Investigation and Study on Present Situation of Clinical Pharmaceutical Care in 39 Medical Institutions in Chong- qing / 中国药房

ABSTRACT OBJECTIVE：To investigate the present situation of clinical pharmacy in different levels of medical institutions in Chongqing，and to investigate the method for optimizing clinical pharmaceutical care. METHODS：By questionnaire survey，50 sample medical institutions（including 15 third level hospitals，25 second level hospitals and 10 first level hospitals）in Chongqing were selected according to the region，the level of medical institutions，comprehensive and specialized hospitals. The team of clinical pharmacists and the development of clinical pharmacy were investigated，and the results were statistically analyzed to find common problems and put forward relevant suggestions. RESULTS & CONCLUSIONS：Totally 45 questionnaires were collected， with a recovery rate of 90％，of which 39 questionnaires were qualified，with a qualified rate of 86.67％. There were 32 hospitals （82.05％）in 39 medical institutions with clinical pharmacy departments and 4 hospitals（10.26％）with clinical pharmacist training base. There were 239 full-time pharmacists in 39 medical institutions，with an average of 6.13 persons in each medical institution， including 4.5 full-time clinical pharmacists，and 2-5 full-time clinical pharmacists（25 hospitals）in most medical institutions. Top 5 clinical departments that clinical pharmacists mainly participated in were respiratory department，cardiovascular department， endocrinology department，ICU and oncology department. Most of the clinical pharmacists（16 hospitals，42.11％）worked in the clinic for more than 50％ to no more than 80％. The number of medical institutions（28-37，＞70.00％）carrying out ADR monitoring， rational drug use knowledge publicity， prescription and medical order comment， ward round， consultation， editing and publishing drug information was relatively high. 28 medical institutions（78.95％）did not carry out the test of therapeutic drugs；39（100％）medical institutions had carried out the education of patients’drug use，in the form of billboards（30 hospitals，78.95％），science lectures（28 hospitals，73.68％）and drug education forms（28 hospitals，73.68％）The contents of drug use education mainly included precautions（39 hospitals，100％），usage and dosage（37 hospitals，97.37％）， ADR（36 hospitals，94.74％）. 29 hospitals had carried out clinical pharmaceutical research（73.68％），mainly rational drug use research（28 hospitals，73.68％）；5 medical institutions（12.82％）had set up joint pharmacy outpatient service，2（5.12％）had set up independent pharmacy outpatient service，the rest had not set up pharmacy outpatient service（26 hospitals，66.67％）. In this survey，it is found that there are some problems，such as incomplete coverage of beds in the ward in pharmaceutical care，weak foundation of scientific research in pharmaceutical departments. It is suggested that the national and local health committees should strengthen the construction of multi-level clinical pharmacy talent echelon，explore and train resident clinical pharmacists，select and build key clinical pharmacy specialties in Chongqing，and establish incentive mechanism for clinical pharmacists. Medical institutions at all levels can adopt multiple ways to accelerate the training of clinical pharmacists，increase the publicity of pharmacists’outpatient service，change the working mode of the ward，cultivate special clinical pharmacists，improve the ways and paths of continuing education，and enhance the strength of scientific research to improve the level of clinical pharmaceutical care.

Clinical characteristics and survival analysis of de novo grade 3 or transformed follicular lymphoma patients / 中华血液学杂志

