Clinical features and laboratory data analysis of Aeromonas bacteremia with hematological diseases / 中华血液学杂志

Objective: To investigate the clinical and laboratory features of Aeromonas bacteremia in patients with hematological diseases, and provide evidence for the prevention and treatment of Aeromonas infection. Methods: A retrospective study of patients with bloodstream infection of Aeromonas in our hospital from January 2014 to December 2018 was carried out. The clinical characteristics, antimicrobial susceptibility, infection seasons, antimicrobial therapy and evolution were analyzed. Results: A total of 42 patients with hematological diseases had Aeromonas bloodstream infection within 5 years. Among them, 39 cases (92.9%) of bloodstream infection occurred in the stage of neutropenia. The median time of fever was 4 (1-27) d, 22 (52.4%) patients only had fever, 6 (14.3%) with gastrointestinal symptoms (abdominal pain, diarrhea, nausea, upper gastrointestinal bleeding) , 8 (19.0%) with pulmonary infection, 13 (31.0%) with skin and soft tissue infections. Seven patients (16.7%) died with skin and soft tissue infection. The resistance of Aeromonas to carbapenems was 68.3%-70.7%, while the resistance rate to cephalosporins, quinolones and aminoglycosides were less than 10%. Conclusions: Aeromonas bacteremia in patients with hematological diseases mainly occur in the neutropenia stage, usually with symptom like fever. The mortality is increased when accompanied by skin and soft tissue infection. Antibiotic use should be based on susceptibility results, and avoid the use of carbapenems.

Perianal swabs surveillance cultures of Carbapenem-resistant Enterobacteriaceae(CRE) can be hints for CRE bloodstream infection in patients with hematological diseases / 中华血液学杂志

Objective: To analyze the hints role of surveillance cultures of Carbapenem-resistant Enterobacteriaceae (CRE) by perianal swabs in patients with hematological diseases, and seek risk factors of CRE bloodstream infection. Methods: The resistance of CRE from 2 914 patients with hematological diseases who cultured perianal swabs, CRE bloodstream infection and risk factors were analyzed during January 2016 to December 2017. Results: In this study, perianal swabs from 2 914 patients with hematological diseases were cultured, 74 patients were CRE positive, and bloodstream infection with CRE was found in 13 of these patients. A total of 87 CRE strains were isolated (The same patient only keep the first one for the same location), including 31 Klebsiella pheuminiae, 43 Escherichia coli, 8 Enterobacter cloacae and 6 other Enterobacteriaceae. The resistance rates to piperacillin / tazobactam, imipenem, meropenam, amikacin, levofloxacin, tigecycline were 91.9%, 74.4%, 98.8%, 17.6%, 74.4% and 8.0%, respectively. Resistance to carbapenem, aminoglycoside, quinolones and tegacycline were highly consistent between two sites from 13 patients, whose both perianal swabs and blood were positive in CRE cultures. Febrile neutropenic time, digestive tract symptoms and perianal infection were independent risk factors for bloodstream infection in patients with perianal swabs positive results, the odds ratios (OR) were 1.10 (P=0.029), 1.13 (P=0.005) and 1.23 (P=0.016), respectively. Conclusion: Perianal swabs surveillance cultures of CRE can be hints for CRE bloodstream infection in patients with hematological diseases, and also can provide suggestions for antibiotics. Long time of febrile neutropenic, digestive tract symptoms and perianal infection can be the early warning for CRE bloodstream infections.

Clostridium perfringens bacteremia with malignant hematopathy:a case report and review of literatures / 中国感染控制杂志

Infection is an important cause of higher mortality in patients with hematological diseases than healthy people, and fever is often the only indication of the disease.Clostridium perfringens(C.perfringens)is a grampositive anaerobic bacillus of the Clostridiumgenus, it belongs to the normal flora of the intestinal tract and is not pathogenic in normal condition.However, when intestinal flora is imbalanced due to low hypoimmunity of human body or influenced by such factors as diet, medicine, environment and other factors, it can enter the blood and cause bacteremia.At present, it has never been reported that bacteremia was caused by C.perfringens in patients with malignant hematological diseases accompanied by neutropenia, this article reported the diagnosis and treatment of C. perfringens bloodstream in one patient with malignant hematopathy, so as to provide basis for diagnosis and treatment of the disease.

Clinicopathologic features and differential diagnosis of splenic B-cell marginal zone lymphoma involving bone marrow / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the clinicopathologic features and differential diagnosis of splenic B-cell marginal zone lymphoma (SMZL) involving bone marrow.</p><p><b>METHODS</b>The clinical and pathologic features of 22 patients with SMZL were retrospectively studied. Immunophenotypic analysis was carried out by flow cytometry and immunohistochemistry. Immunoglobulin heavy chain rearrangement study was performed using polymerase chain reaction-based method.</p><p><b>RESULTS</b>Villous lymphocytes were found in peripheral blood smears of 11/18 of the patients. In bone marrow aspirates, lymphocytosis (> 20%) was demonstrated in 15 cases (15/18) and villous lymphocytes in 6 cases (6/18). Flow cytometry showed CD19(+) CD20(+) FMC7(+) CD22(+) CD10(-) CD2(-) CD3(-) CD7(-) in 18 cases. Bone marrow biopsies of all the 22 patients revealed various degrees and patterns of neoplastic infiltration, as follows: mild (4 cases, 18.2%), moderate (11 cases, 50.0%) or severe (7 cases, 31.8%); intrasinusoidal (16 cases, 72.7%), interstitial (14 cases, 63.6%), nodular (11 cases, 50.0%) or diffuse (1 case, 4.5%). Reactive germinal center formation (CD23(+) bcl-2(-)) was found in 2 cases (91.0%). Immunohistochemical study showed the following results: CD20(+) PAX5(+) CD3(-) CD5(-) CD10(-) cyclin D1(-) CD23(-) CD43(-) Annexin A1(-) CD11C(-) CD25(-) in all the 22 cases, CD38(+) in 2 cases (9.1%) and CD138(+) in 2 cases (9.1%).</p><p><b>CONCLUSIONS</b>Different and overlapping patterns of bone marrow involvement are observed in SMZL. As the histologic and immunophenotypic features are not specific to SMZL, distinction from other types of mature B-cell lymphomas is necessary.</p>

