Objective To investigate the expression of vascular endothelial cell growth factor-C (VEGF-C) and its receptor--vascular endothelial cell growth factor receptor-3 (VEGFR-3) in breast cancer tissue and its correlation with metastasis of lymphonodi axillares.Methods Fifty-eight cases of breast cancer samples and 10 cases of tumor adjacent non-carcinomatous tissue were measured by immunohistochemical staining for expression of VEGF-C and VEGFR-3. Their expression rates were compared between axillary lymph node metastasis and non-metastasis groups.Results The positive rates of VEGF-C and VEGFR-3 as well as the number of VEGFR-3 positive vessels were significantly higher than those in lymph node non-metastasis group (87.5% vs 55.9%; 83.3% vs 38.2%; 8.54±2.54 vs 4.73±2.46, respectively).Conclusion The high expression of VEGF-C and VEGFR-3 as well as the increase in the number of VEGFR-3 positive vessels are related to lymph node metastasis of human breast cancer. VEGF-C/VEGFR-3 system may be a new specific target which contributes to blockage of lymphatic metastasis in breast cancer.

Objective To observe the relationship between morphology of ciliary body and glaucoma with ultrasound biomicroscopy (UBM). Methods Eighty shallow-anterior chamber patients and 80 normal-anterior chamber patients were enrolled as shallow-anterior chamber group and control group, respectively. All patients were greater than 40 years old. The shallow-anterior chamber group included 28 patients of acute angle-closure glaucoma (AACG subgroup), 26 patients of chronic angle-closure glaucoma (CACG subgroup), and 26 patients of primary angle-closure suspects (PACS subgroup). Both eyes of all patients were checked with UBM, and position of each eye on sagittal and coronal section of superior, nasal, inferior and temporal were recorded. Then ciliary process height (CPH), ciliary process thickness (CPT), ciliary process interval (CPI), ciliary process number (CPN), A angle and α angle were measured. Furthermore, the difference between shallow-anterior chamber group and control group, the difference between AACG, CACG and PACS subgroup were compared, as well as the difference between PACS subgroup and control group, and the correlation between A angle and α angle was analyzed. Results Compared with control group, CPH and CPT of shallow-anterior chamber group increased, while CPI, CPN, A angle and α angle decreased (P＜0.05). Except CPH and CPN between CACG and PACS subgroup, there were significant differences of parameters between subgroup of AACG, CACG and PACS (P＜0.05). CPH of PACS subgroup increased than those of control group, while CPI, CPN, A angle and α angle decreased (P＜0.05). There was positive correlation between A angle and α angle. Conclusion Morphologic parameters of ciliary process may be sensitive indexes which can early screen primary angle-closure glaucoma.

Objective To measure the thickness of the iliotibial band(ITB)in normal adult volunteers and to evaluate the value of ultrasonography in the diagnosis of ITB injury.Methods Ultrasonography was used to measure the thickness of the ITB in 20 normal adult volunteers,which were compared with the sonographic findings in 11 patients with iliotibial band friction syndrome(ITBFS).Results The thickness of the ITB in normal volunteers was(1.55±0.40)mm at the level of the femoral condyle and(2.05±0.30)mm at the insertions of tibial tubercle(Gerdy's tubercle).There were no significant differences between the right and left sides.In each of 11 patients with ITBFS,there was a more ITB thickness in symptomatic side than that of asymptomatic side(more than 30% in the difference between two sides).The ITB had a area of decreased echoginicity in symptomatic side.The thickened position of ITB were at insertion resion in 6 cases,at the level of femoral condyle in 3 cases and diffuse in 2 cases.Bursa fluid were found in 4 cases.Conclusions Ultrasonography can effectively evaluate the degree and range of ITB injury,and can give important information for clinical theraphy.

Objective To investigate the incidence,sonographic appearance of the anatomic variation of carpal tunnel median nerve and its accompanying structures in healthy volunteers and explore the value of this variation in carpal tunnel syndrome.Methods A total of 360 hands of 180 healthy volunteers were included in the study.The full course of the median nerve in the forearm and carpal tunnel was examined with high-frequency ultrasound.The median nerve was first located in cross section at wrist and then with continuous cross-sectional scanning to observe the the full course of the median nerve in the forearm and carpal tunnel with high-frequency ultrasound.Results Anatomic variation of carpal tunnel median nerve and its accompanying structures were observed:① High division median nerve were found in 2 wrists (0.56 ％) ;②Bifid median nerve were found in 17 wrists (4.72％) ;③Persistent median artery were found in 22 wrists (6.11％),and 2 wrists (0.56％) were also found accompanied vein.Aanatomic variation of carpal tunnel median nerve accompanied with persistent median artery were observed in 16 wrists (4.44 ％).Conclusions High-frequency ultrasound was sensitive to diagnose the anatomic variation of carpal tunnel median nerve and its accompanying structures.Recognition of these variations can help us to make correct diagnosis of carpal tunnel syndrome.

