1999年 · 第112卷第07期

OBJECTIVE To investigate the function of the αvβ5 integrin in hematopoietic cells. METHODS Tissue culture, integrin expression vectors, gene transfer, polymerase chain reaction (PCR), apoptosis analyses and cytometic analysis were made on hematopoietic cells. RESULTS The β5 integrin cDNA was not expressed in hematopoietic cells following exposure to theβ5 integrin retrovirus vector pGβ5CHT. Unbalanced expression of the αvβ3 and αvβ5 integrins occurred during apoptosis induced by serum depletion and upon differentiation. The treatment of hematopoietic cells with anti-αvβ5 monoclonal antibody inhibited apoptosis induced by serum depletion. Inducible expression of the β5 integrin cDNA in the hematopoietic cell line K562 caused cellular proliferation inhibition. CONCLUSIONS The αvβ5 integrin cDNA in hematopoietic cells can inhibit the proliferation of the hematopoietic cell, cause the differentiation of the hematopoietic cells and induce the apoptosis of the hematopoietic cells.

OBJECTIVE To find out whether there are also penicillin-resistant streptococcus pneumoniae and the resistant rate in China. METHODS A surveillance study which is a part of the international surveillance on pneumococci resistance to penicillin and other antimicrobial agents was conducted in Beijing, China. More than 900 pediatric patients with respiratory tract infections aged from six months to three years selected from two pediatric units were enrolled in the study. Perthroat swabs were immediately streaked onto blood agar plates. Isolates were identified as pneumococci by their typical appearance, gram stain, confirmation tests. Antibiotic susceptibility was assessed by the disk diffusion method and minimal inhibition concentration (MIC) determination according to Protocol and National Committee for Clinical Laboratory Standards (NCCLS). RESULTS Of the 51 streptococcus pneumoniae isolates, 5 strains had zones of inhibition indicative of penicillin resistance, of which two had penicillin MICs ≥ 0.1 mg/L and were considered to be relatively or fully resistant to penicillin. The MICs of two penicillin resistant strains were 2 mg/L and 4 mg/L. Resistant rates to ceftriaxone and cefotaxime were 0% and 10% respectively. For the other ten antimicrobial agents, the resistant rates were as follows: ampicillin 12%, piperacillin 26%, furbenicillin 14%, cefuroxime 6%, erythromycin 54%, clarithromycin 52%, meleumycin 64%, roxithromycin 52%, chloramphenicol 35%, tetracycline 100%. CONCLUSIONS The study suggested that penicillin resistant streptococcus pneumoniae strains existed in China and were also resistant to ampicillin, piperacillin, furbenicillin and cefuroxime. Moreover, the resistant rates of penicillin resistant streptococcus pneumoniae to macrolides and tetracycline were high.

OBJECTIVE To explore the immunological characteristics of natural resistance to Schistosoma japonicum infection in Microtus fortis (MF) living in the Dongting Lake area. METHODS Passive transfer of sera from uninfected laboratory bred MF (BMF) to albinao mice (AM) was performed to observe the acquired protection. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and enzyme-linked immunoblotting (ELIB) methods were used to recognize 4 different life-cycle stage antigens of S. japonicum by sera from wild MF (WMF), BMF, BMF13 and BMF19. Tests were also performed on in vitro killing effect of sera and/or lymphocytes from BMF and WMF to schistosomulae; quantitative determination of C3 and C4 by immunoturbidometry, and interleukin-4 (IL-4) and antibodies to the 4 stage antigens in sera from WMF, BMF and infected BMF by ELISA. RESULTS Compared with the control group, stool eggs per gram (EPG) of AM in the test group was significantly reduced by 81.54%, miracidium hatching rate, by 50.67%, liver egg counts, by 72.07%, the diameter of hepatic egg granuloma, by 70.39 microns. Western blotting probed with the 4 MF sera all revealed 7 specific bands for SSA, 3 for AWA and SEA, but none for CA antigens. The sera and/or lymphocytes from WMF and BMF gave obvious killing effects on schistosomulae with an adjusted death rate of 64.12%-78.83%. The levels of "natural antibodies" produced by MF to S. japonicum were in the following order: anti-SSA > anti-AWA > anti-SEA > anti-CA, all of which increased significantly after the infection. Serum levels of C3, C4 and IL-4 in uninfected BMF were significantly higher than those in AM. After infection, levels of C3 and C4 were further increased respectively by 72.83% and 295.49% in the 4th week and IL-4 by 303.83% in the 9th day. CONCLUSIONS Immunological characteristics of innate resistance in M. fortis to S. japonicum infection were existed with no significant difference between WMF and BMF.

