不同性别血管紧张素转化酶基因型与原发性高血压相关性研究

目的 :探讨男、女不同性别的血管紧张素转化酶 (ACE)基因型与原发性高血压 (EH)的相关关系。方法 :应用聚合酶链反应 (PCR)技术检测 12 8例男性 (其中EH患者 73例 ) ,79例女性(其中EH患者 4 3例 )ACE基因插入 /缺失 (I/D)多态性。结果 :男性组EH患者DD基因型频率(0 .35 6 )和D等位基因频率 (0 .5 75 )显著高于对照者 (0 .182和 0 .4 2 7,分别P <0 .0 5 ,<0 .0 2 )。且ACEDD基因型与男性EH患者的收缩压和脉压增高有关 (P <0 .0 5 )。而女性ACE基因型与EH及血压无显著相关性存在 (均P >0 .0 5 )。结论 :ACE基因I/D多态性对男性EH的发生及血压的增高有显著影响 ,而对女性无此作用。     

血管紧张素转化酶基因多态性与高血压病人胰岛素抵抗相关性的研究

目的　探讨血管紧张素转化酶 (ACE)基因多态性 ,血管紧张素原 (AGT)基因突变与高血压及胰岛素抵抗的关系。方法　用聚合酶链反应 (PCR)检测 76例原发性高血压及 2 8例正常血压者的ACE基因插入 /缺失 (I/D)多态性及AGT基因位点突变 ,同时进行口服葡萄糖耐量及胰岛素释放试验 ,以空腹血糖及空腹胰岛素乘积倒数的对数值(ISI) ,胰岛素曲线下面积IS AUC作为胰岛素敏感性指标。结果　 (1)ACE基因多态性在高血压和正常血压组无显著性差异 ,而AGTT2 35等位基因频率在高血压组高于正常对照组 (0 4 3vs0 32 ,P <0 0 5 )。 (2 )无论是高血压还是正常血压者ACE基因DD型者的ISI均明显低于ID和II型 ,IS AUC显著高于ID和II型〔ISI:- 4 31± 0 2 0vs -3 6 3± 0 2 2和 - 3 2 7± 0 2 4 ,P <0 0 1;IS(AUC) :2 11 1± 5 6 8vs 135 7± 5 4 7、12 6 8± 5 1 7mu·L-1,P <0 0 1〕 ,而AGT基因T2 35 ,T174基因突变与胰岛素抵抗无关 (P >0 0 5 )。结论　ACE基因DD型而非AGT基因可能参与高血压病人及正常血压者胰岛素抵抗的基因调节 ,这可能是ACE基因DD型易发生心血管危险的机制之一     

性别因素对原发性高血压候选基因研究的影响作用

目的探讨研究样本中的性别因素对原发性高血压（EH）候选基因研究结果的影响。方法应用聚合酶链反应这一分子生物学研究方法,分析EH组患者及正常血压对照组（两组中男性女性人数相等）人群血管紧张素转换酶（ACE）基因插入／缺失（I／D）多态性,进而探讨性别比例对该类研究结论的可能影响。结果男性EH组DD基因型频率显著高于男性对照组（x^2=6．98,P=0．004）,D等位基因频率在男性EH组亦较男性对照组显著增高（x^2=6．87,P=0．009）,而ID和II基因型频率在男性EH组和男性对照组间差异无统计学意义（P〉0．05）。女性EH组与女性对照组比较,各基因型和等位基因频率分布差异均无统计学意义（P〉0．05）;男性EH组中的DD基因型分布比例与女性EH组中的DD基因型分布比例相比有显著统计学意义（x^2=4．06,P=0．044）。此外,EH组中男性DD型者的收缩压及脉压水平均显著高于ID型和II型者（P均〈0．05）,但舒张压在3种基因型间差异无统计学意义（P〉0．05）。同时,EH组II、ID基因型的男性的收缩压、舒张压、脉压差异均无统计学意义（P〉0．05）。女性患者中,各基因型间收缩压、舒张压及脉压的水平差异均无统计学意义（P〉0．05）。结论男性中的DD基因型成员与EH（尤其在收缩压、脉压）的关联可能比男性中的II、ID基因型以及所有的女性更为密切。性别可能作为一个混杂因素,对包括ACE基因I／D多态性在内的诸多EH候选基因与EH的相关性研究的结论产生影响。     

ACE I/D基因多态性与武汉地区原发性高血压代谢综合征关系的探讨

目的:探讨武汉地区原发性高血压(EH)代谢综合征(MS)与血管紧张素转换酶(ACE)基因插入/缺失(I/D)多态性的关系.方法:701例武汉地区汉族人群分为3组,其中血压正常对照组303人,EH患者398例,其中EH患者中符合代谢综合征者189例,不伴随代谢综合组209例.应用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)法测定3组人群中ACE I/D基因多态性.结果:①ACE各基因型频率在正常对照组与EH(包括MS与非MS组)组间差异无统计学意义;②ACE Ⅱ基因型EH合并MS患者的胆固醇水平明显高于DD基因型.结论:ACE基因多态性与武汉地区原发性高血压无关,但D等位基因频率明显低于某些西方国家人群;对于EH合并代谢综合征的患者,其胆固醇水平和ACE Ⅱ基因型明显相关.     