Hematopathologic features of T-cell large granular lymphocytic leukemia / 中华病理学杂志

<p><b>OBJECTIVE</b>To explore the hematopathologic features of T-cell large granular lymphocytic leukemia (T-LGLL).</p><p><b>METHODS</b>A retrospective analysis of the clinical presentation, bone marrow morphology, immunophenotyping and T-cell receptor gene rearrangement status were performed in 19 patients with T-LGLL.</p><p><b>RESULTS</b>Of 19 patients, the most frequent hematological abnormalities were anemia and neutropenia (16/19 and 17/19 patients, respectively). Large granular lymphocytes (LGLs) were observed in 17 of 19 peripheral blood smears and 15 of 19 bone marrow aspirate specimens. Lymphocytosis (> 0.2) was present in 17 of 19 patients in their bone marrow aspirate specimens. Bone marrow biopsy specimens revealed lymphocytosis in 16 cases, with a mild to moderate increase of lymphocytes observed in 12 cases (12/16). The pattern of lymphoid distribution was interstitial in bone marrow sections. Intravascular distribution was seen in 8 cases. Lymphoid nodules were present in 4 cases. Flow cytometery showed an immunophenotype of CD3(+) CD4(-) CD8(+) CD56(-) CD57(+) of the tumor cells in 13 cases. Of the other 6 cases, the immunophenotypes included CD8(-) (1 case), CD56(+) (2 cases) and CD57(-) (3 cases). Immunohistochemistry showed CD3+ (10/10), CD57+ (3/3), CD8+ (6/7), TIA-1+ (6/7), granzyme B+ (4/7), perforin + (1/7), CD4- (4/4) and CD56- (9/9). Clonal T-cell receptor γ gene rearrangement by PCR was detected in 12 cases (12/17).</p><p><b>CONCLUSIONS</b>Hematopathologic features of most T-LGLL are distinct. Morphologic, immunophenotypic and molecular analysis of both peripheral blood and bone marrow specimens are essential and complementary in the diagnosis and differential diagnosis of T-LGLL.</p>

The role of bone marrow pathology in diagnosis and differential diagnosis of refractory cytopenia of children / 中华血液学杂志

<p><b>OBJECTIVE</b>To explore the diagnosis and differential diagnosis of refractory cytopenia of children (RCC) according to WHO classification, and discuss the relationship between the cytology reviewed by hematologists and histology reviewed by pathologists.</p><p><b>METHODS</b>We selected 50 non-severe aplastic anemia cases from 2007 - 2010 in our hospital and collected clinical data. Experienced hematologists and pathologists evaluated bone marrow biopsy and smear respectively.</p><p><b>RESULTS</b>Of 50 cases, 23 were male and 27 female (M:F = 1:1.17), the median age at diagnosis was 9 years (ranged from 3 to 14 years). 5 patients had disagreement of diagnosis between hematologists and pathologists. In 3 cases hematologists diagnosed as aplastic anemia (AA) and pathologists as RCC, 2 cases vice versa. The final diagnoses of 50 patients reached consensus between hematologists and pathologists were AA 16 cases, RCC 34 cases including 8 refractory cytopenias with multilineage dysplasia (RCMD) cases. All 16 cases AA showed severe hypocellularity. Only 4 cases (25.00%) RCC showed severe hypocellularity, 19 cases (73.08%) RCC showed mild hypocellularity and 3 cases (11.54%) RCC were normal hypocellularity.</p><p><b>CONCLUSION</b>Our results suggests that RCC was not rare in China. The main feature of RCC was dysplasia because of absence of increased blast. RCC was easily confused with AA. The main points of differential were present dysplastic changes of megakaryocyte best appreciated by the hematologists and morphologists and abnormal location of hematopoietic easily observed by pathologists. Overall, cytology and histology were complementary in the investigation of RCC and AA, because of sometimes one might give information that not be given from the other.</p>

The impact of dietary iodine intake on lipid metabolism in experimental hypothyroid mice / 中国地方病学杂志

