Parathyroid hormone and calcitonin secretion in man: effect of dopamine agonists and antagonists

This study was undertaken to evaluate the physiological role, if any, of dopamine (DA) in modulating parathyroid hormone (PTH) and calcitonin (CT) secretion in man. Infusion of DA (5 micrograms/kg/min) into 6 normal men, decreased serum immunoreactive prolactin (iPRL) and concomitantly increased serum iPTH to 140 +/- 6.8% of baseline (P less than 0.01) at 30 min, with decline thereafter, despite continuation of the DA infusion. Serum iCT levels did not significantly change. Chlorpromazine (50 mg IM), decreased serum iPTH to 75 +/- 5.4% and 79 +/- 3.7% of baseline (P less than 0.01) at 30 and 60 min, respectively, associated with an increase in iPRL. There was subsequent return of iPTH to baseline even though iPRL remained elevated. iCT levels did not significantly change. These observations would suggest that DA may play a physiological role in iPTH, but not iCT, secretion. However, infusion of more nearly physiological doses of DA (0.02, 0.2, and 2.0 micrograms/kg/min) lowered serum iPRL to levels similar to those after the larger DA dose, but with no concomitant increase in either iPTH or iCT. Also, 1) the DA agonist bromocriptine decreased serum iPRL without modifying iPTH or iCT; 2) the DA precursor, levodopa, and the DA antagonist, metoclopramide, had no effect on serum iPTH or iCT levels. These studies suggest that 1) the transient stimulatory effect of DA on iPTH secretion is pharmacological, and 2) DA does not have a physiological role in secretion of iPTH or iCT in man.     

烧伤早期伴发脓毒症患者血清PCT、hs-CRP、COR及WBC的动态变化及临床意义

目的:探讨烧伤早期伴发脓毒症患者血清降钙素原(PCT)、超敏C反应蛋白(hs-CRP)、皮质醇(COR)和白细胞计数(WBC)水平并分析其临床价值。方法:回顾性分析2014年12月至2018年1月本院收治的63例烧伤早期患者的临床资料,其中19例患者伴发脓毒症(脓毒症组),44例患者未伴发脓毒症(无脓毒症组),另选取30例于本院进行体检的志愿者作为健康对照组,依据病情严重程度将脓毒症患者分为脓毒症休克组(n=4)、严重脓毒症组(n=7)、一般脓毒症组(n=8),依据预后情况分为预后良好组(n=13)和预后不良组(n=6)。动态检测并对比所有研究对象血清PCT、hs-CRP、COR和WBC水平。结果:无脓毒症组、脓毒症组血清PCT、hs-CRP、COR和WBC水平高于健康对照组,且脓毒症组高于无脓毒症组(P<0.05)。烧伤后7 d、11 d、15 d,脓毒症组血清PCT、hs-CRP、COR和WBC水平均高于无脓毒症组(P<0.05)。脓毒症休克组血清PCT、hs-CRP、COR和WBC水平高于严重脓毒症组、一般脓毒症组,且严重脓毒症组患者高于一般脓毒症组患者(P<0.05)。预后不良组血清PCT、hs-CRP、COR和WBC水平高于预后良好组(P<0.05)。结论:血清PCT、hs-CRP、COR和WBC水平在烧伤早期伴发脓毒症患者中水平异常升高,与病情严重程度有关,上述指标对预后判断有一定的临床参考价值。     

