Objective To review the complications after endovascular aneurysm repair (EVAR) of high-risk abdominal aortic aneurysms in our medical center.Methods Fifty eight elective high-risk EVAR cases from January 2008 to December 2013 were analyzed retrospectively.Results The technical success rate was 96.6％ (56 of 58 patients).The overall complication rate in perioperative period was 32.8％ (19/58).Eleven systemic complications (19.0％),16 primary endoleaks (27.6％),7 access of site complications(12.1％) were observed.The follow-up rate was 86.2％ (51/58).During the follow up period,the mortality was 7.8％ (4/51),the re-intervention rate was 7.8％ (4/51).The overall complication rate was 29.4％ (15/51),including systemic complications (2/51),secondary endoleak (9.8％) and graft-related complications (11.8％,6/51).Conclusions Endoleak,graft-related complications continue to be the main causes of re-intervention in high-risk aneurysm patients after EVAR.

A competency dictionary of advanced health informatization application persons was compiled by inter-viewing 20 health information persons with behavior events interview , their competency characteristics were coded By Nvivo, the coding frequency and characteristics score in good performance group and ordinary group were ana-lyzed by variance analysis, which showed 8 characteristics of key competency and 12 characteristics of basic compe-tency in advanced health information application persons.

Objective To investigate the correlation between serum soluble epithelial cadherin (sE-cad) and postoperative recurrence and prognosis in patients with advanced gastric cancer.Methods The level of serum sE-cad in 85 patients with advanced gastric cancer (advanced gastric cancer group) was detected by ELISA technique preoperative and postoperative 1 month,and compared with 30 healthy controls(control group).The patients in advanced gastric cancer group were followed up for 3 years,the level of serum sE-cad in recurrent patients and non-recurrent patients was compared.Results The level of serum sE-cad in advanced gastric cancer group preoperative was significantly higher than that in control group [(24.3 ± 14.8) μ g/L vs.(9.4 ± 3.8) μ g/L,P ＜ 0.01].The level of serum sE-cad in advanced gastric cancer group was significantly decreased postoperative 1 month [(12.5 ± 6.4) μ g/L vs.(24.3 ± 14.8) μ g/L,P ＜0.01].The level of serum sE-cad in recurrent patients was significantly higher than that in non-recurrent patients and postoperative 1 month [(20.7 ±9.8)μg/L vs.(12.5 ±6.4),(14.8 ±6.2) μg/L,P＜0.01].Univariate analysis revealed that preoperative high serum sE-cad level was related with tumor size,differentiated degree,lymph node metastasis ratio,depth of tumor invasion (P ＜0.05),but had no relationship with histological type(P＞ 0.05).Elevated preoperative serum sE-cad level negatively affected the postoperative survival rate and recurrence rate.Multivariate Logistic regression anaiysis revealed that preoperative serum sE-cad level was an independent risk factor for postoperative 3 years survival rate in advanced gastric cancer (HR =2.068,P =0.013).Conclusions Preoperative elevated serum sE-cad level is related with pathologic features in patients with advanced gastric cancer,and may be an important prognostic factor.Postoperative monitoring the level of serum sE-cad is useful for evaluating the prognosis and recurrence.

Objective To compare the functional and radiographic outcomes of modified dual plating and less invasive stabilization system(LISS)in treatment of patients with complex tibial plateau fractures.Methods From November 2003 to November 2004,84 patients with complex tibial plateau fracture were treated with modified dual plating or LISS fixation.Their functional and radiographic outcomes were reviewed to compare the differences in bone union time,full weight-bearing time,knee joint's HSS(The Hospital for Special Surgery)scores,complications, tibia plateau angle(TPA)and posterior slope angle(PA).Results The 84 cases had complete follow-up records and a mean tollow-up of 16.2 months(range,12 to 23 months).Nine complications occurred in the modified dual plating group.The mean full weight-bearing time and radiographic bone union time were 16.8 and 15.1 weeks respectively for this group which had a mean HSS score of 87.4 points.Six complications were found in the LISS group.The mean full weight-bearing time and radiographic bone union time were 14.1 and 13.8 weeks respectively for this group which had a mean HSS score of 89.6 points.There were no significant differences between the two groups in changes of TPA and PA.Conclusion LISS can provide as good fixation as modified dual plating can for most complex tibial plateau fractures,but additional medial plate fixation may be necessary for some special cases.

