2000年 · 第113卷第04期

Objective To study p53 expression in pituitary tumors. Methods We evaluated 24 non-invasive pituitary adenomas, 13 invasive pituitary adenomas and 3 primary pituitary carcinomas for their expression of the p53 protein, using immunohistochemical methods (microwave oven treated ABC technique). Results p53 expression was correlated with anaplasia of pituitary tumors: tumors with anaplasia had a higher expression of p53 than those without anapasia. The proportion of p53 positive cases among non-invasive adenomas, invasive adenomas and pituitary carcinomas was 0%, 23.8% and 100%, respectively (P < 0.0l). There was no relationship between the functional subtypes of the pituitary tumors and p53 expression. Conclusions p53 mutation may play a role in the pathogenesis of pituitary tumors, and detection of p53 expression may have significant value in the evaluation of malignancy as well as prognosis.

Objective To investigate the effect of basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF) on limb ischemia/reperfusion injury of rats and the mechanism. Methods The hind limb ischemia/reperfusion injury of male SD rats was induced by tourniquet for 2 hours and then reperfusing for 12 hours with administration of different agents. Animals were divided into control, bFGF-10 and bFGF-50, VEGF-10 and VEGF-50 group by infusing physiological saline, 10 and 50 μg/kg bFGE, 10 and 50 μg/kg VEGF, respectively. Blood was collected to determine malonyldialdehyde (MDA), and the ischemic-reperfused gastrocnemius muscle and the contralateral control one were harvested together for measurement of tissue viability, water content, myeloperoxidose (MPO) activity, ATP and MDA concentration. Results Compared with control group, tissue viability of ischemia/reperfusion limb in bFGF-10 and bFGF-50 group increased by 16.0% (P < 0.05) and 32.8% (P < 0.01), ATP content increased by 14.8% and 35.6% (P < 0.01), and plasma MDA level decreased by 45.2% and 56.2%(P < 0.01). 10 μg/kg bFGF had no significant effect on tissue water content, MPO activity, MDA concentration of ischemia/reperfusion limb, while 50 μg/kg of bFGF lowered these values by 15.7%, 32.5% and 13.6% (P < 0.05) and 14.7% (P < 0.01), MPO activity augmented by 44.9% and 96.1% (P < 0.01), ATP content decreased by 13.1% (P < 0.05) and 33.3% (P < 0.01). Plasma and tissue MDA concentrations in VEGF-10 group had no significant changes (P > 0.05), while in VEGF-50 group, these values were elevated by 46.4% and 38.6%(P < 0.01). Conclusion bFGF attenuated, while VEGF exacerbated ischemia/reperfusion injury of rat limb significantly, the mechanism of which was probably related to preventing or enhancing lipid peroxide, and increasing or decreasing energy store.

Objective To investigate the effects of somatostatin on portal venous pressure (PVP) and splanchnic hemodynamics in cirrhotic portal hypertensive patients. Methods Totally, 20 cirrhotic patients with portal hypertension were included in this study. All patients had the history of hepatitis B and HBsAg ( + ), and were diagnosed as post-necrotic cirrhosis pathologically. We measured the maximum blood flow rate of portal vein and hepatic vein before and after the continuous infusion of somatostatin using the color Doppler ultrasonography. The blood flow was calculated according to the formula Q = 60 π r2V[ Q: blood flow (ml/min), π r2: the sectional area (cm2) and V: the mean maximum blood rate (cm/sec)]. Of 15 patients who had undergone right gastroepiploic venous catheterization, changes of the PVP were observed via a catheter in right gatro-epiploic vein before and after the administration of somatostatin. Results The PVP decreased from 20.8 ± 2.0 mm Hg to 18.2 ± 2.0 mm Hg and 18.0 ± 2.0 mm Hg one hour and 1.5 hour after infusion, respectively, with significant difference (P < 0.01). At the same time, there was no significant change in the arterial systolic and diastolic pressure as well as heart rate. The sectional area of portal vein decreased by 7.28% after infusion of somatostatin, but the change was not significant (P < 0.05). The maximum blood flow rate of portal vein decreased from 19.72 ± 7.75 cm/sec to 15.98 ± 7.26 cm/sec significantly by 18.96%(P < 0.01), and the mean total blood flow of portal vein decreased from 1643.21 ± 577.25 ml/min to 1319.49 ± 622.39 ml/min with significant difference ( P < 0.01). The mean total blood flow of three hepatic vein increased from 1786.22 ± 926.37 ml/min to 1836.17 ± 844.24 ml/min after the infusion of somatostatin, but the difference was of no significance(P > 0.05). Conclusions Our study suggests that the continuous infusion of somatostatin could decrease PVP in cirrhotic patients with portal hypertension. The mechanism might be the decrease of blood flow due to the decrease of blood rate. Somatostatin is not able to constrict portal vein directly.

