载脂蛋白E基因多态性与老年人血脂、血压的相关性研究

目的探讨载脂蛋白E（ApoE）基因多态性与老年人血脂、血压的关系。方法采用聚合酶链式反应-限制性片段长度多态性分析方法（PCR—RFLP）测定252例老年人的ApoE基因型。结果在不同基因型组间，收缩压水平按E3／4＋E4／4〉E3／3〉E2／2＋E2／3顺序递减（P〈0．05）。而舒张压水平在不同基因型组间无差异（P〉0．05）；总胆固醇（TC）和低密度脂蛋白胆固醇（LDL-C）水甲均按E3／4＋E4／4〉E3／3〉E2／2＋E2／3顺序递减（P〈0．05），甘油三酯（TG）、高密度脂蛋白胆固醇（HDL—C）水平在各组问比较无差异（P〉0．05）。结论ApoE基因多态性影响老年人血脂血压水平，甜等位基因携带者除具有较高的TC、LDL．C水平外，还有较高的收缩压水平。     

颈动脉狭窄与ApoE基因多态性的相关性研究

目的 研究载脂蛋白E(ApoE)多态性及脂类代谢与颈动脉狭窄的相关性.方法 应用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)技术,对62例经血管造影证实的颈动脉狭窄患者及71例同期健康体检者的ApoE基因多态性进行分析,并进行血脂测定.结果 颈动脉狭窄组胆固醇(TC)、甘油三酯(TG)和低密度脂蛋白(LDL-C)水平均升高(P＜0.05,P＜0.01);颈动脉狭窄组患者的ε3频率较对照组降低(P＜0.01),ε4频率较对照组升高(P＜0.01),两组的基因型频率无差别;不同年龄、性别及颈动脉狭窄程度的患者ApoE多态性分布无差别.结论 ApoE基因多态性与颈动脉狭窄形成及血脂改变有关,ε4基因是颈动脉粥样硬化形成的危险因子.     

内皮素转化酶1启动子区T-839G基因多态性与颈动脉粥样硬化的相关性

目的研究内皮素转化酶1（ECE-1）启动子T-839G基因多态性与颈动脉粥样硬化的相关性。方法选择经DSA或CTA、MRA诊断的颈动脉粥样硬化患者及与之年龄和性别相匹配的对照者,各518例。采用多聚酶链反应-限制性片段长度多态性（PCR—RFLP）的方法检验ECE-1启动子区T-839G基因多态性。结果两组TT、TG、GG基因型分布差异无统计学意义（χ^2=4．674,P〉0．05）,颈动脉粥样硬化组等位基因频率T略高于对照组（92．3％,89．8％）,G略低于对照组（7．7％,10．2％）,差异有统计学意义（χ^2=3．993,P〈0．05）。两组总计（GG＋TG）／TT的基因型频率差异虽无统计学意义,但按性别和年龄分层后,显示女性和〈64岁者（GG＋TG）／TT基因型频率对照组均高于颈动脉粥样硬化组（女性：OR=0．59;95％CI：0．37～0．94;P=0．03。〈64岁者：OR=0．61;95％CI：0．38～0．97;P=0．04）结论ECE-1启动子区T-839G多态位点G等位基因可能降低女性及年龄〈64岁者颈动脉粥样硬化发生的危险性。     

60例肥胖伴高脂血症患者载脂蛋白E基因多态性分析

目的探讨载脂蛋白E（ApoE）基因多态性与肥胖伴高脂血症的关系。方法选择60例肥胖伴高脂血症患者（观察组）和48例健康体检者（对照组）,采用PCR技术检测两组ApoE基因的基因型,采用全自动生化分析仪检测观察组基因频率较高的血脂水平（TC、TG、HDL-C、LDL-C、ApoAl、ApoB）。结果观察组E3／E3型基因频率明显高于对照组（P〈0．05）;观察组E3／E3型及E3／E4型HDL-C水平明显低于E2／E3型,LDL-C明显高于E2／E3型,P均〈0．05;E3／FA型TC、TG、LDL-C水平明显高于E3／E3型,P均〈0．05。结论ApoE基因多态性与肥胖伴高脂血症发病具有相关性,ApoE基因型中E3／E3型的肥胖者可能更易患高脂血症。     

