Tumor cell metastasis is a process of extracellular matrix hydrolyzed by protease, where tumor cells traverse the defect in the extracellular matrix into the lymphatic system and the capillaries to form new metastasis hematogenously.Matrix metalloproteinases (MMPs) are a kind of enzymes closely related to the metastasis.MMP, especially the relationship between MMP-9 and endometrial cancer metastasis in this paper will be summarized to get a better understanding about it.

Objective To screen the proteins interacting with AMP-activated protein kinase ?2(AMPK?2)in rat brain cDNA library by bacterial two-hybrid system,and to investigate the biological role and the regulatory mechanism of AMPK?2 in brain.Methods The recombinant pBT-AMPK?2 was used as the bait to screen a rat fetal brain cDNA library by bacterial two-hybrid system.The plasmids of positive colonies were extracted and analyzed by DNA sequencing and BLAST search in GenBank.Results Seven proteins binding to AMPK?2 were screened out,including polyubiquitin,small heat shock protein 8,phosphofructokinase,cytochrome C oxidase subunit Ⅰ(COXⅠ),HLA-B-associated transcript 3(BAT3)isoform 1,protein tyrosine phosphatase receptor type D(Ptprd)and islet-brain 1(IB1).Conclusion Polyubiquitin,HSP8,phosphofructokinase,COXⅠ,BAT3 isoform 1,Ptprd and IB1 can interact with AMPK?2 in brain.

Objective To analyze inpatient expenses of percutaneous coronary intervention (PCI) and factors in the department of cardiology of a hospital, in order to provide references for setting the upper expenses limit and keeping expenses within a reasonable control Methods The hospitalization expenses data were collected from inpatients having intracoronary stenting operations in a class 3 grade A hospital in Shanghai from 2004-2006. The study made multi-factor analysis on factors possibly affecting the expenses, and built a model to predict the expense per disease, and estimated the upper limit for medical insurance expense control. These figures were used in an expense appraisal for inpatients from January to June in 2007. Results For the expenses of the 1296 PCI inpatients investigated, the largest share, 84.11%, comes from operation materials. Factors affecting the expenses, as listed by their influence, were in turn the number of stents used, length of stay, age, the status at admission, and rescues made. The study found that the average hospitalization expenses of inpatients from January to June in 2007 fell below the middle control line, and 85% of them lower than the upper control line. Conclusions To lower the medical expenses for the disease, hospitals need to take measures by using less stents, less days of stay, and less medication. Control lines specified per disease can help manage and control medical treatment quality.

In this study, metabolism of nobiletin in rats was studied using ultra-performance liquid chromatography coupled with tandem mass spectrometry (UPLC-MS/MS). As a result, seven major metabolites were found in bile, urine and serum of rats. Three phase I products were assigned to be demethyl and di-demethyl products, and other four phase II products were assigned to be glucuronic and sulfonic conjugates. The four phase II metabolites were reported for the first time. Among the metabolites found in the present study, the glucuronic conjugates of demethyl-nobiletin played a predominant role in the metabolic pathway, indicating that its potential role for glucuronidation-related factors, such as gene polymorphism, drug-drug interaction, etc., in changing the active and toxic effect of nobiletin and that it should be paid more attention in further development.

ObjectiveTo compare the therapeutic effects of a new surgical endoscopic technique, the transilluminated powered phlebectomy (TriVex System, Smith+Nephew) and pointed phlebectomy in the treatment of varicosis of the great saphenous vein of the lower limbs. Methods Thirty-nine patients (46 limbs) received TriVex operations under spinal, or epidural anesthesia. The powered vein resector and an irrigated illuminator device-a minimally invasive system was used for varicose vein surgery. During the same period, 41 patients (46 limbs) underwent pointed phlebectomy. Results The average postoperative hospital stay was 4.6 days in patients receiving TriVex, and 8.1 days for pointed phlebectomy. Compared with the pointed phlebectomy, the incision of TriVex procedure was shorter and the number less. Conclusion This new surgical device is easy to operate, minimally invasive, efficacious and time saving with satisfactory results.

Objective To compare operative risks of the infrarenal aortic artery reconstruction between abdominal aortic aneurysm (AAA) and aortoiliac occlusive disease (AIOD), and to analyze the causes of the difference. Method Clinical data of 340 cases undergoing aortic artery reconstructions including 222 AAA cases and 118 AIOD cases , were analyzed retrospectively. Results The perioperative mortality was 7.6% and the mortality in AAA group (5.4%) was lower than that in AIOD group (11.9%)(P

Objective To sum up the experience in treating thoracic aortic aneurysmal disease caused by blunt injury.Methods From September 2003 to March 2009,12 Patients were admitted into our center due to thoracic aortic aneurysmal disease after blunt injury,including 8 Stanford type B aortic dissections and 4 descending aorta pseudoaneurysms.Diagnosis was established by CT angiography and re-evaluated by angiography before endovascular treatment. Once severe co-morbidity due to iniury wag stabilized,endovascular repair of the lesions Was carried out with stent-graft implantation.Follow.up was done by CTA at 3 months、6 months、1 year and then annually postoperatively.Results Eleven patients underwent endovascular surgery,while 1 died before intervention.Technical success was achieved in all patients with left subclavian artery intentionally covered in 6 cases.Endoleak Was observed in 3 cases andmanaged with balloon dilation in 2 easels.9 cases were followed up without mortality,including 6 disseetions and 3 pseudoaneurysms.No ischemic symptom of left uppar extremity or positive neurological sign or paralysis were observed,CTA revealed no newly-developed dissection or aneurysm、no endoleak or stent migration. Conclusion Thoracic aortic aneurysmal disease after blunt injury mostly locates in aortic isthmus;endovascular stent-graft implantation after stabilization of concurrent disease is effective.

