1996年 · 第109卷第07期

OBJECTIVE To investigate the correlation of human leukocyte antigen (HLA) with susceptibility and clinical manifestations of sarcoidosis. MATERIAL AND METHODS Fifty-five patients with sarcoidosis and one hundred and six normal subjects were investigated. Genomic DNAs were purified using the proteinase K-phenol extraction method. DNA samples were amplified by the polymerase chain reaction (PCR) procedure using the DRB1 group specific primer pairs. RESULTS The gene frequency of HLA-DR5 increased significantly in patients with sarcoidosis (P<0.01), and HLA-DR7 decreased (P<0.05). Gene frequencies of HLA-DR9 and HLA-DR5 increased remarkably in male patients and in patients with stage I and stage IIa, respectively (both P<0.05). CONCLUSIONS It is suggested that HLA-DR gene might contribute to the susceptibility as well as various clinical manifestations of sarcoidosis.

OBJECTIVE To investigate 67Gallium scanning for the detection of alveolitis in idiopathic pulmonary fibrosis and sarcoidosis. METHODS 67Ga scintigraphy was performed in 14 patients with IPF (age: mean±s=58.3±10.3 years), 13 patients with sarcoidosis (age: mean±s=46.9±9.0 years) and 11 controls (age: mean±s=44.0±10.5 years). RESULTS Lung/thigh ratio was respectively 3.18±0.07 in IPF, 3.12±0.94 in sarcoidosis and 2.11±0.26 in controls. IPF and sarcoidosis groups had a significantly higher lung/thigh ratio comparing with the control group (P<0.05). Three patients received67Ga scanning examination after corticosteroid therapy and the 67Ga uptake decreased. CONCLUSIONS The 67Ga scintigraphy is useful in monitoring the activity and extent of alveolitis.

OBJECTIVE To observe the changes of interleukin-1 (IL-1), nitric oxide (NO) and nitric oxide synthase (NOS) in mice with oleic acid-induced acute lung injury (ALI) and the protective effects of interleukin-1 receptor antagonist (IL-1ra). METHODS Male Kunming mice were divided into control, oleic acid and IL-1ra groups. The control group mice were injected saline; the oleic acid group mice were injected oleic acid (0.2 ml/kg): and the IL-1ra group mice were injected the IL-1ra (20 mg/kg). Lung index, lung wet-to-dry weight ratio, and total protein, cell analysis, nitric oxide measurement, NOS activity in BALF, lung pathology examination were made after an hour of administration of drug. RESULTS Preadministration of IL-1ra to the mouse with ALI decreased the lung index, lung wet-to-dry weight ratio and leakage of protein from pulmonary capillary, elevated PaO2, and attenuated lung histologic injury. It was found that in bronchoalveolar lavage fluid (BALF), NO amount and lung NOS activity increased in oleic acid group, BALF NO amount and lung NOS activity decreased obviously after given IL-1ra. CONCLUSIONS This study demonstrated the protective effect of IL-1ra on oleic acid-induced lung injury, NO may participate in the pathological process of lung injury.

OBJECTIVE To investigate whether persistent T lymphocyte activation is a feature of steroid-resistant (SR) asthma and to study the inhibitory effects of dexamethasone and other immuno-inhibiting agents on PHA-induced proliferation of peripheral blood T lymphocytes from SR and steroid-sensitive (SS) asthmatics. MATERIAL AND METHODS 15 SR and 15 SS asthmatics were studied. Serum levels of soluble interleukin-2 receptor (sIL-2R) were measured before and after prednisone therapy by an enzyme-linked immunosorbent assay. PHA-driven proliferative assay was performed to evaluate inhibition of T lymphocyte proliferation. RESULTS Serum levels of sIL-2R were elevated in both patients with SR and SS asthma as compared with normal controls (P<0.001). After a 7-day course of prednisone (20 mg/day), serum levels of sIL-2R decreased significantly in SS asthmatics (P<0.001) but not in SR asthmatics (P>0.1). Proliferation of T lymphocytes from the sensitive but not the resistant asthmatics was significantly (P<0.002) inhibited by dexamethasone (10 mol/L), reflecting a shift of the dose-response curve. In contrast, oxymatrine and thymus-derived immunosuppressors inhibited proliferation of T lymphocytes to a similar degree between SR and SS asthmatics. CONCLUSIONS The results suggest that persistent T lymphocyte activation due to a relative insensitivity of the cells to glucocorticoids is a feature of SR asthma. Immuno-inhibiting agents other than glucocorticoids may be of therapeutic benefit in patients with SR asthma.

