肝硬化患者红细胞免疫功能与脂质过氧化关系的研究

探讨肝硬化患者红细胞免疫功能的变化及其与脂质过氧化的关系。应用红细胞酵母菌花环法测定红细胞免疫功能 ,并采用化学比色法测定血浆丙二醛 (MDA)、超氧化物歧化酶 (SOD)、谷胱甘肽过氧化物酶 (GSH -Px)含量。其中肝硬化患者 31例 ,健康对照 30例。肝硬化组RBC -IC花环率明显提高 ,P <0 .0 5 ;而RBC -C3b受体花环率与正常人无显著性差异 (P >0 .0 5 )。肝硬化组SOD、GSH -Px、SOD/MDA低于正常 (P <0 .0 1) ;而MDA明显高于正常 (P <0 .0 1)。线性相关分析显示 ,RBC -C3b花环率与MDA呈显著负相关 (r= 0 .42 3,P <0 .0 5 )。RBC -ICR与MDA明显正相关 (r=0 .5 2 3,P <0 .0 5 )。肝硬化患者红细胞免疫粘附功能降低 ,与活性氧代谢紊乱密切相关     

肝硬化患者β-胡萝卜素的变化及意义

目的　探讨肝硬化患者血浆 β 胡萝卜素 (P β CAR)含量及其临床意义。 方法　测定 6 3例肝硬化患者和 6 3例年龄及性别配对的正常人P β CAR和血浆过氧化脂质 (P LPO)、红细胞超氧化物歧化酶 (E SOD)、红细胞过氧化脂质 (E LPO)和血清C 反应蛋白 (CRP)的含量 ,并对肝硬化患者的多个因素进行Pearson相关和多元线性回归统计分析。结果　与正常对照组比较 ,肝硬化组P β CAR和E SOD含量明显降低 (P值均 <0 .0 1) ,而P LPO、E LPO和CRP含量明显升高 (P值均 <0 .0 1)。在血吸虫病性肝纤维化、肝炎后肝硬化和酒精性肝硬化中P β CAR和E SOD依次降低 ,而P LPO、E LPO和CRP依次升高 ,三组间差异有显著性 (P值均 <0 .0 1)。相关分析提示肝硬化患者P β CAR与年龄、E SOD、P LPO、E LPO和CRP含量相关 (P值均 <0 .0 1) ,而与患者Child Pugh积分无关 (P >0 .0 5 )。进一步的多元线性回归分析提示肝硬化患者P β CAR含量与E SOD和CRP的关系最密切。 结论　肝硬化患者P β CAR含量显著下降 ,与肝硬化病因和体内氧化抗氧化系统密切相关。     

急性脑梗死患者血浆维生素E、维生素C、β-胡萝卜素含量变化及其临床意义

目的　观察急性脑梗死患者 (ABI)血浆自由基清除剂含量的变化。方法　采用分光光度比色法 ,分析检测 1 2 0例急性脑梗死患者和 5 0例健康成人血浆维生素 E、维生素 C、β-胡萝卜素的含量。结果　急性脑梗死组血浆Vit E、Vit C、β-CAR含量的平均值 (AV)均显著低。结论　血浆 Vit E、Vit C、β-CAR显著降低与急性脑梗死有关 ,早期应用 Vit E、 Vit C、β-CAR有可能阻止脑组织因自由基激活的氧化损伤     

慢性萎缩性胃炎幽门螺杆菌检出量与氧自由基关系的研究

检测71例不同程度感染幽门螺杆菌(HP)的慢性萎缩性胃炎患者(患者组)和70例健康成人(对照组)血浆-一氧化氮(P-NO)、血浆维生素C(P-VC)、血浆维生素E(P-VE)、血浆β-胡萝卜素(P-β-CAR)、血浆过氧化脂质(P-LPO)含量及红细胞超氧化物歧化酶(E-SOD)、红细胞过氧化氢酶(E-CAT)、红细胞谷胱甘肽过氧化物酶(E-GSH-PX)活性和红细胞过氧化脂质(E-LPO)含量。结果与对照组比较,患者组的P-VC、P-VE、P-β-CAR、E-SOD、E-CAT和E-GSH-PX水平均值均显著降低(P<0.001),且随HP增多而降低;P-NO、P-LPO和E-LPO平均值均显著升高(P<0.001),且随HP增多而升高。并均呈一定程度的直线回归和相关(P<0.001)。提示慢性萎缩性胃炎患者体内的NO代谢异常,氧化和抗氧化平衡严重失调,氧自由基反应和脂质过氧化反应病理性加剧,且与HP检出量呈正相关。     

维生素E修饰的透析膜抗氧化作用临床研究

目的　观察维生素E(VitE)修饰的透析膜 (Cl E)的抗氧化作用。方法　选择 2 0 0 3- 0 5～ 2 0 0 3- 0 7首都医科大学附属友谊医院住院的 5 7名血透患者随机分为 3组。A组Cl E ;B组常规透析膜同时服VitE(每天4 0 0mg) ;C组常规透析膜 ,观察 4周。第 1、13次透析前抽血 ,测血浆和红细胞中丙二醛 (MDA )、谷胱甘肽(GSH)、谷胱甘肽过氧化物酶 (GSH px)、过氧化物歧酶 (SOD)、VitE及血浆晚期氧化蛋白质终末产物 (AOPP)。结果　A组观察结束后血浆和红细胞中VitE、GSH px、GSH及SOD比观察前升高 ,MDA及AOPP(红细胞中未测 )下降 ,差异有显著性 (P <0 0 5 )。B组红细胞中VitE比观察前升高 ,血浆和红细胞中MDA下降 ,差异有显著性 (P <0 0 5 ) ,其余指标无明显变化。C组实验前后各指标无明显变化 (P >0 0 5 )。结论　透析患者使用VitE有抗氧化作用 ,用Cl E透析比口服VitE效果更好。     