Objective@#To evaluate the clinical characteristics and survival outcomes of patients with de novo grade 3 or transformed follicular lymphoma (FL).@*Methods@#Fifty-two patients treated at Peking University Cancer Hospital between January 2009 and September 2017 were assessed, including 28 patients with FL 3A grade, 13 patients with FL 3B grade, 11 patients with transformed FL. Baseline characteristics, survival and prognostic factors were analyzed.@*Results@#① Twenty-six male and 26 female patients were enrolled, including 28 patients with FL 3A grade, 13 patients with FL 3B grade, 11 patients with transformed FL. ②The 3-year progression-free survival (PFS) and overall survival (OS) for the entire cohort were 56.0% and 80.6%, respectively. Patients with international prognostic index (IPI) score 0-1 demonstrated significantly better 3-year PFS (80.3% vs 20.1%; t=18.902, P<0.001) and OS (95.7% vs 57.0%; t=10.406, P<0.001) than patients with IPI score 2-3. Three-year PFS (94.1% vs 37.2% vs 25.2%; P=0.002) and OS (100.0% vs 76.0% vs 59.8%; P=0.020) were also significantly different among patients with FLIPI 1 score 0-1, 2, ≥3. FLIPI 2 score was also identified as a prognostic factor for 3-year PFS (68.4%, 0, 0; P=0.001) and OS(87.5%, 76.2%, 0; P=0.003). ③Multivariate analysis indicated a significant association of PFS (HR=3.536, P=0.015) and OS (HR=15.713, P=0.015) with IPI. FLIPI 2 was associated with OS (score 0-1, HR=0.078, P=0.007; score 2, HR=0.080, P=0.022).@*Conclusion@#De novo grade 3 or transformed FL might be a group of curable disease with current treatment strategies. IPI is still a prognostic tool in this scenario.

Prognostic significance of 18F-fluorodeoxyglucose positron emission tomography in patients with diffuse large B cell lymphoma undergoing autologous stem cell transplantation / 中华血液学杂志

Objective@#To evaluate the prognostic value of 18F-fluorodeoxyglucose positron emission tomography (PET)/computed tomography (CT) in patients with diffuse large B cell lymphoma (DLBCL) undergoing autologous hematopoietic stem cell transplantation (auto-HSCT).@*Methods@#Forty-eight patients with DLBCL treated at Peking University Cancer Hospital between November 2010 and December 2014 were assessed. All patients underwent PET/CT scanning prior to or after auto-HSCT. Correlation analysis was done based upon patients characteristics, PET/CT scan results and survival.@*Results@#①Among 48 patients, 27 was male, 21 female, median age was 43 (17-59) years old. ② Patients with negative pre-auto-HSCT PET/CT assessment demonstrated significantly better 3-year progression free survival (PFS) (87.1% vs 53.3%, χ2=7.02, P=0.019) and overall survival (OS) (90.3% vs 60.0%, χ2=6.51,P=0.022) than patients with positive pre-auto-HSCT PET/CT assessment. Three-year PFS (94.1% vs 30.0%, χ2=22.75, P=0.001) and OS (97.1% vs 40.0%, χ2=21.09, P=0.002) were also significantly different between patients with negative and positive post-auto-HSCT PET/CT assessment. ③ Multivariate analysis indicated a significant association of PFS (HR=13.176, P=0.005) and OS (HR=20.221, P=0.007) with post-auto-HSCT PET/CT assessment. Number of prior treatment regimens was associated with PFS (HR=10.039, P=0.040). ④ Harrell’s C index revealed that the value of combined use of number of prior treatment regimens and post-auto-HSCT PET/CT assessment was superior to either one used alone in PFS (Harrell’s C values were 0.976, 0.869 and 0.927 in combined use, number of prior treatment regimens and post-auto-HSCT PET/CT assessment, respectively), and the combined use of ECOG performance status and post-auto-HSCT PET/CT assessment significantly increased the Harrell’s C index in OS (Harrell’s C values were 0.973, 0.711 and 0.919 in combined use, ECOG performance status and post-auto-HSCT PET/CT assessment, respectively).@*Conclusions@#Post-auto-HSCT PET/CT assessment is the main predictor of outcomes in DLBCL patients receiving auto-HSCT. Combined use of post-auto-HSCT PET/CT assessment and number of prior treatment regimens and ECOG performance status is a better prognostic tool in patients with DLBCL undergoing transplantation.

