Objective:To evaluate the effect of laser irradiation on related growth factors in and apoptosis of in vitro cultured infantile hemangioma endothelial cells. Methods:Cultured infantile hemangioma endothelial cells were divided into 3 groups: intense pulsed light (IPL) group irradiated with IPL at a dose of 23 J/cm 2 for 1 session, laser group irradiated with 1 064-nm Nd:YAG laser at a dose of 90 J/cm 2 for 1 session, control group receiving no irradiation. On days 1, 3 and 7 after irradiation, RT-PCR was performed to measure the mRNA expression of vascular endothelial growth factor (VEGF) , VEGF receptor 2 (VEGFR-2) and basic fibroblast growth factor (bFGF) , and Western blot analysis to determine VEGFR-2 protein expression, enzyme-linked immunosorbent assay to detect the levels of VEGF and bFGF in the culture supernatant, and flow cytometry to detect cell apoptosis. Results:Compared with the control group, the laser group showed significantly decreased mRNA expression of VEGF (0.363±0.021 vs. 1.000±0.023, P< 0.001) , VEGFR-2 (0.483±0.017 vs. 1.001±0.031, P=0.001) and bFGF (0.402±0.040 vs. 1.000±0.004, P< 0.001) , decreased VEGFR-2 protein expression (0.332±0.055 vs. 0.768±0.096, P< 0.05) , decreased levels of VEGF (69.389±24.179 ng/L vs. 334.506±13.084 ng/L, P< 0.001) and bFGF (2.386±0.151 ng/L vs. 9.165±0.232 ng/L, P< 0.001) in the culture supernatant, but significantly increased apoptosis rate (18.413%±2.654% vs. 4.300%±0.036%, P< 0.01) on day 7 after irradiation. Compared with the control group, the IPL group also showed significantly decreased mRNA expression of VEGF (0.436±0.041 vs. 1.000±0.023, P< 0.05) , VEGFR-2 (0.493±0.037 vs. 1.001±0.031, P< 0.05) and bFGF (0.490±0.044 vs. 1.000±0.004, P< 0.05) , decreased VEGFR-2 protein expression (0.406±0.037 vs. 0.768±0.096, P< 0.05) , decreased levels of VEGF (128.858±6.063 ng/L vs. 334.506±13.084 ng/L, P< 0.001) and bFGF (2.723±0.471 ng/L vs. 9.165±0.232 ng/L, P< 0.001) in the culture supernatant, but significantly increased apoptosis rate (16.597%±1.877% vs. 4.300%±0.036%, P< 0.01) on day 7 after irradiation. Conclusion:The 1 064-nm Nd:YAG laser may exert a therapeutic effect on hemangioma by inhibiting hemangioma endothelial cells via regulating key factors on the VEGF/VEGFR-2 signaling pathway and cell apoptosis.

Objective To determine the optimum dose of pentazocine when combined with propofol for gastroscopy in elderly patients.Methods One hundred and forty ASA physical status Ⅰ or Ⅱ patients,aged 6575 yr,scheduled for elective gastroscopy under general anesthesia,were randomly assigned into Ⅰ-Ⅳ groups (n =35 each) using a random number table.Before insertion of the gastroscope,pentazocine 0.2,0.4 and 0.8 mg/kg were injected intravenously in Ⅱ-Ⅳ groups,respectively,while the equal volume of normal saline was given in Ⅰ group.Propofol was then administered by target-controlled infusion (TCI).The half-effective concentration (EC50 of propofol was determined by up-and-down sequential trial.The target plasma concentration (Cp) was set at 3.5 μg/ml in the first patient.Gastroscopy was performed at 5 min after the target effect-site and plasma concentrations were balanced.The response to gastroscopy was defined as positive when body movement and/or bucking occurred during gastroscopy.Each time the Cp increased/decreased by 0.3 μg/ml in the next patient depending on whether or not the response to gastroscopy was positive.EC50 and 95 ％ confidence interval of propofol TCI inhibiting the response to gastroscopy were calculated using Probit analysis.The development of respiratory depression and hypotension was observed.Results EC50 (95 ％ confidence interval) of propofol TCI inhibiting the response to gastroscopy was 2.82 (2.63-3.02) μg/ml,2.78 (2.58-2.97) μg/ml,2.16 (2.00-2.32) μg/ml and 2.03 (1.88-2.19) μg/ml in Ⅰ-Ⅳ groups,respectively.Compared with group Ⅰ,EC50 was significantly decreased in Ⅲ and Ⅳ groups,and the incidence of respiratory depression was increased in Ⅳ group (P ＜ 0.05).Conclusion The optimum dose of pentazocine when combined with propofol is 0.4 mg/kg for gastroscopy in elderly patients.

