Objective To investigate the role of vascular endothelial growth factor-C (VEGF-C) and its receptors in the formation of lymphatic vessels and lymphatic metastasis in gastric cancer. Methods By the domestic and overseas literatures review,the expressions of VEGF-C and its receptors in gastric cancer,their role in tumor lymphatic metastasis and prospect in treatment of gastric cancer were summarized. Results There was a significant correlation between VEGF-C and its receptors and the formation of lymphatic vessels and lymphatic metastasis in gastric cancer. VEGF-C high expression might be an early event in lymphatic metastasis and could be considered as an independent predictive factor of lymphaticmicrometastasis. By inhibition of gastric cancer cell from secrete VEGF-C or blockage of the interaction of VEGF-C with VEGFR-3,it was possible to inhibit tumor angiogenesis and the invasion and distant spread of cancer cells,thereby decreased mortality and improve survival. Conclusion VEGF-C and its receptors may promote the formation of lymphatic vessels and lymphatic metastasis in gastric cancer. It may be an effective way to gastric cancer for the treatments against VEGF-C and its receptors.

Objective To evaluate the curative effect of stent angioplasty for treatment vertebral basilar artery stenosis. Methods 34 patients with vertebral basilar artery stenosis diagnosed by DSA were treated with cerebral angioplasty and stenting(CAS ) operation by flexible balloon expandable stents. Results 36 stents were placed in 34 patients. The achievement ratio of operation was 100%. All stenosis showed by DSA were successfully improved without complications.The mean stenosis rate of preoperation and postoperation were (78.3?6.2)% and (3.6?4.2)% respectively. During the further follow up period of 6～38 months, clinical symptoms were disappeared in 31 patients, relieved in 2 patients, recurred in 1 patient.There were no vertebro-basilar system transient ischemic attack and brain infarction onset in those patients.Conclusion Stent angioplasty is safe and effective in the treatment of symptomatic vertebral artery stenosis.

BACKGROUND:Recent studies have demonstrated that surgical trauma leads to lipid peroxidation in erythrocytes.However,injured erythrocytes play an important role in thrombosis following replacement.OBJECTIVE:To evaluate the influence of artificial total knee replacement on the lipid peroxdation in erythrocytes,and the prophylactic treatment of vitamin E and fructose 1,6 diphosphate(FDP)on it.DESIGN,TIME AND SETTING:Contrast clinical study,which was carried out in the Department of Otthopaedics,Affiliated Hospital of Nantong University from January 2003 to June 2006.PARTICIPANTS:Sixty patients with knee osteoarthritis who underwent artificial total knee replacement by anesthesia of epidural block were divided into four groups,including control group,vitamin E group,FDP group and vitamin E+FDP group,with 15 cases in each group.METHODS:Vitamin E was orally taken in the vitamin E group three days before replacement,three times a day,100 mg for each.The administration was performed until the surgical morning.Thirty minutes after the operation,FDP(10 g)was intravenously dripped in the FDP group.Additionally.vitamin E was also orally taken in the vitamin E+FDP group three days before replacement,three times a day,100 mg for each;on the surgical morning,FDP(10 g)was intravenously dripped on the first 30minutes.Blood samples were taken for biochemical determination before and after the operation at 1,3,5,and 7 days.MAIN OUTCOME M[EASURES:Corltents of malonaldehyde(MDA)and cuprum/zincum/superoxide dismutase (Cu-Zn-SOD)in the erythrocytes.RESULTS:MDA level in the vitamin E group and FDP group was significantly higher than that in the vitamin E+FDP group before and 5 and 7 days after replacement(P<0.05);while,Cu-Zn-SOD level was significantly lower(P<0.05).Otherwise,there were no significant differences in vitamin E+FDP group before and after replacement(P>0.05).CONCLUSION:The artificial total knee replacement can enhance lipid peroxidation and decrease antioxygen capability.However,the combination of vitamin E and FDP can prevent and relieve lipid peroxidation and antioxygen capability after replacement.

Myocardial ischemia-reperfusion injury (MI/RI) is an inflammatory cascade process involving the interaction of multiple factors.In recent years,more and more evidence suggests that NOD-like receptor pyrin domain containing 3 (NLRP3) inflammasome,an important component of the innate immune system,is closely associated with the inflammatory damage of MI/RI.Furthermore,blockage of NLRP3 inflammasome or the release of its downstream pro-inflammatory cytokines may provide new therapeutic targets for this disorder.

Microvascular architecture of the oviduct was observed by SEM in 20 adult female Wistar rats which were not pregnant. The oviduct was supplied by 2-4 tubal branches (0.2-0.3mm in diameter) which were derived from the ovarian artery. The tubal branches entered the wall of oviduct and divided into numerous meandering arterioles (0.02-0.07mm in diameter). Intrinsic microvasculature of the oviduct might be divided into three layers: (1) the subserosal vascular plexus which appeared tortuous and formed reticulate anastomosis, (2) a parallel branching vasculature in the muscle coat, and (3) the subepithelial capillary network. The latter arised from the arterioles which ramified terminally near the apex of mucosal folds and broke up into very dense capillaries. Subepithelial capillary density in the fimbriae was markedly higher than that in the isthmus and uterine part. Intrinsic venules of oviduct were less tortuous and less closely accompanied with the arterioles. In mesoviduct, veins were in closely accompanied with the corresponding arteries. In the wall of oviduct, some capillaries and venules drained to the small veins directly and vertically.