Objective To observe the effects of iodine deficiency and iodine excess on the lipid metabolism in an experimental hypothyroid model of mice and to explore the roles of iodine independent of its role in thyroid hormones. Methods Female Balb/c mice were randomly divided into 6 groups: control, severe iodine deficiency (SID), mild iodine deficiency(MID), normal iodine (NI), 10-fold high iodine (10HI) and 50-fold high iodine(50HI), 10 in each group. The mice in control group were fed with low iodine forage, other mice were fed with low iodine forage containing 0.2% methylthiouracilum. All mice drank deionic water containing different concentrations of potassium iodide(KI). The iodine content in water was 326.79, 0, 196.08,326.79, 385621, 19 542.50 μg/L, respectively. After three months, thyroid hormones in the serum were determined by radioimmunoassay.Also, the blood samples were analyzed for total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesteiol (HDL-C) and low density lipoprotein cholesterol (LDL-C) and measured enzymatically by automatic analyzer. Results①The levels of Tr4 in SID[(21.27 ± 9.63)μg/L], MID[(23.41 ± 3.93)μg/L], NI[(22.57 ±4.66)μg/L], 10HI [(21.07 ± 5.03) μg/L] and 50HI groups [(21.46 ± 5.90) μg/L] were distinctively decreased compared with control group[(42.15 ± 8.26)μg/L, all P ＜ 0.01]. There were no statistical significant differences of TT3 between different groups (F = 0.99, P > 0.05 ). ②The level of TG in 10HI group [ ( 1.17 ± 0.16)mmol/L ] was obviously decreased compared with control [(1.39 ± 0.22 )mmol/L] and NI groups[(151 ± 0.22)mmol/L, all P＜ 0.05].Both TG and TC in 50HI group[(1.18 ± 0.22), (1.78 ± 0.15)mmol/L] were significantly decreased compared with control [( 1.39 ± 0.22), (2.14 ± 0.37)mmol/L] and NI groups [(1.51 ± 0.22), (2.00 ± 0.15)mmol/L, all P ＜ 0.05].The difference of serum HDL-C and LDL-C between the groups was not significant(F = 0.55,0.54, all P ＞ 0.05 ).Conclusions Dietary iodine plays a role in the metabolism of serum lipids independent of thyroid hormones.Thus, monitoring the amount of iodine intake during sodium restriction should also be taken extremely important for effectively prevention and cure of cardiovascular disease.

Clinicopathologic features of aggressive natural killer cell leukemia / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the clinicopathologic features of aggressive natural killer cell leukemia (ANKL).</p><p><b>METHODS</b>The clinical and pathologic features were analyzed in 10 patients with ANKL. The complete blood count, peripheral blood smears, bone marrow aspirates and bone marrow biopsies were studied. Immunophenotypic analysis was carried out by flow cytometry and immunohistochemistry. T-cell receptor (TCR) γ gene rearrangement was studied by PCR method.</p><p><b>RESULTS</b>The most frequent hematologic abnormalities observed were anemia (7 cases) and thrombocytopenia (9 cases). Large granular lymphocytes were found on peripheral blood smears of 6 patients. In bone marrow aspirates, lymphocytosis (> 20.0%) was demonstrated in 8 cases and large granular lymphocytes in 6 cases. Bone marrow biopsies revealed various degrees of neoplastic infiltration, as follows: mild (5 cases), moderate (3 cases) and severe (2 cases). The neoplastic cells were mainly interstitial in distribution in 8 cases and diffuse in 2 cases. Hemophagocytosis was observed in 4 cases. Flow cytometry showed CD2+ sCD3- CD4- CD56+ CD57- in all cases, CD7+ in 9 cases, CD16+ in 5 cases, CD8+ in 4 cases and CD5+ in 1 case. Immunohistochemistry performed in 8 cases showed the following results: cCD3+ in 4 cases, CD56+ in 6 cases, TIA-1+ in 6 cases, granzyme B+ in 4 cases and perforin+ in 2 cases. PCR study revealed germline TCRγ gene configuration in all cases.</p><p><b>CONCLUSIONS</b>ANKL is a highly aggressive NK cell-derived lymphoid neoplasm. Comprehensive morphologic, immunophenotypic and molecular analysis are essential in arriving at a correct diagnosis. ANKL needs to be distinguished from other types of NK-cell and T-cell lymphomas.</p>

Clinicopathologic features of lymphoplasmacytic lymphoma / 中华病理学杂志

<p><b>OBJECTIVE</b>To explore the clinicopathologic features of lymphoplasmacytic lymphomas (LPL).</p><p><b>METHODS</b>Routine histological examination was performed on hematoxylin-eosin stained sections of 24 bone marrow biopsies and available 6 concurrent lymph node specimens. Immunohistochemistry study was performed using EliVision methods.</p><p><b>RESULTS</b>Among 24 cases, the male-to-female ratio was 2.4:1 and the median age was 59.5 years (42 - 75). The most common symptom was weakness (83.3%, 20/24). Hyperviscosity and "B" symptoms occurred in 20.8% (5/24) and 8.3% (2/24) respectively. 41.7% (10/24) patients presented with lymphadenopathy. Anemia, leukocytosis and thrombocytopenia were seen in 79.2% (19/24), 8.3% (2/24) and 37.5% (9/24) respectively. Monoclonal Ig light chain expression was detected by serum immunofixation electrophoresis in 23 cases (95.8%), including IgM (20 cases), IgG (2 cases) and IgA (1 case). Basing on the histology and immunohistochemistry findings, the diagnosis was made in 22 bone marrow and 2 lymph node biopsies, respectively. Histologically, the bone marrow and lymph node specimens composed of small lymphocytes, plasmacytoid lymphocytes and plasma cells. The most frequent pattern of bone marrow involvement was diffuse in appearance (63.6%, 14/22), while nodular and interstitial patterns were less common (22.7%, 5/22 and 13.6%, 3/22, respectively). Lymph node involvement was also to be diffuse in pattern. The proliferative cells expressed Pax5, CD20, CD38 and CD138, but were negative for CD5, CD10, CD23, CyclinD1, CD3, CD7 and MPO.</p><p><b>CONCLUSIONS</b>LPL has distinct clinicopathological features. Histological and immunohistochemistry findings are important for its differential diagnosis with chronic lymphocytic leukemia/small lymphocytic lymphoma, splenic marginal zone lymphoma and follicular lymphoma. Waldenström macroglobulinemia is LPL.</p>

