From the rhizome of Smilax stans Maxim., nine compounds were isolated and their structures were determined to be friedelin, diosgenin, 3, 5, 4'-trihydroxy stilbene, 3, 5, 3',4' -tetrahydroxy stilbene, n-butanol- O-?- D-fructopyranoside, sitosterol-3-O-?- D-glucoside,dioscin, methyl protodioscin and pseudo protodioscin on the basis of chemical,spectral methods and comparison with authentic samples.

Primary carcinoma of the gallbladder(PCG) is the most common malignant tumor in biliary system and its morbility has been rising year by year in our country.Because there is no specific clinical manifestation,patients diagnosed finally as PCG have mostly been in intermediate or advanced stage,thus losing the chance of radical resection of gallbladder carcinoma and having a poor prognosis.In this article we analyze the high risk factors,diagnosis of imageology,study of molecular biology,therapeutic progression and existent problems about PCG,by reviewing the related literature about diagnosis and treatment of PCG and the clinical data of 945 patients with PCG who were treated in our hospital in recent fifty years.We realize that early diagnosis of PCG is still difficult nowadays,it is very significant for secondary prevention of PCG to continue to carry out the foundamental and clinical study of PCG.Combined therapy that mainly includes surgical operation remains cardinal therapeutic management,and gene therapy has gradually developed to become a new therapy and displays favourable prospect of application.

Objective To introduce the methods and the advancements of early diagnosis in primary carcinoma of gallbladder (PCG),and improve the early diagnostic rate of PCG.Methods Recent relevant literatures were reviewed.Results It was difficult in early diagnosis of PCG and with a poor prognosis.Comprehending case history and careful examination and being assisted by multiple imaging methods and molecular biology technology could markedly improve the early diagnostic rate.Conclusion Comprehending the progress will contribute a lot of improving the early diagnostic rate and selecting reasonable clinical methods to be used in early diagnosis of PCG.

Objective To identify gene mutations of two cases of epidermolytic hyperkeratosis ichthyosis.Methods Punch biopsies were taken from typical lesions for histopathological examination by light microscopy and transmission electron microscopy.Genomic DNA was extracted from blood samples.Mutations of keratin1(K1)and keratin10(K10)were detected by polymerase chain reaction(PCR)and DNA sequencing;Frequencies of the alleles were screened by PCR-based allele-specific assays(PASA)and restriction fragment-length polymorphism(RFLP)in normal controls.Results There was a single heterozygous point mutation in either K1or K10genes,i.e.2140G→A of K10gene and4226G→A of K1gene,leading to an amino acid alteration of arginine to histidine(K10R156H)and glutamic acid to lysine(K1E477K),respectively.These substitutions were not found in normal controls.Conclusion K10R156H and K1E477K mutations were the cause of the phenotypes in these two cases.

Objective To investigate the expressions and clinical significances of Runt-domain-related 3 (Runx3) and chromodomain helicase DNA-binding protein 5 (CHD5) in colorectal cancer.Methods Ninety-six colorectal cancer tissue samples and matched adjacent normal tissues and 72 colorectal adenoma tissues were collected.Real-time quantitative polymerase chain reaction (qRT-PCR) and Western blotting were used to detect the mRNA and protein expression of Runx3 and CHD5.The associations of Runx3 and CHD5 expression with clinical pathological characteristics,diagnostic value and prognosis relationship of patients were further analyzed.Results Runx3 and CHD5 relative expressions of mRNA and protein were 0.35 ± 0.00,0.28 ± 0.02 and 0.26 ± 0.02,0.31 ± 0.01,which were significantly lower than those in the matched adjacent tissues 0.95 ± 0.02,0.92 ± 0.02 and 0.89 ± 0.03,0.93 ± 0.02 (t =2.36,P ＜ 0.05;t =1.25,P ＜ 0.05;t =1.37,P ＜ 0.05;t =1.13,P ＜ 0.05) and colorectal adenoma tissues 0.89 ± 0.02,0.90 ± 0.02 and 0.85±0.02,0.87±0.04 (t=2.27,P＜0.05;t=2.16,P＜0.05;t=1.25,P＜0.05;t=2.65,P＜0.05).Runx3 and CHD5 expressions differed significantly between tumors with different TNM stages (x2 =4.65,P =0.031;x2 =7.89,P =0.005),depths of tumor invasion (x2 =4.17,P =0.041;x2 =4.86,P =0.028),lymph node statuses (x2 =4.20,P =0.040;x2 =7.02,P =0.008),or histological differentiation (x2 =7.31 P =0.036;x2 =9.54,P =0.023).Linear correlation analysis showed that the expressions of the two genes were positively correlated (r =0.572,P =0.001).Receiver operating characteristic (ROC) curve showed that Runx3 and CHD5 had diagnostic value (AUC were 0.712,0.745;sensitivity and specificity were 45.9％,52.5％ and 83.6％,81.4％ respectively).Runx3 and CHD5 both low expression group compared with the other patient groups in overall survival time (x2 =8.156,P ＜ O.05) and progression-free survival (x2 =6.325,P ＜ 0.05) had statistically significant differences.Conclusion Runx3 and CHD5 are low expressed in colorectal cancer and may prove useful as biomarkers for diagnosis target and prognostic indication in patients with colorectal cancer.

