用IRMA法和ELISA法检测同批新生儿脐血TSH的结果比较

以ＩＲＭＡ和ＥＬＩＳＡ两种方法检测足月产正常新生儿脐血２６４份，结果：９６．２％的样品检测值为ＩＲＭＡ＞ＥＬＩＳＡ，其Ｍ±Ｓｍ分别为７．６４±０．２７ｍＩＵ／Ｌ和４．０７±０．２５ｍＩＵ／Ｌ，（ｕ＝９．７０，Ｐ＜０．０１）；ＴＳＨ值＜５ｍＩＵ／Ｌ的百分率分别为２２．１％和６１．４％，（ｕ＝２．１４，Ｐ＜０．０５）；经配对比较，两法呈现良好的正相关关系，ｒ＝０．７０６（ｔ＝１６．１２，Ｐ＜０．０００５）。根据本实验求得以ＥＬＩＳＡ检测值推算ＩＲＭＡ值的直线回归方程式是：Ｙ＝３．５９９５＋１．０４８０Ｘ。作者认为：用国产ＩＲＭＡ纸片法试剂盒检测新生儿脐血ＴＳＨ时，其上限值可界定在≤９ｍＩＵ／Ｌ。     

应用IRMA法与ELISA法测定静脉血斑sTSH的对比研究

应用ＥＬＩＳＡ法和ＩＲＭＡ法测定９５对滤纸静脉血斑ｓＴＳＨ。结果表明，应用ＩＲＭＡ法和ＥＬＩＳＡ法测定同一个体静脉血斑ｓＴＳＨ其结果无差异性，两者存在正相关（ｒ＝０．４９６），回归方程Ｙ血斑ＥＬＩＳＡ法＝０．４５＋０．７６Ｘ血斑ＩＲＭＡ法。即静脉血斑ｓＴＳＨＩＲＭＡ法的５ｍＵ／Ｌ、１０ｍＵ／Ｌ相当于ＥＬＩＳＡ法的４．２５ｍＵ／Ｌ和８．０５ｍＵ／Ｌ；其次，ＩＲＭＡ法和ＥＬＩＳＡ法对静脉血斑ｓＴＳＨ的测定结果与ＩＲＭＡ法对血清ｓＴＳＨ的测定值均有良好的线性回归关系。因此，静脉血斑ｓＴＳＨ的测定结果在一定程度上可替代静脉血清反映机体甲状腺功能的变化     

新生儿滤纸血斑TSH检测TR—IFMA,IRMA,ELISA的对比研究

对碘缺乏病病区和非病区新生儿脐带滤纸血斑同时利用三种方法检测ＴＳＨ值，结果表明ＩＲＭＡ值＞ＴＲ－ＩＦＭＡ值＞ＥＬＩＳＡ值，三者相关非常显著，相关系数分别是ＴＲ－ＩＦＭＡ与ＥＬＩＳＡ为０．８３８、ＥＬＩＳＡ与ＩＲＭＡ为０．８３５、ＩＲＭＡ与ＴＲ－ＩＦＭＡ为０．７７７。５ｍＵ／Ｌ以下所占百分率ＥＬＩＳＡ为７６．９％、ＴＲ－ＩＦＭＡ为６４．７％、ＩＲＭＡ为４４．８％。经多年补碘的病区与非病区ＴＳＨ值分布频率基本相似。认为三种方法均可用于碘缺乏病监测，但ＩＲＭＡ值偏高，可根据回归方程ＴＲ－ＩＦＭＡ、ＥＩＡ值进行换算。     

孕妇碘负荷对新生儿甲状腺功能及行为神经发育的影响

目的　探讨孕妇高碘负荷 对新生儿甲状腺功能及行为神经发育的影响。方法　生活在地方性高碘地区的孕妇２９１名,收集临产前尿样及出生后１５分钟内的脐带血样,并采集不同乡地下水样５份。酸式消化砷铈接触法测定微量碘, Ｅ Ｌ Ｉ Ｓ Ａ 测定脐血 Ｔ Ｓ Ｈ 和 Ｆ Ｔ４,新生儿２０项行为神经测定方法检查行为神经发育。结果　水碘浓度为４９５１±３３．７μｇ／ Ｌ;孕妇尿碘浓度中位数为８５３２μｇ／ Ｌ;脐血 Ｔ Ｓ Ｈ 中位数５００ｍ Ｕ／ Ｌ,其中, Ｔ Ｓ Ｈ＞ ５．００ｍ Ｕ／ Ｌ 的占５０８％ , Ｔ Ｓ Ｈ≥１０．００ｍ Ｕ／ Ｌ的占１３９％ ; Ｆ Ｔ４为１．４４±０．５１μｇ／ｄ Ｌ,其中 Ｆ Ｔ４＜ ０．８０μｇ／ｄ Ｌ 的为２７％ ;新生儿行为神经发育测定得分为３９０±１１。相关分析显示,孕妇尿碘水平与脐血 Ｔ Ｓ Ｈ 和 Ｆ Ｔ４水平无显著相关关系。新生儿行为神经发育正常。结论　孕妇高碘负荷对新生儿甲状腺功能及行为神经发育未见产生明显影响。     

