高血压脑小血管病老年患者血管性认知功能障碍程度与IL-18、CCL-2等细胞因子的相关性

目的探讨高血压脑小血管病(CSVD)患者血管性认知功能障碍(VCI)程度与血清炎症因子的相关性。方法 60例高血压CSVD患者,根据其认知功能障碍程度分为无VCI(WVCI)组(30例)和非痴呆性VCI(VCIND)组(30例),收集两组一般资料,采用简易精神状态量表(MMSE)进行认知功能评价,比较2组生化指标〔血清高敏C反应蛋白(hs-CRP)、同型半胱氨酸(HCY)、总胆固醇、低密度脂蛋白、三酰甘油、尿酸〕及血清炎症因子〔CCL-2、白细胞介素(IL)-18、肿瘤坏死因子(TNF)-α、组织生长因子(TGF)-β〕水平,并分析VCIND组血清炎症因子水平与MMSE评分的相关性。结果 VCIND组MMSE评分显著低于WVCI组〔(17. 92±3. 61)分vs (29. 30±3. 31)分,t=12. 799,P<0. 05〕,VCIND组hs-CRP、HCY、CCL-2、IL-18及TNF-α水平均显著高于WVCI组,而TGF-β水平显著低于WVCI组(P <0. 05)。IL-18水平与MMSE评分呈负相关性。结论高血压CSVD并伴有VCIND患者血清IL-18水平越高,MMSE评分越高,提示血清IL-18水平可能反映高血压CSVD患者认知障碍的严重程度。     

松龄血脉康对高脂血症血管性痴呆患者血清同型半胱氨酸与超敏C反应蛋白的影响

目的 探讨VD患者血脂异常和同型半胱氨酸(HCY)、超敏C反应蛋白(hs-CRP)在血管性痴呆(VD)发病机制中的关系和作用及松龄血脉康对VD患者的脑保护作用.方法 实验分为4组:正常血脂组、正常血脂治疗组、高血脂组、高血脂治疗组,双抗体夹心ELISA法测定血清hs-CRP、白介素1β(IL-1β)、肿瘤坏死因子α(TNF-α)水平,采用荧光标记免疫检测血清HCY水平,生物化学法测定血脂.结果 高血脂治疗组较高血脂组HCY、hs-CRP、IL-1β、TNF-α浓度显著降低;正常血脂治疗组较正常血脂组HCY、hs-CRP、IL-1β、TNF-α浓度也明显降低;高血脂组较正常血脂组HCY、hs-CRP、IL-1β、TNF-α浓度也明显增高.全部VD患者MMSE评分和HCY、hs-CRP浓度负相关.结论 松龄血脉康能够降低VD患者血清HCY、hs-CRP浓度发挥其脑保护作用,HCY、hs-CRP参与了VD的发病机制,血脂代谢异常通过增强HCY、hs-CRP表达这一途径也参与VD发病.     

高血压病合并不同类型脑小血管病与认知功能障碍的关系

目的:探讨高血压病合并不同类型脑小血管病(CSVD)与认知功能障碍的关系,及其可能机制。方法:收集168例高血压病合并CSVD住院患者的临床资料,CSVD分为腔隙性脑梗死、脑白质变性和脑微出血3种类型。根据其(VCI)程度将患者分为无VCI(NVCI)组(99例)和非痴呆性VCI(VCIND)组(69例),比较2组病例简易精神状态量表(MMSE)评分的差异,并检测2组患者血清白介素1(IL-1)、IL-6、IL-10及高迁移率族蛋白(HMGB1)的水平,研究其发病机制。结果:VCIND组MMSE评分明显低于NVCI组[(16. 20±3. 35)分vs (29. 40±5. 74)分,t=13. 650,P 0. 05)];而各组内3种不同类型CSVD MMSE评分比较,差异无统计学意义(均P 0. 05)。与NVCI组比较,VCIND组血清IL-1、IL-6、HMGB1水平显著升高(均P 0. 05),而IL-10水平比较差异无统计学意义(P0. 05)。结论:高血压病合并不同类型CSVD人群发生VCIND可能与高细胞炎症反应相关。     

