伴有视网膜病-肾病-卒中的遗传性内皮细胞病一例

视网膜病-肾病-卒中的遗传性内皮细胞病(hereditary endotheliopathy with retinopathy,nephropathy and stroke,HERNS)是一种非常少见的遗传性脑小血管病。脑小血管疾病是指颅内小动脉和微动脉病变导致脑卒中发作的一组疾病。通常累及直径<300μm的动脉血管。

血管内皮细胞病的临床、影像学和病理学研究

目的探讨血管内皮细胞病的临床特征、神经影像学和病理学改变。方法分析1例血管内皮细胞病患者的临床表现、实验室检查、神经影像学和病理学资料。结果该例患者反复发生脑卒中,并出现视网膜血管异常、蛋白尿和血尿,眼科检查提示眼底动脉节段性狭窄;头颅MRI显示额顶区和胼胝体长T_1、长T_2信号,注药后增强;数字减影血管造成检查未见颅内血管异常,超微结构检查发现神经、肌肉和皮肤血管出现独特的多层化基底膜。结论血管内皮细胞病易累及大脑、视网膜和肾脏。病理学检查可发现独特的多层化血管基底膜。

表现为内皮细胞病的Castleman病临床分析

目的提高对表现为内皮细胞病的Castleman病的认识。方法对3例肾病病理表现为内皮细胞病的Castleman病进行病例分析,并复习国内外有关文献。结果 3例Castleman病患者,临床分型均为多中心型,主要表现为乏力、全身浅表淋巴结肿大、脾大、轻度贫血、血尿、蛋白尿和C反应蛋白增高,临床诊断2例为慢性肾脏病,1例为急性肾衰竭。结论肾脏病理表现为内皮细胞病的Castleman病临床表现多样,极易漏诊,诊疗工作中如遇肾脏病变伴淋巴结肿大病例,应尽早行淋巴结活检,以期能早期诊断,及时明确治疗方案。

肾毛细血管内皮细胞增生的诊断思路

病理表现为内皮细胞增生的病变可出现多种临床表现,分别对应不同的临床疾病类型,综合分析患者的临床特点及与光镜、免疫荧光和电镜检查相结合才可做出相应的诊断。及早做出准确诊断对肾脏疾病的治疗、预后和管理至关重要。该文就病理表现为内皮细胞增生的肾脏疾病做一介绍,并对其诊断思路进行简要总结。

反应性血管内皮细胞瘤病

报告1例反应性血管内皮细胞瘤病。患者女,34岁。因左前臂红斑、斑块7个月余就诊。皮肤科检查:左前臂近肘窝处见6～8处红斑、丘疹及斑块,较大者直径达4 cm。皮损中见紫癜。皮损组织病理示:真皮毛细血管数量显著增多,成簇或弥漫分布。增生血管均表达CD34和因子Ⅷ。

青少年型皮肌炎的病理特点(附6例报告)

目的 探讨青少年型皮肌炎的皮肤和骨骼肌微血管病理改变规律。方法 6例患儿的发病年龄在 7～ 14岁之间 ,主要表现为急性或亚急性起病的四肢肌肉无力 ,伴随面部和颈部皮肤水纹样皮疹。对所有患者的肌肉进行活检 ,其中 2例患者进行皮肤活检 ,肌肉标本进行常规组织学和酶组织化学染色 ,皮肤和肌肉标本进行电镜检查。结果 6例患者均存在典型皮肌炎的肌肉病理改变特点 ,表现为以肌束衣为主的炎细胞浸润和束周分布的肌纤维空泡变性和再生现象。非特异性酯酶染色显示小血管和毛细血管内皮细胞深染。电镜检查发现皮肤毛细血管内皮细胞坏死消失后残留的基底膜结构和细胞降解产物 ,在部分成熟毛细血管内皮细胞的胞浆内可见管网包涵体 ,该包涵体不出现在小血管坏死和再生的内皮细胞以及平滑肌细胞内。相同改变规律的微血管病变也出现在骨骼肌内。结论 皮肤具有和骨骼肌相同的微血管病理改变规律。内皮细胞损伤是青少年型皮肌炎微血管病的主要病理改变。显然青少年型皮肌炎是血管内皮细胞病。

地中海贫血伴有高雪氏细胞一例报告

高雪氏病系常染色体隐性遗传的类脂质代谢障碍,可发生于任何年龄,临床表现为肝脾肿大,骨髓受累和皮肤暴露部位弥漫性黄棕色色素沉着,在有些疾病中,可在骨髓内查见形态上与高雪氏病相似的高雪氏细胞。现将我们所见一例报告如下。患儿男,12岁,住院号81—302,广东省清远人。面色苍黄、乏力10年。多次在外院诊治,诊断为营养不良性贫血,予以多次反复输血,无明显好转。于1981年来我院就诊。