Objective To observe the effect on the patients with rhinitis medicamentosa treated by oral adenosine triposthate (ATP). Methods There were 150 cases with rhinitis medicamentosa, who had prolonged use of nasal drops of vasoconstricators, such as privine for one month to more than ten years. All cases were due to chronic tonsillitis caused by adenoid hypertrophy, "coryza", allergic rhinitis, deviation of nasal septum, polyp of sinus and sinusitis, and vasomoter rhinitis. Of them, 87 were males and 63 females, aged 5-53 years. After original disease treated, 103 patients were given oral ATP tablets 40 mg three times a day for three days or one week at most, and then compared with the rest 47 patients (controls) treated by nasal drops of dexamethazone of 0.25 mg/ml dilution for 1-2 weeks then given normal saline only. The effects on the experimental group of taking ATP and contrast group of using dexamethazone were determined subjectively by patients' symptoms and objectively by rhinomanomoter of Mastre PF-2001. The investigation lasted eight weeks. Results Patients in the experimental group showed improvement at the beginning several hours to three days after the treatment. Rhinomanometer studies indicated the nasal resistance in 94 cases out of the 103 dropped to more than 50%, with an improved rate of 91.2%. The swollen inferior turbinates became shrunk. The color of the mucosa turned from dark purple to pink. While the time of improvement in the contrast group began at least one week after the treatment. The obvious improvement was shown after 2-3 weeks, and disappearance of symptoms, after 4-8 weeks. The improvement rate was 81%. Conclusion The symptoms of rhinitis medicamentosa can be quickly and effectively improved by taking ATP.

Objective To understand the anatomic relationship between temporomandibular joint (TMJ) and the adjacent important nerves and vessels so as to grasp the way and the scope of operation well and to reduce the occurrence of operating complications. Methods We dissected and mesured the TMJ of seven cadavers to study its anatomic structure, adjacent landmarks and relation with important nerves and vessels. In addition, 20 CT films of central position of nasal septum and symmetry of bilateral anatomic structrues were studied to measure the anterior inclining angle of external auditory meatus. Results There is a close relationship between TMJ and the frontal branch of facial nerve, the transverse facial artery and vein as well as the anterior auricular nerve and vascular plexus. The angles of anterior bevel of the anticular fossa with ala-tragus line and external auditary canal with the coronary plane, and the thinness of the thinnest part of the anticular fossa might be useful parameters in guiding the operating maneuver. Conclusion The operation of TMJ arthroscopy should know thoroughly the anatomic structures of TMJ and its relation with surrounding tissues, even though the operative trauma is small. In so doing the rate of operative complications might be reduced to a minimum.

