Ten percent ethyl acetate oil red dye was injected into the axillary artery of 30adult cadavers.After careful dissection under surgical microscope,the cutaneousarteries in the lateral thoracic region were demonstrated.The skin and subcutaneoustissue in this region is nourished mainly by four axial arteries.In the anterior part,the anterolateral area,accessory lateral thoracic artery is almost always present.It isa direct cutaneous branch of axillary or brachial artery.In the posterior part,thepectoral latissimus dorsi area,direct cutaneous branches,arise from the lateral thoracicartery,subscapulo-dorsal thoracic artery and axillary artery.The distribution of thecutaneous arteries may be monopolized by either one,or one to be the main theother accessory.The diameters of the arteries and accompanying veins,can satisfythe requirment of a cutaneous flap in microvascular surgery.These arteries all possessrich anastomosis between each other and with neighboring arteries.The architactureof the destribution of blood vessels of lateral thoracic region,possibly set up amorphological basis,which may be helpful in cutaneous flap designation.

Based on the related theories of physician behavior analysis, summarize and discuss the incentives mechanism of supplier payment on physician behavior and its inner mechanism, provide theoretical supports and political suggestions for further analysis on payment reform.

To investigate the correlation between traditional Chinese medicine (TCM) syndrome and short-term prognosis of ischemic stroke.

The end stage of chronic renal diseases is characterized by glomerular sclerosis and interstitial fibrosis. Studies have revealed that effective amelioration of renal fibrosis can significantly delay the progression of chronic renal diseases. Peroxisome proliferator activated receptors (PPARs) are ligand-activated nuclear transcriptional factors of the nuclear hormone receptor superfamily, and PPAR-γ is one of the phenotypes of PPARs. The effect of PPAR-γ on inhibiting renal fibrosis has become a hot spot. In this article the research advances of PPAR-γ in amelioration of renal fibrosis are reviewed.

Objective To describe the Reverdin technique for treatment of hallux valgus (HV) based on correction of proximal articular set angle (PASA). Methods Thirty-one Reverdin osteotomies (in 31 feet of 17 female patients)were performed between 1992 and 1998. Reverdin operation is unique among the surgical procedures for its ability to correct large PASA with a medial wedge-type osteotomy of the metatarsal head. Results On the follow-up of 1 to 8 years, patients rated outcomes as excellent or good in 96％ (30 feet). There was no complication of delayed union or avascular necrosis of the metatarsal head. Radiographical follow-up: PASA averaged 19 degrees(range 30-12 degrees), had a postoperative averaged value of 1.95 degrees, HV angles averaged 30 degrees(range 41-23 degrees), had a postoperative value of 14.3 degrees. Intermetatarsal angles averaged 10.9 degrees (range 16-4 degrees), had a postoperative value of 5.8 degrees. Conclusion The preoperative PASA value is the most important factor in hallux valgus evaluation, as well as the selection of operative techniques. The normalization of PASA safegurds more successes and less recurrences.

Objective To detect exon deletions/duplications in the DMD gene in Duchenne and Becker muscular dystrophy pedigrees using multiplex ligation-dependent probe amplification method,and explore the usefulness of multiplex ligation-dependent probe amplification analysis as a method for genetic diagnostics in patients with Duchenne and Becker muscular dystrophy.Methods Exon deletions/duplications in the DMD gene were analyzed by multiplex ligation-dependent probe amplification for two pedigrees with Duchenne muscular dystrophy and Becker muscular dystrophy.Patients and carriers were diagnosed by multiplex ligation-dependent probe amplification.Results The pedigree with Duchenne muscular dystrophy was caused by DelEx45-50 mutation,while the pedigree with Becker muscular dystrophy was caused by Dup Ex3-4 mutation.Patients and carriers were diagnosed by multiplex ligation-dependent probe amplification method.Conclusion Exon deletions/duplications in the DMD gene can be indicated by probe copies using multiplex ligation-dependent probe amplification method under standard operating procedure.Multiplex ligation-dependent probe amplification should be considered as a rapid and accurate clinical method for an initial mutation analysis of DMD gene with exon deletions/duplications.

