缬沙坦对兔急性心肌梗死血小板活化、纤溶活性和内皮血管活性物质的影响

目的　探讨缬沙坦对急性心肌梗死血小板活化、纤溶活性和内皮血管活性物质的影响。方法　新西兰大白兔30只 ,随机分为三组 ,每组 10只 , 组 :假手术组 , 组 :急性心肌梗死组 , 组 :缬沙坦组 ; 、 组分别结扎冠状动脉左室支中点后 4 h,取血分别测定血栓素 B2 (throm boxane B2 ,TXB2 )、6 -酮 -前列腺素 F1α(6 - Keto- prostaglandinF1α,6 - Keto- PGF1α)、内皮素 (Endothelin,ET)、一氧化氮 (Nitric oxide,NO)浓度以及组织型纤溶酶原激活剂 (tis-sue- type plasminogen activator,t- PA)和纤溶酶原激活剂抑制物 (Plasm inogen activator inhibitor,PAI)活性 ;摘取心脏 ,测定心肌梗死范围。结果　 、 组与 组比较 ,血浆 TXB2 、ET、NO浓度和 PAI活性显著升高 (P<0 .0 1) ,6 - Keto- PGF1α浓度、t- PA活性显著下降 (P<0 .0 1) , 组与 组比较 ,血浆 TXB2 、ET、NO浓度和 PAI活性明显降低 (P<0 .0 1) ,6 - Keto- PGF1α浓度、t- PA活性显著升高 (P<0 .0 1) ,梗死范围减小。结论　缬沙坦抑制急性心肌梗死早期血小板活化 ,改善纤溶活性 ,减少 ET和 NO的释放 ,缩小心肌梗死范围     

缬沙坦和卡托普利对缺血再灌注纤溶活性、内皮血管活性物质的影响

目的　探讨缬沙坦和卡托普利对缺血再灌注纤溶活性、内皮血管活性物质的影响。方法　新西兰大白兔 6 0只 ,随机分为五组 ,每组 12只 , 组 :假手术组 , 组 :急性心肌梗死 (AMI)组 , 组 :缺血再灌注 (ischem ic reperfu-sion,IR)组 , 组 :IR+卡托普利组 , 组 :IR+缬沙坦组 ;各组 (除 组外 )分别结扎冠状动脉左心室支中点 ,缺血6 0 min,松开结扎线再灌注 2 4 0 min后 ( 组不进行再灌注 ) ,分别取结扎前、再灌注前、再灌注 2 4 0 min血测定内皮素 (endochelin ,ET)、一氧化氮 (nitric oxide NO)浓度和组织型纤溶酶原激活剂 (tissue- type plasminogen activa-tor,t- PA )、纤溶酶原激活剂抑制物 (,plasm inogen activator inhibitor PAI)活性。结果　冠状动脉结扎后 ,血浆ET、NO浓度和 PAI活性显著升高 (P<0 .0 1) ,t- PA活性显著下降 (P<0 .0 1) ,再灌注后 ,血浆 ET、NO浓度和 PAI活性进一步升高 ,t- PA活性进一步下降 ,与再灌注前对比均有显著性差异 (P<0 .0 1)。再灌注后 ,与 IR组对比 ,卡托普利、缬沙坦均能显著的升高 t- PA活性 ,降低血 PAI活性和 ET、NO浓度 (P<0 .0 1)。结论　卡托普利、缬沙坦有改善缺血再灌注过程中纤溶活性、抑制内皮细胞释放 ET、NO的有益作用     

老年肺心病患者血浆内皮素、血管紧张素Ⅱ、6-酮-前列腺素F1α水平及其相互关系

目的　研究老年肺心病患者血浆内皮素 (ET)、血管紧张素Ⅱ (AngⅡ )、6 酮 前列腺素F1α(6 keto PGF1α)水平及其相互关系。方法　采用放免法测定 30例健康老人、50例老年肺心病 (CPHD)急性发作期及 44例老年慢阻肺 (COPD)缓解期患者血浆ET、肾素活性 (PRA)、AngⅡ、醛固酮 (ALDO)、6 keto PGF1α的水平。结果　CPHD急发期组ET、PRA、AngⅡ、ALDO明显高于COPD缓解期组及正常组 (P <0 .0 1 ) ,而 6 keto PGF1α明显低于COPD缓解期组及正常组 (P <0 .0 1 )。根据血气分析将CPHD急发期组分为Ⅰ型呼衰组 (A组 )、Ⅱ型呼衰组 (B组 )、非呼衰组 (C组 ) ,其中A组与B组血浆ET、PRA、AngⅡ、ALDO均高于C组 (P <0 .0 5～ 0 .0 1 )。而 6 keto PGF1α则低于C组 (P <0 .0 1 )。ET与AngⅡ、PaCO2 呈正相关 ,与6 keto PGF1α、pH、PaO2 呈负相关。结论　ET在老年肺心病肺动脉高压形成过程中起重要作用 ,与呼衰程度呈正比 ,ET升高同时伴有PRA、AngⅡ、ALDO继发性升高及 6 keto PGF1α降低 ,它们之间相互协调、相互制约共同参与肺心病的病理过程。     

