2013年 · 第126卷第16期

Surgical resection remains the mainstay of curative treatment for gastric cancer.Laparoscopic surgery is a form of minimally invasive surgery (MIS) that has become increasingly used in the resection of gastric cancer.Laparoscopic surgery is designed to minimize surgical insults and to maximize patient survival,while not compromising oncologic clearance。

Abstract：Background CKLF-like MARVEL transmembrane domain-containing 7 (CMTM7) located at 3p22.3,is a frequent deletion site and a tumor suppressor gene (TSG) locus in many cancer,which suggests CMTM7 may be a potential TSG.The aim of this study was to investigate the correlations of CMTM7 expression and survival rate in patients with non-small-cell lung cancer (NSCLC).Methods Surgical specimens of 180 cases with pathologically confirmed NSCLC were grouped into 18 tissue microarray slides.CMTM7 expression in these specimens were detected by immunohistochemistry staining and representative cases were confirmed by Western blotting.Univariate and multivariate analyses were performed to identify the association of CMTM7 expression with pathological features and survival of patients with NSCLC.Results A total of 78.9％ of the 180 patients had variations of CMTM7 protein expression,either up-regulated or downregulated.Univariate analysis showed that the patients' survival rate after surgery was highly correlated with CMTM7 expression (P=0.0091).In addition,prognostic factors were examined by multivariate Cox regression analysis,and results suggested that CMTM7 expression was a unique prognostic factor in NSCLC survival.Conclusions The CMTM7 expression may be related to survival of patients with NSCLC and a unique prognostic factor.CMTM7 may play an important role in NSCLC development。

Abstract：Background BRAFV600E mutation is correlated with local aggressive clinicopathological features in papillary thyroid carcinoma; yet the relationship between this genetic variation and distant papillary thyroid carcinoma metastasis was unclear.This study aimed to investigate whether BRAFV600E is predictive for distant metastasis in the Chinese population.Methods One hundred and seven patients with papillary thyroid carcinoma were enrolled in this study,including 43 patients with distant metastasis and 64 patients without.Quantitative real-time polymerase chain reaction was used to detect BRAFV600E mutation,while immunohistochemistry was performed to detect vascular endothelial growth factor (VEGF) expression.The associations between distant metastasis and BRAFV600E mutation,and VEGF expression as well as local clinicopathological factors were determined.Results A total of 28.6％ of the patients in the distant metastasis group harbored BRAFV600E mutation,which was significantly lower than in the without distant metastasis group (68.8％,P ＜0.001).BRAFV600E mutation was negatively correlated with positive VEGF expression (P=0.001).Furthermore,52.2％ of the patients with distant metastasis exhibited VEGF expression,compared with 25.0％ of those without.Higher levels of VEGF expression were also observed in the distant metastasis group.Tumor size,extra-thyroid invasion,and BRAFV600E mutation were independent predictors for distant metastasis according to multivariate analysis (odds ratios were 2.8,12.4,and 0.3; 95％ CI 1.483-5.334,and 2.950-52.407,0.100-0.890; P=0.002,0.001,and 0.030,respectively).BRAFV600E mutation was negatively correlated with distant metastasis in adult subgroup analysis (P=0.005) but was not an independent parameter.Conclusions BRAFV600E mutation is predictive for distant metastasis in papillary thyroid carcinoma but not positively.VEGF may be involved in the pathogenesis of distant metastasis。

Abstract：Background Killing of targeted tumors during adoptive cell transfer therapy is associated with cytotoxic T lymphocyte (CTL) numbers,immunophenotype,tumor-specificity,and in vivo residence time,migration,and distribution.Therefore,tracing in vivo persistence,migration,and distribution of CTLs is important for cancer immunotherapy.Methods Optimal staining concentration for CTL proliferation was determined by cell counting kit-8 (CCK-8) assay and killing efficiencies of CTLs or carboxyfluorescein diacetate succinimidyl ester (CFSE)-labeled melanoma antigen-specific cytotoxic T lymphocytes (CFSE-CTLs) for malignant melanoma cells in vitro were compared.Additionally,CFSE-CTLs were intravenously transfused to mice receiving B16 melanoma,and their residence time,migration,and distribution in vivo were observed by measuring fluorescence intensities of CFSE-CTLs per gram of tissue (％FI/g) in various tissues and analyzing tumor/non-tumor (T/NT) values.Anti-tumor effects of transferred CTLs and correlation between ％FI/g and D-value of tumor size were analyzed.Results Five-micromolar CFSE was optimal for labeling CTLs with minimal cytotoxicity.No significant difference occurred between CTLs and CFSE-CTLs for tumor cell killing (P=0.849) or interleukin-2 (P=0.318) and interferon-y (P=0.201)levels.Distribution of CTLs in vivo varied with time.A negative correlation between ％FI/g in tumors and D-value of tumor sizes by Spearman correlation analysis was observed.CTLs were recruited to and killed tumors from 6 hours to 3 days after cell infusion.CTLs were observed up to three weeks later in the tumor,liver,kidneys,and spleen; this was related to the abundant blood supply or the nature of immune organs.Conclusions CCK-8 assay is a novel method to select optimal CFSE staining concentrations.Fluorescence intensity of transferred CTLs reflects their killing efficiency of tumors.CFSE fluorescent markers can trace in vivo CTL persistence,migration,and distribution because of its stability,long half-life,and low toxicity。