Clinical features, diagnosis, treatment, and prognosis of 99 cases with primary intestinal lymphoma / 中华血液学杂志

Objective@#To investigate the clinical features, diagnosis, treatment and prognosis of primary intestinal lymphoma (PIL) .@*Methods@#The characteristics, diagnosis, treatment methods, and follow-up outcomes of 99 PIL patients, diagnosed in Peking university cancer hospital between Nov.1,1995 and Nov. 30, 2013.@*Results@#There were 65 males and 34 females with a median age of 50 years. The majority of clinical manifestation were non-specific gastrointestinal symptoms, 67.68% of cases presented abdominal pain, 26.26% with acute abdomen. The most common primary sites of ileum and ileocecus were identified in 21 cases, respectively. The positive rate of endoscopic was only 24.24%, and 69 cases were diagnosed by operation. 71 patients (71.72%) were stageⅠ-Ⅱand 28 patients (28.28%) were stage Ⅳ. Hodgkin’s lymphoma was not found in all patients. Of the 99 cases, 77 were B-cell origin (77.78%) and 22 were T-cell origin. 55 cases (55.56%) were diagnosed with diffuse large B cell lymphoma (DLBCL) . 60 cases presented IPI score 0-1 point. The median overall survival (OS) was 100.0 months, and 5 year overall survival (5y-OS) was 53.5%. By multiple-factors analysis, T-cell origin lymphoma was significantly correlated with poor prognosis (P<0.05) . There was no difference of the median OS between the patients with operation and chemotherapy alone (79.0 vs 123.0 months, P=0.616) .@*Conclusion@#PIL is commonly seen in males. Abdominal pain is the most common clinical manifestations and the most primary sites are ileum and ileocecus. The diagnosis value of the endoscopic is limited. DLBCL is the most common pathologic type of PIL. T-cell origin lymphoma is an independent prognostic factor for PIL. Surgery is still commonly used in the diagnosis and treatment of PIL, and the operation do not increase the risk of death of patients with PIL.

Comparison of prognostic models for patients with early-stage diffuse large B-cell lymphoma / 中华血液学杂志

<p><b>OBJECTIVE</b>To compare the prognostic value of different models in patients with early-stage diffuse large B-cell lymphoma (DLBCL).</p><p><b>METHODS</b>Early-stage DLBCL patients diagnosed from January 2000 to December 2012 were analyzed retrospectively. All patients received with at least 2 cycles of immunochemotherapy R-CHOP regimen (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) with or without radiotherapy. The prognostic value of international prognostic index (IPI) , revised IPI (R-IPI) and enhanced IPI (NCCN-IPI) was compared.</p><p><b>RESULTS</b>Ninety-seven cases of early-stage DLBCL were included in the study. The median age was 58 years (15-88 years) with a median follow-up of 34.7 months (range 7.3-77.4 months). The expected 5-year overall survival (OS) for entire group was 82%. There was no patient in the high risk group according to IPI or NCCN-IPI. According to IPI, the 5-year OS in the low, low intermediate, high intermediate risk groups were 95%, 38% and 60%, respectively. According to R-IPI, the 5-year OS in the very good, good, and poor risk groups were 93%, 75% and 60%, respectively. According to NCCN-IPI, the 5-year OS in the low, low intermediate, high intermediate risk groups were 92%, 85% and 29%, respectively.</p><p><b>CONCLUSION</b>NCCN-IPI would be of an ideal prognostic model for early-stage DLBCL patients.</p>