我国西部人群脂联素基因+45位点多态性与肥胖、胰岛素抵抗及2型糖尿病的相关性

目的探讨宁夏汉族人群脂联素基因＋45位核苷酸T／G多态性与肥胖、胰岛素抵抗（IR）及2型糖尿病（T2DM）的相关性。方法采用聚合酶链式反应-限制性内切酶长度多态性技术，对100例T2DM患者和101例正常对照（NC）者脂联素基因＋45位点进行基因分型；并计算BMI和HOMA-IR。结果（1）T2DM组GG基因型频率明显高于NC组（P〈0．01），G等位基因频率明显高于NC组（P〈0．01）。（2）在T2DM组中，GG＋TG基因型的BMI、HOMA-IR大于TT基因型（P〈0．01）。在NC组中，各基因型间BMI、HOMA-IR的差异无统计学意义。在T2DM组中，而BMII〉25组的GG＋TG基因型频率高于BMI〈25组（P〈0．01），G等位基因频率也高于BMI〈25组（P〈0．01）。结论脂联素基因＋45位核苷酸T／G多态性与肥胖、IR及T2DM相关。     

纤维蛋白原Bβ-455G/A多态性与颈动脉粥样硬化斑块的相关性研究

目的研究纤维蛋白原Bp（fibrinogenBβ，FGB）基因启动子区域-455G／A变异与颈动脉粥样硬化斑块的关系。方法缺血性中风病人160例，其中颈动脉粥样硬化斑块病人68例（癍块组），颈动脉未见粥样硬化斑块者92例（非斑块纽），应用多聚酶链反应加H8eⅢ内切酶检测FGB启动子区域-455G／A的多态性，血浆纤维蛋白原水平测定采用凝血酶原时间法，颈动脉斑块采用超声检测。结果A^-455等位基因在斑块组的分布频率为0．17较非斑块组0．07明显增高（χ^2=7．67，P〈O．01）。不同组剐的基因型的分布不同，G／A、A／A基因型在斑块组更常见（χ^2=6．59，P〈0．05）。斑块组血浆纤维蛋白原水平（4．82±1．21）g／L显著高于非斑块组（4．27g／L±0．90g／L，P〈0．01）。结论血浆中纤维蛋白原水平受FGB基因-455G／A多态性的影响，A^-455等位基因是颈动脉粥样硬化斑块形成的危险因素。     

老年冠心病患者载脂蛋白E基因多态性分析

目的探讨载脂蛋白E（apoE）基因的多态性在老年冠心病发病的意义。方法应用聚合酶链反应法（PCR），Hhal内切酶消化法，测定68例老年冠心病患者（CHD组）及70例健康老年（对照组）的apoE基因型。结果冠心病组和对照组共检出6种基因型（E4／4、E4／3、E4／2、E3／3、E3／2、E2／2），冠心病组E3／3基因频率和ε3较等位基因频率对照组低（P〈0．05），差别均有显著性差异，而E4／3、E4／2基因频率和ε4等位基因频率，冠心病组高于对照组（P〈0．05）。结论apoE基因与动脉粥样硬化相关，ε4等位基因是老年CHD的危险因素。     

