Clinical effects of in situ perforation of preserved split scar matrix in combination with scalp transplantation and vacuum sealing drainage in the treatment of hypertrophic scar in non-functional sites after burns / 中华烧伤杂志

Objective: To investigate the clinical effects of in situ perforation of preserved split scar matrix in combination with scalp transplantation and vacuum sealing drainage in the treatment of hypertrophic scar in non-functional sites after burns. Methods: A retrospective observational study was used. From June 2017 to June 2019, 33 patients (24 males and 9 females, aged 8-50 years) who met the inclusion criteria with hypertrophic scars in non-functional sites outside the face after burns were treated in General Hospital of TISCO (the Sixth Hospital of Shanxi Medical University). All patients underwent scalp transplantation after perforation of retained split scar matrix in situ (with scar thinning area of 90-500 cm2), and then the vacuum sealing drainage was performed. The hematoma and infection of wounds were observed on the 7th day after operation. At the same time, the survival rate of skin grafting was observed and calculated. The flatness and thickness of the scar in the operative area were observed in 12 months after operation, and the itching and pain of the patients were recorded. Vancouver Scar Scale was used to score the scar of patients before operation and at 3, 6 and 12 months after operation. The healing time and hair growth of donor site were observed. Data were statistically analyzed with repeated analysis of variance, paired sample t test and bonferroni correction. Results: On the 7th day after operation, local subcutaneous hematoma appeared in the wound of 2 patients, which healed after dressing change; no infection occurred. On the 7th day after operation, the survival rate of skin grafting of patients was 94.6%-99.0%(96.8±1.2)%. Scar flatness was well, the thickness of scar was not significantly higher than that of normal skin in 12 months after operation, and the symptoms of itching pain of patients disappeared or significantly relieved. Vancouver Scar Scale scores of patients before operation and at 3, 6, and 12 months after operation were 12.1±2.8, 8.5±1.5, 7.6±1.6, 6.7±1.3, respectively, and the scores of 3, 6, and 12 months after operation were all significantly lower than that before operation (with t values of 4.48, 4.06, and 3.97, respectively, P<0.01). All the donor sites of the head healed well in 4-7 days after operation. By 3-6 months after operation, all patients had good hair growth in the donor site and achieved no scar healing. Conclusions: The treatment of hypertrophic scar in non-functional sites outside the face after burns by in situ perforation of preserved split scar matrix in combination with scalp transplantation and vacuum sealing drainage can effectively improve the appearance of hypertrophic scar in non-functional areas after burn and reduce its degree of hyperplasia, with scar-free donor site healing.

Status of minimally invasive treatment for adjacent segment disease after lumbar interbody fusion / 中华骨科杂志

Adjacent segment degeneration (ASDeg) is a common complication occurring in patients after lumbar fusion, mainly manifested as adjacent disc herniation, adjacent vertebral fracture or spondylolisthesis, adjacent segment scoliosis, adjacent segment spinal canal stenosis or facet joint degeneration, etc. When patients with imaging manifestations of ASDeg present with clinical symptoms such as lumbosacral pain, root lower limb pain or intermittent claudication, it is called adjacent segment disease (ASDis), and reoperation is often required at this time. At present, open surgery has been widely used in the treatment of symptomatic ASDis, including fusion via posterior approach and transforaminal approach, etc. The traditional surgery is effective, but it always has many disadvantages, such as large surgical trauma, large intraoperative blood loss, long operation time and hospital stay, and slow postoperative recovery. Therefore, surgeons are actively trying to apply various minimally invasive procedures to the treatment for symptomatic ASDis. Anterior lumbar interbody fusion (ALIF) has better recovery effect on intervertebral space height and lumbar lordosis, but it also has higher risk of vascular, urinary system and abdominal organ injury. Minimally invasive transforaminallumbar interbody fusion (MIS-TLIF) has a significant effect on the protection of muscles (such as multifidus muscle) and ligaments. However, compared with open surgery, MIS-TLIF has a limited effect on the correction of coronal and sagittal malformations, and has a higher incidence of superior facet joint violation. lateral lumbar interbody fusion (LLIF) has significant correction effect on coronal and sagittal malformations, complete treatment of intervertebral space, high intervertebral fusion rate, and good intervertebral space height recovery. However, due to the influence of the iliac crest, the surgical segment of LLIF is limited, and there is a risk of injury to the lumbar plexus and iliac vessels at the lower lumbar spine. Extreme lateral lumbar interbody fusion (XLIF) has a low risk of iliac vascular injury, little impact on the original internal fixation, and good interbody fusion effect. However, XLIF is not suitable for patients with a history of retroperitoneal surgery, retroperitoneal abscess, or vascular anatomical abnormalities, and neurological monitoring is often needed during surgery. Compared with open surgery, oblique lumbar interbody fusion (OLIF) has the advantages of less surgical trauma and low risk of common complications (such as dural injury). However, due to the need to pull the sympathetic nerve during operation, OLIF may lead to postoperative limb cold and heat disorders, thus affecting the judgment of surgical decompression effect. Percutaneous endoscopic lumbar discectomy (PELD) can fully decompress the nerve and dural sac while causing less damage to the posterior spinal structure. However, it is not suitable for patients with ASDis complicated with severe spinal stenosis, lumbar spondylolisthesis or cauda equina syndrome. At the same time, PELD has a steeper learning curve than other procedures. Percutaneous endoscopic lumbar interbody fusion (PELIF) also has the disadvantages of steep learning curve and easy to damage outlet nerve, but it has the advantages of less blood loss, shorter hospital stay, faster recovery, and fewer complications (such as deep vein thrombosis and pulmonary embolism) compared with open surgery. This paper reviews the advantages and disadvantages of different minimally invasive procedures in the treatment of symptomatic ASDis and the indications of different minimally invasive procedures through literature retrieval, in order to provide reference for the future minimally invasive methods in the treatment of symptomatic ASDis.

