动脉粥样硬化性脑梗死患者血浆同型半胱氨酸水平及亚甲基四氢叶酸还原酶基因多态性

目的 探讨血浆同型半胱氨酸水平、亚甲基四氢叶酸还原酶基因多态性与动脉粥样硬化性脑梗死之间的关系.方法 选择性别、年龄匹配的动脉粥样硬化性脑梗死患者(脑梗死组)68例及对照组50例,采用荧光偏振免疫法测定血浆同型半胱氨酸水平,聚合酶链反应-限制性片长多态性技术检测亚甲基四氢叶酸还原酶基因多态性.结果 脑梗死组TT基因型(36.8%比16.0%)及T等位基因频率(59.6%比38.0%)均显著高于对照组(P<0.05).脑梗死组血浆同型半胱氨酸水平显著高于对照组(P<0.05).脑梗死组和对照组亚甲基四氢叶酸还原酶 677TT纯合子血浆同型半胱氨酸水平均显著高于CT型和CC型者(P<0.05).结论 血浆同型半胱氨酸水平升高是动脉粥样硬化性脑梗死的危险因素.亚甲基四氢叶酸还原酶 C677T基因多态性与血浆同型半胱氨酸水平密切相关,与动脉粥样硬化性脑梗死显著相关.     

血浆同型半胱氨酸、叶酸、维生素B_(12)水平与脑梗死及血管性痴呆的相关性

目的探讨血浆同型半胱氨酸(Hcy)、叶酸及维生素B12水平与脑梗死及血管性痴呆(VD)的相关性。方法采用直接化学发光技术测定32例VD患者,18例非痴呆性脑梗死患者及20例健康对照组血浆Hcy、叶酸及维生素B12水平。结果 VD患者血浆Hcy水平明显高于非痴呆性脑梗死组及正常对照组(P<0.01),其叶酸及维生素B12水平也明显低于非痴呆性脑梗死组及正常对照组(P<0.01)。但不同程度VD患者间Hcy、叶酸及维生素B12水平无显著差异(P>0.05)。结论高Hcy血症是脑梗死及VD的危险因素,但不能影响VD程度。     

肝硬化高同型半胱氨酸血症与MTHFR基因C667T多态性的关系

目的研究肝硬化血浆同型半胱氨酸(HCY)水平及其与N5,N10-亚甲基四氢叶酸还原酶(MTHFR)基因多态性的关系.方法采用柱前衍生化-HPLC方法检测112例健康对照者、87例肝硬化患者血浆同型半胱氨酸的水平,用多聚酶链反应-限制性内切酶片断长度多态性技术(PCR-RFLP)检测其MTHFR基因C667T多态性.结果健康对照组平均血浆HCY浓度为(8.34±3.59)μmol/L,肝硬化组平均血浆HCY浓度为(21.71±4.85)μmol/L.与健康对照组相比,肝硬化组血浆HCY水平显著升高,差异有统计学意义(P＜0.01).PCR-RFLP检测结果发现MTHFR基因型有3种,即纯合子突变TT(+/+)型,杂合子突变TC(+/)型,正常CC(-/-)型.肝硬化组中+/+型、+/型和/-型频率分别为29.9%、52.9%、17.2%;健康对照组分别为19.6%、33.9%、46.4%,两组差异有统计学意义.肝硬化组MTHFR基因突变无论是纯合子还是杂合子突变基因型,其血浆HCY水平均明显高于正常基因型.结论高同型半胱氨酸血症可能是肝硬化的一个危险因素,血浆HCY水平可作为肝硬化的一个辅助诊断指标,MTHFR基因C667T多态性可能是肝硬化高同型半胱氨酸血症的易感基因之一.     

急性脑梗死患者MTHFR基因多态性与血浆同型半胱氨酸水平的关系

目的 探讨急性脑梗死（ACI）患者N5,N10-亚甲四氢叶酸还原酶（MTHFR）基因多态性与血浆同型半胱氨酸（Hcy）水平的关系.方法 采用多聚酶链反应2-限制性内切酶片段长度多态性技术（PCR2-RFLP）检测48例ACI患者MTHFR基因C677T位点多态性,同时测定血浆总Hcy及血清叶酸、维生素B12、尿酸（UA）.结果 ACI患者MTHFR基因T/T型频率为35.43％,T/C型频率为56.32％,C/C型频率为8.25％;T等位基因频率为63.59％,C等位基因频率为36.41％.MTHFR基因T/T型ACI患者血浆Hcy显著高于其他两型,T/C型与C/C型血浆Hcy水平较比较无显著差异.Hcy中度与轻度增高者MTHFR基因分布比较,P≤0.05.3组基因型间叶酸、维生素B12及UA水平均无显著差异.结论 ACI患者MTHFR基因C677T突变与Hcy水平显著相关,MTHFR基因纯合突变可能是引起高Hcy的一个重要遗传因素.     

