Renal cell carcinoma (RCC) is a common urologic malignancy, comprising 2% to 3% of all malignant diseases. Lym-phangiogenesis significantly affects the lymphatic metastasis of tumors. Vascular endothelial growth factors and their receptors have important functions in the spread of cancer cells. Vascular endothelial growth factor-C, which links the vascular endothelial growth factor receptor-3, can increase lymphangiogenesis and promote lymphatic metastasis. These findings direct research efforts toward lymphangiogenesis in malignant diseases and a possible targeted therapy. An increasing number of studies on the lymphatic vessel of renal cell carcinoma have drawn considerable interest in the treatment of renal cell carcinoma. This paper summarizes recent studies on lymphangiogenesis and the clinical significance of renal cell carcinoma.

Subcortical ischemic vascular dementia is a subtype of vascular cognitive impairment. Its major pathological features are lacunar infarcts and deep white matter changes, and its major clinical manifestation is executive function impairment. Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) provides an opportunity for the study of pure subcorticai ischemic vascular dementia in the absence of Alzheimer's disease. There is currently lack of the gold standard for diagnosing subcortical ischemic vascular dementia. Imaging examination plays an important role in its diagnosis, while the treatment must first consider the control of vascular risk factors, especially hypertension.

Objective To explore the effect of Bacillus Calmette guerin vaccine (BCG) on apoptosis of lymphocytes in asthmatic BALC/c mice Methods Asthmatic BALB/c mice model established by inhaling ovalbumin was treated by BCG Lymphocytes apopotic index and DNA damage index were determined by comet method and xylidine method,respectively Results Apoptosis index and DNA damage percentage of peripheral blood and BALF lymphocytes were significantly elevated after BCG treatment( P

Objective To compare the manipulation of two different methods of percutaneous dilatational tracheostomy (PDT),the guidewire dilating forceps (Portex method) and the modified onestep dilation technique (Ciaglia Blue Rhino method,CBR method).Methods From March 2013 to February 2014,48 patients eligible to meet the criteria of tracheostomy in ICU were collected and were divided into two groups at random.The length of time consumed for operation,amount of blood lost during operation and the operation complications were compared between two groups.The participant surgeons were asked which method they preferred,Portex or CBR.Results Of them,the mean age was 76.7 ± 11.6 years old,and 25 patients (52.1％) were male.The reasons for tracheotomy were the length of time needed for mechanical ventilation support expected to be longer than 2 weeks (n =30),severe disturbance of consciousness (n =17),and upper airway obstruction (n =1).The patients enrolled in the study were randomly divided into Portex and CBR groups.There were no significant differences in age,gender,APACHE Ⅱ score,the reason of tracheotomy,the length of time for mechanical ventilation support before tracheotomy,and the preoperative coagulation function between two groups.CBR method can easily be done with less operation time required than Portex [(5.9 ±4.3) min vs.(9.9 ± 1.5) min,P ＜0.01],and had obviously fewer operation complications and less amount of blood lost than Portex method (P ＜ 0.05).The male surgeons with a slew of surgical practice were in preference to Portex,whereas female doctors with less work experience and without surgical practice preferred CBR.Conclusions The CBR method can easier be done and was better than the Portex method in minimizing operative trauma and reducing the complications,especially it can easily be accepted by female doctors with less work experience and without surgical practice and it is worth using widely in clinic.

Objective To compare the early and delayed tracheostomy in patients treated with prolonged mechanical ventilation in respects of mortality.incidence of nosocomial pneunonia and length of ICU stay.Methods Randomized controlled trials(RCTs)and quasi-randomized controlled trials(quasi-RCTs)were performed by searching throush the Ovide MEDLINE(1996-2006.7),EMBASE(1980-2006.7),Cochrane Database(Issue 2,2006),Chinese Cochrane Centre Database and CBMdisc(1978-2006.7).The published and unpublished data and their references were searched.All RCTs and quasi-RCT of tracheostomy for critically ill patients treated withprolonged mechanical ventilation were included.Data were collected and evaluated by two reviewers independently and separately.RevMan version 4.2 software was used for data analysis.Results Two hundred and eighty-six patients from 4 RCTs and 106 cases from one quasi-RCT were taken for meta analysis.The meta-analysis showed that the early tracheostomy could reduce mortality(OR 0.69,95%CI 0.51,0.95),significantly shorten the duration of mechanical ventilation(WMD-8.49,95%CI-15.32,-1.66)and shorten the length of ICU stay as well(WMD-15.33,95%CI-24.58,-6.08)in patients treated with prolonged mechanical ventilation.but the incidence of nosocemial pneumonia was not different between two sorts of patients(OR 0.91,95%CI 0.70,1.18).Conclusions In case of prolonged mechanical ventilation,the tracheostomy performed at earlier stage may decrease the mortality,and shorten the duration of mechanical ventilation and the length of ICU stay.but cannot reduce the incidence of nosocomial pneumonia.

