Caspase-3在慢性病毒性乙、丙型肝炎及非酒精性肝炎中的表达及意义

目的:检测慢性乙型肝炎、慢性丙型肝炎和非酒精性脂肪性肝炎中Caspase-3的表达,探讨其临床及病理学意义.方法:应用免疫组织化学方法检测Caspase-3在70例慢性乙型肝炎,50例慢性丙型肝炎,50例非酒精性脂肪性肝炎和15例正常肝组织的表达.结果:(1)Caspase-3在慢性乙型肝炎、慢性丙型肝炎、非酒精性脂肪性肝炎中的表达(57.1%、72.0%、82.0%),高于其在正常肝组织中表达(18.8%),差异有统计学意义(P<0.05);并与肝细胞凋亡密切相关(r=0.356,P<0.001);(2)Caspase-3在慢性乙型肝炎、慢性丙型肝炎和非酒精性脂肪性肝炎随病理损伤程度加重其阳性表达率增高,有统计学意义(P<0.05).结论:Caspase-3与慢性乙型肝炎、丙型肝炎和非酒精性脂肪性肝炎的肝细胞凋亡密切相关,并参与肝炎的发病过程.     

慢性丙型肝炎肝组织超微结构研究

为了探究丙型肝炎超微结构形态特点，对43例慢性丙型肝炎(CH-C)肝组织作透射电镜观察。结果：多数病例的肝细胞胞浆内出现脂滴；有的线粒体显示缩小或变形，基质致密，嵴延长；内质网轻度扩张；脂褐素集聚。半数病例血窦内有淋巴细胞或单核细胞，并进入Disse隙或肝细胞间。多数病例贮脂细胞(FSC)增生，有的呈现活化现象．附近有胶原沉积。淋巴细胞与单核细胞出现率以及FSC和胶原出现率与组织学的炎症活动度和纤维化程度分别相一致。10例经干扰素治疗半年后第二次肝组织活检超微结构未见明显改变。结论：丙型肝炎肝组织之超微结构为非特异性改变，但对肝细胞损伤机制的研究和确定慢性化有一定价值。     

慢性病毒性肝炎肝细胞凋亡与Fas抗原和病毒表达的相互关系

为探讨病毒性肝炎肝细胞凋亡及其与病毒和Ｆａｓ抗原表达的关系，应用原位末端标记技术检测一组慢性乙、丙型肝炎患者肝组织中细胞凋亡状况，并以免疫组化方法检测病毒和Ｆａｓ抗原表达。结果３１例患者中，２５例肝组织中检出末端标记阳性细胞，散布于肝小叶和肝窦内，部分炎症坏死灶中和胆管上皮细胞也可检出阳性细胞；组织炎症活动度较大者和病毒抗原阳性者凋亡指数较高；凋亡细胞可为病毒抗原阳性和阴性；Ｆａｓ抗原阳性与阴性组间凋亡程度无显著差异。提示病毒性肝炎患者感染和未感染病毒的肝细胞均可发生凋亡，其机制有待进一步研究。     

Caspase-8在慢性肝炎患者肝组织中的表达及意义

目的探讨Caspase-8在慢性乙型肝炎、慢性丙型肝炎和非酒精性脂肪性肝炎中的作用及机制。方法应用免疫组化方法对70例慢性乙型肝炎、50例慢性丙型肝炎、50例非酒精性脂肪性肝炎和15例正常肝组织进行Caspase-8检测。结果Caspase-8在慢性乙型肝炎、慢性丙型肝炎、非酒精性脂肪性肝炎中的表达（58.6%、64.0%、82.0%）高于其在正常肝组织中表达（13.3%）,差异有统计学意义（P〈0.05）;并与肝细胞凋亡密切相关（r=0.409,P〈0.001）。Caspase-8在重型肝炎中的表达阳性率高,轻型肝炎表达阳性率最低,差异有统计学意义（P〈0.05）。Caspase-8在不同ALT水平肝炎患者肝组织中的表达差异无统计学意义（P〉0.05）;结论 Caspase-8活性增强导致细胞凋亡增多,在肝病理生理过程中起着重要作用。     

