Objective:The aim of this study was to screen and analysize the important virulent genes in golden hamster cheek pochmucosa with precancerous lesions induced by DMBA.Methods:The models of golden hamster cheek poch mucosa precancerous lesions were induced by DMBA(styrene-dimethyl-anthracene).We extracted the total RNA from the normal mucosa and precancerous lesions;then we respectively used the Cy3 to mark the cDNA of normal mucosa and precancerous lesions;and used the Agilent Rat microarray containing 41,000 genes/ESTs to screen the differentially expressed genes;used the screening criteria of Log2Ratio ≥2.5 and Log2Ratio≤-2.5,at last using the Gene Ontology to analysis the biology function of the important virulent genes.Meanwhile,we confirmed the correctness of the results of the Gene Chip by using the RT-PCR to verificate some important pathogenic genes.Results:We detected a total of 1331 differentially expressed genes(up-regulated 747;down-regulated 584).GO analysis showed that these differentially expressed genes mainly related to the macromolecular metabolism,signal transduction and so on.The RT-PCR results of Atp6v0d2 and Sfrp2 were consistent with the gene chip analysis.Conclusion:Towards the screening and analysis of the important differentlily expressed genes in the gold hamster cheek pouch mucosa with precancerous lesions,we found that the special stage-precancerous lesions involved in changes in multiple genes.The further study of these genes is useful to explore the pathogenesis of precancerous lesions in the oral mucosa and effectively prevent the occurrence of precancerous lesions.

To explore the efficacy and safety of human recombinant endostatin (rh-endostatin) plus pemetrexed and cisplatin in the treatment of advanced non-small cell lung cancer (NSCLC).A total of 79 patients with advanced NSCLC were randomly divided into control group (n =39,pemetrexed plus cisplatin) and study group (n =40,rh-endostatin plus pemetrexed and cisplatin).The short-term relative risks of the test group (19/40,47.5％) was significantly higher than that in the control group (10/39,25.6％).And the clinical benefit rate the test group (33/40,82.5％) was higher than that of the control group (23/39,59.0％,P ＜ 0.05).The predominant adverse effects were bone marrow suppression and digestive reactions.And the incidence rate was not significantly different between two groups.

Mental matching is a strategy of teaching materials transacting in emotional latitude of teaching psychology. Used properly, psychology matching strategy can improve the unification between teaching materials and students' need to adjust to the students' learning interests. This paper introduces the connotations and functions of mental matching strategy, and two types of mental matching strategies in the nursing ethics teaching are analyzed.

BACKGROUND: Flap pedicled with nutritional vessels of the lateral antebrachial cutaneous nerve is beneficial for repairing injury of dorsum; however, lacks of system researches of the lateral antebrachial cutaneous nerve compound flap.OBJECTIVE: To study the anatomic theory of the distally based compound flap pedicled with nutrient vessels of the lateral antebrachial cutaneous nerve - cephalic vein.DESIGN: A single sample observation.SETTING: Researching Center of Clinical Anatomy, Military Institute of Orthopaedics, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA.MATERIALS: The experiment was carried out at the Researching Center of Clinical Anatomy, Military Institute of Orthopaedics, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA from January to May in 2004.A total of 30 upper limbs of adult cadavers perfused with red latex through arteries were provided by the Researching Center of Clinical Anatomy, Military Institute of Orthopaedics, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA.METHODS: The radial styloid process was taken as the mark for the microanatomical observation of the follows: ① the origins, branches, distribution and anastomosis of nutrient vessels of the inferior 1/3 segment of lateral antebrachial cutaneous nerve-cephalic vein; ② the relationship of nutrient vessels of lateral antebrachial cutaneous nerve-cephalic vein and radius periosteal vessels; ③ the superficial-deep communicating branches of cephalic vein.MAIN OUTCOME MEASURES: ① The origins, branches, distribution and anastomosis of nutrient vessels of the inferior 1/3 segment of lateral antebrachial cutaneous nerve-cephalic vein; ② The relationship of nutrient vessels of lateral antebrachial cutaneous nerve-cephalic vein and radius periosteal vessels.RESULTS: ① The origins of nutrient vessels supplying the inferior 1/3 segment of the lateral antebrachial cutaneous nerve were: 6 to 11 cutaneous branches of radial artery with an outer diameter of (0.7±0.3) mm, 2 to 6 cutaneous branches of superficial palmar branch, with an outer diameter of (0.5±0.3) mm, 1 to 2 cutaneous branches of recurrent branch nourishing the radial styloid process with an outer diameter of (0.8±0.1) mm, 1 to 2 cutaneous branches nourishing tabatiere anatomique with an outer diameter of (0.6±0.2) mm. 8.0 to 15.0 cm superior to the radial styloid process, there were 1 to 3 spatium intermuscular osteocutaneous perforators of radial artery with an outer diameter of (1.1 ±0.2) mm, and periosteal branches distributed in the denudate area of the middle-inferior radial bone with its cutaneous branches (0.8±0.2) mm in diameter. Above perforators gave rise to cutaneous branches, fascia branches,periosteal branches and nutrient vessels of nerve to superficial vein to form a vessel chain of cutaneous nerve-cephalic vein and vascular networks of deep fascia, superficial fascia and periosteum.CONCLUSION: The nutrient vessels of lateral antebrachial cutaneous nerve-cephalic vein and the nutrient vessels of muscle, bone and skin are homologous. The compound flap of lateral antebrachial cutaneous nerve-cephalic vein pedicled with the cutaneous branches of radial artery can be applied to repair the distal tissue defects of the hand by rotating the flap on the plane of wrist joint.

