肿瘤坏死因子-α基因多态性与非酒精性脂肪性肝病的关系

目的研究肿瘤坏死因子-α(TNF-α)基因-308位点及-238位点多态性在非酒精性脂肪性肝病(NAFLD)患者中的分布,及其在胰岛素抵抗(IR)和 NAFLD 发病中的地位。方法运用聚合酶链反应-限制性片段长度多态性检测117例 NAFLD 患者 TNF-α基因—308位点及—238位点多态性,其中伴肥胖者60例,非肥胖者57例,同时测定患者空腹血清胰岛素(FINS)及空腹血糖,通过体内平衡代谢指数(HOMA)评估 IR,并与120名健康者对照。结果 NAFLD 患者与正常对照组 TNF-α基因-238位点基因多态性分布差异有统计学意义(29.9%比15.8%,P<0.05),而—308位点差异无统计学意义(P>0.05)。NAFLD 患者血清 HOMA-IR、TNF-α明显高于对照者[2.50±0.68比1.16±0.68,(10.54±3.19)ng/L 比(4.54±3.10)ng/L,P<0.01]。FINS、HOMA-IR 在 TNF-α基因-238位点基因变异组明显高于正常基因型组(P<0.05),但在—308位点变异组差异无统计学意义(P>0.05)。NAFLD 患者中无论肥胖或非肥胖患者均较正常对照人群在 TNF-α基因-238位点多态性分布及HOMA-IR、TNF-α差异有统计学意义(P<0.05)。肥胖及非肥胖的 NAFLD 患者之间 HOMA-IR、TNF-α差异无统计学意义(P>0.05)。结论 NAFLD 患者 IR 与其体重关系不显著,非肥胖 NAFLD患者同样有 IR 发生。TNFα基因-238位点 G/A 变异与 IR、NAFLD 易感性相关,TNFα基因-308位点 G/A 的突变与 IR 易感性不相关。NAFLD 发病与 IR、TNF-α密切相关。     

TNFα-308和LTα基因多态性与胃癌预后的关系

目的 研究肿瘤坏死因子α（tumor necrosis factor alpha，TNFα）308位点和淋巴毒素α（1ymphotoxin α，LTα）基因多态性与胃癌预后的相关性。方法 采用多聚酶链反应限制性片断长度多态性方法，检测56例胃癌患者及271例健康对照者TNFα和LTα基因型与等位基因频率。对随访的30例行基因型与1年和3年生存率的相关分析。结果 TNFα-308、LTαNeoI、AspHI基因型与胃癌和胃癌患者1年和3年生存率均无显著相关性。结论 TNFα-308、LTαNeol、AspHI基因多态性与中国湖北汉族人胃癌预后无关。     

强直性脊柱炎与肿瘤坏死因子-α基因启动子-308位点多态性关联研究的Meta分析

目的 探讨强直性脊柱炎（AS）与肿瘤坏死因子（TNF）-α基因启动子-308位点多态性的关联情况。方法检索已发表的有关AS和与TNF—α基因启动子-308位点多态性的文献进行Meta分析。结果 8篇文献共纳入987例AS患者和922名正常对照。综合分析显示不能认为TNF—α启动子-308位点等位基因多态性与AS间存在关联，OR=0．86（0．53，1．38），P=-0．53；东西方人群亚群分析结果显示不能认为东方人群TNF—α启动子-308位点等位基因多态性与AS间存在关联，OR=1．06（0．34，3．33），P=0．91；西方人群TNF—α启动子-308位点等位基因多态性可能与AS间存在关联，OR=0．75（0．59，0．96），P=0．02；在东西方人群不能认为TNF—α启动子-308位点GA＋AA基因型与AS间存在相关关系，OR=0．90（0．52,1．55），P=0．69；TNF—α启动子-308位点等位基因多态性与AS无关联，独立于HLA—B27，OR=0．71（0．42．1．20），P=0．20；在中国人群，TNF—α启动子-308位点等位基因多态性与AS骶髂关节炎严重程度可能存在关联．OR=0．37（0．15,0．90），P=-0．03。结论 Meta分析显示西方人群TNF—α启动子-308位点等位基因多态性可能与AS间存在关联，中国人群TNF—α启动子-308位点等位基因多态性与AS间无关联．但与AS骶髂关节炎严重程度可能存在关联。     

多发性骨髓瘤患者肿瘤坏死因子α水平及其基因启动子多态性的研究

多发性骨髓瘤（MM）是以骨髓单克隆浆细胞增多为特征的B细胞恶性疾病，肿瘤B细胞能以自分泌的方式产生TNFα。近年来研究显示口，TNFα基因启动子具有多态性，而这种多态性可能导致TNFα转录水平的变化，可能会影响TNFα在肿瘤增殖过程中的自分泌模式。因此，TNFα基因启动子与人类疾病的关系，成为国内外学者研究热点。[第一段]     

