肺表面活性蛋白D的研究进展

肺表面活性蛋白D(surfactant protein D,SP-D)属于凝集素家族,与肺的天然免疫有着很大的相关性.目前的研究表明,SP-D参与多种肺部疾病的发生、发展,可以作为多种肺部疾病的生物标记.同时,SP-D可能成为治疗肺部炎症性疾病有效的治疗手段.本文就其基本结构、功能及与肺部疾病相关性作一综述.     

肺表面活性物质相关蛋白质D与哮喘的研究进展

哮喘是呼吸系统常见的慢性炎症性疾病。关于哮喘的生物学标记物种类较多,但目前尚未发现具有特异性的标记物。肺表面活性物质相关蛋白质D(SP-D)主要存在于肺内,但在肺以外的器官系统中也有少量表达。SP-D在机体防御及免疫监视中发挥重要作用,与多种肺部疾病密切相关。其中SP-D是哮喘发生、发展的重要参与者,可作为哮喘的生物学标记物。现就SP-D的功能及其在哮喘中的生物学标记物作用作一综述。     

肺泡表面相关蛋白A和D研究进展与意义

肺泡表面相关蛋白A(pulmonary surfactant-associated protein A,SP-A)、SP-D属于凝集索家族,与肺的天然免疫有着很大的相关性,能够与多种微生物表面的糖类分子以及细胞内核酸分子相结合,介导免疫功能,促使细菌、病毒、真菌以及凋亡和坏死细胞的清除和局限,同时能够与免疫细胞表面分子或者受体结合,调节树突状细胞、巨噬细胞等免疫细胞的功能.许多研究学者关于SP-A和SP-D在肺泡灌洗液、血液及其他体液中的水平有着深刻的研究,证明了SP-A和SP-D与肺内多种炎症、感染性疾病有关.除此之外,有研究学者发现相关重组蛋白在SP-A和SP-D缺陷的肺部感染性疾病的小鼠中具有一定的治疗作用.本文总结了SP-A和SP-D目前研究的深度以及和多种疾病的关系.     

肺泡表面相关蛋白A和D研究进展与意义

肺泡表面相关蛋白A(pulmonary surfactant-associated protein A,SP-A)、SP-D属于凝集索家族,与肺的天然免疫有着很大的相关性,能够与多种微生物表面的糖类分子以及细胞内核酸分子相结合,介导免疫功能,促使细菌、病毒、真菌以及凋亡和坏死细胞的清除和局限,同时能够与免疫细胞表面分子或者受体结合,调节树突状细胞、巨噬细胞等免疫细胞的功能.许多研究学者关于SP-A和SP-D在肺泡灌洗液、血液及其他体液中的水平有着深刻的研究,证明了SP-A和SP-D与肺内多种炎症、感染性疾病有关.除此之外,有研究学者发现相关重组蛋白在SP-A和SP-D缺陷的肺部感染性疾病的小鼠中具有一定的治疗作用.本文总结了SP-A和SP-D目前研究的深度以及和多种疾病的关系.     

肺泡表面相关蛋白A和D研究进展与意义

肺泡表面相关蛋白A(pulmonary surfactant-associated protein A,SP-A)、SP-D属于凝集索家族,与肺的天然免疫有着很大的相关性,能够与多种微生物表面的糖类分子以及细胞内核酸分子相结合,介导免疫功能,促使细菌、病毒、真菌以及凋亡和坏死细胞的清除和局限,同时能够与免疫细胞表面分子或者受体结合,调节树突状细胞、巨噬细胞等免疫细胞的功能.许多研究学者关于SP-A和SP-D在肺泡灌洗液、血液及其他体液中的水平有着深刻的研究,证明了SP-A和SP-D与肺内多种炎症、感染性疾病有关.除此之外,有研究学者发现相关重组蛋白在SP-A和SP-D缺陷的肺部感染性疾病的小鼠中具有一定的治疗作用.本文总结了SP-A和SP-D目前研究的深度以及和多种疾病的关系.     

重型脑外伤并ALI/ARDS患者外周血TLR4和SP-D水平变化及意义

目的 探讨外周血单个核细胞（PBMC）中Toll样受体4（TLR4）及血浆肺表面活性蛋白-D（SP-D）在重型脑外伤并急性肺损伤呼吸窘迫综合征（ALI/ARDS）发生、发展中的作用。方法 研究对象为60例重型脑外伤患者,其中并发ALI/ARDS 35例（ARDS组）,无ARDS 25例（疾病对照组）;另选30例查体健康者作为正常对照组。采用流式细胞术测定各组外周血单个核细胞（PBMC）中Toll样受体4（TLR4）水平,采用ELISA法测定血浆肺表面活性蛋白-D（SP-D）水平;测定各组肺功能指标：第1秒用力呼气量（FEV1）、用力肺活量（FVC）,计算FEV1/FVC与氧和指数（OI）;分析ARDS组、疾病对照组TLR4、SP-D与肺功能指标的相关性。结果 疾病对照组SP-D水平显著高于正常对照组,两组TLR4水平无统计学差异;ARDS组中度及重度者TLR4、SP-D均明显高于正常对照组及疾病对照组,重度者高于中度者,P均〈0.05。疾病对照组FEV1/FVC与正常对照组无显著性差异,OI显著低于正常对照组（P〈0.05）。ARDS组中度和重度者三项肺功能指标均显著低于正常对照组及疾病对照组。重度者低于中度者,P均〈0.05。相关分析结果显示,ARDS组中度和重度者TLR4、SP-D分别与三项肺功能指标均呈负相关;TLR4、SP-D与LIS均呈正相关。疾病对照组TLR4与OI无显著相关,SP-D与OI呈负相关。结论 TLR4和SP-D均参与了重型脑外伤ALI/ARDS的病理过程;SP-D水平测定对评价肺损伤程度的价值大于TLR4。     

