Objective:To study the expression and clinical significance of hypoxia-inducible factor-1? (HIF-1?) in squamous cell carcinoma of buccal mucosa.Methods:45 cases of paraffin embedded samples of squamous cell carcinoma of buccal mucosa were examined with HIF-1? antibody by immunohistochemistrical method. The relationship between HIF-1? expression and clinico-pathological factors such as sex, age, duration of tumour, T classification, differentiation, lymph node metastasis in the neck, recurrence, clinic classification, tumour thickness, the number of mitosis and the degree of lymphocyte invasion was analyzed.Results:The positive expression of HIF-1? was found in 31 out of the 45 cases(69%). HIF-1? positive reaction was predominately located in the center of tumour nest. While analyzing clinico-pathological factors, only T classification (between T1+T2 and T3+T4, P=0.008), lymph node metastasis of the neck (P=0.037) and clinic classification (between stage I+II and III+IV, P=0.011) showed a significant correlation with HIF-1? expression. HIF-1? possitive expression is higher in T3+T4(d=4.87 mm) than that in T1+T2(3.81 mm) (P=0.046). Logistic analysis showed that the longer the patients lived after operation, the less the HIF-1? positive expression.Conclusions:HIF-1? positive expression in squamous cell carcinoma of the buccal mucosa correlates to T classification, lymph node metastasis of neck, clinical classification and survival

Objective To investigate the normal aortic valve histological manifestation and histopathological changes of degenerative aortic valve.Methods In Tianjin Chest Hospital,there were patients due to aortic valve disease undergoing aortic valve replacement surgery in the Department of Cardiovascular Surgery,and in 22 cases,their pathological aorta tricuspid valves were successfully excised from May 2009 to May 2010.The aortic valve tissues were collected,and according to hematoxylin and eosin (HE) staining of the degenerative calcified aortic valves with stenosis,they were divided into pathological valvular calcification locus group and non calcification locus group.Six morphologically normal aortic valve tissues were taken as a control group.The situation of collagen fibers,elastic fibers and collagen content in normal and disorder valves were analyzed by using of IDA-2000 high definition color medical image analysis system.Results With the naked eye,the thickness of the valve leaves with stenosis was increased,and at the valve leaf close to the side of arota,calcified foci were produced.Under light microscope,inflammatory changes were found in the aortic valve endothelium,in the tubular wall,there were aggregations of newly formed capillary with relatively thin wall,cholesterol crystals,cells similar to foam cells and diffuse and nodular calcification commonly seen,Compared with the normal valve,the ratio between collagenous and elastic fibers no matter at calcified or non-calcified region was greater in pathological valve [(3.19-± 1.01)％,(2.62-± 0.34)％ vs.(1.89-± 0.29)％,both P ＜ 0.05],collagen content (ratio =collagen/valve area) was also higher [(65.17 ± 11.48)％,(39.25-± 11.15)％ vs.(22.99 ± 4.78)％,P ＜ 0.05] in pathological valve,and the changes in calcified region were more significant than those in non-calcified region (both P ＜ 0.05).Conclusions Proliferation of collagen and degradation of elastic fibers are obvious in degenerative aortic valve,and the changes are more prominent at calcified region.

Cancer stem cells are a new field with the gradual deep understanding of the stem cell research. Although its history is not long, the rapid development showed a good potential prospect. The existence of cancer stem cells and its use as tumor formation, growth and metastasis-based approach has been widely recognized. In theory, cancer stem cells derived from normal stem cells can transform. Cancer-causing factors can also be derived-from the dedifferentiation induced cells. Because it contains all-round, multi-and single stem cell, with the proliferation and differentiation potential of different directions, it is possible to explain the heterogeneity of tumor cells, and reasons for hypoxic environment, anti-cancer drugs and radiation resilience. In this area, it has been made a lot of progress in recent years. However, there are still some problems to be solved. Such as the identification of cancer stem cells, biological function and mechanism.

Cancer stem cells are a new field with the gradual deep understanding of the stem cell research.Although its history is not long,the rapid development showed a good potential prospect.The existence of cancer stem cells and its use as tumor formation,growth and metastasis-based approach has been widely recognized.In theory,cancer stem cells derived from normal stem cells can transform.Cancer-causing factors can also be derived from the dedifferentiation induced cells.Because it contains all-round,multi-and single stem cell,with the proliferation and differentiation potential of different directions,it is possible to explain the heterogeneity of tumor cells,and reasons for hypoxic environment,anti-cancer drugs and radiation resilience.In this area,it has been made a lot of progress in recent years.However,there are still some problems to be solved.Such as the identification of cancer stem cells,biological function and mechanism.