高雪氏病1例报告

1临床资料患者:女,8岁,因右肩及左髋疼痛,左腿跛行入院检查。家族史:父母健在,体检:发育不良,身材矮小,智力较迟钝,面色苍白,全身有少量散在出血点。浅表淋巴结不肿大。腹部隆起,肝剑突下6.5cm,肋下6cm,质中度硬,无压痛。

高雪氏病1例报告

1临床资料患者:女,8岁,因右肩及左髋疼痛,左腿跛行入院检查。家族史:父母健在,体检:发育不良,身材矮小,智力较迟钝。

Location of Highly Pathogenic Porcine Reproductive and Respiratory Syndrome Virus in Tissues of Natural Cases

[ Objective] The aim of this study was to provide a theoretical basis for the prevention and treatment of highly pathogenic porcine reproductive and respiratory syndrome （HP-PRRS）. [Method] Antigen location and histopathological observation in natural cases infected by highly pathogenic porcine reproductive and respiratory syndrome virus （HP-PRRSV） were analyzed by immunohistochemistry and H. E. staining. [Result] The virus antigen mainly existed in epithelial calls, and also a few in mecrophages, lymphocytes and brain nerve cells. [ Conclusion] The cell and tissue tropism of HP-PRRSV strain in natural cases is different from that of previous strains.

Expression of Angiopoietin-2 and Vascular Endothelial Growth Factor in Oral Squamous Cell Carcinoma and Its Significance

Objective： To investigate the expression of angiopoietin-2 （Ang-2） and vascular endothelialcell growth factor （VEGF） in oral squamous cell carcinoma （OSCC） and their correlations with clinicopathologic parameters, angiogenesis and vessel maturation of OSCC. Methods： The expression of Ang-2 and VEGF was detected in 41 speciments of human OSCC, 30 adjacent noncancerous oral tissues and 10 specimens of normal oral mucosa by conventional immumohistochemistry. Microvessel density （MVD） and vessel maturation index （VMI） were also assessed by double-labelling immumohistochemistry staining against CD34, a marker of pan-endothelial cells, and that against alpha-smooth muscle actin （α-SMA）, a marker of mural cells （pericytes/smooth muscle cells）. Results： The positive expression rate of Ang-2 and VEGF in 41 OSCC tissues was 51.22% and 63.42%, respectively. The expression of Ang-2 and VEGF was significantly higher in OSCC than in adjacent noncancerous oral tissues （all P〈0.05） and normal oral mucosa （all P〈0.05）. In the clinicopathologic parameters, the Ang-2 expression was closely correlated with tumor lymph node metastasis （P〈0.01） and the VEGF expression was correlated with tumor differentiated degree （P〈0.05）, but there was no significant correlation among the Ang-2 and VEGF expression and patients＇ sex, age and TNM stages （all P〉0.05）. The MVD of OSCC positive for both Ang-2 and VEGF was significantly higher than that of OSCC negative for both Ang-2 and VEGF （P〈0.05）. The VMI of OSCC positive for Ang-2 was significantly lower than that of OSCC negative for Ang-2 （P〈0.05）. When Ang-2 expression was combined with the staus of VEGF expression, MVD of OSCC positive for both Ang-2 and VEGF was the highest （51.08±2.99） as compared with that of other status in patient with OSCC （all P〈0.05）. Conclusion： The overexpression of Ang-2 and VEGF may play a crucial role in the development of OSCC. They are closely associated with angiogenesis and vessel maturation of tumor.

进行性脾肿大伴贫血

患儿女,3岁,因进行性脾肿大及贫血8个多月来院求诊。体检:较消瘦,神志清楚。脾大至盆腔,质硬,肝肋下3指。贫血貌,血红蛋白10.3g,白细胞计数2100。入院诊断为脾肿大、脾机能亢进。行脾切除术并同时作肝活检。

Human hepatic sinusoidal endothelial cells can be distinguished by expression of phenotypic markers related to their specialised functions in vivo

The hepatic sinusoids are lined by a unique population of hepatic sinusoidal endothelial cells (HSEC), which is one of the first hepatic cell populations to come into contact with blood components. However, HSEC are not simply barrier cells that restrict the access of blood- borne compounds to the parenchyma. They are func- tionally specialised endothelial cells that have complex roles, including not only receptor-mediated clearance of endotoxin, bacteria and other compounds, but also the regulation of inflammation, leukocyte recruitment and host immune responses to pathogens. Thus understand- ing the differentiation and function of HSEC is critical for the elucidation of liver biology and pathophysiology. This article reviews methods for isolating and studying human hepatic endothelial cell populations using in vitro models. We also discuss the expression and functions of phe- notypic markers, such as the presence of fenestrations and expression of VAP-1, Stabilin-1, L-SIGN, which can be used to identify sinusoidal endothelium and to permit discrimination from vascular and lymphatic endothelial cells.

