Objective To study the anatomic data of the first metatarsal dorsal artery and to provide anatomical basis for clinical tissue transplantation based on the first metatarsal dorsal artery.Methods The 16 adult cadaver specimens with 32 feet were dissected and meas-ured by vernier caliper.Then the anatomic data of the first metatarsal dorsal artery were analyzed.Results Through the examinations of 32 feet sample,the first metatarsal dorsal artery were classified into 5 types.Type Ⅰ:the first metatarsal dorsal artery runs at the surface of the first dorsal interosseous muscle (13 sides,40.6%).Type Ⅱ:the first metatarsal dorsal artery runs in the interior of the first dorsal interosse-ous muscle (11sides,34.4%).Type Ⅲ:the first metatarsal dorsal artery runs underneath the first dorsal interosseous muscle (6 sides, 18.8%).Type Ⅳ:the first metatarsal dorsal artery is slender (1 side,3.1%).TypeⅤ:the first metatarsal dorsal artery is absent (1 side, 3.1%).Distance relationship was measured between the first metatarsal bone and the first metatarsal dorsal artery:the vertical distance be-tween the origin of the posterior branch of the first metatarsal dorsal artery and base of the first metatarsal bone was (2.4 ±0.3)mm,the ver-tical distance between the origin of the posterior branch of the first metatarsal dorsal artery and head of the first metatarsal bone was (10.1 ±1.0)mm;the vertical distance between the origin of the anterior branch of the first metatarsal dorsal artery and the first metatarso-phalangeal joint was (7.6 ±2.7)mm.Conclusion The first metatarsal dorsal artery has clinical reference significance for the hands and feet’s trauma and skin flap transplantation such as thumb reconstruction.

Objective To discuss the correlation between nature of carotid plaque by dual-source CT examination and serum levels of hypersensitive C-reactive protein (hs-CRP),lipoprotein a (LPa) and homocysteine (Hcy),and provide a better theoretical basis for the prevention and treatment of ischemic cerebrovascular disease.Methods Fifty carotid plaque patients with ischemic cerebrovascular disease symptoms (group A),50 carotid plaque patients without ischemic cerebrovascular disease symptoms (group B)and 50 healthy people (group C) were selected.All objects were detected the carotid plaque by dual-source CT,and the serum levels of hs-CRP,LPa and Hcy were detected by the automatic biochemical analyzer.The correlation between the nature of carotid plaque by dual-source CT examination and the serum levels of hs-CRP,LPa and Hcy was analyzed.Results The total number of carotid plaque,number of unstable plaque and number of stable plaque in group A were 357,220 and 137 pieces,respectively.Those in group B were 200,13 and 187 pieces,respectively.There were statistical differences between group A and group B (P ＜ 0.01).Patients in group A and group B were mainly with unstable plaque and stable plaque,respectively.Healthy people in group C were without carotid plaque.The serum levels of hs-CRP,LPa and Hcy in group A were (36.74 ± 13.22) mg/L,(563.15 ± 178.69) mg/L and (40.15 ± 12.31) μ mol/L,respectively.These in group B were (12.36 ± 4.35) mg/L,(393.56 ± 86.45) mg/L and (29.45 ± 7.63) μ mol/L,respectively.These in group C were (3.26 ± 1.26) mg/L,(220.17 ± 35.24) mg/L and (14.32 ± 2.44) μ mol/L,respectively.The serum levels of hs-CRP,LPa and Hcy in group A were significantly higher than those in group B and group C,and those in group B were significantly higher than those in group C,there were statistical differences (P ＜ 0.05).The serum levels of hs-CRP,LPa and Hcy were positive correlation with the number of carotid unstable plaque,the correlation coefficients between the serum levels of hs-CRP,LPa and Hcy and the number of carotid unstable plaque in group A were 0.469,0.398 and 0.363 (P ＜ 0.05),respectively,in group B were 0.276,0.145 and 0.127(P ＜ 0.05),respectively.The correlation coefficients between group A and group B were significantly different (P ＜ 0.05).Conclusions The combination of dual-source CT examination and the serum levels of hs-CRP,LPa and Hcy is more beneficial to judge the stability of plaque,and it can help predict the nature of the carotid plaque.This view is important clinically for the prevention and treatment of the occurrence and the development of the ischemic cerebrovascular disease.

