2003年 · 第116卷第06期

Objective To investigate the changes of subgroups of peripheral blood T lymphocytes in patients with severe acute respiratory syndrome(SARS)and its clinical significance. Methods Subgroups of blood T lymphocytes in 93 patients with SARS were detected by flow cytometer. The results detected in 64 normal subjects and 50 patients with AIDS served as controls. Results The numbers of CD3+, CD4+, and CD8+ lymphocytes all significantly decreased in acute phase of patients with SARS [(722 ±533)/μl,(438 ±353)/μl,(307 ±217)/μl)] compared with those in normal controls [(1527±470)/μl,(787±257)/μl,(633 ±280)/μl, all P <0. 01)], which was different from what we observed in patients with AIDS who had decreased CD4+ [(296±298)/μl] but increased CD8+ [(818 ±566)/μl ] counts. The counts of CD3+, CD4+, and CD8+ lymphocytes decreased more apparently in patients with severe SARS. All the five patients who died had CD4+ counts less than 200/μl. As the patients' condition improved, CD3+, CD4+, and CD8+ counts gradually returned to normal ranges. Conclusion The damage of cellular immunity is probably an important mechanism of pathogenesis Of SARS. Chin Med J 2003; 116(6):827-830

Objective To study the early X-ray and CT findings of patients with severe acute respiratory syndrome(SARS). Methods Chest radiography and CT were performed in 28 patients with SARS within one to three days after onset of the disease. CT examinations includedt conventional spiral CT and high-resolution CT(HRCT). The radiographic and CT findings of these patients were analyzed retrospectively. Results Abnormal CT findings were noted in all the patients, but abnormal chest radiographic findings in 17 cases(60.7%, 17/28). CT showed single small focal patchy opacities in 23 patients(82.1%, 23/28), including oval ground-glass opacities in 20 patients, lobular distribution ground-glass opacities in 2 and small patchy consolidation in one. Multi-focal ground-glass opacities were found in 2 patients and extensive opacities in three. In the 28 patients, a total of 31 lesions were found in the upper(7, 22.6%), middle(3, 9. 7%), and lower lobes(21, 67.7%). The diameter of the lesions ranged from 20 to 35 mm. Conclusion The dominant feature of early SARS patients is focal patchy opacity in the lung, and oval small ground-glass opacities are the common morphological findings on CT. Chin Med J 2003; 116(6):823-826

Objective To explore the clinical and radiological features of severe acute respiratory syndrome(SARS). Methods Analysis of the clinical presentation, chest radiographs, course of disease and features of severe pneumonia in 45 SARS patients diagnosed at our hospital in Beijing between April 5-20, 2003. Also included is a summation of the clinical features of SARS. Results (1)SARS appears to have high infectivity;(2)the most common symptom is fever;(3)the count of leukocyte is normal or decreased;(4)most patients(35/45, 77.8%)had experienced a 24-hour fever prior to the abnormal chest X-ray changes which showed progression of pulmonary infiltrates within 48 hours in 71.1 %(32/45)of the patients and,(5)the percentage of patients who developed severe pneumonia(24. 4%)is higher than those who developed typical pneumonia. Conclusion SARS is a disease with high infectivity and has its own clinical and radiological features. Early recognition, prompt isolation, and appropriate therapy are the key to combate this infection. Chin Med J 2003; 116(6): 819-822

