Volume 87  ·   Issue 36  ·  2007

The patient was a 74-year-old male who suffered from irritating dry cough with dyspnea for 2 and a half years, aggravated with fever for 10 days. Routine examination showed space-occupying lesions in the right lung and was admitted to the hospital. Physical examination showed that the general state was acceptable, bilateral thoracic asymmetry, unequal width of intercostal space, and trachea displaced to the right. The breathing movement of the right chest was smaller than that of the left side, and the tactile speech tremor was weaker than that of the left side. The right lung showed solid sound during percussion, and the breathing sound of the right lung disappeared. Blood routine: white blood cells 13.4×109/L, neutrophils accounted for 0.774. Chest radiograph showed that the right chest width collapsed, the trachea mediastinum shifted to the right. The consistency density of the right lung increased.

Objective to investigate the technical characteristics of laparoscopic partial nephrectomy and the advantages and disadvantages of laparoscopic partial nephrectomy compared with traditional open partial nephrectomy. Methods 26 cases of laparoscopic partial nephrectomy in the past 5 years were retrospectively summarized, including 11 cases of laparoscopic partial nephrectomy and 15 cases of open surgery. The two groups were compared, and the differences in operation time, bleeding volume, hot ischemia time, postoperative feeding time and postoperative hospitalization time were analyzed. Results 11 cases of laparoscopic partial nephrectomy were successfully completed, and there were no cases of open surgery. Compared with the laparoscopic group, the average operation time was (92±36) min vs (138±97) min, the average intraoperative bleeding volume was (150±68) ml vs (176±88) ml, the hot ischemia time was (25±18) min vs (12±5) min, the postoperative liquid feeding time was (31±7) h vs (16±6) h, and the postoperative hospitalization time was (12.0±4.5) d vs (7.0±2.4) d. Conclusion During laparoscopic partial nephrectomy, the renal portal vessels should be blocked, and the tumor should be resected sharply with scissors

Objective to investigate the factors affecting local recurrence of retroperitoneal soft tissue sarcoma after surgery. Methods 77 patients with primary retroperitoneal soft tissue sarcoma who underwent surgery from January 1980 to December 2005 were retrospectively analyzed. Results 57 patients had local recurrence after surgery, the total recurrence rate was 74%, the average time from surgery to recurrence was 14.8 months (3.2 to 99.6 months), and 3 patients had distant metastasis after surgery. By the end of follow-up, 32 patients died, of which 27 died of tumor. The median postoperative survival time was 42.5 months, the overall 5-year and 10-year survival rate was 61.7% and 43.9%, and the 5-year and 10-year survival rate without recurrence was 22.7% and 16.8%. Univariate analysis showed that the intraoperative tumor resection (P =0.0008) and high-grade tumor (P =0.018) were closely related to the increase of local recurrence rate after surgery. In the multivariate analysis, only complete tumor resection (P =0.001) was the independent prognostic factor for reducing the recurrence rate. Conclusion Complete tumor resection and negative surgical margin are the most important factors for reducing the local recurrence rate after operation, and the local recurrence rate in patients with high grade tumor is significantly increased.

Objective to investigate the characteristic fluorescence spectra of bladder cancer tissues induced by ultraviolet laser and to explore its application value in early diagnosis of bladder cancer. Methods Hematoporphyrin monomethyl ether was used as photosensitizer and all-solid-state ultraviolet laser was used as excitation source (wavelength 355 nm) to detect the characteristic fluorescence spectra of bladder cancer tissues. Results there were bimodal characteristic wasps in the autofluorescence of bladder cancer tissues at 445~490 nm, and the characteristic drug peak appeared at 628.65 nm in addition to the tissue peak after incubation with photosensitizer. Conclusion The characteristic drug fluorescence spectra of bladder cancer tissues induced by ultraviolet laser are stable, with good intensity, and the characteristic drug peak is in the visible range, which is easy to recognize with naked eye, which is expected to improve the positive rate of early diagnosis of bladder cancer.

