缬沙坦对原发性高血压患者血清胰岛素样生长因子1和一氧化氮浓度的影响

目的　探讨原发性高血压 (EH)患者缬沙坦治疗前后血清胰岛素样生长因子 1(IGF - 1)和一氧化氮 (NO)水平的变化。方法　用特异性放射免疫法测定 5 0例EH患者 (EH组 )缬沙坦治疗前和治疗 6个月后及 2 5例正常人 (正常对照组 )的血清IGF 1水平。用硝酸酶还原法检测EH组缬沙坦治疗前和治疗 6个月后及正常对照组的血清NO水平。结果　EH患者血清IGF - 1水平明显高于正常对照组 (13.36± 3.36nmol/L比 9.6 7± 2 .5 7nmol/L ,P <0 0 1) ,而EH患者血清NO水平低于对照组 (6 3 35± 17 18μmol/L比 77 15± 13 5 0 μmol/L ,P <0 0 1)。EH并发LVH患者平均血清IGF 1水平明显高于无LVH者 (14 15± 4 2 3nmol/L比 11 5 7± 3 10nmol/L ,P <0 0 1)而其血清NO水平低于无LVH者 (5 6 2 0± 17 15 μmol/L比 6 7 6 8± 18 97μmol/LP <0 0 5 )。缬沙坦治疗 6个月后 ,血清IGF 1水平由 13 36± 3 36nmol/L降至 10 85± 2 97nmol/L(P <0 0 1) ;血清NO水平由 6 3 35± 17 18μmol/L升至 72 0 7±15 4 5 μmol/L(P <0 0 1) ;左室质量指数 (LVMI)由 12 6 39± 18 4 5g/m2 降至 111 13± 15 2 7g/m2 (P <0 0 1)。结论　EH患者血清IGF 1水平升高 ,而NO水平降低 ,尤其是伴发LVH     

急性冠状动脉综合征患者血清热休克蛋白70的变化及其相关因素分析

目的 观察冠心病患者血清热休克蛋白70水平的变化及其相关因素进行分析.方法 共入选冠心病患者66例和无冠心病的健康对照者21例,再将冠心病患者分为急性冠状动脉综合征组46例(包括不稳定型心绞痛23例和急性心肌梗死23例)和稳定型心绞痛组20例.用ELISA测定血清热休克蛋白70水平,同时测定血清高敏C反应蛋白、空腹血糖、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇及甘油三酯水平以及外周血白细胞计数等指标.结果 急性冠状动脉综合症组血清热休克蛋白70水平(4.72±2.01 μg/L)显著高于稳定型心绞痛组(2.33±1.44 μg/L)和对照组(2.41±0.96 μg/L;P<0.01),但在稳定型心绞痛组与对照组之间差异没有统计学意义(P>0.05).冠心病亚组分析显示,血清热休克蛋白70水平在急性心肌梗死组(5.94±1.98 μg/L)显著高于不稳定型心绞痛组(3.49±1.10 μg/L;P<0.01),在不稳定型心绞痛组显著高于稳定型心绞痛组(2.33±1.44 μg/L;P<0.01).线性相关分析发现,热休克蛋白70水平与白细胞计数(r=0.337,P<0.01)、肌酸激酶同工酶(r=0.653, P<0.01)及高敏C反应蛋白(r=0.658,P<0.01)呈正相关,与高密度脂蛋白胆固醇(r=-0.211,P<0.05)呈负相关.结论 血清热休克蛋白70水平可能是预测动脉粥样硬化斑块不稳定性和评估急性冠状动脉综合症病情严重程度的敏感指标.     

乳腺癌患者血清一氧化氮水平变化及临床意义

目的　探讨乳腺癌患者血清一氧化氮 (NO)的变化规律及其临床意义。方法　应用NO(酶法 )试剂盒定量检测 47例乳腺癌患者血清NO浓度。结果　正常对照组、良性病变组和乳腺癌组的血清NO浓度分别为 (91 5± 9 1 ) μmol/L、(1 2 4 4± 1 9 1 ) μmol/L和 (73 2± 1 0 2 ) μmol/L。单因素方差分析表明 ,乳腺癌组血清NO浓度显著低于正常对照组和良性病变组 (P <0 0 0 1 ) ,而良性病变组的血清NO水平明显高于正常对照组 (P <0 0 0 1 )。结论　乳腺癌患者血清NO水平呈先升高后下降的复杂变化规律。检测乳腺癌患者血清NO水平可能有助于判断肿瘤的性质。     