BACKGROUND: Posterior antebrachial skin is beneficial for repairing injury of dorsum of hand; however, according to lacking operative researches on distal pedicel arterial perforators of posterior antebrachial cutaneous nerve nutrient vessel flap, it is still a confusing problem in clinic.OBJECTIVE: To investigate the features of distal antebrachial arterial perforators of dorsal forearm and provide anatomical theories for suitable designing pedicle flap and compound flap at distal flap pedicled with nutrient vessels of posterior antebrachial cutaneous nerve.DESIGN: Single sample observation.SETTING: Researching Center of Clinical Anatomy, Military Institute of Orthopaedics, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA.MATERIAL5: The experiment was carried out at the Researching Center of Clinical Anatomy, Military Institute of Orthopaedics, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA from May to October, 2004. Thirty-three upper limbs of adult cadavers perfused with red latex through arteries were provided by Researching Center of Clinical Anatomy, Military Institute of Orthopaedics, Fuzhou General Hospital of Nanjing Military Area Command of PLA.METHODS: Thirty-three adults upper limbs were dissected and observed with microscope with taking rhe styloid process of ulna and radius as pivot point.MAIN OUTCOME MEASURES: ① Distal antebrachial arterial perforators of dorsal forearm; ② nutrient vessels of distal posterior antebrachial cutaneous nerve; ③ their blood supply relationship with nearby muscle, bone and skin.RESULTS: ① Along extensor digitorum communis muscle, distal antebrachial arterial perforators of dorsal forearm were perforated along bilateral muscular interspace and tendon interspace to form lateral and interior inosculated vascular plexuses of fascia. The axis of lateral muscle interspace, dorsal antebrachial lateral vascular plexuses consisted of lateral branch of dorsal carpal branch of anterior interosseous artery, radial interosseous cutaneous perforators, radial interosseous cutaneous perforators of posterior interosseous artery, carpal dorsal branch of radial artery and its perforators. The axis of medial muscle interspace, dorsal antebrachial medial vascular plexuses was consisted of medial branch of dorsal carpal branch of anterior interosseous artery, ulnaris interosseous cutaneous perforators, ulnaris interosseous cutaneous perforators of posterior interosseous artery, carpal dorsal branch of ulnaris artery and its perforators. ②Above mentioned arterial perforators sent out cutaneous branches, fascia branches and posterior antebrachial cutaneous nerve nutrient vessel to form vascular chain of cutaneous nerve stem and vascular nets of deep and superficial fascia.Muscle-periosteum branches of posterior interosseous artery had some ulnar periostea whose radial interosseous cutaneous perforators were anastoimosed with periosteum vessels in the middle and inferior segments of radius; therefore,there was an anatomic basis for distal pedicele compound flap.CONCLUSION: Blood supply of distal antebrachial arterial perforators of dorsal forearm is characterized by multiple sources, obviously longitudinal distribution and homologous nutrient vessel; therefore, there are three blood-supplied distal pedicled flap or compound flap of posterior antebrachial cutaneous nerve nutrient vessel. Rotation point of distal pediclde flap can reach wrist joint, and the compound flap can be applied in repairing the injury of distal tissue of hand.

