1996年 · 第109卷第06期

OBJECTIVE To study the expression and clinical significance of hepatitis C virus (HCV) antigens in liver tissues of patients with liver disease. PATIENTS AND METHODS Hepatitis C virus antigen in paraffin-embedded liver tissues was detected by immunohistochemical method using polyclonal anti-HCV and monoclonal anti-HCV NS3. RESULTS Among the 252 liver tissues, 25 (9.92%) were positive for HCAg (detected with polyclonal anti-HCV), and 19 (7.74%) were positive for HCV-NS3 (detected with monoclonal anti-HCV-NS3). All of the 19 HCV NS3 positive tissues were also positive for HCAg. Their distribution in liver tissue was similar, locating in the cytoplasm of liver cells. In most tissues, the positive cells scattered in liver lobulus, without obvious approach to the necrosis and infiltration aggregation; while a few samples showed positive cells clustered or diffused, with some necrosis or/and inflammatory infiltration. Of the 252 sera samples, 71 had HCV antibody or/and HCV RNA, showing a good correlation between HCV antigen in liver tissues and HCV marker in sera, but the detection rate of HCV antigen in liver tissues was much lower than that of HCV markers in sera. Two cases had HCV antigen in their liver with no HCV markers in their sera. CONCLUSIONS Stored paraffin-embedded liver tissue can be used in the study of the immunopathology of HCV: no definite relationship between the expression of HCV antigens and liver damage has been found. Further study of the pathogenesis of HCV is needed.

OBJECTIVE To evaluate the relationship between acupuncture and cardiopulmonary function in healthy people. SUBJECTS AND METHODS Healthy male volunteers were divided into 3 groups, 16 of persons each Group 1 was treated with acupuncture at points Neiguan (PC6) and Zusanli (ST36): Group 2 was treated with acupuncture at non-acupoints, and Group 3 was taken as control. The effects of resting cardiopulmonary functions were measured with gas analysis system. The resting heart rate (HR), oxygen consumption (VO2), and carbon dioxide production (VCO2) were recorded over a thirty-minute period at intervals of five minutes, 15 minutes, and 25 minutes. Electroacupuncture was given to Groups 1 and 2. The analysis of variance and t test were used in data analysis. RESULTS In the acupuncture groups, resting heart rate and carbon dioxide production decreased (P<0.05) and oxygen consumption also decreased slightly, although it was statistically insignificant (P>0.05). CONCLUSION Our results indicate that acupuncture can decrease the resting heart rate and carbon dioxide production, thus lowering the metabolic rate.

OBJECTIVE To study the effects of thevetoside (TS), a cardiac glycoside, and an inhibitor of Na+, K+-ATPase, on tumor cells cultured in vitro. METHODS The cytotoxic effects of TS on tumor cells were determined by trypan blue dye exclusion, neutral red vital staining and clonogenic assay. The time-effect relationship and growth inhibition of tumor cells by TS were assayed with trypan blue exclusion method. RESULTS TS at low doses (0.005-0.1 mg·L-1), with dose dependence, was able to kill SMMC-7721, SGC-7901 and HeLa cells. IC50 values for SMMC-7721, SGC-7901 and HeLa cells were 0.007, 0.011 and 0.018 mg·L-1 by trypan blue dye exclusion test and 0.016, 0.055 and 0.078 mg·L-1 by neutral red vital staining test. TS inhibited the clonal forming rate of SMMC-7721 and SGC-7901 significantly with IC50 values of 0.021 and 0.036 mg·L-1, respectively. Only when the cells were continuously treated with TS for more than 8 hours, the drug-induced cell lethality could be displayed and strengthened quickly. The growth of tumor cells was notably inhibited after they were exposed to 0.1 μg/ml of TS for 12 hours. All the experimental results of antitumor activity in vitro showed that SMMC-7721 was most sensitive to TS among the three kinds of tumor cells. CONCLUSIONS TS has cytotoxic action on tumor cells cultured in vitro and this lethal effect must have an action process, in which tumor cells are not dead but suffer from deadly injury and lost the capability of unlimited proliferation.

