A retrospective study on pathological and clinical characteristics of 3 932 children with liver diseases / 中华儿科杂志

<p><b>OBJECTIVE</b>To explore the pathological and clinical characteristics of children with liver diseases by retrospective study on clinical and liver biopsy pathological data of children with liver diseases.</p><p><b>METHOD</b>This retrospective analysis was performed at Beijing No. 302 Hospital among 3 932 children with liver diseases who visited the hospital from January 2001 to December 2012. The kinds of diseases were compared with the results of 1983-2000.</p><p><b>RESULT</b>(1) Liver biopsy was successful in 99.72% (3 932/3 943) of cases of 2001-2012 group, complications occurred in 31 children only. (2) Of the 3 932 cases, 2 647 (67.32%) had hepatitis , non-hepatotropic viral hepatitis and non viral liver disease were seen in 365 cases (9.28%), and 920 cases (23.4%), respectively. Among 2 647 cases with viral hepatitis, 2 115 were hepatitis B (79.90%), 521 hepatitis C (19.69%), 7 were hepatitis A (0.26%) and 4 hepatitis E (0.15%), respectively. (3) In 2001-2012 group, the degrees of inflammatory activity (>G2) of liver were seen in 9.57% (202/2 111) patients with hepatitis B, while 23.57% (132/560) in 1983-2000 group. There was significant difference between the two groups (χ(2)=80.36, P=0.00 ). (4) Significant difference was observed in the rate of non viral liver disease between 2001-2012 group (23.40%, 920/3 932) and 1983-2000 group (9.61%, 98/1 020) (χ(2)=93.46, P=0.00). In 2001-2012 group, including 46 kinds of diseases, which were significantly higher than those of 1983-2000 group (18 kinds). In 2000-2012, the main causes of diseases were liver degeneration (18.26%, 168/920), drug-induced liver injury (13.59%, 125/920), fatty liver (8.80%, 81/920) and liver glycogen accumulation disease (8.70%, 80/920). While in 1983-2000 group, the main causes were liver degeneration (20.41%, 20/98), fatty liver (16.33%, 16/98), glycogen storage disease (10.20%, 10/98) and myopathy (9.18%, 9/98).</p><p><b>CONCLUSION</b>Liver biopsy in children is safe and feasible. Hepatitis B virus was ranked first in children with liver diseases in 2001-2012 group. The kinds of non viral hepatic disorders had changed and extended.</p>

Clinical and pathological characteristics and pathogenesis of autoimmune hepatitis / 中华实验和临床病毒学杂志

<p><b>BACKGROUND</b>To explore the clinical and pathological characteristics and pathogenesis of autoimmunohepatitis (AIH).</p><p><b>METHODS</b>The serum and liver biopsy specimens and clinical data of 26 cases with patients with AIH were analyzed and scored according to the criteria of International autoimmune hepatitis (IAIHG, 1999). The changes of dendritic cells (DC) in the liver tissues were observed with a panel of DC markers (CD-80/B7-1, CD-86/B7-2, CD-1a and HLA-DR) and immunohistochemistry, and the activation of hepatic stellate cells (HSC) and the expression of TGF-alpha were also detected. Liver tissue specimens from 10 patients with chronic viral hepatitis B and C respectively and 5 normal liver specimens were chosen as controls.</p><p><b>RESULTS</b>Mean aggregate scores of 26 AIH cases, including 21 cases of type B (80.8%) and 5 cases of type C (19.2%), which were 18.6 +/- 1.4 and 19.1 +/- 2.1 respectively. There were significant differences between the type B and type C in the average age levels of serum ALT and AST, and alpha-Glo (P <0.001 or P< 0.01 or P <0.05). Histological features of all the AIH liver tissues showed the lesions of chronic active hepatitis such as interface hepatitis/piecemeal necrosis (100%), obvious lobular inflammation (type B 95.2%, type C 100%), bridging necrosis (57.1% type B, 80.0% type C, P<0.05), rosetting of liver cells (71.4% type B, 100% type C, P<0.01), central lobular confluent necrosis (33.3% type B, 80.0% type C, P<0.001), predominant plasmacytic infiltration (type B 95.2%, type C 20.0%, P<0.001). The rates of increased and concentrated DC in the portal and lobular areas, especially in the active lesions in type B and type C AIH were 85.7% (18/21) and 5/5 respectively. It was found that DC and lymphocytes surrounded the hepatocytes which partly expressed HLA-DR antigen, while there were no or a few HLA-DR positive hepatocytes in controls. Meanwhile, the number of alpha-SMA positive HSC and the expression of TGF- were obviously increased in AIH liver tissues.</p><p><b>CONCLUSIONS</b>Several clinical and pathological features of AIH were identified in this study. As an antigen-presenting cell, DC might play an important role in the pathogenesis of AIH. In China, sub-type B of AIH might be more frequent than sub-type C and there were differences in clinical aspects, serology and pathology between the two types.</p>

