二甲双胍降低2型糖尿病大鼠主动脉磷酸化丝裂原活化蛋白激酶的蛋白表达

目的:探讨p38丝裂原活化蛋白激酶(MAPK)与2型糖尿病大鼠主动脉病变的关系及二甲双胍的干预作用。方法:25只雄性Wistar大鼠随机分为对照组和实验组,实验组采用高脂高糖饲料喂养联合链脲佐菌素注射建立2型糖尿病大鼠模型。将成模糖尿病大鼠随机分为2组:2型糖尿病空白对照组(2型糖尿病组,n=7)、2型糖尿病+二甲双胍干预组(二甲双胍组,n=8)。二甲双胍组给予二甲双胍200 mg/kg灌胃8周,于干预末行腹腔葡萄糖耐量试验,次晨心尖取血并分离血清,全自动生化分析仪测定血糖、血脂等生化指标;放免法测定胰岛素水平;采用酶联免疫吸附方法测定血清细胞间黏附分子-1(ICAM-1),血管细胞黏附分子-1(VCAM-1)和核因子-κB水平;取胸主动脉进行苏木素伊红(HE)染色,光镜下观察血管病理变化;免疫组化法检测大鼠胸主动脉磷酸化p38 MAPK、核因子-κB、单核细胞趋化蛋白-1蛋白的表达。结果:(1)HE染色可见2型糖尿病组大鼠主动脉管壁结构层次不清,内膜增厚,内皮细胞肿大变性,中膜平滑肌细胞排列紊乱,胶原纤维增生。(2)与对照组相比,2型糖尿病组大鼠空腹胰岛素[(20.00±5.91)m IU/L vs(11.34±3.88)m IU/L]、核因子-κB[(170.22±21.53)μmol/L vs(78.68±12.15)μmol/L]、ICAM-1[(130.59±16.00)pg/ml vs(75.63±19.52)pg/ml]、VCAM-1[(990.19±119.18)ng/ml vs(616.54±54.51)ng/ml]、总胆固醇[(4.15±0.41)mmol/L vs(2.18±0.93)mmol/L]、甘油三酯[(1.83±0.40)mmol/L vs(0.81±0.27)mmol/L]、低密度脂蛋白胆固醇[(2.53±0.44)mmol/L vs(1.24±0.47)mmol/L]水平明显升高(P0.05),胰岛素曲线下面积(30.78±11.25)m IU·L-1·h vs(47.55±5.23)m IU·L-1·h明显降低(P0.05),主动脉磷酸化p38 MAPK、核因子-κB、MCP-1蛋白表达水平升高(P0.05),差异均有统计学意义。(3)实验结束时二甲双胍组大鼠空腹血糖、空腹胰岛素、核因子-κB、单核细胞趋化蛋白-1、VCAM-1、甘油三酯、总胆固醇水平较2型糖尿病组明显降低(P0.05);二甲双胍组和2型糖尿病组间胰岛素曲线下面积无明显差异(P0.05)。二甲双胍组大鼠主动脉磷酸化p38 MAPK、核因子-κB、单核细胞趋化蛋白-1蛋白表达水平也较二甲双胍组明显降低(P0.05),差异有统计学意义。结论:p38 MAPK信号通路的激活在糖尿病大血管病变发生发展中起重要作用,二甲双胍通过降低p38 MAPK磷酸化水平、抑制炎症反应、调节脂代谢而起到血管保护作用。     

