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 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 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

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 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.

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.

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.

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.

Osteoporosis(OS)is a systemic skeletal disorder characterized by low bone mass and increased risk of fracture.Bone mineral density(BMD)is a gold standard in the diagnosis of OS,but is not sensitive enough for detecting the earlier bone loss.Bone metabolic markers have high sensitivity and specificity.Therefore,they are able to reflect the early changes of bone mass and can be used to monitor the efficacy of anti-OS agents.This article summarizes the research advance in both traditional and newly identified bone metabolic markers.

[Summary] A 19-year-old male patient with central diabetes insipidus complained of polydipsia and polyuria and was found to be accompanied by cervical vertebra lesions.The diagnosis of Langerhans cell histiocytosis was confirmed by laboratory and pathological results.Therefore,it should be alert to consider the possibility of Langerhans cell histiocytosis in a patient with central diabetes insipidus coexisting with the signs of multisystem lesions such as bone disease.