Objective:To study the expression of vascular endothelial growth factor(VEGF) and its receptor Flt1 in the process of mandibular fracture healing.Methods:The fracture models were made in the middle of the left mandible of 25 rabbits,then the specimens from the fracture site were taken 48 hours and 1,3,5 and 8 weeks after operation respectively. The expression of VEGF and Flt1 was detected by immunohistochemistry and in situ hybridization.Results:VEGF mRNA, VEGF and Flt1 were detected in many kinds of cells in the fracture site from 48 hours to 8 weeks after fracture, and high expression of VEGF and Flt1 were detected from 1 to 3 weeks after facture.Conclusions:VEGF and Flt1 are expressed through the process of fracture healing, VEGF may play important role in the process of blood vessel rebuilding after fracture.

Objective To evaluate the outcome of a new modality of operation—tensionfree vaginal tape (TVT) in treatment of female stress urinary incontinence. Methods Thirteen female patients suffering from stress urinary incontinence were treating with TVT operation.All the patients were confirmed to have stable bladder without outlet obstruction via clinical routine and urodynamic examination before operation.TVT tape of Prolene was implanted around mid-urethra via a minimal vaginal incision. Results The mean operation time was (38?7)min and the mean intraoperative bleeding was (45?10)ml.The mean catheterization time was 2 days and mean hospital stay was 4 days.No major bleeding was observed in operation.All patients were cured and the clinical symptoms disappeared after operation except for one patient with post-operative urine retention.This patient was catheterized for 2 weeks and the tape was cut under local anesthesia;then the urine retention disappeared and no incontinence relapsed. Conclusions TVT is a simple,reliable mini-invasive procedure with low incidence of complications.It can be used routinely for treating female stress urinary incontinence.

Objective To investigate urine levels of neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule 1(KIM-1), and its relevant influencing factors in young patients with hyperuricemia.Methods Sixty young subjects with hyperuricemia were randomly selected from physical check-up examination population (the hyperuricemic group), and 60 young subjects with normouricemia were randomly selected at the same time from physical check populationexamination (the control group).Urine NGAL and KIM-1, and other biochemical indicators were evaluated.Clinical data, iab tests, testing items and biochemical indicators between the two groups were analyzed by using t test or analysis of variance test.Regression analysis between the above indicators and urinary NGAL/creatinine (cr) and urine KIM-1/cr ratios were carried by using single regression analysis.Analyzed relevant Relevant influencing factors of urinary NGAL/cr and urine KIM-1/cr ratios were analyzed by using multiple linear regression.Results Urine NGAL/cr and urine KIM-1/cr ratios in the hyperuricemic group were higher than the control group (t=22.152 5, t=24.725 5, P＜0.01).Single regression analysis showed that serum uric acid level and urine NGAL/cr ratio, KIM-1/cr ratio was positively correlations correlated (r=0.63, P＜0.01;r=0.41, P＜0.01).Multiple linear regression analysises showed that serum uric acid,systolic blood pressure, HbA1c, serum creatinin and cholesterol level were the independent factors of urine NGAI/cr ratio.Age, blood uric acid level, systolic blood pressure, HbA1c and serum creatinin levels were independent factors of KIM-1/cr ratio.Conclusion There are high levels in of urine NGAL/cr and KIM-1/cr ratios in population with hyperuricemia.Hyperuricemia, high systolic pressure, diabetes mellitus, declined kidney function and hypercholesterolemia are independent factors of urine high NGAL/creatinin ratio.Oldage,hyperuricemia, high systolic pressure, diabetes mellitus and declined kidney function are independent factors of high urine KIM-1/cr ratio.

Objective To explore the the application of sternocleidomastoid lateral path for thyroid cancer surgery lateral neck lymph node cleaning.Methods 40 patients with thyroid carcinoma were detected in the lateral neck lymph node cleaning using sternocleidomastoid lateral path(experimental group)and 40 cases of patients with thyroid cancer in the lateral neck lymph node cleaning cleaning scope with traditional operation method(control group),comparing with success rates,operation time,quality of life and incidence of complications.Results Experimental group can achieve the purpose of curing in the operation,operation field showed more clearly,the lymph node zone Ⅱ,Ⅲ,Ⅳ,Ⅴ number (32,58,50,35)were higher than traditional surgery group(17,35,33,20).Experimental group can significantly shorten the operation time[(30.0±1.20)min vs(45.0±3.10)min].The difference of incidence of near and forward future overall complications was statistically significant between the two group(P<0.05).Conclusion Sternocleidomastoid lateral path in thyroid carcinoma in the lateral neck lymph node cleaning can achieve the purpose of curing,significantly improve the lymph node zone Ⅱ,Ⅲ,Ⅳ,Ⅴ,shorten the operation time,reduce the recent and long-term complications and improve patient's quality of life.

Aiming at the deficiency in pathology in many TCM universities and colleges we should reform and actively explore the teaching methods,which will be significant to improving the teaching quality of pathology in TCM universities and ensuring the positive teaching effect.

