壮族人群高血压与血脂水平关系的分析

目的:探讨壮族人群中原发性高血压(下称高血压)患者血脂水平与高血压的关系.方法:对2843例入选者测量血压及血脂(TC、TG、HDL-C和LDL-C),比较高血压组与非高血压组的血脂水平.结果:与非高血压组比较,高血压组表现为高TC,高TG、高LDL-C和低HDL-C(均P＜0.01);血脂异常的高血压患病率高于血脂正常者(P＜0.01).结论:壮族人群高血压与血脂水平有关,血脂异常与高血压常并存于同一个体中.     

甘肃省裕固族地区中老年居民血脂水平的流行病学调查

目的 观察甘肃省裕固族地区中老年居民血脂水平及血脂异常状况,为该地区血脂异常的防治工作提供科学依据.方法 采用整群随机抽样方法,对长期居住在甘肃肃南裕固族自治县的511名中老年居民进行现况调查,检测血浆TC、TG、LDL-C、HDL-C水平.结果 ①高TC、高TG、高LDL-C血症为该地区人群血脂异常的主要类型,异常发生率分别为42.86%、60.86%、53.62%.②血脂异常与年龄、性别有关.60岁以上女性TC及LDL-C显著高于男性(P＜0.05).③裕固族中老年TC、LDL-C水平高于汉族,有显著性差异(P＜0.05).④高血压组TC、LDL-C水平与血压正常组有显著性差异(P＜0.01,P＜0.05),超重肥胖组TC、TG、LDL-C水平均高于正常体重组(P＜0.05).结论 该地区中老年居民为血脂异常的高发人群,血脂异常与超重肥胖、腹型肥胖、高血压具有显著相关性.     

T2DM血脂和载脂蛋白代谢及相关性分析

选取T2DM患者132例及正常对照组35例,根据ACR分为A组(43例)、B1组(52例),B2(35例)N组(35例).分别测定TG、TC、HDL-C、LDL-C、ApoA、ApoB、HbA1及ACR.结果(1)DM各组间TG、LDL-C、HDL-C水平差异有统计学意义(P＜0.01～0.05).(2)血脂及Apo各水平在B2组差异均有统计学意义(P＜0.01).(3)ACR与TG(r=0.614)、LDL-C(r=0.368)、TC(r=-0.412,P＜0.05)吴负相关.结论DN较DM患者伴有更明显的血脂及载脂蛋白代谢紊乱.脂质紊乱与DN有密切关系.     

广州汉族与连南瑶族老年人血脂状况及分析

目的 观察广州汉族老年居民和连南瑶族自治县老年居民的血脂水平及血脂异常状况,为有目的进行血脂异常的社区卫生服务防治工作提供科学依据.方法 采用整群随机抽样的方法,对长期居住在广州市的97例汉族老年居民和连南瑶族自治县的222例老年居民进行现状调查,检测不同地区、民族、性别人群中的总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(HDL-C)等指标的水平.结果 ①广州汉族老年居民血脂异常存在性别差异,女性较男性高TG、高LDL-C的发病率高(P＜0.05).②连南老年居民血脂异常的发病率无性别、民族差异.③与连南汉族女性和连南瑶族女性比较,广州汉族女性高TC、高LDL-C的发病率明显较高(P＜0.01、P=0.01).④与连南汉族男性、连南瑶族男性比较,广州汉族男性高LDL-C的发病率明显较高(P均＜0.05).结论 本研究中环境地域、饮食习惯、体力锻炼等因素较种族遗传和性别因素对血脂的影响更大.     