Assessment of causal association between thyroid function and lipid metabolism: a Mendelian randomization study / 中华医学杂志(英文版)

BACKGROUND@#Thyroid dysfunction is associated with cardiovascular diseases. However, the role of thyroid function in lipid metabolism remains partly unknown. The present study aimed to investigate the causal association between thyroid function and serum lipid metabolism via a genetic analysis termed Mendelian randomization (MR).@*METHODS@#The MR approach uses a genetic variant as the instrumental variable in epidemiological studies to mimic a randomized controlled trial. A two-sample MR was performed to assess the causal association, using summary statistics from the Atrial Fibrillation Genetics Consortium (n = 537,409) and the Global Lipids Genetics Consortium (n = 188,577). The clinical measures of thyroid function include thyrotropin (TSH), free triiodothyronine (FT3) and free thyroxine (FT4) levels, FT3:FT4 ratio and concentration of thyroid peroxidase antibodies (TPOAb). The serum lipid metabolism traits include total cholesterol (TC) and triglycerides, high-density lipoprotein, and low-density lipoprotein (LDL) levels. The MR estimate and MR inverse variance-weighted method were used to assess the association between thyroid function and serum lipid metabolism.@*RESULTS@#The results demonstrated that increased TSH levels were significantly associated with higher TC (β = 0.052, P = 0.002) and LDL (β = 0.041, P = 0.018) levels. In addition, the FT3:FT4 ratio was significantly associated with TC (β = 0.240, P = 0.033) and LDL (β = 0.025, P = 0.027) levels. However, no significant differences were observed between genetically predicted FT4 and TPOAb and serum lipids.@*CONCLUSION@#Taken together, the results of the present study suggest an association between thyroid function and serum lipid metabolism, highlighting the importance of the pituitary-thyroid-cardiac axis in dyslipidemia susceptibility.

Analysis of lumbosacral sagittal balance parameter variation in minimally invasive transforaminal lumbar interbody fusion with real-time 3D navigation techniques / 中国骨伤

OBJECTIVE@#To explore the dynamic changes of lumbosacral sagittal parameters after real-time three-dimensional navigation assisted minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) and traditional open TLIF for treatment of lumbar degenerative disease.@*METHODS@#The clinical data of 61 patients with lumbar degenerative disease underwent single-segment surgery from September 2017 to September 2019 were retrospectively analyzed. Among them, 31 cases underwent MIS-TLIF with 3D navigation techniques (MIS-TLIF group) and another 30 cases underwent conventional open TLIF (traditional open TLIF group). The basic information, operative time and intraoperative blood loss were collected. The sagittal radiologic parameters were measured before surgery and 3 months after surgery, including lumbar lordosis (LL), segmental lordosis (SL), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), anterior disc height (ADH), posterior disc height(PDH).And the average disc height(DH) and pelvic incidence to lumbar lordosis mismatch (PI-LL) were calculated.@*RESULTS@#Operative time and intraoperative blood loss in MIS-TLIF group were significantly less than in traditional open TLIF group(@*CONCLUSION@#Real-time navigation-assisted MIS-TLIF and traditional open TLIF can recover DH in a short term for lumbar degenerative diseases, improve LL and PI-LL, and make the arrangement of the sagittal plane of the lumbosacral region more coordinated after surgery. But only the navigation assisted MIS -TLIF can significantly improve SL. Compared with traditional open TLIF, real-time navigation assisted MIS-TLIF in the treatment of degenerative lumbar diseases has the advantages of short operation time and less intraoperative bleeding.