冠心病患者胰岛素抵抗及胰岛β细胞功能检测临床意义的研究

目的:通过口服葡萄糖耐量试验研究空腹血糖正常的冠心病患者胰岛素抵抗状态、胰岛β细胞分泌功能及其临床意义。方法:对冠心病组(35例)及对照组(30例)按空腹及服糖后30、60、120和180min进行糖耐量、胰岛素释放实验,测量各时点血糖值及胰岛素值。同时测量其血压、身高、体重、总胆固醇、甘油三酯,并计算出体重指数(BMI)=体重(kg)/身高2(m2)。按照稳态模型胰岛素抵抗指数(HOMA-IR)=空腹胰岛素(FINS)×空腹血糖(FPG)/22.5;胰岛β细胞分泌指数(HBCI)=20×空腹胰岛素/(空腹血糖-3.5);早期胰岛素分泌指数(△I30/△G30)=口服葡萄糖耐量试验30min胰岛素增量与葡萄糖增量的比值;李氏β细胞胰岛素分泌指数(MBCI)=(空腹胰岛素×空腹血糖)/(血糖2h 血糖1h-2×空腹血糖)公式计算稳态模型胰岛素抵抗指数、胰岛β细胞分泌指数、△I30/△G30及李氏β细胞胰岛素分泌指数值。结果:空腹血糖正常的冠心病患者糖代谢异常(120min血糖≥7.8mmol/L)的发生率为43%,明显高于对照组23%,仅用空腹血糖这些患者将不能被诊断;冠心病组空腹及服糖后120min、180min胰岛素水平、稳态模型胰岛素抵抗指数显著高于对照组[(11.4±9.4)vs(5.3±3.1)mU/L,(71.6±48.5)vs(31.2±22.0)mU/L,(42.7±35.4)vs(8.6±6.9)mU/L,(0.62±0.32)vs(0.47±0.21),P<0.01],△I30/△G30、李氏β细胞胰岛素分泌指数低于对照组[(1.13±0.65)vs(1.42±0.57),(1.03±0.35)vs(1.36±0.37),P<0.01],差异有显著性;Logistic回归分析显示稳态模型胰岛素抵抗指数、120min胰岛素水平、总胆固醇与冠心病的发生显著相关(OR值分别为1.432、0.644、1.116,P<0.05)。结论:空腹血糖正常的冠心病患者糖代谢异常发病率明显高于对照组,简易口服葡萄糖耐量试验可揭示血糖代谢状态,应常规用于冠心病患者血糖代谢异常的诊断。冠心病患者存在胰岛素抵抗及胰岛β细胞分泌功能缺陷。     

吡格列酮对胰岛素抵抗大鼠血浆同型半胱氨酸水平的影响

目的　研究吡格列酮对高脂饮食诱导的胰岛素抵抗大鼠血浆同型半胱氨酸 (Hcy)水平的影响。方法　将 2 4只Wistar大鼠随机分为 3组 :对照组给予普通饲料喂养 ;高脂组喂高脂饲料诱导胰岛素抵抗动物模型 ;盐酸吡格列酮组在喂饲高脂饲料的同时 ,灌胃给盐酸吡格列酮 10mg·kg-1·d-1。各组喂食 11周时 ,分别做空腹血糖、葡萄糖耐量试验和胰岛素耐量试验后处死动物。测定血糖和胰岛素水平 ,用HOMA模型公式计算胰岛素抵抗指数 (HOMAIR)。喂食 11周后测定血浆Hcy水平。结果　试验后 3组间体重变化、空腹胰岛素、空腹血糖、HOMAIR均有显著差异 (P <0 0 5 )。其中吡格列酮组空腹胰岛素、空腹血糖、HOMAIR均显著低于高脂组 (P <0 0 1)。试验后 3组间血浆Hcy也有显著差异 ,高脂组 (35 7± 14 1) μmol/L高于对照组 (9 95± 2 4 0 ) μmol/L和吡格列酮组 (8 8± 1 39) μmol/L。相关分析显示血糖曲线下面积、空腹胰岛素、空腹血糖、HOMAIR、内脏脂肪含量均与血浆Hcy水平显著相关 (P <0 0 5 )。进一步多元逐步回归分析显示仅空腹血糖 (r =0 5 0 4 ,P =0 0 31)和HOMAIR与血浆Hcy相关 (r=0 30 2 ,P =0 0 4 6 )。结论　高脂诱导的胰岛素抵抗与大鼠血浆Hcy水平升高有关 ,吡格列酮可能通过减轻胰岛素抵抗降低血浆H     

