Objective Rats with nonalcoholic fatty liver disease (NAFLD) were used to investigate the secretory state of pancreas and the expression of insulin receptor (IR). Methods NAFLD rat model was reproduced, and then the structure of pancreatic tissue, secretory states of ? and ? cells (serum, tissue) and the expression of IR were examined and determined by means of HE staining, ELISA, and immunohistochemistry. Results In all experimental groups, the structure of pancreatic tissue showed no obvious change; the blood sugar level tended to rise. The insulin level in serum began to elevate obviously at 4th week (P≤0.01), while the insulin content in tissue began to increase at 6th week (P≤0.01), and distributed mainly in the middle part of the pancreas with a tendency of elevation along with the time. The content of glucagon in pancreatic tissue began to increase at 8th week (P≤0.01), and reached the peak at 12th week. The expression of IR in tissue began to decrease at 6th week (P≤0.01), and then tended to be stable after 8th week. Conclusions In NAFLD, there was changes in secretory state of pancreas with the accompaniment of insulin resistance. There was a tendency of elevation of levels of insulin both in serum and pancreatic tissue, but the time of expression was different. The expression of glucagen shows an increase tendency, while the decrease of IR might be the crucial cause of insulin resistance in NAFLD.

Objective To study the changes in serum endotoxin level of the patients with primary biliary cirrhosis (PBC) and the relationship between endotoxin and serum biochemical parameters. Methods Clinical data of 63 cases PBC patients confirmed by liver puncture biopsy were retrospectively studied. The clinical features, results of laboratory tests, pathological findings of all the 63 patients were analyzed. Endotoxin level was determined by limulus amebocyte lysate test in the serum obtained from the 63 cases of patients with primary biliary cirrhosis, and then compared with that of 30 healthy individuals. Results The sex ratio (male to female) of PBC patients was 1 to 8, and the mean age was 43.8 years. The prevalent complaints were jaundice and fatigue. 70.3% patients showed AMA positive. The levels of ?-glutamyltransferase (r-GGT), alkaline phosphatase (ALP) and bilirubin in the serum were markedly elevated in the majority of the patients. Compared with the early stage, the levels of ALT and AST declined slightly during the advanced stage (P

Objective One of the characteristics of rheumatoid arthritis was multiple joints involved symmetrically. The purpose was to study the method of early diagnosis and treatment for the atypical rheumatoid arthritis involving solitary joint. Methods From April 1997 to December 2002, 5 cases which were 1 male and 4 female patients with an average age of 36.8 years (range, 23 to 47 years), suffered from the swelling and pain of knee joint, and were diagnosed as early rheumatoid arthritis. The interval of the onset to surgical treatment ranged from 2 months to 3 years with a mean of 16.2 months. The patients were evaluated with serum test, joint fluids examination and radiological imaging. They were treated by the synovectomy under the arthroscopy, while the appearances of the joint under arthroscopy were recorded, and the synovial tissue was sent to the pathological examination. The improvements of the joints symptoms and the range of motion were assessed at final follow up. Results During the operation, the light green and little muddy joint fluids were found in all patients. ESR of the patients ranged from 29 to 51 mm/1h with an average of 32.2 mm/1h, all of which were higher than normal value, whereas, 3 cases had positive rheumatoid factor and 4 cases showed significant higher ?2-MG. The radiographic findings were osteoporosis in 3 cases, soft tissue swelling in 4 cases and narrowed joint space in 1 case. The synovium were proliferated and enlarged in dark violet, there were creeping pannus and necrosis fibrin deposition in the cartilage. All of the patients were diagnosed as rheumatoid arthritis confirmed by pathological changes of the synovium. The patients were followed up from 4 months to 5 years (mean, 18.7 months). Pain released in 5 cases, swelling reduced in 3 cases, the range of motion improved by 19 degrees. Unfortunately, all of the patients developed later into typical rheumatoid arthritis after the mean interval of 10.9 months (range, 3 to 25 months), the symptoms were consistent with the criteria of American Rheumatoid Association . Conclusion Solitary joint with rheumatoid arthritis is rare and may be the early status of rheumatoid arthritis. The specific appearance under the arthroscopy prompt the early diagnosis of the knee rheumatoid arthritis, and synovectomy by arthroscopy may be benificial to release the symptoms of rheumatoid arthritis.

Objective To explore the effect of elbow release and debridment with arthroscopy for elbow malfunction. Methods The study was carried out on 15 patients (male 11, female 4; age 21-63 years old, average 40.1 years old) with the use of arthroscopy to brisement accretion and articular capsule from August 2001 to December 2003. The mean course was 55.2 months (range, 8-24 months). The flexion angle of joint preopration was 15?-60?, average 30.4?, the extension angle was -80?--20?, average -51.2?. The diagnosis was osteophyma and liberum in 4. The old fracture of radius capitulum was in 2; the old fracture of ulnar olecranon in 2; the old fracture of condyle of humerus in 3; degeneration in 4. The brachial plexus anesthesia,the elbow hung to traction, interna and extra-pathway, to cut synovium and accretion fibers with shver, removal liberum and milling osteophyma, meanwhile brisement articular capsule. Pathology manifestation in arthroscopy: there were a lot hyperemia synovium and fiber accretion. There was cartilage exfoliation in 8, hyperplasy and liberum in 5, ossification of cicatricle in 2. The motion range of elbow was reexamined, if the extension function was restricted, release was performed on anterior soft tissue and capsule. If the flexion function was restricted, release was carried out on posterior capsule via posterior straight approach(3 cm supra point of olecranon). Results All patients recovered daily life and occupation postoperative 7 to 14 days. Transient ulnar nerve paralysis occurred postoperatively in one case, which recovered three months later. There were no blood vessel and nerve injury. The mean follow-up period was 14.1 months (range, 7-20 months). At the final follow-up, the flexion of joint post operation was 70?-120?, to improve average 60.5?; the extension of joint post operation was -20?--5?, to improve average 37.6?. In accordance with HSS scoring system, excellent 7, good 5, fail 3. Conclusion Using of arthroscopy to release elbow joint have many advantages such as less trauma, quick recovery and less sequela. The application in release with arthroscopy is a good way for elbow malfunction.

