Purpose: To study the expression of VEGF, VEGF-C, fit-4 in breast cancer and its relationship with lymph node metastasis and explore the significance of lymphangiogenesis on metastasis via lymphtics. Methods: Paraffin-embedded specimens from 82 patients with primary breast cancer who had undergone radical mastectomy with lymph node dissection were studied. VEGF, VEGF-C, flt-4 expression were investigated by immunohistochemical staining. Results: Positive staining for VEGF, VEGF-C, flt-4 were observed in some breast cancer cells. Furthermore, the expression of VEGF-C, flt-4 were significantly higher in lymph node-positive group than in node-negative group. Correlation was found within the expression of VEGF-C, flt4 also. Conclusions: Clinical significance was found between VEGF-C, flt-4 expression and lymph-node metastasis in breast cancer, and may be involved in the metastatic process.

Objective:To evaluate right heart remodeling and right heart function change after pulmonary resection by echocardiography (ECG) .Methods:A total of 50 patients undergoing pneumonectomy received ECG examination to evaluate right ventricular structure and right heart function change before and after partial pulmonary resection .Re-sults:(1) Compared with before operation , there were no significant changes in right ventricular anterior free wall thickness ,right ventricular ejection fraction on 7d and 30d after operation;(2) Compared with before treatment , there were significant rise in pulmonary artery systolic pressure [PASP ,(20.52 ± 2.46) mmHg vs .(49.65 ± 2.17) mmHg] ,pulmonary artery diastolic pressure [PADP ,(10.82 ± 2.04) mmHg vs .(21.93 ± 1.26) mmHg] and pul-monary artery mean pressure [PAMP ,(13.78 ± 3.67) mmHg vs .(26.67 ± 3.28) mmHg] ,and significant rise in pulmonary vascular resistance [PVR ,(187.69 ± 12.46) dyn .s .cm-1 vs .(368.72 ± 11.94) dyn .s .cm-1 ] on 7d after pulmonary resection , P<0.05 all;all above indexes recovered to normal on 30d after treatment ;(3) Com-pared with before operation ,right ventricular Tei index significantly rose [ (0.36 ± 0.05) vs .(0.69 ± 0.13) , P=0.04] on 7d after operation ,the Tei index recovered to normal on 30d after treatment ,P=0.20. Conclusion:Com-pared with before operation , the PASP ,PADP and PAMP significantly rise on 7d after operation ,they recover to normal on 30d after treatment ;there are no significant change in right ventricular structure .

Objective: To explore independent risk factors of coronary artery calcification (CAC) and analyze correlation among risk factors of CAC and serum osteopontin (OPN) level. Methods: According to results of 64-slice spiral computed tomography (MSCT) coronary angiography, a total of 65 patients were continuously enrolled and divided into CAC group (n=37) and non-CAC control group (n=28). Enzyme linked immunosorbent assay (ELISA) was used to measure serum level of OPN. Single factor and multiple factor Logistic regression analysis’s were used to analyze risk factors of CAC. Spearman’s straight line analysis was used to analyze correlation between risk factors of CAC and serum OPN. Results: 1、 The age, hypertension, diabetes, poor eating habits，lack of exercise, overweight, etc., which were independent risk factors of CAC （OR=3.47～12.96, P=0.018～0.003）by single factor Logistic regression analysis, were inducted to multiple factor Logistic regression analysis, its result showed that age, overweight, poor sleep quality, poor eating habits were independent risk factors of CAC, OR=35.31～5.17, P＜0.01～0.05; 2、Serum level of OPN in CAC group was significant higher than that of non-CAC control group ［(39.919±11.879) μg /L vs. (24.000±6.000) μg /L，P<0.01］; 3、The Spearman straight line correlation analysis indicated that serum level of OPN was correlated with risk factors of CAC : positively correlated with LDL-C, overweight, age, TC（r=0.487～0.286,P＜0.001～＜0.05）, and positively correlated with poor sleep quality, diabetes, poor eating habits, lack of exercise（r=4.10～2.24， P<0.01～0.05）; negatively correlated with HDL-C（r=-0.250,P＜0.05）. Conclusion: Correlation analysis indicates that age, overweight, poor sleep quality, poor eating habits etc. are independent risk factors of CAC；Serum OPN level is correlated with LDL-C, overweight，age, diabetes, lack of exercise etc., so these indicate that must decrease OPN level and risk factors of CAC to relieve CAC and slow down its development.

Objective To discuss the expression of mitochondrial phosphate carrier (PiC) in myocardial injury caused by doxorubicin, and the protective mechanism of curcumin in myocardial injury caused by doxorubicin .Methods 60 adult SD rats were randomly divided into three groups:control group, doxorubicin group, curcumin+doxorubicin group.Control group was injected 0.9% sodium chloride injection (2.5 mL/kg) by rat tail vein injection, one times per week, 6 times in total.Doxorubicin group was injected with 0.5 mg/mL doxorubicin which diluted with 0.9% sodium chloride injection by rat tail vein injection, and the dosage was 1.25 mg/kg(about 0.5 mL).Curcumin+doxorubicin group was injected the same dose doxorubicin as doxorubicin group.After that, 12 mg/mL curcumin injection was added with 30mg/kg by rat tail vein injection.one times per week, 6 times in total.The glutathione peroxidase (Gpx) assay kit, superoxide dismutase (SOD) assay kit and malondialdehyde (MDA) detection kits were used to test the oxidative stress levels in myocardial cells of SD rats.Flow cytometry is used to test the SD rat cardiomyocytes transferred level. Application of Western blot and Real-time PCR technology were used to detect expression of PiC.ResuIts The Gpx activity and SOD vitality in myocardial cells of SD rats in curcumin with doxorubicin group all significantly increased compare with those of doxorubicin group, and all decreased compare with those of control group.But the rate of myocardial apoptosis, content of malondialdehyde and expression of Slc25a3 gene and PiC protein from myocardial cells of SD rats from curcumin with doxorubicin group all significantly increased compare with those of control group , and all decreased compare with those of doxorubicin group.ConcIusion Doxorubicin could increase the expression of PiC in myocardial mitochondria, the levels of oxidative stress, and the apoptosis of myocardial cells, and the effect of curcumin could be effective against the injury induced by doxorubicin .

