绝经后妇女白介素1受体拮抗物基因多态性与骨密度的关系

目的 研究绝经后妇女白介素1（IL-1）受体拮抗物基因（IL-1RN）多态性与骨密度，骨生化指标之间的相互关系。方法 采用PCR和电泳检测IL-1RN多态性，双能X线骨密度仪（DEXA）测定腰椎和股骨颈骨密度。结果 在166例绝经后妇女中发现了A1A1，A1A2和A1A4三种IL-1RN基因型，91%的绝经后妇女属于A1A1型，杂合子A1A2/A4型的腰椎骨密度低于纯合子A1A1型，但这种差异受到体重的影响。两组的骨生化指标差异无显著性。结论 IL-1RN多态性与体重有关，但与骨密度无直接关系。     

绝经后妇女护骨素基因G1181C多态性与骨密度变化相关

目的　寻找护骨素基因(OPG)外显子中的单核苷酸多态性 (SNP),并分析其与绝经后妇女骨密度的关系。方法　在 205名绝经后妇女中,采用PCR和直接测序法确定OPG基因的SNP及基因型。应用双能X线骨密度仪测定腰椎和股骨颈骨密度 (BMD)。同时检测血清骨钙素 (BGP)、尿Ⅰ型胶原交联N端肽(NTx),以及血清护骨素(OPG)和核因子κB受体活化子配体 (RANKL)。结果　在OPG基因第一外显子中发现一个G1181C的SNP,该SNP的基因型频率分布依次为GG型占 0. 566、GC型 0. 346、CC型0. 088。去除年龄和体重的影响后,CC型的腰椎BMD明显高于GC和GG型 (P<0. 05),多元回归分析提示OPG基因型与绝经后妇女腰椎、股骨颈BMD相关 (P<0. 01)。Logistic回归分析显示OPG基因是绝经后妇女发生骨量减少和骨质疏松的独立危险因子,GG型发生骨量减少和骨质疏松的危险是CC型的 2. 83倍(P<0. 05)。结论　OPG基因的G1181C多态性与绝经后妇女BMD存在一定的关联,CC型对绝经后妇女腰椎BMD具有保护作用。     

绝经后妇女雌激素受体、维生素D受体基因多态性的研究

目的　探讨雌激素受体、维生素D受体基因多态性与绝经后妇女骨密度的关系。方法　选取健康的绝经后妇女共 78例 ,运用双能X线骨吸收法进行骨密度的测量。同时 ,应用分子生物学方法检测其雌激素受体、维生素D受体基因限制性片断长度多态性 (PCR RFLP)。结果　绝经后妇女中 ,雌激素受体基因型仅与腰椎骨密度有显著差异。维生素D受体基因型在股骨颈、大转子部位有差异。PvuⅡ多态性和BsmI多态性共同作用对骨密度影响更大。结论　雌激素受体、维生素D受体基因型分布频率明显不同于西方国家 ,并且与骨密度有一定的关联 ,尤其是基因与基因的共同作用与骨密度的关系更为密切     

北京地区汉族妇女PPARγ基因C161→T多态性与骨密度关系的研究

目的 探讨过氧化物酶体增殖体激动受体γ（PPARγ）基因第6外显子C161→T的单核苷酸多态性（SNP）与青年妇女骨峰值及绝经后低骨量妇女骨密度的关系。方法筛选2004年1月至2005年1月北京安贞医院和北京协和医院收集的219例健康青年妇女和102例绝经后低骨量妇女，用双能X线吸收测定法检测研究对象腰椎和髋部的骨密度，用聚合酶链反应一限制性片段长度多态性（PCR—RFLP）分析法检测研究对象的PPARγ基因第6外显子C161→T的基因型。结果研究人群中PPARγ基因第6外显子C161→T的基因型及基因频率的分布符合Hardy—Weinberg定律；校正年龄、体重、身高和体重指数对骨密度的影响后，219名青年妇女和102名绝经后妇女中PPARγ各基因型组间在L2-4、股骨近端部位的BMD值差异均无统计学意义（P〉0．05）。结论PPARγ基因C161→T的SNP可能不是汉族妇女骨质疏松症遗传影响因素，其基因型的检测可能对筛查汉族妇女骨质疏松症高危人群的意义不大。     

