Objective:To observe the morphologic changes of cancer tissues and cells and clinical effect of microwave coagulation therapy (MCT) on oral squamous cell carcinoma.(OSCC), and then to evaluate the possibility of MCT in OSCC treatment.Methods:Forty OSCC patients were involved. MCT was adopted to the treatment of tumor primary focus, and associated with chemotherapy and lymphadenectomy of suprahyoid region or therapeutic neck dissection. After MCT the tissues were extracted for pathological examination immediately and morphologically observated by transmission electron microscope(TEM). All patients were received follow-up investigation for 3 years. The therapeutic effects of the two groups were observed and compared.Results:After MCT, the tissues of primary focus showed degenerative and necrotic tissue, inflammatory granulation, exudative necrosis, hyperplasia or atypical hyperplasia under light microscope. Apoptosis and mastocytes were observed besides the primary focus through TEM. Additionally MCT could protect oral faction, facies and improve survival quality and control local recurrence, which was more advanced than other old method (P

Objective To summarize our experience in treating abdominal aorta saddle embolism(ASE).Methods The clinical data of 21 cases of abdominal ASE were treated with Fogarty catheter and other(methods) during January 2000 to July 2006 were retrospectively assessed.Results After the blood flow was restored by operation,4 died in the postoperative early stage because of sudden cardiac asystole due to(hyperkalemia);in the late stage,6 died of multiple organ dysfunction syndrome socondary from acute renal(failure)(ARF).Eleven patients were cured.Of them,bilateral lower extremites were salvaged in 5 patients;and 6 patients received amputation.Ten patients were followed up,and the blood supply of the salvaged legs was good.Conclusions Early diagnosis and embotism removal are the key points to decrease the mortality and amputation rate of ASE.The intra-operative and post-operative prevention and management of(hyperkalemia) and ARF are important for reduction of mortality.

Objective To analyze the causes of misdiagnosis of aorta diseases for simple inferior limb artery thrombo-embolism,and summarize the clinical experience. Methods Retrospective analysis was made on clinical data of 9 eases misdiagnosed aorta disease,including clinical manifestation,misdiagnosis,improper treatment and final definite diagnosis. Results All 9 cases were misdiagnosed as simple inferior limb thrombo-embolism at first.Three cases were treated with emergent thrombectomy using Fogarty catheter.The correct diagnosis Was achieved by 3-dimensional CT angiography (3DCTA) after operation,and the eitiology of other 6 cases were also pmved as aortic disease by 3DCTA before operation.Among 5 cases of acute aorta dissection with iliac-femoral artery involved,2 cases abandoned surgery with one dying the next day and the other lost to follow-up after being discharged.The other 3 cases were treated with endovascular therapy successfully.One case of abdominal aorta anurysm with mural thrombosis defluxion were treated by aneurysm resection.The other 3 caBes of Leriche syndrome with acute aorta terminal filament thrombosis formation were cured by aortoiliac bypass.The limbs ischemia were improved in all cases without perioperative death.Conclusion Aorta diseases can sometimes lead to acute inferior limb ischemia,mimicking limb artery thrombo-embolism.Preoperative imaging especially 3 DCTA helps to establish correct preoperative diagnosis for a successful treatment.

Objective To investigate changes of endothelin-1(ET-1) and endothelin-converting enzyme (ECE) in different time intervals after autograft vein implantation. Methods A model of autogenous vein graft was established by interposition of the jugular vein into abdominal aorta in 80 Wistar rats. RT-PCR and immunohistochemistry were employed to test mRNA and protein level of ECE, ET-1 and proliferating cell nuclear antigen (PCNA). Results Positive PCNA appeared at 6 hours after transplantation, with time reaching a peak at 1 to 2 week. ECE mRNA increased with time reaching a peak after 1-2 weeks and stabilizing around 8 weeks. ET-1 expression underwent similar tendence with ECE, reaching a peak after 1-2 weeks and stabilizing at 8 weeks at the protein level. Expression of ET-1 and ECE were closely related by the time pattern after vein autograft (r=0.975). Conclusions The process of intimal hyperplasia in its occurrence and pattern of change are related with dynamics of ET-1 and ECE. ECE may lead to intimal hyperplasia of the autografted vein through a passway of ECE to ET-1 to SMC.