Objective to select the candidate gene desmosome glycoprotein 3 (DSG3) from the whole genome expression profiles of purified nasopharyngeal carcinoma, and to further study the expression of DSG3 gene in antisense RNA (aRNA) in purified nasopharyngeal tissues by semi-quantitative reverse transcription (sqRT) -PCR. Methods Tissue specimens (22 patients with nasopharyngeal carcinoma and 12 patients with normal or inflammatory mucosa and tissue) were preserved by RNA protection technique. The cancerous cells in nasopharyngeal carcinoma and mucosal epithelial cells in nasopharyngeal non-cancerous tissues were obtained by microdissection. The RNA of each purified tissue specimen was extracted and sufficient aRNA was obtained by linear amplification. The expression of candidate target gene DSG3 in two different purified nasopharyngeal cells aRNA was further studied by sqRT-PCR. Results In the whole genome expression profiles of purified nasopharyngeal carcinoma and nasopharyngeal non-cancerous tissues, the expression values of DSG3 gene were 2.06±1.60 and 0.48±0.23, respectively, with a difference of 4.24 times. The difference between the two groups was statistically significant (df =16, t =2.145, P =0.0 The difference between the two groups was also statistically significant (df =32, t =3.307, P =0.002). Conclusion the gene expression profile of whole genome microarray combined with sqRT-PCR can be used to screen the candidate target genes related to the pathogenesis of nasopharyngeal carcinoma. High expression of DSG3 gene is an important tumor promoting factor in the development of nasopharyngeal carcinoma.

Objective to compare the prevalence of microalbuminuria in patients with normal glucose tolerance (NGT), impaired glucose regulation (IGR) and type 2 diabetes mellitus (T2DM), and to investigate the risk factors of microalbuminuria. Methods According to the results of 75 g oral glucose tolerance test (OGTT), 1779 subjects were divided into: 752 cases in NGT group, 505 cases in IGR group and 522 cases in T2DM group. All subjects' morning urine albumin was measured by rate scattering nephelometry, and urinary albumin excretion rate was expressed by urinary albumin/creatinine (ACR). The ACR was 30~300 mg/g and diagnosed as microalbuminuria. Results (1) 35 cases in NGT group were diagnosed as microalbuminuria, the prevalence rate was 4.7%; There were 31 cases in IGR group, the prevalence rate was 6.1%; There were 59 cases in T2DM group, and the prevalence rate was 11.3%, which was significantly higher than that in NGT group and IGR group (P<0.01). (2) Logistic regression analysis showed that the independent risk factors of microalbuminuria were systolic blood pressure, OGTT2 h blood glucose and triglyceride. Conclusion The prevalence of microalbuminuria in T2DM patients was significantly increased. Systolic blood pressure, postprandial blood glucose and triglyceride were closely related to the appearance of microalbuminuria.

Objective to simulate the flow state in the main pulmonary artery and the left and right pulmonary artery branches in normal subjects by using CT pulmonary angiography (CTPA) images of multi-slice spiral CT (MDCT) and ultrasound flow data combined with fluid mechanics software.Methods the normal thoracic ECG-gated CTPA images were selected to perform thin-slice multi-plane reconstruction of systolic and diastolic cardiac phases,respectively, and manually segmented in InSpace pulmonary artery reconstruction coordinate map,and the ultrasound measurement data were imported into Fluent software.Results the flow state of normal pulmonary artery branches was different in different cardiac cycles, the systolic pressure was higher than the diastolic and the flow velocity was faster, the right lower lobe artery bears the biggest biphasic pressure difference, but the biphasic flow velocity of segmental artery was not significantly different.Conclusion the right lower lobe artery is the one with elevated pulmonary artery pressure and earlier involvement; It is feasible to study the changes of blood flow in pulmonary artery branches by using CTPA image combined with correlation simulation software.

Objective to investigate the diagnosis and treatment of focal nodular hyperplasia of liver (FNH), and to improve the understanding of focal nodular hyperplasia of liver. Methods the clinical characteristics, imaging manifestations, pathological examination and therapeutic effect of 23 cases of FNH were retrospectively analyzed. Results Among 23 cases of FNH, 13 cases were diagnosed as FNH before operation, 12 cases were examined by CT and MRI, and 1 case underwent B-ultrasound-guided puncture. The tumor diameter was 0.8~8 cm. All 23 cases were resected by surgery, and recovered well after surgery without recurrence. A total of 27 lesions were resected, and it was confirmed by pathology as FNH. Conclusion CT and MRI are valuable diagnostic methods. B-ultrasound-guided puncture can obtain histological diagnosis and determine the nature of FNH. However, it is difficult to make diagnosis and differentiation before FNH operation. Surgical resection should be performed for cases with clinical symptoms or unclear diagnosis.

