山东地区寻常型、脓疱型银屑病与HLA-DRB1基因的关系

目的 探讨HLA-DRB1基因与银屑病的相关性.方法 用序列特异性引物-聚合酶链反应(PCR-SSP)方法对98例寻常型银屑病患者、36例泛发性脓疱型银屑病患者和70例正常对照组进行HLA-DRB1基因分型,并分析了其在各组中的分布.结果 寻常型银屑病患者组DRB1*7、DRB1*10等位基因频率较正常对照组显著增高,泛发性脓疱型银屑病患者组HLA-DRB1*7频率较正常对照组显著增高.结论 寻常型银屑病及泛发性脓疱型银屑病在发病机理方面存在共同的遗传易感基因,而后者又有其特殊的遗传背景.     

HLA-DRB1基因多态性与扩张型心肌病的相关分析

目的探讨扩张型心肌病（IDC）与人类白细胞抗原（HLA）-DRB1基因多态性的关系。方法用聚合酶链反应一序列特异性引物方法检测301例IDC患者（IDC组）与436例正常人（对照组）的HLA-DRB1等位基因分布情况。结果IDC组HLA-DRB1＊11、HLA-DRB1＊12、HLA-DRB1＊14的基因频率明显高于对照组（RR=2．91、4．02、3．78，P〈0．05）；IDC组同时携带HLA-DRB1＊12、DRB1＊14基因型的阳性率亦显著高于对照组（RR=6．24．P〈0．01）。结论HIA-DRB1＊11、DRB1＊12、DRB1＊14与IDC有明显相关性。     

肺结核病患者与HLA-DRBI等位基因的关联

目的：通过对湖北省汉族肺结核病（PTB）患者进行HLA-DRB1基因分型,探讨此人群与HLA-DRB1的相关性。方法：用序列特异性寡核苷酸探针聚合酶链反应（PCR-SSOP）技术对174例PTB患者及1358例健康人群进行HLA-DRB1基因分型。基因频率与Hardy-Weinberg平衡卡方检测使用arlequin软件进行,组间比较用Fisher精确概率法计算P值,检测水准为a=0．05,相对危险系数用RR表示,RR：A（A＋B）／C（C＋D）。结果：174例PTB患者HLA-DRB1基因分型结果与希望值进行H-W平衡检测（P〉0．05）。此人群检出HLA-DRB1等位基因共13种与对照组一致。其中RB1＊08与DRB1＊09基因频率显著高于对照组,差异有统计学意义（P〈O．01）,且RR〉1,说明DRB1＊08与DRB1＊09或与其连锁的单倍型可能是的PTB易感基因;RB1＊10与DRB1＊13基因频率显著低于对照组,差异有统计学意义（P〈0．05）,且RR〈1,说明RB1＊10与DRB1＊13可能是PTB的保护基因。其余等位基因频率组间比较均无统计学意义。结论：湖北省汉族PTB患者这个疾病群体遗传平衡被杂化,其与HLA-DRBl有一定的关联,但有其自身的特点。     

30例重症肌无力患者人类白细胞抗原-Ⅱ基因多态性测定及分析

目的 探讨人类白细胞抗原（HLA）-Ⅱ基因多态性在贵州汉族人群重症肌无力（MG）发病中的作用。方法选择本地区汉族人群中30例MG患者（MG组）、36例神经内科非自身免疫性疾病患者（疾病对照组）及30例健康查体者（正常对照组）,采用PCR-序列特异性引物（PCR-SSP）技术进行HLA-Ⅱ类基因DRB1、DQB1位点分型,并对其与Mc的相关性进行分析。结果MG组HLA-DRB1＊0901和DQB1＊0303等位基因频率显著高于其他两组（P〈0．05）,DQB1＊0601等位基因频率显著低于其他两组（P〈0．05）。结论HIA-DRB1＊0901及DQB1＊0303可能为MC的易感基因,而HLA—DQ＊0601为保护基因。     

HLA—DRB1、DQB1基因多态性与流行性出血热的相关性

目的从基因水平探讨HLA—DRB1、DQB1等位基因多态性与流行性出血热的相关性,以阐述其免疫遗传学特征。方法应用序列特异性引物聚合酶链反应技术检测流行性出血热患者和正常对照组各50例的HLA—DRB1、DQB1等位基因。结果流行性出血热患者与正常对照组比较,HLA—DRB1＊16等位基因分布频率明显增高（Pc=0．0106）,两组间其余HLA-DRB1、-DQB1等位基因分布频率差异无统计学意义（Pc〉0．05）。结论HLA-DRB1＊16等位基因与流行性出血热呈正相关,可能为流行性出血热易感基因之一。     

Graves病白细胞减少易感性与HLA-DRB1基因多态性的关联

目的探讨天津地区汉族Graves病(GD)白细胞减少易感性与HLA-DRB1基因多态性的关联.方法采用聚合酶链反应-序列特异性引物(PCR-SSP)方法检测45例GD白细胞减少患者、50例GD白细胞正常患者和90名正常对照的HLA-DRB1等位基因频率.结果(1)在不考虑白细胞变化的情况下,GD患者DRB1*08基因频率明显高于对照组(P＜0.01,RR=2.62),DRB1*07基因频率明显低于对照组(P＜0.01,RR=0.24).(2)GD白细胞减少组DRB1*08(P＜0.01,RR=4.17)和DRB1*15(P＜0.05,RR=1.69)基因频率较对照组显著增高,DRB1*07基因频率明显低于对照组(P＜0.01,RR=0.13).(3)GD白细胞减少组DRB1*08基因频率(P＜0.01)和DRB1*15基因频率(P＜0.05)均明显高于白细胞正常组,DRB1*09(P＜0.05)基因频率明显低于白细胞正常组.结论天津地区汉族GD白细胞减少易感性与HLA-DRB1*08,HLA-DRB1*15基因频率增加有关;GD的保护性与HLA-DRB1*07基因频率减少有关.     

