Tumor microvessel including two modes,as one is classic vascular structures surrounded with vascular endothelial cells and the other is vasculogenic mimicry( VM) surrounded with cancer cells.Recent studies suggested that anti-angiogenic drugs can inhibit classic microvessel structure significantly, but can not inhibit VM formation and even promote VM formation further more.This is one of the reasons affecting its clinical effica-cy.However,basic research has shown that traditional chinese medicine,gene therapy and drugs which is targeting for VM formation have an unique advantage in anti-VM.In this review, we summarize the progress of cancer therapy on targeting vasculogenic mimicry,and provide a basic for the development of new drugs for cancer thera-py through targeting both angiogenesis and VM formation.

Objective To investigate the stimulating effects of activin A(ACT-A) and follistatin(FS) on the secretion of type I collagen(Col I) and the expression of Col I mRNA of cultured rat renal interstitial fibroblasts in vitro.Methods Rat renal interstitial fibroblasts isolated from normal SD rat renal medulla were cultured in vitro.The cells were divided into three groups:different concentrations of ACT-A(group A),different concentrations of FS(group F),and different concentrations of FS plus 30ng/ml ACT-A(group A+F).The expression of Col I mRNA in cultured rat renal interstitial fibroblasts was detected by RT-PCR,and the expression of Col I protein in cultured rat renal interstitial fibroblasts was examined by immunocytochemistry.Results Renal interstitial fibroblasts were successfully cultured in vitro.In present study,the expression of Col I mRNA increased significantly in cultured rat renal interstitial fibroblasts after stimulated by ACT-A in dose-dependent manner(P0.05).FS could inhibit the effects of ACT-A(30ng/ml) on Col I mRNA and Col I protein of the cultured renal interstitial fibroblasts in dose-dependent manner in A+F group(P

Objective To investigate the effect of PTEN protein on the proliferation of rat renal fibroblasts resulted from the stimulation of TGF-?_1. Methods In vitro, the cultured rat renal fibroblasts were transfected with the adenovirus containing PTEN. Invert fluorescent microscope was used to detect the GFP expression, meanwhile PTEN mRNA was determined by RT-PCR method. 48h after the transfection, TGF-?_1 was added into the culture medium in a concentration of 10ng/ml. After another 24h, the proliferation rate of rat renal fibroblasts was determined by means of MTT method. Immunocytochemistry was also used to detect the expression of PCNA. Results As GFP positive fibroblasts were detected,the expression of PTEN mRNA was significantly increased in the rat renal fibroblasts which were transfected with the adenovirus containing PTEN. Accompanied with the expression of PTEN, the proliferation of cultured rat renal fibroblasts resulted from the stimulation of TGF-?_1 was obviously inhibited, and the expression of PCNA was significantly decreased. Conclusion PTEN could suppress the proliferation of rat renal fibroblasts caused by stimulation of TGF-?_1, and it might be useful to inhibit renal fibrosis and delay the rate of renal impairment.

Objective This study aims to analyze the independent risk factors associated with postoperative delirium of patients undergoing Stanford A aortic dissection surgery.Methods Clinical data of the patients who underwent Stanford A aortic dissection surgery from December 2014 to October 2015 were collected.All patients received surgery under deep hypothermic circulatory arrest(DHCA) and the nasal temperature goal was below 23℃.After surgery,patients were transferred to the cardiovascular ICU,where they received standard postoperative care.The delirium was diagnosed according to the criteria of the confusion assessment method for the intensive care unit(CAM-ICU).The possible risk factors of pre-operation,during operation or post-operation were analyzed via univariate analysis and multivariate logistic regression to determine the independent risk factorsof postoperative delirium.Results 148 patients underwent Stanford A aortic dissection surgery which the incidence of postoperative delirium was 31.1％ (46/148).Univariate analysis showed the associated risk factors were age,hypertension,cognitive impairment,emergency operation,operation time,aorta clamping time,DHCA time,fluctuation of blood pressure during operation,blood transfusion,quality of sleep,length of ICU stay and electrolyte disturbance(P ＜ 0.05).Multivariate logistic regression analysis revealed that hypertension,cognitive impairment,fluctuation of mean arterial blood pressure(MAP) ＞ 30 mmHg (1 mmHg =0.133 kPa),DHCA time ＞ 40 min,postoperative poor quality of sleep and electrolyte disturbance were independently associated with postoperative delirium after Stanford A aortic dissection surgery(P ＜ 0.05).Conclusion Delirium is a frequent complication.Factors independently associated with delirium are hypertension,cognitive impairment,DHCA time,postoperative poor quality of sleep and electrolyte disturbance.Prevent,assess and manage delirium should be paid more attention and reinforced.