Abstract：Background The surgical management of occult breast cancer is controversial.We compared the outcomes of different treatments of occult breast cancer and evaluated the potential prognostic factors for overall survival and recurrence.Methods We retrospectively reviewed 77 patients who presented to our hospital from 1968 to 2011 with a diagnosis of occult breast cancer.Patients were divided into three groups:42 patients (63％) were treated with modified radical mastectomy+axillary lymph node dissection (ALND),16 patients (24％) were treated with ALND+postoperative radiotherapy,and 9 patients (13％) with only ALND.Survival analyses were undertaken to compare the efficacy of these three treatments.Results Of the 77 patients with occult breast cancer,2 patients were lost to follow-up and 8 patients refused surgical treatment:67 patients (90.4％) were included in this analysis.The median follow-up was 62.2 (0.6-328.0)months.Kaplan-Meier analyses showed no significant difference in overall survival and recurrence-free survival between the three groups (P=0.494 and 0.397,respectively).The prevalence of local recurrence was 11.9％ for the mastectomy+ALND,18.8％ for ALND+radiotherapy,and 11.1％ for ALND-only groups,and those for distant recurrence were 2.4％,12.5％,and 11.1％,respectively.Compared with progesterone receptor-negative subjects,progesterone receptor-positive patients had better overall survival and lower recurrence rates (P=0.057 and 0.062,respectively).Conclusions There was no significant difference in outcomes between mastectomy and breast-preserving surgery.Expression of the progesterone receptor should be taken into account when evaluating the prognosis of occult breast cancer。

Abstract：Background Cancer stem cells (CSCs) are the cause of cancer recurrence because they are resistant to conventional therapy and contribute to cancer growth and metastasis.Endocrinotherapy is the most common breast cancer therapy and acquired tamoxifen (TAM) resistance is the main reason for endocrinotherapy failure during such therapy.Although acquired resistance to endocrine treatment has been extensively studied,the underlying mechanisms are unclear.We hypothesized that breast CSCs played an important role in TAM-induced resistance during breast cancer therapy.Therefore,we investigated the biological characteristics of TAM-resistant (TAM-R) breast cancer cells.Methods Mammosphere formation and tumorigenicity of wild-type (WT) and TAM-R MCF7 cells were tested by a mammosphere assay and mouse tumor xenografts respectively.Stem-cell markers (SOX-2,OCT-4,and CD133) and epithelial-mesenchymal transition (EMT) markers were tested by quantitative real-time (qRT)-PCR.Morphological observation was performed to characterize EMT.Results After induction of TAM resistance,TAM-R MCF7 cells exhibited increased proliferation in the presence of TAM compared to that of WT MCF7 cells (P ＜0.05),indicating enhanced TAM resistance of TAM-R MCF7 cells compared to that of WT MCF7 cells.TAM-R MCF7 cells showed enhanced mammosphere formation and tumorigenicity in nude mice compared to that of WT MCF7 cells (P ＜0.01),demonstrating the elevated CSC properties of TAM-R MCF7 cells.Consistently,qRT-PCR revealed that TAM-R MCF7 cells expressed increased mRNA levels of stem cell markers including SOX-2,OCT-4,and CD133,compared to those of WT MCF7 cells (P ＜0.05).Morphologically,TAM-R MCF7 cells showed a fibroblastic phenotype,but WT MCF7 cells were epithelial-like.After induction of TAM resistance,qRT-PCR indicated that MCF7 cells expressed increased mRNA levels of Snail,vimentin,and N-cadherin and decreased levels of E-cadherin,which are considered as EMT characteristics (P ＜0.05).Conclusion TAM-R MCF7 cells possess CSC characteristics and may be responsible for TAM resistance during breast cancer therapy。