The impact of dietary iodine/sodium intake on blood lipid metabolism in mice / 中国地方病学杂志

Objective The present study has been designed to investigate the impact of dietary iodine/sodium intake on blood lipid metabolism in mice. Methods According to body weight and gender, two hundred and sixty Balb/c mice were randomly divided into 2 groups including normal sodium group(Na) and low sodium group(LNa), with 130 animals per group. Each group were then randomly further divided into 5 sub-groups according to the amount of iodine intake: ① severe iodine deficiency(SID); ② mild iodine deficiency(MID); (③normal iodine (NI); ④ 10-fold high iodine ( 10HI ); (⑤ 50-fold high iodine (50HI), 10 groups in total, 26 per group.Eight months later, the body weight and the levels of urinary iodine, thyroid hormones and total cholesterol (TC),Results In Na group, the levels of TG and TC in male mice of SID group[ (1.64 ± 0.35), (3.88 ± 0.35 )mmol/L]and MID group[ ( 1.67 ± 0.31 ), (3.41 ± 0.66)mmol/L] were significantly higher than that of NI group[ ( 1.49 ± 0.42), (3.25 ± 0.47)mmol/L] and the levels of TG in female mice of SID group[(1.52 ± 0.22)mmol/L] were significantly higher than that of NI group[ (1.23 ± 0.22)mmol/L]. In addition, the levels of TG in male mice of 10HI and 50HI groups [ ( 1.16 ± 0.23 ), ( 1.21 ± 0.27 ) mmol/L ] were significantly lower than that of NI group [ ( 1.49 ± 0.42)mmol/L, all P ＜ 0.05], the levels of TC in female mice of 10HI and 50HI groups[(2.37 ± 0.49), (2.48 ± 0.37)mmol/L] were significantly lower than that of NI group[ (2.84 ± 0.37) mmol/L, all P ＜ 0.05 ]. In LNa group,the levels of TG and TC in male mice of SID group[ (1.39 ± 0.40), (3.33 ± 0.46 )mmol/L] were significantly lower than that of NI group [(1.30 ± 0.28), (3.00 ± 0.53) mmol/L, all P ＜ 0.05], the levels of TG, TC and LDL in female mice of SID group[ (1.48 ± 0.26), (2.76 ± 0.43), (0.62 ± 0.22)mmol/L], the levels of LDL in female mice of MID group[ (0.60 ± 0.17 )mmol/L] were significantly lower than that of NI group[(l.22 ± 0.36), (2.51 ± 0.38),(0.48 ± 0.08), (0.48 ± 0.08)mmol/L, all P ＜ 0.05], the levels of TG in male mice of 10HI and 50HI group [ (1.12 ± 0.22), (0.90 ± 0.11 )mmol/L] were significantly lower than that of NI group (all P ＜ 0.05 ), the levels of TC in female mice of 10HI and 50HI groups[ (2.35 ± 0.34), (2.37 ± 0.37)mmol/L], the levels of LDL in female mice of 50HI group[(0.65 ± 0.18)mmol/L], were significantly lower than that of NI group(all P ＜ 0.05). In Na group, the levels of thyroid hormones were distinctively decreased in SID group[TT4(0.00 ± 0.00)nmol/L, FT4 (0.93 ± 0.42)pmol/L, TT3(0.49 ± 0.07)nmol/L, FT3(2.86 ± 0.37)pmol/L] and MID group [TT4 (17.15 ± 15.26)nmol/L, FT4( 18.46 ± 4.31 )pmol/L, TT3(0.67 ± 0. 10)nmol/L, FT3(3.18 ± 0.24)pmol/L] compared with that of the NI group [TT4 (37.15 ± 15.26)nmol/L, FT4(28.46 ± 4.31)pmol/L, TT3(0.85 ± 0.10)pmol/L, FT3(3.87 ± 0.24)pmol/L, all P ＜ 0.05 ]. In LNa group, the levels of thyroid hormones were distinctively decreased in SID group [TT4 (0.00 ± 0.00) nmol/L,FT4(1.03 ± 0.78)pmol/L, TT3(0.51 ± 0.05)nmol/L, FT3(3.01 ± 0.17)pmol/L] and MID group[TT4(19.76 ± 12.22)nmol/L, FT4(21.46 ± 5.37)pmol/L, TT3(0.71 ± 0.21)nmol/L, FT3(3.56 ± 0.23)pmol/L] compared with that of the NI group[TT4(36.23 ± 14.72)nmol/L, FT4(30.96 ± 6.33)pmol/L, TT3(0.89 ± 0.20)nmol/L, FT3(4.05 ± 0.24)pmol/L, all P ＜ 0.05]. Conclusions Dietary iodine intake plays an important role in the blood lipid metabolism. Iodine deficiency could increase while iodine excess could decrease the levels of serum TG, TC or LDL in mice. Monitoring the amount of iodine intake during sodium restriction should have an important role in effective prevention and treatment of cardiovascular disease.