BACKGROUND: The distally based skin flap pedicled with nutrient vessels of saphenous nerve has provided a method with higher achievement ratio to repair the tissue defect of ankle and foot, due to its high rotation point, lacking of distributive characteristics of distally pedicled vessels description for the specific operations, so it is still difficult in clinical application.OBJECTIVE: To investigate the distal artery perforators of medial leg, so as to suggest an anatomical theory for the reasonable design of the distally based compound flap pedicled with nutrient vessels of saphenous nerve-great saphenous vein.DESIGN: A single sample experiment.SETTING: Researching Center of Clinical Anatomy, Military Institute of Orthopaedics, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA.MATERIALS: The experiment was carried out in the Researching Center of Clinical Anatomy, Military Institute of Orthopaedics, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA from May to October, 2004.Thirty-four adult specimens perfused with red emulsion at lateral arteries of upper lower limbs were provided by the Researching Center of Clinical Anatomy, Military Institute of Orthopaedics, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA.METHODS: Specimens of the distal medial legs were dissected with microscope taking the most prominent point of medial malleolus as the pivot point.MAIN OUTCOME MEASURES: ① Distal artery perforators of medial leg; ② Distal nutrient vessels of saphenous nerve-great saphenous vein; ③ Blood supply correlation of nutrient vessel with neighboring muscle, bone and skin.RESULTS: ① The distal artery perforators of medial leg derived from 9 main blood supplying sources were as follows:Intermuscular perforator of posterior tibial artery, superior malleolar branches of anterior tibial artery, osteocutaneous perforators of peroneal artery or posterior tibial artery, medial malleolar branch of medial anterior malleolar artery, tarsal tunnel branch of posterior tibial artery, medial malleolar branch of medial plantar artery, medial malleolar branch of lateral plantar artery, medial malleolar branch of the superficial branch of medial plantar artery and medial maleolar branch of medial tarsal artery. ② The above-mentioned artery perforators sent out cutaneous branches, fascial branches, periosteal branches, nutrient vessels of saphenous nerve and great saphenous vein, thus formed a superior and inferior vascular net of deep fascia, vascular chain of superficial fascia and neurocutaneous superficial vein, and periosteal vascular network. Artery perforators constituted 3 distal longitudinally distributed fascial vascular plexus in medial leg (anterior, middle and posterior), including anterior longitudinally distributed fascial vascular plexus of medial anterior malleolar artery and superior malleolar branch of anterior tibial artery; middle longitudinally distributed fascial vascular plexus of osteocutaneous perforators; posterior longitudinally distributed fascial vascular plexus of malleolar canal artery perforators and intermuscular perforators of posterior tibial arteries.CONCLUSION: The blood supply of distal medial leg, which makes the anatomical basis for distally pedicled compound flaps, has the anatomical characteristics of multiple-sources, longitudinal distribution and homogeneity of nutrient vessels.Three kinds of distally pedicled skin flap supplied by nutrient vessels of saphenous nerve-great saphenous vein can be designed by taking the intermuscular perforator of posterior tibial artery, fascial perforators of medial anterior malleolar artery and artery perforators of tarsal tunnel perforators as pedicle, and the point of rotation is on the plane of medial malleolus, which are suitable for repairing the defects of distal leg, ankle and foot.

