老年冠心病患者载脂蛋白E基因多态性检测的临床意义

目的：探讨载脂蛋白E(apoE)基因多态性与老年冠心病的关系及其对血脂、脂蛋白水平的影响。方法：应用聚合酶链反应—限制性片段长度多态性法(PCR—RFLP)检测l25例老年冠心病患者和ll6例健康老年人(对照组)的apoE基因型；按常规方法测定血浆脂质、脂蛋白水平。结果：冠心病组及对照组共检出6种基因型，分别为：E2／2、E2／3、E3／3、E3／4、E4／4、E2／4；冠心病组E3／3基因型频率(51．2％)和ε3等位基因频率(73．2％)明显低于对照组(69．8％和84．0％，P＜o．05)；E3／4基因型频率(30．4％)和ε4等位基因频率(17．6％)明显高于对照组(11．2％和6．9％，P＜0.05)；冠心病组总胆固醇(TC)、低密度脂蛋白—胆固醇(LDL—C)水平明显高于对照组(P＜0.05)；冠心病患者中E2／3、E3／3、E3／4基因型之间TC、LDL—C水平差异有显著性(P＜0.05)。结论:ε4等位基因是冠心病重要的遗传标记；apoE基因多态性可能通过影响血脂水平而影响冠心病的发生。     

有冠心病家族史儿童载脂蛋白E基因多态性的研究

目的：探讨有冠心病（CHD）家族史儿童载脂蛋白（apo)E基因多态性的分布及其对血脂、脂蛋白、apo的影响。方法：采用改良的聚合酶链式反应－限制性片段长度多态性方法,分析83例有CHD家族史的儿童和282例无CHD家族史的儿童apoE基因型。结果：与无CHD家族史的儿童比较,有CHD家族史儿童apoε4等位基因频率较高（分别为6．0％、15．7％,P＜0．01）。早发CHD家族史的儿童ε4等位基因频率较非早发及无CHD家族史儿童为高,三组之间的ε4等位基因频率差异有性（分别为18．3％、14．8％、6．0％,P＜0．05。apoE基因多态性对有CHD家族史儿童的血脂水平有影响,ε2、ε3、ε4等位基因携带有的血总胆固醇（TC）、低密度脂蛋白－胆固醇（LDL－C）、脂蛋白（a)、apoB100、apoE浓度有差异（P＜0．05）;与ε3等位基因携带比较,ε4具有较高的血TC、LDL－C、apoB100水平和较低的apoAⅠ、apoE水平;ε2等位基因携带的血TC、LDL－C和脂蛋白（a)水平较低（P＜0．05）。结论有CHD家族史儿童apoE基因多态性其他儿童不同,并对血浆脂蛋白代谢产生明显影响。     

载脂蛋白E基因多态性与脑梗死的关系

目的探讨载脂蛋白E（apoE）基因多态性与脑梗死的关系。方法应用聚合酶链式反应-限制性片断长度多态性（PCR—RFLP）技术检测78例脑梗死患者和90名健康对照者apoE基因多态性分布特征。结果发现5种apoE基因型，脑梗死组E3／4基因型频率（23．1％）及ε4频率（14.7%）显著高于对照组（7．8％，5．0％），P〈0．05。而E3／3基因型频率（56．4％）及ε3频率（75.6%）显著低于对照组（78．9％，88．3％），P〈0．05。不同apoE基因型间胆固醇和低密度脂蛋白胆固醇水平差异有统计学意义（P〈0．05）。结论apoE基因多态性与脑梗死有关，并影响血脂水平。     

广东粤北地区瑶族载脂蛋白E基因多态性与原发性高血压的关系

目的探讨广东粤北地区瑶族人群载脂蛋白E（apolipoprote E,apoE）基因多态性与原发性高血压的关系、方法采刚聚合酶链反应-限制性片段长度多态性方法（PCR-RFLP）对200名60岁～80岁广东粤北地区瑶族人群进行apoE基因多态性检测,分析瑶族人群apoE基因频率分布特点,并比较分析不同apoE基凶型与原发性高血压的关系。结果共检测瑶族人群6种apoE基因型,以E3／3型最常见,占64．0％．其次为E3／4型．占17．0%,E2／3、E2／4、E4／4、E2／2基因型分别占15．5％、1．5％、1．0％、1．0％.apoE有3种等位基因：以ε3频率分布最高．为80．3％,其次是ε4,分布的频率为10.3％。ε2频率分布最低,为9．5%。男性和女性apoE基因型分布差异无统计学意义（P〉0．05）。ε4基凶携带者在原发性高血压患者中的分布高于对照组（P〈0．05）。结论广东粤北地区瑶族人群的血压水平受apoE基因多态性的影响,ε4等位基因可能是瑶族人群患原发性高血压的危险因素之一。     

载脂蛋白E基因多态性与轻度认知障碍的关系

目的探讨载脂蛋白E（apoE）基因多态性与轻度认知障碍（MCI）的关系。方法应用限制性片段长度多态分析-聚合酶链反应（RFLP-PCR）方法，测定56例MCI患者和89例同龄对照组apoE基因型和等位基因频率。结果MCI组ε2、ε3、ε4等位基因频率分别为7．14％、71.38％和21．48％，而同龄对照组分别为7．30％、84.83％和7.87％。apoEε4等位基因在MCI患者中出现的频率明显高于对照组，统汁学分析说明差异具有非常显著性（P〈0．01）。结论apoEε4等位基因是MCI的危险因素。     

