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 explore the effects of overexpression of hypoxia inducible factor 1? (HIF 1?) mRNA on vascular endothelial growth factor (VEGF) and novoendotheliasis in venous autografts Methods Wistar rats were randomly divided into two groups with 28 rats in each group A rat experimental model of autogenous vein graft was established by transplanting the right external jugular vein into between the interrupted right common carotid artery The transplanted vein in the experimental group was first immersed into a solution containing recombinant adeno associated virus (rAAV) HIF 1? for 45 minutes Vein grafts and blood simples were taken at 7 or 14 days after transplantation RT PCR, ELISA, immunohistochemistry were used to detected HIF 1? mRNA and VEGF expression Results HIF 1? mRNA and VEGF protein remarkably increased in experimental group, and serum level of E selectin significantly decraesed at day 14 The novoendotheliasis and myo endothelium junction in vein grafts were remodeled at day 14 in the experimental group Conclusion Re establishment of the structure and function of the autograft vein graft endothelium was accelerated by overexpressed HIF 1? mRNA

Objective To evaluate surgical therapies in patients with popliteal aneurysms (PA).Method The clinical data of 25 PA patients admitted from January 1988 to January 2012 were retrospectively analyzed.There were 21 men and 4 women,the mean age was (56 ± 16)years.There were 27 PA in these 25 patients,with bilateral PA in 2 cases.The main symptoms were pulsatile mass in the popliteal fossa,limb pain,acute or chronic distal limb ischemia and limb edema.Result In this series 23out of 25 PA cases recieved operations,17 of them were treated with aneurysmectomy and saphenous vein interposition or bypass grafting,4 of them were treated with aneurysmectomy and prosthetic grafts interposition,1 was treated with aneurism ligation and 1 underwent end-to-end anastomosis after aneurysm resection.There was no perioperative mortality.One patient recieved amputation for distal anastomotic thrombosis and severe limb ischemia.The mean follow-up time is (6.5 ± 0.5) years.After 4 years,a right subclavian artery aneurysm was found in a bilateral PA case and treated surgically.Conclusions Early elective surgical treatment is recommended for patients with PA because PA may go rupture or induce dital limb ischemia and these patients may have good outcome after surgical treatment.Long-term follow-up is warranted to detect the new aneurysm formation.

Objective:The aim of this study was to identify fibrinogen ( FG ) on the development of intimal hyperplasia ( IH ), using an organ culture model. Methods：Segments(n=9 ) of human saphenous vein ( HSV ) wereharvested during coronary artery or infrainguinal vein bypass surgery. The culture medium supplemented with FG (from0 mg/ml to 5 mg/ml ). The proliferation of smooth muscle cell ( SMC ) quantified by 5′-Bromodeoxyuridine (5′-BrdU) uptake in the final four days of the culture period. Histologic analysis and computerized morphometric analysis were used to determine intimal and medial thickness and area，then the intima/media thickness ratio and intima/media area ratio were calculated. Monoclonal antibodies to 5′-BrdU were used as an immunohistochemical maker for proliferating SMC. Results：Addition of FG ( 2.5 mg/ml ) to the cultured medium caused a significant increase in median ( range ) of intima/media thickness ratio and intima/media area ratio of these segments when compared with the normal cultured vein segments ( Wilcoxon paired rank test )：0.387versus 0.215（P=0.017 ）and 0.396 versus 0.229（P=0.015 ），respectively. Addition of FG ( 5.0 mg/ml ) to the cultured medium also caused a significant increase in median ( range ) of intima/media thickness ratio and intima/media area ratio of these segments when compared with the normal cultured vein segments: 0.421 versus 0.215（P=0.008 ）and 0.382 versus 0.229 （P=0.011 ），respectively. However，there were no significant differences in the two vein segments which 2.5 mg/ml or 5.0 mg/ml FG in cultured medium (P>0.05 ).In addition, there was no significant difference in the median ( range ) of intima/media thickness ratio and intima/media area ratio of the segments which FG ( 0.5 mg/ml ) in cultured medium when compared with the normal cultured vein segments ( P>0.05 ). These were supported by SMC proliferation index using staining with 5′-BrdU. Conclusion：High concentration FG at local preianastimotic area may an important factor for IH and early postoprative vein graft restenosis or occlusion.

