2001年 · 第114卷第04期

Objective To clarify the role of vitamin D receptor (VDR) expression in parathyroid proliferation and resistance of parathyroid glands to 1, 25(OH)2D3 with secondary hyperparathyroidism (SHPT). Methods This study used archive parathyroid with 7 uremic patients. The expression of proliferation cell nuclear antigen (PCNA) and VDR was evaluated in nineteen-surgically excised parathyroid tissues,including 11 diffuse hyperplasia (DH-type) and 8 nodular hyperplasia (NH-type) of parathyroid glands, by immunohistochemistry (avidin-biotin complex method). Results The weight of parathyroid in SHPT was remarkably increased by 16.1 times. The numbers of parathyroid cells were increased by 1. 86 times. The rate of PCNA was remarkably increased in parathyroid hyperplasia with SHPT compared with that in control group [(6.35 ± 3.36)‰ vs(1.73 ± 1. 31)‰, P<0.001]. The number of PCNA in DH-type was lower than that in NH-type(P<0.001). The density of VDR in the parathyroid with SHPT was significantly decreased [(40.28 ± 13.13)%vs(83.79 ± 3.77)%, P<0.001], VDR immunoreactivity expression in NH-type was lower than that in DH-type [(27.14 ±4.12)% vs(49.84 ± 7.33)%, P<0.001]. A significantly negative correlation was found between VDR density and the weight of the parathyroid(r = -0.46, P<0.05), the same as VDR and PCNA(r =-0.75. P<0.001). Conclusion VDR density was significantly decreased in parathyroid tissue of uremic patients showing nodular hyperplasia compared with that in diffuse hyperplasia and there was significantly negative correlation between VDR density and the weight of the parathyroid, and this may contribute to the progression of SHPT. Furthermore, VDR deficiency may cause the resistance of parathyroid cells to 1, 25(OH)2D3, in part. Chin Med J 2001; 114(4): 410-414

Objective To study the relationship between human leukocyte antigen (HLA)-DRB1 and DQ alleles and the genetic susceptibility of type 1 diabetes in North Chinese children. Methods Polymerase chain reaction (PCR) techniques were used to amplify the second exon of DRB1and DQ alleles, after which sequence specific olignucleotide probe (SSOP) dot blot hybridization techniques were used to analyze the amplified products. Results DRB1 * 0301, DQA1 * 0301, DQB1 * 0201 alleles and DRB1 * 0301-DQA1 * 0501-DQB1 * 0201haplotype were significantly increased in patients, while DQA1 * 0103 and DQB1 * 0601 alleles were significantly increased in controls. The distribution of DR4 and DR9 haplotypes in patients and controls were not significantly different, but DR3/DR4 and DR4/DR9 heterozygotes were significantly increased in patients. Conclusions DRB1 * 0301, DQA1 * 0301 and DQB1 * 0201 confer susceptibility while DQA1 * 0103 and DQB1 * 0601 confer protection to type 1 diabetes. DRB1 * 0301-DQA1 * 0501-DQB1 * 0201 haplotype offers a predisposition to type 1 diabetes in North Chinese. Although the distribution of DR4 and DR9 in patients and controls had no significant difference, DR3/DR4 and DR3/DR9 heterozygotes were significantly increased in patients, showing that the susceptive effects of DR3 and DR4 or DR4 and DR9haplotypes could be added up. Chin Med J 2001; 114(4): 407-409