Objective To evaluate the relationship between the perfusion mode of neovascularization of carotid plaque in CEUS and the ischemic stroke in transient ischemic attack (TIA) patient.Methods A total of 73 TIA patients according to the inclusive criteria were enrolled.All the patients underwent routine carotid ultrasonic examination.And 61 patients with plaque thicker than 2.5 mm in carotid bifurcation underwent CEUS and follow-up for at least 18 months.All the patients were divided into recurrent and non-recurrent groups.Logistic regression analysis were performed to detect the risk factors for incurrence of ischemic stroke or recurrence of TIA in 18 months.Results There were statistical differences between 2 groups in hypertension,diabetes,hyperlipemia,smoking history,family history of stroke,medication compliance,two-dimensional ultrasound and CEUS characteristics (all P＜0.05).Multivariate Logistic regression analysis showed that all the factors correlated with the recurrency,from big to small order were the CEUS characteristics of carotid plaque,hypertension,medication compliance,diabetes,two-dimensional ultrasound characteristics of carotid plaque.Conclusion CEUS could evaluate the perfusion mode of neovascularization in carotid plaques.For TIA patients,CEUS could predict the incurrence of ischemic stroke or recurrence of TIA,which can guide TIA patients targeted prophylaxis of them.

BACKGROUND:Vascularuzed fibular graft is one of the effective methods for repair of large segmental bone defects in the extremities OBJECTIVE:To explore the clinical effects of vascularized fibular graft for repairing large segmental bone defects in the extremities. METHODS:Twenty-eight non-malignant patients who received vascularized fibular graft for repairing large segmental bone defects in the extremities and were folowed up for more than 20 months were enroled. After lesion removal, vascularized fibula bone graft was used to repair the bone defects. If cases combined with soft tissue defects, fibula flap or anterolateral thigh flap was adopted. RESULTS AND CONCLUSION: Al patients were folowed up for 20 months to 6 years. The grafted bones were healed with the surrounding bone at 3-8 months after fibula bone grafting. The grafted bone was enlarged near to the diameter of recipient bone at 10-22 months after grafting. Based on the Enneking system, the average score of large segmental tibia bone defects was 24.2 points with 81% limb function recovered and 94.1% patient satisfaction; the average score of large segmental femur bone defects was 26.3 points with 87.7% limb function recovered and 100% patient satisfaction; the average score of large segmental bone defects of the distal radius and ulna was 21.75 points with 72.5% limb function recovered and 100% patient satisfaction. These findings reveal that vascularized fibular graft for repairing large segmental bone defects in extremities can effectively promote bone healing and reduce disability, infection, amputation rate; moreover, patients are satisfied with the postoperative recovery of limb function.

Carcinoma ; diagnosis ; pathology ; Humans ; Laryngeal Neoplasms ; diagnosis ; pathology ; Larynx ; pathology

BACKGROUND:For the patients with proximal humeral fractures or serious complications, internal fixation is the effective method that cannot influence the activity of the shoulder with few trauma. OBJECTIVE:To investigate the biomechanical characteristics of percutaneous plate combined with anatomical locking plate fixation for the treatment of proximal humeral fractures. METHODS:Seventy-five patients with proximal humeral fractures were selected from Department of Orthopedics, the Third Affiliated Hospital of Guangzhou Medical University between March 2007 and December 2011. The healing after the locking plate fixation and the shoulder joint score after internal fixation were observed. The biomechanical advantages of locking plate fixation in the treatment of proximal humeral fractures were analyzed. RESUTLS AND CONCLUSION:Al the 75 patients were fol owed up for 6-24 months, average 13.3 months. The X-ray film after treatment showed al the screws were in correct position with satisfactory fracture reduction, and the fractures were healed without neurovascular injury and humeral head necrosis;one case had infection and healed after treatment, 72 cases had no shoulder pain, while three cases had occasional shoulder pain. The Neer score was excel ent in 57 cases, good in 11 cases, moderate in seven cases and poor in none, and the excel ent and good rate was 90.7%. Compared with other fixation implants, the locking plate fixation in the treatment of proximal humeral fractures has the advantages of high fixation strength and satisfactory effect, becoming the first choice for the clinical treatment of proximal humeral fractures.

Objective:To study the value of small dose sufentanil in anesthesia in caesarean section for prevention of chill and dragging pain. Methods:A total of 84 cases of caesarean section maternal in our hospital were choosen for study as the object. And they were randomly divided into two groups, with 42 cases in each group. The experimental group implements the sufentanil 5μg, control group was given 0.5%ropivacaine. Chills,dragging pain and other adverse reactions were compared. Results:The incidence rate of level 0 chills in experimental group was 80.95%,and it's higher than that 50.00%of control group (P<0.01) . Maternal pull pain incidence rate of experiment group was 14.92%, while the control group was 73.81%(P<0.01) . The other adverse reaction rate in experimental group was lower than that in the control group (P<0.01) . Conclusion:Small doses sufentanil anesthesia for cesarean section can significantly reduce the occurrence of adverse reactions such as pain and chills,safe and effective,it's worthy of clinical popularization and application.