卡托普利影响冠心病患者内源性纤溶系统的临床意义及机理

为探讨卡托普利影响冠心病（CHD）患者内源性纤溶系统活性的临床意义及机理，将符合WHO诊断标准的冠心病患者45例，单盲随机分为卡托普利（Captopril）治疗组（23例）及安慰剂对照组（22例），检测两组治疗前后血浆肾素活性（PRA）、血管紧张素Ⅱ（AngⅡ）、血栓素B2（TXB2）、6-酮-前列腺素F1α（6－keto－PGF1α）、纤维蛋白原（Fg）、组织型纤溶酶原激活剂（tPA）及其抑制物（PAI）含量与活性，用t检验统计分析。结果表明，治疗组治疗前的血浆各参数及治疗后的Fg、TXB2水平，与对照组比较无统计意义（P＞0．05）；治疗4周后，治疗组的血浆AngⅡ、tPA含量及PAI活性均显著低于对照组（P＜0．05～P＜0．01），而6－keto－PGF1α、tPA活性、tPA比活性、活性型tPA及纤溶活性水平则显著高于对照组（P＜0．05～P＜0．01）。提示卡托普利可通过降低血浆AngⅡ水平，促进CHD患者受损血管内皮细胞修复，减少血管内皮细胞PAI的合成与分泌，提高其内源性纤溶系统活性。     

缬沙坦治疗原发性高血压对内源性纤溶活性的影响

目的 :观察缬沙坦治疗原发性高血压 (EH)的同时对内源性纤溶活性的影响。方法 :用发色底物分解显色法测定 6 4例EH患者 (EH组 )和 35例正常对照者 (对照组 )的组织型纤溶酶原激活因子 (t PA)、纤溶酶原激活抑制物 (PAI 1)的活性 ,然后EH组口服缬沙坦 80mg ,每日 1次 ,共 8周 ,比较治疗前后的t PA和PAI 1活性变化。结果 :EH组治疗前t PA活性较对照组明显降低 ,PAI 1活性明显升高 (P <0 .0 5 )。经缬沙坦治疗 8周后 ,t PA活性较治疗前显著上升 ,PAI 1活性降低 (P <0 .0 5 )。结论 :缬沙坦在降低血压的同时 ,有改善内源性纤溶活性的作用。     

心力衰竭患者纤溶参数变化及药物干预效果的评价

目的 :了解风湿性心脏病和扩张型心肌病心力衰竭 (心衰 )患者纤溶参数的变化 ,并观察血管紧张素转换酶抑制剂和血管紧张素Ⅱ 1型受体拮抗剂对心衰患者纤溶参数的影响。　　方法 :测定 2 0例健康者 (正常对照组 )以及 2 9例风湿性心脏病和 3 1例扩张型心肌病心衰患者血浆组织型纤溶酶原激活物 (t PA)活性和纤溶酶原激活物抑制物 1(PAI 1)活性 ,随后 60例心衰患者被随机分为常规治疗组 ,常规治疗+福辛普利 (fosinopril) 10mg每日 1次 (福辛普利组 ) ,常规治疗 +氯沙坦 (losartan) 5 0mg每日 1次 (氯沙坦组 ) ,均为2 0例 ,治疗 14天后复测t PA和PAI 1活性。　　结果 :与正常对照组比较 ,风湿性心脏病和扩张型心肌病心衰患者纤溶参数异常 ,t PA活性下降 ,PAI 1活性升高 (P均 <0 0 1)。常规治疗组纤溶参数无显著变化 (P >0 0 5 ) ,福辛普利组和氯沙坦组纤溶参数明显改善 ,表现为t PA活性上升 ,PAI 1活性下降 (P均 <0 0 1) ,二者改善纤溶参数的效果相似 (P >0 0 5 )。　　结论 :风湿性心脏病和扩张型心肌病心衰纤溶参数明显异常 ,血管紧张素转换酶抑制剂和血管紧张素Ⅱ 1型受体拮抗剂能改善心衰患者纤溶参数。     

