1998年 · 第111卷第09期

OBJECTIVE To investigate the incidence of in situ thrombosis of small pulmonary arteries and arterioles during the exacerbation stage of chronic cor pulmonale. METHODS 49 autopsy cases died from the exacerbation of chronic cor pulmonale were chosen as the study group, while 103 other autopsy cases without chronic cor pulmonale and disseminated intravascular coagulation (DIC) as control group. Morphologic and morphometric studies were taken on lung tissues and other organs with focus on the thrombi in small pulmonary arteries and arterioles. RESULTS 44 cases of the study group had multiple thrombi in small pulmonary arteries and arterioles, the incidence is 89.8%, and in 9 of them, thrombi in proximal pulmonary arteries co-existed, the incidence is 18.4%. 80% of the thrombi existed in pulmonary arterioles. In the control group, only 3 cases had thrombi in small pulmonary arteries and arterioles, the incidence is 2.9%. All thrombi adhered to endangium, implying that they were in situ thrombi. No intravascular thrombosis was found in other organs. chi 2 test showed that the incidence of thrombosis and the number of thrombi in small pulmonary arteries and arterioles in cases with chronic cor pulmonale were significantly higher than those of the control group (P<0.01). CONCLUSIONS Multiple in situ thrombosis in small pulmonary arteries and arterioles is a prominent and common pathological change during the exacerbation stage of chronic cor pulmonale. The study suggests a new diagnostic and therapeutic concept and gives a morphological and theoretical basis for the clinical application of anticoagulants or even the thrombolytic agents for the cases of chronic cor pulmonale in the exacerbation stage.

OBJECTIVE To investigate the role of interleukin-4 (IL-4) and interleukin-5 (IL-5) in the pathogenesis of steroid-resistant (SR) asthma. METHODS Fifteen patients with SR asthma and 15 patients with steroid-sensitive (SS) asthma were selected based on their clinical responses to prednisone therapy. The peripheral blood mononuclear cells (PBMCs) were obtained and incubated with phytohemagglutinin (PHA) in vitro for 48 h in the presence or absence of dexamethasone (10-7 mol/L). Expressions of IL-4 and IL-5 mRNA in PBMCs were determined by reverse transcription-polymerase chain reaction (RT-PCR), and mRNA positive PBMCs for IL-4 and IL-5 were measured with in situ hybridization using digoxin-labeled cDNA probes. RESULTS In the absence of dexamethasone, there was no significant difference in the expressions of IL-4 and IL-5 mRNA between SR and SS asthmatics, and the numbers of mRNA positive cells for IL-4 and IL-5 were also similar between these two groups, however, in the presence of dexamethasone (10-7 mol/L), expressions of IL-4 mRNA (P<0.01) and IL-5 mRNA (P<0.05) were significantly inhibited in SS asthmatics, but not in SR asthmatics (P>0.05). The numbers of IL-4 and IL-5 mRNA positive cells decreased from 5.50±1.60 to 2.27±0.98 (P<0.01) and from 5.03±1.29 to 1.67±0.70 (P<0.01), respectively in SS asthmatics, but in the patients with SR asthma, there was no significant change in the number of cells expressing mRNA for IL-4 or IL-5. CONCLUSIONS The gene expression of IL-4 and IL-5 in SR asthma was not inhibited by dexamethasone at the concentration of 10-7 mol/L. It is suggested that the relative unresponsiveness of T cells to glucocorticoids and persistent production of cytokines may be one of the mechanisms of steroid resistance in asthma.

OBJECTIVE To assess the effects of splenectomy on CCl4-induced liver fibrosis in rats. METHODS Wistar rats were injected with CCl4 subcutaneously for 3 to 15 weeks to develop liver fibrosis. Two hundred and thirty-six rats were divided into 9 groups: (1) model group without splenectomy; (2) splenectomized group in which operation was performed before induction of fibrosis; (3) sham-operated group in which caparotomy was done before induction of fibrosis; (4) (5) (6) groups in which splenectomy was performed at the 6th, 9th and 12th week after induction of fibrosis, respectively; and (7) (8) (9) sham operation was also performed at the 6th, 9th and 12th week after induction of fibrosis, respectively. The spleen and liver biopsy, hepatic hydroxyproline, liver homogenate levels of procollagen type Ⅲ (PC Ⅲ), hyaluronic acid (HA), laminin (LN) and volume density of collagen were examined at different times. RESULTS The results showed that the degree of hepatic damage and liver fibrosis in splenectomized group was significantly milder than that in model group and sham-operated groups. Splenectomy might delay the progress of liver fibrosis for about 3 weeks. The role of preventing rat liver fibrosis was also observed when splenectomy was performed after CCl4 induction of fibrosis for 6 and 9 weeks. CONCLUSIONS These results suggest that splenectomy may be of a preventive role against CCl4-induced rat liver fibrosis to a certain degree.

