Objective To evaluate the association between matrix metalloproteinase‐1 (MMP‐1)‐1 607 bp 1G/2G and matrix metalloproteinase‐3(MMP‐3)‐1 171 bp 5A/6A polymorphisms in promoter regions and susceptibility to ovarian cancer by Meta‐a‐nalysis .Methods Case‐control studies with regards of relationship between MMP‐1‐1 607 bp 1G/2G ,MMP‐3‐1 171 bp 5A/6A pol‐ymorphisms in promoter regions and susceptibility to ovarian cancer were searched in electronic databases .Odds ratio (OR) and 95% confidence interval (CI) were used to evaluate the association between polymorphisms and susceptibility .RevMan5 .0 software was applied for data analysis .Results Eight studies ,containing 5 studies for MMP‐1 and 3 studies for MMP‐3 ,were selected .For MMP‐1‐1 607 bp 1G/2G ,OR(95% CI)=0 .95 (0 .74-1 .21) ,P=0 .67 under 1G/1G :1G/2G+2G/2G model ,OR(95% CI)=0 .93 (0 .70-1 .23) ,P=0 .60 under 1G/1G :2G/2G model ,OR(95% CI)=0 .99 (0 .87-1 .14) ,P=0 .91 under 1G :2G model;for MMP‐3‐1 171 bp 5A/6A ,OR(95% CI)=0 .97(0 .68-1 .38) ,P=0 .85 under 5A/5A+5A/6A :6A/6A model .Overall ,there was statisti‐cal significance .Conclusion It is still not confirmed that significant association between the MMP‐1‐1 607 bp 1G/2G and MMP‐3‐1 171 bp 5A/6A polymorphisms in promoter regions and susceptibility to ovarian cancer exists in current literature .

Objective To summarize perioperative care and effect of surgical treatment of total anomalous pulmonary venous connection (TAPVC) in newborns and babies within 6 months.Methods From September 2001 to May 2013,ninetytwo consecutive patients with TAPVC received surgical correction under cardiopulmonary bypass (CPB) with moderate or deep hypothermia.The anatomic subtype included supracardiac type 48,intracardiac type 36,infracardiac type 6 and mixed type 2.There were 36 newboms.Pathological diagnosis was made by echocardiogram,computerized tomography and operative findings during operation.The option of procedure was determined by findings.Respirator assisted breathing after operation and cardiac function was maintained by a variety of positive inotropic drugs,to prevent the happening of the pulmonary hypertension crisis.Results Severely low cardiac output syndrome occurred in 8 patients and they died within 24 hours after operation.The remaining cases postoperative recover smoothly and receive postoperative follow-up about 1 month to 12 years,3 cases of postoperative pulmonary vein stenosis (PPVS) occurred.Conclusion Total anomalous pulmonary venous connection should be surgical treatment as soon as possible with satisfied effect.The key of perioperative care is maintenance of left heart function,negative balance of liquid,prevention and treatment of pulmonary hypertension.

Objective Myocardial infarction and subsequent heart failure remain the most dominant health challenges worldwide.Therapeutic angiogenesis has emerged as a potential novel treatment for severe ischemic heart disease and there is increasing evidence that cell transplantation may improve the perfusion and contractility of myocardium in animal models.This study was designed to examine the endothelial growth potential and whether transplantation of human umbilical cord derived mesenchymal stem cells can improve local blood flow in a mouse ischemic hindlimb model.Methods The mesenchymal stem cells derived from human umbilical cord of passage 5 were differentiated in an endothelial differentiation medium containing vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) in vitro.Samples were observed for 2 weeks.The human umbilical cord derived mesenchymal stem cells were transplanted into a hindlimb ischemia mouse model in vivo.Four weeks later,immunofluence was used to identify the migration and differentiation of the transplanted cells towards endothelial linage.Laser Doppler perfusion image was used to evaluate the local blood flow of the hindlimb.Results Results After incubation with VEGF and bFGF,the human umbilical cord derived mesenchymal stem cells started to form interconnected clusters and a network was formed.Four weeks after transplantation,the transplanted cells were sprouting f0rom the local injection and differentiated into endothelial cells,contributed to the recovery of local blood flow obviously as compared with control group.Conclusion Human umbilical cord derived mesenchymal stem cells have the ability to differentiate into endothelial cells,contribute to the local angiogenesis in a hindlimb ischemia mouse model and represent a new source for therapeutic angiogenesis for clinical applications.

