色素上皮衍生因子启动子区基因多态性与糖尿病微血管病变的关系

目的观察色素上皮衍生因子（PEDF）启动子区单核苷酸多态性（SNP）与糖尿病微血管病变的关系。方法将271例T2DM患者分为无糖尿病微血管病变组105例,合并糖尿病微血管并发症组166例,分析PEDF基因启动子区rs12150053T／C及rs12948385G／A的基因型和等位基因频率。结果两个SNPs位点等位基因频率均有统计学差异（P〈0．05）,rs12948385位点基因型频率也有统计学差异（P〈0．05）。结论PEDF启动子区多态性位点可能是我国北方汉族人群糖尿病微血管病变发病的危险因素之一。     

中国汉族人群PGC-1α基因rs3774923单核苷酸多态性与冠心病的关系

目的本研究探讨过氧化物酶增殖激活物受体辅助激活因子1α（peroxisome prolifemtor-activatedreeeptor γ coactivator-1,PGC-1α）基因rs3774923单核苷酸多态性与中国汉族人群冠状动脉粥样硬化性心脏病（冠心病）发病的关系。方法采用聚合酶链反应-限制性片段长度多态性方法对675例冠心病患者和636例对照组患者进行检验,分析PGC-1α基因rs3774923单核苷酸多态性的基因型和等位基因频率的分布情况。结果PGC-1α基因rs3774923单核苷酸多态性三种基因型（GG型,GA和AA型）在冠心病组的分布频率分别为60．0％,30．2％和9．8％,在对照组分别为58．2％,35．2％和6．4％,两组PGC-1α基因rs3774923单核苷酸多态性的基因型比较,差异无统计学意义（P〉0．05）。PGC-1α基因rs3774923单核苷酸等位基因（G等位基因,A等位基因）分布频率在冠心病组为75．1％和24．9％,在对照组为75．9％和24．1％,两组PGC-1α基因rs3774923单核苷酸多态性的等位基因频率比较,差异无统计学意义（P〉0．05）。Logistic回归分析校正性别、年龄、体质量指数、吸烟、原发性高血压、高脂血症、糖尿病等冠心病的易患因素后,PGC—1α基因rs3774923单核苷酸多态性与冠心病的发病不存在相关关系（P〉0．01）。结论PGC-1基因rs3774923单核苷酸多态性与冠心病的发病不存在相关关系。     

CD86基因启动子－3479 A／C 位点单核苷酸多态性与 ITP 遗传易感性的关系

目的：探讨CD86基因启动子－3479 A／C位点（ rs2715267）单核苷酸多态性与原发免疫性血小板减少症（ ITP）遗传易感性的关系。方法收集93例成人慢性ITP患者（ ITP组）及119例健康对照者（对照组）,提取两组外周血DNA,采用位点特异性PCR进行DNA分型检测。分型结果通过DNA测序方法进行验证。结果 CD86基因启动子－3479 A／C位点基因型AA、AC和CC在ITP组的分布频率分别为40．9％、52．6％及6．5％,在对照组的分布频率分别为49．6％、37．8％及12．6％,两组比较P 均＞0．05;等位基因A和C在ITP组的分布频率分别为67．2％、32．8％,在对照组的分布频率分别为68．5％、31．5％,两组比较P均＞0．05。两组同性别CD86基因启动子－3479 A／C位点等位基因及基因型的分布频率比较P均＞0．05。根据糖皮质激素治疗效果将ITP患者进行分组,结果显示,激素有效组、激素无效组CD86基因启动子－3479 A／C位点等位基因及基因型的分布频率比较P均﹥0．05。结论 CD86基因启动子－3479 A／C位点的单核苷酸多态性可能与ITP的遗传易感性无关。     

