High Plasma Concentrations of Endothelin-like Immunoreactivities in Patients with Hepatocellular Carcinoma

The plasma levels of endothelin-like immunoreactivities (ET-IR) of patients with hepatocellular carcinoma (HCC) were compared with those of patients with liver cirrhosis (LC), using a specific radioimmunoassay for endothelin-1. The mean concentration of plasma ET-IR of 21 HCC patients (30.3 ±8.5 pg/ml, n = 21) (means ± SD) was markedly higher than those in LC (22.1 ±4.7 pg/ml, n = 16) ( p < 0.01), which were also elevated compared with those in normal subjects (9.4 ± 1. 6 pg/ml, n = 91). Moreover, the level of plasma ET-IR reflected the tumor size of HCC patients, which was estimated by the ultrasonic and computed tomographic examinations. Although there was no relation to other biochemical parameters indicating liver function or tumor markers such as α-fetoprotein, a good positive correlation was obtained between plasma ET-IR and C-reactive protein (CRP) concentrations of HCC patients ( r = 0.805, p < 0.01). We measured the tissue contents of ET-IR in HCC and its adjacent LC tissue, but failed to find any significant difference between the mean content of HCC (0.50 ± 0.38 ng/g) and LC (0.44 ± 0.28ng/g). The endothelial cell damage due to cancer growth may not be responsible for the high concentrations of plasma ET-IR of HCC, because plasma thrombomodulin concentrations were not correlated with plasma ETIR levels in HCC patients. Our study implies that the high plasma concentration of ET-IR is pathogenomonic to HCC, although the site of production is still debatable.     

Serum Gastrin in Patients with Various Types of Chronic Gastritis

Fasting serum gastrin was determined in 35 Chinese patients with various types of chronic gastritis and in 23 Chinese control subjects. The mean (± S.D.) fasting serum gastrin levels for 13 patients with chronic atrophic gastritis, 16 patients with chronic gastritis and six patients with acute-on-chronic gastritis were 32.1 (± 38.9) pg./ml., 36.1 (± 23.2) pg./ml. and 33.7 (± 19.4) pg./ml., respectively. The mean (± S.D.) fasting serum gastrin levels for the whole gastritis group (35 patients) and the control group were 34.2 (± 28.8) pg./ml. and 24.6 (± 13.7) pg./ml., respectively. Statistical analysis showed that the mean basal serum gastrin levels of the three gastritis groups did not differ significantly from control subjects and with each other.     

Nocturnal plasma melatonin levels in patients suffering from chronic primary insomnia

Abstract: Polysomnographic sleep patterns and melatonin secretion were investigated in 10 patients (age: 41.3 ± 9.5 years) who suffered from chronic primary insomnia and complained predominantly about difficulties in maintaining sleep and in five healthy controls (age 27.2 ± 0.7 years). Nocturnal plasma melatonin concentrations were obtained hourly, measured by direct radioimmunoassay and statistically compared between insomniacs and controls with age as a covariate. Plasma melatonin levels in the patient group tended to begin increasing earlier in the evening and were significantly (P ± 0.01) lower during the middle of the night (peak value 82.5 ± 26.5 pg/ml) than in the healthy controls (peak value 116.8 ± 13.5 pg/ml). Among the patients, the most severely reduced nocturnal plasma melatonin levels were found in those patients with a history of sleep disturbance lasting for longer than five years (N = 6; age 41.8 ± 11.7 years; duration 15.3 ± 5.9 years; peak value 72.1 ± 25.0 pg/ml); whereas those chronic insomniacs affected for fewer than five years had relatively higher nocturnal levels (N = 4; age 40.6 ± 6.5 years; duration 3.8 ± 1.5 years; peak value 98.2 ± 23.9 pg/ml). These results show that the circadian rhythm of melatonin secretion is disturbed in patients with chronic primary insomnia, and that the nocturnal plasma melatonin secretion is increasingly more affected the longer the patients are unable to maintain a regular sleep pattern.     

