Objective To study the incidence, spreading path, prognosis and treatment of the umbilical metastasis Sister Mary Joseph nodule (SMJN) from malignancies Methods To analyse the clinical feature from 3 cases of SMJN and to review pertinent literatures Results Three cases SMJN were come from advanced primary peritoneal carcinoma in case 1, recurrent mucinous ovarian papillary adenocarcinoma in case 2 after primary cytoreductive surgery and systemic chemotherapy and case 3 with recurrent endometrial carcinoma All patients received umbilical resection and the umbilical metastasis was comfirmed pathologically, while case 3 was diagnosed adenocarcinoma spreading by fine needle respiration before the surgery The mean survival was 63 months following surgery or chemotherapy or radiotherapy, case 1 died of advanced malignancy, while case 2 and case 3 were still alive 58 and 44 months, respectively Conclusions Although the incidence being low, SMJN was the important sign of one of the vast metastatic malignancy and has grave prognosis Umbilical resection should be performed on some patients of SMJN with relative good condition, and chemotherapy or radiotherapy should also performed accordingly

Vascular endothelial growth factor (VEGF) is an endothelial cell-specific mitogen.Studies have shown that VEGF is closely associated with ischemic stroke,and this makes it possible to intervene in ischemic stroke from the level of VEGF and its receptor.This article reviews the biological effect of VEGF and its receptor,mechanism of action involving in various stages of ischemic stroke,and the therapeutic prospect in ischemic stroke.

Objective To assess the value of whole cerebral perfusion weighted map (PWM) and whole cerebral perfusion blood volume (PBV) integrating in scan protocol about CT perfusion (CTP) combined with CT angiography (CTA) in acute cerebral infarction. Methods Twenty-three patients with acute cerebral infarction proved clinically underwent CTP examination combined with CTA. The color-coded images of PWM and PBV were attained using workstation, and the raw data of contract CTA images and subtractive images between contract CTA and non-contract CTA were processed. The diagnostic sensitivity and the value of CTP and PWM, PBV integrating CTP in acute cerebral infraction were evaluated. Results Seven of 9 patients with negative results on CTP images had positive expressions on PWM and PBV images. The sensitivity of CTP was 60.87% and the sensitivity of PWM and PBV integrating CTP was 91.30%. Conclusion The scan protocol of PWM, PBV integrating CTP not only increases detection rate of acute cerebral infraction, but also has ability to predict the clinical prognosis of patients with cerebral infraction.

Objective:To analysis the relationship of cephalometric measurements from intercuspal position(before and after treat-ment)and retruded contact position(before treatment).Methods:18 cases with Class III malocclusion were treated using MBT straight wire appliance technique,all the incisal relationships could be edge-to-edge when the mandible was retruded,X-ray films of intercus-pal position and retruded contact position before treatment and intercuspal position after treatment were taken.The cephalometric meas-urements were statistically analysed by ANOVA.Results:After 25 months treatment the anterior crossbite were corrected in all cases. The molar relationship were class Ⅰ.The measurements of SNB,ANB,MP-FH,MP-SN,U1-SN,L1-MP,Y-axis angle and ANS-Me were significantly changed.Conclusion:After the treatment of Class III malocclusion by MBT straight wire appliance,the sagittal and vertical mandibular location can be between intercuspal position and retruded contact position of pretreatment,and it is more close to the retruded contact position.

Objective: To analyze the relationship between high-sensitivity C-reactive protein (hs-CRP) and P wave dispersion (Pd) in patients with lone atrial ifbrillation (AF), and to explore the effect of inlfammation on atrial electrophysiological remodeling.
Methods: Our research included 2 groups. AF group, containing 71 consecutive paroxysmal lone AF patients, and Control group, containing 71 paroxysmal supra ventricular tachycardia patients with the matched age and gender. The clinical characteristics, electrocardiographic Pd assessment and plasma hs-CRP levels were compared between 2 groups. The relationship between hs-CRP and Pd was studied by linear and multi linear regression analysis.
Results: Compared with Control group, AF group showed increased left atrial diameter, Pd and hs-CRP, all P<0.05. multilinear regression analysis indicated that hs-CRP was positively related to Pd in both groups, P<0.01. Multiple logistic regression analysis revealed that hs-CRP was an independent risk factor for AF occurrence (HR=15.430, 95%CI 6.031-39.476, P<0.001), with adjusted Pd, multiple logistic regression analysis presented that both Pd and hs-CRP were the independent risk factors for AF occurrence, both P<0.001, while the HR for hs-CRP predicting AF occurrence was attenuated from 15.430 to 6.246.
Conclusion: Plasma hs-CRP level and electrocardiographic Pd were the important risk factors for paroxysmal lone AF, the interaction between hs-CRP and AF occurrence could be mediated by Pd, suggesting that inlfammation might be involved in atrial electrophysiological remodeling.

