亚甲基四氢叶酸还原酶基因 C677 T多态性与中国山东地区汉族人群缺血性卒中、高尿酸血症的相关性

目的：探讨亚甲基四氢叶酸还原酶（methylenetetrahydrofolatereductase,MTHFR）基因C677 T 多态性与中国山东地区汉族人群缺血性卒中、高尿酸血症的相关性。方法纳入山东地区汉族急性缺血性卒中患者和年龄、性别相匹配的对照者。采用聚合酶链反应扩增和芯片杂交显色技术检测MTHFR基因C677T 多态性,并测定血清尿酸浓度。结果共纳入山东地区汉族急性缺血性卒中患者145例和年龄、性别相匹配的对照者145名。缺血性卒中组糖尿病构成比（26.90％对6.89％;χ2=20.653,P<0.001）以及空腹血糖[（5.56±1.57）mmol/L对（5.01±1.11）mmol/L;t=－3.390, P=0.001]、高半胱氨酸[中位数,四分位数间距：18.2（16.30~22.55）μmol/L对15.20（12.10~17.85）μmol/L;Z=－6.323,P<0.001]和尿酸[43.0（361.60~490.45）μmol/L对285.9（267.00~346.25）μm o l/L;Z=－10.360, P<0.001]水平均显著高于对照组;缺血性卒中组 T T 基因型（42.07％对15.17％;χ2=25.673, P<0.001）和 T 等位基因（58.28％对34.48％;χ2=33.008, P<0.001）分布频率均显著高于对照组。多变量logistic回归分析显示,尿酸[优势比（ odds ratio, OR）1.018,95％可信区间（confidence interval, CI）1.013~1.024;P<0.001]、TT 基因型（对CT 基因型, OR 6.774,95％CI 1.779~25.507;P=0.005）、高血压（ OR 1.919,95％CI 1.013~3.636;P=0.045）、高半胱氨酸（ OR 1.153,95％CI 1.059~1.258;P=0.001）为缺血性卒中的独立危险因素。将缺血性卒中组与对照组合并,共101例存在高尿酸血症,189例尿酸正常。高尿酸血症组糖尿病患者构成比（32.67％对11.64％;χ2=23.749, P<0.001）以及总胆固醇[（5.67±1.56）mmol/L对（5.10±1.33）mmol/L;t=－3.255,P<0.001]和高半胱氨酸[19.50（17.10~24.70）μmol/L对15.40（12.60~18.05）μmol/L;Z=－7.236,P<0.001]水平显著高于尿酸正常组,TT 基因型（55.45％对13.76％;χ2=56.409,P<0.001）和T等位基因（71.79％对32.54％;χ2=79.561,P<0.001）分布频率显著高于尿酸正常组。多变量logistic回归分析显示,TT 基因型（对CC 基因型,OR 6.434,95％CI 2.334~17.736;P<0.001）、CT 基因型（对CC基因型,OR 2.234,95％CI 1.019~4.898;P=0.045）、高半胱氨酸（OR 1.081,95％CI 1.010~1.157;P=0.024）、总胆固醇（OR 1.363,95％CI 1.123~1.653;P=0.002）为高尿酸血症的独立危险因素。结论 MTHFR基因C677T TT 基因型和血清尿酸水平是中国山东地区汉族人群缺血性卒中的独立危险因素,MTHFR基因C677T TT 基因型亦为该人群高尿酸血症的独立危险因素,调整饮食习惯可能对山东地区汉族人群缺血性卒中的预防具有积极意义。     

