铝碳酸镁治疗幽门螺杆菌相关性胃溃疡及ESD术后人造溃疡有效性的Meta分析

目的系统评价铝碳酸镁联合幽门螺杆菌(H. pylori)根除治疗H. pylori相关性胃溃疡及铝碳酸镁联合质子泵抑制剂(PPI)治疗内镜黏膜下剥离术(ESD)后人造溃疡的有效性。方法计算机检索CBM、CNKI、Wanfang Data、VIP、Pub Med、Embase、Web of Science、Scopus及The Cochrane Library数据库,纳入联用铝碳酸镁治疗H. pylori相关性胃溃疡及联用铝碳酸镁治疗ESD术后人造溃疡的随机对照试验(RCTs),筛选文献、提取数据并评价偏倚风险后,采用Rev Man 5. 3统计软件进行Meta分析。结果①H. pylori相关性胃溃疡:与单独应用H. pylori根除相比,铝碳酸镁联合H. pylori根除治疗能降低溃疡的1年后复发率(ITT分析:RR=0. 48,95%CI:0. 36～0. 65,P 0. 001)。②ESD术后人造溃疡:与单独应用PPI相比,铝碳酸镁联合PPI治疗能提高术后4周的溃疡愈合率(ITT分析,WMD=12. 92,95%CI:10. 15～15. 69,P 0. 001)。结论目前证据表明,在H. pylori根除治疗的基础上联用铝碳酸镁有助于降低H. pylori相关性胃溃疡的1年后复发率;在PPI基础上联用铝碳酸镁有助于加快ESD术后人造溃疡的愈合。     

泮托拉唑单用与联合用药治疗EMR和ESD术后胃溃疡的效果对比

目的研究观察泮托拉唑单用或联合铝碳酸镁治疗EMR和ESD手术后并发胃溃疡的临床疗效。方法选择我院2013年4月至2016年12月收治的348例EMR和ESD术后胃溃疡患者为研究对象,随机分为观察组和对照组。对照组153例,采用半托拉唑进行治疗,观察组195例,采用泮托拉唑联合铝碳酸镁治疗,治疗时间均持续4周。观察记录两组患者治疗后的疗效,溃疡面积减少情况,以及服药后不良反应发生情况。结果观察组服药后总有效率为94.87%,明显高于对照组的81.70%(P0.05)。观察组用药后溃疡面积为(59.32±10.28)mm~2,明显小于对照组的(86.56±12.76)mm~2(P0.05)。不良反应发生方面,观察组和对照组差异无统计学意义(P0.05)。结论泮托拉唑联合铝碳酸镁治疗EMR和ESD术后胃溃疡疗效显著,促进术后胃溃疡创面的愈合,效果优于泮托拉唑单独用药,且不增加不良反应发生率,是一种安全有效的EMR和ESD术后胃溃疡的治疗方法。     

胃黏膜剥离术后溃疡愈合的危险因素分析

[目的]分析胃黏膜病变内镜黏膜下剥离术(ESD)后溃疡愈合的危险因素。[方法]对胃黏膜病变行ESD的连续性患者120例、术后溃疡愈合的危险因素进行单因素和多因素非条件Logistic回归分析;根据是否伴有幽门螺杆菌(Hp)感染将患者分为Hp阳性组、Hp阴性组,比较2组患者的临床和内镜资料,以及ESD后4周、8周的溃疡大小、分期及瘢痕愈合率。[结果]对ESD后8周溃疡愈合的单因素Logistic回归分析结果表明,术前长期使用非甾体类抗炎药(NSAID)、病变部位、局部合并溃疡或瘢痕、伴有Hp感染、术后创面大小与溃疡瘢痕愈合显著相关;随后的多因素Logistic回归分析表明,仅术后创面大小、伴有Hp感染与溃疡瘢痕愈合显著负相关(P0.05)。ESD后4周时,Hp阴性组的溃疡面积显著小于Hp阳性组(P0.05);Hp阴性组的S1期愈合率高于Hp阳性组,但2组差异无统计学意义。ESD后8周时,Hp阴性组的溃疡面积显著小于Hp阳性患者,而且S1期瘢痕愈合率显著高于Hp阳性组(P0.05)。进一步对不同时间的溃疡分期进行分析,术后4周、8周Hp阴性组的的整体溃疡愈合质量均显著高于同期Hp阳性组(P0.05)。[结论]Hp感染是胃黏膜病变ESD后溃疡愈合的危险因素,而且影响了ESD后医源性溃疡的愈合速度和愈合质量。     