Objective To describe a hospital outbreak of severe acute respiratory syndrome(SARS)and summarize its clinical features and therapeutic approaches. Methods The outbreak started with a SARS patient from the community, and a total of 96 people(76 women and 20 men, mean age(29. 5 ±10. 3)years, 93. 8% of whom were health care workers)who had exposure to this source patient became infected in a short time. Clinical data in this cohort were collected prospectively as they were identified. Results (1)The incubation period ranged from 1 to 20(mean: 5. 9 ±3. 5)days. The duration of hospitalization was(17. 2 ±8. 0)days.(2)The initial temperature was(38. 3 ±0. 6)℃, while the highest was(39. 2 ±0. 6)℃(P<0. 001), with fever duration of(9. 0 ±4. 2)days.(3)Other most common symptoms included fatigue(93.8%), cough(85. 4%), mild sputum production(66. 7%), chills(55. 2%), headache(39. 6%), general malaise(35. 4%)and myalgia(21. 9%).(4)The radiographic changes were predominantly bilateral in the middle or lower lung zones. The number of affected lung fields was 1. 2 ± 0. 8 on presentation, which increased to 2. 9 ± 1. 4 after admission(P<0. 001). The interval from the beginning of fever to the onset of abnormal chest radiographs was(3. 5±2. 3)days, which increased in size, extent, and severity to the maximum(6. 7±3. 5)days later. The time before the lung opacities were basically absorbed was(14. 9±7.8)days.(5)Leukopenia was observed in 67. 7% of this cohort. The time between the onset of fever and leukopenia was(4. 4 ±2. 3)days, with the lowest white blood cell count of(2. 80 ±0. 72)x 109/L.(6)The lowest arterial oxygen saturation was(94. 8 ± 3. 1)% with supplementary oxygen.(7)Antibiotical therapies included tetracyclines(91. 0%), aminoglycosides(83. 3%), quinolones(79. 2%); 18. 8% of the patients received a combination of tetracyclines and aminoglycosides, while 11. 5% received a combination of tetracyclines and quinolones, and 63. 5% received a combination of tetracyclines, aminoglycosides and quinolones. Vancomycin was used in 13. 5% of the patients.(8)68. 8% of the patients were treated with methylprednisolones for a mean interval of(4. 9 ±2. 4)days. The initial dose was(67. 3 ±28. 2)mg/d and the maximal dose was(82. 4 ±30.5)mg/d.(9)Human y-globulin, interferon-α, antiviral drugs(oral ribavirin or oseltamivir)were used respectively in 68. 6%, 46. 9% and 92. 7% of the patients.(10)Ninety-five patients(99. 0%)had a complete clinical recovery, and only 1 patient(1. 0%)died. Conclusions SARS appears to be quickly infectious and potentially lethal among health care workers, characterized by acute onset and rapid progression, and mostly bilateral lung involvement on chest radiographs. Proper administration of glucocorticosteroids seems to be of some benefits. Antibiotics, human γ-globulin, interferon-α, and antiviral drugs, although empirically, might be useful to shorten the clinical course. Chin Med J 2003; 116(6):811-818

Objective To summarize the clinical features of severe acute respiratory syndrome(SARS)and to discuss diagnosis and management of the disease. Methods A retrospective study was conducted on 78 cases of SARS referred to the Guangzhou Institute of Respiratory features of severe acute respiratory syndrome(SARS)and to discuss diagnosis and management of the disease. Methods A retrospective study was conducted on 78 cases of SARS referred to the Guangzhou 2003. Items reviewed cover all Institute of Respiratory Diseases(GIRD)between December 22, 2002 and near the end of March 2003. Items reviewed cover all data concerning clinical manifestations, laboratory investigation and radiology. Results The patients in the study consisted of 42 males and 36 females, aged 20-75 yrs(mean age 37. 5 ±11.6 yrs), including 44 affected health-care professionals. Clinical symptoms seen in the group were fever(100.0%), cough(88.5%), and dyspnea(79.5%).There were 12cases(15.3%)with WBCs <4.0 × 109/L,49 cases(62.8%)ranging between(4.0-10.0)x109/L(neutrophil)and 17 cases(21.8%)over 10.0 × 109/L. The average was(7.58±4.96)x109/L, with 0. 75 ±0.14(neutrophil)and 0.18 ±0.11(lymphocyte).Cheste films and CT scanning revealed changes related to pneumonia.The transmissin of the disease was likely via close contact with contagious drople.The prevalences of acute lung injury(ALI,in 37cases)and acute resplratory distress syndro developed me(ARDS, 21 out of 37 cases)were considerably high among the patients. Seven patients who developed ARDS complicated with multipe organs dysfunction sydrome(MODS)died. Conclusions A history of close contact, fever, sign of pneumonia by X-ray and normal-to-lowered WBC counts are favorable for the diagnosis of SARS. Recognition of ALI as the important index for critical SARS and comprehensive supportive management are of paramount in decreasing the mortality of the disease.Chin Med J 2003; 116(6):805-810

