B族维生素降低老年人血浆半胱氨酸的作用

血浆总半胱氨酸(tHcy)浓度升高与心血管事件风险大大增高有关。既往研究揭示,在多数非老年人个体,补充B族维生素能持续降低血浆tHcy水平,尤其是在同时伴高tHcy和低叶酸水平者。本文拟就补充B族维生素对降低老年人血浆tHcy的可能作用进行了分析。对象与方法本文为一随机双盲对照试验,共纳入299例老年男性,年龄均≥75岁。研究中分为随机双盲接受早餐后顿服内含叶酸2mg加维生素B625mg和维生素B12400μg的复合B族维生素药丸的治疗组150例;或仅于早餐后顿服安慰剂的对照组149例,人均用药或随访2年。随访期内每半年复测1次各组血浆tHcy及维生…     

脑梗死患者血清叶酸和维生素B12水平的测定

目的探讨血清叶酸、维生素B12与脑梗死的关系及其临床意义.方法采用放射免疫法测定88例脑梗死患者及39例健康对照组血清叶酸、维生素B12的浓度.结果脑梗死患者血清叶酸、维生索B12水平分别是(4.4±1.8)ng/L及(569±386)pg/L;对照组分别是(7.8±5.2)ng/L及(785±427)pg/L,两组比较均P＜0.05.结论血清叶酸和维生素B12水平可能分别是脑梗死的独立危险因子.     

增龄和性别对维生紊A、E的影响

作者测定了80例健康老年人(男40例,女40例)和80例健康青年人(男40例,女40例)的血清维生素A、E值。结果为:维生素A老年组中,男2.79±0.61μmol/L,女2.62±0.68μmoI/L;维生素A青年组中,男3.06±0.51μmol/L,女3.19±0.58μmol/L。维生素E老年组中,男30.50±7.56μmol/L,女33.28±6.20μmol/L;维生素E青年组中,男30.18±5.44μmol/L,女29.57±6.22μmol/L。据此值作者结论     

同型半胱氨酸与脑梗死关系探讨

目的　探讨血清总同型半胱氨酸 (tHcy)水平与脑梗死关系。方法　测定 112例脑梗死患者及 4 2例健康对照者的血清总同型半胱氨酸 (tHcy)、维生素B12 (VitB12 )和叶酸 (FA)水平。结果　 ( 1)脑梗死组的血清tHcy平均水平 ( 17 10± 8 5 3) μmol/L显著高于对照组 ( 11 18± 3 0 2 ) μmol/L ;( 2 )血清tHcy水平与FA与VitB12 水平均呈负相关 ;( 3)高同型半胱氨酸血症 (Hcy >15 0 μmol/L) ,经校正性别、年龄、吸烟、血脂、血压、血糖等危险因素后 ,脑梗死的相对危险度 (OR)为 4 78,[95 %可信区间 (CI)为 1 70～ 13 4 6 ]。结论　 ( 1)血清tHcy水平升高可增加脑梗死的发病危险度 ;( 2 )FA、VitB12 是tHcy的非遗传影响因素。     

老年期痴呆患者血浆同型半胱氨酸的临床观察

目的　了解老年期痴呆患者同型半胱氨酸 (Homocysteine,HCY)水平并探讨二者之间的关系。方法　老年性痴呆 (AD) 33例 ,血管性痴呆 (VD) 4 3例 ,健康老年人 2 8例 (对照组 )。对所有研究对象 ,空腹取血检测血浆 HCY,同时检测血叶酸和维生素 B1 2 。结果　老年期痴呆患者的HCY平均水平为 1 3.1 2± 4.64μmol/ L (AD)和 1 5.33± 5.0 6μmol/ L(VD) ,对照组 (1 2 .45± 3.0 5μmol/ L ) ,F值分别为 3.972 ,1 0 .82 1和 6.62 5(P<0 .0 5)。血清 HCY与叶酸及维生素 B1 2 水平呈负相关 ,相关系数分别为 0 .2 92和 0 .2 7(P<0 .0 5)。结论　老年期痴呆者有高水平的血清 HCY和低水平的血叶酸。     