Prognostic value of 18F-FDG PET-CT in Hodgkin lymphoma / 中华血液学杂志

<p><b>OBJECTIVE</b>To determine the predictive value of interim and end-of-treatment ¹⁸F-FDG PET-CT after first-line treatment in patients with Hodgkin lymphoma (HL).</p><p><b>METHODS</b>The clinical data of 50 newly diagnosed HL patients were retrospectively analyzed. Baseline, interim and end-of-treatment PET-CT were performed, and then imaging results were analyzed for the survival of patients via software SPSS 13.0.</p><p><b>RESULTS</b>Fifty patients received first-line treatment with ABVD (doxorubicin + bleomycin + vincristine + dacarbazine) or BEACOPP (bleomycin + etoposide + doxorubicin + cyclophosphamide + vincristine + procarbazine+ prednisone) regimen. Interim PET-CT of 35 patients were performed after 2-4 cycles of treatment, 46 patients received PET-CT scans at the end of treatment. After a median follow-up of 29.4 months (12.2-52.4 months), the 3-year progression-free survival (PFS) rates were 100% and 70% for the interim PET-CT negative (n=25) and positive (n=10) patients, respectively (P=0.004). The 3-year PFS rates were 100% and 60% for the post-treatment PET-CT negative (n=36) and positive (n=10) patients, respectively (P<0.01).</p><p><b>CONCLUSION</b>Interim and end-of-treatment PET-CT were correlated with 3-year PFS rates for HL patients. They may play an important role in predicting the outcome of HL. The relationship with OS can not be determined because of the short follow-up time.</p>

Analysis of clinical features and prognosis of 98 patients with mantle cell lymphoma / 中国肿瘤临床

Objective:To study the clinical features, therapeutic effects, survival time, and prognosis of patents with mantle cell lymphoma (MCL). Methods:Clinical data of 98 MCL patients admitted from January 2005 to December 2013 were retrospectively an-alyzed. Results:The median age was 61 years old, and the male-to-female ratio was 2.9∶1. Among these cases, 85 (86.8%) were in Ann Arbor stageⅢ-Ⅳ, 46 (46.9%) had bone marrow involvement, 25 (25.5%) had digestive tract involvement, and 53 chose R-CHOP as first-line treatment. The expected 3-year overall survival (OS) of these patients was only 61.4%. A total of 14 cases were treated with R-CHOP followed by ASCT. The expected 5-year OS was 92.3%, and the OS of the ASCT group was significantly higher than that of the R-CHOP group (75.5 months vs. 43.6 months, P=0.039). Elevated ESR,>60 years old, increased LDH level, B symptoms, and Ki-67≥25% were poor prognostic factors. Conclusion: Most patients with MCL were elder adults with bone marrow involvement. R-CHOP followed by ASCT had better clinical efficacy than conventional chemotherapy in the treatment of MCL.

Relevant risk factors for type 2 diabetes mellitus complicated with osteoporosis / 中国医师进修杂志

Objective To analyze the changes of bone mineral density (BMD) and glucose metabolism in patients with type 2 diabetes mellitus (T2DM) complicated with osteoporosis.Methods Eighty-six patients with T2DM were selected.The patients were divided into T2DM complicated with osteoporosis group and simple T2DM group according to the BMD value.The fasting blood glucose (FBG),fasting insulin (FINS),glycosylated hemoglobin (HbA1c) and course of disease were compared between the 2 groups,and the correlation was analyzed between the indexes and BMD.Ninety-three health examination people were selected as health control group.Results The rate of osteoporosis in health examination people was significantly lower than that in T2DM patients [28.0％(26/93) vs.59.3％(51/86)],there was statistical difference (P ＜ 0.05).There were statistical differences in HbA1c,FINS,BMD,course of disease between T2DM complicated with osteoporosis group (51 cases) and simple T2DM group (35 cases) [(8.57 ± 2.59)％vs.(7.26 ±1.68)％,(13.21 ±4.73) μU/L vs.(17.54 ±5.91) μU/L,(0.764 ±0.130) g/cm2 vs.(0.993 ± 0.123) g/cm2,(11.4 ± 6.4) years vs.(8.6 ± 4.7) years,P ＜ 0.05].The BMD in patients with T2DM was negatively correlated with course of disease,HbA1c,FINS (r =-0.306,-0.185,-0.269; P ＜ 0.05 or ＜0.01),there was no correlation between BMD with FBG (P ＞ 0.05).Conclusion The poor long-term blood glucose control,low insulin level,long course of disease are the risk factors for T2DM complicated with osteoporosis.

