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 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 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: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 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 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.

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.