Severe Acute Respiratory Syndrome(SARS), referred to as "contagious atypical pneumonia"is the fastest spreading communicable disease known in recent history. This disease is different from other kinds of respiratory contagion due to the following aspects: the syndrome happens quickly and the infectivity is high. New problems encountered by the nursing management staff are the precipitate, pestiferous, and large numbers of in-patients and the understanding of appropriate responses, within large complex hospitals, to ensure patient care is actively supported and infectivity is prevented. To deal with these problems, we implemented the following strategies: reinforcement of the management system; optimization of the nursing flow; amendments to related hospital policies; collection of relevant information; adherence to stringent disinfection protocols; isolation of areas; reallocation of hospital resources and more efficient utilization of resources. The above strategies have reinforced the nursing management system's active response, guaranteed daily operation of the hospital's nursing activities, including the quality of care provided by the nurses, and ensured the health of patients, nurses and doctors. Chin Med J 2003; 116(6):834-837

Objective To explore on the immunity of live attenuated Japanese Encephalitis(JE)vaccine(SA14-14-2)to different wild JE virus(JEV)strains. Methods The neutralizing effect of the vaccine against different wild JE virus strains was detected by plaque reduction neutralization test(PRNT), and the immunogenicity was studied on mice by vaccination-challenge protection test. In the PRNT, pooled sera from vaccinated human were tested against 10 strains of JEV, one isolated in Taiwan and 9 from other Asian countries. In the vaccination challenge test, mice received one dose of the live vaccine subcutaneously and were challenged intraperitoneally 14 days later against 22 JEV virus strains, 11 were isolated in China and the other 11 from Tailand, Vietnahailam, Indonesia, India, Philippines and Japan. Results The protection rates to all the 22 challenge virus were 90%-100% when 340 PFU/0. 1 ml vaccinate virus was administered. The neutralizing effect showed that all the JEV isolates many have neutralized by the sera. Conclusion SA14-14-2 live attenuated prepared with strain SA14-14-2 is broadly immunogenic and may have effective protection against in Asian JE affected countries. Chin Med J 2003; 116(6):941-943

Objective To study the clinical value of a new MRI compatible percutaneous bone biopsy system. Methods Twenty-six patients with bone lesions MRI-guided biopsies underwent using a 0. 23-T open MR system combined with an iPath-200 optical leading system. Results Of the 26 biopsies, 23 samples were sufficient for histological examination and the histopathologic diagnoses were confirmed. In the high-risk areas like spine, the biopsies were successfully done in 11 patients. No procedural complications occurred. Conclusion Percutaneous biopsy of bone lesions performed under MRI-guidance in an iPath system was proved to be accurate and safe. Chin Med J 2003; 116(6): 937-940

Objective To study the mechanism of the cellular proteins involved in the process of replication of hepatitis C virus(HCV)negative-strand RNA. Methods Ultraviolet(UV)cross-linking was used to identify the cellular proteins that would bind to the 3'-end of HCV negative-strand RNA. Competition experiment was used to confirm the specificity of this binding, in which excess nonhomologous protein and RNA transcripts were used as competitors. The required binding sequence was determined by mapping, then the binding site was predicted through secondary structure analysis. Results A cellular protein of 45 kD(p45)was found to bind specifically to the 3'-end of HCV negative-strand RNA by UV cross-linking, nhomologous proteins and RNA transcripts could not compete out this binding, whereas the unlabeled 3'-end of HCV negative-strand RNA could. Mapping of the protein-binding site suggested that the 3 '-end 131-278nt of HCV negative-strand RNA was the possible protein-binding region. Analysis of RNA secondary structure presumed that the potential binding site was located at 194-GAAAGAAC-201. Conclusion The cellular protein p45 could specifically bind to the secondary structure of the 3'-end of HCV intermediate negative-strand RNA, and may play an important role in HCV RNA replication. Chin Med J 2003; 116(6):932-936

Objective To obtain the nucleotide sequence and deduced amino acid sequence of cholesteryl ester transfer protein(CETP)cDNA from the tree shrew(Tupaia glis). Methods The cDNA sequence of the tree shrew CETP was obtained by utilizing the technique of switching mechanism at 5 ' end of RNA transcript(SMART)and rapid amplification of cDNA end(RACE)from the first strand of the cDNA. The amino acid sequence of CETP was deduced from the cDNA sequence and its primary and secondary structures were predicted. Results The sequence of CETP cDNA from tree shrew(GenBank accession number AF334033)covers 1636 bp, including 178 bp at the 3' end of the untranslated region and a 1458 bp fragment in a coding region, which provides the complete sequence of mature tree shrew CETP, although not the initiator methionine. The first 24 bp encodes a partial signal peptide. The mature protein consists of 477 amino acids and is longer than the human version by one amino acid(Gly318). Comparing this amino acid sequence with those of other animals' CETPs, the identity between tree shrew and human and rabbit CETP is 88% and 82%, respectively. The protein is extremely hydrophobic as it contains many hydrophobic residues, especially at the C-terminal, consistent with its function in the transfer of neutral lipids. The amino acid residues concerning with binding and transferring neutral lipids are highly conserved. There is a deletion of an N-linked glycosylation site at Asn342 in the tree shrew CETP protein that may participate in the removal of peripheral cholesterol and cholesteryl ester by increasing its activity of transferring cholesteryl ester. Conclusion The possible glycosylation in the tree shrew CETP may be involved in the molecular mechanism of its insusceptibility to atherosclerosis. Chin Med J 2003; 116(6):928-931

