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Background and Aims: The murine double minute 2 (MDM2) gene encodes a negative regulator of the tumour protein p53. A single nucleotide polymorphism (SNP) in MDM2 promoter, SNP309 T > G, has been showed to influence MDM2 protein expression and accelerate tumour formation. To investigate further the role of this locus, we examined the association of the SNP with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) in a northeast Han Chinese population., Methods: MDM2 SNP309 was genotyped in 310 HBV-related HCC patients, 314 non-HCC subjects with HBV infection and 480 healthy controls by using a PCR-RFLP method., Results: Significant differences of MDM2 SNP309 were detected between HBV-related HCC patients and healthy controls (OR 1.729, 95%CI 1.369-2.183, P < 0.0001) or non-HCC subjects with HBV infection (OR 1.351, 95% CI 1.060-1.722, P = 0.015) by a logistic regression analysis. Our data also revealed that subjects with the G allele had higher HBV-related HCC susceptibility than those with the T allele in various genetic models. In a meta-analysis, where we pooled our data with other published studies, the association between this loci and the disease was further confirmed (pooled OR 1.54, 95% CI 1.37-1.72, P < 0.0001)., Conclusions: These results suggested that the MDM2 SNP309 might influence the risk of developing HBV-related HCC in a northeast Han Chinese population., (© 2012 John Wiley & Sons A/S.)

To evaluate the association between psoriasis and risk of diabetes, pertinent studies were identified by searching electronic databases and by reviewing the reference lists of retrieved articles. We included observational studies that examined the association between psoriasis and risk of diabetes. Two reviewers independently assessed eligibility and used a standardized form to collect data from published studies. The study quality was assessed by the Newcastle-Ottawa Scale. A total of 22 eligible studies that included 3,307,516 participants fulfilled the inclusion criteria. Compared to individuals without psoriasis, subjects with psoriasis had a 1.42-fold increased risk of diabetes (95% CI, 1.40-1.45). Findings from this meta-analysis suggest that individuals with psoriasis may have a modestly increased risk of diabetes.

Background: The distribution of the arachnoid membrane and its relationship with the neurovascular structures in the pineal region are still not fully understood., Objective: Because the arachnoid membrane has an intimate relationship with the neurovascular structures in the pineal region and it will always be encountered surgically, we attempted to clarify the formation and distribution of the arachnoid envelope over the pineal region (AEPG)., Methods: The formation and distribution of the AEPG and its relationship with the neurovascular structures in the pineal region were examined by anatomic dissection in 20 adult cadaveric formalin-fixed heads., Results: The supratentorial and infratentorial outer arachnoid membranes converged at the tentorial apex and then embraced and ran forward along the vein of Galen to form the AEPG. The AEPG could be divided into 2 parts. Typically, the posterior part of the AEPG enveloped the vein of Galen and the terminal segments of its tributaries, and the anterior part of the AEPG enveloped the suprapineal recess, the pineal gland, and the distal segment of the internal cerebral veins. The compartment demarcated by the AEPG did not communicate with the adjacent subarachnoid cisterns or space., Conclusion: Previous knowledge about the AEPG, as well as the superior boundary and the contents of the quadrigeminal cistern, needs to be revised. The arrangement and individual variation of AEPG are important for a better understanding of the various growth patterns of the pineal tumors and the relationship between the tumor and the neurovascular structures in the pineal region.

Objective: To investigate the origin of mixed germ cell tumors in the pineal region based on the image data, surgical findings and pathological examination of the tumor., Methods: The preoperative CT and magnetic resonance imaging (MRI) findings and tumor specimens were retrospectively analyzed in 15 cases of pineal mixed germ cell tumors confirmed by postoperative histological examination between January 2000 and September 2010., Results: Radiographic examination of the tumor revealed calcification in 12 cases, cystic changes in 10 cases, and the presence of lipid in 5 cases. On the anteroposterior images, the tumors appeared round or elliptic with smooth edge in 6 cases, and showed irregular shape with multiple processes on the edge in 9 cases. Surgical exploration found all the tumors located in the the suprapineal recess enclosed by the arachnoidal envelope of the Galen vein. Pathologically, 13 specimens contained germinoma component, 9 contained teratoma component, 4 had embryonic carcinoma component, 3 had choriocarcinoma component, 7 showed yolk sac tumor component, and 3 showed rhabdomyoma component. Germinoma components were found on the tumor margin in 7 specimens, and intermingled germinoma and other components were found in 10 specimens., Conclusion: Pineal mixed germ cell tumor originates from the residue germ cells around the pineal gland, and most likely evolves from single primordial germ cells.

