Effect of CD8(+)CD28(-) suppressor T cells induced by dendritic cell with major histocompatibility complex 1 expression RNA interference on immune tolerance in rat intestinal transplantation / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of CD8(+)CD28(-) suppressor T cells(Ts) induced by dendritic cell(DC) with major histocompatibility complex 1(MHC-1) expression RNA interference on immune tolerance in rat intestinal transplantation.</p><p><b>METHODS</b>The expression level of CD8(+)CD28(-)Ts were successfully induced by DC with MHC-1 expression interfered by RNA interference technique under the stimulator of allograft antigen. Orthotopic intestinal transplantation was performed in 36 rats by modified three cuffs method. The recipients were randomly divided into three groups(12 rats in each group):group A was experimental group with CD8(+)CD28(-) Ts being administrated, mixed T cells were injected in group B, while in group C, NS were administrated. On the first day and the seventh day posttransplant, the 36 rats of the 3 groups were administrated through vena dorsalis penis respectively. Six rats were selected randomly from each group and the animals were sacrificed on the 14 th day postoperatively, serum levels of TGF-beta, IFN-gamma and the values of Na(+)-K(+)-ATPase activity of the intestinal graft were assayed and the intestinal pathologic morphology, intestinal allograft survival were observed concerning the remainders.</p><p><b>RESULTS</b>On the 14 th day after operation, the expression levels of TGF-beta and IFN-gamma in group A were significantly up-regulated as compared with those in group B and group C(P<0.05). Na(+)-K(+)-ATPase activity in group A was(6.3+/-1.0) kU/g, much higher than the levels of group B(3.6+/-0.9)kU/g and group C(2.9+/-1.3) kU/g and the differences were significant(P<0.05). The data suggested preliminarily that pathological scores of intestinal graft in group A were lower than those in group B and group C. The survival time of the recipients in group A was 32.0 days, much longer than that in group B (17.5 days, P<0.05) and group C(21.0 days, P<0.05).</p><p><b>CONCLUSION</b>CD8(+)CD28(-) Ts induced by DC with MHC-1 expression RNA interference can alleviate acute rejection and lead to immune tolerance in rat intestinal transplantation.</p>

Clinical analysis of infectious complications following abdominal cluster transplantation / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the characteristic and management of postoperative infection in abdominal cluster transplantation.</p><p><b>METHODS</b>Preliminary experience of two cases of abdominal cluster transplantation including small intestine was reviewed.</p><p><b>RESULTS</b>Combination of five immunosuppressive agents based on tacrolimus was used. Severe Gram-negative bacillus infections occurred. The majority of invasive fungal infections was due to Candida species. Cytomegalovirus (CMV) infection increased monocytes and caused eosinopenia and an inversion of the CD4(+) to CD8(+) cell ratio in recipient I, and human CMV matrix proteins pp71 (CMV-pp71) was detected and identified in bile by PCR. Microabscesses in liver transplant biopsies were presented.</p><p><b>CONCLUSIONS</b>Infectious complications after cluster transplantation were complicated. Strategies to optimize the immunity suppression protocol and early diagnosis and treatment will be important to reduce infection after abdominal cluster transplantation.</p>

Research of rat small intestinal mesentery lymphoid tissue stimulating allograft mixed lymphocyte reaction / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the effect of the small intestinal mesenteric lymphoid tissues stimulating mixed lymphocyte reaction with dendritic cells (DC) and peripheral blood monocyte cells (PBMC), and observe the changes of the MHC molecular expression on DC.</p><p><b>METHODS</b>DC, PBMC and mixed lymphocyte were separated to culture from SD rats. Lymphoid tissue suspension was adopted from small intestinal mesentery of Wistar rats. In the mixed lymphocyte reaction (MLR), the cellular proliferation of small intestinal mesenteric lymphoid tissue antigen act on DC and PBMC was detected with cell counting of CCK-8 assay, the same assay used in small intestinal mesenteric lymphoid tissue antigen and ovalbumin (OVA) acting on DC. FACS analysis was performed after lymphoid tissue suspension stimulating DC to observe the MHC molecular expression.</p><p><b>RESULTS</b>In the lymphoid tissue suspension, 91% of the cells was lymphocyte, others including granulocyte, plasmocyte, epithelium. The effect of stimulating mixed lymphocyte proliferation were higher in DC groups than in PBMC groups with the small intestinal mesenteric lymphoid tissue (P < 0.05). In the proportion of DC and mixed lymphocyte >or= 1:100 groups, the mixed lymphocyte proliferation were higher in the small intestinal mesenteric lymphoid tissues groups than in the OVA groups (P < 0.05). After stimulated by the small intestinal mesenteric lymphoid tissue, DC expressed higher MHC-I and -II molecules than control groups.</p><p><b>CONCLUSIONS</b>The small intestinal mesenteric lymphoid tissue has high antigenicity; the antigen presenting ability of DC was much stronger than granulocytes; DC expresses high MHC-I and MHC-II molecules after stimulated by mixed lymphoid tissue suspension.</p>

