人白介素-10基因转染对大鼠脑缺血再灌注损伤半影区炎性因子基因和蛋白表达的影响

目的 观察人白介素(IL)-10基因转染对大鼠局灶脑缺血再灌注损伤半影区肿瘤坏死因子-α(TNF-α)和白介素-1β(IL-1β)基因和蛋白表达的影响. 方法 建立大脑中动脉栓塞(MCAO)模型,采用立体定向脑室内注射的方式进行转染,逆转录-聚合酶链式反应(RT-PCR)和酶联免疫吸附实验(ELISA)检测其转染效果,氯化三苯四氮唑(TTC)染色测定脑梗死体积,荧光实时定量PCR检测半影区TNF-α和IL-1β基因表达情况,ELISA法检测半影区TNF-α和IL-1β蛋白的含量.结果 正常对照组、缺血对照组、空质粒组和IL-10基因转染组半影区TNF-α蛋白含量分别为(0.66±0.04)、(1.16±0.26)、(1.15±0.26)ng/g和(0.84±0.05)ng/g,IL-1β蛋白含量分别为(0.37±0.05)、(1.25±0.39)、(1.21±0.58)ng/g和(0.62±0.05)ng/g.与正常对照组比较,其余各组TNF-α和IL-1β蛋白含量明显升高(P＜0.01),而IL-10基因转染组TNF-α和IL一1β含量则较缺血对照组和空质粒组显著降低(P＜0.01);正常对照组,缺血对照组、空质粒组和IL-10基因转染组半影区TNF-αmRNA的表达量分别为1.00±0.53、9.42±1.83、9.69±1.96和3.53±1.09;IL-1βmRNA的表达量分别为1.00±0.51、27.81±4.84、23.96±4.90和13.55±4.45.与正常对照组比较,其余各组TNF-α和IL-1βmRNA表达量明显升高(P＜0.01),而IL-10基因转染组TNF-α和IL-1βmRNA表达量则较缺血对照组和空质粒组显著降低(P＜0.01). 结论 人IL-10基因转染后能抑制大鼠局灶脑缺血再灌注损伤半影区TNF-α和IL-1β基因和蛋白的表达,可能是其发挥缺血脑保护作用的机制之一.     

锌指蛋白A20干预人单核细胞炎症因子TNF-α、IL-12以及IL-10表达的实验研究

目的通过阳离子脂质体将A20基因转染入单核细胞,观察A20过表达对促炎因子肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素(interleukin,IL)-12及抗炎因子IL-10表达的调节以及对促炎因子/抗炎因子比率即TNF-α/IL-10和IL-12/IL-10比率的影响,探讨锌脂蛋白A20对单核细胞炎症反应的保护作用及可能的调节机制。方法用Ficoll细胞分离液分离人外周血单核细胞,随机分为A组(空白对照组);B组[脂多糖(lipopolysaccharide,LPS)组];C组(A20转染组);D组(LPS加A20转染组)。荧光显微镜检测GFP报告基因,反转录聚合酶链反应检测内源性A20、外源性A20的mRNA表达;免疫组化检测A20蛋白的表达;双抗体夹心酶联免疫吸附测定(ELISA)方法检测上清液TNF-α、IL-12及IL-10表达水平。结果单核细胞受到LPS(1 mg/L)刺激后,其内源性A20的mRNA和蛋白表达以及TNF-α、IL-12和IL-10表达较对照组均明显升高,差异有统计学意义(P<0.05);TNF-α/IL-10和IL-12/IL-10的比率均明显高于对照组,差异有统计学意义(P<0.05)。转染A20基因的单核细胞,在无LPS刺激的条件下,其内源性A20的mRNA和蛋白表达以及TNF-α、IL-12和IL-10的表达与对照组比较,差异均无统计意义(P>0.05);TNF-α/IL-10和IL-12/IL-10的比率与对照组比较,差异也无统计意义(P>0.05)。而转染A20基因的单核细胞在受到LPS(1 mg/L)刺激后,其促炎因子TNF-α、IL-12的表达均显著低于LPS组,而抗炎因子IL-10的表达明显上调,高于对照组和LPS组;而TNF-α/IL-10和IL-12/IL-10的比率明显下降,低于LPS组,差异有统计学意义(P<0.05)。结论 A20的表达具有炎症活化依赖性;A20过表达可抑制TNF-α、IL-12的表达,而上调抗炎因子IL-10表达,并通过改善促炎因子/抗炎因子的平衡关系,从而达到抑制炎症反应的作用。     