茶色素对冠心病患者血浆总抗氧化能力和氧化型低密度脂蛋白水平的影响

为探讨茶色素对体内抗氧化状态的影响 ,观察了 6 5例冠心病患者口服茶色素后血浆总抗氧化能力和氧化型低密度脂蛋白水平的改变。采用分光光度计测定受检者血浆总抗氧化能力水平 ,采用酶标法测定血浆氧化型低密度脂蛋白水平。结果发现 ,服药前冠心病患者血浆总抗氧化能力水平低于正常对照组 (P <0 .0 1 ) ,血浆氧化型低密度脂蛋白基础水平高于正常对照组 (P <0 .0 1 ) ;与服药前相比 ,服药 4周后茶色素组和维生素E组病人的血浆总抗氧化能力水平升高 (P <0 .0 5 ) ,血浆氧化型低密度脂蛋白水平下降 (P <0 .0 5 ) ;服药 8周后 ,茶色素组和维生素E组病人血浆总抗氧化能力水平进一步升高 (P <0 .0 1 ) ,血浆氧化型低密度脂蛋白水平进一步下降 (P <0 .0 1 ) ;服药前茶色素组、维生素E组及安慰剂组 3组患者之间的血浆总抗氧化能力水平无统计学差异 (P >0 .0 5 )。以上提示 ,冠心病患者的抗氧化能力低下 ,茶色素具有明显的抗氧化作用 ,能抑制体内低密度脂蛋白的氧化 ,推测其对阻止动脉粥样硬化的进一步发展起到有益作用     

吸烟对老年人过氧化脂质及抗氧化维生素的影响

目的　探讨吸烟对老年人过氧化脂质及抗氧化维生素的影响。方法　测定 82例老年男性吸烟者和 82例老年男性非吸烟者的血浆过氧化脂质 (P- LPO)、红细胞过氧化脂质 (E- L PO)及维生素 C、E(P- Vit C、P- Vit E) ,并做配对比较。以直线相关分析法分析日吸烟量、吸烟史与 P-L PO、E- LPO及 P- Vit C、P- Vit E的相关性。结果　与非吸烟组相比 ,吸烟组的 P- LPO、E- LPO平均值显著升高 (P<0 .0 0 1 ) ,而抗氧化维生素 P- Vit C、P- Vit E的平均值显著降低 (P<0 .0 0 1 )。吸烟组 P- L PO、E- LPO和 P- Vit C、P- Vit E值的变化与吸烟史及日吸烟量密切相关 (P<0 .0 0 1 )。结论　吸烟可使老年人的过氧化脂质显著增加 ,抗氧化维生素显著降低。     

维生素E修饰的透析膜抗氧化作用的研究

将30例慢性肾功能衰竭长期血液透析患者随机分为两组各15例,观察组用维生素E修饰的透析膜透析,对照组用纤维素透析膜透析,观察2个月.于第1、24次透析前采血测定血浆和红细胞中丙二醛(MDA)、谷胱甘肽(GSH)、谷胱甘肽过氧化物酶(GSH-px)、过氧化物歧化酶(SOD)、维生素E及血浆晚期氧化蛋白质终末产物(AOPP)水平.结果 观察组血浆和红细胞中维生素E、GSH-px、GSH及SOD明显升高,MDA及AOPP明显下降,P均<0.05.对照组实验前后观察指标无明显变化.提示维生素E修饰的透析膜具有抗氧化作用,其可通过减少脂质氧化而降低透析相关性疾病的发生率.     

大剂量维生素C在急性胰腺炎患者脂质过氧化损伤中的保护作用

目的:观察大剂量维生素C(Vit.C)对急性胰腺炎患者血浆过氧化脂质变化的影响,探讨其对脂质过氧化损伤的保护作用。方法:将84例胰腺炎病人随机分为治疗组和对照组。治疗组应用Vit.C 10g稀释于5％葡萄糖500ml中静脉滴注,每日1次,连用5天;对照组应用Vit.C 1g稀释于5％葡萄糖500 ml中静脉滴注,每日1次,连用5天。另取40例健康成年人作为正常对照组。观察两组患者治疗前后血浆维生素C(P-VC)、过氧化脂质(P-LPO)、血浆维生素E(P-VE)、血浆-β胡萝卜素(P-β-CAR)、全血还原性谷胱甘肽(WB-GSH)、红细胞超氧化物歧化酶(E-SOD)、红细胞过氧化氢酶(E-CAT)的含量变化。结果:急性胰腺炎患者与正常人群相比较,P-VC、P-VE、P-β-CAR、WB-GSH、E-SOD、E-CAT的平均含量明显降低(P<0.05),而P-LPO显著增高(P<0.05)。且以上各指标的变化急性重症胰腺炎(SAP)组较急性轻症胰腺炎(MAP)组为明显(P<0.05)。治疗组经治疗后,P-VC、WB-GSH、E-SOD、E-CAT较对照组明显升高(P<0.05),而P-LPO明显降低(P<0.05)。结论:大剂显Vit.C能提高胰腺炎患者的抗氧化能力,阻断血浆中正在进行的脂质过氧化过程,对脂质过氧化过程有一定的保护作用。     

维生素E治疗阵发性睡眠性血红蛋白尿症1例

维生素E(简称VitE)是生殖的必需因子,其中α-VilE(α-tocopberol)的生理作用最强,它也有稳定红细胞膜、阻止溶血的作用。作者报告α-VitE对一例阵发性睡眠性血红蛋白尿症(PNH)患者红细胞在体内外的作用及减轻溶血的疗效。取患者静脉血作糖水试验,在不同的VitE浓度     

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.