A 39-year-old female with central diabetes insipidus complained of polydipsia and polyuria and was found to be accompanied by lung lesions. The diagnosis of IgG4-related disease was confirmed by laboratory and pathological results. It should be alert to consider the possibility of IgG4-related disease in a patient with central diabetes insipidus coexisting with the signs of multisystem lesions such as lung disease.

[Objective] To discuss the operation and clinical results about surgical treatment of scoliosis of thoracic hemivertebra and diastematomyelia of adolescent.[Methods]From Jan 2001 to June 2007,15 patients were treated with one-stage posterior hemivertebrae and osseous divide resection combined with transpedicular instrumentation and bone graft.There were 6 males and 9 females with an average age of 21.2 years(range 16 to 24 years).All cases were segmented hemivertebrae.Hemivertebrae were located at T11(n=3)and T12(n=12).The status of the spinal fusion,correction rate and instrumentation were evaluated after surgery.[Results]All cases were followed up for 19 to 45 months with an average of 34 months.Cobb's angles of the main curve were 52.3??3.8?before surgery,10.2??1.4? after surgery.At the final follow-up there was 1.6? loss of correction.The mean height was increased by 3.76 cm.The district of bone graft showed good bone fusion.The time of vertebra fusion was 3 to 5 months(mean 3.6 months).No instrumentation,spinal fusion failure or other severe complications were noted.[Conclusion]One-stage posterior hemivertebrae and osseous divide resection combined with transpedicular instrumentation and bone graft can achieve a satisfactory result for the treatment of scoliosis of thoracic hemivertebra and diastematomyelia of adolescent.It can be recommended in clinical practice because of a good stability of fixation and fine spinal fusion.

Daphnetin, isolated from Daphne koreane Nakai, has been reported to dilate blood vesse ls, inhibit thrombosis and have antiinflammatory effect. In this study, type Ⅰ and type Ⅱ protcin kinase A partially purified from rat skeletal muscle and protein kinase C from rat brain were incubated with varying concentrations of daphnetin. Type Ⅱ protein kinase A was siguificantly inhibited by daphnetin at the concentration of 0.0056?mol/L, while type Ⅰ protein kinase A and protein kinasc C were inhibitcd at the concentrations of 5.6?mol／L and 56 ?mol/L, respectively. The results indicated that daphnetin might be used as a specific inhibitor of type Ⅱ protein kinase A

Objective To evaluate the utility of three-dimensional digital subtraction angiography(3D-DSA) in the diagnosis of cerebral vascular diseases.Methods Seventy-one patients suspected and diagnosed with cerebral vascular diseases underwent conventional DSA and 3D-DSA. Three-dimensional (3-D) reconstructed images were obtained at a separate advantage 4.0 workstation after the rotational images were transferred. The available visualization techniques included maximum intensity projection (MIP), shaded surface display (SSD), and virtual angioscopy (VA). Results Sixty-four aneurysms were found in 44 cases. Nineteen cases were diagnosed as cerebral arteriovenous malformation (AVM) and 8 cases of cerebral ischemia were due to cerebral vascular stenosis (internal carotid artery in 6 cases and occlusion of anterior cerebral artery in 2 cases).Conclusions 3D-DSA is reliable, fast and safe for diagnosis of cerebral vascular diseases, especially involving intracanal areurysms AVM and vascular stenosis.

Objective To compare the short-term and long-term efficacy of chemotherapy with biotherapy and same chemotherapy followed by biotherapy on malignant melanoma in stage Ⅲ and Ⅳ.Methods 82 cases with malignant melanoma were treated with chemotherapy(dacarbazing,cis-platin and carmustine)or biotherapy(interleukin-2,interferon ? and dendritic cell vaccine)or biochemotherapy(chemotherapy plus biotherapy).Among them,32 cases were received biochemotherapy,26 for biotherapy and 24 for chemotherapy.Therapentic response was assessed every 3 cycles.The median time of follow up was 2 years(1-4 years).Results Response rate was 71.9% for biochemotherapy,46.2% for biotherapy and 54.2% for chemotherapy(P

Objective: To analyze the short-term and long-term effects of non-operative therapy in the treatment of prolapsed lumbar intervertebral discs. Methods: One hundred and sixty-five subjects were randomized in single-blind method into traction group (A), Tuina group (B), and Tuina and exercise group (C); after 2 courses of treatment, the short-term effects were evaluated. Moreover, 102 cases with significant short-term effects were randomized in single-blind method into exercise group (D) and control group (E). The relapse rates in the two groups were survey one year after treatment; and the lumbar functions were assessed respectively six months and twelve months after treatment. Results: Groups B and C had obviously better effects than group A (χ2=8.359, P＜0.01); the relapse rate after one year was strikingly lower in group D than group E (χ2=12.631, P＜0.01). Conclusion: Tuina plus functional exercise is an effective method in the prevention and treatment of prolapsed lumbar intervertebral discs.

