血管紧张素转换酶2基因多态性与原发性高血压合并脑卒中的关系

目的研究血管紧张素转换酶2（ACE2）基因G9570A多态性与我国南方汉族人原发性高血压合并脑卒中的关系。方法采用聚合酶链反应和限制性片段长度多态性（PCR-RFLP）的方法，检测156例原发性高血压患者，158例原发性高血压合并脑卒中患者及169例健康人群的ACE2基因，并进行组间对照研究，推测ACE2基因G9570A多态性与原发性高血压合并脑卒中发病的相关性。结果男性和女性原发性高血压组G等位基因频率分别为69．8％、57．1％，高于对照组的55．0％、44．2％，差异有统计学意义（P〈0．05）；两组ACE2基因型分布不同，原发性高血压组GG基因型的频率为32．8％，高于对照组的15．9％，差异有统计学意义（P〈0．05）。男性和女性原发性高血压合并脑卒中组A等位基因频率分别为57．3％、62．3％，高于原发性高血压组的30．2％、42．9％，差异有统计学意义（P〈0．01）；两组ACE2基因型分布不同，原发性高血压合并脑卒中组AA基因型的频率为37．7％，高于原发性高血压组的18．6％，差异有统计学意义（P〈0．01）。结论ACE2基因G9570A多态性与我国南方汉族人原发性高血压合并脑卒中可能具有一定相关性。携带A／AA基因的人群发生原发性高血压合并脑卒中的危险性相对较大。     

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。     

血管紧张素转换酶2基因A9570G多态性与高血压合并左心室肥厚的相关性研究

目的探讨血管紧张素转换酶2基因(ACE2)A9570G多态性与高血压合并左心室肥厚的关系。方法选择高血压合并左心室肥厚(LVH)患者172例(LVH组)、高血压未合并LVH患者153例(NLVH组)以及对照组80例,应用聚合酶链反应(PCR)方法检测入选者ACE2基因A9570G多态性,按性别分别比较不同组别中基因型分布及等位基因频率的差异。结果在女性,3组间等位基因频率比较差异有统计学意义(P=0.007),基因型分布差异也有统计学意义(P=0.034),其中LVH组GG基因型及G等位基因频率分别为30.0%和61.0%,高于NLVH组(18.7%和44.8%)及对照组(15.0%和40.0%)。在男性,3组间等位基因/基因型频率比较差异有统计学意义(P=0.002),其中LVH组G基因型/等位基因频率为69.0%,高于NLVH组(47.6%)及对照组(40.0%)。结论 ACE2基因A9570G多态性与高血压患者左心室肥厚相关。     

内皮型一氧化氮合酶基因G894T多态性与蒙古族原发性高血压合并卒中的关系

目的探讨内皮型一氧化氮合酶（eNOS）基因G894T多态性与蒙古族原发性高血压及原发性高血压合并卒中之间的关系。方法选择长期生活在内蒙古乌拉特后旗、三代血亲内无其他民族的蒙古族人群286例,其中原发性高血压合并卒中组70例,原发性高血压组104例,正常血压组112名。采用基质辅助激光解吸电离飞行时间质谱（MALDI-TOF MS）技术检测3组eNOS基因G894T多态性。结果原发性高血压合并卒中组eNOS基因G894T位点GG、GT＋TT基因型频率为75.7%、24.3%,G、T等位基因频率为86.4%、13.6%;原发性高血压基因型频率为81.7%、18.3%,等位基因频率为89.9%、10.1%;正常血压组基因型频率为93.8%、6.2%,等位基因频率为96.9%、3.1%。3组基因型频率及等位基因频率比较,差异均有统计学意义（χ2=12.240,OR=4.811,95%CI：1.879~12.318;χ2=14.175,OR=4.868,95%CI：1.990~11.909;χ2=7.358,OR=3.353,95%CI：1.346~8.351;χ2=8.647,OR=3.481,95%CI：1.448~8.372）,原发性高血压合并卒中组与原发性高血压组比较,差异均无统计学意义（χ2=0.601,OR=1.329,95%CI：0.646~2.734;χ2=0.993,OR=0.398,95%CI：0.720~2.709）。结论eNOS基因G894T多态性的T等位基因与蒙古族人群原发性高血压及原发性高血压合并卒中的发生可能相关。     

