干扰素-α联合叶下珠胶囊治疗慢性乙型肝炎疗效观察

目的探讨干扰素-α联合叶下珠胶囊治疗慢性乙型肝炎的临床疗效。方法选择慢性乙型肝炎患者56例随机分为两组，治疗组为干扰素-α与叶下珠胶囊联合治疗，对照组为单用干扰索-α。结果治疗组治疗后3个月和6个月ALT复常率分别为89．3％和96．4％，而对照组则分别为67．9％和78．6％；治疗组HBeAg阴转率分别为57．1％和67．9％，而对照组则分别为28．6％和39．3％；治疗组HBVDNA阴转率分别为64．3％和71．4％，而对照组则分别为35．7％和42．9％（P〈0．05）。结论干扰素-α联合叶下珠胶囊治疗慢性乙型肝炎，可促进患者肝功能改善，增强抗HBV作用。     

肝泰丸治疗慢性乙型肝炎的临床研究

目的：观察肝泰丸治疗慢性乙型肝炎的临床疗效。方法：将189例慢性乙型肝炎患者随机分为两组进行前瞻性研究。治疗组102例口服肝泰丸10s／次，4次／d；对照组87例选用α1b干扰素(IFN-α1b)3MU，皮下注射，1次／d，15天后改为隔日1次。两组病例疗程均为6个月。观察治疗后患者症状体征的改县情况、ALT、AST的复常情况和HBsAg、HBeAg、HBV DNA的阴转率及抗—HBe的阳转率。结果：治疗结束后治疗组和对照组有效率分别为87．25％和86．2％。HBsAg、HBeAg、HBV DNA阴转率及抗-HBe阳转率：治疗组分别为7.8％、40.2％、43．1％、37.2％；对照组分别为8．0％、41.3％、43.7％、36．8％。经统计学处理：两组的有效率、HBV-M、HBV DNA阴转率及抗-HBe阳转率差异无显著性意义(P＞0．05)。结论：肝泰丸对慢性乙型肝炎患者病毒复制有肯定的抑制作用。     

免疫疗法联合拉米夫定治疗慢性乙型肝炎应用研究

目的 探讨免疫疗法联合拉米夫定对慢性乙型肝炎(CHB)的抗病毒治疗效果。方法 治疗组(免疫疗法 拉米夫定)76例，对照组(单用拉米夫定)38例。2组病例根据血清ALT、HBV标志物水平分为免疫耐受期、免疫清除期。免疫疗法包括应用乙型肝炎疫苗、绿脓杆菌菌毛注射液、胸腺肽注射液。结果 免疫清除期病例的HBeAg阴转率治疗组为15／34(44．1％)，对照组为2／17(11．8％)，P＜0．05。HBV DNA阴转率2组分别为82．5％和70．6％。免疫耐受期病例的HBeAg阴转率治疗组为11／42(26．2％)，对照组1／21(4．8％)，P＜0．05。HBV DNA阴转率治疗组为23／42(54．8％)，对照组6／21(28．6％)，P＜0．05。结论 免疫疗法联合拉米夫定可以提高CHB患者HBeAg及HBV DNA阴转率。     

乙肝解毒胶囊治疗慢性乙型肝炎随机双盲阳性对照临床研究

目的：观察乙肝解毒胶囊治疗慢性乙型肝炎（CHB）的疗效及安全性。方法：60例CHB患者随机分为治疗组（乙肝解毒胶囊）及对照组（当飞利肝宁），每组30例，剂量为4粒／次，3次／d。共6个月，治疗期间检查患者肝功能、乙肝病毒标志物（HBV—M）及HBV DNA的变化。结果：6个月后，治疗组HBeAg、HBV DNA阴转率及HBeAg／HBeAb转换率比对照组明显改善（P〈0．05或0．01），治疗组HBV DNA下降幅度明显大于治疗组（P〈0．05）。治疗3个月和6个月后，HBV DNA水平下降幅率〉2log10 copies／ml的比例治疗组明显高于对照组（P〈0．05或0．01），两组患者的肝功能均有明显改善，但无明显差别（P〉0．05）。结论：乙肝解毒胶囊为有效、安全的抗HBV药物，值得进一步研究及临床应用。     

拉米夫定联合胸腺肽治疗慢性乙型肝炎的疗效观察

目的 评价拉米夫定联合胸腺肽治疗慢性乙型肝炎(CHB)的近、远期疗效和安全性，探讨两者联合治疗的协同作用。方法 将207例HBV DNA及HBeAg阳性的CHB患者随机分为甲乙两组，甲组采用拉米夫定和胸腺肽联合治疗，乙组单用拉米夫定治疗。胸腺肽15mg口服，每日1次，疗程6个月。两组拉米夫定治疗均为100mg，每日1次，口服，其中甲组92例(92／124)、乙组70例(70／83)用药超过12个月。两组在治疗6个月、12个月时分别进行疗效评价，治疗结束后继续随访12个月。结果 治疗6个月时，甲乙两组ALT复常率分别为87．1％和74．7％，甲组显著高于乙组(P＜0．05)，但两组HBV DNA阴转率、HBeAg阴转率及HBeAg／抗—HBe血清转换率均无显著性差异(P＞0．05)。治疗12个月时，甲乙两组ALT复常率和HBV DNA阴转率无显著性差异(P＞0．05)，甲组HBeAg阴转率及HBeAg／抗-HBe血清转换率均显著高于乙组(P＜0．05)。随访结束时，甲组从量复常率、HBV DNA阴转率、HBeAg阴转率及HBeAg／抗—HBe血清转换率均显著高于乙组(P＜0．05)。结论 拉米夫定与胸腺肽联合治疗CHB，疗效明显优于单用拉米夫定，是CHB患者安全有效的治疗方法。     