Objective To explore the apoptosis inducing effects of arsenic trioxide (As2O3) on human bladder cancer cells and elucidate possible mechanisms. Methods After treatment with As2O3, the growth inhibition rates of human bladder cancer cell line BIU-87were studied by MTT and cell counts methods. DNA synthesis rates were detected by 3H-TdR assay. The morphological changes of cancer cells were observed by light and electronic microscopy and cell apoptosis rates were detected by TdT-mediated dUTP nick end labeling (TUNEL). bcl-2 gene expression of BIU-87cells was observed by strept avidin-biotin complex (SABC) immunohistochemical method. Results As2O3 could effectively inhibit the growth of BIU-87 (P <0.05), which were time and concentration dependent. The inhibition rate of 4.0 μmol/L As2O3 for DNA synthesis of cancer cells was 55.64%(P <0.01). Partial cancer cells presented the characteristic morphological changes of apoptosis which depended on the time of exposure to drug (P <0.05) . bcl-2 expression of BIU-87 cells was decreased significantly (P <0.05). Conclusion As2O3 can significantly induce apoptosis in bladder cancer cells by down-regulating the expression of the bcl-2 gene and inhibiting DNA synthesis. This provides a potentially effective method for prevention and cure of human bladder cancer. Chin Med J 2001; 114(4): 402-406

Objective To detect new mutations among 29 glucose-6-phosphate dehydrogenase (G6PD) deficient individuals from Yunnan province. Methods The nitroblue tetrazolium (NBT) method was used to screen G6PD deficient individuals. Mutation was identified by single strand conformation polymorphism (SSCP), amplification created restriction site (ACRS), amplification refractory mutation system (ARMS) and DNA sequencing. Results Among 29 cases, 18 cases of G1388A, 1 case of C1004A, and 1 case of G1381A were identified. Nine cases remained to be defined. The G1381A mutation is a novel mis-sense mutation, with a substitution of threonine for alanine (A461T). The resultant G6PD had reduced enzymatic activity. In addition, G1381A caused a restriction site of Stu I to disappear, providing a rapid method for the detection of this mutation. Conclusion A novel mis-sense mutation G1381A was found. This mutation results in a substitution of threonine for alanine, producing enzyme with reduced activity. The loss of the Stu I restriction site offers a rapid method for the detection of this mutation. Chin Med J 2001; 114 (4): 399-401

Objective To assess retrospectively the clinical characteristics and cell immune function of infections caused by Flavimonas oryzihabitans (F. oryzihabitans). Methods We indentified 11 cases of F. oryzihabitans positive cultures from all microbial cultures collected in our hospital from November 1994 to December 1998. Relevant clinical information was collected,including demographic data, underlying disease, and clinical manifestations of the F. oryzihabitans infections. Minimal inhibitory concentrations (MICs) of 15 antimicrobial agents against the 11 F. oryzihabitans isolates were determined. Cell immune function tests were determined by flow cytometry including T lymphocyte subsets (CD3, CD4, CD8 and ratio CD4/CD8) and NK cells (CD16+56) from peripheral blood. Results Six of these patients with infections caused by F. oryzihabitans were male, 5 were female and the mean age was 47.64 years (range, 5 to 69 years). All but 1 patients had severe underlying diseases. 9 (81.8%) of these patients developed infection while hospitalization and 2 (18.2%) before hospitalization(Cases 2 and 5). 8 (72.7%) of these patients manifested primary F. oryzihabitans bacteremia and one each (9.1%) had pleurisy, soft tissue infection and peritonitis. All these isolates were susceptible to amikacin, gentamicin and ciprofloxacin, but resistance to cefazolin, nitrofurantoin, penicillin and piperacillin. CD3, CD4, CD4/CD8 and CD16+56 value ( ± s) of these patients were significatly lower than normal values (P <0.01) . The mean time of body temperature fell≤37℃ after antibiotic treatment in these patients was 3.5 days (range, 1 to 6 days). All clinical symptom caused F. oryzihabitans after antibiotic treatment disappeared and all patients recovered. Conclusions Infections caused by F. oryzihabitans was very few clinically, and relative to underlying diseases and the presence of foreign material. Immune function abnormality was among mostly factor for the F. oryzihabitans infections. Chin Med J 2001; 114 (4): 394-398

