通心络胶囊对高胆固醇病人单核内皮细胞黏附功能的影响

目的观察通心络胶囊对高胆固醇病人单核内皮细胞黏附功能的影响。方法检测34例高胆固醇病人服用通心络胶囊前后的外周血单核细胞与培养人脐静脉内皮细胞的黏附率。结果高胆固醇病人的总胆固醇降低19．6％，低密度脂蛋白胆固醇（LDL—C）降低31．1％，三酰甘油（TG）降低5．1％，单核内皮细胞黏附率降低27．7％；高胆固醇病人的单核内皮细胞黏附率与总胆固醇、LDL—C呈正相关性。结论通心络胶囊可直接作用于单核细胞而降低其与内皮细胞的黏附性。     

氟伐他汀治疗原发性高胆固醇血症疗效观察

目的;探讨氟伐他汀治疗原发性高胆固醇血症的临床疗效,并观察其安全性。方法：43例高胆固醇血症给氟伐他汀20－40mg,1次／日,口服,比较服药前,后4周,8周血脂变化,结果：服药4周后血清胆固醇（TC）均值下降19．7％（P＜0．01）,甘油三酯（TG）下降11．6％（P＜0．05）,低密度脂蛋白胆固醇（LDL－C）下降24．8％（P＜0．01）,高密度脂蛋白胆固醇（HDL－C）升高4％（P＜0．05）,第8周与4周变化不大,结论：氟伐他汀能有效降低TC,LDL－C和TG,并能轻度升高HLD－C,保护冠状动脉,且安全,价廉,易于接受。     

西立伐他汀治疗原发性高胆固醇血症随机对照研究

目的：比较不同剂量的西立伐他汀（ｃｅｒｉｖａｓｔａｔｉｎ）治疗国人原发性高胆固醇血症的疗效、安全性及耐受性。方法采用多中心,随机、双盲、安慰剂对照,平行组试验,所有入选停止其他降脂治疗且饮食控制达美国心脏协会Ⅰ级（ＡＨＡ－ＳＴＥＰ－Ｉ）或其相应标准,满４周后,接受单盲安慰剂治疗５周（Ａ期）。安慰剂期后,４７０例患随机接受西立伐他汀０．１ｍｇ（ｎ＝１１９）、０．２ｍｇ（ｎ＝１１７）、０．３ｍｇ（     

瑞舒伐他汀治疗对糖尿病肾病患者肾功能的影响

纳入52例LDL—C水平增高且血压控制良好的糖尿病肾病患者,随机分为瑞舒伐他汀组（n=26）和对照组（n=26）。通过监测治疗前和治疗后6个月时的血脂、高敏C-反应蛋白、尿白蛋白和半胱氨酸蛋白酶抑制剂C水平评估瑞舒伐他汀的效果。结果瑞舒伐他汀治疗能够有效地降低总胆固醇、LDL—C和三酰甘油水平,而对照组的血脂指标均未发生变化。虽然瑞舒伐他汀组的估算肾小球滤过率无明显改变,但半胱氨酸蛋白酶抑制剂C水平、尿液白蛋白排泄率和hs—CRP水平均显著性降低。多变量线性回归分析显示,瑞舒伐他汀治疗是尿白蛋白减少的独立影响因素（R^2。=0．53,P〈0．001）。结论瑞舒伐他汀治疗能够降低糖尿病肾病患者的血脂水平并有可能改善肾功能。     