Objective To investigate the effects of fosinopril and valsartan on the expression of intercellular adhesion molecule-1(ICAM-1)and nitric oxide(NO)induced by oxidized low-density lipoprotein(ox-LDL)in human umbilical vein endothelial cells. Methods The levels of NO, ICAM-1, and nitric oxide synthase(NOS)were determined using the nitrate reductase method, ELISA, immunohistochemical and image analyses. Results The ox-LDL can significantly increase the expression of ICAM-1 and inhibit the expression of NO and NOS in a dose-dependent manner. Fosinopril and valsartan can significantly inhibit these roles of ox-LDL. The roles of fosinopril and valsartan were not significantly different. Conclusion Fosinopril and valsartan inhibit oxidized LDL-induced expression of ICAM-1 and increase the expression of NO in human umbilical vein endothelial cells, which is one of the mechanisms of antiatherosclerosis. Chin Med J 2003; 116(6):923-927

Objective To discover and identify differentially expressed genes associated with colorectal adenoma formation and the role of RegIV in colorectal adenoma differentiation. Methods A subtracted cDNA library was constructed with cDNAs that were isolated from either the normal mucosa or adenoma tissue of a single patient. Suppressive subtractive hybridization(SSH)combined with virtual northern blotting was used to characterize differentially expressed genes and contigs were assembled by electronic cloning(in silico cloning)with the EST database. Semiquantitative RT-PCR was performed in 9 colorectal adenomas. Results The amino acid sequence was determined with open reading frame(ORF)prediction software and was found to be 100% homologous to the protein product of Reg IV(a novel gene isolated from a large inflammatory bowel disease library). RegIV was found to be highly expressed in all of the adenoma samples(9/9)compared with the normal mucosa samples, while 5/6 cases showed RegIV to be more strongly expressed in adenocarcinoma. Conclusion RegIV may play an important role in the initiation of colorectal adenoma differentiation, and its detection may be useful in the early diagnosis of colorectal adenoma formation. Chin Med J 2003; 116(6):918-922

Objectives To investigate the immunophenotypes of primary nasopharyngeal non-Hodgkin lymphoma(NPL)and their relationship to Epstein-Barr virus(EBV)infection. Methods The clinical data and biopsies of 73 patients with NPL were collected in Guangzhou. In situ hybridization was performed to detect the EBV-encoded small non-polyadenylated nuclear RNAs(EBERs)on biopsy slides. Immunohistochemistry was used to classify the immunophenotypes of NPL and detect EBV antigen expression. Results Forty-four(60. 27%)of the 73 NPLs were of B cell lineage(CD79α+ /CD3-/CD56-)while the 29 others(39. 73%)were of non-B cell lineage. Seventy-three NPLs could be classified into 3 major immunophenotypes: B cell(CD79α+ /CD3-/CD56-, 44 cases), peripheral T cell(CD79α-/CD3+/CD56-, 22)and NK/T cell(CD79α_/CD3+/CD56+, 7). The percentages of EBV infection differed among the 3 major immunophenotypes(B cell: 11. 36%, 5/44; peripheral T cell: 81. 82%, 18/22; NK/T cell: 100%, 7/7). Both CD56- positive and CD56- negative immunophenotypes could further be divided into 4 subtypes: CD8-/CD4-, CD8+/CD4-, CD8-/CD4+ and CD8+/CD4+. All the CD8-/CD4- NPLs with CD56-positivity(7)or CD56-negativity(2)were infected with EBV. The neoplastic cells of a nasopharyngeal Burkitt' s lymphoma expressed EBV nuclear antigen 1(EBNA1)and EBV RNA(EBERs)only. In the other 29 EBV-infected NPLs, most of the lymphoma cells harboring EBV also expressed EBNA1 and EBERs; 21 of the 29 NPLs had a considerable number of neoplastic cells expressing latent membrane protein 1(LMP1)(21/29, 72. 41 %)and 23 of 29 NPLs expressed latent membrane protein 2A(LMP2A)(23/29, 79. 31%). A few lymphoma cells in 17(17/29, 58. 62%), 23(23/29, 79. 31 %)and 22 NPLs(22/29, 75. 86%)expressed Zta(Bam HI Z transactivator), viral capsid antigen(VGA)and membrane antigen(MA), respectively. Conclusions The prevalence ratio of the 3 immunophenotypes, namely, B cell, peripheral T cell and NK/T cell lymphoma, is about 6:3:1. However, the EBV infection ratio is reversed, 1:8:10. All the NK/T cell(CD56+)and peripheral immature T cell(CD3+/CD8-/CD4-)NPLs were EBV-infected. Except for one Burkitt' s lymphoma, the EBV harbored in both B cell and non-B cell NPLs was mainly latent infection, type Ⅱ, expressing EBNA1, LMP1 and LMP2A. However, the EBV found in a few lymphoma cells could become replicative, expressing lytic proteins. Chin Med J 2003; 116(6):913-917

