ObjectiveTo explore the application value of high freuency two-dimensional and color Doppler ultrasonography in the detection of lower limb deep venous thrombosis.MethodsEighty-nine patients with suspicious lower limb deep venous thrombosis were enrolled and received high frequency two-dimensional and color Doppler ultrasonography examination.Vessel diameter,thrombus position,size and echo and blood flow in vessel were observed.ResultsIn 89 patients,42 cases (47.2％) had femoral-iliac vein thrombus;27 cases(30.3％ ) had vein thrombus in intramuscular of cnemis; 13 cases (14.6％) had deep venous thrombosis of the whole lower limbs; 5 cases (5.6％) had intramuscular haematoma;2 cases (2.2％)had subcutaneous soft tissue edema of cnemis.Eighty-four cases were detected having vein thrombus,2 cases (2.4％) were in both lower limbs; 57 cases (67.9％) were in single left lower limb and 25 cases(29.8％)were in single right lower limb.The ratio between thrombus in single left lower limb and in single right lower limb was 2.28:1.The diameter of popliteal vein and femoral vein in affected side limb was respectively (8.8±1.2) mm and (12.9±2.7) mm,which was significantly larger than those in normal side limb[ (5.9 ±1.5) mm and (9.2±2.1 ) mm](P＜ 0.05).ConclusionHigh frequency two-dimensional and color Doppler ultrasonography has high precision in the diagnosis of lower limb deep venous thrombosis and with certain sensibility and specificity.

Autophagy is a highly conservative biological behavior in eukaryotic cells .This dynamic process involves wrappingcytoplasmic components and combining with lysosomes in cells for catabolism .Auto-phagy can not only take part in maintaining homeostasis ,but also be closely related with tumor development and resistant.Therefore,autophagy is a potential target for antitumor drug resistant .Specific inhibition of autophagy in cancer cells combined with chemotherapy is expected to be an effective cancer treatment strategy .

Background:Vitamin D receptor( VDR)is a member of the steroid hormone receptor superfamily,which plays roles in various biological processes including cell proliferation,differentiation,apoptosis and immune responses,and is low expressed in many malignant tumors. Aims:To evaluate the expression and regulation mechanism of VDR in colorectal cancer. Methods:A total of 30 patients with colorectal cancer admitted from February 2010 to December 2012 at Ren Ji Hospital,School of Medicine,Shanghai Jiao Tong University were enrolled. Expression of VDR in cancerous tissue and para-cancer noncancerous tissue was determined by immunohistochemistry. Clinical data of 224 patients with colorectal cancer were collected from Gene Expression Omnibus( GEO)for analyzing the correlation between VDR expression in cancerous tissue and clinicopathological characteristics as well as survival time. Expression of VDR in human colon cancer cell lines HCT116 and SW620 transfected with enhancer of zeste homolog 2( EZH2 )-siRNA or treated with 5-azacytidine (5-AZA)was determined by real-time PCR,and methylation level of VDR promoter was determined by methylation-specific PCR( MSP). Results:Positivity rate of VDR was significantly lower in colorectal cancer tissue than that in para-cancer noncancerous tissue( 26. 7% vs. 70. 0%,P < 0. 001 ). Expression of VDR was negatively correlated with histological staging,distant metastasis,vascular metastasis and lymph node metastasis of colorectal cancer(P<0. 05). Survival time was significantly longer in patients with high expression of VDR than patients with low expression of VDR (P=0. 032). Compared with cells transfected with control-siRNA,expression of EZH2 mRNA and methylation level of VDR promoter in HCT116 and SW620 cells transfected with EZH2-siRNA were significantly decreased(P<0. 05),and expression of VDR mRNA was significantly increased(P<0. 05). Compared with negative control group,methylation level of VDR promoter in HCT116 and SW620 cells treated with 5-AZA was significantly decreased(P<0. 05),and expression of VDR mRNA was significantly increased(P<0. 05). Conclusions:Expression of VDR in colorectal cancer is down-regulated and positively correlated with a favourable prognosis. Transcriptional repression of VDR in colorectal cancer is co-regulated by histone methylation and DNA methylation.

Objective To study the effect and mechanism of arsenic trioxide on the motility, metastasis and invasion of osteosarcoma in vitro. Methods Wound healing assay, migration assay, invasion assay and Western-blot were performed to study the effect of arsenic trioxide on metastasis of osteosarcoma. Results Through screening MNNG cell was selected to perform the following research. After treatment of As_2O_3, the ability of MNNC cell flattening and spreading along the edges of the wound was inhibited, and the number of MNNG cells with migration and invasion in As_2O_3 - treated group was significantly less than in control group. Arsenic trioxide treatment also resulted in down-regulation of MMP-9. Conclusion This study is the first to report the effectiveness of arsenic trioxide as an inhibitor of osteosarcoma migration and invasion and the mechanism may be down-regulation of MMP-9.

