1997年 · 第110卷第03期

OBJECTIVE To investigate the c-myc gene expression in nasopharyngeal carcinoma (NPC) at mRNA and protein levels, and to evaluate the relationship between the degree of expression and the clinicopathological data. METHODS The expression of c-myc specific mRNA and protein was detected using in situ hybridization with digoxigenin-labeled probe and immunohistochemistry in 12 cases of normal nasopharyngeal epithelium (NE) and 48 cases of NPC. The intensity of staining for each sample was assessed as negative, weak, moderate and intense. Statistical analyses were performed using the Chi square test and the rank sum test. RESULTS For normal NE 41.7% (5/12) had weak (4/12) or moderate (1/12) staining for c-myc protein and 41.7% (5/12) had weak staining for c-myc mRNA. In contrast, 89.6% (43/48) of NPC showed some degree of c-myc protein positive and 87.5% (42/48) showed some degree of c-myc mRNA positive. In most samples, the expression of c-myc protein was consistent with that of c-myc mRNA. C-myc protein and mRNA expression levels in NPC were significantly higher than those in normal NE, and correlated with early recurrence, but they were not significantly related to patient's age, sex, EBVCA-IgA titre, disease stage, lymph node status and metastasis. CONCLUSIONS C-myc gene over-expression may be involved in the pathogenesis and early recurrence of NPC. Further studies are needed to substantiate the preliminary findings.

OBJECTIVE To study the familial occurrence of hemangioblastoma of the central nervous system and to search for an effective way to diagnose and manage the disease. METHODS From 1974 to 1993, six patients with hemangioblastoma with family history underwent surgical treatment at our hospital. Computerized tomography (CT) or magnetic resonance imaging (MRI) technique was used for the diagnoses before operation. RESULTS Each patient had more than two relatives with hemangioblastoma. Multiple lesions were found in two of the six familial hemangioblastoma cases. All the patients recovered well after operation. So far, no victims have been discovered in the third generation. CONCLUSIONS The high occurrence rate of familial hemangioblastoma cases suggests an involvement of hereditary factors. We need a long follow-up study on the descendants of familial hemangioblastoma patients. MRI is of diagnostic value in determining the location and nature of hemangioblastoma in both brain and spinal cord. A thorough examination is necessary for hemangioblastoma patients, and microsurgery is important in removing the tumor.

OBJECTIVE To define the biomechanic function of the shoulder in fast throwing movements in baseball pitching. METHODS Using NAC high-speed video and PIAS LA-555 computer system, overhand pitching movements carried out by 12 healthy Japanese professional baseball pitchers were analyzed in three dimensions. The pitching motion was displayed as stick to sick figures dynamically. RESULTS Pitching motion was a combination of translational and rotational movements. Acceleration and deceleration, being two typical motion patterns, worked sequentially through the anatomic link system from the pivot leg to the pitching hand. During the acceleration phase, the shoulder joint acted as a junction point and a fulcrum, supporting the rotational acceleration motion, shoulder forward flexion and elbow extension. According to the changing glenohumeral angles of the pitching shoulder, shearing force turned into tension force which worked on the anterior shoulder structures and then shifted to the posterior part of the joint. CONCLUSIONS In fast throwing motion, the shoulder functions as an important fulcrum to support the pitching arm during the acceleration phase. Avoiding excessive stress and shearing force on the joint components and enhancing coordination of muscle action are important to a successful throwing motion and the prevention of shoulder injury.

OBJECTIVE To explore the applied microsurgical anatomy of the intrinsic hand muscles and related nerves after nerve injuries in the wrist region and to report the results of new technique for the restoration of motor functions of the injured nerves. METHODS Seven fresh forearm amputation specimens were employed for studying the anatomical and microsurgical characteristics of the relevant tissues. Transfer of the pronator quadratus branch of the anterior interosseous nerve (PBAN) to the recurrent branch of the median nerve (RBMN) and the deep branch of the ulnar nerve (DBUN) to restore the functions of the intrinsic hand muscles was performed on 20 patients from April 1979 to January 1994. Fourteen patients were followed up for 3-9 years with an average of 5 years and 8 months. RESULTS The RBMN, DBUN and PBAN had approximately the same lengths of diameter and similar amounts of fascicles and nerve fibers so that after nerve transfer, the possibilities of misdirected connections were greatly reduced. In the latest follow-up, normal muscle strength was regained in 3 patients, grade VI strength in 6, grade III strength in 3 and grade II strength in 2. CONCLUSIONS This new technique is able to restore the intrinsic hand muscular functions after median or ulnar nerve injuries in the wrist region or distal forearm.

