94, 95% Cl: 1.7727.03, p=0.005] or not was only associated with bleeding after prophylactic EVL. Conclusions: No administration of PPI was significantly associated with increased risk of bleeding after prophylactic EVL. Especially, PPI medication was the only predictor factor in the case of no gastric varix. We suggest PPI therapy should be routinely performed in patients receiving EVL to reduce the risk of post EVL bleeding. Disclosures: Hyung Joon Yim – Grant/Research Support: GSK Korea, Handok Pharm, Gilead

Korea; Speaking and Teaching: BMS Korea The following people have nothing to disclose: Seong Hee Kang, Seung Young Kim, Hae Rim Kim, Eileen L. Yoon, Hyun Jung Lee, Sang Jun Suh, Sung Woo Jung, Ja Seol Koo, Ji Hoon Kim, Yeon Seok Seo, Rok Son Choung, Jong Eun Yeon, Kwan Soo Byun, Soon Ho Um, Sang Woo Lee, Jai Hyun Choi, Ho Sang Ryu Background and Aims Transjugular intrahepatic portosystemic selleck shunt (TIPS) is a common and effective treatment of refractory ascites or refractory variceal bleeding in patients with portal hypertension and cirrhosis. It is unclear whether TIPS has any long-term effects on patient survival in patients with cirrhosis. We aimed to determine whether TIPS is associated with survival in patients with cirrhosis. Methods We created a cohort of adult patients with cirrhosis without previous liver transplantation who were listed for liver transplantation in the United States between 2002-2011

(n=80,519) and followed from the time of listing until the time of death on the waiting list, KPT-330 molecular weight transplantation, or drop-out from the waiting list. Patients MCE were censored if they were still on the waiting list at the time of last follow-up. We used Cox proportional hazards analysis and competing risks analysis to compare patients who had TIPS at the time of listing

(n=6115) to those who did not (n=74,044) with regards to death on the waiting list, transplantation and drop-out from the waiting list, after adjusting for important baseline characteristics (MELD score, underlying liver disease, presence of hepatocellular carcinoma, age, gender, race/ethnicity, diabetes, body mass index, serum albumin, ascites, encephalopathy, portal vein thrombosis, and ABO blood group) Results Among 80, 519 patients listed for liver transplantation, 10, 920 (14%) died on the waiting list, 40,180 (50%) underwent transplantation, 11,288 (14%) dropped out, and 17,771 (22%) were still on the waiting list during a mean follow-up of 1.2 years. Compared to patients who did not have a TIPS, those with a TIPS had lower risk of death on the waiting list (adjusted hazard ratio [AHR] 0.83 95% Cl 0.78-0.90). They also had a lower likelihood of transplantation (AHR 0.87 [0.83-0.90]) and dropout from the waiting list (AHR 0.92 [0.86-0.99]) suggesting that the lower risk of death could not be explained by higher rate of removal of relatively sick patients from the waiting list due to transplantation or drop-out.

Of these 597 patients, 290 (48.5%) patients were diagnosed with IBS using the Rome III criteria and of these 34 (11%) had FAC, 151 (25%) had diarrhoea of these 87 (56%) had FAC, 35 (3.9%) patients were found to have had long term use of NSAID and of those 7 (2%) had FAC and the rest had unexplained abdominal pain and change in bowel habits 121 (20%). And of these 18 (14%) had FAC. Out of the total patients 146 24–4%) had FAC. Patients who had diarrhoeal illness were prescribed 5ASA and of these 87 patients; 39 (44%) responded to treatment evident by resolution of symptoms within 2–6 weeks. Conclusion: Gastroenterologists have been regularly faced with the controversial

histological diagnosis of FAC. Our study has shown that there are around selleck chemicals llc 25% of patients presenting with diarrhoea, abdominal pain/IBS with the histological finding of FAC without a definitive diagnosis. More than 50% of patients

who had diarrhoea had FAC and of these 44% responded to 5ASA. Unfortunately, in some cases of focal active colitis, the underlying aetiology may never be determined. In our opinion this highlights the necessity of further studies on FAC to assess the findings and to selleck products aid gastroenterologist on management of such patients. Key Word(s): 1. IBD; 2. Colitis; 3. Focal active colitis; Presenting Author: SHUBEI WANG Additional Authors: YUNWEI SUN Corresponding Author: YUNWEI SUN Objective: Trinitrobenzene sulfonic acid (TNBS) induced colitis in BALB/c mice has been described as mixed Th1/Th17-mediated inflammation like Crohn’s disease. Oridonin is an effective component isolated from Rabdosia rubescens. It plays an inhibitory role in the transcription factor nuclear factor-kappa