Abstract：Background Smad4 is found mutated in many cancers.It acts as a tumor suppressor in the regulation of TGF-β signaling pathway.The objective of this work was to study the expression of Smad4 in intrahepatic cholangiocarcinoma (ICC) and its relationship with the biological behavior and prognosis of the disease.Methods Forty-nine paraffin-embedded ICC specimens and nine normal liver tissues were analyzed by immunohistochemical methods using Smad4 monoclonal antibodies.The expression of Smad4 was compared with the clinical pathological characteristics of the patients.Results The expression of Smad4 was 100％ positive in normal liver tissues,which was higher than that in the ICC (44.9％).Negative labeling of the Smad4 protein was found in 26.1％ (6/23) of well-differentiated ICCs and 61.5％(16/26) of poorly to moderately differentiated ICCs,and 34.3％ (12/35) and 71.4％ (10/14) showed negative Smad4 labeling (P=0.018) of ICC at pathological Tumor Node Metastasis (pTNM) stage Ⅰ-Ⅱ and pTNM stage Ⅲ-Ⅳ separately.Furthermore,72％ (8/11) of lymph node metastatic ICCs and 73.3％ (11/15) of intrahepatic metastatic ICCs showed negative labeling of the Smad4 protein.The loss of Smad4 expression in those metastatic ICCs was significantly more severe compared with non-metastatic ICCs (P=0.000).Conclusions The expression of Smad4 was associated with the histological grade,clinical stage,and metastasis of ICC (P ＜0.05).The detection of Smad4 may be helpful in determining the degree of malignancy and prognosis of ICC。

Abstract：Background Chronic graft-versus-host disease (GVHD),the commonest long-term complication after allogeneic hematopoietic stem cell transplantation (HSCT),has a negative impact on patients' health related quality of life (HRQoL).This study was designed to investigate the HRQoL in patients with chronic GVHD in China.Methods Two hundred and sixty-four patients with chronic GVHD who were ＞24 months post-HSCT and had been in continuous complete remission since HSCT were enrolled in this retrospective study.HRQoL was evaluated using an SF-36 questionnaire.Multivariate analysis was used to identify the factors that affect HRQoL in patients with chronic GVHD.Results HRQoL in patients categorized as having mild and moderate chronic GVHD was significantly better than in those in the severe category.In the moderate chronic GVHD category,markedly poorer HRQoL was observed in patients with both multiple organ involvement and more severe organ impairment than in those without these factors.According to multivariate analysis,chronic GVHD severity had the greatest significant negative impact on patients' HRQoL; whereas being female was associated with a negative impact on psychological health.Conclusion Chronic GVHD severity strongly correlates with negative impacts on patients' HRQoL。

Abstract：Background Giant cell tumors (GCTs) most commonly occur around the knee.The most beneficial procedure for this disease has been extensive curettage with reconstruction.However,since many GCTs may compromise the subchondral bone,surgery can further jeopardize the articular cartilage and result in secondary osteoarthritis.In this study,we aimed to determine the factors associated with the development of degenerative arthritis and the effect of bone grafting on the prevention of secondary osteoarthritis.Methods We retrospectively analyzed 76 patients with GCT around the knee.The mean age at first diagnosis was 31.1 years.Surgical treatments included extensive curettage and cementation with or without bone grafting in the subchondral bone.Patient follow-up was a median duration of 35 months,ranging from 18 to 113 months.Results The local recurrence rate was 5.3％ (4/76).Secondary degenerative changes occurred in 30.3％ (23/76) of the patients.Less than 10 mm of the residual thickness of the remaining subchondral bone was correlated with secondary degenerative changes in 57 patients (P ＜0.001).Of these 57 patients,56.5％ (13/23) treated with bone cement reconstruction alone developed secondary degenerative changes; following bone grafting,the rate decreased to 29.4％(10/34),with a statistically significant difference (P=0.041).Conclusions GCT patients with less residual thickness of the subchondral bone are more likely to develop degenerative arthritis after curettage.Bone grafting in the subchondral bone area is recommended when the residual thickness of the subchondral bone is less than 10 mm。

