1999年 · 第112卷第12期

OBJECTIVE To investigate the effect of Astragalin on human renal mesangial cells. METHODS Cultured human mesangial cells were treated with Astragalin and Astragalin serum in different concentrations in the presence or absence of PDGF-BB, the proliferation and type IV collagen secretion of mesangial cells were measured by MTT assay and ELISA, and expression of β1 integrin gene was estimated by reverse transcription-polymerase chain reaction (RT-PCR) method, suspectively. RESULTS After 72 hours Astragalin or Astragalin serum treatment, the proliferation of mesangial cells induced by PDGF-BB was inhibited significantly in a dose-dependent manner compared with untreated controls (P < 0.05 and P < 0.01). After 24 hours of Astragalin or Astragalin serum treatment, the secretion of type IV collagen protein in presence of PDGF-BB was significantly decreased and β1 integrin mRNA level decreased significantly compared with untreated control (P < 0.05, P < 0.01). CONCLUSIONS Astragalin inhibits cell proliferation and matrix over-synthesis which might be mediated, at least, partly by decrease of β1 integrin gene over-expression. The study suggested that Astragalin might play a role in preventing the progression of chronic renal diseases.

OBJECTIVE To investigate the expressions of hypothalamic arginine vasopressin (AVP) mRNA, renal AVP V2 receptor mRNA, and AVP-dependent aquaporin-2 (AQP2) mRNA in rats with adriamycin-induced nephrotic syndrome. Effects of Chinese herb Astragalus membranaceus (AM) were also tested. METHODS Sprague-Dawley rats with four weeks of adriamycin-induced nephrotic syndrome (NS) were used in this study. Another group NS + AM was set to testify the effects of AM given 0.5 g/kg daily on NS. Hypothalamic AVP mRNA expression was examined by dot blot method. Reverse transcription polymerase chain reaction was applied for detection of renal cortical and medullary V2 receptor and AQP2 mRNA. The results were normalized by mRNA of glyceraldehyde-3-phosphate dehydrogenase from the same sample. RESULTS All rats receiving adriamycin presented typical nephrosis. No obvious difference in plasma osmolality was detected among NS, NS + AM, and normal control (NC) rats. Hypothalamic AVP mRNA expression was higher in NS rats than NC (53.59±5.49 vs 25.72±1.96, P<0.01). AM completely reversed this up-regulated expression (21.88±1.25). In both cortex and medulla of the kidney, nephrotic rat had increased AVP V 2 expressions by 169% and 55%, respectively, compared with normal control rat. The increment of expression of AQP2 mRNA was consistent with that of V2 receptor in NS rat. AM could partially however significantly correct these up-regulations of V2 and AQP2 mRNA expressions (P<0.01). CONCLUSIONS The up-regulated mRNA expressions of hypothalamic AVP, renal V2 receptor and AQP2 might play a role in edema formation in adriamycin-induced nephrotic rats. AM exerts its therapeutical effects on nephrosis partially through this mechanism.

OBJECTIVE To examine the gene and protein expression of CD11b, L-selectin and CD45, and the relationship between their expression and leukocytopenia during a hemodialysis session. METHODS Ten maintenance hemodialysis patients, 20 uremic non-dialysis patients and 10 healthy volunteers were included in this study. The mRNA expression of CD11b, L-selectin and CD45 in peripheral blood mononuclear cells was detected by RT-PCR, while cell surface expression of these molecules on monocytes was detected by flow cytometry and leukocyte number was counted manually. RESULTS After the start of dialysis, both mRNA expression and cell surface expression of CD11b increased rapidly, while those of L-selectin and leukocyte number fell. The mRNA expression of CD45 first decreased and the cell surface expression increased, followed by a return to pre-dialysis levels, by the end of dialysis. CONCLUSIONS Hemodialysis using a cuprophane membrane can induce rapid upregulation of CD11b and down-regulation of L-selectin, which might influence the normal adhesion and anti-inflammatory response of leukocytes. In this process CD45 may play a role in regulating and/or transducing activation signal.

OBJECTIVE To explore the effect of rhein on the regulation of glucose transporter-1 (GLUT1) overexpression and the possible molecular mechanism that rhein antagonize the effect of transforming growth factor β1 (TGF-β1) in glomerular mesangial cells. METHODS Cultured mouse mesangial cells were used. The expression of GLUT1 mRNA was detected by Northern blotting; the ability of glucose uptake was determined by 2-deoxy-[3H]-D-glucose uptake assay. RESULTS Rhein had no effect on glucose uptake in mesangial cells cultured in normal glucose concentration. TGF-β1 could upregulate the expression of GLUT1 mRNA and glucose uptake in mesangial cells. This effect was markedly attenuated by the addition of rhein in a dose dependent manner. CONCLUSIONS TGF-β1 could upregulate the expression of GLUT1 mRNA and glucose uptake in mesangial cells, resulting in excessive glucose consumption and extracellular matrix production in diabetic nephropathy. Rhein antagonized the effect of TGF-β1 in mesangial cells, so it might be a hopeful remedy for the treatment of patients with diabetic nephropathy.

