庚型肝炎患者肝组织中HGV表达的免疫组化研究

目的探讨庚型肝炎病毒（ＨＧＶ）在庚型肝炎肝组织中的表达状况与临床意义．方法应用免疫组织化学ＰＡＰ方法以鼠抗ＨＧＶＮＳ５单克隆抗体对庚型肝炎患者２０例（急性肝炎２例，慢性肝炎８例，肝硬变１０例，血清ＨＧＶＲＮＡ皆阳性）肝组织中ＨＧＶ抗原进行检测．结果庚型肝炎患者２０例中，８例（４０％）肝组织中检出ＨＧＶ抗原；不同病期检出率分别为：急性肝炎０／２（０％），慢性肝炎２／８（２５％），肝硬变６／１０（６０％），各组间差异无显著意义；阳性信号位于肝细胞胞质；阳性细胞可位于炎症坏死灶周围；抗原阳性与阴性组间肝组织炎症活动度及血清谷丙转氨酶水平无明显差别，但阳性组纤维化指数较高．结论ＨＧＶ感染及其在肝组织中表达可能与肝组织纤维化有一定关系     

单纯HGV感染急性肝炎患者的临床与病理研究

目的 通过对一组急性ＨＧＶ感染患者的肝组织病理和临床资料分析，探讨庚型肝炎病毒感染的致病性，方法 采用免疫组织化学技术对５９例不明原因包性肝炎患者的肝组织，进行乙、丙和庚型肝炎病毒怕检测，部分病例经原位杂交证实。结果 ＨＧＶＮＳ５怕的检出率为（５７．６％〈３４／５９），其中２０直组织中ＨＢｓＡｇ和／或ＨＣＶＮＳ３Ａｇ同时阳性ＩＨＧＶ合并感染组），ＨＧＶ阳性信号主要位于肝细胞浆内。ＨＧＶ单纯感染病例     

重型肝炎患者肝组织基质金属蛋白酶-1及其抑制因子-1 mRNA的表达

目的：观察重型肝炎患者基质金属蛋白酶－1（MMP－1）和金属蛋白酶组织抑制因子－1（TIMP－1）mRNA的表达以及胶原蛋白的沉积情况，从胶原降解的角度探讨重型肝炎致肝纤维化的机制。方法：重型肝炎肝组织标本20例，非肝病患者肝组织6例，用原位杂交法检测肝组织MMP－1和TIMP－1 mRNA-1 的表达，并作I、Ⅳ型胶原的免疫组化以及天狼红胶原染色。结果：与对照组比较，重型肝炎组的MMP－1 mRNA和TIMP－1 mRNA表达显著增加，肝组织胶原蛋白总含量和I、Ⅳ型胶原蛋白含量亦显著增加。肝组织胶原蛋白总含量和I、Ⅳ型胶原蛋白含量与MMP－1 mRNA表达无明显相关性，与TIMP－1 mRNA表达呈正相关。结论：重型肝炎患者肝纤维化的发生与金属蛋白酶抑制因子增加、抑制金属蛋白酶的活性、降低间质胶原蛋白的分解有关。     

肝炎平对肝纤维化大鼠肝组织中M1型胆碱能受体和β2型肾上腺素能受体表达的影响

[目的]研究肝炎平对肝纤维化大鼠肝细胞神经递质受体的作用，探讨其抗肝纤维化的可能机制。[方法]将38只Wistar大鼠分为3组：正常对照（N）组8只、肝炎平（G）组15只及模型（M）组15只。采用光镜及电镜观察肝组织病理学改变；免疫组织化学SP法检测各组肝组织M1型胆碱能受体（M1-AChR）和β2肾上腺素能受体（β2-AR）的表达水平。[结果]G组病理改变较M组明显改善，G组M1-AChR的表达较M组降低而β2-AR的表达较M组显著升高（P〈0．05）。[结论]肝炎平能通过抑制肝组织M1-AChR的表达同时增加β2-AR的表达，从而调节神经递质在肝纤维化中的作用。     