Risk Factors for Diabetes Mellitus in Women with Primary Ovarian Insufficiency

Primary ovarian insufficiency (POI) is not only a gynecological problem but also has serious effects on women’s health such as changes in hormone levels that can trigger fluctuations in blood sugar level and inflammation status. The present study was designed to determine vitamin D, copper, zinc, metabolic parameters [insulin, homeostasis model of assessment-insulin resistance (HOMA-IR)], inflammation parameters such as procalcitonin and high sensitivity C reactive protein (hs-CRP), and lipid profile in POI patients and control subjects with normal menstrual cycles. A total of 43 patients with nondiabetic POI were studied in order to evaluate and compare the findings with those of the control group, which comprised 33 women with normal menstrual cycles. The women with POI had higher levels of serum copper, serum insulin, glucose, LDL-cholesterol, total cholesterol, HOMA-IR, hs-CRP, and procalcitonin, whereas serum vitamin D and zinc levels were lower compared with the healthy control group. Follicle-stimulating hormone (FSH) levels were positively correlated with insulin, glucose, HOMA-IR, hs-CRP, procalcitonin, and copper and negatively correlated with vitamin D and zinc levels. In multivariate statistic analyses with body mass index and FSH as dependent variables, FSH was positively associated with copper and HOMA-IR negatively with vitamin D levels. The present study demonstrated that women with POI have traditional risk factors for diabetes mellitus, including lower levels of vitamin D, whereas higher levels of copper and HOMA-IR.     

Evidence for cigarette smoke-induced calcitonin secretion from lungs of man and hamster

In hamsters, acute cigarette smoke inhalation increased serum levels of the hormone calcitonin; and, in humans, smoking of two high-nicotine content cigarettes increased serum and urine levels of this hormone. The source of this immunoreactive calcitonin (iCT) does not appear to be the thyroid gland, since previously thyroidectomized patients demonstrated a similar response. In the hamster, the increased serum iCT levels were accompanied by a decreased lung tissue iCT content and hypocalcemia. It is suggested that the source of the cigarette smoke-induced hypercalcitonemia is the lung, possibly from the iCT-containing pulmonary neuroendocrine (PNE) cells. Moreover, this response appears to be dependent on the nicotine content of the cigarettes.     

Comparative studies of hamster calcitonin from pulmonary endocrine cells in vitro

The lung-associated peptide calcitonin (CT) has been localized by immunocytochemical means to discrete pulmonary endocrine (PE) cells. A long-term cell culture of CT-staining PE cells has been established. The molecular configuration of immunoreactive (iCT) from PE cell extracts was determined by gel chromatography, revealing predominantly large molecular weight forms of iCT. The size distribution characteristics of PE Cell iCT were similar to those of intact hamster lung. In contrast, hamster thyroid extracts contain predominantly 4000 dalton iCT (presumed monomer) and apparent iCT fragments. The culture media of the PE cells were found to contain mainly 4000 dalton iCT. We conclude that although the predominant forms of iCT found within cultured PE cells are distinct from those found within thyroidal C-cells, both iCT producing cells release mainly the monomer into the media. Malignant human bronchial carcinoid cells store predominantly monomeric iCT while secreting large molecular weight forms of iCT. Since the PE cell is the putative precursor cell to neuroendocrine malignancies, the disparity noted in the processing of CT may have significant pathobiological implications.     

Immunoreactive parathyroid hormone and calcitonin in children's cerebrospinal fluid

Cerebrospinal fluid (CSF) levels of immunoreactive parathyroid hormone (iPTH) and immunoreactive calcitonin (iCT) were measured by radioimmunoassay in 23 outpatient leukemic children on maintenance chemotherapy. These hormones were detectable in the CSF of all patients: iPTH 148 +/- 11 pg/ml (mean +/- SEM); iCT 14.3 +/- 0.8 pg/ml. iPTH and iCT were also measured in serum (iPTH 396 +/- 18 pg/ml; iCT 32.3 +/- 1.4 pg/ml). CSF values were significantly lower (p less than 0.001) than serum concentrations; no significant correlation between the two compartments was found. Our study indicates the presence of iPTH and iCT in the CSF of children.     

