血管紧张素Ⅱ1型受体和血管紧张素转换酶基因多态性与伊贝沙坦降压疗效的关系

目的探讨与血管紧张素Ⅱ1型受体(AT1R)拮抗剂伊贝沙坦降压疗效相关的基因多态性位点。方法152例轻、中度高血压病患者服用伊贝沙坦治疗8周,观察降压疗效,同时采用聚合酶链反应-限制性片断长度多态性对患者血管紧张素-醛固酮系统基因多态性位点AT1R T573C、血管紧张素转换酶(ACE)I/D基因型进行分析。结果携带AT1R 573T等位基因的患者服用伊贝沙坦后,收缩压及脉压降幅明显大于CC基因型患者;在男性患者,基因型为ACE DD的患者舒张压降幅明显大于II型患者;同时携带AT1R 573T和ACE D等位基因的男性患者降压疗效最佳。结论携带AT1R 573T和ACE D等位基因的高血压病患者对伊贝沙坦的降压反应最佳。     

桂西地区壮族人群肾素—血管紧张素系统基因多态性分析

目的探讨肾素—血管紧张素系统（RAS）中血管紧张素Ⅱ1型受体（AT1R）基因A1166C多态、血管紧张素Ⅰ转化酶（ACE）基因插入/缺失（I/D）多态及血管紧张素原（AGT）基因M235T多态在桂西地区壮族人群中的分布频率,比较其在不同种族间分布的差异。方法采用PCR-RFLP技术和DNA测序法检测150例壮族人AT1R基因A1166C、ACE基因I/D和AGT基因M235T多态性,结合文献进行不同种族间的比较分析。结果桂西地区壮族人群AT1R基因A1166C基因型和等位基因频率与土耳其比较差异有统计学意义;桂西地区壮族人群ACE基因I/D基因型频率与法国人、土耳其人比较差异有统计学意义,基因型和等位基因频率与黎巴嫩人、巴林人比较差异有统计学意义;桂西地区壮族人群AGT基因M235T基因型和等位基因频率与法国人、蒙古族人、土耳其人、波兰人比较有统计学差异（P均〈0.01）。结论 RAS基因多态性在不同种族间分布频率存在差异,这种差异势必会影响RAS基因在一些疾病特别是地方高发性疾病发生、发展中的作用。     

云南彝族女性AGT M235T、AT1R A1166C多态性与原发性高血压的相关性研究

目的:研究血管紧张素原(AGT)M235T、血管紧张素Ⅱ1型受体(AT1R)A1166C多态性与云南彝族女性原发性高血压(EH)的相关性。方法:通过现场问卷调查和体格检查获取云南省晋宁县147例彝族女性EH患者和111例彝族女性健康个体的基本资料,采用PCR-RFLP技术检测AGT M235T、AT1R A1166C多态性,并对结果进行相关性分析。结果:①EH患者AGT 235T等位基因频率(78.6%),AT1RAC/CC基因型频率(8.2%)和1166C等位基因频率(4.4%)均高于对照(P0.05)。②单因素分析显示,同时携带235T和1166C的个体患EH风险显著增高(OR=8.250,P0.05)。结论:AT1RA1166C多态性是云南彝族女性EH的遗传易感因素,与AGT 235T等位基因间有协同致EH作用。     

不同性别高血压病患者肾素-血管紧张素系统多基因多态性关联研究

目的探讨不同性别高血压病患者与肾素-血管紧张素系统,包括血管紧张素Ⅱ-1型受体(AT1R)基因、血管紧张素转化酶(ACE)和血管紧张素原(AGT)多基因多态性的相关性。方法应用多聚酶链式反应-限制性酶切法(PCR-RFLP)检测95例高血压病患者和98例健康对照者的AT1R基因1166位点、ACE基因I/D以及AGT基因M235T基因型,比较不同性别两组间基因型和等位基因型的分布频率。结果男性高血压组AT1R基因、AC/CC基因型和ACE基因DD基因型频率高于对照组,1166C和D等位基因频率明显高于对照组;AGT基因TT基因型及T等位基因频率较对照组为高,但差异无统计学意义;在女性,ACE基因D等位基因频率较其对照组为高(P0.05),余各基因型和等位基因频率在病例组与对照组之间均未见差异。结论肾素-血管紧张素系统多个基因位点变异与男性高血压病发病有关,只有较少基因位点多态性参与女性发病。     

血管紧张素Ⅱ 1型受体基因573T〉C和1166A〉C多态性与新疆哈萨克族高血压的关系

目的:研究血管紧张素Ⅱ 1型受体(AT1R)基因573T>C和1166A>C多态性与新疆哈萨克族原发性高血压(EH)的关系.方法:采用病例-对照研究随机选取新疆哈萨克族牧民EH患者(EH组)194例,正常血压者(对照组)115例,采用聚合酶链反应和限制性片段长度多态性技术检测AT1R基因573T>C和1166A>C多态性,用最大似然法估计两位点单体型频率.结果:AT1R基因573T>C多态性在EH组中T、C等位基因频率分别为0.799,0.201,对照组中T、C等位基因频率分别为0.713和0.287,EH组T等位基因频率高于对照组(P<0.05).1166A>C位点仅在EH组检测到1例CC基因型,A、C 2种等位基因和基因型频率在2组间分布差异无统计学意义(均P>0.05).573T>C和1166A>C间未检测到连锁不平衡.T573-A1166组成的单体型频率最高,占70.4%,其次是C573-A1166,为17.1%.2组间单体型分布差异无统计学意义(P>0.05).不同单体型对EH的影响差异无统计学意义(均P>0.05).结论:AT1R基因573T>C的T等位基因和TT及TC基因型是新疆哈萨克族EH可能的易感因素,而573T>C和1166A>C组成的单体型可能与新疆哈萨克族EH无关.     