血浆半胱氨酸蛋白酶抑制剂C与缺血性卒中患者颈动脉粥样硬化的关系

目的 探讨血浆半胱氨酸蛋白酶抑制剂C（cystatin C,CysC）水平与缺血性卒中患者颈动脉粥样硬化斑块的相关性.方法 回顾性分析急性缺血性卒中患者的临床资料,根据颈部血管超声检查结果分为无斑块组和斑块组,再将斑块组分为稳定斑块组和易损斑块组,采用多变量logistic回归分析和Pearson相关分析,探索颈动脉粥样硬化斑块的危险因素.结果 共纳入226例急性缺血性卒中患者,其中172例存在颈动脉斑块,54例无斑块.存在颈动脉斑块的患者中,94例为稳定斑块,78例为易损斑块.斑块组年龄[（71.82 ±9.94）岁对（60.74±13.81）岁;t=6.160,P=0.014]、缺血性心脏病患者比例（11.6％对1.9％;6.169,P=0.020）、收缩压[（148.770± 21.007）mm Hg对（142.240 ± 19.404） mm Hg;t=2.029,P=0.044;1 mm Hg=0.133 kPa]和血浆CysC浓度[（1.046±0.438） mg/L对（0.860±0.214） mg/L;t=3.006,P=0.003]以及颈动脉IMT[（1.122±0.278）mm对（0.878 ±0.250） mm;t =5.762,P=0.000]显著性高于无斑块组.多变量logistic回归分析显示,年龄[优势比（odds ratb,OR）1.079,95％可信区间（confidence interval,CI）1.044 ～1.116;P =0.000]和IMT（OR 31.450,95％ CI 6.233 ～ 158.692;P =0.000）是颈动脉斑块的独立危险因素,而血浆CysC水平与颈动脉斑块无显著独立相关性（P=0.217）.稳定斑块组仅IMT显著性高于易损斑块组[（1.176±0.285） mm对（1.058±0.258） mm;t=-2.824,P=0.005],而且IMT（OR0.195,95％ CI0.059～0.064;P =0.007）是颈动脉斑块稳定性的独立保护因素.Pearson相关性分析显示,血浆CysC水平与年龄（r =0.375,P=0.000）和血清肌酐水平（r=0.462,P=0.000）呈正相关,但与颈动脉IMT（r=0.075,P=0.264）无显著相关性.结论 在缺血性卒中患者中,未发现血浆CysC水平与颈动脉粥样斑块、斑块稳定性以及IMT之间存在相关性.     

急性小动脉闭塞性卒中患者脑微出血的危险因素：回顾性病例系列研究

目的 探讨急性小动脉闭塞性卒中（small artery occlusion,SAO）患者脑微出血（cerebral microbleed,CMB）的危险因素.方法 纳入完成磁敏感加权成像（susceptibility-weighted imaging,SWI）检查的SAO患者,根据有无CMB分为阳性组和阴性组,比较两组间一般临床资料、生化指标以及影像学资料,采用多变量logistic回归分析确定CMB的独立危险因素,采用Spearman相关分析确定CMB与陈旧性腔隙性梗死和脑白质疏松严重程度的相关性.结果 共纳入109例SAO患者,CMB阳性组47例（43.1％）,阴性组62例（56.9％）.CMB阳性组年龄[（65.15±12.91）岁对（62.32 ±11.61）岁;t=0.770,P=0.037]、高血压患者构成比（66.0％对32.3％;x2=16.598,P＜0.001）、凝血酶时间[（14.62 ±2.25）s对（16.49 ±4.68）s;=2.400,P=0.041]、部分凝血酶原时间[（34.98 ±5.20）s对（33.47 ±7.00）s;t=1.532,P=0.010]、国际标准化比率（0.94±0.27对0.91±0.10;t=-0.886,P=0.016）、三酰甘油[（1.16±0.51） mmol/L对（1.76±1.36） mmol/L;t=2.699,P=0.005]、低密度脂蛋白胆固醇[（2.49 ±0.72） mmol/L对（2.64±1.37） mmol/L;t=0.641,P=0.046]以及陈旧性腔隙性梗死（x2 =34.961,P＜0.001）和脑白质疏松（x2 =35.161,P＜0.001）分级与CMB阴性组存在显著性差异.多变量logistic回归分析显示,高血压[优势比（odds ratio,OR）6.368,95％可信区间（confidence interval,CI）2.279 ～ 17.799;P＜0.001]、陈旧性腔隙性梗死（OR3.876,95％ CI 1.080 ～ 13.912;P=0.038）和脑白质疏松（OR 16.797,95％ CI 1.433～196.960;P=0.025）是急性SAO患者CMB的独立危险因素,而三酰甘油≥1.52mmol/L是其独立保护因素（OR 0.270,95％ CI 0.074 ～0.983;P =0.047）.Spearman相关性分析显示,CMB分级与腔隙性梗死分级（r=0.520,P＜0.001）和脑白质疏松严重程度（r=0.553,P＜0.001）呈显著正相关.结论 高血压、陈旧性腔隙性梗死和脑白质疏松是急性SAO患者CMB的独立危险因素,而三酰甘油≥1.52 mmol/L?     

