强力天麻杜仲胶囊治疗椎-基底动脉供血不足的疗效观察

目的观察强力天麻杜仲胶囊对椎-基底动脉血流速度和血浆内皮素(ET)、血栓素B2(TXB2)、6-酮-前列腺素(6-Keto-PGF1α)、血管紧张素Ⅱ(AngⅡ)的影响。方法110例椎-基底动脉供血不足(VBI)病人随机分为3组,治疗组40例,口服强力天麻杜仲胶囊;对照组40例,口服通心络胶囊;基础组30例,静滴金络通。治疗组和对照组均联合基础治疗。采用TCD和放射免疫学方法观察椎-基底动脉血流速度和血浆ET、TXB2、6-Keto-PGF1α、AngⅡ的变化。结果强力天麻杜仲胶囊对VBI的症状改善有效率达92.5%,与通心络比较无统计学意义(P>0.05)。并且能有效加快椎-基底动脉的血流速度,同时能显著降低血浆中ET、TXB2、AngⅡ水平,升高6-Keto-PGF1α的含量。结论强力天麻杜仲胶囊治疗VBI有效。     

通心络胶囊治疗老年不稳定型心绞痛临床观察

目的 观察通心络胶囊治疗老年不稳定型心绞痛的临床疗效.方法 选择老年不稳定型心绞痛气虚血瘀型患者70例,随机分为治疗组和对照组(各35例).对照组给予常规西药治疗,治疗组在常规治疗基础上口服通心络胶囊,每日3次,每次4粒,两组疗程均为4周.观察治疗前后心绞痛发作次数、心电图ST-T变化及血液流变学情况.结果 治疗组与对照组缓解心绞痛总有效率分别为91.4%和80.0%,心电图总有效率分别为82.9%和65.7%,两组比较有统计学意义(P＜0.05).治疗组治疗后血液流变学多项指标均降低,与对照组比较有统计学意义(P＜0.05或P＜0.01).结论 通心络胶囊治疗老年不稳定型心绞痛疗效显著.     

杏丁注射液联合通心络胶囊治疗不稳定型心绞痛

目的 研究杏丁注射液联合通心络胶囊在治疗不稳定型心绞痛中的作用。方法110例不稳定型心绞痛病人随机分为两组．对照组52例给予常规治疗，治疗组58例除了常规治疗外，加用中药杏丁注射液剂及通心络胶囊口服中药，以14d为1个疗程，观察1个疗程后两组临床心电图疗效。结果 治疗组心电图疗效与临床疗效总有效率分别为84．5％、93．1％，明显高于对照组的75．0％、84．6％（P〈O．05）：结论 杏丁注射液联合通心络胶囊在治疗冠心病不稳定型心绞痛时有明显疗效。     

通心络胶囊治疗冠心病稳定型心绞痛40例的临床观察

目的观察通心络胶囊治疗冠心病稳定型心绞痛的临床疗效。方法将80例冠心病稳定型心绞痛患者随机分为通心络组和对照组,每组各40例。在常规治疗的基础上,通心络组口服通心络胶囊4粒,3次/d;对照组口服硝酸异山梨酯缓释片20mg,2次/d,共治疗8周,观察两组患者心绞痛、心电图的临床疗效以及不良反应。结果通心络组与对照组比较：心绞痛治疗总有效率分别为87.5%和67.5%（P〈0.05）;心电图治疗总有效率分别为70.0%和47.5%（P〈0.05）;头痛不良反应发生率分别为2.5%和20.0%（P〈0.05）。结论通心络胶囊治疗冠心病稳定型心绞痛的临床疗效肯定,不良反应发生率低,值得临床推广应用。     

评价不稳定型心绞痛并心衰患者实施中西医结合治疗的临床有效性

目的评价中西医结合治疗不稳定型心绞痛并心衰临床疗效。方法将80例不稳定型心绞痛并心衰患者随机分为对照组和观察组,每组40例;对照组患者给予西医常规药物治疗,观察组在对照组基础上加用通心络胶囊口服治疗,比较两组心绞痛疗效及心电图疗效,并于治疗前后检测患者血浆超敏C反应蛋白(hsCRP)及脑钠肽(BNP)水平。结果观察组较对照组心绞痛疗效及心电图疗效明显更优(P0.05);治疗后,观察组较对照组平均心肌缺血时间明显缩短(P0.05);治疗后,观察组较对照组血清hs-CRP、BNP水平明显降低(P0.05)。结论通心络胶囊联合西医常规治疗气虚血瘀络阻型不稳定型心绞痛并心衰,疗效显著,明显缩短心肌缺血时间,改善心功能,并有效降低血清hs-CRP、BNP水平。     