Objective:To simultaneously determine six components ( paeoniflorin, rosmarinic acid, salvianolic acid B, ligustilide, clyptotanshinone and tanshinone ⅡA ) in refined coronary tablets by UHPLC-DAD. Methods: A Dikma Endevaorsil C18 column (2. 1 mm × 100 mm,1. 8 μm) was used to perform the determination, which was maintained at 30℃ during the analysis. The mobile phase was composed of acetonitrile and 0. 05% phosphoric acid at a flow rate of 0. 3 ml·min-1 with gradient elution. The detection wavelength was respectively set at 230,270,288 and 321 nm. Results:Paeoniflorin, rosmarinic acid, salvianolic acid B, ligustilide, clyptotanshinone and tanshinone ⅡA showed good linearity within the range of 0. 001 0-0. 010 2 μg ( r = 0. 999 8 ), 0. 005 7-0.056 9 μg(r =1.000 0), 0.005 3-0.052 7 μg(r = 1.000 0),0.002 1-0.020 6 μg(r = 1.000 0),0.001 1-0.011 2 μg(r =1. 000 0) and 0. 001 4-0. 014 4 μg(r=0. 999 8),respectively. The average recovery was 98. 78%(RSD=0. 50%), 97. 99%(RSD=0. 76%),98. 44%(RSD=0. 85%),99. 12%(RSD=0. 66%), 98. 82%(RSD=0. 81%) and 97. 80%(RSD=0. 80%), respec-tively. Conclusion:The method is simple, rapid and accurate, which can be used for the quality control of refined coronary tablets.

Objective To investigate the relationships between Glucokinase(GCK) gene 4 tag single‐nucleotide polymorphisms , tagSNPs)sites which named rs12702070 ,rs2268569 ,rs2268573 and rs1476891 polymorphisms and type 2 diabetes in Chinese South‐ern Han Population .Methods This study was designed as a case‐control .499 type 2 diabetes patients and 499 healthy controls were chosen .4 GCK tagSNPs sites were analyzed by improved multiple ligase detection reaction(iMLDR) ,and genotype and allele fre‐quency between T2D group and healthy controls could be determined by chi‐square test ,logistic regression analysis ,and tagSNPs were further analyzed under three genetic modes(dominant ,recessive and additive) .What′s more ,Haploview software was used to construct the haplotype of 4 GCK tagSNPs and the linkage disequilibrium(LD) and relationship between various GCK haplotype and T2D susceptibility could be analyzed .Results Genotype distribution of rs2268573 ,rs2268569 and rs1476891 and allele frequen‐cy in T2D group were no significant differences with health controls .Significant differences in genotype distribution of rs12702070 and allele frequency were observed between T2D group and health controls .Under dominant model and additive model ,genotype distribution of rs12702070 in T2D was significantly different from health controls .One LD domain was observed in 3 tagSNPs a‐mong those 4 sites of GCK gene .There are 4 main haplotypes(TAG ,TGG ,TAT ,CGG)in rs2268569 ,rs12702070 and rs1476891 , but all these haplotypes have no relevance to the individual risk of T2D(P>0 .05) .Conclusion The results indicated that the GCK gene tagSNPs site rs12702070 imparts susceptibility to T2D in Han Chinese ,but not rs2268573 ,rs2268569 and rs1476891 .Four main haplotypes in rs2268569 ,rs12702070 and rs1476891 have no relevance to T2D .

Objective To investigate the etiology,clinical features and outcome of hospitalized patients with bloodstream infections (BSIs) in a tertiary hospital.Methods Positive blood cultures were obtained from the microbiological laboratory in Fuxing Hospital,Capital Medical University from January 1,2012 to December 31,2012.BSIS events were identified and the epidemiology data were collected.Results A total of 149 patients and 154 BSIs events were confirmed by pathogenic and clinical evidence.The inpatients' BSIs rate was 0.8％ in our hospital in 2012.According to the disease entities of the first BSIs onset,15 patients (10.1％) were from surgical departments,83 patients (55.7％) from the medical departments,and 51 patients (34.2％) from ICU.Thirty-three patients (22.1％) were diagnosed as septic shock.Sixty-eight patients died during hospital stay.The in-hospital mortality rate was 45.6％.Among the 154 BSIs events,125 (81.2％) were nosocomial and 29 (18.8％) were community-acquired.A total of 188 strains were isolated from all BSIs,including 106 strains of (56.4％) gram-negative bacilli,67 (35.6％) strains of gram-positive bacteria,and 15 (8.0％) strains of fungi.One hundred and fifty-nine strains of bacteria (84.6％) were isolated from 125 events of hospital-acquired BSIs.Twenty-six strains of bacteria were from catheter related bloodstream infections (CRBSIs).In gram-negative BSIs,there were more enterobacteriaceae in community-acquired BSIs.More non-fermentative bacteria were found in hospitalacquired BSIs than in community-acquired ones.The distribution of gram-negative bacilli was quite different between surgical departments,non-surgical departments and ICU (P =0.049).Conclusions Pathogens of BSIs are quite different according to disease entities and where the patients are from.Local epidemiology of BSIs and distribution of related pathogens are helpful to physicians searching the optimal empirical antibiotics and improving the outcome.