Objective To study the outcome of surgical therapy of perforation of gastric cancer. Methods The clinical data of 37 cases with perforation of gastric carcinoma which underwent different surgical procedures were analyzed retrospectively. Among them,24 cases underwent partial gastrectomy,8 cases underwent radical mastectomy,4 cases had repair of perforation. 1 case received non-operative therapy. Results The preoperative diagnotic rate was 24.3%,and misdiagonsis rate was 75.7%. The perioperative mortality rate was 5.4%,including 1 case that underwent repair of perforation. The post-operative complication rate of patients undergoing palliative gastrectomy,radical gastric cancer operation and repair of perforation was 41.7%,25.0% and 75.0%,respectively,and the mean survival time was 25 months,29 months and 3.0 months,respectively.The partial gastrectomy and radical mastectomy patients had significantly better outcomes than those who underwent repair of perforation or received non-operative therapy.Conclusions For patients with perforation of gastric cancer with resectable lesions and who are in good general coaditon,a one-stage radical gastric resection or palliative subtotal gastrectomy can be performed.

Objective To evaluate risk factors of hepatitis B virus (HBV) reactivation after transarterial chemoembolization (TACE) in patients with HBV-related hepatocellular carcinoma (HCC) with undetectable HBV DNA levels.Methods From August 2012 to Sepemter 2015,all patients who underwent TACE for HBV-related HCC with HBV DNA level less than 103 copies/ml in the First Affiliated Hospital of Soochow University were enrolled into the study.These patients were followed-up for at least 6 months after TACE to assess HBV reactivation.Univariate and multivariate logistic regression analyses were done to evaluate the risk factors related to HBV reactivation in these patients.Results With predetermined inclusion and exclusion criteria,99 patients were enrolled into the study.Twenty-four patients (24.2％) developed HBV reactivation after TACE in the followed-up period.The level of transaminase was significantly higher in the HBV reactivation group than the non HBV reactivation group (P ＜ 0.05).HBeAg positivity and tumors more than 3 in number were independent risk factors of HBV reactivation.Conclusion HCC patients with undetectable levels of HBV DNA had a significant risk of HBV reactivation after TACE.

Background and purpose:Non-small cell lung cancer (NSCLC) patients who have good curative effect on epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) will inevitably acquired drug resistance. It will effect the survival directly. In contrast, few studies have found that EGFR-TKI effectively acquired drug resistance in patients with clinical characteristics. We investigated clinical characteristics of NSCLC patients who experienced acquired drug resistance during geiftinib therapy. Methods:To review the treatment from the beneift of patients with non-small cell lung cancer. All of the data were obtained from Jan. 2007 to Jan. 2014 in Xinjiang tumor hospital. The treatment for failure of acquired drug resistance of clinical manifestations, time to progress (TTP) and post-progression survival (PPS) were retrospectively analyzed. Results:The total collection of 417 patients. Median TTP was 10.2 months (95%CI:9.5-10.9). The TTP of women adenocarcinoma patients who didn’t smoke signiifcantly extended. When acquired drug resistance happened, 63.3%of patients appeared worse symptoms. The progress of the disease is as follows:209 cases (58.4%) from the primary lesion, 137 cases (38.3%) before the transfer, 194 cases (54.2%) of new happened. Patients of epidermal growth factor receptor (EGFR) wild type had more tendencies of symptomatic deterioration and new central nervous system (CNS) transfer than patients of EGFR mutation type. Patients of exon 19 deletion and L858R mutations on the new transfer were different (41.4%vs 6.3%, P=0.02). PPS was 8.9 months (95%CI:7.4-10.4). Smoking history, performance status (PS) score, new CNS lesions and the subsequent chemotherapy is independent factors of PPS. Conclusion:This study suggests that the clinical manifestations of acquired drug resistance according to EGFR mutation status and EGFR mutation genotype may be different. In addition, after the treatment of acquired drug resistance in patients with non-small cell lung cancer, the subsequent clinical beneift from chemotherapy are also associated with PPS.

Extended hemilaminectomy was performed in the treatment of compression of the cervical spinal cord produced by ossification of the posterior longitudinal ligament, multilevel degeneration and protrusion of the intervertebral discs and simple spinal canal stenosis. The results showed that with this operation the cross sectional area of the spinal canal was enlarged by 50% of the original, and the sagittal diameter lengthened 2,5mm postoperatively, so the compression of the. spinal cord was relieved. Since the function of the spinal process, the supra-and interspinal ligaments and the structure of one side of the lamina were preserved, mechanical stability of the cervical spine was maintained.

This study is to evaluate the curative effect of repairing the flexor tendons defect in the fibroosseous sheath by transferring the near flexor digitorum superficial tendons. Thirty-two cases (39 fingers) with acute flexor tendon defect in Zone I were repaired by transferring the flexor digitorum superficial tendons. Early protected passive motion was advocated postoperatively. All cases were followed up for 11 to 23 months. The outcome of fingers were excellent in 24,good in 12 and fair in 3 by TAM score. The percentage of excellent and good outcome was 92. 3%. Microrepair of fresh flexor tendons defect in Zone II by transferring flexor digitorum superficial tendons combined with early protected passive motion can prevent the adhension of tendons effectively and restore finger function earlier.