Oncogene activation and inactivation of tumor suppressor genes is an important molecular mechanism of tumor formation. HER-2 oncogene is associated with breast cancer invasion and metastasis and prognosis, HER-2 overexpressing breast cancer progresses rapidly and has poor prognosis. In recent years, the emergence of targeted therapeutic monoclonal antibody drug Herceptin which built its structure for the HER-2 has significantly inproved HER-2-positive advanced breast cancer.

Objective To discuss causes and prevention of complications and recurrence following sphincter preserving procedure(SPP) for rectal cancer.Methods A retrospective study on clinical and follow-up data of 375 cases of rectal cancer treated by SPP from January 2000 to January 2006 was carried out.Factors relating complications and recurrence after the operation were analyzed with the Logistic regression.Results A follow-up was conducted for 1～60 months(mean,37 months).The 5-year survival rate was 75.77%,and 79 cases of those followed died.Postoperative complications included anastomotic leakage in 14 cases(3.73%),anastomotic stenosis in 37 cases(9.87%),and anastomotic bleeding in 13 cases(3.47%).Anastomotic tumor recurrence was seen in 25 cases.Logistic regression analysis showed that the distance between the tumor and the dentate line was the most important factor for postoperative complications(P=0.017),and the distance and patient's age were the most important factors for recurrence(P=0.040,P=0.041). Conclusions The distance of tumor and patient's age are the most important factors for complications and recurrence following sphincter preserving procedure for rectal cancer.Strict selection of patients for surgery,normative procedure performance,and proper peri-operative management are essential for the prevention of complications and recurrence.

Objective To study the treatment of deep vein thrombosis (DVT) of lower limbs. Methods A series of 82 patients with DVT treated in this hospital from July 1995 to July 2002 were retrospectively analyzed. Sixty-two patients underwent conservative therapy while 20 patients underwent thrombectomy. Results Oedema on diseased limbs subsided in varying degrees in all the patients. However, complete re-perfusion was achieved in only 15 patients, and partial re-perfusion in 9 patients. In the rest of 58 patients, thrombosis was unimproved or recurred, leaving behind the post-thrombotic syndrome. Conclusions Early treatment for acute DVT, conservative therapy or surgical intervention, is effective. Surgery is advisable in most early central type or mixed type patients, whereas conservative therapy in late central type or peripheral type patients. The intravenous interventional therapy is a relatively novel and favorable vascular technique.

Since the study of the mechanism of breast cancer occurrence and development deepens, breast cancer stem cells are receiving more and more attention. Studies have shown that a group of breast cancer stem cells were undifferentiated, with self-renewal and multi-differentiation potential. These cells have a resistance to chemotherapy, radiotherapy, hypoxic, high tumorigenic, high invasion and metastasis. In breast cancer's recurrence,development, and even metastasis, they play an extremely important role. In-depth study of breast cancer stem cell related signal transduction pathways and the regulation of microenvironment are meaningful for clinical targeted treatment of breast cancer. Therefore, we summarized the latest development on breast cancer stem cells in the treatment of breast cancer.

Objective:To investigate the clinical therapeutic effects on mini-phlebectomy treatment for varicosis of lower limbs.Methods:Of 46 cases(70 limbs) of varicosis of lower limbs,25(38 limbs) received flush ligation and stripping of the great saphenous vein (control group),and 21 (32 limbs) received mini-phlebectomy (mini-phlebectomy group).The data of operating time,bleeding quantity,incision number,incision length and hospital stay time was analysed retrospectively in both groups.Results:The operating time,bleeding quantity,incision number,incision length and hospital syay time of mini-phlebectomy group are much less than that of control group.The cure rate of control group and mini-phlebectomy is 71.9% and 91.3% respectively.The difference of cure rate is significant while they are compared.Conclusion:Mini-phlebectomy has the advantage of minimal invasion,less bleeding,efficacious and time saving,it will be an ideal procedure for varicosis of lower limbs

ObjectiveTo explore the relationship between the impairment cognitive function and the location and number of infarcts.MethodsThe composites the scores for memory,processing speed and executive function were detected using the neuropsychological measuring scales and determined the cortical,subcortical and cerebral infarcts by magnetic resonance imaging( MRI),then analyzed the relationship between the impairment cognitive function and the location and number of infarcts.ResultsCompared to the control group,the patients with infarcts in multiple locations had poorer memory(the score of AVLT-5 was 6.14 ± 1.89 and 7.26 ± 1.82,respectively,P ＜ 0.01 ).Compared to the patients without infarcts,a combination of cortical and subcortical infarcts was associated with slow processing speed.The patients with multiple infarcts in multiple locations had significantly lower composites scores for memory(the score of LMT-delay was 10.86 ± 3.48 and 12.69 ± 2.60,respectively,P＜ 0.01 ),processing speed ( the score of SDMT was 27.08 ± 11.13 and 34.23 ± 7.44,respectively,P ＜ 0.01 ) and executive function( the score of TMT-B was 1.34 ± 0.65 and 0.40 ± 0.35,respectively,P ＜ 0.01 ) compared to control group.ConclusionThe multiple infarcts in multiple locations is associated with the impairment cognitive function in patients with cerebral infarcts.Suggesting that both the location and the number of infarcts jointly contribute to cognition impairment.