Objective: To study the depression related factors in elderly patients after stroke and to explore the effect of Chinese medicine anti-depression treatment for improving neurological function in patients with after-stroke depression., Methods: Three hundred and seventy-seven after-stroke elderly patients were sorted, according to their Hamilton Depression Scale-17 (HAMD17) scores, to the non-depression group (NDG, 116 patients) and the depression group (DG, 261 patients). The depression related factors in them were analysed. Moreover, patients in DG were randomly subassigned to two groups, the 135 patients in the treated group were treated with Chinese medicine and general stroke-treatment, and the 126 patients in the control group were treated only with general stroke-treatment for 4 weeks. HAMD17 scores of neurological deficit (NDS), scores of sleep dysfunction rating scale (SDRS), Hamilton anxiety rating scale (HAMA), and treatment emergent symptom scale (TESS) in them were observed before and after treatment., Results: Prevalence rate of depression in patients with cerebral hemorrhage was 79.78% (71/89), significantly higher than that in patients with cerebral infarction, 65.97% (190/288, P < 0.05). Patients of stroke with lesion occurred at cerebellum, brain stem, or cerebral hemisphere (frontal lobe) and those with moderate/severe neurological deficit were more liable to suffer from depression. The HAMD17, HAMA, SDRS, and NDS scores in the treated group after treatment were all improved more significantly than in the control group (P < 0.05). NDS score reduced in the treated group significantly from 19.1 +/- 16.3 before treatment to 31.3 +/- 14.8 after treatment, showing the evident recovery of nerve function., Conclusion: The occurrence of depression after stroke is closely related with the nature and position of the lesion, as well as the degree of neurological deficit in patients. Chinese medicine could improve the depressive manner effectively and thus to make for recovery of neurological function.

To check feasibility and effectiveness of the α-amylase reporter system, two vectors were designed and tested using hepatitis B virus surface antigen (HBsAg) and Homo sapiens granulocyte-macrophage colony stimulating factor 2 (hGM-CSF2) as a model. By integrating the vector containing two independent cassettes into the same genome locus, high-producing clones of HBsAg (or hGM-CSF2) were screened using the α-amylase as a reporter. Results show there was a positive correlation (Correlation coefficient, R (2) > 0.95) between the yield of recombinant proteins and the α-amylase activity of corresponding transformants, which was independent of the gene dosage.

Objective: To review the clinical manifestations, imaging, tumor markers, treatment methods, pathology results and clinical curative effects of pineal region tumors and to evaluate the characteristics and intervention strategies for those tumors., Methods: The clinicopathological data of 132 patients with pineal region tumor treated in our department between January 2000 and May 2008 were retrospectively studied., Results: A moderate predominance in males was presented. The clinical manifestations of the disease included increased intracranial pressure and ocular movement impairment. There were some features but no regularity and specific appearance on imaging including CT and MRI. 88.6% of patients associated with hydrocephalus. A high serum level of alpha-fetoprotein (AFP) was presented in 14 cases and high HCG in 9 cases. Eighteen cases received direct radiation therapy and 7 had radiotherapy post biopsy. 107 cases were treated surgically and 63 cases received postoperative adjuvant treatment. 114 cases had pathology results including 56 germ cell tumors. The patients were followed up for 12 approximately 132 months. Recurrence developed in 23 cases and 12 cases died. The 5-year survival rate was 89.3%., Conclusion: Pineal region tumors are often associated with hydrocephalus and this makes preoperative diagnosis difficult. Imaging examination may help diagnosis but less specific. Germ cell tumors may diagnosed by some tumor markers. Radiation therapy is the choice of treatment for pure germinomas. Other types of pineal region tumors should receive surgical treatment. Postoperative adjuvant treatment based on pathology can provide a good prognosis in pineal region tumor.