OBJECTIVE To clarify whether there is an association of insulin-dependent diabetes mellitus (IDDM) susceptibility with HLA-DQA1 locus in adult-onset IDDM. PATIENTS AND METHODS Possible heterogeneity in immunogenetic aspects was investigated by comparing the findings on relationship between HLA-DQA1 52 Arg(+) and IDDM predisposition in three groups with different ages of IDDM onset (group A 14 years, group B 15-30 years, group C>31 years). RESULTS The frequency of HLA-DQA1 52 Arg(+) in group A (87.5%) was higher than that in control (53.9%, P<0.05) and in group B and C (P<0.05). The frequency of HLA-DQA1 52 Arg(+)/Arg(+) phenotype in group A (75%) was higher than that in group C (23.1%, P<0.05). CONCLUSIONS The contribution of HLA-DQA1 52 arginine to IDDM susceptibility is heterogeneous. Further study is necessary to clarify the immunogenetic entity of IDDM.

OBJECTIVE To set forth the methods of diagnosis and treatment of nephrotic syndrome during pregnancy (NSP) so as to decrease perinatal mortality. MATERIALS AND METHODS Forty cases of NSP including 5 twins in Tianjin Central Hospital of Obstetrics and Gynecology in the past 13 years have been reviewed, and the diagnosis and treatment were compared between group A (1979-1990, 23 cases) and group B (1991-1992, 17 cases). RESULTS NSP occurred before the 20th gestational week in 15% of cases and the patient's condition was serious. Clinically, NSP was classified into three types: simple, nephritis and pregnancy induced hypertension (PIH) type. The perinatal maternal and fetal prognosis was poor. Complications occurred in 27.5% of patients. One patient died from eclampsia and disseminated intravascular coagulation (DIC). The total perinatal mortality was 42.22%, with group A (27 babies including 4 twins), 51.86% (14/27), and group B (18 babies including 1 twin), 27.78% (5/18) (P<0.01). CONCLUSIONS NSP is a result of reproductive immunology and belongs to type III allergic reaction in terms of immunology. Early diagnosis, early treatment and timely termination of pregnancy may improve the outcome.

OBJECTIVE To investigate the effects of methotrexate (MTX) and platelet activating factor (PAF) antagonist ginkgolide B (BN52021) on PAF induced chemotaxis of neutrophils. METHODS All guinea pigs were randomly divided into 12 groups. They were given different dosages of MTX and BN52021 by intra-abdominal injections. The random and chemotactic migration of polymorphonuclear leukocytes (PMNs) were measured by the agarose method. The backs of all guinea pigs were given intradermal injections of PAF and the numbers of the infiltration of inflammatory cells into the skin were determined. RESULTS MTX inhibited random migration and chemotactic migration of PMNs to PAF, LTB4 and PAF-induced intraepidermal accumulation of inflammatory cells in dose- and time-dependent fashion. BN52021 specially inhibited PAF-induced chemotaxis of PMNs and intraepidermal accumulation of inflammatory cells, but did not inhibit PMNs random migration and LTB4-induced chemotaxis of PMNs. CONCLUSIONS The inhibition of PMNs activities may be part of the mechanism of MTX therapy for psoriasis; BN52021 is a selective inhibitor of PAF-induced chemotaxis of PMNs, and therefore can be useful in the treatment of some inflammatory dermatoses such as psoriasis.

OBJECTIVE To examine the effect of selective head cooling (SHC) on brain cell membrane activity involving ATPase, phospholipase A2, content of total membrane phospholipids during postischemic reperfusion, so as to elucidate the possible underlying mechanism on resuscitating effect of SHC. MATERIALS AND METHODS Complete cerebral ischemia (CCI) was induced by the four-vessel model. 56 New Zealand rabbits were allocated randomly into two groups, non-ischemic control group had 30, 180 and 360 minutes reperfusion after CCI (n=8); and SHC group with the same ischemic-reperfusion insult were all treated with SHC (28 degrees C, surface cooling method). Changes of Na+, K+-ATPase, Ca2+, Mg2+-ATPase, phospholipase A2, total phospholipids of brain cell membrane were observed. Comparison of data between two groups was made by Students' t test. RESULTS Compared with non-ischemic controls following 30 minutes CCI, activities of Na+, K+-ATPase stepwisely decreased at 30, 180 and 360 minutes, Ca2+, Mg2+-ATPase dropped at 180 and 360 minutes, phospholipidase A2 increased markedly at 30, 180, 360 minutes, and total phospholipids decreased at 180 and 360 minutes reperfusion (P<0.01). Selective head cooling inhibited all the above changes significantly (P<0.01). CONCLUSIONS The results suggest that selective head cooling initiated soon after reperfusion is beneficial for brain cell membrane function recruitment, which provides favourable effects on the damaged but still remediable brain cells for their resuscitation.

