脂联素基因SNP-11377多态性与冠脉病变程度相关性研究

目的探讨在中国上海地区汉族人群中脂联素基因（APM1）启动子序列单核苷酸多态性（SNP）与冠脉病变程度的关系。方法采用聚合酶链反应-限制性片段长度多态性（PCR—RFLP）方法，分析了325例冠脉造影结果和脂联素启动子序列单核苷酸多态性（-11377G／C）的关系．研究设立了冠心病组（CAD）和正常对照组，并根据冠脉造影结果按照不同病变支数及Gensini评分将分成不同病变组，分析-11377位点基因型及基因频率的差异性。结果（1）冠心病组脂联素基因-11377位点多态性GC、GG基因型频率与对照组比较，显著高于对照组，差异有极显著性（χ^2=12．619，P〈0．05）；（2）冠心病患者脂联素-11377位点G等位基因频率显著高于正常人（χ^2=11．291，P〈0．05）；（3）根据冠脉造影结果冠脉不同病变支数各组比较，脂联素-11377位点基因型差异无显著性（χ^2=11．575，P〉0．05），而等位基因频率具有显著差异性（χ^2=11．582，P〈0．05）；（4）按Genisini标准冠状动脉不同积分各组之间比较脂联素基因型间差异无显著性（χ^2=10．983，P〉0．05），但等位基因频率具有显著差异性（χ^2=8．978，P〈0．05）。结论脂联素SNP-11377G／C各种基因型与冠心病有关，与冠状动脉粥样硬化病变程度无关，而等位基因频率不但与冠心病显著相关，并且与冠状动脉病变程度有关。     

内皮一氧化氮合酶基因5′-侧翼区T^-786→C突变与2型糖尿病并发冠心病的关系

目的研究血管内皮一氧化氮合酶（eNOS）基因5′-侧翼区T^-786→C突变与2型糖尿病（T2DM）并发冠心病（CHD）的关系。方法选择T2DM患者186例，其中65例并发CHD；选择正常人63例作为对照。采用PCR／ASO杂交技术检测T^-786→C突变。结果与对照组相比，T2DM伴CHD组TC基因型及C等位基因频率明显增高（P〈0．05）。与T2DM不伴CHD组相比，T2DM伴CHD组C等位基因频率明显增高（P〈0．05）。在T2DM患者中，与TT组比较，TC组HbA1C明显增高。多元logistic回归分析显示，年龄、血压、病程、LDL-C、脂蛋白（a）、HbA1C、C等位基因与CHD呈正相关（P〈0．01）。结论eNOS基因5′-侧翼区T^-786→C突变增高T2DM患者并发CHD的危险性。     

血管紧张素转换酶基因I/D多态性及醛固酮合成酶基因T-344C多态性与蒙古族人群原发性高血压的相关性研究

目的研究血管紧张素转换酶（ACE）基因及醛固酮合成酶（CYP11B2）基因多态性与蒙古族原发性高血压（EH）的关系。方法应用PCR-RFLP技术检测98例EH患者与正常对照组108名健康受试者ACE基因第16内含子I/D多态性及CYP11B2基因T-344C多态性。结果①蒙古族人ACE基因I/D位点II、ID、DD基因型频率在EH组和正常对照组分别为0.44、0.38、0.18和0.42、0.32、0.26，差异无显著性（χ^2=1.693，P=0.192）；②I、D等位基因的频率分别为0.63、0.37和0.58、0.42，差异无显著性（χ^2=0.808，P=0.363）；③CYP11B2T-344C位点TT、TC、CC基因型的频率在EH组和正常对照组分别为0.46、0.44、0.09和0.37、0.54、0.09，两组之间差异无显著性（χ^2=0.005，P=0.945）。④T、C等位基因频率分别为0.69、0.31和0.64、0.36，差异无显著性（χ^2=0.928，P=0.335）；⑤同时分析CYP11B2基因T-344C基因型与ACE基因I/D基因型在蒙古族人群患EH方面无协同作用。结论ACE基因I/D位点及CYP11B2基因T-344C位点与蒙古族人群患EH无相关性。     

