血清胆红素与冠状动脉狭窄程度的关系

目的探讨血清胆红素水平与冠状动脉狭窄程度的关系.方法分析经冠状动脉造影确诊的冠心病患者192例及对照组非冠心病患者158例的血清胆红素水平.结果冠心病组血清胆红素水平明显低于对照组(P<0.01),并且随着病变严重程度的加重,血清胆红素水平逐渐降低(P<0.01).结论血清胆红素水平与冠状动脉狭窄程度呈负相关.     

血清胆红素水平与冠心病发病及冠状动脉病变程度的相关性

目的探讨血清胆红素水平与冠心病(CAD)发病及冠状动脉病变程度的关系。方法收集9 847例行诊断性冠状动脉造影的疑诊CAD患者进行回顾性分析,以冠状动脉造影阳性(主要血管直径狭窄≥50%)作为诊断CAD的标准,将全部患者分为CAD和非CAD两组。冠状动脉造影病变程度采用Gensini积分评价,根据冠状动脉主要血管受累支数分为0支、单支、两支和三支病变组。分析血清胆红素水平与CAD发病及冠状动脉病变程度的关系。结果 9 847例患者中确诊CAD 6 419例(65.2%)。CAD组的总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL)显著低于非CAD组(P<0.001),且TBIL、DBIL、IBIL水平越低,冠状动脉病变越严重。Logistic回归分析证实TBIL、DBIL是CAD的独立保护因素。结论血清胆红素水平降低患者的CAD发病率明显升高;血清胆红素水平越低,冠状动脉病变越严重;TBIL、DBIL是CAD的独立保护因素。     

血清胆红素水平与女性冠心病关系的探讨

目的：探讨血清胆红素水平与女性冠心病的关系。方法：109例女性患者按冠状动脉造影结果分为冠心病组（74例）和非冠心病组（35例）。同时测定血清胆红素及各项生化指标。冠状动脉狭窄程度用冠状动脉狭窄计分表示。结果：女性冠心病组血清总胆红素、直接胆红素和间接胆红素水平均显著低于非冠心病组（P〈0．01）。相关分析显示，女性冠心病组直接胆红素与总胆固醇（TC）和甘油三酯（TG）呈显著负相关（r1=-0．398，r2=-0．405，P均〈0．01）。三种胆红素水平与冠状动脉病变积分均不呈负相关。结论：低血清胆红素水平是冠状动脉粥样硬化的危险因素。     

老年人血清胆红素与冠心病相关分析

目的探讨老年人血清胆红素与冠状动脉病变的关系. 方法对符合条件的经冠脉造影确诊的老年冠心病患者135例,测定血清总胆红素、直接胆红素、血脂水平及冠状动脉狭窄程度进行Gensini评分,并分为4组（A～D）,A组（0分）;B组（1～20分）;C组（21～40分）;D组（＞40分）. 结果冠心病组血清胆红素水平明显低于对照组（P＜0.01）,且随着冠状动脉狭窄程度的加重,血清胆红素水平逐渐下降.相关分析结果显示,血清总胆红素、直接胆红素与血浆总胆固醇、三酰甘油、低密度脂蛋白胆固醇均呈负相关,与高密度脂蛋白胆固醇呈正相关.Logistic回归分析表明血清总胆红素与冠心病呈独立负相关（OR=0.913,P＜0.05）. 结论血清胆红素是冠心病一项独立的危险因素.     

血尿酸及尿微量白蛋白水平与冠心病患者冠状动脉病变的关系探讨

目的探讨冠心病患者血尿酸水平和尿微量白蛋白水平同冠状动脉病变程度及形态之间的关系。方法选取经冠状动脉造影证实的冠心病患者159例,检测血尿酸水平(UA)和晨尿白蛋白/肌酐浓度值(UACR),并结合冠状动脉造影所见的冠状动脉狭窄程度积分和有无复杂狭窄进行分析。结果有复杂狭窄组血UA水平及UACR较无复杂狭窄组者明显增高(P均0.05);多因素逐步回归分析发现冠状动脉病变的严重程度与血清UA和UACR水平之间存在线性关系。结论血尿酸及尿微量白蛋白升高与冠心病患者的冠状动脉病变程度和形态有一定程度的关系。     

