Objective In order to study the effects of three drainage methods after operation of breast cancer. Methods We demonstrated the drainage reliability of the negative pressure bottles by measuring their negative pressures.We reviewed the incidence of flap dropsy of 103 patients with breast cancer operated from 1988 to 2001.Results Negative pressure of the bottle made by ourselves is 83.33 kPa at the room temperature and 74.12 kPa after 200ml fluid being drained. The incidence of skin flap dropsy of the negative pressure bottle is significantly lower than those in another two groups.Conclusion The negative pressure bottle is reliable, convenient and applicable in all levels of hospital.

Objective To construct a recombinant interfering RNA(miRNA)plasmid vector targeting annexinA3 and observe its impact on the growth and apoptosis of human gallbladder cancer cell line SGC-996.Methods Four small fragments of miRNA and one negative control were sequenced and cloned into vector pcDNATM 6.2-GW/EmGFPmiR.The recombinant plasmids were then transfected into gallbladder cancer cell line SGC-996 by positive liposomal transfection.The transcription and translation level of annexinA3 expression were detected by RT-PCR and Western Blot.Meanwhile, the proliferation and apoptosis of transfected tumor cells were determined by MTT and flow cytometry.Results The recombinant plasmids containing annexinA3 miRNA were successfully constructed.AnnexinA3 expression was significantly knocked down after miRNA plasmid transfection.Transfection of annexinA3 gene miRNA could effectively inhibit the proliferation of gallbladder cancer cell and promote apoptosis.Conclusion AnnexinA3 gene silenced by miRNA can induce the apoptosis of human gallbladder cancer cell line SGC-996.The process might serve as a potential approach for cancer gene therapy.

Objective To evaluate endovascular treatment of segmental occlusive Budd-Chiari syndrome(BCS). Methods We retrospectively analyzed the clinical data of segmental occlusive BCS of 45 cases. Inferior vena cava (IVC) puncture, percutaneons transluminal angioplasty (PTA) and stent implant were performed, respectively. Three-dimensional digital subtraction angiography (3D-DSA) was used to evaluate the IVC lesion from multi-angles and to identify the best work angle in complex BCS cases during endovascular treatment. Results IVC puncture and dilation was successful in 43 cases. The pressure of IVC decreased from (35. 3 ± 3.9)cm H2O to (9.5 ± 2. 0) cm H2O (t = 43. 68, P < 0. 01). The puncture failed in 2 cases and the patients were converted to veno-atrial graft shunt. Acute pericardial tamponade developed during PTA in one case. Postoperatively 35 cases were followed-up for 3 months to 46 months and the follow-up rate was 77. 8%. IVC stent thrombosis was identified in one case necessitating veno-atrial graft shunt 15 months post-operatively. There were no stent migration and hepatic venous obstruction in the remaining cases. The case of pericardial tamponade was cured and discharged after IVC repair. Symptoms disappeared except for intercostal neuralgia during 6 months follow-up. There were no pulmonary embolism and death. Conclusions Good medium and long term result could be achieved after endovascular treatment of segmental occlusive BCS. 3D-DSA is helpful for endovascular treatment of BCS.

Objective To explore the characteristics of endothelial progenitor cells (EPCs) on different scaffolds and to find a new bio-engineered synthetic hybrid scaffold for artificial bio-engineered blood vessels. Methods EPCs were induced from mesenchymal stem cells isolated from rat bone marrow and seeded on ECM scaffold. The surface structure of the scaffold and growth status of EPCs on the scaffold were observed and analysed by electron microscopy. The characteristics and number of those EPCs on different kinds of scaffolds were studied with EPC-specific VWF by immunofluorescence, Western blotting and real-time PCR technique at different time points. Results The cell adhesion rate at 1,3,5 h after seeded on pressed scaffold were higher than that on unpressed scaffolds( P < 0. 01 ). Pressed scaffolds has got a larger cell number( P < 0. 05 )at DIV1, DIV3, DIV7, but there was no significant difference after DIV10. Furthermore, cell shapes of EPCs on pressed scaffolds were more mature and more similar to endothelial cells. A level cell surface on pressed scaffolds was achieved. Western blotting assays revealed EPCs on pressed scaffolds expressed more protein VWF at DIV3, DIV7, DIV10. Real-time PCR results showed EPCs on the two different groups of scaffolds all expressed VWF gene, The quantity of their expression in the two groups were all enhanced after DIV7 (P < 0. 05 ). The quantity of VWF gene expression in the pressed group was much higher than that in the unpressed group at DIV3 ,DIV7,DIV10 (P <0, 01), but there was no significant difference after DIV14. Conclusions Pressed ECM scaffolds can promote adhesion, proliferation and differentiation on EPCs. Pressed scaffolds can be used as the matrix for EPC and fabricated into a novel synthetic tissue bio-engineered vascular scaffold.

