Objective To evaluate the clinical efficacy and complications of the covered stents in the treatment of malignant upper gastrointestinal tract stricture.Methods 53 cases with malignant upper gastrointestinal tract obstruction underwent treatment with covered stents.The therapeutic efficiency and the complications were observed.Results The procedures were successful in 50 cases in one time,the successful rate was 94.3%.The complications included chest pain and foreign body sensation,diarrhea,restenosis,stent migration,esophagus reflux,bleeding.Conclusion The treatment with covered stents was a safe,simple and effective management for the patients with malignant upper gastrointestinal tract obstruction who had lost the chance of surgical resection or refused to undergo operation.

This paper tried to describe the hospital labor union how to play an important role on hospital's development,as well as adopt its own characteristic and advantages in order to improve hospital's medical treament and scientific research.

Objective To study the clinical features and pathology of renal damage in patients with MPA. Method The clinical pathological changes of 23 MPA patients were analyzed and the patients with positive ANCA were compared with those with negative ANCA. Results Most MPA patients were senile and male with the symptoms of lung damage, pleuritis, arthritis and myalgia as well as extrarenal symptoms such as fever, weight-loss, and anorexia. 65.2% of the patients were ANCA (+). Symptoms of renal function damage were hematuria and proteinuria, which could be found in all the patients. Different degree of renal damage could be detected. Glomerular cresent formation, which were mostly fibrous, could be found in all of the 23 patients. Half of the patients have tuft necrosis and interstitial vessel vasculitis. Conclusion MPA patients often have extrarenal symptoms besides renal function damage. Patients with positive ANCA differs from patients with negative ANCA in both clinical manifestation and kidney pathology.

Objective To investigate the correlation between human papillomavirus(HPV) 16/18 subgroup infection and laryngeal squamous cell carcinoma(LSCC).Methods The infection of HPV16/18 in 39 laryngeal carcinoma specimens and 10 vocal cord polyp specimens were detected by in situ hybridization. Results The positive rate of HPV16/18 expression in 39 laryngeal carcinoma specimens was 48.7%(19/39). The positive rate of HPV16/18 subgroup expression in 10 vocal cord polyps was 0(0/10) . Statistical test showed that HPV16/18 subgroup infection was significantly higher in LSCC than that in vocal cord polyps. No statistically association was observed among the frequency of HPV16/18 subgroup infection and TNM stages, degree of differentiation or lymph nodes metastases. Conclusions HPV 16/18 subgroup infection is associated with he pathogenesis of LSCC.

Objective To investigate the relationship among human papillomavirus(HPV)16/18 and the expression of human telomerase reverese transcriptase(hTERT),c-myc protein in laryngeal squamous cell carcinomas and their significance.Methods The infection of HPV16/18 in 39 laryngeal carcinoma specimens and 10 vocal cord polyp specimens were detected by in situ hybridization.The expression of hTERT protein and c-myc protein in 39 laryngeal carcinoma specimens and 10 vocal cord polyp specimens were detected by immunohistochemistry.Results The positive rate of HPV16/18 infection in 39 laryngeal carcinoma specimens was 48.7%(19/39).The positive rate of HPV16/18 expression in 10 vocal cord polyps was 0(0/10).Statistical tests showed that HPV 16/18 infection was significantly higher in LSCC than that in vocal cord polyps.The positive rate of hTERT protein and c-myc protein expression in 39 laryngeal carcinoma specimens was 84.6%(33/39)and 82.1%(32/39)respectively.The positive rate of hTERT protein and c-myc protein expression in 10 vocal cord polyps was 0(0/10)and 10%(1/10)respectively.Statistical tests showed that hTERT and c-myc protein expression was significantly higher in LSCC than that in vocal cord polyps.Spearman rank correlation analysis revealed that there was significant relation among HPV16/18,hTERT and c-myc protein respectively.Conclusions The results suggest that the expression of hTERT and c-myc protein was associated significantly with the infection of HPV16/18 and they intact each other,which can influent the pathogenesis of laryngeal squamous cell carcinomas.

