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2010 Vol. 1, No. 2

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Original Contributions
Expression of Perforin in the Peripheral Blood of Patients with Primary Biliary Cirrhosis and Its Clinical Significance
Xi LI, Dan-xu MA, Lei ZHANG, Ting ZHANG, Li WANG, Qun SHI, Qian WANG, Qing-jun WU, Xuan ZHANG, Feng-chun ZHANG, Yong-zhe LI
2010, 1(2): 125-131.
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  Objective  To study the expression of perforin (also known as pore-forming protein, PFP) in the peripheral blood of patients with primary biliary cirrhosis (PBC) and to analyze the clinical significance of PFP in the pathogenesis of PBC.  Methods  Peripheral blood mononuclear cells PFP mRNA were detected by real-time RT-PCR assay in 86 PBC patients, 56 chronic hepatitis B patients, and 69 health controls. The expressions of PFP protein in CD3-CD56+natural killer cells (NK), CD3+CD8+cytotoxic T lymphocytes (CTL), and CD3+CD56+natural killer T lymphocytes (NKT) were examined by tricolour flow cytometry.  Results  The mRNA expression of PFP was significantly higher in PBC patients (P < 0.05). The percentage of lymphocyte subsets was not significantly different among the three groups (P>0.05), while the percentage of PFP in the three lymphocyte subsets in PBC patients was significantly higher than those in health controls (P < 0.01). The Mayo risk score was significantly correlated with the gene expression of PFP and the percentage of PFP in three types of cells in PBC patients (P < 0.05). The percentage of PFP in NK and CTL cells were also positively correlated with the levels of total bilirubin in PBC patients (P < 0.05).  Conclusions  PFP shows abnormal expression in PBC patients, suggesting that PFP may be involved in the pathogenesis of PBC. The percentages of PFP-positive NK, CTL, and NKT cells can be used as effective indicators in predicting the survival of PBC patients.
Correlation of Memory B Cell and B Cell Activation Factor with Clinical Indicators in Primary Sj?gren's Syndrome Patients and Their First-degree Relatives
Lin WANG, Wen ZHANG, Meng-tao LI, Yan ZHAO
2010, 1(2): 132-136.
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  Objectives  To investigate the expression of CD19+CD27+ (memory B cell) and B cell activation factor(BAFF), in the peripheral blood of patients with primary Sjögren's syndrome (pSS) and their relatives and to analyze the correlations of the cells with clinical indicator.  Methods  Peripheral venous bloodsamples were collected from 41 newly diagnosed pSS patients[females, age 48.7±9.1 years, anti-SSA/SSB (+) 73.2%] from Sjögren's International Collaborative Clinical Alliance(SICCA) and Peking Union Medical College Hospital(PUMCH), and 27 healthy controls (females, age 47.0±3.8 years) and 7 first-degree relatives of the patients (females, age 50.1±5.0 years). The levels of memory B cells in the peripheral blood were measured by flow-cytometric. The level of BAFF in serum was determined with enzyme-linked immunosorbent assay (ELISA). Clinical indicators including IgG, IgA, IgM, C3, C4, Focus score, 5-min salivary rate, ocular score, Schirmer test results were tested simultaneously.  Results  The level of memory B cell in the blood of pSS patients was 11.10%±5.10%, which was significantly higher than that of the healthy controls 9.24%±6.99% (P=0.0002), but was not significant differences between pSS patients and their first-degree relatives (P>0.05). BAFF in pSS was 1.18±0.72 ng/ml, which was significantly higher than that of the healthy controls (0.43±0.19 ng/ml) (P=0.0005) and than that of their first-degree relatives (0.56±0.11 ng/ml) (P=0.015). CD27+ B cell were positively correlated with 5-min salivary rate (r=0.345, P=0.027), negatively correlated with ocular score (r=-0.321, P=0.041); however, it was not correlated with IgG, IgA, IgM, C3, C4, focus score, and Schirmer test results. BAFF was not correlated with IgG, IgA, IgM, C3, C4, focus score, 5-min salivary rate, ocular score, and Schirmer test (P > 0.05).  Conclusions  The memory B cell is highly expressed in pSS patients and their first-degree relatives and is negatively correlated with clinical indicators, suggesting that memory B cell may migrate from peripheral tissues to the gland tissues during the pathogenesis of pSS. BAFF level is remarkably higher in pSS patients than in their first-degree relatives and in healthy controls, suggesting that BAFF may be involved in the development of pSS but is not parallel with the severity of this disease.
