心血管病危险因素与10年后颈动脉粥样硬化的关系

目的探讨基线心血管病危险因素水平及变化与10年后颈动脉粥样硬化患病率的关系。方法1992年和2002年对北京大学社区1323人进行了心血管病危险因素调查,并于2002年进行了颈动脉超声检查;以颈动脉内中膜（IMT）增厚和粥样斑块形成作为评价指标。结果（1）随着基线心血管病危险因素水平的上升,10年后颈动脉粥样硬化患病率持续上升;年龄、吸烟、高血压和高胆固醇血症是颈动脉粥样硬化的独立影响因素;（2）10年后颈动脉粥样硬化患病率随着基线危险因素聚集个数的增加而升高（P〈0．001）;（3）1992年和2002年均有危险因素者的颈动脉IMT增厚和粥样斑块患病率分别为67．1％和42．6％,其患病危险分别是2次调查均无危险因素者的1．7倍和3．1倍。结论传统危险因素对心血管病和颈动脉粥样硬化均产生影响,但强度不同,颈动脉粥样硬化可作为动脉粥样硬化性疾病发病危险的早期评价指标。     

颅内动脉粥样硬化的危险因素

颅内动脉粥样硬化是缺血性卒中的重要病因之一.由于颅内、外动脉在结构和血流动力学方面存在差异,传统血管危险因素,如性别、年龄、高血压、糖尿病等对颅内、外动脉粥样硬化的影响也有所不同.及早识别颅内动脉粥样硬化的危险因素,对于积极防治颅内动脉粥样硬化和降低缺血性卒中发病率具有重要意义.然而,针对危险因素和颅内动脉粥样硬化相关性的许多研究结论并不一致.文章对颅内动脉粥样硬化危险因素的研究现状做了综述.     

关注致动脉粥样硬化的非传统危险因素

动脉硬化是指动脉管壁的增厚、变硬和弹性减低。动脉粥样硬化是动脉硬化的特定类型,指动脉管壁由于钙和脂肪物质在管壁堆积而变厚。尽管对动脉粥样硬化的发病机制至今尚未完全明了,但有较明确的原因即动脉粥样硬化的危险因素,包括传统和非传统危险因素,我们对传统危险因素已逐步认识。随着对血管危险因素的再认识,非传统危险因素开始被关注,这将对血管早期风险评价提供依据。现就非传统危险因素对动脉粥样硬化性血管病变的影响进行阐述。     

动脉粥样硬化型脑梗死不同性别患者危险因素的探讨

目的比较不同性别动脉粥样硬化型脑梗死患者临床危险因素的差异并探讨其意义。方法回顾性分析例女性及例男性动脉粥样硬化型脑梗死患者资料。结果男女患者动脉粥样硬化型脑梗死危险因素的单因素比较显示,年龄、吸烟史、饮酒、收缩压、HDL-C、CRP这6项比较差异有统计学意义(P<0.05);多因素Logistic回归分析显示,年龄[OR=1.07,95%CI=(1.04～1.11)]、吸烟[OR=2.52,95%CI=(1.02～6.54)]、HDL-C水平[OR=3.11,95%CI=(1.23～8.46)]为男性动脉粥样硬化型脑梗死发病的独立危险因素。结论不同性别动脉粥样硬化型脑梗死患者临床危险因素存在差异,制定相应的脑卒中防治策略,具有重要意义。     

他汀类药物是抗动脉粥样硬化的基石

<正> 人类认识冠状动脉粥样硬化性心脏病(冠心病)已有一百多年的历史。随着研究的深入,发现它是一种由多种危险因素所致的慢性疾病,其中主要的致病性危险因素包括血脂异常、糖尿病、高血压和吸烟等。动脉粥样硬化与脂质代谢异常密切相关,尤其是血浆中LDL-C对动脉粥样硬化的发     

睾酮与男性动脉粥样硬化相关危险因素研究进展

大量研究表明睾酮具有抗动脉粥样硬化的作用,老年男性睾酮水平降低与动脉粥样硬化及冠心病的发生发展密切相关。人体的脂质代谢紊乱、胰岛素抵抗、凝血纤溶系统紊乱、高血压、高同型半胱氨酸、吸烟等是动脉粥样硬化形成和发展的重要危险因素。最新大量研究显示男性睾酮水平与动脉粥样硬化的这些危险因素关系密切。现就近几年国内外关于男性睾酮水平变化与这些危险因素的关系的研究进展进行综述。     

幽门螺杆菌感染对脑梗死患者血清同型半胱氨酸水平的影响

<正>脑梗死是人类最常见的致死和致残原因之一,动脉粥样硬化是脑梗死的主要病理基础,高血压、肥胖、吸烟等传统的动脉粥样硬化危险因素仅能解释部分脑卒中事件,很多心脑血管事件发生在无上述危险因素的情况下。因此,探寻新的危险因素与脑卒中发病的关系已成为目前脑卒中流行病学研究的热点课题。近年研究表明,幽门螺杆菌(Helicobacter pylori,Hp)感染与缺血性心、脑血管疾病的发生关系密切。本研究     

非高密度脂蛋白胆固醇的研究进展

动脉粥样硬化（atherosclerosis,AS）是一类多因素性疾病,目前已经明确危险因素有血脂异常、高血压、血糖异常、吸烟和肥胖等。在所有这些危险因素中,低密度脂蛋白（low density lipoprotein,LDL）是致动脉粥样硬化的基本因素。动脉粥样硬化的发生是致病因素和保护因素相互消长的结果,致病因素的增强和（或）保护因素的减弱都会导致疾病的发生。     

男性秃顶群体动脉粥样硬化及危险因素比较

目的:比较男性秃顶群体与一般群体间动脉粥样硬化及危险因素的变化。方法:以湖南省郴州铁路地区男职工为样本总体,总普查符合条件的男性秃顶者348例。按年龄分层,青年组132例,中老年组216例,并随机抽取相应年龄数量为对照组。结果:青年秃顶群体和中老年秃顶群体与对照组间其心血管病危险因素和冠心病、动脉粥样硬化发生率均无显著差异(P>0·05)。结论:男性秃顶群体与对照组之间就整体而言其心血管危险因素及动脉粥样硬化(As)并无差异。     

贯彻循证医学的原则, 重视动脉粥样硬化的预防

动脉粥样硬化是可致残、致死的全身性疾病 ,它导致的严重后果包括脑卒中、心肌梗死、缺血性肾病和间歇跛行。它是全球性疾病 ,不仅是威胁发达国家人民健康与生命的头号杀手 ,也是包括中国在内的发展中国家面临的严峻挑战[1,2 ] 。动脉粥样硬化的发生、发展经历了一个系列过程。其上游是多重危险因素 (吸烟、高血压、血脂异常、糖尿病、肥胖、代谢综合征等 )的流行 ;由于这些危险因素的作用 ,最终导致稳定性动脉粥样硬化疾病或不稳定性动脉粥样硬化疾病。稳定性动脉粥样硬化疾病 ,如稳定性心绞痛的病理生理基础是稳定的动脉粥样硬化斑块 ;不…     

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.