Background: This study was to investigate the pathological significance of protein expression of matrix metalloproteinase-1 (MMP1) and matrix metalloproteinase-3 (MMP3) in colon tissues of remission patients of steroid-dependent uncreative colitis (SDUC)., Methods: To test the possible involvement of MMP-1 and MMP-3 in SDUC, Western- blot and immunohistochemistry were applied to examine the protein expression of MMP-1 and MMP-3 in the colonic healing region from 10 remission patients with SDUC as well as from 10 remission patients with non-SDUC. Ten specimens from normal colon tissues were used as controls., Results: Compared with the control group, the protein expression of MMP-1 and MMP-3 from non-SDUC remission patients slightly increased (p > 0.05), in contrast, those from SDUC patients significantly increased (p < 0.01)., Conclusions: Over-expression of MMP-1 and MMP-3 play a critical role in the pathogenesis of SDUC.

Objective: To investigate the mechanism of hepatocytes transdifferentiation to bile duct epithelial cells (BECs) and intervention of Huangqi decoction (HQD) on hepatic fibrosis formation in rats with secondary cholestasis., Methods: Seventy-five SD male rats were made into cholestatic hepatic fibrosis model animals by bile duct ligation, and randomized into the control group (n = 50) and the HQD group (n = 15). Starting from one week after modeling, they were administered orally with saline and HQD respectively for four weeks. Besides, a sham-operated group was set up with 10 rats operated by choledochus segregating only and administered after then with saline. Rats were killed in batches at different time points, i.e. each five from the control group and sham-operated group at the end of the 1st week, five from the control group for each time at the end of the 2nd, 3rd and 4th week, and all the remaining rats at the end of the 5th week. Their liver tissues were taken for histological change examination, content of hydroxyproline (Hyp) determination; protein expression of BECs marker cytokeratin 7 (CK7) and the hepatocyte specific antigen HepPar detection by Western blot, and CK7-Hep Par co-localization by laser confocal microscopy. Then IPP software was used to analyze Sirius red stained positive areas of CK7 and Hep Par, as well as the average IOD of CK7/Hep Par co-localization., Results: Hepatocytes in hepatic tissues (Hep Par positive cell) in the model rats decreased gradually along was time went by after modeling (Sham > M1w > M2w > M3w > M4w > M5w), which was in parallel with the increase of BECs (CK7 positive cells), degree of fibrosis, Hyp content and CK7 protein expression. Increasing of co-localized positive cells of CK7/Hep Par began at 1 week and reached the peak 3 weeks after modeling, then it decreased gradually. The Hep Par protein expression was negatively correlated with that of CK7; the Hep Par positive cell expression was negatively correlated with CK7 positive cell expression and collagen deposition; while the CK7 positive cell expression was positively correlated with the collagen deposition in the liver tissue. Compared with the model control group, the mortality, CK7/Hep Par co-localized positive cells, fibrosis degree, Hyp content and CK7 protein expression were lesser obviously (P < 0.01), while Hep Par positive cell and protein expressions were higher significantly in the HQD group., Conclusions: Hepatocytes transdifferentiation to BECs might be a key pathological element for secondary cholestatic hepatic fibrosis formation; the restraining action of HQD is possibly a major action mechanism of HQD for effectively intervening and treating secondary cholestasis hepatic fibrosis.

Objective: To elucidate the antifibrotic mechanism of Huangqi decoction in rats with BDL-induced cholestatic liver fibrosis., Methods: Liver fibrosis model was induced by ligating the common bile duct (BDL) in rats. Sham-operation was performed in control rats. The BDL rats were randomly divided into two groups: the BDL group and the Huangqi decoction group. Huanqi decoction was given intragastrically for 4 weeks. At the end of the fifth week after BDL, animals were sacrificed., Results: Compared with the sham control group, mortality rate in BDL group was 33.3% and incidence rate of ascites was 90%, and hepatic function was abnormal in most of the rats in BDL group. The number of Hepatocytes was decreased and the number of cholangiocytes significantly increased in BDL group. In addition, Hyp content of liver tissue and protein expression of CK 7 and a-SMA were significantly increased. Immunostaining indicated that CK 7 and a-SMA were co-localized in BDL group. These changes were markedly suppressed by the Huangqi decoction., Conclusions: These observations suggest that Huangqi decoction can inhibit cholangiocyte proliferation and cholangiocyte transdifferentiation.