OBJECTIVE To review the experience with adrenal surgery which was associated with significant morbidity and notable mortality in the past, although laparoscopic approach is beginning to be accepted as the procedure of choice. METHODS The indications and results of adrenalectomy in 104 patients (36 men, 68 women) over the past 16 years were reviewed. Any potential improvement of surgical results over time was analyzed. RESULTS Ninety-three patients (89%) had functional problems while malignancy was present in 11 patients (11%). Anterior approach was employed in 27 patients, posterior in 56, lateral in 10, and laparoscopic in 11. One patient required conversion from laparoscopic to anterior approach. No operative mortality was seen, but the morbidity occurred in 16.7%. Complication rate decreased significantly in this study period (1981-1990 versus 1991-1996, 22% versus 5%; P = 0.02). Laparoscopic adrenalectomy was successfully performed for 59% of the patients requiring adrenalectomy recently, compared to 68% of posterior adrenalectomy in the past. CONCLUSIONS Adrenal surgery is a safe procedure, associated with acceptable morbidity, which has decreased over time. Laparoscopic adrenalectomy is becoming the preferred approach for the majority of patients requiring adrenalectomy.

OBJECTIVE To explore the mechanism of leukocytosis. METHODS Enzyme linked immunosorbent assay (ELISA) method was used for detecting levels of serum granulocyte colony-stimulating factor (G-CSF) in 47 cases of acute promyelocytic leukemia (APL) during the treatment with all-trans retinoic acid (ATRA). RESULTS The peak of increased serum G-CSF level occurred on the 9th day, and WBC number was the highest on the 11th day. After ATRA treatment, both serum G-CSF level and WBC number increased in 68.1% of the cases. In 19.2% of the cases treated, serum G-CSF level was increased but without obvious change in WBC number, and the reverse was true in 12.7% of the cases. CONCLUSIONS Serum G-CSF level was statistically correlated to the number of WBC, promyelocytes and its late stage by Spearman's rank-order correlation coefficient.

OBJECTIVE To elucidate the stimulating role of the growth factor autocrine loop in the carcinogenesis and development of laryngeal carcinomas. METHODS The reverse transcription-polymerase chain reaction technique was applied, and with β-actin as internal standard, TGF-α and EGFR mRNA in laryngeal carcinomas, macroscopically normal laryngeal mucosas adjacent to the tumor and in vocal cord polyps were quantitatively examined. RESULTS The mRNA index of both TGF-α and EGFR in laryngeal carcinomas and adjacent mucosas was significantly higher than those in vocal cord polyps (P<0.05). The index of TGF-α mRNA was significantly higher in laryngeal carcinomas than in mucosas adjacent to the tumor (P<0.05). CONCLUSIONS The autocrine system consisting of TGF-α and EGFR may play an important role in the very early stage of laryngeal carcinoma, or even when the tissue phenotypic alteration does not occur. The elevated TGF-α mRNA level may trigger a switch from genotypic alteration to the phenotypic. The results are expected to be a theoretical basis for the preventive chemotherapy of laryngeal carcinomas.

OBJECTIVE To explore the association between schizophrenic symptoms and superoxide dismutase (SOD), and to investigate the effect of classic antipsychotic haloperidol plus the extract of Ginkgo biloba (EGb) on SOD. METHODS In 54 patients with chronic refractory schizophrenia, 27 were treated with haloperidol plus EGb (group 1), and the rest received haloperidol plus placebo (group 2). Superoxide dismutase (SOD) levels of these patients were measured before and after treatment and compared with the levels of 25 healthy volunteers. Therapeutic efficacy was equated with a change in clinical rating scores assessed by standardized measurement tools including the Scale for Assessment of Positive Symptoms (SAPS) and the Scale for Assessment of Negative Symptoms (SANS). RESULTS Patients in group 1 improved significantly as demonstrated by scores from both SAPS and SANS, while those in group 2 only by scores from SANS. Assessed by SAPS, the response of patients receiving haloperidol plus EGb was more significant than those receiving haloperidol only. SOD levels before treatment in all patients were significantly higher than those in normal controls. After treatment, SOD levels decreased significantly in group 1 but not in group 2. In addition, before treatment, SOD levels in all patients correlated significantly with SAPS score. The levels of SOD measured before treatment were also correlated with the improvement of patients as measured by SAPS and SANS after 12 weeks. CONCLUSIONS EGb may enhance the efficacy of classic antipsychotic haloperidol on schizophrenia, especially on positive symptoms. It may work through an antioxidant efficacy that is involved in the therapeutic mechanism.