Effect of Treatment with Paromomycin on Endotoxemia in Patients with Alcoholic Liver Disease—A Double-Blind, Placebo-Controlled Trial

The results of experimental and clinical studies support the hypothesis that gut-derived endotoxins might be of relevance for the development and course of alcoholic liver disease. The aim of this study was to test the effect of a nonabsorbable, broad-spectrum antibiotic on endotoxemia in patients with alcoholic liver disease. Fifty patients with alcoholic liver disease (27 with cirrhosis, 23 without cirrhosis) were randomly assigned to receive either paromomycin sulfate (3 × 1 g/day) or placebo in a double-blind fashion for at least 3 weeks, and if possible 4 weeks. Endotoxin concentration, liver function tests, and other laboratory parameters were determined in weekly intervals. Endotoxin concentration was also determined in 15 healthy controls. Groups receiving paromomycin or placebo were similar for clinical and biological items collected initially. Mean initial endotoxin concentrations were significantly elevated in both groups (mean ± SEM; paromomycin, 16.7 ± 5.3 pg/ml; placebo, 17.5 ± 6.9 pg/ml; healthy controls, 2.3 ± 0.4 pg/ml). Although the mean endotoxin concentration was lower in the verum group after 1 week (paromomycin, 8.0 ± 1.9 pg/ml; placebo, 14.6 ± 3.5 pg/ml; p > 0.05), paromomycin treatment had no significant effect on endotoxin concentration or liver function tests during the 4-week period. The beneficial effect of paromomycin treatment on endotoxemia in cirrhotics reported in earlier studies could not be reproduced under the conditions of this trial in patients with alcoholic liver disease.     

支气管扩张患者TNF-α、IL-6、中性粒细胞百分比与疾病严重程度的关系

目的分析支气管扩张患者血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、中性粒细胞百分比(NEU%)变化与疾病严重程度的关系。 方法选取2019年1月至2021年5月我院收治的102例支气管扩张急性加重期患者为对象,按疾病严重程度分为轻度组21例、中度组42例与重度组39例,记录3组入院时及出院时血清TNF-α、IL-6及NEU%变化情况,评估入院时支气管扩张严重程度指数(BSI)与TNF-α、IL-6、NEU%的相关性;记录急性复发再入院情况,比较复发者与未复发者TNF-α、IL-6、NEU%变化情况。 结果3组住院期间未出现死亡病例,入院时重度组TNF-α(59.32±6.99)pg/ml、IL-6(63.44±8.21)pg/ml及NEU%(81.35±4.05)%高于中度组TNF-α(44.28±6.27)pg/ml、IL-6(50.09±6.27)pg/ml及NEU%(72.19±5.17)%及轻度组TNF-α(35.07±4.96)pg/ml、IL-6(39.45±7.51)pg/ml及NEU%(66.27±3.95)%(P<0.05);出院时3组TNF-α[(29.07±5.48)vs. (27.69±5.73)vs.( 26.32±5.82)]pg/ml、IL-6[(34.08±7.30)vs. (32.69±5.94)vs. (30.85±6.12)]pg/ml及NEU%[(57.24±3.91)vs. (56.55±3.96)vs. (54.93±4.91)]%较入院时降低(P<0.05),组间比较差异无统计学意义(P>0.05)。Pearson相关性分析显示,患者入院时BSI指数与TNF-α、IL-6、NEU%正相关(r＝0.612、0.571、0.734,P<0.05)。出院后随访1年,14例失访(13.73%),复发45例(51.14%),21例复发2~3次,复发者出院时TNF-α、IL-6及NEU%高于未复发者(P<0.05),复发者再入院时上述指标高于出院时(P<0.05)。 结论TNF-α、IL-6及NEU%参与支气管扩张急性加重的发生、发展,可评估预后复发情况。     

Effects of aspirin on serum C-reactive protein and interleukin-6 levels in patients with type 2 diabetes without cardiovascular disease: a randomized placebo-controlled crossover trial