B (NF-κB) activation and suppresses the over expression of cytokines in murine splenic lymphocytes, thus making it a potentially therapeutic option for inflammatory disease. Methods: Thus we investigated the effect of oridonin in TNBS induced colitis in BALB/c mice. Results: CD4 T cells play a central role in the development of TNBS colitis. Oridonin 上海皓元医药股份有限公司 significantly increased survival, normalized weight loss, and reduced inflammation severity in mice with TNBS colitis. These effects were associated with a reduction of colonic IFN-γ/IL-17 secretion and a decrement of splenic Th1/Th17 cells and effector memory CD4 T cells. Oridonin treatment inhibited the CD4 T cells proliferation induced by TCR stimulation, while upregulated lymphocytes apoptosis. Increasing of Th1/Th17 cells stimulated by TCR signal could be downregulated in the presence of oridonin. Such immunosuppressive effects were accompanied by inhibition of nuclear translocation of NF-κB. Conclusion: Our study indicates that oridonin has therapeutic effect on TNBS colitis, and it is an immunosuppressive agent acting through modulating the subsets and functions of lymphocytes. Key Word(s): 1. animal models of IBD; 2.

For each primary and secondary variable, comparisons between treatment groups were made by analysis of covariance of change from baseline, with the same variable’s baseline value as a covariate, with main effects of treatment group and acute pain

medication overuse strata. The baseline covariate adjustment was prespecified as the primary analysis. Missing data were imputed using selleck compound a prespecified modified last-observation carried forward methodology (mLOCF) previously described.32,33 For binomial variables, the between-group comparisons were performed with Pearson’s chi-square or Fisher’s exact tests, except that logistic regression with baseline covariate was used for variables with baseline imbalance. This a priori planned analysis corrected for the baseline imbalance. A 2-sided test with P ≤ .05 was considered to be statistically significant. Safety analyses were performed on all randomized patients who received at least 1 dose of study medication at day 0. Contributors.— All authors formed the core writing team for the manuscript and contributed to study conception, design, data analysis, and interpretation. C.C.T., R.E.D., and M.F.B. also provided administrative support and were involved in the collection and/or assembly of data for the PREEMPT trials. S.K.A., S.D.S., Opaganib chemical structure R.B.L., and H.C.D. provided patients

for the PREEMPT trials. All authors contributed to and commented on the manuscript draft and gave their final approval to submit for publication. Demographic and Baseline Headache Characteristics.— A total of 3333 patients were screened for the PREEMPT studies, with 1384 patients randomized and thus included in

the pooled analyses (n = 688 onabotulinumtoxinA; n = 696 placebo). At baseline, there were no notable differences between the pooled treatment groups for most of the important demographic characteristics (Table 1). However, at baseline the onabotulinumtoxinA group compared with the placebo group on average had significantly 上海皓元医药股份有限公司 fewer headache episodes (12.2 vs 13.0; P = .004) and migraine episodes (11.4 vs 12.2; P = .004), and significantly more total cumulative hours of headache occurring on headache days (295.9 vs 281.2; P = .021) (Table 1). Most patients overused acute pain medications during the 28-day baseline; however, very few (1.7%) had opioid overuse. The rate of patient compliance in reporting diary data was high both at baseline (>99%) and throughout the 24-week double-blind phases (>93%). There was no difference in diary compliance between treatment groups. Primary Variable: Frequency of Headache Days.— There was a large mean reduction from baseline in the frequency of headache days in both treatment groups.

