慢性肺心病患者肾上腺髓质素测定的临床意义及相关因素分析

目的　探讨肾上腺髓质素在慢性肺心病发生发展中的作用 ,以及吸烟、缺氧、肺功能等因素对肾上腺髓质素的影响。方法　测定 63例肺心病患者急性发作期肾上腺髓质素 ( ADM)及缓解期与正常组 60例对照 ,并用多元回归分析方法 ,分析病人年龄、病程、吸烟、肺功能等因素对肾上腺髓质素的影响。结果　肺心病急性发作期及缓解期与正常组对照 ,肾上腺髓质素显著升高 ( P<0 .0 0 1) ,一秒钟用力呼气容积占用力肺活量比 ( FEV1% )、动脉氧分压 Pa O2 、吸烟是影响肾上腺髓质素的独立因素。结论　肺心病患者肾上腺髓质素高于正常人 ,且肾上腺髓质素升高与病情的严重程度有关 ,阻塞性通气功能障碍、缺氧、吸烟是影响肾上腺髓质素水平的独立因素     

肾上腺髓质素与肺动脉高压

肾上腺髓质素是一种新发现的降压肽,广泛分布于体内多种脏器,具有调节动脉血压、细胞增殖等作用。肺脏是肾上腺髓质素生成和代谢的重要器官。肺动脉高压时血清中肾上腺髓质素浓度明显升高,其mRNA在右心室表达增加,外源性的肾上腺髓质素能扩张在体和离体的肺动脉,降低肺动脉压,增加肺血流量,认为肾上腺髓质素在肺动脉高压的代偿机制中起重要作用,并有望用于治疗肺动脉高压。     

钙化心肌细胞肾上腺髓质素和受体活性修饰蛋白2mRNA含量的变化

为探讨离体钙化处理的新生大鼠心肌细胞肾上腺髓质素及受体活性修饰蛋白2 mRNA含量的改变及意义.采用β-磷酸甘油制备钙化的心肌细胞;放射免疫分析方法测定心肌细胞中肾上腺含量;竞争性定量逆转录-多聚酶链反应测定心肌细胞肾上腺髓质素和受体活性修饰蛋白2 mRNA水平.结果显示,钙化心肌细胞钙含量较非钙化心肌细胞高3倍(P<0.01),肾上腺髓质素含量较非钙化心肌细胞高136.9%(P<0.01 ),钙化心肌细胞肾上腺髓质素和受体活性修饰蛋白2 mRNA含量分别增加24%(P<0.05)和 25%(P<0.05).而且钙化心肌细胞受体活性修饰蛋白2和肾上腺髓质素基因表达上调的程度相平行.钙化心肌细胞肾上腺髓质素生成增加,肾上腺髓质素和受体活性修饰蛋白2 mRNA 表达亦明显上调,提示肾上腺髓质素/受体活性修饰蛋白2 信号途径在心肌细胞钙化发展中可能具有一定的调节作用.     

肾上腺髓质素在胰岛素瘤患者体内的表达情况

目的研究胰岛细胞瘤患者体内肾上腺髓质素的表达与分布情况;并通过对比研究阐明其表达的特异性.方法收集9例手术治疗的胰岛素瘤患者手术前后的血浆及手术标本,分别用放免法检测血浆中肾上腺髓质素浓度;免疫组化ABC法测定肾上腺髓质素在肿瘤组织中的表达与分布.结果胰岛素瘤患者体内的肾上腺髓质素浓度(7.1±2.7 fmol/m1)比正常对照组(2.6±1.6 fmol/m1)显著增高.在手术前后监测的9例中,血浆肾上腺髓质素浓度从7.1±2.7fmol/ml下降到2.9±1.7 fmol/ml.免疫组化结果显示肾上腺髓质素分布于肿瘤细胞中,而在胰腺基质和主要的胰腺导管中无表达.结论胰岛素瘤患者血浆中肾上腺髓质素明显增高,且在肿瘤组织中明显表达.     

肾上腺髓质素与心血管疾病研究进展

肾上腺髓质素是是近年来发现的一种具有舒血管功能的多肽类激素。研究表明 ,肾上腺髓质素与心血管疾病的发生发展有着密切的关系。作者就这一方面的内容做一综述     

肾上腺髓质素及其受体系统抑制溶血磷脂酸诱导的大鼠主动脉平滑肌细胞增殖

目的观察溶血磷脂酸对肾上腺髓质素及其受体系统生成的影响和肾上腺髓质素在溶血磷脂酸促进血管平滑肌细胞增殖中的作用。方法贴块法培养大鼠胸主动脉血管平滑肌细胞,H3-TdR掺入测定血管平滑肌细胞DNA合成,γ-32P-ATP标记的同位素法测定丝裂原活化蛋白激酶活性,放射免疫法测定血管平滑肌细胞中肾上腺髓质素的含量。结果溶血磷脂酸促进大鼠血管平滑肌细胞肾上腺髓质素生成,上调血管平滑肌细胞肾上腺髓质素及其受体CRLR、RAMP2和RAMP3mRNA表达;肾上腺髓质素可抑制溶血磷脂酸刺激大鼠血管平滑肌细胞3H-TdR掺入,抑制溶血磷脂酸诱导的丝裂原活化蛋白激酶激活。结论溶血磷脂酸上调血管平滑肌细胞肾上腺髓质素及其受体系统,肾上腺髓质素及其受体抑制血管平滑肌细胞增殖的作用与其抑制丝裂原活化蛋白激酶激活有关。     