过氧化物体增殖物激活受体γ活化对胰岛素抵抗合并高血压大鼠代谢及血压的影响

目的探讨过氧化物体增殖物激活受体(PPAR)γ活化对高脂饮食诱发的胰岛素抵抗合并高血压大鼠代谢及血压的影响。方法30只雄性SD大鼠被随机分为正常对照组(n=10)、胰岛素抵抗合并高血压模型组(n=10)及吡格列酮治疗组(n=10)。采用高脂饮食喂饲建立胰岛素抵抗合并高血压大鼠模型,其中治疗组在喂饲高脂饮食9周后给予吡格列酮灌胃(10mg/kg.d),各组均在14周末测定大鼠血压,后处死各组大鼠,测定血糖、胰岛素、肿瘤坏死因子α(TNFα)及血清游离脂肪酸(FFA)水平。结果模型组大鼠血清胰岛素、血糖水平及血压水平均明显高于正常对照组。治疗组血清FFA[(367.3±38.1vs587.3±35.8)μmol/L,P<0.05],TNFα[(10.6±4.2vs24.3±8.8)pg/L,P<0.01],血糖[(8.2±1.3vs9.9±1.8)mmol/L,P<0.05],血清胰岛素[(30.2±5.2vs46.1±17.0)mU/L,P<0.05],血压[(142.7±15.3vs165.4±15.1)mmHg,P<0.05]均显著低于模型组,而胰岛素敏感指数显著高于模型组(4.29±1.04vs2.48±0.80,P<0.01)。结论高脂饮食等环境变化诱发的胰岛素抵抗可能在高血压的发病机制中具有重要的作用;通过促进PPARγ的活化可明显改善胰岛素抵抗,并对高血压具有一定的改善作用。     

瓜蒌皮提取物对糖尿病大鼠血管内皮的保护作用

目的 研究瓜萎皮提取物对糖尿病大鼠血管内皮及血液成分的影响.方法 将用四氧嘧啶造模成功的糖尿病大鼠随机分为3组:糖尿病组、低剂量瓜蒌皮提取物组(5ml·kg-1d-1,每天灌胃一次瓜蒌皮提取物)和高剂量瓜蒌皮提取物组(15 ml·kg-1·d-1,每天灌胃一次瓜蒌皮提取物. 4周后检测大鼠血中一氧化氮(NO)、超氧化物歧化酶(SOD)、丙二醛(MDA)、胆固醇(CH)含量,观察离体胸主动脉环的内皮依赖性舒张反应.结果 低剂量瓜蒌皮提取物组和高剂量瓜蒌皮提取物组与糖尿病组相比,NO、SOD含量显著提高[(40.68±6.78)μmol/L、(46.67±7.32)μmol/L比(37.55±7.27)μmol/L,(87.32±6.76)U/ml、(96.57±7.72)U/ml比(80.35±7.56)U/ml],差异有统计学意义(P＜0.01),MDA含量降低[(10.37±2.76)mmol/ml、(8.36±2.53)mmol/ml比(14.57±2.89)mmol/ml],差异有统计学意义(P＜0.01),胸主动脉环的内皮依赖性舒张明显改善(P＜0.01).结论 瓜蒌皮提取物对糖尿病大鼠血管内皮有保护作用.     

糖调节受损和2型糖尿病患者血浆nesfatin-1水平的变化

采用酶联免疫法测定了初诊2型糖尿病患者、糖调节受损(IGR)患者、正常糖耐量(NGT)者血浆nesfatin-1水平.结果显示,2型糖尿病和IGR组血浆nesfatin-1水平明显高于NGT组[(1.91±0.79和1.80±0.80对1.41±0.58)μg/L,P＜0.01].血浆nesfatin-1水平与体重指数(BMI)、空腹血糖、空腹胰岛素、HbA1C、稳态模型评估的胰岛素抵抗指数(HOMA-IR)呈明显正相关(P＜0.05或P＜O.01).多元回归分析结果表明HOMA-IR和BMI分别是影响血浆nesfatin-1水平的独立相关因素(均P＜0.01).提示血浆nesfatin-1可能参与了胰岛素抵抗和2型糖尿病的发生和发展.     