Objective To assess the effects of both TrkA and p75NTR on nerve growth factor(NGF)-induced differentiation of neuroblastoma cells. Methods Retroviral vectors were constructed to express the high affinity NGF receptor(TrkA)and low affinity NGF receptor(p75NTR). Neuroblastoma cell line IMR-32 was transfected by the vectors expressing either TrkA or p75 NTR or both by using lipofectmineT™ reagent separately or cotransfected at the same time. Southern blot, Northern blot, RT-PCR and flow cytometry were used to determine the success of the transfection. MTT technique was to monitor the cell proliferation. Colony formation in soft agar and tumor forming assay in nude mice were used to test the biological characteristics of the tumor cells. Terminal-deoxynucleotidytransferase-mediated dUTP-biotin nick end labeling(TUNEL)assay was used to test the apoptosis of the tumor cells. Results Stable transformant cell lines expressing TrkA, p75NTR or both genes were established. Studies on these transformant cell lines have shown different NGF responses. The p75NTR transfection only resulted in the mild differentiation response, and transfection of TrkA gene caused remarkable neurite extension, up-regulation of neurofilament and decreased expression of N-myc oncogene after NGF treatment. The cotransfection of the two genes into this cell line resulted in the more rapid and more apparent morphological changes than single TrkA transfected cells after NGF treatment. The cotransfected cells underwent apoptosis after withdrawal of NGF. Conclusions The results indicate that coexpression of both low-and high-affinity NGF receptors are not only more efficient in restoration of NGF-induced differentiation pathway, but also be able to activate the pro-apoptotic activity of low-affinity NGF receptor and make the tumor cells become NGF-dependent and irreversibly differentiated. Chin Med J 2003; 116(6):906-912

Objective To reveal the role of Phosphatidylinositol 3-kinases(P13Ks)in regulating human diploid fibroblast(2BS cell)senescence as well as the possible mechanisms involved. Methods Using a PI3Ks specific inhibitor, LY294002, cell cycle, apoptosis, proliferation, senescence association β-galactosidase staining as well as senescence association CKIs, p16INK4 and p21 Cip1 protein expressions were all measured in the low passages of 2BS cells. Results Both 25 μmol/L and 50 μmol/L concentrations of LY294002 could cause a significant decrease in cells entering into S phase, and this cell cycle of G1 phase arrest was dose-dependent. Meanwhile, LY294002 contributed to apoptosis, caused 2BS cell growth arrest, and activated senescence association β-galactosidase(P<0. 05). In addition, LY294002 could induce time-course expressions of p16INK4 and p21 Cip1 in 2BS cell lines. Conclusions PI3Ks inhibitor LY294002 could induce senescence-like changes in 2BS cell lines. Two senescence associated CKIs, p16INK4 and p21Cip1, might be involved in this senescence phenotype proceeding in 2BS cell lines. Chin Med J 2003; 116(6): 901-905