肺表面活性物质与肺部的免疫调节

肺表面活性物质对肺部外来颗粒、白细胞反应具有重要的调节功能,但其组成成分SP-A、SP-D及磷脂的作用各有不同,本文对PS整体及各成分在肺部免疫调节中的作用分别予以总结。     

慢性阻塞性肺疾病急性加重时血清和痰液中SP-D的变化和临床意义

目的通过测定慢性阻塞性肺疾病(COPD)急性加重期(AECOPD)、稳定期患者的血清和诱导痰中肺表面活性蛋白D(SP-D)的变化,探讨痰和血清SP-D在AECOPD中的临床意义。方法随机选择我院呼吸内科住院及门诊COPD患者共50例,其中24例AECOPD患者、26例COPD稳定期患者。同时随机抽送14例吸烟非COPD和16例不吸烟者作为对照。收集患者及对照组临床资料、血清和诱导痰标本,用ELISA法测定血清及诱导痰中肺表面活性蛋白D(SP-D)水平。结果 AECOPD患者血清SP-D水平显著高于稳定期COPD和非COPD对照组(P<0.05),而痰SP-D水平则与血清水平相反,AECOPD组显著低于稳定期及对照组(P<0.05),AECOPD组血清SP-D水平与痰SP-D水平呈显著负相关性(R=-0.705,P<0.001)。结论痰SP-D水平与血清水平有较好的相关性,监测痰SP-D水平可替代血清监测作为COPD的参考生物学标志物。     

支气管扩张症患儿合并肺部感染的病原菌特征、耐药性及SP-D基因多态性分析北大核心CSCD

目的分析支气管扩张症患儿合并肺部感染的病原菌分布特征、耐药性,以及表面活性蛋白D(SP-D)基因多态性。方法本院2018年1月-2020年1月收治的96例支气管扩张症合并肺部感染患儿为研究组,同期接受治疗的100例支气管扩张但未合并肺部感染患儿为对照组。采集患儿痰液标本进行病原菌的分离鉴定,采用纸片扩散法(K-B法)检测主要病原菌的耐药性,采用PCR限制性片段长度多态性分析法检测SP-D基因rs721917的多态性,采用Logistic回归分析法分析支气管扩张症患儿肺部感染发生的危险因素。结果研究组96例患儿共分离出116株病原菌,其中革兰阴性菌68株,革兰阳性菌42株,真菌6株。主要感染病原菌肺炎链球菌16株,肺炎克雷伯菌16株,大肠埃希菌22株。大肠埃希菌对阿莫西林、头孢噻肟耐药率均超过80%,对亚胺培南、阿米卡星的耐药率均低于20%。肺炎克雷伯菌对红霉素的耐药率为87.50%,亚胺培南耐药率12.50%。肺炎链球菌阿莫西林、红霉素耐药率均超过80%,头孢吡肟、亚胺培南耐药率均低于15%。SP-D基因rs721917位点存在3种基因型:TT、TC、CC,研究组的C等位基因频率(35.42%vs 14.00%)以及CC基因型频率(56.25%vs 41.00%)均高于对照组(均P<0.05)。Logistic回归分析显示,SP-D基因Met11Thr(rs721917T/C)位点基因型多态性是影响支气管扩张症患儿发生肺部感染的独立危险因素(P<0.05)。结论支气管扩张症患儿肺部感染病原菌以革兰阴性菌为主,SP-D基因多态性是影响支气管扩张症患儿发生肺部感染的独立危险因素。不同病原菌耐药性差异较大,临床上应根据药敏试验结果合理选用抗菌药物。     

血清表面活性蛋白与系统性红斑狼疮合并间质性肺病的相关性研究

目的 探讨血清表面活性蛋白A(SP-A)和D(SP-D)与系统性红斑狼疮(SLE)合并间质性肺病(ILD)的相关性及其临床意义.方法 采用双抗体夹心酶联免疫吸附试验(ELISA)检测,并比较SLE组和对照组血清样本SP-A和SP-D水平的差异,分析其与SLE合并ILD的关系,判断与肺部高分辨率CT(HRCT)评分、肺功能、年龄、病情活动指标之间的相关性.结果 SLE组患者血清SP-A和SP-D水平高于健康对照组(P＜0.05).SLE组并发ILD患者血清SP-A和SP-D水平高于未合并ILD者以及对照组(P＜0.05).合并ILD的SLE患者血清SP-D水平与HRCT磨玻璃影评分(r=0.508,P=0.004)和间质病变评分(r=0.468,P=0.009)呈正相关关系,与肺活量(%VC)(r=-0.590,P=0.001)和一氧化碳弥散量(%DLCO)(r=-0.588,P＜0.01)呈负相关关系,而SP-A与上述指标无明显相关.SLE患者血清SP-D水平与年龄呈正相关关系(r=0.352,P=0.001).SLE-ILD组血清SP-D水平与血清IsG(r=0.376,P=0.040)呈正相关关系,SP-A水平与C反应蛋白(CRP)(r=0.403,P=0.027)呈正相关关系.结论 SP-D和SP-A是SLE并发ILD的血清学标志,SP-D与患者的HRCT评分、肺功能指标、年龄和病情活动度相关.     

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.     

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.