Ⅰ型多聚ADP核糖合成酶在心肌梗死后大鼠心肌组织中的活性变化及其对相关炎性细胞因子表达的影响

目的:探讨Ⅰ型多聚ADP核糖合成酶(PARP1)在心肌梗死后大鼠心肌组织中的表达及活性变化,以及对相关炎性细胞因子[白细胞介素(IL)-6、IL-10、肿瘤坏死因子-α(TNF-α)]和转录因子(NF-κB、AP-1)表达的影响.方法:结扎冠状动脉左前降支(LAD)近端建立急性心肌梗死(AMI)模型,随机分为AMI组、梗死低剂量PARP抑制剂3-氨基苯甲酰胺(3AB)干预(3AB30)组、梗死高剂量干预(3AB100)组和假手术组.3AB30组和3AB100组分别在腹腔注射3-AB 30 mg/kg和100 mg/kg,AMI组和假手术组给予同等体积0.9%氯化钠溶液腹腔注射.测定各组大鼠术后第1、3、7天心脏功能,非梗死区PARP1的蛋白表达及活性与IL-6、IL-10、TNF-ɑ的表达和转录因子NF-κB和AP-1的活性.结果:心肌梗死后非缺血区PARP1表达在第1天即明显增加,至第7天仍高于假手术组,3AB在非梗死区不仅可以显著抑制TNF-α、IL-6以及PARP1的蛋白表达量和PARP活性,也能够降低NF-κB和AP-1在非梗死区的DNA结合能力.结论:PARP1抑制剂能够明显抑制PARP活性和PARP1表达,在AMI早期通过抑制NF-κB和AP-1活性及炎性因子TNF-α和IL-6表达,能改善心脏功能,减轻心肌损害.     

重组人生长激素对心肌梗死大鼠心功能及心肌炎性因子表达的影响

目的 观察重组人生长激素(rhGH)对大鼠急性心肌梗死后心功能及心肌炎性因子表达的影响. 方法 结扎大鼠左冠状动脉前降支建立心肌梗死模型,将术后24 h存活的大鼠随机分为对照组和rhGH组,另设假手术组.rhGH组给予rhGH 2 mg.kg-1.d-1皮下注射,对照组和假手术组给予等体积的生理盐水皮下注射,4周后观察rhGH对大鼠心功能及心肌细胞肿瘤坏死因子-α(TNF-α)、白介素-1p(IL-1p)、白介素-6(IL-6)、白介素-10(IL-10)mRNA表达的影响. 结果 与假手术组比较,对照组心肌组织中促炎性细胞因子TNF-α、IL-1β、IL-β和IL-10 mRNA表达(假手术组分别为0.10±0.02、0.08±0.01、0.18±0.01和0.14±0.05;梗死区分别为0.77±0.15、0.93±0.17、1.10±0.14和0.73±0.11;非梗死区分别为0.88±0.14、0.95±0.17、1.18±0.11和0.83±0.16)明显升高.与对照组比较,rhGH组心肌组织中TNF-α、IL-1β、IL-6 mRNA表达(梗死区分别为0.35±0.10、0.36±0.10、0.43±0.11;非梗死区分别为0.51±0.10、0.42±0.11、0.51±0.12)明显下降,IL-10 mRNA表达(梗死区为1.18±0.18;非梗死区为1.21±0.22)升高,P＜0.05.心脏超声显示rhGH组左室功能明显改善. 结论 早期rhGH治疗改善了心肌梗死大鼠心肌炎性因子表达和心脏功能.rhGH有效改善心功能与其降低心肌细胞促炎细胞因子和升高抗炎因子的作用有关.     

益肾调督法电针对β-淀粉样蛋白1～42诱导的阿尔茨海默病大鼠血清和脑内炎性因子的调节作用

目的探讨益肾调督法电针对阿尔茨海默病(AD)大鼠血清和脑内促炎性因子肿瘤坏死因子(TNF)-α、干扰素(IFN)-γ、白细胞介素(IL)-1β和抗炎性因子IL-4、IL-10、转化生长因子(TGF)-β1的影响及炎性调节作用。方法 40只雄性Wistar大鼠随机分成对照组、假手术组、模型组和治疗组各10只。采用双侧海马注射β-淀粉样蛋白(Aβ)1～42建立AD模型。对照组、假手术组和模型组不予任何治疗;治疗组选取百会、肾俞,电针20 min,1次/d,6 d为1个疗程,2个疗程间休息1 d。采用酶联免疫吸附试验(ELISA)和免疫组化法分别检测各组血清和脑组织相关炎性因子的表达水平。结果与对照组和假手术组比较,模型组血清和海马区促炎因子TNF-α、IFN-γ、IL-1β表达升高(P0.05,P0.01),抗炎因子IL-4、IL-10、TGF-β1表达下降(P0.05,P0.01);与模型组比较,治疗组各促炎因子表达下降(P0.05,P0.01),各抗炎因子表达明显升高(P0.05,P0.01)。结论益肾调督法电针刺激不仅可下调AD大鼠血清及海马区促炎因子TNF-α、IFN-γ、IL-1β表达,还可上调AD大鼠血清及海马区抑炎因子IL-4、IL-10、TGF-β1表达,调节抗炎、促炎因子的失衡状态,改善AD持续性炎症反应。     