上海地区绝经后妇女Ⅰ型胶原αl基因多态性与骨密度无关

目的 研究上海地区205名绝经后妇女I胶原α1（COLIA1）基因Sp1结合位点的多态性变化与骨密度的关系。方法 用PCR－RFLP法检测COLIA1基因多态性，基因型中的大写与小写字母（S和s）分别表示无和有限制性内切酶位点。以双能X线骨密度仪测定腰椎和股骨颈等处骨密度。结果 所有样本均为SS基因型，没有发现Ss和ss型。结论 COLIA1基因多态性可能有较大的种族差异，与上海地区绝经后妇女的骨密度无关。该基因对骨密度和骨质疏松症的影响尚需在不同人群中进一步研究。     

北京地区汉族妇女PPARγ基因C161→T多态性与骨密度关系的研究

目的探讨过氧化物酶体增殖体激动受体γ(PPARγ)基因第6外显子C161→T的单核苷酸多态性(SNP)与青年妇女骨峰值及绝经后低骨量妇女骨密度的关系。方法筛选2004年1月至2005年1月北京安贞医院和北京协和医院收集的219例健康青年妇女和102例绝经后低骨量妇女,用双能X线吸收测定法检测研究对象腰椎和髋部的骨密度,用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)分析法检测研究对象的PPARγ基因第6外显子C161→T的基因型。结果研究人群中PPARγ基因第6外显子C161→T的基因型及基因频率的分布符合Hardy-Weinberg定律;校正年龄、体重、身高和体重指数对骨密度的影响后,219名青年妇女和102名绝经后妇女中PPARγ各基因型组间在L2-4、股骨近端部位的BMD值差异均无统计学意义(P>0·05)。结论PPARγ基因C161→T的SNP可能不是汉族妇女骨质疏松症遗传影响因素,其基因型的检测可能对筛查汉族妇女骨质疏松症高危人群的意义不大。     

上海地区绝经后妇女Ⅰ型胶原α1基因多态性与骨密度无关

目的研究上海地区205名绝经后妇女Ⅰ型胶原α1(COLIA1)基因Sp1结合位点的多态性变化与骨密度的关系.方法用PCR-RFLP法检测COLIA1基因多态性,基因型中的大写和小写字母(S和s)分别表示无和有限制性内切酶位点.以双能X线骨密度仪测定腰椎和股骨颈等处骨密度.结果所有样本均为SS基因型,没有发现Ss和ss型.结论 COLIA1基因多态性可能有较大的种族差异,与上海地区绝经后妇女的骨密度无关.该基因对骨密度和骨质疏松症的影响尚需在不同人群中进一步研究.     

北京地区汉族妇女瘦素受体基因Gln223Arg多态性和骨密度的关系

目的　探讨瘦素受体基因Gln2 2 3Arg多态性与青年妇女骨峰值和绝经后骨质疏松妇女骨密度的关系。方法　筛选 2 19例健康青年妇女和 10 2例绝经后骨质疏松妇女 ,用双能X线吸收测定法检测研究对象腰椎和髋部的骨密度 ,用PCR 限制性片段长度多态性分析方法检测研究对象的瘦素受体基因Gln2 2 3Arg的基因型。 结果　本研究人群中瘦素受体基因Gln2 2 3Arg基因型及基因频率的分布符合Hardy Weinberg定律 ,提示本研究人群是一个平衡群体。青年妇女组瘦素受体基因Gln2 2 3Arg的GG基因型组腰椎 2～ 4的骨密度高于GA和AA基因型组 [(1.2 13± 0 .12 7) g/cm2 比(1.15 4± 0 .12 4 ) g/cm2 ,P <0 .0 5 ],在股骨颈、Ward三角区、大转子部位各基因型组间骨密度值无统计学差异 ;10 2例绝经后骨质疏松妇女中LEPR基因Gln2 2 3Arg各基因型组间在腰椎 2～ 4、股骨颈、Ward三角区、大转子部位的骨密度值均无统计学差异。偏相关分析进一步表明青年妇女组的瘦素受体基因多态性与腰椎 2～ 4的骨密度相关 (r =- 0 .15 1,P <0 .0 5 )。结论　瘦素受体基因Gln2 2 3Arg的多态性与青年妇女腰椎 2～ 4骨峰值的获得和维持有关 ,可能是骨峰值独立的影响因素 ,等位基因G可能是骨量的保护因子 ,可作为预测汉族妇女骨质疏松发生危险性的遗传     