OBJECTIVE To investigate the influence of alveolar macrophages (AMs), fibroblasts and interstitial cells on development of lung fibrosis, and the interactions among TGF-β1 PDGF and IGF-1 and these cytokines-effects on lung fibrosis. METHODS Expressions of TGF-β1, PDGF and IGF-1 mRNA in the lung cells and lung tissues in different stages of Bleomycin-A5-induced pulmonary fibrosis in rats were studied through Northern hybridization. RESULTS The expressions of TGF-β1 and PDGF mRNA reached their peaks in AMs of pulmonary fibrosis in rats on the 7th day after Bleomycin-A5 instillation. It was similar with that in the lung tissues. IGF-1 mRNA remained relatively stable in AMs during the course. PDGF and IGF-1 mRNA increased gradually in fibroblasts, and reached the highest expressions in the interstitial cells. There was almost no TGF-β1 mRNA expression in all groups of fibroblasts. CONCLUSIONS AMs are the main sources of TGF-β1 and PDGF in the lung tissues with fibrosis induced by Bleomycin-A5 AMs are activated in the first weekend and secrete TGF-β1 and PDGF to promote fibroblasts proliferation and fibrosis. As fibrosis developed, fibroblasts have established PDGF and IGF-1 autocrine and these three cytokines paracrine nets combined with the interstitial cells to promote lung fibrosis.

OBJECTIVE To examine spontaneous apoptosis of cultured human colon tumor cell lines in vitro and to investigate the role of wild type (wt) p53 in regulation of apoptosis induced by DNA-damaging treatment. METHODS A model system of human tumor progression involving three cell lines was used in this study for examination of apoptosis. They were originally established from human colon villous adenoma, including an early passage of non-tumorigenic cell line, V235E; a late passage of weakly tumorigenic cell line, V235L; and a spontaneous progressing highly tumorigenic cell line. V411. All of them maintain wt p53 expression. For identification of apoptosis, two tests were performed: 1. morphology study using acridine orange (AO)/ethidium bromide (EB) stainning by fluorescence microscopy; 2. DNA electrophoresis on agarose gel. P53 and WAF-1 (a downstream gene of p53) expressions were analysed at mRNA level using Northern blot technique. Apoptotic index of cell lines examined was measured by DNA fluorescence assay. RESULTS Spontaneous apoptosis was demonstrated in cell lines of all stages of progression by both morphology and DNA agarose gel electrophoresis. Apoptosis was further induced in V411 after treatment of cells with 137Cs γ-irradiation and accompanied by increases in p53 and WAF-1 expression. In contrast, a mutant p53 bearing human colon cancer cell line, sw480, lacked spontaneous apoptosis, and upon irradiation neither induction of apoptosis nor increase expression of p53 and WAF-1 were seen. CONCLUSIONS Apoptosis can be maintained in some human tumor cell lines despite transformation and carcinogenesis. Wt p53 and WAF-1 products are two of the potential mediators which effect apoptosis. Additionally, since apoptosis was enhanced by irradiation in V411, but not in sw480, it suggests that wt p53 cancer cells are more sensitive to DNA-damaging treatment than mutant p53 cancer cells. These finding may have implications for cancer therapy.

OBJECTIVE To explore the effect of monoconjugated bilirubin (MCB) on gallstone formation of both categories. METHODS Using a newly established high performance liquid chromatography (HPLC) technique. MCB was extracted, prepared and purified from gallstone patients bile, and its solubility and pro-nucleative activity were observed. RESULTS In a near physiological environment of biliary tract (pH 7.9 and temperature 37 degrees C), the aqueous solubility of MCB (558.25±5.96 μm) was only 1/7 of that of disconjugated bilirubin (DCB) (3410.9±2.42 μm), but 44 times higher than that of unconjugated bilirubin (UCB) (2.43±0.31 μm) (P<0.01, between and two of them). Moreover, the solubility of MCB changed curvilineally with the alteration of pH, being highest at pH 7.9, zero at pH 4.5 and even lower than that of ionized UCB at pH above 9. In 3 groups of model bile systems made from Kibe's formula, the nucleation time (NT) was examined by polarized microscopy after 170 μm and 340 μm of MCB was added in group 1 and 2 respectively (group 3 was the control, with no MCB added). The NT was 3.33±0.52. 2.17±0.41 and 5.83±0.75 days respectively in the 3 groups (P<0.05, between any 2 of the 3 groups) and the nucleative activity (NA) was 0.57 and 0.37 in group 1 and 2 respectively, which confirmed that MCB possessed a dose-related NA which was even stronger than that of glycoprotein (0.56) at the dose of 340 μm. CONCLUSIONS MCB might play an essential role in the formation and nucleation of gallstones with its poor aqueous solubility and strong pro-nucleative activity via certain lithogenic mechanism.

