Objective To investigate the effect of folic acid on the DNA methylation of tumorrelated genes promoters in healthy human peripheral blood mononuclear cells(PBMC). Methods Ten healthy volunteers were divided into two groups, and were randomized to receive either 5 mg folic acid (n=5)or placebo(n = 5) , one time per day for 3 months. The serum folic acid concentration was detected with chemiluminescence enzyme immunoassay kit before and after the intervention. The methylation statuses of five tumor-related genes promoter, including oncogenes c-myc, c-Ha-ras,tumor suppressor genes p16INK4A, E-cadherin and mismatch repair gene hMLH1 in PBMC were detected by bisufite sequencing. Results After folic acid intervention, the level of serum folic acid increased significantly in intervention group (t= -4. 739,P<0. 05) , however no significant difference in control group. After three-month folic acid intervention, the level of methylation of oncogene c-myc promoter increased from 4%, 3. 3%, 4. 1% before intervention, one week after intervention, one month after intervention respectively to 8%(t= -4. 079,P<0. 05), while no significant change in placebo taken group. Before and after the folic acid intervention, there was no significant difference of DNA methylation of other tumor-related genes promoter, including c-Ha-ras、E-cadherin、p16INK4Aand hMLH1. Conclusion Folic acid intervention can up-regulate DNA methylation of oncogene c-myc promoter, but can not affect the promoter methylation status of tumor suppressor genes E-cadherin,p16INK4Aand hMLH1.

Objective: To explore the relationship between the expressions of chemokine receptor CXCR4 and vascular endothelial growth factor C (VEGF-C ) with lymph node metastasis in human rectal cancer. Methods: Immuohistochemical staining was used to detect the expressions of CXCR4 and VEGF-C in 73 samples of human rectal cancer. The relationship between CXCR4 and VEGF-C in 73 samples of human rectal cancer. The relationship between CXCR4 and VEGF-C expressions was analyzed. Results: The positive rate of CXCR4 expression with lymph node metastasis was higher than that without lymph node metastasis (60.1% vs 23.3%,P

Objective:To study the clinical effects of percutaneous transluminal angioplasty (PTA ) versus stent implantation (ST)after PTA for the treatment of femoral and popliteal artery lesion resulted from arteriosclerosis obliterans.Methods:One hundred and three patients (1 1 9 limbs)treated for femo-ral and popliteal artery lesion resulted from arteriosclerosis obliterans for ten years were reviewed,of whom 60 limbs were treated by PTA and the other 47 by PTA combined with stent implantation.Results:Among the 60 limbs of the PTA group,there were 22 limbs involved only in femoral and popliteal artery;1 3 limbs combined with iliac artery lesion;1 7 limbs combined with infrapopliteal artery lesion;8 limbs combined with iliac and infrapopliteal artery lesion.Among the 47 limbs of the ST group,there were 1 8 limbs involved only in femoral and popliteal artery;8 limbs combined with iliac artery lesion;1 5 limbs combined with infrapopliteal artery lesion;6 limbs combined with iliac and infrapopliteal artery lesion. There was no significant difference between the two groups on age,sex,concomitant disease,ankle bra-chial index(ABI)before treatment and Rutherford classification (P>0.05).The patients’Trans-atlantic inter-society consensus (TASC)C/D was lower in the PTA group than that in the ST group (58.3%vs. 76.6%,P=0.047).The follow-up periods were 48.0 (5.0,1 08.0)and 40.0 (3.0,96.0)months respectively (P=0.064).Compared with the PTA group,the ST group had a better short-term total effective rate (93.6% vs.80.0%,P=0.044)and a higher cost [(33 882.7 ±8 695.6)yuan vs. (1 7 754.8 ±3 654.2)yuan,P<0.001 ].The short-term marked effective rate of the ST group was higher than that of the PTA group,but the difference was not significant (31 .9% vs.21 .7%,P =0.231 ).There was no significant difference between the two groups on short-term efficiency,and compli-cation rates (58.3%vs.58.3%,P=0.724;1 .7%vs.2.1%,P=1 .000).There was no death during perioperative period and no short-term deterioration in both the groups.The long-term marked effective rate was lower and the deterioration rate was higher in the ST group than that in the PTA group,but the difference was not significant (8.5% vs.1 5.0%,P=0.381;1 4.9% vs.5.0%,P=0.081 ).There was no significant difference between the two group on long term total effective rate,accumulative limb salvage rate and reoperation rate (66.0% vs.66.7%,P=0.939;94.7% vs.94.1%,P=0.884;31 .9% vs.31 .7%,P=1 .000),and the 1 to 1 0 years primary and secondary patency rates were similar (P=0.837,P=0.622).When compared based on TASC classification,TASC A/B patients in the ST group had a higher short-term marked effective rate,a higher short-term total effective rate and a higher long-term deterioration rate than those in the PTA group,but the difference was not significant (36.4%vs.24.0%,P=0.353;1 00.0%vs.88.0%,P=0.322;1 8.2%vs.4.0%,P=0.21 6).TASC C/D patients had a similar result (30.6%vs.20.0%,P=0.307;91 .7%vs.74.3%,P=0.050;1 3.9%vs.5.7%,P=0.226).Both TASC A/B and TASC C/D patients in the ST group had a similar accumu-lative limb salvage rate with that in the PTA group (90.9% vs.90.6%,P =0.920;97.1% vs. 94.1%,P=0.796).Conclusion:Stent implantation can increase the cost and short term effective rate at the same time and is not superior to PTA on the long term effective rate and limb salvage rate for femo-ral and popliteal artery lesion resulted from arteriosclerosis obliterans.

