急性脑梗死患者细胞因子信号转导抑制因子3水平的变化及意义

目的探讨急性脑梗死(ACI)患者细胞因子信号转导抑制因子3(SOCS-3)及TNF-α和白细胞介素6(IL-6)水平变化的临床意义。方法选择发病72 h的ACI患者65例作为脑梗死组,同期选择年龄匹配的健康体检者20例作为对照组。脑梗死组按不同梗死体积、不同神经功能缺损进行分析,对照组体检时,脑梗死组入院第1、3、7天用ELISA检测血清SOCS-3水平,用化学发光法检测入院第1、7天血清IL-6与TNF-α水平,并进行相关分析。结果与对照组比较,脑梗死组第1、3、7天SOCS-3、IL-6和TNF-α明显上升(P0.01),大梗死体积患者IL-6和TNF-α表达较中、小梗死体积患者明显上升(P0.05)。入院第21天Barthel指数与SOCS-3水平呈正相关(r=0.810,P0.05),与IL-6、TNF-α水平呈负相关(r=-0.672,-0.822,P0.05)。结论 SOCS-3可能参与ACI炎性反应发生、发展的病理过程,观察SOCS-3的变化,对ACI病情评价及预后分析有益。     

急性冠状动脉综合征患者血浆促炎因子和抑炎因子水平变化分析

目的:检测冠心病患者血浆血清超敏C反应蛋白(hs-CRP)、白细胞介素-10(IL-10)和肿瘤坏死因子-α(TNF-α)水平变化,探讨急性冠状动脉综合征时炎症因子在其中的作用。方法:用双抗体夹心ELISA法对44例急性冠状动脉综合征患者入院时和40例正常对照者血浆hs-CRP、IL-10、TNF-α和TNF-α/IL-10水平变化进行研究,同时测定2周后上述指标的变化情况。结果:急性冠状动脉综合征组患者血浆hs-CRP和TNF-α水平明显高于正常对照组(P分别<0.05和<0.01),IL-10水平则明显高于正常对照组(P均<0.05);ACS组TNF-α/IL-10比值明显高于正常对照组(     

巨细胞病毒感染对老年脑梗死患者颈动脉硬化、TNF-α、VCAM-1水平的影响

目的探讨巨细胞病毒(HCMV)感染对老年脑梗死患者颈动脉硬化、血清肿瘤坏死因子(TNF)-α、血管细胞黏附分子(VCAM)-1的影响。方法 56例老年急性脑梗死(ACI)患者为ACI组、30例陈旧性脑梗死(OCI)患者为OCI组、30例健康体检者为正常对照(NC)组,采用彩色多普勒超声测定颈动脉内膜中层厚度(IMT),采用酶联免疫吸附试验(ELISA)测定血清HCMV抗体Ig M和Ig G水平及血清TNF-α、VCAM-1水平,并分析HCMV-Ig G阳性率与血清指标的关系。结果 ACI组HCMV-Ig G、Ig M阳性率及含量明显高于OCI组和NC组(P0.05或0.01);OCI组HCMV-Ig G阳性率及含量明显高于NC组(P0.05或0.01);HCMVIg G阳性组斑块检出率明显高于阴性组(P0.05);其中,HCMV-Ig G阳性组软斑比例显著高于阴性组(P0.05),硬斑比例显著低于阴性组(P0.05),颈动脉IMT、软斑积分显著高于阴性组(P0.05或0.01);ACI组血清TNF-α、VCAM-1含量明显高于OCI组和NC组(均P0.01),OCI组血清TNF-α、VCAM-1含量明显高于NC组(均P0.01);在ACI组和OCI组中,抗HCMV-Ig G阳性患者的血清TNF-α、VCAM-1含量明显高于阴性患者(P0.01或0.05);ACI组抗HCMV-Ig G阳性与阴性患者比较,Ig G明显升高(P0.01);Pearson相关分析显示,TNF-α、VCAM-1含量与HCMV-Ig G阳性率呈正相关(r=0.367,P=0.005;r=0.325,P=0.015)。TNF-α、VCAM-1含量之间呈正相关(r=0.332,P=0.012)。结论 HCMV感染通过提高血清TNF-α、VCAM-1水平,增加了斑块不稳定性,参与了脑梗死动脉粥样硬化的过程。     

特发性肺纤维化患者免疫指标检测的临床意义

目的检测特发性肺纤维化患者外周血中肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和白细胞介素-17(IL-17)的表达,探讨其与肺纤维化改变的关系。方法对49例特发性肺纤维化患者、47例健康人(正常组)以及45例普通肺炎(肺炎组)外周血中TNF-α、IL-6和IL-17表达水平进行检测。结果与正常组相比,肺炎组患者血清中IL-6、IL-17表达水平无差异,不具有统计学意义(P0.05),肺炎组血清中TNF-α表达增高,差异有统计学意义(P0.05);与正常组相比,肺纤维化组血清中IL-6、IL-17和TNF-α浓度呈明显升高趋势(P0.01);与肺炎组相比,肺纤维化血清中组IL-6、IL-17和TNF-α浓度呈明显升高趋势(P0.01)。结论 TNF-α、IL-6和IL-17表达水平与肺部纤维化改变密切相关,其表达水平对疾病诊断、治疗和预后的评估均有一定的实用价值。     

