育龄妇女弓形虫感染的血清学调查

目的探讨弓形虫感染对育龄妇女生殖健康的影响。方法采用金标免疫诊断试验和酶联免疫吸附试验测定4310例育龄妇女血清弓形虫抗体IgG、IgM和循环抗原。结果4310例育龄妇女中血清弓形虫抗体或循环抗原阳性606例,阳性率14.06%,阳性组中流产、死胎、畸形发生率高于阴性组(P<0.01),妇科疾病如子宫肌瘤、宫外孕、盆腔炎、不孕症的患病率也显著高于阴性组(P<0.01)。结论育龄妇女弓形虫感染与异常妊娠结局及某些妇科疾病密切相关,加强对育龄妇女弓形虫血清学监测和健康教育具有十分重要的意义。     

1246例住院儿童弓形虫感染情况调查

目的 研究弓形虫感染与小儿疾病的关系。方法 1246例住院儿童为实验组，267名健康儿童为对照组，使用统一调查表问卷调查，同时采集静脉血，分离血清，采用双抗体夹心酶标一步法检测血清弓形虫循环抗原。结果 实验组和对照组弓形虫循环抗原阳性率分别为3．53％和1．87％，两组阳性率差异无显著性，早产儿，黄疸，新生儿缺氧缺血性脑病（HIE），肺炎，癫痫组弓形虫循环抗原均为阴性，上呼吸道感染，支气管炎，腹泻病组弓形虫循环抗原阳性率与对照组比较差异无显著性（P＞0．05）。喉炎（包括喉炎，急性喉－气管－支气管炎），热性惊厥，哮喘（包括支气管哮喘，喘息性支气管炎）组弓形虫循环抗原阳性率与对照组比较差异有显著性（0．05＞P＞0．01或P≤0．01）。结论 虽然住院儿童与健康儿童血清弓形虫循环抗原阳笥率差异无显著性，但某些疾病患儿弓形虫循环原阳性率与对照组比较，差异有显著性，提示弓形虫急性感染可能是这些疾病的一种病因。     

通辽市育龄妇女弓形虫感染血清学调查

通辽市172名育龄妇女弓形虫抗体阳性率为15.12％（26／172）。26例阳性者流产和畸胎等异常妊娠发生率高于阴性者（X^2=5.04,P〈0.05）,妇科疾病如子宫肌瘤、盆腔炎、宫外孕和卵巢肿瘤等的患病率也高于阴性者（X^2=4.13,P〈0.05）。各类人群中,工人感染率最高,为40.00％。育龄妇女弓形虫感染与异常妊娠及妇科疾病密切相关,加强对育龄妇女弓形虫血清学监测和健康教育具有重要意义。     

抗PADI4抗体检测方法的建立及其在类风湿关节炎中的临床意义

目的检测类风湿关节炎（RA）患者血清中抗肽酰基精氨酸脱亚胺酶4（PADI4）抗体水平，并探讨其在RA中的临床意义。方法选取RA患者109例，系统性红斑狼疮（SEE）患者67例，干燥综合征（pSS）患者48例、系统性硬化症（SSc）患者41例、骨关节炎（OA）患者34例、皮肌炎／多发性肌炎（DM／PM）患者23例、强直性脊柱炎（AS）患者19例，健康对照106名。以重组的人PADI4蛋白为抗原，用酶联免疫吸附法（ELISA）检测患者血清中抗PADI4抗体水平。并研究其与RA患者发病年龄、病程、疾病活动指数DAS28评分、抗环瓜氨酸肽（CCP）抗体、C反应蛋白（CRP）、红细胞沉降率（ESR）、类风湿因子（RF）、免疫球蛋白（IgG、IgM、IgA）、关节x线分期等指标的关系。结果①RA患者血清中抗PADI4抗体的阳性率为45．0％，明显高于其他风湿性疾病患者和健康对照组（P值均〈0．01）。抗PADI4抗体对RA诊断的敏感性为45．0％，特异性为93．5％。②RA患者血清中抗PADI4抗体滴度明显高于其他风湿性疾病患者以及健康对照组（P均〈0．01）。③抗PADI4抗体阳性患者的DAS28评分、抗CCP抗体、ESR、RF、IgG、IgM水平均高于抗PADI4抗体阴性患者（P值均〈0．05）。相关性分析显示抗PADI4抗体水平与DAS28评分（r=0．333，P〈0．01）和抗CCP抗体（r=0．248，P〈0．05）具有相关性。并且阳性组患者出现皮下结节及关节X线Ⅲ期以上改变的比率也明显高于阴性组患者。结论RA患者血清中可以检测到抗PADI4抗体，该抗体在RA中具有很高的特异性，并且与疾病活动及病情严重程度相关，提示PADI4蛋白可能作为自身抗原在RA的发病和病理过程中起重要作用。     