西立伐他汀对血管内皮细胞一氧化氮合酶及细胞间黏附分子的作用

目的　观察西立伐他汀对内皮细胞一氧化氮合酶 (NOsythase ,eNOS)和细胞间黏附分子 1 (intercellularadhesionmolecule 1 ,ICAM 1 )基因的表达 ,NOS活力和黏附的THP 1细胞量的影响。方法　以氧化LDL抑制培养的ECV 3 0 4细胞表达eNOS ,加入不同浓度西立伐他汀后 ,用RT PCR法检测eNOSmRNA ,硝酸还原酶法测定培养基中NO量。以脂多糖 (LPS)及西立伐他汀加入ECV 3 0 4细胞后 ,用RT PCR法检测ICAM 1mRNA ,并测定黏附的THP 1细胞量。结果　随着西立伐他汀浓度增加 ,内皮细胞eNOSmRNA水平增加 ,0 0 1 ,0 1 ,1 0 μmol/L时分别增加 5 0 %,1 5 0 %,3 0 0 %,P均 <0 0 5。培养液中NO亦相应增加 ,0 0 1 ,0 1 ,1 0 μmol/L时分别增加 2 6 7%,92 3 %,2 3 0 %,P <0 0 5。西立伐他汀浓度为 0 1 ,1 0 μmol/L时 ,ICAM 1mRNA分别从 70 7± 1 0 4降至 5 6 2± 6 5 ,3 5 8± 4 2 ,P <0 0 5。黏附于ECV 3 0 4细胞的THP 1细胞在 1 0 μmol/L时被抑制 2 6 %,P <0 0 5。结论　西立伐他汀能诱导内皮细胞eNOS基因的表达及增加NOS活力 ;抑制内皮细胞表达ICAM 1mRNA及THP 1细胞黏附于内皮细胞     

高脂血症兔主动脉NF-κB、VCAM-1和VEGF的表达及氟伐他汀的影响

目的观察高脂饮食后兔主动脉NF-κB、VCAM－1、VEGF的表达及氟伐他汀的影响，探讨高脂血症引起动脉粥样硬化可能的分子生物学机制和氟伐他汀的作用。方法健康雄性新西兰大耳白兔30只，随机分为5组，高脂饮食4周、6周、8周组，正常饮食和高脂饮食加氟伐他汀组。到规定时间点，处死动物取主动脉标本，观察组织形态学变化，用免疫组化的方法检查NF-κB、VCAM－1和VEGF的表达。结果①高脂血症可以引起NF-κB、VCAM－1、VEGF增加，与对照组比较差异有统计学意义（P〈0．01）。②LDL水平与NF-κB表达呈显著正相关（r=0．922，P〈0．01）；NF-κB与VCAM－1、VEGF呈显著正相关（r＝0．937，P〈0．01，r=0．894，P〈0．01）。③氟伐他汀可以减少NF-κB、VCAM－1和VEGF的表达（P＜0．05）。结论NF-κB、VCAM－1和VEGF参与了动脉粥样硬化的进程，炎症是高脂血症的伴随因素，引起了细胞增殖，与动脉粥样硬化密切相关：氟伐他汀可以减少其表达起到抗动脉粥样硬化作用。     

118例高胆固醇血症患者调脂治疗达标情况分析

目的 调查高胆固醇血症患药物治疗达标率。方法 对现行调脂治疗持续时间≥2个月的118例高胆固醇血症患进行血脂检查,并根据1997年我国制定的《血脂异常防治建议》确定血脂是否达标。结果 总胆固醇（TC）和低密度脂蛋白胆固醇（LDL－C）总达标率分别为23．7％、38．1％,他汀类药物LDL－C总达标率高于海鱼油和绞股兰每日20mg辛伐他汀LDL－C达标率高于每日20mg氟伐他汀。结论 现行调脂治疗达标率较低,可能与选择药物的种类和药物剂量有关。     

