血管紧张素转化酶基因多态性与老年人高血压合并左心室肥厚的探讨

目的 探讨血管紧张素转化酶（ACE）基因插入／缺失（I／D）多态性与老年人高血压合并左心室肥厚（LVH）的关系。同时测定血清ACE水平,观察与ACE基因多态性的关系。方法 应用聚合酶链反应（PCR）技术102例老年人进行ACE基因I／D多态性检测,其中正常对照者41例,高血压无心脑血管合并症（CCVD）患者35例,高血压合并LVH者26例。同时,用紫外分光光度法测定其中32例正常人和29例高血压病患者的血清ACE浓度。结果 高血压合并LVH组DD基因型频率0．385和D等位基因频率0．596分别显著高于正常对照组的0．122和0．378（均为P＜0．05）,以及高血压无CCVD组的0．114和0．386（均为P＜0．05）。同时发现DD型者血清ACE水平显著高于Ⅱ型（P＜0．05）。结论 ACE基因缺失多态性可能是老年高血压合并LVH易患者的重要遗传标志。     

血管紧张素转换酶基因多态性与2型糖尿病肾病的相关性

应用PCR技术检测144例2型糖尿病患者（T2DM组）的血管紧张素转换酶（ACE）基因插入/缺失（I／D）多态性,并与67例健康人（对照组）比较,结果两组间ACE等位基因、基因型频率无显著性差异（P〉0．05）;T2DM组伴DN者（80例）DD基因型频率显著高于不伴DN者（64例）（P〈0．05）;DN患者中肾功能不全者DD基因型及D等位基因频率均明显高于肾功能稳定者（P〈0．05）。提示ACE基因I／D多态性与T2DM的易感性无关,与DN的发生、发展密切相关。     

血管紧张素I转换酶基因I／D多态性与特发性肺纤维化的相关性研究

目的探讨血管紧张素I转换酶（ACE）基因I／D多态性在特发性肺纤维化（IPF）发病中的作用。方法应用PCR技术检测42例IPF患者（IFP组）和90例健康查体者（对照组）ACE基因I／D多态性,并分析不同基因型和等位基因者IPF发病危险性。结果IPF组DD基因型和D等位基因频率均显著高于对照组（P〈0．05）;与Ⅱ基因型比较,携带DD型和D等位基因个体发生IPF的风险分别增加2．97倍（95％CI为1．13—7．73）和1．96倍（95％CI为1．16—3．32）,P均〈0．05。结论ACE基因I／D多态性与IPF发病有关,DD基因型和D等位基因可能增加IPF的患病风险。     

昆明地区汉族2型糖尿病肾病与血管紧张素Ⅰ转换酶基因多态性的相关性研究

应用多聚酶链反应（PCR）方法检测昆明地区汉族184名2型糖尿病（DM）患者（110名为2型DN，74名为非2型DN）和56名健康者ACE基因I／D多态性，比较各组间的基因频率。结果 （1）昆明地区汉族2型DN组DD基因型及D等位基因频率显著高于正常组和非2型DN组，（P〈0．05）。（2）2型DN组Ⅱ基因型及Ⅰ等位基因频率显著低于正常组和非2型DN组（P〈0．05）。结论（1）昆明地区汉族2型DN与ACE基因I/D多态性有关联。（2）DD基因型及D等位基因可能是2型DN的易感基因，Ⅱ基因型及Ⅰ等位基因可能为2型DN的保护基因。     

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。     

血管紧张素转换酶基因多态性与原发性高血压病关系的研究──粤东地区人群研究

原发性高血压为一多因素性疾病，其遗传机制与多种基因变异有关，尤其与编码肾素血管紧张素系统的基因相关。为探测血管紧张素转换酶（ACE）基因多态性与原发性高血压发生的关系，本文应用聚合酶链反应检测粤东地区60例原发性高血压病患者和60例正常人ACE基因插入／缺失多态性。结果表明正常组缺失型等位基因出现的相对频率为0．375，原发性高血压组缺失型等位基因出现的相对频率为0．492，两者差别无显著意义（P＞0．05）。我们认为ACE基因插入／缺失多态性与原发性高血压无密切关系，不宜作为该地区原发性高血压的诊断基因。     

