老年冠心病患者血清对氧磷酶活性分析

目的:了解老年人血清对氧磷酶(PON1)活性及其与冠心病(CHD)之间的关系。方法:冠状动脉造影确诊的CHD患者106例(老年组62例,非老年组44例),用乙酸苯酯法和比色法分别测定老年组和非老年组血脂、血清PON1活性、超氧化物歧化酶(SOD)及丙二醛(MDA)含量并进行对比分析。结果:老年CHD患者PON1活性为(103±84)μkat/L,SOD为(43.6±5.7)kU/L,MDA为(9.8±1.6)μmol/L,均显著低于非老年组的(121±75)μkat/L,(54.2±6.1)kU/L,(5.5±0.8)μmol/L(均P<0.01),PON1活性与HDL、SOD呈正相关(r=0.392、r=0.485,P<0.05),与MDA呈负相关(r=-0.426,P<0.05),与其余血脂无相关性。结论:CHD患者PON1活性均呈减少趋势,老年患者血清PON1活性更低。     

老年脑梗死患者血清对氧磷酶1活性与氧化应激的关系及其在动脉粥样硬化中的作用

目的 探讨老年脑梗死患者血清对氧磷酶1活性与氧化应激的关系及其在动脉粥样硬化中的作用.方法 通过DSA检查确诊颈动脉狭窄的老年脑梗死患者72例作为研究对象(其中轻度狭窄33例,中度狭窄24例,重度狭窄15例),以非脑血管病健康体检者38例作为对照组,用分光光度计法、黄嘌呤氧化酶法和硫代巴比妥酸反应物质法分别测定血清对氧磷酶1活性、超氧化物歧化酶和丙二醛含量,分析对氧磷酶1活性与超氧化物歧化酶、丙二醛之间的关系.结果 脑梗死组患者血清对氧磷酶1活性(95.62±18.26 ku/L)和超氧化物歧化酶含量(69.59±10.56 ku/L)显著低于对照组(分别为168.36±27.82 ku/L和98.34±13.42 ku/L,P<0.01],而丙二醛含量(24.46±5.68nmol/L)显著高于对照组(15.64±8.26 nmol/L,P<0.01).轻度、中度和重度狭窄组患者对氧磷酶1活性(分别为112.48±19.32、98.64±10.84和81.95±13.42 ku/L)、超氧化物歧化酶(分别为80.62±13.26、70.26±14.09和58.82±10.06ku/L)和丙二醛含量(分别为19.52±8.48、23.56±9.81和27.28±9.89nmol/L)差异均有显著性(均P<0.01),并且对氧磷酶1活性和超氧化物歧化酶含量随颈动脉狭窄程度加重,呈逐渐下降的趋势,而丙二醛含量随颈动脉狭窄程度加重呈上升趋势.相关分析表明,对氧磷酶1活性与超氧化物歧化酶含量正相关(r=0.628,P<0.01),而与丙二醛含量负相关(r=－0.541,P<0.01).结论 老年脑梗死患者血清对氧磷酶1活性降低及氧化应激增强,对氧磷酶1活性和氧化应激及其复杂的相互作用参与动脉粥样硬化发生和发展.     

冠状动脉再次血运重建患者血清对氧磷酶-1的活性研究

目的了解血清对氧磷酶-1活性水平对再次冠状动脉血运重建的预测价值。方法以比色法测定200例行经皮冠状动脉介入治疗获得完全血运重建患者的血清对氧磷酶-1活性水平。术后随访1年,在首次介入手术后第6个月进行造影随访。将随访期内需要再次血运重建的患者归入再次血运重建组,无需再次血运重建的患者归入单次血运重建组,同期冠状动脉造影排除冠状动脉粥样硬化性心脏病(冠心病)患者100例作为非冠心病对照组。分析各组血清对氧磷酶-1活性水平的差异。结果再次血运重建组62例,单次血运重建组138例。所有患者均完成1年随访,6个月冠状动脉造影复查率88.5%(177/200),12个月造影复查率69%(138/200)。再次血运重建组、单次血运重建组、非冠心病组的血清对氧磷酶-1活性水平值分别为(109.2±98.6)μkat/L、(132.8±79.4)μkat/L、(156.4±82.8)μkat/L,方差分析示3组血清对氧磷酶-1活性水平差异有统计学意义(P0.05)。结论冠心病再次血运重建组血清对氧磷酶-1活性水平低于单次血运重建组和非冠心病对照组,故血清对氧磷酶-1活性水平对预测RCR有重要的价值。     