Objective To investigate the effect of cavernous nerve injury on the nNOS-containing nerve fibers in corpus cavernosum. Methods Thirty-three male Sprague Dawley (SD) rats were randomly divided into 3 groups: sham-operated controls (n=5) underwent pelvic exploration without transection of the cavernous nerve; unilateral injury group (n=14) had their cavernous nerve cut on one side; and bilateral injury group (n=14)underwent neurotomy on both sides. Corpora cavernosa were harvested at the 3rd week and 6th month after surgery. nNOS-positive nerve fibers were examined with streptavidin-peroxidase immunohistochemistry techniques (SP method). Results After bilateral ablation, the nNOS-positive nerve fibers were significantly decreased at the 3rd week (17 ± 4) and remained so at the 6th month (16 ± 4) . For the unilateral injury group, the nNOS-positive nerve fibers were similarly decreased on the side of the neurotomy at the 3rd week (18 ± 6), but by the 6th month, the number increased significantly (61±9) and approximated the level on the contralateral side (81 ±13). Conclusion Following unilateral cavernous nerve ablation in rats, nNOS-containing nerve fibers regenerate 6 months after surgery. This regeneration process does not occur in animals with bilateral cavernous nerve injury, suggesting that during radical pelvic surgery, the cavernous nerve has to be preserved at least on one side in order to maintain the capacity for penile erection. Chin Med J 2000; 114(4): 391-393

Objective To analyze the effect and mechanism of hyperbaric oxygen (HBO) treatment for severe brain injury (SBI). Methods Fifty-five patients were divided into a treatment group of 35 patients and a control group of 20patients. We observed the alterations of clinical, brain electric earth map (BEAM), endothelin (ET) and transcranial ultrasonic Doppler (TCD) findings before and after HBO treatment as well as outcome. Results In the treatment group, Glasgow coma scale, BEAM and outcome improved after HBO treatment; compared with that of the control group, it showed a significant difference. After one course of treatment, treatment group ET was reduced from 91. 24±12.18 ng/L to 68.88±14.37 ng/L(P<0.01); in control group, ET was reduced from 90.78±15.71 ng/L to 83.12±12.22 ng/L, with a statistically significant difference(P<0.05). TCD records of MCA mean velocity(Vm)was reduced from 64.2±4.8cm/s to 51. 6±4.2 cm/s(P<0.01), and a decrease in MCA systolic velocity(Vs)and pulse index(PI)values was statistically significant(P<0.01). Conclusion HBO treatment can improve the clinical, BEAM and outcome of severely brain injured patients, by decreasing acute stage ET and improving the blood velocity of MCA and decreasing cerebral vascular resistance. HBO treatment can reduce cerebral vascular spasms, cerebral ischemia and hypoxia. One of the important mechanisms of HBO treatment for severe brain injury is the lowering of intracranial pressure. Chin Med J 2001; 114(4): 387-390

Objective To study the role of simian virus 40 (SV40) early region gene coding product large tumor antigen (Tag) expression and the interaction between Tag and tumor suppressors p53 and pRb in human brain tumorigenesis. Methods Tag was investigated by immunoprecipitation followed by silver staining and Western blot in 65cases of human brain tumors and 8 cases of normal brain tissues. Tag-p53 and Tag-pRb complexes were screened in 18 and 15 Tag positive tumor tissues, respectively. Results Tag was found in all 8 ependymomas and 2 choroid plexus papillomas. 90%of pituitary adenomas (9/10), 73%of astrocytomas (11/15), 70%of meningiomas (7/10), 50%of glioblastomas multiforme (4/8), 33%of medulloblastomas (2/6). 5 oligodendrogliomas, 1 pineocytoma, and 8 normal brain tissues were negative for Tag. Tag-p53 complex was detected in all 18 Tag positive tumors. Tag-pRb complex was found in all 15 Tag positive tumors. Conclusion SV40 Tag is expressed in human brain tumors and can form specific complexes with tumor suppressors p53 and pRb. The inactivation of p53 and pRb due to the formation of Tag-p53 and Tag-pRb complexes may be an important mechanism in the etiopathogenesis of human brain tumors. Chin Med J 2001; 114 (4): 382-386

