老年冠心病患者载脂蛋白E基因多态性检测的临床意义

目的：探讨载脂蛋白E(apoE)基因多态性与老年冠心病的关系及其对血脂、脂蛋白水平的影响。方法：应用聚合酶链反应—限制性片段长度多态性法(PCR—RFLP)检测l25例老年冠心病患者和ll6例健康老年人(对照组)的apoE基因型；按常规方法测定血浆脂质、脂蛋白水平。结果：冠心病组及对照组共检出6种基因型，分别为：E2／2、E2／3、E3／3、E3／4、E4／4、E2／4；冠心病组E3／3基因型频率(51．2％)和ε3等位基因频率(73．2％)明显低于对照组(69．8％和84．0％，P＜o．05)；E3／4基因型频率(30．4％)和ε4等位基因频率(17．6％)明显高于对照组(11．2％和6．9％，P＜0.05)；冠心病组总胆固醇(TC)、低密度脂蛋白—胆固醇(LDL—C)水平明显高于对照组(P＜0.05)；冠心病患者中E2／3、E3／3、E3／4基因型之间TC、LDL—C水平差异有显著性(P＜0.05)。结论:ε4等位基因是冠心病重要的遗传标记；apoE基因多态性可能通过影响血脂水平而影响冠心病的发生。     

广东粤北地区瑶族载脂蛋白E基因多态性与原发性高血压的关系

目的探讨广东粤北地区瑶族人群载脂蛋白E（apolipoprote E,apoE）基因多态性与原发性高血压的关系、方法采刚聚合酶链反应-限制性片段长度多态性方法（PCR-RFLP）对200名60岁～80岁广东粤北地区瑶族人群进行apoE基因多态性检测,分析瑶族人群apoE基因频率分布特点,并比较分析不同apoE基凶型与原发性高血压的关系。结果共检测瑶族人群6种apoE基因型,以E3／3型最常见,占64．0％．其次为E3／4型．占17．0%,E2／3、E2／4、E4／4、E2／2基因型分别占15．5％、1．5％、1．0％、1．0％.apoE有3种等位基因：以ε3频率分布最高．为80．3％,其次是ε4,分布的频率为10.3％。ε2频率分布最低,为9．5%。男性和女性apoE基因型分布差异无统计学意义（P〉0．05）。ε4基凶携带者在原发性高血压患者中的分布高于对照组（P〈0．05）。结论广东粤北地区瑶族人群的血压水平受apoE基因多态性的影响,ε4等位基因可能是瑶族人群患原发性高血压的危险因素之一。     

载脂蛋白E基因多态性对血脂水平的影响及与冠状动脉狭窄的关系

为探讨载脂蛋白E基因多态性对血脂水平的影响及与冠状动脉狭窄程度的关系 ,采用聚合酶链反应—限制片段长度多态性对 95例冠心病患者和 46例正常对照者载脂者蛋白E基因型进行分析 ,同时测定血脂及载脂蛋白B水平。并根据冠状动脉受累支数不同将冠心病患者分为冠状动脉多支病变组和单支病变组。结果显示 ,5 5例冠状动脉病变多支组和 40例冠状动脉单支病变组E3/ 4基因型和ε4等位基因频率均高于对照组 (P <0 .0 1) ,且多支病变组E3/ 4基因型和ε4等位基因频率高于单支病变组 (P <0 .0 5 )。与E3/ 3及E2 / 3基因型比较 ,E3/ 4基因型者有较高的总胆固醇、低密度脂蛋白胆固醇和载脂蛋白B水平及较低的高密度脂蛋白胆固醇水平。与对照组比较 ,冠心病组E3/ 4基因型升高总胆固醇、低密度脂蛋白胆固醇和载脂蛋白B的作用及降低高密度脂蛋白胆固醇的作用更明显。表明载脂蛋白E基因多态性影响血胆固醇代谢 ,ε4等位基因与冠心病危险性增加有关 ,ε4等位基因频率升高的冠心病者冠状动脉受累支数加重 ,推测ε4等位基因可能与冠状动脉狭窄程度存在内在联系。     

