白细胞介素-6对人冠脉平滑肌细胞表达MMP-3和PAPP-A基因的影响

目的:探讨炎症因子白细胞介素-6(IL-6)对人冠脉平滑肌细胞表达基质金属蛋白酶-3(MMP-3)、妊娠相关血浆蛋白-A(PAPP-A)基因的影响。方法:(1)应用相同浓度的IL-6(10ng/ml)刺激人冠脉平滑肌细胞,分别在共同培养0h,2h,4h,8h,24h,36h后收集细胞,观察细胞因子的时间效应;(2)应用不同浓度的IL-6(0ng/ml,5ng/ml,10ng/ml,50ng/ml)刺激人冠脉平滑肌细胞,共同培养6h后收集细胞,观察细胞因子的剂量效应;(3)应用实时荧光定量聚合酶链反应(PCR)的方法检测细胞内MMP-3、PAPP-A基因的表达量。结果:相同浓度IL-6刺激时,人冠脉平滑肌细胞MMP-3和PAPP-A基因的表达量在2h时开始发生上调,8h左右达高峰,而后开始下降;随着IL-6剂量加大,MMP-3、PAPP-A基因表达量呈上升趋势(MMP-3:r=0.919,P=0.000;PAPP-A:r=0.941,P=0.000)。结论:炎症因子IL-6能促进冠脉平滑肌细胞中斑块稳定相关标记物MMP-3和PAPP-A表达,可能是炎症在急性冠脉综合征发生发展中起重要作用机制之一。     

IL-1β、IL-6对人冠脉平滑肌细胞表达基质金属蛋白酶-3及基质金属蛋白酶组织抑制剂-1的影响

目的研究炎症因子白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）对人冠脉平滑肌细胞表达基质金属蛋白酶-3（MMP-3）和基质金属蛋白酶组织抑制剂-1（TIMP-1）的影响。方法①应用20μg/L的IL-1β、10μg/L的IL-6刺激人冠脉平滑肌细胞,分别在共同培养0、2、4、8、24、36h后收集细胞。②应用不同浓度的IL-1β（0、5、20、40μg/L）、IL-6（0、5、10、50μg/L）刺激人冠脉平滑肌细胞,共同培养6h后收集细胞。③应用实时荧光定量PCR的方法检测细胞内MMP-3和TIMMP-1基因的表达量。结果同剂量IL-1β、IL-6刺激下,MMP-3的表达量在2h时就开始上调,8h达高峰,而后开始下降;在不同剂量IL-1β、IL-6刺激下,MMP-3的表达量在实验剂量范围内随着IL-1β、IL-6的剂量加大呈上升趋势（IL-1β:r=0.907,P=0.000;IL-6:r=0.919,P=0.000）。而TIMP-1表达量在2h时就开始下调,IL-1β刺激下在8h左右达最低,IL-6刺激下在4h左右达最低,而后开始上升;在不同剂量IL-1β、IL-6刺激下,TIMP-1的表达量在实验剂量范围内随着IL-1β、IL-6的剂量加大呈下降趋势（IL-1β:r=-0.768,P=0.004;IL-6:r=-0.799,P=0.002）。结论炎症因子IL-1β、IL-6对冠脉平滑肌细胞中斑块稳定相关标记物MMP-3、TIMP-1表达的影响,可能是炎症在急性冠脉综合征的发生发展中起非常重要作用的机制之一。     