Objective to screen serum protein markers of laryngeal squamous cell carcinoma (LSCC) by surface enhanced laser desorption ionization time-of-flight mass spectrometry (SELDI-TOF-MS) and establish a predictive model for the diagnosis of laryngeal carcinoma, and to detect serum protein markers related to lymph node metastasis of laryngeal carcinoma. Methods 252 serum samples were collected, including 142 laryngeal carcinoma patients and 110 normal controls, among which 89 laryngeal carcinoma serums, 30 laryngeal carcinoma serums with lymph node metastasis and 65 normal controls were the experimental group, 53 laryngeal carcinoma serums and 45 normal controls were the blind validation group. Protein profiles were determined by SELDI-TOF-MS using weak cation exchange chip (WCX2). The differences of protein profiles between laryngeal carcinoma and normal human serums were analyzed by Biomarker Wizard and Biomarker Pattern (BPS) software, and a predictive model for the diagnosis of laryngeal carcinoma was established and verified by blind method. Results 18 differential protein peaks were detected by weak cation chip (WCX2) in the range of mass-to-charge ratio (M/Z) 2000~50 000, which can identify laryngeal carcinoma The sensitivity was 86.52% and the specificity was 84.62% (32/36). The sensitivity was 84.91% and the specificity was 82.22% in blind validation. Fourteen differential protein peaks were detected among patients with laryngeal carcinoma with or without lymph node metastasis. Conclusion The marker proteins related to laryngeal carcinoma and lymph node metastasis can be screened from serum by SELDI-TOF-MS. The established predictive model of laryngeal carcinoma diagnosis may have important clinical significance for early detection and diagnosis of laryngeal carcinoma.

Objective to investigate the hotspot mutations of SLC26A4 gene and its incidence frequency among deaf-mute students in 21 regions of China, and to analyze and speculate the epidemiological status of large vestibular aqueduct syndrome in China.Methods 1552 deaf-mute students from 21 provinces, municipalities and autonomous regions in China were investigated. Among them, 1290 were Han nationality, 69 were Uygur nationality, 37 were Hui nationality, 31 were Mongolian nationality, and 125 were from 18 ethnic groups, including Yi, Zhuang, Bai and Miao nationality. All the patients were collected from peripheral blood and DNA extracted, and the mutations of IVS7-2A>G and other mutations in SLC26A4 gene were detected by sequence analysis. Results The sequence analysis of exon 7+8 of SLC26A4 gene showed that 199 of 1552 deaf patients from all over China carried mutations in exon 7+8 and intron 7, of which 83 carried homozygous mutations in IVS7-2A>G, 114 carried heterozygous mutations in IVS7-2A>G, and 2 carried other mutations in this region. The total detection rate of IVS7-2A>G reached 12.7% (197/1552), among which the detection rate of IVS7-2A>G in 1290 Han patients reached 14.3%, and the detection rate of IVS7-2A>G in 69 Uygur patients was 0. The detection rate of IVS7-2A>G in Gaobeidian, Zhuozhou, Hebei and Anyang, Henan were significantly higher than the national average. Conclusion The screening of SLC26A4 gene hotspot mutation showed that the proportion of hereditary deafness caused by SLC26A4 gene mutation was higher in China, which revealed that SLC26A4 gene screening and diagnosis will play an important role in the etiological diagnosis of deafness, and it has certain advantages in the etiological screening of large-scale deafness patients.