血管紧张素转换酶2基因多态性与高血压合并缺血性脑卒中

目的 研究血管紧张素转换酶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 (PCR-RFLP)的方法，检测136例单纯原发性高血压患者及139例原发性高血压合并缺血性脑卒中患者的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相关性。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，差异有统计学意义（P<0.05）；两组ACE2基因型分布不同，差异有统计学意义（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, 差异有统计学意义（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, 差异有统计学意义（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，原因可能与其血管紧张素Ⅱ水平较高有关。     

ACE2基因A9570G多态性与2型糖尿病及糖尿病心肌病的相关性研究

目的 探讨血管紧张素转化酶2(angiotensin l converting enzyme 2,ACE2) 基因A9570G多态性与2型糖尿病(Type 2 diabetes,T2DM)及糖尿病心肌病(diabetic cardiomyopathy,DCM)的相关性.方法选择广东地区无血缘关系的T2DM患者共358例,其中84例并发DMC,所有病人按是否并发DMC分为DMC组和DM组,应用聚合酶链反应和限制性内切酶片段长度多态性的方法检测ACE2基因A9570G多态性,并结合临床、生化指标及超声心动图参数进行分析.结果在男性,对照组和T2DM组等位基因频率及基因型构成差异无统计学意义(χ2=0.002,P=0.964),但DCM组G等位基因频率/G基因型分布高于对照组及T2DM组,差异有统计学意义(χ2=4.409,P=0.036,χ2=6.105,P=0.013).在女性,三组间等位基因频率及基因型构成差异无统计学意义(χ2=0.037,P=0.981及χ2=0.890,P=0.926).根据不同基因型对DMC组患者进行亚组分析发现,男性G基因型患者反映心脏早期舒张功能的室间隔舒张末期厚度(IVSTd)值明显高于A等位基因,差异有统计学意义(t=2.243,P=0.029);女性则未观察到这种差异(F=1.156,P=0.324).结论 ACE2基因A9750G多态性可能与男性T2DM并发DCM的遗传易感性相关,并且与其早期舒张功能不全严重程度有一定关系.     

高血压伴左心室肥厚患者ACE2350G/A及Chymase基因多态性与心房颤动的关系

目的 研究血管紧张素转换酶基因2350G→A单核苷酸多态性（ACE2350G/A）及胃促胰酶（Chymase）基因多态性在高血压伴左心室肥厚（LVH）人群中心房颤动（房颤）及非房颤患者中的分布,探讨高血压伴LVH患者房颤发生的分子遗传学机制,为房颤的防治提供临床和实验依据.方法 2010年8月至2013年6月泰州市人民医院收治的408例高血压伴LVH住院患者,根据有无房颤分为LVH-房颤组和LVH组,利用聚合酶链反应（PCR）及限制性酶切技术进行检测ACE2350G/A及Chymase基因的CMA/B多态性.结果 LVH-房颤组ACE2350基因G、A等位基因的频率明显高于LVH组（x2=5.503,P=0.019）.ACE2350基因多态性与高血压伴LVH患者房颤相关.CMA/B基因在房颤组与LVH组G、A等位基因频率差异无统计学意义（x2=0.933,P=0.334）,CMA/B基因与高血压伴LVH患者房颤发生无显著相关.与正常人相比,各类型LVH患者的CMA/B基因的GG,AA及G、A等位基因频率差异均有统计学意义.结论 ACE2350基因多态性与高血压伴LVH患者房颤发生相关,AA基因型增加房颤的发生风险,A等位基因为房颤发生的危险基因.CMA/B基因与高血压伴LVH患者房颤发生无显著相关.     

