门脉高压性胃病患者胃黏膜Ghrelin的表达

目的研究Ghrelin在门脉高压性胃病(PHG)胃黏膜上的表达。方法用免疫组化方法检测36例门脉高压患者和15例对照组(内镜检查胃黏膜大致正常)胃黏膜Ghrelin的表达。结果门脉高压组胃黏膜Ghrelin表达阳性细胞面积(18.89%±5.47%)与对照组(8.51%±5.31%)比较,差异有显著性(P<0.001);PHG组胃黏膜Ghrelin表达阳性细胞面积(20.82%±6.35%)与单纯门脉高压症(PHT)组(17.51%±4.40%)比较有增高趋势,但无显著性差异(P>0.05)。结论Ghrelin可能参与了门脉高压时高动力循环的形成和发展,分泌Ghrelin的内分泌细胞对PHG时胃黏膜损害具有相当的抵抗力。     

其它肝脏疾病：肝硬化

血管内皮生长因子在门脉高压患者胃黏膜的表达——白云等（河北 邢台市人民医院）；《胃肠病学和肝病学杂志》，2007，16（1）：63-65[目的：探讨血管内皮生长因子（VEGF）在肝硬化门脉高压（PHT）患者胃黏膜的表达及其在门脉高压性胃病（PHG）发病中的作用。方法：分别采集PHG、PHT和正常对照组胃黏膜组织。应用免疫组化法检测胃黏膜VEGF蛋白的表达。     

血红素加氧酶-1在门静脉高压性胃病患者胃黏膜的表达

目的 探讨血红素加氧酶-1(HO-1)在肝硬化门静脉高压性胃病(PHG)患者胃黏膜的表达情况及其意义.方法 分别采集22例正常受试者(对照组)、20例门静脉高压(PHT)患者(PHT组)和22例PHG患者(PHG组)的胃黏膜标本,观察胃黏膜组织学变化,测定门静脉血流量(PVF).应用免疫组织化学法和Western blot方法检测HO-1蛋白在胃黏膜组织的表达情况,并分析HO-1蛋白与PVF、内镜下PHG严重程度的相关性,以及内镜下PHG严重程度与临床参数的相关性.结果 PHG组和PHT组患者胃黏膜中HO-1蛋白表达明显高于对照组(P＜0.05),而PHG组与PHT组之间比较差异无统计学意义(P＞0.05).PHG患者胃组织HO-1蛋白表达与内镜下PHG严重程度积分呈显著正相关(r =0.459,P＜0.05).内镜下PHG严重程度积分与食管静脉曲张程度(r=0.059,P＞0.05)、Child-Pugh分级(r=-0.001,P＞0.05)均无显著性相关.PHG组与PHT组患者的胃黏膜组织HO-1蛋白表达与PVF无显著性相关(r=0.071,P＞0.05).结论 HO-1蛋白在PHG患者胃黏膜中呈高表达,参与了PHG患者胃黏膜血液循环紊乱的发生.     

汉防己甲素对肝硬化大鼠胃黏膜微循环及超微结构的影响

目的:观察汉防己甲素降低大鼠肝硬化门脉高压(PHT)的疗效和对胃黏膜微循环及其超微结构的影响.方法:制作肝硬化PHT模型,成模后分为模型(M)组、汉防己甲素(T)组、普萘洛尔组(P)及正常对照(N)组,治疗15 d后进行各指标的测定.结果:与M组比较,T组门静脉压力(PVP)明显降低(P<0.01),ALT,HA及PCⅢ指标下降(P<0.05),平均动脉压(MAP)和心率(HR)无明显变化;P组引起了PVP明显降低(P<0.01)和HR的减慢(P<0.05),MAP,ALT,HA及PCⅢ无明显变化;T组、P组光镜下胃黏膜毛细血管最大直径及面积明显减小(P<0.01),透射电镜下胃黏膜超微结构的损伤明显减轻.结论:汉防己甲素能有效、安全地降低大鼠肝硬化门脉压力,可有效改善其胃黏膜微循环及超微的变化,为临床治疗门脉高压性胃病提供实验依据.     

肝硬化门脉高压性胃病与幽门螺杆菌关系的探讨

目的探讨肝硬化门脉高压性胃病(PHG)与幽门螺杆菌(Hp)感染的关系及临床意义。方法对72例PHG和50例慢性胃炎患者进行了胃镜、病理检查和Hp检测,并进行对比分析。结果伴有PHG 的肝硬化门脉高压患者的Hp感染率为23.07%,不伴有PHG者为25.0%,两者差异无显著性(P>0.05), 轻度PHG患者Hp感染率为23.80%,重度为20.0%,差异无显著性(P>0.05)。门脉高压患者的Hp感染率显著低于慢性胃炎组(23.60%比72.0%,P<0.01),但门脉高压患者慢性活动性胃炎的发生与Hp的感染密切相关,活动性胃炎的Hp感染率(53.84%)比非活动性胃炎Hp感染率(16.94%)显著升高(P< 0.01)。结论肝硬化门脉高压性胃病的Hp感染率降低,可能与肝硬化患者胃内环境不适合Hp的生存有关。门脉高压患者胃黏膜的活动性炎症,可能是由Hp感染引起,与肝硬化门脉高压关系不大。     