血清胆红素及脂蛋白a与冠脉病变关系的研究

目的探讨血清胆红素及脂蛋白a与冠状动脉病变程度的关系。方法将103例患者按冠脉造影结果分为冠心病组和对照组,测定血清胆红素及脂蛋白a浓度。结果冠心病组的胆红素低于对照组,而脂蛋白a高于对照组。冠脉病变范围越大、狭窄越重,总胆红素水平越低,脂蛋白a浓度越高,差异均有统计学意义。结论血清胆红素、脂蛋白a与冠脉病变的严重程度有较强的相关性。     

载脂蛋白A5与冠状动脉病变的关系

目的探讨冠心病患者血清载脂蛋白A5(ApoA5)水平及与冠状动脉病变的关系。方法根据冠状动脉造影结果,将120例受试者分为冠心病组(73例)和对照组(47例),应用酶联免疫吸附测定法检测受试者血清ApoA5水平。比较不同冠状动脉病变数量、狭窄程度和病变分型血清ApoA5水平。结果冠心病患者血清ApoA5水平明显低于对照组(P<0.01);冠心病患者血清ApoA5水平与冠状动脉病变数量、冠状动脉狭窄程度及冠状动脉病变分型有关,多支病变组ApoA5水平明显低于单支病变和双支病变组(P均<0.05);轻、中、重度狭窄组ApoA5水平逐渐降低(P均<0.05);A、B、C型病变组ApoA5水平也逐渐降低(P均<0.05)。结论 ApoA5与冠心病的发生和进展有关,低ApoA5水平可能是冠心病的危险因素。     

血清胆红素与冠心病的关系

目的 :探讨血清胆红素与冠心病的发病关系。方法 :将入选 2 19例患者行冠状动脉造影 ,依据造影结果分为两组 :主要冠状动脉狭窄≥ 5 0 %为冠心病组 ,共 12 6例 ,冠状动脉造影正常者为对照组 ,共 93例 ,两组均采空腹静脉血测定血清总胆红素 ,比较两组间血清总胆红素浓度变化。结果 :冠心病组血清总胆红素水平显著低于对照组 ,且胆红素浓度与冠心病发病呈负相关。结论 :低血清胆红素水平可能是导致冠心病的危险因素之一     

血清总胆红素与冠状动脉狭窄的相关性

目的 :探讨血清总胆红素水平与冠状动脉狭窄程度的关系。方法 :符合条件的冠状动脉造影患者 14 6例 ,根据狭窄程度分成 3组。正常组 :6 0例 ,血管狭窄程度 <10 %。轻度狭窄组 :16例 ,狭窄程度 10 %～ 4 9%。重度狭窄组 :70例 ,至少一支血管狭窄 >5 0 %。采空腹肘静脉血测定血清总胆红素水平并进行比较。结果 :正常组血清总胆红素显著高于轻度狭窄组及重度狭窄组 （P<0 .0 5 ） ,轻度狭窄组与重度狭窄组之间血清总胆红素水平差异无显著性。重度狭窄组中单支病变与两支病变、单支病变与三支病变的总胆红素水平有高度显著差异 （P<0 .0 1）。血清总胆红素水平越低者 ,冠状动脉狭窄程度越重。结论 :血清总胆红素水平与冠状动脉狭窄程度呈负相关。     

低密度脂蛋白胆固醇水平与冠状动脉病变的关系

目的探讨血清低密度脂蛋白胆固醇（low density lipoprotein cholesterol，LDL—C）水平与冠心病患者冠状动脉病变的关系。方法经选择性冠状动脉造影328例，根据冠状动脉造影结果分为冠心病组和对照组；冠心病组根据病变范围分为单支病变、双支病变、多支病变：根据病变狭窄程度分为轻度、中度、重度狭窄组。分别测定其血脂水平。结果冠心病组甘油三酯、LDL-C和总胆固醇水平明显高于对照组。总胆固醇和LDL—C水平与冠状动脉病变呈正相关；双支病变组与三支病变组明显高于对照组及单支病变组（P〈0．01），中度狭窄组和重度狭窄组明显高于对照组及轻度狭窄组（P〈0．01）。结论总胆固醇与LDL-C能够反映冠心病患者冠状动脉的病变情况，其水平随冠状动脉病变范围及病变程度的加重而升高，可作为预测冠状动脉病变的一个因素。     

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.     

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.     

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.     

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.