Carcinoma of gallbladder is the most frequently encountered malignancy of the biliary system. Early diagnosis is very difficult and the tumour resection rate is low,and the prognosis of carcinoma of gallbladder is very poor. With the increasingly widespread acceptance of laparoscopic cholecystectomy (LC),the number of cases of unsuspected gallbladder carcinoma (UGC) has increased. However,management of UGC is a difficult issue in the absence of established guidelines. High age and history of stones are the risk factors for gallbladder carcinoma and they are related to UGC. Surgical handling and pneumoperitoneum play an important role in the metastasis. The surgical approach used for cholecystectomy would not seem to influence the outcome in patients with UGC. The tumour stage is the most important prognostic factor. To understand UGC better, we review its clinical characteristics,investigation,prognosis and especially the recent advances in the diagnosis and treatment of this disease.

Objective To study the inducing apoptosis of Hedyotis diffusa extract (HDE) on human hepatocarcinoma cell line Bel7402 and its molecular mechanism. Methods Human hepatocarcinoma cell line Bel7402 was used in vitro cell culture, there were 3 groups:control group, HDE group and 5-Fu group, the Bel7402 cells were dealed with them respectively. The apoptosis morphologic changes of human hepatocarcinoma cells were observed by invert microscope. The apoptosis rate was detected with hematoxylin stain by light microscope. Inhibition of Bel7402 cell proliferation was measured by MTT assay. The expression of oncogene Bcl-xl and anti-oncogene p53 of Bel7402 ceils were observed with RT-PCR assay. Results Compared with the control group, the condensation of nuclear, vacuolar degeneration of mitochondria could be found through light microscope. The apoptosis rate of HDE group was remarkably increased compared with that in control group (P

Objective To investigate the effect of intrathecal glial cell line-derived neurotrophic factor (GDNF) on p38 mitogen-activated protein kinase (p38MAPK) protein expression in the spinal cord dorsal horn in a rat model of neuropathic pain. Methods Male SD rats 6 weeks old weighing 180-200 g were used in this study.One hundred and twenty rats in which intrathecal catheters was successfully implanted were randomly divided into 4 groups ( n = 30 each): group Ⅰ control ( group C); group Ⅱ sham operation ( group S); group Ⅲ neuropathicpain (group P) and group Ⅳ GDNF. In groupⅢ and Ⅳ I6 spinal nerve was ligated. In group Ⅳ intrathecal GDNF was administered every other day for 14 d after spinal nerve ligation. In group Ⅲ normal saline was given instead. Ten animals from each group were selected at 3, 7 and 14 d after spinal nerve ligation, the mechanical pain threshold was measured, and then the rats were decapitated. The I4-6 segment of the spinal cord of the operated side was isolated. p38MAPK protein expression in the spinul dorsal horn was determined by immunohistochemistry and Western blotting. Results Intrathecal GDNF significantly attenuated spinal nerve ligationinduced increase in p38MAPK protein expression in spinal dorsal horn of the operated side. Conclusion IT GDNF can relieve neuropathic pain by inhibiting p38MAPK protein expression in the spinal dorsal horn.

Objective To study the difference between the metabolic syndrome(MS)diagnosis made with International Diabetes Federation(IDF)worldwide definition and the Adult Treatment Panel Ⅲ (ATPⅢ)of National Cholesterol Education Program(NCEP).Methods Cross-sectional study and descriptive study were used.Results There were 1328 MS patients diagnosed with IDF and 1527 MS patients diagnosed with ATPⅢ.There were 199 MS patients diagnosed with ATPⅢbut not with IDF and these MS patients all had 3-4 risk factors.According to the abnormality of glucose.blood pressure and lipid regulation stated in ATPⅢ criteria.759 more patients were diagnosed as MS than with IDF criteria.Conclusions MS diagnosed with ATP Ⅲ criteria iS more objective than with IDF criteria and ATPⅢ criteria has more space for further theoretical study.