Aim:  Low-grade inflammation plays a pivotal role in atherogenesis in type 2 diabetes. Next to its antithrombotic effects, several lines of evidence demonstrate anti-inflammatory properties of aspirin. We determined the effects of aspirin on inflammation – represented by C-reactive protein (CRP) and interleukin-6 (IL-6) – in type 2 diabetic subjects without cardiovascular disease and assessed differential effects of aspirin 300 mg compared with 100 mg.
Methods:  A randomized, placebo-controlled, double-blind, crossover trial was performed in 40 type 2 diabetic patients. In two periods of 6 weeks, patients used 100 or 300 mg aspirin and placebo. Plasma CRP and IL-6 levels were measured before and after both periods.
Results:  Use of aspirin resulted in a CRP reduction of 1.23 ± 1.02 mg/l (mean ± s.e.m.), whereas use of placebo resulted in a mean increase of 0.04 ± 1.32 mg/l ( P  = 0.366). Aspirin reduced IL-6 with 0.7 ± 0.5 pg/ml, whereas use of placebo resulted in a mean increase of 0.2 ± 0.8 pg/ml ( P  = 0.302). There were no significant differences in effects on CRP and IL-6 between 100 and 300 mg aspirin.
Conclusions:  Our results indicate that a 6-week course of aspirin does not improve low-grade inflammation in patients with type 2 diabetes without cardiovascular disease, although a modest effect could not be excluded. No significant differential effects between aspirin 100 and 300 mg were found.     

γ-干扰素联合微卡免疫治疗结核病小鼠的实验研究

目的研究γ-干扰素联合微卡对结核分枝杆菌感染小鼠的免疫治疗作用及其免疫学机制。方法60只BALB/c小鼠用随机数字表法随机分为正常组、模型组、γ-干扰素组、微卡组及联合组,每组12只。除正常组不造模外,其余4组小鼠经尾静脉注射结核分枝杆菌(H₃₇Rv,10⁶个菌/只)。微卡组于攻毒后10 d腹腔内注射微卡22.5μg/只。γ-干扰素组攻毒后10天腹腔注射γ-干扰素(1万U/只,1次/d)5 d,间隔2 d,继续腹腔注射5 d。联合组2者均注射。感染6周后处死30只小鼠(每组6只),称取小鼠体质量和肺脏及脾脏质量。取肺、脾组织进行结核菌培养和菌落计数,观察肺脏病理改变,同时用ELISA法检测血清IFN-γ、IL-4水平和用RT-PCR法测定肺组织IFN-γmRNAI、L-4 mRNA的表达。其余30只小鼠观察60 d,计算其存活时间。结果模型组肺组织病理改变以渗出为主,病变广泛,增生改变不明显;3个用药组病变范围局限,并可见类上皮细胞、纤维母细胞。模型组观察期结束无一小鼠存活;正常组和联合组在观察期内无一死亡,γ-干扰素组和微卡组在观察期内仅有1只小鼠死亡。感染后6周,γ-干扰素组肺脾菌荷量(×10⁶CFU/g-x±s)(分别为7.12±0.51,6.42±0.48)和微卡组(分别为(6.31±0.47),(6.07±0.39))较模型组(分别为26.18±0.96,18.43±0.85)明显减少(P<0.05),与γ-干扰素组、微卡组比较,联合组肺脾菌荷量为(分别为2.67±0.36,2.12±0.33)减少更显著(P<0.05)。模型组小鼠血清IFN-γ的表达和肺组织IFN-γmRNA(分别为(162±46)pg/ml,(0.18±0.06))的表达较正常组(分别为(521±198)pg/ml,(0.98±0.13))均显著降低(P<0.01),模型组小鼠血清IL-4的表达和肺组织IL-4 mRNA(分别为(102±24.8)pg/ml,(1.46±0.25))的表达较正常组(分别为(56.2±14.5)pg/ml,(0.04±0.01))均显著增高(P<0.01)。γ-干扰素组小鼠血清IFN-γ的表达和肺组织IFN-γmRNA的表达(分别为(402±134)pg/ml,(0.66±0.08))和微卡组(分别为(416±153)pg/ml,(0.68±0.09))均显著高于模型组(P<0.05);与γ-干扰素组、微卡组比较,联合组(分别为(493±145)pg/ml,(0.81±0.11))增高更显著(P<0.05)。γ-干扰素组小鼠血清IL-4的表达和肺组织IL-4 mRNA的表达(分别为(73.5±15.3)pg/ml,(0.63±0.12))和微卡组(分别为(71.3±14.6)pg/ml,(0.59±0.13))均显著低于模型组(P<0.05);与γ-干扰素组、微卡组比较,联合组(分别为(60.8±12.7)pg/ml,(0.28±0.03))降低更显著(P<0.05)。结论γ-干扰素和微卡可减少结核病小鼠肺和脾脏结核菌数量,并增强Th1型免疫反应,抑制Th2型免疫反应,增强小鼠抵抗结核分枝菌感染的能力,且两者联用具有协同作用。     

