慢性间歇低氧诱导小鼠学习记忆障碍的实验研究

目的 探讨慢性间歇低氧（CIH）诱导小鼠空间学习记忆能力的变化及CIH对认知功能损伤的可能机制.方法 60只ICR雄性幼鼠随机分为常氧对照组（UC组）和间歇低氧组（CIH组）,每组30只;CIH组小鼠置于低氧舱内,通过吹入氮气及压缩空气,每60s做一次缺氧/再氧合循环,使氧浓度波动在6％～8％和20％～ 21％之间,每天8h.CIH组根据低氧造模时间分为3d（A组）、1周（B组）、2周（C组）、4周（E组）、6周（F组）,以及造模结束后常氧饲养1月的10周组（G组）,共6组,每组5只小鼠,同期设6组对照,每组5只小鼠.在慢性间歇低氧3d、1周、2周及6周终点,采用Morris水迷宫的方法测定CIH组和UC组空间学习记忆功能的变化;Western blot法分别测各组海马N-甲基-D-天冬氨酸受体（NMDAR）亚单位1（NR1）蛋白表达的变化;采用免疫荧光标记测定海马Caspase-3表达情况.结果 ①CIH组小鼠在间歇低氧3d时,水迷宫逃避潜伏期较对照组有所延长,但无统计学差异（P＞0.05）;随着间歇低氧时间的延长,逃避潜伏期较对照组逐渐延长（P＜0.05）;低氧6周后,CIH组逃避潜伏期[（68.64±26.52）s]较对照组[（21.36±14.14）s]明显延长（P＜0.01）.低氧6周后,CIH组穿越平台次数[（4.58±2.58）次]较对照组[（8.06±2.74）次]明显减少（P＜0.01）;②与对照组比较,CIH组B、C、E、F及G组小鼠海马神经元NR1蛋白表达均降低（P＜0.叭）,C、E组降至最低水平（P＜0.01）;复氧1月后的G组NR1蛋白与F组相仿,仍较对照组降低（P＜0.01）.CIH各组海马Caspase-3表达均明显升高,并成时间-效应关系,除A组外,其余各组与对照组相比,差异均有统计学意义（P均＜0.01）,CIH组组内指标比较无显著差异（P＞0.05）.结论 慢性间歇低氧诱导小鼠空间学习记忆障碍,且随低氧暴露时间延长学习记忆功能损害加重,这可能与海马神经元NR1蛋白表达下调以及与Caspase-3介导的海?     

慢性间歇低氧对大鼠肝细胞IRS-2、 FoxO1表达的影响

目的 观察慢性间歇低氧条件下,大鼠肝细胞形态学变化及胰岛素受体底物-2 (IRS-2)、叉头框蛋白O1(FoxO1)的蛋白表达,并探讨IRS-2、FoxO1与胰岛素抵抗的相关性.方法 取24只6周龄健康雄性Sprauge-Dawley大鼠,采用随机数字表法分为正常对照组(NC组)、慢性间歇低氧4周组(CIH4组)、慢性间歇低氧8周组(CIH8组),每组8只.CIH4组和CIH8组暴露于间歇低氧舱内:最低氧浓度6％ ～ 8％,持续时间8 h/d.NC组无间歇低氧暴露正常饲养,CIH4组、CIH8组和NC组分别于第4周、第8周及第8周禁食12 h后测定空腹血糖、空腹胰岛素水平,并采用稳态模型评估-胰岛素抵抗指数(HOMA-IR)和胰岛素敏感性指数(ISI)评价胰岛素抵抗,对肝组织行HE染色观察形态学变化,采用免疫组织化学方法测定肝细胞IRS-2、FoxO1蛋白表达,以平均灰度值表示其蛋白表达量,二者成反比关系.结果 与NC组相比,CIH4组、CIH8组空腹血糖、胰岛素、HOMA-IR升高,ISI降低,且CIH8组更为显著,差异有统计学意义(F=50.23 ～90.26,P均＜0.05).与NC组相比,CIH4组与CIH8组IRS-2蛋白表达降低,FoxO1蛋白表达增高且在核内重新分布,CIH8组更为显著,差异有统计学意义(F=69.46,618.94,P均＜0.05).Pearson相关分析显示:HMOA-IR与IRS-2平均灰度值呈正相关(r=0.857,P＜0.05),与FoxO1平均灰度值呈负相关(r=-0.926,P＜0.05),ISI与IRS-2平均灰度值呈负相关(r=-0.823,P＜0.05),与FoxO1平均灰度值呈正相关(r=0.848,P＜0.05).结论 慢性间歇低氧条件下,大鼠肝细胞受损并发生胰岛素抵抗,同时IRS-2和FoxO1蛋白表达异常,且随暴露时间延长肝细胞损伤程度及胰岛素抵抗程度均逐渐加重.     