质子泵抑制剂与瑞巴派特联合治疗ESD术后溃疡疗效随机对照试验的Meta分析

目的:比较质子泵抑制剂(proton-pump inhibitors,PPIs)、瑞巴派特(rebamipide)联合与单用质子泵抑制剂治疗内镜下黏膜剥离术(endoscopic submucosal dissection,ESD)后溃疡的疗效.方法:用关键词或主题词检索Pub Med、EMBASE、OVID、Cochrane Library、万方数据库和CNKI中国期刊全文数据库以获得有关比较PPI、瑞巴派特联合与单用PPI治疗ESD术后溃疡疗效的随机对照试验.检索时间从建库至2015-02.根据纳入和排除标准由2名研究者独立进行文献质量评价.结果:纳入的5项研究包括了670例患者.分析结果显示:PPI联合瑞巴派特治疗ESD术后溃疡患者的溃疡愈合率明显高于单独使用PPI治疗的患者(OR=2.68,95%CI:1.81-3.97).对于直径20 m m的溃疡,联合治疗的疗效明显优于单独使用PPI治疗(OR=4.77,95%CI:2.22-10.26).治疗4 wk后,联合治疗组的溃疡缩减率高于PPI单独治疗组(MD=68.39,95%CI:35.73-101.05).结论:本Meta分析结果显示:PPI与瑞巴派特联合治疗组愈合ESD术后溃疡的效果优于单独使用PPI治疗组,尤其对于大溃疡亦是如此.但是,上述结论仍需要更多高质量的研究去证实.     

PPI联合瑞巴派特促进内镜黏膜下剥离术术后溃疡愈合的疗效分析

目的系统评价质子泵抑制剂(proton pump inhibitors,PPI)联合瑞巴派特治疗内镜黏膜下剥离术(endoscopic submucosal dissection,ESD)术后溃疡的有效性和安全性。方法计算机检索Pub Med、Web of Science、Medline、Embase、Cochrane Central Register of Controlled Trials、CENTRAL、CJFD、CBM、CNKI、VIP及Wan Fang Data,检索时间截至2015年8月1日,查找所有比较PPI联合瑞巴派特预防ESD术后溃疡出血作用的随机对照试验(RCTs)。由2名评价者按照纳入和排除标准独立选择文献、提取资料、评价质量,采用Rev Man 5.2和Stata 12.0软件进行Meta分析。结果共纳入6项RCTs,共724例患者。合并结果显示:与单用PPI相比,应用PPI联合瑞巴派特后溃疡愈合率明显升高(OR=2.40,95%CI:1.68~3.44);根据疗程长短(4周和8周)进行亚组分析显示:联合用药组溃疡愈合率均高于单用PPI组(4周:OR=2.22,95%CI:1.53~3.24;8周:OR=3.19,95%CI:1.22~8.31)。对于直径2 cm溃疡,联合用药组疗效更明显(OR=4.77,95%CI:2.22~10.26)。而对于溃疡部位、是否合并H.pylori感染,两者疗效无明显差异。用药过程中两组均无明显不良反应。结论 PPI联合瑞巴派特疗效优于单用PPI,尤其对于直径2 cm的溃疡。受纳入研究数量和质量限制,需要开展更多高质量、大样本、多中心的RCTs进一步论证其安全性。     

替普瑞酮联合雷贝拉唑预防胃ESD术后出血的疗效研究

背景:内镜黏膜下剥离术(ESD)作为治疗早期胃癌的新型微创手段,能减少术后并发症,提高患者的生活质量。但ESD治疗引起的医源性溃疡仍亟待解决。目的:观察替普瑞酮联合雷贝拉唑对促进胃ESD术后溃疡愈合、预防术后出血的临床疗效。方法:选取行胃ESD治疗的早期胃癌和癌前病变患者120例,随机分为A、B两组,A组给予替普瑞酮联合雷贝拉唑治疗,B组给予雷贝拉唑单药治疗,疗程均为8周。比较两组迟发性出血和溃疡愈合情况。结果:A组和B组的迟发性出血发生率无明显差异(P=0.679)。ESD术后第7天,两组溃疡分期无明显差异(P0.05);术后第30、60天,A组溃疡愈合分期均明显高于B组(P0.05)。ESD术后第30天,A组溃疡直径、溃疡面积减少率均显著高于B组(P0.05);术后第60天,两组溃疡直径和面积减少率均无明显差异(P0.05)。结论:替普瑞酮能有效促进ESD术后溃疡愈合,尤其是在溃疡早期愈合中,从而减少术后出血的发生率。     