TNF-α基因多态性与肺癌易感性相关性的研究

目的观察TNF-α基因启动子区-308位核苷酸多态性基因型在肺癌和对照人群中的分布,以及这种多态性对该基因表达的影响。方法PCR—RFLP分析112例肺癌和99例正常人的TNF-α．基因启动子区-308位核苷酸多态性。免疫组织化学方法检测肺癌组织中TNF-α的表达,比较不同基因型肺癌之间TNF-α基因表达的差异性。结果肺癌组与对照组的基因型分布为TNF-α1／1（52．7％、46．5％）,TNF—α1／2（35．7％、48．5％）,TNF—α2／2（11．6％、5．1％）;等位基因频率为TNF—α（70．5％、70．7％）,TNF-α2（29．5％、29．3％）,组间差异没有显著性,P〉0．05。两种基因型个体在TNF-1α基因表达上,TNF-α2／2基因型个体高于TNF-α1／1基因型的个体,两者差异显着,P〈0．001。结论TNF—α-308位核苷酸的多态性基因型在肺癌和正常人中的分布之间没有明显差别,这种多态性可能不是肺癌易感的遗传因素,但这种多态性与该基因的表达有关。     

培菲康治疗非酒精性脂肪性肝病的临床观察

目的评价双歧二三联活菌（培菲康）制剂结合基础治疗在非酒精性脂肪性肝病（NAFLD）中的作用。方法正常健康人30例为正常对照组;选择临床诊断非酒精性脂肪性肝病64例,随机分为易善复治疗组和易善复加培菲康治疗组。易善复治疗组32例,口服易善复456mg,3次／d;易善复加培菲康治疗组32例,口服易善复456mg及双歧三联活（培菲康）80mg,3次／d,两组均结合低热量饮食、运动等基础治疗,共4周。治疗前、后分别测定肝功能、肿瘤坏死因子（TNF—α）、胰岛素抵抗（IR）、脂联素（APN）等。结果治疗前,易善复治疗组和易善复加培菲康治疗组TNF—α、IR、ALT均高于正常对照组,APN与之相反。治疗后,两治疗组丙氨酸转氨酶（ALT）、IR、TNF—α比治疗前降低,有显著差异（P〈0．05）,APN显著升高。治疗后易善复加培菲康治疗组较易善复治疗组有显著差异（P〈0．05）。两组均无严重不良反应发生。结论双歧三联活菌（培菲康）制剂可减少NAFLD患者TNF-α、IR,降低肠源性内毒素血症,改善APN、肝功能,不良反应甚微,可作为NAFLD的药物治疗选择。     

肿瘤坏死因子基因启动子-308位多态性与强直性脊柱炎相关性研究

目的 探讨肿瘤坏死因子（TNF）启动子多态性与强直性脊柱炎（AS）的相关性。方法 采用聚合酶链反应限制性片段长度多态性（PCR－RFLP），对78例AS患者和52名HLA－B27阳性健康人群进行TNF启动子多态性分析。同时采用酶联免疫吸附法（ELISA）检测了患者和正常人群血甭TNF－α水平。结果 78例AS患者中为308.1.1基因型的有61例（78．2％），明显高于HLA－B27阳性的健康人（55．8％）（P＜0．05），而AS患者的－308．1．2和－308．2．2基因型频率和相应降低，且后两种基因型患者血清TNF－α水平及临床部分指标明显高于－308．1．1基因型的患者。结论 研究显示－308．1的等位基因在AS患者中比HLA－B27阳性的正常对照人群更多见。TNF基因该区域多态性与AS存在相关性。     

黑龙江地区慢性阻塞性肺疾病与肿瘤坏死因子基因多态性的相关性研究

肿瘤坏死因子（TNF）在慢性阻塞性肺疾病（COPD）的气道炎症和肺功能损害中起重要作用。已知肿瘤坏死因子α（TNF-α）和TNF-β存在单核苷酸多态性（SNP）TNF-α-308G/A和TNF-β＋252G/A，影响TNF在气道内的表达，因而可能是COPD发病的分子机制之一。我们的研究采用聚合酶链反应-限制性片段长度多态性（PCR-RFLP）和等位基因特异性聚合酶链反应（AS-PCR）方法，分析黑龙江地区汉族COPD患者及健康人群的TNF基因多态性分布情况，探讨其多态性在COPD发病中的作用。     

肿瘤坏死因子α及其基因启动子区变异与2型糖尿病的关系

胰岛素抵抗(IR)是2型糖尿病发病的重要环节,但IR的发生机制十分复杂,某些细胞因子,如TNFα在IR中起促进作用。TNFα基因启动子区-308bp处存在G→A变异[1],研究表明,该变异与组织TNFα水平相关。我们通过对部分河北地区汉族人TNFα基因启动子区变异的测定,探讨TNFα基因多态     

TNFα启动子的多态性与中国汉族人群HBV感染后果的相关性

宿主基因以及包括HBV基因型在内的环境因素对HBV感染造成的不同后果已被广泛研究、最近一些研究表明肿瘤坏死因子-α（TNFα）在清除病毒和宿主对HBV反应上起关键的作用．个体产生TNFα的能力是受一个基因复合体的影响。在这次研究中，我们的主要目的是判断TNFα启动子的单核苷酸多态性（SNPs）是否与中国汉族人HBV感染的不同后果有关。     

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.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

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.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.