A 68?year?old female patient was admitted to the hospital for multiple masses in the mouth and lungs as well as on dorsal hands for more than 20 days without obvious subjective symptoms. No abnormalities were found by physical examination. Dermatological examination showed two bean?sized dark?red nodules on the upper jaw as well as one pigeon egg?sized dark?red nodule on the left dorsal hand, and all the nodules were hard with smooth surfaces and limited mobility. Positron emission tomography?computed tomography (PetCT) revealed multiple metastases to the brain, lymph nodes, lungs, gastrointestinal tract, both kidneys, multiple bones and intermuscular tissues. Pathology of nodules from the upper jaw showed lowly differentiated tumor cells with osteoid matrix, chondroid structures and tumor bone in local areas, and immunohistochemical examination of tumor cells found positive staining for S100(focally), vimentin, CD99, P63 and Ki?67(60%), but negative staining for keratin. A diagnosis of osteosarcoma of the right side of the upper jaw was considered. Pathology of nodules from the dorsal hand revealed no obvious abnormalities in the epidermis, while there was a diffuse infiltration of medium?to large?sized histiocyte?like cells in the whole dermis with cell atypia and irregularly red?stained bone matrix and tumor bone in some regions. Immunopathology showed positive staining for Ki67(60%), and negative staining for CD3, CD10, CD20, Bcl?2, and Bcl?6. A diagnosis of cutaneous metastasis of osteosarcoma was made. The patient refused further treatment and died 6 months after the onset of lesions.

Objective To investigate the expression of vascular endothelial factor C(VEGF-C) and E-cadherin in gastric cancer and explore the relationship between expression of VEGF-C and E-cadherin and the pathogenesis of gastric cancer.Methods Real-time quantitative reverse ranscriptase-polymerase chain rection was applied on 40 cases of gastric cancer and corresponding adjacent noncancerous tissues,in order to detect mRNA expression of VEGF-C and E-cadherin gene.VEGF-C and E-cadherin protein expression in gastric cancer and adjacent normal gastric mucosa were detected by immunohistochemistry.Statistical analysis was carried out to analyze the correlation among VEGF-C,E-cadherin and protein expression with various clinical parameters in these gastric cancer patients.Results The expression of VEGF-C protein in 40 cases of gastric cancer's cancer tissues was 0.461±0.012,significantly higher than that in the adjacent normal tissues(0.036+0.023;t=1.101,P＜0.05),but E-cadherin expression was significantly lower than that of the adjacent normal tissues (0.079±0.002 vs.0.321±0.005;t=1.844,P＜0.05).There was correlation between VEGF-C mRNA expression with histological grading,TNM staging,lymph node and distant metastasis (t=-1.621,-1.474,-2.378,-1.966,P＜0.05).There was correlation between E-cadherin mRNA expression with tumor size,histological grading,TNM stage,there was a significant difference (t=1.875,1.673,1.544,P＜0.05).VEGF-C and E-cadherin protein expression was negatively correlated(r=-0.688,P＜0.05).Conclusion Up-regulated of VEGF-C gene and decreased expression of E-cadherin may play an important role in the carcinogenesis of gastric cancer