OBJECTIVE To establish the normal patterns of lumbar vertebral marrow in normal Chinese, to determine its normal value of relaxation times (T1 and T2), and to investigate the relationship between relaxation time and age or sex. METHODS 320 of 1000 cases (sampled randomly) received MR imaging. According to the MRI findings of sagittal T1WI, marrow patterns were established. 268 cases were studied quantitatively (T1 and T2 measurements). RESULTS The normal bone marrow patterns of lumbar vertebra were divided into four main patterns (six subgroups). The normal values of relaxation times (T1 and T2) were measured. T1 or T2 value decreased with aging. No significant difference in T1 value between two sexes (<40 years old: u = 0.4307, P>0.50;≥ 40 years old: u = 0.554, P>0.05). No significant difference was seen in T2 value between two sexes before 40 years old (u = 1.3628, P>0.10), but significant difference after 40 years old (u = 2.1498, P<0.05). CONCLUSIONS To establish the normal patterns of lumbar vertebral marrow and determine its normal values of relaxation times have important clinical value in the diagnosis of bone marrow diseases.

OBJECTIVE To investigate the distribution characteristics of some common and trace elements in both serum and lymphocyte in patients with essential hypertension and to analyse their possible role in the pathogenesis of hypertension. METHODS A cross-sectional study was carried out in 102 hypertensive patients matched with equal number of normotensive subjects by sex, age, and hypertensive family history; all of them were randomly selected from the same community. Both intralymphocytic and serum concentrations of some relevant elements including Na+, K+, Ca2+, Mg2+, Zn2+, Cu2+ and P were measured for all studied subjects, using the inductively coupled plasma spectrometry (ICPS). RESULTS 1. Both intralymphocytic and serum concentrations of Na+ (P = 0.009, 0.004 respectively), and Ca2+ (P = 0.001, 0.049 respectively) in hypertensive group were significantly higher than those in the normotensives. 2. Stepwise regression analysis disclosed that systolic and diastolic blood pressure had significant correlation with age, serum Na+/K+ ratio and intralymphocytic Ca2+, Mg2+ concentrations (P<0.001 for both). 3. According to hypertensive family history, the method of multiple variance analysis had been employed for 4 subgroups and the results revealed that the concentrations of serum Ca2+ and lymphocytic Na+ were significantly higher in hypertensives with or without family history than in normotensives without family history. Furthermore, intralymphocytic Na+ concentration was significantly higher in normotensives with positive family history than that in normotensives without family history. CONCLUSIONS The serum and intralymphocytic distribution characteristics of elements in hypertensive patients compared with normotensive controls suggested that there might exist certain defects of the ion-transporting system on cell membrane which might be genetically linked.

OBJECTIVE To understand the relationship among congenital choledochal cyst, anomalous junction of pancreaticobiliary duct (AJPBD) and pancreatitis. METHODS 25 children with choledochal cyst treated in our hospital were included in this study. Their ages ranged from 2 months to 14 years. Intraoperative cholangiography was performed in 24 children. Pancreatic samples obtained from the head and body of the pancreas at operation were observed under light and electron microscope. Serum amylase was analyzed one week before and after operation respectively. Bile amylase in the cyst and gallbladder was measured at operation. RESULTS The incidence of AJPBD was 70%. Inflammatory cell infiltration and fibrous hyperplasia were seen in the pancreatic specimens of 5 children, of whom 4 had AJPBD. No ultrastructural changes were found in 2 children without AJPBD, while different changes were seen in 6 with AJPBD, including those showing no pathological changes under light microscope. All the changes became more severe as the age of the patient increased. The bile and serum amylase levels were higher in children with AJPBD than those without AJPBD (P<0.05). CONCLUSIONS Congenital choledochal cyst has a close relationship with AJPBD and pancreatitis. Pancreatic pathological changes have a long and chronic course from ultrastructural changes to macroscopic changes for the developing of pancreatitis.

