Objective To systematically review the short-term and long-term efficacy of eversion carotid endarterectomy (eCEA) and patch carotid endarterectomy (pCEA) for the treatment of carotid artery stenosis.Methods The published literature on eCEA and pCEA control studies in medline,PubMed,Ovid,CNKI and CBM (1970.5-2016.10) databases were retrieved by computers.Two reviewers selected literature and extracted data independently according to the inclusion and exclusion criteria.Cochrane Collaboration Network Special Software Rev Man 5.2 was used to analyze the meta-analysis of short-term and long-term outcome measures.Results A total of 1 137 articles were retrieved.Ten studies were included and analyzed (3 of them were randomized controlled trial).A total of 3 213 patients were enrolled,including surgical intervention 3 299 case/time (1 512 in the eCEA group and 1 787 in the pCEA group).The results of meta-analysis showed that:(1) the mean operative time in the pCEA group was shorter 22±8 min than that in the pCEA group.The intraoperative utilization ratio of shunt tube,eCEA was significantly lower than pCEA,they were 12.6 %(53/421) and 50.2% (357/711) respectively (OR,0.11,95%CI 0.08-0.15,P<0.01).The postoperative incidence of stroke within 30 d (OR,0.42,95%CI 0.23-0.76,P=0.004) and the incidence of stroke after 30 d in eCEA were lower than those in pCEA (OR,0.26,95%CI 0.09-0.78,P=0.02).There was significant difference.(2) eCEA reduced the incidence of restenosis at day 30 after procedure (OR,0.57,95%CI 0.38-0.86,P=0.008).Conclusion Compared with pCEA,eCEA has the advantages of reducing the operation time and lowering the utilization rate of shunt tube.At the same time,eCEA can reduce the occurrence of stroke within 30 d and 30 d after procedure,and significantly reduce the incidence of restenosis.

BACKGROUND:Vascular smooth muscle is the main cell component of constructing vascular wall tissue structure and maintaining vascular tension.Studies have shown that smooth muscle progenitor cells obtained from peripheral blood can differentiate into vascular smooth muscle cells.OBJECTIVE:To compare smooth muscle progenitor cells dedved from human peripheral blood with mature vessel wall smooth muscle cells in cell morphology and proliferation potential.DESIGN,TIME AND SETTING:Cell culture and observation trials were performed at the Key Laboratory of Molecular Medicine in Jiangxi province from October 2008 to April 2009.MATERIALS:Peripheral blood 20mL were adopted from 6 healthy volunteers,and great saphenous vein were sourced from 6 patients with varicose vein.METHODS:Mononuclear cells were isolated from human peripheral blood and cultured in fibronectin,platelet derived growth factor-BB and EGM-2 medium.At the same time,the smooth muscle cells were obtained from great saphenous vein with the collagenase digestion method.High-glucose DMEM medium was used for the culture.MAIN OUTCOME MEASURES:Cellular morphology;Cellular immumofluorescence method and RT-PCR method were used to detect the expression of α-SMA and calponinl.MTT method was used to analyze the proliferation activity.RESULTS:The smooth muscle progenitor cells denved from human peripheral blood exhibited biological characteristics of vascular smooth musc Je cells.they were found to express α-SMA and calponin1.The proliferation activity of smooth muscle progenitor cells was also greater than vascular smooth muscle cells.CONCLUSlON:Peripheral blood mononuclear cells in the stimulus of platelet-derived growth factor can differentiate into smooth muscle progenitor cells.Compared to smooth muscle cells,smooth muscle progenitor cells proliferate better,and are not easy to age in a long time of cultivation.Smooth muscle progenitor cells are a ideal ceil source of tissue engineered vessel.

Objective　To study the expression of p73 in human non-small cell lung cancer (NSCLC) and the relationship between p73 expression and clinico-pathological parameters. Methods　Expression of p7 3 gene was detected by RT-PCR in 32 human NSCLC tissues, tissues adjacent to ca ncer and non-cancer lung tissues. Results　p73 gene expression up-regulated substantially and detected in 87.5%(28/32) of human NSCLC tissues while expressed at low level in tissues adjacent to cancer and non-cancer lung tissues. Conclusion　Marked up-regulation of p73 gene expres sion is found in human NSCLC.