血管紧张素Ⅱ和血管紧张素1-7对内皮细胞释放组织纤溶酶原激活物及其抑制剂-1的影响

目的 :研究血管紧张素Ⅱ (AngⅡ )和血管紧张素 1 7[Ang ( 1 7) ]对内皮细胞分泌组织纤溶酶原激活物 (t PA)和纤溶酶原激活物抑制剂 1(PAI 1)的影响。方法 :培养内皮细胞株 (ECV30 4 ) ,分为AngⅡ和Ang ( 1 7)刺激组 ,培养基中AngⅡ和Ang ( 1 7)加至终浓度为 5、10、2 5、5 0、10 0nmol/L ,2 4h后测定上清液中的t PA和PAI 1的含量。结果 :内皮细胞在AngⅡ终浓度为 5 0、10 0nmol/L组刺激 2 4h后 ,其分泌的PAI 1含量较对照组有明显升高 ,差异有统计学意义 (P <0 .0 5 )。而Ang ( 1 7)在同样浓度组却显著降低PAI 1(P <0 .0 5 ) ,AngⅡ和Ang ( 1 7)两组t PA含量差异无统计学意义 ( P >0 .0 5 )。结论 :AngⅡ对内皮细胞株分泌的PAI 1有显著的升高作用 ,而Ang ( 1 7)对PAI 1作用相反。两者对t PA均无显著影响。提示AngⅡ和Ang ( 1 7)对纤溶系统的调节有一定作用     

ET/NO、t-PA/PAI-1及TXA2/PGI2与糖尿病肾病的关系

糖尿病肾病（DN）患者肾脏微血管病变的发生发展与血管内皮细胞损伤、血小板活化、纤溶活性降低密切相关。血管内皮功能受损时，对血管内皮细胞合成分泌的多种血管活性肽，如内皮素（ET）、一氧化氮（NO）、组织型纤溶酶原激活物（t—PA）、纤溶酶原激活物抑制剂（PAI）-1有明显的影响，而纤溶活性降低与PA活性降低及PAI增加有关。现就ET／NO、t—PA／PAI-1及血栓素（TXA2）／前列环素（PGI2）与DN的关系综述如下。     

福辛普利对早期急性心肌梗塞患者纤溶活性的影响

目的 :探讨福辛普利对早期急性心肌梗塞 (AMI)患者纤溶活性的影响。　　方法 :49例发病 2 4小时内的 AMI患者随机分福辛普利组 2 6例和常规治疗组 2 3例。常规治疗组静脉滴注硝酸甘油 ,口服肠溶阿司匹林等 ,福辛普利组在常规治疗基础上口服福辛普利 ,每次 10 mg,每日 1次。检测治疗前和治疗后 2周时血浆组织纤溶酶原激活剂 (t PA)活性、含量及其抑制物 (PAI- 1)活性。　　结果 :治疗前福辛普利组和常规治疗组 t PA活性、t PA含量、PAI- 1活性无显著性差异 (P分别 >0 .0 5 )。治疗后 2周时福辛普利组 t PA活性显著高于常规治疗组 (P<0 .0 1) ,t PA含量、PAI- 1活性显著低于常规治疗组 (P分别 <0 .0 1)。　　结论 :福辛普利能提高 AMI患者内源性纤溶活性 ,可能是血管紧张素转换酶抑制剂减少 AMI后再梗塞事件和早期病死率的机制之一 ,但有待进一步研究     

血管内皮生长因子预防血管成形术后再狭窄的机制研究

目的:探讨血管内皮生长因子(VEGF)预防血管成形术后再狭窄的机制.方法:用高脂饲养建立实验性动脉粥样硬化家兔模型,将VEGF作用于正常健康兔和动脉粥样硬化家兔主动脉血管内皮细胞(VEC).采用亚硝酸还原法测一氧化氮(NO),放免法测内皮素(ET)、6-酮-前列腺素1α( 6-keto-PGF1α),采用发色底物显色法测定血浆纤溶酶原激活物(t-PA)和纤溶酶原激活物抑制物-1(PAI-1)活性.并用WST-1比色法观察VEGF对上述VEC增殖的影响.结果:与空白对照组(VEGF 0 μg/L)比较, 10 μg/L、20 μg/L VEGF处理组NO、6-keto-PGF1α、PAI均明显增加,而ET、t-PA、t-PA/PAI均明显降低,并呈剂量依赖性.与正常健康兔VEC(正常VEC)比较,动脉粥样硬化家兔VEC(异常VEC)分泌ET、PAI、t-PA均明显增加,而NO、6-keto-PGF1α、t-PA/PAI均明显降低.结论:动脉粥样硬化家兔伴有内皮功能异常,而VEGF能促进正常和异常VEC的增殖并分泌NO、PGI2、PAI,而抑制ET、t-PA的分泌,使t-PA/PAI降低.     

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.     

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.     

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.