Traditional Chinese medicine (TCM) usually views polycystic ovary syndrome (PCOS) as a menstrual disease or infertility disease. Reproductive dysfunction in PCOS is characterized by ovarian androgen excess and disturbance of follicular development, and its main clinical manifestations include delayed menstruation, scant menstruation, amenorrhea or infertility. Insulin resistance is a key pathological mechanism of PCOS. "Tiangui" (kidney essence) as a sex-stimulating essence in female in TCM theory, is essential to the menstruation and pregnancy of women. The disturbance of Tiangui (including time, status and rhythm) would result in female reproductive problems. Current studies of Tiangui indicate that ovary is the target organ of PCOS treatment, and its functional characteristics are consistent with the properties of Tiangui in time frame, state form and rhythm cycle. It is then concluded that ovarian dysfunction in PCOS can be expressed as disorder of Tiangui.

Objective To investigate the role of phosphatidylinositol 3-kinase (PI3K)/protein-serine-threonine kinases(Akt) signal transduction pathway in EphB receptor-mediated neuropathic pain in rats.Methods Forty-eight pathogen-free male SD rats aged 2-3 months weighing 150-180 g were randomly divided into 6 groups (n =8 each):groups sham operation (groups S1 and S2 ); groups chronic constrictive injury (CCI) (groups C1and C2 ) and groups EphBI-Fc (EphB receptor antagonist) + CCI (groups E1 and E2 ).Neuropathic pain was induced by placing 4 ligatures on left sciatic nerve at 1 mm intervals with 5-0 silk thread in groups C1,C2,E1 and E2.EphBI-Fc 0.5 μg in 5 μl normal saline was injected intrathecally 1 h before operation and at 1 and 2 d after operation (group E1 ) or on 5th day after operation (group E2).Normal saline 5 μl was injected intrathecally instead of EphBI-Fc 1 h before operation and at 1 and 2 days after operation (groups S1 and C1 ) or on 5th day after operation (groups S2 and C2 ).Pain withdrawal latency to noxious thermal stimulation (PWL) and pain withdrawal threshold to noxious mechanical stimulation (PWT) were measured before operation and at 1,3 and 5 d after operation.The animals were sacrificed at 5 d after operation after measurement of pain threshold.The lumbar segment of spinal cord (L4-6) was removed for determination of c-Fos,PI3K and phosphorylated Akt(p-Akt) expression.Results CCI significantly reduced PWL and PWT and up-regulated spinal c-Fos,PI3K and p-Akt expression in groups C1 and C2 as compared with groups S1 and S2.EphB1-Fc significantly decreased hyperalgesia and the upregulated spinal Fos,PI3K and p-Akt protein expression induced by CCI in groups E1 and E2 as compared with groups C1 and C2.Conclusion Spinal EphB receptor is involved in the development and maintenance of neuropathic pain through PI3K/Akt signal transduction pathway.

Objective To investigate the biological effects of insulin resistance(IR)on the porcine granulosa cells which iS induced by wortmannin,the PI-3K inhibitor and mediated by key molecules including GLUT4 and MAPK during insulin signaling.Methods The model of IR porcine granulosa cell was established in in vitro culture by treatment of wortmannin,and was assessed the amount of3H glucose uptake as well as medium glucose levels by glucose oxidase method.The protein and mRNA expression of GLUT4 and MAPK were evaluated by immunofluorescence and RT-PCR respectively.Resuits The glucose intake was decreased by 40% with treatment of wortmannin at 1.5 μmol/L(P＜0.05).GLUT4 and MAPK were localized mainly to cytoplasm of grantdose cells.When granulosa cells were insulin resistant,the expression of GLUT4 was down-regulated whereas MAPK was up-regulated as compared with the controls.Conclusions Wortmannin treatment can lcad to decreased expression of GLUT4 and increase of IR granulose cells.This metabolic phenotype could induce increased expression of MAPK and mitogenic potential,indicating the cross-talk between two pathways of insulin signaling within ovarian cells.