去整合素金属蛋白酶10基因启动子区多态性变化与腔隙性脑梗死发病风险的关系

目的观察腔隙性脑梗死患者去整合素金属蛋白酶（ADAM）10基因启动子区多态性变化,分析此多态性变化与腔隙性脑梗死发病风险的关系。方法研究对象为173例腔隙性脑梗死患者（梗死组）和297例非脑血管病体检者（对照组）,采用Snapshot分型技术检测ADAMIO基因启动子区rs653765和rs514049位点多态性,采用B型彩色多普勒超声仪测量颈动脉内膜中层厚度（CIMT）;比较两组位点多态性及其与梗死组性别、年龄、CIMT的关系。结果梗死组ADAMIO基因rs653765位点CC基因型频率显著低于对照组（P=0．0080）、隐性模型CT＋TT基因型频率显著高于对照组（OR：0．54,95％a为0．36—0．81,P=0．0029）,T等位基因频率显著高于对照组（OR=1．95,95％CI为1．37～2．79,P=0．0002）;两组ADAMl0基因rs514049位点的基因型频率和等位基因频率无显著差异（P〉0．05）。携带ADAMIO基因rs653765位点T等位基因的男性发生腔隙性脑梗死的风险显著升高（OR=1．51,95％CI为1．00—2．28,P=0．048）,而≥70岁人群中携带cT基因型或T等位基因者发生腔隙性脑梗死的风险显著升高（OR=1．69,95％CI为1．00—2．85,P=0．046）;ADAMl0基因rs653765和rs514049位点的多态性与腔隙性脑梗死患者cI．MT无明显相关。结论ADAMl0基因rs653765位点T等位基因可能与腔隙性脑梗死的发病有关。     

PAX6基因多态性与精神分裂症的关系探讨

目的探讨PAX6基因多态性与精神分裂症的关系。方法选取270例首发精神分裂症患者（患者组）与320例健康志愿者（对照组）,采用阳性与阴性症状量表（PANSS）评定精神分裂症临床症状;通过检索数据库HapMap,在PAX6基因3’非翻译区（3’-UTR）选取两个标签单核苷酸多态性（SNP）rs3026401、rsl506位点,采用DNA基因组提取试剂盒提取DNA及进行连接酶检测反应（LDR）以测定SNP。采取病例对照研究方法比较两组间SNPrs3026401、rsl506位点基因型和等位基因分布频率。结果患者组（n=262）与对照组（n=318）的SNPrsl506基因型、等位基因分布频率差异无统计学意义;SNPrs3026401基因型、等位基因分布频率组间差异有统计学意义（P均〈0．05）。患者组SNPrs3026401不同基因型的阴性症状评分差异有统计学意义,即GG〉AA、GG〉AG（P均〈0．05）;阳性症状评分、一般精神病理因子评分差异无统计学意义。结论PAX6基因rs3026401多态性可能是精神分裂症的危险因素之一。     

Connexin40基因多态性与心房颤动的相关性研究

目的探讨Connexin40基因多态性与心房颤动的相关性。方法采用等位基因聚合酶链反应（PCR）的方法，对北京地区110例研究对象进行两种Connexin40单核苷酸多态性的检测，其中孤立性房颤组50例，高血压房颤组18例，单纯高血压组12例，健康对照组30例。结果孤立性房颤、高血压房颇、单纯高血压与健康对照组之间Connexin40启动子区域—44位点（G→A）单核苷酸多态等位基因频率和基因型频率存在分布差异显著（p〈0．05）；房颤组与非房颤组相比，在Connexin40启动子区域-44位点A基因型频率及A等位基因频率高于非房颤组（p〈0．05）；孤立性房颤、高血压房颤、单纯高血压与健康对照组之间Connexin40启动子区域（＋71）的基因型频率及等位基因频率的分布差异没有显著性（p〉0．05）.结论Connexin40基因多态性（-44G→A）与心房颤动发生具有相关性。     

浙江温州地区人群染色体9p21上rs1333049位点的单核苷酸多态性分布与冠心病的相关性

目的研究浙江温州地区汉族人群中染色体9p21上的rs1333049位点上的单核苷酸多态性（single nucleotide polymorphism,SNP）与冠心病的相关性。方法对冠心病组（至少1支主要冠状动脉内径狭窄≥50.00%）181例和对照组173例,采用聚合酶链反应和基因测序方法,检测染色体9p21上rs1333049位点基因多态性。结果 3种基因型均可在rs1333049位点上检测到,并且其基因型的分布亦符合Hardy-Weinberg平衡定律。冠心病组rs13330^149位点的CC、CG基因型分布及C等位基因频率均高于对照组,差异有统计学意义（均P〈0.01）。结论 rs1333049位点G/C基因的多态性与冠心病发病相关,其中的C等位基因亦可能是浙江温州地区汉族人群冠心病患者的易感性标志之一。     