Objective To explore the repair possibilities of endothelial progenitor cells (EPCs)in peripheral blood in patients with different extents of obstructive sleep apnea (OSA) through measuring the levels of pro-angiogenic factors and different subgroups EPCs in peripheral blood in patients with OSA. Methods Ninety adult patients with OSA, 30 healthy controls with matched age and gender were enrolled for this study. The subjects performed Polysomnography, were divided in-to four group based on Apnea Hypopnea Index (AHI). The serum levels of HIF-1α, SDF-1αand VEGF were assessed by ELISA. Mononuclear cells were isolated from peripheral blood with density gradient centrifugation, and flow cytometry was used to detect levels of CD133+KDR+EPC, CD133+CD34+EPC, CD34+KDR+EPC and ALDHloCD34+KDR+EPC based on AL-DH activity, and CD133, CD34, PE-KDR related cell surface markers. Results The levels of CD133+KDR+EPC, CD133+CD34+EPC, CD34+KDR+EPC were higher in OSA groups than those of control group, both of which were higher in severe OSA group than those of in mild and moderate OSA groups. The levels of ALDHloCD34+KDR+EPC were higher in mild and moderate OSA groups than that of the control groups, and the levels of ALDHloCD34+KDR+EPC were significantly lower in se-vere OSA group than those of control, mild and moderate OSA groups. Serum levels of HIF-1α. VEGF were significantly high-er in OSA groups compared to those in control groups, both of which were higher in severe OSA group than those of mild and moderate OSA groups. Serum levels of SDF-1αwere significantly lower in severe OSA groups than those of mild, moderate OSA and control groups (P<0.05). Conclusion The mobilization and recruitment of different subtypes of EPCs are obvious-ly increased in patients with OSA, but ALDHloCD34+KDR+EPC with vascular repair capacity keeps to invariability, even de-creases in patients with severe OSA, which results in endothelial damage, and increases the risk of cardiovascular disease.

Objective To investigate the effect of different dose of dexmedetomidine for pre-venting the visceral traction reaction during caesarean section under spinal anesthesia.Methods Two hundred ASA physical status Ⅰ-Ⅱ patients,full-term primiparas scheduled for elective cesarean sec-tion were enrolled in this randomized,placebo-controlled study.Patients were randomly allocated to receive dexmedetomidine in four groups:group C (0.9% normal saline),group D1(dexmedetomidine 0.6 μg/kg),group D2(dexmedetomidine 0.8 μg/kg),group D3 (dexmedetomidine 1.0 μg/kg),50 cases in each group.Two minutes after cutting umbilical,groups D1,D2,D3 received an intravenous infusion single-dose of 0.6,0.8,1.0 μg/kg dexmedetomidine respectively for 10 minutes.Group C was injected the same dose of saline.Maternal blood pressure (BP),heart rate (HR),Ramsay scores,visceral traction reaction conditions were recorded at three points:before iv (T0 ),10 min af-ter iv (T1 )and abdominal exploration (T2 ).Results As for the inhibition of visceral traction pain, groups D2 and D3 were obviously better than groups D1 and C,and there was no statistically signifi-cant difference between groups D2 and D3 at T2 (P <0.05 ).The effects of slowing down heart rate and increasing blood pressure were weaker in group D2 than that in group D3 at T2 .Ramsay scores were higher in groups D2 and D3 than in groups D1 and C (P <0.05),and there was no significant difference between groups D2 and D3 at T2 .Conclusion Administration of dexmedetomidine 0.8 μg/kg could alleviate the visceral traction reaction and had little effect on maternal hemodynamics.

Objective To assess the value of magnetic source imaging (MSI) in localizing the linguistic center of auditory function of epileptic patients before operation. Methods Epileptic focus and the linguistic center of auditory function in 24 patients were localized with MSI before operation. And the relationship between epileptic focus and auditory language area was observed. Results The linguistic center of auditory function was localized in left temporal lobe in 14 patients, in right temporal lobe in 5 patients and in bilaterial temporal lobe in 5 patients. Epileptic focus was localized in left temporal lobe in 14 patients, in left temporal lobe and left parietal lobe in 1 patient, in right temporal lobe in 4 patients, in right temporal lobe and parietal lobe in 1 patient, in left frontal lobe and left temporal lobe in 1 patient, in right frontal lobe, right temporal lobe and parietal lobe in 1 patient, and in bilaterial temporal lobe in 2 patients. Epileptic focus was superimposed with the linguistic center of auditory function in 10 patients, while was not superimposed with the linguistic center of auditory function in 10 patients. The epileptic focus was localized in front of the linguistic center of auditory function in 3 patients, in behind of the linguistic center of auditory function in 1 patient. The lesion of the patient suffered from dysembryoplastic neuroepithelial tumor was not excised completely because the epileptic focus was superimposed with the linguistic center of auditory function, and the patient appeared language functional disturbance after operation in short period, remaining auditory hallucination occasionally after operation. Conclusion Epileptic focus and the linguistic center of auditory function can be localized accurately and the relationship between them can be observed clearly with MSI. MSI is useful to reduce the occurrence of language disturbance after operation.