Objective: To study the distribution of the direct medical cost for the pneumoconiosis and to provide the clue for the trauma insurance., Methods: 936 cases including 109,530 records were divided into several groups by the stages of pneumoconiosis and categories of the cost. The groups (stage I, stage II, stage I with tuberculosis and stage II with tuberculosis) were analyzed by descriptive statistics and non-parameter test., Results: The medical cost of out-patient clinic was between 476.7 and 2307.9 yuan per patient per year. The hospitalization medical cost of stage I and II ranged from 3207.1 yuan to 7787.3 yuan per patient per year. There was no difference between stage I and II in statistically significant (P>0.05)., Conclusion: The lower and upper inter-quartile range of the total medical cost per patient per year is from 3207.1 yuan to 7787.3 yuan. In the categories of the hospitalization cost, drugs and bed fees attain a higher proportion.

Objective: To explore the dynamic changes of serum interleukin-6 (IL-6) and IL-8 in acute traumatic brain injury (TBI) and their correlations to the severity of brain injury and the condition of the patients., Methods: Thirty-four patients with acute TBI were divided into two groups according to the Glasgow Coma Scale (GCS) score, clinical manifestations and the imaging data, namely patients with GCS score < or = 8 and those with GCS score between 9 and 12. Radioimmunoassay was employed to determine the serum levels of IL-6 and IL-8 at 6 different time points within 15 days after the injury in the two groups., Results: The serum IL-6 reached the peak level on the second day after the injury in patients with GCS score < or = 8 and on the 7th day in patients with GCS score of 9-12, showing significant differences in IL-6 variations between the two groups (P=0.046). The peak serum level of IL-8 occurred on the 7th day in patients with GCS score < or = 8 and on the 3rd day in patients with GCS score of 9-12, also showing significant differences (P=0.045). The peak level of IL-6 on the second day after the injury was significantly higher than the peak level of IL-8 that occurred on the 7th day, demonstrating significant differences in the variations of IL-6 and IL-8 after the injury (P=0.000)., Conclusion: The changes of serum IL-6 and IL-8 levels show positive correlations to the severity of the condition of the patients sustaining TBI. IL-6 variation is more obvious than that of IL-8 without intimate correlations between them. Clinically, serum IL-6 level can be more informative than serum IL-8 level in evaluating the changes of the condition of the TBI patients in early stage following the injury.

Objective: To study the distribution of the direct medical cost for the pneumoconiosis and provide a clue for the compensation., Methods: According to the electronic records for the medical cost of pneumoconiosis, 237 patients were investigated with questionnaires. Their medical cost was described by disability levels, types of work, the categories of tuberculosis, ages and length of work., Results: In the 237 cases of questionnaires, there were 161 cases with complications, accounting for 67.9%, and the proportion of the emphysema in the complication cases was 21.1%. The proportion of the disability level IV for pneumoconiosis patients was about 55.7% in all cases. Their total medical cost ranged from 3946.5 yuan RMB to 8819.3 yuan RMB per patient per year, and the median was 6954.2 yuan RMB per patient per year., Conclusion: The disability levels can be considered as the standard for the pneumoconiosis compensation to a certain extent.

Objective: To explore the predisposing factors for postoperative epilepsy in patients with gliomas., Methods: A total of 258 glioma patients with complete clinical data receiving cranial surgeries were analyzed retrospectively. With gender, age, predominant symptoms, positive signs, history of preoperative epilepsy, time of epilepsy onset, tumor location, surgical approaches, cortical injury, arterial and venous injury, scope of tumor resection, postoperative edema, tumor pathology, tumor recurrence, number of operation, radiation therapy as the independent variables, the occurrence of postoperative epilepsy was analyzed as the dependent variable using logistic regression to identify the risk factors for postoperative epilepsy., Results: History of preoperative epilepsy, surgical approaches, postoperative edema, tumor pathology and tumor recurrence were identified as the risk factors for postoperative epilepsy in glioma patients., Conclusions: Postoperative epilepsy severely affected the quality of life of glioma patients, and rigorous treatment targeting the risk factors may decrease the occurrence of postoperative epilepsy.