沉默Nrf2基因的骨髓间充质干细胞移植对大鼠心肌梗死后心室重构和纤维化的影响

目的探讨以si RNA为载体沉默骨髓间充质干细胞(MSC)中核因子E2相关因子2(Nrf2)基因后细胞移植对大鼠心肌梗死后心肌纤维化和心室重构的影响及可能机制。方法建立心肌梗死大鼠模型,随机分为沉默Nrf2基因的MSC移植组(MSCNrf2-/-组)、过表达Nrf2基因的MSC移植组(MSCNrf2+/+组)和生理盐水转染MSC移植组(对照组),每组12只。细胞移植后28天,采用Masson染色检测心肌梗死边缘区胶原沉积含量和纤维化程度,Western blot检测梗死心肌Nrf2和血红素氧合酶1(HO-1)蛋白表达水平,超声心动图评价梗死后心功能。结果 si RNA-Nrf2转染MSC后,Nrf2蛋白表达明显减少。移植后第28天,MSCNrf2-/-组心肌组织纤维化程度较对照组加重,MSCNrf2+/+组心肌组织纤维化程度较对照组减轻(P0.05);MSCNrf2-/-组梗死心肌中Nrf2、HO-1蛋白表达较对照组下降(P0.05),而MSCNrf2+/+组梗死心肌中Nrf2、HO-1蛋白表达较对照组增加(P0.05);超声心动图结果显示,与对照组比较,MSCNrf2-/-组左心室舒张期末内经(LVEDD)和左心室收缩期末内经(LVESD)增大,左心室射血分数(LVEF)下降(P0.05),MSCNrf2+/+组LVEDD和LVESD均减小,LVEF无下降(P0.05)。结论 si RNA-Nrf2可有效干扰MSC中Nrf2蛋白的表达,降低外源性MSC对梗死心脏的修复能力,增加心肌梗死区胶原沉积,进而促进心室重构,降低心功能。由此推测Nrf2信号通路在干细胞移植治疗心肌梗死后心肌重构和纤维化中起了关键作用。     

异丙肾上腺素对大鼠心肌缺血再灌注损伤中高迁移率族蛋白1表达的影响及机制

目的探讨异丙肾上腺素(ISO)对大鼠心肌缺血再灌注(I/R)损伤中高迁移率族蛋白1(HMGB-1)表达的影响及作用机制。方法健康雄性大鼠48只,随机分为假手术组(SO组)、I/R组、异丙肾上腺素预处理组(ISO-I/R组)、锌原卟啉Ⅸ(ZnPPⅨ)+ISO-I/R组(ZnPPⅨ组),每组12只。建立大鼠心肌I/R模型;检测各组大鼠的心肌梗死范围、肌酸激酶、乳酸脱氢酶(LDH)、TNF-α、白细胞介素(IL)6、超氧化物歧化酶(SOD)、丙二醛、血红素加氧酶1(HO-1)和HMGB-1表达的变化。结果与I/R组比较,ISO-I/R组心肌梗死面积明显缩小(P<0.01),LDH、肌酸激酶、TNF-α、IL-6、丙二醛、HMGB-1明显降低,SOD、HO-1明显升高(P<0.05);与ISO-I/R组比较,ZnPPⅨ组心肌梗死面明显扩大,LDH、肌酸激酶、丙二醛、TNF-α、IL-6、HMGB-1明显升高,SOD和HO-1明显降低(P<0.05)。结论 ISO能够明显诱导HO-1的表达并进一步抑制HMGB-1的释放,从而有效发挥对大鼠I/R损伤的心肌保护作用。     

