1996年 · 第109卷第02期

OBJECTIVE Acute focal bacterial nephritis (AFBN) or acute lobar nephronia represents an acute localized non-liquefactive infection of the kidney caused by bacterial infection. The main manifestations consist of fever, chills, abdominal pain, flank pain, and tenderness and percussion pain of the costoverbral angles. Ultrasound and CT examinations identify the renal parenchymal space-occupying lesion which may resemble renal abscess or carcinoma. The clinical symptoms and the renal mass disappear following anti-infection treatment. METHODS AND RESULTS Between January 1985 and May 1994, we treated 15 patients with AFBN, 10 men and five women, aged 16-56 years with an average of 30 years. The left kidneys in 11 patients and the right kidneys in four were affected. All of the patients presented a fever and persistent flank pain on affected side. Ultrasound showed local enlarged renal volume and space-occupying masses with low level echoes. CT scans demonstrated focal enlargement of affected kidneys and low-density solid space-occupying lesions. CT reconstructions showed wedge-shaped masses. 14 patients responded to appropriate parenteral antibiotics. The inflammatory masses diminished gradually in about 4 weeks. CONCLUSIONS We believe that acute focal bacterial nephritis should be strongly suspected when a patient presents fever, chills and pain on the affected side and has a history of urinary tract infection. In addition, ultrasound and CT examinations suggest evidence of parenchymal space-occupying lesion, and the renal mass and its clinical symptoms disappear following anti-infection treatment.

OBJECTIVE To study the relationship between chondroitin sulfate proteoglycan (CSPG) and coronary atherosclerosis in youth. MATERIAL AND METHODS Immunohistochemistry of chondroitin sulfate proteoglycan and SM-α-actin was performed on 39 human coronary arteries, including normal vessels and vessels with fatty streaks, intermediate lesions and plaques. Some of the lesional vessels were taken for β-lipoprotein immunohistochemical study. CSPG contents were quantitated by image analyzer and the coronary arteries from one heart were processed for immunoelectron microscopy. RESULTS The range of CSPG distribution was extensive and CSPG area density was increased significantly in the intima with atherosclerotic lesions. The increase of CSPG was parallel to the numbers of smooth muscle cell (SMC) with positive SM-α-actin reaction and was likely related to the phenotype transformation of SMC. Similar distribution of β-lipoprotein and CSPG were found within the lesional regions. CONCLUSIONS The increase of CSPG in atherosclerotic lesion may be an important factor resulting in the deposition of lipids in the vascular wall so as to promote the formation and development of atherosclerosis.

OBJECTIVE To examine whether high energy shock waves (HESW) can inhibit tumor growth in vivo and whether it can promote the metastasis of the heterografted tumors of nude mice. MATERIALS AND METHODS Observations were made on the effect of HESW on tumor growth, histological and ultrastructural (transmission electron microscope, TEM) variations and metastasis to lymph nodes and viscera in the nude mice with heterografted tumors. The Dornier HM3 lithotripter was used under the working voltage of 15 kV, the impulse number being 0, 400 and 800 respectively, the temperature of waterbath, 35-37 ℃ and the impulse rate, 60/min. RESULTS HESW did have cytotoxic effect on tumors in vivo, including acute and chronic lethal effects and growth inhibitory effect, and it could act on levels of cell membrane, cytoplasmic organelles and nuclear chromatin. At a definite working voltage, this effect was positively proportional to the impulse number. The action mechanism of HESW in vivo might be direct mechanical damage and indirect inhibition of tumor growth as a result of causing damage to the blood supply. Histological examination showed no metastatic foci to the lymph nodes and viscera of the nude mice with the heterografted tumors. CONCLUSIONS HESW do inhibit tumor growth in vivo, but temporarily. This observation showed no tumor metastasis in the nude mice after the impulsion of HESW, but further studies on this topic are needed. It can be predicted that HESW will become a clinical method to treat the tumors after further investigation on its mechanism of action.

OBJECTIVE To evaluate the efficacy and safety of selective arterial embolization in the management of internal bleeding caused by trophoblastic diseases. PATIENTS AND METHODS Four patients with internal bleeding caused by trophoblastic diseases were diagnosed with arteriography and treated with selective arterial embolization as a life-saving measure. Effect of controlling bleeding was assessed by follow-up arteriogram and clinical observation. RESULTS The embolization successfully controlled the bleeding in all patients. Operation time was short with a mean of 42 minutes. The shock was corrected dramatically. Fever and pain were common complications. CONCLUSIONS Selective arterial embolization is a life-saving measure in the management of internal bleeding caused by trophoblastic diseases.