Objective To evalvate the efficacy of patient-controlled epidural analgesia (PCEA) combined with ganciclovir for treatment of postherpetic neuralgia in patients.Methods A total of 60 patients with PHN,aged 51-86 yr,of ASA physical status Ⅰ-Ⅲ,were randomly assigned into 2 groups (n =30 each) using a random number table:ganciclovir group (F group) and PCEA combined with ganciclovir group (FB group).In FB and F groups,ganciclovir 0.25 g was infused intravenously twice a day for 7 consecutive days.In addition,continuous PCEA was performed simultaneously in group FB and the PCEA solution contained ropivacaine 300 mg,prednisolone 20 mg and dezocine 10 mg in 250 ml of normal saline.At 1 day before treatment (T0) and 7 days,1 month,and 6 months after treatment (T1-3),pain was assessed with visual analogue scale (VAS),and the quality of life (QOL) score and pair relief rate were recorded.Results VAS and QOL scores were significantly lower at T1-3 than at T0 in the two groups.Compared with F group,VAS scores were significantly decreased,and QOL score and pain relief rate were increased at T1-3 in FB group.Conclusion PCEA combined with ganciclovir can effectively alleviate postherpetic neuralgia in the patients.

Objective To investigate whether the effect of rabeprazole in treating gastroesophageal reflux disease is related to CYP2C19 gene polymorphisms.Methods 278 patients with gastroesophageal reflux disease confirmed by endoscopy and proton-pump inhibitor testing were enrolled in this study,including non erosive reflux disease (NERD) in 122 cases,the reflux esophagitis (RE) in 98 cases and Barrett esophagus in 58 cases.They were treated with rabeprazole for 8 weeks.GerdQ scores before and after the treatment were completed,endoscopy was performed again in patients with RE after treatment.The blood CYP2C19 genotyping was detected by matrix assisted laser desorption ionization time of flight mass spectrum(MALDI-TOF-MS).Results According to the genotype of CYP2C19,they were divided into extensive metabolizers,intermediate metabolizers and poor metabolizers,accounted for 39.57%,42.45% and 17.98%,respectively.There was no significant difference in GerdQ scores of three groups before treatment,and also had no significant difference after 8 weeks treatment,but in each subgroup GerdQ scores after treatment was decreased significantly than before treatment.The total effective rate of 98 patients with RE by endoscopy was 86.73%,but there was no significant difference in total effective rate of the three groups after treatment.Conclusion Rabeprazole is effective in the treatment of gastroesophageal reflux disease.Moreover,rabeprazole is less affected by CYP2C19 genotype and therefore its curative effect is more stable.

AIM:To develop the method for analyzing bulleyacinitine A in plasm from mice through the treatment of subcutaneous injection of bulleyacinitine A by liquid chromatography tandem mass spectrometry(LC-MS/MS).METHODS:50 ?L mouse plasma sample added zolpidem as internal standard and pH 9.2 buffer solution was extracted with ethylether,followed by liquid chromatography and mass spectrometric detection.The mobile phase was consisted of methanol-buffer solution(85∶15)(buffer solution consisted of 20 mmol/L ammonium acetate and 0.1% formic solution).The flow rate was 300 ?L per minute.The separation column was C_ 18 column.The electrospray ionization tandem mass spectrometry and the multiple reaction monitoring mode were applied to detecting the bulleyacinitine A in plasma.RESULTS:The assay was linear from 0.1 to 1 000 ng/mL.The recovery rate was more than 80%.CONCLUSION:The method could be used to detect bulleyacinitine A level in mouse plasma,which offers advantages of sensitiveness,specificity and simpleness.

Objective To investigate the expressions and functions of the fusion gene SYT-SSX1 and SYT-SSX2 in synovial sarcoma.Methods The synovial sarcoma tissue samples and clinical data of 22 synovial sarcoma patients were collected.The expressions of fusion genes were detected by RT-PCR.The relationships between fusion gene and clinicopathologic factors were statistically analyzed.The abilities of proliferation,migration and invasion of 3T3 cells transfected with tusion gene plasmids were detected by MTT,migration and invasion assays.Results There were 11 cases with expression of SYT-SSX1 gene and 9 cases with that of SYT-SSX2 genes.The ratio of SYT-SSX1 and SYT-SSX2 was about 1:1.The SYT-SSX1 positive tumors were most biphasic SS and the tumor volumes of patients with SYT-SSX1 positive were larger than that of patients with SYT-SSX2 positive (P =0.028).The SYT-SSX1 positive NIH3T3 cells exhibited higher abilities of proliferation,migration and invasion than SYT-SSX2 positive.Conclusions The ratio of expression of SYT-SSX1 and SYT-SSX2 in synovial sarcoma was about 1∶1.Both SYT-SSX1 and SYT-SSX2 can promote the growth and migration in NIH3T3 cell.The abilities of proliferation and migration of SYT-SS1 were more potent than that of SYT-SSX2.

