Objective To assess the feasibility and effectiveness of percutaneous transluminal angioplasty (PTA)for the salvage of immature arteriovenous fistula (AVF) and to identify the incidence of arterial and venous puncture site spasm.Methods The medical records and radiological data of 88 patients with 112 interventional procedures for immature AVFs were retrospectively reviewed.Results The stenosis lesions were (2.0 ± 1.4) cm long.Technical success rate and clinical success rate were 80.4％ (78/97) and 92.8％ (90/97) for PTA via brachial artery,85.7％ (6/7) and 100％ (7/7) for PTA via vein,25％ (2/8) and 50％ (4/8) for PTA via both brachial artery and vein,respectively.Spasm of pure arterial PTA occurred in 2 patients (2.1％) and was mild and moderate.Spasm of pure venous PTA occurred in 2 patients (28.6％) and was both moderate.Spasm of combined arterial and venous PTA occurred in 3 patients (37.5％) and from being severe to completely occluded.By comparison,there were statistical differences of technical and clinical success rate (P =0.000,0.019 ; P =0.000,0.029),fistulas spasm rate was statistically significant different (P =0.000).Conclusions Endovascular therapy was effective in restoring the dysfunctional native AVFs,it was safer and more effective and with less sideeffects especially in selecting coronary balloon to treat patients without large phlebangioma and round fistulas.

Objective To investigate the expressions of vascular endothelial growth factor (VEGF)-C,-D and VEGF receptor-3 (VEGFR-3/Flt-4) in pN0 early gastric cancer (ECG) and their relationship with lymph node micrometastasis.Methods From January 2005 to January 2010,the paraffin-embedded specimens of 61 pN0 ECG were collected.The expressions of VEGF-C,VEGF-D and VEGFR-3 in 61 pN0 early gastric cancer tissue,25 adjacent tissue and CAM5.2 expression in 868 hematoxylin-eosin staining negative lymph nodes were detected by immunohistochemical assay.The rate of lymph node micrometastasis of 61 pN0 ECG was evaluated.According to the data type,t test,x2 test or Fisher exact probability were performed for the relationship analysis between the expressions of VEGF-C,VEGF-D and VEGFR-3 in pN0 stage ECG and lymph node micrometastasis.Results The high expressions of VEGF-C,VEGF-D and VEGFR-3 in the 61 pN0 ECG were 34.4％ (21/61),34.4％ (21/61) and 44.3％ (27/61) respectively,which were higher than those of adjacent tissues [12.0％ (3/25),8.0％ (2/25) and 16.0％ (4/25) respectively] (x2=4.433,6.321 and 6.144 respectively,all P＜0.05).There were 10 cases (16.4％) of pN0 ECG with lymph node micrometastasis.In pN0 ECG,the low expressions of VEGF-C and VEGFR-3 in negative Flt-4 vascular invasion (FVI) were common than positive FVI (x2 =15.828,6.879 and 9.244,all P＜0.05).The high expressions of VEGF-C and VEGFR-3 were related to the depth of tumor invasion (x2 =5.561 and 5.678,both P＜0.05),the density of VEGFR 3 positive vascular (FVD) (t=2.987and 5.652,both P＜0.01) and lymph node micrometastasis (x2 =6.705 and 6.192,both P＜0.05),but not related to the degree of differentiation (P＞0.05).However,the high expression of VEGF-D was not related to depth of tumor invasion,FVD and lymph node micrometastasis (all P＞0.05),but related to the degree of differentiation (x2 =8.472,P =0.004).The high expressions of VEGF-C,VEGF-D and VEGFR-3 were not related to gender,age,tumor location,macroscopic type and tumor size (all P＞0.05).Conclusions The high expressions of VEGF-C,VEGFR-3 were related to lymph node micrometastasis in pN0 ECG.Although the high expression of VEGF-D was not related to lymph node micrometastasis,it could indirectly affect lymph node micrometastasis through VEGF-C-VEGFR-3 axis in pN0 ECG.

Objective To study the locations, types and causes of different pseudoaneurysms in order to find out the optimal individualized treatment for different pseudoaneurysms. Methods Different methods were applied in treating 21 patients with pseudoaneurysm, which were located at limb (n = 11 ), spleen (n =3), kidney (n = 2) , common lilac artery (n = 1), internal iliac artery (n = 1), gallbladder (n = 1) and penis (n = 1 ). Different managements were employed in treating these pseudoaneurysms. Temporary obstruction of blood circulation with balloon together with arterial anastomosis or direct incision neoplasty was performed in 9 cases with pseudoaneurysms at limb arteries close to the larger joints. Endovascular stent graft was used to isolate the trunk type of pseudoaneurysm in 4 cases, in 2 of them branch arterial embolism and stent graft endovascular exclusion were applied as they had common iliae artery trunk type of pseudoaneurysm at the opening of internal iliac artery. Gelfoam together with metallic coils embolization was employed in 6 cases with terminal type of pseudoaneurysms. Results After different treatments, tumor cavities disappeared in the 21 cases with pseudoaneurysms. Distal arterial pulse returned to normal and no nerve damage occurred in 11 cases with limb pseudoaneurysms. No internal hemorrhage was observed and distal blood circulation returned to normal after graft endovascular exclusion in 2 eases with pseudoaneurysms at spleen artery trunk and in 2 cases with pseudoaneurysms at iliac artery trunk. In 6 cases with terminal type of pseudoaneurysms,the tumor cavity disappeared, hemorrhage stopped and no ischemic necrosis of organ occurred. But one of them with multiple traumatic pseudoaneurysms located at the second grade branch died one week after embolism due to a serious pelvic trauma accompanied with serious infection. Conclusion Based on the locations, types and causes of pseudoaneurysms, different individualized treatment should be adopted in order to obtain optimal results with least damages.