Plasma Cholecystokinin Responses after Ingestion of Liquid Meal and Intraduodenal Infusion of Fat, Amino Acids, or Hydrochloric Acid in Man: Analysis with Region Specific Radioimmunoassay

A highly sensitive and precise radioimmunoassay system for plasma cholecystokinin (CCK) was developed with the anli-CCK-8 specific antiserum which raised against N-terminal amino acids residue of sulfated CCK-8 and reacted with CCK-8, CCK-33, and CK-39 but not with gastrin and its related peptides. Mean concentration of the fasting plasma CCK determined with this method using CCK-8 as standard was 12.9 ± 5.9 pg/ml in normal subjects (n = 26), and in patients with hepatic cirrhosis it was significantly higher (36.7 ± 16.9 pg/ml, n = 9, p < 0.01) than in normal subjects. In six young healthy volunteers, intraduodenal infusion of fat caused a significant increase ( p < 0.05) of plasma CCK from a basal level of 8.0 pg/ml to a peak of 43.0 ± 12.0 pg/ml at 20 min after starting of infusion. In the same subjects, a significant increase of plasma CCK was also observed by amino acids infusion, but no elevation of plasma CCK level was found during intraduodenal acidification.     

Estradiol concentration in the serum of the one-humped camel (Camelus dromedarius) during the various reproductive stages

During the estrous cycle of the camel the concentration of estradiol (E₂) varies between 9 and 110 pg/ml. In early estrus, the peak level of E₂ (74.7 ± 6.61 pg/ml, n = 11) is maintained for 2.9 ± 1.83 days. The length of an estrous cycle is 17.2 days. In the 10th month of pregnancy the level of E₂ rises abruptly to 338.3 ± 162.42 pg/ml and continues to rise until the 12th month, peaking at 606 ± 120.27 pg/ml. The hormone concentration then drops until the day of parturition (mean 113.4 ± 26.51 pg/ml). The level of E₂ during the nonbreeding season (May–November) is low (6–48 pg/ml).     

Plasma Renin Activity and Hypertension in Acute Glomerulonephritis*

Summary: The relationship between plasma renin activity (PRA), plasma volume (PV) and mean arterial pressure (MAP) in children with acute glomerulonephritis was assessed in two groups of patients between the ages of three to six years. One group with normal blood pressure (13 children) and a group with significantly elevated blood pressure (20 children) were compared with a control group of ten normal children.
In patients who developed hypertension (MAP: 113 ± 3 mmHg), the mean PRA was 0±45 ± 0±1 ng/ml/hr, and the mean PV measured in ten of these children was 1526 ± 47±9 ml/M². In the group of normotensive patients with acute glomerulonephritis (MAP = 79 ± 1±8 mmHg), the mean PRA was 1±6 ± 0±32 ng/ml/hr, the mean PV in four of these patients was 1285±37±6 ml/M². The children in the control group (MAP = 77± 1±6 mmHg) had a mean PRA of 7±93 ± 0±2 ng/ml/hr and six of these children had a mean PV of 1115 ± 103 ml/M².
The results showed children who developed hypertension had significantly higher PV lower PRA than children with acute glomerulonephritis who were normotensive and the control subjects. A positive correlation was found between MAP and PV and negative correlation between MAP and PRA. There was no significant difference in MAP, PV and PRA between children with acute glomerulonephritis with normal blood pressure and children in the control group.     

Circulating hepatocyte growth factor as a marker of thrombus formation in unstable angina pectoris

A new enzyme-linked immunosorbent assay can detect 10 pg/ml of human hepatocyte growth factor (HGF). Circulating HGF was significantly higher in patients with unstable angina (296+/-184 pg/ml, mean+/-SD, n=36) than in healthy volunteers (201+/-64 pg/ml, n=250, p<0.0001). Individual concentrations exceeded the mean control value +2 SD (329 pg/ml) in 12 of the 36 (33%) patients with unstable angina. The present study indicates that this new, sensitive HGF assay can successfully detect thrombosis in patients with unstable angina.     

