中老年人288例脂肪肝患者的临床研究

目的 掌握中老年人脂肪肝患病状况。方法 对2229名中老年人进行体格检查，通过询问病史，测量身高、体重、血压、血脂、血糖及B超等检查，研究脂肪肝的患病状况。结果 脂肪肝患病率为12．9％，性别、年龄对脂肪肝患病率无明显影响。仅15．6％脂肪肝患者有消化道症状，肝功能异常者占25．3％。脂肪肝患者多合并有高甘油三酯、高胆固醇、高血压、糖尿病及糖耐量异常、高尿酸血症。肥胖、高甘油三酯、高胆固醇、高血压、糖尿病及糖耐量异常、高尿酸血症均为脂肪肝的危险因素。结论 中老年人脂肪肝患病率高，必须加强脂肪肝的监测与防治，降低其患病率。     

钦州市258名公安男干警高血脂高血尿酸症及脂肪肝患病情况分析

目的了解本市公安干警高血脂、高血尿酸及无症状脂肪肝患病情况，探讨其相关影响因素和预防对策。方法对258名男干警的体检资料进行整理分析，了解其身高、体重、总胆固醇（TCHO）、甘油三酯（TG）、尿酸（UA），脂肪肝情况。结果肥胖患病率为44．19％，高脂血症患病率为44．96％，高尿酸血症患病率为19．38％，B超检出无症状脂肪肝84例，患病率为32．56％。结论肥胖是高尿酸血症、高脂血症、脂肪肝患病的主要危险因素，在公安干警中应加强健康教育，积极进行体育锻炼，提倡平衡膳食，预防心脑血管疾病的发生。     

老年人脂肪肝与冠心病危险因素的相关性

目的探讨老年人脂肪肝与冠心病危险因素之间的关系。方法调查920例老年男性,分析其脂肪肝与年龄、体质指数(BMI)、平均血压、谷丙转氨酶、总胆固醇、甘油三酯、空腹血糖、吸烟和饮酒之间的关系,并对脂肪肝、肥胖与高血压、高胆固醇血症、高甘油三酯血症、糖尿病之间的关系进行多元回归分析。结果920例老年男性非肥胖(BMI<28kg/m2)与肥胖(BMI≥28kg/m2)者脂肪肝的患病率(分别为111%和409%)比较,差异有显著性(P<005)。脂肪肝的患病率与高甘油三酯血症呈显著正相关(OR=3491,P<001),与高胆固醇血症、糖尿病呈正相关(OR=1539、1585,均为P<005)。当将肥胖和脂肪肝分别与冠心病的危险因素进行相关分析,在脂肪肝组中冠心病危险因素除高血压外OR值均高于肥胖组。结论在男性老年人群中,脂肪肝与冠心病的危险因素有相关性。     

哈萨克族成人脂肪肝危险因素探讨

目的探讨哈萨克族成人脂肪肝的相关危险因素。方法调查经B超诊断的73例哈萨克族脂肪肝患者的身高、体重、腰围、饮酒程度、食肉程度、血压、空腹血糖和血脂等指标,并与80例健康体检的非脂肪肝哈萨克族人群作对照。结果脂肪肝患者伴发肥胖症者63例（86．3％）、糖耐量异常及糖尿病者36例（49．3％）、高血压病者39例（53．4％）和高脂血症者32例（43．8％）,分别高于对照组的41．3％、12．5％、12．5％和18．6％（均P〈0．05）;脂肪肝患者在体重指数、饮酒程度、血压、空腹血糖和甘油三酯方面均高于对照组,差异有统计学意义（P〈0．05—0．01）;经Logistic回归分析显示,体重指数、饮酒、高脂饮食、甘油三酯和血糖水平成为脂肪肝的危险因素。结论哈萨克族脂肪肝发生的危险因素是饮酒、高脂饮食和肥胖。     

健康人群脂肪肝的危险因素分析

目的探讨健康人群发生脂肪肝的特点及危险因素。方法回顾性分析493例健康人体检人群脂肪肝及540例轻度脂肪肝患者的临床资料,对其危险因素行单因素及多因素相关分析。结果单因素发现性别(男)、年龄(50～59岁)、超重或肥胖、高血压、高尿酸血症(HUA)、高总胆固醇、高甘油三酯、高低密度脂蛋白、高血糖与脂肪肝有关;多因素分析显示性别(男)、年龄(50～59岁)、超重或肥胖、高血压、HUA、高甘油三酯血症、高低密度脂蛋白血症、高血糖是发生脂肪肝的危险因素。结论脂肪肝是多因素共同作用的结果,要加大对脂肪肝人群进行有针对性的健康管理。     