白细胞介素-6对人冠状动脉平滑肌细胞表达基质金属蛋白酶-3和基质金属蛋白酶抑制剂-1的影响

目的 探讨炎症因子白细胞介素-6（IL-6）对人冠状动脉（冠脉）平滑肌细胞表达基质金属蛋白酶-3（MMP-3）和基质金属蛋白酶组织抑制剂-1（TIMP-1）的影响.方法 （1）应用10 μg/L浓度的IL-6刺激人冠脉平滑肌细胞,分别在共同培养0、2、4,8、24、36小时后收集细胞.（2）应用不同浓度的IL-6（0、5、10、50 μg/L）刺激人冠脉平滑肌细胞,共同培养6小时后收集细胞.（3）应用实时荧光定量PCR方法检测MMP-3、TIMP-1基因的表达量.结果 同剂量IL-6刺激下,MMP-3的表达量在2小时时就开始发生上调,8小时达高峰,而后开始下降;在不同剂量IL-6刺激下,MMP-3的表达量在实验剂量范围内随着IL-6的剂量加大呈上升趋势.而TIMP-1表达量在2小时时就开始发生下调,4小时达最低,而后开始上升;在不同剂量IL-6刺激下,TIMP-1的表达量在实验剂量范围内随着IL-6的剂量加大呈下降趋势.结论 炎症因子IL-6对人冠脉平滑肌细胞中斑块稳定相关标记物MMP-3、TIMP-1表达的影响,可能是炎症在急性冠脉综合征（ACS）发生发展中起作用.     

细胞因子对人冠脉平滑肌细胞PAPP—A、MMP-3、TIMP-1基因表达的影响

目的探讨细胞因子白细胞介素（IL）-1β、IL-6对人冠脉平滑肌细胞中妊娠相关血浆蛋白-A（PAPP—A）、基质金属蛋白酶-3（MMP-3）、金属蛋白酶组织抑制剂-1（TIMP-1）基因表达的影响。方法应用相同浓度IL-1β（20μg／L）、1L-6（10μg／L）各自刺激人冠脉平滑肌细胞，共同培养0、2、4、8、24、36h后收集细胞。应用不同浓度IL-1β（0、5、20、40μg／L）、[L-6（0、5、10、50μg／L）刺激人冠脉平滑肌细胞，共同培养6h后收集细胞。应用实时定量PCR的方法检测细胞内PAPP—A、MMP-3、TIMP-1基因表达量。结果同剂量IL-1β刺激下，MMP-3和PAPP—A基因表达量在2h时开始发生上调，8h左右达高峰，而后开始下降；而TIMP-1表达量在2h时开始发生下降，8h左右达最低，而后开始上升。在不同剂量IL-1β刺激下，MMP-3、PAPP—A基因表达量随着剂量加大呈上升趋势（MMP-3：r=0．907，P=0．000；PAPP—A：r=0．972，P=0．000），TIMP-1呈下降趋势（r=-0．768，P=0．004）。不同剂量组MMP-3、TIMP-1、PAPP—A表达量具有显著性差异（MMP-3：F=24．047，P=0．000；TIMP-1；F=33．737，P=0．000；PAPP—A：F=264．699，P=0．000）。MMP-3在20μg／L和40μg／L组间没有显著性差异（P=0．154）；TIMP-1仅40μg／L组和其他组间具有显著性差异，其余组间无显著性差异（P=0．383）；PAPP—A在各组间均有显著性差异。在同剂量IL-6的刺激下，MMP-3、PAPP—A表达量随时间变化趋势和IL-1β相似，而TIMP-1则在4h时就达到最低，随后开始上升。在不同剂量IL-6刺激下，MMP-3、PAPP—A亦有随剂量加大表达量上升趋势（MMP-3：r=0．919，P=0．000；PAPP—A：r=0．941，P=0．000），TIMP-1呈下降趋势（r=-0．799，P=0．002）。不同剂量组MMP-3、TIMP-1、PAPP—A表达量均有显著性差异（MMP-3：F=14．081，P=0．001；TIMP-1：F=5．727，P=0．022；PAPP—A：F=25．128，P=0．000）。MMP-3在5μg/L和10μg／L组间没有显著性差异（P=0．292）；TIMP-1对照组与10μg／L和50μg／L组间具有显著性差异，其余各组间没有显著性差异（P=0．253）；PAPP—A基因表达量在5μg／L和10μg／L组没有显著性差异（P=0．065）。结论炎症因子IL-1β、IL-6对冠脉平滑肌细胞中斑块稳定相关标记物PAPP—A、MMP-3、TIMP-1表达的影响，可能是炎症在急性冠脉综合征发生发展中作用机制之一。     