血尿酸水平与冠状动脉病变程度的关系

目的:探讨血清尿酸水平与冠脉病变程度的关系。方法:216例经过冠脉造影确诊为冠心病的患者,以冠脉病变程度分组,同时检测空腹血尿酸水平。结果:冠状动脉正常组血尿酸水平为(293.98±74.49)μmol/L,冠状动脉单支病变组血尿酸水平为(309.65±50.98)μmol/L,冠状动脉双支病变组血尿酸水平为(358.28±79.08)μmol/L,冠状动脉多支病变组血尿酸水平为(366.71±92.24)μmol/L。狭窄组患者的血尿酸水平(348.45±)μmol/L明显高于对照组(293.98±74.49)μmol/L,P<0.01,差异有统计学意义。血尿酸水平与冠心病的病变血管数目呈正相关(r=0.324,P<0.01)。结论:随着冠状动脉病变程度的增加,血尿酸水平也逐渐升高。     

急性炎症反应时血清对氧磷酶1活性变化及苯扎贝特的干预作用

目的观察急性炎症反应期小鼠血清对氧磷酶1活性的变化,探讨苯扎贝特潜在的抗氧化作用机制。方法8周龄C57BL/6小鼠32只,随机分为四组,每组8只:普通饲料饲养8周(对照组)、添加150mg/(kg·d)苯扎贝特饲养8周(苯扎贝特组)、普通饲料饲养8周 腹膜内注入脂多糖(脂多糖组)和添加150mg/(kg·d)苯扎贝特饲养8周 腹膜内注入脂多糖(苯扎贝特 脂多糖组)。取血清,以苯乙酸作为对氧磷酶1的底物,用分光光度仪测定小鼠血清对氧磷酶1活性。结果与对照组[32.71±4.40μmol/(min·L)]比较,脂多糖组血清对氧磷酶1活性[3.23±0.76μmol/(min·L)]显著降低(P<0.05),苯扎贝特组血清对氧磷酶1活性[120.97±39.83μmol/(min·L)]显著升高(P<0.01);苯扎贝特 脂多糖组血清对氧磷酶1活性[41.4±10.65μmol/(min·L)]显著高于脂多糖组(P<0.01),但与对照组比较差异无显著性。血清对氧磷酶1活性与高密度脂蛋白胆固醇呈正相关(r=0.538,P=0.001)。结论急性炎症反应时血清对氧磷酶1活性明显降低,苯扎贝特能有效升高血清对氧磷酶1活性,逆转脂多糖诱导的对氧磷酶1活性降低,提示苯扎贝特具有抗氧化作用。这种作用可能与升高高密度脂蛋白胆固醇有关。     

冠心病患者抗心磷脂抗体与PON、ox-LDL、MDA和SOD的相关性

目的:观察和分析冠心病患者抗心磷脂抗体(ACA)与血清对氧磷酶(PON)活性、氧化低密度脂蛋白(oxLDL)、丙二醛(MDA)和超氧化物歧化酶(SOD)的相关性。方法:酶联免疫法检测118例冠心病患者、68例正常对照者血清ACA、ox-LDL、硫代巴比妥酸法测定MDA、黄嘌呤氧化酶法测定SOD、乙酸苯酯法测定PON。结果:冠心病患者ACA阳性率为24%,显著高于对照组(阳性率为9%,P0.05)。ACA阳性冠心病患者PON活性为(122±40)kU/L、ox-LDL为(0.81±0.26)mg/L、MDA为(7.6±1.1)μmol/L、SOD为(72±20)μU/L,与ACA阴性冠心病相比PON活性降低,ox-LDL、MDA升高,SOD无明显变化。相关分析显示PON活性与ox-LDL、MDA呈负相关(分别r=-0.825,P0.01;r=-0.735,P0.01),与SOD无相关性。结论:ACA阳性冠心病患者反映脂质过氧化程度的ox-LDL、MDA增高,而PON活性降低。     

冠状动脉慢血流现象与血清脂质过氧化水平的关系

目的: 观察冠状动脉慢血流现象（CSF）患者血清脂质过氧化水平的变化,并探讨CSF的影响因素。方法: 采用TIMI帧计数（TFC）法作为测定CSF的指标,将入选病例分为两组:CSF组35例,正常对照组35例,均排除既往冠心病、心肌病及其他类型心脏病。采用生化法测定血清中超氧化物歧化酶（SOD）,谷胱甘肽过氧化物酶（GSH-PX）,丙二醛（MDA）,过氧化脂质（LPO）的含量。结果: CSF组的血清MDA、LPO明显高于对照组［MDA:（18.9±2.0）μmol/L vs.（10.5±1.3）μmol/L,P<0.01］,［LPO:（2.8±0.4）μmol/L vs.（1.9±0.2）μmol/L,P<0.01］;CSF组血清GSH-PX明显高于对照组［GSH-PX:（0.22±0.04）μmol/L vs.（0.20±0.03）μmol/L,P<0.05］。CSF组血清SOD明显低于对照组［SOD:（72±11）kU/L vs.（79±10）kU/L,P<0.01］。在校正体质量指数、总胆固醇、尿素氮等后CSH-PX、MDA、LPO是CSF的危险因素（分别OR=3.987、4.782、3.381;分别为P<0.05、P<0.01、P<0.01）。SOD则是其保护因素（OR=0.892,P<0.05）。结论: CSF患者血清SOD下降,MDA、LPO、GSH-PX上升,体内氧化应激增强。     