Clinicopathologic study of 15 splenectomy specimens of patients with hairy cell leukemia / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the clinicopathologic features, diagnosis, differential diagnosis and the prognosis of hairy cell leukemia (HCL).</p><p><b>METHODS</b>Fifteen splenectomy specimens of HCL patients were investigated retrospectively using HE and immunohistochemistry in correlation with the follow-up information.</p><p><b>RESULTS</b>(1) The male to female ratio was 2.75:1, age ranged from 36 to 68 years with a median of 47 years. The most consistent clinical feature at presentation was marked splenomegaly (100%). Other symptoms included anemia (80.0%), thrombocytopenia (60.0%), leucocytosis (53.3%), pancytopenia (20.0%) and the absence of B-symptom. (2) The proportion of hairy cells was (14.6 +/- 7.2)% in periphery blood and (47.3 +/- 23.8)% in bone marrow. The positive rate of TRAP assay was 62.5% in bone marrow; 85.7% for TPA test and the detection rate for RLC was 25% by transmission electric microscopy. The frequency of bone marrow involvement was 100%. (3) The average weight of 15 spleens was (3012 +/- 1974) g. The size of 6 spleens ranged from 16 cm x 10 cm x 5 cm to 32 cm x 20 cm x 14 cm. The white pulp of spleen showed a characteristic atrophy feature or even absent due to leukemic infiltration, predominantly involving the red pulp with some sinusoidal pattern. "Blood pool" change was an infrequent feature (3/15 cases). The nuclei of leukemic cells were round (13 cases) or bean-shaped (2 cases), nucleoli inconspicuous or disappeared. The abundant cytoplasm and prominent cell border resulted in a "fried egg" appearance. By immunohistochemistry, leukemic cells were positive for CD45RA, CD20, PAX-5, CD25, CD11c, Annexin A1 and cyclinD1, but negative for CD3 and CD43. (4) 13 cases (86.7%) have been followed-up and all are alive. Among them, 9 cases are living well more than 5 years and 7 more than 10 years.</p><p><b>CONCLUSIONS</b>Splenomegaly is frequently the first manifestation of patients with HCL and occurred predominantly in the middle to elderly adults. Definite diagnosis of HCL requires a combined histological and immunohistochemical assessment of the splenectomy specimen, bone marrow biopsy and aspirate.</p>

P-glycoprotein regulating biphasic insulin secretion in rat pancreatic beta cells / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>A 65-kD mdr1 (multi-drug resistance protein 1, P-glycoprotein)-like protein has been suggested to be the regulatory protein to the chloride channel protein 3 (ClC-3) mediating insulin granules acidification and release in mouse pancreatic beta cells. But the protein has not been deeply investigated. In this study, we identified existence of the 65-kda protein in rat islets and preliminarily explored its biological functions.</p><p><b>METHODS</b>Total RNAs of rat kidneys served as positive controls, and pancreas, islets and INS-1 cells were extracted for reverse-transcript PCR (RT-PCR), respectively. The cDNAs were run with specific primers selected from the mRNA of abcb1b encoding P-glycoprotein. All PCR products were visualized in agarose gel electrophoresis and sequenced. Homogenates of rat islets and INS-1 cells were applied to SDS-PAGE. P-glycoprotein was detected by a specific monoclonal antibody, C219. Biphasic insulin release was measured in static incubations of rat islets with radioimmunology assay.</p><p><b>RESULTS</b>Compared with positive control, expression of the P-glycoprotein mRNA segments were detected in the islets, INS-1 cells and pancreas. Sequence analysis confirmed that the PCR products were matched with mRNA of P-glycoprotein. A 65-kda protein was recognized by the antibody in the islets homogenate but not in that of INS-1 cells in Western-blotting. Instead, the homogenate of INS-1 cells contained a 160-kda protein recognized by the antibody. Insulin secretion of rat islets were stimulated by high glucose (16.7 mmol/L), and showed biphasic curve during 60-minute incubation. After co-incubation with cyclosporine A (CsA), specific inhibitor to P-glycoprotein, the second phase of insulin secretion was reduced significantly while the first phase was not influenced.</p><p><b>CONCLUSIONS</b>The 65-kda protein expressed in rat islets is most likely a mini-P-glycoprotein. It may play a key role regulating biphasic insulin release.</p>

