浙江汉族人群Toll样受体4基因多态性与幽门螺杆菌相关消化性溃疡的关系

背景：幽门螺杆菌（H.pylori）感染是消化性溃疡的主要病因,然而其致病性存在个体差异,可能与宿主遗传易感性和先天性免疫机制有关。Toll样受体（TLR）在机体的先天性抗感染免疫中起重要作用。目的：探讨浙江汉族人群TLR4基因Asp299Gly多态性与H.pylori相关消化性溃疡的关系。方法：以聚合酶链反应-限制性片段长度多态性（PCR-RFLP）方法检测118例浙江汉族消化性溃疡患者和210名健康对照者的TLR4基因Asp299Gly等位基因和基因型;行快速尿素酶试验和血清H.pyloriIgG检测判断H.pylori感染情况。结果：本组浙江汉族人群TLR4基因Asp299Gly均为AA纯合子基因型,未见突变基因型AG和GG。消化性溃疡组H.pylori感染率为94.9%,显著高于正常对照组的62.4%（P=0.000）;两组Asp299Gly基因型频率差异无统计学意义。结论：浙江汉族人群TLR4基因Asp299Gly多态性与H.pylori相关消化性溃疡无相关性。     

TLR4基因多态性与慢性胃炎幽门螺杆菌感染无相关性

目的:研究我国湖北汉族人群TLR4基因 Asp299Gly多态性与慢性浅表性胃炎及幽门螺杆(H pylori)感染的关系．方法:采用病例-对照研究和多聚酶链反应-限制性片段长度多态性(PCR-RFLP)方法,检测 115例慢性浅表性胃炎患者115例和正常对照者2644例的TLR4等位基因Asp299Gly基因型分布．结果:慢性浅表性胃炎患者的H pylori阳性率 89．6％,显著高于正常对照组61．7％(P<0．000 1, OR=5．319．95％CI:2．784-10．162)．在H pylori 感染相关性的慢性胃炎组和正常对照组中 TLR4基因Asp299Gly基因型所有个体均为 AA纯合子,未发现的突变型,其基因型、等位基因以及携带者频率总体分布无显著性差异．结论:TLR4基因Asp299Gly基因多态性与H pylori相性慢性胃炎无明显相关性．     

CD14及Toll样受体4基因多态性与大肠癌的相关性研究

目的探讨我国湖北汉族人Toll样受体（TLR）4基因Asp299Gly和CD14 C-260T基因多态性分布与大肠癌的相关性。方法采用聚合酶链反应限制性片段长度多态性（PCR—RFLP）方法，检测110例大肠癌患者及160例正常对照者TLR4基因Asp299Gly及CD14 C-260T基因型及等位基因频率的分布。结果大肠癌组CD14 C-260T基因型与正常对照组比较，差异有统计学意义（P〈0．05）。正常对照组CC基因型的频率为15．6%，明显低于大肠癌组的31．8％（P=0．0027，OR=0．3968，95％CI=0．2209～0．7129）；正常对照组中CT基因型的频率为48．1％，明显高于大肠癌组的30．9％（P=0．0056，OR=2．074，95%CI=1．246～3．452）。所有样本中均未发现TLR4基因Asp299Gly的突变型。结论CD14 C-260T基因多态性与中国湖北汉族大肠癌显著相关，而TLR4基因Asp299Gly多态性与大肠癌无关。     

TLR4和TNF-α基因多态性与支气管哮喘的相关性研究

目的探讨Toll样受体4和肿瘤坏死因子-α基因多态性与支气管哮喘的关系。方法采用病例对照研究和PCR-DNA测序的方法,检测50例支气管哮喘患者和30例对照组的TLR4的Asp299Gly和TNF-308的基因多态性。结果 （1）在支气管哮喘和健康对照组间,未发现TLR4Asp299Gly突变型。（2）支气管哮喘和正常对照组间未发现存在TNF-308G-A替换多态性。结论 （1）TLR4Asp299Gly基因多态性与支气管哮喘的易感性不相关,TNF-α基因多态性与支气管哮喘的易感性无相关性。     

TLR4基因Asp299Gly及TLR2基因Arg753Glu、Arg677Trp多态性与中国湖北汉族炎症性肠病无相关性

目的:研究TLR4基因Asp299Gly及LTLR2基因 Arg753Glu及Arg677Trp多态性在中国汉族人群中的分布,探讨其与炎症性肠病的相关性．方法:采用聚合酶链反应-限制性片段长度多态性方法,检测120例中国湖北汉族炎症性肠病患者与110例正常对照者TLR4 基因ASp299Gly及TLR2基因Arg753Glu及 Arg677Trp基因型,分析该基因多态性与炎症性肠病以及临床亚型的相关性．结果:炎症性肠病患者和健康对照者均未检测出TLR4基因ASp299Gly及TLR2基因 Arg753Glu及Arg677Trp突变型．结论:TLR4基因Asp299Gly及TLR2基因 Arg753Glu及Arg677Trp基因多态性与中国湖北汉族人群炎症性肠病的易感性无相关性．     

