2型糖尿病伴高甘油三酯血症患者血清胰岛素样生长因子结合蛋白1水平与胰岛素抵抗的相关性分析

目的探讨糖、脂代谢不同人群的血清胰岛素样生长因子结合蛋白1（IGFBP-1）水平与胰岛素抵抗（IR）的关系。方法选取正常人（NC）、高TG血症患者、2型糖尿病（T2DM）患者及T2DM＋高TG患者共66例,测定血清IGFBP-1、胰岛素、血糖和血脂水平。结果（1）血清IGFBP-1水平,高TG血症组较NC组、T2DM＋高TG组较T2DM组均明显下降（P〈0.05）。（2）多元逐步回归分析显示血清IGFBP-1水平与TG、HOMA-IR负相关（P〈0.05）,与HDL-C正相关（P〈0.05）。结论高TG血症人群血清IGFBP-1明显下降,提示存在明显肝脏IR。     

新诊断的2型糖尿病患者胰岛素强化治疗前后氧化应激水平的变化

目的评价新诊断的2型糖尿病（T2DM）患者胰岛素强化治疗前后氧化应激水平的变化。方法30例新诊断的T2DM患者采用胰岛素泵强化治疗,治疗前后进行超氧化物歧化酶（SOD）、谷胱甘肽过氧化物酶（GSH—Px）、丙二醛（MDA）水平测定。结果胰岛素泵强化治疗后,患者血浆中的SOD、GSH—Px水平明显上升（P〈0．01）、MDA水平明显下降（P〈0．01）。结论新诊断的T2DM患者胰岛素强化治疗后氧化应激水平明显降低。     

糖耐量正常的2型糖尿病一级亲属氧化应激水平与胰岛素敏感性的相关性研究

目的观察2型糖尿病（T2DM）患者及糖耐量正常的T2DM一级亲属（FDRs）体内氧化应激状态,探讨氧化应激与胰岛素敏感性之间的关系。方法检测外周血清丙二醛（MDA）、谷胱甘肽过氧化物酶（GSH—PX）、超氧化物歧化酶（SOD）、8-异前列腺素F2a（8-isoPGF2a）水平,高胰岛素正葡萄糖钳夹技术评估胰岛素敏感性。结果T2DM组、FDRs组较NC组MDA、8-isoPGF2a水平升高（P〈0．05）,而血GSH—PX、SOD水平降低,差异有统计学意义（P〈0．05）;MDA、8iso—PGF2a与葡萄糖输注速率（GIR）呈明显负相关（r=-0．415和-0．443,P〈0．05）,GSH—PX、SOD与GIR呈明显正相关（r=0．327和0．439,P〈0．05）。结论T2DM患者及糖耐量正常的T2DM一级亲属存在氧化应激状态的改变,且与胰岛素敏感性密切相关。     

2型糖尿病患者氧化应激状态与红细胞腺苷酸代谢的关系

目的探讨2型糖尿病（T2DM）患者氧化应激状态与红细胞腺内苷酸代谢的关系。方法应用高效液相色谱法和比色酶法分别测定104例T2DM和32例正常对照者（NC）组红细胞内ATP、ADP、AMP含量和SOD、GSH-Px、CAT、anti-ROS、MDA活性,分析二者的关系。结果（1）T2DM组较NC组,SOD、GSH-Px、CAT、Anti-ROS活力和ATP、ATP/ADP、SOD/MDA下降,MDA、ADP含量升高（P均〈0.05）。（2）T2DM组内,ATP含量与SOD活性、SOD/MDA正相关;ADP与SOD、抗ROS活性负相关;AMP与GSH-Px正相关;ATP/ADP与SOD、GSH-Px、SOD/MDA正相关,（P均〈0.05）。结论T2DM患者体内氧化应激水平的升高与腺苷酸代谢异常相关。     

Ⅱ型糖尿病患者颈动脉粥样硬化与血尿酸、纤维蛋白原的关系

目的:探讨Ⅱ型糖尿病(T2DM)患者血清尿酸（UA）、纤维蛋白原(Fg)水平是否与颈动脉粥样硬化(AS)有关。方法: T2DM患者218例,根据有无颈AS分为2组, 对患者年龄、病程、高血压病、UA、肌酐(Cr)、总胆固醇（TC）、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇（HDL-C）、糖基化血红蛋白和Fg等AS危险因素进行单因素和多因素分析。结果: logistic回归分析显示年龄、病程、UA、Cr、UA /Cr、LDL-C,Fg与T2DM颈AS有相关性。UA危险因素的多元逐步回归分析显示病程、颈AS、Cr、TG、TC与UA相关;Fg危险因素的多元逐步回归分析显示,颈AS与Fg相关。结论: T2DM颈AS患者血清中UA、Fg明显升高,是AS的危险因素。     

