国产非洛地平与依那普利治疗原发性高血压的疗效比较

目的:比较非洛地平与依那普利对轻中度原发性高血压的降压疗效和安全性.方法:72例轻中度原发性高血压患者随机接受非洛地平(5 mg～20 mg)和依那普利(5 mg～20 mg)(各36例)治疗4周.结果:非洛地平和依那普利的降压总有效率分别是94.4%和91.3%(P>0.05).结论:非洛地平对轻中度原发性高血压疗效较好而且安全.     

替米沙坦降压疗效的临床研究

目的　前瞻性评估替米沙坦治疗原发性高血压的降压疗效和安全性。　方法　 139例轻中度原发性高血压病人随机服用替米沙坦 4 0～ 80mg或福辛普利 10～ 2 0mg共 2 6周 ,服药前、后行动态血压监测 (ABPM ) ,观察 2 4hSBP和DBP、谷峰比值、给药末 6h血压变化、降压有效率和不良反应。结果　替米沙坦和福辛普利均能有效降低血压 ,2 6周治疗有效率分别为 75 %和 72 % (P >0 0 5 ) ,替米沙坦谷峰比值较福辛普利高 (SBP :72 %vs 6 2 % ,P <0 0 5 ;DBP :75 %vs 6 3%P <0 0 5 ) ,且较福辛普利具有更强的降低清晨 2 :0 0 - 8:0 0血压的作用 (P <0 0 5 )。替米沙坦不良反应发生率较少。结论　替米沙坦治疗轻中度原发性高血压安全有效 ,耐受性好 ,可持续 2 4h理想的控制血压     

国产拉西地平对广西轻中度原发性高血压50例患者24 h动态血压的影响

目的探讨拉西地平(司乐平)对广西轻中度原发性高血压的降压疗效。方法选50例轻中度原发性高血压患者采用自身对照开放法,停用原来降压药物2周后随诊血压(CBP)仍≥160/95 mmHg(1 mmHg=0.133 kPa)者口服拉西地平4～8 mg/d共4周,期间不服用其他降压药。结果治疗4周后随诊血压(CBP)降低总有效率为88%,动态血压曲线明显降低,谷峰比值收缩压为65.2%,舒张压为61.1%。结论国产拉西地平4～8 mg/d对轻中度原发性高血压患者具有安全有效的降压作用,耐受性好,不良反应少。     

厄贝沙坦和依那普利治疗原发性高血压的对比研究

目的对比观察厄贝沙坦与依那普利治疗轻中度原发性高血压的疗效和安全性。方法随机观察厄贝沙坦(41例,150mg～300mg)与依那普利(42例,10～20mg)治疗高血压患者4周和8周的有效率,并分两组进行比较。结果两组治疗第2周后开始平均收缩压、舒张压较治疗前明显降低(P<0.01),在整个治疗期间血压持续平稳下降;厄贝沙坦与依那普利治疗4周降低舒张压总有效率分别为90.2%(37/41)和83.3%(35/42),8周降低舒张压总有效率分别为95.1%(39/41)和90.5%(38/42),两组比较P>0.05。结论厄贝沙坦是一安全、有效、长效,耐受性好,不良反应轻的降压药物。     

钠催离及依那普利联用治疗高血压性心脏病心力衰竭

目的 :探讨钠催离与依那普利联用对高血压性心脏病心力衰竭的疗效及安全性。方法 :联合用药组给予钠催离 2 .5 mg,1次 / d,依那普利 5～ 10 mg,2次 / d;依那普利组 （对照组剂量为 5～ 10 mg,2次 / d）。结果 :联合用药组有效率 88% ,对照组 6 8% ,二者有显著差异 （P<0 .0 5 ）。结论 :钠催离与依那普利联用对高血压性心脏病心力衰竭安全有效 ,降压效果优于单用依那普利。     

依那普利与卡托普利治疗原发性高血压的疗效比较

目的比较卡托普利与依那普利对原发性高血压的降压疗效和安全性.方法1,2级原发性高血压患者50例,随机分为卡托普利组(n=25)与依那普利组(n=25),分别口服卡托普利37.5mg～75mg/天和依那普利10mg～20mg/天,治疗4周.结果卡托普利组SBP/DBP下降17/12-mmHg(P＜0.01),依那普利组SBP/DBP下降21/13mmHg(P＜0.01).卡托普利组总有效率80%与依那普利组84%相似.两组用药前后电解质、血糖及血脂均无明显变化.结论依那普利治疗高血压的疗效与对照药卡托普利相似,其疗效确切,不良反应少,耐受性好.     