葡萄籽原花青素联合阿托伐他汀治疗老年颈动脉粥样硬化患者的观察

目的 观察葡萄籽原花青素和阿托伐他汀联合应用对老年患者颈动脉粥样硬化的疗效. 方法 将存在颈动脉粥样硬化斑块的老年高脂血症患者122例,随机分为单药组63例,给予阿托伐他汀20 mg/d；联合用药组59例,给予阿托伐他汀l0mg/d和葡萄多酚胶囊400mg/d.治疗前及治疗后3、6、12个月测定患者平均最大颈动脉内中膜厚度(MMCIMT)、斑块积分、斑块性质及血脂和超敏C反应蛋白(hs-CRP)水平的变化. 结果 治疗3个月后,单药组和联合用药组患者与治疗前比较血清总胆固醇(TC)[(4.9±1.0)比(6.5±0.7)mmol/L、(4.7±0.6)比(6.3±0.6)mmol/L]、三酰甘油(TG)[(2.3±0.5)比(2.9±0.4)mmol/L、(2.2±0.7)比(3.0±0.4) mmol/L]、低密度脂蛋白胆固醇(LDL-C) [(3.3±0.9)比(4.2±0.7)mmol/L、(3.1±0.6)比(4.0±0.6)mmol/L]降低(均P＜0.01),且随着治疗时间的延长进一步降低.联合用药组患者治疗3个月后高密度脂蛋白胆固醇(H DL-C)水平较治疗前升高20.2％ (P＜0.05).治疗后两组患者血清hs-CRP水平均下降(均P＜0.05).单药组治疗3个月MMCIMT较治疗前减小1.3％(P＞0.05),治疗6个月减小3.4％ (P＞0.05),12个月减小5.1％(P＜0.05).联合用药组治疗3个月后MMCIMT较治疗前减小2.0％(P＞0.05),6个月减小5.3％(P＜0.05),12个月减小8.6％(P＜0.01).12个月组间比较差异有统计学意义(P＜0.01).单药组治疗3个月斑块积分较治疗前减小6.8％(P＞0.05),治疗6个月减小14.5％ (P＞0.05),12个月减小19.2％(P＜0.05)；联合用药组患者治疗3个月斑块积分减少13.1％(P＞0.05),且随着治疗时间的延长,斑块积分进一步降低(6个月下降28.0％,P＜0.05；12个月下降45.0％,P＜0.01).治疗6个月(P＜0.05),两组12个月联合治疗组斑块积分降低更明显(P＜0.01)；联合用药组较单药组斑块总数和不稳定斑块数减少更明显. 结论 葡萄籽原花青素与阿托伐他汀联合应用,可加强抗动脉粥样硬化治疗的效果.     

伊托必利、多潘立酮和甲氧氯普胺联合用药对FD患者胃肠功能和Ghrelin表达的影响

目的:研究伊托必利、多潘立酮和甲氧氯普胺联合应用对功能性消化不良(FD)患者胃肠功能和Ghrelin含量的影响.方法:以FD患者为研究对象,依据罗马Ⅱ标准,将符合纳入标准的患者120例随机分为6组,分别给予盐酸伊托必利,多潘立酮,甲氧氯普胺,以及联合用药给予盐酸伊托必利+多潘立酮,盐酸伊托必利+甲氧氯普胺和多潘立酮+甲氧氯普胺,观察用药前后各临床症状积分改善程度、胃肠排空率及血清Ghrelin的水平改变.结果:各组FD患者服药后消化不良等症状均明显改善,在症状缓解率,联合用药组明显优于单独用药组(P＜0.01);在胃排空率,各联合用药组明显优于单独用药组(54.26%±18.57%,55.12%±18.22%.47.17%±15.21% vs 36.23%±11.68%,32.16%±10.08%,32.24%±10.12%,均P＜0.01);在肠排空率,联合用药组中伊托必利+多潘立酮组和伊托必利+甲氧氯普胺组明显优于多潘立酮+甲氧氯普胺组(89.27%±11.36%.88.67%±13.25% vs 69.16%±19.26%.均P＜0.011:单独用药组中伊托必利明显优于多潘立酮或甲氧氯普胺(78.23%±12.56% vs58.96%±12.20%,58.33%±12.57%,P＜0.01);但伊托必利单独用药明显优于多潘立酮+甲氧氯普胺联合用药(P＜0.05).FD患者血清Ghrelin水平明显降低(P＜0.05).经药物治疗后Ghrelin水平明显回升,联合用药组明显高于单独用药组(P＜0.05或0.01).结论:伊托必利、多潘立酮和甲氧氯普胺联合用药比单独用药更有效,可显著改善FD患者的胃肠动力,该功能可能与血清ghrelin水平改变有关.     