Objective To investigate the expressions of CXCR4 in Barrett esophagus (BE), esophageal adenocarcinoma (EADC) and esophageal squamous cell carcinoma (ESCC), and its relationship with pathology, clinical staging and lymph node metastasis. Methods The expressions of CXCR4 in 56 cases of normal esophageal mucosa, 80 BE (including 22 BE with multifocal dysplasia), 25 EADC and 48 ESCC were examined with immunohistochemical method. Results CXCR4 was expressed in most samples of BE (80. 8% ), EADC (68. 0% ) and ESCC (78.4%) without significant difference ( P ＞ 0. 05 ), which was significantly higher than that in normal esophageal mucosa (39. 3%, P ＜0. 01 ). The level of CXCR4 expression in BE, EADC or ESCC were not related with gender, age, or location of the foci ( P ＞ 0. 05). There was no significant difference in CXCR4 expression between BE without dysplasia or BE with multifocal dysplasia ( P ＞ 0. 05 ). CXCR4 expression level in well-differentiated EADC was significantly higher than that of mild or poorly differentiated (P ＜ 0. 05 ). CXCR4 expression level was higher in EADC with lymph node metastasis than those without ( P ＜ 0. 05 ). CXCR4 level in ESCC with TNM staging grades Ⅲ -Ⅳ was higher than that of grades Ⅰ - Ⅱ, and this variable was also higher in cases with lymph node metastasis than those without (P ＜ 0. 05), so was the case of well and poorly differentiated ESCC (P ＜ 0. 01 ). Conclusion Increased expression level of CXCR4 may be a common feature of EADC and ESCC, which is irrelevant to pathological types. CXCR4 level rises at the stage of BE, which is associated with the degree of tumor differentiation, lymph node metastasis and TNM staging. CXCR4 expression is of guiding significance in the diagnosis of BE, EADC and ESCC, and is the potential drug target.

Objective To compare the diagnostic value of MRS acquired by body coil(BODY)and endorectal Coil(ERC)in the detection of prostate cancer.Methods MRI and 3D MRS were performed in 12 patients with prostate disease,in which 6 of them were proved to have prostate cancer and the other 6 noncancerous disease.Both BODY and ERC MRS were performed in 7 patients,and only BODY MRS was performed in the other 5 patients.All MRS data were quantitatively assessed with a per-sextant method.The metabolic ratio of(Choline+Creatine)/Citrate[(Cho+Cre)/Cit]was measured in each ROI.ROC analysis was carried out to assess and to compare the diagnostic value of BODY and ERC MRS in patients with prostate cancer with Wilcoxon test.Results (1)The ratios of(Cho+Cre)/Cit in the prostate cancer group(median 1.744,0.295 to 7.998)was statistically higher than that in the non-prostate cancer group (median 0.412,0.112 to 2.113)acquired by using BODY MRS(Z=-9.159,P＜0.01).(2)The ratios of(Cho+Cre)/Cit in the prostate cancer group(median 1.975,0.479 to 7.998)was statistically higher than that in the lion-prostate cancer group(median 0.400,0.104 to 2.232)acquired by using ERC MRS(Z=-9.200,P＜0.01).(3)The mean ratios of(Cho+Cre)/Cit in the prostate cancer group and in the non-prostate cancer group acquired by using both coils were not of statistically significant difference(P＞0.05).(4)ROC analysis for diagnosing prostate cancer showed no significant difference(P=0.851)between the areas under the curve of BODY and that of ERC MRS(Az=0.93 1 and 0.935 respectively).Conclusion The BODY MRS could provide comparable diagnostic efficacy to ERC MRS in patients with prostate cancer.

Objective To invstigate the effect of ultrasound microbubble mediated miRNA delivery on mi-gration,invasion and cloning ability of human hepatoma HepG2 cells. Methods The migration,invasion and col-ony forming ability of HepG2 cells were measured after transfection with antisense miRNA-21/221 and miRNA-199a mimic via the optimal ultrasound microbubble transfection method. Results Compared with the control group ,the migration ,invasion and cloning ability of cells were significantly inhibited after transfection with miRNA mimics(P < 0.05,respectively),especially for miR-199a(relative cell migration rate was 31.05%,the number of invasive cells were 38.67 ± 4.51 and the number of clones were 105.67 ± 5.86). Conclusion The pres-ent study may provide new ideas and clues for gene therapy and prognosis of hepatocell ular carcinoma through ana-lyzing the effect of miRNAs on the biological characteristics of human hepatoma HepG2 cells.