脑梗死患者颈动脉斑块与血浆同型半胱氨酸水平及亚甲基四氢叶酸还原酶基因多态性的关系

目的探讨血浆同型半胱氨酸水平、亚甲基四氢叶酸还原酶(MTHFR)基因多态性与脑梗死患者颈动脉斑块之间的关系。方法选择颈动脉系统急性脑梗死患者128例,采用荧光偏振免疫法测定血浆同型半胱氨酸水平,聚合酶链反应-限制性片长多态性技术检测MTHFR基因多态性。应用彩色超声心动仪进行颈动脉超声检查,根据超声结果将患者分为颈动脉粥样硬化斑块组(简称斑块组)和无斑块组,比较两组血浆同型半胱氨酸水平及MTHFR基因多态性。结果斑块组TT基因型(35.8%比17.0%)及T等位基因频率(58.6%比40.4%)均显著高于无斑块组(P<0.05)。斑块组血浆同型半胱氨酸水平显著高于无斑块组(22.42±11.04μmol/L比17.89±5.96μmol/L,P<0.05)。各组内MTHFR 677TT纯合子同型半胱氨酸水平均显著高于CT型和CC型者(P<0.05)。Logistic回归分析表明,校正性别、年龄、高血压、糖尿病、高脂血症、吸烟、饮酒等危险因素后,血浆同型半胱氨酸水平仍为颈动脉粥样硬化斑块的独立危险因素[OR 1.160(95%CI 1.034～1.301),P<0.05]。结论血浆同型半胱氨酸水平升高是脑梗死患...     

慢性肾衰竭血透患者N5, N10-亚甲基四氢叶酸还原酶基因多态性和血浆同型半胱氨酸水平的研究

目的研究血透患者N5, N10-亚甲基四氢叶酸还原酶(MTHFR)基因多态性及血清叶酸、维生素B12 (Vit B12)水平与血浆总同型半胱氨酸(tHcy)的关系.方法运用聚合酶链反应-限制性内切酶片断长度多态性技术(PCR-RFLP),检测53例血透患者(HD组)及40例健康对照组(C组)的MTHFR基因多态性;用高效液相色谱法和荧光探测仪测定血浆tHcy水平;用免疫化学发光法测定血清叶酸、Vit B12水平.结果 (1)MTHFR基因型有3种,纯合子突变型(+/+)、杂合子突变型(+/-)、正常型(-/-).HD组中(+/+)型频率为30.2 %,(+/-)型频率为45.3%,(-/-)型频率为24.5%,T等位基因频率为52.8%,基因型分布和等位基因频率与C组比较差异无显著性.(2)HD组中98%的患者存在着高Hcy (＞15.0 μmol/L)血症,平均血浆 tHcy 水平显著高于C组(38.68 μmol/L 对15.47 μmol/L,P<0.01).(3)HD组中(+/+)型平均血浆tHcy水平高于(-/-)型(45.32 μmol/L 对28.44 μmol/L),两者差异具有显著性(P=0.038).(4)HD组血清叶酸、Vit B12均与血浆tHcy水平呈负相关(r=-0.377,P=0.005;r=-0.311,P=0.023).结论血透患者血浆tHcy水平升高不仅与患者尿毒症时对其清除及代谢障碍有关,还受到MTHFR基因多态性和叶酸、Vit B12水平的影响.     

血管性痴呆病人同型半胱氨酸、叶酸和维生素B_(12)水平的相关性分析

目的探讨血管性痴呆病人同型半胱氨酸、叶酸和维生素B12之间的相关性。方法选取长治医学院附属和平医院2010年—2014年老年病科住院的单纯脑梗死病人32例及血管性痴呆病人38例。选同期体检中心休检的老年人30例为对照组。分别测定血浆同型半胱氨酸及血清叶酸、维生素B_(12)浓度,分析其在3组中水平的差异及其与血管性痴呆的关系。并对血管性痴呆组给予维生素B_(12)干预治疗。结果与对照组相比,血管性痴呆组与单纯脑梗死组血浆同型半胱氨酸水平升高,血清叶酸和维生素B_(12)水平均降低,差别有统计学意义(P0.05);与单纯脑梗死组相比,血管性痴呆组血浆同型半胱氨酸水平升高,血清叶酸和维生素B12水平均降低,差别有统计学意义(P0.05);血管性痴呆组血浆同型半胱氨酸浓度分别与血清叶酸、维生素B_(12)浓度呈负相关(r~1=-0.24,P0.05;r~2=-0.45,P0.01);血管性痴呆组维生素B12治疗后简易精神状态量表评分高于治疗前(t=2.32,P0.05),同型半胱氨酸低于治疗前(t=4.12,P0.05)。结论血浆同型半胱氨酸增高可能是血管性痴呆的危险因素;叶酸尤其是维生素B12的缺乏与血管性痴呆病人血浆同型半胱氨酸的增高有关;补充维生素B12可能改善血管性痴呆病人的认知障碍。     