Objective To investigate the clinical effects,feasibility,points for attention and complications of treating distal radial fractures through minimally invasive palmar locking plate.Methods A total of 22 patients with distal radial fractures managed by minimally invasive palmar locking plate from August 2009 to August 2010 were enrolled in the study.According to AO classification,there were five patients with type A2 fractures,three with type A3,four with type B1,seven with type B3,two with type C1 and one with type C2.Two vertical or parallel palmar incisions of 2 cm long were performed.The distal transverse incision was along the proximal wrist crease,while the distal and proximal vertical incisions were close to the radial side of flexor carpi radialis.Then,palmar locking plate was inserted through deep pronator quadratus.Results Follow-up period was 10-18 months(mean,12 months).According to Dienst function evaluation criteria,the results were excellent in 13 patients,good in six,fair in three and poor in zero,with excellence rate of 86％.Complications were as follows:one patient had delayed healing of proximal wrist crease incision;one patient had numbness of thenar eminence and the symptom was disappeared three months postoperatively;two patients remained pain on ulnar side of the wrist joint;two patients had limited function of the wrist joint.Conclusions Minimally invasive palmar locking plate is safe,mini-invasive and reliable when treating distal radial fractures,which is conducive to early functional exercise.Furthermore,the method achieves satisfactory appearance of the incision which meets the minimal invasion and thus deserves clinical practice.

Objective To evaluate the association of angiotensin (AGT ) gene M235T polymorphism with essential hypertension (EH) .Methods The literatures examining the association of the M 235T polymorphisms with EH were selected in electronic data-bases .Using RevMan5 .0 ,heterogeneity and pooled effect sizes were calculated .Results Totally ,29 articles ,with 5 971 cases and 6 443 controls were finally included in this study .The odds ratio (OR) value of TT+ TM∶MM genotype was 1 .13 (95% CI 1 .00-1 .25 ,P=0 .04) in worldwide populations .Subgroup analysis showed that the OR values of TT ∶MM genotype were 1 .13 (95% CI 0 .90-1 .42 ,P=0 .28) in subjects published before 2008 and 1 .29(95% CI 0 .94-1 .75 ,P=0 .11) in those after 2008(year of 2008 included) .The OR values of T ∶M in Han population was 1 .24 (95% CI 1 .01-1 .53 ,P=0 .04) .Conclusion TT+ TM genotype of the M235T polymorphisms is associated with EH in worldwide populations ,and T allele is also correlated with EH in Han popu-lation .

AIM:To investigate the ameliorative effect of ischemic postconditioning (I-postC) on pia mater microcirculation in rats subjected to cerebral ischemia reperfusion (I/R) and its mechanisms. METHODS:Thirty-two male Wistar rats were randomly divided into sham,I/R,I-postC,and ischemic preconditioning (IPC) groups. The global cerebral I/R injury was induced by shunting carotid artery in rats. Pia mater microcirculation and cerebral microcirculatory perfusion were measured after reperfusion. The content of soluble intercellular adhesion molecule-1 (sICAM-1) in plasma was detected using enzyme linked-immunosorbent assay (ELISA). Myeloperoxidase (MPO),malondialdehyde (MDA),and superoxide dismutase (SOD) in cerebral tissue were detected. The expressions of vascular endothelial cell cadherin (VE-cadherin) and NF-?B p65 in cerebral tissue were assayed by Western blotting. RESULTS:(1) The disturbance of the blood flow in microvessel induced by I/R was improved significantly by I-postC. In addition,I-postC alleviated significantly the decrease in diameters of microvesseles,cerebral microcirculatory perfusion and cerebral VE-cadherin content induced by I/R (P