Effect of Helicobacter pylori eradication on serum ghrelin and obestatin levels

AIM: To investigate changes in serum ghrelin and obestatin levels before and after Helicobacter pylori (H. pylori ) eradication. METHODS: A total of 92 patients presenting with symptoms of dyspepsia were enrolled in the study. Upper endoscopy was performed on all patients and used to diagnose H. pylori infection according to the presence of characteristic histopathological findings; seventy patients were diagnosed with H. pylori infection and the remaining 22 non-infected patients were classified as healthy controls. H. pylori eradication was accomplished by administering the classical triple therapy drug regimen, consisting of lansoprazole 30 mg bid , amoxicillin 1 g bid , and clarithromycin 500 mg tid for 14 d. The eradication of H. pylori was assessed with C14-urea breath test, which was performed at eight weeks after treatment. Levels of serum active ghrelin and obestatin were assessed at beginning of the study (prior to treatment) and after eight weeks. The levels were comparatively analyzed between the H. pylori negative control group, the H. pylori eradicated group, and the H. pylori non-eradicated group. RESULTS: A total of 92 patients, 50 females and 42 males with a mean age of 38.2 ± 11.9 years (range: 19-64), were analyzed. H. pylori eradication success was achieved in 74.3% (52/70) of H. pylori positive patients. The initial levels of ghrelin in the H. pylori positive and control cases were 63.6 ± 19.8 pg/mL and 65.1 ± 19.2 pg/mL (P=0.78), respectively, and initial obestatin levels were 771±427 pg/mL and 830 ± 296 pg/mL (P=0.19), respectively. The difference between the initial levels and the week 8 levels of ghrelin and obestatin in the control group was insignificant [4.5% (P=0.30) and -0.9% (P=0.65), respectively]. The difference between the initial and week 8 levels of ghrelin and obestatin in the H. pylori non-eradicated group were also insignificant [0.9% (P=0.64) and 5.3% (P=0.32), respectively]. The H. pylori eradicated group had a greater change in obestatin levels when compared to the     

Serum VEGF increases in diabetic polyneuropathy,particularly in the neurologically active symptomatic stage

Aim To identify the relationship between vascular endothelial growth factor (VEGF) and diabetic polyneuropathy (DPN). Methods Two hundred and twenty diabetic patients participated, 113 with DPN and 107 without DPN. All patients were also classified according to the four stages of DPN (no neuropathy: stage 0; asymptomatic neuropathy: stage 1; symptomatic neuropathy: stage 2; disabling neuropathy: stage 3). Serum VEGF concentration was measured using an enzyme‐linked immunosorbent assay (ELISA) and levels between the patients with and without DPN and also between the different stages of DPN, were compared. Results The mean serum VEGF level in all patients was 264.6 ± 218.8 pg/ml. The mean serum VEGF level was higher in patients with DPN (310.1 ± 224.3 pg/ml) than in the patients without DPN (216.5 ± 204.0 pg/ml, P = 0.0014). Serum VEGF was higher in the ‘symptomatic’ stage (stage 2, 364.8 ± 225.9 pg/ml) in comparison with the ‘asymptomatic’ (stage 1, 256.7 ± 224.4 pg/ml, P = 0.015) and ‘disabling’ (stage 3, 180.3 ± 109.4 pg/ml, P = 0.042) stages. The mean serum VEGF level in patients with diabetic retinopathy (261.1 ± 210.6 pg/ml) and in patients with diabetic nephropathy (241.5 ± 185.7 pg/ml) was not increased. Conclusions The serum VEGF level is increased in patients with DPN, particularly in patients in the neurologically active ‘symptomatic’ stage.     

Expression of serum vascular endothelial growth factor correlates with clinical outcome in multiple myeloma

