老年期痴呆患者血清Tau蛋白免疫印迹分析

目的 探讨血清Tau蛋白水平对老年期痴呆患临床诊断的意义。方法 应用单克隆抗Tau蛋白抗体(Anti—Tau 1)和免疫狭缝印迹(ISB)技术对112例老年期痴呆患[Alzheimer病(AD)75例、多发性梗塞性痴呆(MID)37例]和24名年龄配对的老年健康人的血清测定Tau蛋白水平,用分子分析仪并联计算机(IBM)扫描进行分析,血清Tau蛋白的相对浓度以校准强度(CI)表示。结果 研究显示老年期痴呆患组的血清Tau蛋白含量(CI值：总计=0.114±0．03．AD=0．110±0．03,MID=0．123±0．04)与对照组(CI值为0．116±0．04)的差异无显性(P值均>0．05),也不受有或无apo E4等位基因(ε4)的影响。结论 在临床上诊断老年期痴呆时,有必要采用相同技术对脑脊液(CSF)中的和血清中的Tau蛋白进行同步分析比较。     

脑梗死患者血清抗β2-糖蛋白1抗体水平变化与颈动脉粥样硬化的相关性

目的　探讨脑梗死患者血清抗β2-糖蛋白1（β2-GP1）抗体水平与颈动脉粥样硬化（CAS）斑块及其危险因素的相关性。方法　选取303例前循环脑梗死患者,应用血管多普勒超声仪进行颈部血管超声检测,根据有无CAS斑块及狭窄程度将患者分为三组,其中无斑块无狭窄组79例,有斑块无狭窄组98例,有斑块有狭窄组126例,有斑块有狭窄组中1级狭窄41例,2级狭窄34例,3级狭窄30例,4级狭窄21例。采用ELISA检测患者血清抗β2-GP1抗体水平,用酶法测量血糖、甘油三酯及总胆固醇水平,用直接法测量血清低密度脂蛋白胆固醇（LDLC）及高密度脂蛋白胆固醇（HDLC）水平。结果　无斑块无狭窄组、有斑块无狭窄组、有斑块有狭窄组患者血清抗β2-GP1抗体水平分别为16.02±16.23　kRU/L、21.43±16.15　kRU/L、34.89±19.15　kRU/L;有斑块无狭窄组、有斑块有狭窄组患者血清抗β2-GP1抗体水平明显高于无斑块无狭窄组（P＜0.05或P＜0.01）,有斑块有狭窄组患者血清抗β2-GP1抗体水平明显高于有斑块无狭窄组（P＜0.01）;血清抗β2-GP1抗体水平随CAS狭窄程度的增加而增高。Logistic回归分析显示,抗β2-GP1抗体水平与LDLC水平密切相关。结论　血清抗β2-GP1抗体参与动脉粥样硬化的形成、发展,LDLC是血清抗β2-GP1抗体增高的独立危险因素,血清抗β2-GP1抗体可作为CAS的血清生化指标之一。     

sFas与sFasL在自身免疫疾病中的意义

目的　研究sFas与sFasL在系统性红斑狼疮 (SLE)等自身免疫疾病中的意义及抗单链DNA(ssDNA)抗体与sFas和sFasL介导凋亡的相关性。方法　采用夹心ELISA方法检测 31例SLE病人 ,32例类风湿关节炎 (RA)病人 ,2 0例 1型糖尿病 (IDDM )病人及 5例多发性硬化病 (MS)病人血清中sFas与sFasL含量及抗ssDNA抗体水平。结果　在SLE、RA、IDDM及MS患者血清中的sFas含量 (pg/ml)分别为 2 881± 16 5 3 ,988± 6 96 ,135 2± 413 ,15 40± 5 6 6 ,明显高于正常对照 (P <0 0 0 2 ) ,SLE病人sFas含量高于RA ,MS ,IDDM病人。SLE、RA患者血清sFasL含量 (pg/ml)分别为5 35± 431、12 38± 1184,明显高于正常对照 (P <0 0 2 ) ,MS、IDDM患者血清sFasL含量 (pg/ml)分别为 2 5 1± 140 ,2 11± 73 ,低于正常对照 (P >0 0 5 )。在SLE、RA病人中 ,高浓度sFasL者伴有高浓度sFas。在SLE病人中 ,所有抗ssDNA抗体阳性者均伴有高浓度sFas,所有抗sFas阴性者 ,ssDNA抗体也为阴性。结论　在SLE等疾病中sFas水平明显高于正常人 ,可作为疾病进展与治疗效果的判断指标。抗ssDNA抗体与sFas具有关联性。sFas与sFasL在疾病中的相互作用及动态变化有待进一步研究     