阿托伐他汀钙对扩张型心肌病患者外周血单个核细胞分泌促炎性细胞因子的影响

目的探讨不同浓度的阿托伐他汀钙对脂多糖(LPS)诱导的扩张型心肌病(DCM)心力衰竭患者的外周血单个核细胞(PBMCs)促炎性细胞因子表达的影响.方法选择心功能Ⅱ、Ⅲ、Ⅳ级的稳定期DCM患者25例,清晨采外周静脉血并分离出PBMCs,然后用细胞因子刺激剂LPS刺激PBMCs并分别加入终浓度为0、10-7、10-6、10-5mol/L的阿托伐他汀钙培养24h,离心后提取上清液并用放射免疫法测细胞因子白细胞介素-1(IL-1)β、IL-6、肿瘤坏死因子-α(TNF-α)水平.结果随着阿托伐他汀钙浓度的增加,PBMCs分泌IL-1β、IL-6、TNF-α水平呈进行性下降(P＜0.01);10-7、10-6、10-5mol/L阿托伐他汀钙组PBMCs分泌IL-1β、IL-6,TNF-α水平均显著低于0 mol/L组(均P＜0.05);10-5mol/L阿托伐他汀钙组PBMCs分泌IL-1β、IL-6、TNF-α水平均显著低于10-6、10-7mol/L组(均P＜0.05),而10-6mol/L组和10-7mol/L组IL-1β、IL-6、TNF-α水平则差异无统计学意义(均P＞0.05).结论阿托伐他汀钙呈剂量依赖性抑制LPS诱导的DCM患者外周血PBMCs促炎性细胞因子表达增加.这可能是他汀类药物对DCM有益的原因之一.     

高原地区急性脑梗死患者炎性反应相关因子含量的变化

目的探讨高原不同海拔地区急性脑梗死(acute cerebral ischemic,ACI)患者炎性反应相关因子之间的关系。方法采用ELISA法和放射免疫法,检测高海拔(3400 m)ACI患者40例(高海拔ACI组)、中度海拔(2260 m)ACI患者48例(中度海拔ACI组)血清可溶性细胞间黏附分子-1(sICAM-1)、白细胞介素(IL)的IL-1β、IL-2、IL-6和IL-8和TNF-α的水平。同期选择健康体检者70例作为高海拔对照组(30例)和中度海拔对照组(40例)。结果不同海拔地区ACI组TNF-α、IL-1β、sICAM-1和IL-8水平显著高于各对照组;高海拔ACI组IL-6显著高于对照组(P<0.01);与中度海拔ACI组比较,高海拔ACI组血清TNF-α、IL-1β、IL-6和sICAM-1水平明显增高(P<0.01)。除高海拔对照组TNF-α水平高于中度海拔对照组(P<0.05),两对照组其余指标无显著性差异。IL-2在4组间变化不大。ACI患者血清sICAM-1水平与TNF-α、IL-1β和IL-6呈正相关(r=0 564,P<0 01),而与IL-2和IL-8无相关性。结论在高原ACI的发病过程中,可能存在由TNF-α、IL-1β、IL-6和IL-8介导的炎性反应,sICAM-1参与脑缺血的发病过程。随着海拔增高及慢性缺氧加重,炎性反应增强,导致脑组织损伤加重的倾向。     

颈动脉狭窄及细胞因子与脑梗死认知关系研究

目的 探讨颈动脉粥样硬化(AS)斑块所致狭窄程度及血清细胞因子变化与急性脑梗死患者认知功能的关系.方法 根据颈AS斑块所致狭窄的程度将96例急性脑梗死患者分为5组,另设40例健康体检者为对照组.同时进行颈动脉彩超检查及简易智能精神状态检查量表(MMSE)评定,检测血清白细胞介素-10(IL-10)、白细胞介素-1β(IL-1β)、C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、基质金属蛋白酶-9(MMP-9)的水平.结果 急性脑梗死患者MMSE评分除Ⅰ级狭窄组外,其余各组总分均低于对照组(P＜0.05);与对照组相比,Ⅱ级、Ⅲ级狭窄组在注意计算、回忆能力方面有显著降低(P＜0.01), Ⅳ、Ⅴ级狭窄组在时间和地点定向力、记忆力、注意计算力、回忆、复述、阅读、书写、结构能力等9个方面有显著降低(P＜0.05);与对照组相比,各组血清IL-1β、CRP、TNF-α水平随狭窄程度加重而逐渐升高(P＜0.05),IL-10水平逐渐降低(P＜0.05),MMP-9水平与颈动脉狭窄程度无相关性;脑梗死患者MMSE评分与IL-1β、CRP、TNF-α水平呈负相关(r=-0.348,r=-0.343,r=-0.454,均P＜0.01),与IL-10水平成呈相关(r=0.696, P＜0.01),与MMP-9水平无相关性.结论 急性脑梗死患者血清IL-1β、CRP、TNF-α水平升高,且与颈AS狭窄程度呈正相关,IL-10水平下降与狭窄程度呈负相关;急性脑梗死颈动脉狭窄患者认知功能下降.     

