高血压病患者血浆5种神经肽水平的临床研究

目的探讨高血压病患者血浆５种神经肽：〔神经肽Ｙ（ＮＰＹ）、降钙素基因相关肽（ＣＧＲＰ）、Ｐ物质（ＳＰ）、脑啡肽（ＥＮＫ）及神经降压肽（ＮＴ）〕的水平在高血压病发病中的临床意义。方法用放射免疫分析法测定３０例高血压病患者血浆５种神经肽的水平；并与３０例正常对照组比较。结果３０例高血压病组血浆ＮＰＹ、ＣＧＲＰ、ＳＰ、ＥＮＫ、ＮＴ水平与各自的正常对照组比较差异均非常显著（Ｐ＜０．００１）。结论５种神经肽均参与了高血压病的发病机理及病理生理过程；５种神经肽水平与高血压病严重程度密切相关     

高血压患者硝苯地平治疗前后血浆内皮素和降钙素基因相关肽的变化

目的观察硝苯地平降压治疗对血浆内皮素（ＥＴ）和降钙素基因相关肽（ＣＧＲＰ）水平的影响。方法３１例原发性高血压（ＥＨ）患者口服硝苯地平控释片４０ｍｇ／ｄ×１４，用放免法直接测定治疗前后的血浆ＥＴ和ＣＧＲＰ水平。结果ＥＨ患者血浆ＥＴ水平明显高于对照组（８５．６±２１．０ｖｓ４２．１±２０．３ｐｇ／ｍｌ，Ｐ＜０．００１）；ＣＧＲＰ水平明显低于对照组（２３．０±８．１ｖｓ５５．４±１７．８ｐｇ／ｍｌ，Ｐ＜０．００１）。舒张压与ＥＴ水平呈正相关（ｒ＝０．５３０２，Ｐ＜０．００５），ＥＴ与ＣＧＲＰ呈弱的负相关（ｒ＝０．３７０７，Ｐ＜０．００５）。治疗后，血压和ＥＴ水平明显下降（Ｐ均＜０．００１），ＣＧＲＰ水平显著增高（Ｐ＜０．００１）。结论硝苯地平是一种有效的降压药，它可通过调节ＥＨ时多种血管活性多肽之间的平衡关系，对器官保护具有重要作用     

肝硬化患者血浆ET1,CGRP变化意义探讨

目的：为了解ＬＣ患者血浆ＥＴ，ＣＧＲＰ水平，探讨其临床意义，方法：采用放射免疫分析法检测健康成人及ＬＣ患者血浆ＥＴ，ＣＧＲＰ水平，结果：ＬＧ组血浆ＥＴ１明显高于对照组（Ｐ〈０．０１），ＣＧＲＰ明显低于对照组（Ｐ〈０．０１），ＬＣ组内ＥＴ１，ＣＧＲＰ水平与肝功分级，血浆蛋白及ＡＬＴ，ＡＳＴ值无明显相关性（Ｐ〉０．０５）。结论：作为血管活性物质ＥＴ与ＣＧＲＰ相互拮抗，调节门脉压力保持动态平衡。ＬＣ门脉     

胰岛素受体基因第8外显子多态性与原发性高血压病的关系

目的：探讨ＩＮＳＲ基因第８ 外显子ＮｓｉＩ多态性与原发性高血压（ＥＨ）的关系。方法：ＥＨ 患者（ｎ＝ １２０）和正常对照组（ｎ＝ ８６）进行血压、身高、体重及空腹血糖（Ｇｌｕ）、血总胆固醇（Ｔｃｈ）、甘油三脂（ＴＧ）浓度测定；用饱和盐析法常规提取外周血白细胞ＤＮＡ，采用多聚酶链式反应（ＰＣＲ）结合限制性内切酶方法检测基因多态性。结果：高血压组除收缩压、舒张压显著高于对照组外，其它临床指标如体重指数、空腹血糖及血脂水平两组间无显著差异；ＩＮＳＲ基因Ｎ２ 等位基因频率在ＥＨ组高于正常对照组（０．２５４ｖｓ０．１６９， Ｐ＜ ０．０５）。结论：ＩＮＳＲ基因ＮｓｉＩ多态性与中国人高血压病有关，Ｎ２ 等位基因可能是中国人高血压病的一个易感基因     

急性心肌梗塞患者及其血管再通后血浆中内皮素和降钙素基 …

采用同位素放射免疫法检测４１例发病６ｈ内的急性心肌梗塞组（ＡＭＩ）及该组溶栓再通后２ｈ，２４ｈ血浆中的内皮素（ＥＴ），降钙素基因相关肽（ＣＧＲＰ）的浓度，另检测３８例发病２４ｈ的ＡＭＩ患者及４１例正常健康人血浆中ＥＴ、ＣＧＲＰ浓度。结果：ＡＭＩ患者血浆中ＥＴ与ＣＧＲＰ的正常平衡被破坏，发病６ｈ内较２４ｈ这种平衡的破坏较明显，且随着血管的再通，ＥＴ与ＣＧＲＰ逐渐趋向于正常平衡。     