OBJECTIVE To explore the relationship between phosphatidylinositol 3-kinase (PI 3-kinase) and psoriasis. METHODS We constructed eukaryotic expression vector PcDNA 3-PI 3-kinase, by which digoxin-labeled RNA probe of PI 3-kinase was generated. After that, we detected the expressions of PI 3-kinase in the skins of twelve patients with plaque psoriasis and five normal subjects by dot blot, in situ hybridization and immunohistochemistry. RESULTS The expression of PI 3-kinase mRNA and protein in psoriatic lesions increased obviously compared with that in normal skin. The expression of the PI 3-kinase gene conformed to the expression of its protein in psoriatic and normal human skins. CONCLUSIONS Over-expression of PI 3-kinase may be related to the hyperproliferation of psoriatic keratinocytes. Transfection of the anti-sense gene of PI 3-kinase into psoriatic keratinocytes might be a best way to elucidate the issue.

OBJECTIVE To analyse comparatively the relevant data from bone tumor registries in China, Japan, and the United States. METHODS The data of 38,959 histologically confirmed primary bone tumors collected by the Chinese Bone Tumor Registry 1957-1988, 20,272 collected by the Japanese Bone Tumor Registry 1972-1990, and 11087 diagnosed and treated at Mayo Clinic, USA were used for comparative analysis by race, age, sex and skeletal distribution. For reliability, we used ratios of different tumors to osteosarcoma for frequency analysis. We also included some data from the SEER 1973-1987 as well as from Memorial Sloan-Kettering Cancer Center, USA. RESULTS The relative frequency of osteosarcoma (OS) is higher in China and Japan than in the United States. There were only limited number of OS patients aged over 50 years in Chinese and Japanese groups, which might be due to the lower incidence of OS subsequent to Paget's disease in Asians. More osteosarcoma occurred in the flat bones in the Americans than in the Chinese and Japanese. The relative frequency of chondrosarcoma (CS) was higher in the American group than in the Asian groups. The average age of CS patient was younger in the Chinese than in the Japanese and the Americans. The data confirmed the previous report that the incidence of Ewing sarcoma was higher in western people than in Asians. The data showed that the comparative frequency of chordoma is higher in the Americans than in the Asians and that the incidence of giant cell tumor of bone is higher in the Chinese and Japanese than in the Americans. CONCLUSIONS The findings from this analysis provide useful information for the epidemiologic study and the clinical diagnosis of bone tumors.

Purpose To understand the potential interaction between antiarrhythmic therapy and the implantable cardioverter-defibrillator (ICD) in patients who receive pharmacologic therapy as an adjunct to ICD therapy. Data source MEDLINE searching was employed and the information was indexed from approximately 3600 journals published world-wide from 1966 to 1998. Study selection and data extraction Data were collected from 66 of approximately 455 originally identified articles and abstracts using explicit methodological criteria. Results The ICD therapy has been widely used for therapy of life-threatening ventricular arrhythmias (VT/VF) and prevention of recurrence of sudden cardiac death. Studies reported that 40%-70% or 10%-40% of ICD patients required concomitant antiarrhythmic medication to reduce the frequency of sustained arrhythmic episodes and to minimize the frequency of device discharges. Most studies on antiarrhythmic drug-ICD interactions have been performed in experimental animals. Antiarrhythmic drugs can influence the effectiveness of ICD to terminate arrhythmias through their effects on defibrillation threshold (DFT). Studies have demonstrated a rise in DFTs with class Ib agent lidocaine and class Ic agents encainide and flecainide. Class Ia agents, as well as amiodarone, bretylium and propafenone may have more variable effects on DFT probably because of the difference between acute and chronic drug dosing, dose-related changes, active metabolites, and reproducibility in determining DFT. Class Ⅲ agents, with the exception of amiodarone, consistently decrease DFT. These drugs can be used as front-line agents in ICD patients. CONCLUSIONS Antiarrhythmic drugs can increase, decrease, or have no effect on DFT. Class Ⅲ agents except amiodarone can be safely administered in conjunction with ICD patients as long as the interaction between these therapeutic modalities is appreciated.