Objective To evaluate the application of Endoscopic ultrasonography (EUS)in preoperative diagnosis of gastric cancer and staging. Method 78patients were assigned to EUS and gastroscope examination before operation,the staging result were compared with pathological staging result. Result Compared with pathological staging,the accurate rate of EUS in T staging and N staging before gastric cancer was 85.9% and 80.77%. Conclusion EUS can be used in judgment of gastric cancer staging accurately,may be of significance in the decision of operation plan.

Objective Non small cell lung cancer( NSCLC) is a common tumor and the blood of NSCLC patients is generally in a state of high coagulation.However, as a predictor of coagulation, few study has been done on the role of D-dimer level in lung cancer.This article aimed to analyze the prognostic value of plasma D-dimer level in patients with advanced NSCLC and its relation with pulmonary embolism Methods The study collected patients with lung cancer treated in Tianjin Chest Hospital from January 1, 2013 to October 31, 2015.The serum levels of D-dimer were measured by enzyme-linked immunosorbent assay.Based on different lev-els, the patients were divided into high expression group and normal expression group.The relationship between D-dimer level and the prognosis of lung cancer patients were analyzed by Kaplan-Meier method and Log-rank test univariate analysis.T test was used to ana-lyze the difference of D-dimer between patients with and without pulmonary embolism. Results In all the enrolled subjects,103 ca-ses (73.75%) of plasma D-dimer were normal, while 37 patients (26.25%) were elevated.Survival analysis showed that the patho-logical status, tumor size and D-dimer were independent prognostic factors; and the D-dimer in patients with pulmonary embolism was 5.37 ±1.23 μg/mL, while the patients without pulmonary embolism was 0.43 ±0.73μg/mL, D-dimer in patients with pulmonary embol-ism was high than the patients without pulmonary embolism, showing significant difference (P<0.05). Conclusion Plasma D-dimer is an independent prognostic factor for the prognosis of lung cancer, which is obviously higher in patients with lung cancer and pulmonary embolism than in patients without pulmonary embolism.

Objective To investigate the activation of nuclear factor-κB(NF-κB),which was stimulated by angiotensin-Ⅱ(AngⅡ)through classical pathway in human pulmonary microvascular endothehal cells(HPMEC).Method The experiment was divided into two groups:in Ang Ⅱ group,HPMECS were incubated with 10-6mol/L AngⅡ for 0,0.5,1,2 and 4 hours,respectively;in losartan group,HPMEC was pretreated with 10-6mol/L losartan(inhibitor of AngⅡ type 1 receptor)for 1 hour,and then stimulated with 10-6mol/L AngⅡ for 2 hours,and the nucleax protein and the cell plasma protein were prepared by lysis and centrifugation.Electrophoretic mobility shift assay(EMSA)was used to detect the NF-κB DNA binding activity.The inhibitor of κBa(IκBα)was detected by Western blotting.The data were expressed as(x±s)and analyzed with one way analysis of variance.A P value less than 0.05 indicated significant difference.Results Compared with the activity of NF-κB at 0 h (100.0±25.1)after AngⅡstimalation,the activity increased significantly at 0.5 hour(144.5±16.1,P＜0.05),and reached peak value at 2 hours(270.1±27.2,P＜0.05).The concentration of IκBα at 0 hours was 44.4%±2.1%,decreased markedly at 0.5 hours(38.9%±3.6%,P＜0.05),and to the lowest level at 2hours(32.6%±2.3%,P＜0.05).The activity of NF-κB(115.4±10.7)and the concentration of IκBα(43.6%±3.7%)in losartan group had ilo significant difference with AngⅡ group at 0 h(P＞0.05).The activity of NF-κB and the concentration of IκBα in losartan group had significant difference with AngⅡ group at 2hours.Conclusions NF-κB can be activated through classical pathway,which stimulated by AngⅡ in HPMEC.

