Objective To investigate the clinical and pathologic features of primary hepatic carcinoma(PHC) associated with hepatitis B virus,HBV). Methods 200 cases of the patients with PHC were diagnosed by histopathologic examination and surgery. The history of HBV infection, its infective patterns and abnomal liver function were obtained from the medical history, and the tests of liver function and HBV five markers. The pathologic features of PHC associated with HBV were determined by analysis of histopathologic changes and views of surgery. Results The markers of HBV were positive in 181 out of 200 cases with PHC, and the positive rate of HBV infection was 90.5%. The postitive rate of HBsAg, anti-HBe and anti-HBc was the highest among the five markers of HBV (50.83%). The positive rate of HBsAg and HBeAg and anti-HBc was only 4.97%. The PHC patients without history of HBV infection and asymptomatic carriers of HBV accounted for 61.33% and 6.63%, respectively. The cases with cured hepatitis and no relapse accounted for 8.29%. The cases with chronic hepatitis B and with liver cirrhosis accounted for 22.10% and 1.66%, respectively. Liver functions were slightly abnomal in approximately one-half patients with PHC. Histopathologic features were as following: HCC accounted for 91.95%, and nodular type, macro-type and small hepatic carcinomas accounted for 55.25%, 30.94% and 13.81%,respectively. The distributions of PHC were mainly in right lobe of liver. The incidence of venous cancer embolism was 12.71%. The incidence of liver cirrhosis was 83.32%. Conclusions ⑴There was relationship between HBV and PHC. The main infective pattern of HBV was the positive HBsAg, anti-HBe and anti-HBc;⑵Pathologic lesion of liver was hidden after infection of HBV;⑶The incidence of active cirrhosis was high; and ⑷There were many pathologic features in patients with PHC associated with HBV.

The zinc finger protein A20 exists in many kinds of ceils in the body and plays multiple roles in physiological and pathological processes such as regulation of immune response,inflammatory diseases and cancers by inhibiting cell apoptosis induced by tumor necrosis factor (TNF) and restricting NFKB signaling pathway.Recently,the role of A20 in generation and development of tumors draws wide attention,hence,we summarized recent research progress of the relation between A20 and cancer in this review.

Objective To observe the effects of Qutantongluo decoction on the expression of TGF-β1 in renal tissue of diabetic nephropathy(DN) rats,which can help to understand the mechanism of action.Methods The rats models of diabetic nephropathy were established by injecting with streptozotocin intraperi-toneally.All Wistar rats were randomly divided into 6 groups:the normal control group,the model control group,Benazepril Hydrochloridec group ( 1 mg/kg ·d-1 ),Qutantongluo decoction low dose group (3 g/kg ·d-1 ),Qutantongluo decoction median dose group (4.5 g/kg · d-1 ),and Qutantongluo decoction high dose group (6 g/kg · d-1 ).Rats in the normal control group and the model control group were given celiac perfusion of distilled water once at the same time and dose.All the rats were gavaged once daily for 8 weeks.The expression of TGF-β1 at the level of gene and protein in renal tissue were tested by immunohistochemistry and RT-PCR methods.Results Compared with the model control group(2.79±0.22),the expression of TGF-β1 at the level of protein in renal tissue of Benazepril Hydrochloridec group (1.55 ±0.12)and the Qutantongluo decoction low dose group ( 1.54± 0.16),Qutantongluo decoction median dose group (1.49 ± 0.17),Qutantongluo decoction high dose group(l.39±0.25) decreased significantly (P＜0.05).Compared with the model control group (0.35±0.07),the expression of TGF-β1 mRNA in renal tissue of Benazepril Hydrochloridec group(0.35± 0.07)and the Qutantongluo decoction low dose group(0.39±0.03),Qutantongluo decoction median dose group (0.35± 0.06),Qutantongluo decoction high dose group (0.32± 0.07) decreased significantly (P＜0.05).Conclusion Qutantongluo decoction can down regulate the expression of TGF-β1 in kidney,which may be one of the mechanisms of Qutantongluo decoction effectiveness in clinical treatment of diabetic nephropathies.