病毒性心肌炎患者外周血miR-223、HMGB1表达关系的研究北大核心CSCD

目的探究病毒性心肌炎患者外周血微小RNA(miRNA)-223、高迁移率蛋白B1(HMGB1)的表达变化。方法本院收治的100例病毒性心肌炎患者为心肌炎组,同时期体检健康者85例为对照组,采用qRT-PCR检测外周血miR-223,采用酶联免疫吸附试验检测HMGB1,比较心肌炎组与对照组以及心肌炎组患者治疗前后miR-223、HMGB1表达水平差异,并分析miR-223、HMGB1表达水平对患者转归的影响;采用Pearson相关性分析法分析患者治疗前后外周血miR-223与HMGB1表达水平的相关性。结果心肌炎组患者miR-223相对表达量为0.57±0.13,HMGB1为(3.69±0.52)ng/ml,与对照组的1.16±0.20和(0.74±0.15)ng/ml比较差异均有统计学意义(均P<0.05);心肌炎组患者治疗后miR-223表达水平高于治疗前,HMGB1表达水平低于治疗前(均P<0.05),且治疗前及治疗后miR-223与HMGB1表达水平均呈负相关(r值分别为-0.675和-0.637,均P<0.01);miR-223高表达患者心律失常、恢复迁延率低于低表达者,痊愈率高于低表达者(均P<0.05);HMGB1高表达患者心律失常、恢复迁延率高于低表达者,痊愈率低于低表达患者(均P<0.05)。结论病毒性心肌炎患者外周血miR-223表达下调,HMGB1表达上调,miR-223与HMGB1表达水平呈负相关。miR-223高表达患者和HMGB1低表达患者的转归情况较好,提示miR-223、HMGB1表达水平的变化对预测病毒性心肌炎患者的预后有一定价值。     

帕金森病患者UA、IL-2、IL-6及TNF-α水平的表达及与认知功能的相关性

目的探讨帕金森病(PD)患者血浆血尿酸(UA)、白细胞介素(IL)-2、IL-6及肿瘤坏死因子(TNF)-α水平及与认知功能的关系。方法收集73例PD患者为PD组,另选取120例健康体检者作为健康组,分别测定两组血浆UA、IL-2、IL-6及TNF-α水平,分析其与认知功能的关系。结果 PD组UA水平蒙特利尔认知评估量表(MoCA)评分低于健康组(P<0.01);IL-2、IL-6、TNF-α水平高于健康组(P<0.01);治疗后PD患者UA、IL-2、IL-6、TNF-α水平及MoCA评分较治疗前均有所改善(P<0.01);UA、IL-6、TNF-α水平与MoCA评分有相关关系(r=0.63、0.47、0.48,均P<0.05),IL-2与MoCA评分无相关关系(r=0.43,P=0.059)。结论 PD患者UA低表达及IL-6、TNF-α高表达与认知功能障碍有一定的关系,可通过检测这些指标以预测认知功能障碍的发生情况。     

慢性阻塞性肺疾病血浆IL-16、TNF-α和FIB的表达

目的探讨COPD患者急性加重治疗前后IL-16、TNF-α和FIB在血浆水平的表达。方法收集2012年10月-2013年12月确诊为COPD(共96例)急性加重的患者,同时选取20例健康体检者为正常对照组。将受试者分两组,正常对照组(20例)和COPD(96例),并按肺功能分级将COPD组分为4组(Ι级20例,Ⅱ级26例,Ⅲ级23例,Ⅳ级27例,共96例),采用酶联免疫吸附法(ELASA)检测血清中IL-16、TNF-α和FIB的表达。结果 COPD患者血浆IL-16、TNF-α和FIB水平显著高于健康对照组,P均0.01。COPDⅠ级、Ⅱ级、Ⅲ级、Ⅳ级两两比较,IL-16、TNF-α和FIB表达水平随气道受限严重程度增高而显著升高,差异均有统计学意义(P均0.05)。血浆IL-16、TNF-α和FIB在COPD患者中呈直线正相关,相关系数分别为0.733、0.651和0.576,差异均具有统计学意义(P均0.05)。COPD急性加重患者血浆中IL-16、TNF-α、FIB水平在治疗后显著降低,但仍显著高于正常对照组(P均0.01)。结论血浆IL-16、TNF-α、FIB在COPD中表达水平增高,并与肺功能下降程度呈正相关。     

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.