Objective To investigate the occurrence of cardiotoxicity of chemotherapeutic drugs in gynecological cancer patients without heart disease,and patients with coronary heart disease or congenital heart disease for providing a basis for the clinical prevention of heart side effects during chemotherapy.Methods Thirty cases with gynecological cancer complication with or without coronary heart disease or congenital heart disease before or during chemotherapy admitted from Jan.2004 to Dec.2010 were retrospectively analyzed.Results For all 30 patients,there were heart failures in 3 cases ( 10％,3/30),myocardial infarction in 3 cases (10％,3/30),angina pectoris in 1 cases (3％,1/30),ST-T or T-wave changes in 9 cases (30％,9/30),and arrhythmia in 8 cases (27％,8/30).Conclusions Cancer chemotherapy drugs to the heart may produce an immediate or long-term toxicity,in which could significantly effects on the survival and prognosis of patients.It is very important to prevent the occurrence of cardiotoxicity of chemotherapeutic drugs in gynecological cancer patients with heart diseases during chemotherapy.

BACKGROUND: Previous studies have confirmed that atrial natriuretic peptide (ANP) exists in different regions of rat gastric mucosa in different densities, and ANP can inhibit the spontaneous contraction of gastric smooth muscles in rat, guinea pig and human.OBJECTIVE: To investigate the ultrastructural localization of ANP-synthesizing cells and the correlation between ANP-synthesizing cells and microvessel density in rat gastric mucosa.DESIGN: Single sampling study.SETTING: Affiliated Hospital of Chengde Medical College. MATERIALS: Eighteen adult male Wistar rats of clean grade, weighing 300-350 g, were used in this study.METHODS: This study was conducted in the Laboratory of Chinese Materia Medica Immunology, Chengde Medical College from October 2004 to July 2007. The ultrastructural localization of ANP-synthesizing cells in rat gastric mucosa was performed by postembedding immunoelectron microscopy technique. The area density of ANP-synthesizing cell distribution was calculated by histochemical technique (saffron solution and toluidine solution staining included). Microvessels of rat gastric mucosa were revealed distinctively by tannic acid-ferric chloride staining method and scanning electron microscope technique.MAIN OUTCOME MEASURES:①The ultrastructural localization of ANP-synthesizing cells in rat gastric mucosa.②The distribution characteristics of gastric microvessels in different regions of rat gastric mucosa.③The distribution characteristics of ANP-synthesizing cells in rat gastric mucosa.④Correlation between ANP-synthesizing cell distribution and microvessel density.RESULTS: ① Ultrastructural localization of ANP-synthesizing cells: It was confirmed that ANP-cells were the enterochrochromaffin (EC) cells. ② Observation of microvessels: The microvessels were stained successfully by tannic acid-ferric chloride and scanning electron microscope technology. Microvessels of gastric mucous were in wriggled way and cut in different cross-sections. They could be clearly observed in distinct three-dimensions. The microvessel density was the largest in the basal glands of rat gastric mucous. ③ Distribution of ANP-synthesizing cells: It was identified that EC cell was only a chromaffin cell in the rat gastric mucosa. The chromaffin granules (brown granules) were localized in the cytoplasm of EC cells. Negative staining for chromaffin granules was detected in the submucosa and smooth muscle. EC cells had different distribution densities in different regions. The density order of EC cells was gastric cardiac region ＞ gastric pyloric region ＞ gastric fundic region in mucosal layer. ④ Correlation between ANP-synthesizing cells and microvessel density: Correlation analysis showed that there was a positive correlation between ANP-synthesizing cells and microvessel density in the gastric cardiac region(r = 0.53, P ＜ 0.05, n=18), and there was a negative correlation between above-mentioned two indices in the gastric pyloric region(r = 0.38, P ＞ 0.05 , n=18)and in the gastric fundic region(r = -0.29, P ＞ 0.05, n=18).CONCLUSION: ANP-synthesizing cells are the EC cells of gastric mucosa. There is a positive correlation between ANP-synthesizing cells and microvessels in the rat gastric cardiac region, while there is a negative correlation between ANP-synthesizing cells and microvessels in the rat gastric pyloric region and in the gastric fundic region.