中枢神经系统疾病中弓形虫感染的检测研究

目的 了解中枢神经系统疾病尤其是脑囊中病患者中弓形虫感染情况,研究弓形虫抗体、抗原检测方法的效果和意义。方法 应用ELISA和IFAT抗体检测方法及单克隆抗体（4C10、1E9）夹心ELISA抗原检测方法对270例脑囊虫病、154例疑似脑囊虫病、88例原发性癫痫患者和144例健康人群血清进行弓形虫抗体、抗原检测和比较。结果 ELISA和IFAT检测各组人群抗弓形虫抗体阳性率分别为15．93％、13．64％、12．50％和6．25％、14．07％、13．64％、14．77％和5．56％。各 组弓形虫抗原阳性率分别为2．22％（6／270）、3．25％（5／154）、2．27％（2／88）、0．00％（0／144）。13例循环的阳性者,其抗体滴度为1：1600者1例,等于或高于1：3200者12例。结论 中枢神经系统疾病在脑囊中病患者中弓形虫感染率明显高于健康人群,提示部分脑囊虫病患者并发或继发了弓形虫感染,或脑弓形虫感染误诊为脑囊虫病或原发性癫痫病;与IFAT相比,ELISA检测抗弓形虫抗体较客观、易于定量;当患者血清中抗弓形虫抗体滴度等于或高于1：1600时,提示有弓形虫现症感染的可能性,应进一步进行弓形虫抗原、DNA或其他病原学检查;单克隆抗体（4C10、1E9）夹心ELISA可应用于弓形虫感染的诊断。     

不良妊娠结局妇女弓形虫感染的调查分析

目的 探讨弓形虫感染与不良妊娠结局的关系。方法 采用酶联免疫吸附实验法，检测长春地区93名有流产、畸形等不良妊娠结局的孕产妇（实验组）及107名正常孕产妇（对照组）血清弓形虫抗体，进行两组间感染率差异的分析。结果 弓形虫抗体阳性率实验组（19．35％，18／93）明显高于对照组（5．61％，6／107）（P〈0．01）。结论弓形虫感染是流产、畸形等不良妊娠结局的原因之一。     

肺炎支原体感染与冠状动脉粥样硬化的关系

目的探讨肺炎支原体（MP）感染与冠状动脉粥样硬化（CAS）的关系。方法采用EusA法检测CAS患者（CAS组）和健康者（对照组）的血清MP抗体IgG、IgM,胶乳增强免疫比浊法检测CAS组的血清高敏C反应蛋白（Ha-CRP）,酶法检测血脂,ELISA法检测TNF-α、IL-1β、IL-6。结果CAS组MPIgG阳性率明显高于对照组（P〈0．01）;与MPIgG阴性患者比较,CRP组MPIgG阳性患者的TC、TG、LDL-C明显升高,HDL—C明显降低,TNF-α、IL-1β、IL-6明显升高（P〈0．01或〈0．05）。各检测指标与CAS患者MP感染均独立相关,以Hs—CRP、IL-6的相关性最大（P〈0．01或〈0．05）。结论MP感染与CAS有关,其可能通过感染及炎症反应参与CAS的发生、发展。     