Objective To evaluate the prognostic significance of MMP-2 , MMP-9 and Cathepsin-D expression in lymph node-negative human breast carcinoma. Methods Specimens from the primary breast tumors of 270 axillary lymph node negative breast cancer patients were studied for MMP-2 , MMP-9 and Cathepsin-D protein expression by immunohistochemical staining. Results The positive expression of MMP-2, MMP-9 and Cathepsin-D was 56.7%(153/270),59.6%(161/270) and 55.6%(150/270), respectively. In univariate analysis, MMP-2, MMP-9 and the co-expression of MMP-2 and MMP-9 were significantly associated with tumor free survival. In multivariate analysis, co-expression of MMP-2 and MMP-9 was unfavorablely related with tumor free survival(RR=2.487; P

Objective To assess the feasibility of characterizing pleural fluid on the basis of spectral imaging features utilizing spectral CT imaging. Methods Gemstone spectral imaging(GSI) was used to examine 20 pleural fluids filled tubes (11 exudates and 9 transudates ) following diagnostic thoracentesis. Effusions were classified as transudates or exudates using laboratory markers based on Light criteria. CT values on 140 kVp QC image were compared between two groups. Using GSI viewer, various CT spectral imaging parameters (CT values on different energy level, effective-Z, iodine-water concentration,calcium-water concentration and calcium-fat concentration ) were calculated and compared between two groups. The difference of these spectral characteristic parameters was evaluated statistically by independent-samples t test. Results According to Light criteria, the mean CT value on QC image of exudates [ ( 19. 56 ±4. 10) HU ] was higher than that of transudates [ ( 13.44 ±3.46) HU] (t =3.002,P =0. 010).Difference of CT value was found more obvious in the lower keV. On 40 keV images, the difference of CT value of two groups was the largest, the mean value of exudates [ (47.49 ± 14. 60) HU ] was significantly higher than that of transudates[ ( 19. 76 ± 6. 85) HU ] ( t = 5.520, P = 0. 000). While On 140 keV, the mean CT value were (9.76 ±4. 16)and (6.22 ±3. 17) HU and the difference of the two group has no statistically significant difference (t =2. 107,P =0. 050). The mean slope rates of exudates (0.51 ± 0.23)was significantly larger than that of transudates (0. 18 ± 0. 08 ) ( t= 4. 287, P = 0. 001 ). The effective-Z (7. 89 ± 0. 16), iodine-water concentration [ (5. 74 ± 1.28 ) g/L], calcium-water concentration[ (7. 89 ±1.78) g/L] and calcium-fat concentration [ (25.95 ± 1.74) g/L] of exudates were significantly higher than those of transudates [ 7.67 ± 0. 07, ( 1.70 ± 0. 95 ) g/L, (2. 53 ± 1.37 ) g/L, ( 20. 82 ± 1.40 ) g/L ] ( t = 4. 080,6. 998,6. 546,6. 301 ,P ＜ 0. 05 ). Conclusions The spectral curve and spectral imaging parameters of exudates is found to be different from transudates. The low energy spectral imaging plays an important role in the characterization of pleural fluid. Gemstone spectral CT imaging provides a new multiparameter method to differentiate transudates and exudates.

Objective To evaluate the clinical effects of autologous osteochondral transplantation for talar lesions after anterolateral tibial osteotomy.Methods Between October 2011 and June 2015,10 patients with osteochondral lesions on the lateral talar dome underwent autologous osteochondra] transplantation after anterolateral tibial osteotomy.All donor grafts were harvested from the lateral femoral condyle of the ipsilateral knee.They were 6 men and 4 women,aged from 25 to 54 years(average 35.8 years).According to Hepple classification,7 patients belonged to stage Ⅴ and 3 to stage Ⅳ.The lesion areas ranged from 110 mm2 to 247 mm2,averaging 178.6 mm2;the lesion depths ranged from 6 mm to 11 mm,averaging 7.8 mm.The ankle function and pain were assessed according to American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and visual analogue scale (VAS) preoperatively and postoperatively.Results The 8 patients were followed up for an average of 31.6 months (from 18 to 51 months).All the patients achieved bone union 6 weeks after operation and were free of infection,malunion or hardware failure.The average AOFAS and VAS scores were improved from preoperative 65.5 and 6.9 to 91.3 and 1.3 at the last follow-up,respectively.Four cases were rated as excellent and 4 as good.Conclusions Anterolateral tibial osteotomy can provide excellent exposure of the lateral talar lesions for autologous osteochondral transplantation without problems related to the osteotomy itself.Also it may lead to good functional recovery in a short term.

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