缬沙坦和尼群地平对原发性高血压患者血清可溶性粘附分子影响的对比研究

目的　对比研究缬沙坦和尼群地平对原发性高血压 (EH )患者血压及血清可溶性粘附分子sICAM 1,sVCAM 1水平的影响。方法　随机对照方法设计 ,将 6 4例轻中度原发性高血压患者分为两组 ,分别予缬沙坦 (80mg/d)和尼群地平 (10～ 30mg/d)治疗 6周 ,治疗前后抽血 ,用酶联免疫方法 (ELISA)测定外周血清中可溶性粘附分子sICAM 1,sVCAM 1水平。另选择 2 5例健康人作为对照组。结果　治疗前与对照组比较 ,高血压患者血清中可溶性粘附分子sICAM 1,sVCAM 1水平升高 ,分别为 [(318 2± 2 7 5 ) μg/Lvs (2 71 5± 2 6 8) μg/L ,P <0 0 5 ]和 [(5 90 6± 4 0 1) μg/Lvs (4 17 9± 38 7) μg/L ,P <0 0 1]。治疗后两组的血压均明显下降 (P <0 0 5 ) ,两组间无差异。缬沙坦组可溶性粘附分子sICAM 1,sVCAM 1水平均较治疗前明显下降 ,分别为[(32 0 5± 2 3 6 ) μg/Lvs (2 80 2± 2 5 4 ) μg/L ,P <0 0 5 ]和[(5 86 2± 4 2 5 ) μg/Lvs (4 5 1 2± 38 9) μg/L ,P <0 0 1]。而尼群地平组可溶性粘附分子sICAM 1,sVCAM 1水平较治疗前无明显下降 (P >0 0 5 )。结论　与尼群地平比较 ,缬沙坦不仅能有效降低血压 ,还能抑制血管壁的炎症反应 ,有利于预防和延缓动脉粥样硬化的发生和发展。     

血管细胞黏附分子-1与老年多梗死性痴呆关系的研究

目的了解多梗死性痴呆患者血清可溶性黏附分子的变化及临床意义。方法采用酶联免疫法和DTNB直接法测定了82例多梗死性痴呆患者血清可溶性血管细胞黏附分子1(sVCAM1)水平和血GSH Px活力,并与23例健康人对照比较。结果多梗死性痴呆患者血清黏附分子水平〔sVCAM1轻度痴呆(993.62±108.92)ng/ml,中度痴呆(1190.32±43.95)ng/ml,重度痴呆(1625.22±220.90)ng/ml明显高于健康对照组(P<0.01);GSH Px活力(73.98±22.32U·ml-1·min-1)明显低于健康对照组。sVCAM1水平与痴呆程度呈正相关(r=0.6975,P<0.05)。结论可溶性黏附分子与多梗死性痴呆密切相关,可溶性黏附分子可作为多梗死性痴呆治疗时的主要监测指标之一。     