AECOPD患者血清降钙素原与其它炎症指标水平的相关性分析

目的：分析慢性阻塞性肺疾病急性加重（AECOPD）患者血清降钙素原与其它炎症指标水平的相关性。方法：选择2012年1月至2012年12月我院重症医学科收治的195例AECOPD患者作为研究对象,所有患者均采血后行降钙素原（procalcitonin,PCT）、超敏c反应蛋白（C-reactiveprotein,hs-CRP）、血常规（blood General,WBC）、血沉（erythrocyte sedimentationrate,ESR）、白介素六（interleukin-6,IL-6）检测,同时采集痰标本后行痰培养和药敏试验检测,分析其血清PCT水平与其它炎症指标的相关性。结果：195例AECOPD患者中,PCT增高者43例（22．1％）,正常者152例（77．9％）,其血清PCT水平与hs-CRP、WBC、中性粒细胞百分比（neutrophilpercentage,NEUT％）均显著相关（P〈0．05）,相关系数分别为0．262、0．382、0．333,与ESR、IL-6、痰培养结果无明显相关性（P〉0．05）。结论：血清PCT水平判定AECOPD患者是否合并感染有一定的局限性,联合检测hs-CRP、WBC、NEUT％,可作为诊断AECOPD感染的有力补充。     

AECOPD患者血清降钙素原与其它炎症指标水平的相关性分析

目的:分析慢性阻塞性肺疾病急性加重(AECOPD)患者血清降钙素原与其它炎症指标水平的相关性。方法:选择2012年1月至2012年12月我院重症医学科收治的195例AECOPD患者作为研究对象,所有患者均采血后行降钙素原(procalcitonin,PCT)、超敏C反应蛋白(C-reactive protein,hs-CRP)、血常规(blood General,WBC)、血沉(erythrocyte sedimentation rate,ESR)、白介素六(interleukin-6,IL-6)检测,同时采集痰标本后行痰培养和药敏试验检测,分析其血清PCT水平与其它炎症指标的相关性。结果:195例AECOPD患者中,PCT增高者43例(22.1%),正常者152例(77.9%),其血清PCT水平与hs-CRP、WBC、中性粒细胞百分比(neutrophil percentage,NEUT%)均显著相关(P0.05),相关系数分别为0.262、0.382、0.333,与ESR、IL-6、痰培养结果无明显相关性(P0.05)。结论:血清PCT水平判定AECOPD患者是否合并感染有一定的局限性,联合检测hs-CRP、WBC、NEUT%,可作为诊断AECOPD感染的有力补充。     

Opsonic Activity of Sera and Blister Fluid from Severely Burned Patients Evaluated by a Chemiluminescence Method

Burn wound sepsis is the most common and severe complication in the patients with severe burn. To know the systemic and local defect in immunity of burned patients, we measured the luminol-enhanced chemiluminescence (CL) response of normal polymorphonuclear leukocytes (PMNs) upon exposure to zymosan particles, bacteria or Candida albicans that were opsonized with any of patient's serum, blister fluid of burn wound or pooled normal serum (blood type AB). Sera from patients exhibited lower opsonic activities than those of pooled normal serum in the early postburn days. The levels of serum immunoglobulins, complement components and plasma fibronectin were found to correlate well with opsonin-index (OI), which was determined based on the CL response data obtained during the course of infusion therapy with fresh frozen plasma. Furthermore, patient's blister fluid showed much lower opsonic activity against bacteria such as Pseudomonas aeruginosa than patient's own serum. These results indicate that blister fluid is also not effective to opsonize bacteria because of the marked depression of the levels of immunoglobulins and complement components. Destruction of the skin barrier by thermal injury and impairment of systemic or local humoral immunity may predispose these patients to burn wound sepsis.     

Calcitonin gene expression induced by lipopolysaccharide in the rat pituitary

Procalcitonin (PCT), the precursor protein of calcitonin (CT), has been considered recently as a significant indicator of bacterial infection and sepsis. However, the major source of PCT in sepsis remains unclear. The hypothalamic-pituitary-adrenal axis is activated during sepsis. Moreover, immunoreactive CT (iCT) can be detected in the pituitary. Therefore, we examined the effects of lipopolysaccharide (LPS) administration on CT mRNA expression in the pituitary. After administration of LPS, CT mRNA expression in the pituitary was increased significantly. The increase of CT mRNA was associated with significant elevations of the iCT levels in the serum. These results imply that the pituitary is one of the sources of the serum PCT during sepsis.     