老年脊柱手术患者血清炎性细胞因子水平与术后认知功能障碍的关系

目的探讨老年脊柱手术患者血清白细胞介素(IL)-1β、IL-6、肿瘤坏死因子(TNF)-α、高敏C反应蛋白(hs-CRP)水平与术后认知功能障碍的关系。方法选择台州市第一人民医院2015年1月至2016年12月骨科老年脊柱手术患者100例,其中31例出现术后认知功能障碍,作为认知功能障碍组,69例未发生认知功能障碍,作为非认知功能障碍组。采用酶联免疫吸附试验(ELISA)测定血清IL-1β、IL-6、TNF-α水平。采用免疫浊度法测定血清hs-CRP水平。结果认知功能障碍组年龄明显高于非认知功能障碍组(P0.05),术前,认知功能障碍组血清炎性指标和非认知功能障碍组比较差异无统计学意义(P0.05)。术后,两组血清IL-1β、IL-6、TNF-α、hs-CRP水平均明显高于术前(P0.05),认知功能障碍组血清IL-1β、IL-6、TNF-α、hs-CRP水平明显高于非认知功能障碍组(P0.05)。术后认知功能障碍发生率与血清IL-1β、IL-6、TNF-α、hs-CRP水平升高值均呈正相关(P0.05)。结论老年脊柱手术患者血清IL-1β、IL-6、TNF-α、hs-CRP水平升高,血清IL-1β、IL-6、TNF-α、hs-CRP升高幅度与术后认知功能障碍的发生有关。     

血管性痴呆高脂血症患者血清HCY与hs—CRP临床研究

目的 检测血管性痴呆(VD)伴高血脂患者血清HCY、hs-CRP、IL-1β、TNF-α浓度值和血脂水平值,探讨VD患者血脂异常和HCY、hs-CRP在VD发病机制中的关系和作用.方法 实验分为4组:非VD血脂正常组(N组) 、非VD高血脂组(H组)、VD血脂正常组(V组)、VD高血脂组(VH组),双抗体夹心ELISA法测定hs-CRP、IL-1β、TNF-α,采用荧光标记免疫检测法血清HCY水平,生物化学法测定血脂.结果 VH、V、H组和N组比较HCY、hs-CRP、IL-1β、TNF-α浓度显著增高;VH组和H、V组比较HCY、hs-CRP、IL-1β、TNF-α浓度明显增高;H组和V组比较无显著性差异.全部VD患者MMSE评分和HCY、hs-CRP浓度值具有负相关性.结论 HCY、hs-CRP参与了VD的发病机制,血脂代谢异常通过增强HCY、hs-CRP表达这一途径也参与VD发病机制.     

阿尔茨海默病患者血清中血管内皮生长因子和炎症因子相关性研究

目的检测阿尔茨海默病（AD）患者血清中VEGF和炎症因子TNF-α、IL-1β、IL-6水平,探讨AD患者血管源性机制。方法实验分为3组：正常组、血管性痴呆（VD）组、AD组。双抗体夹心ELISA法测定VEGF和TNF-α,放射免疫法检测IL-1β、IL-6,MMSE评分。结果AD组、VD组与正常组比较TNF-α、IL-1β、IL-6浓度明显增高（P〈0.01）;AD、VD与正常组比较VEGF浓度降低（P〈0.01）;AD组与VD组比较VEGF、TNF-α、IL-1β、IL-6浓度无明显差别（P〉0.05）;全部AD、VD患者MMSE评分与VEGF浓度值具有正相关性,全部AD、VD患者MMSE评分与TNF-α、IL-1β、IL-6浓度值具有负相关性。结论炎症和血管修复功能的降低共同参与了AD和VD的发病机制,初步证实了AD的血管源性发病机制。     

老年早期糖尿病肾病患者血清胱抑素C与氧化应激的相关性

目的探讨早期糖尿病肾病(DN)患者中血清胱抑素C(CysC)与氧化应激的关系。方法将入选的120例老年2型糖尿病(T2DM)患者按照尿白蛋白排泄率(UAER)分为正常白蛋白尿组、微量白蛋白尿组,30例健康者为对照组。检测血清CysC,超敏C反应蛋白(hs-CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、同型半胱氨酸(Hcy)、超氧化物歧化酶(SOD)的含量。结果 T2DM患者血清CysC、hs-CRP、IL-6、TNF-α、Hcy较健康者明显升高(P<0.01);糖尿病微量白蛋白尿组患者血清CysC、hs-CRP、IL-6、TNF-α、Hcy、SOD水平较糖尿病正常白蛋白尿组比较差异有统计学意义(P<0.01);不同血清CysC水平糖尿病患者氧化应激指标的比较,CysC>1.4 mg/L组的hs-CRP、IL-6、TNF-α、Hcy血清水平高于CysC≤1.4 mg/L组(P<0.01),通过CysC与hs-CRP、IL-6、TNF-α、Hcy的多元线性相关分析,CysC与hs-CRP、IL-6、TNF-α、Hcy均呈显著正相关,CysC与SOD呈显著负相关。结论血清CysC参与氧化应激损伤过程,影响DN的发生发展。     