Objective To investigate the value on clinical application of dynamic and combined detection of serum tumor markers alpha-fetoprotein (AFP),Golgi protein 73 (GP73),vascular endothelial growth factor (VEGF) and alpha-L-fucosidase (AFU) in early diagnosis and monitoring treatment of primary hepatocellular carcinoma.Methods Serum levels of AFP,GP73,VEGF,AFU in 98 patients with primary hepatocellular carcinoma (the malignant group) before and 3 months after treatment were detected by electrochemiluminescence immunoassay and enzyme-linked immunosorbent assay,which compared with the levels of 50 liver benign lesions (the benign group) and 50 healthy subjects (the normal group).Results The levels of serum AFP,GP73,VEGF,AFU in the malignant group before treatment were (219.16 ± 56.89) μg/L,(355.42 ± 109.26) μg/L,(88.21 ±24.22) μg/L,(276.51 ±83.20) U/L.These indexes in the benign group were (14.95 ± 3.26) μ g/L,(56.43 ± 15.72) μ g/L,(2.68 ± 1.27) μ g/L,(25.38 ± 11.17)U/L.These indexes in the normal group were (14.67 ± 3.07) μ g/L,(55.06 ± 14.21) μ g/L,(2.36 ± 1.14) μ g/L,(24.29 ± 10.10) U/L.There were statistical differences between the malignant group and the benign group,normal group (P ＜ 0.01).The levels of these indexes after treatment in the malignant group were (25.66 ±8.17) μg/L,(65.32 ±24.15) μg/L,(4.67 ± 1.89) μg/L,(35.23 ± 12.36) U/L,there were statistical differences between before treatment and after treatment (P ＜ 0.01).The sensitivity and accuracy of combined detection of these tumor markers in diagnosis of primary hepatocellular carcinoma were 95.92％ (94/98) and 93.24％(138/148),which were statistically higher than single detection(P＜ 0.05).Conclusion The dynamic and combined detection of serum tumor markers could be applied as supplementary means in early diagnosis and monitoring treatment of primary hepatocellular carcinoma.

Objective To explore the values of combined detection of carcino embryonic antigen (CEA),carcinoma antigen 125 (CA 125),cytokerain 19 fragment 21-1 (CYFRA2 1-1),carcinoma antigen Scc-Ag (Scc-Ag) and neuron specific enolase (NSE) for diagnosis and treatment of lung cancer.Methods The concentrations of CEA,CA125,CYFRA21-1,Scc-Ag and NSE in 198 patients with lung cancer (lung cancer group),50 with benign pulmonary disease (benign disease group) and 50 healthies (health control group) were detected by electrochemiluminescence immunoassay (ECLIA).The concentration of Pro-GRP31-98 was detected by enzyme linked immunoassay.Results Six tumor markers in lung cancer group showed significant diffcrence compared with those of benign disease group and health control group (P ＜ 0.01).The concentrations of serum tumor molecular markers were significantly higher in Ⅲ,Ⅳ stage group than those in [,Ⅱ stage group.Before the treatment,the concentrations of serum tumor molecular markers in lymph node metastasis group and lymph node recurrence group were significantly higher than those in no lymph node metastasis group and no lymph node recurrence group after the treatment (P ＜ 0.01).The positive rate of CEA,CA125 in lung adenocarcinoma group,CYFRA21-1 and Scc-Ag in lung squamous cell carcinomas group and NSE and Pro-GRP31-98 in small cell lung carcinoma group were significantly different from the other two kinds of pathological types (P ＜ 0.01).The positive rates of CEA and CA125 combinated detection in lung adenocareinoma,CYFRA21-1 and Scc-Ag combinated detection in lung squamous cell carcinomas,NSE and Pro-GRP31-98 combinated detection in small cell lung carcinoma was significantly higher than the individual detection respectively.The sensitivitv rates of CEA,CA125,CYFRA21-1,Scc-Ag,NSE and Pro-GRP31-98 were 52.52 ％,51.01％,48.99 ％,53.03 ％,49.49 ％ and 50.50 ％,respectively.And the combinated detection sensitivity rate of the six tumor markers was 96.46 ％,which significantly higher than that of a single marker (P ＜ 0.01).Conelusions The tumor molecular markers of CEA,CA125,CYFRA21-1,Scc-Ag,NSE and Pro-GRP31-98 may be the indicators in diagnosis of lung cancer.The combined detection of serum tumor molecular markers would significantly improve the sensitivity of diagnosis for lung cancers.At the same time,it should be valuablc for determination of clinical stage,histological type and follow-up studies of lung cancer.

