消瘦、肥胖及胰岛素依赖型糖尿病儿童青春期前血清瘦素与胰岛素浓度

瘦素（Ｌｅｐｔｉｎ）是肥胖基因的产物,为脂肪细胞衍生的激素,可将体内能量贮存状况信息传递给大脑。其生成减少或机体对其反应下降均可导致能量消耗减少、多食,进而引起严重肥胖。本文探讨了青春期前消瘦、肥胖与胰岛素依赖型糖尿病（ＩＤＤＭ）儿童血清瘦素水平与胰岛素浓度的关系。对象与方法　４９名日本儿童（男３３,女１６）,其中１６名消瘦儿童〔年龄（９－２±０－５）岁,体重指数（ＢＭＩ）（１５－２±０－５）ｋｇｍ２〕,１７名单纯性肥胖儿童〔年龄（８－３±０．４）岁,ＢＭＩ（２５－１±１．０）ｋｇｍ２〕,１…     

腹主动脉结扎大鼠心房纤维化的实验研究

高血压患者有较高心律失常的发生率，房性心律失常可能与左房扩大或心房纤维化有关。为观察压力负荷增高大鼠中心房纤维化的发生情况，将Ｗｉｓｔａｒ大鼠随机分成假手术组和手术组，手术组大鼠行肾上腹主动脉部分结扎。术后４，８，１２周分别测定大鼠颈动脉压及心房胶原容积分数（ＣＶＦ），结果发现：①手术组左室舒张压明显高于假手术组（４，８，１２周分别为１８．５±２．５ｋＰａｖｓ１５．７±１．９ｋＰａ，１８．６±２．７ｋＰａｖｓ１５．３±１．３ｋＰａ，１９．６±３．１ｋＰａｖｓ１５．２±１．９ｋＰａ，Ｐ＜０．０５或０．０１）。②手术组心房ＣＶＦ明显高于假手术组（４，８，１２周左、右房分别比较：４．２３±０．７６％ｖｓ２．９３±０．８７％，４．６５±１．４５％ｖｓ３．１１±１．０７％，５．６２±１．６２％ｖｓ３．２３±１．２８％；３．８８±１．１５％ｖｓ２．５１±０．８４％，４．２４±１．６５％ｖｓ２．５１±０．８４％，５．３４±１．３２％ｖｓ２．３３±１．１４％；Ｐ＜０．０５或０．０１），手术组心房ＣＶＦ有逐渐上升趋势。③左房ＣＶＦ与左室舒张压之间无直线相关关系（ｒ＝０．１６９１，Ｐ＞０．０５）。提示在高血压大鼠模型中存在心房?     

脑囊虫病患者化疗前后血清中五种细胞因子变化的观察

采用吡喹酮、阿苯达唑、干芜散三种药物治疗脑囊虫病患者３０例,用双抗体夹心 ＥＬＩＳＡ法检测治疗前后患者血清中 ＩＦＮ－γ、ＩＬ－４、ＩＬ－５、ＩＬ－６、ＩＬ－１０五种细胞因子的变化,结果显示治疗前脑囊虫病患者血清中 ＩＦＮ－γ、ＩＬ－４、ＩＬ－５、ＩＬ－６、ＩＬ－１０的水平分别为 ４９．３±９．８６μｇ／Ｌ、１５７±６．９μｇ／Ｌ、２３８±９．８μ／Ｌ、１１６±１２．５μｇ／Ｌ及 ３６７±１５．１μｇ／Ｌ。治疗后这五种细胞因子的水平分别为 ７５．１±１０．６μｇ／Ｌ、９１±１３．２μｇ／Ｌ、１０１±１１．９μｇ／Ｌ、８３．６±１１．０μｇ／Ｌ及 ８９±５．９μｇ／Ｌ,均已趋于正常。治疗前脑囊虫病人明显表现为Ｔｈ２型细胞因子表达,说明脑囊虫病人细胞免疫功能低下,而体液免疫功能升高,且脑囊虫病患者免疫机能紊乱状态可以通过化疗得到纠正。     

Kv1.4通道电流与大鼠心室肌细胞瞬间外向钾电流特性的比较

克隆的大鼠外向钾通道Ｋｖ１．４亚型表达于２９３细胞（ＲＣＫ４）。用膜片钳全细胞钳制法系统比较该克隆的大鼠瞬间外向钾电流（Ｉｔｏ）和天然大鼠心室肌细胞Ｉｔｏ的特点和动力学特性。两种通道电流形态相似,呈“Ａ”型电流,在＋４０ｍＶ时电流失活时间常数τ依次为３６．６±２ｍｓ和４１．０±２ｍｓ（Ｐ＞０．０５）。Ｋｖ１．４通道电流激活曲线用二相Ｂｏｌｔｚｍａｎｎ方程拟合,一相半数最大激活电位（Ｖ１／２,１）为－２１．０±３．９ｍＶ、二相半数最大激活电位（Ｖ１／２,２）为２７．０±３．９ｍＶ;天然大鼠心室肌细胞Ｉｔｏ激活曲线用单相Ｂｏｌｔｚｍａｎｎ方程拟合,半数最大激活电位为１０．８±１．１ｍＶ（Ｐ＜０．０５,ｖｓＫｖ１．４通道电流的Ｖ１／２,１）。ＲＣＫ４细胞通道电流半数最大灭活电位（Ｖ１／２）为－４９．８±１．８ｍＶ,斜率因子（ｋ）为３．８±０．２７;天然大鼠心室肌细胞Ｉｔｏ的Ｖ１／２为－３１．６±１．７ｍＶ,ｋ为５．４±０．２１。灭活后再激活的恢复时间比较,Ｋｖ１．４通道电流明显长于天然大鼠心室肌细胞Ｉｔｏ,分别为１．８９±０．２ｓ和３９．２±１．６ｍｓ（Ｐ＜０．０５）。研究表明克隆的大鼠Ｋｖ１．４通道电流与天然大?     