Comparable effects of Jiedu Granule, a compound Chinese herbal medicine, and sorafenib for advanced hepatocellular carcinoma: A prospective multicenter cohort study / 中西医结合学报

OBJECTIVE@#Sorafenib has been extensively used for the treatment of advanced hepatocellular carcinoma (HCC), and Chinese herbal medicine has also been used to manage advanced HCC. The present work evaluates the effectiveness and safety of Jiedu (JD) Granule, a compound of traditional Chinese herbal medicine, side-by-side with sorafenib for the treatment of advance HCC.@*METHODS@#Patients with advanced HCC receiving treatment with JD Granule or sorafenib were enrolled from December 2014 to March 2018. The primary endpoint was overall survival (OS). The secondary endpoints were progression-free survival (PFS) and safety. Propensity score matching (PSM) analysis was used to control for possible selection bias from the study group allocation process.@*RESULTS@#Of the 325 patients included, 161 received JD Granule and 164 received sorafenib. No significant differences were found in OS or PFS among patients receiving JD Granule compared to sorafenib (P > 0.05). Median OS of the two study groups was 6.83 months (95% confidence interval [CI]: 5.83-9.47) in the group receiving JD Granule and 8 months (95% CI: 6.67-9.80) in the group receiving sorafenib, with half-, 1- and 2-year survival rates of 53.6%, 31.2% and 13.2% vs 60.1%, 35.5% and 14.2%, respectively. Even after PSM, the median survival time did not differ between the JD Granule group (9.03 months; 95% CI: 6.37-14.2) and the sorafenib group (7.93 months; 95% CI: 6.5-9.97), with comparable half-, 1- and 2-year survival rates. The most common adverse events (AEs) were diarrhea (13.7%) and fatigue (5.6%) in the JD Granule group, and hand-foot skin reaction (46.3%) and diarrhea (36.6%) in the sorafenib group. The JD Granule was more cost-effective than sorafenib treatment for advanced HCC.@*CONCLUSION@#Compared to sorafenib, JD Granule was more cost-effective and caused fewer AEs for the treatment of Chinese patients with advanced HCC.

Prognostic evaluation of P53 and BCL2 proteins in MYC/BCL2 double expression DLBCL / 中华血液学杂志

Objective@#To investigate the strong expression (S+) of P53 and BCL2 proteins in MYC/BCL2 double-expression DLBCL (DEL) and whether they can be used for the prognostic evaluation and stratified diagnosis of DELs.@*Methods@#Tissue microarray were made by filed FFPE blocks of 174 DLBCL cases. The translocation of MYC, BCL2 and BCL6 genes were detected by FISH, and the proteins were detected by IHC. Data of clinicopathologic features and follow up of patients were collected and OS (overall survival) and PFS (progression free survival) were analyzed by statistics.@*Results@#Eight double-hit lymphomas (DHLs) were identified in all cases, and 45 DELs were selected from 166 remaining cases, which have no significant difference in OS and PFS compared with non-DEL cases (P=0.668 and P=0.790) . Of 42 DEL-cases with follow up data, 24 cases with P53+ or/and BCL2 (S+) are significantly shorter OS and PFS than others (P=0.003 and P=0.000) , in which the cases with P53+/BCL2 (S+) co-expression were the worst prognosis, and P53/BCL2 co-weaker positive DEL cases even have superior OS and PFS than those non-DELs. Although statistics showed that the cases of P53+ or/and BCL2 (S+) have a lower OS and PFS in total cases (P=0.063 and P=0.024) , it is not the case when the DEL-cases take out from total cases, that is the cases with P53+ or/and BCL2 (S+) are as similar OS and PFS as others in non-DEL group (P=0.590 and P=0.550) .@*Conclusion@#The strong expression of P53 and BCL2 proteins can be used as indicators of stratified diagnosis and poor prognosis of DEL.