RAS三种不同基因多态性与原发性高血压的相关性

目的 探讨肾素—血管紧张素系统(RAS) 血管紧张素原(AGT)基因T704C多态性、血管紧张素转换酶(ACE)基因I/D多态性及血管紧张素Ⅱ的1型受体(AT1R)基因A1166-C多态性与原发性高血压（EH）的关系.方法 采用PCR及PCR-限制性片段长度多态性(PCR-RFLP)方法,对220例EH患者（EH组）和1 004例非原发性高血压患者（NEH组）ACE基因Alu I/D多态性、AGT基因T704C多态性、AT1R基因A1166-C多态性进行基因型检测,计算等位基因频率.结果 两组AGT基因型及ACE基因型、等位基因频率均有显著差异（P分别 ＜0.01、0.05、0.05）;EH组TC-II、TC-AA、II-AA联合基因型频率显著低于NEH组（P均＜0.05）,CC-ID、CC-DD 、CC-AA、CC-AC+CC联合基因型频率显著高于NEH组(P均 ＜0.01).结论 携带AGT 基因CC基因型、ACE基因D等位基因者可能为发生EH易感人群;TC-II、TC-AA、II-AA联合基因型对EH的发生可能起负协同作用,而CC-ID、CC-DD、CC-AA、CC-AC+CC联合基因型可能起正协同作用.     

ACE基因I／D、AT1R基因A1166C多态性与奥美沙坦酯降压作用的关系

目的探讨血管紧张素转换酶（ACE）基因I／D、血管紧张素Ⅱ-1型受体（ATlR）基因A1166C多态性与奥美沙坦酯降压作用的关系。方法76例轻、中度高血压（EH）患者服用奥美沙坦酯治疗8周;用聚合酶链式反应一限制性片段长度多态性对其血白细胞基因组DNA肾索-血管紧张素-醛固酮系统基因多态性位点ACEI／D、ATlRA1166C基因型进行检测。结果ACE基因含D等位基因患者的SBP、DBP、脉压降幅及降压总有效率均高于含I等位基因者,DD＋AA基因型患者的SBP降幅高于DD＋AC基因型者（P均〈0．05）。结论ACE基因含D等位基因EH患者对奥美沙坦酯降压治疗敏感;ACE、AT1R基因联合作用可能影响奥美沙坦酯的降压疗效。     

AT1R 1166A／C和CYP11B2-344C／T基因多态性与2型糖尿病肾病的关系

目的研究2型糖尿病患者AT1受体基因1166A／C（ATIR1166A／C）与醛固酮合酶（CYP11B2）基因-344C／T（CYP11B2—344C／T）多态性与糖尿病肾病（DN）的相关性。方法研究对象分为DN组73例,糖尿病非肾病（non-DN）组72例及正常对照（NC）组52名。应用聚合酶链反应-限制性内切酶片断长度多态性（PCR—RFLP）方法检测各组基因多态性。结果DN组AT1R 1166A／CAC基因型和C等位基因频率高于Non-DN组（P均〈0．05）。DN组ATlR1166A／C各基因型临床指标比较,AC基因型患者的BUN、Cr、UA、UAER、SBP和DBP均明显高于AA基因型患者。2型糖尿病患者AT1R 1166A／C多态性与DN相关（P〈0．05）,但CYP 11B2—344C／T多态性并未发现与DN相关。结论蚌埠地区汉族人群存在AT1R 1166A／C多态性,其AC基因型与糖尿病肾病有显著相关性。     

血管紧张素Ⅱ的Ⅰ型受体基因中A1166C多态性位点与急性心肌梗塞相关性研究

目的 研究血管紧张素ⅡR的Ⅰ型受体基因（angiotensin ⅡR type 1 receptor，AT1R）的多态性位点A1166C与急性心肌梗塞发生风险的关系。方法 采用聚合酶链式反应．限制酶片段长度多态性（PCR—RFLP）技术，对96例急性心肌梗塞患者和96例正常对照个体进行分型。结果 在病例组与对照组间A1166C位点的基因型和等位型频率均无显著差异（P〉0．05）。结论 AT1R基因的A1166C多态性位点对急性心肌梗塞的发生风险不产生影响。     

血管紧张素ⅡⅠ型受体基因A1166C位点基因多态性与肝硬化的关系

目的:建立多聚酶链式反应．限制性片段长度多态分析(PCR-RFLP)法检测血管紧张素ⅡⅠ型受体基因(ATIR)A1166C位点的多态性．方法:对50例血清抗HBs阳性的健康对照者及46例HBV感染后肝硬化患者的血管紧张素ⅡⅠ型受体基因A1166C位点基因多态性的多态性进行分析．根据血管紧张素ⅡⅠ型受体基因设计引物,在A1166C位设计DdeⅠ酶切位点,根据PCR产物酶切结果判断该位点为A或C．结果:两株纯合子与AT1R序列同源性在99%以上,并在A1166C位点出现预期变异;肝炎和肝硬化两组间A1166C位点无论是基因型还是等位基因均无显著性差异(P>0．05)．结论:PCR-RFLP的方法可用于AT1R基因A1166C位点基因多态性的检测,该位点的变异尚未显示其与肝纤维化有关．     

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.