OBJECTIVE To study the neurotrophic effects of Schwann cells in culture on damaged spinal anterior horn neurons. MATERIALS AND METHODS Dissociated from rat sciatic nerves undergoing Wallerian degeneration by trypsin-collagenase. Schwann cells were cultured for 96 hours to form a trophoblast, onto which embryonic day 14 rat spinal anterior horn neurons plated on glass coverslip and cultured for 4 hours were transferred for cocultivation without cell-cell contact between Schwann cells and spinal anterior horn neurons. The effect of survival and neurite outgrowth activity promoting factors secreted from Schwann cells on spinal anterior horn neurons were examined under phase-contrast microscope at 24, 48, 72 and 96 hours after cocultivation. RESULTS When cultured for 24 hours, almost all the spinal anterior horn neurons, that had been damaged in the course of dissociation from spinal nervous tubes, survived, and some of them grew with short neurites. 96 hours after cocultivation, about 1/3-1/2 of the neurons survived and their bodies enlarged with neurites by more than six times of their body diameters. Contrarily, none of the neurons in the control group (no Schwann cell trophoblast) survived simultaneously. CONCLUSIONS By the model of Schwann cell-spinal anterior horn neuron cocultivation separated by glass coverslip, it was well confirmed that Schwann cell can secrete a neuron survival promoting factor and a neurite outgrowth promoting factor, which undoubtedly play a crucial role in peripheral nerve regeneration.

OBJECTIVE In the concept of guided tissue regeneration (GTR), a space is created for selected cells to differentiate, proliferate and repair the defect at last by implanting a membrane around the defect area, which serves as a physiologic barrier. This experiment was designed to test GTR in long bone, namely, guided bone regeneration (GBR). METHODS Ten New Zealand rabbits were used in this experiment. A piece of silicone membrane sutured as a tube was used to bridge a 10-mm defect on radius. 10-mm defects were also produced on the control sides. Radiography of forelimbs was taken weekly until 12 weeks. Gross sample examination, 3-point bending test and histology were involved in evaluating bone regeneration. RESULTS By the 12th week, seven of 10 experimental sides were healed, 2 were healed with a connective cartilage zone, and I was not healed. None of the control was healed but the defect was occupied by soft tissue. CONCLUSIONS The results of this preliminary study showed that GBR is present in long bone of rabbits. The following points relate to the mechanism of GBR; providing a space for bone regeneration; preventing surrounding tissue from the defect; increasing the density of osteogenic precursor cells and concentration of bone morphogenetic protein (BMPs); and maintaining a complete blood clot to bridge the fracture ends in the tube, which provides a structure for osteogenic cells ingrowth.

OBJECTIVE To propose a practical and reasonable classification of chronic suppurative parotitis (CSP) on the basis of the various entities. METHODS Clinical, laboratory, sialographic, scintigraphic, histopathologic (including ultrastructural) study of recurrent parotid swellings (RPS) was performed in 291 patients over a 10-year period. RESULTS It is suggested that CSP should be classified into recurrent parotitis in childhood (RPC), recurrent parotitis in adults (RPA), chronic obstructive parotitis (COP) and should be differentiated from other subdivisions including subclinical Sjögren's syndrome (SCSS), chronic parotid swelling of Sjögren's syndrome and sialadenosis with retrograde infection. RPA is a continuation of recurrent parotid swelling from childhood (RPC) to adulthood. Remission can take place spontaneously in RPC and RPA so that self-conservative therapy is mainly used for reducing the parotid swellings. COP is recurrent parotid swellings and/or purulent discharge resulting from various obstructive factors. Mild COP can recover completely with the use of conservative methods, severe COP is often resistant to conservative treatment and should be treated with surgical modality or injection of methyl violet into the diseased gland. Treatment with methyl violet is considered as a convenient and practical method with a definite effect. SCSS is an autoimmune disease and should be treated as systemic disease. CONCLUSIONS Because there exists confusion in the nomenclature of RPS this revised classification is based on the various entities and can be used as a guide in the diagnosis and treatment of RPS.

Despite the increasing prevalence of gallbladder stone disease in China, Stones located in the hepatic ducts above the bifucation, the intrahepatic lithiasis, is still a common disease. Because of the high morbidity rate and high reoperation rate, treatment of intrahepatic stones remains one of the most difficult problems in abdominal surgery in spite of the advances of hepatic surgery in the last 30 years. The present report is based on the recent developments in surgical treatment of intrahepatic stones in China.

A recent nation-wide sampled survey on deaths of children in China showed that the first leading cause of deaths of children under the age of 5 years was still pneumonia in 1991. However, the mortality rate of pneumonia in children of this age group declined dramatically.

The major disease that afflict the lung, such as asthma, pulmonary carcinoma and chronic obstructive pulmonary disease (COPD) are increasing in incidence, prevalence and mortality. Pulmonary infections are prevalent in aging population. In China, pulmonary complications of immune compromized patients are increasing.