亚甲基四氢叶酸还原酶基因多态与脑梗死

血浆同型半胱氨酸 (Ｈｃｙ)浓度升高是动脉粥样硬化的危险因素 ,其代谢的关键酶 5 ,1 0 亚甲基四氢叶酸还原酶(ＭＴＨＦＲ)基因突变引起酶活性下降 ,导致高Ｈｃｙ血症。本组探讨脑梗死患者ＭＴＨＦＲ基因多态性以及Ｈｃｙ和叶酸浓度的关系。1 材料与方法 :病例组 75例 (男 43例 ,女 32例 )。年龄35～ 86岁 ,平均 (60 6± 1 2 1 )岁 ,为急性脑梗死住院患者。对照组 62例 (男 34例 ,女 2 8例 ) ,年龄 30～ 78岁 ,平均 (57 4± 1 1 2 )岁 ,为健康体检者。以上两组均为在黑龙江省生活30年以上汉族人。测定血压、血糖、血脂、血浆叶酸及Ｈｃ…     

老年糖尿病患者高同型半胱氨酸血症与肾病及胰岛素抵抗的关系

目的探讨老年2型糖尿病患者血清总同型半胱氨酸(tHcy)水平与不同程度肾病和胰岛素抵抗的关系。方法测定98例老年2型糖尿病患者和36例健康对照者血清tHcy及血糖、血脂、肾功能、胰岛素等指标。结果(1)糖尿病组血清tHcy显著高于对照组[(172±76)μmol/L对(94±35)μmol/L,P<001],糖尿病组tHcy水平随着肾病程度的加重而升高,其中肾功能受损组显著高于无肾病组[(286±79)μmol/L对(157±63)μmol/L,P<0001];(2)与正常tHcy组比较,高tHcy组的年龄、尿酸、肌酐、胰岛素抵抗指数(HomaIR)均显著升高(P<005),肌酐清除率(Ccr)显著降低(P<001);(3)相关分析显示,糖尿病患者血清tHcy水平与肌酐、尿酸、HomaIR、年龄均呈显著正相关,与Ccr呈显著负相关。结论老年糖尿病患者高tHcy血症是肾功能减退及胰岛素抵抗的两个重要相关因素。     

亚临床甲状腺功能减退患者同型半胱氨酸水平与冠状动脉粥样硬化的关系

目的探讨亚临床甲状腺功能减退(甲减)患者血清总同型半胱氨酸(tHcy)水平与冠状动脉粥样硬化的关系。方法应用荧光偏振免疫发光法测定40例正常对照(A组)、45例亚临床甲减无血管病变患者(B组)、43例亚临床甲减合并心绞痛患者(C组)和38例亚临床甲减合并心肌梗死患者(D组)的血清tHcy水平。结果A,B,C,D组的tHcy值分别为8.25±1.62,14.68±2.46,18.96±4.65,25.72±5.14(μmol/L),各组间均有显著性差异(P<0.01)。结论亚临床甲减患者tHcy升高可加速冠状动脉粥样硬化的发生和发展,tHcy水平与冠状动脉粥样硬化的严重程度一致。     

急性脑梗死患者血浆一氧化氮等自由基水平的变化及意义

我们通过检测脑梗死患者血浆一氧化氮 (ＮＯ)、超氧化物歧化酶 (ＳＯＤ)、维生素Ｃ(ＶＣ)和维生素Ｅ(ＶＥ)水平的变化 ,探讨自由基在急性脑梗死中的作用机制及意义。1　资料与方法1 1　研究对象　随机选择自 1998年 5月至 1999年 5月入院 ,发病时间为 72ｈ以内〔(2 3 0 0± 2 89)ｈ〕的脑梗死患者6 0例 ,作为急性期组 ;既往无明显的心、脑、肺、肝、肾等主要脏器疾病 ,排除糖尿病和肿瘤等 ;男 36例 ,女 2 4例 ,年龄(5 9 41± 4 17)岁。恢复期组 :急性期组中同意进行系统监测的 30例患者 ,男 19例 ,女 11例 ,年龄 (5 8 92± 4 0 1)岁。对照…     

东菱克栓酶治疗老年脑梗死23例疗效观察

1998～ 2 0 0 1年 ,我们采用东菱精纯克栓酶治疗老年急性脑梗死患者 2 3例 ,取得较好疗效 ,现报告如下。资料与方法 :将 5 1例脑梗死患者 (男 32例 ,女 19例 ;年龄 6 0～ 85岁 ,平均 6 3.2 8± 7.72岁 )随机分为两组。治疗组 2 3例 ,男 15例、女 8例 ,年龄 6 1～ 85 (平均 6 6 .2 2± 5 .4 6 )岁 ;对照组 2 8例 ,男 17例、女 11例 ,年龄 6 0～ 82 (平均 6 5 .0 1±6 .37)岁。两组年龄及病情无显著性差异 ;均经详细询问病史、神经系统检查及头颅磁共振确诊 ,符合 1995年全国第四届脑血管病会议通过的脑血管疾病诊断要点。治疗组将东菱克栓酶 …     

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.