Extracranial-intracranial arterial bypass, an elegant procedure, was first performed and developed gradually by M. Gazi Yasargil. It has been used in the management of ischemic cerebrovascular disease, moyamoya disease, intracranial aneurysms and brain tumors.This article focuses on its application in the ischemic cerebrovascular disease, and reviews it from the aspects of cerebral hemodynamics of ischemic cerebrovascular disease, indications for arterial bypass, preoperative evaluation, operating modes, intraoperative assessment,complications, postoperative care and prognosis.

Objective To investigate the effect of antisense VEGF on radiation sensitivity of esophageal cancer cells in vivo.Methods Sixteen male BLBA/C/nu nude mice were randomly divided into 4 groups and prepared cells were injected subcutaneously on paw pat of mice(2?106/100 ?L/mice): The size of the subcutaneous tumors was measured before and after irradiation and transfection.The effect of treatment was evaluated by speed of tumor growth. The expression level of VEGF was examined in different groups by RT-PCR,western blotting respectively.Results The absolute growth delay (AGD)for antisene group, irradiation group and antisene plus irradiation group was 3.0?2.6, 10.1?5.4 and 27.4?3.1 days,and nominal growth delay (NGD) was 24.4?3.1 days. The enhancement factor of antisense VEGF for radiotherapy was 2.41. A decreased expression level of endogenous VEGF mRNA and protein were found in antisene group by RT-PCR and western blotting analysis.Conclusion Antisense VEGF and radiotherapy may enhance radiotherapic effect for esophageal cancer xenografts.

Objective To study curative efficacy of radix notoginseng saponin dispersible tablets combined with rivaroxaban in treatment of tibial fracture after operation and its effects on joint function and the leves of inflammatory factors .Methods 90 patients of tibial fracture who received therapy from March 2014 to March 2016 in our hospital were selected.According to random number table,all elective surgery,those patients were divided into the observation group (n=45) and the control group (n=45),the control group was treated with radix notoginseng saponin dispersible tablets,while the observation group was treated combined with rivaroxaban.After two weeks of treatment, the hemorheology, inflammatory factors, joint function were compared between two groups.Results The patient swelling time and bed time in the observation group were shorter than the control group (P<0.05);after treatment,the levels of red cell volume, whole blood viscosity,fibrinogen in the observation group were lower than the control group (P<0.05);the levels of tumor necrosis factor TNF-α, IL-1,IL-6 in the observation group were lower than the control group (P<0.05);after treatment three months and six months,the Baird-Jackson scores in the observation group were higher than the control group (P <0.05).Conclusion Radix notoginseng saponin dispersible tablets combined with rivaroxaban is well for tibial fracture after operation,which can improve hemorheology,reduce the level of inflammatory factors,promote joint functional recovery.

Patients with moyamoya disease often have cognitive impairment.The specific mechanisms are unclear.Surgical intervention relieving low perfusion state of cerebral blood flow may be the only effective way in the treatment of moyamoya disease,maintain or improve cognitive function at present; however the related surgical indications,timing of surgery,postoperative hyperperfusion syndrome,as well as long-term efficacy and other issues must be resolved.

Background and purpose: DNA methylation is an important mechanism for regulating gene expression, and plays an important role in the tumorigenesis. Study shows that DNA methylation is a potentially promising biomarker in tumor diagnosis, prognosis as well as treatment selection. This study aimed to analyze the methylation status and assessed possible clinical value of 3 DNA repair genes BRCA1, GSTP1 and MGMT in breast cancer samples of Chinese women. Methods:Using methylation speciifc PCR (MSP), we analyzed the methylation status of 3 DNA repair genes BRCA1, GSTP1 and MGMT in 106 paired breast tumors and corresponding normal tissues. Results: The methylation rates of BRCA1, GSTP1 and MGMT were 24.5% (26/106), 29.2% (31/106) and 18.9%(20/106) in breast cancer tissues, which were higher than those (7.5%, 11.3%and 4.7%) in paired normal breast tissues, respectively (P<0.01). Methylation in at least one of the genes was found in 50.9%(54/106) of the breast cancer and 19.8%(21/106) in paired normal breast tissues. And the mean number of genes hypermethylated in each tumor and paired normal breast tissues were 0.73 and 0.24, respectively (P<0.000 1). The methylation status of BRCA1 was more frequent in the younger patients than in the older patients (P=0.007) and most BRCA1 methylated patients were ER negative (P=0.020). Methylation status of GSTP1 was signiifcantly correlated with tumor size, lymph node metastasis (P=0.028 and 0.033, respectively). MGMT methylation was significantly correlated with tumor stage, higher tumor grade and lymph node metastasis (P=0.016, 0.025 and 0.030, respectively). High frequency simultaneous methylation of these 3 genes was more often in those with higher tumor stage and lymph node metastasis (P=0.028 and 0.007, respectively). Conclusion:Hypermethylation of BRCA1, GSTP1 and MGMT genes may be linked to various known clinicopathological features of breast cancer in Chinese women, and the increasing multiple gene methylation in tumors may indicate an aggressive phenotype for breast cancer. Detection of the methylation status of these genes may be useful for identifying patients at high risk for breast cancer.