BACKGROUND:Posterior antebrachial skin is beneficial for repairing injury of dorsum,however,the systematic anatomic characteristics of distally based compound flap pedicled with nutrient vessels need to be further studied.OBJECTIVE:To investigate the anatomic characteristics of distally based flap pedicled with nutrient vessels of the posterior antebrachial cutaneous nerve and compound flap.DESIGN:Single sample observation.SETTING:Research Center for Clinical Anatomy,Military Institute of Orthopaedics,Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA.MATERIALS:The experiment was carried out at the laboratory for Research Center for Clinical Anatomy,Military Institute of Orthopaedics,Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA from October to December 2004.A total of 30 upper limbs of adult cadavers perfused with red latex through arteries were provided by Research Center for Clinical Anatomy,Military Institute of Orthopaedics,Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA.METHODS:All 30 adults upper limbs were dissected and observed under the microscope based on the pivot point of styloid process of ulna and radius.The following microdissection was emphasized:The origins,branches,distribution and anastomosis of nutrient vessels of the posterior antebrachial cutaneous nerve;The blood supply relationship of nutrient vessels of posterior antebrachial cutaneous nerve and vicinal bone and skin.MAIN OUTCOME MEASURES:The ordgins and branches of nutrient vessels of posterior antebrachial cutaneous nerve,and whose blood supply relationship with vicinal bone and skin.RESULTS:The origin of nutrient vessels of posterior antebrachial cutaneous nerve were as follows:Proximal part:2-6cutaneous perforators of radial collateral artery,with an outer diameter of (0.6±0.3) mm;Distal part:3-5 cutaneous perforators of dorsal carpal branch of anterior interosseous artery,with an outer diameter of (0.8±0.2) mm;Others:6-9cutaneous perforators of posterior nterosseous artery,with an outer diameter of (0.7±0.3) mm.Posterior interosseous artery sent out 6-8 muscle- periosteum branches with an outer diameter of (0.3-1.0) mm,which distribute on ulnar periosteum;Radial bone-skin perforators of posterior interosseous artery anastomosed with periosteal vessels of mid-inferior bare area of radial bone.All above mentioned cutaneous perforators gave off cutaneous branches,fascia branches,periosteal branches and nerve-nutrient vascular branches,all of which formed a vascular chain of cutaneous nervous stem and vascular networks of deep fascia,superficial fascia and periosteum.CONCLUSION:The nutrient vessels of posterior antebrachial cutaneous nerve have the same origins as the vicinal bone-skin nutrient vessels,and the rotation point of its distally based pedicled flap and compound flap can reach the plane of wrist joint,which may be helpful to design a kind of more convenient and simplified flap to repair the distal tissue defects of the hand.

BACKGROUND: Flap pedicled with nutritional vessels of the cutaneous antebrachial medialis nerve is beneficial for repairing injury of dorsum of hand; but it needs the support from systemic anatomic research on distally based compound flap.OBJECTIVE: To study the anatomic theory of the distally based compound flap pedicled with nutrient vessels of the cutaneous antebrachial medialis nerve -basilic vein.DESIGN: Single sample observation.SETTING: Research Center for Clinical Anatomy, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA.MATERIALS: The experiment was carried out at the laboratory for Research Center for Clinical Anatomy, Military Institute of Orthopaedics, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA from March to August 2003. A total of 30 upper limbs of adult cadavers perfused with red latex through arteries were provided by Research Center for Clinical Anatomy, Military Institute of Orthopaedics, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA. Each cadaver was injected with a mixture of red gelatin to show the branches, distributions and anastomosis of the lesser vessels on the stained small arteries of the finger tips.METHODS: All 30 adult upper limbs were dissected and observed under the microscope based on the pivot point of styloid process of ulna: ①The origins, branches, distribution and anastomosis of nutrient vessels of the inferior 1/3 segment of medial antebrachial cutaneous nerve-basilic vein, and whose blood supply relationship with ulnar periosteal vessels. ②The superficial and deep communicating branches of basilic vein.MAIN OUTCOME MEASURES: ①The origins, branches, distribution and anastomosis of nutrient vessels of medial antebrachial cutaneous nerve, and whose blood supply relationship with vicinal bone and skin. ② The superficial and deep communicating branches of basilic vein.RESULTS: ①The origins of nutrient vessels supplying the inferior 1/3 segment of the lateral antebrachial cutaneous nerve were 5-9 cutaneous branches of ulnar artery with an outer diameter of (0.7±0.3)mm. The ascending and descending branches of wrist superior branches sent out several cutaneous branches nourishing basilic vein, with an outer diameter of (0.6±0.3) mm. Between the position of (6.0-16.0) cm superior to ulnar malleolus, anterior interosseous artery sent out 2-3 perforating bone-skin branches, with an outer diameter of (0.7±0.2) mm; Posterior interosseous artery sent out 1-3 bone-skin perforating branches, with an outer diameter of (0.6±0.3) mm. Both of them were distributed on periosteum and skin of the corresponding area. All above-mentioned cutaneous perforators gave off cutaneous branches, fascia branches, periosteal branches and nutrient vascular branches of cutaneous nerve-superficial vein, and a vessel chain of cutaneous nerve-basilic vein and vascular networks of deep fascia, superficial fascia and periosteum formed. ②Ulnar artery had two accompanying veins, one was grossus, and the other thin. The two veins accompanied along two sides of artery, and the accompanying vein of arterial cutaneous branches infused. Superior wrist cutaneous branches of ulnar artery had two accompanying veins. One pumped into ulnar branch of ulnar vein, and the other one passed through deep fascia, then entered subcutaneous tissue, and straightly pumped into basilic vein. The injected position was (2.3±0.8) cm superior to ulnar malleolus, with an outer diameter of (2.8±0.5) mm.CONCLUSION: The nutrient vessels of medial antebrachial cutaneous nerve-basilic vein and the nutrient vessels of bone and skin are homologous. The rotation point of their distally based pedicled flap and compound flap can reach the plane of wrist joint, which can be applied to repair the distal tissue defects of the hand.

