老年人脂肪肝与肥胖、血脂、血糖和血压关系的研究

目的探讨老年人脂肪肝与肥胖、高脂血症、糖尿病和高血压的关系。方法调查887例老年人,分析脂肪肝与年龄、体质指数(BMI,kg/m2)、谷丙转氨酶、总胆固醇、甘油三酯、空腹血糖、平均血压、吸烟和饮酒之间的关系,并对脂肪肝、肥胖分别与高血压、高胆固醇血症、高甘油三酯血症、糖尿病之间的关系进行多元回归分析。结果非肥胖(体质指数,BMI<28kg/m2)老年人群脂肪肝的发病率男性为11.3%,女性为22.3%。肥胖(BMI≥28kg/m2)老年人群中脂肪肝的发病率男性为40.4%,女性为50.0%。男性脂肪肝者与高甘油三酯血症明显相关(P<0.01),与高胆固醇血症、DM+IGT有关(P<0.05),而女性脂肪肝者与高甘油三酯血症和DM+IGT明显相关(P<0.01),与高血压有关(P<0.05)。当将肥胖和脂肪肝分别与冠心病的危险因素进行比较,男女脂肪肝人群中高胆固醇血症、高甘油三酯血症、糖尿病的OR值均高于肥胖人群。结论老年人脂肪肝与代谢综合征有相关性。     

脂肪肝

老年人脂肪肝与冠心病危险因素的相关性一—邱东鹰等(上海复旦大学附属中山医院老年病科200032)《中华老年医学杂志》2005，24(1)：21-23[探讨老年人脂肪肝与冠心病危险因素之间的关系。方法：调查920例老年男性，分析其脂肪肝与年龄、体质指数（BMI)、平均血压、谷丙转氨酶、总胆固醇、甘油三酯、空腹血糖、吸烟和饮酒之间的关系，并对脂肪肝、肥胖与高血压、高胆固醇血症、高甘油三酯血症、糖尿病之间的关系进行多元回归分析。     

杭州社区人群脂肪肝与心血管病危险因素之间关系

目的:探讨杭州社区人群脂肪肝与心血管病危险因素之间的关系.方法:调查2009年1月至2009年12月在我院体检中心接受体检的2734例杭州居民,分析脂肪肝与体重指数(BMI)、总胆固醇(TC)、甘油三酯(TC)、空腹血糖(FPG)、动脉血压之间的关系.并对脂肪肝与高血压、高胆固醇血症、高甘油三酯血症、糖尿病之间的关系进...     

老年脂肪肝的临床特点及相关危险因素

目的　探讨老年脂肪肝的独立危险因素及其临床特点。方法　回顾性分析 1 92例老年脂肪肝和 2 2 1例非老年脂肪肝病人的临床资料 ,并随机抽取非脂肪肝的老年患者 82例作为对照组。对老年脂肪肝组和对照组的血脂等变量进行回归分析 ,比较老年脂肪肝和非老年脂肪肝的临床特点和肝功能的改变。结果　酗酒 (OR =36 678)、体重指数 (OR =2 0 795)、甘油三酯 (OR =2 70 2 )、2型糖尿病 (OR =2 569)和空腹血糖 (OR=1 836)与老年脂肪肝的形成有关。老年脂肪肝组高血压、冠心病的发生率高于非老年脂肪肝组 ,而肥胖、高脂血症、乙型与丙型肝炎病毒感染的比例显著低于非老年脂肪肝组。老年脂肪肝组ALT升高的比例 (2 1 9% )显著低于非老年脂肪肝组 (39 4% ) ,A/G <1 5的比例 (2 6 0 % )高于非老年脂肪肝组 (1 5 4% )。结论　酗酒、肥胖、高甘油三酯血症、2型糖尿病和空腹血糖升高为老年患者发生脂肪肝的独立危险因素。老年脂肪肝患者更易合并高血压和冠心病。老年脂肪肝患者的肝功能改变以慢性损害多见。     

青年男性冠心病危险因素Logistic回归分析

目的探讨青年男性冠心病主要危险因素。方法选择经冠脉造影确诊为冠心病的青年男性为主要研究对象,将同期入院排除冠心病的青年男性作为对照组。收集两组年龄、身高、体重、体重指数(BMI),既往高血压病、血脂异常、糖尿病、吸烟以及早发冠心病家族史;各组血液生化指标:血尿酸(UA)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、脂蛋白a(LPa)、空腹血糖(FBG)。应用SPSS17.0软件对上述资料进行统计学分析。结果青年男性冠心病组既往糖尿病、血脂异常、吸烟史比例,BMI、TG水平均高于对照组,两组高血压、早发冠心病家族史比例,TC、LDL、HDL、LPa、UA、FBG水平无统计学差异;经Logistic多因素回归分析显示,青年男性冠心病发病主要相关危险因素有高甘油三酯血症、吸烟、超重/肥胖。结论青年男性冠心病患者主要危险因素有吸烟、高甘油三酯血症、超重/肥胖;控制体重、戒烟、控制甘油三酯水平,可能有助于减少青年男性冠心病的发生。     

