我国长寿地区百岁老人慢性肾脏病的流行病学调查

目的 探讨我国长寿地区百岁老人慢性肾脏病(CKD)的患病情况及相关危险因素.方法 选取7个中国长寿之乡的所有百岁老人,以及在该地区按百岁老人编码尾数随机选取的40～、60～、80～和90～岁人群为研究对象,进行CKD及相关危险因素的问卷调查、体格检查和血尿检测,采用非条件Logistic回归分析CKD的影响因素.结果 在资料完整的363名百岁老人中,CKD患病率为50.41%(95%CI 45.27%～55.56%),女性患病率高于男性;各年龄组间比较,女性CKD患病率都随年龄增加而升高,而男性的CKD患病率随年龄增加先升高后下降.多因素Logistics回归提示高尿酸血症、高TG、女性、贫血、增龄和高血压为CKD的危险因素.结论 我国长寿地区百岁老人CKD患病率为50.41%,CKD的危险因素为高尿酸血症、高TG、女性、贫血、增年和高血压.     

泰安市区成年健康查体人群慢性肾脏病流行病学调查分析

目的探讨泰安市区成年健康查体人群慢性肾脏病(CKD)流行病学特征,调查CKD的患病情况及相关危险因素,明确CKD的高危人群。方法采用多阶段分层整群抽样的方法,抽取16 000例18周岁以上城镇常住居民进行问卷调查、体格检查及血、尿等实验室检查,采用二分类非条件Logistic回归分析CKD相关的危险因素。结果 14 399例研究对象进入统计分析,CKD患者共1366例(9.49%),男性患病率为9.21%,女性为9.85%,男女患病率比较,P=0.126。CKD患病率随年龄增加而逐渐增加(P=0.000),60岁后患病比例明显加大。CKD知晓率为1.4%。CKD患者年龄、体质量指数、收缩压、舒张压、血肌酐、空腹血糖、甘油三酯、总胆固醇、低密度脂蛋白均高于非CKD者。Logistic回归分析显示,年龄每增加10岁、女性、高收缩压、既往肾病史、糖尿病、高甘油三酯血症、高胆固醇血症、高尿酸血症、吸烟为CKD发生的独立危险因素。结论泰安市区成年健康查体人群CKD患病率为9.49%,60岁后CKD患病比例明显加大。年龄每增加10岁、女性、高收缩压、既往肾病史、糖尿病、高甘油三酯血症、高胆固醇血症、高尿酸血症、吸烟为CKD发生的独立危险因素。     

白银市健康体检人群高尿酸血症流行特征分析

目的了解甘肃省白银市健康人群高尿酸血症流行特征,为预防高尿酸血症提供参考依据。方法分析5 362名白银市机关事业单位和退休人员2013年健康体检资料,并将调查对象分为高尿酸血症和正常血尿酸组,分析高尿酸血症与高血压、高血脂、高血糖发生的关系。结果 5 362名体检人群中检出高尿酸血症患者486例,患病率9.06%,其中,男性为12.97%,女性为4.82%,男性高于女性(χ2=107.773,P0.05);男性高尿酸血症患病率以49岁~和50岁~两个年龄组患病率最高(χ2=34.376,P0.05),女性高尿酸血症患病率随年龄增长呈递增趋势,高尿酸血症组合并高血压(χ2=96.676)、高血脂(χ2=91.955)、高血糖(χ2=112.714)的发生率明显高于正常血尿酸组(χ2=12.555,均P0.05)。结论高尿酸血症是严重危害人群健康的潜在性疾病,并与多种代谢性疾病密切相关,应高度重视和积极预防。     

