血清学非甲—戊型急性肝炎的病因分析

探讨血清学非甲 -戊型急性肝炎的病因。采用免疫组织化学和原位杂交技术对 6 5例血清学非甲 -戊型急性肝炎患者的肝组织 ,分别进行乙、庚、丙型肝炎病毒抗原和TT病毒核酸 (TTVDNA)检测。 6 5例肝组织中乙、庚、丙型肝炎病毒抗原及TTVDNA的检出例次分别为 34、32、18和 2 0 ,前两者检出率明显为高 ,差异显著(P <0 0 5 ) ,仍有 10 8%病因不明。在单纯急性乙、庚型肝炎病毒、TT病毒感染及非A -G、TTV感染中 ,部分肝功能组间比较无显著差异 (P >0 0 5 )。隐匿性的HBV ,庚型肝炎病毒感染是血清学证实为急性非甲 -戊型肝炎的主要病因。部分病例病因分型仍不明确 ,提示有另外的致病因子存在。     

病毒性肝炎治疗研究的展望

目前已知病毒性肝炎有甲、乙、丙、丁、戊和庚型。此外，尚有非甲～庚(NonA～G)型。除了甲型肝炎自愈倾向十分明显，为害较轻外，乙、丙两型均能形成慢性，并可转为恶性；丁、戊、庚型肝炎也缺特效疗法。以下仅就目前病毒性肝炎治疗研究的前景作一概述，以供参考．     

庚型肝炎病毒感染对急性肝炎致病性的探讨

目的 探讨急性肝炎患者肝组织中庚型肝炎病毒（ＨＧＶ）的感染状况及其致病性。方法 采用免疫组织化学方法对３７例血清学肝炎病毒标记甲￣戊型均阴性的急性肝炎患者肝穿肝组织中的ＨＧＶ ＮＳ５抗原等进行检测,并对ＨＧＶ感染的致病性进行研究。结果 ＨＧＶ ＮＳ５抗原的检出率为３７．８％（１４／３７）,其中ＨＧＶ ＮＳ５单项阳性４例（急性庚型肝炎组）。结果 ＨＧＶ ＮＳ５抗原的检出率为３７．８％（１４／３７）,     

184例戊型肝炎肝外脏器损害临床资料分析

戊型肝炎是由戊型肝炎病毒(HEV)引起的急性传染病,其临床表现与甲型病毒性肝炎相似,但本病黄疸型多见,病情较重,而且也有肝外系统损害表现。收集2000年1月至2002年12月单纯戊型肝炎患者资料184例,结果报告如下。 1 临床资料 1.1 一般资料 184例患者符合2000年9月全国传染病与寄生虫病学术会议修订的病毒性肝炎诊断标准。即抗-HEV-IgM阳性,结合临床作出诊断,并排除甲、乙、丙、丁、庚型肝炎病毒感染。其中男128例,女56例。急性黄疸型肝炎     

30例非甲～戊型肝炎中庚型肝炎病毒感染分析

了解庚型肝炎病毒在本地区非甲－戊型肝炎中的流行情况及其临床特征。方法用ＲＴ－ＰＣＲ和ＥＬＩＳＡ法对３０例非甲－戊型肝炎患者的血清进行ＨＧＶ－ＲＮＡ和抗－ＨＧＶ检测。结果３０例非甲－戊型肝炎患者中检出３例,ＨＧＶ－ＲＮＡ阳性,其中２例为急性肝炎,１例为慢性肝炎。     

丙型肝炎病毒性标记阳性的自身免疫性肝炎

目前已鉴定出甲、乙、丙、丁、戊和庚型6种肝炎病毒，上述病毒与自身免疫性肝炎(AIH)的发生是否直接有关尚不明确。尽管最近有在AIH患者中检出庚型肝炎病毒RNA的报告，但检出率甚低，推测两者间未必直接相关。由于以往在AIH中丙型肝炎病     

单纯HGV感染急性肝炎患者的临床与病理研究

目的 通过对一组急性ＨＧＶ感染患者的肝组织病理和临床资料分析，探讨庚型肝炎病毒感染的致病性，方法 采用免疫组织化学技术对５９例不明原因包性肝炎患者的肝组织，进行乙、丙和庚型肝炎病毒怕检测，部分病例经原位杂交证实。结果 ＨＧＶＮＳ５怕的检出率为（５７．６％〈３４／５９），其中２０直组织中ＨＢｓＡｇ和／或ＨＣＶＮＳ３Ａｇ同时阳性ＩＨＧＶ合并感染组），ＨＧＶ阳性信号主要位于肝细胞浆内。ＨＧＶ单纯感染病例     

非甲—庚型肝炎患者TT病毒感染的检测及序列分析

在急慢性输血后肝炎、散发性肝炎及爆发性肝炎中，有相当比例的患者用现有甲、乙、丙、丁、戊、庚型肝炎实验室诊断方法尚不能分型，在排除已知的致病因素外，仍有３．５０～１５％的肝炎病人病因不明。通常将这些不明原因的肝炎称之为非甲－庚型肝炎。１９９７年日本学者报道发现一种新的肝炎病毒，并命名为ＴＴ病毒（ＴＴＶ）［１］。我们根据日本报道的ＴＴＶ基因序列，建立套式聚合酶链反应（ｎｅｓｔｅｄＰＣＲ）方法，在我国北京地区非甲庚型肝炎患者中检测出ＴＴＶ基因，并进行了序列分析，现将结果报道如下。材料与方法一、标…     

庚型病毒性肝炎动物模型—恒河猴肝的超微结构及免疫组织化学研究

庚型肝炎由单股正链ＲＮＡ病毒引起，是一种新型病毒性肝炎［１３］。１９９６年我们曾对８例单纯庚型肝炎病毒（ＨＧＶ）感染患者进行过临床病理分析，并作了报道［４，５］。为了进一步探索庚型肝炎的发生，发展规律，我们建立了恒河猴庚型肝炎动物模型，并对它的血清学及肝脏组织学改变进行动态观察，现将观察结果报告如下。材料与方法一、研究动物选用中国云南健康恒河猴，雌雄各１只，年龄２～２．５岁，体重２～３ｋｇ，动物购于中国科学院动物研究所，经血清病原学检测，甲，乙，丙，戊，庚肝炎病毒指标均阴性。二、血清学检测实验…     

血清甲型—戊型肝炎病毒指标阴性患者肝组织中病毒抗原和核酸检测及其临床意义

本文采用免疫组织化学和原位杂交技术对血清学检测甲～戊肝炎病毒指标阴性患者肝组织中病毒抗原及核酸进行检测 ,并择重对ＴＴＶ在血清甲型～戊型肝炎指标阴性患者中的作用进行探讨。对象与方法1.对象 :10 4例肝病患者为 1995年～ 1998年 12月河南省安阳市第五人民医院及北京佑安医院病人 ,全部病例均行经皮肝穿活检 ,男性 68例 ,女性 3 6例 ,年龄 2个月～ 74岁 ,平均年龄 42 .95岁。患者既往均无静脉用药史 ,排除甲、乙、丙、丁、戊型肝炎和ＣＭＶ、ＥＢＶ感染及中毒性和酒精性肝损伤。急性肝炎 5 9例 ,慢性肝炎 3 5例 ,亚急性重型肝炎 8例…     

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.