Abstract：Background Heme oxygenase-1 (HO-1) can be induced by inflammatory cytokines,oxidation,ischemia,hypoxia,and endotoxins.As a "graft survival protective gene," HO-1 is a hot spot in organ transplantation research.However,the role of HO-1 gene expression in the function of human colon adenocarcinoma cell line (Caco-2) cells has not been reported previously.Methods The role of HO-1 in the proliferation and migration of Caco-2 cells was analyzed using a stable HO-1 expression plasmid.We constructed a recombinant adeno-associated virus plasmid containing the HO-1 gene,heme oxygenase 1 (HMOX1),which was transfected into Caco-2 intestinal cells.We identified a number of target genes by global microarray analysis combined with real-time polymerase chain reaction (PCR) and chromatin immunoprecipitation assay.Results Our results showed that significant HO-1 upregulation was demonstrated in the Caco-2 cells after HO-1 transfection.Restoration of HO-1 expression promoted proliferation and invasion in vitro.The CTNND1 gene,a member of the armadillo protein family,was identified as a direct HO-1 target gene.Conclusion Overexpression of HO-1 promotes Caco-2 cell proliferation and migration by targeting the CTNND1 gene。

Abstract：Background B7-H3 has been widely studied in the context of tumor progression in recent years,and behaves as a tumor cell marker in a variety of tumors including colorectal carcinoma.The mechanism of B7-H3 in tumor progression is complicated and not clear yet.Studies have revealed that B7 family molecules are expressed on infiltrated lymphocytes as well as tumor cells in tumor microenvironment,which indicates that different expression pattern may lead to different clinical outcomes.Methods The expression of B7-H3 was detected in tissues of 98 colorectal carcinoma patients by using immunohistochemistry.Then the expression of B7-H3 on CD3+ T lymphocytes isolated from fresh cancer tissues of 12 colorectal carcinoma patients was analyzed by flow cytometry assay.The relationship between the expression of B7-H3 on CD3+ T lymphocytes and patients' clinical pathological parameters was demonstrated with statistical analysis.Results Patients with more CD3+ T cell infiltration survived much longer than patients with less CD3+ T cell infiltration (P ＜0.05); B7-H3 was highly expressed by infiltrating CD3+ T lymphocytes in colorectal carcinoma tissues.The expression of B7-H3 was found to be significantly related with lymph node metastasis status (P ＜0.05),but not with the patient's gender,age,tumor size,differentiation degree,depth of tumor invasion,Dukes' stage,distant metastasis and whether or not mucinous adenocarcinoma was present (P ＞0.05).Moreover,the survival time of patients with low expression of B7-H3 was obviously longer than those of high B7-H3 expression patients,but the seven-year survival rate showed no difference between the high and low B7-H3 expression patients (P ＞0.05).Conclusion The negative costimulatory molecule B7-H3 on infiltrating CD3+ T lymphocytes in colorectal carcinoma bears importance in the clinical pathological progress and prognosis of colorectal carcinoma。

Abstract：Background Xanthogranulomatous cholecystitis (XGC) is a rare type of gallbladder inflammation.Unlike other cholecystitis,it can be easily misdiagnosed as gallbladder cancer based on radiological images.In response to misdiagnosis,extended surgical treatments are inappropriately given to patients,which is not beneficial to their health and/or recovery.In this study,we set out to determine whether tumor biomarkers can help to avoid misdiagnosis in patients with XGC.Methods Between January 2005 and January 2012,a total of 37 preoperative patients at Sir Run Run Shaw Hospital were suspicious of having gallbladder cancer and was pathologically confirmed to be XGC after surgical operations.Before operations,all patients received a tumor biomarker test to verify diagnosis,which included serum CA 19-9,carcinoembryonic antigen (CEA),and CA 12-5.Results A measured amount (54.05％) of cases (20 in 37) had at least one elevation over the thresholds of CA 19-9 (37 IU/L),CEA (5 ng/ml),and CA 12-5 (35 IU/L),which increased the suspicion of malignancy and consequently enhanced the difficulty to make right diagnosis of XGC as benign.45.95％ of cases (17 in 37) had an elevation in CA 19-9.2.70％of cases (one in 37) had an elevation in CEA and 24.32％ of cases (nine in 37) had an elevation in CA 12-5.Analysis with Fisher's exact test discovered that the presence of common bile duct stone was a contributor to elevations of CA19-9 in patients with XGC.However,even in cases without common bile duct stones,42.86％ of patients (nine in 21) had elevations of at least one tumor biomarker.Among them,26.09％ of patients (six in 21) had elevations of CA 19-9,with the maximum of 536.29 IU/L.Conclusions The elevations of tumor biomarkers in XGC were frequent,suggesting their inabilities to clarify the disease's nature,especially when there was a suspicion of gallbladder cancer.Intraoperative frozen pathology of gallbladder might be a possible solution.However,it is against the en bloc surgical principle and has the potential to cause tumor cell spreading.More research should be conducted,such as the discovery of a novel biomarker,so that XGC can less likely be misdiagnosed as malignancy until the final pathological judgment。