载脂蛋白E基因多态性与散发性阿尔茨海默病的关系

目的：探讨载脂蛋白E（apoE)基因多态性与散发性阿尔茨海默病（SAD）遗传易感性的关系。方法：应用限制性片段长度多态分析－聚合酶链反应（RFLP－PCR）方法，测定58例SAD和60例同龄对照者apoE基因型和等位基因，并与59例血管性痴呆（VD）患者进行对比研究。结果：SAD组ε4等位基因频率（19．82％）和3／4型频率（25．86％）均明显高于对照组（5．00％和6．67％；χ2＝13．87，P＜0．01）和VD组（6．70％和10．17％，χ2＝11．5，P＜0．05），VD组ε4频率（6．70％）与对照组比较，差异无显著性（χ2＝11．61，P＞0．05），结论：apoEe4等位基因是SAD的遗传易感基因。     

冠心病患者载脂蛋白E基因型与血脂、脂蛋白水平的相关性

目的 :探讨冠心病 (CHD)患者载脂蛋白E(apoE)基因型与血脂、脂蛋白水平的相关性。 方法 :应用聚合酶链反应 限制性片段长度多态性法 (PCR RFLP) ,检测 119例CHD患者和 112例正常人 (对照组 )的apoE基因型 ;按常规方法测定血脂及脂蛋白水平。结果 :CHD组及对照组共检出 6种基因型 ,分别为 :ε2 /2、ε2 /3、ε3/3、ε3/4、ε4/4、ε2 /4 ;CHD组ε3/4基因型及ε4等位基因频率均显著高于对照组 (分别为P <0 .0 5 ,P <0 .0 1) ;CHD组ε2 /3、ε3/3、ε3/4基因型之间胆固醇 (TC)、低密度脂蛋白胆固醇 (LDL C)水平差异有显著性意义 (P <0 .0 5 )。结论 :apoE3/4基因型明显升高CHD患者TC、LDL C水平 ;apoE基因多态性可能通过影响血脂水平而影响CHD的发生     

新疆维族apoE基因多态性与寿命和血脂关系的分析

目的：探讨载脂蛋白E（apoE)基因多态性与人类寿命的关系,方法：采用PCR－RFLP技术检测了160名维族apoE基因型,其中长寿老人35名,男性心肌梗死病人54名,青年男性71名,就apoE基因频率分布及血脂的关系进行了比较分析,结果;维族长寿老人ε4等位基因的频率率最低（0．057）,普通青年男性居中（0．127）,心肌梗死病人最高（0．213）（P＜0．01）,冠心病病人中ε4携带者心肌梗死首次发病年龄平均为51．3岁,而非携带者为58．3岁,两组比较P＜0．05,apoE基因与血脂的关系在长寿老人和青年对照表现为ε4等位基因携带者血清总胆固醇和低密度脂蛋而非携带者为58．3岁,两线比较P＜0．05,apoE基因与血脂的关系在长寿老人和青年对照组表明为ε4等位基因携带者血清总胆固醇和低密度的脂蛋白胆固醇最高（P＜0．05）,但冠心病病人中无此差异。结论：ε4等位基因携带者的平均寿命低于其他等位基因携带者,其机制还有待于从不同方面进一步研究。     

载脂蛋白E多态性与冠心病患者脂代谢的临床研究

目的研究载脂蛋白E(apoE)多态性与冠心病(CHD)及其脂代谢之间的关系。方法采用等电点聚焦电泳免疫印迹技术测定91例CHD及105例正常对照者的apoE表型,并用酶法测定他们的脂质水平。结果CHD组和对照组apoE表型分布及等位基因频率无显著性差异(P＞0．05)。CHD组不同apoE表型之间血脂水平比较发现,apoE基因多态性与胆固醇(TC)(P＜0．01)、低密度脂蛋白胆固醇(LDL-C)(P＜0．01)、甘油三酯(TG)(P＜0．05)有关,即E4等位基因携带者具有较高的TC和LDL-C水平,而E2等位基因携带者具有较低的TC和LDL-C水平。E2和E4等位基因携带者TG水平均升高。结论apoE基因多态性影响CHD患者的脂代谢,并通过影响脂代谢在CHD中起重要作用,但不是CHD的一个独立危险因素。     

血管紧张素转换酶和血管紧张素原基因多态性与冠心病的关系

目的探讨血管紧张素转换酶（ACE）插入／缺失（I／D）多态性和血管紧张素原（AGT）M235T基因多态性与冠心病（CHD）的关系。方法应用多聚酶链反应结合限制性内切酶法（PCR—RFLP）对110例冠心病患者、62例冠状动脉造影正常者以及18名门诊常规体检无冠心病史者基因多态性进行分析。结果①CHD组ACE基因DD基因型及D等位基因频率明显高于健康对照组（分别为43．6％、60．5％比26．3％、44．4％）,差异有统计学意义‘P〈0．05）。CHD组AGT基因TT基因型及T等位基因频率明显高于对照组（分别为66．4％、78．6％比42．5％、60．6％）,差异有统计学意义（尸〈0．05）。②男性CHD组ACE基因DD基因型和D等位基因频率以及AGT基因TT基因型和T等位基因频率均显著高于对照组（均P〈O．05）。女性CHD组ACE基因DD基因型和D等位基因频率以及AGT基因‘rr基因型和T等位基因频率与对照组比较差异无统计学意义（P〉0．05）。③联合分析ACEDD型及AGTTr型罹患冠心病的相对风险,其比数~L（OR）为4．904,高于单基因ACEDD型（2．175）及AGTTT型（2．669）。结论ACE基因I／D多态性及AGT基因M235T多态性与CHD有显著相关性,同时具有ACEDD型及AGT TT型发生冠心病的相对风险显著高于单基因ACEDD型及单基因AGT‘丌型。性别也可作为冠心病的危险因素。     

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.