新生儿出生方式对脐带血TSH的影响分析

目的　为进一步认识新生儿出生方式是脐带血 Ｔ Ｓ Ｈ 向高值偏移的重要影响因素。方法　调查沿海城市出生的新生儿 １ ０１４ 例，其中阴道产 ７６３ 例，剖宫产 ２５１ 例，采脐带血，使用免放分析（ Ｉ Ｒ Ｍ Ａ）检测 Ｔ Ｓ Ｈ。同期检测孕妇尿碘。结果　在孕妇尿碘中位数 ２１６．６４μｇ／ Ｌ 状况下，脐带血 Ｔ Ｓ Ｈ＞ ５ｍ Ｕ／ Ｌ 的频率，阴道产与剖宫产组分别为 ５６７％ 与 ２０３％ ，差异非常显著（χ２＝ １００．３８）。结论　首次揭示在孕妇碘营养明显改善后，新生儿在娩出过程中 Ｔ Ｓ Ｈ 的升高是一种普遍现象，以阴道娩出者最明显，是导致脐带血 Ｔ Ｓ Ｈ 向高值偏移的重要因素之一，并建议用剖宫产脐带血 Ｔ Ｓ Ｈ 值或足跟血 Ｔ Ｓ Ｈ 值校正阴道产脐带血 Ｔ Ｓ Ｈ 值。     

ELISA法与DELFIA法测定新生儿TSH的结果分析

目的比较双位点酶免法（Ｔｗｏ－ｓｉｔｅＥＬＩＳＡ）和时间分辨荧光免疫法（ＤＥＬＦＩＡ）测定新生儿ＴＳＨ的结果。方法采用芬兰进口试剂盒测定２１８例足月正常新生儿足血和脐血的成对ＴＳＨ值。结果ＥＬＩＳＡ法和ＤＥＬＦＩＡ法测定的脐血ＴＳＨ值有明显的相关性,其相关系数ｒ＝０．９１（ｔ＝３２．４１,Ｐ＜０．００１）;两种方法测定的足血ＴＳＨ值也有良好的相关性,其相关系数ｒ＝０．７８（ｔ＝１８．４０,Ｐ＜０．００１）;ＥＬＩＳＡ法测定值在足血和脐血间的相关系数却甚低,ｒ＝０．２１（ｔ＝３．１７,Ｐ＜０．０１）;ＤＥＬＦＩＡ法测定值在两者间的相关系数也很低,ｒ＝０．１５（ｔ＝２．２４,Ｐ＜０．０５）。结论ＥＬＩＳＡ和ＤＥＬＦＩＡ两种方法测定的脐血和脐血之间、足血和足血之间均呈现良好的正相关,但两种方法各自测定的脐血和足血之间相关性均不明显     

二种影响TSH测定结果的因素分析

目的　了解影响采样地区和测定方法对 Ｔ Ｓ Ｈ 测定值的因素。方法　以碘缺乏病重度流行区（四川）和非流行区（上海）新生儿脐带血样,用 Ｉ Ｒ Ｍ Ａ 法和 Ｅ Ｌ Ｉ Ｓ Ａ 法对血样的 Ｔ Ｓ Ｈ 浓度进行测定。结果　以两种方法对两地的 Ｔ Ｓ Ｈ 比较和用两地的样本对两种方法的比较,差异均有非常显著性意义（ Ｐ＜ ０．０１）。与其他地区的相关关系的比较表明：虽然 Ｉ Ｒ Ｍ Ａ 法和 Ｅ Ｌ Ｉ Ｓ Ａ 法所测定的 Ｔ Ｓ Ｈ 值之间存在着相关的联系,但不同测定者之间尚有一定的差异。结论　为说明 Ｔ Ｓ Ｈ 的测定值与其它指标之间的背离现象提供了一些数据,同时认为有必要进一步对 Ｔ Ｓ Ｈ 的测定方法做全国性的标准化和对其上限值（切点）进行讨论和确定。     

