microRNA-192表达量与溃疡性结肠炎患者炎性反应及预后的相关性

[目的]探讨分析microRNA-192表达量与溃疡性结肠炎患者炎性反应及预后的相关性。[方法]选取120例溃疡性结肠炎患者,其中活动期67例,缓解期53例。根据溃疡性结肠炎活动期患者临床严重程度将患者分为轻度组(25例)、中度组(22例)和重度组(20例)。检测血清microRNA-192水平,采用Mayo评分、Baron评分,评估患者炎性反应程度,分析microRNA-192水平变化与溃疡性结肠炎患者炎性反应及预后的关系。[结果]活动期患者血清miR-192表达量为(0.19±0.04)显著低于缓解期患者的(0.25±0.07),差异有统计学意义(t=5.906,P<0.05)。重度组患者血清miR-192表达量低于中度组和轻度组,且组间比较差异有统计学意义(P<0.05);而重度组患者Mayo评分、Baron评分均高于中度组和轻度组,且组间比较差异有统计学意义(P<0.05)。Pearson相关性分析结果显示,血清miR-192表达量与Mayo评分、Baron评分均呈负相关关系(均P<0.05)。复发率为47.50%(57/120),根据预后情况将患者分为...     

神经生长因子在溃疡性结肠炎中的表达和意义

背景:溃疡性结肠炎(UC)病因复杂,其发病机制是国内外研究的热点,近年来肠道神经系统(ENS)异常越来越受学者们关注。目的:探讨神经生长因子(NGF)在UC中的表达及其意义。方法:纳入2011年1月-2013年5月山西医科大学第一医院确诊的UC患者40例,选取同时期单纯性结肠息肉患者10例和健康体检者10例作为对照组,采集肠黏膜标本和静脉血。分别采用免疫组化染色和ELISA法检测NGF在UC患者和对照组肠黏膜和血清中的表达。结果:NGF在UC组肠黏膜组织中的表达显著高于对照组(P0.01)。轻度与中度、重度UC患者肠黏膜组织NGF表达差异有统计学意义(P0.05),但中度与重度间差异无统计学意义(P0.05)。UC肠黏膜组织中NGF表达与UC严重程度呈正相关(rs=0.505,P0.05)。NGF在UC肠黏膜组织中的表达与病变部位无关。NGF在UC患者血清中的表达与肠黏膜组织中的表达呈负相关(r=-0.529,P0.05)。结论:NGF在UC肠黏膜组织中的高表达可能与UC发病机制有关,NGF可能是连接神经系统与免疫系统的桥梁,且与UC严重程度呈正相关;NGF在UC患者血清中的表达可有助于疾病程度的判断。     

Siglec-1在溃疡性结肠炎患者外周血单核细胞中的表达

目的分析Siglec-1在溃疡性结肠炎(ulcerative colitic,UC)患者外周血单核细胞中的表达水平,并分析其临床意义。方法收集40例UC活动期患者、30例UC缓解期患者、40名健康体检者的全血,流式细胞术检测各组患者外周血单核细胞中Siglec-1的表达水平。结果 UC活动期患者外周血单核细胞Siglec-1的阳性细胞数明显高于健康对照组和UC缓解期组,差异有显著统计学意义(P0.01);不同分级(轻度、中度、重度)UC活动期患者外周血单核细胞Siglec-1阳性细胞数差异也有统计学意义(P0.05)。结论 Siglec-1可能与UC的发生、发展有关,有望成为评价UC患者病情活动性及严重程度的指标之一。     