Abstract：Background No randomized trial has been performed to compare the efficacy of an intracoronary bolus of tirofiban versus urokinase during primary percutaneous coronary intervention (PCI).We investigated whether the effects of adjunctive therapy with an intracoronary bolus of urokinase was noninferior to the effects of an intracoronary bolus of tirofiban in patients with ST-elevation myocardial infarction (STEMI) undergoing PCI.Methods A total of 490 patients with acute STEMI undergoing primary PCI were randomized to an intracoronary bolus of tirofiban (10 μg/kg; n=247) or urokinase (250 kU/20 ml; n=243).Serum levels of P-selectin,von Willebrand factor (vWF),CD40 ligand (CD40L),and serum amyloid A (SAA) in the coronary sinus were measured before and after intracoronary drug administration.The primary endpoint was the rate of complete (＞70％) ST-segment resolution (STR) at 90 minutes after intervention,and the noninferiority margin was set to 15％.Results In the intention-to-treat analysis,complete STR was achieved in 54.4％ of patients treated with an intracoronary bolus of urokinase and in 60.6％ of those treated with an intracoronary bolus of tirofiban (adjusted difference:-7.0％;95％ confidence interval:-15.7％ to 1.8％).The corrected TIMI frame count of the infarct-related artery was lower,left ventricular ejection fraction was higher,and the 6-month major adverse cardiac event-free survival tended to be better in the intracoronary tirofiban group.An intracoronary bolus of tirofiban resulted in lower levels of P-selectin,vWF,CD40L,and SAA in the coronary sinus compared with an intracoronary bolus of urokinase after primary PCI (P＜0.05).Conclusions An intracoronary bolus of urokinase as an adjunct to primary PCI for acute STEMI is not equally effective to an intracoronary bolus of tirofiban with respect to improvement in myocardial reperfusion assessed by STR.This may be caused by less reduction in coronary circulatory platelet activation and inflammation。

Abstract：Background Prenatal lead and cadmium exposure will not only influence the mother's organ systems,but also will provide an environment that may influence the fetus and neonate in a harmful way.In the present study,we detected the blood lead levels (BLLS) and cadmium levels for the duration of pregnancy and 6-12 weeks after delivery and to analyze the influencing factors of BLLs in healthy pregnant women.Methods A cohort study survey was carried out.We recruited 174 healthy pregnant women without pregnancy or obstetric complications or abnormal pregnancy outcomes as the gravida group,and 120 healthy non-pregnant women as the control group.Results The lead concentrations in the three pregnancy trimesters and in the postpartum period were:(5.98±2.43),(5.54±2.01),(5.59±1.97),and (6.76±1.74) μg/dl; and (6.75±2.13) μg/dl in the control group.The cadmium concentrations in the three pregnancy trimesters and postpartum period were 1.61±0.45,1.63±0.46,1.64±0.49,and 1.67±0.57.We found that the BLLs in the gravida group were lower than in the control group during all three trimesters.Occupations,supplement nutritional elements (dietary supplements and nutritional (food) elements),and the time of house painting could affect BLLs in pregnant women.Lead-related occupations,using cosmetics,and living in a house painted more recently than one year previously are risk factors of high BLLs among pregnant women,while calcium,iron,zinc,and milk supplements are protective factors.Conclusions These findings may help people,especially pregnant women,to reduce lead exposure via supplements of calcium,iron,zinc,and milk or avoiding contacting risk factors。