血清学非甲—戊型急性肝炎的病因分析

探讨血清学非甲 -戊型急性肝炎的病因。采用免疫组织化学和原位杂交技术对 6 5例血清学非甲 -戊型急性肝炎患者的肝组织 ,分别进行乙、庚、丙型肝炎病毒抗原和TT病毒核酸 (TTVDNA)检测。 6 5例肝组织中乙、庚、丙型肝炎病毒抗原及TTVDNA的检出例次分别为 34、32、18和 2 0 ,前两者检出率明显为高 ,差异显著(P <0 0 5 ) ,仍有 10 8%病因不明。在单纯急性乙、庚型肝炎病毒、TT病毒感染及非A -G、TTV感染中 ,部分肝功能组间比较无显著差异 (P >0 0 5 )。隐匿性的HBV ,庚型肝炎病毒感染是血清学证实为急性非甲 -戊型肝炎的主要病因。部分病例病因分型仍不明确 ,提示有另外的致病因子存在。     

Fas/FasL在丁型肝炎发病机理中的作用

目的检测丁型肝炎病人肝组织Fas/FasL和HDAg表达,了解Fas/FasL在丁型肝炎致病机理中的作用。方法采用免疫组化单、双标记技术,检测48例丁型肝炎病人肝组织Fas、FasL和HDAg表达,以54例乙型肝炎作疾病对照。结果 Fas以肝细胞浆表达为主,HDAg以肝细胞核和胞浆表达为主,二抗原表达及分布呈一致性。FasL主要表达在浸润淋巴细胞浆、肝细胞核,与HDAg表达及分布不全一致,丁型肝炎组Fas、FasL检出率及表达强度较对照组高,三成分在各型肝炎中的表达强度有显著性差别意义。结论 Fas、FasL和HDAg均与肝组织炎症活动和病理损害相关,HDV感染可诱导肝细胞大量表达Fas,CTL通过Fas/FasL途径介导的肝细胞凋亡与HDV致病可能有关。     

丁型肝炎患者肝组织中Bcl-2、Bax和肝细胞凋亡表达

目的 探讨bcl-2、bax及肝细胞凋亡在丁型肝炎发病机理中的作用。方法 采用免疫组织化学单、双标记染色和TUNEL技术、检测77例丁型肝炎患者肝组织HDAg、bcl-1、bax及肝细胞凋亡表达，以67例乙型肝炎作对照，结果 bcl-2和bax均以肝细胞浆表达为主。HDAg以肝细胞核表达为主。HDAg和Bax与凋亡细胞表达及分布有相关性，三成分在各型肝炎中的表达强度差异有显著意义（P＜0.05）。结论 HDAg、bax和肝细胞凋亡表达强度和阳性细胞分布均与肝组织炎症活动及病理损害程度相关，HDV感染可诱导肝细胞表达bax，增强肝细胞凋亡，这一机制在丁型肝炎发病机理中可能有一定重要作用。     

影响肝前体细胞增殖分化的因素研究

对影响肝前体细胞增殖分化的因素进行初步探讨。采用免疫组织化学(IHC)的方法分别对59例重型肝炎(SH)病例肝组织标本表达干细胞因子受体(c—kit)、谷胱甘肽S转移酶π(GST—π)、细胞角蛋白19(CT—19)、细胞角蛋白18(CT—18)、增殖细胞核抗原(PCNA)及G 些细胞因子如白细胞介素—18(IL—18)、一氧化氮合酶(NOS)和转化生长因子-β1(TGF-β1)的情况进行检测。重型肝炎中肝前体细胞主要以管状细胞和小肝细胞样细胞的形式存在。IL-18可在少数管状细胞弱表达；NOS在枯否细胞、肝细胞、管状细胞和小肝细胞样细胞中均有很好的表达；而TGF-β1在管状细胞罕见表达。在人重型肝炎后肝细胞再生过程中肝前体细胞主要是管状细胞和小肝细胞样细胞，一些细胞因子可能参与了这些细胞的活化、增殖和分化过程，如IL—18和NO；而TGF-β1有助于这些前体细胞优先增殖并促进过渡肝细胞分化。     

肝细胞凋亡及凋亡相关基因Caspase-3、Bcl-2在慢性乙型重型肝炎中的作用

目的 探讨肝细胞凋亡及凋亡相关基因Caspase-3、Bcl-2在慢性乙型重型肝炎(慢重肝)发生发展机制中的作用.方法 选择慢重肝肝组织标本68例(慢重肝组),正常肝组织标本20例(对照组).采用原位末端转移酶标记技术(terminaldeoxynucleotidyl transferase-mediated dUTP...     