Geostatistics combined with geographical information system (GIS) was applied to analyze the spatial variability of soil total K and available N in urban area of Shenyang City. The results showed that the theoretical semivariogram models of soil total K was best described by an exponential model, while soil available N was best fitted by a Gaussian model. The ratios of nugget to sill of soil total K and available N were 10.65% and 17.96%, respectively, indicating that there existed significant spatial correlations between soil total K and available N, and the spatial variability was mainly caused by structural factors. The spatial distributions of soil total K and available N in urban area of Shenyang were analyzed by kriging interpolation, and it was found that the content of soil total K had no definite spatial distribution pattern, while the content of soil available N was higher in the around and lower in the middle of the city.

Objective: To explore suitable scaffold material for big segmental long bone defect by studying the properties of the prepared deproteinized bone., Methods: Cancellated bone were made as 30 mm x mm x 3 mm bone blocks from inferior extremity of pig femur along bone trabecula. The deproteinized bone was prepared with an improved method. Their morphological features, components, cell compatibility, mechanical and immunological properties were investigated respectively., Results: Deproteinized bone maintained natural reticular pore system. The main organic material is collagen I and inorganic composition is hydroxyapatite. It has good mechanical properties, cell adhesion rate and histocompatibility., Conclusion: This deproteinized bone can be applicable as scaffold for reparation of big segmental defect in long bone.

Objective: We report two rare cases of primary choriocarcinoma in the pineal region verified histologically. In both cases, the pre-operative serum level of human chorionic gonadotropin (HCG) was significantly elevated to 128-/+935.7 and 9 -/+088.9 mIU/ml, respectively, and serum alpha-fetoprotein (AFP) was negative. The tumors were microsurgically removed, and postoperative hydrocephalus were treated by endoscopic third ventriculostomy. Both patients underwent chemotherapy and radiotherapy. After adjunctive treatment, the serum HCG decreased within normal range. During the two-year-long follow-up, no radiological (MRI) evidence was found to suggest recurrence in MR imaging, and the serum HCG was normal in one patient, but mildly elevated in the other. HCG measurement can be crucial to the diagnosis and post-treatment monitoring of choriocarcinoma, and radical surgical tumor removal and combined modality therapy including chemotherapy and radiotherapy may ensure good results.

Objective: To explore the correlation between X-ray-induced rat cerebral neuron apoptosis and radiation doses., Methods: In a controlled experiment, the rats in the experimental group received X-ray radiation at different doses (2, 4, 6 and 8 Gy), and the apoptotic cerebral neurons were counted after in situ end-labeling and immunohistochemical staining., Results: X-ray radiation induced apoptosis of rat cerebral neurons, and the apoptotic rate varied with the radiation doses. Significant difference in the apoptotic rate was noted before and after radiation (P<0.0001), and between different radiation dose groups (P<0.005). The apoptotic rate differed significantly at different time points after the radiation., Conclusion: Low or medium doses of X-ray is able to induce rat cerebral neuron apoptosis depending on the radiation doses and following a definable time course.

Objective: To study the clinical features of posttraumatic epilepsy and evaluate the surgical procedures for anti-epileptic treatment and their therapeutic effects., Methods: Neurological and scalp EEGs were performed in 35 patients with posttraumatic epilepsy, who also underwent CT, MRI examination, single photon emission computerized tomography (SPECT) and positron emission tomography (PET) prior to intracranial surgery, with intraoperative monitoring of the cortical EEG., Results: With the cortical EEG monitoring, 16 patients underwent surgical resection of the epileptogenic foci identified by intraoperative EEG, 7 had multiple subpial transection and 12 received stereotactic radiosurgery for the epileptogenic foci localized by PET. In most of the cases, the epileptogenic foci were located around the lesions of encephalomalacia. During the follow-up of 32 patients varying from 1 to 4 years, 18 patients became seizure free, 10 had obvious reduction in the frequency of seizure while 4 failed to respond favorably to the treatment., Conclusions: Seizures of posttraumatic epilepsy may aggravate the brain dysfunction due to primary trauma, and surgical treatment often yields good effect and lessens the toxic and adverse effect of antiepileptic drugs. Stereotactic radiosurgery guided by PET is safe and effective in the treatment of patients with posttraumatic epilepsy.

