炎症在高血压病并发陈旧性心肌梗死中的作用

目的探讨炎症在高血压病并发陈旧性心肌梗死中的作用.方法高血压病并发陈旧性心肌梗死患者27例、高血压患者28例和30例健康人,分别用放免法测定血浆炎症介质肿瘤坏死因子α(TNF-α)、白介素1β(IL-1β)、白介素6(IL-6)含量,用免疫比浊法测定血浆炎症介质C反应蛋白(CRP)含量.同时常规测定体重指数、吸烟指数、血压、血浆空腹血糖、血脂、尿酸.结果高血压患者血浆CRP、TNF-α、IL-1β、IL6含量水平升高,并发陈旧性心肌梗死患者进一步升高.多元线性回归分析,血浆CRP、TNF-α、IL-1β、IL6含量与体重指数、收缩压(SBP)、血浆空腹血糖(FPG)、甘油三酯(TG)呈直线正相关,且SBP、FPG、TG进入上述血浆炎症介质含量直线回归方程.结论高血压病并发或不并发陈旧性心肌梗死患者均有炎症活动;SBP、FPG、TG可能通过炎症介导心肌梗死.     

炎症在高血压病患者肾功能损害中的作用

目的 探讨炎症介质在高血压肾功能损害中的作用。方法 38例高血压病患者(分为肾功能正常组(19例)、肾功能异常组(19例))和38例健康人，分别用放免法测定血浆肿瘤坏死因子。(TNFα）、白介素1β(IL-β)、白介素6(IL6)及尿微量白蛋白(ALB)、α1微球蛋白(αIMG)、β2微球蛋白(β2MG)，用免疫比浊法测定血浆C反应蛋白(CRP)，酶免法测量尿视黄醇结合蛋白(RBP)。比较各组之间血浆CRP、TNFα、IL1β、IL6及尿ALB、α1MG、β2MG、RBP水平及各指标之间相关分析。结果 血浆CRP、TNFα、IL1β、IL6水平在高血压病患者升高，随肾脏功能损害的加重而进一步升高。多元线性回归分析，尿ALB、β2MG、α1MG与SBP呈直线相关，SBP与血浆IL1β、TNFα呈直线关系，尿RBP与血浆IL6呈直线相关。结论 SBP是肾脏功能损害的独立危险因素，炎症在高血压病肾脏功能损害中起重要作用。     

炎症在高血压病患者肾功能损害中的作用

目的探讨炎症介质在高血压肾功能损害中的作用.方法 38 例高血压病患者(分为肾功能正常组(19例)、肾功能异常组(19例))和38例健康人,分别用放免法测定血浆肿瘤坏死因子α(TNFα)、白介素1 β(IL1β)、白介素6(IL6)及尿微量白蛋白(ALB)、α1微球蛋白(α1 MG)、β2微球蛋白(β2 MG),用免疫比浊法测定血浆C反应蛋白(CRP),酶免法测量尿视黄醇结合蛋白(RBP).比较各组之间血浆CRP、TNFα、IL1β、IL6及尿ALB、α1 MG、β2MG、RBP水平及各指标之间相关分析.结果血浆CRP、TNFα、IL1β、IL6水平在高血压病患者升高,随肾脏功能损害的加重而进一步升高.多元线性回归分析,尿ALB、β2 MG、α1 MG与SBP呈直线相关,SBP与血浆IL1β、TNFα呈直线关系,尿RBP与血浆IL6呈直线相关.结论 SBP是肾脏功能损害的独立危险因素,炎症在高血压病肾脏功能损害中起重要作用.     