2型糖尿病并发高甘油三酯血症患者发生急性胰腺炎的影响因素分析

目的探讨2型糖尿病患者并发高甘油三酯血症与急性胰腺炎发生的关系,以指导糖尿病患者急性胰腺炎的预防和治疗。方法选取2013年1月-2016年12月榆林市第一医院收治的2型糖尿病并发急性胰腺炎患者46例为试验组,另选取本院同期收治的单纯2型糖尿病患者52例为对照组。记录患者的年龄、性别、糖尿病病程、身高、体质量、腹围、吸烟、饮酒、胆结石、高血压、血糖、血脂情况[TC、TG、HDL-C、LDL-C]。检测患者糖尿病相关并发症的发生情况。计数资料2组间比较采用χ2检验,计量资料2组间比较采用t检验;采用logistic回归进行多因素分析。结果 2组患者在年龄、性别构成、身高、体质量、腹围、吸烟饮酒习惯、高血压、胆结石、糖尿病病程等方面的差异无统计学意义(P值均0.05);试验组患者的TC、TG、LDL-C水平均显著高于对照组,差异均有统计学意义(t值分别为5.122、4.127、3.524,P值分别为0.01、0.01、0.012),对照组患者的HDL-C水平显著高于试验组,差异统计学意义(t=2.231,P=0.037);试验组患者的糖尿病微血管病变(糖尿病视网膜病变、糖尿病慢性肾病)发病率显著高于对照组(χ2=92.126,P0.01);多因素分析结果显示,高TG水平的2型糖尿病患者发生急性胰腺炎的风险较TG水平正常的患者增加了47.6%(比值比=1.476,P=0.031),高LDL-C的2型糖尿病患者发生急性胰腺炎的风险较LDL-C水平正常的患者增加了48.7%(比值比=1.487,P=0.045)。结论应加强对2型糖尿病患者的血脂检测,针对伴高甘油三酯血症的2型糖尿病患者应积极控制血糖、血脂水平,以降低急性胰腺炎的发生率。     

高血压病患者血尿酸、血脂水平与颈动脉内膜-中层厚度的相关性分析

对134例高血压病患者(观察组)及55例体检健康血压正常者(对照组)进行血尿酸(UA)、血脂TC、HDL-C、LDL-C、TG及颈动脉内膜-中层厚度(IMT)检测.结果观察组UA、TC、LDL-C、TG均显著高于对照组(P＜0.05);观察组血脂异常者(76例)UA显著高于血脂正常者 (P＜0.05),HDL-C明显低于血脂正常者与对照组(P＜0.05);直线相关分析显示,IMT与UA、LDL-C与TC呈正相关.认为IMT可作为预测动脉粥样硬化病情的一个重要指标,血清Ua测定有助于反映高血压病患者IMT的增厚程度.     

低血糖生成指数控制饮食对老年糖尿病血脂异常患者血脂水平的影响

目的 探讨低血糖生成指数控制饮食对老年糖尿病合并血脂异常患者血脂水平的影响.方法 22例老年糖尿病合并血脂异常患者,未用任何降脂降糖药物,在营养治疗中给予低血糖生成指数控制饮食,比较患者控制饮食前后空腹血糖(FPG)、餐后2 h血糖(2 h PG)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)等的变化.结果 经过6 w的低血糖生成指数控制饮食,FPG由(7.92±1.21) mmol/L降至(6.23±0.66) mmoL/L(P ＜0.01),2hPG由(13.73±3.35)mmol/L降至(8.54±0.85) mmol/L(P＜0.01),TG由(1.82±0.64) mmol/L降至(1.13±0.43) mmol/L (P＜ 0.01),TC由(5.44±0.29) mmol/L降至(5.05±0.77) mmol/L(P＜0.01),LDL-C由(3.72±0.48)mmol/L降至(3.21±0.67) mmol/L(P＜0.0l),HDL-C由(1.41±0.25) mmol/L升至(1.61±0.29) mmol/L(P ＜0.01),其差异均具有统计学意义.结论 低血糖生成指数控制饮食可以明显改善老年糖尿病合并血脂异常患者的血脂水平.     

福建沿海地区超重及肥胖人群血压、血脂现状分析

目的:调查福建沿海地区人群超重和肥胖的现状及其与血压、血脂的相关性。方法:通过横断面调查方法,纳入福建省沿海地区30岁以上人群3343例,进行身高、体质量、血压、腰围、血糖、血脂等指标检测,采用统计学方法分析BMI与血压、血脂的相关性。结果:调查地区超重及肥胖检出率为34.6%和10.0%,男性超重率显著高于女性(40.4%比30.7%,P0.05);超重和肥胖人群比例在70岁以前均随年龄增加而逐渐显著增高,70岁以后有下降趋势。与年龄匹配的正常体重人群比较,青年(40岁)超重和肥胖人群血压、腰围显著升高(P均0.01);中老年(40岁)超重和肥胖人群血压、腰围、TC、LDL-C水平显著升高,而HDL-C水平显著降低(P0.05或0.01)。偏相关分析显示BMI与腰围、收缩压、舒张压、TC、LDL-C和HbA1c水平呈显著正相关(r=0.701,0.218,0.238,0.068,0.120,0.135,P均0.01),与TG和HDL-C水平呈显著负相关(r均=-0.069,P均0.01)。多元线性回归分析显示BMI与腰围、性别、年龄、DBP、HDL-C、FBG显著相关。控制年龄、性别、血糖等混杂因素后,二元Logistic回归分析显示:超重(OR=2.283,95%CI 1.915~2.721)和肥胖(OR=4.419,95%CI 3.329~5.865)是高血压、血脂异常的危险因素[超重(OR=1.356,95%CI 1.160~1.584),肥胖(OR=1.691,95%CI 1.319~2.167)],P均0.01。结论:福建沿海地区人群超重/肥胖率较高,超重、肥胖人群中高血压、血脂异常、糖尿病、心血管危险因素聚集比例显著增高,控制体重对高血压、血脂异常及糖尿病等慢性病的防治具有重要意义。     

