过氧化体增殖物激活型受体α/γ激动剂对代谢综合征患者高敏C反应蛋白和基质金属蛋白酶9的影响

目的了解过氧化体增殖物型激活受体α/γ激动剂单用与联用对代谢综合征患者高敏C反应蛋白和基质金属蛋白酶9的影响。方法 256例代谢综合征患者随机分为基础治疗组、非诺贝特组、吡格列酮组、非诺贝特+吡格列酮组。所有患者进行生活方式干预及应用相应药物。在控制血压的基础上,基础治疗组加服安慰剂;非诺贝特组加服非诺贝特0.2 g,每日1次,睡前服;吡格列酮组加服吡格列酮15 mg,每日1次;非诺贝特+吡格列酮组按相同剂量加服上述2种药物。共干预24周。干预前后测定所有患者高敏C反应蛋白和基质金属蛋白酶9的浓度。结果干预前后各组的血清高敏C反应蛋白分别为:非诺贝特组6.32±1.65 mg/L和3.52±1.98 mg/L,吡格列酮组5.85±1.59 mg/L和3.33±1.16 mg/L,非诺贝特+吡格列酮组6.49±1.34 mg/L和2.47±0.91 mg/L;干预前后各组的基质金属蛋白酶9的浓度分别为:非诺贝特组179.3±54.9μg和L/144.9±30.8μg/L,吡格列酮组188.7±62.4μg/L和146.9±27.8μg/L,非诺贝特+吡格列酮组177.5±58.7μg/L和128.8±34.8μ...     

老年急性心肌梗死患者血清基质金属蛋白酶9和C反应蛋白的变化

目的探讨老年急性心肌梗死患者血清基质金属蛋白酶9(MMP-9)和C反应蛋白(CRP)浓度的变化。方法选择合并糖尿病的老年急性心肌梗死患者23例(A组);无糖尿病的老年急性心肌梗死患者23例(B组);无冠心病及糖尿病的老年健康体检者23例(对照组),抽血检测血清MMP-9和CRP的浓度,比较3组间的差异。结果各组平均血清MMP-9浓度与CRP浓度:A组为(397.25±68.91)μg/L、(8.52±2.45)mg/L,B组为(373.28±111.84)μg/L、(7.27±2.24)mg/L,对照组为(290.76±75.49)μg/L、(3.21±1.11)mg/L,各组间比较差异均有显著性意义,血清MMP-9浓度与CRP浓度呈正相关。结论在老年急性心肌梗死患者的发病中,血清MMP-9与CRP同样是重要的炎性标记物。     

注射用血塞通对PCI术后急性心肌梗死病人炎症因子、基质金属蛋白酶的影响

目的观察注射用血塞通对PCI术后急性心肌梗死病人炎症因子、基质金属蛋白酶的影响。方法选择在本院就诊的80例急性心肌梗死病人,随机分为对照组和血塞通组,对照组术后给予常规阿司匹林、氯吡格雷、阿托伐他汀口服;血塞通组在对照组治疗基础上,加用注射用血塞通。2周后分别测定两组病人血清脑钠肽、超敏C反应蛋白、基质金属蛋白酶2及白细胞介素6的表达水平。结果血塞通组治疗2周后,血清中脑钠肽(427.8 pg/m L±39.9 pg/m L vs 964.4 pg/m L±67.5 pg/m L,P0.05)、超敏C反应蛋白(2.9 mg/L±0.4 mg/L vs 8.8 mg/L±0.9 mg/L,P0.05)、基质金属蛋白酶2(824.63 ng/m L±59.61 ng/m L vs 1 829.42 ng/m L±110.23 ng/m L,P0.05)及白细胞介素6(29.4μg/L±4.6μg/L vs 61.8μg/L±8.1μg/L,P0.05)较对照组均明显降低。结论注射用血塞通可减轻急性心肌梗死病人急诊介入治疗术后病人的心肌损伤。     

氟伐他汀对急性心肌梗死患者循环单核细胞基质金属蛋白酶9和组织因子表达的影响

目的观察氟伐他汀对急性心肌梗死患者循环单核细胞基质金属蛋白酶9、组织因子表达的影响。方法分离30例急性心肌梗死患者和30例正常对照者循环血单核细胞,在体外无血清培养,设两孔,一孔直接培养,一孔加入氟伐他汀(360μg/L)干预48h,酶联免疫吸附法测定上清液中基质金属蛋白酶9、组织因子的含量。结果急性心肌梗死非干预组基质金属蛋白酶9、组织因子均高于正常对照非干预组(351±141μg/L比121±10μg/L,P<0.01;41.4±13.6ng/L比25.5±5.4ng/L,P<0.01)。急性心肌梗死氟伐他汀组较非干预组基质金属蛋白酶9和组织因子表达明显下降(226±89μg/L比351±141μg/L,P<0.01;31.4±11.2ng/L比41.4±13.6ng/L,P<0.05)。结论急性心肌梗死患者循环血单核细胞产生基质金属蛋白酶9、组织因子增加,氟伐他汀能抑制单核细胞表达基质金属蛋白酶9、组织因子。     