老年非杓型高血压病患者内皮素和降钙素基因相关肽含量变化及氨氯地平对其影响

目的探讨老年非杓型高血压病（ＥＨ）患者内皮素（ＥＴ）和降钙素基因相关肽（ＣＧＲＰ）含量变化及氨氯地平对其影响。方法观察氨氯地平治疗老年非杓型ＥＨ患者疗效及其治疗前后ＥＴ和ＣＧＲＰ含量变化。结果老年非杓型ＥＨ患者血浆ＥＴ水平明显高于老年杓型ＥＨ患者,而ＣＧＲＰ则明显降低;氨氯地平使老年非杓型ＥＨ患者白昼及夜间血压下降,治疗后老年非杓型ＥＨ患者血浆ＥＴ水平降低,而ＣＧＲＰ明显升高。结论ＥＴ及ＣＧＲＰ参与了老年非杓型ＥＨ的病理过程,氨氯地平是一种治疗老年非杓型ＥＨ患者有效药物,能纠正老年非杓型ＥＨ患者ＥＴ与ＣＧＲＰ之间的失衡。     

老年非杓型高血压病患者内皮素和降钙素基因相关肽含量变化及 …

目的 探讨老年非杓型高血压病（ＥＨ）患者内皮素（ＥＴ）和降钙素基因相关肽（ＣＧＲＰ）含量变化及氨氯地平对其影响。方法 观察氨氯地平治疗老年非杓型ＥＨ患者疗效及其治疗前后ＥＴ和ＣＧＲＰ含量变化。结果 老年非杓型ＥＨ患者血浆ＥＴ水平明显高于老年杓型ＥＨ患者,而ＣＧＲＰ则明显降低;氨氯地平使老年非杓型ＥＨ患者白昼及夜间血压下降,治疗后老年非杓型ＥＨ患者血浆ＥＴ水平降低,而ＣＧＲＰ明显升高。结论 ＥＴ及Ｃ     

肾素基因与中国人2型糖尿病及其微血管病变、冠心病和高血压的相关性

在４２１例中国人中应用肾素基因的一个四核苷酸〔ＡＣＡＧ〕串列重复顺序多态标记（Ｓｉｍｐｌｅｔａｎｄｅｍｒｅｐｅａｔｐｏｌｙｍｏｒｐｈｉｓｍ，ＳＴＲＰ）研究肾素（ＲＥＮ）基因与中国人２型糖尿病、冠心病及高血压以及糖尿病肾病、糖尿病视网膜病变的相关情况。中国人肾素基因的〔ＡＣＡＧ〕ｎ＿ＳＴＲＰ基因型中以４／４型，等位基因中以４型（ＡＣＡＧ重复次数＝８）为最多见。〔ＡＣＡＧ〕ｎ＿ＳＴＲＰ频率分布存在种族间差异。在２型糖尿病、冠心病、高血压间及各组与对照组间以及２型糖尿病中有或无糖尿病肾病、视网膜病变组间肾素基因〔ＡＣＡＧ〕ｎ＿ＳＴＲＰ频率分布均无明显差异。结果表明：中国人的２型糖尿病及糖尿病微血管病变以及冠心病、高血压的遗传因素中，肾素基因不是主要参与者     

高血压病及其并发症与AT1R基因多态性

目的：本研究通过检测一型血管紧张素Ⅱ受体（ＡＴ１Ｒ）基因的Ｃ１１６６等位基因在正常人和原发性高血压（ＥＨ）患者中的频率,探讨ＡＴ１Ｒ基因多态性与原发性高血压以及与高血压左室肥厚、动脉硬化、微白蛋白尿之间的关系。方法：ＥＨ患者（ｎ＝１２０）和正常对照组（ｎ＝８６）进行血压、身高、体重及空腹血糖（Ｇｌｕ）、血总胆固醇（Ｔｃｈ）、甘油三脂（ＴＧ）浓度测定,并测定７８例高血压患者的左室重量指数（ＬＶＭＩ）     

老年高血压病及冠心病的胰岛素抵抗及其与血脂的关系

目的：探讨老年高血压和冠心病患的胰岛素抵抗及其与血脂的关系。方法：以胰岛素曲线下面积／葡萄糖曲线下面积（Ｉ／Ｇ）和胰岛素抵抗指数作为胰岛素抵抗指标，与空腹因脂指标进行直线相关分析。结果：与正常对照组（ｎ＝２０）比较，高血压组（ｎ＝２５）与冠心病组（ｎ＝２０）的血清甘油三酯（ＴＧ）、低密度脂蛋白（ＬＤＬ－Ｃ）、空腹胰岛素、空腹胰岛素／空腹葡萄糖比值、胰岛素曲线下面积、葡萄糖曲线下面积和Ｉ／Ｇ均显     

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.