胃旁路手术治疗2型糖尿病模型大鼠的机制

目的 探讨胃旁路术(GBP)对2型糖尿病(非胰岛素依赖型糖尿病,NIDDM)大鼠模型治疗作用的可能机制.方法 将60只已成功建模的SD成年雄性2型糖尿病大鼠随机分为胃旁路术组(A组)和假手术组(Sham-A组),每组30只.观察、记录所有SD大鼠手术前后体重、空腹血糖(FPG)水平、胰岛素(FINS)水平,计算胰岛素敏感指数(IAI)=1/FPG×FINS);ELISA法检测手术前后血浆胰高血糖素样肽-1(GLP-1)、葡萄糖依赖性促胰岛素激素(GIP)的水平,RT-PCR检测胰腺组织胰高血糖素样肽-1受体(GLP-1R)mRNA、葡萄糖依赖性促胰岛素激素受体(GIPR) mRNA表达变化.结果 GBP术后8wA组糖尿病大鼠的空腹血糖由术前的(20.05±3.50) mmol/L下降至(5.85±0.72) mmol/L(P ＜0.05),且长期维持在较低水平;GBP术后8wA组糖尿病大鼠的空腹胰岛素水平由术前的(7.55±3.15)μU/ml升高至(14.85±2.52)μU/ml(P＜0.05);GBP术后8wA组糖尿病大鼠的空腹胰岛素敏感指数由术前的(0.32±0.12)下降至(0.12±0.06)(P＜0.05).空腹血清GLP-1由术前的(16.86±0.85) pmol/L上升至(35.58±2.15) pmol/L(P ＜0.05),经25％葡萄糖灌胃30 min后更加明显;空腹血清GIP由术前的(7.65±0.75)pmoL/L下降至(4.28±0.08) pmol/L(P＜0.05),经25％葡萄糖灌胃30 min后更加明显.胰腺GLP-1R mRNA表达由术前的(1.01±0.02)倍上升至(5.38±0.65)倍(P＜0.05);胰腺GIP mRNA术前术后无明显变化.结论 GBP对SD大鼠2型糖尿病模型具有明显的治疗作用;其可能机制是过早进入空肠下段的食物,促进GLP-1分泌、减少GIP分泌,同时促进GLP-1R高表达,进而促进胰岛素分泌和(或)增加胰岛素敏感性.     

绝经前后正常糖耐量女性负荷后1h血糖水平及其与代谢相关因素关联分析

目的探讨绝经前后正常糖耐量女性负荷后1h血糖(1hPG)水平差异及其与代谢相关因素间的关联性研究。方法选择正常糖耐量女性219例,按照不同绝经阶段分为:绝经前组115例,绝经后组104例。比较2组代谢相关指标及口服葡萄糖耐量测试空腹血糖、1hPG、负荷后2h血糖及1、2h胰岛素水平,分析1hPG与代谢相关因素之间的关系。结果绝经后组1hPG[(7.27±2.10)mmol/L vs(6.55±1.86)mmol/L]、空腹胰岛素[(9.86±4.16)mU/L vs(8.58±3.73)mU/L]、1h胰岛素(79.32 mU/L vs 59.13 mU/L)、2h胰岛素(55.39mU/L vs 45.72mU/L)及胰岛素抵抗指数(2.14±0.91 vs 1.86±0.84)明显高于绝经前组(P<0.01)。全体、绝经前组、绝经后组1hPG与腰围、收缩压、舒张压、TG、TC、LDL-C、胰岛素抵抗指数呈正相关,与HDL-C呈负相关(P<0.01)。其中1hPG与HOMA-IR相关性最强。多重线性回归分析显示,绝经后组1hPG受HOMA-IR、收缩压、HDL-C、LDL-C水平影响(P<0.01)。结论在正常糖耐量人群中,相比于绝经前女性,绝经后女性1hPG水平更高。1hPG与HOMA-IR及代谢危险因素呈正相关。HOMA-IR、收缩压、HDL-C、LDL-C是绝经后女性1hPG增高的独立危险因素。     