Development of a database for war wound / 军事医学

Objective To develop a war wound database that is capable of data acquisition , audit, storage, query and statistical analysis,and can be used to record wounds, diagnosis,treatment and outcomes.Methods Based on requirement analysis and database design , the basic structure and function of this database system were determined before we developed this database system by Java on Oracle 11g.Results The database had eight data modules , including basic information , wounded information , wound conditions , first aid and treatment information , medication information , surgical information , medical evacuation , and operational background .The database management system ( DBMS ) was established , and the functions were ensured .Conclusion The records of war wound in the databases are highly continuous , timely, and standardized .They can adapt to the language of medical support research and war wound treatment research .

Roles of exosomes in tumor formation, diagnosis and treatment / 国际肿瘤学杂志

Exosomes are subcellular membrane structures secreted by both normal cells and tumor cells.They contain a variety of specific microRNAs (miRNAs) and signaling molecules,and have important research value in tumorigenesis,tumor diagnostic classification and immunotherapy.The effect of exosomes on tumorigenesis is a double-edged sword,and the miRNAs act as molecular markers and contribute to classify morphologically intractable tumors such as glioblastoma.In antineoplastic therapy,exosomes can be used as drug carriers or induce a new type of immunotherapy through their own characteristics.

Design and implementation of big data ad-hoc queries and statistics subsystem for miliary electronic health records / 军事医学

Objective To improve the analysis efficiency and interactive experience of the Military Electronic Health Records System(MEHRS)and to realize quick response of ad-hoc queries and statistics in the MEHRS with big data columnar storage and processing technologies.Methods We carried out requirement analysis and functional design of the ad-hoc queries and statistics subsystem of the MEHRS,proposed a three-tier architecture which included the archive storage layer,statistical pretreatment layer and statistical application layer.After the selection and evaluation of big data processing technologies,CarbonData columnar storage was used to store preprocessed data and executed statistics with Spark SQL on the basis of medical business data modeling and preprocessing.Results Five testing tasks were executed on two million archives in the following two subsystems:one with modeless and non-preprocessed MongoDB storage,the other with modeled and preprocessed CarbonData storage.The latter could finish these tasks within seconds and was dozens of times more efficient than the former statistically.Conclusion This study designs and implements a big data technology proposal that satisfies the quick response of ad-hoc queries and statistics in the MEHRS, providing powerful and flexible technical support for big data statistical analysis.

Design and optimization of storage models in military electronic health record database / 军事医学

Objective To store and use the military electronic health record ( EHR) data effectively , and to improve the flexibility, scalability, and statistical query performance of data storage .Methods The military EHR data access patterns were analyzed,a military EHR storage model using MongoDB document database was designed ,and the storage model was optimized by storing the whole document and the reduced summary document separately .Results The storage model was used in the military EHR system , which can meet the demands of document query and statistical query at the same time . The optimized model improves the statistical query performance without losing scalability .Conclusion This model can meet the daily needs of the EHR system and is of practical application value.

Clinical Observation of Tong Du Wen Yang Needling for Amyotrophic Lateral Sclerosis / 上海针灸杂志

Objective To observe the clinical efficacy of Tong Du Wen Yang (unblocking the Governor Vessel and warming yang) in treating amyotrophic lateral sclerosis (ALS).Method Twenty-eight eligible ALS patients were randomized into two groups by following the visiting sequence. Thirteen patients in the control group were intervened by orally taking Riluzole tablets; 15 cases in the treatment group were by Tong Du Wen Yang needling in addition to oral administration of Riluzole tablets. Before treatment and after 6-month treatment, the therapeutic efficacies were evaluated by using the Chinese medicine syndrome and sign scoring for Wei-flaccidity diseases and Appel function scale.Result After the treatment, the Chinese syndrome and sign scoring scores for Wei-flaccidity dropped in both groups, and the decrease in the treatment group was more significant than that in the control group (P<0.05). The Appel scores dropped in both groups after the treatment, while the decrease in the treatment group was less significant than that in the control group (P<0.05).Conclusion Tong Du Wen Yang needling plus orally taking Riluzole tablets can produce a more significant efficacy than using Western medication alone in treating ALS.