Differential effects of thermal injury on circulating insulin-like growth factor binding proteins in burn patients

The results of this report provide evidence that insulin-like growth factor-1 binding proteins (IGFBPs) in human sera are differentially regulated as a result of severe burn injury. Using the ligand binding technique,¹²⁵I-IGF-1 visualizes 5 different protein bands corresponding to those previously reported for IGFBP-1 to 4 with apparent sizes of 23–42 kd in serum samples prepared from severely burned patients and healthy individuals. The level of IGFBP-3 was significantly decreased within 3–5 days of injury and remained depressed for up to 20 days post injury. The average level of this binding protein reached its lowest value within 3–5 days of the injury (3.8±1.48% relative to day 0–1 value, n=4, p<0.001). Serum samples from 3 to 4 patients showed no recovery within 20 days post injury and the level of IGFBP-3 remained significantly depressed (p<0.01). In contrast, the levels of IGFBP-2 and IGFBP-4 increased 2 and 3 fold in the same serum samples within 3–5 days of the burn injury, respectively. This increase returns to normal (day 0–1 value) within 7–10 days for IGFBP-2, but the level of IGFBP-4 remained elevated 4 fold relative to the day 0–1 (p<0.01). However, the abundance of IGFBP-1 in these serum samples was not significantly altered by the burn injury. By controlling for protein loading, these apparent alterations of IGFBPs in the sera of burned patients were not due to hemodilution. Similarly, significant reductions in IGFBP-3 were not likely due to IGFBP-3 specific protease activity in the sera of burn patients since incubation of sera from burn patients and normal individuals at 37° C did not alter the pattern of IGFBPs in sera obtained from normal individuals. Of interest, the level of IGF-1 protein in these samples was also markedly reduced following severe burn injury similar to IGFBP-3. The results of this study suggest that a marked reduction of serum IGF-1 seen in burn patients is associated with a significant reduction of IGFBP-3, a major IGF-1 binding protein in human serum.     

多囊卵巢综合征患者血清抗苗勒管激素与肥胖、胰岛素抵抗程度的相关性分析

目的:探讨多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者血清抗苗勒管激素(anti-Müllerian hormone,AMH)水平与肥胖、胰岛素抵抗(insulin resistance,IR)程度的相关性。方法:选择在我院生殖中心就诊的139名PCOS患者为研究组,并以月经周期正常、因输卵管因素或男性因素导致不孕者48名作为对照组。检测和比较PCOS患者的血清AMH、性激素水平及代谢指标,分析血清AMH水平与PCOS患者肥胖、胰岛素抵抗程度的关系。结果:PCOS组患者体质量指数(body mass index,BMI)、黄体生成素(luteinizing hormone,LH)、睾酮(testosterone,T)、垂体泌乳素(pituitary prolactin PRL)、空腹血糖(fasting plasma glucose,FPG)、空腹胰岛素(fasting insulin,FINS)、稳态模型胰岛素抵抗指数(homenostasis models assessment-insulin resistance index,HOMA-IR)的水平均显著高于对照组(P0.05),PCOS组和对照组年龄、卵泡刺激素(follicle stimulating hormone,FSH)比较差异无统计学意义(P0.05)。PCOS各表型组的血清AMH浓度、LH/FSH比值均明显高于对照组(P0.05)。肥胖组患者的AMH浓度低于正常体重组,BMI、FPG、FINS、HOMA-IR、甘油三脂(triglycerides,TG)水平均高于正常体重组,LH、LH/FSH、高密度脂蛋白(high density lipoprotein,HDL-C)水平均低于正常体重组(P0.05)。高HOMA-IR组患者的血清AMH浓度、LH、LH/FSH水平均明显低于低HOMA-IR组,BMI、T、FPG、FINS、TG、低密度脂蛋白(low density lipoprotein,LDL-C)水平均高于低HOMA-IR组(P0.05)。PCOS患者血清AMH浓度和BMI及HOMA-IR均存在显著负相关。结论:PCOS患者血清的AMH水平较对照组明显升高,与其肥胖、胰岛素抵抗(IR)程度呈显著负相关。     