OBJECTIVE To investigate the attitudes toward organ transplantation, organ donation and recipients in young people in Beijing, Shanghai, and Wuhan. METHODS A questionnaire was designed for 3012 young people aged 20-45 years (999 in Beijing, 990 in Shanghai, and 1023 in Wuhan). The data of questionnaire were processed with SPSS software. RESULTS Over 90% of the respondents knew that human organs can be transplanted; over 85% considered that organ transplantation is a welfare undertaking; more than 85% thought that when someone's organ is in critical condition, it is necessary to perform organ transplantation; over 70% expressed willingness to receive organ transplantation if it is needed or possible. In the mode of organ donation, 70% emphasized that organ donation should be dependent on volunteers and the donor should be rewarded in a certain form. Organ recipients in sequence are relatives, specialized medical institutions, friends, members of volunteer organizations, and others. The factors affecting the attitudes towards organ transplantation are analyzed. CONCLUSIONS There is a better attitude toward organ transplantation among young people in cities. The conventional attitudes and feudal habits are one of the major obstacles to the course of organ donation in China.

OBJECTIVE To investigate the effects of pulse methylprednisolone (MP) and monthly intravenous cyclophosphamide (CTX) therapy (MP+CTX) on renal infiltrating cells in patients with rapid progressive glomerular nephritis (RPGN). METHODS Twelve patients with RPGN (>50% crescents) were given MP+CTX therapy and received repeated renal biopsies within 4 to 12 weeks after MP+CTX treatment. Seven were diagnosed as type II RPGN, including one case of IgA nephropathy, 2 cases of idiopathic RPGN and 4 cases of lupus nephritis and five were diagnosed as type III RPGN, including 2 cases of idiopathic RPGN and 3 cases of vasculitis. The changes of infiltrating CD4+, CD8+, CD68+ and proliferating cell nuclear antigen-PCNA+ cell levels were determined by four PAP method in glomeruli and interstitium. RESULTS In the patients before MP+CTX therapy, there were higher levels of infiltrating CD4+ and CD8+ cells (306±118 and 223±98.4Num/mm2) in renal interstitium, CD68+ cells (17.2±9.95 Num/G) in glomeruli and (1120±229 Num/mm2) in interstitium, and PCNA+ cells (7.56±3.57 Num/G) in glomeruli and (17.6±6.85 Num/mm2) in interstitium as compared with those in the patients after MP+CTX therapy (CD4+/CD8+ cells were 171±87.5/121±38.4 Num/mm2, CD68+ cells were 9.04±4.33 Num/G and 600±107 Num/mm2, and PCNA+ cells were 2.04±1.43 Num/G and 9.40±4.45 Num/mm2). These changes were associated with improving renal dysfunctions (the levels of serum creatinine and proteinuria decreased gradually from 766±356 to 284±192 μmol/L and 2.60±1.46 to 1.29±0.85 g/day). CONCLUSIONS Our data indicate that the renal infiltrating cells may play an important role in renal injury in patients with RPGN. The effects of MP+CTX therapy on improving renal dysfunctions may partially contribute to its amelioration of infiltrating cells in renal tissues. The degrees of CD4+, CD68+, and PCNA+ cells in the kidney may be useful indicators of MP+CTX therapy for RPGN.