肾上腺素能β3受体基因多态性与冠心病及冠状动脉病变程度的相关性研究

目的探讨肾上腺素能β3受体（β3-AR）基因多态性与冠心病及冠状动脉病变的相关关系。方法选择冠心病患者120例,114名健康者为对照。应用聚合酶链反应-限制性片段长度多态性（PCR—RFLP）检测分析肾上腺素能良受体基因型,比较对照组与冠心病组的基因型及等位基因频率之间的差异,同时对冠心病患者中不同β3肾上腺素能受体基因型的冠状动脉病变程度进行比较。结果①冠心病组和对照组Trp64Trp、Trp64Arg和Arg64Arg的基因型频率分别为68．3％、30．0％、1．6％和69．2％、29．8％、0．9％。冠心病组Arg等位基因频率（16．6％）与对照组频率（15．8％）近似（P〉0．05）,突变频率两组相比差异无统计学意义。②冠心病不同冠脉病变支数亚组间多态性分布差异无统计学意义（χ^2=0．471,P=0．790）。结论肾上腺素能艮受体基因多态性与冠心病及不同冠脉病变支数无相关性。     

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(χ^2=3．580，P=0．058)；基因型频率之间差异无显著性(χ^2=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。     

冠心病患者与正常人凝血因子Ⅶ基因多态性的研究

目的：探讨中国汉族人群中凝血因子Ⅶ基因R353Q、HVR4多态性的分布及其与冠心病和心肌梗死的关系。方法：利用聚合酶链反应和限制性内切酶片段长度多态性核苷酸分型技术，检测234例冠心病患和105名正常对照的凝血因子Ⅶ基因型，并结合选择性冠状动脉造影结果进行分析。结果：基因型频率符合Hardy-Weinberg平衡定律。凝血功能指标凝血酶原时间、部分凝血活酶时间、凝血酶时间不受凝血因子Ⅶ基因多态性的影响。R353Q和HVR4基因多态性与冠心病和狭窄血管支数之间比较差异均无显性。R353Q基因型频率和等位基因频率在非心肌梗死组和心肌梗死组比较有明显差异（χ^2=4.711,P＜0．05，OR＝0．37，95％CI 0．15－0．94），而VR4基因多态性在两组间比较无统计学意义（χ^2=0.142,P＞0．05）。结论：汉族人群中存在凝血因子Ⅶ基因的R353Q和HVR4多态性，其中Q等位基因可能是心肌梗死的遗传保护因子。     

内皮一氧化氮合酶基因5''''-侧翼区T-786→C突变与2型糖尿病并发冠心病的关系

目的研究血管内皮一氧化氮合酶(eNOS)基因5'-侧翼区T-786→C突变与2型糖尿病(T2DM)并发冠心病(CHD)的关系.方法选择T2DM患者186例,其中65例并发CHD;选择正常人63例作为对照.采用PCR/ASO杂交技术检测T-786→C突变. 结果与对照组相比,T2DM伴CHD组TC基因型及C等位基因频率明显增高(P＜0.05).与T2DM不伴CHD组相比,T2DM伴CHD组C等位基因频率明显增高(P＜0.05).在T2DM患者中,与TT组比较,TC组HbA1 c明显增高.多元logistic回归分析显示,年龄、血压、病程、LDL-C、脂蛋白(a)、HbA1c、C等位基因与CHD呈正相关(P＜0.01).结论eNOS基因5'-侧翼区T-786→C突变增高T2DM患者并发CHD的危险性.     

