Sima Qian. Die Macht der Historiographie

Das Shiji ist ein chinesisches Geschichtswerk, das an der Wende zum 1. Jh. v. AZ geschaffen wurde. Sima Tan hat das Werk begonnen und sein Sohn Sima Qian hat es fertig gestellt. Ursprünglich war es mit Taishigong Shu "Buch des hoheitlichen Hofastrologenâ€? betitelt. Das Endprodukt war monumentalen Ausmaßes und umfasste die gesamte Menschheitsgeschichte; das heißt natürlich, was Sima Qian bis dahin von den Menschen auf der Welt bekannt sein konnte. Das Reich der Mitte, als die Spitze der Zivilisation, umliegende Staaten und die Barbaren finden im Shiji ihren Platz. Die Geschichte beginnt mit den legendären Kaisern Chinas und geht bis in die Zeit von Sima Qian, bis zum "Erscheinen des Einhorns" – vom Beginn des 1. Jh. v. AZ reicht sie also mehr als 2000 Jahre in die Vergangenheit zurück

Perioperative Risk Factors for Prolonged Blood Loss and Drainage Fluid Secretion after Breast Reconstruction

Background: Surgical breast reconstruction is an integral part of cancer treatment but must not compromise oncological safety. Patient-dependent risk factors (smoking, BMI, etc.) are said to influence perioperative outcomes and have often been investigated. Here, we analyzed independent perioperative risk factors for increased postoperative blood loss or drainage fluid volume loss and their possible impact. Methods: Patients undergoing breast reconstructions after breast cancer with either tissue expanders, definitive breast implants, or autologous breast reconstruction were analyzed. The collected data on patients’ characteristics, blood, and drainage fluid loss were correlated and statistically investigated. Results: Traditional patient-dependent risk factors did not influence blood loss or drainage volumes. On the contrary, patients with preoperative anemia had significantly higher drainage outputs compared to non-anemic patients (U = 2448.5; p = 0.0012). The administration of low molecular weight heparin showed a tendency of increased drainage output. Similar correlations could be seen in prolonged procedure time, all of which contributed to prolonged hospital stay (τb = 0.371; p < 0.00001). Conclusions: Preoperative anemia is one of the most critical factors influencing postoperative drainage fluid output. Previously assumed patient-dependent risk factors did not affect drainage output. Preoperative anemia must be monitored, and if possible, treated preoperatively to reduce postoperative morbidity

Evaluation of the External Jugular Vein Overlying the Sternocleidomastoid Muscle as Venous Lymph-Node Flap

Background: Until recently, vascularized lymph-node flaps were based on arterial and venous donor vessels. Now, venous lymph-node flaps form a novel promising concept in the treatment of advanced-stage lymphedema. In preliminary studies, the external jugular vein has shown promising results as a venous lymph-node flap. However, nothing is known about the number of lymph nodes adjacent to the external jugular vein. Methods: Standardized specimens of the external jugular vein and surrounding fatty tissue directly overlying the sternocleidomastoid muscle were obtained during routine neck dissection. Histologic evaluation was performed in order to evaluate for the presence of lymph nodes within the tissue. Results: A total of 20 specimens were evaluated. There was no vein in 4 of the samples. We found lymph nodes in 9 of the remaining 16 samples. In 7 samples, lymph nodes were absent. Conclusion: Our results suggest that the vein directly overlying the sternocleidomastoid muscle may not be the ideal candidate for a venous lymph-node flap