Objective To investigate the effects of estrogen on the expression of KLK6 mRNA and protein in human ovarian cancer cell line HO8910.Methods HO8910 cells were incubated for 72 hours in two groups:the test group with 17-?E_2 at different concentration(10~(-10)、10~(-9)、10~(-8)、10~(-7)mol/L)and the control group with Ethanol.Real-time fluorensence quantitive RT-PCR and flow cytometry were used to measured the expression of KLK6 mRNA and protein in the two groups.The cell proliferation was measured by 3-(4,5-dimethylthiazol-z-yl)-2,5-dipheny tetrazolium blue(MTT)calorimetric assay,while the cell cycle was determined by flow cytometry.Results The expression ofKLK6 mRNA(3.83?0.41、4.14? 0.49、6.26?0.38、7.28?1.82)and protein(10.62?0.35,10.89?0.12、11.88?0.28、12.07?0.15) in the test group of H08910 cells(10~(-10)10~(-9)10~(-8)10~(-7)mol/L)was higher than that in the ethanol control group(P

Objective: To explore the effect of Slit2/ROBO1 protein (Slit2/ROBO1) signaling pathway in high glucose-induced epithelial-mesenchymal transdifferentiation (EMT) and its mechanism. Methods: Human renal tubular epithelial cells (HK-2) were cultured in vitro and subjected to high glucose concentration and time gradient experiments. First, for concentration gradient experiment, the sample was randomly divided into normal group, control group 1, control group 2, high glucose group 1, high glucose group 2. While for high glucose time gradient experiment, the sample was randomly divided into normal group, control group, high glucose 24 h group, high glucose 36 h group and high glucose 48 h group. Western blotting was used to detect the expression changes of Slit2, ROBO1, α-smooth muscle actin (α-SMA) and fibronectin in HK-2 cells, and then the optimal high glucose stimulation concentration and time were screened out. Slit2 over-expressed plasmid and negative control plasmid were transfected into HK-2 cells to verify the successful transfection, the cells were then randomly divided into normal group, control group, high glucose group, high glucose empty group and high glucose Slit2 group. The total protein was extracted after stimulation with optimal high glucose concentration and time, and Western blotting was then performed to detect the change in expression of fibronectin and α-SMA. Results: In the high glucose concentration gradient experiment, the expression of Slit2 declined significantly in high glucose group 1(0.647±0.048) and high glucose group 2(0.210±0.023) than in the normal group (1.000±0.050); the expression of ROBO1 declined significantly in high glucose group 1(0.703±0.041) and high glucose group 2(0.303±0.022) than in the normal group (1.000±0.057); while the expression of fibronectin increased significantly in high glucose group 1(1.953±0.042) and high glucose group 2(2.997±0.078) than in the normal group (0.990±0.059), and the expression of α-SMA increased significantly in high glucose group 1(1.767±0.012) and high glucose group 2(2.427±0.059) than in the normal group (1.033±0.067), all the differences were of statistical significance(P<0.05). Compared with the high glucose group 1, the expressions of Slit2 and ROBO1 decreased, and of fibronectin and α-SMA increased significantly in the high glucose group 2(P<0.05). In the high glucose time gradient experiment, compared with the normal group, the expressions of Slit2 in high glucose 36 h group and high glucose 48 h group decreased (0.943±0.032 vs. 0.557±0.020, 0.450±0.055, respectively), and the expression of ROBO1 decreased (1.000±0.058 vs. 0.600±0.023, 0.227±0.028, respectively). Compared with the normal group, the expression of fibronectin increased significantly in high glucose 24 h group, high glucose 36 h group and high glucose 48 h group (0.970±0.040 vs. 1.247±0.052, 1.733±0.084, 2.780±0.090, respectively), and the expression of α-SMA increased significantly in high glucose 24 h group, high glucose 36 h group and high glucose 48 h group (1.033±0.067 vs. 1.277±0.041, 1.767±0.120, 2.537±0.078, respectively), and the difference was statistically significant (P<0.05). Compared with high glucose 24 h group, the expression of Slit2 declined significantly in high glucose 36 h group and high glucose 48 h group(0.893±0.034 vs. 0.557±0.020, 0.450±0.055, respectively), and the expression of ROBO1 declined significantly (0.930±0.025 vs. 0.600±0.023, 0.227±0.028, respectively), the expressions of fibronectin and α-SMA increased significantly with statistical significance (P<0.05). Compared with high glucose 36 h group, the expression of Slit2 and ROBO1 declined significantly, and the expression of fibronectin and α-SMA increased significantly in high glucose 48 h group (P<0.05). In the high glucose environment, and achieving Slit2 overexpression and negative control plasmid transfection, the expression of fibronectin increased significantly in high glucose group, high glucose+empty group and high glucose+Slit2 group (2.760±0.012, 2.667±0.027, 1.460±0.034, respectively) than in normal group (1.000±0.058); the expression of α-SMA increased also in high glucose group, high glucose+empty group and high glucose+Slit2 group (2.487±0.048, 2.557±0.037, 1.270±0.017, respectively) than in normal group (1.000±0.050) with statistical significance (P<0.05). Compared with the high glucose+empty group, the expression of fibronectin and α-SMA declined significantly in the high glucose+Slit2 group(P<0.05). Conclusion: The decreased expression of Slit2 and ROBO1 is involved in the high glucose-induced renal tubular EMT. Overexpression of Slit2 may significantly inhibit the high glucose-induced EMT.