Objective To evaluate the efficiency of normal sacral nerve root transposition in repair of the sacral plexus root avulsion. Methods A total of 30 adult SD rats were chosen and divided into three groups,ie,group A(the sciatic nerve received no repair),group B(the autologous sacral plexus root nerve was bridged with the right L6 nerve root by the translocation of the left L6)and group C (the right L5 nerve root nerve was bridged by the translocation of the left L6),10 rats per group.The left side of the rats was used as the control side and the right one as the experimental side.Twelve weeks after operation,the rats in each group were selected for the histomorphological observation of the nerves under the microscope and the electron microscope.The models were evaluated by observing the survival rates of the rats,BBB scores,electron microscope weight and muscle fiber CSA(cross section area)of double biceps femoris,triceps surae and tibial muscle. Results Twelve weeks after operation,the BBB scores in groups B and C was higher than that in group A,with statistical difference(P<0.01)between three groups.A remarkable improvement was found in the ratio of weight and muscle fiber CSA of double biceps femoris,triceps surse and tibial muscle.The repair efficiency in the group C was better than that in the group B.In the group B,the biceps femoris,triceps surae and tibial muscle recovered at different degrees.The biceps femoris recovered the best,when a great deal of myelinated nerve fiber regeneration was observed under the microscope and the electromicroscope.Electromyography revealed the volatility in the muscles of three groups,with larger peak value for the proximal biceps femoris and the triceps muscle but smaller peak value for the distal anterior tibial muscle. Conclusions L6 transposition combined with auto-graft of nerve root or without the auto-graft can reconstruct the partial function of the sciatic nerve in the paraplegia rats,when the latter has the better effect.

Objective To investigate the clinical application value of selective arterial embolization in the treatment of iatrogenic hemorrhage.Methods 32 cases with iatrogenic hemorrhage were retrospectively analyzed.The location and feature of bleeding were identified by selective percutaneous artery angioraphy,and then super-selective interventional embolization were performed.The embolic agents inclued gelfoam medical line,steel coils or polyvinyl alcohol (PVA)particles.Results In 32 patients,26 cases with active bleeding signs were found by angiography,they mainly presented contrast medium overflow,6 cases with pseudo-aneurysms,1 case with ar-teriovenous fistula.All patients underwent interventional embolization successfully.Only 1 case underwent twice procedure because of rehaemorrhagia on the 8 days after embolization.Follow-up for a month after arterial embolization,25 cases had no severe compli-cations,1 case died by multiple organ failure.In 6 negative cases,3 cases died by hemorrhagic shock,3 cases stopped hemorrhage after medical treatment.Conclusion Selective angiography is a safe and effective measure for the treatment of iatrogenic hemor-rhage.

[Abstract ] Objective Cardiac shock wave therapy (CSWT) can promote arteriogenesis in ischemic myocardia , but the mo-lecular mechanism remains unclear .The study aimed to explore the effect of CSWT on arteriogenesis in human cardiac microvascular endothelial cells ( HCMEC ) and the role of focal adhesion kinase (FAK) and Calcium-activated potassium channels (KCa) in the sig-nal conduction pathway of CSWT arteriogenesis . Methods HC-MEC cells cultured in vitro were randomly divided into control group , CSWT group , CSWT +T ( FAK inhibitor PF-573228 ) group and CSWT+F( SCa inhibitor iberiotoxin ) group.Each group received one CSWT(0.09 mJ/mm2, 200Times) 48 h after added stimulant.24 hours'conventional culture later , tests were made on the levels of endothelial nitric oxide synthase ( eNOS ) and vascular endothelial growth factor ( VEGF) mRNA as well as the changes of related protein expression . Results ①QPCR test showed that eNOS , VEGF mRNA expressions increased in CSWT group compared with control group (4.61 ±0.19 vs 3.99 ±0.17, P<0.05), while compared with CSWT group, eNOS, VEGF mRNA expressions in CSWT +T group were decreased (0.62 ±0.10 vs 0.40 ±0.02, P<0.05), eNOS, VEGF mRNA expressions in CSWT +F group were also decreased (0.53 ±0.02 vs 0.64 ±0.02, P<0.05), all the differ-ences were of statistical significance .②Western blot showed that eNOS , VEGF protein expressions increased in CSWT group compared with control group(0.63 ±0.02 vs 0.43 ±0.02, P<0.05), while compared with CSWT group , eNOS, VEGF protein expressions in CSWT+T group were decreased (0.36 ±0.01 vs 0.29 ±0.02, P<0.05), eNOS, VEGF protein expressions in CSWT +F group were also decreased (0.37 ±0.02 vs 0.30 ±0.02, P<0.05), all the differences were of statistical significance . Conclusion CSWT can improve eNOS , VEGF mRNA and protein expressions in HCMEC cells and FAK and KCa may participate in the signal conduction pathway of CSWT arteriogenesis .