国人载脂蛋白E基因多态性与冠心病发病之间的相关性

目的 探讨载脂蛋白E基因112bp与158bp位点多态性与血脂水平及冠心病发生之间的关系。方法采用生物化学法分别测量经冠状动脉造影证实的89例冠心病患者及43例正常人空腹血脂水平，应用聚合酶链反应限制片长多态性分析方法对载脂蛋白E基因DNA244bp的5’末端片段进行限制性片段长度多态性分析。结果冠心病组甘油三酯、总胆固醇、低密度脂蛋白、载脂蛋白B及脂蛋白（a）水平均高于对照组（P〈0．05），而载脂蛋白A1水平则低于对照组（P〈0、05）；冠心病组载脂蛋白Eε2基因型频率明显为低（P〈0．001）。结论载脂蛋白E基因多态性特征会明显影响人群中个体的血浆脂质水平，从而增加人群中个体发生冠心病的危险。     

老年冠心病患者载脂蛋白E基因多态性分析

目的探讨载脂蛋白E（apoE）基因的多态性在老年冠心病发病的意义。方法应用聚合酶链反应法（PCR），Hhal内切酶消化法，测定68例老年冠心病患者（CHD组）及70例健康老年（对照组）的apoE基因型。结果冠心病组和对照组共检出6种基因型（E4／4、E4／3、E4／2、E3／3、E3／2、E2／2），冠心病组E3／3基因频率和ε3较等位基因频率对照组低（P〈0．05），差别均有显著性差异，而E4／3、E4／2基因频率和ε4等位基因频率，冠心病组高于对照组（P〈0．05）。结论apoE基因与动脉粥样硬化相关，ε4等位基因是老年CHD的危险因素。     

安徽地区冠心病人群冠状动脉病变特征与载脂蛋白E基因多态性的研究

目的研究安徽地区冠心病人群冠状动脉病变特征与载脂蛋白E(ApoE)基因多态性的相关性,评估其在冠心病诊疗及预防中的临床应用价值。方法收集2019年9月至2020年9月在合肥市第二人民医院心内科住院行冠状动脉造影检查的患者共199例,根据研究内容不同采用两种分组方式(分别是冠心病组和对照组,ε2、ε3和ε4组),采用PCR-荧光探针法检测ε2、ε3和ε4等位基因以及rs7412和rs429358的基因型。通过比较等位基因ε2、ε3、ε4携带者的冠状动脉病变特征,分析ApoE基因型/亚型与冠心病的发病及严重程度之间的关系。结果ε2、ε3和ε4在样本中的频率分别为13.6%、69.3%和17.1%,ApoE基因多态性与冠心病的发生有相关性(ε2:r=0.160,P<0.05;ε4:r=0.154,P<0.05);ε2、ε3和ε4组Gensini评分差异有统计学意义(P=0.026,0.013,0.001),犯罪血管狭窄程度和病变血管支数与ApoE基因多态性差异无统计学意义(ε2=0.15,ε3=0.822,ε4=0.276;ε2=0.324,ε3=0.849,ε4=0.233);犯罪血管病变类型中ε4携带者以局限性为主,差异有统计学意义(P=0.027)。结论 ApoE基因多态性与冠心病的发生具有良好的相关性,在安徽地区冠心病人群中,冠状动脉病变严重程度及犯罪血管病变类型与其相关。     

载脂蛋白E基因多态性与颈动脉粥样硬化性狭窄的相关性研究

目的研究载脂蛋白E（ApoE）多态性在颈动脉粥样硬化性狭窄发病中的作用。方法应用聚合酶链反应一限制性片段长度多态性（PCR．RELP）技术，对25例颈动脉粥样硬化性狭窄患者（狭窄组）和25例同期健康体检者（对照组）的ApoE基因多态性进行分析。结果与对照组比较，狭窄组ε3频率降低（P〈0．05），ε4频率升高（P〈0．01），ε3／ε4和ε4／ε4基因型频率增高（P〈0．05、0．01）；对以上两组再按ApoE基因型分别分为ApoE2（ε2／2＋ε2／3）、ApoE3（ε3／3）、ApoFA（ε3／4＋ε4／4）；其中ApoE4狭窄程度增加。结论ApoE基因多态性与颈动脉粥样硬化性狭窄形成有相关性，ε4基因是颈动脉粥样硬化性狭窄形成的危险因子。     