冠心病患者血浆纤溶酶原激活物抑制物-1水平的变化

目的 :探讨纤溶酶原激活物抑制物 1(PAI 1)与冠心病及其不同临床亚型的相关性及其与冠状动脉病变程度的关系。方法 :选择 345例非糖尿病的住院患者 (其中 2 95例已行冠状动脉造影 ) ,分为对照组和冠心病组 ,测定血浆PAI 1抗原水平。结果 :血浆PAI 1抗原水平在对照组与冠心病组间无统计学差异。与稳定型心绞痛组 (SAP)相比 ,不稳定型心绞痛 (UAP)患者PAI 1水平显著升高 [(2 5 .0± 7.2 ) μg/L比 (2 2 .3± 7.1) μg/L ,P <0 .0 5 ],经Logistic回归分析 ,PAI 1水平与UAP仍有显著性相关 ,调整后的OR值为1.83(P <0 .0 5 )。PAI 1血浆水平与冠状动脉病变支数无关。结论 :血浆PAI 1抗原水平升高可能与UAP有关 ,但与冠心病的发生无关 ,且对冠状动脉病变范围无预测价值。     

高浓度葡萄糖对人胰岛β细胞凋亡影响的分子机制

目的　初步探讨高浓度葡萄糖对人胰岛 β细胞凋亡的影响及其分子机制。　 方法　分离培养人胰岛细胞 ,并分为对照组、高糖组和高糖 氨基胍组 ,3 7℃ ,5 %CO2 培养 72h ,测定培养液上清液中胰岛素、一氧化氮 (NO)、还原性谷胱甘肽 (GSH)水平。原位末端核苷酸标记法 (TUNEL)和胰岛素免疫组化双染色法及ELISA法检测胰岛 β细胞凋亡 ,RT PCR检测胰岛细胞p5 3、Bcl 2和胰岛素基因启动转录因子 1 (PDX 1 )mRNA表达水平。　结果　高糖组胰岛 β细胞凋亡小体富计因子(1 91± 0 6 9)、β细胞凋亡率 (1 4 8% )、NO〔(1 82 3± 1 5 5 ) μmol/L〕和 p5 3mRNA(0 3 0 6± 0 0 3 9)表达水平均显著高于高糖 氨基胍组〔分别为 1 1 9± 0 3 3、6 8%、(1 5 4 2± 1 9 7) μmol/L、0 1 3 9±0 0 6 9,P <0 0 1〕和对照组〔分别为 1 0 6± 0 2 6、4 2 %、(1 1 7 3± 2 1 7) μmol/L、0 1 2 5± 0 0 1 5 ,P <0 0 5〕 ,而胰岛素释放量、GSH、bcl 2mRNA和PDX 1mRNA表达水平则显著低于高糖 氨基胍组(P <0 0 5 )和对照组 (P <0 0 5 )。　结论　高浓度葡萄糖可通过诱导人胰岛 β细胞凋亡及PDX 1表达降低使胰岛素分泌减少 ,其机制与高糖状态下胰岛 β细胞抗氧化能力降低引起NO介导的p5 3高表达和PDX 1低表     

不稳定型心绞痛与血胆红素的关系

目的:探讨血清胆红素水平与不稳定型心绞痛的关系。方法:心内科住院患者98例,经冠状动脉造影分成两组,冠心病(CHD)组65例,其中不稳定型心绞痛(UAP)组35例,稳定型心绞痛(SAP)组30例;非CHD组33例。均采用2,4-二氯苯胺重氮盐(DCA)比色法测定血清胆红素水平。结果:UAP组血清总胆红素(15.17±4.10)μmol/L、间接胆红素(11.31±3.12)μmol/L水平明显低于SAP组[(18.69±5.48)μmol/L,(14.27±4.06)μmol/L]和对照组[(17.86±3.53)μmol/L,(14.08±2.58)μmol/L,P0.01],而SAP组与对照组相比无显著性差异(P0.05)。结论:血清胆红素水平与不稳定型心绞痛有关,有可能成为评价不稳定型心绞痛患者的生化标志物。     

可溶性CD40配体与急性冠状动脉综合征的关系

观察急性冠状动脉综合征、稳定型冠心病患者可溶性CD4 0配体变化及其与血脂水平的关系 ,采用酶联免疫吸附法测定血清可溶性CD4 0配体浓度。结果发现急性冠状动脉综合征患者可溶性CD4 0配体水平 (3.17± 2 .84 μg L)显著高于正常对照者 (1.19± 1.0 5 μg L ,P <0 .0 1)和稳定型冠心病患者 (1.6 1± 1.4 6 μg L ,P <0 .0 5 )。可溶性CD4 0配体水平受甘油三酯 (r=0 .2 3,P <0 .0 5 )、载脂蛋白B(r=0 .2 4 8,P <0 .0 5 )及高密度脂蛋白胆固醇等因素的影响 (r=- 0 .2 5 3,P <0 .0 5 )。以上提示可溶性CD4 0配体水平的升高可能与急性冠状动脉综合征的发生有关 ,是动脉粥样硬化斑块不稳定的标志     