Objective to observe the regulatory effect of pharmacological dose of glucocorticoid on glucocorticoid receptor in rat growth plate chondrocytes; To investigate the mechanism of glucocorticoid inhibiting longitudinal bone growth in rats. Methods 3-week-old clean grade pure male SD rats, 12 experimental groups were treated with dexamethasone (200 μ g/100 g, 10 d); Eight rats in the control group were injected with equal volume of normal saline. The tibia length and coronal section of the tibia were measured. The growth plate histology was observed by Mallory tricolor staining, and the total thickness of growth plate, the thickness of proliferation zone and the thickness of hypertrophy zone were measured. Immunohistochemical analysis of glucocorticoid receptor. Results (1) The tibia length, total thickness of growth plate, the thickness of proliferation zone and the thickness of hypertrophy zone in the experimental group were 28.9 mm ± 1.2 mm, 4.01 μ m ± 0.28 μ m, 1.98 μ m ± 0.13 μ m and 1.67 μ m ± 0.18 μ m, respectively; 30.5 mm±1.1 mm,5.53 μ m±0.46 μ m,2.25 μ m±0.30 μ m,2.87 μ m±0.19 μ m were significantly behind the control group, and the differences were statistically significant (all P<0.05). (2) Glucocorticoid receptor was expressed in both the resting zone and the hypertrophic zone of the growth plate; However, the expression of glucocorticoid receptor was not observed in the proliferation zone. (3) The expression of glucocorticoid receptor in chondrocytes in the resting zone and hypertrophic zone of growth plate was enhanced by dexamethasone treatment. Conclusion Glucocorticoid receptor is necessary for longitudinal bone growth.

Objective to observe the effects of 3T3-L1 preadipocyte differentiation and free fatty acid (FFA) on the expression of C5L2 gene and protein in 3T3-L1 (pre) adipocytes. Methods Reverse transcription (RT) -PCR and flow cytometry were used to detect the expression of C5L2 mRNA and protein in 3T3-L1 (pre) adipocytes at different differentiation periods and after FFA treatment. Results the expression of C5L2 mRNA in 3T3-L1 adipocytes increased differentiation-dependently, while the expression of C5L2 protein increased significantly at the early stage of differentiation, and the expression of C5L2 protein increased by 21% at 6 h after induction of differentiation (61% ± 18% vs 51% ± 15%, P<0.05). Differentiation reached its peak at 12 h, with an increase of 38% (70%±12% vs 51%±15%, P<0.01); In 3T3-L1 mature adipocytes, 0.5 mmol/L and 1.0 mmol/L oleic acid inhibited the expression of C5L2 mRNA by 46% (0.58±0.21 vs 1.08±0.46, P<0.05) and 84% (0.18±0.04 vs 1.08±0.46, P<0.05), respectively, while 0.125 mmol/L oleic acid significantly downregulated the expression of C5L2 protein by 36% (35%±8% vs 54%±7%, P<0.01). At 1.0 mmol/L, the expression of C5L2 mRNA and protein was significantly reduced by 41% (0.57±0.28 vs 0.97±0.41, P<0.05) and 55% (24%±13% vs 54%±7%, P<0.01), respectively. There was no significant difference between oleic acid and palmitic acid on the expression of C5L2 in preadipocytes. Conclusion Acylating protein/C5L2 pathway was involved in the regulation of adipocyte differentiation.

Objective to construct the expression plasmid of rat Pim-3 green fluorescent protein (GFP) and observe its expression and activity in living liver tissues. Methods the target cDNA was obtained by reverse transcription-PCR, and the recombinant plasmid was identified and sequenced by enzyme digestion; Hepatocyte apoptosis was induced by intraperitoneal injection of endotoxin and D-galactosamine (D-GalN). The animals were divided into groups A, B, C and D (normal, control, empty plasmid and recombinant plasmid groups, 8 in each group); The expression of GFP in liver tissue was detected by fluorescence microscopy, and the expression of Pim-3 was detected by reverse transcription (RT) -PCR. Hepatocyte apoptosis was analyzed by nick end labeling technique (TUNEL) and caspase-3 activity was detected. Results GFP expression plasmid pEGFP-N2/Pim-3 was successfully constructed, and recombinant plasmid and empty plasmid DNA were successfully transfected into rat liver tissues by hydrodynamic injection. The relative expression levels of Pim-3 in the four groups were 0.06±0.02, 0, 0, 0.49±0.15, respectively. The differences between group D and the other three groups were statistically significant (all P<0.01); The apoptosis index (AI) of hepatocytes in the four groups was (3.1±0.7) %, (72.5±6.1) %, (69.8±5.7) % and (4.9±1.2) %, respectively; The activity of caspase-3 in liver tissue was (60±15), (147±55), (142±50) and (76±27) pmol·min-1·mg-1, respectively. The difference between group D and group B and group C was statistically significant (all P<0.01). Conclusion The recombinant plasmid pEGFP-N2/Pim-3 can be effectively expressed in rat liver tissue and exert its inhibitory effect on hepatocyte apoptosis.