AIM: To observe effect of the iris location to femtosecond - combined wavefront guided LASIK for myopia and astigmatism.?METHODS:The patients with astigmatism >1. 0D during the same time and followed up for 1a were selected. A total of 129 eyes in 67 patients were treated under iris location with femtosecond-combined wavefront guided LASIK ( experimental group) and 161 eyes in 82 cases with femtosecond-combined wavefront guided LASIK ( control group) . Laser cutting went with the same laser machine. The uncorrected visual acuity ( UCVA ) , best corrected visual acuity ( BCVA) , and wavefront aberration between the two groups were compared at 1, 3, 6mo and 1a after surgery.?RESULTS:At 1 and 3mo after surgery, the number of patients with better postoperative UCVA than preoperative BCVA between the two group showed a statistically significant difference (χ2=6. 423, P=0. 011,χ2=14. 431, P=0. 01 ); at 1d and 1mo after surgery, the residual astigmatism showed a statistically significant difference between two groups (t=1. 98, P<0. 05; t=2. 23, P<0. 05). At 3, 6mo and 1a after surgery, the differences on the change of residual astigmatism between the two groups weren’t significant ( P > 0. 05 ). At 6mo and 1a after surgery, the differences on UCVA between the two groups weren’t significant ( P > 0. 05 ). Until 1a after surgery, the root mean square ( RMS ) of high order wavefront aberration of the two groups, spherical aberration and coma aberration ( COMA ) were all enhanced compared to before surgery(P<0. 05). At 1, 3mo after surgery, the RMS showed a statistically significant difference between two groups (P<0. 05). At 1, 3, 6mo, 1a after surgery, the increase of COMA in experimental group was significantly lower than that in control group (P<0. 05).? CONCLUSION: Iris location technology applied in femtosecond - combined wavefront guided LASIK for myopia and astigmatism, can make the vision recovery faster, the RMS of high order and COMA increase less, the residual astigmatism less, show better and more stable treatment effect.

AIM:To contrast analysis of postoperative variation of corneal posterior surface heights after Femtosecond LASlK ( FS - LASlK ) and small incision lenticule extraction ( SMlLE) for high myopia.
●METHODS: Sixty-seven cases of high myopic patients (132 eyes) operated with laser corneal refractive in our hospital from May to Dec. in 2015 (-6. 00D≤spherical equivalent degree≤-10. 00D) were selected and divided into FS-LASlK group and SMlLE group. The thickness of corneal flaps at FS-LASlK and the thickness of map at SMlLE were designed to be 110μm. Corneal posterior surface heights were examined by Pentacam at preoperation, postoperative 3 and 6mo after FS-LASlK and SMlLE operation. Surface height changes after preoperative, postoperative 3 and 6mo were compared by measuring Pentacam corneal analysis system.
●RESULTS: Six months after operation, the FS-LASlK posterior corneal surface height was 6. 47 ± 1. 65mm, significantly higher than 5. 20 ± 1. 32mm before operation. SMlLE posterior corneal surface height was 6. 40 ± 1. 33mm, significantly higher than 5. 18 ± 1. 25mm before operation, the differences were statistically significant( P<0. 05). Six month after surgery, two methods of corneal surface height variation obtained was 1. 29 ± 1. 28mm and 1. 22 ± 0. 89mm, there was no significant difference ( P>0. 05).
●CONCLUSION:After FS-LASlK and SMlLE, the corneal posterior surface is protrusive. FS - LASlK is slightly obvious than SMlLE in early period. The stability of the posterior surface is better after SMlLE.

Objective To investigate the relationship between the polymorphisms of both aldose reductase (AR) and endothelial nitric oxide synthase (eNOS) genes in chromosome 7q35 and the susceptibility to diabetic nephropathy (DN) in type 2 diabetes of Han nationality in North China. Methods The C(-106)T in the promoter region of AR gene as well as the G894T in exon 7 and the 27 bp repeat polymorphism in intron 4 of the eNOS gene were investigated in 85 healthy controls and 134 type 2 diabetics with or without DN. The C(-106)T as well as the G894T genotype were determined by PCR RFLP method and sequencing the PCR products. The 27 bp repeat polymorphism alleles were determined by PCR combined with agarose gel electrophoresis and sequencing the PCR products. Results The frequencies of the C allele and C/C genotype in AR gene as well as T allele and T/G genotype in exon 7 and the 4a allele and 4a/4b genotype in intron 4 of eNOS gene were significantly higher in DN+ group than those in DN-group (all P