肝癌和癌旁肝组织中IGF-Ⅰ,IGF受体mRNA的表达

目的 探讨胰岛素样生长因子I(IGF-I)及其受体(IGF-I R)在肝细胞癌变过程中的作用及意义.方法 采用DNA-RNA原位杂交方法观察肝癌(n=30)和癌旁肝组织中IGF-I,IGF-I受体mRNA的表达.结果 在肝癌和癌旁肝组织中IGF-I的表达率分别为40.0%和50.0%,IGF-I受体的表达率分别为46.7%和53.3%;IGF-I,IGF-I受体在分化较差的癌细胞和不典型增生肝细胞中表达最为明显. 结论 IGF-I和IGF-I受体可能在肝细胞癌变过程中发挥重要作用.     

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.     

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.     

N-acetyl-L-cysteine combined with mesalamine in the treatment of ulcerative colitis： Randomized,placebo-controlled pilot study

AIM： To evaluate the effectiveness and safety of oral N-acetyl-L-cysteine （NAC） co-administration with mesalamine in ulcerative colitis （UC） patients.
METHODS： Thirty seven patients with mild to moderate UC were randomized to receive a four-wk course of oral mesalamine （2.4 g/d） plus N-acetyl-L-cysteine （0.8 g/d） （group A） or mesalamine plus placebo （group B）. Patients were monitored using the Modified Truelove-Witts Severity Index （MTWSI）. The primary endpoint was clinical remission （MTWSI ≤ 2） at 4 wk. Secondary endpoints were clinical response （defined as a reduction from baseline in the MTWSI of ≥ 2 points） and drug safety. The serum TNF-α, interleukin-6, interleukin-8 and MCP-1 were evaluated at baseline and at 4 wk of treatment. RESULTS： Analysis per-protocol criteria showed clinical remission rates of 63% and 50% after 4 wk treatment with mesalamine plus N-acetyl-L-cysteine （group A） and mesalamine plus placebo （group B） respectively （OR = 1.71; 95% CI： 0.46 to 6.36; P = 0.19; NNT = 7.7）. Analysis of variance （ANOVA） of data indicated a significant reduction of MTWSI in group A （P = 0.046） with respect to basal condition without significant changes in the group B （P = 0.735） during treatment. Clinical responses were 66% （group A） vs 44% （group B） after 4 wk of treatment （OR = 2.5; 95% CI： 0.64 to 9.65; P = 0.11; NNT = 4.5）. Clinical improvement in group A correlated with a decrease of IL-8 and MCP-1. Rates of adverse events did not differ significantly between both groups.
CONCLUSION： In group A （oral NAC combined with mesalamine） contrarily to group B （mesalamine alone）, the clinical improvement correlates with a decrease of chemokines such as MCP-1 and IL-8. NAC addition not produced any side effects.     

Delorme's transrectal excision for internal rectal prolapse

Surgical therapy of functional outlet obstruction in patients with internal rectal intussusception may include abdominal, perineal, or transrectal procedures. Because abdominal procedures often result in significant physiologic impact but unrelieved constipation, the authors have elected Delorme's transrectal excision for management of these patients. Since a short-term placebo effect attends many therapies, this report describes results of transrectal excision only after a threeyear postoperative period. Delorme's transrectal excision of internal intussusception accomplished sustained symptomatic relief in over 70 percent of otherwise refractory constipated patients. The association of internal intussusception with other abnormalities underscores the importance of defining both anatomic and functional components when selecting patients whose constipation may require surgical therapy. Critical technical elements, surgical pitfalls, and potential complications of the procedure are discussed.Poster presentation at the meeting of The American Society of Colon and Rectal Surgeons, Toronto, Canada, June 11 to 16, 1989.     

The oral glucose tolerance test: A comparison of the time points on the basis of limit values,normal dispersion,and reproducibility

Summary Time points in the glucose tolerance test (GTT) are compared on the basis of limit values, dispersion within a reference population, and reproducibility. We suggest using the distance between a limit value and the median reference value as a measure of the magnitude of abnormality. The distance between 140 mg/100 ml and the median fasting plasma glucose value is chosen as a standard distance and limits for other points in the GTT are calculated to equal this standard distance of abnormality. We suggest that the probability of correctly interpreting an inividual result is directly related to the reproducibility of the test and inversely related to the percentage of the total range of values which is dispersed among the normal population. The ratio of reproducibility to percentage normal dispersion is proposed as an index of the probability of correctly interpreting an individual result. According to this index, the probability of correct interpretation varies in order: fasting plasma glucose concentration>3-h>2-h>0.5-h>1-h plasma glucose concentration.