AIM: To observe the early changes of local cerebral blood supply in dogs during the acute vertebral artery stenosis by 99 TcmECD cerebral blood flow perfusion imaging(CBFPI).METHODS: Twenty-four dogs were randomized into groups of normal controls(A),moderate stenosis(B),severe stenosis(C) and arterial occlusion(D),with 6 in each group.Group A were free from any intervention,but Group B,C and D were undergone ligation of the right vertebral arteries by the extent of 50%～69%(Group B),70%～99%(Group C) or 100%(Group D).The imaging agents were injected intravenously 0.5-1 h after ligation and the single photon emission computed tomography(SPECT) was performed after 1 h.RESULTS: CBFPI examination of the early changes of cerebral blood supply during the acute vertebral artery stenosis by visualization showed that the sensitivity was 33.3%,83.3% and 100% in Group B,C and D,respectively,with an average sensitivity of 72.2%,while semi-quantitative assessment suggested that the sensitivity was 50%,100% and 100% in the three groups,respectively,with an average sensitivity of 83.3%.When examining the activity ratio for regions of interest(ROI) by semi-quantitative 99 Tcm-ECD CBFPI,the findings suggested that Group D and C decreased significantly(exception in cerebellum in Group C),but Group B had no evident changes,as compared with Group A.By comparison of the groups of B-C,B-D and C-D,differences were observed in the right temporal lobes,whereas the changes in left temporal lobes were seen in Group B-C or B-D.The changes were seen in occipital lobes when groups of B and D were compared,but with no differences in cerebellum.CONCLUSION: The degree of stenosis in vertebral arteries may involve varied regions,the temporal lobe is susceptive,followed by occipital lobe,while cerebellum is somewhat resistant from the involvement.

Objective To investigate the roles of activin A(ACT-A) and follistatin(FS) in renal interstitial fibrosis.Methods Renal interstitial fibroblasts were isolated from SD rat kidney and primarily cultured.The cells were divided into A group,F group and A+F group,and then each group was further divided into 5 subgroups according to their culture media being added with ACT-A(0,0.3,3,30,or 100 ng/ml),FS(0,0.3,3,30,or 100 ng/ml),and ACT-A(30 ng/ml) plus FS(0,0.3,3,30,or 100 ng/ml) respectively.Levels of type Ⅳ collagen(Ⅳ-C) and hydroxyproline(HYP) in the supernatants of cultured fibroblasts were measured by ELISA assay.Results Concentrations of Ⅳ-C and HYP in cultured rat renal interstitial fibroblasts were in a dose-dependent manner with ACT-A treatment.FS had no effect on these concentrations,but it inhibited the effects of ACT-A on Ⅳ-C and HYP in the supernatants of cultured fibroblasts in a dose-dependent manner.Conclusion ACT-A might be involved in occurrence and development of renal fibrosis by affecting renal interstitial fibroblasts.Exogenous FS could suppress the effects of ACT-A on the cultured renal fibroblasts.

Objective:To observe the effects of acupuncture-moxibustion on symptoms,signs,and Th1/Th2 cytokine,and regulation on Th1/Th2 in patients with perennial allergic rhinitis(PAR) to provide experimental basis for acupuncture treating allergic rhinitis and investigate the mechanism.Methods:Thirty patients with allergic rhinitis were treated with acupuncture-moxibustion,and 30 healthy cases were the control.Clinical symptoms,signs,and nasal mucosa were observed,and contents of IL-4,IFN-γ,and granulocyte-macrophage colony stimulating factor (GM-CSF) in the supernatant of peripheral blood monocyte cultured with PHA by ELISA,before treatment,after one course of treatment,and after two courses of treatment.Results:Before the treatment,the contents of IL-4,and GM-CSF were higher (P＜0.01) and IFN-γ was lower (P＜0.01) in the PAR cases than in the control cases.In the PAR cases,the content of GM-CSF was positive correlation with that of IL-4 (P＜0.01),and negative correlation with IFN-γ (P＜0.01).After the treatment,contents of IL-4 and GM-CSF were lowed (P＜0.01),content of IFN-γ was increased (P＜0.05),and all IL-4,GM-CSF and IFN-γ had no difference compared with those in the control cases.Conclusion:Acupuncture moxibustion could improve the symptoms and signs in PAR patients,enhance the immune function.It may be achieved by regulating the expression of Th1 and Th2,correcting the imbalance of Th1/Th2.