Objective To compare the therapeutic effect of endovascular repair (EVAR) and open surgical repair(OSR) of abdominal aortic aneurysm in high-risk patients. Methods The clinical data of 55 patients from 1998 to 2008 with infrarenal abdominal aortic aneurysm who received surgical treatment were analyzed by using the customized probability index. The perioperative and short term advantages and disadvantages of OSR group (n=20) were compared with EVAR group (n=35). Results All patients in OSR group were followed up, 94% patients in EVAR group were followed up, the mean follow up time were 75 and 70 months respectively. (1) Compared to OSR group, the EVAR group had shorter operation time [(3.1±0.6) h vs (4.9±0.9) h, P<0.05], (2) EVAR group had shorter ICU and hospital stay after operation and less blood loss (P<0.01), (3) Compared to OSR group, the EVAR group had lower mortality within 30 d(2.86% vs 15%), (4)the EVAR group had lower peri-operative complications(17% vs 40%), (5) The main complications of EVAR were endoleak (8.57%), (6) The main complications of OSR was cadiovascular incidence(25%). Conclusions Endovascular treatment, indicated for AAA in high-risk patients, can cut down the perioperative incidence of cadiovascular events, mortality and complications. CPI is useful to estimate the perioperative incidence of cadiovascular events, mortality and complications, and can be used to guide the therapeutic method.

Objective To compare selective coverage and chimney technology of the left subclavian artery (LSA) in thoracic endovascular aortic repair (TEVAR).Methods Eighty-one cases were retrospectively reviewed from January 2005 to January 2013 with two different management of the LSA during TEVAR:selective coverage (SC) vs chimney (C).Technical success rates,operating time,endoleaks,and perioperative cerebrovascular accidents,spinal cord ischemia (SCI),left arm ischemic symptoms and mortality were analyzed.The survival rate was also evaluated.Statistical analysis was performed using the x2 test,t-test and Kaplan-Meier survival curve.Results There were 37 patients in group SC and 34 in group C.Operating time was (61 ± 22) min for SC,and (101 ± 20) min for C (P =0.000) ; left arm ischemic symptoms occurred in 23.4％ in group SC,and 2.9％ in group C (P =0.011).Technical success rates were 100％ and SCI were 0 for both SC and C.Endoleaks,perioperative cerebrovascular accidents,and mortality were similar between the two groups.Conclusions During TEVAR,selective coverage of the left subclavian artery is safe,effective; meanwhile,chimney technology is safe,effective for patients whose left subclavian arteries need revascularization.

Objective To explore more satisfactory results in correcting the aesthetically short nose combined with low and blunt nasal tip by using autologous cartilage grafts.Methods External rhinoplasty approach was preferred.Nasal septal cartilage and auricular cartilage or rib cartilage of patients were adopted,as necessary,various shapes of grafts were carved,such as septal extention graft,columella strut and shift graft.Then we used these autologous cartilage grafts with suture and removal techniques to correct the aesthetically short nose combined with low and blunt nasal tip.The length of the nose (n-prn) and the projection of nasal tip (sn-prn) were measured before and after the operation.Paired t-test was adopted to evaluate the results.Results Thirty-one patients accepted the nasal tip rhinoplasty with autologous cartilage whose nasal tip was over rotation,blunt and low.All the patients were followed up for 3 months.Thirty patients satisfied with the results,accounting for 96.7 ％ of the total.()ne (3.3 ％) patient dissatisfied with the result because of postoperative asymmetry nostrils.Nose length before and after surgery was significantly different (P＜0.05).Nasal tip projection before and after surgery was also significantly improved (P＜0.05).Conclusions It is an effective method to use autologous cartilage graft for correcting the aesthetically short nose combined with low and blunt na sal tip,with low complications.

Objective To investigate the mechanism of unbalanced expressions of endothelin receptors (ETA/ETB )in cerebral vasospasm (CVS)after subarachnoid hemorrhage (SAH).Methods The rat CVS models were established by injecting autologous blood into the cisterna magna the second time.Basilar artery morphology was observed under light microscope and immunofluorescence staining was conducted to dynamically detect ETA/ETB receptor expression.Results The cross-sectional area of the basilar artery in the SAH model group decreased at 2 d to 3 d,and then gradually returned to normal.ETA receptor expression in endothelial cells of the basilar artery increased at 2 d after SAH,peaked at 3 d and remained increased till 14 d.ETB receptor expression increased significantly in endothelial cells at 3 d,peaked at 7 d and remained the same level till 14 d.Conclusion The results suggest that ETA/ETB receptors play an important role in cerebral vasospasm after SAH.The specific expression differences of ETB receptor subtypes in the brain vascular layers need further study.