This study examined effect of a new intervertebral cervical disc prosthesis in relieving the neurological symptoms and signs, improving the patients' ability to perform daily activities, reducing pain, and maintaining the stability and segmental motion. From December 2003 to October 2004, 12 patients, who had received 14 replacements of cervical artificial discs, were followed-up for 2 to 8 months (with a mean of 5.2 months). Of them 5 had cervical spondylotic myelopathy and 7 had cervical disc herniation. The patients included 7 males and 5 females, with their age ranging from 35 to 62 y and a mean of 50.3 y. Single-level replacements were performed in 10 cases and 2 cases received two-level replacement. Operation time of the single-level surgery averaged 130+/-50 min and the time of two-level surgery was 165+/-53 min on average (from skin incision to skin suturing). Neurological or vascular complications during or after surgery was not observed. Japanese Orthopedic Association scores (JOA scores) increased from 8.6 to 15.8 on average. There was no prothesis subsidence or excursion. Replaced segments were stable and the range of motion was partially restored, being 4.68 degrees (3.6 degrees -6.1 degrees ) in flexion and extension position and 3.51 degrees (2.5 degrees -4.6 degrees ), 3.42 degrees (2.6 degrees -4.3 degrees ) in left and right bending position. No obvious loss of physiological curvature was noted. CT or MRI follow-up showed that excursion was less than 1.5 mm) in 2 of 14 levels and between 1.5 mm and 3 mm) in 1 of 14 levels. No ossification in the replaced levels was observed. It is concluded that satisfactory short-term results were achieved in the 12 cases of artificial disc replacements. Different from anterior cervical discectomy and fusion, the replacement could achieve quick functional recovery and did not lead to the movement limitation of cervical vertebrae. At least a 5-years follow-up was needed to assess the long-term effect of the prosthesis on its neighboring segments.

Objective To evaluate the technique of selective portal vein embolization before hepatectomy and its value in the preparation of major hepatic resection for those with insufficient future remnant liver.Methods From Jan 2008 to July 2012,6 patients who suffered from hepatic tumors underwent selective ipsilateral portal vein embolization (PVE) due to insufficient future remnant liver volume (FRLV) before second-stage major hepatic resection.Results Technically,all six PVE were completed successfully with only minor liver function damages.The average FRLV increased from (474.33 ± 89.19)cm3 to (722.67 ± 151.51) cm3 (t =-5.587,P =0.003).The average tumor burden (total tumor volume)increased from (134 ± 181) cm3 to (270 ± 346) cm3 (t =-1.64,P =0.16).Five cases underwent secondstage major hepatectomy 6 weeks after PVE,while in 1 case a resection attempt was abandoned because of uncontrolled tumor growth during the period.During the follow-up period (median 37 months),1 died,4 survived,2 were tumor-free.Conclusions Selective portal vein embolization is a safe and effective method to induce hepatic hypertrophy in the appropriate clinical setting.Before PVE,hepatic tumor should be controlled beforehand with chemotherapy or TACE to ensure the scheduled second-stage hepatectomy.

Objective:To study the morphology of middle cerebral artery ( MCA ) M1 segment .Me-thods:We selected the MRA data of 794 MCA (400 of the left side and 394 of the right side ) from Ja-nuary 1, 2011 to June 30, 2011 consecutively and analyzed the morphology of the MCA M 1 segment in axial, anteroposterior and lateral view , measured the length of the M1 segment, and analyzed the simila-rity of the left and right side M1 segment morphology .Results:In axial, anteroposterior and lateral view , the MCA M1 segment showed C-shape >L-shape >S-shape .In axial view , it was about 373 ( 47%) M1 segment performance for the C-shape, of which 340 (42.8%) M1 segments showed bowing to the dorsal side, only 33 (4.2%) M1 segments showed bowing to the ventral side .In anteroposterior view, it was about 322 (40.6%) M1 segments of the performance of the C-shape, of which 262(33.0%) M1 segments showed a bowing to the superior , 60 (7.6%) showed bowing to the inferior .The similarity of the left and right MCA M1 segments was 27.2% (114/419) in axial view and 42.7% (179/419) in anteroposterior view.It was more similar in anteroposterior view than in axial view .Along with the increase of age, in the axial view, L-shape converted to C-shape very obviously, but only mildly elevated in S-shape .In anteroposterior view , the L-shape converted to the C-shape or S-shape along with the increase of age.Conclusion:The different morphology of MCA M1 segment in axial and anteroposterior view may be involved in the development of intracranial atherosclerosis .