Immunity,Transferrin, and Survival in Kwashiorkor

In a study of 40 children with kwashiorkor, serum albumin, transferrin, and immunoglobulin levels were measured. Treatment included chloroquine, pyrimethamine, multivitamins, folic acid, iron compounds, and a high-protein diet. After two weeks the mean serum transferrin values in the children who survived and those who died were 1·30 mg./ml. and 0·33 mg./ml., respectively. Many of the children died immediately after treatment started, and it is suggested that in children with severe kwashiorkor and low serum transferrin levels any increase in free-circulating iron may result in overwhelming infection and death. Thus the appropriate time for instituting iron therapy in such patients should be reconsidered.     

强化胰岛素治疗对脓毒症患者 血清D-乳酸及前降钙素水平的影响及疗效观察

目的探讨强化胰岛素治疗对脓毒症患者血清D-乳酸及前降钙素水平的影响及疗效观察。方法选取脓毒症患者72例,随机分为强化组和对照组,每组36例。两组患者均予以抗生素抗感染、能量支持及治疗基础疾病等常规治疗,必要时行机械通气或血管活性药物。强化组患者将50 U胰岛素加入50 mL生理盐水中微量泵控制血糖5.0~7.0 mmol/L;对照组患者血糖控制在10.0~11.9 mmol/L,当血糖超过时才加用胰岛素治疗。观察两组患者治疗前和治疗7 d后血清D-乳酸及前降钙素水平的变化,并比较其临床疗效。结果治疗7 d后,两组患者血清D-乳酸及前降钙素水平均较前明显下降（P〈0.01或P〈0.05）,且强化组下降值明显大于对照组（P〈0.05）;强化组患者的临床总有效率明显高于对照组（94.44%vs.77.78%）（χ2=4.18,P〈0.05）。结论强化胰岛素治疗脓毒症患者具有较好的临床疗效,能明显降低血清D-乳酸及前降钙素水平的影响,改善肠黏膜屏障功能。     

The relationship between levels of plasma-soluble urokinase plasminogen activator receptor (suPAR) and presence of migraine attack and aura

Migraine is one of the most common types of pain associated with sterile inflammatory conditions. Soluble urokinase plasminogen activator receptor (suPAR) is a potential novel inflammatory marker. We aim to determine the association between serum values of suPAR, procalcitonin, fibrinogen, and high-sensitivity C-reactive protein (hs-CRP) and migraine disease characteristics. The study involved a total of 60 migraine patients (33 patients in the interictal period, 27 patients in the attack period) and 30 healthy individuals. The serum values of suPAR were found to be significantly higher in migraine patients in the attack period than in migraine patients in the interictal period, and in healthy individuals (p?p?=?.001 for both). Significant differences were found between plasma levels of fibrinogen in migraine patients versus control subjects (p?相似文献   

Cloning and characterization of the complementary DNA for the B chain of normal human serum C1q

Normal human C1q is a serum glycoprotein of 460 kDa containing 18 polypeptide chains (6A, 6B, 6C) each 226 amino acids long and each containing an N-terminal collagen-like domain and a C-terminal globular domain. Two unusual forms of C1q have been described: a genetically defective form, which has a molecular mass of approximately 160 kDa and is found in the sera of homozygotes for the defect who show a marked susceptibility to immune complex related disease; a fibroblast form, shown to be synthesized and secreted, in vitro, with a molecular mass of about 800 kDa and with chains approximately 16 kDa greater than those of normal C1q. A higher than normal molecular mass form of C1q has also been described in human colostrum and a form of C1q has been claimed to represent one of the types of Fc receptor on guinea-pig macrophages. To initiate studies, at the genomic level, on these various forms of C1q, and to investigate the possible relation between the C1q genes and the procollagen genes, the complementary DNA corresponding to the B chain of normal C1q has been cloned and characterized.     