类风湿关节炎与TLR4单核苷酸多态性关联研究的Meta分析

目的探讨类风湿关节炎(RA)与TLR4基因Asp299Gly多态性的关联情况。方法检索已发表的有关RA和TLR4基因Asp299Gly多态性的文献．进行Meta分析。结果3项研究共纳入718例RA患者和1392名正常对照，综合分析显示TLR4基因Asp299Gly多态性不是RA的关联基因，OR=1．23(0．67，2．25)，P=0．5；TLR4基因Asp299Gly多态性分布在男女性RA患者分布差异无统计学意义，OR=0．48(0．22．1．03)，P=0．06：在共同表位基因阳性和阴性患者组差异无统计学意义，OR=0．67(0．40，1．13)，P=0．13；在类风湿因子(RF)阳性和阴性患者组差异无统计学意义，OR=I．02(0．51，2．02)，P=-I；RA患者中，Asp299Asp基因型患者发病早于Asp299Gly基因型者，OR=-4．35(-7．45，-1．25)，P=0．006。结论Meta分析显示，TLR4基因Asp299Gly多态性与RA易感性无关联．但Asp299Asp基因型者起病早于Asp299Gly基因型者。应在东方人群进一步开展随机对照和前瞻的队列研究揭示其在RA发病中的作用。     

白细胞介素-1基因多态性与消化性溃疡的关系

背景：大量临床流行病学证据表明消化性溃疡发病率的地域差异与宿主免疫遗传因素密切相关,目前宿主炎症因子基因多态性与消化性溃疡的关系正受到广泛关注。目的：探讨白细胞介素（IL）-1B-511、IL-1RN基因多态性与消化性溃疡的关系。方法：选取2008年9月～2009年5月昆明医学院第一附属医院确诊的57例十二指肠溃疡（DU）、38例胃溃疡（GU）以及40例非萎缩性胃炎（NAG）患者。以快速尿素酶试验和Giemsa染色检测幽门螺杆菌（H.pylori）感染,采用PCR-RFLP检测IL-1B-511、IL-1RN基因多态性。分析IL-1基因多态性、H.pylori感染、年龄与不同疾病之间的关系。结果：NAG、DU和GU组之间H.pylori感染率、IL-1B-511、IL-1RN基因型频率的差异无统计学意义。与NAG和DU相比,年龄≥60岁是GU的危险因素（OR=5.650,95%CI：1.811～17.624;OR=3.159,95%CI：1.254～7.955）。IL-1B-511、IL-1RN基因型和H.pylori感染与消化性溃疡类型无关（P〉0.05）。结论：在昆明市,年龄≥60岁是GU的危险因素,IL-1基因多态性与消化性溃疡无关。     

Toll样受体4基因Asp299Gly多态性与溃疡性结肠炎及大肠腺癌

溃疡性结肠炎（UC）是一种主要累及直肠及结肠黏膜的慢性非特异性疾病，有癌变的可能，病因涉及遗传、免疫、环境等因素。大肠癌的发生也与基因和环境因素有关，而环境因素致癌最终取决于个人对肿瘤的易感性。Toll样受体（TLR）4通过其亮氨酸重复序列区域识别并结合细菌脂多糖（LPS），活化NF—κB及炎症因子转录，产生炎症。TLR4基因突变使肠黏膜先天性免疫细胞和肠上皮TLR4分子结构发生改变，引起免疫系统失常，导致机体处理肠腔内大量细菌和LPS等病原分子的能力下降，进而使肠黏膜在长期刺激下产生感染、炎症、过敏、易激乃至癌变。我们运用PCR-限制性片段长度多态性分析（RFLP）技术探讨TLR4基因Asp299Gly多态性与UC及大肠腺癌的关系，以阐明疾病的遗传易感性。     

消化性溃疡的中西医结合诊治方案

胃或十二指肠黏膜的局限性组织缺损，表浅者为糜烂深达肌层者为溃疡。组织缺损系由胃酸、胃蛋白酶自我消化所致，故称消化性溃疡。近年发现其发病与幽门螺杆菌（H.pylori）感染关系密切，故对H.pylori（＋）者又称H．pylori相关性溃疡。     

TLR4基因Asp299Gly多态性与中国汉族炎症性肠病及大肠癌患者无关

Toll样受体(Toll-like receptor，TLR)作为革兰阴性菌脂多糖(lipopolysaccharide，LPS)的受体，其基因第四外显子Asp299Gly的突变，可改变TLR4的细胞外结构，导致对革兰阴性菌的LPS无反应或LPS信号途径抑制。炎症性肠病(inflammatory bowel disease，IBD)是涉及多基因的肠黏膜免疫性疾病，在正常情况下几乎无法在肠黏膜表面检测到TLR4，但在IBD的肠上皮表面却可检测到TLR4的表达呈显著上调。研究发现，LPS可促进结肠癌细胞株的生长，具有促癌作用，提示TLR4在IBD和大肠癌发病机制中可能具有一定的功能。     

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.