Clinicopathologic features of peripheral T-cell lymphoma, unspecified with follicular pattern / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the clinicopathologic features of peripheral T-cell lymphoma, unspecified (PTL-U) with follicular pattern.</p><p><b>METHODS</b>The clinical data, hematoxylin and eosin-stained sections of lymph node biopsies and follow-up data of 18 cases of PTL-U associated with follicular growth pattern were reviewed and studied. Eight cases of reactive lymphoid hyperplasia were used as controls. Semi-quantitative observation by retiform micrometer rule was carried out. Immunohistochemical study was also performed in all cases. T-cell receptor and immunoglobulin heavy chain gene rearrangement studies were conducted by polymerase chain reaction-based method.</p><p><b>RESULTS</b>The median age of the patients was 53 years. The male-to-female ratio was 1.57:1 in lymphoma group. All of the lymphoma patients presented with superficial lymphadenopathy, with (8/18) or without B symptoms. Histologically, the lymphoma was characterized by follicles of various sizes and shapes. The T zones were expanded by medium-sized lymphoma cells which contained clear cytoplasm and irregular nuclei. Mitotic figures were commonly identified. Immunohistochemical study confirmed that the lymphoma cells were of T-lineage. The proliferative index, as highlighted by Ki-67, was higher [average = (38.24 +/- 13.42)%/mm2] than that in the control group. T-cell receptor gene rearrangement was demonstrated in 71.4% (10/14) of the lymphoma cases.</p><p><b>CONCLUSIONS</b>A definitive diagnosis of PTL-U with follicular pattern can be made on the basis of morphologic examination, immunohistochemical assessment and clinical features. Cases with atypical features can further be delineated by molecular analysis. Long-term follow up of these patients is prudent.</p>

Clinical significance of ZAP-70 protein expression in chronic lymphocytic leukemia/small lymphocytic lymphoma / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the clinicopathologic features and prognostic significance of ZAP-70 protein expression in chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL).</p><p><b>METHODS</b>The histologic features of 52 cases of CLL/SLL with lymph node and/or bone marrow biopsies performed were retrospectively reviewed. Immunohistochemical study using EliVision for ZAP-70 protein was adopted.</p><p><b>RESULTS</b>The lymph nodes of the 12 cases studied showed effacement of the nodal architecture and was replaced by a monotonous infiltration of small lymphoid cells. Among them, proliferation centers were identified in 6 cases. Similar morphologic pattern was seen in the 40 bone marrow biopsy samples, but no proliferation center formation obtained. The infiltration pattern of tumor cells in the bone marrow were further subdivided into nodular (n = 9), interstitial (n = 3), mixed (n = 9) and diffuse types (n = 19). There was no significant difference found on survival rates between the diffuse infiltration and non-diffuse infiltration groups (Fisher's exact test, P = 0.199). ZAP-70 protein was mainly located in the cytoplasm and nuclei of lymphoma cells. There were 21 cases (40.4%) positive for ZAP-70 and among them, 11 died of this disease or the related infections. On the other hand, ZAP-70 was negative in 31 cases (59.6%) and only 4 of them died of this disease or related infections. The overall survival in ZAP-70-negative group was higher than that of the ZAP-70-positive group (59 months versus 39 months, chi(2) = 6.991, P = 0.008). Follow-up information was available in 51 patients. Among the 21 dead cases, 15 died of CLL/SLL or the related infection.</p><p><b>CONCLUSION</b>A positive expression of ZAP-70 protein in CLL/SLL suggests a poor prognosis.</p>

Clinicopathologic studies of 13 cases of chronic eosinophilic leukemia / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the role of bone marrow biopsy (BMB) in diagnosis and differential diagnosis for chronic eosinophilic leukemia (CEL).</p><p><b>METHODS</b>Clinical and pathological features of thirteen CEL patients were analyzed retrospective. Routine histologic examination was performed on H-G-E, reticulin fiber and toluidine blue stained sections of plastic material emdedded samples of bone marrow biopsies.</p><p><b>RESULTS</b>(1)The male-to-female ratio was 12:1. The median age was 40 (23-67) years old. They presented as fever, anemia, hemorrhage and so on. Most of organs and tissues were also be involved. (2) Peripheral blood counts characterized by eosinophilia (18.1 +/-16.2) x 10(9)/L, (3) BMB showed eosinophils were predominant components, others such as neutrophils, erythrocytes, megakaryocytes were decrease. Degree of reticular fiber was from (1+) to (3+). (4) Follow-up information was available in only 4 patients, whose conditions were stable.</p><p><b>CONCLUSION</b>Combine with the clinical manifestations of CEL patients, it is important in diagnosis and differential diagnosis for CEL by observing the histomorphology features of bone marrow biopsy carefully.</p>