太原市社区人群与定期体检人群空腹血糖、血脂及血尿酸水平的调查分析

目的比较社区人群与定期体检人群之间血糖、血脂和血尿酸水平以及糖尿病、高血脂和高尿酸血症患病率的差异,为糖尿病、高脂血症、高尿酸血症的一级预防提供依据。方法对9960名太原市社区常住居民及我院体检中心定期体检的健康体检者的空腹血糖、血脂、尿酸水平及异常率进行调查,并比较其差异。结果太原市社区人群空腹血糖、血脂、血尿酸水平与定期体检人群比较差异无统计学意义;两人群高密度脂蛋白胆固醇、血尿酸水平有性别差异(P<0.05);同性别两人群各指标水平差异无统计学意义。社区人群糖尿病和高血脂患病率高于定期体检人群(P<0.05),高尿酸血症患病率未发现有差异;社区人群和定期体检人群糖尿病、高血脂(除高甘油三酯血症外)、高尿酸血症患病率有性别差异(P<0.05);两人群中男性低密度脂蛋白胆固醇异常率和高尿酸血症患病率差别有统计学意义,两人群中女性三种疾病患病率均有统计学差异(P<0.05)。社区男性人群糖尿病患病率、低密度脂蛋白胆固醇异常率随年龄增加有增高趋势,高密度脂蛋白胆固醇异常率、高尿酸血症随年龄增加有降低趋势,女性人群三种疾病患病率随年龄增加均有增高趋势;定期体检男性人群高密度脂蛋白胆固醇、低密度脂蛋白胆固醇患病率及...     

2012—2016年南京市区体检人群血尿酸的职业、年龄、性别分布特点和相关因素分析

目的:分析南京市来自6个行业体检人群血尿酸的年龄、性别分布特点,和高尿酸血症(HUA)的患病情况及其影响因素。方法:纳入2012年至2016年南京市4家医院参加健康体检的107478例体检者,比较不同性别、不同年份的HUA发病率;按照血尿酸值分为正常组和HUA组,比较两组代谢指标、年龄,计算不同行业体检人群的血尿酸水平,并采用多因素logistic回归方法计算HUA发病危险OR值。结果:HUA总体患病率为14.9%,男性HUA的患病率明显高于女性(20.5%比2.5%,χ2=5850.1,P<0.01),女性HUA的患病率随着年龄的增加呈上升趋势(20~29、30~39、40~49、50~59、60~69和≥70岁组的HUA患病率分别为1.0%、0.7%、0.9%、2.7%、3.8%和9.6%;趋势P<0.01)。HUA组的高血压、高血脂、糖尿病患病率及体重指数均高于血尿酸正常组(P≤0.01)。卫生行业人群血尿酸水平[(298±91)μmol/L]和HUA患病率(10.4%)最低,公安行业的血尿酸水平[(342±82)μmol/L]和HUA患病率最高(16.5%)。血尿酸水平与血脂、血糖、血压等代谢指标相关(P≤0.01),多因素logistic回归分析显示,男性、高血压、高甘油三酯、高胆固醇、肥胖、职业类别和高尿酸血症的发生相关。结论:南京地区体检人群中男性HUA患病率明显高于女性,女性HUA的患病率随着年龄的增加而增加。卫生行业体检人群的血尿酸水平和HUA患病率最低,而公安职业类别人群最高。男性、高血压、高脂血症、肥胖、职业类别与HUA的发生相关。     

江苏省高邮市农村高尿酸血症流行病学调查

目的 明确江苏省高邮市农村高尿酸血症(HUA)的患病率,探讨影响该地区人群血尿酸水平因素.方法 对4504名居民进行横断面调查,收集空腹静脉血检测血尿酸、血脂、血糖、肾功能等指标,同时进行问卷调查和体格检查.采用t检验、方差分析、x2检验进行分析,危险因素分析采用二项Logistic回归分析.结果 当地居民HUA的患病率为11.9％,其中男性为15.7％,显著高于女性8.6％(P＜0.01),男性患HUA风险为女性的1.98倍.女性随年龄增长患HUA风险增大.腰臀比、高血压、血肌酐、甘油三酯为男性患HUA的风险因素;年龄、体质量指数、高血压、血肌酐、甘油三酯为女性患HUA的风险因素.结论 高尿酸血症在江苏苏北农村有较高患病率,年龄及性别差异影响HUA患病率,维持理想体质量、血压及血脂水平等在防治HUA中起重要作用.     