实验性高血压大鼠局灶性脑缺血再灌注后肾上腺髓质素及其mRNA的表达

目的探讨肾上腺髓质素与脑缺血再灌注损伤及高血压的关系。方法应用改良Kellen的方法制备实验性高血压大鼠,采用栓线法制成大鼠大脑中动脉闭塞模型,阻断血流2 h后进行再灌注。免疫组织化学法检测高血压大鼠与非高血压大鼠局灶性脑缺血再灌注后肾上腺髓质素阳性细胞百分率并进行比较,逆转录聚合酶链反应检测大鼠局灶性脑缺血再灌注后脑组织肾上腺髓质素mRNA表达的情况。结果正常大鼠脑内有肾上腺髓质素mRNA表达,假手术后肾上腺髓质素mRNA表达略有增加,但与正常对照组相比差异无显著性(P>0.05);大鼠脑缺血再灌注后肾上腺髓质素mRNA过表达,与正常对照组及假手术组相比差异有显著性(均P<0.05);大鼠脑缺血再灌注后,缺血侧及缺血对侧肾上腺髓质素mRNA均有高表达,但以缺血侧最显著(P<0.05)。正常对照组和假手术组大鼠大脑组织中均有肾上腺髓质素阳性细胞表达,肾上腺髓质素阳性细胞百分率分别为2.87%±0.78%和2.47%±0.59%(P>0.05)。缺血再灌注非高血压组肾上腺髓质素阳性细胞高表达,以缺血侧为明显,阳性细胞百分率为59.42%±3.71%,缺血对侧亦明显,阳性细胞百分率为36.87%±5.28%,两者相比差异有显著性(P<0.05),与假手术组及正常对照组相比差异也有显著性(P<0.05)。比较高血压组与非高血压组肾上腺髓质素阳性细胞百分率发现,高血压组肾上腺髓质素阳性细胞百分率(缺血侧为78.60%±4.82%,缺血对侧为57.52%±5.22%)明显高于非高血压组(P<0.05)。结论脑缺血再灌注后肾上腺髓质素及其mRNA高表达。高血压组肾上腺髓质素的高表达更显著。肾上腺髓质素与脑缺血再灌注损伤相关,与高血压血管内皮损伤有关。     

肾上腺髓质素缺失对单侧输尿管结扎小鼠MMP-1/TIMP-1表达的影响

目的 探讨肾上腺髓质素在肾间质纤维化实验动物肾脏基质金属蛋白酶-1/基质金属蛋白酶抑制剂-1(MMP-1/TIMP-1)表达中的作用.方法 结扎肾上腺髓质素基因敲除小鼠及野生小鼠单侧输尿管,制备肾间质纤维化实验动物模型并给予缬沙坦灌胃治疗,采用免疫组化、原位杂交、RT-PCR方法检测MMP-1及TIMP-1的表达.结果 单侧输尿管结扎 (UUO) 小鼠肾脏MMP-1的表达减弱,而TIMP-1的表达显著上调,基因敲除小鼠较野生小鼠更为明显,采用缬沙坦治疗可部分抑制TIMP-1的表达.结论 肾上腺髓质素可以通过纠正MMP-1/TIMP-1的失衡,对UUO介导的肾间质纤维化起到保护作用.     

肾上腺髓质素与肺动脉高压

肾上腺髓质素是一种新发现的降压肽，广泛分布于体内多种脏器具有调节动脉血压、细胞增殖等作用。肺脏是肾上腺南素生成和代谢的重要器官。肺动脉高压时血清中肾上腺髓质纱深度明显升高，其ｍＲＮＡ在右心室表达啬外源性的肾上腺髓质素能扩张在体和离体的肺动脉，降低肺动脉压，啬肺血流量，认为肾上腺髓质素在肺动脉高压的代偿机制中起重要作用，并有望用于治疗肺动脉高压。     

肾上腺疾病中的骨骼肌胰岛素抵抗现象

多种肾上腺疾病存在骨骼肌胰岛素抵抗(IR)现象.醛固酮通过影响胰岛素受体功能和信号转导,或通过诱导氧化应激导致骨骼肌IR;糖皮质激素干扰胰岛素信号和糖原合成,或促进脂肪分解,减少骨骼肌胰岛素介导的葡萄糖摄取;儿茶酚胺诱导或加重骨骼肌IR,可能与血清脂联素水平下降有关;肾上腺偶发瘤患者骨骼肌IR发生率增加,这可能与亚临床...     

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.