Objective To explore the safety and clinical effects of laparosepie splenectomy.Methods Clinical data of 24 cages of laparoscopic splenectomy in our hospital from 2002 to 2008 were retrospectively analvzed.Among these 24 cases,there were 6 cases with liver cirrhosis,10 cases with ITP,2 cases with hemolytic anemia(Evens syndmm),2 cases with spelenic rupture,and 4 cases optimum spleen ambuty.Results All the 24 cases were successfully underwent laparoscopic splenectomy.The mean operation time wag 146 minute.the mean volume of blood loss was 220 ml.the postoperative gastrointestinal peristalsis time Was from 24 to 48 hours.The mean hospitalization time was 9 days after operation.Conclusions Provided mastering operation indication and technique,Laparoscopie spleneetomy is a safe and minimally invasive surgery.

Objective To reveal the relationship between a certain ratio of the length to width of a slender narrow pedicle and random flap in survival area with an experimental study. Methods 25 pigs were randomly divided into 5 groups. The ratio of length to width of slender narrow pedicle in 5 groups was different and every ratio's slender narrow pedicle was carrying 5 different sizes of random flaps. In each group, these 5 flaps were created randomly in each pigs' bilateral back. The flaps were evaluated with the general observation, fluorescence examination, blood flow ECT test, and computerized analysis of survival area. Results When the ratio of the length to width of the slender narrow pedicle was constant, along with the flap area increased, the flap survival area also increased, but when the flap reached a certain area, the distal flap would develop necrosis, the flap survival area would not reduce; when the flap size remained unchanged, along with the ratio of the length to width of the slender narrow pedicle increased, the flap survival area was not affected, but, when the ratio of the length to width of the slender narrow pedicle increased to a certain limit, distal flap would lead to necrosis, and the flap survival area would reduce. Conclusion The slender narrow pedicle flap is a new and practical random flap. The pedicle of random flap can be designed as slender shape, and the ratio of pedicle width to flap length is far less than traditional ratio. Increasing the flap size or ratio of the length to width of a slender narrow pedicle in a certain extent will not lead to flap necrosis.

Objective To investigate the effect of bone marrow derived endothelial progenitor cells (EPC)transplantation on microenvironments in a murine model of chronic vein thrombosis.EPCs transplantation was evaluated whether it can up-regulate thrombus organization and recanalization associated cytokines(VEGF,ANG-1 and MCP-1). Method EPCs from immature Wister rats' bone marrow were isolated using a Ficoll density gradient centrifugation,and cultured in fibronectin-coated plate in EGM-2M Vmedium.EPCs were harvested on the 10th day,then were transplanted into chronic inferior vens cava thrombus of adult Wister rat through the femoral vein.Rats were divided into three groups:blank control group(group A,sham operation),the control group(group B,the medium injected)and the experimental group(group C,EPCs injected).The rats were sacrificed after 28 days.VEGF,ANG-1 and MCP-1 mRNA was measured by real-time quantitative PCR and protein expression change by Western blotting from IVC and thrombus tissue. Results EPCs were identificated successfullv by immunohistochemistry,immunofluorescence and function,then were transplanted into chronic inferior vena cava thrombus of adult rats.After EPCs transplantation,the VEGF,ANG-1 and MCP-1 mRNA expression in group C expression was significantly up-regulated with statistical significance(P＜0.01)compared with group A and group B in IVC and thrombus tissue by real-time PCR.There was no significant difference between group A and group B (P＞0.05).VEGF,ANG-1 and MCP-1 protein expression were similar to mRNA expression.There was significant increase in group C compared to group A and group B(P＜0.01)and no statistical significance between group A and group B(P＞0.05).Conclusion EPCs deriving from bone marrow may change the microenvimnment of chronic vein thrombus through up-regulating thrombus organization and recanalization associated cytokines(VEGF,ANG-1 and MCP-1).