不同严重程度溃疡性结肠炎患者血清TNF-α、IL-6及IL-8的表达及意义

目的探讨溃疡性结肠炎不同严重程度患者血清肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6、IL-8的表达情况及其临床意义。方法溃疡性结肠炎患者47例,按照Truelove-Witts分级标准分为轻度、中度和重度组,并于同期随机抽取健康体检者47例为对照组,采用酶联免疫吸附试验(ELISA)检测并比较各组的血清TNF-α、IL-6、IL-8水平。结果溃疡性结肠炎患者组血清TNF-α、IL-6以及IL-8水平高于健康对照组(P0.05);不同严重程度溃疡性结肠炎组的TNF-α、IL-6以及IL-8水平比较有统计学差异(P0.05),重度组TNF-α、IL-6以及IL-8水平高于轻度组、中度组,中度组TNF-α、IL-6以及IL-8水平高于轻度组。结论通过检测血清TNF-α、IL-6、IL-8水平可以有效评估溃疡性结肠炎患者的病情进展。     

溃疡性结肠炎体内Toll样受体5核因子-κB及白细胞介素17表达及相关性研究

目的 探讨Toll样受体5(TLR5)、核因子-κB(NF-κB)及白介素17(IL-17)在溃疡性结肠炎(UC)患者结肠组织及外周血中的表达及临床意义。方法 收集2012年12月至2014年1月郑州大学第一附属医院门诊和住院的活动期UC患者70例,其中轻度UC患者30例,中度25例,重度15例。另外收集30名健康志愿者的血清样本作对照,20例结肠癌行外科手术切除的正常结肠断端取正常结肠组织作对照。分别采用免疫组织化学SABC检测结肠黏膜中TLR5与NF-κB的表达,ELISA检测外周血IL-17的含量。结果 TLR5和NF-κB在各组结肠黏膜的表达差异及IL-17在各组外周血的表达差异均有统计学意义(P<0.01),UC患者组高于对照组,重度UC患者高于中度及轻度UC患者。另外,TLR5与IL-17呈显著正相关(r=0.823,P<0.01)。结论 TLR5可能通过活化NF-κB增加IL-17的表达参与了溃疡性结肠炎的发生与发展,检测其变化对疾病严重程度的评价具有重要临床意义。     

类固醇激素依赖型溃疡性结肠炎缓解期IL-23表达的研究

目的 探讨IL-23在缓解期类固醇激素依赖型溃疡性结肠炎患者结肠组织中表达的病理意义.方法 采用Western blot分析及免疫组化SABC法检测15例缓解期激素依赖型溃疡性结肠炎患者炎症修复区结肠组织IL-23的蛋白表达情况,予统计学软件统计分析,并以30例缓解期的一般溃疡性结肠炎患者(15例SASP维持治疗,15例强的松维持治疗)炎症修复区结肠组织及10例正常结肠黏膜组织为对照组.结果 与正常对照组比较,SASP维持治疗及强的松维持治疗缓解期一般溃疡性结肠炎患者炎症修复区结肠组织IL-23的蛋白表达均轻度升高(P>0.05),而缓解期激素依赖型溃疡性结肠炎患者炎症修复区结肠组织IL-23的蛋白表达显著高于一般溃疡性结肠炎组(P<0.01).结论 IL-23的过度表达可能在溃疡性结肠炎类固醇激素依赖发病机制中起关键作用.     

类固醇激素依赖型溃疡性结肠炎缓解期IL-23表达的研究

目的 探讨IL-23在缓解期类固醇激素依赖型溃疡性结肠炎患者结肠组织中表达的病理意义.方法 采用Western blot分析及免疫组化SABC法检测15例缓解期激素依赖型溃疡性结肠炎患者炎症修复区结肠组织IL-23的蛋白表达情况,予统计学软件统计分析,并以30例缓解期的一般溃疡性结肠炎患者(15例SASP维持治疗,15例强的松维持治疗)炎症修复区结肠组织及10例正常结肠黏膜组织为对照组.结果 与正常对照组比较,SASP维持治疗及强的松维持治疗缓解期一般溃疡性结肠炎患者炎症修复区结肠组织IL-23的蛋白表达均轻度升高(P>0.05),而缓解期激素依赖型溃疡性结肠炎患者炎症修复区结肠组织IL-23的蛋白表达显著高于一般溃疡性结肠炎组(P<0.01).结论 IL-23的过度表达可能在溃疡性结肠炎类固醇激素依赖发病机制中起关键作用.     