Primary diffuse large B-cell non-Hodgkin's lymphoma of the small intestine: clinicopathologic features, management, and prognosis in 24 patients / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the clinicopathological features of primary diffuse large B-cell lymphomas (DLBCLs) of the small intestine, CD10 expression, and their relationship to prognosis.</p><p><b>METHODS</b>Twenty-four cases of small intestinal DLBCLs were studied clinically and pathologically. All cases were staged according to the Ann Arbor classification of lymphoma.</p><p><b>RESULTS</b>Fifteen cases (62.5%) were at stages I and II, and nine cases (37.5%) at stages III and IV. The Karnofsky performance status ranged from 40% to 100% (mean 75.5%). Twenty cases (83.3%) received surgical resection, sixteen cases (66.7%) received chemotherapy, and no patient received radiotherapy. Seven of 19 cases (36.8%) were CD10+. Although there was no statistically significant difference(P = 0.28) in therapy result between the CD10+ and CDO1--groups, patients with CD10+ lymphoma more frequently presented with stages I compared with those with CD10 - lymphoma (P = 0.013). Follow-up information was available in 19 cases ranging from 1 to 111 months (mean 32.7 months). Five cases died of the disease. The mortality rate was 26.3%. The analysis of survival rate showed a longer overall survival duration in the stage I and II group compared with that of the stage III and IV group ( P = 0.0197 ) , but there was no significant difference between CD10+ and CD1- groups.</p><p><b>CONCLUSION</b>The primary small intestnal diffuse large B cell lymphoma patients at stage I and II respond better to therapy including surgical resection and chemotherapy than those at stage III and IV. CD10+ expression is more common in stage I lymphomas.</p>

Prognostic factors of retroperitoneal soft tissue sarcomas: analysis of 132 cases / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Retroperitoneal sarcoma is a rare disease with poor prognosis. The aim of this study was to investigate the prognostic factors of the disease.</p><p><b>METHODS</b>Between January 1988 and December 2003, 132 patients with retroperitoneal sarcoma were surgically treated in our hospital, 79 of them were followed up for 1 - 122 months (median: 19 months). Their clinicopathological data including tumor size, histological subtype, grade and resection margin status, were studied. The Kaplan-Meier method and log-rank test were used to analyze the disease-specific survival rates after the resection.</p><p><b>RESULTS</b>Among the 132 patients, 98 (74.2%) received macroscopic complete resection, 29 (22.0%) incomplete resection, and 5 (3.8%) surgical biopsy. In the 79 patients who were followed up, macroscopic clear resection of retroperitoneal sarcoma (n = 49) was associated with a significantly higher survival rate compared with unclear resection (n = 30, P < 0.001). The median survival period was 31 months (95% CI, 20.09 - 41.91; actuarial 1-year survival, 85.7%) in the patients with the tumor completely resected and 11 months (95% CI, 6.71 - 15.29; actuarial 1-year survival, 46.7%) in those with incomplete resection. Patients with high-grade sarcomas had a significantly shorter survival time (n = 39; median: 24, 95% CI: 5.71 - 42.29) than those with low-grade sarcomas (n = 40; median: 15; 95% CI: 8.80 - 21.20; P < 0.01). Moreover, compared with the patients with the tumor sized < 15 cm in diameter (n = 53), the survival rate was lower in those with a sarcoma sized > 15 cm (n = 26). (Median: 12, 95% CI: 8.26 - 15.74 vs median: 24, 95% CI: 17.25 - 30.75; P < 0.05). Furthermore, the survival of the patients with liposarcomas (n = 29, median: 29, 95% CI: 12.84 - 45.16), leiomyosarcomas (n = 14, median: 11, 95% CI: 6.11 - 15.89), and others (n = 36, median: 22, 95% CI: 14.95 - 29.05) varied significantly (P < 0.05).</p><p><b>CONCLUSION</b>Completeness of resection, tumor volume, grade, and subtype are prognostic factors of retroperitoneal soft tissue sarcomas.</p>