OBJECTIVE To evaluate the toxic response to intrahepatic arterial administration of radioactive phosphorus-32 glass microspheres (32P-GMS) in domestic pigs. METHODS Through selective catheterization of hepatic artery, 32P-GMS was infused to 5 healthy domestic pigs in a dosage equivalent to the therapeutic dose for human being, and 31P-GMS was infused to other 5 healthy domestic pigs. Two pigs served as the whole course blank controls. One pig from each group was surrendered to euthanasia at week 1, 2, 4, 8 and 16, respectively, and liver biopsies were performed on the rest of pigs at the corresponding time points. Liver tissues from different sites were taken for light and electron microscopy. The ultrastructural histopathological changes were evaluated semiquantitatively. RESULTS The accumulative amount of 32P-GMS in the target tissue attained more than 90% of the total dose administrated. Histologically, abnormal hepatocytes were easily found at week 1 or 2. At week 4 they were less than at week 1 or 2, and endothelium of the sinuses were damaged prominently. At week 8 they were scarcely seen, and liver tissue recovered gradually. The histological features of liver tissue restored to normal at week 16. Semiquantitative analysis of ultrastructural morphology in the experimental group showed no statistical difference (P>0.50) between the nuclear abnormality (Nabn) and mitochrondrial variability (Mvar) at week 1 or 2, but revealed prominent difference (P<0.01, P<0.001) as compared with those in other groups. In the experimental group the Nabn in tissues showed no significant difference (P>0.20) between week 8 and week 16. CONCLUSIONS 32P-GMS internal irradiation at the dosage equivalent to human therapeutic dosage exerts reversible injury to domestic pig liver tissue, and it takes more than 8 weeks for the injured liver tissue to recover.

OBJECTIVE To investigate portal hemodynamics and its correlation with esophageal variceal bleeding (EVB) in cirrhotics with portal hypertension by using a newly-developed technique, color Doppler velocity profile (CDVP). METHODS Hemodynamics of portal trunk (PT), right anterior branch (RAB) and splenic vein (SV) were evaluated in 48 cirrhotics with portal hypertension and 35 normal volunteers by CDVP. The parameters included maximum cross-sectional velocity (CS-Vmax), flow volume, congestion index (CI), profile parameter N and pattern of flow curve. Stepwise logistic regression model was employed to determine EVB-relating factors in cirrhotics. RESULTS CS-Vmax in PT and RAB was significantly lower in cirrhotic group than that of normal group, being 14.91±3.08 cm/s, 9.44±2.70 cm/s vs 30.52±6.75 cm/s, 12.82±2.69 cm/s, respectively (P<0.01 for both). Flow volume of PT and SV was significantly higher in cirrhotic group compared with that of normal group, being 25.16±10.48 ml·min-1·kg-1, 15.83±9.18 ml·min-1·kg-1 vs 20.43±5.57 ml·min-1·kg-1, 5.81±2.04 ml·min-1·kg-1, respectively (P<0.01 for both). CI of PT, RAB and SV was significantly higher in cirrhotic group than in normal group, being 0.142±0.0654, 0.105±0.0496, 0.0884±0.0431 vs 0.0326±0.0142, 0.0757±0.0342, 0.0483±0.0230, respectively (P<0.01 for all). In dynamic variation of flow volume over time, RAB and SV in cirrhotic group increasingly presented flat pattern and periodically changed pattern, respectively (P<0.01 for both). Between cirrhotic subgroups without and with EVB history, there were significant differences in flow volume, CI and N value of SV, splenic size, degree of esophageal varices (EV) and portal hypertensive gastropathy (PHG), and stepwise logistic regression revealed that N value of SV, splenic size, degree of EV and PHG were four independent factors in relation to EVB. EVB scores calculated from the regression equation had a close correlation with EVB. In patients with EVB score >0, 88.9% of them had EVB, and in those with EVB <0, 76.9% of them had no history of EVB. CONCLUSIONS In cirrhotics with portal hypertension, portal venous system has the features of elevated vascular resistance and hyperdynamics, and the latter mainly results from increased blood flow in SV. EVB score may become a valuable parameter in predicting occurrence of EVB.

OBJECTIVE To investigate the role of dobutamine stress echocardiography in evaluating cardiac β-adrenergic receptor (β-AR) function and responsiveness in children. METHODS Left ventricular ejection fraction (EF), fractional shortening (FS), left ventricular end systolic volume index (ESVI), the ratio of systolic blood pressure and ESVI (SP/ESVI) were measured by dobutamine stress echocardiography (DSE) in 30 children with β-AR hypersensitivity, 15 children with dilated cardiomyopathy and 30 normal children respectively. RESULTS Before pharmacological stress, EF and FS were 0.72 and 0.39 respectively in β-AR hypersensitivity group versus 0.70 and 0.35 respectively in control group. There was no difference of the indices between the two groups (P > 0.05). SP/ESVI was 0.76, higher than the value of 0.66 in control group (P < 0.05); EF, FS and SP/ESVI were 0.41, 0.15 and 0.10 respectively, which were significantly lower than those in control group. After dobutamine stress of 5 μg·kg -1·min-1 and 10 μg·kg-1·min-1, EF, FS and SP/ESVI were significantly increased in patients with β-AR hypersensitivity and there were no changes in children with dilated cardiomyopathy compared with values of baseline. CONCLUSIONS Cardiac β-AR function and responsiveness can be evaluated by dobutamine stress echocardiography.