764-3对野百合碱性肺动脉高压大鼠肺动脉胶原沉积的影响

目的：观察７６４－３对野百合碱（ＭＣＴ）性肺动脉高压大鼠肺动脉胶原沉积的影响，探讨其可能的作用机制。方法：将雄性Ｗｉｓｔａｒ大鼠随机分为４组即正常组，正常给药组，ＭＣＴ对照组，ＭＣＴ给药组。给药大鼠从第１５天起，皮下注射７６４－３（４０ｍｇ／ｋｇ）１次／日。实验结束时，行血流动力学和病理形态学检查，并测定肺动脉羟脯氨酸（ＨＹＰ）和总蛋白含量。结果：ＭＣＴ性肺动脉高压大鼠肺动脉羟脯氨酸含量较正常组明显增高，平均分别为２４９．５±４９．９μｇ和１２４．２±２１．７μｇ（Ｐ＜０．００１），泡内肺肌型动脉中膜平滑肌细胞（ＳＭＣ）肥大、呈分泌型改变，细胞间胶原沉积；７６４－３能显著降低肺动脉羟脯氨酸含量（平均由２４９．５±４９．９μｇ降至１８６．８±３８．５μｇ，Ｐ＜０．０１），中膜ＳＭＣ结构逆转，胞体多细长，细胞间胶原减少。结论：７６４－３能部分抑制胶原在肺动脉壁的过度沉积，降低ＭＣＴ性肺动脉高压。而其减少胶原沉积、降低肺动脉高压的机制，很可能是通过逆转中膜ＳＭＣ表型改变     

灰仓鼠和子午砂土鼠实验感染多房棘球蚴的比较观察

目的：寻求一种对多房棘球蚴易感和实验周期短的动物模型。方法：３种动物在实验感染多房棘球蚴原头节后不同时期剖检，观察多房棘球蚴在其体内的发育状况。结果：在感染后第９１ｄ剖检的３种动物平均湿囊重和囊重占体重的百分比分别为：灰仓鼠１５．０±２．１ｇ和３２．３％；子午砂土鼠３．３±１．１ｇ和６．９％；ＮＩＨ小鼠０．６±０．６ｇ和２．４％。第１８８ｄ时各为１１．８±２．７ｇ和２１．７％；８．１±５．１ｇ和１５．４％；８．４±８．３ｇ和２６．７％。灰仓鼠和子午砂土鼠在第９１ｄ时，原头节已发育成熟。而ＮＩＨ小鼠在１８８ｄ原头节才发育成熟。结论：灰仓鼠感染多房棘球蚴的易感性高于其他两种动物，其感染率高，囊泡发育佳，生长速度快。该鼠是感染多房棘球蚴的一种比较理想的实验动物。     

抗氧化剂对脂质过氧化内皮细胞表达细胞粘附分子的影响

为研究一氧化氮合酶抑制剂左旋硝基精氨酸诱导的肺动脉高压大鼠各部位离体血管环对多巴胺－ １ 受体反应性的影响，采用大鼠肺动脉、肠系膜动脉和肾动脉离体血管标本，在去甲肾上腺素收缩血管后，用多巴胺－ １ 受体选择性激动剂非诺多泮使血管舒张，所有实验在吲哚美辛（１０ μｍｏｌＬ） 和普萘洛尔（３ μｍｏｌＬ） 存在下进行。左旋硝基精氨酸组大鼠各动脉对非诺多泮的反应性均有不同程度的降低，以肺动脉最明显，最大舒张占预收缩的百分比为４５．５％ ±４．１％ ，低于对照组的９７．３ ％ ±１０ ．６ ％（ Ｐ＜ ０．０１）；亲合常数为２０４２ ±２２１，低于对照组的４２７４ ．２±５１２（Ｐ＜ ０．０１） ，接近对照组的去内皮水平。肠系膜动脉和肾动脉对非诺多泮的反应性亦有下降，但下降程度明显低于肺动脉。结果提示，内皮依赖性受体介导多巴胺－ １ 的舒张效应降低是左旋硝基精氨酸形成肺动脉高压的因素之一。     