OBJECTIVE To evaluate the utility of immunohistochemical staining of p53 expression in endoscopic biopsy specimens in clinical practice. METHODS Using a streptavidin-peroxidase (S-P) conjugate method with monoclonal p53 antibody Do-7, the expression of p53 was investigated immunohistochemically in 150 endoscopic biopsies and paired brushings from patients with benign and malignant gastric diseases. Among them, 22 cases with gastric carcinoma underwent the gastrectomy and the immunohistochemistry was repeated in the resected cancerous tissues of the same patient. RESULTS p53 expression in endoscopic specimens was detectable in 35.7% cases of gastric carcinoma (n=70), 5.9% of gastric polyps (n=17), 16.7% of gastric mucosal dysplasia (n=18) and 4.0% of chronic atrophic gastritis (n=25), but no protein expression was observed in cases of chronic active gastritis (n=20). In 22 patients with tumor resection, 8 (36.4%) were identified with p53 expression in endoscopic specimens before surgery, while 10 (45.5%) were identified with the same expression in surgical specimens, the real positive rate was 80.0%, no false positives were observed in endoscopic specimens. Furthermore, p53 expression in gastric carcinoma was closely correlated with clinical stage and lymph nodes involvement, but did not correlate with histologic type. CONCLUSIONS Assay of p53 by immunohistochemistry in endoscopic biopsy specimens and brushings is an easy and reliable technique to assess p53 status in gastric carcinoma, and thus could serve as a marker to foresee the prognosis in these patients and assist in the diagnosis of malignancy before surgery. It may also be a valuable marker in screening patients with high risk of gastric carcinoma.

OBJECTIVE To measure serum 7S collagen (7S-C) and type VI collagen (VI-C) levels by radioimmunoassay (RIA) in Chinese patients with various liver disorders and in CCl4-treated SD rats, and to investigate the significance of the elevated levels of serum 7S-C and VI-C. METHODS Serum 7S-C and VI-C levels were measured in 40 healthy control subjects, 168 patients with various liver disorders and non-hepatic diseases, and 52 CCl4-treated SD rats by using RIA which was developed in our hospital. RESULTS Serum 7S-C and VI-C were significantly elevated in patients with chronic active hepatitis (CAH), liver cirrhosis (LC), hepatic cellular carcinoma (HCC) (P<0.01 respectively), chronic persistent hepatitis (CPH), and some with non-hepatic diseases (P<0.05). Serum 7S-C, serum laminin and hyaluronic acid were well correlated. Serum 7S-C and VI-C were not closely correlated. Both collagens were correlated with serum albumin/globulin ratio, aminotransferase and total bilirubin, not with alkaline phosphatase. In CCl4-treated SD rats, serum 7S collagen and type VI collagen levels were correlated with the degree of hepatic fibrosis. CONCLUSIONS Serum 7S collagen and type VI collagen are useful markers for diagnosing liver fibrosis. And the combined measurement of IV-C, VI-C and other markers of connective tissue metabolism or biochemical data seems to provide additional information to predict progressive hepatic fibrosis.

OBJECTIVE To study the manifestations of Behcet's disease (BD) in the digestive tract and its differential diagnosis from common inflammatory bowel diseases. METHODS The symptoms and endoscopic, X-ray's or surgical characteristics of 24 cases of Behcet's disease with digestive tract manifestations were analysed. RESULTS The lesions mainly occurred in tileocecum, and frequently led to hemorrhage that required surgery. The recurrent rate was as high as 77.7%. CONCLUSIONS Importance should be attached to early diagnosis of BD of the digestive tract to prevent serious complications.

OBJECTIVE To investigate the long-term prognostic influence of patency of the infarct-related coronary artery. METHODS One thousand two hundred and sixty seven cases of acute myocardial infarction with thrombolytic treatment between July 1991 and January 1995 in 36 collaborative hospitals were followed-up after discharge with a total follow-up rate of 84.5%. Patency of infarct-related coronary artery was assessed by uniform clinical criteria. Eight hundred and forty three patients with patency were followed up for 16.0±10.4 months and 424 patients without patency for 19.2±12.22. Death or up to the end of March, 1995 was used as the end point. RESULTS Comparisons of patients with patent versus nonpatent infarct-related coronary artery during follow-up showed: (1) Cardiac death rate was 2.85% in patients with patency while 4.72% in those without patency (logrank test, P>0.1). (2) Three-year survival rates calculated by Kaplan-Meier curve were 91.6% and 73.9% respectively (logrank test, P<0.001). (3) Incidence of reinfarction were 5.7% and 5.9% respectively (P<0.05). (4) Patients with class III-IV NYHA cardiac function occurred in 11.3% and 17.9% respectively (P<0.01). (5) By Cox regression model analysis patency of infarct-related coronary artery, recurrent infarction, age and infarct sites were independent prognostic factors. Survival probability increased by 33.5% in patients with patency compared to those without patency. CONCLUSIONS It is evident that patency of infarct-related coronary artery could improve long-term survival.