Objective To investigate the distribution of antigen-processing genes transporter associated with antigen processing (TAP), low molecular weight proteasome (LMP2) and HLA-DM in the Shanghai population and to explore the possible role of these genes in the genetic susceptibility to autoimmune diseases IgA nephropathy(IgAN) and multiple sclerosis(MS). Methods Eighty normal Shanghai Chinese, 60 patients with IgAN and 21 patients with MS were randomly selected and genotyped for antigen-processing genes (TAP1, TAP2, LMP2, HLA-DMA and -DMB) using polymerase chain reaction-sequence specific oligonucleotide (PCR-SSO) and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Two-locus linkage disequilibrium analysis was performed. Results Four TAP1, 6 TAP2, 2 LMP2, 3 DMA and 4 DMB alleles were observed. Statistically significant associations were found between TAP1B-TAP2A, TAP1B-LMP2H and TAP2D-HLA-DMA* 0101 (Pc < 0.01). There was no association between antigen-processing genes and either IgAN or MS. Conclusion The polymorphisms of antigen-processing genes in this Shanghai population are similar to those observed in the other ethnic populations. No association was found between IgAN or MS and any antigen-processing genes tested in Shanghai population. Chin Med J 2000; 113(4): 372-375

Objective To evaluate the effect of recombinant bovine basic fibroblast growth factor (rbFGF) on accelerating healing of burn wounds, donor sites and chronic dermal ulcers in multicenters. Methods One thousand and twenty-four patients with burns, donor sites and chronic dermal ulcers were recruited for this prospective and multicenter clinical trial and another 641 patients with the similar wounds were used as controls. All patients were divided into three groups: burn group, donor site group, and chronic dermal ulcer group. In the burn group, 654 patients with superficial second-degree burns (superficial Ⅱ°) or deep second-degree burns( deep Ⅱ°) were treated topically with either recombinant bovine basic fibroblast growth factor ( rbFGF plus vehicle, rbFGF 150 AU/cm2/day, 330 patients) or placebo (vehicle without rbFGF, 324 patients). In the donor site group, 509 patients were treated with rbFGF and 317 patients with placebo in a similar way as described elsewhere. In the chronic dermal ulcer group, 185 patients were treated with rbFGF and the controls were themselves. Photography, histological evaluation and clinical examination were used to evaluate the results of wound healing. Results All of superficial second-degree burns, deep second-degree burns and the donor sites treated with recombinant bovine basic fibroblast growth factor had an accelerated rate of granulation tissue formation and epidermal regeneration as compared with that in the controls. Superficial second-degree burns and deep second-degree burns treated with recombinant bovine basic fibroblast growth factor healed in 9.89 ± 2.45 and 17.04±4.56 days, respectively, whereas the average healing time in those receiving placebo was 12.35±2.74 and 21.21±4.88 days. The donor sites treated with rbFGF or placebo healed in 10.68±4.55 and 14.74 ± 6.46 days, respectively. All chronic dermal ulcers except 12 patients treated with rbFGF healed within 6 weeks. Histological evaluation of punch-biopsy specimens from the burn wounds, donor sites and chronic dermal ulcers seven days after treatment supported the impression of accelerated wound healing after rbFGF treatment. Conclusions rbFGF is effective in shortening the wound healing time and improving the wound healing quality. Accelerating wound healing is of clinical benefit in reducing the length of hospitalization, costs and emotional burden of the patient. Chin Med J 2000; 113(4): 367-371

Objective To establish a mouse model of middle cerebral artery occlusion, which mimics focal ischemia in humans and to demonstrate the advantages and disadvantages of the model. Methods CD-1 mice (n = 126) had permanent middle cerebral artery occlusion for 24 h, or temporary occlusion for either one hour followed by 23 h of reperfusion or 2 h of occlusion with 22 h of reperfusion. The middle cerebral artery was occluded by insertion of a suture through the internal carotid artery. Reperfusion was established by suture withdrawal. The degree of occlusion and the extent of reperfusion were determined using laser Doppler. Infarct volume was measured with 2, 3, 5-triphenyl tetrazolium chloride staining, and the blood-brain barrier disruption was demonstrated using albumin immunohistochemistry. Results Blood flow decreased to 14% - 19% of baseline in both the permanent and temporary occlusion groups and was restored to 51% - 75% of baseline after reperfusion. The infarct volume was smaller in the 1 h/23 h temporary occlusion group (P < 0.05) than in either the 24 h permanent occlusion group or the 2 h/22 h temporary occlusion group. Blood-brain barrier disruption was also smaller in the 1 h/23 h temporary occlusion group than in either the 24 h permanent occlusion or the 2 h/22 h temporary occlusion group (P < 0.05). Conclusion Permanent or temporary middle cerebral artery occlusion causes reproducible brain injury in the mouse. Blood-brain barrier disruption and infarct volume remain important markers of focal cerebral ischemia. Chin Med J 2000; 113(4): 361-366