Objective To compare the accuracy of full field digital mammography (FFDM) and digital breast tomosynthesis (DBT) in predicting size of ductal carcinoma in situ (DCIS).Methods Totally 30 women pateints with DCIS confirmed by histology were analyzed retrospectively.Two radiologists measured the size of the lesions on FFDM,DBT images respectively,and compared with pathological results.Two kinds of inspection methods correlation with pathology were compared with Pearson correlation analysis.Results Size of DCIS measured by doctor 1 and doctor 2 between FFDM and histology had correlation (r=0.857,0.818,both P＜0.01),and those between DBT and histology also had correlation (r=0.924,0.885,both P＜0.01).Intraclass correlation coefficient (ICC) of two doctors was 0.947 on FFDM,and 0.908 on DBT.Conclusion DBT provides a better estimation of the size of DCIS.Two physicians had high consistency for lesion size evaluation.For DCIS with microcalcifications,both FFDM and DBT provide smaller estimations compared with pathology,thus a bigger surgical resection of lesion is needed.

Objective To observe the therapeutic effect of herbal fumigation and steaming for rheumatoid arthritis(RA) and to explore its anti-inflammation mechanism.Methods Twenty-two RA patients were randomized into two groups: group A(N=10) received meloxican and methotrexate,and group B(N=12) received herbal fumigation and steaming of Xunzheng Prescription(mainly composed of Rhizoma et Radix Notopterygii,Radix Angelicae Pubescentis,Radix Saposhnikoviae,Ramulus Cinnamomi,Herba Asari,Rhizoma Chuanxiong,Caulis Piperis Kadsurae,Radix Cynanchi Paniculati,Rhizoma Curcumae Longae,Lignum Sappan,Borneolum Syntheticum) additionally.The treatment lasted 20 days.The changes of joint symptoms and signs,erythrocyte sedimentation rate(ESR) and C-reactive protein(CRP) were observed before and after treatment.Serum tumornecrosis factor ?(TNF-?) and intercellular adhesion molecule 1(ICAM-1) contents were detected by enzymelinked immunoassay.Results Compared with group A,joint pain and tenderness index as well as morning stiffness time were improved in group B (P

Objective In this study,we measured the levels of urinary monocyte chemoattractant (MCP)-1 and interferon-γ-inducible protein (IP-10) and further analyzed their associations with clinical and pathological data in lupus nephritis patients in order to find the non-invasive biomarkers which canpredict disease activity.Methods MCP-1,IP-10,VEGF levels were measured in urine samples from 64 lupus nephritis patients and 20 healthy volunteers.Clinical disease activity was determined by SLEDAI and BILAG scores.The lupus nephritis patients were divided into two groups:active disease group (SLEDAI scores ≥ 10points,n=36) and non-active group (SLEDAI score＜10 points,n=28).Of all patients enrolled,37 patients had a concomitant kidney biopsy performed at the time of urine collection.The predictive performance of uri-nary MCP-1 and IP-10 for renal flare,the Student's t test,Mann-Whitney U test,Chi-square test,and re-ceiver operating characteristic (ROC) curves were constructed for analysis.Results The urinary MCP-1 and urinary IP-10 levels of the active group was significantly higher than that of the non-active group [MCP-1672.39(318.05,2 554.23)pg/ml vs 152.52,(55.61,330.44)pg/ml,Z=-4.717,P＜0.01; IP-10 (38±19) pg/ml vs (22±16) pg/ml,t=3.576 P＜0.01].The level of urinary MCP-1 was positively correlated with the levels of hematuria and 24 hours protein quan-tification,as well as the scores of SLEDAI and BILAG (rbemahuria=0.570,P=0.000; r24hpro=0.569,P=0.000; rSLEDAI=0.600,P=0.000; rBILAG=0.606,P=0.000),and it was also positively correlated with the scores of cellular crescent,wire loop,and AI (rCC=0.405,P=0.015; rwire loop=0.430,P=0.014; rAI=0.352,P=0.003),while nega-tively correlated with the level of C3 and plasma albumin (rc3=-0.564,P=0.000; ralb=-0.587,P=0.000).It had no correlation with the scores of wire loop and CI (P＞ 0.05).The level of uIP-10 was positively correlated with the protein quantification in 24 hours and the scores of SLEDAI and BILAG (r24hpro=0.305,P=0.018; rSLEDAI=0.334,P=0.009; rSILAG=0.496,P=0.000),while negatively correlated with the level of C4 (rC4=-0.301,P=0.016).The R0C curve of uMCP-1 to predict the activity of SLE showed that its specificity was 75.0％,sensitivity was 83.3％,and the area under the ROC curve was 0.85±0.05.The ROC curve of urinary IP-10 to predict the activity of SLE showed that its specificity was 50.0％,sensitivity was 97.2％,its area under the ROC curve was 0.74±0.06.The ROC curve of urinary MCP-1 to predict renal flare shows that its specificity was 45.5％,its sensitivity was 100％,and the area under the ROC curve was 0.74±0.80.The ROC curve of urinary IP-10 to predict renal flare showed that its specificitywas 36.4％,its sensitivity was 73.3％,and its area under the ROC curve was 0.49 ±0.10.Conclusion Urinary MCP-1 and urinary IP-10 predict renal flare in patients with lupus nephritis.Furthermore,urinary MCP-1 is a more specific and sensitive forecaster of renal flare in patients with a history of lupus nephritis than urinary IP-10.