炎性因素对A型行为高血压患者早期肾脏损害的影响

目的探讨炎症介质对A型行为高血压患者早期肾脏损害的影响。方法研究对象90例分为A型行为高血压组(A组,n=30)、非A型行为高血压组(B组,n=30)及健康对照组(C组,n=30),检测、比较各组间血CRP、IL-1β、IL-6、TNF-α水平及尿β2微球蛋白、微量白蛋白水平并作相关分析。结果A组血CRP、IL-1β、IL-6、TNF-α水平及尿β2微球蛋白、微量白蛋白水平明显高于B组(P均<0·05);B组血CRP、IL-1β、IL-6、TNF-α水平及尿微量白蛋白水平明显高于C组(P均<0·05)。经多元线性回归分析,尿β2微球蛋白与血CRP、IL-1β、IL-6、TNF-α水平直线相关(P<0·05~0·01);尿微量白蛋白与血IL-1β、IL-6水平直线相关(P<0·05~0·001)。而且血浆CRP、IL-1β、IL-6和TNF-α含量亦互相呈正相关(P均<0·001)。结论A型行为高血压患者早期肾脏损害较非A型行为高血压者严重,A型行为是高血压病肾脏损害的独立危险因素;炎症介质可能在A型行为高血压患者早期肾脏损害中起重要作用。     

炎性因素对A型行为高血压患者早期肾脏损害的影响

目的探讨炎症介质对A型行为高血压患者早期肾脏损害的影响.方法研究对象90例分为A型行为高血压组(A组,n=30)、非A型行为高血压组(B组,n=30)及健康对照组(C组,n=30),检测、比较各组间血CRP、IL-1β、IL-6、TNF-α水平及尿β2微球蛋白、微量白蛋白水平并作相关分析.结果A组血CRP、IL-1β、IL-6、TNF-α水平及尿β2微球蛋白、微量白蛋白水平明显高于B组(P均<0.05);B组血CRP、IL-1β、IL-6、TNF-α水平及尿微量白蛋白水平明显高于C组(P均<0.05).经多元线性回归分析,尿β2微球蛋白与血CRP、IL-1β、IL-6、TNF-α水平直线相关(P<0.05～0.01);尿微量白蛋白与血IL-1β、IL-6水平直线相关(P<0.05～0.001).而且血浆CRP、IL-1β、IL-6和TNF-α含量亦互相呈正相关(P均<0.001).结论 A型行为高血压患者早期肾脏损害较非A型行为高血压者严重,A型行为是高血压病肾脏损害的独立危险因素;炎症介质可能在A型行为高血压患者早期肾脏损害中起重要作用.     

炎症在2型糖尿病患者肾功能损害中的作用

目的探讨炎症在2型糖尿病(DM)肾功能损害中的作用。方法60例2型糖尿病患者[依据尿白蛋白排泄率(UAER)和内生肌酐清除率(Ccr)分为单纯DM组20例,糖尿病肾病(DN)肾功能正常组20例,DN肾功能不全组20例]和20例健康人,分别用免疫比浊法测定血浆C反应蛋白(CRP),放免法测定血浆肿瘤坏死因子α(TNFα),白介素1β(IL1β),白介素6(IL6)。结果2型糖尿病患者血浆CRP,TNFα,IL1β,IL6水平升高,且随肾脏损害的加重而进一步增高,多元线性回归分析表明Ccr与病程、IL1β、收缩压(SBP)呈直线相关,24小时尿蛋白排泄量(UPER)与血浆IL6、SBP、TNFα水平呈直线相关。结论2型糖尿病患者存在炎症反应,炎症在糖尿病肾功能损害中起重要作用。     

2型糖尿病患者血浆炎症因子水平与糖代谢及胰岛素抵抗的关系

目的 探讨2型糖尿病(T2DM)患者血浆炎症因子(IL-1β、IL-6、 TNF-α、C-RP)水平与糖代谢及胰岛素抵抗(IR)的关系.方法 分别检测60名健康者、60例T2DM患者血浆中的炎症因子水平及其他相关指标,并进行统计分析.结果 T2DM组各炎症因子、FPG水平均高于正常对照组;TNF-α与C-RP的水平与HbA1c及IR指数呈正相关(P＜0.05).结论 血浆IL-1β、IL-6、 TNF-α、C-RP与T2DM的发生发展相关,TNF-α、C-RP是T2DM糖代谢紊乱和IR的重要指标.     