Objective To study the effect of various treatments for the Budd-Chiari syndrome (BCS). Methods The clinical data of different treatments in 260 BCS patients were analysed retrospectively. Results Of the 260 patients,273times of BCS underwent interventional treatment?operative treatment or the combination of operation and interventional therapy, including percutaneous transluminal angioplasty(PTA) or/and stenting of the inferior vena cava(IVC)in 149 cases (160 times), percutaneous transhepatic angioplasty or/and stenting of the hepatic venous in 15 cases (17 times ),the combination of the two methods in 10 cases,radical resection in room temperature in 8 cases, mesocaval shunt in 16 cases,mesojugular shunt in 5 cases,mesoatriumr shunt in 8 cases,IVC-atrium shunt in 6 cases,splenopneumoexy in 18 cases, mesocaval shunt combined with PTA and stenting of the IVC in 17 cases, and transcardic membranotomy combined with PTA and stenting of the IVC in 8 cases . Two patients died in the operation:One died of cardiac tamponade,and the another died of operrative hemorrhagic shock.During the follow-up period of 3 months～6 years,20 patients recurred,of whom 7 died of hepatic failure,the other patients recovered satisfacorily. Conclusions The interventional treatment is the first choice for BCS.For patients unable to get interventional treatments or failure for interventional treatments, operation or operation combined with interventional therapy should be considered.

ObjectiveTo retrospectively analyze clinical data of patients who has left-side valvular disease combined with severe tricuspid regurgitation and evaluate the effect of our modified tricuspid annuloplasty with enforcement of artificial felt strip.Methods76 patients who had left-side valvular disease combined with severe tricuspid regurgitation received operations between Jan.2008 and Jun.2010.The average age of the patients was 53.5 years old (32 male and 44 female).Besides the severe tricuspid regurgitation, other combined cardiac impairments included mitral valvar disease (52 cases), aortic valvar disease(5 cases), double valvar disease(19 cases) and left atrial thrombosis(22 cases).6 patients had grade II cardiac function according to the NYHA criteria, while 47 and 23 were in grade III and IV, respectively.Other signs included cyanosis(5cases), jaundice(11 cases), neck vein engorgement(48 cases) , ascites(22 cases), hepatomegaly(41 cases) and pitting edema in the lower limbs(68 cases).The concomitant operative procedures included mitral valve replacement in 52 patients,aortic valve replacement in 5 patients, double valve replacement in 19 patients, removal of left atrial thrombus in 22 patients,left atrium folding in 21 patients and left atrium appendage suture in 68 patients.Left-sided valve disease were corrected first,TAP was performed on the beating heart after the heart had been defibrillated.The anteroseptal commissure was plicated first.A double-armed 3-0 pledgeted suture was taken through the base of the septal leaflet, 5-6 mm from the commissure, extending along the annulus, and out from the point in the anterior annulus 10-12 mm from the anteroseptal commissure.Both ends of the suture was tied until the two Teflon pledgets approximated each other near the commissure.Then a semicircular De Vega type of plicating with a 3-0 prolene was taken, starting just from the anterior annulus near the anteroposterior commissure, and extending clockwise to a point just cephalad to the posteroseptal commissure.The suture was tied with positioning a 27-29 mm valve siser across the tricuspid valve.At last, a 3-5 mm width felt strip was prepared and was sutured to the plicated posterior annulus region with interrupted mattress sutures of 2 to 3 2-0 prolene.A favorable result was considered when TR was not marked by saline injection.Echocardiography was routinely examined one week postoperatively and patients were followed up 6 month after discharge.ResultsThere is no death in all patients.The CVP diminished significantly from 16mmHg preoperatively to 8mmHg postoperatively (P = 0.0021).The systomic pulmonary pressure diminished from 59 mmHg preoperatively to 41 mmHg postoperatively (P = 0.038).Echo one week postoperative showed no tricuspid regurgitation in 56 patients and mild in 18 patients, while 2 had moderate tricuspid regurgitation.The diameter of right atrium diminished significantly postoperatively, too.The ejection fraction was improved even though there was not significant difference as compared with preoperative data.The cardiac function of all patients improved and the signs of right heart failure were alleviated or disappeared.Follow up 1 to 36 months showed no change of the regurgitation except for one become moderate from mild when discharged.No hepatic congestion or edema was observed in all patients.ConclusionThese new modifications make the technique more selective in the remodeling of the tricuspid annulus.It could achieve better coaptation of the anterior leaflet with the others, successful annular reduction, better maintenance of the contractile property of the tricuspid ring, better distribution of pursing force in the more dilated region.It could prevent the tear of the endocardium in the posteroseptal region in the long period of time postoperatively.