Effects of intraoperative expansion on expression of stenosis-related genes in saphenous vein graft / 局解手术学杂志

Objective To investigate the effect of high pressure distention on the expression of stenosis-related genes of saphenous vein graft(SVG) during the coronary artery bypass grafting(CABG).Methods The biopsy specimens of saphenous vein collected from 10 patients who have undergone CABG,were divided into expansion group and no-expansion group.Real-time PCR and immunohistochemical staining were performed for examination of mRNA and protein expression of VE-cad,Egr-1,VCAN respectively.Student's t and Chi-square test were used to do statistic analysis.Results The results of RT-PCR showed that the mRNA transcription of Egr-1,VCAN in the expansion group were statistically significantly higher than those in no-expansion group(P<0.05).The mRNA transcription VE-cad in expansion group was statistically significantly lower than that in the no-expansion group(P<0.05).The immunohistochemical staining results showed that the expression of Egr-1 and VCAN in expansion group were significantly stronger than those in no-expansion group,while the expression of VE-cad was significantly lower than no-expansion group.Conclusion The intraoperative expansion of SVG can increase the expression of stenosis-related genes Egr-1 and Versican,and decrease the expression of stenosis-related gene VE-cad,which may be related with the SVG stenosis after CABG.

Long-term Follow-up of Patients with Hepatitis-Associated Aplastic Anemia / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To explore the clinical characteristic, therapeutic efficacy and prognosis of patients with hepatitis-associated aplasitc anemia (HAAA).</p><p><b>METHODS</b>the clinical data and labrotatory examination results of 30 cases of HAAA were analyzed retrospectively, the 6-month response ratio and overall survival (OS) were assessed.</p><p><b>RESULTS</b>HAAA most commonly occured in males, with the occurence rate of males and females was 4:1, the median onset age was 16 (4-43) years old, HAAA oriented focus on sever aplastic anemia (SAA)(4 cases,13%) and very sever aplastic anemia (VSAA)(22 cases,73%). Aplastic anemia (AA) could be seen on occurence of hepatitis (accompanied aplastic anemia) (7 cases,23%), or after the onset of hepatits (delayed aplastic anemia) (23 cases,77%), but more often occured in the latter. Statistical analysis showed that when compared with the patients of delayed aplastic anemia, patients accompanied aplastic anemia possesses lower levels of glutamic-pyruvic transaminase(ALT), aspertate aminotransferase (AST) and total bilirubin (TBIL)(P=0.042,0.012,0.001), and possessed a more obvious lymphoid cell disorder when AA occured, with more lower peripheral blood CD19B cells proportion (P=0.046) and more obvious imbalance of CD4/CD8ratio, but the difference was no statistical significant (P=0538). Factors affecting the 6-month respose were the severity of AA (P=0.044), the peak level of bilirubin of hepatitis (P=0.006) and the propotion of mature monocyte in bone marrow (P=0.034). The long-term follow-up showed that the 2-year OS of HAAA was 64.3±9.2%, the 6-month curative efficacy significantly affect the prognosis (P<0.001).</p><p><b>CONCLUSION</b>HAAA more often occur in young male, HAAA is mainly SAA and VSAA and mostly non-A-C hepatitis associated aplastic anemia, patients usually have a high incidence of early infection. Patients acompanied with aplastic anemia possess more obvious immunological derangement; the treatment efficacy for HAAA is poor, patients who haven't obtained 6-month response indicate a sinister prognosis, allogeneic hematopoietic stem cell transplantion is a better choice for these patients.</p>

Application of optic coherent tomography in assessing visual performance of idiopathic macular epiretinal membrane patients / 天津医药

Objective To investigate the correlation between retinal deformation degree and retina thickness (RT) detected by optic coherent tomography (OTC) in patients with idiopathic macular epiretinal membrane (IMEM). Methods The 66 eyes (56 patients) with IMEM diagnosed by OCT were retrospectively analyzed in this study. After best corrected visual acuity (BCVA), ocular fundus and OCT examination, patients were divided into three groups (mild, medium and severe) according to retinal deformation degrees. The RT value was measured manually. Results There were significant differences in RT values between mild, moderate and severe groups:(311.95 ±51.78) μm, (447.13±41.95) μm and (560.00± 58.23) μm (P<0.05). The values of BCVA were 0.78±0.16, 0.38±0.12 and 0.27±0.14 for mild, moderate and severe groups, there were significant differences between them (P<0.05). There was no significant correlation between RT and BCVA in mild group (r=-0.352,P=0.128). There was negative correlation between RT and BCVA in medium group and serious group (r=-0.768 and-0.482,P<0.05). Conclusion The retinal deformation degree and RT are two objective indicators to assess visual performance in patients of IMEM. When RT is more than 400 μm, it can be used as objective criteria for surgical intervention.