Objective To evaluate the prevention and management for the complications in interventional therapy for the lower extremity arteriosclerosis obliterans (ASO). Methods In this study 207 ASO cases received interventional therapy. The relationship between complication rates and different TASC type and the influence of diabetes mellitus (DM) with coronary heart disease (CHD) on critical organs complication rates was analyzed. Results The intervention succeeded in 190 cases. There was 17 failures, including 13 procedure failures and 4 deaths due to postoperative critical organ complications. Among the complications there were puncture site hemorrhage in 12, pseudoaneurysm in 4, alimentary tract hemorrhage in 2, arteriorrhexis in 6, cerebral infarction in 8, acute heart failure in 9, respiratory failure in 13, renal failure in 6, thrombosis in 5 and blue-toe syndrome in 1. The intraoperative complication rate of femoral-political type (39.84%, 51/128) was high than that of aorta-iliac type (18.99%, 15/79) (P< 0.05). Those critical organ complication rates of patients with DM and patients with DM&CHD were 27.66% (13/47)and 24.49% (12/49)respectively, they were higher than that of patients without (5%, 2/40) (P<0.05). Conclusions The high complication rates during interventional therapy of ASO were because of misoperation and complicated pathological type and together with DM and CHD. These rates could be decreased when we treated DM and CHD before operation and chosen a reasonable method and shorten the duration of operation.

Objective To evaluate endovascular treatment of Budd-Chiari syndrome(BCS)with occlusion of hepatic veins.Methods Retrospective analysis on the clinical materials of 32 BCS cases with occlusion of hepatic veins was made.Four cases received inferior vena cava(IVC)angioplasty or stent implant and splenorenal shunt;Transfemoral vein or transjugular hepatic vein angioplasty was performed in 10 cases,and percutaneous transhepatic recanalization combined with transjugular and/or transfemoral vein angioplasty of hepatic veins was performed in 16 cases,respectively.Two cases failed therapy attempt.Results A failure to find the main hepatic vein in percutaneous transhepatic venography lead to the abandent of therapy in 2 cases.Hepatic vein angioplasty and IVC angioplasty was successful in the other 30 cases.The pressure of hepatic vein decreased from(43±8)cm H_2O to(16±4)cm H_2O(t=21.23,P<0.01).The symptoms were obviously relieved,ascites disappeared,abdominal distension palliated,chest and abdominal wall varicose veins collapsed one week after endovascular treatment.During perioperative procedure,2 cases with liver puncture bleeding were cured by laparotomy.The follow-up duration was 5 months to 65 months and mean(26.0±2.0)months.There was no stent migration and hepatic vein restenosis and occlusion.Chest and abdominal wall varicose veins disappeared and esophagus phlebeurysma were ameliorated as shown by esophageal barium series.There were no pulmonary embolism and death.Conclusions The procedure of endovascular treatment of BCS with occlusion of hepatic veins is simple,mini-traumatic and effective.

ObjectiveTo evaluate gallbladder conserving gallstone removal and polyps resection using combination laparoscopy,hard gallbladder endoscopy and soft choledochoscopy.MethodsClinical data of 122 patients with cholecystolithiasis or polyps undergoing removal of calculus (polyps) and preservation of gallbladder were analyzed retrospectively.ResultsGallstones in 56 patients and polyps in 24 cases was removed or resected successfully by laparoscopy and hard gallbladder endoscopy; In the remaining 34 cases stones were completely removed by combination soft choledochoscopy; 8 cases were converted to laparoscopic cholecystectomy.Romoved stone was single in 25 cases and multiple in 65 cases,with the number ranging from 1to 52,the diameter of stone ranged from 0.2 cm to 3.2 cm.In the 24 gallbladder polyps,7 cases were single,17 cases were multiple,the diameter of polyp ranged from 0.8cm to 1.2 cm.The operation time was 40-125 (78) min. The mean hospitalization was 4 days. No intraoperative and postoperative complications occurred.All patients were followed up for 1year.Gallstones recurred in 3 cases,and the recurrence rate was 3.06％. ConclusionsLaparoscopy combined with hard gallbladder endoscopy and soft choledochoscopy for removing calculi (polyp) and conserving gallbladder is safe and feasible.