高血压病患者血清Ⅲ型、Ⅳ型前胶原、透明质酸浓度变化及苯那普利干预

目的了解高血压病患者血清Ⅲ型前胶原（ＰⅢＰ）、Ⅳ型前胶原（ＰⅣＰ）、透明质酸（ＨＡ）的变化以及苯那普利对其影响。方法应用放射免疫技术测定４７例高血压患者和２１例健康体检者血清ＰⅢＰ、ＰⅣＰ、ＨＡ的浓度,并给高血压患者以苯那普利治疗十二周后复测上述指标。结果高血压组ＰⅢＰ、ＰⅣＰ、ＨＡ分别为１２６．８±１７．４μｇ／Ｌ,６４．１±１０．１７μｇ／Ｌ、７９．２３±９．７８μｇ／Ｌ明显高于对照组的８４．２±１１．９μｇ／Ｌ,５１．７２±９．２４μｇ／Ｌ、４１．３３±６．２５μｇ／Ｌ（Ｐ＜０．０１）;苯那普利治疗十二周后,高血压组上述指标分别为８９．４±１０．０９μｇ／Ｌ、５９．８±７．１μｇ／Ｌ、６５．４±８．１６μｇ／Ｌ,与治疗前相比Ｐ＜０．０１或Ｐ＜０．０５,差异显著,有统计学意义。结论血清ＰⅢＰ、ＰⅣＰ、ＨＡ水平与血压升高密切相关并致心肌纤维化。血管紧张素转换酶抑制剂－苯那普利能在有效控制血压的同时明显降低血清ＰⅢＰ、ＰⅣＰ、ＨＡ含量     

虫草多糖对大鼠Ito细胞增殖及胶原基因表达的影响

目的　研究虫草多糖（ＣＰ）对大鼠Ｉｔｏ细胞增殖及Ⅰ、Ⅲ型前胶原基因ｍＲＮＡ表达的影响,探索ＣＰ抗肝纤维化的作用机制。方法分离、培养大鼠Ｉｔｏ细胞,采用~３Ｈ－胸腺嘧啶（~３Ｈ－ＴｄＲ）和~３Ｈ－脯氨酸（~３Ｈ－Ｐｒｏ）掺入法测定Ｉｔｏ细胞增殖及胶原合成;用原位杂交法检测Ｉｔｏ细胞Ⅰ、Ⅲ前胶原基因ｍＲＮＡ含量。结果　在０．１～８０μｇ／ｍ剂量范围内,ＣＰ可明显抑制Ｉｔｏ细胞~３Ｈ－ＴｄＲ和~３Ｈ－Ｐｒｏ的掺入。当ＣＰ浓度为１０μｇ／ｍｌ时,抑制率分别为２７．９％和４５．４％（Ｐ均＜０．０５）。随着浓度的增加和作用时间的延长,其抑制作用逐渐加强,１０μｇ／ｍｌ ＣＰ可显著抑制Ⅰ、Ⅲ型前胶原ｍＲＮＡ的表达,抑制率分别为３２．６０％和３７．３２％（Ｐ均＜０．０１）。结论 ＣＰ在体外可抑制Ｉｔｏ细胞的增殖和胶原合成,下调Ⅰ、Ⅲ型前胶原ｍＲＮＡ表达,并呈剂量和时间依赖性,提示ＣＰ对Ｉｔｏ细胞增殖和胶原合成的抑制可能是其体内抗肝纤维化作用的主要途径。     

经食管电生理检查中的交替文氏现象

在５６１例经食管电生理检查中，检出各类交替文氏现象（ＡＷ）８１例，共１３７例次，占１４．４％，其中Ａ型、Ｂ型、ＡＢ混合型、三层房室ＡＷ分别为４４，６０，１８，６例次，分别占３２．１％、４３．８％、１３．１％、４．４％；房室结双径路间、束支、房室旁束的ＡＷ分别为５，２，２例次，分别占３．６％、１．５％、１．５％。将７９例ＡＷ者（Ａ组）与８０例无ＡＷ者（Ｂ组）的电生理资料进行比较，显示：①窦性心率（ＳＲ），Ａ组较Ｂ组慢（７２±１４．２ｂｐｍｖｓ７８±１２．６ｂｐｍ，Ｐ＜０．００１）。②房室相对不应期（ＡＶＲＲＰ）、房室功能不应期（ＡＶＦＲＰ）、房室有效不应期（ＡＶＥＲＰ），Ａ组分别为６０９．０±１１９．４，４９６．６±９６．０，３６０．０±８８．０ｍｓ，与Ｂ组（５４６．０±６８．９，４２９．３±６１．５，３０７．０±５１．３ｍｓ）比较差异有高度显著性，Ｐ均＜０．００１。③心房有效不应期（ＡＥＲＰ），Ａ组与Ｂ组比较无显著差异（２６５．０±４２．３ｍｓｖｓ２６５．０±３７．３ｍｓ，Ｐ＞０．０５）。④随Ｓ１Ｓ１刺激间距缩短，Ａ组的房室传导顺序为：１１→文氏型→２１→交替文氏型→３１或心房Ｐ波脱漏；Ｂ组的房室传导顺序则?     

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.