白细胞介素-1β和白细胞介素-6对妊娠相关血浆蛋白-A表达的影响

目的探讨炎性因子白细胞介素-1β(interleukin-1β,IL-1β)、白细胞介素-6(interleukin-6,IL-6)对人冠状动脉平滑肌细胞(human coronary artery smooth muscle cell,HCASMC)表达妊娠相关血浆蛋白-A(pregnancy-associated plasma pro-tein-A,PAPP-A)的影响。方法应用20μg/L的IL-1β、10μg/L的IL-6各自刺激HCASMC,共同培养0、2、4、8、243、6 h后收集细胞。应用不同浓度的IL-1β(0、5、20、40μg/L)I、L-6(0、5、10、50μg/L)刺激HCASMC,共同培养6 h后收集细胞。应用实时定量聚合酶链反应的方法检测细胞内PAPP-A基因的表达量。结果在同剂量IL-1βI、L-6刺激下,PAPP-A的表达量在2 h时就开始发生上调,8 h达高峰,而后开始下降;在不同剂量IL-1βI、L-6刺激下,PAPP-A的表达量在实验剂量范围内随着剂量的加大呈上升趋势(IL-1β:r=0.972,P=0.000;IL-6:r=0.941,P=0.000)。结论炎性因子IL-1βI、L-6能促进HCASMC中斑块稳定相关标记物PAPP-A的表达,可能是炎症在急性冠状动脉综合征发生发展中的重要作用机制之一。     

白细胞介素-6对兔血管平滑肌细胞产生C反应蛋白的影响

目的:探讨白细胞介素-6(IL-6)能否诱导体外原代培养的兔血管平滑肌细胞(VSMCs)产生C反应蛋白(CRP)。方法:体外原代培养新西兰兔腹主动脉VSMCs。分别用白细胞介素(IL)-6(10 ng/ml)、IL-1β25 ng/ml或IL-6(10 ng/ml)+IL-1β(25 ng/ml)刺激VSMCs 48 h。对照组用等体积的IL-6的溶剂孵育48 h。反转录聚合酶链反应(RT-PCR)和免疫印迹法(Western blot)分别检测培养细胞CRP mRNA和蛋白的表达情况。结果:对照组的原代VSMCs未见CRP的产生。VSMCs与IL-6单独孵育48 h后,CRP mRNA的表达量是对照组的(3.50±1.17)倍,能产生少量CRP,与对照组相比有差异。单独应用IL-1β不能诱导VSMCs产生CRP,但是在IL-1β和IL-6的联合刺激下,CRP mRNA表达量是对照组的(5.92±1.30)倍,CRP的合成亦达最大值。结论:IL-6能诱导原代培养的兔VSMCs产生CRP。尽管单独应用IL-1β不能刺激VSMCs产生CRP,但是它却能显著增强IL-6诱导CRP的表达。     

IL-22对人气道细胞的作用

目的 探讨IL-22对人气道上皮细胞、气道平滑肌细胞、气道成纤维细胞的生理学作用.方法 用实时定量PCR 检测气道上皮细胞、气道平滑肌细胞、气道成纤维细胞哮喘血清刺激前后IL-22R1 mRNA表达的变化.不同浓度的IL-22(10 ng/ml,100 ng/ml,1 000 ng/ml)刺激气道上皮细胞、气道平滑肌细胞和气道成纤维细胞后,用MTT法检测细胞的增殖,用流式细胞技术(FACS)检测细胞的凋亡和坏死.结果 哮喘血清刺激后气道上皮细胞IL-22R1 mRNA表达降至正常对照组的9%,气道平滑肌细胞IL-22R1 mRNA表达升高至正常对照组的345倍,而气道成纤维细胞IL-22R1 mRNA表达无明显变化.高剂量(1 000 ng/ml)的IL-22刺激气道上皮细胞和气道成纤维细胞12、24 h可显著降低细胞增殖(P<0.05,P<0.01).三种不同浓度的IL-22刺激气道上皮细胞24 h后均导致细胞凋亡显著下降(P<0.05),低浓度的IL-22(10 ng/ml)导致细胞坏死增加(P<0.01).不同浓度的IL-22刺激气道平滑肌细胞后,细胞凋亡和坏死无显著性变化.中、高浓度IL-22(100 ng/ml,1 000 ng/ml)刺激气道成纤维细胞后,细胞坏死率显著下降(P<0.05).结论 IL-22在支气管哮喘中对气道上皮的作用具有双重性,并与支气管哮喘的病程相关;而对气道平滑肌细胞的作用则可能与浓度及病程相关.支气管哮喘后续阶段,IL-22对气道成纤维细胞作用轻微.     

