Objective Todetecttheexpressionlevelsoftumornecrosisfactor-α(TNF-α)and interleukin-6(IL-6)inintracranialaneurysms.Methods Sixteenconsecutivepatients(aneurysm group)with intracranial aneurysm confirmed by digital subtraction angiography (DSA)and clipped by microneurosurgery were enrolled retrospectively. A total of 19 trauma patients without vascular disease confirmed by CT and magnetic resonance imaging (MRI)in the same period were used as a control group. Hematoxylin-eosin (HE)staining and immunohistochemical staining were used to detect the aneurysm wall tissue and the colored portions of TNF-α and IL-6 in normal vessel wall,the mean value of optical density after its expression was analyzed,and the intensity of staining was compared. Results (1)Each layer of artery walls of the control group had no obvious TNF-α and IL-6 expression. The inner,media and out membranes of the aneurysm wall tissue of the aneurysm group had positive expression of TNF-αand IL-6. (2)The mean optical densities of TNF-α and IL-6 in patients of the aneurysm group were 0. 182 ± 0. 069 and 0. 148 ± 0.062 respectively,and they were higher than 0. 144 ± 0. 031 and 0. 105 ± 0. 020 of the control group. The differences were statistically significant (all P<0. 05). (3)The mean optical densities of TNF-α expression of each layer of the inner,media and out membranes in the aneurysm walls were 0. 224 ± 0. 071,0. 134 ± 0. 040,and 0. 106 ± 0. 065,respectively. There were significant differences (P<0.01). (4)The mean optical density expressed by IL-6 in the out membrane of the aneurysm walls was lower than the media and inner membranes (0. 096 ± 0. 018 vs. 0. 145 ± 0. 050,and 0. 148 ± 0. 070). There were significant differences (P<0. 05). (5)The results of Spearman correlation analysis showed that the mean optical density of TNF-αof the aneurysm group was positively correlated with that of IL-6 (r=0. 452, P<0.05).Conclusion TheexpressionlevelsofTNF-αandIL-6intheaneurysmwalltissueare higher,and they may be involved in intracranial aneurysm formation and rupture.

ObjectiveTo investigate the correlation between the expression of VEGF and the lymph node metastasis of colorectal carcinoma.MethodsVEGF was detected by immunohistochemistry in 24 cases of colorectal carcinoma with lymph node metastasis and 16 case of colorectal carcinoma without lymph node metastasis.CD34 was used as a marker to evaluate the MVD.All the data were analyzed using 10.1 statistical package.The comparison was performed by x2 test and Spearman rank correlation analysis.The level of significance is α =0.05.Resultsin the 40 cases of colorectal carcinoma,24 cases encountered lymph node metastasis with an MVD (40.65 ± 11.80) and 21 cases were VEGF positive (87.5％).In the 16 cases without metastasis,the MVD was (25.02 ± 11.52) and 4 cases were VEGF positive (25.0％).MVD and VEGF were significantly different between thecases with lymph node metastasis and those without (t =-4.138,x2 =16.00,P ＜0.01 ).In the 40 cases,there were 25 cases with positive VEGF with an MVD (41.33 ± 11.61 ) and 15 cases with negative VEGF with and MVD (22.84 ±8.88).The difference between the cases with positive VEGF and those with negative VEGF (t =5.301,P ＜0.05 ).VEGF level was positive correlated with MVD in the colon cancer ( rs =0.539,P ＜ 0.05 ).Conclusion VEGF may play a role in promoting the lymph node metastasis of colorectal carcinoma

Objective    To investigate the learning curve of non-tube and early oral feeding procedure following McKeown minimally invasive esophagectomy (MIE). Methods    We analyzed the clinical data of 38 patients (26 males, 12 females, aged 42–79 years) with esophageal cancer who received non-tube and early oral feeding procedure after surgery at the Affiliated Tumor Hospital, Zhengzhou University from November 2017 to August 2018. They suffered upper thoracic esophageal cancer (n=4), middle thoracic esophageal cancer (n=22) or lower thoracic esophageal cancer (n=12). Results    McKeown MIE was successfully performed on 38 patients. Oral feeding began 1.7 (1-4) days after surgery in the 38 patients with non-tube. Pneumonia/atelectasis occurred in 5 patients (13.1%), respiratory failure in 1 patient (2.6%), arrhythmia in 3 patients (7.9%), hoarseness in 5 patients (13.1%), anastomotic fistula in 1 patient (2.6%), cervical incision infection in 1 patient (2.6%), pneumomediastinum and infection in 1 patient (2.6%) and gastric emptying disorder in 2 patients (5.2%). No death was observed. After 26 patients with McKeown MIE were treated with enhanced recovery after surgery procedure, the operation time and complications could reach a relatively stable state and entered a plateau phase of learning curve. Conclusion    Non-tube and early oral feeding procedure following MIE is technically safe and feasible. It can shorten hospital stay, relieve the discomfort of placement of nasogastric and nutrition tube and may reduce the incidence of complications. The learning curve of non-tube and early oral feeding procedure following MIE is  about 26 cases.