载脂蛋白E基因多态性与脑梗死的关系

目的探讨载脂蛋白E（apoE）基因多态性与脑梗死的关系。方法应用聚合酶链式反应-限制性片断长度多态性（PCR—RFLP）技术检测78例脑梗死患者和90名健康对照者apoE基因多态性分布特征。结果发现5种apoE基因型，脑梗死组E3／4基因型频率（23．1％）及ε4频率（14.7%）显著高于对照组（7．8％，5．0％），P〈0．05。而E3／3基因型频率（56．4％）及ε3频率（75.6%）显著低于对照组（78．9％，88．3％），P〈0．05。不同apoE基因型间胆固醇和低密度脂蛋白胆固醇水平差异有统计学意义（P〈0．05）。结论apoE基因多态性与脑梗死有关，并影响血脂水平。     

eNOS基因5'侧翼区T-786C多态性与冠心病的相关性研究

目的探讨内皮型一氧化氮合酶（eNOS）基因5’侧翼区T-786C多态性与中国汉族人冠心病和冠状动脉狭窄支数的关系。方法依据eNOS基因5’侧翼区T-786C位点设计引物，应用多聚合酶链反应-限制性片段长度多态性（PCR-RFLP）分析方法检测136例经冠状动脉造影证实的冠心病（冠心病组）和77例非冠心病（对照组）患者的eNOS基因T-786C多态性。结果（1）冠心病组TT＋TC和CC基因型频率分别为72．8％、25．7％、1．5％，对照组分别为92．2％、6．7％、0（χ^2=11．5，P〈0．01）；（2）冠心病组C等位基因的频率高于对照组C等位基因的频率（14．3％比3．9％，χ^2=11．5，P〈0．01）；（3）多元logistic回归显示eNOS T-786C基因多态性是冠心病的独立危险因素（OR值5．261，95％CI：2．010～13．768）；（4）在1、2、3支冠脉血管狭窄组中。TC＋CC基因型频率分布分别为21．4％、25．0％和33．3％（χ^2=1．83，P〉0．05），C等位基因频率分别为10．7％、12．5％、18．5％（χ^2=2．66，P〉0．05）。结论（1）eNOS T-786C基因多态性是冠心病的遗传危险因素，并独立于冠心病其它的经典危险因素；（2）eNOS T-786C基因多态性与冠脉狭窄的支数元关。     

北京地区55岁及以上人群载脂蛋白E基因多态性分布特点及其与血脂的关系

目的探讨载脂蛋自E（ApoE）基因多态性在北京地区≥55岁人群中的分布特点及其对血清胆固醇（TC）和低密度脂蛋白胆围醇（LDL—C）水平的影响。方法2000年7-9月,在北京的城区、平原地区和山区,随饥抽取≥55岁者2103人,检测ApoE基因多态性和血脂水平。结果①2103人轼冈型分布以E3／3最多（1428人,67．9％）,以下依次为E2／3（306人,14．6％）,E3／4（291人,13．8％）,E2／4（38人,1．8％）,E2／2（21人,1．0％）和E4／4（19人,0．9％）;等位基因分市s3占82．1％,e2占9．2％．e4占8．7％.②基因型分布在不同年龄、地区间,差异均有统计学意义（P=0．045．P=0．002）。≥75岁者E2／3、E3／3基因型较多,E2／4、E3／4、E4／4基因型较少;与〉／75岁者比较,〈75岁者F4／4明显增多：E3／3基因型山区高于平原,平原又高于城市,而E3／4则相反．城市高于平原高于山区。与ApoE3组比较,ApoE2组TC和LDL—C较低,差异均有统计学意义（P〈0．01）;而ApoFA组TC和LDL—C均增高,但差异无统计学意义（P〉0．05）。④经年龄、性别、体质量指数分层竹,与ApoE3组相比,ApoE2组的Tc和LDL—C均明显降低（P〈0．01,TC在女性中等异不明湿）;ApoE4组的TC和LDL—C水平在符年龄组、男性、体质量指数〈28kg／m3者中均增高,俺差异尢统计学意义（P〉0．05）;结论〉155岁的人群中,ApoE2基因型者TC和LDL明显降低．存北京地区血脂预防重点应放在〈75岁老人及城区老人中。     

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.