This paper introduces a kind of evaluation method in pipetting performance on new fully automated biochemistry analyzers by experiments. The performance of sample pipetting volume is confirmed by dye dilution method, the performance of reagent pipetting volume and dummy volume is done by weighing method. Meanwhile, researches and comparative researches on dummy volumes in different conditions have been made, providing valuable reference for clinical applications of automatic biochemistry analyzers.
Automation, Laboratory ; instrumentation ; methods ; Biochemistry ; instrumentation ; methods

Objective The current study is aimed to investigate the association of single nucleotide polymorphisms and gene expression in peptidylarginine deiminase Ⅳ (PADI4) with rheumatoid arthritis (RA).Methods The gene expression of PADI4 was examined using real-time quantitative reverse transcription-polymcrase chain reaction (RT-PCR) in 70 patients with RA and 81 healthy controls. Four exonie SNPs of the PADI4 gene (PADI4_89, _90, _92, _104) were genotyped using DNA sequencing and TA cloning.Results The distribution of PADI4_89, _90, _104 SNPs in RA was different from that of healthy controls. The increased RA susceptibility was significantly associated with minor alleles. When haplotypes were construe -ted with 4 SNPs, two major haplotypes, ACCC and GTGT were found in all samples, and GTGT haplo-type (carrying only the minor alleles) was significandy associated with increased RA susceptibility (P<0.01)in comparison with the reference haplotype ACCC. There was over expression of PADI4 in RA than controls(P<0.05). C, enotypes carrying the minor alleles had higher expression level of PADI4 in RA and controls than those with the common alleles. Conclusion PADI4 SNPs and haplotypes are associated with RA susceptibility in Chinese. PADI4 is over-expressed in the blood of RA patients, and there is significant association between the haplotypes and expression level of the PADI4 gene.

Purpose To investigate the serum prostate specific antigen( PSA)feature of high grade prostatic intraepithe1ia1 neop1asia ( HGPIN)patients,and the association of the number of cores positive for HGPIN on initia1 biopsy and the risk of cancer deve1opment in second biopsy. Methods 492 cases of patients with suspicious prostate cancer were schedu1ed for transrecta1 u1trasound prostatic biopsy with an 8-core temp1ate. In the first biopsy,186 cases of patients with PCa,34 cases of patients with iso1ated HGPIN( on1y one core invo1ved with HGPIN)and 13 cases of patients with extensive HGPIN( two or more cores invo1ved with HGPIN),64 cases of pa-tients with LGPIN,195 cases of patients with BPH. The va1ues of PSA were ana1yzed and compared within these groups. In patients with extensive HGPIN or iso1ated HGPIN we proposed a repeat 8-core biopsy after 6 months independent of serum PSA 1eve1. The same measure was app1ied for patients diagnosed as LGPIN or BPH in the first biopsy with accompanying increase or persistent e1evation of serum PSA 1eve1. The incidence of PCa was ana1yzed and compared within these groups. Results The serum PSA 1eve1s were no sig-nificant1y different between LGPIN and BPH(P>0. 05),between iso1ated HGPIN and LGPIN(P>0. 05),and between iso1ated HG-PIN and BPH(P>0. 05). The serum PSA 1eve1s were significant1y different between extensive HGPIN and LGPIN(P<0. 05),be-tween extensive HGPIN and BPH(P<0. 05),and between extensive HGPIN and iso1ated HGPIN(P<0. 05). In the second biopsy, the incidence of PCa in patients with extensive HGPIN was 38. 48%,that in patients with iso1ated HGPIN was 9. 68%,that in patients with LGPIN was 12. 50%,and that in patients with BPH was 12. 20%. Conclusions The features of PSA in patients with iso1ated HGPIN are simi1ar to BPH,PSA 1eve1 in patients with extensive HGPIN were between PCa and BPH,and patients with extensive HG-PIN have a higher incidence of PCa in second biopsy than iso1ated HGPIN and BPH.

Objective To determine the prognosis and staging non small cell lung cancer (NSCLC) that extends across the fissure into adjacent lobe after surgery.Methods 3752 patients with histopathologically confirmed non small cell lung cancer (NSCLC) received surgical reeessetion from January,1997 to April,2007.Among them,163 patients have a tumor invasion beyond fissure.After matching by pathologic TNM staging (7th),326 patients whose tumor defined in a single lobe were eligible for analysis.Results Histopatholngic staging of matched patients was I a:10 patiens(6.1％ ),I b:79 patients (48.5％),Ⅱa:5 patients (3.1％ ),111:44 patients (27.0％) and Ⅲa:25 patients( 15.3％ ).5 years survival in patients with stage 1 tumors crossing the interlobar fissure was 51％,while in patients not cross the interlobar fissure was 63％ ( P ＜0.05 ).There was no difference in survival for tumors stage Ⅱa and above with regard to importance of interlobar extension.The T2 tumor extending across a lung fissure had a reduction in survival compared with T2 tumor not cross the lung fissure and similar to the T3 tumor without the fissure invasion.Conclusion Our results suggest that TNM staging should be modified for tumor extends the fissure into adjacent lobe.