高脂血症合并高尿酸血症与冠状动脉病变临床相关性分析

目的 探讨高脂血症合并高尿酸血症与冠状动脉病变临床相关性.方法 选取我院2016年9月-2019年8月临床疑诊冠心病患者6 5例为研究对象,所有纳入患者根据心电图检查结果 分为冠心病组(2 0例)和非冠心病组(4 5例).运用Logistic回归分析,对冠心病相关因素进行单因素以及多因素回归分析.结果 冠心病组患者高尿酸血症、高脂血症发病率、糖尿病率、高龄率、高血压率、高脂血症联合高尿酸血症率高于非冠心病组,上述均为独立危险因素(P<0.05);冠心病组患者的血脂水平、尿酸水平高于非冠心病组患者(P<0.05).结论 冠状动脉病变程度与发病情况、高脂血症合并高尿酸血症存在一定的关联,可为临床提供给予评估意义.     

冠状动脉造影患者心血管病危险因素与冠状动脉病变程度的相关性分析

目的探讨心血管疾病危险因素与冠状动脉造影病变程度相关性。方法入选行冠状动脉造影住院病例920例,其中确诊冠心病患728例(占79．13％),排除冠心病患192例(占20．87％)。冠状动脉造影病变程度由病变支数,经造影是否诊断冠心病及病变Gensini总积分表示。危险因素包括性别、年龄、高血压病、吸烟、2型糖尿病、血脂异常、高尿酸。采用单因素和多因素分析。结果(1)单因素分析显示,在病变程度不同的各组间比较,随各组中存在单个危险因素病例百分率的增加,冠状动脉造影病变支数和病变Gensini总积分随之增加。(2)多因素Logistic回归分析(前进法)显示,高LDL-C为冠状动脉造影诊断冠心病最显的独立相关危险因素(OR=2．816,95％可信区间1．903,4．167,P=0．001),其他危险因素依次为男性、吸烟、2型糖尿病、低HDL-C、高血压病、高尿酸血症和增龄。性别分组后分别经多因素Logistic回归(前进法)分析显示,男性组中高LDL-C为冠状动脉造影诊断冠心病最显的独立相关的危险因素(OR=2．965,95％可信区间1．880,4．676,P=0．009)。女性分组中吸烟(OR=2．840,95％可信区间0．553,5．378,P=0．001)和高尿酸血症(OR=2．132,95％可信区间1．048,3．641,P=0．017)为冠状动脉造影诊断冠心病最显的独立相关的危险因素。结论高LDL-c是冠状动脉造影诊断冠心病最显的独立相关危险因素,在男性组中更为突出,但其他危险因素如男性、吸烟、2型糖尿病、低HDL-c、高血压病、高尿酸和增龄亦不可忽视,并且各危险因素在不同性别中危险程度有所不同,应该加以区别对待和重视。     

冠心病与血尿酸改变的相关分析

目的探讨冠心病与高尿酸血症的相关性.方法选择1999-2003年我院心内科收治的126例疑诊为冠心病并行冠状动脉造影的病例,分为冠脉正常组(53例)和冠心病组(73例),检测二组的血尿酸水平及相关血脂、血糖等生化指标.结果冠心病组血尿酸显著高于正常冠脉组(372±94mmol/L与358±92mmol/L),P＜0.01;急性心肌梗死患者高尿酸血症明显高于正常组.结论高尿酸血症与冠心病密切相关,是冠心病的独立危险因素之一.     

高甘油三酯—低高密度脂蛋白血症与冠状动脉病变

为了分析高甘油三酯血症—低高密度脂蛋白血症与冠状动脉病变的关系 ,对 5 4例稳定型心绞痛和陈旧性心肌梗死患者行冠状动脉造影术 ,同时测定吸烟年限、血糖、收缩压、胆固醇、低密度脂蛋白、甘油三酯、高密度脂蛋白等冠心病危险因素 ,将研究对象分为无主要危险因子组 (n =15 )、高甘油三酯—低高密度脂蛋白血症组 (n =11)、合并糖尿病组 (n =15 )及合并糖尿病和高甘油三酯—低高密度脂蛋白血症组 (n =13) ,比较各组冠状动脉病变程度、类型和罹患支数 ,并应用逐步回归法研究上述因素与冠状动脉狭窄度积分的关系。结果发现 ,合并糖尿病和高甘油三酯—低高密度脂蛋白血症组冠状动脉狭窄度积分较其它各组显著增高 (P <0 .0 5 ) ,B2 、C型病变较无主要危险因子组多见 (P <0 .0 5 ) ,且三支病变显著增多 ;冠状动脉狭窄度积分与血糖、甘油三酯、高密度脂蛋白等因素存在线性回归关系 (P <0 .0 5 )。提示 ,血浆甘油三酯浓度越高 ,高密度脂蛋白浓度越低 ;血糖浓度越高 ,冠状动脉狭窄度积分越高 ,冠状动脉病变程度越重。     