The OR values in our study varied from 1–1.4 or 1–1.5, suggesting a weak association between these SNP and digestive system cancers. However, the results are consistent with the ‘common disease–common variant’ model, which is essentially equivalent to the suggestion that alleles of low penetrance (typically <1.5-fold increased risk) contribute substantially to the genetic risk of cancers. Future large prospective studies or clinical Doxorubicin trials are warranted to evaluate the SNP–SNP and SNP–environment (NSAID use) interactions on the risk of digestive system cancers. “
“Many persons infected with hepatitis

C virus (HCV) are unknown to the healthcare system because they may be asymptomatic for years, have not been tested for HCV infection, and only seek medical care when they develop liver-related complications. We analyzed

data from persons who tested positive for past or current HCV infection during participation in the National Health and Nutrition Examination Survey (NHANES) from 2001 through 2008. A follow-up survey was conducted 6 months after examination to determine (1) how many participants testing positive for HCV infection were aware of their HCV status before being selleckchem notified by NHANES, (2) what actions participants took after becoming aware of their first positive test, and (3) participants’ knowledge about hepatitis C. Of 30,140 participants tested, 393 (1.3%) had evidence of past or current HCV infection and 170 (43%) could be contacted during the follow-up survey and

interviewed. Only 49.7% were aware of their positive HCV infection status before being notified by NHANES, and only 3.7% of these respondents reported that they had first been tested for HCV because they or their 上海皓元医药股份有限公司 doctor thought they were at risk for infection. Overall, 85.4% had heard of hepatitis C; correct responses to questions about hepatitis C were higher among persons 40-59 years of age, white non-Hispanics, and respondents who saw a physician after their first positive HCV test. Eighty percent of respondents indicated they had seen a doctor about their first positive HCV test result. Conclusion: These data indicate that fewer than half of those infected with HCV may be aware of their infection. The findings suggest that more intensive efforts are needed to identify and test persons at risk for HCV infection. (HEPATOLOGY 2012;55:1652–1661) The estimated number of persons with chronic hepatitis C virus (HCV) infection increased from 2.7 million during 1988-19941 to 3.2 million during 1999-2002.

001), and cell proliferation gene REG1A (P = 0.063) in our pediatric CD cohort. Conclusion:  The retrieval of 28 genes previously reported in association with adult CD emphasizes the importance of these genes in the pediatric setting. The observed upregulation of REG1A and MMP2, and their known impact on cell proliferation and extracellular matrix remodeling, agrees with the clinical behavior of the disease. Moreover, the expressions of bacterial- and virus-related genes in our CD-patient tissues support the concept that microbial agents are important in the etiopathogenesis of

CD. “
“Although the chronicity of hepatitis B virus (HBV) infection Angiogenesis inhibitor is the result of impaired HBV-specific immune responses

that cannot eliminate or clear the infected hepatocytes efficiently, many issues remained unsettled. It is thus crucial to have a suitable laboratory animal to study the immunopathogenesis of HBV infection and the mechanisms of HBV persistence. To meet the requirement of a mouse model resembling natural chronic HBV infection in human, there are several approaches in the development of mouse animal model by using hydrodynamic-based transfection of HBV DNA, delivery of adenovirus or adeno-associated viral vectors containing HBV DNA for studying HBV immune responses. Selinexor solubility dmso These immunocompetent nontransgenic mouse animal models will provide new approaches to investigate the mechanisms of immune pathogenesis in HBV

infection. Hepatitis B virus (HBV) causes acute 上海皓元 and chronic inflammatory liver diseases and subsequent hepatic cirrhosis and hepatocellular carcinoma (HCC). During chronic HBV infection, a dynamic balance between viral replication and the host immune response is pivotal to the pathogenesis of liver disease. It is widely accepted that adaptive immune responses, particularly cellular immune responses, mediate the clearance of HBV.[1, 2] Although the chronicity of HBV infection is the result of impaired HBV-specific immune responses that cannot eliminate or clear the infected hepatocytes efficiently, many issues remained unsettled. It is thus crucial to have a suitable laboratory animal to study the immunopathogenesis of HBV infection and the mechanisms of HBV persistence. However, the study of HBV infection has been hampered by the shortage of animal model susceptible to HBV infections (such as chimpanzees) and the inability of HBV to propagate in common experimental animals, namely mouse. Nonetheless, the immunopathogenesis of HBV infection has been obtained from observation of human infections and was greatly enhanced by studies in chimpanzees, woodchuck, and HBV-transgenic (Tg) mice.