NT—ProBNP、CRP及D—Dimer在COPD急性加重期合并肺动脉高压中的相关性研究

目的探讨血清氨基末端脑纳肤前体（amino-terminalpro-brain natriuretic peptide, NT Pro BNP）、C反应蛋白（C-reaction protein, CRP）及D二聚体（D-Dimer）水平在慢性阻塞性肺疾病急性加 重期（AECOPD）合并肺功脉高压（PH）患者中的临床意义及相关性。方法入选126例AECOPD患者,超声心动图测得肺功脉收缩压（PASP）值,根据PASP分为3组：对照组？40mmHgH5例、轻度 PH组（40-60 mmHgH7例和中重度PH组（〉60 mmHg）34例。对所有人选患者进行血清NT-Pro BNP、CRP、D-Dimer水平和动脉血气分析检测。结果 AECOPD合并中重度PH组患者NT-Pro BNP [0711.15±437.05） ng/L],PCO2 [（47. 24±8.60） mmHg]、CRP[（25.53±1. 73） mg/L]及D-Dimer [（648.88士618.37）μgiL]水平高于对照组[NT-Pro BNP： （221. 78 ± 63. 62） ng/L; PCO2： （40.04± 6.83） mmHg;CRP： （11.51±2.00） mg/L;D-Dimer：（302. 58±233. 44）同/口,差异均具有统计学意义 （t = -4.005, -3.880,-3.094, -4.073; P值均〈0.05） ;而PO,[（59.43±16. 49） mmHg]低于对照组 [（71.28±15.16）mmHg] ,差异具有统计学意义（t=3.276;P〈0.0日。AECOPD合并中重度PH组患者NT-ProBNP[O 711. 15士437.05） ng/L丁和PCO2[（47. 24±8. 60） mmHg]水平高于轻度PH组 [（NT-Pro BNP：（583. 77士213.98） ng/L;PCO2 ：（40. 85±8. 96） mmHg],差异均具有统计学意义（ t = -3.069,-3.442; P值均〈 O. 05）;而PO, [（59.43土16.49） mmHgJ低于轻度PH组[C66.81± 16.22） mmHgJ,差异具有统计学意义（t = 2. 061; P 〈0.05） 0 AECOPD合并轻度PH组患者CRP [（17.55±4.17） mg/L]及D-Dimer [（ 501. 61 ± 218.71）阅/L]水平高于对照组[CRP： （11.51 ± 2.00） mg/L;D-Dimer： （302.58土233.44）μg/口,差异均具有统计学意义（ t = -1.452,-2.551; P值 均〈0.0日。NT-ProBNP与PASP、PCO,均呈正相关（r =0. 346, t =4.11; r =0. 336, t =3.97; P值 均〈0.0日。PCO2、CRP、D-Dimer与PASP均呈正相关（r=0. 389, t =4. 70; r =0. 245, t =2. 81; r = 0.349, t =4.15; P值均〈0.05） ;PO2与PASP呈负相关（γ=-0.262, t =-3. 02, P〈0. 0日。结论 血清NT-ProBNP、CRP及D-Dimer水平与PASP密切相关,可以作为AECOPD患者判断PH严重程度的 指标。     

炎性指标与老年矽肺合并脑卒中患者颈动脉粥样硬化的相关性分析

目的探讨同型半胱氨酸(Hcy)、高敏C反应蛋白(hs-CRP)和胱抑制素C(CysC)与老年矽肺合并脑卒中患者颈动脉粥样硬化的相关性。方法选择开滦钱家营医院和华北理工大学附属医院收治的老年男性矽肺合并脑卒中患者152例作为观察组,患者又根据颈动脉内膜中层厚度(IMT)分为正常组32例(IMT≤1.0mm);增厚组54例(1.0mmIMT1.3mm),斑块组66例(IMT≥1.3mm)。选择同期男性健康查体者90例作为健康组,单纯脑卒中男性患者90例作为对照组。测定各组血清Hcy、hs-CRP和CysC水平,采用Pearson相关性分析,用多元logistic回归分析颈动脉粥样硬化的危险因素。结果 3组血清Hcy、hs-CRP和CysC水平比较,差异有统计学意义(P=0.001)。观察组Hcy[(14.35±4.51)μmol/Lvs(5.27±2.19)μmol/L和(11.65±3.97)μmol/L]、hs-CRP[(6.20±2.38)mg/Lvs(2.12±0.64)mg/L和(4.99±2.53)mg/L]和CysC[(2.27±0.47)mg/Lvs(0.72±0.25)mg/L和(1.51±0.58)mg/L]水平均较健康组和对照组明显增高,有统计学差异(P0.05);斑块组与增厚组和正常组Hcy、hs-CRP和CysC水平两两比较,均有统计学差异(P0.05)。增厚组和斑块组Hcy、hs-CRP和CysC水平与IMT呈正相关(P0.05,P0.01)。多元logistic回归分析示,Hcy、hs-CRP和CysC是颈动脉粥样硬化形成的危险因素(OR=2.615,95%CI:1.492～4.662;OR=3.104,95%CI:1.582～6.998;OR=2.087,95%CI:1.495～4.535,P=0.000)。结论 Hcy、hs-CRP和CysC水平可能可以作为老年矽肺合并脑卒中患者是否发生颈动脉粥样硬化的筛选指标。     