Objective To sum up our experience in the diagnosis and management of acute superior mesenteric venous thrombosis (SMVT). Methods We retrospectively reviewed 41 patients treated for acute SMVT admitted in our hospital from Jan 1978 to Aug 2003. Before 1995 (group Ⅰ), a surgery was preformed in patients with suspected acute SMVT. Since Jan 1995 (Group Ⅱ), aggressive medical therapy was immediately delivered, and the patients were subjected to laparatomy with suspected peritonity. Results There were 13 cases in group Ⅰ, and 28 in group Ⅱ. Mortality in group Ⅰ was 38.5%, and that in group Ⅱ was 10.7% (P

Objective To investigate the expression and relationship of early growth response gene-1((Egr-1)),platelet-derived growth factor-B(PDGF-B) and tranforming growth factor(TGF-?_1) in autogenous vein graft in rats,and the role in vein graft intimal hyperplasia(IH).Methods Autogenous vein graft model was(established) in 90 wistar rats.The vein graft samples were harvested at 1,2,6,24 hours,and 3,7,14,28,42 days after surgery.Normal vein was used as control group.Egr-1、PDGF-B,TGF-?_1 mRNA was measured by reverse transcription-PCR and in situ hybridization.Western blotting and immunohistochemistry were used to detect the protein expression of Egr-1,PDGF-B and TGF-?_1. Results Expression of Egr-1,PDGF-B,TGF-?_1 mRNA and protein was not detected in normal vein.In grafting vein,expression level of Egr1mRNA reached a peak at 28days,and the positive rate of Egr-1mRNA was 45%?6%;(PDGF-BmRNA) reached a peak at 14days(48%?6%);a peak of TGF-?_1mRNA was 46%?9% reached at 7days;Egr-1 protein expression reached a peak at 28days, and the positive rate of Egr-1 protein was 40%?9%.PDGF-B protein reached a peak at 28days(45%?4%),TGF-?_1 protein reached a peak at 14days(41%?7%).Conclusions Intimal hyperplasia of vein graft is closely associated withexpression of Egr-1、PDGF-B and TGF-?_1;the activation and expression of PDGF-B and TGF-?_1 may be(modulated) by Egr-1,and they may contribute to increase expression of Egr-1 by feedback.

Objective To evaluate expression of inducible nitric oxide synthase (iNOS) in human abdominal aortic aneurysm (AAA) and to identify its initiation in the oxidative vascular injury. Methods This study included 22 AAA patients and 10 cadaveric normal abdominal aorta. In situ hybridization and immunofluorenscent staining were used to localize iNOS messenger RNA (mRNA) and protein. Double staining with a combination of in situ hybridization and immunofluorenscent staining was used to simultaneously demonstrate iNOS mRNA expression and its cellular localization. The presence of end-product of oxidative injury induced by iNOS was indirectly assessed with immunofluorenscent staining by anti-nitrotyrosine antibody, its cellular localization were assessed by double immunofluorenscent staining. Results In situ hybridization and immunohistochemistry confirmed the presence of iNOS in media and adventitia of AAA in all 22 patients. Specific cell markers identified iNOS mRNA-positive cells were T and B lymphocytes, macrophages, and smooth muscle cells. Positive immunostaining for nitrotyrosine was present in macrophages and smooth muscle cells. Normal abdominal aorta demonstrated virtually no iNOS or nitrotyrosine expression. Conclusion Stimulated expression of iNOS is associated with degeneration of AAA in human beings leading to oxidative tissue and cellular injury in AAA.