Objective To determine at the mRNA level whether the MAGE-A1 and-A3 genes are expressed in cancer cell lines from salivary glands and relevant clinical carcinomas, and thus to distinguish cancerous tissues from normal tissues and benign tumors in salivary glands. Methods The expression of the MEGE-A1 and MEGE-A3 genes at the mRNA level was determined by reverse transcription and polymerase chain reaction(RT-PCR)in 2 cell lines of human adenoid cyst carcinomas(ACC-2 and ACC-M), in 18 malignant tumors and 9 benign salivary gland tumors, and in 10 samples of normal salivary gland tissues. Results Both MAGE-A1 and-A3 genes were expressed in ACC-2 and ACC-M cell lines. None of the 9 benign tumors or the 10 normal tissue samples of salivary glands expressed the genes. The MAGE-A1 and-A3 genes were expressed in 9(50%)and 11(61%)of 18 salivary gland carcinomas, respectively, and at least 1 of the 2 genes was expressed in 14(78 %)of them. Of the 18 salivary gland carcinomas, 6 low-differentiated carcinomas(33%)expressed both genes, whereas 4 high-differentiated carcinomas(22%)expressed neither gene. Conclusions The MAGE-A1 and-A3 genes can be expressed in cancer cell lines of salivary glands and relevant clinical carcinomas in addition to other malignant tumors of various histological origins. The results suggest the possibility of immunotherapy against salivary gland carcinomas by using MAGE-gene-encoded products as target antigens for tumor-rejection. Chin Med J 2003; 116(6): 897-900

Objective To establish hybridomas that produce anti-death receptor-5(DR5)monoclonal antibodies(mAbs)and check the surface expression of DR5(sDR5)on cell lines. Methods The cDNA of human DR5 was cloned into pGAPZa. Recombinant Pichia pastoris clones generated via homologous recombination secreted high levels of sDR5. The sDR5 was purified using a nickel ion column. BALB/c mice were immunized with sDR5 and spleen cells were fused with the SP2/0-Ag 14. Monoclonal antibodies were tested by ELISA for their abilities binding to sDR5 and by flow cytometry for the reactivities to surface DR5 of Jurkat cells. Surface expression of the TRAIL receptor was determined by flow cytometric analysis measuring the binding of anti-DR5 mAb. Results Isotypes of mAbs were determined to be IgG1 and IgM, all of which were reactive to sDR5 as observed through ELISA. It was discovered using flow cytometry that only IgG was able to bind to DR5 on the plasma membrane of Jurkat cells. sDR5 was found to completely inhibit anti-DR5 mAb binding to Jurkat cells. Approximately 95% of Jurkat cells, 98% SW480, 99% U937, 100% U87, 86% HCT116, 64% HL-60, 47% HeLa and 13% K562 cells express membrane DR5. Conclusions These results demonstrate that anti-DR5 mAb is able to specifically bind to DR5 and that DR5 is expressed at high levels on Jurkat, SW480, U87, U937 and HCT116 cell lines, and at medium levels on HL-60 and HeLa cell lines. The expression of DR5 on K562 cell line is low. Chin Med J 2003; 116(6): 947-950

Objective To investigate the effects of p57kip2 and cyclinE proteins on the genesis and progression of human pancreatic cancer. Methods The expression of p57kip2 and cyclinE proteins in tumor tissues and adjacent tissues of pancreatic cancer in 32 patients was detected by SP immunohistochemical technique. Results The p57kip2 protein positive-expression rate in tumor tissues of pancreatic cancer was 46. 9%, which was lower than that in adjacent pancreatic tissue(P < 0. 05). The p57kip2 protein positive-expression correlated significantly with tumor cell differentiation(P < 0. 05)and did not correlate significantly with lymph node metastasis(P>0. 05). The cyclinE positive-expression rate in tumor tissues was 68. 8%, which was higher than that in adjacent pancreatic tissues(P <0. 05). The cyclinE positive-expression also correlated significantly with tumor cell differentiation and lymph node metastasis(P<0. 05). The cyclinE protein positive-expression rate in the tumor tissues of the p57kip2 protein positive-expression group was lower than that in the p57kip2 protein negative-expression group, and there were no significant correlation between the two groups(r=-0.112, P>0. 05). Conclusion Decreased expression of the p57kip2 protein and/or over-expression of the cyclinE protein may play an important role in the genesis and progression of human pancreatic cancer. Chin Med J 2003; 116(6): 944-946