老年期痴呆患者血浆同型半胱氨酸的临床观察

目的　了解老年期痴呆患者同型半胱氨酸 (Homocysteine,HCY)水平并探讨二者之间的关系。方法　老年性痴呆 (AD) 33例 ,血管性痴呆 (VD) 4 3例 ,健康老年人 2 8例 (对照组 )。对所有研究对象 ,空腹取血检测血浆 HCY,同时检测血叶酸和维生素 B1 2 。结果　老年期痴呆患者的HCY平均水平为 1 3.1 2± 4.64μmol/ L (AD)和 1 5.33± 5.0 6μmol/ L(VD) ,对照组 (1 2 .45± 3.0 5μmol/ L ) ,F值分别为 3.972 ,1 0 .82 1和 6.62 5(P<0 .0 5)。血清 HCY与叶酸及维生素 B1 2 水平呈负相关 ,相关系数分别为 0 .2 92和 0 .2 7(P<0 .0 5)。结论　老年期痴呆者有高水平的血清 HCY和低水平的血叶酸。     

多梗死性痴呆患者血浆、脑脊液胰岛素含量与智能水平的关系

采用放射免疫法(RIAs)检测多梗死性痴呆(MID)患者55例,脑梗死(CI)72例,正常对照组32例。结果:MID急性发作组(8.92±1.69)mIU/L和稳定期组(8.14±2.01)mIU/L患者血浆胰岛素水平高于对照组(6.59±1.46)mIU/L(P均<0.01),而脑脊液(CSF)胰岛素含量、CSF/血浆胰岛素比值显著低     

多梗死性痴呆患者血浆、脑脊液胰岛素含量与智能水平的关系

目的研究多梗死性痴呆(MID)患者血浆、脑脊液(CSF)胰岛素水平的变化及其与智能水平的关系. 方法采用放射免疫测定法(RIAs)对55例MID患者血浆、CSF胰岛素含量进行测定,并与72例脑梗死(CI)患者及32例健康对照进行比较.患者智能水平测定采用简易智能量表(MMSE),并参考DSM-Ⅳ诊断标准及Hachinski缺血评分. 结果 MID急性发作组[(8.92±1.69) mIU/L]和稳定期组[(8.14±2.01) mIU/L]患者血浆胰岛素水平高于对照组[(6.59±1.46) mIU/L](P均< 0.01),而CSF胰岛素含量、CSF/血浆胰岛素比值显著低于对照组(P< 0.01 ),且CSF/血浆胰岛素比值与患者MMSE评分呈正性相关关系( r= 0.7542,P<0.01).CI急性期组血浆胰岛素水平显著高于对照组 ( P < 0.05 ), 但CSF/血浆胰岛素比值与MID急性期组和MID稳定期组比较均有显著性差异( P < 0.01 ). 结论 MID患者异常的血浆、CSF胰岛素水平可能是参与其智能损害的多种病理生理机制之一.     