Objective To evaluate the influence of gestational diabetes mellitus (GDM) on maternal and perinatal outcomes in twin pregnancies. Methods We retrospectively analyzed the clinical features of both twin and singleton pregnancies, which delivered in Guangzhou Women and Children's Medical Center between January 1, 2012 and December 31, 2013. The twin pregnancies were divided into two groups:those with (GDM-T, n=51) and without GDM (non-GDM-T, n=130), which were matched by maternal age and delivery time (within one month) in a ratio of 1∶2 among singleton pregnancies with (GDM-S, n=102) and without GDM (non-GDM-S, n=102), respectively. The differences of adverse maternal and perinatal outcomes among these four groups were examined. The overall assessment of pregnancy outcomes was completed using Delphi method. Statistical analysis was performed with one-way analysis of variance, t test, Kruskal-Wallis test, rank test, Chi-square test or Fisher's exact test. Results (1) When compared to GDM-S and non-GDM-S group respectively, less women conceived with the help of assisted reproductive technology, higher proportion of women underwent and gestational age at delivery tend to be earlier in GDM-T and non-GDM-T group (all P<0.01). In oral glucose tolerance test,the fasting blood glucose level of GDM-T group was higher than the other three groups (F=21.716, P<0.01), the glucose levels at 1 and 2 h were higher than non-GDM-T and non-GDM-s respectively (both P<0.01), but no significant difference was found when compared with GDM-S group (P>0.01). Similarly, no significant difference was found in prenatal glycosylated hemoglobin value between GDM-T and GDM-S group (P>0.01). (2) There was no significant difference in the incidences of hypertensive disorders of pregnancy, anemia, premature rupture of membranes, oligohydramnios, placental abruption, postpartum hemorrhage, asphyxia neonatorum, small for gestational age, hypoglycemia of newborn, hyperbilirubinemia of newborn and perinatal death between GDM-T group and the other three groups(all P>0.01). Higher incidences of hypertensive disorders of pregnancy and postpartum hemorrhage were shown in the GDM-T group than in the GDM-S and non-GDM-S groups, respectively (both P<0.01). The incidences of preterm birth in GDM-T and non-GDM-T group were both higher than that in GDM-S and non-GDM-S, respectively [54.9%(66/102), 53.8%(140/260), 5.0%(10/102) and 3.0%(6/102), all P<0.01], while no significant difference was found between GDM-T and non-GDM-T group (P>0.01). (3) The overall assessment of pregnancy outcomes did not show any difference between GDM-T group and the other three groups (χ2=6.707, P>0.01). However, the score for fetal outcomes in the GDM-T group was higher than in the GDM-S and non-GDM-S group, but lower than in non-GDM-T group [M(Q)=1.0(2.3), 0.0(3.0), 0.0(0.0), 1.0(2.8) score, χ2=122.818, P<0.01]. Conclusions GDM does not increase the risk of adverse pregnant outcomes in twin pregnancies.