Increasing evidences have shown the existance of a mitochondrial nitric oxide synthase(mtNOS),which binds to the matrix face of the mitochondrial inner membrane and produces nitric oxide(NO) through a Ca~(2+)sensitive pathway.Under physiological condition,the NO catalyzed by mtNOS regulates mitochondrial oxygen consumption and transmembrane potential via reversible competition with cytochrome C oxidase.The reaction of NO with superoxide anion,which was produced by mitochondrial respiratory chain,yields peroxynitrite.Peroxynitrite irreversibly modifies susceptible targets in mitochondria and induces oxidative and/or nitrative stress.In addition,NO has also been implicated in the programmed cell death.This article reviews the current understanding of mtNOS's role in the regulation of mitochondrial functions.

Free radicals are extensively existed in aerobic organisms with high reactivity. In cerebral ischemia, free radicals can be generated in excess of cellular antioxidant capacity resulting in severe damage. Hydroxyl radical is one of the most potent and reactive species. It plays a key role in neuronal damage induced by ischemia and reperfu-sion. This review will focus on: possible routes forthe formation of hydroxyl radical during cerebral ischemia; changes of hydroxyl radical contents induced by ischemia; the effect of hydroxyl radical on ischemic neuronal damage; the protective effects of hydroxyl radical scavengers on neuronal damage induced by ischemia.

Gallbladder volvulus is defined as the rotation of the gallbladder on its mesentery along the axis of the cystic duct and cystic artery. It is an unusual and rare occurrence with a predilection for women in their sixth or eighth decades of life. Only about 400 cases have been reported in the literature. The etiology of gallbladder volvulus remains speculative; however, the presence of a redundant mesentery is a prerequisite for torsion. Clinical symptoms are non-specific. Some form of right upper quadrant abdominal pain is nearly always present. Although recent advances in radiographic studies have aided in the diagnosis of many diseases,radiographic studies remain nonspecific in diagnosing gallbladder torsion. Laboratory evaluations are often nonspecific. An elevated white blood cell count is a frequent finding.Liver function tests are commonly normal. Gallbladder volvulus leads to gangrene or perforation because of occlusive obstruction of biliary drainage and blood flow. With early diagnosis and surgical intervention, the disease maintains a low mortality. Here, we present a review of the literature about gallbladder volvulus in order to enhance recognition of gallbladder volvulus.

To discuss the status quo of gallbladder cancer in China,88 articles published in China were collected and the clinical data of 7882 patients who were suffering from gallbladder cancer was analyzed.The requirements for the literature were:domestic articles published from 1980.1 to 2008.6,the gallbladder cancer cases must exceed 50,the cases must come from the same domestic hospital,and if the cases were reduplicative,the maximum were selected.Analysis of the data showed that primary carcinoma of the gallbladder was the most common malignant tumor in the biliary tract,with a higher incidence in females than males.The cancer's pathologic characteristics of undiscoverable growth and poor differentiation led to its clinical significance of difficult early stage diagnosis,high degree of malignancy,poor prognosis,and adenocarcinoma formation.Although the technique of surgical operation has constantly progressed over time,gallbladder cancer surgery possesses a lower rate of radical resection.Every biliary surgeon should brainstorm and deliberate about how to face the status quo of gallbladder cancer in China.This article participates in that discussion by identifying several noticeable problems in the diagnosis and treatment of gallbladder cancer.

Objective To evaluate the advances in minimally invasive surgery treatment for hepatolithiasis. Methods Literatures about the advances in minimally invasive surgery treatment for hepatolithiasis were collected and reviewed. Results Hepatectomy and bile duct exploration using laparoscopy can get better effect. Fibrocholedochoscopy play an important role in the course of operation and after operation for hepatolithiasis. Conclusion The individualization treatment program should be used for hepatolithiasis. Association application of multipathway minimally invasive operation, such as laparoscopy, fibrocholedochoscopy and so on, can increase the cure rate of hepatolithiasis.