肿瘤坏死因子α和白细胞介素1β对内皮细胞妊娠相关血浆蛋白A表达的影响

目的 观察肿瘤坏死因子α和白细胞介素1β对内皮细胞妊娠相关血浆蛋白A表达的影响并探讨其机制.方法原代培养大鼠主动脉内皮细胞,选择生长良好的第3～4代细胞用于实验.实验分组:①空白对照组;②10、20、40、60及100μg/L肿瘤坏死因子α培养细胞24 h组;③1、5、10、20及50μg/L白细胞介素1β培养细胞24 h组;④60μg/L肿瘤坏死因子α培养细胞2、4、8、16、24及48 h组;⑤20μg/L白细胞介素1β培养细胞2、4、8、16、24及48 h组;⑥核因子κB抑制剂BAY11-7082干预组:预先用核因子κB抑制刺BAY11-7082(20 μmol/L)与内皮细胞共同孵育60 min后,再加入60 μg/L肿瘤坏死因子α或20μg/L白细胞介素1β作用48 h.实验结束后收集细胞及培养上清液,用乳酸脱氢酶试剂盒检测各组培养上清液中乳酸脱氢酶活性,用逆转录聚合酶链反应测定细胞中妊娠相关血浆蛋白A mRNA的表达,用酶联免疫吸附法检测上清液中妊娠相关血浆蛋白A蛋白水平.结果 不同浓度肿瘤坏死因子α和白细胞介素1β作用24 h后,大鼠内皮细胞妊娠相关血浆蛋白A mRNA及上清液中妊娠相关血浆蛋白A蛋白表达水平随肿瘤坏死因子α和白细胞介素1β浓度的增加而升高(P<0.05);60μg/L肿瘤坏死因子α和20μg/L白细胞介素1β作用于大鼠内皮细胞不同时间,妊娠相关血浆蛋白A表达水平显著高于空白对照组(P<0.05),且随刺激时间的延长,妊娠相关血浆蛋白A的表达逐渐升高;核因子κB抑制剂BAY11-7082作用后,妊娠相关血浆蛋白A表达水平明显降低(P<0.05).结论 肿瘤坏死因子α和白细胞介素1β上调内皮细胞妊娠相关血浆蛋白A的表达,而核转录因子的活化是其对内皮细胞妊娠相关血浆蛋白A表达上调的主要机制.     

炎性因子对妊娠相关血浆蛋白A分泌的影响

目的 研究炎性因子白细胞介素-6(IL-6)和白细胞介素-1β(IL-1β)对人冠状动脉平滑肌细胞 (HCASMC)分泌妊娠相关血浆蛋白A(PAPP-A)的影响.方法 一期:分别加入20μg/L的IL-1β(IL-1β组)、10μg/L的IL-6(IL-6组)和0μg/L的炎性因子(对照组),孵育2、4、8、24、36 h后,分别收集细胞上清液;二期:分别采用 IL-1β(0、5、20、40μg/L)和IL-6(0、5、10,50μg/L)刺激HCASMC,6 h后收集细胞和细胞上清液.采用ELISA法检测 细胞上清液内PAPP-A的表达量.结果 一期;IL-1β组PAPP-A表达量在2 h时开始增加,8、24、36 h其浓度显著高于对照组,并随时间的延长而不断增加;IL-6组PAPP-A的表达量在2 h开始增加,4、8、24、36 h其浓度显著高 于对照组,并随时间的延长而不断增加.二期:随着IL-1β和IL-6剂量的增加,PAPP-A的表达量不断升高,其中IL-1β组20μg/L和40μg/L均显著高于0μg/L时的浓度;IL-6组10μg/L和50μg/L均显著高于0μg/L时 的浓度.结论 IL-1β和IL-6可使HCASMC分泌PAPP-A增加,并呈时间和剂量依赖性.     

