川芎嗪联合环磷腺苷葡胺治疗肺尘埃沉着病合并肺心病患者的临床效果

目的探讨川芎嗪联合环磷腺苷葡胺对肺尘埃沉着病(尘肺)合并肺心病患者的临床效果。方法选择92例尘肺合并肺心病,按抽签法分为对照组和试验组,每组46例。对照组予以环磷腺苷葡胺治疗,静脉滴注150 mg环磷腺苷葡胺和250 ml 5%葡萄糖注射液,1次/d,持续治疗14 d。试验组基于对照组联合川芎嗪治疗,静脉滴注120 mg川芎嗪和250 ml 5%葡萄糖注射液,1次/d,持续治疗14 d。比较两组临床疗效,血清白细胞介素(IL)-6、脑钠肽(BNP)、D-二聚体(D-D)、纤维蛋白原(FIB)、心肺功能及不良反应发生情况。结果两组有效率差异有统计学意义(P0.05)。治疗后,两组血清IL-6、BNP、FIB水平比较差异有统计学意义(P0.05)。试验组心肺功能显著优于对照组(P0.05)。两组均有腹泻、呕吐、恶心发生,药物不良反应发生率差异无统计学意义(P0.05)。结论川芎嗪联合环磷腺苷葡胺对尘肺合并肺心病患者的效果优于环磷腺苷葡胺,能够降低血清IL-6、BNP、D-D、FIB水平,缓解病情。     

参麦注射液联合环磷腺苷葡胺对老年心力衰竭病人血清CK-MB、BNP、NPY水平及生活质量的影响

目的观察参麦注射液联合环磷腺苷葡胺对老年心力衰竭病人血清肌酸激酶同工酶(CK-MB)、脑利钠肽(BNP)和神经肽Y(NPY)水平变化及生活质量的影响。方法选取2015年4月—2016年10月在我院就诊的心力衰竭病人80例为研究对象,根据治疗方式不同分为对照组与研究组,每组40例。对照组予以常规治疗,在此基础上,研究组给予参麦注射液联合环磷腺苷葡胺治疗。治疗14 d后,比较两组临床疗效、血清CK-MB、BNP、NPY水平、生活质量以及不良反应发生情况。心功能指标包括左室射血分数(LVEF)、左心室短轴缩短率(LVFS)、每搏输出量(SV)和心排出量(CO)。结果研究组治疗总有效率为92.50%,对照组治疗总有效率为75.00%,组间比较差异具有统计学意义(P 0.05);研究组血清CK-MB、BNP、NPY水平低于对照组,差异具有统计学意义(P 0.05);研究组LVFS、LVEF、SV、CO水平均高于对照组,差异具有统计学意义(P 0.05);研究组生活质量评分高于对照组,差异具有统计学意义(P 0.05);研究组中不良反应总发生率为12.50%,对照组不良反应总发生率为17.50%,组间比较差异无统计学意义(P0.05)。结论对老年心力衰竭病人实施参麦注射液联合环磷腺苷葡胺治疗,能有效改善血清CK-MB、BNP、NPY水平,提高临床疗效和生活质量,减轻心肌损伤,改善心功能,且不会增加毒副反应,安全性较高。     

环磷腺苷葡胺治疗病毒性心肌炎的临床疗效观察

目的观察环磷腺苷葡胺治疗病毒性心肌炎的临床效果。方法将152例病毒性心肌炎患者随机分为研究组和对照组。对照组采用维生素C、能量合剂等常规方法治疗,研究组在常规治疗的基础上,选用环磷腺苷葡胺185mg加入5%葡萄糖溶液250ml静脉滴注,1次/d。结果对照组痊愈32例(42.10%),好转22例(28.95%),无效22例(28.95%),总有效率为71.05%;研究组痊愈56例(73.68%),好转14例(18.42%),无效6例(7.89%),总有效率为92.10%;两组总有效率和痊愈率比较,差异均有统计学意义(P<0.05)。结论环磷腺苷葡胺治疗病毒性心肌炎具有很好的效果,其安全、可靠,值得在临床上应用和推广。     