PTP-1B 及 IRS-1在慢性间歇低氧大鼠肝细胞中的表达

目的：探讨慢性间歇低氧(CIH)对大鼠肝细胞蛋白酪氨酸磷酸酶-1B(protein tyrosine phosphatase-1B,PTP-1B)及胰岛素受体底物-1(insulin receptor substrate-1,IRS-1)蛋白表达量的影响及其导致胰岛素抵抗发生的可能机制。方法选取健康雄性 SD 大鼠24只,按随机数字表法分为正常对照组(NC 组)、慢性间歇低氧4周组(CIH4组)、慢性间歇低氧8周组(CIH8组),每组8只。NC 组无间歇低氧暴露正常饲养,CIH4组及 CIH8组于上午9时至下午5时放入间歇低氧仓暴露于间歇低氧环境中,舱内最低氧浓度为6%~7%。分别于第4周及第8周检测大鼠空腹血糖及空腹胰岛素水平,用稳态模型胰岛素抵抗指数(HOMA-IR)以及胰岛素敏感指数(insulin sensitive index,ISI)评价胰岛素抵抗, SABC 法免疫组织化学试剂盒检测 CIH 大鼠肝细胞 PTP-1B 及 IRS-1蛋白表达,以平均灰度值表示PTP-1B 及 IRS-1的蛋白表达量,并做统计学分析。结果与 NC 组比较,CIH4组及 CIH8组空腹血糖、空腹胰岛素及 HOMA-IR 升高,ISI 降低,差异有统计学意义(P <0.05),且 CIH8组更为显著;与 NC 组相比较,CIH4组及 CIH8组 PTP-1B 蛋白表达增加,IRS-1蛋白表达减少,差异有统计学意义(P <0.05),Pearson 相关分析显示,HOMA-IR 与 PTP-1B 平均灰度值呈负相关、与 IRS-1平均灰度值呈正相关;ISI 与 PTP-1B 平均灰度值呈正相关、与 IRS-1平均灰度值呈负相关。结论①CIH 暴露使大鼠空腹血糖及胰岛素水平升高且发生胰岛素抵抗,随着 CIH 暴露时间的延长,胰岛素抵抗程度加重。②CIH 导致大鼠肝细胞 PTP-1B 蛋白表达增加,IRS-1蛋白表达减少,PTP-1B 及 IRS-1可能共同参与了 CIH 大鼠胰岛素抵抗的发生发展。     

慢性间歇低氧老龄大鼠脑血管内皮功能的研究

目的 探讨慢性间歇低氧(CIH)对老龄鼠脑血管及内皮素-1(ET-1)、一氧化氮(NO)、血管内皮生长因子(VEGF)表达的影响.方法 应用间歇低氧处理方式建立CIH老龄大鼠实验模型,实验3、6、9周后,检测血浆ET-1、NO和VEGF的含量;观察脑血管病理变化与脑组织中小动脉血管壁厚度与外径之比(WT%)与VEGF蛋白的表达.结果 CIH组血ET-1、VEGF表达均增加,NO表达减弱,从第3周ET-1含量较空白对照(UC)组增高(t=2.47,P<0.05),VEGF含量较空白对照(UC)组升高(t=2.38,P<0.05),NO含量较UC组降低(t=2.39,P<0.05).VEGF水平与间歇低氧时间呈正相关,第9周[(171.1±13.5)pg/ml]表达最强,与第3周[(129.3±12.3)pg/ml]比较升高明显(t=2.38,P<0.05),较UC组[(109.8±8.6)pg/ml]增高(t=3.46,P<0.01).光镜下UC组脑血管未见明显的病理变化,CIH组可见脑细胞水肿和血管增生.CIH组大鼠脑小动脉WT%改变从第3周即强于UC组(t=2.34,P<0.05),脑组织VEGF的表达在CIH组各时间段均显著高于UC组(t=2.37,P<0.05),随着CIH作用时间的累积,脑组织VEGF和脑小动脉WT%改变均有加重的趋势,第9周明显高于第3周(t=2.32和t=2.35,均P<0.05).结论 CIH可诱导老龄大鼠ET-1、VEGF表达增强,NO水平下降,导致脑细胞肿胀,小动脉管壁增厚,管腔狭窄,提示纠正VEGF、ET-1/NO的表达紊乱应成为OSAS综合防治的一个重要方面.     