2型糖尿病肾病患者血清细胞粘附分子变化与氧化应激的关系

目的　探讨 2型糖尿病肾病患者 (DN)血清细胞粘附分子变化及其与氧化应激的关系。　方法　检测DN患者血清可溶性细胞间粘附分子 1(sICAM 1)、可溶性血管细胞粘附分子 1(sVCAM 1)、血清丙二醛 (MDA)含量和超氧化物歧化酶 (SOD)活性。　结果　早期DN及DN患者血清sVCAM 1水平〔分别为 (1 75± 0 48)、(1 91± 0 2 7)mg/L〕明显高于对照组〔(1 6 7± 0 72 )mg/L ,P <0 0 5和0 0 1〕 ,DN组明显高于单纯糖尿病 (DM)组〔(1 5 8± 0 39)mg/L ,P <0 0 5〕 ;DM组、早期DN组和DN组患者血清sICAM 1〔分别为 (75 6 0 0± 12 5 47)、(80 2 2 1± 12 4 81)、(897 6 0± 10 5 80 ) μg/L〕明显高于对照组〔(5 82 6 4± 10 2 73) μg/L ,P <0 0 0 1〕 ,其中DN组明显高于单纯DM组和早期DN组 (分别P <0 0 1和<0 0 5 ) ;单纯DM组、早期DN组和DN组患者血清SOD活性〔分别为 (86 5 9± 13 85 )、(85 6 9±11 32 )、(71 73± 16 35 )NU/L〕显著性低于对照组〔(92 73± 11 2 5 )NU/ml,P <0 0 1〕 ,MDA含量〔分别为(3 99± 1 36 )、(4 2 6± 1 95 )、(6 5 0± 2 98)nmol/ml〕显著性高于对照组〔(3 72± 0 5 7)nmol/ml,P <0 0 1〕。DM患者血清sVCAM 1与sICAM 1、收缩压、尿素氮 (BUN)和肌酐 (Cr)呈正相     

不稳定性心绞痛患者活化血小板表达细胞分化抗原40配体及其与可溶性黏附分子水平的关系

目的 :探讨不稳定性心绞痛 (UA)患者体内血小板活化及表达细胞分化抗原 40配体 (CD40L)与其血清可溶性黏附分子水平的关系。　　方法 :流式细胞术测定 3 8例UA患者 (UA组 ) ,2 2例稳定性心绞痛 (SA)患者 (SA组 )及 2 1例对照者 (对照组 )血小板P 选择素 (CD62P)及CD40L表达 ,并与体外诱导的健康人血小板活化程度及CD40L表达水平进行比较。同时用ELISA法测定 3组研究对象的血清可溶性细胞间黏附分子 1(sICAM 1)和血管细胞黏附分子 1(sVCAM -1)浓度 ,分析UA患者血小板表达CD40L与其可溶性黏附分子水平的关系。　　结果 :UA组血小板CD62P、CD40L表达显著高于SA组及对照组 (P <0 0 1) ,达到了健康人血小板在体外经中等浓度诱导剂刺激时CD62P、CD40L的表达水平。同时 ,UA患者血清sICAM 1、sVCAM 1浓度也显著高于SA组及对照组 ,并分别与其血小板表达CD40L呈显著正相关 (γ =0 483 ,γ =0 5 16,P <0 0 5 )。　　结论 :UA患者体内血小板过度激活的同时可表达炎性介质CD40L ,并与其血清可溶性黏附分子水平升高有关。     

老年急性脑血管病患者细胞因子及其受体的研究

目的　探讨老年急性脑血管病患者细胞因子及其受体的变化。方法　采用酶联免疫吸附试验测定 6 5例老年急性脑血管病患者血清可溶性白细胞介素 2受体 (sIL 2R)、可溶性白细胞介素 6受体 (sIL 6R)、可溶性细胞间粘附分子 1(sICAM 1)及转化生长因子 β1(TGF β1)的含量。另选 38名健康人作为对照。结果　老年急性脑血管病患者的血清sIL 2R为 (75 4± 2 0 3)U/ml,sIL 6R为 (5 8± 12 )mg/L ,sICAM 1为 (5 5 8± 2 11) μg/L ,比对照组均明显升高 ,而TGF β1[(2 2± 10 ) μg/L]含量明显减少。头颅CT显示病灶大小与血清sICAM 1含量呈显著正相关。 结论　血清sIL 2R、sIL 6R、sICAM 1及TGF β1含量可作为判断老年脑血管病患者病情变化的指标之一     