"""Keep away from chemotherapy""may not just a dream for lymphoma:review new data from the 54th ASH annual meeting" / 白血病·淋巴瘤

The 54th ASH annual meeting should be considered as a revolution for treatment of lymphoma.Keep away from chemotherapy will not be just a dream,it based on the deep understand of lymphoma genesis and quick development of different targeted agents.The typical examples are the dramatic novel agents targeting B cell receptor signaling pathway and microenvironment.There combination,such as R-square regimen,showed unbelievable efficacy in indolent B cell lymphomas and tiny side effects.It is sure that therapy breakthroughs in aggressive B cell lymphomas and T/NK cell lymphomas are in the very near future.

Effect of catalpol and puerarin freeze-dried powder on coagulability, hemorheology and no in rats with Qi-deficiency and blood-stasis syndrome / 中国中药杂志

<p><b>OBJECTIVE</b>To study the effect of catalpol and puerarin freeze-dried powder for injection (CPFPI), a new compound traditional Chinese medicine (TCM) preparation, on coagulability, hemorheology and NO in rats with qi-deficiency and blood-stasis syndrome.</p><p><b>METHOD</b>The model of rats with qi-deficiency and blood-stasis syndrome was established by hunger, fatigue, cold-dampness, panic and high fat diet. Coagulation time (CT) was observed by the glass method, and bleeding time (BT) was measured by tail-cutting method. The effects of CPFPI were also evaluated with prothrombin time (PT), activated partial thromboplastin time (APTT) and thrombin time (TT). HCT was measured by the electric tesistance method, hemorheology indicators were observed by auto-hemorheological instrument. The level of NO in blood serum was measured by NO assay kit.</p><p><b>RESULT</b>CPFPI 65.40 mg x kg(-1) significantly prolonged CT, BT, PT, APTT and TT in rats. The viscosity of whole blood and plasma, hematocrit, erythrocyte aggregation and rigidity index, and reduced viscosity of whole blood in 65.40 mg x kg(-1) groups were lower than model group. CPFPI 65.40 mg x kg(-1) can raise the level of NO in blood serum. 32.70 mg x kg(-1) markedly prolonged CT, PT and APTT and decreased whole blood viscosity, erythrocyte aggregation index and whole blood reduction viscosity.</p><p><b>CONCLUSION</b>CPFPI has a significant effect in improving coagulability and hemorheology index and enhancing NO content in blood serum.</p>

Distribution of puerarin contained in Zige freeze-dried powder injection in rat liver and kidney / 中国中药杂志

<p><b>OBJECTIVE</b>To investigate the distribution process of puerarin contained in Zige freeze-dried powder injection in rat liver and kidney and the safety of Zige freeze-dried powder injection.</p><p><b>METHOD</b>Rats were divided into the Zige freeze-dried powder injection group and the puerarin freeze-dried powder injection control group randomly. The liver and kidney samples were collected at 5, 10, 20, 30, 45, 60 and 120 min after intravenous administration of puerarin (26.7 microg x g(-1)) through caudal vein and detected by HPLC.</p><p><b>RESULT</b>The concentration of puerarin in kidney reached the max value of 58.12 microg x g(-1) for the Zige freeze-dried powder injection group and 71.28 microg x g(-1) for the Puerarin freeze-dried powder injection group. The value of AUC(0-2h) was 26.24 microg x h x g(-1) for the Zige freeze-dried powder injection group and 35.24 microg x h x g(-1) for the puerarin freeze-dried powder injection group, MRT(0-2h) was 0. 39 h for the Zige freeze-dried powder injection group and 0. 42 h for the puerarin freeze-dried powder injection control group. Compared with the control group, the Zige freeze-dried powder injection group showed a significant decrease in Cmax and AUC(0-2h) (P < 0.05), with no notable difference in peak time tmax and MRT(0-2h). The two groups showed no obvious difference in tmax Cmax, AUC(0-2h) and MRT(0-2h) of puerarin in rat kidney.</p><p><b>CONCLUSION</b>Compared with Zige freeze-dried powder injection, Zige freeze-dried powder injection can reduce the distribution of puerarin in rat kidney, with no obvious change in the elimination of puerarin in rat kidney. It also showed no significant change in distribution and elimination in liver. This indicates that Zige freeze-dried powder injection is safer to kidney than puerarin freeze-dried powder injection.</p>