Objective To investigate the value of combined detection of serum tumor biomarkers including alpha-fetoprotein (AFP),tumor specific growth factor (TSGF),golgi protein 73 (GP73) and osteopontin (OPN) in diagnosis of primmy hepatic carcinoma.Methods AFP,TSGF and GP73 levels were measured by electro-chemiluminescence immunoassay,and OPN levels by enzyme-linked immunosorbent assay (ELISA) in 122 cases of primary hepatic carcinoma,50 cases of liver benign lesions and 50 cases of healthy control.The biological parameters and the levels of AFP,TSGF,GP73 and OPN were studied.Results The serum levels of AFP,TSGF,GP73 and OPN in primary hepatic carcinoma were higher than those in the liver benign disease group and the normal control group (all P ＜ 0.01).Sex and age of the patients at diagnosis showed no significant association with the levels of the four serum tumor biomarkers in the primary hepatic carcinoma groups (all P ＞ 0.05).But the tumor size,amount,tumor stage,metastasis and recurrence showed significant association with the levels of those in the primary hepatic carcinoma groups (all P ＜ 0.05).The sensitivity,specificity and veracity of serum AFP,TSGF,GP73 and OPN as individual diagnostic marker was only 57.38 ％,68.85 ％,70.49 ％ and 69.67 ％,respectively.The sensitivity of combined detection of AFP and TSGF was 80.33 ％,and that of combined detection of AFP,TSGF and GP73 was 85.25 ％.While,the sensitivity of the four serum tumor markers in combination was 98.36 ％,the accuracy was 95.65 ％.The sensitivity and accuracy of combined detection with the four serum tumor markers were significantly higher than those of the individual markers and other combination detection methods (all P ＜ 0.05).Conclusions Serum markers of AFP,TSGF,GP73 and OPN can serve as a means for diagnosis of primary hepatic carcinoma.Combined detection of the four serum tumor biomarkers can improve the sensitivity,accuracy and the negative predictive value,which is benefit to early diagnosis and interference.

Objective To compare the incidence of limb dysfunction, sensory disturbance and lymphedema after different treatment methods in breast cancer patients, and evaluate the clinically relevant factors of limb dysfunction. Methods According to the different processing operation of axillary lymph nodes, 235 patients with breast cancer during 2005 to 2012 were divided into axillary lymph node dissection group in Mastoscopy (group A, n=120) and routine axillary lymph node dissection group (group B, n=115). The flexion, extension, abduction, adduction activity of the ipsilateral shoulder were compared with the contralateral, and the circumference of the up-and-down 15 cm of both upper limbs olecroanon were measured. The incidence of limb dysfunction of the patients was followed up in 6 months, 1 year and 2 years. Results There was no significant difference in limb activity and sensory disturbance between 2 groups 6 months, 1 year and 2 years after operation (P>0.05), the incidence of limb lymphedema was higher in group B than in group A (P<0.05). Radiotherapy was related with limb lymphedema in both groups (P<0.05). Conclusion Compared with the conventional axillary lymph node dissection, endoscopic axillary lymph node dissection can reduce the incidence of limb lymphedema after operation, but there was no significant difference in the limb activity and sensory disturbance between 2 groups. Postoperative radiotherapy is a risk to increase the occurrence of limb lymphedema.

Objective To investigate the relationship between neurogenic bowel dysfunction (NBD) and substance P in rats suffering from spinal cord injury (SCI). Methods 60 male Sprague-Dawley rats, weighted (220±40) g, were randomly divided into three groups: sham group (n=20), normal group (n=20) and model group (n=20) and then were subdivided into subgroups of 24 h, 1 week, 3 weeks, and 5 weeks respectively after SCI. SCI model was established at thoracic 10 segment of rat with NYU impactor device. The colon tissue of the rats was resected and stored. Substance P in serum and tissue was measured by ELISA. The tissue was examined by real-time RT-PCR and Western blotting to analyze the expression of substance P. Results The colon intestinal transmission function decreased and delineated at minimum value at 3 weeks in the model group. There was statistical significance with respect to the content of substance P in serum and tissue between the sham group and model group at 3 weeks. The expression of substance P in the sham group was (3.12±0.51) times of the model group (P<0.05). Conclusion Substance P may take part in NBD after SCI in rats.