湖北省新生儿脐带血TSH水平评价

目的了解湖北省特需人群（育龄及孕产妇女）的碘营养水平。方法采用免疫放射（ＩＲＭＡ）法。共测定湖北省４７个市（县）正常产新生儿脐带血５３３５例。结果湖北省新生儿ＴＳＨ＞５ｍＵ／Ｌ者占４９．７％。其中１９９８年新生儿ＴＳＨ值＞５ｍＵ／Ｌ者占４４．８％,比１９９７年的５４．９％明显下降（Ｐ＜０．０１）。结论特需人群（育龄及孕产妇女）的碘营养状有所改善,但距碘缺乏病消除标准仍有一定差距     

TSH双位点单抗免疫放射测定法的建立及临床应用

采用本所制备及鉴定的二株不同位点的抗ｈ－ＴＳＨ单抗１３Ｂ４和８Ｅ７，建立了高灵敏度、高特异的ｈ－ＴＳＨ免放测定法。其中经饱和硫酸铵和ＰｒｏｔｅｉｎＡＳｅｐｈａｒｏｓｅ亲和层析柱纯化的１３Ｂ４以Ｉｏｄｏｇｅｎ固相法进行碘标，纯化的８Ｅ７（１∶１００稀释度）作塑料管固相抗体。方法学鉴定表明，本法与生理剂量的其他糖蛋白激素ｈ－ＦＳＨ、ｈ－ＬＨ、ｈＣＧ无明显交叉反应，灵敏度达０．０２６ｍＵ／Ｌ（－ｘ±２ｓ），批内ｃｖ为１．２３～７．３０％，批间ｃｖ为１２．３％。稀释度试验示平行线性关系好，ｒ＝０．９９９。初步临床应用结果表明：甲亢６４例，ＴＳＨ值为未测得（ＮＤ）～０．３１ｍＵ／Ｌ，９５％可信限为ＮＤ～０．２６３ｍＵ／Ｌ；甲减２８例，ＴＳＨ范围为６．６～１８２ｍＵ／Ｌ；甲状腺功能正常者９８例ＴＳＨ为１．４５ｍＵ／Ｌ（Ｐ＿（５０）），９５％可信限为０．３２６～６．０５９ｍＵ／Ｌ。本法与瑞士Ｓｅｒｏｎｏ酶免药盒同时测定１２８例，两种结果的相关系数ｒ＝０．８４４（Ｐ＜０．０１）。经上海华山医院等４家医院初步临床试用，结果表明本法与国内外同类型药盒相比，测定方法简便，相关性高，临床符合率好。     

重型肝炎患者外周血内皮素及一氧化氮水平变化的意义

目的探讨内皮素（ＥＴ）和一氧化氮（ＮＯ）在重型肝炎（ＳＨ）发病中的作用．方法检测３０例ＳＨ,３２例慢性肝炎（ＣＨ）患者外周血ＥＴ和ＮＯ代谢物ＮＯ－２的水平,并用ＮＯ合成酶底物左旋精氨酸（ＬＡｒｇ）进行治疗前后对比．结果ＳＨ患者外周血ＥＴ和ＮＯ－２水平（１３９ｎｇ／Ｌ±１４ｎｇ／Ｌ,１２７μｍｏｌ／Ｌ±４０μｍｏｌ／Ｌ）明显高于ＣＨ组（８５ｎｇ／Ｌ±１５ｎｇ／Ｌ,６３μｍｏｌ／Ｌ±２５μｍｏｌ／Ｌ,Ｐ＜００１）．合并有Ⅲ,Ⅳ期肝性脑病与肝肾综合征患者外周血ＥＴ和ＮＯ－２水平（１４９ｎｇ／Ｌ±１３ｎｇ／Ｌ,１６２μｍｏｌ／Ｌ±３４μｍｏｌ／Ｌ）明显高于非肝性脑病患者（１１５ｎｇ／Ｌ±１２ｎｇ／Ｌ,８８μｍｏｌ／Ｌ±２４μｍｏｌ／Ｌ,Ｐ＜００１）和Ⅱ期肝性脑病患者（１３６ｎｇ／Ｌ±１０ｎｇ／Ｌ,１２２μｍｏｌ／Ｌ±２６μｍｏｌ／Ｌ,Ｐ＜００１）;ＬＡｒｇ静脉滴注后血浆ＥＴ水平和平均动脉压（ＭＡＰ）显著下降,而肌酐清除率（ｃＣｒ）和尿钠含量明显增加．结论ＥＴ和ＮＯ水平升高是引起ＳＨ多脏器功能障碍的重要因素．ＬＡｒｇ长期治疗可能促进ＳＨ患者脑水肿形成和肝肾综合征发生．     

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.