乌司他丁对急性缺血性脑卒中患者血清炎性因子水平及预后的影响

目的探究乌司他丁对急性缺血性脑卒中患者血清炎性因子水平及预后的影响。方法选取2011年1月—2013年1月徐州市中心医院收治的急性缺血性脑卒中患者100例,根据治疗方法不同将所有患者分为常规治疗组(CON组)及乌司他丁联合常规治疗组(UTI组)。观察两组患者治疗前后血清炎性因子变化〔包括超敏C反应蛋白(hs-CRP),肿瘤坏死因子α(TNF-α),白介素1β、6、10(IL-1β、IL-6、IL-10)〕、并发症发生情况(包括脑疝、肺部感染和压疮)及预后情况(包括病死率及平均生存时间)。结果治疗前两组患者血清hs-CRP、TNF-α、IL-1β、IL-6和IL-10水平比较,差异无统计学意义(P0.05);治疗后UTI组患者血清hs-CRP、TNF-α、IL-1β、IL-6水平均低于CON组,IL-10水平高于CON组(P0.05)。UTI组患者脑疝、肺部感染、压疮发生率均低于CON组(P0.05)。UTI组患者病死率为4%(2/50),低于CON组的20%(10/50)(P0.05);UTI组患者平均生存时间为(15.7±2.3)个月,长于CON组的(13.5±1.7)个月(P0.05)。结论乌司他丁可有效改善急性缺血性脑卒中患者血清炎性因子水平,减少并发症的发生及降低病死率,提高生存时间。     

稳定期中重度慢阻肺患者血清IL-6、IL-8、TNF-α、hs-CRP与肺功能的相关性研究

目的观察稳定期中重度慢性阻塞性肺疾病患者血清白介素-6(IL-6)、白介素-8(IL-8)、肿瘤坏死因子α(TNF-α)及超敏C反应蛋白(hs-CRP)水平,分析其与肺功能FEV_1占预计值的百分比(FEV_1%pred)、第1秒用力呼气容积与用力肺活量的比值(FEV_1/FVC)的相关性。方法选择符合标准的慢阻肺患者80例和健康体检结果正常者80例,检测血清IL-6、IL-8、TNF-α及hs-CRP水平,测定FEV_1%pred、FEV_1/FVC。结果慢阻肺组患者血清IL-6、IL-8、TNF-α及hs-CRP水平明显高于健康对照组,差异有统计学意义(P0.01)。Ⅱ级、Ⅲ级和Ⅳ级肺功能慢阻肺患者血清IL-6、IL-8、TNF-α及hs-CRP水平逐渐升高,肺功能指标中的FEV_1/FVC、FEV_1%pred水平逐渐下降,两组间比较差异均有统计学意义(P0.01)。慢阻肺患者血清IL-6、IL-8、TNF-α及hs-CRP与肺功能指标中的FEV_1/FVC、FEV_1%pred均呈负相关(P0.05)。结论稳定期慢阻肺患者血清炎性因子IL-6、IL-8、TNF-α及hs-CRP水平均升高,并且与肺功能呈负相关,患者存在气道炎症,可能是导致其肺功能进行性下降的原因之一。     

影响老年急性脑梗死病人神经功能缺损程度的相关因素分析

目的探讨老年急性脑梗死病人血清hs-CRP、TNF-α、IL-6、Hcy、D-二聚体(D-dimer)的水平与神经功能缺损程度的相关性。方法选取2015～2018年我院收治的160例急性脑梗死病人作为病例组,依据NIHSS评分将入院病人依次分为低评分组65例、中评分组49例、高评分组46例。另选取同期于我院行健康体检的160例健康志愿者作为对照组。检测各组hs-CRP、TNF-α、IL-6、Hcy、D-dimer的水平,并分析上述指标与NIHSS评分的相关性。结果病例组的hs-CRP、TNF-α、IL-6、Hcy、D-dimer水平均高于对照组,差异有统计学意义(P0. 01)。高评分组的hs-CRP、TNF-α、IL-6、Hcy、D-dimer水平均高于中评分组与低评分组,中评分组上述指标水平均高于低评分组,差异有统计学意义(P0. 01)。hs-CRP、TNF-α、IL-6、Hcy、D-dimer的水平与NIHSS评分均呈正相关(r=0. 426、0. 734、0. 478、0. 593、0. 452,P0. 05)。结论 hs-CRP、TNF-α、IL-6、Hcy、D-dimer在老年急性脑梗死病人中异常升高,且均是加剧神经功能缺损严重程度的相关因素。     

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.