芍药苷对脂多糖诱导的THP-1细胞炎症因子分泌和ABCA1表达的影响

目的观察芍药苷(PF)对脂多糖(LPS)诱导的THP-1细胞炎症因子和三磷酸腺苷结合盒转运体A1(ABCA1)表达的影响。方法用含PF(10-8、10-7、10-6、10-5、10-4mol/L)培养基预处理细胞0.5 h,再用含LPS(1mg/L)培养基共同培养细胞24 h。ELISA检测细胞培养液上清中白细胞介素1β(IL-1β)、白细胞介素6(IL-6)、白细胞介素8(IL-8)和肿瘤坏死因子α(TNF-α)水平,Western blot检测细胞中ABCA1蛋白的表达。结果与对照组比较,LPS组细胞上清液中IL-1β、IL-6、IL-8和TNF-α的水平显著性升高(P0.05),ABCA1蛋白表达显著性下调(P0.05)。与LPS组比较,LPS+PF(10~(-6)、10~(-5)和10~(-4)mol/L)组上清液中IL-1β、IL-6、IL-8和TNF-α的水平显著性降低(均P0.05),ABCA1蛋白表达显著性上调(P0.05),呈现浓度依赖性。结论芍药苷抑制LPS诱导的THP-1细胞炎症因子分泌和ABCA1表达下调。     

Three layer functional model and energy exchange concept of aging process

Relying on a certain degree of abstraction, we can propose that no particular distinction exists between animate or living matter and inanimate matter. While focusing attention on some specifics, the dividing line between the two can be drawn. The most apparent distinction is in the level of structural and functional organization with the dissimilar streams of ‘energy flow’ between the observed entity and the surrounding environment. In essence, living matter is created from inanimate matter which is organized to contain internal intense energy processes and maintain lower intensity energy exchange processes with the environment. Taking internal and external energy processes into account, we contend in this paper that living matter can be referred to as matter of dissipative structure, with this structure assumed to be a common quality of all living creatures and living matter in general. Interruption of internal energy conversion processes and terminating the controlled energy exchange with the environment leads to degeneration of dissipative structure and reduction of the same to inanimate matter, (gas, liquid and/or solid inanimate substances), and ultimately what can be called ‘death.’ This concept of what we call dissipative nature can be extended from living organisms to social groups of animals, to mankind. An analogy based on the organization of matter provides a basis for a functional model of living entities. The models relies on the parallels among the three central structures of any cell (nucleus, cytoplasm and outer membrane) and the human body (central organs, body fluids along with the connective tissues, and external skin integument). This three-part structural organization may be observed almost universally in nature. It can be observed from the atomic structure to the planetary and intergalactic organizations. This similarity is corroborated by the membrane theory applied to living organisms. According to the energy nature of living matter and the proposed functional model, the decreased integrity of a human body's external envelope membrane is a first cause of the structural degradation and aging of the entire organism. The aging process than progresses externally to internally, as in single cell organisms, suggesting that much of the efforts towards the restoration and maintenance of the mechanisms responsible for structural development should be focused accordingly, on the membrane, i.e., the skin. Numerous reports indicate that all parts of the human body, like: bones, blood with blood vessels, muscles, skin, and so on, have some ability for restoration. Therefore, actual revival of not only aging tissue of the human body's membrane, but the entire human body enclosed within, with all internal organs, might be expected. We assess several aging theories within the context of our model and provide suggestions on how to activate the body's own anti-aging mechanisms and increase longevity. This paper presents some analogies and some distinctions that exist between the living dissipative structure matter and inanimate matter, discusses the aging process and proposes certain aging reversal solutions.     

