不同理化因素对人芽囊原虫体外存活的影响

目的观察不同理化因素对人芽囊原虫体外生存和发育的影响。方法将人芽囊原虫感染者新鲜粪便定量分成若干份,分装于有盖小平皿中,设自然因素及常用消毒剂试验组,用直接涂片法镜检,以原虫数量和细胞活度为指标,观察自然因素(温度、湿度、紫外线、渗透压)和化学消毒剂(HCl、酒精、碘酒、新洁而灭)组人芽囊原虫的生长发育情况,记录实验结果并照像。结果低温、高温、干燥及消毒剂均可致人芽囊原虫数量减少,细胞活度降低,而紫外线照射和低渗对原虫数量和细胞活度无明显影响。结论低温、高温、干燥和常用消毒剂对体外人芽囊原虫有抑制或杀灭作用。     

人芽囊原虫保存方法的初步研究

目的 观察冻存剂、温度等因素对人芽囊原虫活力的影响，探索理想的人芽囊原虫保存方法。 方法 从患者阳性粪便中分离人芽囊原虫，分装到2 ml无菌冻存管内，分别加入10%二甲基亚砜（dimethylsulfoxide, DMSO）、40%丙三醇（GL）和15%乙二醇（EG）作冻存剂，放置于不同的温度下保存，用台盼蓝染色法和原虫培养法测定细胞的活力和增殖能力。 结果 虫体在室温（18 ℃～20 ℃）下可存活3周，在4 ℃～6 ℃存活不到1周。加入冻存剂后，置－20 ℃和液氮（－196 ℃）下可存活3个月以上。用40% GL作冻存剂，于液氮低温下冻存的虫体保存半年后复苏， 活力仍达41.7%，培养72 h后多见分裂相细胞。 结论 应用40% GL作为冻存剂， 在液氮中低温保存人芽囊原虫效果较佳。 4 ℃不适于保存人芽囊原虫。     

人芽囊原虫的形态观察及致病性研究

为探讨人芽囊原虫的形态及其致病性,采用３０°斜面鸡蛋培养基对人芽囊原虫进行体外培养,在光学显微镜和扫描电镜下观察其形态和致病性。在形态观察中可见空泡型、阿米巴型和颗粒型 ３ 种形态,并证实有出芽生殖和颗粒形虫体增殖现象。以不同数量培养４８ ｈ 的圆形空泡型虫体感染小白鼠观察其致病性。结果显示, Ｄ 组（空白对照组）和 Ａ 组（感染数为 １０４ ／只）在肠粘膜上未发现虫体; Ｂ组（感染数为２０４ ／只）和 Ｃ组（感染数为 ３０４ ／只）在肠粘膜上发现虫体并能够致肠粘膜损伤,提示对肠粘膜损伤的轻重程度与人芽囊原虫感染数量有关。     

南昌市艾滋病患者合并人芽囊原虫感染情况及危险因素分析

目的　了解江西省南昌市艾滋病患者人芽囊原虫感染状况及其危险因素。方法　2016年5—9月采用横断面调查法对南昌市艾滋病患者进行问卷调查,并采集调查对象粪便,采用PCR法检测粪便基因组中人芽囊原虫DNA以判定感染状况;同时采集调查对象血液样本,检测其中CD4+ T淋巴细胞数量。采用单因素分析和多因素logistic回归分析对南昌市艾滋病患者人芽囊原虫感染的危险因素进行分析。结果　2016年5—9月在南昌市累计调查艾滋病患者505例,人芽囊原虫感染率为4.16%。单因素分析结果显示,与南昌市艾滋病患者感染人芽囊原虫有关的危险因素包括职业（[χ2] = 8.595,P = 0.049）、受教育程度（[χ2] = 14.494,P = 0.001）、日常饮用水类型（[χ2] = 10.750,P = 0.020）、感染HIV途径（[χ2] = 8.755,P = 0.026）、是否接受抗HIV治疗（[χ2] = 23.083,P = 0.001）;多因素logistic回归分析显示,日常直接饮用自来水是南昌市艾滋病患者感染人芽囊原虫的危险因素[比值比（odds ratio,OR） = 7.988,95%可信区间（confidential interval,CI）：（1.160,55.004）],接受抗HIV病毒治疗是人芽囊原虫感染的保护因素[OR = 0.183,95% CI：（0.049,0.685）]。结论　南昌市艾滋病患者人芽囊原虫感染率为4.16%。日常直接饮用自来水是南昌市艾滋病患者感染人芽囊原虫的危险因素,接受抗HIV治疗是保护因素。     