原发性高血压血管紧张素转换酶2基因多态性与胰岛素抵抗的关系

目的:探讨原发性高血压患者血管紧张素转换酶2(ACE2)基因单核苷酸多态性(SNP)与胰岛素抵抗的关系。方法:采用病例对照研究方法,以社区人群中确诊的96例原发性高血压患者为研究对象(病例组),以性别、年龄相匹配的健康人为对照组,测定空腹血糖、胰岛素,计算稳态模型胰岛素抵抗指数(HOMA-IR),应用聚合酶链反应(PCR)检测其ACE2基因G9570A多态性。结果:与对照组比较,病例组G9570A基因多态性构成无显著差异;病例组中男性病例基因表型A组HOMA-IR高于G组,女性病例基因表型AA组HOMA-IR高于AG组及GG组。结论:高血压人群ACE2基因多态性与胰岛素抵抗存在一定关系,基因型A/AA可能是高血压患者胰岛素抵抗的遗传易感指标。     

中国北方汉族人群CYP4F2基因rs2108622多态性与原发性高血压的相关性研究

目的：探讨我国北方汉族人群CYP4F2基因单核苷酸多态性位点rs2108622与原发性高血压的相关性。方法：采用病例-对照研究的方法,选取在北京安贞医院就诊的北方汉族原发性高血压者765例（HT组）和同期健康体检血压正常者477例（NT组）。应用TaqMan荧光定量法对CYP4F2基因rs2108622进行基因分型,评估该多态性位点与我国北方汉族人群原发性高血压发病风险的关系。结果：rs2108622位点在HT组和NT组的基因型分别为AA型61/35、AG型296/162、GG型403/273;A等位基因频率分别为27.5%/24.7%,G等位基因频率分别72.5%/75.3%。两组间基因型和等位基因频率分布,差异均无统计学意义（分别为P=0.218,P=0.123）。多因素Logistic回归分析显示：等位基因模型（OR=1.147,95%CI=0.853!1.543）、显性模型（OR=0.788,95%CI=0.549!1.131）、隐性模型（OR=1.153,95%CI=0.549!2.422）、纯合子模型（OR=1.018,95%CI=0.48!2.157）、加性模型（OR=0.872,95%CI=0.649!1.172）均未发现该多态性位点与原发性高血压存在相关性。根据性别进行亚组分析显示：男性亚组中A等位基因频率在HT组（27.5%）高于NT组（23.7%）,但差异无统计学意义（P=0.096）。而在女性亚组中各基因型和等位基因频率分布两组间比较,亦均差异无统计学意义（P=0.579和P=0.677）。结论：本研究发现CYP4F2基因rs2108622多态性位点可能与中国北方汉族人群原发性高血压的发病不存在相关性。     

新疆哈萨克族高血压患者内皮型一氧化氮合酶基因G894T多态性研究

目的探讨哈萨克族人群内皮型一氧化氮合酶(eNOS)基因多态性与原发性高血压关联性.方法应用聚合酶链反应、限制性内切酶方法检测了新疆巴里坤县203例哈萨克族高血压病患者和190例正常人群eNOS基因G894T多态性.结果哈萨克族正常人群及高血压患者的eNOS基因G894T多态GG、GT、TT基因型频率分布分别为0.74,0.24,0.02和0.81,0.18,0.01,G和T等位基因分布频率分别为0.86,0.14和0.90,0.10,符合Hardy-Weinberg平衡.群体相关分析结果表明eNOS基因的G及T等位基因分布在高血压病组(EH)及正常血压组(NT)差异无显著性(χ2=3.580,P=0.058);基因型频率之间差异无显著性(χ2=4.037,P=0.133).然而男性EH组G等位基因频率(0.90)高于NT组(0.86);T等位基因频率(0.06)低于NT组(0.14).结论 eNOS基因G894T多态性可能与新疆巴里坤哈萨克族男性高血压有关.     

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.