Effect of iodine on the pathogenesis of postpartum thyroiditis / 中国地方病学杂志

Objective To explore the effect of iodine on the pathogenesis of postpartum thymiditis.Methods Forty-four female C57BL/6J mice,8-week old,fed by low iodine dietary(the concentration of iodine≤35 μg/kg),were randomly divided into 4 groups:non-pregnancy experimental autoimmune thymiditis(non-pregnancy EAT)group with 8 mice,EAT of mice was induced by immunization with pig's thyroglobulin(Tg)in the presence of complete Freund's adjuvant.Six mice in non-pregnancy EAT group survived at the end of experiment;normal iodine-PPT(NI-PPT)group,10-fold high iodine-PPT(10HI-PPT)group and 50-fold high iodine-PPT(50HI-PPT)group with 12 mice in each group.The last 3 groups mice,who received the same immunization schedule as the above,were mated with adult male mice followed by induction of EAT.In the end,7,6 and 6 mice were noticed to be pregnant in each group.All animals were killed 4 weeks after postpartum.Histological severity of thyroid specimens was evaluated.The serum level of thyroglobulin antibody(Tg-Ab),thyroid pomxidase antibody(TPO-Ab),TT3 and TT4 were measured by radioimmunoassay(RIA).The expression level of IFN-γ/IL-4 mRNA in spleenwere assayed by RT-PCR.Results Pathological examination showed the infiltration of inflammatory cells.epithelial cell applanation,follicle atrophy or destruction.The severity of inflammation in non-pregnancy EAT bgroup.NI-PPT group and 10HI-PPT group was less serious than that in the 50HI-PPT group,the difference has bstatistical significance(P＜0.05).The level of TPO-Ab in non-pregnancy EAT group,NI-PPI-group,10HI-PPTgroup and 50HI-PPT group wag(14.32±8.85)%,(64.45±10.52)%,(38.46±5.57)%and(90.09±9.98)%.respectively the difference being statistically significant between any two groups(P＜0.05).There was no statisticaldifference(F＝0.484,P＞0.05)of Tg-Ab among non-pregnancy EAT group[(33.74±3.71)%],NI-PPT group [(29.65±2.06)%],10HI-PPT group[(37.21±3.87)%]and 50HI-PPT group[(33.87±4.17)%].There was no statistical difference(F＝1.596,P＞0.05)of TT3 among non-pregnancy EAT group (2.47±0.69)%,NI-PPT group(1.57±0.25)%,10HI-PPT group[(1.60±0.28)%]and 50HI-PPT group[(1.82±0.75)%].The level of TT4 in 50HI-PPT group[(66.68±5.47)%]was lower than that in non-pregnancy group,NI-PPT group and 10HI-PPTgroup[(99.87±5.97)%,(89.13±7.64)%and(91.05±5.82)%],the difference being statistically significant(P＜0.05).The expression level of IFN-γ mRNA was increasing,being 1.02±0.10,1.37±0.10,1.39±0.12 and 1.68±0.06 in non-pregnancy EAT group,NI-PPT group,10HI-PPT group and 50HI-PPT group.The difference had a statistical significance between any two groups except for NI-PPT group and 10HI-PPT group(P＜0.05).The expression level of IL-4 mRNA in 10HI-PPT group(0.49±0.04)and 50HI-PPT group(0.53±0.06)were all higher than non-pregnancy EAT group(0.24±0.05)and NI-PPT group(0.35±O.05),the differences being statistically significant (P＜0.05).Conclusions Adequate iodine supplementation during pregnancy and postpartum period is necessary,but iodine excess could induce postpartum thyroiditis.So iodine supplementation during pregnancy and postpartum should be adequate and reasonable.

Detection of serum fibrosis markers in patients with autoimmune thyroid diseases / 中国地方病学杂志

Obecfive To study the clinical significance of detecting serum proeollagen type Ⅲ(PCⅢ) and hyaluronie acid(HA)in patients with autoimmune thyroid diseases(AITD).Methods According to the thyroid function,the 114 patients with AITD were divided into hyperthyroidism group(38),hypothyroidism group(35),and sub-hypothyroidism group(41).In addition,40 healthy persons were served as controls.The level of serum PCⅢ was determined with ELISA and that of serum HA with RIA.The level of FT3,FT4 and sTSH were detected by immumnofluorometric assay.Results Serum FT3(18.35±6.19)pmol/L]and FT4[(76.28±23.49)pmol/L]level of patients with hyperthyroidism were obviously higher than those of the controls[(4.75±0.31),(16.12±3.27) pmol/L],but serum sTSH[(0.15±0.07)mU/L]was obviously lower than that of the control[(3.78±0.15)mU/L],the differences were statically significant(P＜0.01).Serum FT3[(3.36±0.26)pmol/L]and FT4 [(6.37±2.19) pmol/L]level of patients with hypothyroidism were both lower than those of the controls(P＜0.05).but serum sTSH[(44.58±13.29)mU/L]was obviously higher than that of the control(P＜0.01).Serum FT3 [(4.86±0.45)pmol/L]and FT4[(15.26±2.78)pmol/L]level of patients with sub-hypothyroidism had no statistical difference compared with those of the controls(P＞0.05),but serum sTSH[(14.26±4.73)mU/L] was obviously higher than that of the controls(P＜0.01).The level of sernm PCⅢ[(4.63±1.22)μg/L]in pafients with hyperthyroidism was significantly higher than that of any other group(P＜0.05).There waB no statistical significant difference in PCⅢ among the patients with hypothyroidism,the patients with sub-hypothyroidism and controls [(3.64±1.12),(3.54±1.17)and(3.56±1.07)μg/L],respectively(P＞0.05).The level of serum HA [(31.13±10.28)μg/L]in patients with hypothyroidism was significantly higher than that of any other group(P＜0.05).There was no statistical significant difference in HA among the patients with hyperthyroidism,the patients with sub-hypothyroidism and controls[(22.24±7.22),(22.43±7.99)and(23.09±9.19)μg/L,respectively,P＞0.05].Conclusions It is very significant to understand myocardial fibrosis early through detecting sernm PCⅢ in patients with hyperthyroidism.Measurement of serum PCⅢ and HA will be useful to discovery hepatic fibrosisearly in patients with a long course of hyperthyroidism.

