认知功能的年老化过程、个体差异及影响因素

目的：研究认知功能的年老化过程，个体差异及主要影响因素，方法：在微机上完成对1350例20－90岁健康成人的7项认知能力测验，对认知功能年老化过程，个体差异及主要影响因素进行分析。结果：（1）各项认知能力随年老明显减退，在60岁和80岁选择进入两个明显的减退阶段；（2）各项测验结果的个体差异随年老明显增大；（3）教育程度对认知功能的年老化过程有明显影响；（4）某些认知能力存在性别和职业差异，结论：认知功能年老化过程的同时个体差异随之增大，并与教育、职业和性别等因素有关系。     

血脂及增龄对冠心病合并2型糖尿病患者冠状动脉造影及微量蛋白尿的影响

目的探讨血脂及增龄对冠心病合并2型糖尿病患者冠状动脉造影及微量蛋白尿的影响。方法按年龄、血脂及年龄与血脂分组，对203例冠心病合并2型糖尿病患者的冠状动脉造影及24h微量蛋白尿进行对比分析。结果与〈60岁组相比，≥60岁组四支血管病变比例（P〈0．05）及左主干受累（P〈0．05）比例高，而单支血管病变比例低（P〈0．05）；且≥60岁组微量蛋白尿水平明显高于〈60岁组（P〈0．05）；胆固醇异常组与胆固醇正常组单支、双支、三支及四支血管病变、狭窄部位和狭窄程度的差异无显著性，且两组微量蛋白尿水平差异亦无统计学意义。年龄与血脂进行交叉分组对比分析，高龄低脂组病例数明显高于低龄高脂组（P〈0．05）；但高龄低脂组单支病变明显低于低龄高脂组（P〈0．05），四支病变明显高于低龄高脂组（P〈0．05）；微量蛋白尿水平对比显示高龄低脂组明显高于低龄高脂组（P〈0．05）。结论胆固醇的降低不能改变冠心病合并2型糖尿病患者冠状动脉病变及微量蛋白尿水平随增龄而改变的趋势。     

北京健康人群睾酮和雌二醇水平及其增龄性变化

目的 调查北京地区各年龄段健康人群血清睾酮及雌二醇水平，分析其与增龄的相关性。方法用放免法测定血清样本睾酮及雌二醇浓度。结果 北京地区60～69及70-79岁二组男性健康人群血清睾酮水平显著低于青、中年人群（P〈0．05）；女性健康人群血清睾酮水平分别在30-39及60-69岁二个年龄段呈快速下降，而在30-59岁年龄区间呈相对稳定；北京地区50-59岁及60-69岁二组健康女性血清雌二醇水平显著低于20～49年龄段人群；血清睾酮及雌二醇水平与增龄间均无显著直线相关（r〉-0．975）。结论 北京地区健康人群血清睾酮及雌二醇亦平随增龄呈规律性下降，但不适宜作为人群增龄或老化的生物学指征。     

DEXA测定老年人骨密度186例报告

于１９９５年９月体检人群中，随机采用Ｈｏｌｏｇｉｃ２０００型双能Ｘ线骨密度仪（ＤＥＸＡ）测量１８６例骨密度。结果提示年龄每增５岁，髋部、Ｗａｒｄ区及腰椎１～４三处之骨密度递减（Ｐ＜０．０５）。≥６０岁组之骨峰骨量亦随增龄而降低（Ｐ＜０．０１）。骨峰值在≥６０岁组下降２个标准差以上者占６１．３％。女性除Ｗａｒｄ区骨量，均低于男性（Ｐ＜０．０１）。     

血脂及增龄对2型糖尿病合并冠心病患者眼底血管病变的影响

目的 探讨血脂及增龄对2型糖尿病合并冠心病患者眼底血管病变的影响。方法 按年龄及血脂分组，对203例2型糖尿病合并冠心病患者的眼底荧光血管造影特点进行对比分析。结果 与〈60岁组相比，≥60岁组视网膜Ⅲ期病变比例高，而视网膜正常者及病变Ⅰ期者所占比例低；胆固醇异常组与胆固醇正常组视网膜病变各分期无统计学意义。结论 胆固醇的降低不影响2型糖尿病合并冠心病患者视网膜病变；患者视网膜病变有随增龄而改变的趋势。     

执行衰退假说及其行为学研究策略

执行衰退假说（executive decline hypothesis）是近年来认知年老化研究领域内一个新兴的理论，该理论主要关注执行功能与大脑额叶皮层的关系，以及执行功能在认知年老化过程中的作用。具体来说有两层含义：第一，在排除一般性认知（大脑）衰退的基础上，仍存在执行（额叶）功能特异性的随龄衰退；第二，执行（额叶）功能的降低是引起人们日常复杂认知功能（记忆、学习、推理）随龄衰退的主要原因。然而，在随后的认知行为学研究中，特别是考虑了加工速度指标后，却遇到了很大的困难。本文较详细地介绍执行衰退假说的神经生物学背景，并在Salthouse（2001）五阶段分析策略的基础上，提出了一套新的认知行为学研究策略，从而对执行功能和加工速度在认知年老化过程中的作用进行客观的评价。     

随增龄立体视锐度响应速度变化规律的探讨

目的 探讨具有正常立体视锐度者的响应速度及随增龄的变化规律。方法 使用 TSJ－3型同视机随机点画片及《立体视觉检查图》，检查具有正常立体视锐度者164人，记录通过各级画片时的响应速率。结果 50岁以上老年人通过远近立体视的响应速度较中、青、幼年组明显减慢；40岁组的近立体视响应速度从100″开始减慢，而远立体视响应速度与中、青、幼年组差异无显著性。结论 老年人响应速度减慢与随增龄而的眼－脑功能衰减有关，感知速度作为评价感知活动的另一项指标同感知能力同样重要。     

高血压和高脂血症对老年人纯音听阈影响

目的研究老年性耳聋与高血压及高脂血症的相关性。方法采用ＭａｄｓｅｎＭ－５　型听力计测定了老年男性高血压与高脂血症患者及健康老年人各５０例的纯音听阈，各组分为６０岁组及７０岁组，进行组间比较。结果（１）高血压组、高脂血症组与健康组的平均听阈均随增龄而增高，但两个疾病组中的６０岁及７０岁组在０．２５～８ｋＨｚ各频率的平均听阈均显著高于同龄健康组（Ｐ值＜０．０５或０．０１）；（２）听力损伤发生率在高血压两年龄组分别为４８％及７２％，高脂血症组分别为４４％及６４％，健康组分别为８％及１６％，疾病组中的两个年龄组也均明显高于同龄健康组（Ｐ值＜０．０１）。结论高血压及高脂血症对老年人听阈有明显影响，是加重老年聋的因素。     

认知速度随龄衰减规律及其临床应用

利用自行设计的软件程序和微机人机对话方式,应用两维年龄回归分析方法,对734名46～75岁的受试者进行四项认知作业速度的测试,结果表明:四项认知作业速度出现随龄按比例进行性衰减的特点,并为认知速度老化程度的检测及其临床应用提供了实验依据。     

恶性肿瘤患者血清β_2-微球蛋白测定的临床意义

为观察恶性肿瘤患者血清β２－微球蛋白（β２－ＭＧ）的变化，我们检测了６０例恶性肿瘤患者的血清β２－ＭＧ水平，并与对照组比较。现报告如下。资料与方法：对照组６０例，年龄６０～７０岁；其中冠心病１５例，糖尿病２５例，高血压病２０例；观察组为６０例恶性肿瘤...     

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.