类固醇激素依赖型溃疡性结肠炎缓解期IL-23表达的研究

目的 探讨IL-23在缓解期类固醇激素依赖型溃疡性结肠炎患者结肠组织中表达的病理意义.方法 采用Western blot分析及免疫组化SABC法检测15例缓解期激素依赖型溃疡性结肠炎患者炎症修复区结肠组织IL-23的蛋白表达情况,予统计学软件统计分析,并以30例缓解期的一般溃疡性结肠炎患者（15例SASP维持治疗,15例强的松维持治疗）炎症修复区结肠组织及10例正常结肠黏膜组织为对照组.结果 与正常对照组比较,SASP维持治疗及强的松维持治疗缓解期一般溃疡性结肠炎患者炎症修复区结肠组织IL-23的蛋白表达均轻度升高（P〉0.05）,而缓解期激素依赖型溃疡性结肠炎患者炎症修复区结肠组织IL-23的蛋白表达显著高于一般溃疡性结肠炎组（P〈0.01）.结论 IL-23的过度表达可能在溃疡性结肠炎类固醇激素依赖发病机制中起关键作用.     

血清降钙素原和C-反应蛋白在评价溃疡性结肠炎病情中的临床价值

[目的]探讨血清降钙素原(PCT)和C-反应蛋白(CRP)在评价溃疡性结肠炎病情中的临床价值。[方法]检测120例溃疡性结肠炎患者(病例组)和30例健康体检者(正常对照组)外周血PCT和CRP水平。[结果]病例组缓解期、活动期患者PCT水平分别为(1.56±0.36)μg/L、(6.57±2.96)μg/L,均明显高于正常对照组[(0.33±0.16)μg/L],P0.01;病例组缓解期、活动期CRP水平分别为(6.78±3.85)mg/L、(23.46±12.53)mg/L,均明显高于正常对照组[(0.68±0.23)mg/L],P0.01;活动期患者PCT、CRP水平缓解期患者(P0.01)。病例组轻度、中度、重度病情患者PCT水平分别为(3.64±1.78)、(5.67±2.75)、(8.96±1.86)μg/L,CRP水平分别为(8.75±3.64)、(22.78±6.57)、(31.45±11.34)mg/L;中度、重度病情患者的PCT、CRP水平均明显高于轻度者(P0.01),重度病情患者PCT、CRP水平均明显高于中度者(P0.01)。[结论]血清PCT和CRP水平可能成为评价溃疡性结肠炎病情活动及严重程度的辅助指标。     

CD163在溃疡性结肠炎患者组织及血清中的表达及临床意义

[目的]检测CD163在溃疡性结肠炎患者组织及血清中的表达水平，并探讨其在溃疡性结肠炎发病过程中的作用及临床意义。[方法]选取接受治疗的溃疡性结肠炎患者60例作为研究组，其中疾病活动期患者38例，疾病缓解期患者22例；另选择同期已排除炎症性肠病诊断的普通肠炎患者20例作为疾病对照组，20例经结肠镜检查无任何消化道疾病的健康人群作为健康对照组。采用酶联免疫吸附法(ELISA)检测所有纳入研究对象血清中CD163、C反应蛋白(CRP)、肿瘤坏死因子(TNF-α)的表达水平；免疫组化法测定患者组织黏膜中CD163的表达情况；采用ROC曲线评估血清CD163表达水平对溃疡性结肠炎发生的诊断价值；并对影响溃疡性结肠炎疾病发生的相关因素进行Logistic回归分析。[结果]研究组患者血清CD163、CRP、TNF-α水平明显高于疾病对照组和健康对照组(P<0.05)。研究组中疾病活动期患者血清CD163、CRP、TNF-α水平明显高于缓解期患者(P<0.05),病情重度患者血清CD163、CRP、TNF-α水平明显高于中度和轻度患者(P<0.05),E3型患者血清CD163、CR...     

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.