抗氧化低密度脂蛋白抗体的检测及临床意义

目的探讨血清抗氧化低密度脂蛋白(ox-LDL)抗体的检测方法,并观察分析血清抗ox-LDL抗体水平对冠状动脉粥样硬化斑块稳定性的评估价值.方法用酶联免疫吸附法(ELISA法)检测100例冠心病患者[17例急性心肌梗死(AMI),41例不稳定型心绞痛(UAP),42例稳定型心绞痛(SAP)]及31例正常健康对照者(对照组)血清抗ox-LDL抗体水平;并对100例患者进行了1年随访.结果血清抗ox-LDL抗体水平在AMI组(1.39±0.68)和UAP组(1.35±0.62)明显高于对照组(0.81±0.31,P<0.01)和SAP组(0.94±0.36,P<0.01);随访1年后,有22例患者发生心脏事件.血清抗ox-LDL抗体水平在发病组(1.67±0.69)明显高于病变稳定组(1.03±0.44,P<0.01).Logistic回归分析结果血清抗ox-LDL抗体水平与患者预后关系密切(P<0.01).结论血清抗ox-LDL抗体水平与冠心病患者预后密切相关,可以作为冠状动脉粥样硬化斑块易损性的评估指标.     

Ⅰ型糖尿病儿童的抗胰岛素抗体

作者最近检查124名病史在半年以上的Ⅰ型青年糖尿病人,以Goldman方法测定了血清中抗胰岛素结合量,发现病人体内存在抗胰岛素抗体。为了比较,按HLA DR型的抗原型别将病人分为6组:3/3,3/一,4/4,4/一,3/4和一/一(一为非OR_3或OR_4)。病人平均年龄14.7±0.5岁,病程5.8±0.4年,病情控制以HbA1c均值在7.6±0.2％为标准.结果显示HLA DR型各组的年龄、病程、HbA1c水平,胰岛素的型号等无差异,显示DR 3/3组病人的抗胰岛素结合水平显著低于其他组(2.5±0.4vS,13.6±1.4μS/ml,(P<0.0001),DR 3/一组病人与其他组病人相比较,其抗胰岛素结合量无区别。     

抗氧化低密度脂蛋白抗体的检测桨临床意义

目的 :探讨血清抗氧化低密度脂蛋白 (ox LDL)抗体的检测方法 ,并观察分析血清抗ox LDL抗体水平对冠状动脉粥样硬化斑块稳定性的评估价值。方法 :用酶联免疫吸附法 (ELISA法 )检测 10 0例冠心病患者 [17例急性心肌梗死 (AMI) ,41例不稳定型心绞痛 (UAP) ,42例稳定型心绞痛 (SAP) ]及 31例正常健康对照者 (对照组 )血清抗ox LDL抗体水平 ;并对 10 0例患者进行了 1年随访。结果 :血清抗ox LDL抗体水平在AMI组 (1.39± 0 .6 8)和UAP组 (1.35± 0 .6 2 )明显高于对照组 (0 .81± 0 .31,P <0 .0 1)和SAP组 (0 .94± 0 .36 ,P <0 .0 1) ;随访 1年后 ,有 2 2例患者发生心脏事件。血清抗ox LDL抗体水平在发病组 (1.6 7± 0 .6 9)明显高于病变稳定组(1.0 3± 0 .44 ,P <0 .0 1)。Logistic回归分析结果 :血清抗ox LDL抗体水平与患者预后关系密切 (P <0 .0 1)。结论 :血清抗ox LDL抗体水平与冠心病患者预后密切相关 ,可以作为冠状动脉粥样硬化斑块易损性的评估指标     

不孕妇女抗弓形虫抗体抗精子抗体及IFN-γ的检测与分析

目的 了解不孕妇女血清抗弓形虫IgG抗体(ATAb)、抗精子抗体(AsAb)及其外周血细胞培养上清中γ-干扰素(IFN-γ)的水平,探讨ATAb、AsAb与不孕的关系以及与IFN-γ的相关性. 方法 应用酶联免疫吸附试验分别检测并比较182例不孕妇女及94例正常生育妇女血清ATAb、AsAb,同时测定并比较其外周血细胞培养上清中IFN-γ水平. 结果 182例不孕妇女血清ATAb、AsAb阳性率分别为15.38%(28/182)、18.13%(33/182),与正常生育组妇女血清ATAb、AsAb阳性率6.38%(6/94)、5.32%(5/94)比较,差异均有显著性 (χ2 ATAb=4.65,P＜0.05;χ2 AsAb=8.57,P＜0.01);不孕妇女外周血细胞培养上清中IFN-γ水平为(0.970±0.493) μg/L,显著高于正常生育妇女组(0.531±0.274) μg/L (P＜0.01). 结论 弓形虫感染与不孕有一定关系,AsAb是与不孕有密切联系的重要免疫因素.不孕症患者体内IFN-γ水平异常增高,可能通过影响机体生殖免疫功能而导致不孕.     