Research of therapeutical effect and immunologic mechanism of Jiawei Foshou San on model rats of endometriosis / 中国中药杂志

<p><b>OBJECTIVE</b>To explore the effect and mechanism of Jiawei Foshou San on the accretion ectopic endometrium of rats.</p><p><b>METHOD</b>Endometriosis model was established by surgical implant of endometrial tissue which belongs to its body in rats. Jiawei Foshou San was administrated to the model rats. Twenty-eight days later, the length of ectopic endometrium was measured by vernier caliper, the spleen was weighed by electronic balance, the content of tumor necrosis factor (TNF)-alpha in blood serum and peritoneal fluid was detected by ELISA test, the expression of interleukin (IL)-8 in ectopic endometrium was detected by immunohistochemical method, the expression of NF-kappaB p65 protein and inhibitory KBalpha (IkappaBalpha) protein in ectopic endometrium were analyzed by western blot.</p><p><b>RESULT</b>Jiawei Foshou San 0.045, 0.09, 0.18 g x kg(-1) group reduced the volume of ectopic endometrium. Jiawei Foshou San 0.18 g x kg(-1) group raised the spleen exponent of model rats. Jiawei Foshou San 0.09, 0.18 g x kg(-1) group decreased the content of TNF-alpha in blood serum and peritoneal fluid, and the content of IL-8 in ectopic endometrium was also decreased. Jiawei Foshou San can decrease the expression of NF-KB p65 and increase the expression of IkappaBalpha in ectopic endometrium.</p><p><b>CONCLUSION</b>Jiawei Foshou San can inhibit the accretion of endometriosis implants of rats, and its mechanism might be associated with improving the environment of body.</p>

Autoimmunity and lymphoma / 白血病·淋巴瘤

The association between autoimmunity and lymphoma is bidirectional: patients with autoimmune disorders have an increased risk of developing malignant lymphoma, and autoimmune symptoms occur in the context of malignant lymphoma much more often. The epidemic features, clinical characteristics,and biologic mechanisms that underlie this association have been investigated in many studies, and this review is focused on recent progresses in this area.

Preparation of cardiomyopathy model in rats with type 2 diabetes / 中国组织工程研究

BACKGROUND: Diabetic cardiomyopathy is closely related to the high incident rate of diabetic heart failure. It is extremely significant to set up the successful dietetic cardiomyopathy model for the study on improving cardiac function.OBJECTIVE: To understand the influence of high blood sugar on myocardium by setting up the model of type 2 diabetes and diabetic cardiomyopathy.DESIGN: Completely randomized design, randomized and controlled study,in which, the experimental animals were taken as the objects.SETTING: Department of endocrinology of a university.METHODS: In the experiment, 99 newly born Wistar male rats were employed, randomized into experiment group (75 rats) and the control group(24 rats). In the control group, abdominal injection was done with sodium citrate buffer and the single abdominal injection was done with strptozocin(STZ)90 mg/kg in the experiment group. Ten weeks later, the glucose tolerance was assayed to determine the set-up of diabetes model. The ultrastructure of myocardium of rats was tested under electronic microscope after being sacrificed.MAIN OUTCOME MEASURES: To observer whether the myofibrillae and mitochondria of myocardiocytes alter or not in diabetic rats.RESULTS: In the experiment group, the fasting blood sugar[(8.87± 0.76)mmol/L] was slightly higher than that[ (5.88 ± 0. 45)mmol/L] in the control group, the blood sugar 2 hours after meal was remarkably higher than that in the control group and the glucose tolerance was abnormal. Under the electronic microscope, the myofibrillae presented focal degeneration and disarranged order of myofilament; mitochondria of myocardiocytes presented swelling and focal proliferation.CONCLUSION: This model is the satisfactory carrier for the study on diabetes Ⅱ and its myocardiopathy, which lays an experimental foundation for the study on cardiac function of type 2 diabetes.