雌激素受体和骨钙素基因多态性位点联合PXh单倍型对绝经后妇女骨密度的影响

目的 探讨雌激素受体(ER)基因(Xba Ⅰ、Pvu Ⅱ)、骨钙素基因(Hind Ⅲ)多态性位点联合型与绝经后妇女骨密度的相关性.方法 采用双能X线(DXA)骨密度仪检测307例绝经后妇女腰椎和左侧股骨上端骨密度,聚合酶链反应-限制性片段长度多态性(PCR-RFLP)技术检测ER基因Xba Ⅰ、PvuⅡ和Hind Ⅲ多态性.结果 (1)XX型大转子骨密度C(O.600±0.104)g/cm2]低于xx型[(0.653±0.119)g/cm2],P<0.05;Xx型、有X等位基因组的股骨颈[分别为(0.695±0.087)g/cm2和(0.697±0.088)g/cm2]、大转子[(0.592±0.106)g/cm2和(0.594±0.105)g/cm2]、Ward's三角[分别为(0.500±0.115)g/cm2和(0.505±0.123)g/cm2]骨密度低于xx型[分别为(0.737±0.108)g/cm2、(0.653±0.119)g/cm2、(0.554±0.130)g/cm2]、无X等位基因组[分别为(0.737±0.108)g/cm2、(0.653士0.119)g/cm2、(0.554±0.130)g/cm2],均P<0.05.(2)PP型、有P等位基因组Ward's三角骨密度分别低于pp型、无P等位基因组(P<0.05).(3)hh型、有h等位基因组的股骨颈、大转子、Ward's三角骨密度低于HH型,无h等位基因组骨密度低于HH型(均P<0.05).(4)含有PX、PXh单倍型组股骨颈、大转子、Ward's三角骨密度分别低于元PX、无PXh单倍型组(均P<0.05).结论 ER基因Xba Ⅰ、骨钙素基因Hind Ⅲ多态性与绝经后妇女骨密度相关,X、h等位基因对骨密度有不利影响,PXh单倍型可作为福州地区绝经后妇女骨质疏松的遗传标记物.     

年龄、身高、体重、体重指数与武汉地区绝经后骨质疏松症患者骨密度的关系

目的探讨年龄、身高、体重、体重指数等指标对武汉地区绝经后骨质疏松症患者骨密度的影响,为骨质疏松防治提供参考依据。方法用DEXA法测定118例武汉地区绝经后骨质疏松症患者腰椎、股骨颈、大转子、转子内区、髋部总体和Ward's三角的BMD值,同时记录受试者年龄、体重、身高等指标,并计算体重指数。用SPSS12.0统计软件进行年龄、身高、体重、体重指数与各部位骨密度Pearson相关分析,不同年龄组间比较采用t检验。结果年龄与Ward's三角骨密度呈负相关;身高与股骨颈及髋部总体的骨密度呈正相关;体重与股骨颈、转子内区、髋部总体和Ward's三角骨密度呈正相关;体重指数与转子内区骨密度呈正相关。相对高龄组患者较相对低龄组患者股骨颈骨密度差异有统计学意义。结论年龄、身高、体重和体重指数均是影响绝经后骨质疏松症患者BMD的因素;以体重对骨密度的影响最大。保持体重有利于延缓绝经后骨质疏松症的发生。高龄绝经后骨质疏松症患者尤其要防止股骨颈骨折的发生。     

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.     

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.     

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.     

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.