河北地区健康人群携带幽门螺杆菌的VacA和CagE毒力基因型分析

目的探讨河北地区健康人群携带幽门螺杆菌(Helicobacter pylori,Hp)的VacA和CagE基因型分布情况,为当地Hp流行病学研究和胃病预防提供参考。方法从84名健康体检者胃黏膜组织分离培养Hp,提取DNA,利用PCR方法扩增毒力基因VacA的s基因、m基因、i基因以及CagE基因片段,分析健康人群中Hp流行株的基因型,以及Hp菌株VacA和CagE基因型与健康人群血型、年龄、性别的相关性。结果共分离58株Hp,PCR检测VacA基因均阳性,其中VacA基因的s1型阳性率为98.28%,且以s1a亚型为主,占91.38%;m区以m1b和m2亚型为主,占62.08%;i区阳性率为75.86%,以i1为主,占58.62%。毒力基因组合分型以s1m2i1和s1m1i1为主,占46.55%。CagE基因阳性率为89.7%,其中以CagE2亚型为主,占87.93%,CagE1亚型占1.72%。不同年龄、性别人群VacA基因亚型构成差异无统计学意义(P0.05)。结论河北地区健康人群感染的Hp大多含VacA和CagE基因,其致病性均较高。VacA基因以s1a、m2/m1b、i1为主,cagE以cagE2为主,这可能是当地消化道疾病高发的一个重要原因,因此应重视对健康人群的胃部检查,预防Hp感染。     

cag A阳性幽门螺杆菌与老年胃十二指肠病的相关性

目的 探讨本地区老人幽门螺杆菌（Hp）tagA基因存在状况及其与老年胃十二指肠病的关系。方法 收集89例老年和96例青壮年慢性胃炎、消化性溃疡患菌及30例正常对照人群的血清标本及胃组织标本,应用血清学检验其Hp-cag A阳性菌株感染状况。结果 89例老年患者中慢性胃炎、胃溃疡、十二指肠溃疡的Hp-cag A基因的阳性率分别为73．5％（38／52）、81．3％（13／16）及85．7％（18／21）;96例青壮年患者中慢性胃炎、胃溃疡、十二指肠溃疡的Hp-cag A基因的阳性率分别为59．3％（32／54）、68．8％（11／16）及61．5％（16／26）;对照组Hp-cag A阳性病株感染率为33．3％,各疾病组间Hp-cag A阳件菌株感染率差异无显著性（P〉0．05）．仍均高于对照组（P〈0．05）;cag A阳性Hp菌株感染率老年组高于青壮年组（P〈0．05）。结论 本地区老年患者cag A阳性Hp菌株感染与上述3种胃十二指肠疚病的发生均密切相关．老年患者感染的Hp绝大多数为cag A阳性菌株。     

地区差异与老年人幽门螺杆菌感染的相关性

目的了解北京地区老年人群中幽门螺杆菌（Hp）的感染状况和地区差异。方法采用随机抽样人户问卷调查的方法，调查北京不同地区（城区、郊区、山区）60岁及以上的老人2006例，应用免疫印迹法检测血清Hp-IgG抗体。结果山区老人Hp的感染率为91．1％。城区为82．6％，郊区为77．2％，山区明显高于城区和郊区（P〈0．001）。结论北京城区、郊区和山区老年人群中的Hp感染率存在着显著差异，但地理因素不是决定性因素。     