单核细胞与高密度脂蛋白胆固醇比值在冠心病合并高尿酸血症患者中的变化及其与冠心病患者冠状动脉狭窄程度的关系研究

背景单核细胞与高密度脂蛋白胆固醇比值(MHR)是近年发现的一种新型炎性标志物,与人体内氧化应激和炎性反应密切相关。目前已证实,MHR升高与冠心病的病理过程及不良预后有关,且与冠心病患者的心血管事件发生相关。高尿酸血症参与了炎性反应,在理论上会提高MHR,从而加速冠状动脉粥样硬化病变进展,但相关研究较少。目的分析MHR在冠心病合并高尿酸血症患者中的变化,并探讨其与冠心病患者冠状动脉狭窄程度的关系。方法选取2017年6月—2018年6月于中国科学技术大学附属第一医院经冠状动脉造影确诊的冠心病患者1 337例,根据尿酸水平分为高尿酸血症组(n=318)和尿酸正常组(n=1 019);根据冠状动脉造影结果分为轻度狭窄组(n=507)、中度狭窄组(n=482)和重度狭窄组(n=348);选取同期于本院体检健康者204例为对照组。比较对照组、尿酸正常组和高尿酸血症组与对照组、轻度狭窄组、中度狭窄组和重度狭窄组受试者一般资料和实验室检查指标,MHR与冠心病患者冠状动脉狭窄程度的相关性分析采用Pearson相关分析;冠心病患者冠状动脉狭窄程度的影响因素分析采用多因素Logistic回归分析。结果对照组受试者低密度脂蛋白胆固醇(LDL-C)、MHR低于高尿酸血症和尿酸正常组(P0.05),尿酸正常组患者MHR低于高尿酸血症组(P0.05)。对照组受试者LDL-C、尿酸及MHR低于轻度狭窄组、中度狭窄组和重度狭窄组(P0.05),轻度狭窄组患者糖尿病病史率、吸烟史率、LDL-C、MHR低于中度狭窄组和重度狭窄组(P0.05),中度狭窄组患者糖尿病病史率、吸烟史率、LDL-C、MHR低于重度狭窄组(P0.05);Pearson相关分析结果显示,MHR与冠心病患者冠状动脉狭窄程度呈正相关(r=0.826,P0.001)。多因素Logistic回归分析结果显示,LDL-C[OR=3.228,95%CI(1.374,7.588)]、MHR[OR=3.597,95%CI(1.024,12.634)]是冠心病患者冠状动脉狭窄程度的影响因素(P0.05)。结论 MHR在冠心病合并高尿酸血症患者中较高,与冠心病患者冠状动脉狭窄程度呈正相关,且是冠心病患者冠状动脉狭窄程度的影响因素。     

特发性二尖瓣腱索断裂患者心血管病危险因素与冠状动脉造影结果的相关性分析

目的探讨特发性二尖瓣腱索断裂患者心血管病危险因素与冠状动脉(冠脉)造影结果的相关性。方法入选行冠脉造影的特发性二尖瓣腱索断裂患者195例,其中冠脉造影正常组143例(占74.33%),冠脉造影异常组(即确诊合并有冠心病)52例(占26.67%)。危险因素包括性别、年龄、吸烟史、高血压病、2型糖尿病、缺血性心血管病家族史、血脂异常、高尿酸血症、血红蛋白、总胆红素、体重指数。采用单因素和多因素分析。结果 (1)单因素分析显示,合并冠心病组发病年龄较冠脉造影正常组大,合并冠心病组吸烟比例、高血压病史比例、缺血性心血管病家族史比例、总胆固醇水平、甘油三酯水平、低密度脂蛋白胆固醇水平、尿酸水平均显著高于冠脉造影正常组。(2)多因素Logistic回归分析显示,缺血性心血管病家族史是特发性二尖瓣腱索断裂患者合并冠心病最显著的独立相关危险因素(OR=29.628,95%可信区间8.234-106.604,P=0.001),其它危险因素依次为高血压病史、高尿酸血症。结论缺血性心血管病家族史是特发性二尖瓣腱索断裂患者合并冠心病的独立相关危险因素,对于合并有冠心病高危因素(如高龄、有高血压病史、高尿酸、吸烟史、高脂血症)的特发性...     

血清尿酸水平与老年冠心病患者易感风险因素的相关性研究

目的分析血清尿酸水平与老年冠心病易感风险因素的相关性。方法回顾性采集2017年1月至2019年1月我医院老年冠心病患者200例(冠心病组)和同期医院门诊接诊的非冠心病老年患者150例(对照组)的临床资料。患者入院后即刻采集外周静脉血,测定血清尿酸水平;并记录各基线资料情况,将冠心病可能的易感风险因素纳入,经单因素与多因素分析找出风险因素,分析血清尿酸水平与老年冠心病患者各易感风险因素的相关性。结果初步单因素分析发现,吸烟、合并糖尿病、低高密度脂蛋白胆固醇(HDL-C)血症、冠心病家族史、肾小球滤过率等均可能是老年冠心病患者易感风险因素(χ^2=6.739、15.655、6.331、9.615、23.279,P均<0.05);多因素分析证实,吸烟、合并糖尿病、低HDL-C血症、冠心病家族史、肾小球滤过率均是老年冠心病易感风险因素(OR=1.777、2.381、1.883、1.967、3.205,均P<0.05);吸烟、合并糖尿病、低HDL-C血症、有冠心病家族史、肾小球滤过率<100 ml/min的老年冠心病患者,其血清尿酸水平均高于其他患者(t=8.017、5.907、8.509、7.164、13.839,均P<0.001);经Spearman相关性分析检验证实,血清尿酸水平与老年冠心病患者吸烟、合并糖尿病、冠心病家族史等易感风险因素均呈正相关(r=0.409、0.422、0.422,均P<0.001),与低HDL-C血症、肾小球滤过率呈负相关(r=-0.428、-0.481,均P<0.001)。结论血清高尿酸水平与吸烟、糖尿病等诸多冠心病易感风险因素有紧密联系,可能是冠心病发病的独立危险因素。     