[Objective]To assess the accuracy and value of radiographic technique using computed tomography(CT) measurements in cadaveric specimens during anterior cervical corpectomy in order to define the safe lateral limit of dissection.[Method]The gutter of C4～6 corpectomy on 5 cadaveric samples was filled with radioopaque dye.An antero-posterior X-ray was used to measure the narrowest distance from dye column to the line of uncovertebral joints.A CT scan confirmed the distance from the borderline of the gutter to vertebral arteries.[Result]The distance between the X-ray dye column and the line of uncovertebral joints averaged 4.7 mm in the left and 4.2 mm in the right.While the distance from the borderline of the gutter to vertebral arteries with CT scan averaged 6.1 mm in the left and 5.9 mm in the right.The measured distance by radiographic technique underestimated the true distance.[Conclusion]Intraoperative radiographic technique can estimate the lateral distance between the gutter of corpectomy and vertebral arteries by measuring the distance from the dye column to the line of uncovertebral joints.This technique provides surgeons an additional margin of safety during anterior cervical corpectomy.

Organ transplantation is the gold standard of treatment for patients with end-stage organ failure.However,transplant recipients must take immunosuppressive drugs lifelong to fight against rejection,which is inevitably caused by the recipient' s immune system in response to transplanted foreign tissues.Despite advances in the prevention of acute rejection,it is still a significant and potentially devastating complication of solid organ transplantation.Moreover,chronic allograft dysfunction as a result of acute and chronic alloimmune-mediated injury still develops in a majority of transplant recipients regardless of continuous immunosuppression.While host adaptive immune responses elicited by T lymphocytes are primarily responsible for allotransplant rejection,emerging evidence supports an important role of the innate immune system in the development of organ rejection.Innate immune recognition is initiated by a set of diverse receptors that belong to different protein families including the family of toll-like receptors (TLRs).TLR signaling is a highly specialized system that can identify a variety of microbial and endogenous mediators,and activate the innate immune system in response to danger.The discovery of TLRs over the past 10 years has started a new era in understanding the molecular events that initiate and regulate the inflammatory response following organ transplantation.They influence the adaptive immune reactions and contribute to ischemic reperfusion injury,acute and chronic allograft rejection,and tolerance induction.Their role as potential targets for therapeutic intervention has just begun to be appreciated.In this article,we summarize the structural and functional characteristics of TLRs and their ligands.We focus on the studies to define the roles of TLRs in ischemic reperfusion injury,allotransplant rejection,and immune regulation in both animal models and clinical transplantation.