老年人消化性溃疡与却感染、服用非甾体消炎药的关系

目的 探讨老年人消化性溃疡（PU）及其常见并发症出血与幽门螺杆菌（Hp）感染、服用非甾体消炎药（NSAIDs）之间的关系。方法 采用病例对照分析方法，收集60岁以上老年消化性溃疡病（PUD）连续住院患者784例为研究组．再根据有无并发出血将研究组分为出血亚组（416例）与非出血亚组（368例）：选同期住院的60岁及以上老年慢性胃炎患者261例为对照组．所有患者均经胃镜明确诊断．并进行Hp快速尿素酶试验．统计患者NSAIDs的服用情况。结果 ①研究组服用NSAIDs的百分率及坳感染率均显著高于对照组（P〈0．05）；②研究组出血亚组服NSAIDs者的Hp阳性率（22．6％）低于未服NSAIDs者（73．8％）（P〈0．05）；③非出血亚组服NSAIDs者的Hp阳性率（30．0％）低于未服NSAIDs者（82．0％）（P〈0．05）；④研究组出血亚组中无论胃溃疡（Gu）还是十二指肠溃疡（Du）患者服用NSAIDs百分率均高于非出血亚组（P〈0．05）；出血亚组中GU患者却感染率（62％）比非出血组（82．5％）明显降低（P〈0．05），而出血亚组中DU患者Hp感染率（66．7％）与非出血组（70．6％）比较无明显差别（P〉0．05）。结论 ①老年人PUD的发病与Hp感染及服用NSAIDs密切相关，②服用NSAIDs可以增加老年PUD出血的危险性，而Hp感染并不增加老年PUD出血的危险性。③老年人PUD（不论出血和非出血）服NSAIDs者坳感染率降低。     

湖南省境内老年人群T淋巴细胞白血病病毒抗体普查分析

采用明胶粒子凝集反应法（ＰＡ法）对湖南省境内人群１６１０份血清标本进行了人类Ｔ淋巴细胞白血病病毒Ⅰ型（ＨＴＬＶ－Ⅰ）抗体检测，将老年人组与青中年人组进行对照分析。发现６例阳性者，其中老年人１例，青中年人５例，此结果证实湖南省境内人群中存在ＨＴＬＶ－Ⅰ感染者。老年人群中感染率为０．１９％，青中年人群中感染率为０．４６％，提示ＨＴＬＶ－Ⅰ在湖南省内人群中有散在流行，老年人亦有感染，应予以重视。     

健康体检人群幽门螺旋杆菌感染的调查北大核心CSCD

目的分析达州市健康体检人群幽门螺旋杆菌（Hp）感染的流行特征及相关危险因素。方法选择2014年1月至2015年12月在达州市中心医院进行健康体检的受检者,采用13C-尿素呼气试验进行Hp检测,并对其中自愿接受问卷调查者收集其社会人口学信息、饮食习惯、生活方式等资料,分析Hp感染的相关危险因素。结果25160例受检者Hp感染率为38．0％（9561／25160）,男、女性感染率分别为38．1％（6037／15841）和37．8％（3523／9319）,男、女性Hp感染率差异无统计学意义（χ2=0．23,P=0．630）。不同年龄组人群Hp感染率差异有统计学意义（χ2=116．07,P〈0．01）,除老年组外,Hp感染率均有随年龄增加而升高的趋势。无业者Hp感染率高于其他职业者（χ2=13．55,P=0．020）,共用茶杯或牙杯者、喝生水或生吃蔬菜或水果不削皮者Hp的感染率较无共用茶杯或牙杯者、不生吃果蔬／喝生水者显著升高（χ2=4．23、6．77,P=0．040、0．010）。暂未发现不同饮食习惯、吸烟、饮酒、不同饮用水水源等对Hp感染的影响（均P〉0．05）。结论达州市健康体检人群Hp感染率略低于全国自然人群,与国内其他地区健康体检人群Hp感染率相近;不良的个人卫生习惯与Hp感染有密切关系,应增强个人卫生习惯的健康教育和宣传,提高对HP相关危险因素的认识。     

兰州地区人群血清幽门螺杆菌致病因子抗体与上消化道疾病的关系

目的研究兰州地区患者中幽门螺杆菌(Hp)致病因子VacA、CagA、UreA和UreB与上消化道疾病的关系。方法病理学HE染色诊断患者,免疫印迹技术检测80例慢性萎缩性胃炎(16例)、消化性溃疡(24例)及胃癌患者(40例)血清中VacA、CagA、UreA和UreB抗体,分析与疾病的相关性。结果兰州地区人群上消化道疾病患者中HpCagA、VacA、UreA和UreB抗体阳性率依次为87.50%、95.00%、82.50%和80.00%;消化性溃疡组UreB抗体阳性率显著低于胃癌组(P0.05);在消化性溃疡、胃癌组中CagA抗体阳性率显著高于萎缩性胃炎组(P0.05)。结论兰州地区上消化道疾病患者中Hp感染率高,以Ⅰ型菌株为主;UreB与胃癌的发病关系密切;CagA在消化性溃疡和胃癌发生中的作用更为明显。     