Objective To investigate the condition of the oral mucosae in Xinjiang Uygur centenarians and explore some related factors. Methods The oral mucosae and mucosal exfoliative cells of 140 Xinjiang Uygur centenarians were examined. Saliva and blood were collected from some centenarians. Salivary immunoglobulins (IgA, IgM, IgG), complements (C3 and C4), nitrous oxide (NO), 10 trace elements, serum sex hormones, thyroid hormones and osteocalcin (OST) were analysed using immunoglobulin, complement and NO kits, an ionochromatophotometer, and the kits for sex hormones and thyroid hormones, and fluorescence enzyme-linked immunosorbent assay, respectively. Results Most centenarians (64.29%) had normal labial, buccal, palatal and gingival mucosae. The abnormal changes in mucosae were mainly vascular nevus patches and senile plaques. Their mucosal exfoliative cells showed similar characteristics to those in elderly Han. The centenarians who had normal mucosae had higher level of the trace element molybdenum (Mo) in their saliva than who had abnormal mucosae (P < 0.01). Conclusion The oral mucosal condition of Uygur centenarians was generally good. The abnormal changes in oral mucosae of the centenarians were lesions not harmful to health and may be related to the lower level of Mo in their saliva. Chin Med J 2000; 113(4): 358-360

Objective To elucidate the role of p38 in heat-induced apoptosis in the monocytic cell line Raw264.7. Methods Apoptosis was detected using flow cytometric analysis, DNA electrophoresis, Westero blot and a protein kinase assay. Results A marked increased in p38 activity was detected 15 min after heating and reached maximal activity 30 min post stimulation, then returned to the pre-stimulated level 2 h later. The percentage of apoptotic cells was obviously increased 3 h after heating. Stimulation of p38 preceded the induction of apoptosis, and the p38 specific inhibitor, FHPI, can inhibit thermal injury induced cell apoptosis. Conclusions p38 activation is required for heat-induced apoptosis in Raw264.7 cells, and stimulation of the p38 signaling pathway contributes to cell death. Chin Med J 2000; 113(4): 354-357

Objective To understand the role of genetic factors in the occurrence of esophageal cancer (EC). Methods A genetic epidemiological survey of 132 039 subjects, one-tenth of the whole population of Yangquan city, Shanxi Province in Northern China, was conducted in 1994. A total of 228 families with at least one newly occurring EC patient in each family were matched with equal number of control families for a 1:1 case-control study. Results The heritability of esophageal cancer among first degree relatives was 52.6%, that among second degree relatives was 31.2%, and the weighted average heritability was 49.2%. The segregation ratio was 0.176 ± 0.033, significantly less than 0.25, suggesting a multifactorial inheritance or decreased penetrance of a major locus. EC patients in families did not fit the binominal distribution, suggesting evidently familial aggregation. The relative risks among the first degree relatives were 10.49 for males, 7.69 for females, and 9.17 for combined data. The attributive risks among first degree relatives were 62.13/100 000 for males, 99.94/100 000 for females and 75.15/100 000 for combined data. All of these figures were higher than 40.17/100 000, the average of general population of the city. Conclusion Genetic factors play an important role in the pathogenesis of esophageal cancer in this area.