ABSTRACT
BACKGROUND: Shilajit is a commonly used Tibetan medicine, and its water extract is mainly used for various heat-related syndrome, especially that of stomach, liver and kidney. Shilajit is found to exudate from rocks of cliff at an altitude of 2000-4000 m as a water-soluble mixture of black paste and animal feces of Trodocterus spp. or Ochotona spp. Because it is difficult to reach the exudation points so as to explain the its formation process, the source of Shilajit still remains unclear and controversial, which severely impedes its safety and efficacy in clinical application. METHODS: In this work, a series of investigations as rock flakes identification, porosity determination, rock mineral analysis, scanning electron microscopy (SEM), and energy dispersive spectrometer (EDS) have been carried out to clarify the source of Shilajit, including the storage condition and exudation process of its organic matter, and to investigate the geological structure of the exudation points as well as physical and chemical characteristics of the mother rocks. RESULTS: The Shilajit exudation points were mainly distributed on the steep cliffs, where there were cavities and sections that could not be eroded by rainwater. The fundamental structure of the exudation points was determined by the rock's bedding planes, joints, fracture surfaces and faults, and developed into micro-topography later. The exudation points were distributed in the Triassic strata and scattered in the Early Mesozoic granitoids. The lithologic features were mainly slate, carbonaceous slate and sandy slate etc. The background rocks were characterized by intergranular pores, dissolved pore, joint and fracture development. Organic matter was widely distributed in these pores and fissures, which had condition for storage and exudation of organic matter. CONCLUSIONS: Shilajit mainly distributed on sunny steep slopes and cliffs with a slope of 60° or above at altitude of 2000-4000 m. The lithology character of the Shilajit exudation area were mainly various metamorphic rocks of sedimentary rocks that were rich in organic carbon. The organic matter in Shilajit was found to flow out naturally from rocks along pore, structural plane and even accumulate on the surface of rock as a result of storage environment change caused by rock tectonic action.
ABSTRACT
OBJECTIVE: To investigate the location of the artery correlated with rectus abdominis musculocutaneous flap in order to promote the reconstruction of the breast after radical mastectomy for breast cancer. METHODS: An anatomic study was carried out on 15 cadavers of 30 sides, which were immersed in paraformaldehyde less than six months. Whole thorax-epigastric wall was cutterd, which scale was from subclavian as upper limit to inguinal ligament, the lower limit across left and right of middle axillary. Veins or arteries of inferior epigastric and internal thorax in hang were injected with red or blue ink to show all of vessel branches. RESULTS: The external diameters of both the superior epigastric arteries and inferior vessels were 1.87 +/- 0.28 mm and 2.25 +/- 0.32 mm respectively. The myocutaneous arteries from inferior abdomen vessels had an intensive horizontal distribution on hilum. The perforators significantly decreased but could be found to pass through anterior rectus sheath in Rand. The distances between lateral perforators and I , II and III parts in external edge of anterior rectus sheath were 1.22, 1.46 and 1.57 cm, respectively; and the distances between medial perforators and I, II, and III parts at median line were 1.54, 1.62, 1.66 cm. Perforators were more thick and intensive near hilum than in other part. The subcostal arteries derived from inferior abdomen artery and 1.25 +/- 0.37 cm away from costal arch. After dividing into subcostal artery, the outer diameter of 67 percent of subcostal artery was bigger than that of inferior abdomen arteries. The branches of subcostal arteries were distributed at the 2/3 lateral rectus abdominis, forming an extensive choke anastomosis system with intercostal anterior artery and vessels supplied diaphragmatic muscle. The rectus abdominis at the level of xyphoid was supplied by a branch came from inferior thorax artery, which diverged epigastric vessels at the same time. CONCLUSION: During the process of making the inferior transverse rectus abdominis musculocutaneous flap base on superior epigastric vessels and superior rectus abdominis, reservation of pro-theca edge 1 cm of rectus abdominis can protect inferior abdomen artery from injury. Reservation of more than 2 cm pro-theca and rectus abdominis below costal arch at the flag will protect effectively subcostal artery from injury. No damage of subcostal arteries can influence the survival of musculocutaneous flap.