CagA基因菌株Hp与胃、十二指肠疾病

目的通过检测胃、十二指肠疾病患者的幽门螺杆菌（Hp和CagA-Hp-IgG（细胞毒素相关蛋白抗体），探讨CagA基因菌株Hp与胃、十二指肠疾病的相关性。方法206例因胃肠症状在门诊、住院就诊者，男143例，女63例，年龄18岁～76岁．在内镜检查同时取胃粘膜组织4块，十二指肠溃疡者取距幽门1cm～2cm大弯侧，胃溃疡取溃疡边缘处，胃炎取炎症区．2块进病理检查，2块分别用尿素酶快速试验及用PCR法检测Hp，同时抽取静脉血3mL作CagA-Hp-IgG抗体检测．结果用尿素酶快速试验及PCR法检出Hp阳性者180例，男性感染率91％，女性78％，二者差异显著（P＜0．005），各年龄组构成无明显差异．两种检测方法的检出率无明显差异（P＞0．05）．检出CagA-Hp-IgG阳性者95例，在Hp感染组中阳性率89／180（50％），非感染组阳性率6／26（23％），二者差异显著（P＜0．05）．感染组CagA阳性者中，十二指肠球部溃疡44／55（80％），胃溃疡21／34（61％），慢性胃炎24／91（26％），三者差异明显（P＜0．025）．病理结果为轻、中、重度炎症CafA-Hp阳性率分别为25％，56％，70％，三者差异显著（P＜0．005）．结论CagA基因菌株Hp较CagA阴性菌株Hp具有更强的导致炎症的作用．CagA基因Hp是十二指肠球部溃疡、胃溃疡的重要发病因素．     

酒精性脂肪肝患者幽门螺杆菌感染率调查

目的探讨酒精性脂肪肝（alcoholicfattyliver,AFL）患者幽门螺杆菌（HellCObaeterpylori,Hp）感染情况。方法收集2012年5月-2013年5月在西安交通大学医学院第二附属医院体检中心体检人群为研究对象,采用上腹部B超检测其有无脂肪肝,再结合饮酒史诊断AFL,并采用血Hp抗体检测Hp感染,生化分析仪检测肝功能,用SPSS13．0软件进行统计分析。结果①AFL组403例,Hp感染率为22．6％;对照组1867例,Hp感染率为21．6％,2组比较差异无统计学意义（P〉0．05）。②轻、中、重度AFL患者Hp感染率分别为23．0％、21．1％、20．7％,3组比较差异无统计学意义（P〉0．05）。③AFL患者中,Hp阳性和阴性人群的肝功能无明显差异（P均〉0．05）。结论Hp感染与AFL及肝功能无明显关系。     

360例宫颈疾病患者HPV亚型检测与分析

采用核酸分子快速杂交基因分型技术对360例宫颈分泌物进行21种人乳头瘤病毒（HPV）亚型检测,对高危型HPv感染病例与宫颈细胞（病理）学检查结果进行回顾性分析。结果显示,360例宫颈疾病患者中HPV感染135例（37．5％）。高危型以16、58型为主,构成比分别为20.1％和12．9％。按宫颈炎／糜烂、不典型鳞状上皮细胞（ASCUS）、宫颈上皮内轻度瘤变（CINⅠ）、宫颈上皮内中度瘤变（CINⅡ）、宫颈上皮内重度瘤变（CINⅢ）／宫颈癌顺序,高危型HPV感染率依次递增分别为：20％、50％、66．7％、91．2％和94、1％。CINⅡ、CINⅢ／宫颈癌中高危型HPV感染率明显高于宫颈炎／糜烂、ASCUS和CINⅠ（P均〈0．05）。认为HPV感染率及亚型分布有地域差异,以高危型HPV16型感染最多。随着宫颈病变程度加重,高危HPV感染率增高。     

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.