Immortalization of human umbilical vein endothelial cells with telomerase reverse transcriptase and simian virus 40 large T antigen

Objective: To establish normally conditionally-immortalized human umbilical vein endothelial cells (HUVECs) by ectopic expression of the human telomerase catalytic enzyme (hTERT) and simian virus 40 large T (SV40 LT) antigen. Methods:Primary HUVECs were transfected with recombinant retrovirus containing hTERT or SV40 LT respectively. Subsequently drug resistant cell clones were screened and expanded for further studies. Endothelial cell biomarkers were confirmed by examination.Results: The morphological phenotype of the transfected cells was similar to the non-transfected cells. Von Willebrand factor,hTERT and SV40 LT could be detected in transfected HUVECs. Moreover, higher telomerase activity in transfected cells was maintained for over 50 population doublings compared with only low level of endogenous telomerase transiently at early population doublings in primary HUVECs. When exposed to TNF-α (tumor necrosis factor-α), the expression of E-selectin in transfected cells was significantly up-regulated, but no alteration of endothelial lipase was found. Conclusion: Ectopic coexpression of hTERT and SV40 LT can effectively immortalize HUVECs without tumorigenicity in vitro. Immortalized HUVECs may be an ideal target of further molecular function studies.

Ephrin-B2 is differentially expressed in the intestinal epithelium in Crohn's disease and contributes to accelerated epithelial wound healing in vitro

AIM:Eph receptor tyrosine kinases and their membrane bound receptor-like ligands, the ephrins, represent a bi-directional cell-cell contact signaling system that directs epithelial movements in development. The meaning of this system in the adult human gut is unknown. We investigated the Eph/ephrin mRNA expression in the intestinal epithelium of healthy controls and patients with inflammatory bowel disease (IBD). METHODS: mRNA expression profiles of all Eph/ephrin family members in normal small intestine and colon were established by real-time RT-PCR. In addition, differential expression in IBD was investigated by cDNA array technology, and validated by both real-time RT-PCR and immunohistochemistry. Potential effects of enhanced EphB/ephrin-B signaling were analyzed in an in vitro IEC-6 cell scratch wound model. RESULTS: Human adult intestinal mucosa exhibits a complex pattern of Eph receptors and ephrins. Beside the known prominent co-expression of EphA2 and ephrinAl, we found abundantly co-expressed EphB2 and ephrin-B1/2. Interestingly, cDNA array data, validated by real-time PCR and immunohistochemistry, showed upregulation of ephrin-B2 in both perilesional and lesional intestinal epithelial cells of IBD patients, suggesting a role in epithelial homeostasis. Stimulation of ephrin-B signaling in ephrin- B1/2 expressing rat IEC-6-cells with recombinant EphB1-Fc resulted in a significant dose-dependent acceleration of wound closure. Furthermore, fluorescence microscopy showed that EphB1-Fc induced coordinated migration of wound edge cells is associated with enhanced formation of lamellipodial protrusions into the wound, increased actin stress fiber assembly and production of laminin at the wound edge. CONCLUSION: EphB/ephrin-B signaling might represent a novel protective mechanism that promotes intestinal epithelial wound healing, with potential impact on epithelial restitution in IBD.

Thalidomide effect in endothelial cell of acute radiation proctitis

AIM: To determine whether thalidomide prevents microvascular injury in acute radiation proctitis in white rats. METHODS: Fourteen female Wistar rats were used: six in the radiation group, six in the thalidomide group, and two in normal controls. The radiation and thalidomide groups were irradiated at the pelvic area using a single 30 Gy exposure. The thalidomide (150 mg/kg) was injected into the peritoneum for 7 d from the day of irradiation. All animals were sacrificed and the rectums were removed on day 8 after irradiation. The microvessels of resected specimens were immunohistochemically stained with thrombomodulin (TM), von Willebrand Factor (vWF), and vascular endothelial growth factor (VEGF). RESULTS: The microscopic scores did not differ significantly between the radiation and thalidomide groups, but both were higher than in the control group. Expression of TM was significantly lower inthe endothelial cells (EC) of the radiation group than in the control and thalidomide groups (P < 0.001). The number of capillaries expressing vWF in the EC was higher in the radiation group (15.3 ± 6.8) than in the control group (3.7 ± 1.7), and the number of capillaries expressing vWF was attenuated by thalidomide (10.8 ± 3.5, P < 0.001). The intensity of VEGF expression in capillaries was greater in the radiation group than in the control group and was also attenuated by thalidomide (P = 0.003). CONCLUSION: The mechanisms of acute radiation- induced proctitis in the rats are related to endothelial cell injury of microvessel, which may be attenuated with thalidomide.