不同药物治疗丙型肝炎的疗效探讨

本文对40例急性丙型肝炎、32例慢性丙型肝炎分别以齐墩果酸、强力宁、α-干扰素、肝康灵（复方小柴胡汤）等药物分组治疗，并随访观察疗效，结果显示强力宁组2个疗程对急性丙型肝炎有较好的降酶作用，但复发率为60％；α－干扰素对慢性丙型肝炎也有降酶效果，复发率为50％；肝康灵对慢性丙型肝炎显示较好的降酶效果，复发率为30％。本文对急慢性丙型肝炎进行了讨论。     

Bcl—2及相关蛋白bax在慢性乙型肝炎肝组织中的表达

目的：探讨原癌基因ｂｃｌ－２及相关蛋白ｂａｘ在慢性乙型肝炎发病中的作用。方法：采用免疫组化技术研究１４例慢性迁延性肝炎和１９例慢性活动性肝炎组织中原癌基因ｂｃｌ－２及相关蛋白ｂａｘ的表达。结果：慢迁肝，慢活肝和正常肝组织中ｂｃｌ－２表达均较低，三组间差异不明显（Ｐ值〉０．０５）；慢迁肝和慢活肝中肝细胞ｂａｘ表达较正常肝细胞增加，而又以慢活肝中有更多ｂａｘ蛋白表达，结论：乙肝病毒ｂａｘ蛋白可能有诱导     

B超显示肝静脉对急慢性肝病的诊断价值探讨

采用Ｂ型超声观察了１０１例病毒性肝炎及肝硬化病人的肝静脉显示情况，结果为：（１）急性肝炎及慢性廷延性肝炎组其肝静脉显示多为良好（Ⅰ级）；（２）慢性活动性肝炎组肝静脉显示以稍差及差比例最高（Ⅱ、Ⅲ级）；（３）肝硬化组肝静脉显示绝大多数为差（Ⅲ级）。此种规律性对于病毒性肝炎及肝硬化的诊断分型、预后判断具有一定的参考价值。     

慢性病毒性肝炎与肝脂肪变性

慢性乙型、丙型肝炎是目前我国最为常见的两种病毒性肝炎类型.患者不仅表现为肝功能异常,肝脏影像学及病理检查还发现部分患者在肝细胞变性坏死同时伴有脂肪变性.目前认为,病毒和宿主代谢因素是导致肝脂肪变性的重要原因,而脂肪变性对于慢性病毒性肝炎患者肝纤维化进展和抗病毒疗效均产生重要影响.因此,对慢性病毒性肝炎患者发生肝脂肪变性机制的深入研究将为制定更为合理、有效的治疗方案提供重要理论依据.     

慢性丙型肝炎的组织学特点和分类

目的研究慢性丙型肝炎的组织病理学特点和新的病变程度的分类，并与慢性乙型肝炎作比较。方法对４９例慢性丙型肝炎和４５例慢性乙型肝炎的肝组织标本，由三位病理科医师双盲读片，记录主要的组织学改变，并根据新老慢性肝炎分类评估。结果慢性丙型肝炎最为突出的组织学改变为肝脂肪变（６１％）、胆管损害（５７％）、肝窦内炎症细胞（４７％）和淋巴细胞聚集（４３％），均较慢性乙型肝炎多见，差异有显著性。本组病例按新的国际分级、分期与传统的慢活肝、慢迁肝的分类比较，二者之间有一定的相关性，但前者更能准确反映病变的程度。结论新的慢性肝炎的组织学分类法优于传统的分类法。值得推广。     

慢性肝病HBV DNA、HDV RNA原位杂交及HBsAg、HBcAg标记研究

目的与方法：为探明病毒性肝炎与肝癌的关系，以地高辛配基探针原位分子杂交及免疫组织化学技术对云南６８例慢性肝病患者进行ＨＢＶＤＮＡ、ＨＤＶＲＮＡ、ＨＢｓＡｇ、ＨＢｃＡｇ标记，并研究其相互关系。其中慢性迁延性肝炎２７例，慢性活动性肝炎１６例，肝细胞癌（Ｈ...     

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.