Objective To explore the influence of G4 cyberknife treatment of large hepatocellular car-cinoma on liver function,and to evaluate its treatment safety.Methods Sixty-three large liver cancer patients treated with routine G4 cyberknife treatment were retrospectively analyzed,and then statistical analysis of the difference in liver function before and after treatment was conducted.Results After G4 cyberknife treatment of 1 2 months,the levels of ALT,ALP,TBIL,PA were respectively 23.00 U /L,1 1 1 .00 U /L,1 3.70 μmol/L, (81 .87 ±1 3.94)%.Compared with the levels before treatment [28.00 U /L,32.00 U /L,1 1 .30 μmol/L, (86.07 ±1 4.07)%],there were no signi-ficant differences found (Z =-1 .677,P =0.094;Z =-0.504, P =0.61 4;Z =-1 .945,P =0.053;t =1 .271 ,P =0.21 3).The level of ambumin was (34.84 ±4.75)g/L at 1 2 months after treatment,which decreased and the difference compared with the level before treatment [(37.45 ±4.1 4)g/L]was significant (t =3.357,P =0.002).The Child-Pugh grade was 5.80 ±1 .1 7 respectively at the time points of 1 2 months after treatment,and no significant difference was found compared with the Child-Pugh grade before treatment (5.48 ±0.81 ,t =-1 .668,P =0.1 06).Conclusion G4 cyberknife treatment does not cause liver injury.It is safe and reliable in large liver cancer treatment.So,it is worth widely clinical popularizing.

Objective To further clarify the pathogenesis of different types of Kaposi′s sarcoma (KS) by measuring the protein expressions of caspase-3 and E-cad in tumor tissues of Xinjiang Uygur patients with acqured immunodeficiency syndrome (AIDS)-Kaposi′s sarcoma (KS) and classical KS.Methods From July 2011 to October 2014, 38 patients with KS at the First Affiliated Hospital of Xinjiang Medical University and Urumqi Infectious Disease Hospital were enrolled, among whom 28 were male and 10 were female, and all of them were uygur.Immunohistochemical and Western blot methods were used to detect the expressions of caspase-3 and E-cad proteins in 22 cases of AIDS-KS patients and 16 cases of classic KS.The quantitative data of normal distribution were analyzed by t test, while count data were compared with χ2 test with R × C table.Results KS lesions in patients with classic KS were confined to the skin, without mucosal, lymph node or visceral involvement.Lesions in AIDS-KS patients were not only confined to the skin and superficial lymph nodes, but also oral mucosa involved in 12 cases and internal organs involved in 7 cases.Liver and lung involvement was more common.The CD4+T lymphocyte count in patients with AIDS-KS was (200.8±166)/μL.All 15 AIDS cases with CD4+ T cell count less than 200/μL developed opportunistic infections.CD4+ T lymphocyte count of patients with classic KS was (562.52±222.66)/μL and the 16 patients with CD4+T lymphocyte count greater than 350/μL had no opportunistic infections.The results of immunohistochemistry showed that the positive expression rate of caspase-3 protein in KS tissues in patients with AIDS-KS was 68.2%, in patients with classic KS was 100.0%, with significant difference between two groups (χ2=7.37, P=0.01).The positive expression rate of E-cad protein in KS tissues in patients with AIDS-KS was 72.7%, in patients with classic KS was 100.0%, with significant difference between two groups (χ2=5.18, P=0.03).Western blotting showed that the gray value of caspase-3 in the KS tissue of patients with AIDS-KS was 0.55±0.36, and that in patients with classic KS was 0.86±0.56, with significant difference between two groups (t=-2.070, P<0.05).The gray value of E-cad in the KS tissue of patients with AIDS-KS was 0.54±0.41, and that in patients with classic KS was 0.85±0.45, with significant difference between two groups (t=-2.060,P<0.05).Conclusions There are differences in the protein expressions of caspase-3 and E-cad in tumor tissues of patients with AIDS-KS and classical KS in Xinjiang Uygur patients with Kaposi's sarcoma, which may correlate with a faster progression and a higher mortality rate for AIDS-KS.

