1998年 · 第111卷第01期

OBJECTIVE To investigate whether or not heparin can accelerate the healing process of acetic acid-induced gastric ulcers in rats and to identify the mechanisms for heparin to produce this effect, so that we can develop a new therapeutic application to heparin besides its traditional anticoagulant activity. METHODS Male Sprague-Dawley rats were used to produce acetic acid-induced gastric ulcers. Heparin in the doses of 100, 500, and 1000 U/kg were administered intravenously through the tail vein once daily, starting 1 day after ulcer induction for 7 days in the dose-response experiment or heparin 1000 U/kg at a time schedule of 3, 5, and 7 days in the time-response study, respectively. The gastric mucosal blood flow (GMBF) was measured using a laser Doppler flowmeter under ether anesthesia. The rats were then sacrificed and the ulcer areas were measured. The gastric mucosa was then scraped for the determinations of mucosal prostaglandin E2 (PGE2) level and myeloper-oxidase (MPO) activity. RESULTS Heparin in the doses of 500 and 1000 U/kg accelerated the healing of acetic acid ulcers in a dose-dependent manner. The highest dose of heparin also reduced the ulcer areas in a time-dependent fashion. The effect was accompanied by an increase in gastric mucosal PGE2 levels. The same dose of heparin not only decreased the gastric mucosal MPO activity but also increased the GMBF in a time-related manner. CONCLUSIONS Heparin with the doses used in the present study accelerated the healing of acetic acid-induced gastric ulcers in rats in a dose- and time-dependent manner, and this action was related to its effects to increase the levels of gastric mucosal PGE2 and GMBF as well as to decrease the gastric mucosal MPO activity.

OBJECTIVE To investigate the therapeutic effect of Astragali on sodium and water retention in aortocaval fistula-caused experimental congestive heart failure and its involved mechanisms. METHODS In aortocaval fistula-caused chronic (5 wk), heart failure rats treated with and without Astragali 1.0 g/day intraperitoneally, changes of cardiac and renal function, renal response to atrial natriuretic peptide (ANP) were examined. Dot blot analysis was used to determine the effect of Astragali on hypothalamic arginine vasopresin (AVP) mRNA expression, and mRNA expressions of aortic and renal AVP V1a receptor, renal AVP V2 receptor and aquaporin-2 (AQP2) were simultaneously detected by RT-PCR method. RESULTS Rats with aortocaval fistula impaired cardiac and renal functions evidenced by higher right atrial pressure (RAP), left ventricular end-diastolic pressure (LVEDP), lower + dP/dtmax of left ventricle, glomerular filtration rate (GFR), renal plasma flow (RPF), urine volume (UV), urinary sodium excretion (UNaV) and free water clearance (CH2O) compared with sham-operated control (P<0.05). There was no change in serum sodium, hematocrit and plasma osmolality. Astragali could remarkably improve the cardiac and renal functions. Dot blot analysis demonstrated upregulated hypothalamic AVP mRNA expression in this experimental heart failure. The AVP V1a receptor mRNA level of aortic arch and renal medulla were reduced, while in renal cortex it was elevated. The mRNA expressions of AVP V2 receptor and AQP2 were increased in renal cortex while decreased in medulla. Astragali could partially or completely correct those abnormal mRNA expressions. Analysis on plasma atrial natriuretic peptide (ANP), urinary cyclic guanidino monophosphate excretion (UcGMP V), urinary cyclic guanidino monophosphate excretion/plasma atrial natriuretic peptide (UcGMP V/pANP), and further correlation and linear regression analysis between UcGMP V and plasma ANP showed that there was blunted renal response to ANP in heart failure rat, and astragali could improve the renal reaction to ANP significantly. CONCLUSIONS Chinese herb, astragali have therapeutic effects on sodium and water retention in aortocaval fistula-induced heart failure, the mechanisms of which might be the improvement of cardiac and renal functions, partly correction of abnormal mRNA expressions of AVP system and AQP2, and amelioration of blunted renal response to ANP.