冠状动脉狭窄程度与冠心病危险因素的相关性分析

目的探讨冠状动脉狭窄程度与冠心病危险因素的相关性。方法连续性收集我科行冠状动脉造影的患者121例,根据造影结果,将患者分为冠心病组89例与对照组32例。收集2组患者临床、实验室和影像学资料,采用单因素和多因素logistic回归模型进行分析。结果冠心病组男性、糖尿病、吸烟比例和LDL-C水平均高于对照组,HDL-C水平低于对照组(P<0.05);多因素logistic回归分析示,糖尿病(OR=3.769,P=0.042)、LDL-C水平(OR=1.873,P=0.021)是冠心病的独立危险因素。中、重度冠状动脉狭窄患者吸烟比例均高于轻度狭窄者,中度狭窄患者男性比例、年龄与尿酸水平和重度狭窄患者高血压、糖尿病比例均高于轻度狭窄者,差异均有统计学意义(P<0.05);logistic回归分析示,年龄(OR=1.094,P=0.001)、高血压(OR=3.340,P=0.003)、糖尿病(OR=3.877,P=0.003)和吸烟(OR=4.536,P=0.003)与冠状动脉狭窄程度相关。结论冠心病的危险因素与冠状动脉狭窄程度存在显著相关性,其中糖尿病是两者共同的重要危险因素。     

冠状动脉粥样硬化性心脏病患者血清尿酸特点分析

目的分析冠状动脉粥样硬化性心脏病（冠心病）患者血清尿酸浓度的特点,探讨检测血清尿酸浓度在预防冠心病发生中的作用。方法选取2010年3月至2011年2月在广东省人民医院住院,怀疑冠心病的患者430例为研究对象。首先根据造影结果分为冠心病组316例,对照组114例,测定两组的血清尿酸浓度,并进行对比分析。然后,根据世界卫生组织高尿酸血症诊断标准,将患者分成高尿酸血症组和非高尿酸血症组,比较两组的冠心病患病率。最后,患者按血清尿酸浓度分为4个浓度组,比较4组冠心病的患病率。结果冠心病组血尿酸浓度高于对照组,差异有统计学意义[（374.42±98.54）μmol.L-1vs.（374.42±98.54）μmol.L-1,P〈0.05]。高尿酸组中冠心病患病率高于非高尿酸组,但差异无统计学意义（P=0.217）。不同血清尿酸浓度的4组中,血清尿酸浓度越高,冠心病患病率也越高,与浓度最低组比较,差异有统计学意义（P=0.001）。结论血清尿酸浓度可能是冠心病的危险因素之一,血清尿酸浓度高者患冠心病的可能性较大;加强血清尿酸浓度检测对预防冠心病的发生具有重要意义。     

413例冠脉造影患者危险因素与冠脉病变的相关性研究

目的：探讨冠脉造影患者心血管危险因素与冠脉病变的相关性。方法：对于南方医院住院的2004年6月至2008年12月的413例行冠脉造影患者，采集病历数据，包括性别、年龄、体重指数、吸烟、高血压病、2型糖尿病、低密度脂蛋白-胆固醇（LDL-C）、高密度脂蛋白-胆固醇（HDL-C）、甘油三酯（TG）、尿酸（UA）、纤维蛋白原（Fg）、C-反应蛋白（CRP）及血清总胆红素（TBIL）等指标，冠脉造影通过直径目测法判断是否患冠心病。以单因素分析心血管危险因素与冠脉病变的关系，采用多因素Logistic回归分析筛选冠心病的独立相关危险因素。结果：（1）冠心病组患者男性比例、平均年龄、体重指数、LDL-C、TG、UA、CRP、Fg水平均显著高于非冠心病组，HDL-C水平显著低于非冠心病组，合并吸烟、高血压、糖尿病的病例显著多于非冠心病组（P〈0．05～〈0．01）；（2）Logistic回归分析显示，LDL-C、吸烟、糖尿病、高血压、体重指数、HDL-C、增龄、高尿酸入选回归方程（OR=3．559～1．003，P〈0．05～〈0．001），其中LDL-C为最显著的独立相关出素（OR：3．559，95％可信区间2．143～5．911，P〈0．001）。结论：LDL-C水平升高、吸烟、糖尿病、高血压、体重指数上升、HDH—C水平降低、增龄、高尿酸水平为冠心病的显著，独立相关因素。     

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.     

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.