AIM:To construct recombinant adenovirus vector carrying human miR-133a and study its expression in human mesenchymal stem cells(hMSCs).METHODS:The PCR product containing miR-133a was amplified from human genomic DNA and inserted into the adenoviral shuttle vector pAdTrack-CMV.Then the recombinant shuttle plasmid linearized by pmeⅠwas cotransformed into competent E.coli.BJ5183 with the adenoviral backbone plasmid pAdEasy-1 to generate the recombinant adenovirus vector rAd-mir-133a.rAd-mir-133a was then packaged and amplified in human embryonic kidney 293(HEK293) cells.The purified rAd-miR-133a was used to infect the hMSCs and the expression of miR-133a was detected by non-quantitative RT-PCR and real-time PCR.RESULTS:The recombinant adenovirus shuttle vector pAdTrack-CMV-miR-133a was constructed and verified by restriction endonuclease analysis and DNA sequence analysis.rAd-miR-133a was successfully packaged and amplified in HEK293 cells.The transcriptions of primary miR-133a and mature miR-133a were over-expressed in the hMSCs infected with rAd-miR-133a.CONCLUSION:The recombinant adenovirus vector carrying human miR-133a is successfully constructed,which lay a foundation for miR-133a function study.

Objective To analyze the methods and effects for treating unstable posterior pelvic ring fracture combined with sacral nerve injury and further identify the relationships among the diagnostic methods,surgical approaches and clinical outcomes.Methods A total of 38 patients with posterior pelvic ring fracture combined with sacral plexus injury treated from January 2000 to January 2010 were enrolled in the study.There were 20 males and 18 females at an average age of 35 years (range,10 to 59 years).The causes of fractures included traffic injury in 20 patients,fall injury in 12,weighty object impingement injury in five,and stabbing injury in one.Classification of posterior pelvic ring fractures included fracture and dislocation of sacroiliac joints in eight patients,fracture of ilium wing in two and sacrum fracture in 28.According to the Denis typing of sacrum fractures,there was one patient with type Ⅰ fracture,14 with type Ⅱ fracture and 13 with type Ⅲ fracture.All 38 patients presented the decrease or loss of skin sensation around the lower extremities,perineal region and crissum.Simultaneously,30 patients suffered motor dysfunction of the lower extremities,while 20 patients had bladder and anus sphincter dysfunction or sexual disorder.Thirteen patients were suspected of sacral plexus avulsion and four of them were confirmed by myelography or MRI examination.All patients had at least one associated injury.The average ISS was 21.9 points ( range,9 to 47 points).Therapeutic methods were fracture reduction and fixation in the absence of nerve decompression for eight patients and nerve decompression for 30 patients including 26 patients being also managed by fracture reduction and fixation.Operation time ranged from 6 days to 6 months.The clinical outcomes were evaluated according to the British Medical Research Council (BMRC) evaluation criteria of sensation and movement function.Results Thirty-four patients were followed up for average 4.9 years ( range,1 to 10 years),during which their pelvis obtained stable recovery.The neurological outcome was excellent in two patients,good in four and unchanged in two in the nondecompression group and was excellent in 16 patients,good in nine and unchanged in one in the decompression group,with the decompression group superior to the non-decompression group ( P ＜ O.05 ).Conclusions For unstable posterior pelvic ring fracture combined with sacral nerve injury,nerve decompression and release combined with internal fixation can better improve the sacral nerve function and obtain good pelvic ring stability and is worth of clinical application.