OBJECTIVE To investigate whether the down-regulation of renal parathyroid hormone/parathyroid hormone related protein (PTH/PTHrP) receptor messenger ribonucleic acid (mRNA) expression is a general phenomenon in patients with different stages of renal disease, besides chronic renal failure. METHODS Twenty-five patients were divided into the following groups: (1) chronic glomerulonephritis with normal renal function (GNN) (2) chronic glomerulonephritis with moderate renal insufficiency (GNI) (3) severe chronic renal failure undergoing maintenance dialysis (CRF) (4) acute renal failure during oliguric phase (ARF) (5) normal control without renal suffering (NC). Using relatively quantitative reverse transcription/polymerase chain reaction (RT/PCR) method, we investigated PTH/PTHrP receptor mRNA expression in renal specimens obtained through biopsy or operation. The levels of plasma C-terminal PTH, serum phosphorus and calcium were also observed at the same time. RESULTS Plasma C-terminal PTH levels in GNI, CRF and ARF patients were 1.90, 9.73 and 8.63 times higher than those in NC. However, the difference between GNN and NC was insignificant. CRF and ARF patients also presented obviously elevated serum phosphorus (1.61, 1.86 vs 1.14 mmol/L) and reduced serum calcium (1.82, 1.71 vs 2.26 mmol/L) compared with that in the control. These two parameters for GNN and GNI patients were normal. The levels of PTH/PTHrP receptor mRNA (corrected by beta-actin mRNA) in the kidney of GNN, GNI, CRF and ARF patients was markedly decreased by up to 35.7%, 68.5%, 77.9% and 92.2%, respectively. CONCLUSIONS The down-regulation of renal PTH/PTHrP receptor mRNA occurs much earlier than the changes of renal function, plasma PTH, serum phosphorus and calcium in the course of human renal disease.

OBJECTIVE To explore the immunophenotype of myeloid cells in myelodysplastic syndyomes (MDS) and its clinical implications. METHODS A panel of monoclonal antibody was used to detect CD13+, CD33+, CD15+ and CD14+ antigens on the membrane surfaces of myeloid cells in the bone marrow from 51 MDS, 21 aplastic anemia (AA), 21 paroxysmal nocturnal hemoglobinuria (PNH) patients. 10 acute myeloblastic leukemia (AML) patients and 15 normal subjects by immunoenzymatic assay. The morphology and chromosome karyotype of bone marrow cells of MDS patients were also examined. RESULTS CD14+, CD13+ and CD33+ cells in the bone marrow were more in MDS patients than in normal controls, AA patients and PNH patients. CD15+ cells in the bone marrow were less in MDS patients than in normal controls. CONCLUSIONS The percentages of CD14+, CD13+ and CD33+ positive cells in the bone marrow of MDS patients were related to the percentage of myeloblasts, the chromosomal aberrations and the response to treatment. It indicated that there is immunophenotypic misexpression of myeloid cells in MDS patients. Immunophenotype analysis of myeloid cells might be useful for the diagnosis and treatment of MDS patients.

OBJECTIVE To study the activity of liver glycogen synthase in analogous model of NIDDM rats. METHODS Male Wistar rats were injected with low dose of streptozotocin (STZ) (30 mg/kg body weight) via tail vena and those animals with glucose tolerance impaired and level of insulin equal to or higher than that of the controls at 18th week were taken as the analogous rat model of NIDDM. The activity of liver glycogen synthase (GS) was assayed at the end of experiment. RESULTS Type I-enzyme: 0.18±0.06 mumol/min.g versus 0.24±0.09 mumol/min.g, P<0.05, and total-enzyme: 1.52±0.43 mumol/min. g versus 1.84±0.42 mumol/min.g, P<0.05. CONCLUSIONS The GS activity of diabetic rats was significantly lower than that of control.