吉林地区农村中老年体脂肪分布与血脂水平的关系

目的 分析中老年人体脂肪分布与血脂水平的相关性.方法 2010 ～2011年吉林农村整群抽样1 332名40 ～70岁朝鲜族和汉族中老年进行体检,采用日本TANITA株式会社生产的BC-600型体成分计测定体脂肪指标,检测血脂指标,分析体质指数(BMI)、腰臀比(WHR)、体脂肪率(BFP)与血脂异常的相关性.结果 血脂异常患病率为46.4％,朝鲜族高于汉族(P =0.001),血脂异常组体脂肪指标和血脂指标均高于正常组(P＜0.01).BMI、WHR和BFP均与甘油三酯(TG)、总胆固醇(TC)和低密度脂蛋白胆固醇(LDL-C)呈正相关,与高密度脂蛋白胆固醇(HDL-C)呈负相关.腹型肥胖组血脂异常患病率明显高于全身肥胖组(P＜0.05).腹型肥胖组TG异常检出率高于全身肥胖组,而HDL-C异常检出率低于全身性肥胖组(P＜0.05).结论 血脂异常患病率存在民族差异,体脂肪分布与血脂异常指标和血脂水平有关.     

老年甲状腺功能减退患者血脂水平变化

目的探讨老年性甲状腺功能减退患者的血脂水平变化情况及其相关性。方法收集2009年2月至2014年3月在该院内分泌门诊及病房就诊的患者79例老年性甲状腺功能减退患者作为病例组,即老年性甲减组。按照对照组与病例组患者的性别构成相同,年龄相差5岁以内,随机选择同期在该科门诊或病房检查甲状腺功能正常患者79例作为对照组。两组患者空腹12 h后,于次日清晨采集静脉血10 ml,1 000 r/min,离心5 min,取其血清分装2份,一份用于检测血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH),另一份用于检测血清胆固醇(TC)、血清甘油三酯(TG)、血清高密度脂蛋白胆固醇(HDL-C)和血清低密度脂蛋白胆固醇(LDL-C)。比较两组患者的血脂水平有无差异,同时分析FT3、FT4、TSH与血脂的相关性。结果两组FT3、FT4、TSH水平均有统计学意义(P0.05),且老年性甲减组FT3和FT4水平均低于对照组,TSH水平高于对照组。两组TC、HDL-C、LDL-C差异均有统计学意义(P0.05),且老年性甲减组TC和LDL-C水平高于对照组,HDL-C水平低于对照组;TG无统计学意义(P0.05)。FT3与TC、TG、HDL-C、LDL-C均存在负相关性r=-0.521、-0.217、-0.181、-0.469(P0.05),其中与TC、LDL-C显著相关(P0.01)。FT4与TC、TG、HDL-C、LDL-C存在负相关性,r=-0.538、-0.202、-0.159、-0.475(P0.05),其中与TC、LDL-C显著相关(P0.01)。TSH与TC、TG、HDL-C、LDL-C均存在正相关性,r=0.551、0.293、0.167、0.471(P0.05),其中与TC、LDL-C显著相关(P0.01)。结论老年性甲状腺功能减退症可引起血脂增高,血脂与老年人甲状腺功能有较强的相关性,其中TC、LDL-C与老年人甲状腺功能显著相关。因此,血脂的检测对老年性甲状腺功能减退症的病情轻重判断、疗效观察及预后的估计具有一定的临床意义。     

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.