ABSTRACT
Autopsy has played a unique role in the progression of clinical medicine, medical education, epidemiology, and public health. However, the autopsy rate has been decreasing during the past several decades worldwide, and its necessity is frequently argued. Autopsy-based research in China, a country with the world's largest population, is very important for studying the spectrum and epidemiology of diseases as well as for discovering new diseases. This article summarizes the brief history of autopsy in China and analyzes the cause of its decline in recent decades by reviewing previously published papers, review articles, self-collected materials, and private correspondence. Since the first officially permitted autopsy in 1913, China witnessed the highest autopsy rate between 1950 and 1970, and since then the autopsy rate began to decline as it in other parts of the world. The main reasons for the reduction in autopsy rates in China include negligence by hospital administrators and relevant government authorities, unmotivated clinicians, helpless pathologists, unenforceable regulations and laws, and local cultures and customs.
Subject(s)
Humans , Autopsy , History , Biomedical Research , History , China , History, 20th Century , History, 21st Century , History, MedievalABSTRACT
<p><b>OBJECTIVE</b>To explore the effects of hepatitis B virus X protein (HBx) on hepatoma cell growth through p14(ARF)-dependent and p14(ARF)-independent pathways.</p><p><b>METHODS</b>HBx and p14(ARF) were transfected either separately or in combination into HepG2 cells containing wt-p53 but not expressing p14(ARF). The cells were divided into 4 groups, namely pcDNA3 (control), pcDNA3HBx, pcDNA3p14(ARF), and pcDNA3HBx + pcDNA3p14(ARF) groups. Flow cytometry was used to examine the apoptosis rates and cell cycle progression of HepG2 cells in different groups. The expression of p14(ARF), MDM2, p53, and p21(WAF1) proteins were investigated by detecting the activity of p21(WAF1) promoter-luciferase and using Western blotting.</p><p><b>RESULTS</b>The apoptosis rates of HepG2 cells in pcDNA3HBx and pcDNA3p14(ARF) groups were significantly higher than that in the control group (14.11%, 13.72% vs 10.66%). Compared with the control group, pcDNA3HBx and pcDNA3p14(ARF) groups also showed significantly higher cell percentages arrested at G(0)/G(1) phase (63.62%, 61.75% vs 57.42%), luciferase activity of p21 promoter (1.25-/+0.05, 1.09-/+0.06 vs 0.77-/+0.03) and expressions of p53 and p21(WAF1). The cell apoptosis rate, percentage of cells in G(0)/G(1) phase and expression level of p14(ARF) were even higher in pcDNA3HBx+pcDNA3p14(ARF) group (18.61%, 66.74%, and 3.53-/+0.43, respectively) than in either p14(ARF) or HBx group.</p><p><b>CONCLUSION</b>HBx induces p53 expression through p14(ARF)-dependent and independent pathways to activate p21(WAF1) promoter, leading to G(0)/G(1) arrest and apoptosis of HepG2 cells.</p>