Objective To investigate the factor V Leiden mutation associated with activated protein C resistance(APCR) in Chinese. Methods Thirty "normal" individuals and twenty patients with thrombotic disease from Chinese Han Nationality were studied with APTT±APC, PCR followed by MnLI restriction enzyme analysis, PCR based direct sequence-specific primers(PCR-SSP)and DNA sequence analysis. Results In one healthy control, the activated protein C (APC) sensitivity ratio (SR) was found to be significantly lower (0.8) than that in other normal control (> 2.0). This individual was identified to be heterozygous for FV Leiden mutaiton (Arg506-Gln). His grand-uncle, father, brother and son were also identified to be heterozygous for FV Leiden. The APC resistance was found in 3 other cases of thrombotice diseases, but with no FV Leiden mutation. Conclusion This is the first four generations family case of FV Leiden mutation associated with APCR reported within Chinese ethnic population. It is note-worthy that more FV Leiden or whether other gene defects may be associated with APC resistance and acquired APCR causing thrombosis in Chinese population. Chin Med J 2001; 114(4): 379-381

Objective To investigate the clinical and pathological characteristics of pauci-immune crescent glomerulo¬nephritis (PICGN) in Chinese patients. Methods During 13 years (1985 - 1998), 6400 patients underwent non-transplanting renal biopsy. Twenty-four patients were diagnosed as PICGN. All clinical and laboratory data of these patients were collected from the patients ' records and used for detailed analysis. The diagnosis is based on clinico¬pathologic findings. Results Of the 24 patients, 16 were females and 8 were males, with median age of 33 years (ranged 10-76 years). Microscopic polyarteritis (MPA) (33.3%) and systemic vasculitis (8.3%) were the secondary diseases. The incidence of PICGN was 0.38%in renal biopsies and 22.9%in crescentic glomerulonephritis. Clinically, most patients (75.0%) showed rapidly progressive nephritis with enlarged kidneys. At onset, gross hematuria was noted in 58.3%of patients, hypertension in 45.8%^ nephrotic syndrome in 41 .7%, and oliguria in 25.0%. However, systemic symptoms were rare except for anemia. Pathologically, necrosis of glomerular capillaries (62.5%), infiltration of monocytes and neutrophil cells in glomeruli (66.7%), and vasculitis in the interstitium (53.3%) were observed. In addition,glomerulosclerosis was noted in 45.8%, severe tubular atrophy in 83.3%and interstitial fibrosis in 75.0%. Anti-neutrophil cytoplasmic antibodies (ANCAs) were positive in 52.2% . All patients except two received intensively immunosuppressive therapy. Sixteen patients were available for long-term follow up (median 29.8 months, range 8-92 months). Twelve of them had life-sustaining renal function, four had normal serum creatinine (<124 nmol/L) and only 4 patients were dialysis-dependent. Conclusion PICGN is not rare in China. Early diagnosis and administration of immunosuppressive therapy, particularly in patients with rapidly progressive glomerulonephritis (RPGN), are important for good prognosis. Chin Med J 2001; 114(4): 374-378

Objective To gain a better understanding of genetic changes in Cantonese nasopharyngeal carcinoma(NPC). Methods Comparative genomic hybridization (CGH) was performed on 17 primary nasopharyngeal carcinomas. Results A novel copy number gain an chromosome 4q and loss of chromosome 1p were found at a high frequency (> 50%). Conclusions Current analysis revealed a comprehensive profile of the chromosomal regions showing gain of chromosomes 4q, 12q, and 1 q as well as loss of chromosomes 1p, 3p, 11q, 14q, 15q, 13q, Xq, 9q,10p, 10q, and 16q. Frequently altered loci may encode oncogenes or tumor suppressor genes involved in the development of primary NPC. Chin Med J 2001; 114 (4): 418-421

Objective To investigate the effect of acidum vitamin A on tyrosinase activity and provide experimental evidence for therapy of pigment disorder of skin. Methods Tyrosinase activity was estimated by measuring the rate of oxidation of DL-dopa. Results The levels of tyrosinase activity in the acidum vitamin A group were significantly greater than those of the control group (P <0.01). Conclusion Tyrosinase activity can be increasingly induced by acidum vitamin A. Chin Med J 2000; 114(4): 415-417