Lymph node metastasis of malignant tumor is a complex pathological process closely related to tumor lymphangiogenesis. With tumor growth, some growth factors of lymphatic vessels are secreted and new lymphatic vessels are formed around or inside the tumor. Then, the tumor cells invade the lymphatic vessels, follow the lymph flow into every lymph node station, and gradually form the lymph node metastasis. Normal cells are in a relatively stable internal environment. Cell proliferation, differentiation, and apoptosis, as well as secretion and expression of related factors, occur in accordance with the normal process. However, the balance is broken with tumor growth and progression. A gradual formation of a suitable external environment for the tumor growth, namely, the tumor microenvironment, occurs. And the pathological and physiological characteristics of tumor microenvironment, which contains numerous lymphangiogenic growth factors and inflammatory conditions, hypoxia, acidic microenvironment, and high interstitial fluid pressure, promote tumor lymphangiogenesis and formation of tumor lymph node metastasis.

Objective To analyze the anticoagulation in patients with atrial fibrillation.Methods A retrospective analysis of anticoagulant therapy situation in 926 patients with atrial fibrillation was conducted,in order to sum up experience and improve the understanding of atrial fibrillation.Results In 926 patients with atrial fibrillation,there were no anticoagulant therapy in 675 patients,accounting for 72.89%,while only 251 cases received the treatment of anticoagulation,accounting for 27.11%.Only 66 patients aged>75 years were treated with anticoagulant therapy,accounting for 33.17%.The patients with coronary heart disease,in 17.60% and with anticoagulation treatment,the patients with diabetes in 28.37% and received anticoagulation therapy,28.32% patients with anticoagulation therapy in patients with hypertension,30.77% patients with cardiac insufficiency with anticoagulant therapy.Choice of treatment of aged>75,hypertension,coronary heart disease,clinical treatment strategies and patients were the main factors that affected the use of warfarin,but only>75 years of age,coronary heart disease,choice of treatment factors with statistical significance of three factors(OR=7.02,12.73,4.79,all P<0.05).675 cases without anticoagulant therapy in 101 patients with non warfarin treatment indications without the use of warfarin anticoagulation treatment,accounted for 14.96%.In addition,there were 574 AF patients with warfarin treatment indications and treatment with warfarin,analysis of its causes:63 cases had anticoagulant contraindications,172 cases for the doctor too much about bleeding complications,440 patients were not in accordance with the requirements of the detection of INR.Conclusion The positive effect of warfarin in prevention of ischemic stroke,but in basic hospital application of warfarin anticoagulation in patients with severe AF deficiency,should raise the awareness of risk of grassroots medical staff and patients of atrial fibrillation complicating embolism,do a good job of educating patients,to reduce the incidence of embolic events in patients with atrial fibrillation.