代谢综合征患者血浆甘油三酯水平对HDL亚类分布的影响

目的探讨代谢综合征(MS)患者血浆甘油三酯(TG)水平对高密度脂蛋白(HDL)亚类分布的影响。方法选取在南华大学附属第一医院就诊的MS患者血样,全自动生化分析仪测定血脂含量及载脂蛋白浓度,根据美国国家胆固醇教育计划NCEP ATP-Ⅲ文件,将MS患者按TG浓度分4组,即TG1.69 mmol/L、1.69mmol/L≤TG2.25 mmol/L、2.25 mmol/L≤TG5.64 mmol/L、TG≥5.64 mmol/L,采用双向电泳-免疫印迹检测法测定MS患者和99例正常人血浆HDL亚类的相对含量。结果与对照组相比,MS患者血浆总胆固醇(TC)、TG、低密度脂蛋白胆固醇(LDLC)、载脂蛋白B100(Apo B100)、preβ1-HDL、HDL3b含量及Apo B100/AⅠ和LDLC/HDLC比值均显著性增高(P0.05或P0.001),HDLC、Apo AⅠ、HDL2b、HDL2a显著降低(P0.05或P0.001)。并且随着血浆TG水平的升高,小颗粒的preβ1-HDL、HDL3a和HDL3b含量升高,而大颗粒的HDL2b和HDL2a含量降低。结论MS患者HDL亚类分布异常,小颗粒的preβ1-HDL和HDL3b含量升高,而大颗粒的HDL2b和HDL2a含量降低,血浆TG含量变化可能是影响MS患者HDL亚类异常的因素之一。     

代谢综合征患者白细胞介素6水平与HDL亚类分布的相关性分析

目的探究代谢综合征(MS)患者血浆白细胞介素6(IL-6)水平与高密度脂蛋白(HDL)亚类分布及其相关性。方法收集MS组患者135例和对照组健康体检人群77例的血样,酶联免疫吸附法(ELISA)测定IL-6含量,按IL-6浓度将MS患者分为低IL-6组(IL-6≤66.76 ng/L)、中IL-6组(66.76 ng/LIL-6113.84 ng/L)、高IL-6组(IL-6≥113.84 ng/L)。双向电泳-免疫印迹法测定血浆HDL亚类的相对含量,全自动生化分析仪测定血脂浓度及载脂蛋白含量。分析不同性别对IL-6、血脂、载脂蛋白及HDL亚类分布的影响,及IL-6水平与HDL亚类分布的相关性。结果与对照组比较,MS组IL-6、preβ1-HDL、HDL3b、HDL3c、TC、TG、LDLC含量以及LDLC/HDLC和Apo B100/Apo AI均显著增高(P0.05或P0.01),而HDL2a、HDL2b、preβ2-HDL、Apo AI和HDLC含量显著降低(P0.05或P0.01)。与对照组同性别比较,MS组男性或女性HDL亚类的相对含量有差异(P0.05或P0.01);与同组男性比较,对照组和MS组女性血脂、血浆载脂蛋白水平差异均无统计学意义(P0.05)。MS患者血浆IL-6含量的升高与HDL亚类分布异常存在相关性,即IL-6的含量与小颗粒的preβ1-HDL、HDL3b水平呈正相关,与大颗粒HDL2b水平呈负相关。结论 MS患者血浆IL-6水平升高,且HDL颗粒呈变小趋势,高水平的IL-6可能与HDL亚类分布异常和血脂紊乱有关。     

代谢综合征患者血浆网膜素1水平与HDL亚类分布的相关性分析

目的探讨代谢综合征(MS)患者血浆网膜素1(Omentin-1)水平对高密度脂蛋白(HDL)亚类分布的影响。方法收集在南华大学附属医院就诊的MS患者102例和对照组81例的血样,采用全自动生化分析仪测定血脂浓度及载脂蛋白含量,酶联免疫吸附法测定Omentin-1的含量,双向电泳-免疫印迹法测定人血浆HDL亚类的相对含量。按Omentin-1浓度均值加减去一个标准差作为分割点,将MS患者分为3组:低Omentin-1组(Omentin-1≤9.10μg/L)、中Omentin-1组(9.10μg/LOmentin-126.68μg/L)、高Omentin-1组(Omentin-1≥26.68μg/L)。结果随着Omentin-1浓度的降低,MS患者血浆甘油三酯(TG)、总胆固醇(TC)及ApoB100/AⅠ和LDLC/HDLC比值均显著性增高(P0.05或P0.01),高密度脂蛋白胆固醇(HDLC)、ApoAⅠ含量显著降低(P0.05或P0.01)。与低Omentin-1组相比,高Omentin-1组中小颗粒的preβ1-HDL和HDL3b含量显著下降(P0.05或P0.01),而大颗粒的HDL2a含量显著上升(P0.05)。结论 MS患者血浆Omentin-1水平降低,且HDL颗粒呈变小趋势,低水平的Omentin-1可能与HDL亚类分布异常和血脂紊乱有关。     