中青年动脉粥样硬化性脑梗塞患者血清胱抑素C水平与脑梗塞及动脉硬化的关系

目的:探讨中青年动脉粥样硬化性脑梗塞(ACI)患者血清胱抑素C(CysC)水平与脑梗塞(CI)及动脉硬化严重程度的关系。方法:选择我院2013年2月~2015年9月收治的82例中青年ACI患者为研究对象,按脑梗塞体积大小分为小梗塞组(36例)、中梗塞组(22例)和大梗塞组(24例);根据脑梗塞严重程度分为轻度CI组(54例)和重度CI组(28例);根据动脉粥样硬化斑块性质分为稳定斑块组(45例)和不稳定斑块组(37例)。另选择46例年龄相当的健康人为健康对照组。测量、比较各组急性期和恢复期血清CysC水平和颈动脉内膜中层厚度(IMT)的关系。结果:与急性期比较,ACI各亚组恢复期的血清CysC水平均显著降低(P均<0.01);与健康对照组比较,小、中和大梗塞组急性期和恢复期血清CysC水平[恢复期:(0.81±0.24)mg/L比(1.03±0.13)mg/L比(1.09±0.19)mg/L比(1.18±0.10)mg/L]均显著升高,且大梗塞组显著高于小和中梗塞组(P均<0.01)。与健康对照组比较,轻度和重度梗塞组急性期和恢复期血清CysC水平[恢复期:(0.81±0.24)mg/L比(1.07±0.15)mg/L比(1.19±0.16)mg/L]均显著升高,且重度梗塞组显著高于轻度梗塞组(P均<0.01)。与健康对照组比较,稳定斑块组和不稳定斑块组急性期血清CysC水平[(0.81±0.24)mg/L比(1.18±0.15)mg/L比(1.39±0.27)mg/L]和IMT[(0.72±0.10)mm比(1.24±0.17)mm比(1.30±0.14)mm]显著升高和增厚,且不稳定斑块组的显著高于和厚于稳定斑块组(P均<0.01)。结论:脑梗塞患者血清胱抑素C水平显著升高,可作为脑梗塞防治的指标。     

冠心病合并脑梗死患者血清MMP-9、Hs-CRP及sCD40L水平变化及意义

目的 观察冠心病合并脑梗死患者血清基质金属蛋白酶（MMPs）、高敏C反应蛋白（Hs-CRP）及可溶性CD40配体（sCD40L）水平,并探讨其意义.方法 选择冠心病合并脑梗死41例（合并组）、单纯冠心病42例（冠心病组）、同期健康体检者37例（对照组）,采用ELISA法检测各组血清MMP-9、Hs-CRP及sCD40L.结果 合并组血清MMP-9、Hs-CRP、sCD40L水平分别为（876.18±193.39） ng/mL、（10.23 ±2.14）mg/L、（9.23±3.12） μg/L,冠心病组分别为（487.20±129.62） ng/mL、（6.98±1.86） mg/L、（5.97±2.52） μg/L,对照组分别为（159.49±68.84） ng/mL、（3.23±1.21）mg/L、（2.94±1.18） μg/L;3组两两比较,P均＜0.01.血清MMP-9（OR=3.159,95％ CI：3.125 ～4.321）、Hs-CRP（OR=2.321,95％ CI：2.174 ～3.131）、sCD40L（OR=1.241,95％ CI：1.175 ～1.879）是冠心病合并脑梗死患者发病的独立危险因素,P均＜0.01.结论 冠心病合并脑梗死患者血清MMP-9、Hs-CRP及sCD40L水平明显增高,可能与粥样斑块不稳定有关,可作为冠心病合并脑梗死的预测指标.     