Vitreopapillary traction:a possible reason of anterior ischemic optic neuropathy / 天津医药

Objective To discuss the relevance between vitreopapillary traction (VPT) and anterior ischemic optic neu?ropathy (AION). Methods Two patients suffering from AION were underwent routine ophthalmic examination, and visual field (VF), fundus fluorescence angiography (FFA) and optical coherence tomography (OCT) examination. The images were analyzed. Results VPT syndrome was observed by OCT in both cases. In addition, the affected parts of VPT were consis?tent to that of AION. Conclusion Vitreopapillary traction is a possible reason of anterior ischemic optic neuropathy.

Advances and Updates on pathological diagnosis of lymphoma / 中国肿瘤临床

The 2008 World Health Organization Classification of Tumors of Hematopoietic and Lymphoid Tissues (4th edition) has greatly advanced the diagnosis, treatment, academic exchange, and research of lymphoma worldwide. A new revised edition will be published soon, in which the diagnosis and management of lesions at the very early stages of lymphomagenesis, the diagnostic criteria for several entities, and the genetic/molecular landscape of numerous lymphoid neoplasms and their clinical correlates have been clarified, refined, detailed, and expanded. Furthermore, several new concepts have been suggested in the upcoming revised edition, although the framework of classification remains the same. These updates will lead to development of more targeted therapeutic strategies and increase our confidence in the era of precision medicine. This manuscript will review the major advances and updates that are helpful for our un-derstanding and improvement in tumor diagnosis.

Clinical decision on a patient with ALK+diffuse large B cell lymphoma / 中国肿瘤临床

Anaplastic lymphoma kinase (ALK)-positive diffuse large B-cell lymphoma (DLBCL) is a rare and distinct variant of DLBCL. It is classified as a unique subtype of DLBCL in the 2008 WHO classification of lymphomas. No standard and effective therapeutic regi-men is available for ALK+DLBCL because it shows a more aggressive clinical course and frequent relapse. Therefore, a standardized and individualized treatment is needed to benefit more patients diagnosed with ALK+DLBCL through a multiple disciplinary team. This arti-cle presents a case of an ALK+DLBCL patient who relapsed after transplantation and was successfully treated with the ALK kinase inhibi-tor Crizotinib.

Clinical anatomic type observation of the first metatarsal dorsal artery / 局解手术学杂志

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.

Clinical decision on solitary brain metastasis in patients with non-small cell lung cancer / 中国肿瘤临床

Solitary brain metastasis in non-small cell lung cancer (NSCLC) patients was previously considered as Stage IV. Gen-erally, only chemotherapy or radiotherapy rather than surgery was considered the treatment for these patients;hence, achieving the de-sired effect was difficult. In recent years, the treatment benefit for these patients significantly increased. Several patients were even pro-vided the chance of being cured through standardized and individualized treatment by a multiple disciplinary team (MDT). This article introduces two solitary brain metastasis patients with NSCLC who were treated by MDT in Tianjin Medical University Cancer Institute and Hospital. This article aims to explore a complete set of diagnostic and treatment practices for the benefit of more patients.

Clinical curative effect observation of PPH in treatment of complexity hemorrhoids and circular hemorrhoid / 局解手术学杂志

Objietive Observe the clinical curative effect of PPH in treatment of complexity hemorrhoids and circular hemorrhoid. Methods From January 2010 to January 2014, the clinical data of 278 patients who underwent PPH to treat complexity hemorrhoids, mixed hemorrhoid and circular hemorrhoid were retrospectively analyzed. The postoperative recent and forward curative effect was observed. Results The average operativetime was 28 minutes, and the average hospital stay were 6. 1 days. There were postoperative complications such as pain, anal skin edema, bleeding and urinary retention. 186 cases were cured (66. 9%),35 cases were markedly improved (12. 6%),20 ca-ses were of poor effect (7. 2%),and recurrence occured in 37 cases (13. 3%). Conclusion PPH has the advantages of simple in operation and quick in postoperative recovery. But there were to many postoperative complications and the recurrence rate is high. So PPH needs more further observation and study.