冠心病介入手术后阿托伐他汀对冠脉再狭窄的影响

目的：观察经皮冠状动脉介入（PCI）术后患者服用阿托伐他汀后血清低密度脂蛋白-胆固醇（LDL—C）水平达标情况及其与冠脉再狭窄的关系。方法：选择我院因冠心病行PCI术患者91例,术后除接受抗血小板等常规治疗外,均服用阿托伐他汀（20mg／d）,6～18月后再次行冠脉造影术（CAG）,根据CAG评分结果患者被分为病变进展组（n=32）和病变未进展组（n=59）;又根据第二次手术前LDL—C水平分为LDL-C≥2．1mmol／L（n=43）,1．64LDL—c〈2．1mmol／L（n=30）,LDL—C〈1．6mmol／L（n=18）三亚组,并探讨其相关性。结果：与病变未进展组患者比较,病变进展组LDL-C降低幅度[（0．46±0．81）mmol／L比（-0．04±0．65）mmol／L],降低百分比[（13．18±31．67）％比（-8．21±37．22）％]明显减小（P均〈0．05）;LDL-C≥2．1mmol／L组,1．6≤LDL-C〈2．1mmol／L组,LDL-C〈1．6mmol／L组病变未进展者比例逐渐升高（58．1％比63．3％比83．3％,P〈0．05）;Spearman分析显示,CAG前LDL水平与冠脉评分呈负相关（r=-0．70,P〈0．0001）。结论：常规治疗量的阿托伐他汀可使多数患者低密度脂蛋白胆固醇水平达标并有效遏制冠心病患者冠脉再狭窄。     

他汀类药物对藏族高尿酸血症合并高胆固醇血症患者疗效的研究

目的：探讨藏族人群血尿酸与颈动脉内-中膜厚度（IMT）的关系以及他汀类药物对藏族高尿酸血症合并血脂异常患者的疗效。方法：所有患者每晚口服阿托伐他汀20mg，连续12周。在服药前及治疗后12周采血测定血尿酸（UA），总胆固醇（TC），甘油三酯（TG）．高密度脂蛋白胆固醇（HDL-C），低密度脂蛋白胆固醇（LDL-C）．血尿素氮（BUN），肌酐（Cr），转氨酶水平。B型超声测量IMT。结果：80名人选患者均有血TC及尿酸异常。多元回归分析表明．服药前TC．TG．LDL（β=0．145-0．189），HDL（β=-0．181）和UA（β=0．284）与IMT相关（P〈0．05～〈0．01）。阿托伐他汀降低TC水平33．8％，TG24．9％．LDL-C12．2％．而HDL-C虽有升高趋势，但不显著（P〉0．05）。血尿酸水平明显降低达12．6％。结论：高尿酸血症与颈动脉粥样硬化相关。阿托伐他汀降低血脂、血尿酸含量有效。     

辛伐他汀与氟伐他汀调脂疗效的比较

目的：观察比较辛伐他汀（simvastatin,商品名：舒降之,默沙东公司生产）与氟伐他汀（fluvastatin,商品名,来适可,诺华制药公司生产）临床调脂疗效及耐受性,方法：将100例TC＞5．2mmol/L伴或不伴TG＞1．7mmol/L的对象随机分成辛伐他汀组（n=50)与氟伐他汀组（n=50),辛伐他汀组给予辛伐他汀20mg/d,氟伐他汀组给予氟伐他汀40mg/d,两组疗程均为12周,治疗．前,治疗后6周,12周分别测定TC,TG,HDL－C,LDL－C以及ALT,AST,CK值,结果：两组治疗6周后及治疗12周后,TC,TG,LDL－C水平与治疗前比较均有显著下降（P＜0．01）,治疗12周HDL－C水平与治疗前比较明显升高（P＜0．01）,两组间比较,治疗6周后,TC降低判别有非常显著意义（P＜0．01）,治疗12周后,TC,LDL－C降低判别有显著意义（P分别＜0．05和＜0．01）,HDL－C升高差别有显著意义（P＜0．05）。两组均未见明显不良反应,结论：辛伐他汀20mg/d,氟伐他汀40mg/d调脂疗效均较好且完全,其中,辛伐他汀在降低TC,LDL－C水平以及升高HDL－C水平优于无氟伐他汀,但对肝功能影响辛伐他汀氟伐他汀大。     

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.