血管性痴呆患者幽门螺杆菌感染和胰岛素抵抗的相关性研究

目的探讨幽门螺杆菌(Hp)感染和胰岛素抵抗与血管性痴呆(VaD)的相关性。方法收集VaD患者86例(VaD组)及健康体检者52例(对照组),根据Hp感染情况,将VaD患者进一步分为2组,Hp阳性组50例,Hp阴性组36例。以13碳尿素呼气试验阳性作为Hp感染的诊断指标,分别检测空腹血糖、空腹胰岛素,根据自我平衡模型分析法计算胰岛素抵抗指数(HOMA-IR)。结果 VaD组Hp阳性率显著高于对照组(58.14%vs 28.58%,χ2=10.273,P=0.002)。与对照组比较,VaD组的空腹血糖[(5.53±0.60)mmol/L vs(5.19±0.38)mmol/L,P=0.0004]、空腹胰岛素[(10.29±4.95)μIU/L vs(8.77±4.02)μIU/L,P=0.0317]、HOMA-IR(2.57±1.34 vs2.06±0.96,P=0.0179)均明显升高。Hp阳性组空腹血糖、空腹胰岛素、HOMA-IR均显著高于Hp阴性组,差异有统计学意义(P0.05,P0.01)。结论 Hp感染和胰岛素抵抗都与VaD显著相关,且Hp感染和胰岛素抵抗密切相关,三者可能存在相互关联的发病链条,Hp感染可能通过诱发或加重胰岛素抵抗导致VaD产生或发展。     

有氧运动对空腹血糖正常的脑梗死患者糖耐量的影响

目的:探讨有氧运动对空腹血糖(FBG)正常的脑梗死患者糖耐量的影响。方法:选择88例脑梗死致偏瘫患者作为研究对象,按照入院先后顺序编号,均分为有氧运动康复组(接受含有氧运动的综合康复训练);常规康复组(接受综合康复训练,但未接受有氧运动)。训练前和训练6周后评价比较两组的运动功能、日常生活活动(ADL)能力、FBG、口服葡萄糖耐量试验(OGTT)2h血糖、稳态模型胰岛素抵抗指数(HOMA-IR)以及血脂水平。结果:训练前,两组的糖耐量相关指标、Fugl-Meyer评分和ADL评分均无显著差异(P均0.05);与训练前比较,两组训练后的Fugl-Meyer评分和ADL评分均显著升高(P均0.01),但两组间比较仍无显著差异(P0.05)。训练后两组的FBG水平无显著差异(P0.05),与常规康复组比较,有氧运动康复组OGTT 2h血糖[(8.97±0.91)mmol/L比(7.76±0.82)mmol/L]、HOMAIR[(1.57±0.39)比(1.30±0.41)]、甘油三酯[(1.97±0.48)mmol/L比(1.50±0.52)mmol/L]和总胆固醇[(5.06±0.53)mmol/L比(4.28±0.49)mmol/L]水平显著降低,P均0.01。结论:有氧运动可明显降低脑梗死患者餐后血糖水平,胰岛素抵抗和血脂水平,可预防心脑血管疾病的复发。     

Three layer functional model and energy exchange concept of aging process

Relying on a certain degree of abstraction, we can propose that no particular distinction exists between animate or living matter and inanimate matter. While focusing attention on some specifics, the dividing line between the two can be drawn. The most apparent distinction is in the level of structural and functional organization with the dissimilar streams of ‘energy flow’ between the observed entity and the surrounding environment. In essence, living matter is created from inanimate matter which is organized to contain internal intense energy processes and maintain lower intensity energy exchange processes with the environment. Taking internal and external energy processes into account, we contend in this paper that living matter can be referred to as matter of dissipative structure, with this structure assumed to be a common quality of all living creatures and living matter in general. Interruption of internal energy conversion processes and terminating the controlled energy exchange with the environment leads to degeneration of dissipative structure and reduction of the same to inanimate matter, (gas, liquid and/or solid inanimate substances), and ultimately what can be called ‘death.’ This concept of what we call dissipative nature can be extended from living organisms to social groups of animals, to mankind. An analogy based on the organization of matter provides a basis for a functional model of living entities. The models relies on the parallels among the three central structures of any cell (nucleus, cytoplasm and outer membrane) and the human body (central organs, body fluids along with the connective tissues, and external skin integument). This three-part structural organization may be observed almost universally in nature. It can be observed from the atomic structure to the planetary and intergalactic organizations. This similarity is corroborated by the membrane theory applied to living organisms. According to the energy nature of living matter and the proposed functional model, the decreased integrity of a human body's external envelope membrane is a first cause of the structural degradation and aging of the entire organism. The aging process than progresses externally to internally, as in single cell organisms, suggesting that much of the efforts towards the restoration and maintenance of the mechanisms responsible for structural development should be focused accordingly, on the membrane, i.e., the skin. Numerous reports indicate that all parts of the human body, like: bones, blood with blood vessels, muscles, skin, and so on, have some ability for restoration. Therefore, actual revival of not only aging tissue of the human body's membrane, but the entire human body enclosed within, with all internal organs, might be expected. We assess several aging theories within the context of our model and provide suggestions on how to activate the body's own anti-aging mechanisms and increase longevity. This paper presents some analogies and some distinctions that exist between the living dissipative structure matter and inanimate matter, discusses the aging process and proposes certain aging reversal solutions.     