急性心肌梗死患者血清内脏脂肪素与基质金属蛋白酶的相关性研究

目的探讨急性心肌梗死(AMI)患者血清内脏脂肪素及基质金属蛋白酶(MMP)-2、MMP-9水平的变化。方法选择2015年3月~2016年3月淄博市中心医院心内科住院的首次AMI患者75例(AMI组),另选择年龄、性别相匹配的健康体检者60例(对照组),采用定量夹心酶联免疫吸附法检测血清内脏脂肪素、MMP-2、MMP-9及其他生化指标。对血清内脏脂肪素与MMP-2、MMP-9、高敏C反应蛋白及其他临床生化指标进行Pearson相关性分析。结果 AMI组LDL-C、内脏脂肪素、MMP-2、MMP-9及高敏C反应蛋白水平明显高于对照组[(3.45±0.87)mmol/L vs(2.89±0.65)mmol/L,(8.06±2.21)μg/L vs(5.53±1.23)μg/L,(150.18±74.58)μg/L vs(64.60±25.86)μg/L,(478.77±165.46)μg/L vs(263.54±99.35)μg/L,(12.07±2.50)mg/L vs(4.62±1.82)mg/L,P0.01]。AMI组血清内脏脂肪素与MMP-2、MMP-9、高敏C反应蛋白呈正相关(P0.01)。结论急性心肌梗死患者血清内脏脂肪素水平显著升高,表明血清内脏脂肪素与动脉粥样硬化斑块的破裂密切相关。     

急性冠状动脉综合征患者血清基质金属蛋白酶2及胱抑素C水平的临床意义

目的探讨血清基质金属蛋白酶2(MMP-2)及胱抑素C在急性冠状动脉综合征患者中的临床意义。方法选择急性冠状动脉综合征患者80例,其中急性心肌梗死组40例,不稳定性心绞痛组40例,另选择非冠心病患者30例(对照组)。采用速率散射比浊法和酶联免疫吸附法分别检测各组血清胱抑素C、MMP-2及高敏C反应蛋白(hs-CRP)水平。结果急性心肌梗死组和不稳定性心绞痛组血清MMP-2水平明显高于对照组[(294.41±35.62)μg/L,(197.79±29.43)μg/L vs(96.09±21.96)μg/L,P<0.05],胱抑素C明显低于对照组[(0.63±0.09)mg/L,(0.76±0.07)mg/L vs(0.88±0.07)mg/L,P<0.05]。直线相关分析显示,血清MMP-2与hs-CRP呈正相关,而胱抑素C与hs-CRP呈负相关。结论血清MMP-2及胱抑素C均参与急性冠状动脉综合征的发生、发展;血清MMP-2及胱抑素C可能成为急性冠状动脉综合征早期预测及危险分层的重要指标。     

吡格列酮对糖尿病大鼠血清MMP-9水平及其外周血单核细胞中MMP-9表达的影响

目的:观察过氧化物酶体增殖物激活受体γ(PPARγ)配体吡格列酮对糖尿病大鼠血清基质金属蛋白酶9(MMP-9)浓度和外周血单核细胞中MMP-9表达的影响。方法:40只Wistar大鼠随机分为5组,即对照组、糖尿病组和不同剂量5、10、20mg/(kg.d)吡格列酮治疗组,每组8只。给糖尿病组和3个吡格列酮治疗组大鼠腹腔注射链脲霉素制作糖尿病大鼠模型后,各吡格列酮治疗组以不同剂量的吡格列酮灌胃:5、10、20mg/(kg.d),共28d;对照组和糖尿病组以等量生理盐水灌胃。比较治疗前、后的血清MMP-9浓度的变化。分离大鼠外周血单核细胞,用RT-PCR和Westernblot检测MMP-9表达的变化。结果:与对照组比较,吡格列酮降低血清MMP-9的浓度(P0.05),降低外周血单核细胞中MMP-9的表达。结论:吡格列酮可以降低糖尿病大鼠血清MMP-9浓度及外周血单核细胞中MMP-9的表达,提示其在降糖之外还具有心血管保护作用。     