豫籍汉人AIH—Ⅰ型和AIH—Ⅰ型-PBC重叠综合征在HLA—DRB1和DQA1基因的遗传易感性

目的在HLA—DRB1和DQA1基因座位上分析豫籍汉人自身免疫性肝炎-Ⅰ型（AIH-Ⅰ型）和自身免疫性肝炎-Ⅰ型-原发性胆汁性肝硬化（AIH—Ⅰ-PBC）重叠综合征患者的遗传易感性。方法应用PCR-SSP技术对58例AIH—Ⅰ,61例AIH-Ⅰ型-PBC重叠综合征患者及50例正常对照组进行基因分型。结果各组各个基因座位均符合Hardy-Weinberg平衡检验,基因频率的分布存在统计学差异（P〈0．01或〈0．05）。与正常对照组比较,AIH—Ⅰ型组DQA1＊01、DRB1＊07·DQA1＊01和DRB1＊07-DQA1＊03均存在统计学差异（P〈0．05或〈0．01）;A1H—Ⅰ型-PBC组DRB1＊08、DRB1＊12、DRB1＊08-DQA1＊01和DRB1＊12-DQM1＊01均存在统计学差异（P〈0．01）。AIH-Ⅰ型-PBC组与AIH—Ⅰ型组比较,DRB1＊08、DRB1＊14、DRB1＊12、DQA1＊06、DRB1＊08．DQA1＊01、DRB1＊14-DQA1＊01、DRB1＊07-DQA1＊01和DRB1＊10-DQA1＊05均存在统计学差异（P〈0．0167）。结论在豫籍汉人中,DQA1＊01可能是AIH—Ⅰ型的抵抗基因;DRB1＊08可能是MH-Ⅰ型-PBC重叠综合征的易感基因,而DRB1＊12可能是抵抗基因。DRB1＊07-DQA1＊01单倍型可能是AIH-Ⅰ型患者的强危险因素,DRB1＊08一DQA1＊01单倍型可能是AIH-Ⅰ型-PBC重叠综合征患者的强危险因素。     

204例肾移植受者HLA-A、HLA-B、HLA-DRB11基因分型结果分析

采用PCR—SSP法对204例肾移植受者（观察组）进行HLA-A、HLA-B、HLA-DRB。座位基因分型，计算基因频率并与7t118例健康人（对照组）比较。结果观察组频率〉10％的等位基因有A＊02、A＊24、A＊11、A＊33、B＊15、B＊40、B＊13、DRB1＊15、RB1＊04、DRB1＊12、RB1＊07、RB1＊09。其中DRB1＊15、DRB1＊08、DRB1＊04、A＊02、A＊34与对照组比较有统计学意义。认为具有与对照组相同高频基因的患者更易找到无关供体；DRB1＊04、A＊02、A＊34可能为患肾脏疾病的风险基因，DRB1＊15、DRB1＊08则可能为保护基因。     

壮、汉族HLA—DRB1＊07基因与乙肝疫苗应答相关性对比研究

目的对比广西壮、汉民族HLA-DRB1＊07基因与乙肝疫苗免疫应答的相关性。方法以广西73名壮族、97名汉族健康大学生作为研究对象进行全程乙肝疫苗接种,采用PCR—SSP技术检测受试者外周血细胞DNA的HLA—DRB1＊07基因,采用ELISA方法检测其血清乙肝病毒标志物（HBsAg,抗-HBs,HBeAg,抗-HBe,抗-HBc）。结果壮族与汉族之间乙肝疫苗的应答率无显著性差别（84．21％V886．60％,P=0．658）,壮族与汉族人群之间HLA-DRB1＊07基因携带频率的差异也无统计学意义（9．21％vs6．19％。P=0．454）,但壮、汉族中HLA—DRB1＊07携带者的疫苗应答率都显著低于非携带者（P=0．00／P=0．03）。结论民族差异不是广西人群乙肝疫苗应答效果的影响因素;广西壮、汉族人中携带HLA—DRB1＊07基因都可能是导致机体对乙肝疫苗无／弱应答的因素。     

新疆维吾尔族慢性胃炎患者HLA-DRB1等位基因与幽门螺杆菌感染的关系

目的研究新疆维吾尔族慢性胃炎患者HLA-DRB1等位基因与幽门螺杆菌（Hp）感染的关系。方法采用幽门螺杆菌分离培养技术检测33例维吾尔族慢性胃炎患者幽门螺杆菌感染情况,采用PCR-SSP检测HLA-DRB1＊0405、HLA-DRB1＊08、HLA-DRB1＊12等位基因,并与36例汉族慢性胃炎患者进行比较。结果1）新疆维吾尔族慢性胃炎患者Hp阳性率（78.8%）显著高于汉族慢性胃炎患者（58.3%）（P〈0.05）;2）维吾尔族、汉族慢性胃炎患者Hp感染与HLA-DRB1＊0405、HLA-DRB1＊08、HLA-DRB1＊12等位基因无相关性（P〉0.05）。结论1）维吾尔族慢性胃炎患者Hp感染率高于汉族慢性胃炎患者;2）维吾尔族、汉族慢性胃炎患者Hp感染与HLA-DRB1＊0405、HLA-DRB1＊08、HLA-DRB1＊12等位基因无关。     

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.