补体应答基因32基因对心肌梗死心肌细胞凋亡及免疫机制的影响

目的探讨补体应答基因(RGC)32基因对心肌梗死心肌细胞凋亡及免疫机制的影响。方法建立心肌梗死模型,Western印迹检测心肌组织中RGC32的蛋白表达;从大鼠乳鼠获得原代心肌细胞,分为正常对照组、阴性对照组(转染不具有干扰作用的siRNA并进行缺血缺氧处理)、缺血缺氧组、缺血缺氧+RGC32-siRNA组(转染干扰RGC32表达的siRNA并进行缺血缺氧处理),细胞培养48 h后,通过Western印迹检测各组细胞中RGC32、含半胱氨酸的天冬氨酸蛋白水解酶(Caspase)3、Bcl-2相关X蛋白(Bax)、Notch1、Hes1的蛋白表达;TUNEL法检测各组细胞凋亡率;RT-PCR检测各组细胞炎症因子白细胞介素(IL)-6和肿瘤坏死因子(TNF)-α表达。结果心肌梗死心肌组织中RGC32的蛋白表达显著高于正常心肌组织(P0.05);阴性对照组和缺血缺氧组RGC32、Caspase3、Bax、Notch1、Hes1、IL-6和TNF-α表达及细胞凋亡率差异无统计学意义(P0.05),缺血缺氧组RGC32、Caspase3、Bax、IL-6和TNF-α表达及细胞凋亡率均显著高于正常对照组和缺血缺氧+RGC32-siRNA组,Notch1和Hes1表达均显著低于正常对照组和缺血缺氧+RGC32-siRNA组(P0.05)。结论 RGC32基因在心肌梗死心肌组织表达升高,抑制心肌细胞RGC32基因表达可降低细胞凋亡,提高免疫及激活Notch1通路。     

杜仲木脂素对糖尿病脑病大鼠的治疗作用及机制研究

目的 探讨杜仲木脂素对糖尿病脑病(DE)大鼠的治疗作用及核因子E2相关因子2(Nrf2)/血红素氧化酶1(HO-1)信号通路的影响。方法 构建DE大鼠模型,将建模成功的48只大鼠随机分为模型组、杜仲木脂素低剂量组(200 mg/kg)、杜仲木脂素高剂量组(400 mg/kg)、二甲双胍组(200 mg/kg),每组12只。另选取12只健康大鼠作为对照组。各组每天给予相应药物干预1次,连续6周。检测大鼠认知和记忆能力、血清白细胞介素6(IL-6)、TNF-α、丙二醛、超氧化物歧化酶(SOD)、脑组织海马区中Nrf2、HO-1信使RNA(mRNA)和蛋白表达水平;并观察脑组织海马区病理学变化。结果 与对照组比较,模型组大鼠逃避潜伏期、血清IL-6、TNF-α、丙二醛水平显著升高,经过原平台位置次数、原平台象限停留时间、血清SOD水平、脑组织海马区中Nrf2、HO-1 mRNA和蛋白表达水平显著降低(P<0.05);与模型组比较,杜仲木脂素低、高剂量组大鼠逃避潜伏期、血清IL-6、TNF-α、丙二醛水平显著降低,经过原平台位置次数、原平台象限停留时间、血清SOD水平、脑组织海马区中Nr...     

IKKα对缺血再灌注损伤小鼠的保护作用及其对M1与M2型巨噬细胞的影响

目的探讨IκB激酶复合物(IKKα)对缺血再灌注(IR)损伤小鼠的保护作用及其对M1与M2型巨噬细胞的影响。方法 C57BL/6-IKKα条件性基因敲除小鼠(mIKKα~(-/-))及同窝出生的年龄性别匹配的对照组小鼠各9只,各自分为MIRI模型组(6只)和假手术组(3只),以上各组小鼠分别于IR3 d及7 d后进行心脏超声及血流动力学检测;IR模型组于IR3 d及7 d后分别处死(3只),HE及Masson染色进行心肌病理学观察,免疫组织化学法检测心肌组织中炎性因子白细胞介素-12A(IL-12A)、肿瘤坏死因子-α(TNF-α)、白细胞介素-10(IL-10)、CD68相对表达量,Western Blot法检测心肌组织中M1/M2型巨噬细胞表型标记物诱导型一氧化氮合酶(iNOS)、表型标记物(Arg1)蛋白相对表达量,实时荧光定量PCR法检测心肌组织中M1型巨噬细胞表型标记物(iNOS、TNF-α、IL-1β)mRNA的表达量以及促M2巨噬细胞因子[肿瘤坏死因子-β(TGF-β)、白细胞介素-10(IL-10)]、M2巨噬细胞Arg1mRNA的表达量。结果与IKKα~(flox/flox)模型组比较,mIKKα~(-/-)模型组IR 3 d及7 d的左心室舒张末期内径(LVIDd)、心肌梗死面积及胶原附着面积、炎性因子IL-12A、IL-10、CD68阳性区域评分、M1型巨噬细胞表型标记物iNOS蛋白量及iNOS、TNF-α和IL-1βRNA的表达量均增加(P0.05);左室射血分数(EF)、左室室壁心肌纤维缩短率(FS)、M2型巨噬细胞表型标记物Arg1蛋白量和Arg1mRNA的表达量均降低(P0.05);促M2巨噬细胞极化因子(TGF-β、IL-10)mRNA表达量比较差异无统计学意义(P0.05)。结论 IKKα对缺血再灌注损伤小鼠的炎症反应具有保护作用,该作用可能与IKKα调节心肌巨噬细胞聚集并向M1型巨噬细胞活化有关。     

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.     

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.