The development of the imaging technology enables diagnostic methods of detect intracranial aneurysms diversified. In recent years, the diagnosis of aneurysms was confirmed by digital subtraction angiography (DSA) which was regarded as the "gold standards". However, CT angiography (CTA), which appears as a fast, non-invasive, and easily achievable examination, is becoming as a new option in clinic. With the development of the CT facility and upgrade of the workstation software, CTA is more widely used in both diagnosing and treating intracranial aneurysm. This article reviews the sensitivity and specificity of CTA in the detection of intracranial aneurysms, and systematically analyzes its advantages and disadvantages as well as its development, imaging methods.

Objective To investigate the relationship between inflammatory factors, coronary artery dilation, and their clinical significance. Methods The cases undergone coronary angiography in our hospital last year were collected and divided into three groups: the first one included 11 patients whose angiography showed coronary artery dilation, the second group included 35 cases of atherosclerosis, and the third includes 24 cases with normal angiography. sES, MMP9 and TIMP1 were measured by ELISA method. Results Patients with coronary artery dilation were found to have significantly higher sES and MMP-9 level in comparison with atherosclerosis group and normal group[(153.7?152.7)ng/L,(90.1?54.2)ng/L,(76.5?37.2)ng/L, respectively](P

0.05).Conclusions Our results suggest that ascites contributes to the exaggerated fibrinolysis in cirrhosis, whereas cirrhosis self, in the absence of ascites, leads to a slightly fibrinolynic state. The t-PA/PAI imbalance was not a main cause of hyperfibrinolysis in patients with cirrhosis.

Objective To analyze the clinical and laboratory results and epidemiological characteristics of brucellosis.Methods The clinical and laboratory characteristics brucellosis cases (confirmed by Brucellosis Guidelines 2012) at the Department of Infectious Disease of the First Hospital of Jilin University between 2000 and 2016,were retrospectively evaluated.The patients were divided into two groups according to acute and chronic stages.According to the range of lesions,the lesions were divided into two groups,and comparative analysis of data between groups was done.Results The ages of the 607 patients (489 males,118 females) were ranged from 2 to 80 years.Among the 607 patients,570 (93.9％) were diagnosed with acute brucellosis,37 (6.1％) with chronic brucellosis.Focal involvement was found in 418 (68.9％) patients.Among them,382 patients were in acute stage,and the other in chronic phase (36).Acute patients' alanine aminotransferase (ALT) and aspartate transaminase (AST) were higher than those of chronic brucellosis (U/L:47.2 vs 26.7,44.5 vs 24.0,Z =-3.684,-3.754,all P ＜ 0.05).Although the white blood cell count,platelet values,C-reactive protein,and blood sedimentation were higher in patients with focal involvement (x 103/mm3:7.3 vs 5.4,211 vs 176;mg/L:56.0 vs 30.5;mm/h:37 vs 28,Z =-4.407,-2.709,-2.334,-2.137,all P ＜ 0.05),patients without focal involvement had higher ALT and AST (U/L:33.3 vs 53.9,30.2 vs 48.1,Z =-4.102,-3.730,all P ＜ 0.05).Peripheral arthritis was the most common type of osteoarticular involvement in 317 patients with focal involvement,and peripheral arthritis was found to be the most frequently identified in the knee joint,112 patients (35.3％).Totally 80 patients were followed up,the relapse rate was 20.0％ (16/80),2 patients treatment failure,only 1 patient died after 1 month of treatment who was diagnosed neuropathic brucellosis.Conclusions Focal involvement should be investigated in the presence of leucocytosis,and pain of a certain part.

Objective To study whether placenta previa and type affect the body mass of newborns and increase the occurrence rate of small for gestational age (SGA).Methods The clinical data in 290 inpatients with placenta previa in our hospital from January 2013 to December 2016 were retrospectively analyzed;contemporaneous 290 inpatients with non-placenta previa were randomly selected as the control group.The influences of placenta previa and type on fetal gestational weeks,neonatal body mass and SGA were comparatively analyzed by using the standard t test or Chi-square tests.The Logistic regression analysis was adopted to analyze the association between placenta previa and the adverse pregnancy outcomes.Results Compared with non-placenta previa group,the age in the patients with placenta previa was elder(30.9 ±4.6 vs.29.1 ± 4.0,P＜0.01),had more gravidas (3.2 ± 1.8 vs.2.2±1.4,P＜0.01) and parities (1.4+0.7 vs.1.1±0.6,P＜0.01),lower pregnant weeks at birth (37.7±1.7 vs.39.0± 1.5,P＜0.01).The neonatal body masses in the complete placenta previa and dangerous placenta previa were (3 038.1 ± 450.0)g and (2 940.9 ± 503.0)g respectively,which were on the significantly lower side compared with the non-placenta previa group(P＜ 0.05).After correcting the risk factors of ages,gravidas,parities,GDM and gestation weeks,the risk of complete and dangerous placenta previa was slightly higher[OR 1.21,95％CI(0.29,6.02);OR 2.25,95％CI(0.88,5.77)],but the difference was not statistically significant.Conclusion Complete and dangerous placenta previa has a higher risk of SGA.