胱抑素C、嗜铬粒蛋白A在慢性心力衰竭中的作用及相关性

目的：通过检测慢性心力衰竭（CHF）患者血清胱抑素C（CysC）和嗜铬粒蛋白A（CgA）含量的变化,探讨两者之间的相关性及在CHF发生、发展中的作用。方法：选取我院心内科CHF住院患者48例,其中心功能Ⅱ级组15例、Ⅲ级组17例和Ⅳ级组16例。另选正常体检者20例作为正常对照组。观察各组血清CysC和CgA含量变化并进行相关性分析。结果：①与正常对照组比较,CHF患者中CysC[（664.85±14.42）μg/L∶（991.19±108.59）μg/L]和CgA[（67.55±5.987）ng/ml∶（317.79±160.028）ng/ml]水平明显升高（P均〈0.001）;且心功能Ⅳ级的高于Ⅲ级,Ⅲ级的高于Ⅱ级[CysC（1115.5±40.81）μg/L∶（990.12±32.65）μg/L∶（859.8±20.727）μg/L,CgA（522.13±65.958）ng/ml∶（276.88±2.205）ng/ml∶（146.2±3.144）ng/ml,P均〈0.001],②血清CysC和CgA呈正相关（r=0.931,P〈0.001）。结论：慢性心力衰竭患者血清胱抑素C和嗜铬粒蛋白A水平均显著升高,其水平随心功能NYHA分级的加重而升高,且二者呈正相关,可能共同参与了心衰的发生、发展。     

冠心病合并阻塞性睡眠呼吸暂停低通气综合征患者冠状动脉狭窄程度及血清胱抑素C的变化

目的观察冠心病合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的冠状动脉狭窄程度及血清胱抑素C(CysC)的变化。方法采用回顾性研究的方法,纳入162例冠心病且有夜间睡眠打鼾、呼吸暂停或白天嗜睡症状的患者,根据睡眠监测结果分为单纯冠心病组(C组)62例[呼吸暂停低通气指数(AHI)<5次/h]和冠心病合并OSAHS组(CO组)100例(AHI≥5次/h),再依据AHI将CO组分为轻度组24例、中度组28例和重度组48例;另以冠状动脉造影证实狭窄<50%且否认夜间睡眠打鼾的患者52例为对照组(N组)。计算Gensini评分评估冠状动脉狭窄程度,检测空腹血清CysC水平。采用SPSS 20.0统计软件比较各组间冠状动脉狭窄程度及血清CysC水平的差异。结果 CO组Gensini评分高于N组和C组(23.58±25.78比2.47±2.91和13.89±24.19,P<0.01和P<0.05),且重度OSAHS组Gensini评分高于轻度组(27.71±28.26比15.71±18.22,P<0.05);CO组血清CysC水平高于N组和C组[(1.02±0.20)mg/L比(0.87±0.14)mg/L和(0.87±0.18)mg/L,均为P<0.05],且重度OSAHS组血清CysC水平高于轻度组和中度组[(1.10±0.17)mg/L比(0.89±0.15)mg/L和(1.02±0.21)mg/L,P<0.01和P<0.05]。结论冠心病合并OSAHS患者的血清CysC水平高于单纯冠心病患者和无冠心病者;冠心病合并OSAHS患者的冠状动脉狭窄程度较单纯冠心病患者严重。     

肝硬化患者血清可溶性热休克蛋白水平与肠壁通透性的关系研究*

目的 检测肝硬化患者可溶性热休克蛋白（sHSP25和sHSP72）水平,探讨其与肠道通透性的关系。方法 采用ELISA 法检测55例肝硬化患者和19例健康人血浆sHSP25和sHSP72水平。以血二胺氧化酶（DAO）为肠道通透性的评价指标,使用分光光度法检测肝硬化患者血二胺氧化酶水平,采用改良鲎试验法测定肝硬化患者血清内毒素水平。结果 肝硬化患者血sHSP25水平[（205.8±52.2） μg/L]和sHSP72[（190.0±45.2） μg/L]水平显著高于健康人[分别为 （89.1±29.2） μg/L和（65.5±20.2） μg/L,P<0.001];肝硬化患者血内毒素水平显著高于健康人[（0.35±0.11） Eu/ml 对（0.04±0.02） Eu/ml,P<0.001];肝硬化患者血浆sHSP25和sHSP72水平与DAO或内毒素呈正相关（sHSP25：DAO,r2=0.479,P<0.01;内毒素：DAO,r2=0.573,P<0.01;sHSP72：DAO,r2=0.35,P<0.05;内毒素：DAO,r2=0.24,P<0.01）。结论 肝硬化患者血浆sHSP25和sHSP72水平升高,其与肠道通透性有一定的相关性。热休克蛋白表达增加可能为机体对内毒素血症的保护性反应。     

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.