脑梗死患者血浆HDL亚类组成及含量研究

目的:分析脑梗死患者血浆高密度脂蛋白(HDL)亚类组成及含量。方法:采用双向电泳-免疫印迹检测法分析50例脑梗死患者和50例正常者HDL亚类的组成及含量。结果:与对照组比较,脑梗死患者血浆中preβ2-HDL和HDL2b含量显著降低(均P<0.01),小颗粒preβ1-HDL含量显著增加(P<0.01);患者血浆三酰甘油(TG)水平与preβ1-HDL、HDL3b、HDL2a和HDL2b含量呈显著负相关(均P<0.05),HDL-C、载脂蛋白AⅠ含量与preβ1-HDL、preβ2-HDL、HDL3c、HDL3b、HDL3a、HDL2a和HDL2b含量呈显著正相关(均P<0.05)。结论:脑梗死患者血浆大颗粒HDL含量明显降低,小颗粒HDL含量明显增加,提示脑梗死患者HDL代谢过程异常。     

肥胖伴糖耐量异常者经吡格列酮治疗后血清脂蛋白亚类的变化

目的　研究肥胖伴糖耐量异常者血高密度脂蛋白（HDL）亚类分布情况以及吡格列酮干预后对血浆HDL亚类分布的影响。方法　比较40例健康人与40例肥胖伴糖耐量异常者血浆高密度脂蛋白（HDL）亚类分布,了解肥胖伴糖耐量异常者血浆HDL亚类分布特点。采用配对设计的随机分组方法,以性别作为随机配对的条件,将40例肥胖伴糖耐量异常者作为研究对象分为安慰剂组和吡格列酮组,药物干预12周后,抽取受试者空腹12　h静脉血,24　h内进行HDL各亚组分含量的测定以及对氧磷酶1（PON-1）活性的测定。分析血浆HDL亚类分布与PON-1活性的相关性。结果　肥胖伴糖耐量异常者血清HDL分布异常,HDL2a和HDL2b减低,而小颗粒的preβ1-HDL、preβ2-HDL、HDL3a升高,差异具有统计学意义（P<0.05）。与安慰剂组比较,吡格列酮组用药后12周,受试者血清HDL中HDL2a、HDL2b、PON-1显著升高,preβ1-HDL显著降低,差异具有统计学意义（P<0.05）。相关性分析显示,preβ1-HDL与PON-1呈负相关,　HDL2b与PON-1呈正相关,相关性有显著性。结论　肥胖伴糖耐量异常患者血清中HDL亚类分布异常,成熟代谢过程受阻,趋向于较弱的抗动脉粥样硬化的分布趋势。吡格列酮通过改善HDL亚类的分布以及提高PON-1活性,增强了HDL抗动脉粥样硬化的作用。HDL亚类分布中成熟的大颗粒含量越高,PON-1的活性越强,抗动脉粥样硬化能力越强。     

脑卒中患者血浆HDL亚类组成及与血压的相关性

目的研究脑卒中患者高密度脂蛋白(high density lipoprotein,HDL)亚类组成及相对百分含量的变化,并探讨脑卒中患者血压与HDL亚类组成的关系。方法采用双向电泳-免疫印迹检测法分析了79例正常对照和98例脑卒中患者HDL亚类组成及相对百分含量。结果脑梗死组preβ1-HDL(P<0.05或P<0.001)、HDL3c(P<0.001)水平显著增加,而HDL2a(P<0.05)及HDL2b(P<0.05或P<0.001)水平显著减少。脑出血组preβ1-HDL、HDL3c含量显著增加(P<0.05),而HDL2b含量显著减少(P<0.001)。受试者按收缩压水平分组发现,随着收缩压水平逐渐升高,小颗粒的preβ1-HDL、HDL3c及HDL3a水平均有升高趋势,而大颗粒的HDL2b水平有降低趋势。与正常组比较,收缩压高组(组Ⅳ:160 mmHg≤收缩压<180 mmHg)及收缩压极高组(组V:收缩压≥180 mmHg)preβ1-HDL、HDL3c含量均显著升高(P<0.05),而HDL2b含量显著降低(P<0.05)。且收缩压水平与preβ1-HDL、HDL3c水平呈正相关(r=0.235,r=0.250),而与HDL2b水平呈负相关(r=-0.228)。结论脑卒中患者HDL颗粒直径呈变小趋势,并且随着收缩压水平升高,其HDL颗粒的变小程度更加明显。     

血浆晚期氧化蛋白产物与HDL亚类组成的关系

目的 探讨血浆晚期氧化蛋白产物(AOPPs)对血浆高密度脂蛋白(HDL)亚类组成及含量的影响.方法 采用氯胺-T法和双向电泳免疫印迹检测法对346例受试者分别测定血浆AOPPs的相对含量和血浆HDL亚类的组成及含量.按AOPPs浓度均值加或减去一个标准差作为分割点,将受试者分为3组,即低AOPPs(AOPPs≤60μmol/L)组、中AOPPs(60 μmol/L＜ AOPPs ＜90 μmol/L)组、高AOPPs(AOPPs ≥90μmol/L)组.结果 与低AOPPs组相比,高AOPPs组中preβ1-HDL及HDL3a显著增多(P＜0.001),而HDL2a、卵磷脂胆固醇酰基转移酶及HDL2b显著降低(P＜0.001),各组胆固醇酯转运蛋白无变化.相关性分析表明AOPPs与血浆HDL亚类分布存在显著相关.结论 随着血浆AOPPs水平的升高HDL颗粒有变小的趋势,AOPPs可能阻碍了HDL的成熟代谢.     