Unusual responses of nocturnal pineal melatonin synthesis and secretion to swimming: Attempts to define mechanisms

Abstract: The effect of swimming at night on rat pineal melatonin synthesis was compared with that of light exposure at night. Rats were forced to swim at 0030 hr (lights out at 2000 hr) and sacrificed by decapitation 15 and 30 min later, immediately after swimming. Other groups of animals were exposed to white light (650μW/cm²) for 15 and 30 min at same time. Swimming caused a rapid and highly significant drop in the melatonin content in the pineal gland; however, the activity of N-acetyltransferase (NAT), the supposed rate limiting enzyme in the melatonin production, was not changed. Despite the drop in pineal melatonin levels, serum concentrations of the indole remained elevated in the rats that swam. In contrast, melatonin levels in the pineal and serum of light exposed rats fell precipitously, accompanied by a significant suppression of NAT activity. Since we anticipated that the strenuous exercise associated with swimming may induce release of artrial natriuretic peptide (ANP) from the heart, which in turn could cause the release of pineal melatonin, in a second study we injected physiological saline intravenously to stretch the cardiac muscle and release ANP. Three milliliters of normal saline was injected during the day into the jugular vein of anesthetized rats that were pretreated with isoproterenol to stimulate pineal melatonin production. Animals were killed 15 min after the saline injection, and pineal NAT activity and pineal melatonin levels were measured. The saline injections caused no alteration in the elevated levels of either NAT or melatonin. These data suggest that the disparity in pineal NAT activity (which was high) and pineal melatonin (which was low), in animals swum at night, may not be caused by ANP which is released during strenuous exercise such as swimming.     

Melatonin and photoperiodic time measurement: Seasonal breeding in the sheep

Abstract: Well-established circadian physiology supports the view that photoperiodic time measurement utilizes the coincidence between the presence of light and a photosensitive phase of a 'biological clock' to alter reproductive status—the so-called external coincidence model of seasonal breeding. In this review, we examine the mechanism whereby photoperiod interacts with presumed suprachiasmatic nuclei activity to allow endogenous melatonin to normally synchronize reproductive activity to the optimal time of year. The Romney Marsh sheep is particularly explored as an experimental model. It is suggested that the on/off activity of seasonal reproduction may be a robust mechanism able to be predictably manipulated by the judicious use of the light/dark cycle and exogenous melatonin, but firmly based on circadian principles.     

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.     

Serological survey of HIV and syphilis in pregnant women in Madagascar

Objectives Peripartal transmission of human immunodeficiency virus (HIV) and Treponema pallidum, the causative agent of syphilis, leads to severe consequences for newborns. Preventive measures require awareness of the maternal infection. Although HIV and syphilis testing in Madagascar could be theoretically carried out within the framework of the national pregnancy follow‐up scheme, the required test kits are rarely available at peripheral health centres. In this study, we screened blood samples of pregnant Madagascan women for HIV and syphilis seroprevalence to estimate the demand for systemic screening in pregnancy. Methods Retrospective anonymous serological analysis for HIV and syphilis was performed in plasma samples from 1232 pregnant women that were taken between May and July 2010 in Ambositra, Ifanadiana, Manakara, Mananjary, Moramanga and Tsiroanomandidy (Madagascar) during pregnancy follow‐up. Screening was based on Treponema pallidum haemagglutination tests for syphilis and rapid tests for HIV, with confirmation of positive screening results on line assays. Results Out of 1232 pregnant women, none were seropositive for HIV and 37 (3%) were seropositive for Treponema pallidum. Conclusions Our findings are in line with previous studies that describe considerable syphilis prevalence in the rural Madagascan population. The results suggest a need for screening to prevent peripartal Treponema pallidum transmission, while HIV is still rare. If they are known, Treponema pallidum infections can be easily, safely and inexpensively treated even in pregnancy to reduce the risk of transmission.     

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.     

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.