环磷腺苷葡胺注射液对中老年心动过缓(窦性)治疗中的应用效果分析

目的探究在中老年心动过缓(窦性)治疗的过程中,使用环磷腺苷葡胺注射液治疗的效果。方法针对40例中老年心动过缓(窦性)患者采用常规方法治疗,并归为对照组,针对另外40例患者采用环磷腺苷葡胺注射液治疗,并归为观察组,两组共80例患者均为我院2013年2月到2016年5月间收治。结果针对性比较两组患者的治疗有效率发现,观察组患者97.5%明显较高(对照组为67.5%),组间比较差异具有统计学意义(P0.05)。两组患者均没有出现明显的不良反应。结论环磷腺苷葡胺注射液对中老年心动过缓(窦性)治疗中的应用效果分析发现,其能够较好的改善患者症状,同时帮助患者得到恢复,提高患者治疗的有效率,同时不会产生明显的不良反应,因此值得临床使用。     

丹红注射液联合环磷腺苷葡胺治疗急性脑梗死43例临床分析

目的 观察丹红注射液合用环磷腺苷葡胺治疗急性脑梗死的临床疗效.方法 将86例急性脑梗死患者随机分为对照组和观察组,各43例.对照组给予常规治疗,观察组在常规治疗的基础上加用丹红注射液和环磷腺苷葡胺治疗.结果 观察组总有效率95.35%,明显高于对照组的72.09%,差异有统计学意义(P<0.05),治疗期间两组均没有发生不良反应.结论 在常规治疗基础上加用丹红注射液和环磷腺苷葡胺治疗急性脑梗死疗效显著,副反应少,是治疗急性脑梗死的有效方法.     

卡托普利联合环磷腺苷葡胺对老年慢性心力衰竭患者血清C-反应蛋白的影响

目的评价卡托普利联合环磷腺苷葡胺对老年慢性心力衰竭患者血清C-反应蛋白(hs-CRP)的影响。方法 70例老年慢性心力衰竭患者分为观察组和对照组。对照组运用常规治疗,包括强心、利尿和扩张血管等。观察组在对照组用药方式的基础上,加用卡托普利片及环磷腺苷葡胺治疗。结果治疗2 w后,观察组总有效率(94.29%)高于对照组(77.14%)(P<0.05);两组hs-CRP与治疗前相比均有所降低(P<0.01);观察组hs-CRP水平〔(8.42±2.75)mg/L〕低于对照组〔(10.15±3.40)mg/L〕(P<0.05)。结论卡托普利联合环磷腺苷葡胺治疗老年慢性心力衰竭患者疗效佳,可有效改善心功能,并改善患者血清hs-CRP水平。     

环磷腺苷葡胺联合咪达普利治疗慢性心力衰竭的临床疗效

目的观察环磷腺苷葡胺联合咪达普利治疗慢性心力衰竭(CHF)的临床疗效。方法选取2015年3月—2018年1月达州市中心医院收治的CHF患者87例,采用随机数字表法分为对照组(n=43)和观察组(n=44)。在常规抗心力衰竭治疗基础上,对照组患者采用咪达普利治疗,观察组患者采用环磷腺苷葡胺联合咪达普利治疗;两组患者均连续治疗2周。比较两组患者临床疗效,治疗前后心功能指标[包括心脏指数(CI)、左心室射血分数(LVEF)及6分钟步行距离]、心肌细胞损伤相关指标[包括血清氨基末端脑钠肽前体(NT-proBNP)、胰岛素样生长因子1(IGF-1)及白介素6(IL-6)水平]及健康调查简表(SF-36)评分,并观察两组患者治疗期间不良反应发生情况。结果 (1)观察组患者临床疗效优于对照组(P<0.05)。(2)治疗前两组患者CI、LVEF、6分钟步行距离比较,差异无统计学意义(P>0.05);治疗后观察组患者CI、LVEF高于对照组,6分钟步行距离长于对照组(P<0.05)。(3)治疗前两组患者血清NT-proBNP、IGF-1、IL-6水平比较,差异无统计学意义(P>0.05);治疗后观察组患者血清NT-proBNP、IL-6水平低于对照组,血清IGF-1水平高于对照组(P<0.05)。(4)治疗前两组患者SF-36评分比较,差异无统计学意义(P>0.05);治疗后观察组患者SF-36评分高于对照组(P<0.05)。(5)两组患者治疗期间不良反应发生率比较,差异无统计学意义(P>0.05)。结论环磷腺苷葡胺联合咪达普利治疗CHF的临床疗效确切,能有效改善患者心功能,减轻心肌细胞损伤,提高患者生活质量,且安全性较高。     