ACE基因、CYP11B2基因多态性联合分析与原发性高血压合并缺血性脑血管病的相关性研究

目的探讨血管紧张素转换酶（ACE）基因I／D多态性和醛固酮合酶（CYP11B2）基因-344T／C多态性联合分析与原发性高血压（EH）及合并缺血性脑血管病（ICVD）的关系。方法运用聚合酶链反应（PCR）、限制性片段长度多态性（RFLP）等技术检测正常对照（NE）组305例、单纯高血压（SEH）组324例和高血压合并缺血性脑血管病（ICVD）组297例的ACE、CYP11B2基因型，结合临床资料统计分析。结果ACE基因DD型及D等位基因频率在ICVD组显著高于NE组和SEH组（P〈0．0125），在SEH组与NE组问无显著差异；CYP11B2三种基因型在各组分布差异无显著性；ACE基因DD型＋CYP11B2基因TC／CC型分布在三组间有显著差异（P〈0．05），DD—TC／CC频率在ICVD组显著高于NE组和SEH组（P〈0．0125），在SEH组与NE组间差异无显著性；Logistic回归分析提示，年龄、体重指数（BMI）、血清总胆固醇（CHOL）、血糖（GLU）、基因联合DD—TC／CC是EH人群发生ICVD的独立危险因素，而ACE基因DD型未进入回归方程。结论ACE基因I／D多态性和CYP11B2基因-344T／C多态性与高血压无明显关系，但在高血压人群中，年龄、BMI、CHOL、GLU、ACE基因DD型＋CYP11B2基因TC／CC型可能是其发生ICVD的独立危险因素，ACE基因与CYP11B2基因可能存在协同作用。     

醛固酮合成酶基因多态性与高血压及左室肥厚的关系

目的：本研究旨在观察血管紧张素转换酶（ACE）基因I／D多态性和醛固酮合成酶（CYP11B2）基因－344C／T多态性与高血压（EH）及左室肥厚（LVH）的相关性。方法：将136例原发性高血压病患者分为LVH组72例,无LVH组64例;应用多聚酶链式反应（PCR）、限制性内切酶方法检测ACE和CYP11B2基因的多态性。结果：（1）无LVH组LVH组ACE基因I／D多态性基因型和等位基因分布差异均有显著性（P＜0．05）,LVH组Ⅱ基因型和Ⅰ等位基因频率显著高于无LVH组。（2）无LVH组与LVH组CYP11B2基因－344C／T多态性基因型和等位基因分布差异均有显著性（P＜0．05）,LVH组CT基因型和C等位基因频率显著高无LVH组。（3）LVH组中的CT＋Ⅱ联合基因型频率高于无LVH组（P＜0．05）。结论：（1）ACE型I／D和CYP11B2基因－344C／T多态性与高血压发生无相关性。（2）ACE基因Ⅱ多态性与LVH相关。(3）CYP11B2基因－344CT基因型与LVH相关。（4）CYP11B2基因－344CT基因型和ACE基因Ⅱ基因型共存对LVH的发病具有协同作用。     

血管紧张素转换酶和血管紧张素Ⅱ-1型受体基因多态性与冠心病的相关性分析

目的研究血管紧张素转换酶（ACE）基因I／D多态性和血管紧张素Ⅱ-Ⅰ型受体（AT1R）基因A1166／C多态性与冠心病（CHD）的关系。方法采用聚合酶链反应-限制性片段长度多态性（PCR—RFLP）技术检测130例CHD组和90例对照组ACE和AT1R基因多态性。结果ACE—DD基因型频率在CHD组显著高于对照组（38．5％，14．4％，P〈0．001）。AT1R—AC基因型在两组间差异无显著性（13．1％，10％，P〉0．05），但合并AC基因型的DD型患者发生CHD和MI的OR值（5．836和3．985）明显高于合并AA型（3．102和2．979）。结论ACE基因I／D多态性中DD基因型是冠心病发病的独立危险因素之一，AT1R—C等位基因增加ACE—DD型发生CHD和MI的危险，二者具有协同作用。     

血管紧张素转化酶2基因多态性与高血压合并缺血性脑卒中

目的研究血管紧张素转化酶2（angiotention-converting cnzyme 2，ACE2）基因G9570A多态性与中国南方高血压患者发生缺血性脑卒中的关系。方法采用聚合酶链反应和限制性片段长度多态性的方法，检测单纯原发性高血压136例及原发性高血压合并缺血性脑卒中患者139例的ACE2基因．同时测定颈动脉内膜中层厚度及血浆血管紧张素Ⅱ水平，并进行组间对照研究，探讨ACE2基因G9570A多态性与原发性高血压患者中缺血性脑卒中发病的关系。结果原发性高血压合并缺血性脑卒中组A等位基因频率分布高于原发性高血压组（P〈0．05）；两组ACE2基因型分布不同（P〈0．05）；原发性高血压合并缺血性脑卒中组携带A／AA基因者血浆血管紧张素Ⅱ水平高于携带G／GG基因者（P〈0．05）。在男性原发性高血压合并缺血性脑卒中组携带A基因者颈动脉内膜中层厚度高于携带G基因者（P〈0．05）。结论原发性高血压患者中，携带A／AA基因者发生缺血性脑卒中的危险性相对较大．可能与其血管紧张素Ⅱ水平较高有关。     

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.     

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.