Unusual responses of nocturnal pineal melatonin synthesis and secretion to swimming: Attempts to define mechanisms

Abstract: The effect of swimming at night on rat pineal melatonin synthesis was compared with that of light exposure at night. Rats were forced to swim at 0030 hr (lights out at 2000 hr) and sacrificed by decapitation 15 and 30 min later, immediately after swimming. Other groups of animals were exposed to white light (650μW/cm²) for 15 and 30 min at same time. Swimming caused a rapid and highly significant drop in the melatonin content in the pineal gland; however, the activity of N-acetyltransferase (NAT), the supposed rate limiting enzyme in the melatonin production, was not changed. Despite the drop in pineal melatonin levels, serum concentrations of the indole remained elevated in the rats that swam. In contrast, melatonin levels in the pineal and serum of light exposed rats fell precipitously, accompanied by a significant suppression of NAT activity. Since we anticipated that the strenuous exercise associated with swimming may induce release of artrial natriuretic peptide (ANP) from the heart, which in turn could cause the release of pineal melatonin, in a second study we injected physiological saline intravenously to stretch the cardiac muscle and release ANP. Three milliliters of normal saline was injected during the day into the jugular vein of anesthetized rats that were pretreated with isoproterenol to stimulate pineal melatonin production. Animals were killed 15 min after the saline injection, and pineal NAT activity and pineal melatonin levels were measured. The saline injections caused no alteration in the elevated levels of either NAT or melatonin. These data suggest that the disparity in pineal NAT activity (which was high) and pineal melatonin (which was low), in animals swum at night, may not be caused by ANP which is released during strenuous exercise such as swimming.     

Melatonin and photoperiodic time measurement: Seasonal breeding in the sheep

Abstract: Well-established circadian physiology supports the view that photoperiodic time measurement utilizes the coincidence between the presence of light and a photosensitive phase of a 'biological clock' to alter reproductive status—the so-called external coincidence model of seasonal breeding. In this review, we examine the mechanism whereby photoperiod interacts with presumed suprachiasmatic nuclei activity to allow endogenous melatonin to normally synchronize reproductive activity to the optimal time of year. The Romney Marsh sheep is particularly explored as an experimental model. It is suggested that the on/off activity of seasonal reproduction may be a robust mechanism able to be predictably manipulated by the judicious use of the light/dark cycle and exogenous melatonin, but firmly based on circadian principles.     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Serological survey of HIV and syphilis in pregnant women in Madagascar

Objectives Peripartal transmission of human immunodeficiency virus (HIV) and Treponema pallidum, the causative agent of syphilis, leads to severe consequences for newborns. Preventive measures require awareness of the maternal infection. Although HIV and syphilis testing in Madagascar could be theoretically carried out within the framework of the national pregnancy follow‐up scheme, the required test kits are rarely available at peripheral health centres. In this study, we screened blood samples of pregnant Madagascan women for HIV and syphilis seroprevalence to estimate the demand for systemic screening in pregnancy. Methods Retrospective anonymous serological analysis for HIV and syphilis was performed in plasma samples from 1232 pregnant women that were taken between May and July 2010 in Ambositra, Ifanadiana, Manakara, Mananjary, Moramanga and Tsiroanomandidy (Madagascar) during pregnancy follow‐up. Screening was based on Treponema pallidum haemagglutination tests for syphilis and rapid tests for HIV, with confirmation of positive screening results on line assays. Results Out of 1232 pregnant women, none were seropositive for HIV and 37 (3%) were seropositive for Treponema pallidum. Conclusions Our findings are in line with previous studies that describe considerable syphilis prevalence in the rural Madagascan population. The results suggest a need for screening to prevent peripartal Treponema pallidum transmission, while HIV is still rare. If they are known, Treponema pallidum infections can be easily, safely and inexpensively treated even in pregnancy to reduce the risk of transmission.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.