非洛地平缓释片对原发性高血压病人血压和胰岛素抵抗的影响(摘要)

通过正常血糖胰岛素钳夹技术(EICT)测定葡萄糖代谢率作为胰岛素抵抗 (ISR)指数 ,并观察非洛地平(felodipine)缓释片对原发性高血压病人血压和 ISR的干预作用。1　材料和方法　　 1997年 5月至 1998年 2月我院的42～ 6 8岁的轻中度原发性高血压病人2 0例 ,均除外糖尿病、冠心病。　　分组 :所有病人在测定血压后行EICT测定葡萄糖代谢率 ,2 0例原发性高血压病人葡萄糖代谢率为 6 .34±1.86 mg/ (kg· min)。以葡萄糖代谢率低于 5 .6 4mg/ (kg· min)作为存在 ISR的指标 ,据此把原发性高血压病人分为2组 ,1组为伴有 ISR的原发性高血压…     

动态血压观察卡维地洛降压疗效

目的 :观察卡维地洛的降压疗效。方法 :服用安慰剂 10～ 14 d后服用卡维地洛 10～ 40mg/ d,上午 8时顿服 ,总疗程为 4周 ,共治疗轻中度原发性高血压 ( EH)患者 2 5例。采用血压监测仪测定 2 4h动态血压。结果 :治疗 4周后 2 4h平均血压、白昼及夜间平均血压、血压负荷值均较用药前显著下降 ( P <0 .0 1) ,收缩压和舒张压的谷 /峰比值分别降低 5 4.1%和 65 .6%。结论 :卡维地洛每日 1次投药能有效地控制轻中度 EH患者 2 4h血压水平。     

氨氯地平与依那普利治疗社区老年1、2级原发性高血压的疗效比较

目的比较氨氯地平、依那普利治疗老年1、2级原发性高血压的临床疗效和安全性。方法70例老年1、2级原发性高血压患者随机分为两组,氨氯地平组(n=35)给予氨氯地平5mg/d；依那普利组(n=35)给予依那普利10mg/d。8周后统计疗效。结果治疗后两组疗效间差异无显著性意义(P＞0．05),均可降低收缩压和舒张压,与治疗前比较差异均有显著性意义(P＜0．05),降压幅度组间差异无显著性意义(P＞0．05)。治疗前后对心率影响两组相比差异无显著性意义(P＞0．05)。两组均无严重不良反应。结论氨氯地平和依那普利治疗老年1、2级高血压安全有效,值得推广,可作为一线治疗药物。     

西拉普利与依那普利治疗Ⅱ型糖尿病并高血压的临床研究

目的探讨西拉普利与依那普利治疗Ⅱ型糖尿病合并轻一中度高血压患者，观察其降压疗效，微量白蛋白排泄量，糖代谢的影响，及其比较研究。方法选择Ⅱ型糖尿病并高血压患者符合1978年WHO诊断的轻中度原发性高血压80例，随机分为西拉普利和依那普利组各40例，两组性别、年龄、病情、病程均具有可比性(P>0.05)。所有入选病例进入治疗前均停用降压药物两周，血糖控制稳定2周；服用降压药前和服药8周后分别查空腹血糖、胰岛素和75g葡萄糖耐量后2小时血糖、胰岛素及治疗前后尿微量白蛋白排泄量测定；治疗方法根据随机分组分别服用由罗氏集团制药厂生产的西拉普利(商品名一平苏，每片2.5mg)和由常州制药厂生产的依那普利(怡那林，每片10mg)。每日1次，每次1片。若4周后未达理想疗效，自第5周开始改服每日2片，一次顿服，总疗程8周。结果西拉普利每日2.5～5mg治疗Ⅱ型糖尿病并轻、中度原发性高血压疗效具有持续时间更长，服用剂量小，降压总有效率达95%，收缩压(SBP)、舒张压(DBP)下降幅度和下降百分率高于依那普利组，而且副作用发生率较低，对尿微量白蛋白排泄量(μg/min)的影响，西拉普利组较依那普利组明显减少，且治疗后血肌酐浓度降低(P<0.001)。结论西拉普利既可降低Ⅱ型糖尿病合并高血压的血压，又能降低尿微量白蛋白排泄量和降低血肌酐浓度，从而起到特殊的肾保护作用。     

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.