Objective To analyse the effect of matrine on sex hormone level, metal ion content and soluble tumor necrosis factor receptor in male patients with liver cirrhosis.Methods 70 cases male patients diagnosed with liver cirrhosis of decompensation period were selected in the hospital and randomly divided into experimental group and control group, 35 cases in each group.The experimental group were treated with 250 mL matrine sodium chloride injection on the basis of conventional treatment and the control group were given equal 0.9%sodium chloride injection, once a day, intravenous drip for a consecutive treatment of 4 weeks.The liver function, sex hormone levels, metal ion content, and soluble tumor necrosis factor receptor indicators were detected before and after treatment in two groups.ResuIts Compared with control group, serum liver enzymes and total bilirubin in experimental group decreased (P<0.05);the content of serum testosterone increased and estradiol levels decreased (P<0.05);serum zinc, iron and magnesium content increased, manganese content decreased (P<0.05); serum soluble tumor necrosis factor receptor levels decreased (P<0.05). ConcIusion Matrine adjuvant therapy could regulate the level of sex hormone and metal ion in male patients with liver cirrhosis, reduce the level of soluble tumor necrosis factor receptor, improve liver function in patients with cirrhosis.

Objective To investigate the relationships between Glucokinase (GCK) gene 6 (tag single-nucleotide polymorphisms,tagSNPs)sites which named rs12702070,rs2971672,rs2268569,rs2268573,rs2300587 and rs1476891 polymorphisms and type 2 diabetes in Chinese Southern Han Population.Methods This study was designed as a case-control.499 type 2 diabetes patients and 499 healthy controls were chosen.All subjects were from August 2013 to December 2014 in Zhongshan Affiliated Hospital of Sun Yat-sen University.6 GCK tagSNPs sites were analyzed by improved multiple ligase detection reaction (iMLDR),and genotype and allele frequency between T2D group and healthy controls could be determined by chi-square test,logistic regression analysis,and tagSNPs were further analyzed under three genetic modes(dominant,recessive and additive).What's more,Haploview software was used to construct the haplotype of 6 GCK tagSNPs and the linkage disequilibrium (LD) and relationship between various GCK haplotype and T2D susceptibility could be analyzed.Results Genotype distribution of rs2268573,rs2300587,rs2268569 and rs1476891 (x2 were 3.361,2.076,0.582 and 0.918 respectively,all P ＞0.05) and allele frequency (x2 were 0.222,1.980,0.590 and 0.851 respectively,all P ＞ 0.05) in T2D group were no significant differences with health controls.Significant differences in genotype distribution of rs2971672 and rs12702070 (x2 were 6.896 and 7.990 respectively,all P ＜ 0.01) and allele frequency (x2 were 4.708 and 5.979,P ＜ 0.05 and P ＜ 0.01 respectively) were observed between T2D group and health controls.Under dominant model (rs2971672:OR =1.74,95％ CI =1.17-2.57,P ＜ 0.01;rs12702070:OR =1.54,95 ％ CI =1.17-2.04,P ＜ 0.01) and additive model (rs2971672:OR =1.51,95 ％ CI =1.06-2.14,P ＜ 0.05;rs12702070:OR =1.26,95％ CI =1.04-1.52,P ＜ 0.05),Genotype distribution of rs2971672 and rs2971672 in T2D were significantly different from health controls.There are two LD domains in 5 tagSNPs among those 6 sites of GCK gene.There are three main haplotypes(TC,TA,CA)in rs2971672 and rs2300587,and four main haplotypes (TAG,TGG,TAT,CGG) in Rs2268569,rs12702070 and rs1476891.Although TAG,TGG,TAT and CGG have no relevance to the individual risk of T2D (P ＞ 0.05),haplotype TA and CA reduce the individual risk of T2D with OR 0.81 (95％ CI:0.66-1.00,P＜0.05) and0.78 (95％ CI:0.62-0.98,P ＜0.01)respectively.Conclusions The results indicated that GCK gene 2 tagSNPs sites included rs2971672 and rs12702070 imparts susceptibility to T2D in Han Chinese,but not rs2268573,rs2300587,rs2268569 and rs1476891.Haplotype TA and CA in rs2971672 and rs2300587 reduce the individual risk of T2D and four main haplotypes (TAG,TGG,TAT,CGG) in rs2268569,rs12702070 and rs1476891 have no relevance to T2D.