OBJECTIVE To investigate the expression of cathepsin B (CB) in human gastric carcinoma tissue. METHODS The expression of CB in human gastric tissue was studied by using monospecific polyclonal rabbit antibody raised against human liver CB for immunohistochemistry, and full length cDNA of CB for in situ hybridization and dot blot. RESULTS CB overexpression in gastric carcinoma was found when compared with non-neoplastic gastric tissue at both mRNA and protein levels. Diffuse cytoplasmic CB staining of mRNA and protein were identified in malignant cells of 53.3% and 69.1% of gastric adenocarcinoma respectively. The increased staining of CB in malignant cells was associated with the depth of the invasiveness and growth pattern as well as metastasis of lymph nodes, but not with the histological classification. It was also found that there were the expression of CB in stromal cells of the tumor and the expression localized mainly in the endothelial cells of the microvessels which correlated with angiogenesis. CONCLUSIONS These results indicate that the expression of CB in gastric carcinoma is related to tumor progression, and leads to development of the invasive phenotype.

OBJECTIVE To explore the inhibiting effect of superoxide dismutase (SOD) on the growth of hepatocellular cancer cell line HepG2. METHODS By gene transfer technique, hepatocellular cancer cells (HepG2) were transfected with a retroviral vector containing human CuZnSOD cDNA. The elevated SOD gene expression of the transfected cells was compared with the parental and neo control cells. RESULTS Compared to the control cells, cancer cells transfected with SOD gene showed an inhibited cell growth, a reduced number of cells in S phase and decreased clone forming ability in soft agar, as well as a smaller tumor size formed in nude mice. CONCLUSIONS The overexpression of CuZnSOD gene could, to certain extent, suppress the cell growth of hepatocellular cancer cell line HepG2.

OBJECTIVE To demonstrate the presence of adrenomedullin in the central nervous system. METHODS Using immunohistochemical method (ABC) and reverse transcription-polymerase chain reaction (RT-PCR) analysis, the distribution of immunoreactive (IR-) AdM and AdM mRNA was observed in the rat and the human brain. RESULTS Immunoreactive (IR-) AdM and AdM mRNA were detectable in almost every region of the rat brain examined, including cerebral cortex, paraventricular tissues, hypothalamus, mesencephalon, medulla oblongata and cerebellum. The levels of AdM mRNA in paraventricular tissues and medulla oblongata were higher than those in the other brain regions. AdM mRNA was also detectable in the human brain. CONCLUSIONS The present study shows that AdM is present in the central nervous system, suggesting that AdM might act as a neurotransmitter, neuromodulator or neurohormone in rats or humans.