血管紧张素Ⅱ与氧化应激对慢性间歇低氧大鼠肺组织损伤的影响

目的 观察血管紧张素Ⅱ(AngⅡ)及氧化应激水平在慢性间歇低氧(CIH)大鼠肺组织中的动态变化,探讨其在慢性间歇低氧相关性肺损伤机制中的可能作用机制.方法 将72只雄性wistar大鼠用随机数字表法分为正常对照组(UC组)、实验对照组(SC组)、5％间歇低氧组(CIH组),每组再分为1、2、3、4周4个亚组,每个亚组6只大鼠.UC组不予任何处理,CIH组循环暴露于氮气和压缩空气中,SC组循环给予压缩空气.观察各亚组大鼠肺组织HE病理变化,检测肺组织MDA含量、SOD活性、AngⅡ蛋白、AngⅡmRNA表达水平.结果 肺组织病理检查可见CIH组肺泡间隔增厚,部分肺泡萎缩不张,肺泡上皮可见炎性细胞浸润,且随时间延长病理损伤逐渐加重,NC组及SC组未见明显病理损害;与UC组及SC组比较,CIH组大鼠肺组织AngⅡ蛋白表达量及AngⅡmRNA水平于各个时间点均逐渐增加(21.3±1.7、26.5 ±1.3、34.6±2.2、36.3±0.9,均P＜0.05),MDA含量在1、2、3、4周逐渐增高[(2.3±0.7)、(2.9±0.4)、(3.7±0.7)、(5.2 ±0.1)nmol/mg],于4周达到高峰,而SOD活性于各个时间点均逐渐下降(均P＜0.05);并且CIH组肺组织AngⅡ蛋白、AngⅡmRNA水平与MDA含量均呈正相关(r=0.751,0.782,P＜0.01),而AngⅡ蛋白、AngⅡmRNA含量与SOD活性均呈负相关(r=-0.743,-0.904,P＜0.01).结论 慢性间歇低氧可激活氧化应激和AngⅡ,二者互为因果,可能是慢性间歇低氧肺损伤的重要发生机制.     

模拟阻塞性睡眠呼吸暂停综合征大鼠血压及血管重构变化的实验研究

目的:模拟阻塞性睡眠呼吸暂停综合征(OSAS)大鼠模型,研究OSAS继发高血压血管重构的病理形态改变。方法:1将32只SD雄性大鼠按随机列表法分为慢性间歇低氧组(CIH组)与常氧对照组(NC组),CIH组实验过程中置于低压氧舱中行间歇低氧模式,NC组置于同样规格氧舱中常氧对照。每两周监测尾动脉血压一次,于低氧时程6、12周末对腹主动脉进行HE染色、Masson染色观察其病理形态学改变,采用免疫组织化学检测腹主动脉α-平滑肌肌动蛋白(α-SMA)、增殖细胞核抗原(PCNA)及纤维粘连蛋白(FN)的表达分析腹主动脉增殖及纤维化,PCR检测ECM标志物转化生长因子-β1(TGF-β1)mRNA。结果:与NC组比较,CIH组血压逐渐升高(P0.01);腹主动脉管腔存在重构相关的病理形态学变化,PCNA、FN及TGF-β1mRNA表达均增加,α-SMA表达降低(均P0.05)。结论:OSAS大鼠模型存在血压升高及腹主动脉血管重构的病理变化,这将为今后研究OSAS继发高血压的病理生理机制提供更坚实的理论基础。     