MTHFR基因多态性与脑卒中的相关性

目的探讨河南豫北地区汉族脑卒中人群中N5,N10亚甲基四氢叶酸还原酶(MTHFR)基因C677T基因多态性。方法应用聚合酶链反应限制性片段长度多态性技术对151例脑卒中患者和151名健康对照人群进行HFR/C677T基因多态性分析,并对MTHFR/C677 T位点进行单倍型分析;同时检测两组同型半胱氨酸(Hcy)水平。结果两组FR/C677T基因型和等位基因频率有显著差异(P0.05),脑卒中组Hcy水平明显高于对照组(P0.05)。结论 MTHFR T/T基因型可能与脑卒中相关。     

H型高血压患者MTHFR基因型分布及与血管性痴呆的关系

目的探讨H型高血压患者亚甲基四氢叶酸还原酶(MTHFR)基因型分布与血浆同型半胱氨酸(Hcy)及血管性痴呆(VD)的关系。方法共纳入研究者576例,根据血压及Hcy水平分为H型高血压组188例、非H型高血压组109例、高Hcy非高血压组165例、正常对照组114例,收集一般临床资料和血生化检查结果,采用酶联免疫吸附试验测定血浆Hcy水平,筛选VD,采用多聚酶链式反应-荧光定量法检测MTHFR基因型,并比较各组MTHFR基因型分布及VD的发生率。结果血浆Hcy水平与收缩压、舒张压呈正相关(r=0. 763、0. 817,P0. 05); 4组VD发生比例H型高血压组非H型高血压组高Hcy非高血压组正常对照组(P0. 05); H型高血压组T/T型基因及T等位基因频率显著高于非H型高血压组及高Hcy非高血压组(P0. 05);非H型高血压组及高Hcy非高血压组T/T型基因及T等位基因频率显著高于正常对照组(P0. 05)。Logistic回归分析显示:在校正年龄、性别、体重指数(BMI)、吸烟及饮酒史、心率、肌酐、尿酸、血糖、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、三酰甘油(TG)后,高Hcy血症(HHcy)是VD的危险因素(OR=8. 461,P0. 05);引入高血压为协变量时,HHcy仍然是VD的危险因素(OR=4. 211,P0. 05)。在校正性别、年龄、BMI、Hcy、收缩压、舒张压时,与C/C型基因组相比,C/T基因、T/T基因型VD的风险均增加(OR=4. 193、8. 781,P0. 05)。结论 MTHFR基因C677T突变与HHcy、高血压及VD的发生相关;可以通过MTHFR基因型的分析来预测VD。     

亚甲基四氢叶酸还原酶基因多态性与分支动脉粥样硬化疾病早期神经恶化相关性研究

目的探讨血浆同型半胱氨酸及亚甲基四氢叶酸还原酶(MTHFR)C677T基因多态性与分支动脉粥样硬化疾病早期神经恶化(END)的相关性。方法分支动脉粥样硬化疾病患者168例,根据诊断分为END组88例,非END组80例。采用美国国立卫生研究院卒中量表(NIHSS)评分评估患者神经功能。采用多变量logistic回归分析确定END的危险因素。通过PCR荧光定量进行基因分型,分析基因型的分布情况。结果 END组糖化血红蛋白、同型半胱氨酸和入院时NIHSS评分明显高于非END组(P<0.05,P<0.01)。多因素logistic回归分析显示,糖化血红蛋白(OR=1.531,95%CI:1.143～1.982,P=0.024)、同型半胱氨酸(OR=2.786,95%CI:1.193～6.943,P=0.036)和入院时NIHSS评分(OR=1.668,95%CI:1.175～2.342,P=0.004)为END的危险因素。MTHFR C677T基因T/T型同型半胱氨酸(18.33±0.74)μmol/L最高,其次C/T型同型半胱氨酸(16.11±0.79)μmol/L,C/C型同型半胱氨酸(13.29±0.53)μmol/L最低(P=0.024)。结论血浆同型半胱氨酸水平是分支动脉粥样硬化疾病患者END的独立危险因素。MTHFR C677T基因T/T型血浆同型半胱氨酸水平最高。     

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.     

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.     

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.