原发性老年高血压患者高尿酸血症患病率的调查研究

目的了解原发性老年高血压患者高尿酸血症的患病率情况。方法选取资料完整的原发性老年高血压患者2057例,男性780例,女性1277例,60~70岁871例;71~80岁674例和>80岁512例,并分别按年龄、性别对高尿酸血症的患病率进行统计分析,并比较各年龄段间男性与女性患病率差异。结果所有患者血尿酸为(385.42±106.34)μmol/L,高尿酸血症患病率为46.1%,其中男性高尿酸血症患病率为48.6%,女性高尿酸血症患病率为44.6%,男性高尿酸血症患病率虽高于女性,但差异无统计学意义(P=0.083);60~70岁、71~80岁和>80岁高尿酸血症患病率分别为46.5%,44.5%,47.7%,其中男性分别为52.0%,45.8%,46.7%,女性分别为43.1%,43.6%,48.2%。60~70岁患者中,男性高尿酸血症患病率明显高于女性(P<0.01)。结论原发性老年高血压患者高尿酸血症患病率高,而且男性与女性的患病率相当。     

芜湖市中老年健康体检人群代谢综合征和慢性肾脏疾病的关系

目的 观察芜湖市中老年健康体检人群代谢综合征（MS）及其组分与慢性肾脏疾病（CKD）患病率之间的关系。方法 共有24095名芜湖城区人口（男性14616名,女性9479名）入选本研究,平均年龄51.49±9.16岁。测量体重、身高和血压,同时检测血常规、尿常规、血脂和肾功能。结果 芜湖市中老年人群MS的患病率为14.1%,CKD的患病率为8.3%,MS的体检人群CKD的患病率高于非MS的体检人群（12.7%比7.6%,P<0.001）。在年龄和性别校正后MS与CKD之间OR＝1.55（95%CI为1.38～1.74,P<0.001）,其中＜60岁男性人群OR＝1.74 （95%CI为1.51～2.00,P<0.001）。肥胖、高甘油三酯血症、低高密度脂蛋白胆固醇（HDLC）血症、高血压、高血糖与CKD之间的OR值分别为1.18（95%CI为1.06～1.30）、1.11（95%CI为1.00～1.23）、1.27（95%CI为1.07～1.52）、1.31（95%CI为1.19～1.45）和1.15（95%CI为1.02～1.30）。与0个MS组分比较,有1、2、3、4个MS组分与CKD的OR值分别1.21（1.07～1.38）、1.40（1.23～1.61）、1.79（1.54～2.09）和2.25（1.77～2.88）。结论 芜湖市中老年健康体检人群中MS与CKD存在相关性（特别是＜60岁男性人群）。MS各组分均是CKD的独立危险因素,其中高血压和低HDLC显著相关。同时CKD患病率随着MS组分的增加而增加。     

高尿酸血症及其影响因素分析

目的了解人群血尿酸水平和高尿酸血症的患病率及其影响因素。方法对2007年3月～2009年10月在本院进行健康体检的2556名人群的血尿酸水平和高尿酸患病率的结果进行统计分析。结果高尿酸血症的患病率为16．6％;男性高尿酸血症的患病率为19．1％,女性为13．3％,男性高于女性（P〈0．01）,且血尿酸水平和高尿酸血症患病率有逐年增高趋势（P〈0．01）。结论高尿酸血症存在不同年份、性别、年龄间差别,与多种因素有关。     

老年退休人群尿酸水平与糖尿病相关性的横断面研究

目的了解某部老年退休人群糖尿病水平的分布特点及其尿酸水平与糖尿病发病的相关性。方法以2017年某部退休人群中老年体检者626例作为研究对象,收集入选者一般临床资料,采用多因素logistic回归模型分析血尿酸水平与糖尿病的关联。结果本研究男性237例(37.9%),高尿酸血症(HUA)患病率为26.4%,糖尿病患病率为19.3%。HUA患者超重比例、体质量、体质量指数、腰围、舒张压和TG水平明显高于非HUA者,HDL-C明显低于非HUA者(P<0.05)。糖尿病患者70～79岁和80～89岁、超重比例、体质量、体质量指数及腰围明显高于非糖尿病者,TC和HDL-C水平明显低于非糖尿病者。调整混杂因素后,logistic分析显示,血尿酸水平升高与糖尿病患病风险升高有关(95%CI:1.011～1.200,P=0.033),其中女性人群血尿酸水平升高与糖尿病患病风险升高有关(95%CI:1.100～1.106,P=0.009),男性与糖尿病患病风险无关(P>0.05);以血尿酸正常人群作为参照,HUA人群糖尿病患病风险明显升高35.1%(P=0.034);女性HUA人群糖尿病患病风险升高109.6%(P=0.002),男性与糖尿病患病风险无关(P>0.05)。结论某部女性老年人群尿酸水平升高与糖尿病患病风险升高有关,应加强老年体检人群的尿酸水平检测及防控。     

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.