肝炎后肝硬化门脉高压性肝病相关因素的临床研究

为探讨肝炎后肝硬化门脉高压性胃病(PHG)形成的相关因素,对68例肝炎后肝硬化门脉高压患者按胃镜下有无PHG分组对照研究,比较两组患者性别、年龄、实验室检查、B超及胃镜检查资料。发现两组的肝功能分级、门静脉内径、食管静脉曲张程度差异有显著性(P<0.05),而与性别、年龄、血氨水平及脾静脉内径无相关性(P>0.05)。PHG组幽门螺杆菌(Hp)感染率较对照组低(P<0.05)。     

选择性iNOS抑制剂对肝硬化大鼠门脉高压性胃黏膜病变的影响

目的:探讨选择性诱导型一氧化氮合酶抑制剂氨基胍(aminoguanidine,AG)对肝硬化大鼠门脉高压性胃黏膜病变的防治作用及其机制.方法:将SD大鼠30只随机分为对照组( n =10)、模型组( n = 10)和AG组( n = 10),予400mL/L CCl4皮下注射12 wk建立肝硬化大鼠模型,AG组为皮下注射CCl4同时予AG饮用.观察比较各组大鼠胃黏膜形态及组织学变化,应用免疫组化法检测胃黏膜诱导型一氧化氮合酶(iNOS)的表达,并测定胃黏膜溃疡指数、门静脉压力.结果:AG组胃黏膜病变程度较模型组减轻,溃疡指数明显低于模型组(3.00±2.31 vs 10.60±3.47,P<0.01);模型组胃黏膜iNOS吸光度、面密度值均较对照组增高(0.64±0.04 vs 0.25±0.03;0.344±0.068 vs 0.017±0.008,均P<0.01),AG组胃黏膜iNOS吸光度值、面密度值(0.46±0.09,0.159±0.021)均较模型组明显下降(均P<0.01).AG组门脉压力较模型组降低.结论:AG可在一定程度上减轻门脉高压性胃黏膜病变,其机制可能主要通过抑制胃黏膜iNOS表达.     

门脉高压性胃病患者胃黏膜中ET-1与HIF-1的表达及其意义

目的 探讨门脉高压性胃病(PHG)患者胃黏膜中内皮素-1(ET-1)和缺氧诱导因子-1(HIF-1)的表达及其相关性,为PHG的发病机制提供一定理论依据.方法 随机选择从2010年11月至2011年6月期间的PHG患者60例、门静脉高压症(PHT)无PHG患者30例和正常对照者20例,PHG组中分为轻型34例、重型26...     

肝硬化门脉高压性胃病大鼠胃黏膜iNOS的表达

目的观察肝硬化门脉高压性胃病形成过程中不同阶段大鼠胃黏膜诱生型一氧化氮合酶（iNOS）表达情况，探讨iNOS在门脉高压性胃病形成中的作用。方法34只SD大鼠随机分为对照组（6周、12周组各7只）和模型组（6周、12周各10只），模型组采用皮下注射Ccl4法分别于6周和12周两个时间点制备大鼠肝纤维化、肝硬化模型。测定各组大鼠门静脉压力，观察胃黏膜形态学、组织学变化并计算胃黏膜溃疡指数。应用免疫组化法检测大鼠胃黏膜iNOS的表达。结果肝纤维化、肝硬化大鼠门脉压力均明显高于同期对照组（P〈0．05，P〈0．01）。肝纤维化、肝硬化大鼠均出现胃黏膜病变，溃疡指数高于对照组（P均〈0．01），肝硬化大鼠较肝纤维化大鼠严重。肝纤维化、肝硬化大鼠胃黏膜iNOS表达均较对照组明显增强（P均〈0．01），且肝硬化大鼠强于肝纤维化大鼠（P〈0．01）。胃黏膜溃疡指数与iNOS表达强度及门脉压力间呈正相关（P〈0．01）。结论胃黏膜iNOS在门脉高压性胃病（PHG）形成中表达增强，可能是参与PHG形成的重要因素。     

瑞巴派特对门脉高压性胃病胃黏膜中瘦素表达的影响

目的:观察瑞巴派特对门脉高压性胃病胃黏膜中瘦素表达的影响,评价其对门脉高压性胃病的胃黏膜保护作用．方法:将患者随机分为正常对照组、正常干预组、空白对照组及试验组各15例,其中正常干预组及试验组给予口服瑞巴派特治疗．治疗前后内镜检查对比,用RT-PCR法分别检测治疗前后胃黏膜组织中瘦素mRNA的表达水平．结果:0 wk时,正常对照组瘦素mRNA表达量为0．344±0．202,空白对照组0．816±0．132,实验组0．803±0．143,与正常对照组相比,空白对照组与实验组的瘦素mRNA的表达有差异 (P<0．05);4 wk时,空白对照组瘦素mRNA表达量为0．867±0．170,试验组为1．120±0．237,正常干预组为0．397±0．199,与空白对照组相比, 试验组瘦素mRNA的表达增多;与正常干预组相比,试验组在治疗后其瘦素mRNA的表达显著升高(P<0．01)．内镜检查前后对比:药物治疗4 wk时试验组14例中胃黏膜的内镜表现不同程度改善12例(12/14),而空白对照组无一例改善．结论:瑞巴派特可通过增加胃黏膜中的瘦素表达,对门脉高压性胃病的胃黏膜起保护作用．     

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.     

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.     

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.     

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.