Metallic elements in exhaled breath condensate and serum of patients with exacerbation of chronic obstructive pulmonary disease

Biomarkers in exacerbated chronic obstructive pulmonary disease may be useful in aiding diagnosis, defining specific phenotypes of disease, monitoring the disease and evaluating the effects of drugs. The aim of this study was the characterization of metallic elements in exhaled breath condensate and serum as novel biomarkers of exposure and susceptibility in exacerbated chronic obstructive pulmonary disease using reference analytical techniques. C-Reactive protein and procalcitonin were assessed as previously validated diagnostic and prognostic biomarkers which have been associated with disease exacerbation, thus useful as a basis of comparison with metal levels. Exhaled breath condensate and serum were obtained in 28 patients at the beginning of an episode of disease exacerbation and when they recovered. Trace elements and toxic metals were measured by inductively coupled plasma-mass spectrometry. Serum biomarkers were measured by immunoassay. Exhaled manganese and magnesium levels were influenced by exacerbation of chronic obstructive pulmonary disease, an increase in their concentrations--respectively by 20 and 50%--being observed at exacerbation in comparison with values obtained at recovery; serum elemental composition was not modified by exacerbation; serum levels of C-reactive protein and procalcitonin at exacerbation were higher than values at recovery. In outpatients who experienced a mild-moderate chronic obstructive pulmonary disease exacerbation, manganese and magnesium levels in exhaled breath condensate are elevated at admission in comparison with values at recovery, whereas no other changes were observed in metallic elements at both the pulmonary and systemic level.     

不同预后脓毒症患者血清降钙素原、C反应蛋白与凝血功能指标和APACHE Ⅱ评分的关系分析

目的:探讨不同预后脓毒症患者血清降钙素原(PCT)、C反应蛋白(CRP)与凝血功能指标和急性生理和慢性健康状况评分系统Ⅱ(APACHE Ⅱ)评分的关系.方法:回顾性分析2015年1月至2019年1月期间深圳市第二人民医院重症医学科收治的160例脓毒症患者(脓毒症组)与在深圳市第二人民医院接受住院治疗的160例非脓毒症患...     

The pathomorphology of the superior cervical sympathetic ganglia in burns

Structural changes of upper cervical sympathetic ganglions of 75 patients who died in different stages of burn disease at the age of 19-85, were studied by neurohistological and neurohistochemical methods. It was determined that neurones change at earlier stages of burn disease begins with their reactivity increase. Later hypertrophy, atrophy and decay of neurones body take place. Sharp cateholamine exhaustion in the structures of upper cervical sympathetic ganglions is also determined during the first days of burn trauma (burn shock stage). Some restoring of mediator stock takes place in subsequent periods of burn disease.     

重症慢性阻塞性肺病急性发作期患者血清PCT, hs-CRP及D-D的表达及意义

目的:探究重症慢性阻塞性肺病(COPD)急性发作期患者血清降钙素原(PCT)、超敏C反应蛋白(hs-CRP)和D-二聚体(D-D)的表达及意义。方法:选取2014年9月-2016年9月我院收治的146例COPD患者作为研究对象,其中73例COPD急性发作期(AECOPD)患者纳入急性期组,73例COPD缓解期患者纳入缓解期组,另选取同期来我院体检的40例健康者作为对照组。比较三组研究对象的血清PCT、hs-CRP和D-D水平,同时比较急性期组细菌感染与无细菌感染患者、不同肺功能分级的患者血清PCT、hs-CRP和D-D水平的差异。结果:急性期组与缓解期组患者的血清PCT、hs-CRP和D-D水平较对照组显著升高(P0.05),急性期组的血清PCT、hs-CRP和D-D水平较缓解期组显著升高,差异有统计学意义(P0.05)。合并细菌感染组血清PCT、hs-CRP水平均显著高于无细菌感染组(P0.05),而D-D水平则无统计学差异(P0.05)。不同肺功能分级患者间的血清PCT、hs-CRP和D-D水平比较差异显著(P0.05),且肺功能分级越高水平越高(P0.05)。结论:AECOPD患者的血清PCT、hs-CRP和D-D水平均显著的升高,三者联合检测能够有效反映患者病情严重程度,并有利于诊断患者是否存在有细菌感染。