非酒精性脂肪性肝病与心律失常相关性的研究进展

非酒精性脂肪性肝病是一组临床代谢综合征，可增加各种心脏疾病的风险。其不仅是冠状动脉粥样硬化性心脏病（冠心病）的危险因素，也是包括心房颤动在内的各种心律失常的危险因素。其心律失常机制可能与心外膜脂肪组织、炎症、胰岛素抵抗和心脏重构等有关。非酒精性脂肪性肝病与心律失常发生和复发、心血管不良预后有关，需引起临床重视。本文从心律失常类型、机制和治疗3方面对非酒精性脂肪性肝病与心律失常的研究进展进行综述。     

支链氨基酸在非酒精性脂肪性肝病发生发展中的作用

非酒精性脂肪性肝病是常见慢性肝病，有进展为非酒精性肝炎、肝纤维化和肝癌的风险，发病机制多样，其中支链氨基酸代谢异常可引起肝细胞氧化应激、自噬、线粒体功能障碍等，是导致非酒精性脂肪性肝病发生发展的最主要机制，对其进展进行综述，分析支链氨基酸代谢异常对非酒精性脂肪性肝病发生与发展的可能作用，以期提高临床认知与诊治水平。     

酒精性肝病

多烯磷脂酰胆碱（易善复）治疗酒精性肝病和脂肪肝的系统评价，酒精性肝病白细胞介素6的检测及意义，甘利欣联合凯西莱治疗酒精性肝病的临床观察，三七对酒精性脂肪肝大鼠血清TNF-α、Leptin水平的影响，葛花决明饮治疗酒精性脂肪肝68例临床观察     

酒精性肝病

瘦素与酒精性肝病肝纤维化的关系，(还原型谷胱甘肽治疗酒精性肝病临床疗效观察，活血清肝汤配合易善复治疗酒精性肝炎45例，凯西莱治疗酒精性肝病疗效观察，纳洛酮对酒精性脂肪肝大鼠作用探讨。     

酒精性肝硬化51例临床分析

酒精性肝硬化５１例临床分析温州市第二人民医院（３２５０００）陈超，薛战雄随着人民生活的改善，酒类消耗量日益增多，酒精性肝病发病率亦随之增高，但国内有关酒精性肝硬化的文献报道不多，现总结我院２年半的临床资料，并就其发病机制、诊断、治疗等方面作一初步探讨...     

酒精性肝病肌肉减少症:发病机制与治疗进展

酒精性肝病(ALD)是酒精滥用最常见的临床后果,包括酒精性脂肪肝、酒精性肝炎、肝纤维化和肝硬化。骨骼肌损失或肌肉减少症是酒精性肝病的主要并发症。肌肉减少症会对临床结局造成不利影响,包括生存期、生活质量、肝脏疾病的其他并发症及移植预后。本文就酒精性肝病肌肉减少症的发病机制和治疗进展进行综述,为进一步研究该病的发病机制和治疗方案提供依据。     

血清高尔基体蛋白73在非酒精性脂肪性肝病中的作用

高尔基体蛋白73是一种可经切割释放入血的高尔基体跨膜蛋白。越来越多的研究表明，血清高尔基体蛋白73的升高与非酒精性脂肪性肝病的发生发展密切相关，有望作为诊断和评估非酒精性脂肪性肝病的潜在血清学标志物。本文就现有研究对血清高尔基体蛋白73在非酒精性脂肪性肝病中的研究进展进行综述，并简析其发挥作用的潜在机制，以期为非酒精性脂肪性肝病的治疗靶点提供新的选择。     

酒精性肝病的治疗进展

酒精性肝病是西方国家导致肝硬化最重要的原因，在我国所有肝病中的比例也呈逐年增加趋势。酒精性肝病包括轻度酒精性肝损伤、酒精性脂肪肝、急性酒精性肝炎、酒精性肝纤维化和肝硬化。近年来，对酒精性肝病发病机制的研究逐步深入，酒精性肝病的治疗也取得了一些进展。     

非酒精性脂肪性肝炎与肿瘤坏死因子α基因多态性的研究进展

非酒精性脂肪性肝病（NAFLD）是一类肝组织学与酒精性肝病相似，但无过量饮酒史的临床病理综合征，包括单纯性脂肪肝、非酒精性脂肪性肝炎（NASH）、脂肪性肝纤维化和脂肪性肝硬化等4个病理过程。目前多数研究认为，NASH的进展与终末期肝病的发生有关，所以NASH发病机制方面的研究正成为肝病研究的一个热点。针对NASH发病机制的研究主要包括胰岛素抵抗和炎症坏死两方面，在影响炎症坏死过程的众多细胞因子中，TNF-α的重要作用已被重视，TNF-α基因多态性在炎症坏死过程中的作用也日益引起重视，现对NASH与TNF-α基因多态性方面的研究进展作一综述。     

非酒精性脂肪性肝病的运动处方制定

非酒精性脂肪性肝病(NAFLD)是世界范围内最常见的慢性肝病病因，且发病率逐渐上升，是多种心血管疾病、 糖尿病和慢性肾病的危险因素，因此，非酒精性脂肪性肝病的防治非常重要。虽然运动疗法作为一种治疗手段已被 证实对非酒精性脂肪性肝病的相关危险因素有改善作用，但不同的运动疗法对非酒精性脂肪性肝病的作用还需更 多证据。进一步的研究和实践应基于运动处方的制定，探索不同运动处方治疗非酒精性脂肪性肝病的安全性和疗 效。     

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.