Abstract：Background Several randomized controlled trials (RCTs) have compared endoscopic and symptomatic relapses in patients with erosive gastroesophageal reflux disease (GERD).We have summarized current evidence for rabeprazole 10 or 20 mg once daily for GERD maintenance treatment over 1 or 5 years.Methods MEDLINE,EMBASE,and the Cochrane Central Register of Controlled Trials were searched,through August 2012,for eligible RCTs of adults with erosive GERD.The efficacies of rabeprazole 10 and 20 mg/d were compared.Results The search identified 288 citations,and five RCTs containing 1480 patients were considered eligible.Heartburn relapse rates did not differ significantly between patients treated with rabeprazole 10 and 20 mg/d for 1 year (relative risk (RR)=1.29; 95％ confidence interval (CI):0.97-1.72),but differed in patients treated for 5 years (RR=1.274; 95％ CI:1.005-1.615).Endoscopic relapse rates differed significantly between rabeprazole 10 and 20 mg/d for 1 year (RR=1.92;95％ CI:1.21-3.06),for 5 years (RR=1.667; 95％ CI:1.073-2.589),and in combined 1-and 5-year maintenance trials (RR=1.785; 95％ CI:1.298-2.456).Conclusion Rabeprazole 20 mg/d was superior to rabeprazole 10 mg/d in preventing endoscopic relapse of erosive GERD,but that the two dosages were equivalent in symptomatic relief over 1 year。

Abstract：Objective To review the main neuropsychiatric disorders and cognitive deficits in patients with Cushing's disease (CD) and the associated pathophysiological mechanisms underlying CD.These mechanistic details may provide recommendations for preventing or treating the cognitive impairments and mood disorders in patients with CD.Data sources Data were obtained from papers on psychiatric and cognitive complications in CD published in English within the last 20 years.To perform the PubMed literature search,the following keywords were input:cushing's disease,cognitive,hippocampal,or glucocorticoids.Study selection Studies were selected if they contained data relevant to the topic addressed in the particular section.Because of the limited length of this article,we have frequently referenced recent reviews that contain a comprehensive amalgamation of literature rather than the actual source papers.Results Patients with active CD not only suffer from many characteristic clinical features,but also show some neuropsychiatric disorders and cognitive impairments.Among the psychiatric manifestations,the common ones are emotional instability,depressive disorder,anxious symptoms,impulsivity,and cognitive impairment.Irreversible effects of previous glucocorticoid (GC) excess on the central nervous system,such as hippocampal and the basal ganglia,is the most reasonable reason.Excess secretion of cortisol brings much structural and functional changes in hippocampal,such as changes in neurogenesis and morphology,signaling pathway,gene expression,and glutamate accumulation.Hippocampal volume loss can be found in most patients with CD,and decreased glucose utilization caused by GCs may lead to brain atrophy,neurogenesis impairment,inhibition of long-term potentiation,and decreased neurotrophic factors; these may also explain the mechanisms of GC-induced brain atrophy and hippocampal changes.Conclusions Brain atrophy and hippocampal changes caused by excess secretion of cortisol are thought to play a significant pathophysiological role in the etiology of changes in cognitive function and psychiatric disturbances.The exact mechanisms by which GCs induce hippocampal volume loss are not very clear till now.So,further investigations into the mechanisms by which GCs affect the brain and the effective coping strategy are essential。

HIV still remains a global public health problem despite decades of interventions to eliminate the virus.In 2010,there were 390 000 children globally,under 15 years old,newly infected with HIV,mainly through mother-to-child transmission.1 China had 780 000 HIV infected people at the end of 2011,of these,28.6％ were women and 1.1％ were children infected through mother-to-child transmission.2 The first case of mother-to-child transmission (MTCT) of HIV in China was reported in 1995.3 Few years later,the proportion of MTCT in China increased from 0.1％ in 1997 to 0.4％ in 2002.4 The Ministry of Health in China in conjunction with the Central for Maternal and Child Healthcare and the Chinese Centre for Disease Control launched prevention of mother-child transmission of HIV (PMTCT) programs in China in 2003.The programs were launched in five provinces with high prevalence of HIV namely,Henan,Guangdong,Yunnan,Guangxi and Xinjiang。

Iliac vein compression syndrome (IVCS),also known as May-Thurner syndrome or Cockett syndrome,is caused by compression of the left common iliac vein between the right common iliac artery and the vertebrae.A recent imaging study have demonstrated that at least a 25％compression of the left iliac vein at the arterial crossover point may be present in 66％ of the asymptomatic patient population.1 With the development of interventional technique,endovascular management as a less invasive means is becoming the first-line treatment,which can not only treat the thrombosis but also correct the venous anatomic abnormalities.2 In this study,we described a novel technique combining percutaneous aspiration thrombectomy (PAT) with Fogarty catheter thrombectomy (FCT) as the thrombus removal therapy without femoral venotomy in patients with acute deep vein thrombosis (DVT) due to IVCS and evaluated its technical feasibility and short-term outcomes。