Different Imaging Techniques in the Diagnosis of Pancreatic Carcinoma
Hong YANG, Jia-ming QIAN, Ai-ming YANG, Tao GUO, Can-rong MAI, Xing-hua LU, Jian WANG, Xin WANG
2010, 1(2): 137-140.
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  Objective  To analyze the role of different imaging techniques in the diagnosis of pancreatic carcinoma and learn the changing in the past fourteen years, in order to improve the knowledge of pancreatic carcinoma.  Methods  The clinical data and imaging results of 414 patients with pancreatic carcinoma who received imaging examinations in our hospital from August 1995 to August 2009 were retrospectively analyzed.  Results  The most sensitive imaging techniques were encoscopic retrograde cholangio-pancreatography (ERCP) and endoscopic ultrasonography (EUS). Comparison of the periods between 1995-2003 and 2004-2009 showed that rate of using ultrasound as the initial choice has decreased significantly from 90.3% to 74.5%, while the rate of computed tomography was increasing(9.0% vs. 24.6%) (both P=0.000). The coincidence rate between magnetic resonance cholangio-pancreatography (MRCP) and ERCP in the diagnosis ofpancreatic duct and bile duct was 86.7% and 75.0%, respectively; furthermore, compared with ultrasound, CT, and EUS, MRCP was the most sensitive technique in detecting lesions in these locations. Angio-CT showed a performance of 80% in the detection of vascular invasion in splenic vessels and in portal vein, and 60% in the superior mesenteric vessels.  Conclusion  Different imaging techniques have varied performances in the diagnosis of pancreatic carcinoma and should be applied reasonably.
Prevalence of Overweight and Obesity among Rural Elderly Women in Liaoning Province and Its Risk Factors
Sha-sha YU, Hong-mei YANG, Xin-gang ZHANG, Zhao-qing SUN, Li-qiang ZHENG, Ying-xian SUN
2010, 1(2): 141-144.
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  Objective  To investigate the prevalence of overweight and obesity among rural elderly women and its risk factors.  Methods  A cross-sectional cluster survey was conducted during 2004-2005 in Liaoning province, China. A total of 3232 elderly women age ≥ 60 years were enrolled. Their baseline lifestyle and other factors were obtained. Overweight and obesity were separately defined according to both the World Health Organization (WHO) criteria and Chinese criteria.  Results  When the WHO criteria were applied, the prevalence of overweight and obesity was 17.7% and 2.2%, respectively. When the Chinese criteria were applied, the corresponding figures were 23.7% and 5.8%, respectively. Multivariate logistic regression analysis showed that Mongolian nationality and current drinking were the risk factors for overweight or obesity. Aging and current smoking status were negatively correlated with overweight and obesity.  Conclusions  Although the prevalence of obesity was low, the prevalence of overweight was relatively high among rural elderly women. Unhealthy lifestyle, aging, and ethnicity are risk factors of overweight and obesity in this population.
Establishment of Two Murine Models of Ulcerative Colitis and Comparison of the Mechanism of Colitis-related Inflammatory Reactions
Zheng MIAO, Jia-ming QIAN, Jing-nan LI, Xiao-yan TANG, Xiao-ou YANG
2010, 1(2): 145-149.
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  Objective  To establish two murine models of ulcerative colitis (UC) and explore the mechanism of colitits-related inflammatory reactions.  Methods  Totally 12 C57BL mice were randomly divided into two groups:dextransulfatesodium (DSS) model group (n=8, allowed to drink 3% DSS for 5 days) and DSS control group (n=4, allowed to drink water for 5 days). In addition, 8 BALB/C mice were randomly divided into oxazolone (OXZ) model group(n=4, mice were skin-sensitized with 3% OXZ 0.2 ml in 100% ethanol for 2 days followed by intrarectal administration of 0.8% OXZ 0.15 ml in 50% ethanol 5 days later) and OXZ control group(n=4, mice were skin-sensitized with 100% ethanol for 2 days followed by intrarectal administration of 50% ethanol 0.15 ml 5 days later). The disease activity index (DAI), tissular general score, and histological score were calculated. The levels of myeloperoxidase (MPO), interleukin 4 (IL-4), interferon-γ (INF-γ), tumor necrosis factor-α(TNF-α), and nuclear factor-Kappa B (NF-κB) in the colon tissue were determined.  Results  DAI, tissular general score, and histological score were significantly different in either DSS or OXZ model group when compared with their control groups. MPO, TNF-α, and NF-κB significantly increased in DSS and OXZ model groups. In addition, INF-γ significantly increased in DSS model group and IL-4 significantly increased in OXZ model group.  Conclusions  Both DSS and OXZ can induce ulcerative colitis in mice. OXZ-induced murine colitis is highly associated with T helper cell type 2 (Th2), which is more similar to human UC.