Clinical observation of rabeprazole combined with bismuth potassium citrate in treatment of peptic ulcer

目的 评价雷贝拉唑联合枸橼酸铋钾治疗幽门螺杆菌(Hp)感染活动性消化性溃疡(PU)的临床疗效、安全性及复发率.方法 将160例消化性溃疡患者分为治疗组和对照组(各80例).治疗组予以雷贝拉唑+枸橼酸铋钾+阿莫西林克拉维酸钾+呋喃唑酮四联方案,共7天,继予雷贝拉唑+硫糖铝抗溃疡治疗,十二指肠溃疡患者疗程4周,胃溃疡患者疗程8周.对照组予奥美拉唑+阿莫西林克拉维酸钾+呋喃唑酮三联方案,共7天,继予奥美拉唑+硫糖铝抗溃疡治疗,十二指肠溃疡患者疗程4周,胃溃疡患者疗程8 周.完成全疗程4周后复查14C-尿素呼气试验及胃镜检查.结果 两组患者治疗1周后,症状改善显效率均达到95.00％以上;治疗组Hp根治率为95.00％,对照组为81.25％,两组比较差异有统计学意义(P＜0.01);治疗组溃疡总愈合率为93.75％,对照组为78.75％,两组比较差异有统计学意义(P＜0.(01);两组不良反应发生率均较低,两组比较差异无统计学意义(P＞0.05);治疗组1年随访消化性溃疡复发率和Hp复阳率分别为8.86％和12.66％,对照组分别为27.40％和35.62％,两组比较差异均有统计学意义(P＜0.01).结论 雷贝拉唑联合枸橼酸铋钾方案治疗活动性消化性溃疡能迅速控制临床症状,促进溃疡早期愈合,具有Hp根治率高,小良反应少,疗效可靠的特点.     

质子泵抑制剂联合依托必利对胃食管反流病的疗效评价

目的 观察质子泵抑制剂（proton pump inhibitor,PPI）联合盐酸伊托必利（itopride hydrochloride,ITO）对胃食管反流病（gastroesophageal reflux disease,GERD）的疗效,并评价该治疗方案的安全性及耐受性.方法 经内镜、24 h食管pH测定或PPI试验确诊的GERD患者93例,按治疗方案随机分为PPI联合ITO治疗组及PPI单药治疗组,PPI联合ITO治疗组：糜烂性食管炎（EE）16例,非糜烂性反流病（NERD）21例,Barrett食管（BE）14例,共51例;PPI单药治疗组：EE 14例,NERD 16例,BE 12例,共42例.采用前瞻性、随访对照研究,于治疗前、治疗8周后、24周后进行GerdQ评分及内镜检查.结果 8周初始治疗后,两组内的3个亚型患者GerdQ评分均较治疗前明显降低,差异有统计学意义（P＜0.01）,24周后两组内EE及BE患者GerdQ评分较8周时进一步降低,差异有统计学意义（P＜0.05）;治疗8周及24周后两组EE患者食管黏膜愈合率分别为81.3％、71.4％（8周,P=0.00047）及93.8％、85.7％（24周,P=0.00036）,PPI联合ITO治疗组食管黏膜愈合率高于PPI单药治疗组,差异有统计学意义（P＜0.05）.结论 就改善反流相关症状及食管黏膜愈合率而言,PPI联合ITO维持治疗方案优于PPI单药治疗,具有良好的安全性和耐受性.     

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.     

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.     

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.     

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.