血脂异常对血清细胞黏附分子水平的影响

目的 :探讨血脂异常对血清细胞间黏附分子 1(ICAM 1)、血管细胞黏附分子 1(VCAM 1)和E 选择素水平的影响。方法 :入选 12 0例研究对象 ,其中高胆固醇血症 (Ⅰ组 ) 31例 ;高三酰甘油血症 (Ⅱ组 ) 30例 ;混合性高脂血症 (Ⅲ组 ) 2 9例 ;血脂正常 (Ⅳ组 ) 30例。用酶联免疫吸附法检测血清ICAM 1、VCAM 1和E 选择素水平 ,比较上述 3个指标在各组间的差异。结果 :总胆固醇水平 ,Ⅰ组 [(6 .5 5± 0 .6 7)mmol/L]和Ⅲ组 [(6 .2 7±0 .6 7)mmol/L]显著高于Ⅳ组 [(4.38± 0 .4 9)mmol/L],P <0 .0 1;三酰甘油水平 ,Ⅱ组 [(3.39± 0 .6 0 )mmol/L]和Ⅲ组 [(3.4 4± 0 .6 2 )mmol/L]显著高于Ⅳ组 [(1.39± 0 .4 0 )mmol/L],P <0 .0 1。同时 ,血清ICAM 1水平在Ⅰ组 [(76 4± 71) μg/L]、Ⅱ组 [(74 9± 71) μg/L]和Ⅲ组 [(82 3± 80 ) μg/L]明显高于Ⅳ组 [(6 0 4± 6 7) μg/L],P <0 .0 1;血清VCAM 1水平在Ⅰ组 [(1837± 16 4 ) μg/L]、Ⅱ组 [(1836± 16 0 ) μg/L]和Ⅲ组 [(196 3± 181) μg/L]明显高于Ⅳ组 [(130 7± 14 9) μg/L],P <0 .0 1;血清E 选择素水平在Ⅰ组 [(6 6± 12 ) μg/L]、Ⅱ组 [(70± 14 ) μg/L]和Ⅲ组 [(81± 17) μg/L]明显高于Ⅳ组 [(39± 11) μg/L],P <0 .0 1。结论 :血脂异常可使血清I     

脑梗死患者血浆对氧磷酯酶-1和氧化低密度脂蛋白水平的变化及意义

目的探讨脑梗死患者血浆对氧磷酯酶-1(PON-1)活性和氧化低密度脂蛋白(ox-LDL)含量变化以及它们在脑梗死发生发展过程中的作用。方法用对氧磷为底物的速率法和酶联免疫吸附法(ELISA)分别测定75例急性期脑梗死患者血浆PON-1活性和ox-LDL水平,并与35例脑出血患者及46例健康对照组比较。结果(1)脑梗死患者血浆PON-1活性为(138.2±25.3)U/L,明显低于脑出血组〔(168.2±28.2)U/L〕及健康对照组〔(171.1±28.5)U/L〕(P<0.01);脑梗死患者血浆ox-LDL水平为〔(615.3±253.2)μg/L〕,明显高于脑出血组〔(460.9±193.0)μg/L〕及健康对照组〔(437.7±187.4)μg/L〕(P<0.01)。(2)大梗死灶组血浆PON-1活性明显低于中梗死灶组和小梗死灶组。而大梗死灶组血浆ox-LDL水平明显高于中梗死灶组和小梗死灶组(P<0.01)。(3)相关分析表明,脑梗死时血浆PON-1活性与ox-LDL水平呈负相关(r=-0.556,P<0.01),而与血脂水平无明显的相关关系。结论脑梗死患者血浆PON-1活性降低和ox-LDL水平升高,提示血浆PON-1可能通过降低抗氧化能力机制参与了脑梗死的病理生理过程。     