Primary non-Hodgkin lymphoma of small bowel: a clinical analysis of 34 cases / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To study the clinical characteristics,treatment and prognosis of primary non-Hodgkin's lymphoma of small bowel.</p><p><b>METHODS</b>The records of 34 patients with a confirmed diagnosis of primary non-Hodgkin's lymphoma of small bowel, registered between Jan. 1996 and Dec. 2005 at our hospital, were retrieved and analysed retrospectively.</p><p><b>RESULTS</b>Twenty-seven patients had B-cell lymphoma and 7 had T-cell lymphoma of the small bowel. The major symptoms included abdominal pain and intestinal obstruction. According to Ann Arbor staging classification, 22 patients belonged to stage I~II, including 20 cases of B-cell lymphoma and 2 cases of T-cell lymphoma, and 12 patients belonged to stage III~IV, including 7 cases of B-cell lymphoma and 5 cases of T-cell lymphoma. Compared with T-cell lymphoma patients, B-cell lymphoma patients had lower lymphoma stages (P<0.05). Twenty-seven patients were treated with surgical resection. Fourteen patients were treated with six cycles of cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) chemotherapy, and 8 patients were treated with Rituximab at the same time. T-cell lymphoma patients were more often treated with emergent operation than B-cell lymphoma patients would (P<0.05). It happened more frequently that B-cell lymphoma patients reached complete remission and their accumulative survival rate was longer than T-cell lymphoma patients did (P<0.05).</p><p><b>CONCLUSION</b>Patients with stages I and II B-cell lymphoma of small bowel respond well to surgery and chemotherapy, and the treatment and prognosis of patients with T-cell lymphoma of small bowel are unsatisfactory.</p>

Anti-tumor mechanism of norcantharidin for the implanted tumors of human gallbladder carcinoma in nude mice in vivo / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the anti-tumor mechanism of norcantharidin (NCTD) for the implanted tumors of human gallbladder carcinoma in nude mice in vivo.</p><p><b>METHODS</b>Animal model of implanted tumors of human gallbladder carcinoma in nude mice was established. Mice were randomly divided into control, 5-FU, NCTD and NCTD + 5-FU groups and were taken different treatment. The expressions of PCNA, Ki-67, cyclin D1, p27, Bcl-2, Bax, Survivin, nm23/nm23-H1, MMP2 and TIMP2 proteins or genes in each tissue section of every group were determined by immunohistochemistry and RT-PCR.</p><p><b>RESULTS</b>(1) On proliferation-related gene proteins, the expression of PCNA, Ki-67, cyclin D1 was significantly decreased, with significantly increased expression of p27 protein, in paraffin sections of NCTD group when compared with control group (P < 0.05); The expression of PCNA mRNA, cyclin D1 mRNA was decreased, with significantly increased expression of p27 mRNA in NCTD group. (2) On apoptosis-related gene proteins, the expression of Bcl-2 was significantly decreased in paraffin sections of NCTD group when compared with control group (P < 0.05); The expression of Bcl-2 mRNA, Survivin mRNA was significantly decreased, with significantly increased expression of Bax mRNA in NCTD group. (3) There was significant difference on invasion around tumor and lung metastasis in NCTD group when compared with control group (P < 0.01). On metastasis-related gene proteins, the expression of nm23 and TIMP2 was significantly increased, with significantly decreased expression of MMP2 in paraffin sections of NCTD group when compared with control group (P < 0.05); The expression of nm23-H1 mRNA, TIMP2 mRNA was significantly increased, with significantly decreased expression of MMP2 mRNA in NCTD group.</p><p><b>CONCLUSIONS</b>The anti-tumor mechanism of NCTD for human gallbladder carcinoma in nude mice might correlated with inhibition of cell proliferation, blockage of cell cycle, induction of cell apoptosis, reducing of cell motility and invasive capability, alteration of the expression of proliferation-, apoptosis- and metastasis-related gene proteins such as PCNA, Ki-67, cyclin D1, p27, Bcl-2, Bax, Survivin, nm23, MMP2 and TIMP2.</p>

The in vitro effect of norcantharidin on proliferation and invasion of human gallbladder carcinoma GBC-SD cells and its mechanism / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To study the effect and mechanism of action of norcantharidin on proliferation and invasion of GBC-SD cells.</p><p><b>METHODS</b>GBC-SD cells of human gallbladder carcinoma were cultured by cell culture technique. The tetrazolium-based colorimetric assay was used to evaluate cell growth. The Matrigel experiment and the crossing-river test were used to examine the invasiveness of GBC-SD cells. Expression of MMP(2), TIMP(2), PCNA and Ki-67 proteins of GBC-SD cells was determined by streptavidin-biotin complex method.</p><p><b>RESULTS</b>Norcantharidin inhibited the growth and proliferation of GBC-SD cells in a dose and time dependent manner, with an IC(50) value of 56.18 micro g/ml at 48 h. The Matrigel experiment showed that norcantharidin began to inhibit the in vitro invasion of GBC-SD cells at the concentration of 5 micro g/ml. At 40 micro g/ml, the invasive action of GBC-SD cells was inhibited completely and their crossing-river time was prolonged significantly. After treatment with norcantharidin, the expression of PCNA, Ki-67, MMP(2) was significantly decreased. With the increase in TIMP(2) expression, the MMP(2) to TIMP(2) ratio was decreased significantly (P < 0.05).</p><p><b>CONCLUSION</b>Norcantharidin inhibits the in vitro proliferation and growth of human gallbladder carcinoma cells at relatively low concentrations by inhibiting PCNA and Ki-67 expression. Its anti-invasive activity may be the results of decrease in MMP(2) to TIMP(2) ratio and reduced cell motility.</p>