Expression and activity of inducible nitric oxide synthase and endothelial nitric oxide synthase correlate with ethanolinduced liver injury

AIM： To study the expression and activity of inducible nitric oxide synthase （iNOS） and endothelial nitric oxide synthase （eNOS） in rats with ethanol-induced liver injury and their relation with liver damage, activation of nuclear factor-KB （NF-κB） and tumor necrosis factor-α （TNF-α） expression in the liver. METHODS： Female Sprague-Dawley rats were given fish oil （0.5 mL） along with ethanol or isocaloric dextrose daily via gastrogavage for 4 or 6 wk. Liver injury was assessed using serum alanine aminotransferase （ALT） activity and pathological analysis. Liver malondialdehyde （MDA）, nitric oxide contents, iNOS and eNOS activity were determined. NF-κB p65, iNOS, eNOS and TNF-α protein or mRNA expression in the liver were detected by immunohistochemistry or reverse transcriptase-polymerase chain reaction （RT-PCR）. RESULTS： Chronic ethanol gavage for 4 wk caused steatosis, inflammation and necrosis in the liver, and elevated serum ALT activity. Prolonged ethanol administration （6 wk） enhanced the liver damage. These responses were accompanied with increased lipid peroxidation, NO contents, iNOS activity and reduced eNOS activity. NF-κB p65, iNOS and TNF-α protein or mRNA expression were markedly induced after chronic ethanol gavage, whereas eNOS mRNA expression remained unchanged. The enhanced iNOS activity and expression were positively correlated with the liver damage, especially the necro-inflammation, activation of NF-KB, and TNF-α mRNA expression. CONCLUSION： iNOS expression and activity are induced in the liver after chronic ethanol exposure in rats, which are correlated with the liver damage, especially the necro-inflammation, activation of NF-KB and TNF-α expression, eNOS activity is reduced, but its mRNA expression is not affected.

Inhibitory effect of antisense vascular endothelial growth factor RNA on the profile of hepatocellular carcinoma cell line in vitro and in vivo

AIM： To evaluate the effect of antisense vascular endothelial growth factor （VEGF） RNA （PCMV-FGEV） transfection on the profile of hepatocellular carcinoma （HCC） SMMC-7721 cells in vitro and in vivo.METHODS： SMMC-7721 cells were transfected with PCMV-FGEV antisense, PCMV-VEGF sense and empty vector plasmid encapsulated by lipofectamine as antisense group, sense group and control group respectively. The positive cell clones were selected with G418. The stable transfection and expression of VEGF in the cells were determined by RT-PCR and immunohistochemistry. Cell proliferation was observed by Mnassay. FACS analysis was used to determine the effect of PCMV-FGEV transfection on cell apoptosis. The growth of transfected cells in vivo was also observed in nude mice.RESULTS： VEGF expression was reduced in SMMC-7721 transfected with PCMV-FGEV, which was confirmed by RT-PCR and immunohistochemistry. No effect of PCMV- FGEV transfection was found on cell proliferation and cell apoptosis of SMMC-7721 in vitro. The growth of cells transfected with PCMV-FGEV was slow in nude mice and accompanied with obvious apoptosis. The latent time of tumors in the antisense group was 25.0 ：l： 1.8 d, which was longer than that in sense and control groups （F= 19.455, P〈 0.01）. The average tumor weight in antisense group （0.96 g±0.28 g） was the smallest among the three groups （F= 21.501, P〈 0.01）.CONCLUSION： The expression of VEGF can be inhibited by antisense PCMV-FGEV. Antisense PCMV-FGEV has no effect on cell proliferation and apoptosis of SMMC-7721 in vitro but can inhibit tumor growth and induce cell apoptosis in vivo.

Role of the endothelium in inflammatory bowel diseases

Inflammatory bowel diseases(IBD) are a complex group of diseases involving alterations in mucosal immunity and gastrointestinal physiology during both initiation and progressive phases of the disease.At the core of these alterations are endothelial cells,whose continual adjustments in structure and function coordinate vascular supply,immune cell emigration,and regulation of the tissue environment.Expansion of the endothelium in IBD(angiogenesis),mediated by inflammatory growth factors,cytokines and chemokines,is a hallmark of active gut disease and is closely related to disease severity.The endothelium in newly formed or inflamed vessels differs from that in normal vessels in the production of and response to inflammatory cytokines,growth factors,and adhesion molecules,altering coagulant capacity,barrier function and blood cell recruitment in injury.This review examines the roles of the endothelium in the initiation and propagation of IBD pathology and distinctive features of the intestinal endothelium contributing to these conditions.