C反应蛋白及其基因多态性与冠心病发病的相关性研究

采用全自动生化分析仪测定188例冠心病患者（冠心病组）和98例健康查体者（对照组）的血清C反应蛋白（CRP）水平，同时应用聚合酶链反应检测CRP的1059O／C基因多态性，结合冠状动脉造影结果进行分析。结果冠心病组的自然对数转换CRP（InCRP）水平显著高于对照组，Logistic回归分析显示InCRP水平（0R：1．44，P〈0．01）与冠心病独立相关，1059G／C基因多态性等位基因和基因型的分布频率符合Hardy-Weinberg平衡（χ^2=0.297，P〉0.05），两组1059G／C基因型和等位基因的分布趋势相同，差异无显著性；C等位基因携带者的InCRP水平低于GG基因型（P=0．024），而冠状动脉病变程度不受1059G／C基因多态性的影响（妒=1．374，P〉0．05）。认为血清CRP水平升高可能是冠心病的独立危险因子,CRP水平可能受其1059G／C基因多态性的影响。     

eNOS基因5′-侧翼区T-~(786)→C突变与2型糖尿病患者内皮依赖性血管舒张功能的关系

目的探讨2型糖尿病(T2DM)患者内皮一氧化氮合酶(eNOS)基因5′-侧翼区T-786→C突变与T2DM患者内皮依赖性血管舒张功能(EDD)关系。方法选择无血管并发症的男性T2DM患者162例。采用PCR/ASO探针杂交技术检测eNOS基因5′-侧翼区T-786→C突变。采用高分辨超声检测肱动脉血流介导的EDD。结果T/C或C/C组EDD为3·73%±0·50%,明显低于T/T组(4·15%±0·49%)(P<0·01)。多元逐步分析结果显示,在所有T2DM患者中,EDD与C等位基因呈负相关(P=0·001)。在吸烟者中,T/C或C/C组EDD明显低于T/T组(P<0·05),在非吸烟者中则不然。多元逐步分析结果显示,在吸烟者中,C等位基因是EDD下降的独立危险因子(P<0·01),在非吸烟者中则不然。结论eNOS基因5′-侧翼区T-786→C突变是T2DM患者内皮功能异常的遗传危险因子,尤其是吸烟的T2DM患者。     

ADAM33基因Met764Thr位点多态性与支气管哮喘发病及患者肺功能的相关性

目的探讨中国华南地区汉族人群ADAM33基因Met764Thr位点多态性与支气管哮喘（简称哮喘）及其患者肺功能的相关性。方法对164例中国华南汉族哮喘患者（哮喘组）及112名汉族健康者（健康对照组），应用聚合酶链反应和限制性片段长度多态性（PCR-RFLP）、DNA测序及肺功能测定的方法。结果（1）不同种族人群ADAM33基因Met764Thr位点等位基因频率的比较差异无统计学意义（χ^2=6．77，P〉0．05）；（2）ADAM33基因Met764Thr位点3种基因型（Met764／Met764、Met764／Thr764、Thr764／Thr764）在哮喘组分布频率分别为78．7％（129／164）、18．3％（30／164）、3．0％（5／164）；健康对照组分布频率分别为91．1％（102／112）、6．3％（7／112）、2．7％（3／112）；各基因型分布频率哮喘组与健康对照组比较差异有统计学意义（χ^2=8．46，P〈0．05）。ADAM33基因Met764Thr位点，Thr764等位基因在哮喘组与健康对照组分布频率分别为0．122、0．058，哮喘组与健康对照组Met764及，Thr764等位基因频率比较差异有统计学意义（χ^2=6．27，P〈0．05）；（3）单变量Logistic回归分析Met764Thr位点基因多态性与哮喘的关系表明，相对Met764／Met764基因型而言，Met764／Thr764杂合型与Met764／Thr764＋Thr764／Thr764基因型均能显著增加哮喘发生的危险性[OR值及95％可信区间（CI）分别为3．389（1．430～8．030）、2．767（1．308～5．854），P均〈0．05]；（4）在哮喘组中3种基因型的用力肺活量（FVC）实测值／预测值％、第一秒用力呼气容积（FEV1）实测值／预测值％水平比较差异有统计学意义（F值分别为0．49、5．17，P均〈0．05）。结论ADAM33基因Met764Thr位点基因多态性与中国华南汉族人群哮喘发病及患者的肺功能相关。     

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.     

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.