安徽省阜阳市HIV/AIDS患者人芽囊原虫感染 流行特征及危险因素

目的　调查安徽省阜阳市HIV/AIDS患者人芽囊原虫感染情况及其危险因素。方法　2016年采用横断面调查方法对安徽省阜阳市HIV/AIDS感染者进行问卷调查,收集调查对象一般人口学信息、社会经济状况、生产生活方式信息。采集调查对象粪便,通过PCR方法检测粪便基因组中人芽囊原虫DNA以判定感染状况;同时采集调查对象血液,检测其中CD4+T淋巴细胞数量和HIV病毒载量。采用单因素分析和多因素logistic回归分析对HIV/AIDS患者人芽囊原虫感染的危险因素进行分析。结果　本研究共招募398名HIV/AIDS病例,平均年龄为49.3岁、平均体重为55.9 kg、平均身高为164.4 cm。人芽囊原虫感染率为6.78%,不同性别（[χ2] = 1.589,P = 0.207）、受教育程度（[χ2] = 0.508,P = 0.776）、婚姻（[χ2] = 0.419,P = 0.811）和职业（[χ2] = 2.744,P = 0.615）患者感染率差异均无统计学意义。人芽囊原虫感染者和非感染者年龄（t = 0.370,P = 0.712）、身高（t = 1.587,P = 0.113）、体重（t = 0.516,P = 0.606）、CD4+ T淋巴细胞数量（t = 1.187,P = 0.230）和HIV病毒载量（t = 0.193,P = 0.496）差异均无统计学意义。饮用非自来水[OR = 6.554, 95% CI：（1.876,22.903）]和养狗[OR = 5.895,95% CI：（2.017,17.225）]是HIV/AIDS患者感染人芽囊原虫的危险因素。结论　安徽省阜阳市HIV/AIDS患者人芽囊原虫感染率较高,饮用非自来水和养狗是该人群人芽囊原虫感染的危险因素。     

安徽阜阳HIV阳性者合并人芽囊原虫感染及其影响因素分析

目的 了解安徽省阜阳市HIV阳性者合并人芽囊原虫感染情况及其影响因素。方法 采用横断面调查的方法对安徽省阜阳市开发区309名HIV阳性者进行问卷调查, 并采集其粪便和血液样本用于人芽囊原虫、 CD4+ T淋巴细胞和细胞因子检测。采用单因素分析和Logistic回归分析对影响HIV和人芽囊原虫合并感染的因素进行分析。结果 在309名参与调查的HIV阳性者中, 302人参与粪样检测, 286人参与问卷调查, 同时参与2项检测者263人。调查发现, HIV阳性者合并人芽囊原虫感染率为17.11%, 其中女性感染率为21.90%, 明显高于男性 （11.90%）（P < 0.05）。在HIV合并人芽囊原虫感染影响因素Logistic回归模型分析中, 仅营养状况良好 （OR = 0.263, 95% CI： 0.073,0.945） 有统计学意义。结论 HIV阳性者合并人芽囊原虫感染率较高, 营养状况好坏可能是影响合并感染的原因之一。     

重庆市江津区社区医院住院人群人芽囊原虫感染情况及其影响因素分析

目的　了解重庆市江津区住院人群人芽囊原虫感染情况及其影响因素。方法　采用横断面调查的方法对重庆市江津区某社区医院住院人群进行问卷调查,并采集粪便和血液样本,进行镜检和PCR检测。采用单因素分析和logistic回归分析对人芽囊原虫感染的影响因素进行分析。结果　共调查198名住院患者,人芽囊原虫感染率为10.61%（21/198）,女性感染率（12.10%）高于男性（8.11%）,但差异无统计学意义。10 ~ 20岁年龄组感染率最高,为19.23%;其次为60岁以上年龄组,为17.74%;20 ~ 40岁年龄组患者感染率最低,为2.38%;不同年龄组患者人芽囊原虫感染率差异有统计学意义（[χ2] = 9.538,P = 0.035）。家庭厕所为旱厕的患者人芽囊原虫感染率显著高于家庭厕所为水冲厕所的患者（33.30%和9.10%;[χ2] = 4.908,P = 0.027）。感染的人芽囊原虫基因型有ST1、ST3、ST6和ST7 4种基因型,以ST6和ST3型为主,分别占47.62%（10/21）和38.10%（8/21）;其中男性感染的基因型仅有ST3型和ST6型。多因素logistic回归分析结果显示,家庭中是否饲养宠物是影响人芽囊原虫感染的重要因素之一[OR = 3.798,95% CI（1.245,11.581）,P < 0.05]。结论　重庆市江津区社区住院人群人芽囊原虫感染率较高,主要基因型为ST6型和ST3型,饲养宠物可能是影响人芽囊原虫感染的主要因素之一。     