中国人Ⅱa型高脂蛋白血症载脂蛋白E基因多态性的研究

为探讨中国人Ⅱa型高脂蛋白血症患者载脂蛋白E基因多态性及其与血脂和载脂蛋白水平的关系,采用聚合酶链反应－限制片长多态性法,分别对87例Ⅱa型高脂蛋白血症患者及230例血脂正常者的载脂蛋白E基因型、空腹血脂及载脂蛋白AⅠ、AⅡ、B100、CⅡ、CⅢ和E进行了全面分析。结果发现,Ⅱa型高脂蛋白血症患者的血清甘油三酯、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、非高密度脂蛋白胆固醇,以及载脂蛋白B100、CⅡ、CⅢ和E水平较对照组显著升高（P＜0．01）;;血清载脂蛋白E／CⅢ比值显著降低（P＜0．05）;Ⅱa型高脂蛋白血症组与对照组载脂蛋白E基因型及等位基因频率分布均以E3／3和ε3最高,Ⅱa型高脂蛋白血症组的ε4等位基因有增高的趋势,而ε2等位基因有降低的趋势（P＞0．05）。携带ε2等位基因组血清载脂蛋白E水平较E3／3基因型组显著升高,而携带ε4等位基因组血清载脂蛋白E水平较E3／3基因型及携带ε2乘位降低基因组显著（P＜0．001）。此结果提示,ε2及ε4等位基因与Ⅱa型高脂蛋白血症患者的血清载脂蛋白E水平有关。     

载脂蛋白E基因多态性与冠心病的相关性

目的 探讨载脂蛋白E基因遗传变异与冠心病病变程度的相关性及对预后的影响.方法 抽取251例冠心病患者和200例对照者,应用常规方法测定血脂和脂蛋白水平,采用聚合酶链反应限制片长多态性技术对两组载脂蛋白E基因型频率分布进行分析.结果 共检测出5种基因型,分别为载脂蛋白ε3/3、ε3/2、ε4/3、ε4/2及ε4/4,ε2/2未见.不同载脂蛋白E等住基因型对血脂、脂蛋白水平的作用具有较大差异;在正常血脂水平亚组,冠心病组载脂蛋白ε4/3基因型和ε4等位基因频率明显高于对照组,ε3/3基因型和ε3等位基因频率则明显低于对照组;而在高脂血症亚组,两组之间载脂蛋白E各基因型和等位基因型频率均未见统计学差异.冠心病组心功能Ⅲ～Ⅳ级患者的载脂蛋白ε4/3基因型和ε4等位基因频率高于心功能Ⅰ～Ⅱ级患者,并具有较低的ε3/3基因型频率.结论 载脂蛋白E基因多态性与冠心病的发生发展密切相关,且对心脏功能有一定的作用;载脂蛋白ε4/3基因型和ε4等位基因是冠心病发病重要的遗传易患标记之一,并可能与冠心病心功能低下或心脏事件的发生有关;ε3/3基因型为冠心病的保护因子.     

载脂蛋白E基因多态性与脑梗死的关系

目的探讨载脂蛋白E（apoE）基因多态性与脑梗死的关系。方法应用聚合酶链式反应-限制性片断长度多态性（PCR—RFLP）技术检测78例脑梗死患者和90名健康对照者apoE基因多态性分布特征。结果发现5种apoE基因型，脑梗死组E3／4基因型频率（23．1％）及ε4频率（14.7%）显著高于对照组（7．8％，5．0％），P〈0．05。而E3／3基因型频率（56．4％）及ε3频率（75.6%）显著低于对照组（78．9％，88．3％），P〈0．05。不同apoE基因型间胆固醇和低密度脂蛋白胆固醇水平差异有统计学意义（P〈0．05）。结论apoE基因多态性与脑梗死有关，并影响血脂水平。     

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.