Levels of serum leptin in the autoimmune thyroid diseases / 中国地方病学杂志

Objective To observe the levels of serum leptin in Gaves disease(GD)and thyroiditis(HT)Datients and to discuss the immunological role of leptin in the pathogenesis of autoimmune thyroid disease(AITD).Methods 102 newly diagnosed female AITD patients were divided into 3 groups:GD hyperthyroid group,HT hypothyroid group and subclinical hypothyroid group.Age,sex and BMI-matched 27 euthyroid,healthy subjects served as controis.The levels of FT3,FT4 and sTSH were determined by immunofluorometrie assay.ELISA kit was aDplied to measure the levels of serum leptin.Results Serum FT3 and FT4[(19.74±15.39),(78.25±58.68)pmol/L]levels of GD hyperthyroid patients were obviously higher than those of the controls[(4.87±0.25),(15.96±3.15)pmol/L,P＜0.01],but serum sTSH and leptin levels[(0.15±0.08)mU/L,(8.73±1.92)μg/L]were obviously lower than those of the controls[(3.81±0.19)mU/L,(12.38±3.51)μg/L,P＜0.01or＜0.05].Serum FT3 and FT4[(3.36±0.26),(6.95±3.29)pmol/L]levels of HT hypothyroid patients were obviously lower than those of the controls(P＜0.05),but serum sTSH and leptin levels[(45.48±35.83)mU/L,(17.17±3.82)μg/L]were obviously higher than those of the controls(P＜0.01 or＜0.05).Serum FT3 and FT4[(4.67±0.60),(14.87±2.14)pmol/L]levels of subclinical hypothyroid patients had not statistical difference comparing with those of the controls(P＞0.05),but serum sTSH and leptin levels[(13.67±8.66)mU/L,(16.25±3.67)μg/L]were obviously higher than those of the controls(P＜0.01 or＜0.05).Conclusions Leptin might have an immuoregulation role in the pathogenesis of AITD.In addition,serum levels of leptin in AITD is also influenced by many other related hormones.

The effects of iodine/selenium on the function of antigen presentation of peritoneal macrophages in rats / 中华预防医学杂志

<p><b>OBJECTIVE</b>To observe the effects of iodine/selenium on the function of antigen presentation of peritoneal macrophages in rats and explore the immunological mechanisms of iodine/ selenium's role in pathogenesis of autoimmune thyroid diseases (AITD).</p><p><b>METHODS</b>Female Lewis rats were randomly divided into four groups including (1) low selenium and normal iodine group (L(sE)N(I)) (2) low selenium and high iodine group (L(Se)H(I)) (3) normal selenium and normal iodine group (N(Se)N(I) ) (4) normal selenium and high iodine group (N(Se)H(I)). All rats were fed by a special diet with lower selenium and iodine in it and drunk ion-free water containing different levels of iodine and selenium for 3 months. Peritoneal macrophages of each group and OVA allergized T cells were prepared and cultured together. Then the function of antigen presentation were estimated by detecting the levels of IL-2 in the culture supernatant. The levels of the expression of co-stimulator CD86 in the spleen of each group were determined by RT-PCR.</p><p><b>RESULTS</b>The level of IL-2 in the supernatant in N(Se)H(I) (43.22 +/- 3.27) pg/ml was much stronger than N(Se)N(I) [the level of IL-2 was (25.74 +/- 2.45) pg/ml, P < 0.05]. The level of IL-2 in L(Se)N(I) (15.79 +/- 2.13) pg/ml was significantly lower than N(Se)N(I) (P < 0.05). The expression of CD86 mRNA in N(Se)H(I) (CD86/beta-actin: 0.52 +/- 0.10) were higher than N(Se)N(I) (CD86/beta-actin: 0.35 +/- 0.04), P < 0.05.</p><p><b>CONCLUSIONS</b>High iodine could promote the presentation function of macrophages to a higher state than normal. Therefore, high iodine intake might become an importantly inducing factor in thyroid autoimmunity. Low selenium could weaken the ability of recognizing and presenting OVA antigen of peritoneal macrophages which might destroy immunological homeostasis and thus the low selenium intake might also become an inducer of AITD.</p>

Effect on mouse S180 MDR tumour cell expression correlated factorial matter by 70% ethanol with Huanglian Jiedu Tang / 中国中药杂志

<p><b>OBJECTIVE</b>To observe the effect on P170, LRP, TOPO II of S180 tumour MDR mice for matter by 70% ethanol with Huanglian Jiedu Tang, and then discuss the molecular biology base for clinic.</p><p><b>METHOD</b>18-22 gramme mice were divided into four groups for normal S180 tumour cell group, matter by 70% ethanol with Huanglian Jiede Tang 100 mg x kg(-1) and 50 mg x kg(-1) in random. Each mouse was given S180 cell 0.2 mL by celiac, and after 24 hours give cisplatin for Injective 3 mg x kg(-1), ip, once a week. And give cyclophosphamide and 5-FU 3 mg x kg(-1), ig, once every day. After 15 days, collect lively mice ascites and give it for onefold normal mice. And then repeat before process. At the same time, every group was given corresponding medicine for 0.2 mL x 10 g(-1). The normal group and the model group were given the same cubage water, all together fore weeks. At last observd the P170, LRP, TOPO II by flow cytometry.</p><p><b>RESULT</b>Matter by 70% ethanol with Huanglian Jiedu Tang could obviously reduce the express of P170 and LRP, and the activiation of TOPO II.</p><p><b>CONCLUSION</b>Matter by 70% ethanol with Huanglian Jiedu Tang can intervene the ocurrence of the multi-drug resistance of tumour cells by regulating the biology gene.</p>