哮喘患者胰岛β细胞功能与肿瘤坏死因子α、白介素6及C-反应蛋白相关性的研究

目的 通过临床对哮喘患者进行观察,分析胰岛β细胞功能与肿瘤坏死因子α(TNF-α)、白介素6(IL-6)和C-反应蛋白(CRP)的相关性.方法 选取20例慢性持续期哮喘患者作为试验对象,同时选取20名健康对照者进行对比分析,分别检测TNF-α、IL-6和CRP水平,同时进行胰岛素释放试验,计算胰岛素抵抗指数、胰岛素敏感指数以及胰岛β细胞功能指数,分析胰岛β细胞功能与TNF-α、1L-6和CRP的相关性.结果 与对照组相比,哮喘患者的TNF-α、IL-6和CRP水平升高,胰岛素抵抗指数、胰岛β细胞功能指数升高,胰岛素敏感指数下降,两组之间比较差异具有统计学意义(P＜0.05).经过多元逐步回归分析结果显示,TNF-α、IL-6和CRP水平的增加和胰岛β细胞功能呈正相关(P＜0.05).结论 哮喘患者在患病过程中有胰岛素抵抗的症状表现,TNF-α、IL-6和CRP与该情况有密切的相关性.     

青年与老年急性心肌梗死患者血浆炎性因子的对比分析

目的:检测青年(≤40岁)和老年(60~80岁)急性心肌梗死患者血浆高敏C反应蛋白(hs-CRP)、纤维蛋白原(Fib)、血浆白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)及丙二酫(MDA)的变化,并分析炎性因子与年龄的相关性及其临床意义。方法:选取我院因急性心肌梗死入院的患者300例,其中青年患者和老年患者各150例。所有患者均行冠状动脉造影检查,观察冠状动脉病变情况。并于入院即刻取静脉血5m L,通过生物化学和酶联免疫吸附实验(ELISA)方法检测血浆hs-CRP、Fib、IL-6、TNF-α及MDA的变化,并分析血浆炎性因子水平与年龄的相关性。结果:与青年组比较,老年组急性心肌心肌梗死患者高血压、糖尿病及陈旧性脑卒中比例更高(P<0.01);双支病变、三支病变的比例更高(P<0.01);血浆hs-CRP、Fib、IL-6及TNF-α水平升高更显著(P<0.01),血浆脂质过氧化产物丙二醛含量更高(P<0.01)。结论:血浆炎症因子与急性心肌梗死患者年龄相关。其原因可能与老年患者基础病多,累及病变血管多、血浆过氧化损伤严重有关。     

多项指标联合检测腹水临床意义研究

目的探讨肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、血管内皮生长因子(VEGF)及C-反应蛋白(CRP)、癌胚抗原(CEA)、乳酸脱氢酶(LDH)在肝硬化合并自发性腹膜炎(SBP)、恶性肿瘤、肾性腹水中的水平及临床意义。方法收集浙江大学医学院附属第一医院2008—2009年收集的26例SBP、31例恶性肿瘤、12例肾病患者的腹水,采用酶联免疫吸附法(ELISA)检测其中IL-6、TNF-α、VEGF的生物学活性,雅培Ci8200全自动生化、免疫分析仪检测CRP、CEA、LDH等指标,并对结果进行比较分析。结果 SBP腹水TNF-α、IL-6、CRP高于肾性和恶性腹水组,差异有统计学意义(P均<0.05);恶性腹水组VEGF、CEA、LDH高于肾性腹水组和SBP组,差异有统计学意义(P均<0.01);恶性腹水组CRP浓度高于肾性腹水组,差异有统计学意义(P<0.01);联合VEGF、CEA、LDH诊断恶性腹水的敏感性和特异性分别为90.3%和76.3%;联合TNF-α、IL-6、CRP诊断SBP腹水敏感性和特异性分别为96.2%和72.1%。结论腹水中TNF-α、IL-6、CRP的升高有助于SBP的诊断,腹水中VEGF、CEA、LDH的浓度对鉴别良、恶性腹水具有一定临床价值。     

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.