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Objective@#To investigate the grading system for lymph vessel tumor emboli and its prognostic value in patients with invasive carcinomas of no special type (ICNST) of the breast.@*Methods@#Clinical data of 466patients with ICNST were collected from January 2006 to December 2008 in the Fourth Hospital of Hebei Medical University. The expression levels of D2-40, estrogen receptor(ER), progesterone receptor(PR) and human epidermal growth factor receptor 2 (HER-2) were analyzed using immunohistochemical staining. Grades for lymph vessel tumoremboli were classified based on the number of mitotic and apoptotic figures in tumor cells under a high-power field. Correlation analysis was performed using Spearman rank correlation test. Kaplan-meier curves and Log-rank tests were used to analyze the survival rate. Multivariate Cox proportional hazard model was used to analyze the prognostic factors.@*Results@#Among the 466 patients, grades for lymph vessel tumor emboli were categorized as follows: 280 cases were grade 0 (60.1%); 112 cases were grade 1 (24.0%); 58 cases were grade 2 (12.5%); 16 cases were grade 3 (3.4%). Correlation analyses showed that lymph vessel tumor emboli grading system was positively correlated with lymph node metastasis (r=0.365, P<0.001). Kaplan-Meier univariant analysis showed that histological grading, lymph vessel tumor emboli grading system, lymph node metastasis, the expression levels of ER, PR and HER-2 and molecular typing were associated with prognosis of patients (P<0.05 for all). Multivariate analysis of Cox proportional hazard model showed that lymph vessel tumor emboli grading system and lymph node metastasis were independent prognostic factors in patients with ICNST(P<0.05 for all).@*Conclusion@#Grading system for lymph vessel tumor emboli canpredict the clinical outcome of patients with ICNST.
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To investigate the clinic value of microsurgical shunt for the treatment of varicocele combined with asthenspermia,the clinical data and therapeutic method for 3 patients,who conducted the microscope spermatic vein high ligation combined with superficial epigastric vein flow,were retrospectively analyzed.No postoperative complications were found,and the original symptoms and signs were disappeared.All patients were conducted scrotal ultrasound and semen routine after 3 months,and all indexes,including maximum internal diameter of the cord vein (erect position),sperm density,sperm survival rate,sperm deformity rate and sperm forward movement rate,were gradually improved.Consequently,high ligation of spermatic vein combined with vascular bypass surgery under the microscope can block the countercurrent venous blood and establish a new return channel to the testis.Meanwhile,it can also protect the testicular artery and lymph-vessel.It is worth to be spread for the treatment ofvaricocele combined with asthenospermia.
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Objective To detect the expression of vascular endothelial growth factor(VEGF)-C and VEGF-D in normal gastric tissue and gastric carcinoma tissue,and further investigate the relationship between VEGF-C,VEGF-D and lymph vessel density (LVD),lymph node metastasis.Methods The expression of VEGF-C and VEGF-D in gastric carcinoma tissues were examined by using SP immunohistochemical method in 30 normal gastric tissue and 75 gastric carcinoma tissue respectively.The lymph vessel were marked by LYVE-1 and calculated LVD.Results The rate of positive expression of VEGF-C and VEGF-D in gastric carcinoma tissue was significantly higher than that in normal gastric tissue,there was significant difference [73.3 ％ (55/75) vs.33.3 ％ (10/30),66.7 ％ (50/75) vs.30.0 ％ (9/30),P ＜0.01].The level of LVD in gastric carcinoma tissue with lymph node metastasis (40 cases) was significantly higher than that in without lymph node metastasis (35 cases)[(8.85 ± 1.24)/HP vs.(4.75 ± 1.04)/HP](P =0.000).The level of LVD increased when the expression level of VEGF-C and VEGF-D gradually went up.Conclusions The level of LVD increases in gastric carcinoma tissue.VEGF-C and VEGF-D are two significant factors for LVD and lymph node metastasis.
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ObjectiveTo introduce a new procedure of penile lengthening which yields satisfactory outcomes and avoids persistent postoperative hydrophallus with the results of fresh body researches.MethodsIndirect intralymphatic injection and routine H-E staining were used to investigate the ramification of lymphatics of penis on fresh bodies.We found that the lymphatic return of penis was primarily mediated by dorsal and bilateral superficial lymph vessels,which converged dorsally at the root of penis and then ramified into the superior region of pubic symphysis and bilateral inguinal grooves.However,most previous incisions were done at the converging region of lymph vessels at the dorsal root of penis.It blocked most lymphatic return.Our modified method avoided interruption of lymph vessels in the converging region.Based on the results of the above investigations,the operative incision at the root of penis was shifted upward by 1.5 cm,and then the lengthened cavernous body of penis was covered by scrotal flap.ResultsEighty patients who accepted the new method achieved satisfactory outcomes.Postoperative hydrophallous decreased gradually from the 3rd day and vanished basically on the 6-7 day.ConclusionsOur modified procedure of penile lengthening reduces the damage of these vessels.Consequently,postoperative hydrophallus resolves fast and the new procedure yields high success rates,sound appearance and sensation of penis.Therefore,the new procedure is an ideal option for surgenons in clinical practice.