Objective To investigate the stapled trans-anal rectal resection (STARR) and Altemeir's resection for rectum prolapse in spinalcord injury (SCI) patients. Methods Anus bowel disease of 260 SCI patients were investigated, 21 cases with rectum prolapse who wereinvalid for nonoperative treatment chose Altemeir's resection or STARR depending on the degree of rectum prolapse. They were recorded ac- cording to International Spinal Cord Injury Bowel Function Based and Extension Set before and 12 months after operation. Results 85 SCIpatients were with rectum prolapse (32.7%), 21 patients complicated with constipation and mixed hemorrhoid, 19 with rectal mucous membraneprolapse (<7 cm), 4 with rectal internal mucous intussusception, 2 were completely rectum prolapse (≥7 cm). Rectum prolapse of Ⅰdegree was found in 13 cases, Ⅱ in 5 cases, and Ⅲ in 3 cases. Patients with Ⅰ or Ⅱ degrees rectum prolapse accepted STARR, those withⅢ degrees accepted Altemeir's resection. No serious complication was found. Self-report of intestinal dysfunction affecting the quality oflife during the 12 months after operation significantly decreased (P<0.01), so as the need of drawing out defecate with hands (P<0.01), theusage of liner, plug, or antidiarrheal (P<0.001). The symptom such as endless defecate feeling, abdominal distension, abdominal pain, abdominaldiscomfort were significantly alleviated (P<0.05). Conclusion STARR and Altemeir's resection are both safe and effective operationfor rectum prolapse in SCI patients.

Objective To investigate the clinical value of serum tumor makers CA15-3,19 fragments of cellular keratin antigen(CYFRA21-1)combined with the color Doppler ultrasound and mammography X-ray in diagnosis of early breast cancer.Methods According to the postoperative pathologic diagnosis,collected 106 cases of patients with breast cancer (breast cancer group) and 50 cases of patients with benign breast lesions (control group),the serum tumor makers CA15-3,CYFRA21-1,the color Doppler ultrasound and mammography X-ray were compared with postoperative pathology and statistical analyzed retrospectively.Results The sensitivity of CA15-3 was 63.2%(67/106),specificity was 94.O% (47/50);the sensitivity of CYFRA21-1 was 73.6%(78/106),specificity was 88.0%(44/50);the sensitivity of color Doppler ultrasound was 77.4%(82/106),specificity was 90.0%(45/50);the sensitivity of mammography X-ray was 75.5%(80/106),specificity was 92.0%(46/50);the sensitivity of the four combined detections was 96.2%(102/106),specificity was 80.0%(40/50).The sensitivity of combined detection was higher than any of them individually,there was statistical significance (P<0.05).Conclusions Combined diagnosis is an effective way of early breast cancer detection.It has high positive rate of diagnosis and reliable guidance significance for diagnosis and treatment.

ObjectiveStromal cell-derived factor -1 (SDF-1 ) is closely related to the biological characteristics of breast cancer. We aimed to explore whether estrogen affected breast cancer by SDF-1. MethodsThe breast cancer cell line MCF-7 and MRC5 were chosen, and divided into three groups: the control group, the estrogen group and the estrogen + estrogen receptor blocker group. Each group was cultured with different physiological concentrations of 17-β estrogen at certain time, and the same alcohol concentration of 17-β estradiol at different time points, and then the enzyme-linked immunosorbent assay (ELISA) was used to measure the concentration of SDF-1 in culture medium, and the semi-quantitative reverse transcriptionpolymerase chain reaction (RT -PCR) was used to detect the expression of SDF-1 mRNA in each group.ResultsSDF-1 can be detected in the culture medium of both MCF-7 and MRC5 cell lines. All different concentrations of 17-β estradiol may increase the secretion of SDF-1 in MCF-7 cells. When adding 17-β estradiol to the concentration of 107mol/L, the secretion of SDF-1 reached the peak in 2 hours, which was 6 times and 2.7 times that of control group ( P ＜ 0.01 ). The effect could be ehminated by pure estrogen receptor ICI182,780. In addition, the mRNA expression of SDF-1 was consistent with the SDF-1 protein levels-l07 mol/L group. The expression of SDF-1 mRNA was higher than both that of the control group and the blocking group in 2 hours (P ＜ 0.05 ). ConclusionsIn some breast cancer cell lines, physiological concentrations of estrogen can increase the secretion of SDF- 1, and this effect is mainly achieved through the estrogen receptor. Estrogen can influence the biological characteristics of breast cancer by SDF-1.