Objective To analyze the clinical features of AIDS-related Kaposi's sarcoma (AIDSKS) patients in Xinjiang uygur autonomous region,and to evaluate the efficacy of highly active antiretroviral therapy (HAART) and systemic chemotherapy.Methods Clinical data on 70 AIDS-KS patients admitted in Sixth People' s Hospital of Xinjiang Uygur Autonomous Region from January 2008 to June 2013 were reviewed.The demographic characteristics,progress of KS,extent of lesions,treatment and prognosis of these patients were retrospectively studied.The efficacy of different therapies and the prognosis were compared using t or x2 test.Results The average age of 70 AIDS-KS patients was (40 ± 10) years,and the ratio of male and female was 2.5 ∶ 1.Sixty-six out of 70 (94.29％) patients were Uyghur ethnic.Among 70 patients,23 cases (32.9％) were rapidly progressed.Lesions often progress to plaques and nodules affecting head,neck,trunk,limbs and internal organs.Among 64 evaluable cases,the fatality rate in treatment group was 7.7 (4/52),which was significantly lower than that in patients who did not receive treatment (4/12,x2 =5.861,P ＜ 0.05).After 6-month of HAART or HAART sequenced by chemotherapy,CD4+ T lymphocyte counts were significantly increased (t =35.258 and 42.528,P ＜0.01),while it was decreased or remained in low level in patients received other treatments or untreated.HAART sequenced by chemotherapy,chemotherapy sequenced by HAART,and chemotherapy alone were effective for all AIDS-KS patients,while the effective rate in patients received HAART alone was 86.4％ (19/22),and immune reconstitution inflammatory syndrome (IRIS) was appeared in 45.5％ (10/22)patients.Conclusions AIDS-KS more frequently occurs in young Uighur males.The lesion may affect various organs,and some progress rapidly.HAART plus chemotherapy may reduce the incidence of IRIS and improve the prognosis.

Objective To investigate the difference of expression and distribution of Toll-like receptor 4 (TLR4)between acquired immunodeficiency syndrome (AIDS)-related Kaposi sarcoma (AIDS-KS)and classic Kaposi sarcoma (KS).Methods The subjects were collected from The First Teaching Hospital of Xinjiang Medical University from January 2010 to January 2012,including 11 patients with AIDS-KS,7 patients with classic KS,7 human immunodeficiency virus (HIV)infective patients without KS and 7 healthy volunteers.Clinical data and biopsy specimens were collected.The expression of TLR4 was detected by immunohistochemical method.Statistical analysis of mean between two groups was conducted by using t test.Statistical analysis of ranked data was conducted by using U test.Comparison between groups was analyzed with one-way ANOVA.Results The expressions of TLR4 were both strongly positive in patients with AIDS-KS and classic KS,and mainly in alien vascular endothelial cells (VEC)and tumor cells.TLR4 was located on cell membrane and cytoplasm,and also in the nucleus. TLR4 was rarely expressed in the skin tissue in HIV infective patients without KS and healthy volunteers. The expressions of TLR4 in AIDS-KS,classic KS,HIV infective patients and healthy volunteers were 0.242±0.443,0.208±0.059,0.072±0.042 and 0.065 ±0.031 ,respectively (F =33.70,P <0.01 ). The expressions of TLR4 were lower in HIV infective (AIDS ) patients without KS and healthy volunteers.The expression level of TLR4 was significantly higher in KS patients compared with non-KS patients (t=4.097,P =0.003).However,TLR4 expression had no significant difference between AIDS-KS and classic KS patients (t =0.480,P =0.638).The expression of TLR4 was significantly higher in AIDS-KS patients compared with HIV infective patients (t=2.900,P =0.010).Conclusions The study identifies that TLR4 is highly expressed in patients with AIDS-KS or classic KS.It is suggested that TLR4 may play an important role in occurrence and development of KS.