001), and cell proliferation gene REG1A (P = 0.063) in our pediatric CD cohort. Conclusion:  The retrieval of 28 genes previously reported in association with adult CD emphasizes the importance of these genes in the pediatric setting. The observed upregulation of REG1A and MMP2, and their known impact on cell proliferation and extracellular matrix remodeling, agrees with the clinical behavior of the disease. Moreover, the expressions of bacterial- and virus-related genes in our CD-patient tissues support the concept that microbial agents are important in the etiopathogenesis of

CD. “
“Although the chronicity of hepatitis B virus (HBV) infection Gefitinib order is the result of impaired HBV-specific immune responses

that cannot eliminate or clear the infected hepatocytes efficiently, many issues remained unsettled. It is thus crucial to have a suitable laboratory animal to study the immunopathogenesis of HBV infection and the mechanisms of HBV persistence. To meet the requirement of a mouse model resembling natural chronic HBV infection in human, there are several approaches in the development of mouse animal model by using hydrodynamic-based transfection of HBV DNA, delivery of adenovirus or adeno-associated viral vectors containing HBV DNA for studying HBV immune responses. click here These immunocompetent nontransgenic mouse animal models will provide new approaches to investigate the mechanisms of immune pathogenesis in HBV

infection. Hepatitis B virus (HBV) causes acute 上海皓元 and chronic inflammatory liver diseases and subsequent hepatic cirrhosis and hepatocellular carcinoma (HCC). During chronic HBV infection, a dynamic balance between viral replication and the host immune response is pivotal to the pathogenesis of liver disease. It is widely accepted that adaptive immune responses, particularly cellular immune responses, mediate the clearance of HBV.[1, 2] Although the chronicity of HBV infection is the result of impaired HBV-specific immune responses that cannot eliminate or clear the infected hepatocytes efficiently, many issues remained unsettled. It is thus crucial to have a suitable laboratory animal to study the immunopathogenesis of HBV infection and the mechanisms of HBV persistence. However, the study of HBV infection has been hampered by the shortage of animal model susceptible to HBV infections (such as chimpanzees) and the inability of HBV to propagate in common experimental animals, namely mouse. Nonetheless, the immunopathogenesis of HBV infection has been obtained from observation of human infections and was greatly enhanced by studies in chimpanzees, woodchuck, and HBV-transgenic (Tg) mice.

More than

45% of severe cases are due to inversions involving intrachromosomal homologous recombination between the segmental duplications int22h-1 located in intron 22 of the F8 gene and one of the two duplicons int22h-2 or int22h-3 situated approximately 400 and 500 kb more telomerically. Inversion of click here intron 1 present in 1 to 3% of severe cases is secondary to a similar mechanism between other duplicated sequences. Sequencing of the complete human genome has shown that ~ 5% is composed of duplicated sequences. Several segmental duplications are implicated in many genomic disorders (Charcot-Marie-Tooth, Smith Magenis). Several other duplications represent polymorphisms that are neutral suggesting that they have played a role in the genomic evolution. With respect to HA, besides intron 22 and 1 inversions, the presence of duplicated sequences in the F8 gene and their pathogenic implications have not been studied. Using microarray-based comparative genome hybridization assay, we delimited duplications of the 5’ position of F8 gene (including exons 1 to 22 and exon 1 only) in normal and HA patients harbouring different

severities of HA. The causal effects of the duplications could be explained by different rearrangements inside F8 gene. These findings show that duplications resulting from a recombination between homologous sequences at Xq28 may be present in both learn more normal subjects and HA patients. These duplications may be neutral in function except if they are accompanied by a more complex rearrangement medchemexpress disturbing the F8 gene. LB03 First in human clinical experience of a high purity factor X concentrate MT ALVAREZ1, I FERNANDEZ1, R LUDDINGTON2, M NORTON3 and C DASH3 1Hospital Universitario La Paz, Madrid, Spain; 2Department of Haematology, Addenbrooke’s Hospital, Cambridge, UK; 3Bio Products Laboratory (BPL), Elstree, UK Introduction: Severe factor X deficiency is a rare (1:~1,000,000) and potentially life-threatening bleeding disorder. BPL has developed

a high-purity factor X concentrate (FACTOR X) specifically for the management of this condition. Objectives: To evaluate the pharmacokinetics (PK), safety and efficacy of FACTOR X in patients with severe and moderate hereditary factor X deficiency (<5% normal FX:C). PK parameters for FX:C (one-stage clotting assay) and FX:Ag are assessed at baseline and 6 months post-baseline with sampling timepoints up to 144 hours (6 days) post-infusion. Efficacy in bleed management is assessed over at least 6 months. Results: PK data: Data from the first 2 patients’ baseline FX:C PK profiles give incremental recoveries of 1.64 and 1.92 IU/dL per IU/kg, and half-lives of 25.1 and 39.4 hours (non-compartmental analysis). Efficacy data: One patient has experienced a shoulder haemarthrosis, starting 7 days after the PK dose.