Objective To explore the effects and the underlying mechanisms of inhibiting three kinds of DNA methyltransferases(DNMT1,DNMT3a and DNMT3b) on the re-expression of cancer/testis antigen(CTA) in hepatic cells.Methods Transient transfection of HepG2 cells with siRNA was targeted against DNMT1,DNMT3a and DNMT3b(DNMT1+3a+3b),DNMT1 and DNMT3a(DNMT1+3a),DNMT1 and DNMT3b(DNMT1+3b),DNMT3a and DNMT3b(DNMT3a+3b),respectively.The other batch of cells was treated with 5'-aza-deoxycytidine(5-aza-dC) as positive control.Real-time PCR and Western blotting were used to detect the expressions of DNMTs and CTAsm,and the promoter methylation of partial CTA genes was detected with methylation specific PCR(MSP).Results Expressions of DNMT1,DNMT3a and DNMT3b declined significantly after siRNA interference in HepG2 cells.Two CTAs,CT10 and SSX1,re-expressed in the cells transfected by DNMT1+3a and DNMT1+3b.MAGE1 and MAGE3 were equally expressed in all cells despite been transfected or not.Demethylation occurred in the promoter region of CT10,while the promoter region of MAGE1 was in a state of unmethylation.Conclusions In HepG2 cells,CTA promoter can be demethylated via interference of DNMTs,which may lead to the re-expression of CTA that was originally unexpressed due to methylation.

Objective To investigate the relationship of apoptosis, proliferation and its related factors (p53, Fas ) with clinical pathological characteristics in hepatocellular carcinoma (HCC). Methods Apoptosis, nuclear antigen of proliferating cells (PCNA), p53, and Fas proteins were detected by labelling technique of in situ terminal deoxynucleotide transferase and immunohistochemical method on 35 HCC samples. Statistical analysis was employed to evaluate the correlations between the experimental data and clinical pathological characteristics. Results There was no significant difference between the apoptotic index (AI), PCNA index (LI), expressions of p53 and Fas and the age, sexual distinction of patient, and tumor size. Expressions of p53, Fas, and AI were not associated with the histological types of tumor at all. However, the index of PCNA was much higher in poorly differenciatiated type than that in trabecular type and pseudo glandular type of HCC. Importantly, following the advanced Edmondson stages and the TNM stages, p53 expression and LI increased in HCC, but AI showed a lower level at same time. Conclusion The malignancy of HCC is negatively correlated with AI but positively with PCNA. The apoptosis in HCC occurs in a p53-dependent manner. The higher mutant of p53 and the lower regulation of Fas expression may contribute to the genesis and progression of HCC.

AIM: To investigate mutations of oncogene k-ras in colorectal cancer tissues and the relationship between mutations of k - ras and biological behavior of colorectal carcinoma. METHODS:The specimens of 123 patients with colorectal cancer were collected. Real - time fluorescence quantitative PCR were performed to detect k-ras mutations at codon 12 and codon 13 of exon 1, and the results were analyzed with the corresponding clinical pathological data. RESULTS: Among 123 colorectal cancer cases, point mutations were detected in 53 cases (40.8% ) , point mutations at codon 12 were found in 42 (34.1 % ) cases, and 11(8.9% ) cases at codon 13.No closely relationship between mutations of k-ras and tumor size, location, invasive depth and differentiation extent was observed. The rate of k-ras mutation in the cases with more invaded lymph nodes was higher than that in the cases without invaded lymph nodes ( P < 0.05 ) , and the rate of k-ras gene mutation in the cases with hepatic metastases was higher than that in no hepatic metastases (P <0.05). The rate of k - ras gene mutation was higher in TNM staging Ⅲ/Ⅳ than that in Ⅰ/Ⅱ( P < 0.05 ). CONCLUSION: Mutation of oncogene k-ras plays an important role in the carcinogenesis and development of colorectal cancer, and it is closely associated with invaded lymph notes and hepatic metastases, suggesting that mutation of k- ras indicates a poor prognosis.

Cancer pain is an inherently subjective feeling. As such, a patient's report of pain is the basis of assessment. Self-re-ported questionnaires are extensively used in clinical practice and research. Single-item unidimensional rating scales are often used to assess pain intensity. Numerical rating scale is recommended by the European Palliative Care Research Collaborative. Multidimension-al measurements, such as brief pain inventory and short-form McGill pain questionnaire (revised version), can also be used for more comprehensive pain assessments than other questionnaires. Furthermore, specific tools can be applied when cancer-related break-through pain or neuropathic pain is assessed. For patients with cognitive function impairments, face rating scale is a useful tool to screen pain. Multidimensional measurements should also be used for further evaluation. In cancer pain evaluation, the development of simple and practical computer-administered questionnaires is a new trend. Repeated cancer pain assessment is strongly recommended regardless of the applied scale.