慢性间歇低氧对大鼠糖代谢及肝脏 TRB3、P-AKT 表达的影响

目的：通过建立慢性间歇低氧(chronic intermittent hypoxia,CIH)大鼠模型,观察CIH 对大鼠糖代谢的影响以及肝脏胰岛素相关信号通路 Tribbles 同源蛋白3(TRB3)、磷酸化蛋白激酶 B (P-AKT)的变化。方法将40只健康雄性 SD 大鼠随机分为5组,每组8只。正常对照组(NC组)、慢性间歇 低 氧 2 周 组(CIH2组)、慢 性 间 歇 低 氧 4 周 组(CIH4组)、慢性间歇低氧6周组(CIH6组)、慢性间歇低氧8周组(CIH8组),实验组每天给予8 h 间歇低氧处理。实验结束后检测5组大鼠空腹血糖,采用酶联免疫吸附试验(ELISA)检测空腹胰岛素,用稳态模型胰岛素抵抗指数(HOMA-IR)系统评价胰岛素抵抗。采用 HE 染色观察各组肝脏组织形态变化,SABC 法免疫组织化学试剂盒检测大鼠肝细胞 TRB3蛋白以及胰岛素信号通路中关键激酶蛋白激酶 B (AKT)磷酸化水平蛋白的表达,以平均灰度值表示 TRB3、P-AKT 的蛋白表达量。结果随着间歇低氧暴露时间延长,各组与 NC 组比较,其空腹血糖水平(F =116.185,P <0.05)、胰岛素水平(F =45.189,P <0.05)、HOMA-IR (F =110.876,P <0.05)、TRB3蛋白表达水平(F =11 5.253,P <0.05)升高,而 P-AKT 蛋 白 表 达 水 平(F =99.553,P <0.05) 降 低,且以 CIH8组 最 为 显 著 (P <0.05)。Pearson 相关分析显示： HMOA-IR 与 TRB3平均灰度值呈负相关(r =-0.828,P <0.05),与P-AKT平均灰度值呈正相关(r =0.903,P <0.05)。结论 CIH 可导致大鼠肝细胞受损,糖代谢异常,发生胰岛素抵抗,并随着间歇低氧暴露时间的延长,胰岛素抵抗程度加重。CIH 使肝脏中 TRB3蛋白表达增加,P-AKT 显著降低,且与 HOMA-IR 具有明显的相关性,TRB3的激活可能在 CIH 所致的糖代谢异常中起重要作用。     

慢性间歇低氧对大鼠血压和交感神经兴奋性的影响

目的 通过观察不同程度慢性间歇低氧(chronic intermittent hypoxia,CIH)作用下大鼠血压与交感神经活性水平动态变化,探讨CIH对血压及交感神经活性的影响及血压与交感神经活性之间的相关性,并明确CIH诱发高血压发病的机制.方法 168只雄性6周龄Wistar大鼠,体重160 ～ 180 g,采用随机数字表法分为非暴露组(UD)、重度间歇低氧组(IH1)、中度间歇低氧组(IH2)、轻度间歇低氧组(IH3)、持续低氧组(CH)及对照组,分别给予不同程度和频率的低氧环境.UD组8只大鼠于实验前处死,其余各实验组每组32只大鼠,分别于2、4、6、8周时随机抽取8只处死,留取静脉血抗凝离心后- 80℃保存血浆,并于实验前、实验结束后分别测定动脉收缩压,实验结束后测定血浆中去甲肾上腺素(norepinephrine,NE).结果 各组大鼠实验前收缩压差异无统计学意义(F=0.008,P＞0.05),随着实验时间延长,各间歇低氧组大鼠收缩压逐渐升高,4周开始明显高于UD组、对照组及CH组(均P＜0.05)且血压水平与低氧程度正相关(F =9.844,P＜0.01),IH1组明显高于IH3组(P＜0.05),而对照组和CH组无明显改变.各间歇低氧组大鼠血浆NE随实验时间延长而逐渐升高,8周时明显高于UD组、SC组及CH组(均P＜0.05或P＜0.01),且NE水平与低氧程度正相关(F=11.537,P＜0.01),IH1组明显高于IH3组(P＜0.05),SC组和CH组大鼠血浆NE变化不显著.大鼠血浆NE与血压呈显著正相关(r=0.538,P＜0.01).结论 CIH作用可以引起大鼠血压增高和交感活性增强且存在明显的低氧程度依赖性和时间过程规律性,推测CIH引起大鼠血压增高可能与交感活性增强相关.     