After 6 weeks of treatment, significant improvements in pain and bloating were reported in the treatment group compared with the control.98 A study from Korea showed probiotics (Bacillus subtilis and Streptococcus faecium) were effective in reducing the severity and frequency of abdominal pain compared with placebo in diarrhea-predominant or alternating type of IBS.99 Another recent Korean study showed composite probiotics containing Bifidobacterium bifidum BGN4, Lactobacillus acidophilus AD031, and other species were safe and effective in the treatment Akt inhibitor of patients

with IBS.100 A third Korean study using Lactobacillus acidophilus for a small number of patients of IBS also showed potential efficacy.101 A Chinese study showed that treatment with a probiotic preparation was effective in reducing the symptoms of abdominal pain, bowel movement frequency,

urgency and distension in IBS-like patients with chronic diarrhea.102 To many physicians, IBS is purely a psychosomatic disorder. The published reports on PI-IBS,5 SIBO,6 the relationship between gut flora and Tigecycline in vitro GI sensorimotor functions,3 and the potential for probiotics7,8 and antibiotics9 to alter these functions and to improve some of the symptoms of IBS provide strong evidence in support of a major role for the gut flora in the pathogenesis of IBS. In this we see the beginning of a paradigm shift in our understanding 上海皓元医药股份有限公司 of IBS. This is reminiscent of the evolution in our understanding of the pathogenesis of peptic ulcer disease, also once thought to be a psychosomatic

disorder103 before the advent of endoscopic capability and discovery of the Helicobacter pylori bacterium by Warren and Marshall, who were awarded the 2005 Nobel Prize in Physiology and Medicine.104 Asia, the home of two-thirds of the world’s population, with its diverse culture, socioeconomic profile, and food hygiene, is a fertile ground to study these exciting developments. “
“A 22-year-old Japanese woman was found to have severe esophageal varices and then suffered from hepatic encephalopathy. She was diagnosed with Budd-Chiari syndrome (BCS) due to hepatic vein (HV) thrombosis accompanied by portal vein thrombosis without inferior vena cava (IVC) obstruction. Latent myeloproliferative neoplasm (MPN) lacking the JAK2-V617F mutation was considered to be the underlying disease. Liver transplantation was strikingly effective for treating the clinical symptoms attributable to portal hypertension. Although thrombosis of the internal jugular vein occurred due to thrombocythemia, which manifested after transplantation despite anticoagulation therapy with warfarin, the thrombus immediately disappeared with the addition of aspirin.

Previous studies revealed that protein kinase B (Akt) played a key role in tumor progress and prognosis and it has a close correlation with tumor lymphnode metastasis. But

the role of Akt played in the lymphangiogenesis of stomach cancer is still unknown. In the current study, we analysed the relationship of the protein expression of Akt/mTOR signaling pathway with lymphangiogenic factor VEGF-C/-D and also with lymph vessel density (LVD) in situ and in vitro and eventually to clarify whether a Akt/mTOR/ VEGF-C/-D signaling pathway exist in the gastric cancer. Methods: 1. In situ gastric cancer tissue http://www.selleckchem.com/products/Decitabine.html experiments: 55 fresh gastric cancer tissues with matched normal gastric mucosas from patients with disparate pathological stages were collected and fresh-frozen in liquid nitrogen after surgical resections performed at the first affiliated hospital of Nanchang University. Of these, 42 were male and 13 were female. None of the patients had received chemo-, radio- or immuno-therapy before resection. Part of each specimen were routinely processed, fixed in 10% buffered formalin, and embedded R428 in vitro in paraffin for histopathological analysis (hematoxylin and eosin

stain) and for immunohistochemical staining. The expression status of p-Akt, p-mTOR, D2-40, VEGF-C and – D was detected by immunohistochemistry. 2. In vitro experiments: SGC7901 stomach cancer cells were divided into LY294002 intervention group and Rapamycin intervention group. MTT method was used to determine the effects of these two drugs on SGC7901 stomach cancer cells surviving. Western blot was used to detected the expression level of Akt, p-Akt, mTOR, p-mTOR, VEGF-C and -D after the above two drugs intervention. Results:  1. Immunohistochemical expression and relationship of p-Akt, p-mTOR, VEGF-C, VEGF-D in gastric cancer tissue. The positive expression rates of p-Akt, p-mTOR, VEGF-C, VEGF-D in gastric caner were 74.5%, 85.45%, 72.73% and 58.18%, respectively. The expression level of p-Akt was correlated with p-mTOR, VEGF-C and -D expression