2型糖尿病合并非酒精性脂肪肝患者经吡格列酮治疗后核苷酸结合寡聚化结构域样受体蛋白3的变化

目的 探讨吡格列酮治疗2型糖尿病（T2DM）合并非酒精性脂肪肝（NAFLD）患者血清核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)水平的改变。方法 收集上海健康医学院附属周浦医院内分泌科2021年1月到2022年10月就诊的T2DM合并NAFLD患者80例，随机分为对照组及吡格列酮治疗组，随访4周。分析两组研究对象基线及随访时血糖、血脂、肌酐、谷丙转氨酶等生化指标；运用ELISA双抗体夹心法检测外周血NLRP3水平。结果 最终吡格列酮组35例、对照组36例完成全部试验。吡格列酮组基线血清NLRP3为（5.4±1.1）μg/L，随访时为（4.8±0.8）μg/L，有明显下降；而对照组基线血清NLRP3为（5.2±1.0）μg/L，随访时为（5.2±0.8）μg/L，无明显改变，并且随访时吡格列酮组血清NLRP3水平低于对照组。除随访时吡格列酮组TC水平高于对照组外，两组间血糖、血脂、肝肾功能均无明显差异。结论 T2DM合并NAFLD患者使用吡格列酮治疗后在改善糖脂代谢的同时，也可以降低血清NLRP3水平。     

急性冠状动脉综合征患者血清基质金属蛋白酶2的变化

目的探讨急性冠状动脉综合征与血清基质金属蛋白酶2的关系。方法经皮腔内冠状动脉造影确诊的冠心病患者61例,其中急性冠状动脉综合征患者46例,包括急性心肌梗死16例,不稳定型心绞痛30例,稳定型心绞痛15例;另设冠状动脉造影排除冠心病但有临床胸闷、胸痛症状的24例患者作为对照组。运用酶联免疫吸附法测定造影前后血清基质金属蛋白酶2浓度。结果造影前,急性冠状动脉综合征组、稳定型心绞痛组及对照组血清基质金属蛋白酶2水平分别为56.9±11.9μg/L、48.2±10.8μg/L和46.6±10.5μg/L,急性心肌梗死组和不稳定型心绞痛组基质金属蛋白酶2水平分别为58.6±14.8μg/L和53.4±9.3μg/L。急性心肌梗死组及不稳定型心绞痛组与稳定型心绞痛组之间基质金属蛋白酶2水平有显著性差异,稳定型心绞痛组与对照组之间没有统计学差异。血清基质金属蛋白酶2水平与C反应蛋白、白细胞计数、冠状动脉病变评分和冠状动脉狭窄程度之间呈正相关,与冠状动脉病变支数、肌钙蛋白、肌酸激酶同工酶、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇和血小板计数之间无明显相关性。经皮腔内冠状动脉成形术及支架术患者基质金属蛋白酶2水平在术后1天均较术前明显升高。结论急性冠状动脉综合征患者血清基质金属蛋白酶2浓度明显升高,其水平与冠状动脉内粥样硬化斑块的稳定性可能相关,有助于冠心病的危险分层,对评价冠状动脉病变严重程度及预后可能有重要意义。     

冠心病患者不同类型血清氧化型低密度脂蛋白和高敏C反应蛋白水平的差异

目的比较血清氧化型低密度脂蛋白、高敏C反应蛋白水平在不同类型冠心病中的差异。方法检测了82例冠心病患者(急性冠状动脉综合征42例、稳定型心绞痛20例和陈旧性心肌梗死20例)和22例正常对照者血清氧化型低密度脂蛋白、高敏C反应蛋白、高密度脂蛋白胆固醇、总胆固醇和高密度脂蛋白胆固醇水平,并比较各指标水平在不同类型冠心病中的差异。结果血清氧化型低密度脂蛋白水平在冠心病组明显高于对照组(62.5±24.8μg/L比42.3±17.9μg/L,P<0.05),在急性冠状动脉综合征组明显高于稳定型心绞痛组和陈旧性心肌梗死组(68.9±23.4μg/L比41.5±21.3μg/L和50.5±21.6μg/L,P<0.05);血清高敏C反应蛋白水平在冠心病组明显高于对照组(15.58±4.32mg/L比6.94±1.93mg/L,P<0.05),在急性冠状动脉综合征组明显高于稳定型心绞痛组和陈旧性心肌梗死组(19.31±1.43mg/L比10.29±1.01mg/L和9.56±1.72mg/L,P<0.05);血清低密度脂蛋白胆固醇水平在冠心病组明显高于对照组(3.46±1.11mmol/L比2.87± 0.82mmol/L,P<0.05),但在急性冠状动脉综合征组与稳定型心绞痛组和陈旧性心肌梗死组差异无显著性(3.64±0.85mmol/L比3.06±1.23mmol/L和3.40±1.35mmol/L);血清总胆固醇/高密度脂蛋白胆固醇比值在冠心病组明显高于对照组(3.46±1.11比2.87±0.82,P<0.05),在不同类型冠心病中亦有差异(P<0.05)。结论血清氧化型低密度脂蛋白和高敏C反应蛋白水平及总胆固醇/高密度脂蛋白胆固醇比值在冠心病不同类型中有差异,可能为诊断冠心病的指标。     

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.