A total of 34 multiple myeloma (MM) patients (17 recently diagnosed and 17 in progression of the disease) treated at the Department of Haematology, Blood Neoplasms and Bone Marrow Transplantation Medical University in Wroc?aw were studied. Among the 19 females and 15 males, aged 31-72 years, there were 17 IgG, 9 IgA and 1 IgM, one with plasma cell leukaemia and 6 with light chain disease. Staging according to Durie and Salmon disclosed: 7--IIA stage, 15--IIIA and 12--IIIB. Blood hyperviscosity symptoms (HS) developed in 9 patients, and precomatic state or coma was observed in four of them. Control group was constituted of 14 healthy subjects--10 women and 4 men aged 32-51 years. Vascular endothelial growth factor (VEGF) serum concentration in MM patients varied from 0 pg/ml to 760 pg/ml, mean 148.75 pg/ml, SD = 204.4 and in controls 0 pg/ml--164 pg/ml, mean 31.5, SD = 23.3; p < 0.05. The mean VEGF level in recently diagnosed patients was higher than in progression of the disease, mean 188.6 pg/ml, SD = 230.6 and mean 110.9 pg/ml, SD = 177.9; respectively, but the difference was not statistically significant. The patients with stage III had significantly (p < 0.05) higher VEGF level than those in stage II (mean 303.1 pg/ml, SD = 302.2 and mean 89.0 pg/ml SD = 121.6) respectively. The group of MM patients with renal failure (creatinine level > 2 mg%) had higher VEGF level than those with normal renal function: mean 199.9 pg/ml, SD = 235, and mean 46.9 SD = 47 respectively, p < 0.01. Elevated VEGF level was also present in comatic and precomatic patients when compared with hyperviscosity patients without these symptoms (p < 0.05). In multiple myeloma patients no correlation was found between the serum VEGF level and percentage of bone marrow plasma cells, serum beta-2-m and monoclonal Ig levels, levels of Hb, albumine and LDH. Median survival time (M-ST) of patients with VEGF higher than 71, 0 pg/ml was 32 months, M-ST of patients with VEGF below 71 pg/ml was 52 months. In summary: serum level of VEGF in advanced state of multiple myeloma was elevated and correlated with clinical state. An elevated serum level of VEGF is associated with a poor prognosis.     

Impaired lipopolysaccharide-inducible tumor necrosis factor production in vitro by peripheral blood monocytes of patients with viral hepatitis

We investigated lipopolysaccharide-induced tumor necrosis factor production in vitro by peripheral blood monocytes from patients with various liver diseases. Tumor necrosis factor production was found to be significantly reduced in patients with chronic hepatitis B (n = 17; 135 +/- 30 pg tumor necrosis factor/ml; mean +/- S.E.M.) and patients with chronic non-A, non-B hepatitis (n = 15; 212 +/- 22 pg tumor necrosis factor/ml) compared with healthy control individuals (n = 47; 411 +/- 40 pg tumor necrosis factor/ml; p less than 0.0005 and p less than 0.01, respectively). This reduced tumor necrosis factor production was not only seen with an optimal stimulating concentration of lipopolysaccharide (100 ng/ml) but also with suboptimal concentrations (0.1 ng/ml). In contrast to patients with chronic viral hepatitis, monocytes from patients with alcohol-induced cirrhosis (n = 26; 444 +/- 49 pg tumor necrosis factor/ml), primary biliary cirrhosis (n = 7; 412 +/- 81 pg tumor necrosis factor/ml) and alcohol-induced fatty liver changes (n = 5; 401 +/- 62 pg tumor necrosis factor/ml) produced normal amounts of tumor necrosis factor when stimulated with an optimal concentration of lipopolysaccharide. Lipopolysaccharide (0.1 ng lipopolysaccharide/ml)-stimulated peripheral blood monocytes of patients with chronic hepatitis B (n = 15; 102 +/- 32 pg/ml) or non-A, non-B hepatitis (n = 13; 97+/- 16 pg/ml) could not be induced to produce more tumor necrosis factor either when prestimulated with gamma-interferon (170 +/- 45 pg/ml and 149 +/- 32 pg/ml, respectively), a lymphokine known to activate monocytes, or with the cyclooxygenase inhibitor indomethacin to reduce the suppressive effect of prostaglandin E2 (148 +/- 40 pg/ml and 153 +/- 45 pg/ml, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)     