OBJECTIVE To evaluate the effect of recombinant human granulocyte colony stimulating factor (rhG-CSF) on accelerating neutrophil recovery and decrease fatal infections for childhood acute myeloid leukemia (AML). METHODS From November 1992 to March 1997, 45 patients were enrolled into our study and 15 were newly diagnosed. All were treated with high dose chemotherapy combined with rhG-CSF. RESULTS Of 15 newly diagnosed patients, 13 achieved complete remission (CR) after one course of therapy and 2 achieved CR after two courses of therapy. For newly diagnosed patients, the durations of absolute neutrophil counts (ANC)<0.5 x 109/L were 5 days and 10 days in rhG-CSF group and control group respectively (P<0.05). The incidences of infection of these two groups were 40% and 60% respectively (P<0.05). As for patients who received intensive therapy, the durations of ANC<0.5 x 109/L were 5 days and 8 days in rhG-CSF group and control group, respectively (P<0.05), and the incidences of infection were 25% and 44.4% respectively (P<0.05). CONCLUSIONS The application of rhG-CSF in children with AML after chemotherapy may hasten the hematopoietic recovery. The duration of neutropenia was shortened by 3-4 days, and the incidence of fatal infection was reduced. rhG-CSF does not stimulate AML growth in vivo.

OBJECTIVE To evaluate the reproducibility of ThermoscanTM, an infrared emission detection ear thermometer, and to establish the normal reference range of ear temperature in Chinese neonates. METHODS Neonates were recruited from the inpatients population with exclusion of those suffering from infections. RESULTS Forty-nine neonates were recruited with 1,115 temperature taking sessions. Mean left ear temperature was 36.64 ℃±0.35 ℃. Mean right ear temperature was 36.64 ℃±0.37 ℃. Clinical repeatability for left and right ear was 0.17 ℃ and 0.17 ℃, respectively. CONCLUSIONS Thermoscan produced reproducible results in Chinese neonates. The normal range of ear temperature for Chinese neonates is 35 ℃ to 37 ℃. Ear temperature >37.8 ℃ should be regarded as fever.

OBJECTIVE To analyze the 40 years' experience of intestinal atresia and to introduce a new design of long-oblique anastomosis for disproportional loops of the intestine. METHODS A total of 449 cases of congenital atresia of the small intestine were classified into three groups according to the embryopathology: high group (145 cases), including duodenal and high jejunal atresia; middle group (288), including ileo-jejunal atresia; and low group (16), including terminal ileal atresia. To analyze the survival rate and mode of treatment, we assigned the cases into 3 groups according to the year of admission: 1) 1956-1969 (173 cases), under the general pediatric surgical care; 2) 1970-1985 (147), under the specialty neonatal surgical care; and 3) 1986-1996 (129), with additional use of total parenteral nutrition. RESULTS The ileojejunal atresia group (middle group) had the highest mortality rate (47.6%). The overall mortality rate decreased as the time went by, dropping from 64.7% in the early years down to 18.6% in the recent years, and no hospital death occurred in the recent couple of years. CONCLUSIONS Besides the improvement of neonatal surgical techniques, selecting a proper surgical procedure according to the embryopathology is essential to the reduction of mortality. The long-oblique anastomosis is particularly acceptable in China at present for marked disproportional loops.

Purpose To summarize the results of gene analysis for five types of glycophorin (GP) variants found in a screening survey conducted in several regions of Southern China. Data sources Papers cited in Chinese biochemical and biomedical literatures with a bibliographic review of articles relevant to hematology and biochemistry. Study selection All GP variant reports of our research group published during 1991-1997 were included. Data extraction Data concerning 5 types of GP variants found in Southern China were briefly abstracted. GP variant frequencies with their phenotypes among 3 districts and those among Han, Li, Buyi and Yao ethnic groups were calculated. Results Five phenotypes of GP variants [Sta, MiⅢ, MiⅤ (J.L.), MiⅥ and a novel case] were identified from 180 unrelated healthy individuals (Hunan, Hainan) and 222 residents of a tertian malaria hyperendemic area (Guizhou), using immunoblotting techniques, Southen hybridization and PCR-direct sequencing. Conclusions These five types of GP variants were first reported in China. There were some differences in the geographical distribution of GP variants among Hunan, Hainan and Guizhou districts. Mi III GP was commonly found in national minorities of Li and Buyi, while the frequency of Sta GP occurrence was considerably higher in Han ethnic group. The frequency of GP variants in a malaria hyperendemic area of Guizhou Province does not depend upon the severity of tertian malaria morbidity.