阿德福韦酯联合复方鳖甲软肝片治疗肝纤维化的临床观察

目的：观察阿德福韦酯联合复方鳖甲软肝片治疗慢性乙型肝炎和代偿期肝硬化患者抗肝纤维化的临床疗效。方法：120例慢性乙型肝炎肝纤维化患者随机分为阿德福韦酯与复方鳖甲软肝片联合治疗组及单用阿德福韦酯对照组，每月查肝功能等生化指标，每3个月检测HBV—M、HBVDNA，分别于治疗前和治疗12个月后用放射免疫法检测血清肝纤维化指标。结果：12个月后两组患者肝功能均明显恢复，两组比较差异无显著性意义；两组HBeAg阴转率、HBeAg／HBeAb血清转换率、HBV DNA阴转率差异均无显著性意义（均P〉0．05）；联合治疗组患者肝纤维化程度改善更明显（均P〈0．05）。结论：阿德福韦酯与复方鳖甲软肝片联合治疗组在抗肝纤维化程度方面优于单用阿德福韦酯组。     

中药复方肝欣合剂抗肝纤维化作用的临床研究

目的:观察中药复方肝欣合剂对慢性乙型肝炎及肝纤维化的疗效。方法:选择慢性乙型肝炎肝功能及肝纤维化指标异常的患者80例,随机分成两组,治疗组患者口服中药复方肝欣合剂,对照组患者口服强肝丸,观察治疗后肝功能和肝纤维化指标的变化。结果:两组患者血清ALT、TBil、HA、LM和PCⅢ均有明显降低,Alb亦有明显提高,两者相比较有统计学意义(P<0.05或P<0.01)。结论:中药复方肝欣合剂具有明显的抗肝纤维化作用。     

抗纤软肝胶囊联合阿德福韦酯治疗慢性乙型肝炎肝纤维化的临床研究

目的:评价抗纤软肝胶囊联合阿德福韦酯治疗慢性乙型肝炎肝纤维化的疗效.方法:将104例慢性乙型肝炎肝纤维化患者随机分为3组:抗纤软肝胶囊治疗组、阿德福韦酯治疗组和抗纤软肝胶囊联合阿德福韦酯治疗组,治疗前后分别进行肝功能、肝纤维化血清学指标检测及超声影像学检查.结果:治疗1年后,①3组患者肝功能、肝纤维化指标和超声影像学指标均有不同程度的好转;②阿德福韦酯组和联合治疗组ALT降低和Alb升高幅度与抗纤软肝胶囊组相比较,差异有显著性意义(P＜0.05);③联合治疗组在肝纤维化指标(HA、LN、C-Ⅳ)和超声影像学指标(门脉主干内径、脾厚度)方面的改善与其他两组比较,差异有显著性意义(P＜0.05).结论:抗纤软肝胶囊和阿德福韦酯均有一定的抗慢性乙型肝炎肝纤维化的作用,两者联用时抗纤维化疗效更好.     

Effect of adefovir dipivoxil combined with composite danshen pill on hepatocirrhosis

目的 观察阿德福韦酯联合复方丹参滴丸治疗乙型肝炎肝硬化代偿期患者的疗效.方法 81例乙型肝炎肝硬化代偿期患者,随机分为3组,联合治疗组给予阿德福韦酯和复方丹参滴丸,对照组给予阿德福韦酯或复方丹参滴丸治疗,疗程均为6个月,观察治疗后6个月3组患者HBV-DNA、肝功能、血小板、脾脏厚度及肝纤维化指标的变化情况.结果 治疗6个月后,阿德福韦酯组和联合治疗组患者血清HBV-DNA、肝功能均较治疗前明显好转(P＜0.05),而复方丹参滴丸组患者HBV-DNA水平无明显下降(P＞0.05),仅部分肝功能指标有所好转;联合治疗组肝纤维化指标较治疗前显著改善(P＜0.05),复方丹参滴丸组患者肝纤维化指标部分改善.而阿德福韦酯组肝纤维化指标无显著性好转(P＞0.05).结论 阿德福韦酯联合复方丹参滴丸治疗能有效抑制乙肝病毒复制,改善肝功能,减轻肝纤维化.     

中药复方对实验性大鼠肝纤维化的影响

目的 观察中药复方对实验性大鼠肝纤维化的影响. 方法 按照完全随机化原则将80只实验动物Wistar大鼠随机分为8组,每组10只,分别为正常对照组、模型对照组、中药金三莪预防组、中药复方预防组、中药金三莪治疗组、中药复方低剂量治疗组、中药复方中剂量治疗组、中药复方高剂量治疗组.以40%四氯化碳石蜡油作为腹腔造模剂进行腹腔造模,预防组从造模之日起给予中药复方和中药金三莪治疗,治疗组从造模4 w起给予中药复方和中药金三莪治疗.病理切片观察大鼠肝纤维化的变化情况. 结果 经过预防和治疗之后大鼠肝纤维化程度有比较明显的改善. 结论 该中药复方可能通过抗炎、保肝等综合作用起到抗肝纤维化的作用.     