Objective To investigate the cardioprotective effects of the inhibitor of JAK/STAT pathway on ischemia-reperfusion injury in cultured immature rat cardiacmyocytes.Methods The cultured immature rat cardiacmyocytes were randomly divided into normal control group,ischemia-reperfusion group,AG490 treatment group and RMP treatment group.The cell viability was measured by MTT method.The contents of lactate dehydrogenase(LDH) and malondialdehyde(MDA),the superoxide dismutase(SOD) activity and the rate of cell apoptosis were detected.Results Compared with the normal group,the cell viability decreased significantly,the contents of LDH and MDA in the supernatant of the cells increased significantly,the SOD activity decreased and the rate of apoptosis of cells increased significantly in ischemia-reperfusion group(all P

BACKGROUND: The role of p53 gene in human lung cancer has been confirmed. Since the discovery of p63 gene as the homologue of p53, its role and possible mechanism-have aroused the attention of investigators all over the world. But the principle concerning transcription and expression of p63 in small-cell lung carcinoma (SCLC) remains unclear.OBJECTIVE: To investigate the level of the expression of p63 gene in SCLC and lung adenocarcinoma tumor tissues, peri-carcinoma tissues and normal tissues, and observe the expression of p63 protein in these tissues so as to understand the principle and clinical significance concerning p63gene expression in SCLC and lung adenocarcinoma.DESIGN: Controlled experiment.SETTING: Department of Thoracic and Cardiovascular Surgery, Research Institute of Field Surgery of Daping Hospital of Third Military Medical University of Chinese PLA.PARTICIPANTS: Six SCLC specimens dissected during the surgical operation in Daping Hospital, Third Military Medical Univers ity of Chinese PLA, between October 2000 and September 2002 , were recruited. There were 4 male and 2 female patients aged 42 to 67 years (mean age of 50.7years); 15 specimens of lung adenocarcinoma were also collected at the same time. Tumor tissues, peri-carcinoma tissues and normal tissues were chosen in each specimen.METHODS: Reverse transcriptase polymerase chain reaction (RT-PCR)was used to detect and compare the transcription expression of two subtypes of p63 gene (TAP63 and △NP63)in the tumor tissues of 6 cases of SCLC and 15 cases of lung adenocarcinoma. At the same time, immunohistochemical staining technique was used to detect the expression of p63protein in the above tissues.MAIN OUTCOME MEASURES: ① Expression of p63 protein detected by RT-PCR in tissue specimens. ② Expression of p63 protein detected in tissue specimens detected by immunohistochemical staining technique.RESULTS: ① Expression of p63 protein detected by RT-PCR in tissue specimens: The positive expression of △Np63 gene could be found in 5cases (83%, 5/6) of SCLC cancer tissues and 1 case of SCLC peri-carcinoma tissues (17%, 1/6), and the expression of TAp63 was not observed in all of the tumor, peri-carcinoma and normal tissues of SCLC. There was no expression of △Np63 or TAp63 in tumor, peri-carcinoma and normal tissues of lung adenocarcinoma. ② Expression of p63 protein detected by immunohistochemical staining in tissue specimens: The positive expression rate of p63 protein in SCLC tumor tissues was significantly higher than that in lung adenocarcinoma tissues [83% (5/6), 17% (1/6), P ＜ 0.01].CONCLUSION: p63 gene shows positive expression in SCLC, among which the expression level of △NP63 is increased while the expression level of p63 protein is obviously higher in SCLC than in adenocarcinoma tissues, which may be related to its regulatory role in the occurrence and development of SCLC. It is presumed that△NP63 gene has high transcription expression level in SCLC, which might inhibit cellular apoptosis, promote the proliferation of tumors, play the role as an oncogene. It suggests that p63 may be one of the factors influencing the prognosis of SCLC.

Objective　To estimate the value of applying left heart bypass technique in esophageal carcinoma resection and gastroesophageal reconstruction. Methods　The operation was performed under lef t he art bypass. Results　Applying left heart bypass during esophagea l carcinoma resection and gastroesophageal reconstruction increased the probabil ity of the resection. The patient lived better and without operative complicatio n. Conclusion　In case of esophageal carcinoma with invasion of descending aorta by carcinoma, left heart bypass may increase the probability of the resection and enhance the safety of surgical treatment.

Objective To evaluate the relationship between the let-7 rs10877887 polymorphism and cancer risk in the Chinese population.Methods We searched all relevant studies published on association between the let-7 rs10877887 polymorphism and cancer risk in PubMed,Embase and Wanfang databases up to December 31,2016 were searched.A total of 4 case-control studies comprising 2 754 cases and 3 481 controls were included in this meta-analysis.The pooled odds ratio (OR) and 95% confidence interval (95%CI) were calculated to examine the strength of the association.Sensitivity analyses were performed to assess the stability of the results,publication bias was also assessed.Results The pooled results showed that there was a significant association between the let-7 rs10877887 polymorphism and overall cancer risk under the dominant model (CC+CT vs.TT:OR=0.90,95%CI=0.82-1.00,P=0.048).Conclusion Base on present studies,the results of this meta-analysis indicated that there is a significant association between the let-7 rs10877887 polymorphism and overall cancer risk in the Chinese population,the let-7 rs10877887 polymorphism could decrease the risk of cancer.