Objective To evaluate risk factors of the prognosis in acute arterial embolism of the upper extremities. Methods The clinical data of 62 consecutive patients admired in our hospital with the diagnosis of acute arterial embolism in the upper extremities, from July 1988 to January 2008, were retrospectively reviewed. The risk factors including age, gender, cardiac function, location of embolism, embolectomy and duration of iaehemia were analyzed by cumulative Loots regression. Results There were 62 patients, 33 men and 29 worsen, with a mean age of 63. 5 years (35～86 years). Among them, 37 patients received Fogarty embolectomy and 25 patients received medical treatment including thrombolysis, anticoagulation and antiplatelet therapy because of poor risk for surgery. The iachemic status meliorated in 55 patients (88.7%) with 2 patients receiving amputation and 2 patients dying during the peri-operative period. The result of cursulative Logits regression shewed that the duration of ischemia, cardiac function and embolectomy played the significant role on the prognosis (P < 0.01 ), but age, sex and the location of embolism did not show the significant role. In those only receiving the medical treatment, 23 patients restored blood flow to different degree. Conclusions Embolectomy with Fogarty catheter within 8 hours of onset was the most effective treatment for acute arterial embolism in the upper extremities. For peor-risk patients, early medical treatment including thrombolysis, antieoagulation and antiplatelet treatment, can also restore the blood flow in the isehemie limbs.

Objective To assess apoptosis mediated by the cell death receptor Fas in peripheral T lymphocytes of patients with abdominal aortic aneurysm. Methods The apoptotic pathway was triggered by anti-Fas monoclonal antibody in cultured and activated peripheral T-cells from 20 AAA patients. Control groups consisted of 15 patients with aortic atherosclerotic occlusive disease(AOD)and 25 healthy individuals. Cell survival and death rate were assessed. Results Cross-linkage of Fas receptor exerted a strong apoptotic response on T cells from AOD patients and healthy controls, while the effect on T cells was very limited from that of AAA patients. The evaluation of cell Survival rate showed a significantly higher percentage in AAA group(98.9%±10.3%)than in the AOD subjects(58.9%±15.2%)or the healthy group(59.4%±12.9%;P＜0.001＝.Apoptosis assessment by annexin V and propidium iodide staining and flow cytometry showed similar results. The defect in AAA group was not due to decreased fas expressed at normal levels. Moreover,it specifically involved the Fas system because cell death was induced in the normal way by methylprednisolone. Conclusions Fas-induced apoptosis in activated T cell from AAA patients is impaired. This may disturb the normal down-regulation of the immune response and thus provide a new insight into possible mechanisms and routes in the pathogenesis of AAA.

Objective To report our surgical experience in treating 19 cases of solitary iliac aneurysms (SIA). Methods The clinical data of 19 consecutive patients with SIA between January 1985 and January 2008 were retrospectively reviewed. There were 18 men and 1 woman, aging from 39 to 77 years ( mean 62 ± 7 years). Results There were 30 SIAs in the 19 patients, including 25 ( 83.3% ) common iliac aneurysms, 4 (13.3%) internal ihac aneurysms and 1 (3. 3% ) external iliac aneurysm. Eleven patients ( 57.9% ) had multiple ancurysms, with 9 patients ( 47.4% ) having bilateral SIA. Two patients had coexistent peripheral vascular occlusive disease. There were 2 patients suffering form ruptured SIA, one was saved by emergency operation and one died before an surgery could be attempted. Seventeen patients underwent successful open aneurysmectomy and artificial graft implantation leaving no ischemic complications of the pelvic organs. One patient with right common iliac aneurysm underwent endovascular repair without endoleak. There was no operative death during porioperative period. The surviving patients remained stable and had good patency of grafts during the follow-up period. Conclusions Early management of SIA is important, CT angiogarphy (CTA) is necessary not only to evaluate the SIAs, but also to detect multiple aneurysms or arterial occlusive disease. Close and long-term follow-up is mandatory for the early detection of the formation of new anearysms.