.955).The return model had remarkable statistical significance(P

Objective To analyze the survival rate and hospitalization information for 81 2 cases of very low birth weight (VLBW)and extremely low birth weight (ELBW)infants.Methods The retrospective study was con-ducted in a single center,Department of Neonatology,Hubei Women and Children Hospital,from January 2009 to De-cember 201 4,where the data of 81 2 infants with birth weight(BW)less than 1 500 g was analyzed in regard to perinatal condition,treatment and complications of these in relation to prognosis.Results (1 )A total of 621 cases(76.5%) had favorable prognosis.(2)There was a significant difference in the favorable prognosis rate between different BW groups (χ2 =28.87,P <0.05)and different gestational age(GA)groups (χ2 =1 4.77,P <0.05).The favorable prog-nosis rate for the male infants(χ2 =4.69,P <0.05),puerpera age between 1 7 -25 and 36 -46 years old (χ2 =1 1 .1 9, P <0.05),usage of prenatal hormones(χ2 =8.02,P <0.05),the infants without intrauterine infection (χ2 =8.61 ,P <0.05),the mother without gestational hypertension (χ2 =7.20,P <0.05)and gestational diabetes mellitus(χ2 =1 9.2, P <0.05)were different compared to the control groups.(3)Infants with peripherally inserted central catheter (PICC) (χ2 =33.31 ,P <0.05)and recovery birth weight within 1 0 days(χ2 =29.65,P <0.05)had higher favorable prognosis rate compared to the control groups,which had significant differences.(4)Infants with intraventricular haemorrhage (IVH)(χ2 =1 3.1 6,P <0.05),respiratory distress syndrome (RDS)(χ2 =7.59,P <0.05),necrotizing enterocolitis (NEC)(χ2 =1 3.02,P <0.05)and serious asphyxia (χ2 =6.05,P <0.05)had lower favorable prognosis rates than those did not,with significant differences.(5)Logistic analysis:the lower BW,smaller GA,earlier birth,unused PICC, serious asphyxia,IVH,RDS were risk factors for poor prognosis(all P <0.05).Conclusions The favorable prognosis rate of VLBW and ELBW infants has improved gradually,and is closely related to GA,BW,maternal age,perinatal care,prevention complication,treatment of disease and social factors etc.

Objective To investigate MSCT findings of hepatic focal nodular hyperplasia(FNH),and improve its diagnostic value. MethodsThree-phasia MSCT scans of 16 cases with FNH confirmed by pathology were reviewed retrospectively. ResultsThere was single in 13 cases,double in 3 cases.17 lesions is hypodensity and 3 lesions is isodensity on plain MSCT.During MSCT enhancement all lesions were markedly and homogeneously enhanced in arterial phase.isodensity in portal and delay plase.1 lesion found scar. ConclusionDynamic contrast-emhanced MSCT could show the charcteristics of FNH.