OBJECTIVE To summarize the clinical and pathological findings of Alport syndrome (AS), detect the distribution of type Ⅳ collagen within basement membrane of patients with AS and evaluate the diagnostic value of indirect immunofluorescence (iIF) study of type Ⅳ collagen in AS. METHODS Fourteen patients belonging to 12 families were collected from January 1990 to June 1996. The clinical examinations include biochemical examination, audiometry and ocular examination. IIF technique was used to detect the location of chains of type Ⅳ collagen in 6 renal and 5 skin specimens from 8 Alport patients. RESULTS Among fourteen patients, 11 were male and 3 female (mean age 29.4 years). Microscopic hematuria was found in 13 patients, and recurrent gross hematuria in 7. All had proteinuria. Three patients presented nephrotic syndrome. Slowly progressive renal failure occurred in 10 of 11 males (11-39 years) and 1 female (40 years). Sensorineural deafness was observed in 9 patients particularly high frequency sound. Anterior lenticonus were presented in 2. Five families transmitted as X-linked dominant (XD) trait and 3 autosomal dominant, 3 autosomal recessive inheritance. In 7 renal biopsies, the findings by light microscopy mostly revealed focal and segmental sclerosis glomerulonephritis (4/7). The results of IF were negative in 4. Ultrastructural studies showed variable thickening, thinning of glomerular basement membrane (GBM) in 7 specimens with lamellation and basket wearing of GBM in 1. Using the iIF technique, the α3, 4, 5 (Ⅳ) chains were observed to be absent within both GBM and EBM of 4 male XD-AS patients. Six patients were treated with hemodialysis, 2/6 with transplantation. CONCLUSIONS Alport syndrome (AS) is a heterogeneous hereditary disease characterized by progressive hematuric nephritis with or without sensorineural hearing loss and ocular defects. Ultrastructural alterations of GBM are helpful to the diagnosis of AS. IIF study suggests that type Ⅳ collagen in basement membrane of AS was abnormal and IIF study of type Ⅳ collagen chains distribution is useful for confirming the diagnosis of AS.

OBJECTIVE To investigate the incidence rate, pathologic changes, mechanisms and diagnostic methods in renal bone disease. METHODS The blood levels of carboxyterminal parpthyriod hormone (C-PTH), 1,25(OH)2D3, calcium and phosphate, aluminum in serum and bone tissue were measured. The bone biopsy and bone scan with 99m technetium methylene diphosphonate (99mTC-MDP) were performed in 51 uremic patients. RESULTS One hundred per cent of the patients had varying degree of pathologic changes in bone, in which 50.9% of the patients presented high-turnover bone disease, 7.8% of the patients presented low-turnover bone disease and 41.8% of the patients had mixed-type bone disease. The levels of serum C-PTH were predominently high in high-turnover bone disease while the levels of serum 1,25(OH)2D3 were significantly decreased in low-turnover bone disease. There was a high positive rate for the diagnosis of renal bone disease by bone scan with 99mTC-MDP. CONCLUSIONS The examination of bone pathology is the most valuable method for the diagnosis of renal bone disease. Bone scan with 99mTC-MDP has reference value when clinical conditions do not allow to make bone biopsy.

OBJECTIVE To sequence E2/NS1 gene from genotype Ⅲ Chinese isolates of hepatitis C virus (HCV) and analyze homology corresponding to the region of the reported isolates. METHODS E2/NS1 gene derived from genotype Ⅲ Chinese isolates of HCV was amplified by reverse transcripase-polymerase chain reaction (RT-PCR) and cloned into vector pcDNA3. Dideoxy chain termination METHODS were used to sequence E2/NS1 gene. RESULTS E2/NS1 gene derived from genotype Ⅲ Chinese isolates of HCV was cloned for the first time and named HC-W14. Identity of HC-W14 in nucleotide and putative amino acid to those of genotype Ⅲ Japanese isolates of HCV were 88.37% and 89.29% respectively. Homology to that of non-type Ⅲ isolates was relatively low. CONCLUSIONS High variation existed in E2/NS1 region between genotype Ⅲ and Ⅱ Chinese isolates of hepatitis C virus. The variability of E2/NS1 gene should be taken into account in the development of vaccine against HCV in China.

OBJECTIVE To investigate a new way to detect filarial larvae in mosquitoes and apply it to the surveillance of filariasis. METHODS An oligonucleotide probe that was species-specific to W. malayi was synthesized and marked with 32P using molecular biological technique. Then the probe was tested with dot hybridization in detection of W. malayi filarial larvae from mosquitoes. RESULTS The minimal detectable limit was found to be 2 ng DNA of filarial larvae or microfilaria (Mf.), with no cross reaction with other animal filariae. A single larva can be detected when infected mosquitoes were tested one by one. One infected mosquito can be detected from a group of 20 mosquitoes tested together. CONCLUSIONS Our probe is sensitive and specific. It is practical to apply our probe to mosquito surveillance in Brug's filariasis endemic areas.

Diffuse panbronchiopitis (DPB) is a disease characterized by chronic inflammation of bronchioles and terminal bronchioles. Most DPB cases have been found in Japan in the past three decades. We report the first typical DPB in the mainland of China diagnosed by open lung biopsy.