血尿酸水平与冠状动脉病变程度的关系

目的:探讨血清尿酸水平与冠脉病变程度的关系. 方法:216例经过冠脉造影确诊为冠心病的患者,以冠脉病变程度分组,同时检测空腹血尿酸水平.结果:冠状动脉正常组血尿酸水平为(293.98±74.49)μmol/L,冠状动脉单支病变组血尿酸水平为(309.65±50.98)μmol/L,冠状动脉双支病变组血尿酸水平为(358.28±79.08)μmol/L,冠状动脉多支病变组血尿酸水平为(366.71±92.24)μmol/L.狭窄组患者的血尿酸水平(348.45±)μmol/L明显高于对照组(293.98±74.49)μmol/L,P＜0.01,差异有统计学意义.血尿酸水平与冠心病的病变血管数目呈正相关(r=0.324,P＜0.01).结论:随着冠状动脉病变程度的增加,血尿酸水平也逐渐升高.     

载脂蛋白M与冠状动脉病变的关系

目的探讨冠心病患者血清载脂蛋白M水平与冠状动脉病变的关系。方法根据冠状动脉造影结果,将120例受试者分为冠心病组(73例)和对照组(47例),应用酶联免疫吸附法检测受试者血清载脂蛋白M水平。比较冠心病组与对照组血清载脂蛋白M水平;比较不同冠状动脉病变数量和狭窄程度血清载脂蛋白M水平。结果冠心病组患者血清载脂蛋白M水平(10.12±1.79 mg/L)明显低于对照组(11.69±2.02 mg/L,P<0.01);冠心病患者多支病变组载脂蛋白M水平(9.19±1.22 mg/L)明显低于单支病变(11.22±1.69 mg/L)和双支病变(10.36±1.94 mg/L)组(P均<0.01);轻度狭窄组(11.39±1.58 mg/L)、中度狭窄组(10.14±1.46 mg/L)及重度狭窄组(9.04±1.30 mg/L)载脂蛋白M水平逐渐降低(P<0.05);冠状动脉病变数量(r=-0.485)和狭窄程度(r=-0.508)与血清载脂蛋白M水平呈负相关(P均<0.01)。结论载脂蛋白M可能是抑制动脉粥样硬化的保护因子。     

血清胆红素与血脂及冠状动脉病变程相关性研究

目的:探讨冠心病患者血清胆红素与血脂及冠状动脉病变程度的相关性.方法:将346例冠状动脉造影患者分为冠心病(287例)对照组(59例).分别测定血清胆红素、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)及高密度脂蛋白胆固醇(HDIL-C)浓度.根据美国心脏病学会(AHA)评分标准,结合冠状动脉造影结果进行冠状动脉狭窄程度评分.观察2组病例总胆红素(TBIL)与血脂及冠状动脉狭窄程度的相关性.结果:外周血TBIL浓度冠心病组(7.6±3.2)μmol/L比对照组(12.1±3.2)μmol/L低,差异有显著性(P<0.05);TC、LDL-C浓度冠心病组(5.79±1.53)mmol/L、(5.34±1.48)mmol/L较对照组(3.82±1.15)mmoL/L、(2.27±0.69)mmol/L高差异有显著性(P<0.05);HDL-C浓度冠心病组(1.11±0.57)mmol/L较对照组(1.46±0.23)mmol/L低差异有显著性(P<0.05);冠心病组TBIL与LDL-C、TC呈负相关,与HDL-C呈正相关;冠状动脉狭窄指数与TBIL、LDL-C、HDL-C有相关关系;多因素回归分析显示LDL-C及TBIL与冠状动脉狭窄指数明显相关.结论:冠心病患者TBIL水平降低;冠心病患者TBIL与TC及LDL-C有显著负相关,与HDL-C呈显著正相关;冠心病患者冠状动脉狭窄程度与TBIL及HDL-C呈负相关.     

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.     

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.     

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.     

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.