Objective To explore the risk factors and optional treatment strategies for postoperative hypoxemia in patients undergoing acute Stanford A aortic dissection surgery.Methods From December 2012 to April 2014,108 patients received acute Stanford A aortic dissection surgery in Henan Provincial People' s Hospital.Of them,74 men vs.34 women,age (43.2 ± 10.1) years old,and weight (71.3 ± 18.4) kg.The operation was performed within 14 days since disease onset.All patients received surgery under deep hypothermic circulatory arrest(DHCA) and the nasal temperature goal was below 20 ℃ .Postoperative hypoxemia was defined as the arterial partial oxygen over inspired oxygen fraction(PaO2/FiO2) more than 200 after admission to ICU.Pulmonary protective ventilation management took place immediately after hypoxemia was diagnosed.Comparison analysis was performed between hypoxemia group and non-hypoxemia group in age,gender,body mass index (BMI),smoking history,duration of cardiopulmonary bypass(CPB),duration of DHCA,blood transfusion,length of mechanical ventilation,length of ICU stay and mortality.Results The incidence of postoperative hypoxemia was 40.7％ (44/108).There were no statistical differences in age,gender,hypertension,diabetes mellitus or COPD history.In the hypoxemia group,11 cases developed pulmonary infection,3 cases underwent tracheotomy and 10 cases died.In the non-hypoxemia group,4 patients died.Postoperative hypoxemia was significantly associated with more mortality,length of ventilation time,length of ICU stay and in hospital(P ＞ 0.05).Univariate analysis showed the associated factors were BMI,smoking history,preoperative hypoxemia,LVEF ＜ 0.45,operation time,aorta clamping time,DHCA time and blood transfusion.Multivariate analysis showed the independent predictive factors were preoperative hypoxemia,DHCA ＞40 min,blood transfusion ＞ 10 U and BMI ＞25 kg/ m2.Conclusion Obesity,massive blood transfusion,long DHCA time and preoperative hypoxemia are independent risk factors of postoperative hypoxemia in patients undergoing acute Stanford A aortic dissection surgery.Perioperative pulmonary protection should be paid more attention and reinforced.

Objective To analyze the incidence rate and the perioperative risk factors associated with delirium after cardiac surgery.Methods We enrolled 622 patients between October 2014 and March 2015 in the department of cardiovascular surgery in Henan Provincial People's Hospital who were allocated to group PD and non-PD according to the Confusion Assessment Method(CAM) after the cardiac operation.Baseline demographics,perioperative data,and postoperative outcomes of these patients were recorded and analyzed via chi-square test and multivariate logistic regression analysis to determine the risk factors of postoperative delirium.Results Postoperative delirium was detected in 102 patients according to CAM criteria.The incidence was 16.4％.Multivariate logistic regression analysis revealed that age (OR =3.456;95％ CI:2.431-4.569),preoperative atrial fibrillation (OR =1.987;95％ CI:3.562-7.862),prolonged surgery duration (OR =1.246;95％ CI:3.164-5.982),postoperative pain (OR =5.356;95 ％ CI:1.386-9.374)were independently associated with postoperative delirium after cardiac surgery.Conclusions Delirium is a frequent complication,age,preoperative atrial fibrillation,prolonged surgery duration,postoperative pain are independent risk factors for delirium following cardiac surgery.Management according to potential risk factors may be associated with preferable therapeutic outcomes.

Objective To investigate the effect of soluble endothclial protein C receptor(sEPCR) on natural killer(NK) cells and Th17 cells of epithelial ovarian cancer(EOC) patients and further to study the mechanism of the occurrence and development of epithelial ovarian cancer.Methods 35 cases with epithelial ovarian cancer were selected as the experimental group,and 35 healthy women were chosen as the control group.Peripheral venous blood sample(8 ml)was extracted from each subject.Plasma,serum and peripheral blood mononuclear cells(PBMCs) were obtained from the blood sample.ELISA was used to detect the level of plasma sEPCR and serum IL-17 and IL-21.Flow cytometry was used to detect proportions of NK cells and Th17 cells in PBMCs.Results Compared to the control group,the level of plasma sEPCR in the experimental group increased significantly(P ＜ 0.05).The level of serum IL-17,IL-21 and proportion of NK and Th17 cells in PBMCs significantly decreased(P ＜ 0.05).Correlation analysis showed that sEPCR was negatively correlated with IL-17,IL-21,Th17 cells and NK cells,and the correlation coefficient r was-0.71,-0.62,-0.68 and-0.79,respectively.Conclusion sEPCR in epithelial ovarian cancer patients possibly promotes the proliferation of tumor cells through inhibition of NK and Th17 cells.