Objective: To investigate the effectiveness of treatment of recurrent malignant brain gliomas by surgical excision combined with biodegradable polymers of interstitial chemotherapy., Methods: In 30 patients with recurrent malignant brain gliomas, the tumor was surgically removed and Vp-16 biodegradable polymers were implanted during operation in the tumor bed at a dose of 100 - 150 mg. The patients were followed up for 3 - 24 months, and the results were compared with 46 cases with the recurrent malignant brain gliomas who received operation only., Results: At 3, 6, 12, 24 months after treatment, the recurrent rate was 16.7%, 30%, 50% and 83.3%, respectively; the mortality rate was 6.67%, 20%, 40% and 70%, respectively. All the patients had no apparent side-effects of chemotherapy., Conclusion: Surgical treatment combined with interstitial chemotherapy with biodegradable Vp-16 polymers improves the treatment result of recurrent malignant brain gliomas compared to surgery alone.

Sho-saiko-to extract, a Chinese herbal medicine, is widely used for treatment of chronic hepatitis in Japan. However, it is not clear what conditions Sho-saiko-to extract improves hepatic inflammation and fibrosis. We therefore induced various stages of liver injury in model rats and administered Sho-saiko-to extract. We then evaluated the liver inflammation and liver fibrosis-improving effects of Sho-saiko-to extract. The liver injury model rats were produced by administration of various doses of dimethylnitrosamine (DMN) and Sho-saiko-to extract was administered to these rats. Then the liver inflammation and fibrosis-improving effects of Sho-saiko-to extract were evaluated according to L-asparate aminotransferase (AST), L-alanine aminotransferase (ALT), liver retinoid levels, levels of hydroxyproline, Transforming Growth Factor-beta (TGF-beta), and the liver fibrosis area. These indicators depended on the total doses of DMN. The ability of Sho-saiko-to extract to improve liver inflammation and fibrosis was limited to the following levels of the respective parameters: AST levels (234-264 U/l), ALT levels (208-232 U/l), TGF-beta levels (1102-1265 pg/g liver tissue), hydroxyproline levels (633-719 nmol/g liver tissue), and liver fibrosis area (9.7-10.6 times for normal rat). These findings suggested that Sho-saiko-to extract is effective in the treatment of liver inflammation and fibrosis up to a certain degree of severity, but it produces no improvement in more severe cases.

Three recovery mutants of an avirulent Tomato mosaic virus genus: (Tobamovirus) (ToMV-K) with back mutations of the replicase and/or movement protein (MP) genes, have been constructed by site-directed mutagenesis, and infectious plasmids (pToMV-K) were obtained. The rescued phenotypes of the progeny viruses showed that the replicase and MP recovery mutant (ToMV-K(rase-mp)) induced severe symptoms on both systemic and necrotic plants similar to those induced by the virulent strain. The replicase back mutant (ToMV-K(rase)) produced chlorosis and mosaic symptoms on N. tabacum cv. Huangmiaoyu (systemic host), while the MP recovery mutant (ToMV-K(mp)) produced no systemic symptoms on Huangmiaoyu tobacco. Sequencing of the cDNA of progeny viruses revealed that the "back mutants" maintained these mutation sites during infection. Protein immunoblots indicated that the 98 and 126 kDa proteins were expressed in the plants systemically infected by ToMV-K and pToMV-K, whereas no 98 kDa protein was detected in the plants infected by ToMV. The MPs (27 kDa) of ToMV-K and pToMV-K in the plants were smaller in size than those (30 kDa) of ToMV and pToMVK(rase-mp). These data suggest that ToMV-K replicates and spreads by expressing the truncated 98 and 126 kDa replicases and 27 kDa MP in plants. The opal mutation at nucleotides (nt) 2670-2672 of the replicase gene mainly contributes to the attenuation of ToMV-K, whereas the mutations at nt 5632-5664 of the MP gene attenuate the induced symptoms.

Objective: To explore the application and characteristics of electromagnetic navigation in neurosurgical operation., Methods: Neurosurgical operations with the assistance of electromagnetic navigation were performed in 12 patients with intracranial tumors., Results: Total removal of the tumor was achieved in 8 cases, subtotal removal in 3 and removal of the majority of the tumor in 1 case. The error in the navigation averaged 1.9+/-0.9 mm and the time consumed by preoperative preparation was 19+/-2 min with the exception in 1 case., Conclusion: In comparison with optic navigation, electromagnetic navigation offers better convenience and absence of signal blockage, and with a head frame, automatic registration can be achieved.