OBJECTIVE To investigate the exercise hemodynamic benefits of activity-sensing rate adaptive ventricular pacing (VVIR) over fixed rate pacing (VVI) mode. METHODS Activity sensing rate adaptive pacemaker was implanted in 19 patients (13 males and 6 females, mean age 54.8 years) with bradycardia. All patients underwent symptom-limited upright bicycle exercise in VVIR and VVI pacing modes in random order after implantation. With electrocardiogram monitor and M-mode echocardiography, heart rate, stroke volume and cardiac output were measured at rest and at each stage of exercise. RESULTS All patients were pacemaker dependent, without any spontaneous heart rhythm throughout this study. In the activity sensing ventricular pacing mode, all patients achieved a significant increase in exercise duration compared to fixed rate ventricular pacing mode (mean±s, 437±45 vs 323±23sec; P<0.01), with a mean maximum pacing rate of 113±23ppm. Although the cardiac output was significantly improved in both pacing modes (10.2±1.4L/min with VVIR and 7.5±1.1L/min with VVI), the maximum exercise cardiac output in VVIR was increased over VVI by 46% (P<0.05). Additionally, the stroke volume was significantly increased by 50% or more at rest in VVI mode, but was relatively maintained in VVIR mode (P>0.05). CONCLUSIONS Rate adaptive ventricular pacing can significantly improve the exercise capacity and cardiac output in patients with bradycardia. The increment of exercise cardiac output in VVIR mode is mainly dependent upon the pacing rate during exercise.

OBJECTIVE To determine if a relationship exists between the extent of iron-catalyzed injury and the degree of tissue iron overload during reperfusion. METHODS To selectively increase tissue iron only during early reperfusion, isolated, buffer perfused rabbit hearts were exposed to 20 μM Fe2+-100 μM ADP during the last 3 minutes of ischemia and the initial 4 minutes of reperfusion. Control groups were exposed to ADP and iron-ADP regimens that did not increase intracellular iron. All the hearts received 30 minutes of normothermic global ischemia and 30 minutes of reperfusion. Heart function was monitored continuously throughout each experiment. Tissue iron and biochemical markers were analyzed at the end of experiments. RESULTS Hemodynamic recovery was decreased and tissue lipid peroxide levels were increased in the 20 μM Fe2+-100 μM ADP group compared to controls. The recoveries of developed pressure and positive/negative dP/dT at 30 minutes of reperfusion were negatively correlated with tissue iron levels, while cytosol and membrane lipid peroxide levels correlated positively with the iron levels during reperfusion. CONCLUSIONS The extent of oxidative injury during reperfusion was directly related to the tissue iron burden present during reperfusion. Increased lipid peroxidation was the principal chemical marker of iron-catalyzed injury.

OBJECTIVE To clarify whether free radical, which may play a role in pigment gallstone formation, is present in pigment gallstones in vivo. MATERIALS AND METHODS Free radical signal of gallstones from 18 patients was detected by electron paramagnetic resonance spectroscopy at 77K under anaerobic condition and in air (control). As soon as the anaerobic determination was finished, the fresh anaerobic sample was exposed to air and stored in a freezer at -20℃. RESULTS Free radical signal (g=2.0038) was detected in fresh anaerobic samples containing more than 2% bilirubin compound, and the signal intensity correlated linearly with the content of calcium bilirubinate (r=+0.95, P<0.0005). During the storage at -20℃ and exposure to air, the signal intensity of each anaerobic sample and its control increased gradually, eventually reaching the same stable level. Fe(III) signal intensity was enhanced synchronously and related linearly with free radical signal (r=+0.99, P<0.0005). CONCLUSIONS Free radical exists originally in pigment gallstones in vivo, and it may play an important role in pigment gallstone formation. The free radical signal carried by gallstones may be strengthened by the action of oxygen in air on bilirubin. The transition metal ions probably take part in the formation of bilirubin free radical.

Orthopaedics in China originates from two great branches of medicine: traditional Chinese Medicine (TCM) and western medicine (WM).