Relationship between LAPTM4B gene polymorphism and susceptibility of lung cancer / 北京大学学报(医学版)

Objective: To investigate the possible association between the allelic variation of LAPTM4B and the genetic susceptibility of lung cancer. Methods: The genotype of LAPTM4B was analyzed in 134 unrelated healthy adult individuals and 166 patients with lung cancer by utilizing polymerase chain reaction based on special primers. The genotypical distribution of LAPTM4B was analyzed by ? 2 test. Results: The allelic frequencies of the *2 were 40.1% and 28.0% in the lung cancer group and the healthy control group respectively, which was significantly different between the two groups (P 0.002). There was a significant difference in the overall genotypical distribution between the patients and the controls (P0.005). The risk of suffering from lung cancer was increased 1.91 times in the individuals of the *1/2 genotype (95%CI: 1.178-3.110) and 3.26 times in the individuals of the *2/2 genotype of LAPTM4B (95%CI:1.338-7.929) compared with the *1/2 genotype. No association was observed between the genotypical distribution of LAPTM4B and the clinical information on patients of lung cancer such as gender, age, pathological type, differentiation classification of TNM and infection of HBV. Conclusion: This study suggests that the allele *2 of LAPTM4B might be the risk factor of lung cancer, which could be associated with genetic susceptibility of lung cancer.

Apoptosis and its modulation in type Ⅰ diabetes mellitus / 中国病理生理杂志

Apoptosis, also known as programmed cell death,is a normal process contributing to tissue tumor during development and in the adult.During development apoptosis is involved in tissue homeostasis and eliminating nonfunctional,superfluous or harmful cells.It is an active process controlled by some gene and factors such as caspases, bcl-2, Fas/FasL and NO.Type 1 diabetes mellitus is regarded as a chronic autoimmune disease resulting from progressive destruction of insulin-producing ?-cells in the pancreas.The relationship between apoptosis with its modulation and type 1 diabetes mellitus was reviwed.

The function of Fas, FasL and Bcl- 2 in the pathogenesis of autoimmune thyroid disorders / 中国病理生理杂志

AIM: To investigate the expression and function of apoptosis-related protein, Fas, FasL, and Bcl-2 in the pathogenesis of autoimmune thyroiditis. METHODS: Immunohistochemical staining was performed on 20 Hashimoto's thyroiditis (HT), 20 Graves' disease (GD), and 20 thyroid follicular adenoma (TFA, as control). RESULTS: All the cases expressed Fas, mainly on the cell surface and cytoplasm. FasL was found in all except 3 of the TFA. Bcl-2 in 15 of HT, 19 of GD, 17 of TFA. In TFA follicular cells expressed moderate Fas and minimal or absent FasL. In HT, follicles adjacent to infiltrating lymphocytes showed a increased levels of Fas and FasL, but infiltrating lymphocytes exhibited weaker staining of Fas and FasL than thyrocytes. In GD, thyrocytes and lymphocytes showed nearly similar Fas with HT, but rather weaker for FasL than HT. Bcl-2 was nearly similar in GD and TFA, but follicular cells in vicinity of lymphocytes and lymphocytes located in germinal centers of HT tissues exhibited significantly weaker. CONCLUSION: The expression of Fas, FasL and Bcl-2 in Hashimoto's thyroiditis and Graves' disease was nearly similar. Strong FasL expression and weak Bcl-2 expression on the follicles in HT may induce apoptosis. These results provide further proof that the functions of Fas and its ligand and Bcl-2 may play an important part in the pathogenesis of autoimmune thyroid diseases. The lymphocytes do not seem to be directly engaged in the process with their own FasL, but they may provide some cytokines that, in turn, up-regulates Fas and/or FasL leading to apoptosis.