Association between Hyperuricemia and Other Metabolism Dysfunctions
Shu-fen LIU, Yuan-jie LI, Cheng-jin HUANG, Qi WANG, Wei QIN, Xiao-rong GAI, Ying SHEN, Ling QIU, Xue-jun ZENG
2010, 1(2): 150-154.
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  Objective  To explore the association between hyperuricemia and other metabolism dysfunctions.  Methods  A cross-sectional study in 2074 health examination subjects in our hospital in 2008. We calculated the prevalences of hyperuricemia and other metabolism dysfunctions and explored the association between hyperuricemia and other metabolism dysfunctions using bivariate correlation analysis and Logistic multiple analysis.  Results  The prevalence were as follows:hyperuricemia is 14.27%, obesity 12.07%, hypertension 24.70%, fasting hyperglycaemia 19.46%, hypercholesteremia 36.38%, hypertriglyceridemia 28.68%, fatty liver 40.28%. The prevalences of metabolism dysfunctions were significantly higher in hyperuricemia group than in non-hyperuricemia group, and such significant differences still existed after having been adjusted with age. Bivariate correlation analysis showed that hyperuricemia was significantly correlated with age, gender, body mass index, systolic blood pressure, diastolic blood pressure, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, total cholesterol, triglyceride, non-high-density lipoprotein cholesterol, glucose, creatinine, and fatty liver. Logistic multiple regression analysis showed that the level of serum uric acid was independently associated with obesity, hypertension, low-density lipoprotein cholesterol, hypertriglyceridemia, and fatty liver.  Conclusions  Hyperuricemia is independently associated with obesity, hypertension, hypertriglyceridemia, and fatty liver. It can increase the risk of these metabolic disorders.
Role of ERCC1 Expression in Predicting the Outcome of Platinum-based Chemotherapy in Patients with End-stage Non-small-cell Lung Cancer
Xiao-hong NING, Yu-zhou WANG, Zhao SUN, Ji LI, Yan-ping ZHOU, Chun-mei BAI
2010, 1(2): 155-159.
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  Objective  To explore the role of expression of excision repair cross-complementation group 1 (ERCC1) in predicting the outcomes of platinum-based chemotherapy in patients with end-stage non-small-cell lung cancer.  Methods  The expression of ERCC1 was detected with immunohistochemical methods in paraffin-embeded tumor specimens obtained from 39 patients with chemo-naive non-small-cell lung cancer. The relationship between ERCC1 expression and the response rate of platinum-based chemotherapy as well as its possible values in predicting overall survival (OS) and time to progression (TTP) were analyzed.  Results  ERCC1 was highly expressed in 39 tumors (56.4%). The expression of ERCC1 showed no association with gender, age, pathologic type, grade of differentiation, smoking history, and smoking index. The response rate of platinum-based chemotherapy was significantly higher in patients with low ERCC1 expression (P < 0.05). Furthermore, ERCC1 expression had no notable influence on OS and TTP.  Conclusion  The expression of ERCC1 in lung tumor may be useful in predicting the effectiveness of platinum-based chemotherapy for end-stage non-small-cell lung cancer.
Relationship between Aggressive Septal Ablation and Significant Left Atrial Appendage Activation Delay following Catheter Ablation of Persistent Atrial Fibrillation
Chen-xi JIANG, Chang-sheng MA, Jian-zeng DONG, Xing-peng LIU, De-yong LONG, Rong-hui YU, Ri-bo TANG, Jia-hui WU, Cai-hua SANG, Man NING, Xiao-hui LIU
2010, 1(2): 160-166.