Objective To evaluate the effect of preoperative localization of Adamkiewicz artery (AKA)by CT for patients undergoing endovascular descending thoracic aortic repair. Methods From May 2003 to April 2005, 12 patients received CT examination for the detection of the AKA before undergoing endovascular descending thoracic aortic repair. Eight patients were of Stanford type B dissecting aortic aneurysm, 2 of Crawford typeⅠthoracoabdominal aortic aneurysm (TAAA) , 1 of descending thoracic aortic pseudoaneurysm and 1 of descending thoracic aortic aneurysm combined with abdominal aortic aneurysm. The inclusion criterion was that the segment from T8 to L1 needed to be partially excluded. The CT assessment accentuated the identification of the level at which the aorta gave rise to the AKA-originating intercostal/lumbar artery and approval of the continuity from the origin of the intercostal/lumbar artery at the aorta to the anterior spinal artery (ASA). Results Thirteen AKAs were identified in 9 patients (75%). A single AKA was visualized in 5 cases and double in 4. Two AKAs arose from the T8 intercostal artery, 2 from T9, 3 from T10, 3 from T11 and 3 from T12. The continuity from the origin of the intercostal artery at the aorta to the ASA was identified in 8 patients. Ultimately, 10 AKAs were preserved while 3 sacrificed. More than 15-mm both proximal and distal landing distance of the stent-graft was achieved in all patients, and no paraplegia occurred perioperatively or during the follow-up raging from 3 to 19 months ( mean 12 months). Complete false lumen thrombosis of the thoracic aorta or aneurysmal thrombosis was evidenced on CT at 3 month in 11 patients while 1 patient with dissecting aneurysm caused by Marian's syndrome died for unknown cause 2 days after being discharged. Conclusion Localization of AKA by CT before stent-grafting in the descending thoracic aorta may enable us to avoid covering the origin of the AKA-originating intercostal/lumbar artery at the aorta, hence, the remaining segment from T8 to L1 could be saved for reliable landing the sten-graft.

Objective To evaluate the efficacy of endovascular repair (EVR) for aneurysms or dissection aneurysms of the aortic arch. Methods Twelve aortic dissection aneurysm (ADA) patients with the primary entry located within 15 mm beyond the origin of the left subclavian artery (LSA) and two aortic arch aneurysm patients underwent EVR from June 2003 to August 2004. EVR with intentional coverage of the LSA without any supportive bypass was employed in 8 ADA patients, and the preliminary cervical reconstruction combined with EVR in the remaining 6 cases. Results Technical success was achieved in all cases. One case died of postoperative cerebral infarction. No neurological deficits or limb ischemia developed perioperatively or during the follow up period raging from 1 to 14 months and complete thrombosis of the thoracic aortic false lumen and remarkable anenrysmal thrombosis were revealed by CT in all 12 ADA cases and the remaining aneurysm case respectively. Conclusions EVR is effective in the management of aneurysms or dissection aneurysms of the aortic arch.

ObjectiveTo evaluate the safety, feasibility and efficacy of transplantation of purified peripheral blood CD34+ cells in treatment of critical ischemia of the lower extremities.MethodsFrom May 2009 to March 2010, seven cases of critical ischemia of the lower extremities received purified peripheral blood CD34+ cells transplantation, among those 6 were caused by thromboangiitis obliterans and 1 by thrombosis coexistent with nodular erythema. Mean age was ( 39 ± 11 ) years ( range 23 - 54 ), and all patients were not suitable for surgical or endovascular revascularization. G-CSF was subcutaneously injected for 5 days before apheresis for peripheral blood mononuclear cells. Then CliniMACS system was used to isolate the CD34+ cells. If the number of CD34+ cells was between 105/kg and 106/kg , they were all intramuscular injected into patients' calf and foot. ResultsTechnical success and limb salvage were achieved in all cases. The mean number of transplanted cells was (7. 1 ±2.3) × 105/kg [ range(4.6 ×105 -1 × 106 )/kg]. All cases were followed-up, ranging from 6 - 14 months (mean 8 ± 3 months). One month after transplantation, the rest pain was obviously relieved in all cases, and the Wong-Baker FACES pain rating scale score significantly decreased from 7. 1 ±2. 0(4 - 10)to 1. 1 ± 1.1 (0 -2) ,P =0. 0000. The pain-free walking distance was significantly improved from (4 ± 4) min (range 1 -10 min)to (12 ± 7 ) min (range 5 - 21min , P =0.04) at 3 months and(20.4 ± 12.5) min(range 6 -40 min, P = 0.02) at 6 months, respectively. The ankle-brachial index increased from 0. 54 ± 0. 18 ( range 0. 41 - 0. 87 ) to 0.66 ±0. 13(range 0. 52-0. 86 , P=0. 17)at 3 months and 0.72 ±0. 13(range 0.56 -0.91, P=0. 07)at 6 months, respectively. Of 6 cases with the toe ulcer, the ulcer was healed in 3 and apparently shrank in 3. Transcutaneous partial oxygen pressure rose from (29 ± 14)mm Hg(range 10 -52 mm Hg)to 46 ±14 mm Hg ( range 27 - 63 mm Hg, P = 0. 04) at 3 months and (57 ± 10) mm Hg( range 41 - 66 mm Hg, P =0.001) at 6 months,respectively.No serious complications were found either perioperatively or postoperatively.ConclusionsTransplantation of purified peripheral blood CD34+ cells is safe, feasible and effective in the treatment of critical ischemia of the lower extremities.