Objective to study the effect of cyclosporine on the main histocompatibility complex (MHC) of the host. Methods Fourteen New Zealand rabbits were randomly divided into 3 groups, 4 in the control group and 5 in each of the low-dose and high-dose cyclosporine groups. RNA of peripheral blood mononuclear cells was extracted every 5 days, and a little RNA was extracted from liver, spleen, kidney and thymus after the experiment. The expression of MHC class Ⅰ and MHC class Ⅱ mRNA was determined by RT-PCR, and their protein expression was determined by Western blot. Results After 10 days of treatment, the expression of MHC class Ⅰ and MHC class Ⅱ mRNA in peripheral blood mononuclear cells of low-dose cyclosporine group increased from 0.23±0.04 and 2.77±0.25 to 1.78±0.15 and 7.30±0.51, respectively, and the protein expression increased from 2.31±0.14 and 12.52±1.23 to 11.32±1.45 and 22.31±1.91, respectively (all P<0.01). The mRNA expression of MHC class Ⅰ and MHC class Ⅱ in peripheral blood mononuclear cells increased from 0.24±0.06 and 2.56±0.33 to 4.72±0.28 and 14.20±2.58, respectively, and the protein expression increased from 2.42±0.06 and 12.51±1.31 to 13.81±1.38 and 24.22±2.88, respectively (both P<0.01). After 15 days until the end of the experiment, the expression of MHC decreased to the level before the initial treatment. Conclusion Cyclosporine can transiently increase the expression of MHC class Ⅰ and MHC class Ⅱ in the host.

Objective to construct a fusion gene vaccine of secreted coxsackievirus group B type 3 (CVB3) capsid protein 1 (sVP1) and three-copy complement 3 fragment (C3d3), and to observe its immune effect. Methods C3d3 cDNA and CVB3 VP1 gene with interleukin 2 (IL-2) signal peptide were spliced to construct eukaryotic expression plasmid pcDNA3/sVP1-C3d3. BALB/c mice were randomly divided into three groups, and pcDNA3/sVP1-C3d3, pcDNA3/sVP1 and pcDNA3 plasmids were injected intramuscularly, respectively. Serum neutralizing antibody titers, specific cytotoxic T lymphocyte (CTL) killing activity and blood virus titers of mice were detected at different times, and the immune protection effect of the vaccine was observed. Results the neutralizing antibody titers of mice increased with the increase of immunization times. After the third immunization, the neutralizing antibody titers and specific CTL killing rate of pcDNA3/sVP1-C3d3 group (33.6±1.7) and the specific CTL killing rate (66.1%±2.7) were observed After infecting mice with lethal dose of CVB3, the virus titer in blood of mice immunized by fusion gene was significantly reduced, and the survival rate was 50%, while the pcDNA3/sVP1 group was only 25%, and the pcDNA3 group did not survive. Conclusion C3d can significantly enhance the specific immune response induced by sVP1 gene immunization.

Objective to observe the therapeutic effect of human insulin transgenic mouse bone marrow mesenchymal stem cells (mMSCs) implanted into the liver of type 1 diabetic mice on diabetes.Methods Green fluorescent protein (GFP) mMSCs were isolated, and human insulin retrovirus vector was constructed. The stem cells were transfected and transplanted into the liver of diabetic mice. The changes of body weight, blood glucose and serum insulin level of mice were detected and histological analysis was performed. The blood glucose levels were (10.4±2.8) mmol/L and (6.5±0.9) mmol/L at 7 and 42 days after transplantation, respectively, and (26.8±2.5) mmol/L and (25.4±4.1) mmol/L in untransplanted mice, respectively. The difference between the two groups was statistically significant (P<0.05). Human insulin secretion was detected in the serum and liver of the mice in the treatment group. Conclusion Intrahepatic transplantation of mMSCs expressing exogenous insulin can effectively reduce the blood glucose level and alleviate the symptoms of diabetes in diabetic mice, which is a new way of gene therapy for diabetes.