The expression of thyroid transcription factor-1 in pulmonary sclerosing hemangioma and a further investigation on histogenesis of the tumor / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the histogenesis and pathologic features of pulmonary sclerosing hemangioma (SH) and its expression of thyroid transcription factor-1 (TTF-1).</p><p><b>METHODS</b>Seventeen cases of pulmonary sclerosing hemangioma were reevaluated and 12 cases were immunostained with a panel of antibodies including TTF-1, EMA, cytokeratin, etc. Six cases were studied by electron microscopy.</p><p><b>RESULTS</b>All cases exhibited the classic histologic features with variable proportions of solid, papillary, hemorrhagic or hemangiomatic, and sclerotic pattern. The tumours consisted of solid sheets or aggregates of pale polygonal cells and papillae and clefts lined by cuboidal or columnar cells. Both TTF-1 and EMA expressions were observed in the surface lining cuboidal cells and the pale polygonal cells. In only one case both chromogranin and synaptophysin showed weakly positive in few polygonal cells and a small number of granules with high electron density was found in the polygonal cells by electronic microscopy.</p><p><b>CONCLUSIONS</b>It is suggested that pulmonary sclerosing hemangioma is an epithelial neoplasm derived from primitive respiratory epithelium capable of differentiating toward pneumocytes or Clara cells. The immunohistochemical markers such as TTF-1, EMA and CK play an important part in diagnosis of SH.</p>

A PRELIMINARY PATHOLOGICAL STUDY OF IgA NEPHROPATHY-LIGHT-AND ELECTRON MICROSCOPIC OBSERVATION / 解放军医学杂志

In this study, renal biopsy specimens from 150 cases of IgA nephropathy were studied with light-and electron microscopically. Histological lesions from minimal change to diffuse mesangial proliferation were observed. According to the degree of the renal lesions, the 150 cases were divided into 6 subtypes. Proliferation of mesangial matrix was found to be the striking ultrastructural alteration, which often appeared as focal segmental or global proliferation of mesangial cells, as well as marked increase in mesangial matrix. Electron-dense deposits were largely localized in mesangial matrix and in suben dothelial regions. However, no positive correlation could be seen between the number of the deposits and the degree of the lesions.

PANETH'S CELL ADENOMA OF THE STOMACH / 解放军医学杂志

Two cases of Paneth's cell adenoma of the stomach are reported and their morphological, histochemical, immunohistochemical, ultrastructural and immunocytochemical features are described. Both surgical specimens showed varied dysplasia with severe atrophic gastritis and intestinal metaplasia. 60%-70% of the tumor cells contained coarse eosinophilic cytoplasmic granules that are PAS positive but unstained by alcian blue at pH 2.5, and exhibited positive antiserum immunoreaction for ly-sozyme. The Paneth's nature of these granules was confirmed by electron microscopy and immunoelec-tron microscopy. In addition, some endocrine cells were detected in the neoplastic glands. The characteristics of Paneth's cell adenoma of the stomach are discussed and a close relationship between the histogenesis and intestinal metaplasia is suggested.

CMPase CYTOCHEMICAL AND ANF IMMUNOCYTOCHEMICAL OBSERVATION ON THE ATRIAL MUSCLE CELLS OF HUMAN / 解剖学报

The human atrial muscle cells were investigated by ultrastructural CMPase cytochemistry and atrial natriuretic factor (ANF) immunocytochemistry. The primary lysosomes and ANF were labelled by these techniques, respectively. ANF was localized in the atrial specific granules, these granules were similar in size and 0.20? 0.051?m in diameter, distributed over the entire cytoplasm, preferentially being located in the subsarcolemmal and perinuclear region and forming clusters. Primary lysosomes were various in size, 0.30?0.191?m in diameter, significantly larger than atrial specific granules (P

INVESTIGATION OF PEROXISOMES (MICROBODIES) IN HUMAN LIVER CELLS WITH ULTRACYTOCHEMISTRY AND STEREOLOGY / 解剖学报

Peroxisomes (microbodies) were studied with CATase, G-6-Pase, TPPase, CMPase cytochemistry and stereology by electron microscopy in 15 cases of normal human liver specimens. In human hepatocytes peroxisomes are ellipsoid or round intracellular bodies. They contain homogeneous fine granular matrix, and surrounded by unit membrane, and distribute randomly in the cytoplasm. By stereological analysis, the peroxisomes accounted for 1.33?0.38% of the cytoplasmic volume, their numerical density in spase was 9.76?1.63/100 ?m~3 cytoplasm, and the ratio of mitochondria to peroxisomes in quantity was 6.22?1.17. The result of G-6-Pase cytochemistry showed no luminal connection between endoplasmic reticulum and peroxisomes. The membrane similar to smooth endoplasmic reticulum seem to be connected with peroxisomes which was G-6-Pase negative, hence such membrane may be peroxisomal membrane system rather than smooth endoplasmic reticulum. The TPPase cytochemistry showed that peroxisomes did not connect with the Golgi complex structurally, and the Golgi complex may not be involved in the biogenesis of peroxisomes. Some figures resembled fission and budding of peroxisomes were viewed, and this finding suggested that new peroxisomes formed probably by division of preexisting peroxisomes.