OBJECTIVE To analyze the relationship between the proto-oncogene c-fos change and neuronal degeneration in the hippocampus of the patients with Alzheimer's disease. METHODS The post mortem human hippocampal tissues were divided into three groups, namely, the aged, the young and Alzheimer's disease (AD) groups. Each group consisted of 10 patients. The diagnosis of AD was made by clinical manifestation and argentatine (Bodían) staining. Patients of both the young and the aged groups had no neurological disorders. The proto-oncogene c-fos mRNA was investigated in the hippocampal neurons using the method of in situ hybridization. RESULTS The optical density of stained area and the integral within proto-oncogene c-fos mRNA revealed a significant increase in the hippocampal neurons in cases of Alzheimer's disease as compared with the controls. CONCLUSIONS The over-expression of the proto-oncogene c-fos might play a role in the pathological process of Alzheimer's disease. These changes might result from a suffering stage of the hippocampal neurons or from a compensatory mechanism in the surviving neurons which are not yet affected-by the pathological process.

OBJECTIVE To study the role of IL-6 in systemic lupus erythematosis (SLE). METHODS We constructed eukaryotic expression vector pcDNA3- IL-6 encoding for IL-6 and injected it intramuscularly into BXSB mice. 22 of the 3.5-month-old male BXSB mice were divided into two groups. One group was injected with the pcDNA3-IL-6 100 micrograms per mouse twice at the interval of 20 days. Another group was injected with plasmid pcDNA3 at the same time as control. The ANA and proteinuria were monitored every 10 days, and the IL-6 activity in serum, IgG, C3 deposition and IL-6 expression in kidney detected at the 40th day. RESULTS IL-6 encoding plasmid had harmful effects on murine SLE with increased ANA level, proteinuria, IgG, C3 deposition and IL-6 expression in kidney, but there was no difference of serum GPT levels between the two groups. CONCLUSIONS Excessive production of IL-6 could play an important pathogenic role in SLE. Blocking or reducing IL-6 secretion might be a new therapy for SLE.

OBJECTIVE To elucidate the mechanisms of protective immunity in mice elicited by living hookworm (Ancylostoma caninum third-stage infective larvae (L3). METHODS The number of migrating infective larvae recovered from the lungs was used as an endpoint for vaccine immunity. The timing of maximal L3 lung entry was determined by counting the number of lung larvae at several time points after infection with 500 or 1000 L3. Mice were immunized either orally or subcutaneously with 500 L3, followed by two boosts of L3 once every two weeks. The immunized mice were challenged orally with 500 L3 one week after the final boost. To evaluate the protective immunity, the number of L3 recovered from the lungs of the immunized mice during the time of maximal larval entry was compared with that of controls. Host immunity was also evaluated by comparing circulating anti-L3 antibodies between immunized and controlled mice, using both enzyme immunoassays and immunoblotting techniques, and by lung histopathology. RESULTS The peak time of larval entry into the lungs occurred 48 hours after infection. Mice immunized either orally or subcutaneously with L3 exhibited a marked reduction (90.2% and 86.2% respectively) in the number of recovered lung larvae in comparison to controls (P < 0.01). The protection might be associated with circulating anti-L 3 antibodies, including antibodies directed against 132-200 kDa L3 antigens, as well as three major antigens ranging from 28 to 51 kDa. Larvae migrating through the lungs of vaccinated mice showed cuticular damages accompanied with host-inflammatory cell invasion. CONCLUSIONS Immunization with living L3 protects mice against lung invasion after challenged with hookworm infection. Vaccine immunity is associated with circulating antibodies against L3 antigens and lung inflammatory responses. The mouse model is potentially useful for developing a hookworm vaccine.

OBJECTIVE To test the validity of continuous low-flow perfusion with low-potassium dextran (LPD) to preserve rabbit lung. METHODS Isolated rabbit lungs were preserved for eight hours either in Ringer's solution by simple storage (Group I) or in continuous low-flow perfusion with LPD (Group II). After preservation, lung functions were assessed to compare these two methods. RESULTS The water gain in Group I was higher than that in Group II. During reperfusion, the functional test values for the immersed lungs were lower than those for the perfused lungs. The lipid peroxidation product (MDA) was significantly decreased in perfused lungs during reperfusion. CONCLUSIONS Low-flow perfusion with LPD is better than immersion for the lung preservation.