慢性便秘患者血清中5-羟色胺、生长抑素的表达及意义

目的检测慢性便秘（CC）患者血清中5-羟色胺（5-HT）、生长抑素（SS）的表达水平及其影响因素。 方法收集自2016年10月至2017年2月于青岛市市立医院干部保健科就诊符合慢性便秘诊断标准的患者48例,其中男性31例,女性17例,平均年龄（70.0±12.7）岁,对照组为37例无便秘患者,男性24例,女性13例,平均年龄（64.4±9.0）岁。采用酶联免疫吸附实验法测定入组患者血清中5-HT、SS的表达水平;正态分布的计量资料采用（ ±s）表示,两组间比较采用t检验进行统计学分析。 结果慢性便秘患者血清中5-HT的含量为（23.30±6.57）pg/mL明显低于无便秘者（29.61±9.49）pg/mL,两者差异有统计学意义（t=-3.624,P=0.001）;而慢性便秘患者血清中SS的含量为（20.82±5.96）pg/mL明显高于对照组（16.92±6.47）pg/mL,差异有统计学意义（t=2.886,P=0.005）;不同年龄（t=-0.762,P=0.450）,不同性别（t=-0.907,P=0.369）,不同伴随症状如腹痛（t=0.894,P=0.376）、腹胀（t=-0.711,P=0.480）、排便费力（t=-1.534,P=0.132）、排便不尽感（t=1.339,P=0.187）的慢性便秘患者血清中5-HT的表达差异均无统计学意义（P>0.05）;不同年龄（t=-0.694,P=0.491）,不同性别（t=-0.028,P=0.977）,有无临床伴随症状如腹痛（t=-0.095,P=0.925）、腹胀（t=0.546,P=0.587）、排便费力（t=-1.391,P=0.171）、排便不尽感（t=0.110,P=0.913）的慢性便秘患者血清中SS的表达差异均无统计学意义（P>0.05）。 结论5-HT、SS在慢性便秘患者血清中的表达有其特点,年龄、性别及有无临床伴随症状对便秘患者血清中5-HT、SS的表达无明显影响。     

Soluble CCN2/connective tissue growth factor levels in Egyptian systemic sclerosis patients: Possible association with cutaneous and pulmonary fibrosis

Aim of the workTo assess plasma levels of CCN2 in systemic sclerosis (SSc) patients and study its relation with the disease characteristics.Patients and methodsPlasma from 59 Egyptian patients with SSc (19 diffuse and 40 limited subtype) and 50 healthy controls were assayed for CCN2 levels by Enzyme-Linked Immunosorbent Assay (ELISA). Skin fibrosis was assessed using the modified Rodnan total skin thickness score (mRTSS).ResultsThe mean age of patients was 39.4 ± 11.8 years (19–69 years), 41 females/18 males with mean disease duration of 6.6 ± 5.3 years. mRTSS was 13.1 ± 5.5 (median 12; range 3–28). Plasma CCN2 were significantly higher in patients with diffuse subtype (3296.2 ± 1540.5 pg/ml) than those with limited SSc (1984.4 ± 1174.1 pg/ml) (p = 0.001) and controls (1878.5 ± 501.2 pg/ml) (p = 0.78). In addition, plasma CCN-2 levels were increased in SSc patients with interstitial pulmonary fibrosis (2836.5 ± 1614.4 and 1861.6 ± 925.6 pg/ml, respectively; p = 0.04), in patients with early SSc than those with late (2843.1 ± 1586.7 and 2128.2 ± 1265.8 pg/ml respectively; p = 0.03). Patients with mRTSS ≥ 12 had higher CNN2 levels than those with lower scores (2783.6 ± 270.1 and 1842.9 ± 907.4 p = 0.03). CCN2 levels significantly correlated with mRTSS (r = 0.4, p = 0.002) and negatively with DLco (r = −0.39, P = 0.003) and FVC % (r = −0.38, r = 0.003). There was no significant relation to other organs involvement or to the presence of autoantibodies.ConclusionThe work indicates the importance of CCN2 in cutaneous and pulmonary fibrosis in patients with SSc especially those with diffuse subtype. An additional prospective large scale, a longitudinal study should be carried out to support these findings and to reveal the mechanistic connections between CCN-2 levels and SSc disease manifestations.     

Dithiothreitol treatment permits measurement of melatonin in otherwise unusable saliva samples

Abstract: Melatonin research has primarily utilized blood as the source of samples, but there is now increasing interest in measuring levels of the hormone found in saliva. One impediment to this approach is that several melatonin assays involve a column-extraction step that can prove very time-consuming or even impossible when salivary samples are excessively viscous. We have treated 67 samples with dithiothreitol to enhance their passage through the column. Following this treatment, all samples passed freely through the columns. The minimum and maximum values measured were 0.7–50.0 pg/ml for the untreated controls and 1.0–51.9 pg/ml for the treated samples. The means (± SEM) for these groups were 9.5 ± 1.6 and 9.9 ± 1.7, respectively, and were not significantly different from one another as assessed by Student's t-test (P = 0.08). In summary, we have found that this technique permits us to obtain values on samples which would otherwise be unusable and that such treatment does not alter the melatonin values yielded by RIA analysis.     