高密度脂蛋白颗粒大小与青年冠心病无症状性心肌缺血的关系

目的 探讨高密度脂蛋白(HDL)颗粒大小与青年冠心病无症状性心肌缺血(SMI)的相关性。方法 共纳入469例青年冠心病患者,其中无症状性心肌缺血组194例(SMI组,n=194),有症状性心肌缺血组275例(non-SMI组,n=275)。收集患者的一般资料,检测血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDLC)、高密度脂蛋白胆固醇(HDLC)、载脂蛋白A1(ApoA1)水平及相关生化指标。计算HDL颗粒大小的量化指标HDLC/ApoA1,以及相关脂质参数TC/HDLC、non-HDLC、TG/HDLC、LDLC/HDLC。应用多因素Logistic回归分析明确HDL颗粒大小(HDLC/ApoA1)与青年冠心病SMI发生的关系。结果 与non-SMI组比较,SMI组患者血清TC、尿酸、LDLC、LDLC/HDLC、TC/HDLC、non-HDL水平偏低,HDLC、ApoA1、HDLC/ApoA1值更大(均P＜0.05)。相关分析结果显示,HDL颗粒大小(HDLC/ApoA1)与Gensini积分呈负相关(r=－0.405,P＜0.05)。多因素分析显示,HDL颗粒大小(HDLC/ApoA1)是青年冠心病患者SMI的独立预测因子(OR=0.697,95%CI:0.233~0.910,P=0.007)。受试者工作特征曲线显示,以0.36为HDL颗粒大小(HDLC/ApoA1)临界值预测青年冠心病SMI发生的灵敏度为92.1%,特异度为75.5%。结论 HDL颗粒大小(HDLC/ApoA1)与青年冠心病SMI患者冠状动脉病变严重程度呈负相关,对青年冠心病SMI具有较强的预测价值。     

人血浆高密度脂蛋白亚类分布与动脉粥样硬化

高密度脂蛋白(HDL)是一类不均一的脂蛋白,各种HDL亚类具有不同而又相关的代谢功能.血浆脂质和载脂蛋白含量变化会影响HDL亚类分布.高甘油三酯血症、高胆固醇血症、特别是混合型高脂血症患者血浆HDL颗粒变小,而且随着血浆甘油三酯、总胆固醇含量的升高,上述变化会更加明显.提示HDL成熟代谢受阻,胆固醇逆向转运减弱.不同的载脂蛋白在HDL合成及代谢中起着各不相同的作用.当血浆apoAⅠ含量增加时,所有的HDL亚类均增加,且大颗粒的HDL2b增加最为明显.ApoAⅡ具有双重功能,有使小颗粒HDL3b、HDL3a以及大颗粒的HDL2b同时增加的作用.血浆apoB100、CⅡ以及CⅢ在HDL组装中具有协同作用,apoAⅠ对抗上述载脂蛋白引起HDL颗粒变小的作用.此外,糖尿病和冠心病患者血浆HDL颗粒呈变小趋势.使用他汀治疗的冠心病患者血浆HDL亚类分布的改善滞后于血浆脂质水平的正常化,表明HDL亚类图谱分析有助于冠心病患者的风险分层.     

荷丹片对高脂血症患者血脂谱、PCSK9水平及高密度脂蛋白颗粒的影响

目的观察荷丹片对高脂血症患者血脂谱、前蛋白转化酶枯草溶菌素9(PCSK9)以及高密度脂蛋白(HDL)亚型的影响。方法 37例高脂血症患者随机入选荷丹组(荷丹片4.38 g/d,n=18)和安慰剂组(n=19),治疗8周后,分别检测血脂谱、PCSK9以及HDL亚型的变化。结果荷丹片治疗8周可轻度降低低密度脂蛋白胆固醇(LDLC)水平,但对总胆固醇(TC)、甘油三酯(TG)以及高密度脂蛋白胆固醇(HDLC)水平及血浆PCSK9水平无影响。但是,经荷丹片治疗后HDLC大颗粒亚型的浓度及大颗粒亚型的比例增加,HDLC小颗粒亚型的浓度及比例减少,但HDLC的血浆水平无变化。结论荷丹治疗8周可以改善LDLC水平以及HDLC的亚型浓度及比例。     

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.