OBJECTIVE To present our initial experience in transurethral vaporization of the prostate (TVP) using an oval electrode for the treatment of benign prostatic hyperplasia (BPH). METHODS A total of 82 patients underwent TVP procedures with the oval electrode. The newly designed oval-shaped electrode can work with a High Frequency Electrosurgery Unit. Prostate gland tissue was vaporized through an Fr 24 percutaneous nephroscope transurethrally. The operation procedure was similar to transurethral resection of the prostate (TURP) or transurethral laser prostatectomy (TULP). Power setting ranged from 240 W to 320 W. Local vaporization temperature reached 120 ℃. RESULTS Urination was recovered in all 82 patients after TVP. Mean post-treatment International Prostate Symptom Score (I-PSS) reduced from 27.10 to 5.05; mean bladder residual urine volume dropped from 147.71 ml to 33.2 ml; and mean urine flow rate (MFR) increased from 4.45 ml/s to 14.57 ml/s (P < 0.01). The initial results of short-term follow-up were excellent. CONCLUSIONS TVP with the oval electrode is easy to perform and causes less hemorrhage and few complications. It especially benefits elderly and/or critically-ill patients. We believe that TVP with our oval electrode is feasible with low risk.

Vecuronium is a new nondepolarizing muscle relaxant with the intermediate clinical duration. The previous study showed that the neuromuscular blocking effect of vecuronium in children differed from that in adults. There is no reference dealing with the causes of the difference. To determine whether the difference results from changes in elimination, distribution or sensitivity, we studied the pharmacokinetics and pharmacodynamics of vecuronium in adults and children during nitrous oxide-enflurance anesthesia.

It has been a difficult problem to repair or reconstruct common bile duct after choledochectomy. The substitutious made from different materials by various methods have been tried for nearly a century, but almost all of them have had the same problem of retrograde infection. The purpose of this study is to verify a polyurethane replacement which can wave self-rhythmically through a bag under diaphragm.

In the past, total resection of the gastric stump and esophagojejunostomy were carried out for cardiac cancer of the gastric stump. After surgery, patients were usually severely affected in quality of life. In this study, we applied the gastroesophagostomy after cardiectomy of the gastric stump.

Acute upper gastrointestinal haemorrhage is a common reason for admission to hospital. Approximately 20% of our annual upper endoscopy workloads are performed for upper gastrointestinal bleeding. The incidence of acute upper gastrointestinal haemorrhage increases markedly with age and is higher in men than in women. Peptic ulcers account for approximately half the lesions, with gastric ulcers less common than duodenal ulcers.

The neuroendocrine and immune systems are bidrectionally linked. Products of the immune system like lymphokines and monokines modulate the neuroendocrine functions while various neuroendocrine signals also affect the immuune functions. Neuroendocrine and lymphoid cells share a number of neurotransmitters, neuromodulatory substances, hormones and their receptors suggesting the existence of a bidrectional regulation between the two systems. Evidence shows that such a reciprocal interaction exists between the pineal gland and the immune system.

We report a rare association between the use of rifampicin and the development of pseudomembranous colitis. The diarrhoea promptly responded to oral vancomycin and the withdrawal of antituberculous medications. The long latency between the administration of rifampicin and the onset of disease was an atypical feature of pseudomembranous colitis.

The list of known causes of granulomatous peritonitis is long and well established. However, as far as we know, only one case about a granulomatous response to escaped gallstone granuloma may clinically resemble tumor deposits, it should cause the attention of histopathologists. In this report, we present a case of an omental foreign body-type granulomatous reaction to gallstones spilt during a previous laparoscopic cholecystectomy.

Hypertrophic cardiomyopathy (HCM) is one of the primary cardiomyopathies. The primary pathologic changes are left ventricular hypertrophy and ventricular septal hypertrophy. Based on the location of myocardial hypertrophy and the outflow tract of left ventricle, HCM can be classified into two types: obstructive and non-obstructive HCM. HCM is considered a familial disease. However, there are few reports of more than 10 cases in a family. The authors report 11 cases of HCM with familial line investigations.