Objective To investigate the effect on the miemvnscular density(MVD)and the expression of vascular endothelial growth factor(VEGF)in VX2 tumor after transcatheter arterial chemoembolization(TACE)combined with endostatin.Methods The VX2 tumor model wag established.The rabbits bearing tunlor were randomly divided into three groups as the control group.TACE group and TACE combined with endostatin group.with 10 rabbits in each group.In the control group,normal saline was administered via the hepatic artery.In the TACE group,lipiodol(0.2 ml/kg)and ADM(2.g/kg)were administered.Lipiodol(0.2 ml/kg),ADM(2 mg/kg)and endostatin(2 mg/kg)were administered for each rabbit in the TACE combined with endostatin group.Seven days after operation,the rabbits were sacrificed and the tumors were removed.Immunohistochemistry wag performed to demonstrate the expression of VEGF and the MVD wag caleulated.The ANOVA wag used for statistics.Results The average absorbance values of VEGF were 0.130±0.038.0.200±0.049 and 0.120±0.047 respectively for the 3 groups.There was signiflcant difference among the three groups(F=9.42,P＜0.01).rnle expression of VEGF in the TACE group was the hiShest among the 3 groups.Compared with the otIler two groups,there had signifieant differences(q=4.93,5.63,P＜0.01).The average absorbance value of the TACE combined with endostatin group was lower than that of control group,but there was no significant difference between them(q=0.70,P＞0.05).The values of MVD were(80±17),(84±16)and(57±13)/HPF for the 3 groups respectivelv.There wag significant difference among them(F=8.70,P＜0.01).111e value of MVD in the TACE combined with endestatin group was the lowest, and there were significant differences when compared with the control group (q=4.63, P＜0.01) and the TACE group (q =5.48, P＜0.01).There was no significant difference between the control group and the TACE group (q = 0.85, P ＞ 0.05) in MVD.Conclusion Compared with chemoembolization only, ehemoembolization combined with endostatin can significantly depress the expression of VEGF and decrease the angiogenesis of the tumor.The combined method has a beneficial effect on prognosis of hepatic tumor.

Objective To review the clinical experiences of modified Nuss procedure and technique for complicated pectus excavatum. Methods From September 2006 to October 2009,45 children (27 boys and18 girls), aged 3 - 16 years [mean (6.4 ± 3.5 )years] with complicated pectus excavatum underwent modified Nuss procedure. VATS was used in 6 cases. 3 patients associated with lung cyst were treated by open surgery and 1 case with ASD was treated by Hybrid procedure.Results The surgery was successfully performed in all patients. The mean operative time was 54 minutes and the average hospital stay was 7 days. Postoperative evaluation was"excellent"in 30 cases , "good"in 13, and"moderate"in 2. Conclusion Modified Nuss procedure is a safe and effective method for correction of complicated pectus excavatum.

Objective:To analyze the early and middle term clinical effects of mitral valve repair in children with mitral insufficiency.Methods:From January 2012 to January 2019, a total of 202 cases of children with mitral insufficiency treated by mitral valve repair were selected from the department of cardiothoracic surgery of Nanjing Children's Hospital, patients with atrioventricular septal defect, single ventricle and ischemic mitral regurgitation were excluded. Echocardiography was used to compare the preoperative and postoperative left ventricular function and degree of regurgitation in children to evaluate the early and middle term efficacy of mitral valvuloplasty.Results:There were 5 cases of early death(5/202, 2.5%) and 3 cases of late death(3/202, 1.5%). The mean follow-up time was(19.49±17.48) months(1-68 months). Postoperative echocardiography showed that the left heart function and mitral regurgitation were significantly improved.Conclusion:Mitral valvuloplasty can significantly correct mitral insufficiency in children, and it has satisfactory mid-term efficacy and good clinical value.

Objective To evaluate the feasibility and safety of embedding the totally implantable venous access port (TIVAP) via the access of right brachiocephalic vein (BCV).Methods The clinical data of 493 patients,who underwent the placement of TIVAP by using right BCV route during the period from March 2013 to December 2015,were retrospectively analyzed.The patients included 137 males and 356 females,with a mean age of (47.3±13.2) years old (ranging from 29 to 78 years old).The puncture success rate and TIVAP indwelling procedure-related complications were analyzed.Results The technical success rate was 100％,the success rate of initial puncturing was 99％ (488/493).The mean operation time was (22.5± 8.3) minutes (range of 18-35 minutes).Mis-puncturing of artery happened in 3 patients (0.61％,3/493);and no severe complications such as hemothorax or pneumothorax occurred.After implantation,the patients carried TIVAP for 124-986 days,with a mean of (271.1±53.8) days.The incidence of complications was 2.25％ (11/488),including hemorrhage at port site (n=2),catheter-related infection (n=l),partial thrombosis (n=2),and formation of fibrous protein sheath (n=6).No serious complications such as displacement or rupture of catheter,or catheter pinch-off syndrome (POS),etc.were observed.Conclusion The implantation of TIVAP by using right BCV route has high puncturing success rate,the technique is safe and reliable,and it can provide another option of catheter access for the clinical performance of TIVAP implantation.