Background Blepharitis is an induce factor for multiple ocular surface diseases.Research showed that bacteria play an important role in the pathogenesis of blepharitis.To make sure the pathogenic bacteria and effective antimicrobial agents are of clinical significance for the prevention and treatment of blepharitis.Objective The purpose of this study was 1o investigate the bacterial isolates of conjunctival sac secretion and meibomian secretion in the patients with blepharitis and study their in vitro antimicrobial susceptibility.Methods Forty-five patients with anterior blepharitis and 45 cases with posterior blepharitis were included in Beijing Chaoyang Hospital from December 2006 to December 2012,and 45 patients for laser in situ keratomileusis were enrolled in the same period as control group.The secretions of the conjunctival sac and meibomian were collected with sterile cotton swab,and bacterial isolates were cultured in bouillon culture-medium.The number of eyes with different bacteria was examined and calculated.Then the bacteria were switched to blood agar plates,and antimicrobial susceptibility test to erythromycin,gentamicin,tobramycin,rifampin,levofloxacin were performed by M ueller Hinton (M-H) medium paper method.Results The total germiculture positive rates were 81.1％,76.1％ and 65.0％ in the anterior blepharitis group,posterior blepharitis group and the control group,showing a significant difference among them (x2 =12.80,P=0.00).The germiculture positive rates in meibomian secretion were 84.4％ and 78.8％ in the anterior blepharitis group and the posterior blepharitis group,which were significantly higher than 67.8％ in the control group (x2=7.30,P =0.03).There was no statistically significant difference in the germiculture positive rate of conjunctival sac section among the three groups (77.8％,73.3％ and 62.2％) (x2 =5.60,P=0.06).The main bacteria in conjunctival sac secretion and meibomian secretion were staphylococcus epidermidis,staphylococcus aureus and corynebacterium in all the subjects,but streptococcus pneumoniae and gram-negative bacillus were not detected in the control group.Staphylococcus showed the highest susceptibility to gentamicin,tobramycin and rifampicin,with the sensitive rate ＞70％.Corynebacterium was susceptible to various drugs.Streptococcus pneumoniae had susceptibility to erythromycin and tobramycin.However,Gram-negative bacillus was not susceptible to all the drugs above.Conclusions Bacteria participate in the pathogenesis of blepharitis,but the germiculture positive rate,bacterial species and drug susceptibility of bacteria are obviously different between patients with blepharitis and normal population.Reasonable application of antimicrobial agents is important to blepharitis.