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.     

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.     

N-acetyl-L-cysteine combined with mesalamine in the treatment of ulcerative colitis： Randomized,placebo-controlled pilot study

AIM： To evaluate the effectiveness and safety of oral N-acetyl-L-cysteine （NAC） co-administration with mesalamine in ulcerative colitis （UC） patients.
METHODS： Thirty seven patients with mild to moderate UC were randomized to receive a four-wk course of oral mesalamine （2.4 g/d） plus N-acetyl-L-cysteine （0.8 g/d） （group A） or mesalamine plus placebo （group B）. Patients were monitored using the Modified Truelove-Witts Severity Index （MTWSI）. The primary endpoint was clinical remission （MTWSI ≤ 2） at 4 wk. Secondary endpoints were clinical response （defined as a reduction from baseline in the MTWSI of ≥ 2 points） and drug safety. The serum TNF-α, interleukin-6, interleukin-8 and MCP-1 were evaluated at baseline and at 4 wk of treatment. RESULTS： Analysis per-protocol criteria showed clinical remission rates of 63% and 50% after 4 wk treatment with mesalamine plus N-acetyl-L-cysteine （group A） and mesalamine plus placebo （group B） respectively （OR = 1.71; 95% CI： 0.46 to 6.36; P = 0.19; NNT = 7.7）. Analysis of variance （ANOVA） of data indicated a significant reduction of MTWSI in group A （P = 0.046） with respect to basal condition without significant changes in the group B （P = 0.735） during treatment. Clinical responses were 66% （group A） vs 44% （group B） after 4 wk of treatment （OR = 2.5; 95% CI： 0.64 to 9.65; P = 0.11; NNT = 4.5）. Clinical improvement in group A correlated with a decrease of IL-8 and MCP-1. Rates of adverse events did not differ significantly between both groups.
CONCLUSION： In group A （oral NAC combined with mesalamine） contrarily to group B （mesalamine alone）, the clinical improvement correlates with a decrease of chemokines such as MCP-1 and IL-8. NAC addition not produced any side effects.     

Delorme's transrectal excision for internal rectal prolapse

Surgical therapy of functional outlet obstruction in patients with internal rectal intussusception may include abdominal, perineal, or transrectal procedures. Because abdominal procedures often result in significant physiologic impact but unrelieved constipation, the authors have elected Delorme's transrectal excision for management of these patients. Since a short-term placebo effect attends many therapies, this report describes results of transrectal excision only after a threeyear postoperative period. Delorme's transrectal excision of internal intussusception accomplished sustained symptomatic relief in over 70 percent of otherwise refractory constipated patients. The association of internal intussusception with other abnormalities underscores the importance of defining both anatomic and functional components when selecting patients whose constipation may require surgical therapy. Critical technical elements, surgical pitfalls, and potential complications of the procedure are discussed.Poster presentation at the meeting of The American Society of Colon and Rectal Surgeons, Toronto, Canada, June 11 to 16, 1989.     

The oral glucose tolerance test: A comparison of the time points on the basis of limit values,normal dispersion,and reproducibility

Summary Time points in the glucose tolerance test (GTT) are compared on the basis of limit values, dispersion within a reference population, and reproducibility. We suggest using the distance between a limit value and the median reference value as a measure of the magnitude of abnormality. The distance between 140 mg/100 ml and the median fasting plasma glucose value is chosen as a standard distance and limits for other points in the GTT are calculated to equal this standard distance of abnormality. We suggest that the probability of correctly interpreting an inividual result is directly related to the reproducibility of the test and inversely related to the percentage of the total range of values which is dispersed among the normal population. The ratio of reproducibility to percentage normal dispersion is proposed as an index of the probability of correctly interpreting an individual result. According to this index, the probability of correct interpretation varies in order: fasting plasma glucose concentration>3-h>2-h>0.5-h>1-h plasma glucose concentration.