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  Objective  To elucidate the significant left atrial appendage activation following ablation of persistent atrial fibrillation, and explore its relationship with aggressive septal ablation.  Methods  A total of 201 patients with persistent atrial fibrillation underwent catheter ablation from June 2007 to February 2009. Action mapping of left atrium was performed and the local potential of left atrial appendage was recorded at the end of the procedure. Transthroacic ultrasound was performed one month later to evaluate the function of left atrium.  Results  Significant left atrial appendage activation delay was found in 23 out of 201 patients undergoing persistent atrial fibrillation ablation. Of these 23 patients, 14 patients suffered from this condition in their first were found at index procedures, of whom septal line ablation was performed in nine (odds ratio 15.2, 95% confidence interval 4.6-50.8, P < 0.001). The delay was found in another 9 patietns during their redo procedures (including two with biatrial activation dissociation), all of whom received extensive left septal complex fractionated elegrams ablation in their prior procedures (P=0.002). Activation mapping demonstrated the earliest breakthrough of the left atrium changed to coronary sinus in 18 (85.7%) patients. After 1 month, the mitral A wave velocity was 18.2±17.0 cm/s, and decreased significantly as compared with preablation (20.2±19.1 vs. 58.2±17.9 cm/s, P=0.037) in patients undergoing redo procedures. Fourteen (60.9%) remained arrhythmia-free during follow-up, which lasted 10.6 ±6.2 months.  Conclusion  Septal line ablation and extensive septal complex fractionated elegrams ablation are correlated with significant left atrial activation delay or even biatrial activation dissociation, and should be performed with prudent consideration.
Wegener's Granulomatosis Combined with Pulmonary Tuberculosis: Report of 8 Cases and Literature Review
Jie LIU, Yi XIAO
2010, 1(2): 167-170.
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  Objective  To analyze the clinical manifestations of patients with Wegener's granulomatosis (WG) and pulmonary tuberculosis (TB).  Methods  We retrospectively analyzed the clinical data of 8 patients with Wegener's granulomatosis combined with pulmonary tuberculosis in Peking Union Medical College Hospital from May 1990 to May 2010.  Results  There were 5 men and 3 women aged 19-70 years. Five patients were initially diagnosed as Wegener's granulomatosis but were confirmed to be with pulmonary tuberculosis during corticosteroid therapy. All these five patients had positive acid-fast bacilli smear test results, and four of them denied past a history of tuberculosis or tuberculosis exposure. Two were diagnosed as Wegener's granulomatosis and pulmonary tuberculosis almost the same time. In the remaining one case, tuberculosis was diagnosed firstly, and then Wegener's granulomatosis was also identified. The most common clinical manifestation in lung was hemoptysis, followed by cough and expectoration. Other involved organs included kidney (abnormal red blood cells in urine) and ear/nose/throat (suppuration and hearing impairment). Management was mainly based on anti-TB therapy and enhanced corticosteroid therapy.  Conclusions  Patients with Wegener's granulomatosis combined with pulmonary tuberculosis are not uncommon. Early diagnosis and treatment can improve the prognosis.
Fechtner Syndrome in a Chinese Family: A Case Report and Literature Review
Jing YANG, Bao-lai HUA, Shu-jie WANG, Chang-wen GE, Lian-kai FAN, Ye-hua HAN, Yong-qiang ZHAO
2010, 1(2): 171-175.
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  Objective  To analyze the clinical and laboratory abnormalities and genetic defect of inherited thrombocytopenia in a Chinese family.  Methods  We collected the clinical data and blood samples of a proband and his family members, examined the characteristic morphological features of platelets and leukocytes on blood smears with Wright's-Giemsa staining, observed the ultrastructure of platelet and leukocyte under electron microscope, and detected expression of platelet membrane protein by flow cytometry. Genomic DNA was isolated from the peripheral blood of the proband and 3 members of his family. All the exons and exon-intron boundaries of the MYH9 gene were amplified by polymerase chain reaction (PCR), followed by direct sequencing.  Results  In the peripheral blood smears, 90% of platelet were large platelets, the expressions of platelet membrane glycoproteins (CD41, CD61, CD42a, CD42b) and platelet function were within the normal range. Electron microscope showed no capsule separating the inclusion bodies in neutrophil cytoplasmic. A heterozygous G to A mutation was found in the proband and two members of his family at nucleotide 5521 in exon 38 of MYH9 gene, leading to the encoding of non-myosin heavy chain A (NMMHC2A) No. 1841 of glutamate into lysine.  Conclusion  MYH9 gene mutation and thrombocytopenia and giant platelets are the main features of Fechtner syndrome.
2010, 1(2): 119-120.
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2010, 1(2): 179-189.
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2010, 1(2): 191-195.
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2010, 1(2): 201-205.
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