卡介苗免疫小鼠T淋巴细胞亚群表达穿孔素与抗结核作用的相关性

目的 探讨卡介苗免疫小鼠抗结核作用和T细胞亚群表达穿孔素的相关性.方法 120只清洁级KM雄性小鼠分为2个对照组(各20只)、2个卡介苗组(各20只)、攻毒组(20只)和结核病组(20只).2个卡介苗组与攻毒组小鼠腹部皮内接种卡介苗,接种3个月后攻毒组和结核病组小鼠接受MTB攻击,同时对照1组和卡介苗1组小鼠取血后处死.攻毒组和结核病组小鼠于接受MTB攻毒1个月后与对照2组和卡介苗2组小鼠取血后处死.观察所有小鼠的肺、肝和脾组织病理学改变,并经组织匀浆涂片查找抗酸杆菌和MTB培养.流式细胞仪检测分析血液标本中表达穿孔素的T细胞亚群计数及其占总淋巴细胞百分率.多组间免疫学指标的比较采用单因素方差分析,两组间比较采用t检验.结果 结核病组小鼠的肺、肝和脾组织均有结核病表现,1个月内死亡11只,其他3组小鼠均未发现结核病表现,也无死亡鼠.卡介苗组小鼠表达穿孔素的CD8+T细胞数[(5.9±0.9)×103]明显高于对照组[(4.8±0.8)×103],差异有统计学意义(F=42.24,P＜0.01);结核病组小鼠表达穿孔素的CD+百分率[(5.6±0.9)%]明显低于卡介苗组[(7.3±1.1)%],差异有统计学意义(F=35.51,P＜0.05);攻毒组小鼠获得卡介苗免疫后,在致病量MTB攻击下表达穿孔素的CD3+、CD8+和CD4+ CD8+ T细胞数[(20.1±5.5)×103、(8.7±0.4)×103和72±19]及其占总淋巴细胞百分率[(23.3±3.3)%、(10.7±1.6)%和(0.084±0.015)%]均明显高于对照组[(11.1 ±3.0)×103、(4.8±0.8)×103和30±7及(14.9±1.7)%、(6.7±0.9)%和(0.040±0.006)%]、卡介苗组[(13.0±3.2)×103、(5.9±0.9)× 103和36±5及(15.5±1.7)%、(7.3±1.1)%和(0.044±0.007)%]及结核病组[(12.6±1.6)×103、(5.0±0.1)×103和31±3及(14.0±1.7)%、(5.6±0.9)%和(0.035±0.005)%],CD4+/CD8+比值(0.54±0.17)明显低于对照组(0.76±0.22),差异均有统计学意义(F值为4.54～74.98,均P＜0.05或P＜0.01).结论 卡介苗免疫主要诱导表达穿孔素的CD8+ T细胞水平升高,在致病量MTB攻击下卡介苗免疫小鼠不发生结核病,可能与表达穿孔素的CD3+、CD8+和CD4+ CD8+ T细胞水平升高相关;穿孔素表达水平高低可能是判断宿主抗结核免疫力强弱的重要标志之一.     

慢性间歇低氧对大鼠肝脏的损伤及4-羟基-2,2,6,6-四甲基哌啶的干预作用

目的 探讨慢性间歇低氧(CIH)对大鼠肝脏损伤机制和4-羟基-2,2,6,6-四甲基哌啶( tempol)的干预作用及其可能机制.方法 应用CIH大鼠模型,模拟OSAS慢性间歇低氧/再氧和病理生理过程.32只雄性Wistar大鼠采用随机数字表法分为低氧对照组、低氧干预组、低氧盐水组和常氧对照组,共4组,每组8只.CIH各组最低氧浓度均为5％,低氧频率均为30次/h,8 h/d.暴露6周后处死大鼠,取肝脏组织行石蜡切片HE染色观察肝细胞形态变化,酶联免疫吸附法(ELISA)测定大鼠肝脏中核因子-κB、谷胱甘肽过氧化物转移酶(GSH-PX)和丙二醛的水平.结果 肝脏病理检查可见低氧对照组及低氧盐水组肝细胞胞膜破坏,细胞水肿,胞质稀疏,核深染;低氧干预组、常氧对照组未见明显肝脏损害.与常氧对照组比较:低氧对照组和低氧盐水组核因子-κB[(12.4±2.0) ng/g,(12.2±1.9) ng/g]和丙二醛[(101±22)μmol/g,(99±18) μmol/g]水平均升高(均P＜0.05),GSH-PX活性[(88±17) U/mg,(90+15) U/mg]均下降(均P＜0.05);与低氧对照组、低氧盐水组比较,低氧干预组核因子-κB[(7.8 +1.3) ng/g]和丙二醛[(59±10) μmol/g]水平均下降(均P＜0.05),GSH-PX活性[(181±29) U/mg]均升高(均P＜0.05);低氧干预组与常氧对照组比较,GSH-PX和丙二醛水平差异均无统计学意义(均P＞0.05),但核因子-κB水平高于常氧对照组[(4.1±0.9) ng/g,P＜0.05];低氧对照组与低氧盐水组比较以上指标差异均无统计学意义(均P＞0.05).核因子-κB水平与GSH-PX活性和丙二醛水平分别呈负相关(r=-0.0754,P＜0.01)和正相关(r =0.689,P＜0.01)关系.结论 CIH可通过氧化应激和激活前炎性转录因子核因子-κB造成肝脏损伤;tempol可通过抗氧化作用清除活性氧干预CIH肝脏损害的发生.     