Objective To design and synthesize compounds with protein tyrosine kinase(PTK)inhibitory activity with L029 as the lead compound. Methods L029 derivatives were designed and synthesized from L029 by reduction and/or substitution with the 3-dimethylamino-1-propyl,methyl acetate,methyl propionate in its active H and other sites. PTK activity was measured by enzyme-linked immunosorbent assay(ELISA). The inhibitory rate was calculated to screen out the compounds with PTK inhibitory activity. Re-sults Five target compounds were synthesized and their structures were confirmed by 1H NMR and MS. Three compounds T2,T3 and T5 were screened out with strong PTK inhibitory activity. Conclusion The synthetic routes of the target compounds are simple with mild reaction condition,and 3 compounds show strong inhibitory activity by ELISA. These results can provide reference for the further design and synthesis of this kind of molecules.

Objective o evaluate the association between IL-28B ( rs12979860 ) polymorphism andantiviraltherapeutic effectbydetecting the genotype of interleukin-28B( IL-28 B) in patients with hepatitis C ( HCV ) .Methods Of total 1153 HCV patients, 303 diagnosed with CHC had been treated with pegylated interferon plus ribavirin for 24-48 weeks.IL-28B ( rs12979860 ) was genotyped by two-color fluorescent TaqMan assay.Results Among 1153 patients, CC, CT and TT genotype frequencies of IL-28B rs12979860 are 83.26%, 16.22%and 0.52%respectively.The results of HCV genotypingof 580 in 1153 cases, the frequencies of 1b, 2a and their non-1b/2a type are 63.45%, 35.00%and 1.55%respectively;In 303 CHC patients with clear medical history, the proportion of SVR was71.98% in patients with CC genotype and 16.90%in those with either the CT or TT genotypes.Logistic regression model was adopted to analyze the association of rs12979860 with SVR while adjusting for age, gender, viral load and HCV GT factors.Populations carrying combined genotype ( CT +TT) are making it harder to get SVR compared with those with CC genotype (OR, 95%CI:11.10,5.35-23.04;P<0.000 1).The percentages of SVR in HVC patients with 1b and 2a genotypeare 48.02% and 81.19% respectively.there is a statistically significant difference between these subgroups (χ2 =30.639,P<0.000 1).Conclusion IL-28B rs12979860 genotype is closely related to SVR in CHCpatients.Patients with CC genotype have a higher virus sustained response rate than those carrying CT or TT genotype.The SNP , rs12979860, might be applied as a predictor of clinical antiviral efficacy in the furture.

Objective To evaluate the safety and efficacy of endovascular repair(EVR)for type B acute aortic dissection(AAD). Methods Between Feb 2002 and May 2008.39 consecutively admitted patients with the confirmed diagnosis of acute type B aortic dissection were studied.All patients were treated bv EVR.Left comnlon carotid artery were covered after bypass in 2 cases.of which fenestrated stent graft (SG)at innominate artery was used in one;1 case underwent left lower extrernity amputation:13 left subclavian artery(LSA)and 1 aberrant risht subclavian artery were completely covered without bypass.5 LSA were pattially covered.All cases were followed by CTA after EVR.the porfusion status of the false lumen were monitored in the aorta at the level of the stented segment(L1)and distal to the stent graft (L2).Results The procedure Was technically successful in all cases;30-day mortality rate was 10.3%.At the 1-month follow-up,false lumen in L1 thrombosed in 100%,a complete thrombosis of the false lumen Was observed in 21 patients(77.8%).partial thrombosis in 6(22.2%).with complete reabsorption of the thrombus and remodelling of the true lumen in 5(18.5%);False lumen in L2 thrombosed only in 7 patients(28%),complete thrombosis in 2(8%)and partial thrombosis in 5(20%).Conclusions The results of endovascular repair of acute type B dissection Was satisfactory.30-day mortalitv rate was related to severe complications before EVR.