Objective:To evaluate the distribution characteristics of postinterventional cerebral hyperdensities (PCHDs) in patients with acute anterior circulation large vessel occlusive stroke after interventional therapy using the Alberta Stroke Program Early CT Score (ASPECTS) and to investigate its predictive value for symptomatic intracranial hemorrhage (sICH).Methods:Consecutive patients with acute anterior circulation large vessel occlusive stroke underwent endovascular mechanical thrombectomy (EMT) in the Stroke Center of Dongguan People's Hospital from January 2018 to December 2020 were retrospectively enrolled. The clinical, imaging and follow-up data were collected. The immediate PCHDs-ASPECTS after endovascular therapy were analyzed. Multivariate logistic regression analysis and receiver operator characteristic (ROC) curve were used to investigate its predictive value for sICH. Results:A total of 161 patients were enrolled in the study, including 115 males (71.4%). The baseline National Institutes of Health Stroke Scale (NIHSS) score was 13.6±5.6; 66 patients (41.0%) developed PCHDs and 35 (21.7%) had sICH. The baseline NIHSS score, the proportion of patients with severe stroke, the number of retrieval attempts and the detection rate of PCHDs in the sICH group were significantly higher than those in the non-sICH group, while diffusion weighted imaging-ASPECTS and PCHDs-ASPECTS were significantly lower than those in the non-sICH group (all P<0.05). Multivariate logistic regression analysis showed that PCHDs had a significant independent positive correlation with sICH (odds ratio 6.036, 95% confidence interval 1.45-25.123; P=0.013), and PCHDs-ASPECTS had a significant independent negative correlation with sICH (odds ratio 0.70, 95% confidence interval 0.496-0.992; P=0.045). ROC analysis showed that the area under the curve predicted by PCHDs-ASPECTS was 0.832 ( P<0.05). When its cut-off value was 8 points, the sensitivity and specificity were 74.3% and 83.3% respectively. Conclusions:In patients with acute anterior circulation large vessel occlusive stroke treated with EMT, the immediate postoperative PCHDs is an independent predictor of sICH, and PCHDs-ASPECTS can early predict the risk of sICH after EMT.

AIM:To investigate the effect of ankyrin repeat domain 49(ANKRD49)on epithelial-mesenchy-mal transition(EMT)in NCI-H1299 cells,and to explore its mechanism.METHODS:The ANKRD49 was over-ex-pressed in NCI-H1299 cells.The morphological changes of ANKRD49-overpressing NCI-H1299 cells were observed under microscope.The mRNA and protein expression levels of EMT-related markers[E-cadherin,transforming growth factor-β1(TGF-β1),vimentin and α-smooth muscle actin(α-SMA)]and EMT-related transcription factors(Snail1,Slug,Twist and ZEB1)were detected by RT-qPCR Western blot.Immunofluorescence staining was performed to observe the localiza-tion and expression of E-cadherin and vimentin in ANKRD49-overexpressing cells or control cells.Immunohistochemical method was performed to examine the levels of E-cadherin,α-SMA,Snail,Slug and ZEB1 in lung tissues of nude mice in-oculated with ANKRD49-overexpressing H1299 cells or control cells.RESULTS:Compared with the control group,the ANKRD49 overexpressing cells showed mesenchymal cell morphology(fusiform and less tight connections).RT-qPCR and Western blot results showed that the mRNA and protein levels of mesenchymal markers vimentin and α-SMA in ANKRD49 overexpressing cells were significantly higher than those in cells of control group,while the mRNA and protein levels of epithelial marker E-cadherin were lower than those in cells of control group.Compared with control group,the im-munofluorescence intensity of E-cadherin of H1299 cells decreased in after ANKRD49 overexpression,while that of vimen-tin increased significantly.Snail,Slug and ZEB1 expression were significantly elevated in ANKRD49 overexpressing cells compared with control group.The levels of E-cadherin in lung tissues of nude mice inoculated with ANKRD49-overexpressing H1299 cells declined,while the levels of α-SMA,Snail,Slug and ZEB1 increased compared with those in control mice.CONCLUSION:ANKRD49 promoted EMT of NCI-H1299 cells by increasing the expression of Snail1,Slug and ZEB1 and consequent downreguation of E-cadherin and upregulation of vimentin and α-SMA.

The present case report described a patient with paroxysmal atrial fibrillation who received pulsed-filed ablation guided by intracardiac echocardiography and 3-dimentional mapping system.All four pulmonary veins were isolated in the procedure,good clinical results and acute safety profile were achieved.The present case reveals the safety and feasibility of the technique for the treatment of paroxysmal atrial fibrillation.