2型糖尿病患者血清巨噬细胞抑制因子-1与颈动脉粥样斑块相关性的观察

目的 探讨T2DM患者血清巨噬细胞抑制因子-1（MIC-1）与颈动脉粥样斑块的相关性.方法 根据多普勒超声结果,将113例T2DM患者分为合并颈动脉粥样斑块组（A,n=55）与单纯T2DM组（B,n=58）,另选正常对照组（C,n=57）.ELISA测定研究对象血清MIC-1水平. 结果 A、B组血清MIC-1水平高于C组（P＜0.01）,A组高于B组（P＜0.01）.相关分析显示,血清MIC-1水平与FPG、HbA1 c、SBP、DBP、TG、肿瘤坏死因子α（TNF-α）呈正相关（r=0.183、0.287、0.173、0.194、0.270、0.287,P＜0.05）,与HDL-C呈负相关（r=-0.410,P＜0.01）.多元线性逐步回归分析表明,HbA1 c、TG、HDL-C是血清MIC-1水平的独立影响因素（β=0.204、0.176、0.296,P＜0.05）. 结论 T2DM患者血清MIC-1水平升高,T2DM合并颈动脉粥样斑块患者血清MIC-1水平较单纯T2DM患者进一步升高.HbA1c、TG、HDL-C是MIC-1的独立相关因素.     

何首乌饮对衰老大鼠抗氧化能力及血脂的影响

目的探讨何首乌饮的抗衰老机制。方法采用D-半乳糖连续腹腔注射致亚急性衰老大鼠模型,测定何首乌饮灌胃后大鼠血清中血脂和丙二醛（MDA）含量、总抗氧化能力（T-AOC）、谷胱甘肽过氧物酶（GSH-Px）活性、超氧化物歧化酶（SOD）活力。结果亚急性衰老模型组大鼠血清甘油三酯（TG）、总胆固醇（TC）、MDA含量明显升高,高密度脂蛋白胆固醇（HDL-C）、SOD、GSH-Px、T-AOC明显下降,与正常对照组大鼠比较差异显著（P〈0.05,P〈0.01）,经何首乌饮灌胃治疗后TG、TC、MDA含量下降,HDL-C、SOD、GSH-Px、T-AOC含量升高均接近正常水平,与模型组大鼠有显著差异（P〈0.01）。结论何首乌饮明显提高衰老大鼠体内的HDL-C、SOD、GSH-Px、T-AOC水平,降低TG、TC、MDA含量,何首乌饮具有抗衰老作用,其抗衰老作用可能与此有关。     

单核细胞趋化因子与2型糖尿病胰岛素抵抗相关性的研究

ELISA方法测定96例2型糖尿病患者（T2DM组）及24例健康对照者（NC组）空腹血清MCP-1水平及其他临床指标，对结果进行统计学分析。结果T2DM组血清MCP-1水平高于NC组（P〈0．01），血清MCP-1与SBP、FPG、TG、TC、LDL—C、UA、HbA1c、Fins（P〈0．05）、HOMA—IR（P〈0．01）正相关，与HDL-C和BMI无相关性。多元逐步回归分析显示MCP-1与HOMA-IR独立相关。由此推测，MCP-1作为一种炎性因子，可能参与了IR及T2DM的发生和发展。     

2型糖尿病患者合并代谢综合征与血清高敏C反应蛋白相关性分析

目的探讨2型糖尿病（T2DM）患者合并不同数目代谢综合征（MS）组分与血清高敏C反应蛋白（hsCRP）的相关性。方法将474例T2DM患者根据合并MS组分数目不同,分为不伴有其他MS组分的单纯T2DM（G0组）,合并1个组分（G1组）,合并2个组分（G2组）,合并3个组分组（G3组）,分析hsCRP与MS各组分之间的关系。结果随着合并MS异常组分的增多,hsCRP呈上升趋势（P〈0.01）;相关分析显示,hsCRP与体质量指数（BMI）、TG、SBP、TC、LDL、腰臀比、年龄呈正相关（P〈0.05或〈0.01）,与HDL水平呈负相关（P〈0.05）;多元逐步回归分析显示,BMI、TG、年龄为血清hsCRP升高的独立危险因素（P〈0.01）。结论 hsCRP可以作为T2DM患者MS发病风险的预测因子。     

血清nesfatin_1在2型糖尿病合并冠心病中的诊断意义

目的探讨血清nesfatin-1水平在2型糖尿病（T2DM）合并冠心病（CHD）患者中的变化及其临床意义。方法选取T2DM合并CHD患者62例（T2DM合并CHD组）,单纯T2DM患者60例（单纯T2DM组）,单纯CHD患者59例（单纯CHD组）,门诊健康体检者55例（对照组）,用酶联免疫吸附法检测血清 nesfatin-1水平,并测定空腹血糖（FBG ）、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）水平,HbA1c和空腹血清胰岛素（FINS）,计算体质指数（BMI）,并作相关分析。结果 T2DM合并CHD组血清nesfatin-1水平均显著高于单纯T2DM组、单纯CHD组和对照组,差异有统计学意义（ P＜0.05）;T2DM合并CHD组nesfatin-1水平均与TG和HOMA-IR呈正相关（ r＝0.58、0.43,均 P＜0.05）;T2DM与nesfatin-1和HOMA-IR密切相关（B＝2.84、2.37,均 P＜0.05）;T2DM合并CHD与nesfatin-1和TG密切相关（B＝3.16、2.69,均 P＜0.05）。结论血清nesfatin-1与T2DM合并CHD的发病有一定联系。     

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.