Objective To assess the condition of left ventricular outflow tract obstruction (LVOTO) under resting conditions and physiological exercise in hypertrophic cardiomyopathy (HCM) patients.Methods A total of 60 patients with HCM and left ventri cular outflow tract gradient (LVOTG) ＜ 50 mm Hg (1 mm Hg =0.133 kPa) at rest were enrolled consecutively,and LVOTG at rest and exercise were measured by echocardiography.Of 51 patients with gradients ＜ 30 mm Hg at rest,26 were latent LVOTO with exercise peak value LVOTG ≥ 30 mm Hg,25 were non LVOTO with exercise peak value LVOTG ＜ 30 mm Hg,and 9 were resting obstruction with LVOTG 30-49 mm Hg.The morphological characteristics of different types of obstruction were analyzed.Results Patients with latent LVOTO were more likely to have SAM(73.1％ vs 8.0％),narrow of LVOT(46.2％ vs 4.0％),higher resting gradients [(16.9 ±7.2) mm Hg vs (7.1 ± 4.3) mm Hg] and mitral regurgitation grade at rest than patients with non-obstructive (all P values ＜ 0.05).The distribution of septal hypertrophy were different in the two groups (P ＜ 0.05).Multivariate logistic regression analysis showed independent predictors of latent LVOTO were SAM (OR 6.431,95 ％ CI 2.323-291.112,P =0.002) at rest and distribution of septal hypertrophy (OR 0.011,95％ CI 0.001-0.179,P =0.008).Conclusions Approximately half of patients with nonobstructive HCM at rest have latent LVOTO.SAM and distribution of septal hypertrophy may be useful to identify patients with latent obstruction.

Objective To assess the treatment of splenic artery aneurysms (SAA) and prognosis.Methods Clinical data of 18 SAA patients treated in our hospital from 1999 to 2011 were retrospectively analyzed. Results There were 18 patients diagnosed as SAA,including 7 males and 11 females.The average age was 53.8 ± 7.3 years.8 patients were asymptomatic found by routine physical examination,7 patients complained upper left abdominal pain,3 cases suffered from aneurysm rupture. Diagnosis was established by three-dimensional computed tomography angiography (3DCTA) in 14,Digital subtraction angiography (DSA) in 3 and magnetic resonance angiography (MRA) in 1 patient.Three patients with ruptured splenic artery aneurysm underwent emergent operations,11 patients underwent elective surgery or interventional therapy.Surgical procedures included aneurysmectomy and splenectomy in 4 patients,distal pancreatectomy in 5 cases; aneurysmectomy and splenic artery ligation in one patient; and aneurysmectomy with splenectomy and colon resection in 1 case.Interventional embolization by coils of the splenic aneurysm in 3 patients.The remaining 4 being asymptomatic and with tumor diameter less than 2 cm were put on a close follow-up.There was no perioperative mortality.Two were lost to follow-up.16 cases were followed-up for averaging 3.2 years. 1 patient died of cerebral hemorrhage after four years. Conclusions Splenic artery aneurysms was a rare disease and with usually occult symptoms,but rupture can leads to abdominal apoplexy.Open surgery and minimally invasive endovascular treatment is effective and offers a good prognosis.

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 evaluate the short term results of endovascular laser for the treatment (ELVT) of great saphenous varicosity. Methods Twenty one cases (a total of 27 lower extremities) were enrolled. Treatment included EL combined with ligation and resection of communicating branches. One patient underwent high ligation and resection of the great saphenous vein for the purpose of pathology after ELVT treatment. Result Twenty patients were followed-up for a period of 2～6 months. Color Duplex ultrosonography was conducted 2 weeks,4 weeks,and 6 mos,respectively. Thrombotic obliteration was found in all cases. Pathology study showed perforation of the vein with intimal injury and thrombosis. Conclusion The short term efficacy of EL treatment is definite with insignificant side-effect,and quick patient recovery. The mechanism is related to direct thermal injury of laser to the venous intima resulting in thrombotic obliteration.