北京社区老年男性干部人群代谢综合征的流行病学研究

目的 调查北京部分社区老年男性干部人群代谢综合，征（MS）患病率。方法 于2003年9月和2004年5月在136个驻京部队干休所社区随机抽取1736人进行横断面调查，以中国糖尿病协会的建议为诊断标准，对老年男性干部人群的MS患病率进行了分析。结果 北京部分社区老年男性干部人群的MS患病率为30．7％，肥胖为39．6％、高血压为62．0％、高血糖为56．4％、高甘油三酯血症为37．1％。老年组和高龄老年组MS和高血压的患病率相似，高龄老年组的肥胖和高甘油三酯血症患病率显著低于老年组，而高血糖患病率则明显高于老年组，MS危险率也显著高于老年组。MS、糖代谢异常和高血压随年龄逐步增加，而高甘油三酯血症和肥胖的患病率则逐步下降。结论 北京部分社区老年男性干部人群具有较高的MS患病率，MS和各组分的患病率在不同的年龄段有所不同。进一步的流行病学调查和对人群进行干预的研究十分必要。     

老年人脂肪肝与肥胖、血脂、血糖和血压关系的研究

目的探讨老年人脂肪肝与肥胖、高脂血症、糖尿病和高血压的关系。方法调查887例老年人,分析脂肪肝与年龄、体质指数(BMI,kg/m2)、谷丙转氨酶、总胆固醇、甘油三酯、空腹血糖、平均血压、吸烟和饮酒之间的关系,并对脂肪肝、肥胖分别与高血压、高胆固醇血症、高甘油三酯血症、糖尿病之间的关系进行多元回归分析。结果非肥胖(体质指数,BMI<28kg/m2)老年人群脂肪肝的发病率男性为11.3%,女性为22.3%。肥胖(BMI≥28kg/m2)老年人群中脂肪肝的发病率男性为40.4%,女性为50.0%。男性脂肪肝者与高甘油三酯血症明显相关(P<0.01),与高胆固醇血症、DM+IGT有关(P<0.05),而女性脂肪肝者与高甘油三酯血症和DM+IGT明显相关(P<0.01),与高血压有关(P<0.05)。当将肥胖和脂肪肝分别与冠心病的危险因素进行比较,男女脂肪肝人群中高胆固醇血症、高甘油三酯血症、糖尿病的OR值均高于肥胖人群。结论老年人脂肪肝与代谢综合征有相关性。     

广西华支睾吸虫病分布及流行趋势

目的 了解广西华支睾吸虫病分布范围及流行趋势，为该病的防治提供科学依据。方法用Kato-Katz法或改良醛醚法粪检华支睾吸虫虫卵。收集既往资料与现场调查数据作统计分析。结果2004年广西华支睾吸虫病流行县市为59个，受威胁人口3852．6万。与1985年相比，流行县（市）增加了36个，受威胁的人口增加了2628．8万。2002年人群平均感染率为9．8％，为1987～1989年（1．2％）的8．1倍；轻、中、重、超重度感染分别占49．5％、36．2％、9．8％和4．5％。目前某些地区华支睾吸虫成为优势虫种，感染率达33．0％。结论广西华支睾吸虫病流行范围扩大，受威胁人口增多；有些地方华支睾吸虫已成为优势虫种，使当地人体寄生虫病谱发生了变化。     

老年人高尿酸血症的患病特征调查及相关因素分析

目的探讨老年人高尿酸血症的患病特征及相关因素。方法选择1393名老年人，以血尿酸≥420μmol／L为界限，比较高尿酸血症组和尿酸正常组的临床资料和生化指标，对影响血尿酸水平的诸多因素进行Logistic回归分析。结果老年人高尿酸血症的患病率为13．35％，其中男性明显高于女性。与尿酸正常组相比，高尿酸血症组的体重、体重指数、收缩压、血胆固醇、甘油三酯和低密度脂蛋白胆固醇明显增高，高密度脂蛋白胆固醇明显降低；同时肥胖症、高甘油三酯血症、肾功能不全和代谢综合征的患病率明显升高；Logistic回归分析表明，甘油三酯、血肌酐是影响血尿酸水平的主要危险因素。结论老年人高尿酸血症常伴发肥胖、代谢异常和肾功能不全等，甘油三酯、血肌酐与血尿酸水平升高强烈相关。     

上海市机关职员高脂血症脂肪肝流行病学调查

目的：通过流行病学调查探讨高脂血症和脂肪肝在特定人群中的患病率及其相关困素。方法：对参加健康体检的上海市4009名机关职员进行调查，男／女为18：1，年龄20～8l岁，平均46±14岁。结果：肥胖症(体重指数BMI>24kg／m^2)、高脂血症和脂肪肝(实时超声探查)等的患病率分别为31.6％、28.9％和12．9％。男性高脂血症(主要是高甘油三酯血症)和脂肪肝患病率均显著高于女性，随着年龄增长，两病患病率逐渐增加，至50岁以上男女间两病患病率差异渐小，单因素相关分析显示，脂肪肝与性别、年龄、血脂、BMI等16个指标有关：Logistic多元回归分析发现，脂肪肝主要与腹围／臀围比值、ALT异常、BMI、HBsAg阳性(负相关)、高脂血症、高血、糖耐量损害和糖尿病、性别以及眼底动脉硬化等因素密切相关。结论：肥胖及其系列病已成为上海市机关职员的常见病，向心性肥胖．高脂血症等与脂肪肝的发病相关。     

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.     

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.     

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.     

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.