Objective To investigate the expression of TLR9 mRNA of peripheral blood mononuclear cells (PBMCs) in patients with acute pancreatitis .Methods Fifty two AP patients with the disease duration in 24 h were collected ,peripheral EDTAK2 coag‐ulation vein blood were collected on the first ,third and fifth day ,then plasma were cryop reserved to detect pancreatic elastase , proinflammatory cytokines and anti‐inflammatory cytokines .Then the peripheral EDTAK2 coagulation vein blood two to three months after treatment were collected in the same method to undertake these tests ,and act as the reference level value .Peripheral blood was collected from 36 acute pancreatitis patients .Three months later ,peripheral blood was collected again from these 36 peo‐ple as controls .PBMCs were isolated by Ficoll‐Hypaque gradient centrifugation .RT‐PCR was adopted to determine the relative con‐tent of the expression of TLR9 mRNA of the PBMCs .Results The relative content of expression of TLR9 mRNA were significant‐ly up‐regulated in the patients with acute pancreatitis ,compared with that of controls (P<0 .05) .The up‐regulated expression of TLR9 mRNA was related to expression of TNF‐a and IL‐1 .Conclusion The up‐regulated expression of TLR9 mRNA in acute pan‐creatitis patients indicates that infective factors might be mediated by TLR 9 .

Objective To evaluate the application of measurement of T2*value,width of substantia nigra pars compacta (SNc) and the ratio of the width to the midbrain diameter in diagnosing Parkinson disease (PD) in early stage with susceptibility weighted imaging ( SWI) by 3T MR. Methods 59 patients with early stage idiopathic PD patients and 59 healthy controls,ranging in same ages and gender,had been scanned with routine sequences and SWI sequences by 3T MR. T2*value,width and the ratio of the width to the midbrain diameter of SNc were measured. The results of measurement were analyzed and compared. Results (1) The T2*values, width and the ratio of the width to the midbrain diameter was decreased in homolateral side SNc of symptoms of subjects with PD compared with the healthy controls ( <0.05) . (2) There was a significant reduction in the T2*values and the ratio of the width to the midbrain diameter in contralateral side SNc symptoms of subjects with PD compared with the healthy controls (P<0.05) . There was no differences in width of SNc ( >0.05) . Conclusion Measurement of T2*value, width and the ratio of the width to the midbrain diameter of SNc with SWI is reliable to diagnose PD.

Objective Using 3.0T magnetic resonance imaging and diffusion tensor magnetic resonance imaging, quantitative analysis of nerve fibers in region of interest was conducted in patients with psychosis associated with parkinson disease (PDPsy), PD patients without psychotic symptoms and normal control group, then investigate the relationship between FA value change in the region of interest and PDPsy, and the pathogenesis of PDPsy. Methods Sixteen patients with PDPsy, 24 PD patients without psychotic symptoms and 20 healthy persons with the corresponding age and sex (normal control group) were enrolled in this study. The patients with PDPsy and patients without psychotic symptoms have the matched gender, age and disease duration. All patients were underwent routine MR plain scan and DTI scan. The FA graph was reestablished, and the FA values of the bilateral substantia nigra-striatum fiber loop through the site (substantia nigra, red nucleus, nucleus, globus pallidus), frontal, occipital lobe and cingulate associated with schizophrenia were statistical analyzed. Results The nigral FA values in PDPsy and PD groups were significantly lower than that in control group. The frontal lobe and occipital lobe FA values in PDPsy group were significantly lower than those in control group. The frontal lobe, occipital lobe and cingulate FA values in PDPsy group were lower than those in PD group, but there were no significant differences between the two groups. The frontal lobe and occipital lobe FA values in PD group were lower than those in the control group, but there were no significant differences between the two groups. Conclusion DTI is a noninvasive and quantitative measurement for FA values of various brain regions in patients with PDPsy. It can reveal the PDPsy corresponding neural loop changes at the molecular imaging level, and can provide more information for the pathogenesis and clinical manifestations of PDPsy.

Objective This report was to discuss the efficacy and complications of non-surgical therapy for patients with early lower extremity deep vein thrombosis.Methods A total of 412 patients were treated with thrombolysis or anticoagulation in our department during January 2000 and December 2006.Their clinical data were retrospectively analyzed.Results All patients were followed up for 12 to 83 months (mean,41 months).After treatment,42 patients(10.2%)were completely recovered,331 patients (80.3%)experienced large improvement,32 patients(7.8%)had mild improvement and 7 patients (1.7%)were failed,resulting in total effective rate of 98.3%.In comparison with long clinical course group(>7 days),the recovery rate and improvement rate of short clinical course group(≤7 days)was significantly increased(11.0% vs 5.4%,χ2=4.17,P<0.05;8.7%vs 1.8%,χ2=4.96,P<0.05).Complications included bleeding(2.2%),pulmonary embolism(1.9%),cerebral accident(0.7%),post-thrombotic syndrome(84.0%)and recurrence(6.1%).Bleeding rate in patients≥60 years was significantly higher(4.3%vs 0.8%,χ2=6.82,P<0.01).Incidence of post-thrombotic syndrome was significantly increased in long clinical course group(98.2% vs 81.7%,χ2=3.67,P<0.05).Condusions Non-surgical therapy,including thrombolysis and anticoagulation,might be safe and effective for patients with early lower extremity deep vein thrombosis.Early identification and management would be helpful to improve outcomes and reduce post-thrombotic syndrome.