检测抗核包膜蛋白抗体的临床意义初探

目的进一步探讨抗核包膜蛋白抗体的临床意义。方法对48例原发性胆汁性肝硬化（PBC）及1881例对照组血清标本以间接免疫荧光法检测抗核抗体（ANA），选择抗核包膜蛋白抗体阳性的病例进行临床回顾性分析。结果1929例血清标本中50例抗核包膜蛋白抗体阳性，相关疾病包括PBC等多种系统性自身免疫病。抗核包膜蛋白抗体在PBC患者组中的阳性率为39．58％，明显高于其他系统性自身免疫性疾病组（x^2=134，P〈0．01）及非自身免疫性肝脏疾病组即；109，P〈0．01），诊断PBC的特异性为98．35％。结论抗核包膜蛋白抗体与多种疾病相关，这种现象可能与其靶抗原的异质性相关。但其对诊断PBC价值较高。     

自身抗体阴性类风湿关节炎的临床及实验室特点

目的 探讨自身抗体阴性类风湿关节炎（rheumatoid arthritis，RA）的临床及实验室特点。方法 分析247例RA患者，比较自身抗体阴性RA（30例）与抗体阳性RA的临床及实验室特点，以骨关节炎患者（34例）作为对照组。结果 自身抗体阴性的RA占12．1％（30／247），自身抗体阴性RA患者的晨僵时间较自身抗体阳性RA患者短（P〈0．05）；血清免疫球蛋白IgG、IgA及γ球蛋白比率水平显著低于自身抗体阳性RA患者（P〈0．01）。而自身抗体阴性RA患者的红细胞沉降率（ESR）、C反应蛋白（CRP）、免疫球蛋白IgM、γ球蛋白比率均明显高于骨关节炎患者（P〈0．05），同时与骨关节炎患者比较，其血红蛋白降低及血小板升高的幅度更明显（P〈0．05）。结论 RA患者中自身抗体阴性者占12．1％．提示自身抗体阴性RA并不少见。ESR、CRP、免疫球蛋白IgM及γ球蛋白的增高在自身抗体阴性RA的诊断中有参考意义。     

慢性心力衰竭患者心脏β1受体自身抗体与心功能及QTcd的相关性分析

目的通过β1肾上腺素受体自身抗体水平的检测，分析其与心功能及心电图表现的相关性，并观察β受体阻滞剂卡维地洛的治疗作用。方法65例慢性心力衰竭患者采用酶联免疫法测定患者血清中β1受体自身抗体水平，据此分为β1受体自身抗体阳性组（β1阳性组）30例和β1受体自身抗体阴性组（β1阴性组）35例，采用超声心动图测量左室舒张末径，左室收缩末径和左室射血分数进行心功能检测，常规12导心电图测量QTcd值。在血管紧张素转换酶抑制剂、利尿剂和洋地黄制剂治疗基础上加用β受体阻滞剂卡维地洛，随访半年。结果（1）治疗前β1阳性组左室舒张末径显著大于β1阴性组[（66．01±5．47）vs（63．07±5．64）mm；P〈0．05）]，左室收缩末径大于β1阴性组[（54．24±8．43）vs（50．72±6．12）mm；P=0．052）]，左室射血分数显著低于β1阴性组[（32．16±9．00）vs（36．64±8．20）％；P〈0．05）]。治疗后两组左室舒张末径、收缩末径均较治疗前显著减小（P〈0．01），左室射血分数较治疗前提高（P〈0．01）。β1阳性组左室舒张末径、收缩末径和左室射血分数与β1阴性组无差异（P〉0．05）。（2）治疗前β1阳性组心率显著高于β1阴性组[（94±14）vs（87±16）次／min；P〈0．05）]，β1阳性组QTcd值显著大于β1阴性组[（71．14±34）vs（58．33±14）ms；P〈0．05）]，治疗后两组心率及血压均较治疗前显著减低（P〈0．01），β1阳性组QTcd值较治疗前显著减低（P〈0．05），β1阳性组心率和QTcd值与β1阴性组无显著差异（P〉0．05）。结论β1受体自身抗体阳性者心功能较差且QTcd值长，β受体阻滞剂可以抑制心肌重构，改善心功能，减小QT离散度，提示β1受体自身抗体参与心力衰竭的病理生理过程，阳性者可能临床预后差。     

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.     

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.     

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.