通心络胶囊对代谢综合征患者血浆Ang-2和6-Keto-PGF1a水平的影响

目的观察通心络胶囊对代谢综合征患者血浆血管生成素2（Ang-2）和6-酮-前列腺素F1a（6-Keto-PGF1a）水平的影响。方法将40例代谢综合征患者随机分为治疗组和对照组各20例,两组均行常规治疗;治疗组加服通心络胶囊,疗程为4周。治疗前后比较两组血浆Ang-2及6-Keto-PGF1a变化。结果与对照组比较,治疗组治疗第14、28天血浆Ang-2降低,6-Keto-PGF1a升高（P均〈0.01）。结论通心络胶囊可能通过影响血浆Ang-2和6-Keto-PGF1a变化,改善代谢综合征患者的胰岛素抵抗,最终改善其临床症状和预后。     

通心络胶囊对冠心病患者可溶性细胞间粘附分子1和血管细胞粘附分子1的影响

目的　观察通心络胶囊对不稳定型心绞痛患者血清可溶性细胞间粘附分子 1和血管细胞粘附分子 1含量的影响 ,以探讨通心络胶囊防治动脉硬化性疾病的机制。方法　 72例不稳定型心绞痛病人被随机分为通心络治疗组和对照组 ,服药前及服药后一个月用酶联免疫吸附法检测可溶性细胞间粘附分子 1和血管细胞粘附分子 1含量。结果　通心络组血清可溶性细胞间粘附分子 1含量由治疗前的 348.8± 12 5 .8ng/L下降到治疗后的 2 5 6 .8± 98.6ng/L ,差异有非常显著性统计学意义 (P <0 .0 1) ;血管细胞粘附分子 1含量由治疗前的 6 79.7± 2 99.8ng/L下降到治疗后的 5 6 6 .8± 2 6 8.7ng/L ,差异有非常显著性统计学意义 (P <0 .0 1)。对照组治疗前后两种粘附分子的含量变化没有统计学意义 (P >0 .0 5 )。治疗后通心络组两种粘附分子的含量都明显低于对照组 ,差异有非常显著性统计学意义 (P <0 .0 1)。结论　通心络胶囊能明显降低不稳定型心绞痛病人血清可溶性细胞间粘附分子 1和血管细胞粘附分子 1含量 ,其作用可能与血管内皮保护有关     

针刺对中风先兆证的干预机制探讨

目的探讨针剌对中风先兆证治疗的机制.方法对30例中风先兆病人(治疗组)针刺治疗后血浆TXB2、6-Keto-PGF1α含量进行检测,并与健康同龄人作对照(对照组).结果中风先兆证病人血TXB2含量明显升高,6-Keto-PGF1α含量明显下降,与对照组比较差异有显著意义(P＜0.01).提示中风先兆证病人的二者含量有改变,经针刺治疗后对此能做明显的调整,这种作用与临床疗效呈正相关.结论针刺能治疗中风先兆证,其机制可能与调整其血浆TXB2、6-Keto-PGF1α之间的平衡,改善脑血流量,提高脑代谢率有关.     

低分子肝素钙与通心络联合治疗不稳定型心绞痛临床观察

目的观察低分子肝素钙与通心络胶囊联合治疗不稳定型心绞痛的疗效及安全性.方法将68例确诊为不稳定型心绞痛病人随机分为治疗组(38例)和对照组(30例),两组均常规治疗,对照组腹壁皮下注射低分子肝素钙5000抗Xa国际单位/次,每12 h1次,连用7 d,治疗组在对照组基础上再口服通心络胶囊,每次4粒,每日3次,2周后比较两组疗效及不良反应.分别观察治疗前后临床症状、心电图、凝血酶原时间(PT)、部分凝血酶时间(KPTT)、纤维蛋白原(Fg)、血小板(PLT)的变化.结果治疗组总有效率为94.8%,对照组为86.7%,但两组比较差异无统计学意义(P＞0.05),两组治疗后PT、KPTT较治疗前延长,Fg减少,但均未见严重出血现象.结论低分子肝素钙与通心络胶囊联合应用治疗不稳定型心绞痛疗效显著、安全.     

通心络胶囊治疗不稳定型心绞痛伴高脂血症病人的临床研究

目的 观察通心络胶囊治疗永稳定型心绞痛伴高脂血症病人的临床疗效。方法 选择65例不稳定型心绞痛伴高脂血症病人，随机分为治疗组和对照组，对照组常规服药，治疗组在此基础上加用通心络胶囊，疗程为1个月。分别于治疗前和治疗后1个月进行心绞痛、血脂疗效及总疗效的评价。结果 治疗组缓解心绞痛总有效率为90．9％，明显优于对照组的65．6％（P〈0．05）。治疗组在降低总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固（LDL—C）水平亦明显优于对照组（P〈0．05）。结论 通心络胶囊治疗不稳定型心绞痛是安全有效的。     

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.     

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.     

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.