血管紧张素转化酶多态性与北京降压0号长期降压效果的关系

目的:探讨不同血管紧张素转化酶(ACE)基因插入/缺失(I/D)多态性的基因型的原发性高血压(EH)患者对北京降压0号治疗的长期反应性。方法:根据ACE I/D基因多态性,将EH患者分为II组(16例),ID组(11例)及DD组(15例),共42例。使用北京降压0号1片/d,共1年,观察降压疗效。结果:II组显效10例,有效5例,总有效率93.8%;ID组显效5例,有效4例,总有效率81.8%;DD组显效11例,有效2例,总有效率86.7%,控制率分别为75.0%、72.7%、60.0%,各组疗效差异无统计学意义(P>0.05),3组平均血压下降值比较,舒张压下降值II组高于ID组(P<0.05),其余均差异无统计学意义。结论:ACE I/D基因多态性对北京降压0号治疗EH的长期效果无影响。     

原发性高血压血管紧张素转换酶基因多态性与性别的关系

目的　研究血管紧张素转换酶 (ACE)基因插入 缺失 (I D)多态性与不同性别原发性高血压 (EH)的关系。方法　应用聚合酶链反应技术分析 138例原发性高血压患者及 6 0名正常对照组的ACE基因型。结果　原发性高血压组缺失纯合子 (DD)基因型及D等位基因频率显著高于对照组 (P<0 .0 5 )。且男女两性相比 ,原发性高血压组男性DD基因型频率显著高于女性 (P <0 .0 5 ) ,收缩压水平亦显著高于女性 (P <0 .0 5 )。结论　原发性高血压与ACE基因I D多态性之间存在一种特殊的伴性关系。     

α-内收蛋白、ACE基因多态性及环境因素与高血压病的关系

目的　研究α -内收蛋白基因、血管紧张素转换酶 (ACE)基因多态性及环境因素与原发性高血压病 (EH)的关系。方法　聚合酶链反应 (PCR) -琼脂糖凝胶电泳检测基因型。结果　 (1)α -内收蛋白基因、ACE基因各基因型及TrpTrp +DD联合基因型在正常血压组和EH组的分布差异无显著性。 (2 )在与EH有关的危险因素存在的条件下 ,肥胖组、高甘油三酯血症组、吸烟组α -内收蛋白基因TrpTrp型EH患者患病率高于其他基因型 ,有统计学差异 (P <0 0 5)。结论　EH是环境与遗传因素共同作用的结果 ,环境因素可能更重要     

血管紧张素转换酶基因多态性与原发性高血压病心肌纤维化的关系

目的　探讨血管紧张素转换酶 ( ACE)基因多态性与原发性高血压病 ( EH)心肌纤维化的关系。方法　以多聚酶链反应 ( PCR)方法检测 168例 EH患者的 ACE基因型 ;放射免疫法检测血清 型前胶原 ( PC )、透明质酸( HA)和层粘蛋白 ( LN)。结果　高血压病心肌纤维化组 DD基因型和 D等位基因频率分别为 0 .42 9和 0 .60 ,显著高于非纤维化组 0 .18和 0 .42 1( P<0 .0 5 )。DD型与 II型比较心肌质量指数、PC 显著升高 ,差异有显著性 ( P<0 .0 5 )。结论　 ACE基因 DD型可能是高血压病心肌纤维化的重要危险因素     

ACE基因I/D和AT1R基因A1166C多态性与氢氯噻嗪降压疗效的相关性研究

目的 探讨血管紧张素转换酶(ACE)基因I/D与血管紧张素Ⅱ-1型受体(AT1R)基因A1166C多态性与氢氯噻嗪(HCTZ)降压疗效的关系.方法 原发性高血压患者服用HCTZ 6周后,按不同ACE基因型和AT1R基因型分组,比较不同基因型组合患者的血压下降值.结果 ACE基因DD、ID、II基因型患者收缩压均下降,DD基因型患者收缩压下降值显著大于ID、II型患者(P＜0.05);AT1R基因AC(CC)和AA基因型患者收缩压下降值组间比较无显著差异(P＞0.05);DD AC(CC)基因型组合患者收缩压亦下降,与其他基因型组合患者比较无显著差异(P＞0.05).多因素分析结果表明,治疗前醛固酮浓度和DD基因型是影响患者收缩压下降的主要因素.结论 ACE基因的DD基因型与HCTZ的降压疗效相关;AT1R基因AC(CC)、DD AC(CC)型组合患者对HCTZ的降压反应可能优于其他基因型组合患者.     

血管紧张素转换酶基因多态性与非杓型高血压的关系

目的研究血管紧张素转换酶 ( ACE)基因插入 /缺失 ( I/ D)多态性与非杓型高血压 ( EH)的关系。方法　 1应用聚合酶链反应 ( PCR)方法扩增 5 0例正常人、99例高血压患者的 ACE基因上 2 87bp片段 ,根据插入 ( I)或 /缺失( D)来判断其多态性。 2高血压患者行 2 4h动态血压监测 ( ABPM) ,根据 ABPM结果分为杓型 EH组和非杓型 EH组。结果　 1非杓型组与健康对照组相比 ,其 D等位基因及 DD基因型显著升高。 2非杓型组与杓型组相比 ,其 D等位基因及 DD基因型显著升高。3杓型组与健康对照组相比 ,ACE基因型和等位基因频率无显著性差异。结论　ACE基因多态性与非杓型高血压有关联性 ,DD基因型提示可能与高血压昼夜节律改变有关     

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.     

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.