Objective To detect the impact of reactive oxygen species ( ROS) on mitochondrial morphology and distri-bution during mitosis.Methods A viral vector in which the fluorescence gene was specifically under the control of mito-chondrial promoter was constructed and confirmed through DNA sequencing and Western blotting.After transfecting HeLa s3 cell with packaged virus, the HeLa s3-COX4tp-EGFP cell line stably expressing the mitochondrial fluorescence signal was obtained.With immunofluorescent staining, the impact of ROS on the morphology and distribution of mitochondria dur-ing mitosis was inspected.Result The cell line constantly expressing mitochondrial fluorescence signals was successfully constructed.Meanwhile,it was found that H2 O2 treatment could significantly change the morphology and distribution of mi-tochondria during mitosis by confocal microscopy.Conclusion Our study demonstrates that ROS can affect the morphology and distribution of mitochondria during mitosis.This research help study the relationship between the mitochondrial function and the regulation of mitosis in the future.

Objective To evaluate the clinical significance of direct trocar insertion using optical trocar in the establishment of the primary port during trans-peritoneal laparoscopic surgical procedures.Methods A prospective study was conducted by collecting the data of 120 patients who should be performed abdominal laparoscopic surgery from April 2015 to December 2015.The 120 patients were randomly divided into a research group and a control group.The research group consisted of 34 male patients and 26 female patients,mean age was (52.0 ± 11.9) years and mean BMI was (24.9 ± 2.9) kg/m2.In research group,patients were positioned laterally with the flank padded and elevated.A predetermined position was drawn prior to surgery between the umbilicus and lateral rectus abdominis,for the creation of the primary laparoscopic trocar port.The predetermined point was incised,and then the method of direct trocar insertion using the optical access trocar was used for establishment of the primary port.After this maneuver was completed the surgery continued as indicated.The control group consisted of 36 male patients and 24 female patients,whose mean age was (52.9 ± 11.4) years and mean BMI was (25.2 ± 2.4) kg/m2.This group underwent the traditional method of port construction by incision into the abdomen.The time of constructing the passage,leakage rate,bleeding rate,and injury rate of abdominal organs were compared.Results In research group,the time of building primary port was clearly shorter than that in control group (2.7min vs.15.9min,P ＜ 0.05),the leakage rate was also obviously reduced compared to that in control group (0 vs.30％,P ＜ 0.05).Neither groups observed any significant bleeding nor visceral organ damage throughout the study.Conclusion Direct trocar insertion using optical trocar to establish observation port is a highly efficient and safe method in trans-peritoneal laparoscopic operation,which should be research thoroughly in clinical practice.

BACKGROUND:Segmental bone defects resulting from osteoporotic fractures, trauma, congenital bone dysplasia and progressive bone disorder are very common, and bone tissue engineering provides a new approach to bone defect repair. Growth factors related to bone tissue engineering bone have been reported a lot and have achieved some results. How to mimick the natural timing of different growth factors with different bioactivities has become the current hotspot in bone repair. OBJECTIVE: To review the new developments in vascular endothelial growth factor and bone morphogenetic protein in bone tissue engineering. METHODS: The first author searched CNKI (1990/2015) and Medline database (1990/2015) for related articles using the key words of “osteogenic factors, angiogenic factors, tissue engineering bone, bone repair, vascularization, vascular endothelial growth factor, bone morphogenetic protein, sequential release, seed cels, cytoskeleton” in Chinese and English, respectively. Mechanism of action and research direction about vascular endothelial growth factor and bone morphogenetic protein were summarized. RESULTS AND CONCLUSION:Totaly 313 papers were searched initialy, and finaly 87 papers were enroled in result analysis. The results show that different growth factors play different roles in bone repair. Vascularization and osteogenesis are the most important processes in bone repair. The osteogenic factors play an important role in maintaining bone structure and bone formation. The angiogenic factors can provide oxygen and nutrients for tissue growth, differentiation and functionalization. The combination of osteogenic and angiogenic factors has a better osteogenic effect than osteogenic or angiogenic factors used alone. However, the most important problem is how to control the exogenous osteogenesis and the release dosage of angiogenic factors in bone repair.