Objective to investigate whether necrotic tumor tissue can sensitize dendritic cells (DC) after microwave coagulation therapy (MCT) and whether sensitized DC has specific anti-tumor effect.Methods After MCT treatment of subcutaneous tumor nodules in BALB/c mice, the necrotic tissue fragments were removed, grinded and filtered, and the filtrate was incubated with DC derived from bone marrow in vitro to obtain sensitized DC. The morphology and phenotype of DCs were observed. The cytotoxicity of specific CTL induced by DC was detected by 3H-TdR incorporation assay, and the inhibition of subcutaneous tumor in vivo was detected by 51Cr release assay. Finally, the killing specificity of T cells extracted from spleen cell suspension of tumor-bearing mice after sensitized DC treatment in vivo and in vitro was detected. Results The morphological characteristics and phenotype of DCs co-cultured with necrotic CT-26 tumor tissue filtrate after MCT treatment were typical for sensitized DCs. The proliferation intensity of T cells induced by sensitized DC and unsensitized DC at different DC/T ratios were: 80±10 vs 10±5 at DC/T ratio 1:10, 58±7 vs 9±4 at DC/T ratio 1:20, respectively, and the differences were statistically significant (all P<0.01). The killing rates of CTL induced by sensitized DC and unsensitized DC on CT-26 tumor cells at different E/T ratios were: 13.6±2.5 vs 1.1±0.4 at E/T ratio 10, and 2±5 at E/T ratio 20, respectively 5.22±0.65 vs 2.18±0.41, and 6.09±0.83 vs 3.91±0.51 at E/T ratio 50, there was no significant difference between the two groups (all P>0.01). In vivo experiment, the size of subcutaneous transplanted tumor was more and more obvious with the prolongation of the survival time of mice in the sensitized DC group, unsensitized DC group and normal saline control group. At 40 days, the average tumor weights of the three groups were 4.5 g ± 1.1 g, 6.9 g ± 1.6 g and 9.0 g ± 1.5 g, respectively, and the differences between the groups were statistically significant (all P<0.01).

Case 1: A 42-year-old female suffered from progressive nasal congestion with pain in her right nose for more than 5 months. Four days ago, she developed epistaxis without obvious trigger. Physical examination showed that a dark red new organism was seen in the right common nasal passage, with unclear boundary and a little secretion attached to the surface. CT scan showed soft tissue density shadows in bilateral maxillary sinus, right ethmoid sinus and nasal cavity, with uniform density and no obvious calcification shadows (Figure 1A). The bone of the medial wall and part of the posterior wall of the right maxillary sinus was destroyed, and the soft tissue shadows invaded the right pterygopalatine fossa, and part of the nasal septum was resorbed. In the enhanced examination, the right maxillary sinus lesion was significantly uneven and patchy enhancement (Figure 1B), and the left maxillary sinus lesion was slightly enhanced.

actinomycosis is a chronic pyogenic granulomatous disease caused by conditional pathogenic bacteria Actinomyces. Tonsil actinomycosis is rare, has no characteristic clinical manifestations, and is easily misdiagnosed or misdiagnosed as tumor or simple inflammation [1]. A total of 9 patients with tonsil actinomycosis were treated in the Second Affiliated Hospital of Zhejiang University School of Medicine from January 2000 to December 2006. The clinical characteristics and diagnosis and treatment process are analyzed and reported as follows.

A 21-year-old male was admitted to our hospital on February 12, 2007 due to pale complexion and fatigue for more than 1 month. One month ago, the patient developed fatigue, pale complexion and decreased attention without obvious inducement, accompanied by persistent headache, back and limb soreness. The routine blood test in the local hospital showed that white blood cells (WBC) were 5.2×109/L, hemoglobin (Hb) was 83 g/L, mean red blood cell volume (MCV) was 84.1 fL, platelet (PLT) was 135×109/L, and reticulocytes were 0.064. Blood total bilirubin (TBIL) 50.4 μ mol/L, direct bilirubin (DBIL) 15.9 μ mol/L; Blood smear showed uneven size of red blood cells, with dotted red blood cells; Bone marrow smear showed obviously active hyperplasia, grain/red ratio =2:1, anti-double-stranded DNA antibody and anti-ENA antibody were negative; There was no abnormality in immunoglobulin and complement, which was considered as hemolytic anemia.