Objective To explore the difference between laparoscopic transabdominal preperitoneal hernia repair (TAPP) and open preperitoneal hernia repair for the treatment of inguinal hernia under local anesthesia.Methods A total of 64 cases with inguinal hernia underwent hernia repair in Beijing Daxing District Hospital of Capital Medical University from January 2014 to January 2015 were retrospectively analyzed.Thirty-four cases in test group were applied with TAPP and used D(9 * 13) mesh to repair for inguinal hernia,and 30 cases in traditional group with open preperitoneal hernia repair which used D10 mesh to repair for inguinal hernia.Results All operations were successfully completed.There was statistically significant difference in operation time(P =0.000),postoperative activity time(P =0.000),postoperative hospitalization time (P =0.003) and pass flatus time (P =0.000) between these two groups.There was no statistically significant difference in wound seroma(P =0.216),hematoma (P =1.000),analgesics (P =0.090) and recurrence rate of the first year (P =1.000).Conclusions Both TAPP and tension free repair of inguinal hernia under regional anesthesia are safe and effective methods for the treatment of inguinal hernia,which has its advantages.Surgeon should choose the suitable procedure according to patient's condition reasonably.

Objective:To investigate high mobility group protein 1(HMGB1), tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)levels and their clinical significance in elderly patients with viral pneumonia.Methods:One hundred and sixty elderly patients with viral pneumonia admitted to the Sixth Hospital Affiliated to Anhui Medical University were enrolled as research subjects.In addition, 40 elderly people who underwent regular physical examination were considered as the control group.Patients with viral pneumonia were divided into the low-risk group, middle-risk group and high-risk group according to CURB-65 scores and pneumonia severity index(PSI)scores.HMGB1, TNF-α and IL-6 levels were compared between different groups.The correlations of CURB-65 scores and PSI scores with HMGB1, TNF-α, IL-6 levels were analyzed.Multivariate Logistic regression analysis was used to examine influencing factors for the severity of viral pneumonia in elderly patients.Results:HMGB1, TNF-α and IL-6 levels were higher in research subjects than in the control group.As the severity of viral pneumonia increased, so did HMGB1, TNF-α and IL-6 levels(all P<0.05). HMGB1, TNF-α and IL-6 levels in the severe viral pneumonia group were significantly higher than those in the non-severe viral pneumonia group( P<0.05). HMGB1, TNF-α and IL-6 levels were positively correlated with CURB-65 scores and PSI scores(CURB-65 score: r=0.463, 0.392 and 0.497, P=0.015, 0.003 and 0.025; PSI score: r=0.596, 0.515 and 0.381, P=0.007, 0.011 and 0.009). HMGB1, TNF-α and IL-6 levels were influencing factors for the severity of viral pneumonia in elderly patients( OR=1.344, 1.422 and 1.351, P=0.006, 0.015 and 0.009). Conclusions:HMGB1, TNF-α and IL-6 levels are closely correlated with the severity of viral pneumonia and are helpful for early assessment of viral pneumonia.

BACKGROUNDLocally advanced lung cancer includes IIIA and IIIB lung cancer that tumors are localized within the chest and with no clinic and pathologic distal metastasis. In this study the results of extended resection of a portion of heart or great vessels with cardiopulmonary bypass was summarized in the treatment of locally advanced lung cancer.

METHODSLobectomy or pneumonectomy combined with extended partial excision of the heart or great vessels were carried out in 10 patients with locally advanced lung cancer. The operations included aortic resection and reconstruction with left heart bypass in 2 cases, extended resection of left atrium with normal cardiopulmonary bypass in 5 cases, and resection and reconstruction of superior vena cava in 3 cases respectively.

RESULTSThe patients had no operative complication except for one haemothorax, which was controlled by re-exploration. One patient died of brain metastasis 6 months after operation and another one died of multiple metastasis 26 months after operation. The others were alive.

CONCLUSIONSCPB is a safe and effective anesthetic procedure during extended resection of locally advanced lung cancer although it is controversial for aggravating operative trauma, complex technique and higher cost.