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.     

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.     

N-acetyl-L-cysteine combined with mesalamine in the treatment of ulcerative colitis： Randomized,placebo-controlled pilot study

AIM： To evaluate the effectiveness and safety of oral N-acetyl-L-cysteine （NAC） co-administration with mesalamine in ulcerative colitis （UC） patients.
METHODS： Thirty seven patients with mild to moderate UC were randomized to receive a four-wk course of oral mesalamine （2.4 g/d） plus N-acetyl-L-cysteine （0.8 g/d） （group A） or mesalamine plus placebo （group B）. Patients were monitored using the Modified Truelove-Witts Severity Index （MTWSI）. The primary endpoint was clinical remission （MTWSI ≤ 2） at 4 wk. Secondary endpoints were clinical response （defined as a reduction from baseline in the MTWSI of ≥ 2 points） and drug safety. The serum TNF-α, interleukin-6, interleukin-8 and MCP-1 were evaluated at baseline and at 4 wk of treatment. RESULTS： Analysis per-protocol criteria showed clinical remission rates of 63% and 50% after 4 wk treatment with mesalamine plus N-acetyl-L-cysteine （group A） and mesalamine plus placebo （group B） respectively （OR = 1.71; 95% CI： 0.46 to 6.36; P = 0.19; NNT = 7.7）. Analysis of variance （ANOVA） of data indicated a significant reduction of MTWSI in group A （P = 0.046） with respect to basal condition without significant changes in the group B （P = 0.735） during treatment. Clinical responses were 66% （group A） vs 44% （group B） after 4 wk of treatment （OR = 2.5; 95% CI： 0.64 to 9.65; P = 0.11; NNT = 4.5）. Clinical improvement in group A correlated with a decrease of IL-8 and MCP-1. Rates of adverse events did not differ significantly between both groups.
CONCLUSION： In group A （oral NAC combined with mesalamine） contrarily to group B （mesalamine alone）, the clinical improvement correlates with a decrease of chemokines such as MCP-1 and IL-8. NAC addition not produced any side effects.     

Delorme's transrectal excision for internal rectal prolapse

Surgical therapy of functional outlet obstruction in patients with internal rectal intussusception may include abdominal, perineal, or transrectal procedures. Because abdominal procedures often result in significant physiologic impact but unrelieved constipation, the authors have elected Delorme's transrectal excision for management of these patients. Since a short-term placebo effect attends many therapies, this report describes results of transrectal excision only after a threeyear postoperative period. Delorme's transrectal excision of internal intussusception accomplished sustained symptomatic relief in over 70 percent of otherwise refractory constipated patients. The association of internal intussusception with other abnormalities underscores the importance of defining both anatomic and functional components when selecting patients whose constipation may require surgical therapy. Critical technical elements, surgical pitfalls, and potential complications of the procedure are discussed.Poster presentation at the meeting of The American Society of Colon and Rectal Surgeons, Toronto, Canada, June 11 to 16, 1989.     

The oral glucose tolerance test: A comparison of the time points on the basis of limit values,normal dispersion,and reproducibility

Summary Time points in the glucose tolerance test (GTT) are compared on the basis of limit values, dispersion within a reference population, and reproducibility. We suggest using the distance between a limit value and the median reference value as a measure of the magnitude of abnormality. The distance between 140 mg/100 ml and the median fasting plasma glucose value is chosen as a standard distance and limits for other points in the GTT are calculated to equal this standard distance of abnormality. We suggest that the probability of correctly interpreting an inividual result is directly related to the reproducibility of the test and inversely related to the percentage of the total range of values which is dispersed among the normal population. The ratio of reproducibility to percentage normal dispersion is proposed as an index of the probability of correctly interpreting an individual result. According to this index, the probability of correct interpretation varies in order: fasting plasma glucose concentration>3-h>2-h>0.5-h>1-h plasma glucose concentration.