Objective To evaluate the status of abnormal glucose metabolism in patients being alive over 3years after liver transplantation and discuss the possible mechanism of post-transplant diabetes mellitus ( PTDM ).Methods In this study, the clinical data of patients with liver transplantation were collected from April 2001 to December 2008. Patients with diabetes mellitus before operation and those who had died and failed to appear during follow-up were exluded. 199 patients living over 3 years after liver transplantation were follow-up. The prevalence of PTDM was evaluated according to fasting plasma glucose(FPG). Among those without diabetes according to FPG,32patients underwent 75 g oral glucose tolerance test (OGTT) , and fasting and 2 h plasma glucose and insulin were determined. 32 patients were divided into three groups [normal, impaired glucose regulation ( IGR ) , and PTDM groups], proportion of PTDM and homeostasis model assessment ( HOMA ) index were calculated. Results In patients alive over 3 years after liver transplantation, the prevalence of PTDM was 34.67% according to FPG. The OGTT result showed that the proportion of PTDM was 9.38%, IGR, including impaired fasting glucose(IFG) and impaired glucose tolerance ( IGT ) , was 56. 25% , while 34. 37% remained normal. The homeostasis model assessment β cell function index( HOMA-β ) decreased progressively from normal group, IGR group to PTDM group,and that in PTDM group was significantly lower than those in normal and IGR group( P＜0.01 ). IGR group had the highest homeostasis model assessment for insulin resistance (HOMA-IR) and PTDM group the next, and HOMA-IR in IGR group was significantly higher than normal group. Conclusion In patients alive over 3 years after liver transplantation, the prevalence of PTDM reached 44.05%. Insulin resistance existed during early period of impaired glucose regulation, while the degeneration of β cell progressed with the worsening of impaired glucose regulation.

Objective To investigate the expression of monocyte chemoattractant protein-1(MCP-1)and CCR2 in peripheral blood and pleural fluid of tuberculous pleurisy patients.Methods Flow cytometry was used to detect the expression of CCR2 in the peripheral blood mononuclear cell and pleural fluid cell of tuberculous pleurisy patients;ELISA was used to detect the content of MCP-1 in serum and pleural fluid.Results MCP-1 in surem and pleural fluid and CCR2 in the peripheral blood mononuclear cell and pleural fluid cell of tuberculous pleurisy patients was significantly higher than that of the healthy normal controls[MCP-1:(340.8±220.8)and(9.0±3.8)ng/L,P＜0.01;CCR2(18.2±10.1)%and(6.9±3.5)%,P＜0.05];Both MCP-1 and CCR2 were detected in pleural fluid and both of them were positivley correlated(r=0.227,P＜0.05).Conclusion The expression of MCP-1 and CCR2 in peripheral blood of tuberculous pleurisy patient are significantly elevated which are significance molecule participating in the pathogenesis of tuberculous pleurisy.

Objective To report a family with lipoid proteinosis (LP) from Shandong province and to analyze mutations in the extracellular matrix protein 1 (ECM1) gene in this family.Methods Eight members in a threegeneration family with LP were clinically investigated,and two patients were identified to suffer from LP,including the proband (Ⅲ 1) and her mother (Ⅱ 2).Both of the patients presented with papules on the palpebral margin,short and thick lingual frenum,and hoarseness.Indirect laryngoscopy showed infiltrating and thickening of the vocal cord.Pathological examination of lesions on the palpebral margin and laryngeal mucosa revealed deposits of hyaline-like material in the dermis,which was strongly positive for periodic acid-Schiff (PAS) staining and resistant to diastase digestion.The pathological diagnosis was LP.Blood samples were collected from all the family members and 100 ethnically matched,unrelated and unaffected Chinese human controls followed by DNA extraction.PCR and sequencing were performed to detect the ECM1 gene,and nested PCR followed by agarose gel electrophoresis to analyze mutations in the coding region of the ECM1 gene.Results Both of the two patients were compound heterozygotes.Three missense mutations,incluing p.P169T,p.A44T and p.R392W,were found in the ECM1 gene of the affected mother,with p.P169T in one allele and p.A44T as well as p.R392W in the other.The girl patient inheried the missence mutation p.P169T from her mother and a synonymous mutation c.879G ＞ A from her father (Ⅱ 1).Nested PCR showed that the c.978G ＞ A mutation generated a splice-acceptor site AG,which leaded to a splicing defect.Conclusion A novel synonymous splice-acceptor site mutation c.879G ＞ A in the ECM1 gene is identified in the family with LP.