Hedgehog (HH) signaling pathway was first discovered in Drosophila, and it plays an important role in the embryonic development of a series of organisms. Besides, the relationship between HH signaling pathway and tumor has also attracted widespread attention in recent years.HH protein is a secretory signaling protein,which can transform a 45 000 precursor into a 19 000 functional protein through self-splicing process.In vertebrate,HH gene encoding HH protein has at least three homologous genes:Sonic Hodgehog (SHH), Indian Hodgehog (IHH) and Desert Hodgehog (DHH).

In recent 10 years, there have been many randomized controlled trials of targeted drugs for pancreatic cancer (including cytotoxic drugs) and their combinations compared with gemcitabine monotherapy, but the results are not satisfactory, and there is still debate in this field. Recently, Sultana et al. made a systematic review of published and unpublished randomized controlled trials of chemotherapy for advanced pancreatic cancer, and the results were published in J Clin Oncol, June 20, 2007 (J Clin Oncol, 2007, 25: 2607-2615).

A 24-year-old female was admitted to the hospital because "a mass in the right lower abdomen was found for 1 month". Physical examination showed a smooth, non-tender mass of 8 cm ×8 cm in the right lower abdomen. A child was 6 months old. The patient did not resume menstruation from postpartum to medical treatment. CT examination showed that the parenchymal mass of the lower pole of the right kidney was unclear, and the density was uneven at plain scan. The CT value of the solid part was 45 HU, and the CT value of the cystic component was about 17 HU. Enhanced scan showed that the solid part of the arterial phase was mildly uniformly enhanced, and the CT value of the cystic component was about 70 HU, and the CT value of the delayed scan of the venous phase was 65 HU. The middle calyx of the right kidney was slightly compressed and displaced, and the right renal hilum moved upward. There was no dilatation or effusion in both renal pelvis and ureters. No obvious enlarged lymph nodes were found retroperitoneally, and there was no ascites. B-ultrasound examination showed that the long diameter of the right kidney was 151 mm and the wide diameter was 50 mm.

Objective to explore an optimal surgical method that not only ensures the thoroughness of radical surgery for early tongue cancer, but also maximizes the preservation or restoration of postoperative body function and facial and neck appearance, so as to improve the quality of life.Methods Six patients with early tongue cancer were treated with neck lymph dissection with concealed incision, preservation of external jugular vein, sternocleidomastoid muscle, accessory nerve and major auricular nerve, combined with intraoral hemilateral tongue and oral floor enlargement and immediate repair of forearm skin flap, and the radical curative effect, postoperative function protection, oral function and facial and neck appearance of this procedure were evaluated.Results Compared with conventional radical neck lymph dissection, the neck incision was concealed, beautiful and fully exposed. Conclusion Concealed neck incision, preservation of external jugular vein, sternocleidomastoid muscle, accessory nerve and great auricular nerve combined with enlarged intraoral hemilateral resection of tongue and floor of mouth and immediate repair of forearm skin flap is a reasonable surgical method for the treatment of early tongue cancer, which can alleviate and avoid the destruction of facial and neck appearance, shoulder function, ear sensory impairment, speech, swallowing and chewing function after operation on the premise of guaranteeing the radical treatment of tongue lesions and cervical lymph nodes, and improve the postoperative quality of life.

We regretfully retract the following article：＂ HAO Ji-hui et al, The modulating effect of proapoptotic protein Bax on the resistance of malignant lymphoma cells to tumor necrosis factor related apoptosis inducing ligand-induced apoptosis＂, published in National Medical Journal of China 2007,87 ： 134-137. We are taking this action at the request of the author. The author wrote letter to our Editorial Office to clarified： the work of the paper was finished in Queen Mary University and he took part in it. The intellectual property of this work entirely belongs to theInstitute of Cell and Molecular Science, Queen Mary University of London. Without the permission of British University and Jia Li, Liu Feng-ting, he published the paper. The author beg to withdraw the paper from the journal, and apologize to readers and editors. The National Medical Journal of China apologize for inconveniencing you in this way.