Blood endothelin-1 levels before and after carotid endoarterectomy for atherosclerotic stenosis

BACKGROUND: Elevated plasma levels of endothelin-1 (ET-1) have been reported in advanced atherosclerosis. Further in vivo demonstration of cause-effect relationship between atherosclerotic lesion and high levels of ET-1 needs to be carried out. The aim of this study was to determine whether circulating levels of ET-1 are influenced by removing haemodynamically significant atherosclerotic stenosis in selected patients with mono or bilateral carotid atherosclerotic stenosis. METHODS: Cubital venous ET-1-immunoreactive (IR) levels were measured in 20 patients: 11 (mean age+/-S.D. 63.1+/-5.36 years; range 53-70 years) were affected by monolateral, and nine patients (mean age+/-S.D. 64.7+/-9.8 years; range 52-78 years) by bilateral extracranial carotid artery atherosclerotic stenosis. ET-1-IR levels were evaluated before and 7 days after monolateral surgical endoarterectomy. Pre-surgery levels of ET-1-IR were compared with those obtained from 18 healthy younger volunteers (mean age+/-S.D. 27.8+/-2.7 years; range 20-50 years). FINDINGS: The mean cubital venous levels of ET-1-IR in the atherosclerotic patients before endoarterectomy (mean+/-S.D. 4.50+/-3.35 pg/ml; range 1.28-10.66 pg/ml) were significantly higher than those observed in healthy subjects (mean+/-S.D. 0.641+/-0.137 pg/ml; range 0.36-1.02 pg/ml) (P=0.000). The mean ET-1-IR level decreased significantly after endoarterectomy in the group of patients with monolateral stenosis (pre-surgery: mean+/-S.D. 4.35+/-3.11 pg/ml; range 1.28-10.66 pg/ml; post-surgery: mean+/-S.D. 3.05+/-2.94 pg/ml, range 0.28-8.86 pg/ml) (P=0.005), but not in patients with bilateral extracranial carotid stenosis submitted to monolateral endoarterectomy (pre-surgery: mean+/-S.D. 4.77+/-3.79 pg/ml; range 2.18-10.3 pg/ml; post-surgery: mean+/-S.D. 4.60+/-3.70 pg/ml; range 2.20-11.10 pg/ml). INTERPRETATION: The removal of a haemodynamically significant atherosclerotic vascular stenosis is associated with a decrease in the circulating ET-1-IR levels 7 days after surgery when haemodynamically significant atherosclerotic lesions are absent.     

Evaluation of Right Ventricular Function by Using Tissue Doppler Imaging in Patients after Repair of Tetralogy of Fallot

Background: The aim of this study was to assess the relation between plasma B-type natriuretic peptide (BNP) levels and right ventricular function evaluated by tissue Doppler imaging (TDI) in patients after repair of tetralogy of Fallot (ToF). Methods: Twenty-five patients with a mean age of 14.1 ± 4.4 years who underwent repair of ToF at a mean age of 4.9 ± 5.1 years enrolled in this study. The control group consisted of 29 healthy children at a mean age of 13.1 ± 2.8 years. The right ventricle and pulmonary regurgitation (PR) were assessed by two-dimensional echocardiography and color Doppler. Blood samples for BNP levels were taken and TDI was performed at rest. Results: Plasma BNP levels were significantly higher in patients than in controls (28.3 ± 24.1 vs. 7.4 ± 2.3 pg/mL, P = 0.0001). The myocardial performance index (MPI) (1.08 ± 0.35 vs. 0.58 ± 0.11, P = 0.0001) was higher and isovolumic acceleration (IVA) (3.1 ± 0.7 vs. 5.4 ± 1.0 m/s², P = 0.0001) was lower in patients. The correlations were also significant between the degree of PR and MPI (r = 0.7, P = 0.0001) and also IVA (r =−0.7, P = 0.0001). The correlations were also significant between the BNP level and MPI (r = 0.6, P = 0.0001), IVA (r =−0.4, P = 0.002) and the degree of PR (r = 0.6, P = 0.0001) . Conclusion: As a result, plasma BNP level increases in patients with ToF and both MPI and IVA from the right ventricular basal segments might be used to assess the right ventricular function .