急性冠状动脉综合征患者血浆细胞粘附分子和转化生长因子的变化及其意义

目的 :探讨急性冠状动脉综合征 (ACS)患者外周血可溶性细胞粘附分子 1(sICAM 1)和转化生长因子 β(TGF β)浓度变化及其意义。方法 :符合ACS诊断的 4 5例于入院后 1h内抽取肘静脉血5ml,测定sICAM 1和TGF β ,同时测定肌酸激酶 (CK)、乳酸脱氢酶 (LDH)、肌酸激酶同工酶 (CK MB) ,并设健康对照组。结果 :血浆sICAM 1水平显著升高 ,其中不稳定型心绞痛 (UAP)为 35 9.0 8± 35 .12 μg/L,非Q波性急性心肌梗死 (NQAMI)为 4 95 .34± 4 9.16 μg/L、Q波性急性心肌梗死(AMI)为 5 83.5 1± 5 4 .2 7μg/L,与对照组 (2 5 3.5 1± 38.4 3μg/L)比较有显著差异 (P <0 .0 0 1) ;血浆TGF β浓度明显下降 ,其中UAP为4 6 .72± 10 .15 μg/L,NQAMI为 4 1.6 9± 9.0 8μg/L,AMI为36 .72± 8.79μg/L,与对照组 (6 2 .10± 14 .4 6 μg/L)比较有显著差异 (P <0 .0 0 1)。sICAM 1与TGF β呈显著负相关 ;sICAM 1和CK、CK MB、LDH呈显著正相关 (P <0 .0 1)。结论 :血清sICAM 1和TGF β浓度的变化反映了ACS患者炎症和免疫状态 ,抑制致炎因子的作用 ,适度增强抗炎因子的作用 ,必将成为有效防治ACS的一个新途径     

培哚普利对老年心力衰竭患者血中可溶性细胞间黏附分子-1和细胞凋亡抑制因子的影响

目的　观察培哚普利对老年慢性心力衰竭 (CHF)患者循环血中可溶性细胞间黏附分子 1(sICAM 1)和细胞凋亡抑制因子 (Fas Apo 1)水平的影响。方法　用酶联免疫方法检测 5 3例老年CHF患者治疗前后及 2 5例健康老年人血中sICAM 1和Fas Apo 1水平。结果　老年CHF患者sICAM 1和Fas Apo 1水平分别为 (6 0 2 .6 1± 14 8.5 8) μg Lvs(0 .2 7± 0 .0 8) μg L ,显著高于 2 5例健康老年人 (178.5 4± 31.0 1) μg Lvs (0 .12± 0 .0 4 ) μg L ,且随着心功能损害程度加重而升高 ,各组间比较差异有显著性意义。培哚普利组与治疗对照组治疗前后血中sICAM 1和Fas Apo 1浓度水平差异有显著性意义 ,培哚普利组较治疗对照组治疗后血中sICAM 1和Fas Apo 1下降明显。结论　外周血中sICAM 1和Fas Apo 1水平可反映老年CHF的程度 ;培哚普利可明显降低老年CHF患者血中sICAM 1和Fas Apo 1的水平 ,从而保护和改善心功能。     

老年冠心病和扩张型心肌病患者心力衰竭时血清可溶性细胞间黏附分子的检测

目的　观察老年冠心病和扩张型心肌病患者心力衰竭时血清黏附分子的变化。方法　采用固相酶联免疫吸附试验的夹心法 ,分别测定 38例冠心病心力衰竭和 16例扩张型心肌病 (DCM)心力衰竭时血清可溶性细胞间黏附分子 1(sICAM 1)和E 选择素。同时以同期 33例健康者作为对照组。结果　血清sICAM 1在冠心病组 (5 .6 0±0 .78)ng ml和DCM组 (5 .5 3± 0 .74 )ng ml均高于健康对照组 (4.0 1± 0 .39)ng ml;血清E 选择素在冠心病组 (44 .2 1±2 9.31)ng ml和DCM组 (43.80± 2 5 .6 6 )ng ml亦高于健康对照组 (2 3.4 2± 15 .84 )ng ml ,且心功能Ⅳ级组血清sICAM 1和E 选择性水平均高于心功能Ⅱ级组。结论　血清sICAM 1和E 选择素水平在心力衰竭时均升高 ,可能与动脉粥样硬化无明显相关 ;但可预示心力衰竭的严重性     

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.