Objective: To explore the value of CYP2C19 genotype polymorphisms for guiding the strategy of anti-platelet therapy in coronary artery disease (CAD) patients after percutaneous coronary intervention (PCI) with clinical prognosis.
Methods: A total of 326 CAD patients with PCI treatment received CYP2C19 genotype examination. According to CYP2C19 polymorphisms, the patients were divided into 3 groups. The patients with CYP2C19*1/*1, fast metabolism were defined as Routine group, who received clopidogrel 75 mg/day,n=128. The patients with CYP2C19*1/*2, CYP2C19*1/*3, CYP2C19*2/*3, CYP2C19*2/*2, CYP2C19*3/*3, medium and slow metabolism were further divided into 2 groups as High clopidogrel group, who received clopidogrel 150 mg/day,n=99 and Ticagrelor group, who received ticagrelor 90 mg/bid,n=99. The changes of platelet aggregation rate (PAgT) at before and 1, 3, 6 months after PCI were observed, the major adverse cardiac events (MACE) and bleeding condition were compared among different groups at 6 months after PCI.
Results: The PAgT was similar between High clopidogrel group and Routine group at 1, 3, 6 months after PCI, P>0.05;while compared with High clopidogrel group and Routine group, the PAgT decreased in Ticagrelor group at 1, 3, 6 months after PCI,P<0.05. The occurrence of MACE was similar between High clopidogrel group and Routine group at 6 months after PCI,P>0.05; while compared with High clopidogrel group and Routine group, Ticagrelor group had much less MACE occurrence,P<0.05. Ticagrelor group had no more major bleeding events than the other 2 groups,P>0.05.
Conclusion: High dose clopidogrel does not increase MACE occurrence in CAD patients with CYP2C19 medium and slow metabolism after PCI. Ticagrelor may decrease PAgT and MACE occurrence without elevating the major bleeding events.

Objective To observe the clinical efficacy of Tanreqing Injection combined with levofloxacin injection in treatment of acute episode of chronic bronchitis and its effect on bacterial clearance rate. Methods Totally 66 patients were randomly divided into treatment group and control group (33 cases for each). Both groups were given expectorant and antispasmodic treatment. The treatment group was given Tanreqing Injection combined with levofloxacin injection, while the control group was given levofloxacin injection only. The treatment course was 12 days. The clinical symptoms, signs, and sputum culture before and after treatment were observed. The clinical efficacy and the bacterial clearance rate of the two groups were compared. Results The markedly effective cases and the effective cases in the treatment group were 15 and 29 respectively, and those in the control group were 7 and 21 respectively, with statistical significance (P<0.05). The bacterial clearance rate was 89.5% (17/19) in the treatment group, while 55.6%(10/18) in the control group, with significant difference (P<0.05). Conclusion Acute episode of chronic bronchitis treated by Tanreqing Injection combined with levofloxacin injectcion is more effective than levofloxacin injection only.

Objective To explore the mechanism of vessel endothelial dysfunction in rats under intermittent hypoxia (IH). Methods The respiratory simulation system was used to simulate IH. Sixty C57BL/6J rats (male) were randomized into control group and IH group. The rats of IH group were exposed to IH 8 hours per day for 6 weeks. The serum levels of hypoxia inducible factor (HIF)-1a and stromal cell derived factor (SDF)-1a were assessed by ELISA. The serum levels of reactive oxygen species (ROS) were detected in two groups. The serum expression of miR-199a-5p was detected by real-time fluorescent quantitative PCR in two groups. The dual luciferase report system and point mutation test were used to verify target gene for HIF-1a. Results The serum levels of HIF-1a and SDF-1a were significantly higher in IH group than those of control group (μg/L:1.60±0.02 vs. 1.19±0.02, 1 823.00±8.97 vs. 1 444.00±17.90, P<0.01). The serum level of ROS was significantly higher in IH group than that of control group (U/mL:487.66±35.73 vs. 211.57±23.82, P<0.01). The serum level of miR-199a-5p expression was significantly lower in IH group compared to that of control group (1.31±0.07 vs. 3.47± 0.17, P<0.01). The result of dual luciferase reporter gene detection confirmed that target gene of miR-199a-5p was HIF-1a. Conclusion The serum level of miR-199a-5p is decreased first due to IH, and then its target gene (HIF-1a) is increased. HIF-1a can induce the increased level of SDF-1a, and its receptor (CXCR-4 ) is also increased. Finally, HIF-1a can increase the serum level of ROS, resulting in the endothelial dysfunction.