阿托伐他汀和环磷腺苷葡胺联合治疗慢性心力衰竭的临床分析

目的研究分析联合应用阿托伐他汀和环磷腺苷葡胺对慢性心力衰竭的治疗作用。方法选取n=90例慢性心力衰竭患者,随机分为研究组和对照组,对照组进行常规的抗CHF治疗,研究组采用阿托伐他汀和环磷腺苷葡胺联合治疗,用药3个疗程后进行心肌重塑情况和治疗效果评价。结果研究组患者的治疗显效率、有效率和总有效率明显高于对照组(P0.05),无效率显著低于对照组(P0.05)。研究组患者的心率、左心室舒张末期容积(LVEDV)和左心室收缩末期容积(LDESV)均明显低于对照组(P0.05),左心室射血分数(LVEF)明显高于对照组(P0.05)。结论联合应用阿托伐他汀和环磷腺苷葡胺能够有效地治疗慢性心力衰竭,推荐临床使用。     

临床治疗慢性心衰使用倍他乐克联合环磷腺苷葡胺治疗的效果

目的探讨冠心病慢性心力衰竭患者应用环磷腺苷葡胺与倍他乐克的临床效果。方法本次研究样本选取2017年5月-2019年4月于本院治疗的80例冠心病慢性心力衰竭患者。按照数字表法将所有患者分为参照组与研究组,每组各40例,参照组接受常规治疗,研究组则使用环磷腺苷葡胺与倍他乐克片联合治疗。观察和对比两组患者的治疗效果。结果研究组血浆脑钠肽(BNP)水平低于参照组,左心室射血分数(LVEF)高于参照组,6 min步行试验(6MWT)长于参照组,差异具有统计学意义(P<0.05);两组无显著不良反应发生情况。结论采用环磷腺苷葡胺与倍他乐克治疗冠心病慢性心力衰竭患者可有效改善患者的心功能,消除活动限制,且安全性高。     

环磷腺苷葡胺治疗毛细支气管炎临床疗效观察

目的探讨环磷腺苷葡胺治疗毛细支气管炎临床疗效与安全性。方法对我院儿科收住的120例毛细支气管炎患儿随机分为治疗组与对照组。两组均给予常规治疗,治疗组给予环磷腺苷葡胺注射液,每日2～5 mg/kg,静脉滴注,每日1次。观察两组患儿咳嗽、气促、喘息、肺部体征改善时间及住院天数。结果治疗组有效率(93.3%)明显高于对照组(80%),P<0.05。治疗组咳嗽、气促、喘息、肺部体征改善时间及住院天数较对照组明显缩短,P<0.05。结论环磷腺苷葡胺治疗毛细支气管炎疗效确切,安全可靠,值得临床推广应用。     

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.     

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.     

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.     

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.     

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.     

Language of CTO interventions – Focus on hardware

The knowledge of variety of chronic total occlusion (CTO) hardware and the ability to use them represents the key to success of any CTO interventions. However, the multiplicity of CTO hardware and their physical character and the terminology used by experts create confusion in the mind of an average interventional cardiologist, particularly a beginner in this field. This knowledge is available but is scattered. We aim to classify and compare the currently used devices based on their properties focusing on how physical character of each device can be utilized in a specific situation, thus clarifying and simplifying the technical discourse.