Objective:To analyze correlation factors of hemodynamic damage after carotid artery stenting.Methods:In this study, 66 cases (71 lesions) who undertook carotid artery stenting were col-lected and the correlation factors of hemodynamic damage were analyzed .Results:Hemodynamic damage emerged in 23 cases (32.4%), of which, 11.3%developed hypotension.The distance between bifurca-tion and lesions (P=0.002 0), plaque distribution (P=0.000 2), plaque character (P=0.001 9), post-dilation ( P =0.002 6 ) were associated with hemodynamic damage by single factor analysis . However, only eccentric plaque (P=0.015 3) and calcified plaque (P=0.009 7) were associated with hemodynamic damage by multiple factors analysis .All the patients could reach stable circulation by drugs during operation , and no cerebral ischemic events ( transient ischemic attack or stroke ) and cardiovascu-lar ischemic events happened .Conclusion: The distance between bifurcation and lesions , eccentric plaques, calcified plaques are correlation factors of hemodynamic damage .

This study examined effect of a new intervertebral cervical disc prosthesis in relieving the neurological symptoms and signs, improving the patients' ability to perform daily activities, reducing pain, and maintaining the stability and segmental motion. From December 2003 to October 2004, 12 patients, who had received 14 replacements of cervical artificial discs, were followed-up for 2 to 8 months (with a mean of 5.2 months). Of them 5 had cervical spondylotic myelopathy and 7 had cervical disc herniation. The patients included 7 males and 5 females, with their age ranging from 35 to 62 y and a mean of 50.3 y. Single-level replacements were performed in 10 cases and 2 cases received two-level replacement. Operation time of the single-level surgery averaged 130±50 min and the time of two-level surgery was 165±53 min on average (from skin incision to skin suturing).Neurological or vascular complications during or after surgery was not observed. Japanese Orthopedic Association scores (JOA scores) increased from 8.6 to 15.8 on average. There was no prothesis subsidence or excursion. Replaced segments were stable and the range of motion was partially restored, being 4.68° (3.6°-6.1°) in flexion and extension position and 3.51° (2.5°-4.6°) 3.42° (2.6°-4.3°) in left and right bending position. No obvious loss of physiological curvature was noted. CT or MRI follow-up showed that excursion was less than 1.5 mm) in 2 of 14 levels and between 1.5 mm and 3 mm) in 1 of 14 levels. No ossification in the replaced levels was observed. It is concluded that satisfactory short-term results were achieved in the 12 cases of artificial disc replacements. Different from anterior cervical discectomy and fusion, the replacement could achieve quick functional recovery and did not lead to the movement limitation of cervical vertebrae. At least a 5-years follow-up was needed to assess the long-term effect of the prosthesis on its neighboring segments.

Objective To explore the application and effects of quality control circle activities on the compliance rate of upper limb functional exercise in elderly patients after permanent pacemaker implantation. Methods The application of quality control circle was used to analyze the causes, so as to find out the real cause of low compliance of upper limb functional exercise in permanent pacemaker implantation elderly patient including lack of accessary for upper limp training excise, the lake of education materials pacemaker for upper limb functional training after implantation without image, the lack of upper limb function exercise knowledge after pacemaker implantation in nurses, fear of pacemaker shift and bleeding, 5 aspects of team coaching patients with upper limb functional exercise, according to it due to the development of effective countermeasures which organized the implementation of standardized management. Results After the implementation of quality control circle activities, the follow-up rate of upper limb functional exercise in elderly patients increased from 57.89% to 100.00% before permanent pacemaker implantation, and the difference was statistically significant (P< 0.05). The goal of the event rate increased to 151%, and progress rate of 72.74%. Conclusions The application of quality control circle can improve follow-up rate in permanent pacemaker implantation in elderly patients after upper limb functional exercise, the upper limb function, and the quality of life of patients, as well as the members of quality control techniques, professional knowledge, communication and coordination, team spirit, and ability to explore problems were improved.

Objective To explore the automated identification and diameter measurement methods for inferior vena cava (IVC) based on clinical ultrasound images of IVC. Methods An automated identification and localization method based on topology and automatic tracking algorithm was proposed. Tracking algorithm was used for identifying and continuously locating to improve the efficiency and accuracy of measurement. Tests were conducted on 18 sets of ultrasound data collected from 18 patients in intensive care unit (ICU),with clinicians' measurements as the gold standard. Results The recognition accuracy of the automated method was 94.44％ (17/18),and the measurement error of IVC diameter was within the range of±1.96s (s was the standard deviation). The automated method could replace the manual method. Conclusion The proposed IVC automated identification and localization algorithm based on topology and automatic tracking algorithm has high recognition success rate and IVC diameter measurement accuracy. It can assist clinicians in identifying and locating IVC,so as to improve the accuracy of IVC measurement.