In order to develop ELISA method for measuring the degradation fragment of fibronectin (MAD2),hybridoma technique was used to obtain the monoclonal antibody (McAb)IgG 1 against MAD2 without cross reaction with fibronectin.The sera from 277 patients with hepatocellular carcinoma (HCC),76 with metastatic hepatic carcinoma (HMC),98 with alimentary canal carcinoma (ACC) and 156 with chronic liver disease(CLD) and 48 healthy subjects were assayed with ELISA method using this antibody.The examination showed that the mean value of MAD2 from the patients with HCC showed obviously significant difference compared with those of CLD,HMC,ACC and normal control groups ( p

To investigate MT 1 MMP mRNA expression in the development of liver fibrosis and during the reversal of liver fibrosis ,we undertook a dynamic observation by situ hybridization. Liver fibrosis model was established by intraperitoneal injection with CCl 4 in Wistar rats, then allowed them fo recover spontaneously to observe the reversal of liver fibrosis .The results showed that MT 1 MMP mRNA was expressed mainly in mesenchymal cells(such as hepatic stellate cell), also in a part of hepatocytes.The levels of MT 1 MMP mRNA expression were increased gradually in the development of liver fibrosis and decreased gradually during reversal of liver fibrosis. These results suggest that the expression of MT 1 MMP may have an important role in the development of liver fibrosis and its reversal.

To study the mechanism of matrix degradation in alcoholic liver disease (ALD), the liver tissues from 28 patients with ALD were divided into three groups according to their fibrosis degree. The mRNA expression of matrix metalloproteinase 1 (MMP 1), matrix metalloproteinase 2 (MMP 2), membrane type metalloproteinase (MT1 MMP), and tissue inhibitors of metalloproteinase (TIMP) was detected using in situ hybridization method. The results showed that the cells with positive MMP 1, MMP 2, MT1 MMP, and TIMP mRNA staining were mainly located around the fibrotic central veins, walls of sinusoids, and portal triads. These positive cells were the cells of hepatic sinusoidal walls and a few hepatocytes, meanwhile, some cells expressed both the MMP 2 and the MT 1MMP mRNA. The positive cells of the MMP 2, MT1 MMP, and TIMP mRNA increased in parallel with the severity of fibrosis, whereas the expression of MMP 1 mRNA decreased. These changes were observed predominantly in moderate fibrosis group. There findings demonstrated that down regulation of MMP 1 expression and up regulation of TIMP expression might be involved in excessive accumulation of extracellular matrix (ECM) in ALD. MMP 2 might collaborate with MT1 MMP in degradation of ECM. thereby contributing to fibrosis of central veins.Hepatic stellate cells might be the main cellular source of MMP 1, MMP 2, MT1 MMP and TIMP in ALD.

micro), hepatocyte ballooning degeneration, mild diffuse lobular inflammation and perisinusoidal collagen deposition. Zone 3 accentuation could be detected. Mallory hyaline, vacuolated nuclei in periportal hepatocytes were common. NASH has some clinical and pathological characteristics. The authors hold that combinative consideration of clinics, pathology and laboratory can ensure the diagnosis of NASH, and liver biopsy interpretation continues to be the "gold standard " for diagnosis.

To study the significance of immunocytes in pathogenesis of autoimmune hepatitis (AIH), 36 cases of patients with AIH were analyzed. Dendritic cell (DC) and lymphocytes (LC) in the liver tissues were observed with a panel of DC markers and monoclonal antibodies of lymphocyte by the method of immunohistochemistry, and DC was isolated and incubated from peripheral blood from 8 patients who were selected from these 36 patients. The expression of surface markers on DC and lymphocytes and their numbers were detected by using the flow cytometric analysis. The results showed that the expression levels of HLA DR were much higher than those in control groups ( P

Objective To explore the effects of severe acute respiratory syndrome coronavirus (SARS-CoV) on heart and its conduction system in SARS patients. Methods Six specimens of heart tissue and one specimen of heart condunction system from patients who died from SARS were studied histologically, and by histochemical and in situ hybridization examinations. Results The pathological changes showed that a part of cardiomyocytes manifested slight vacuolar degeneration, atrophy and cytoplasmic lysis, stromal edema, mild mononuclear infiltration, and vasculitis. SARS-CoV was identified within some cardiomyocytes and specialized cardiomyocytes which belonged to the conduction system of the heart by in situ hybridization in combination with Macchiavello's viral inclusion stain. Conclusions The results showed that SARS-CoV could invade not only cardiomyocytes, but also the specialized cells of heart conduction system, thus resulting in mild viral myocarditis-like pathological changes. The results provided the evidence in explaining the clinical manifestations of cardiac dysfunction in patients with SARS.