OBJECTIVE To detect the redox tolerance index (RTI) for hepatic energy reserve. PATIENTS AND METHODS 27 patients with chronic active hepatitis B (CAH) and 34 patients with post-hepatitis B liver cirrhosis (LC) were studied. RESULTS The RTI was significantly lower in CAH and LC cases than in normal controls (P<0.01). There was no difference between CAH and LC. The RTI of decompensated LC was significantly lower than that of the compensated LC (P<0.05), indicating that there was no correlation between RTI and the parameters of routine liver functions. CONCLUSION It is suggested that the RTI based on redox theory is effective and accurate in predicting hepatic energy reserve.

OBJECTIVE To investigate the effects of gypenosides (Gs) on cellular immunocompetence in the γ-ray-irradiated mice. MATERIALS AND METHODS Tested mice of ICR strain were treated continuously with Gs for 10 days before or after 4 Gy γ-irradiation. Body weight and splenic weight of mice were measured. The blastogenic response of splenocytes to mitogens, such as PHA, Con A and LPS were also detected. The cellular immunocompetence was measured by 3H-thymidine incorporation in each tested mouse. RESULTS Body weight as well as splenic weight decreased in γ-ray-irradiated mice. The blastogenic responses of splenocytes to mitogens were inhibited after γ-ray irradiation. To treat with Gs was effective to enhance the recovery of body weight, splenic weight and immunocompetence in γ-ray-irradiated mice from radiation damage. CONCLUSIONS Four Gy γ-ray irradiation could decrease splenic weight and cellular immunocompetence of mice. Gs could help the recovery of the splenic weight and cellular immunocompetence in γ-ray-irradiated mice.

OBJECTIVE To investigate the effects of glycyrrhizae (GL) and glycyrrhizic acid (GA) on cellular immunocompetence in the γ-ray-irradiated mice. MATRIALS AND METHODS Tested mice of ICR strain were treated with GL and GA for 10 days continuously after 4 Gy γ-irradiation. The counts of total leukocytes, lymphocytes, neutrophils and monocytes in peripheral blood of mice were measured. The blastogenic responses of splenocytes to mitogens, such as PHA, PWM, Con A and LPS were also detected. The cellular immunocompetence was measured by 3H-thymidine incorporation in each tested mouse. RESULTS The leukocytes and their differential counts decreased in γ-irradiated mice. The blastogenic responses of splenocytes to mitogens were inhibited by γ-ray irradiation. GL and GA were effective in enhancing the recovery of leukocyte count and the blastogenic responses of splenocytes to mitogens, such as PHA, PWM, Con A and LPS from the inhibition of 4 Gy γ-irradiation. CONCLUSIONS Four Gy γ-ray irradiation can decrease leukocytes and their differential counts, and the blastogenic responses of splenocytes of mice. GL and GA can help the recovery of the cellular immunocompetence in the γ-irradiated mice.

OBJECTIVE Giant cell tumor of bone (GCT) is a comparatively common bone tumor in Chinese. Though GCT is generally considered as a benign tumor, it can pursue an aggressive course. The present study attempts to clarify whether the flow cytometric study can be an useful tool for prognosis of GCT patients. METHODS DNA content and cell cycle studies on 96 pathologically confirmed GCT specimens and anti-GCT monoclonal antibody (GCF-5 McAb) labeling study on 30 GCTs were made by flow cytometry. RESULTS 29 GCTs (30.2%) exhibited aneuploid and 67 (69.8%) diploid. Of 71 primary tumors, 16 (22.5%) exhibited aneuploid. The DNA index was 0.97+0.15, and the average S, G2/M phase cells 15.23+6.15%. Of 25 recurrent tumors, 13 (52%) were aneuploid, with an average DI of 1.08+0.17. The average S, G2/M phase cells was 19.56+7.12%. Between the primary and recurrent tumor groups, there was significant statistical difference both in S, G2/M phase cell percentage (P<0.05) and DNA content (P<0.01). There was no significant difference between Jaffe's grade I and grade II groups in DNA content or in S, G2/M phase cell percentage. GCF-5 McAb could combine with almost all cells of S, G2/M phase and part of the cells in G0/G1 phase. Significant relationship existed (r=0.468, P<0.05) between the percentages of S, G2/M phase cells and GCF-5 positive cells. Between the primary and the recurrent tumor groups, there was a significant difference in the percentage of both S, G2/M phase cells and GCF-5 positive cells. CONCLUSIONS Apparently flow cytometric study is of value in the evaluation of the biological behavior of GCT as well as the prognosis of the patients.