Objective To detect amniotic fluid ABH blood group substances and ABO blood group genotype by the polymerase chain reaction with sequence-specific primers(PCR-SSP) to increase the prenatal diagnosis of fetal ABO blood group .Methods 53 pregnant women with gestational age 16 -25 weeks were selected .Amniotic fluid was extracted for detecting ABH blood group substances by the serological indirect agglutinating reaction ;the amniotic fluid cells were separated for extracting DNA .Then the PCR-SSP technique was adopted to analyze the ABO blood group genotypes .Results 16 specimens of amniotic fluid were non-se-creting type phenotype(30 .2% ) and 37 specimens of amniotic fluid were secreting type phenotype (69 .8% );48 specimens of amni-otic fluid were detected out the ABO blood group genotype by the PCR-SSP method .ABO blood group of fetal amniotic fluid cells by the gene identification was consistent to the detection results of amniotic fluid secreting type ABH blood group substances .Con-clusion The PCR-SSP technique can accurately detect the fetal amniotic fluid cells ABO blood group .

Objective To study the relationship between expression of p75 gene and apoptosis of cerebrum cells in type 2 diabetic rats.Methods Ten type 2 diabetic rats and ten natural rats were used to test the expression of brain p75 mRNA by RT-PCR technique, and the apoptosis of cerebrum cells was measured by agarose gel electrophoresis (AGA).Results The expression of brain p75 mRNA and apoptosis of cerebrum cells in type 2 diabetic rats were higher than that of the natural group.Conclusion The apoptosis of cerebrum cells in type 2 diabetic rats increases, and it is positively correlated with the expression of brain p75 gene mRNA.

Objective To investigate bone age of left-hand wrist in healthy adolescents of Shenyang and Beijing for assessing the process of skeletal development.Methods From 2008 to 2012,1333 adolescents (aged form 4.0 to 18.0 ys) of Shenyang and Beijing were enrolled in this study.Skeletal age was estimated by left hand and wrist X-ray using CHN atlas by 2 qualified radiologists.The correlation between skeletal and chronological age was analyzed using correlation analysis.Skeletal age and chronological age were compared using paired t test.The differences between skeletal and chronological age in genders and regions were compared using independent-samples t test.SPSS for Windows (version 13.0)was used for statistical analysis.P ＜ 0.05 was considered as significant difference.Results (1) Close correlation was found between skeletal age and chronological age (P ＜ 0.01) for both two genders and two regions.(2)Among 28 groups of investigation,16 groups (boys,11 groups) had higher skeletal ages than chronological ages with statistical significance,including Shenyang boys aged 6.0-18.0 ys,Shenyang girls aged 6.0-7.9 ys and 14.0-15.9 ys,Beijing boys at 6.0-15.9 ys and Beijing girls at 8.0-13.9 ys.(3) Comparison between boys and girls:5 groups showed significant difference,including 8.0-9.9 ys,10.0-11.9 ys and 16.0-18.0 ys groups in Shenyang and 6.0-7.9 ys,10.0-11.9 ys groups in Beijing.(4) Comparison between Shenyang and Beijing:6 groups showed statistical significance,including boys at 10.0-11.9 ys,12.0-13.9 ys and 16.0-17.9 ys and girls at 6.0-7.9 ys,8.0-9.9 ys and 10.0-11.9 ys.Conclusion Although CHN atlas method could reflect adolescent bone development,the skeletal age is higher than chronological age in many groups,and the difference between skeletal and chronological age is statistically different between genders and between two regions.This research can be used as a reference for the study of skeletal development and for further emendation of CHN atlas.