[Summary] Interleukin-2 receptor antagonist (IL-2Ra,ie,basiliximab and daclizumab),a new antibody agent,is widely employed in lowering the risk of acute rejection after organ transplantation,but it meanwhile causes increasing concerns on the effect it exerts on glucose metabolism in transplant recipients,and so far the exact effect still remains controversial.New onset diabetes after transplantation (NODAT) is one of the most influential metabolic complications affecting graft survival and patients' long-term outcomes.Some of the current researches indicate that IL2Ra may improve glucose metabolism in the transplant recipients,some show just the opposite,yet others show no effects.Hence further investigations focusing this aspect are needed.

Objective To study the application of suture and ligature and swelling technique in the removal of giant skin benign tumor in none-extremity position.Methods The swelling technique was merely used in those whose lesions were located on face and neck before operation.If the lesions were located on scalp or truck,suture and ligature and swelling technique would be combined in the treatment.Firstly,the lesion was sutured and ligated one or two circles all around.Then swelling fluid was injected under lesion,and incision was done inside or between sutures.Results The area of lesion once excised was 154.00-2394.75 cm2,and the quantity of swelling fluid was 150 1950 ml.The longest time to suture and to ligate the lesion was one hour,and operative bleeding was obviously decreased.Conclusions Suture,ligature and swelling technique might be helpful to decrease operative bleeding during excision of giant skin benign tumor in none-extremity position,and therefore increase operative safety.

Objective To investigate the perception of Mandarin's tones by children with speech development disorders so as to provide a theoretical basis for clinical rehabilitation.Methods Thirty children with speech development disorders (DPDs) aged 4 to 6 were matched with 30 healthy counterparts as a control group.Both groups underwent the tone perception experiment,which included tone identification and discrimination tasks.The speech stimuli were 11 computer-simulated voices expressing a continuum of sounds from Mandarin speech ranging from /bá/ to /bà/.The two groups were compared in their ability to identify and differentiate the tones.Results Both groups showed typicalS-shaped identification curves in a category pattern.The category boundaries of the control group were between stimulus steps 6 and 7,significantly different from those of the experimental group where the boundary fell between stimulus steps 5 and 6.On the distinguishing curve,both groups presented obvious peak values.The stimulus steps of the peaks and the crossing points of the identification curves were consistent.In addition,the average ahsolnte value (b1) of the identification curve and the peaks' degree of steepness (DP) of the DPD group's distinguishing curve were significantly lower than those of the control group.At the same time,the average boundary width (Wcb) was significantly higher than that of the control group.Conclusion Children with speech development disorders perceive Mandarin tones with categories different from those of normal children.They may have difficulty in perceiving tones,which might be an important factor leading to pronunciation errors.

Objective To explore the reason of misdiagnosis and discuss the reoperation in thyroid carcinoma.Methods The data of 77 patients that had reoperation because of misdiagnosis were analyzed.Results The daignosis of all 77 cases were only based on pre-operative physical and uhrasound examination.The post-reoperative follow up (3～41 monthes):no case was found local recurrence.Conclusions The preoperative frozen section may avoid misdaignosis and the effect of reoperation for misdaignosed cases are satisfactory.