不稳定型心绞痛与PAI-1及血小板活性的临床研究

目的　探讨老年不稳定型心绞痛 (UAP)与纤溶酶原激活物抑制剂 1型 (PAI 1)及血小板活化功能的临床意义。　 方法 　测定 87例老年UAP患者发作时的血清PAI 1水平与血小板活化因子CD62p活性 ,并与 89例健康对照组比较。　 结果　UAP组的PAI 1的水平 (99.77± 3 2 .95 ) μg·L-1较对照组 (5 5 .0 0± 2 1.2 3 ) μg·L-1明显升高 (P <0 .0 1) ;而CD62p活性 (12 .5 6± 4.66) %较对照组 (6.3 3± 2 .3 8) %也有显著升高 (P <0 .0 1)。　 结论 　老年不稳定型心绞痛的发作与PAI 1水平和血小板活性增高有密切联系。     

阵发性心房颤动凝血状态的研究

目的　探讨阵发性心房颤动 (房颤 )患者凝血标记物改变的临床意义。方法　测定阵发性房颤患者血浆纤维蛋白原 (Fg)、血管性血友病因子 (vWF)、D 二聚体 (DD)、血小板颗粒膜糖蛋白 1 4 0 (GMP 1 4 0 )、凝血酶抗凝血酶Ⅲ复合物 (TAT)和纤溶酶原激活物抑制物 1 (PAI 1 )水平。结果　与对照组比较 ,阵发性房颤组的Fg、vWF和PAI 1增高〔Fg :(2 36± 0 67)g/Lvs (3 1 2± 0 98) g/L ,P <0 0 0 1 ;vWF :79 36 %± 2 6 39%vs1 0 6 2 8%± 2 8 67% ,P <0 0 0 1 ;PAI 1 :(52 58± 2 6 52 )ng/mlvs (68 0 7± 1 4 53)ng/ml,P <0 0 5〕 ,余指标无显著性差异 ,持续性房颤组Fg、vWF、DD、TAT和PAI 1显著升高 (P <0 0 5～ 0 0 0 1 ) ;与阵发性房颤组比较 ,持续性房颤组DD、TAT显著升高〔DD :(1 34± 0 55)mg/Lvs (1 79± 0 88)mg/L ,P <0 0 5 ;TAT :1 7 51ng/mlvs 2 1 54ng/ml,P <0 0 5〕 ;三组间GMP 1 4 0无显著性差异。 结论　阵发性房颤患者在房颤发作间歇期仍存在血液高凝状态 ,其程度介于正常组和持续性房颤患者之间     

老年腹透患者的血清维生素水平

目的了解老年腹膜透析患者血清维生素水平变化。方法对2014年6~12月该院收治的56例老年腹透患者的血清维生素水平进行横断面调查,与年龄配对的非慢性肾脏病人进行比较。结果腹透组血红蛋白(Hb)和血浆白蛋白(Salb)浓度均显著低于对照组〔Hb:分别为(98.5±10.0)g/L和(132±16.8)g/L〕,P0.01;Salb:分别为(31.1±5.4)g/L和(36.3±3.4)g/L,P0.01〕。腹透组的血清维生素B1〔(77.0±20.7)nmol/L〕和维生素C〔(41.1±9.3)umol/L〕明显低于对照组〔分别为(86.3±25.5)nmol/L和(45.6±12.3)μmol/L,P0.05〕。其他微量元素如维生素A、维生素E、维生素B2、维生素B6、叶酸(B9)在两组间无统计学差异(P0.05)。按原发病分组,慢性肾小球肾炎组(CGN组)维生素B1水平〔(74.5±22.5)nmol/L〕低于对照组〔(86.3±25.5)〕nmol/L(P0.05)。腹透组患者的Hb和血清维生素C水平呈正相关(r=0.286 3,P0.05);腹透总KT/V与血清维生素B1呈负相关(r=-0.282 8,P0.05)。Salb、24 h腹透液量、残肾KT/V与各种维生素浓度均无相关性。结论老年腹透患者虽无维生素B1和C缺乏,但其血清维生素B1和C水平低于正常人。腹透总KT/V与血清维生素B1水平呈负相关,血浆维生素C水平和Hb水平呈正相关。     

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.