新疆维吾尔族人群9p21单核苷酸多态性与冠心病的关联性研究

目的研究染色体9p21上两个单核苷酸多态性（single nucleotide polymorphism,SNP）位点（rs2383206、rs10757274）在新疆维吾尔族人群中的分布,探讨其与冠心病（coronary heart disease,CHD）的关联性。方法采用病例对照研究,选择172例冠状动脉造影证实的CHD患者和147例患者为对照组作为研究对象,应用LDR—PCR技术对rs2383206、rsl0757274位点进行SNP分型及分析。结果rs2383206GG基因型频率在冠心病组和对照组分别为34．9％和24．4％,G等位基因频率分别为58．1％和49．3％;两组间比较差异均有统计学意义（P〈0．05）;rsl0757274GG基因型频率在冠心病组和对照组分别为32．O％和21．8％,G等位基因频率分别为54．9％和46．6％;两组间比较差异均有统计学意义（P〈0．05）。调整相关因素后,多因素Logistic回归分析,结果提示两个SNP的GG基因型仍是CHD的危险基因型,rs2383206的OR值为1．91,95％CI（1．03～3．53）,rsl0757274的OR值为2．03,95％CI（1．08～3．80）,P值均〈0．05。结论9p21位点rs2383206、rsl0757274的多态性与维吾尔族族人CHD有关联。     

腹泻型肠易激综合征患者中IL-10基因多态性的研究

目的 探讨腹泻型肠易激综合征（D-IBS）与IL-10基因启动子区域-1082、-819和-592位点单核苷酸多态性之间的关系。方法用扩增受阻突变系统-PCR方法对41例健康对照和43例D-IBS患者IL-10基因启动子区域-1082、-819和-592位点单核苷酸多态性进行研究。结果 -819位点D-IBS患者T／T基因型频率显著高于健康对照组（67．4％比39．0％,P〈0．05）,C／T和C／C基因型频率虽较对照组低（分别为23．3％比43．9％和9．3％比17．1％）,但差异无统计学意义（P〉0．05）;-0592位点D-IBS患者A／A基因型频率显著高于对照组（67．4％比39．0％,P〈0．05）,C／A和C／C基因型频率均较对照组低（分别为23．3％比43．9％和9．3％比17．1％）,但差异无统计学意义（P〉0．05）;-1082位点基因型频率差异无统计学意义（P〉0．05）。IL-10启动子-819位点T等位基因频率在D-IBS患者显著高于健康对照组（79．1％比61．0％,P〈0．05）,C等位基因频率在D-IBS患者显著低于健康对照组（20．9％比39．0％,P〈0．05）;-592位点A等位基因频率在D-IBS患者显著高于对照组（79．1％比61．0％,P〈0．05）,C等位基因频率在D-IBS患者显著低于对照组（20．9％比39．0％,P〈0．05）;-1082位点G或A等位基因频率在D-IBS患者与对照组间差异无统计学意义。结论IL-10基因启动子区域一819T／T和-592A／A基因型可能与D-IBS发生有关。     

124例冠心病患者三磷酸腺苷结合盒转运体A1基因启动子区-477CT单核苷酸多态性分析

目的 研究三磷酸腺苷结合盒转运体A1基因启动子区-477C/T单核苷酸多态性与血浆高密度脂蛋白胆固醇和冠心病的关系。方法 用聚合酶链反应限制片长多态性检测124例冠心病患者和111例正常人的三磷酸腺苷结合盒转运体A1基因启动子区-477位点基因型，并比较基因型在冠心痛组与正常人组间、冠心痛组中不同临床表现型之间分布的差异性及三种基因型与冠心痛相关临床指标的关系。结果 TT基因型及T等位基因在冠心病组中的分布频率明显高于正常人组（P〈0．05和P〈0．01）。急性冠状动脉综合征组，TT基因型及T等位基因明显高于稳定型心绞痛组（P〈0．05和P〈0．01）。多支病变组TT基因型明显高于单支病变组（P〈0．05）。在冠心病组中，TT基因型血浆高密度脂蛋白胆固醇水平明显低于CC基因型（P〈0．001）。结论 三磷酸腺苷结合盒转运体A1基因启动子区-477C／T单核苷酸多态性可显著影响中国冠心痛患者血浆高密度脂蛋白胆固醇水平，而且与冠状动脉病变程度及冠心病严重程度相关。     

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.