levels, respectively (P < 0.05 or 0.01). At the meanwhile, the expression level of p-mTORwas also correlated with VEGF-C and – D (P < 0.05 or 0.01). 2.  Immunohistochemical expression of p-Akt, p-mTOR, VEGF-C, VEGF-D in gastric cancer tissue and their 上海皓元医药股份有限公司 relationships with LVD. The LVD was deteceted by immunostain of D2-40. The results revealed that the mean LVD in gastric cancer was 94.18±72.965, ranged from 0-263.The mean LVD was 23.31±21.569 in normal gastric tissue, ranged from 0-95, which has a significant difference when compared with that of cancer tissue (P < 0.001). A closely relationship was found between LVD and p-Akt, p-mTOR, VEGF-C, VEGF-D, respetively(P < 0.05 or 0.01). We also found that the expression level of p-mTOR, VEGF-C and VEGF-D were different among the p-Akt’s negative group, positive group,and strongly positive group (P < 0.05).

Previous studies revealed that protein kinase B (Akt) played a key role in tumor progress and prognosis and it has a close correlation with tumor lymphnode metastasis. But

the role of Akt played in the lymphangiogenesis of stomach cancer is still unknown. In the current study, we analysed the relationship of the protein expression of Akt/mTOR signaling pathway with lymphangiogenic factor VEGF-C/-D and also with lymph vessel density (LVD) in situ and in vitro and eventually to clarify whether a Akt/mTOR/ VEGF-C/-D signaling pathway exist in the gastric cancer. Methods: 1. In situ gastric cancer tissue Selleck NVP-AUY922 experiments: 55 fresh gastric cancer tissues with matched normal gastric mucosas from patients with disparate pathological stages were collected and fresh-frozen in liquid nitrogen after surgical resections performed at the first affiliated hospital of Nanchang University. Of these, 42 were male and 13 were female. None of the patients had received chemo-, radio- or immuno-therapy before resection. Part of each specimen were routinely processed, fixed in 10% buffered formalin, and embedded PD-0332991 nmr in paraffin for histopathological analysis (hematoxylin and eosin

stain) and for immunohistochemical staining. The expression status of p-Akt, p-mTOR, D2-40, VEGF-C and – D was detected by immunohistochemistry. 2. In vitro experiments: SGC7901 stomach cancer cells were divided into LY294002 intervention group and Rapamycin intervention group. MTT method was used to determine the effects of these two drugs on SGC7901 stomach cancer cells surviving. Western blot was used to detected the expression level of Akt, p-Akt, mTOR, p-mTOR, VEGF-C and -D after the above two drugs intervention. Results:  1. Immunohistochemical expression and relationship of p-Akt, p-mTOR, VEGF-C, VEGF-D in gastric cancer tissue. The positive expression rates of p-Akt, p-mTOR, VEGF-C, VEGF-D in gastric caner were 74.5%, 85.45%, 72.73% and 58.18%, respectively. The expression level of p-Akt was correlated with p-mTOR, VEGF-C and -D expression

levels, respectively (P < 0.05 or 0.01). At the meanwhile, the expression level of p-mTORwas also correlated with VEGF-C and – D (P < 0.05 or 0.01). 2.  Immunohistochemical expression of p-Akt, p-mTOR, VEGF-C, VEGF-D in gastric cancer tissue and their 上海皓元医药股份有限公司 relationships with LVD. The LVD was deteceted by immunostain of D2-40. The results revealed that the mean LVD in gastric cancer was 94.18±72.965, ranged from 0-263.The mean LVD was 23.31±21.569 in normal gastric tissue, ranged from 0-95, which has a significant difference when compared with that of cancer tissue (P < 0.001). A closely relationship was found between LVD and p-Akt, p-mTOR, VEGF-C, VEGF-D, respetively(P < 0.05 or 0.01). We also found that the expression level of p-mTOR, VEGF-C and VEGF-D were different among the p-Akt’s negative group, positive group,and strongly positive group (P < 0.05).