成都地区社区居民高血压前期与糖脂代谢关系的研究

目的探讨成都地区社区居民高血压前期和糖脂代谢紊乱之间的关系。方法利用成都地区慢性病防治项目的现况调查资料,分析年龄40岁及40岁以上中老年人群的数据,比较高血压前期与正常血压人群的糖脂代谢情况,并进一步分析高血压前期与相关危险因素的关系。结果高血压前期组空腹血糖受损、单纯性糖耐量异常、空腹血糖受损合并糖耐量异常以及糖尿病的患病率均明显高于正常血压组(P<0.05);高血压前期组高胆固醇血症、高甘油三酯血症、高LDL-C和低HDL-C的患病率明显高于正常血压组(P<0.05);Logistic回归分析显示,男性、老龄、肥胖、餐后血糖、胆固醇和甘油三酯升高都是高血压前期的危险因素(P<0.05),女性和HDL-C升高是高血压前期的保护因素,其中年龄和性别是不可控制的因素。结论高血压前期与糖脂代谢关系密切,是糖尿病和高脂血症发生发展的重要危险因素。成都地区社区中老年人群高血压前期的患病率高且更易发生糖尿病和血脂紊乱。尽早对社区人群进行高血压前期和糖脂代谢干预,对降低心血管疾病事件的发生和疾病负担具有重要意义。     

成都地区社区居民高血压前期与糖脂代谢关系的研究

目的探讨成都地区社区居民高血压前期和糖脂代谢紊乱之间的关系。方法利用成都地区慢性病防治项目的现况调查资料,分析年龄40岁及40岁以上中老年人群的数据,比较高血压前期与正常血压人群的糖脂代谢情况,并进一步分析高血压前期与相关危险因素的关系。结果高血压前期组空腹血糖受损、单纯性糖耐量异常、空腹血糖受损合并糖耐量异常以及糖尿病的患病率均明显高于正常血压组(P<0.05);高血压前期组高胆固醇血症、高甘油三酯血症、高LDL-C和低HDL-C的患病率明显高于正常血压组(P<0.05);Logistic回归分析显示,男性、老龄、肥胖、餐后血糖、胆固醇和甘油三酯升高都是高血压前期的危险因素(P<0.05),女性和HDL-C升高是高血压前期的保护因素,其中年龄和性别是不可控制的因素。结论高血压前期与糖脂代谢关系密切,是糖尿病和高脂血症发生发展的重要危险因素。成都地区社区中老年人群高血压前期的患病率高且更易发生糖尿病和血脂紊乱。尽早对社区人群进行高血压前期和糖脂代谢干预,对降低心血管疾病事件的发生和疾病负担具有重要意义。     

中老年人288例脂肪肝患者的临床研究

目的 掌握中老年人脂肪肝患病状况。方法 对2229名中老年人进行体格检查，通过询问病史，测量身高、体重、血压、血脂、血糖及B超等检查，研究脂肪肝的患病状况。结果 脂肪肝患病率为12．9％，性别、年龄对脂肪肝患病率无明显影响。仅15．6％脂肪肝患者有消化道症状，肝功能异常者占25．3％。脂肪肝患者多合并有高甘油三酯、高胆固醇、高血压、糖尿病及糖耐量异常、高尿酸血症。肥胖、高甘油三酯、高胆固醇、高血压、糖尿病及糖耐量异常、高尿酸血症均为脂肪肝的危险因素。结论 中老年人脂肪肝患病率高，必须加强脂肪肝的监测与防治，降低其患病率。     

冠心病三支病变54例危险因素的临床分析

目的:探讨冠心病三支病变与危险因素之间的关系。方法:对冠心病三支病变患者(观察组)54例与单支、双支病变患者(对照组)70例7种心血管危险因素(年龄、性别、吸烟、饮酒、高血压、糖尿病、高脂血症)进行统计学分析。结果:两组之间年龄、性别、饮酒、高血压、高甘油三酯血症无显著差异.而吸烟、高胆固醇血症、糖尿病差异显著(P<0.05～<0.01)。结论:糖尿病,高胆固醇血症,吸烟为冠心病三支病变的重要危险因素,防治中应作相关积极处理。     

新疆偏远农村地区成年人血压与肥胖指标的关系

目的探讨新疆偏远农村地区成年人群体质量指数(BMI)、腰围和腰臀比等肥胖指标与血压水平和高血压患病率的关系。方法采用四阶段分层整群随机抽样的方法,抽取调查现场年龄≥18岁的研究对象11 340人进行问卷调查及体格检查,分析人群血压水平及高血压患病率。分别按BMI、腰围和腰臀比分层,评价不同类型肥胖人群的血压水平和高血压患病率。采用多因素Logistic回归分析高血压的影响因素。结果人群收缩压和舒张压分别为(126.3±21.4)和(80.9±13.4)mm Hg,男性收缩压和舒张压高于女性(均P0.05);高血压患病率为32.1%,男性患病率高于女性(35.7%比29.3%,P0.05)。随着BMI、腰围和腰臀比的增加,收缩压、舒张压及高血压患病率逐渐增高(BMI18.5、18.5~24.0、24.0~28.0、≥28.0 kg/m2组高血压患病率分别为18.0%、24.7%、37.3%、54.0%;腰围70、70~80、80~90、90~100、100~110、≥110 cm组高血压患病率分别为14.7%、20.9%、30.1%、43.1%、55.4%、70.7%;腰臀比0.75、0.75~0.80、0.80~0.85、0.85~0.90、0.90~0.95、0.95~1.00、≥1.00组高血压患病率分别为17.5%、20.7%、25.4%、32.0%、39.2%、46.1%、53.0%;均P趋势0.01)。多因素Logistic回归分析发现性别、年龄、民族、超重或肥胖、腹型肥胖、糖尿病、高三酰甘油血症、高胆固醇血症、高低密度脂蛋白胆固醇血症和低高密度脂蛋白胆固醇血症是高血压的危险因素。结论新疆偏远农村地区人群高血压患病率高。随着BMI、腰围和腰臀比的增加,收缩压、舒张压及高血压患病率逐渐增高。性别、年龄、民族、超重或肥胖、腹型肥胖、糖尿病、高三酰甘油血症、高胆固醇血症、高低密度脂蛋白胆固醇血症和低高密度脂蛋白胆固醇血症是高血压的危险因素。     

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.     

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.