复方丹参与苦参素注射液合用对慢性乙型肝炎患者肝纤维化指标的影响

目的:观察复方丹参注射液与苦参素注射液合用对慢性乙型肝炎患者肝纤维化指标的影响.方法:选择肝纤维化指标异常的慢性乙型肝炎102例,随机分为两组,治疗组52例,采用复方丹参注射液40ml静滴,苦参素注射液0.4g肌注,1次/d,基础护肝治疗,酌情使用甘草酸二铵、茵栀黄、维生素类等;对照组50例,仅给予基础护肝治疗.疗程均为60天.观察肝功能(ALT、TBil、A/G)、乙肝病毒指标(HBsAg、HBeAg、HBV DNA)及肝纤维化指标(HA、CG、LN、ⅣC)的变化.结果:治疗组与对照组比较,在肝功能及乙肝病毒指标改善方面差异无显著性意义(P＞0.05);在肝纤维化指标改善方面差异有极显著性意义(P＜0.01).结论:复方丹参注射液与苦参素注射液合用,可显著改善肝纤维化指标,减缓肝纤维化进展速度.     

复方甘草酸苷治疗慢性乙型肝炎对血清肝纤维化指标的影响

目的观察复方甘草酸苷治疗对慢性乙型肝炎患者肝纤维化指标的影响。方法64例慢性乙型肝炎患者随机分成两组,治疗组34例用复方甘草酸苷注射液,对照组30例用硫普罗宁注射液,两组均治疗1个月,观察肝功能及肝纤维化指标的变化。结果治疗组对降低肝纤维化指标方面明显优于对照组(P<0.01),但在改善肝功能方面无显著性差异。结论复方甘草酸苷能降低慢性乙型肝炎患者血清肝纤维化指标。     

蕲艾煎剂抗肝纤维化作用的临床研究

目的：观察蕲艾煎剂对慢性乙型肝炎及肝纤维化的疗效。方法：选择慢性乙型肝炎肝功能及肝纤维化指标异常的患者80例，治疗组患者口服蕲艾煎剂，对照组患者口服复方甘草酸苷片，观察治疗后其肝功能、肝纤维化指标及门静脉、脾静脉内径。结果：两组患者天门冬氨酸氨基转移酶（AST）、丙氨酸氨基转移酶（ALT）、总胆红素（TBil）、肝纤维化指标均明显降低，但两组比较，差异无显著性意义（P〉0．05），且门静脉、脾静脉内径治疗前后未见明显变化。结论：蕲艾煎剂具有明显的抗肝纤维化作用，效果与复方甘草酸苷片相当。     

利肝克纤冲剂抗肝纤维化的临床研究

目的：观察中药利肝克纤冲剂在抗肝纤维化方面的疗效。方法：选取90例肝纤维化患者随机分为两组，治疗组60例，对照组30例，治疗6个月。观察治疗前后两组患者的症状、体征、肝功能、肝纤维化指标及B超影像学的变化，评价中药利肝克纤冲剂抗肝纤维化的疗效。结果：治疗组总有效率为86．67％，对照组总有效率为43．33％，两组比较，差异具有显著性意义（P〈0．01）。结论：利肝克纤冲剂可明显改善肝纤维化患者的症状、体征、肝功能、血清肝纤维化4项指标（HA、LN、PCⅢ及Ⅳ-c）及B超影像学表现，具有明显抗肝纤维化疗效。     

益气活血通络方联合恩替卡韦治疗慢性乙型肝炎肝纤维化的临床观察

目的:观察益气活血通络方联合恩替卡韦治疗慢性乙型肝炎肝纤维化的临床疗效。方法:将60例慢乙肝肝纤维化患者随机分为对照组和观察组,每组30例,对照组患者单服恩替卡韦片,观察组患者在对照组患者治疗的基础上给予益气活血通络方加减治疗。观察两组患者治疗前后乙肝病毒血清学标志物(HBV-M)、HBV DNA、肝功能指标、肝纤维化指标及肝硬度值的变化。结果:治疗后两组患者的肝功能均有明显改善,与治疗前相比差异有显著性意义(P0.05),且两组治疗后比较差异有显著性意义(P0.05);两组患者HBV DNA定量阴转率均为90.0%(27/30),与治疗前相比差异有显著性意义(P0.01),但治疗后两组间比较无差异无显著性意义(P0.01)。两组患者的肝纤维化指标及肝硬度值较治疗前均有明显下降(P0.05),而且观察组疗效明显优于对照组(P0.05)。结论:益气活血通络方联合恩替卡韦对慢性乙型肝炎肝纤维化有较好的治疗作用,能够改善患者的肝功能,延缓或逆转肝脏纤维化,对控制病情进展具有重要意义。     

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.     

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.     

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.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.