重庆市江津区社区医院住院人群人芽囊原虫感染情况及其影响因素分析

目的　了解重庆市江津区住院人群人芽囊原虫感染情况及其影响因素。方法　采用横断面调查的方法对重庆市江津区某社区医院住院人群进行问卷调查，并采集粪便和血液样本，进行镜检和PCR检测。采用单因素分析和logistic回归分析对人芽囊原虫感染的影响因素进行分析。结果　共调查198名住院患者，人芽囊原虫感染率为10.61%（21/198），女性感染率（12.10%）高于男性（8.11%），但差异无统计学意义。10 ~ 20岁年龄组感染率最高，为19.23%；其次为60岁以上年龄组，为17.74%；20 ~ 40岁年龄组患者感染率最低，为2.38%；不同年龄组患者人芽囊原虫感染率差异有统计学意义（[χ2] = 9.538，P = 0.035）。家庭厕所为旱厕的患者人芽囊原虫感染率显著高于家庭厕所为水冲厕所的患者（33.30%和9.10%；[χ2] = 4.908，P = 0.027）。感染的人芽囊原虫基因型有ST1、ST3、ST6和ST7 4种基因型，以ST6和ST3型为主，分别占47.62%（10/21）和38.10%（8/21）；其中男性感染的基因型仅有ST3型和ST6型。多因素logistic回归分析结果显示，家庭中是否饲养宠物是影响人芽囊原虫感染的重要因素之一[OR = 3.798，95% CI（1.245，11.581），P < 0.05]。结论　重庆市江津区社区住院人群人芽囊原虫感染率较高，主要基因型为ST6型和ST3型，饲养宠物可能是影响人芽囊原虫感染的主要因素之一。     

人芽囊原虫在不同培养基中生长状况的观察

目的筛选培养人芽囊原虫的最适培养基。方法将同一株人芽囊原虫阳性粪便标本以2×105细胞/管接种至RPMI1640、199和LES培养基中,加入20%小牛血清及青、链霉素,pH值为7.5,放置厌氧罐中于37℃恒温培养,每24h计数,每6d转种1次。观察人芽囊原虫在3种培养基中的存活时间、虫体密度和虫体形态。结果人芽囊原虫在RPMI1640培养基中存活时间最长、虫体密度最高,虫体以空泡型多见;在LES培养基中存活时间最短、虫体密度最低,但虫体形态清晰、规则;在199培养基中存活时间和虫体密度均介于前两者之间。结论RPMI1640培养基适宜人芽囊原虫的生长繁殖,为人芽囊原虫体外培养的首选培养基;LES培养基中虫体形态清晰、规则,可用于人芽囊原虫的形态学研究;199培养基也可用于人芽囊原虫的体外培养,但不作为首选。     

安徽省阜阳市HIV/AIDS患者人芽囊原虫感染 流行特征及危险因素

目的　调查安徽省阜阳市HIV/AIDS患者人芽囊原虫感染情况及其危险因素。方法　2016年采用横断面调查方法对安徽省阜阳市HIV/AIDS感染者进行问卷调查，收集调查对象一般人口学信息、社会经济状况、生产生活方式信息。采集调查对象粪便，通过PCR方法检测粪便基因组中人芽囊原虫DNA以判定感染状况；同时采集调查对象血液，检测其中CD4+T淋巴细胞数量和HIV病毒载量。采用单因素分析和多因素logistic回归分析对HIV/AIDS患者人芽囊原虫感染的危险因素进行分析。结果　本研究共招募398名HIV/AIDS病例，平均年龄为49.3岁、平均体重为55.9 kg、平均身高为164.4 cm。人芽囊原虫感染率为6.78%，不同性别（[χ2] = 1.589，P = 0.207）、受教育程度（[χ2] = 0.508，P = 0.776）、婚姻（[χ2] = 0.419，P = 0.811）和职业（[χ2] = 2.744，P = 0.615）患者感染率差异均无统计学意义。人芽囊原虫感染者和非感染者年龄（t = 0.370，P = 0.712）、身高（t = 1.587，P = 0.113）、体重（t = 0.516，P = 0.606）、CD4+ T淋巴细胞数量（t = 1.187，P = 0.230）和HIV病毒载量（t = 0.193，P = 0.496）差异均无统计学意义。饮用非自来水[OR = 6.554， 95% CI：（1.876，22.903）]和养狗[OR = 5.895，95% CI：（2.017，17.225）]是HIV/AIDS患者感染人芽囊原虫的危险因素。结论　安徽省阜阳市HIV/AIDS患者人芽囊原虫感染率较高，饮用非自来水和养狗是该人群人芽囊原虫感染的危险因素。     

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.