阿德福韦酯治疗前C和/或C区变异HBV感染近期疗效观察

目的 观察阿德福韦酯（ADV）治疗前C和／或C区变异的慢性乙型肝炎患者和无变异的HBeAg阳性慢性乙型肝炎患者1年期的疗效。方法 选择36例前C和／或C区变异的HBeAg阴性慢性乙型肝炎患者和13例HBeAg阳性慢性乙型肝炎患者，给予ADV10mg，每日1次口服，疗程1年。结果接受ADV治疗1年后前C区变异组、C区变异组，前C／C区变异组和无变异HBeAg阳性组患者的ALT复常率分别为81．8％（9／11），84．6％（11／13），83．3％（10／12）和84．6％（11／13），各组之间无显著性差异（P〉0．05）；HBV DNA阴转率分别为34．4％（4／11），30．8％（4／13），25％（3／12）和38．4％（5／13），各组之间无显著性差异（P〉0．05）。结论阿德福韦酯治疗前C和／或C区变异慢性乙型肝炎和无变异HBeAg阳性慢性乙型肝炎的1年期疗效相似。     

阿德福韦酯治疗HBeAg阴性慢性乙型肝炎22例临床观察

目的观察阿德福韦酯治疗HBeAg阴性慢性乙型肝炎的疗效。方法46例HBeAg阴性慢性乙型肝炎患者被随机分成阿德福韦酯组和拉米夫定组，阿德福韦酯组予阿德福韦酯10mg口服，1次／日；拉米夫定组予拉米夫定100mg口服，1次／日，治疗观察18个月。结果治疗6月、12月、18月时阿德福韦酯组HBV DNA阴转率分别为54．5％、63．6％、77．3％，肝功能复常率分别为50％、59．1％、72．7％；拉米夫定组治疗6月、12月、18月时HBV DNA阴转率分别为75％、66．7％、54．1％，肝功能复常率分别为62．5％、66．7％、54．1％，两组治疗6月和18月时HBV DNA阴转率、肝功能复常率比较都有显著性差异（P〈0．05）。结论阿德福韦酯治疗HBeAg阴性慢性乙型肝炎有较好的抗病毒疗效，安全性良好。     

拉米夫定联合苦参素治疗慢性乙型肝炎临床观察

目的 观察啦米夫定联合苦参素治疗慢性乙型肝炎病人的近期疗效。方法 选择36例慢性乙型肝炎患者用拉米夫啶100mg，1次／d，服1年，苦参素胶囊200mg，3次／d，服3个月作为观察组。选择36例慢性乙型肝炎患者用拉米夫定100mg，1次／d，服1年治疗作为对照组。结果 疗程结束时，两组肝功能复常率比较无显著性差异(97．2％对91．67％，P＞0．05)；HBVDNA阴转率无显著性差异(97．2％对80．6％，P＞0．1)；HgeAg阴转率有显著性差异(69．23％对28％，P＜0．005)。治疗6个月时，HBVDNA阴转率比较有显著性差异(91．67％对52．78％，P＜0．005)。结论 拉米夫定联合苦参素胶囊治疗慢性乙型肝炎可显著提高HBeAg阳转率，巩固疗效。     

乙型肝炎病毒E抗原、大蛋白与乙肝病毒DNA的关系

目的：探讨乙型肝炎病毒（HBV）表面E抗原（HBeAg）、大蛋白（LHBs）与乙肝病毒DNA（HBV DNA）的关系。方法分别检测109例HBeAg阳性和116例HBeAg阴性的乙型肝炎患者的LHBs、HBV DNA表达情况,并进行对比分析。结果 HBeAg阳性组中,LHBs、HBV DNA的检测率分别为89．9％和84．4％,二者比较无统计学差异（P＞0．05）;HBV DNA定量与HBeAg定量和LHBs均呈正相关（r分别为0．81、0．94,P均＜0．05）,不同HBV DNA载量组间HBeAg定量和LHBs含量均有统计学差异（P均＜0．01）。结论对HBeAg阴性患者而言,LHBs能在一定程度上反映体内HBV的复制情况,可作为HBV DNA的补充,指导临床诊治和用药。     

参灵肝康胶囊联合阿德福韦酯治疗慢性乙型肝炎临床观察

目的:观察参灵肝康胶囊联合阿德福韦酯治疗慢性乙型肝炎(CHB)的临床疗效.方法:将112例CHB患者随机分为两组.治疗组56例,口服阿德福韦酯胶囊(10mg/次,1次/d,共服18个月)和参灵肝康胶囊(4粒/次,3次/d,持续18个月);对照组56例,与治疗组同疗程同剂量口服阿德福韦酯胶囊.结果:治疗结束后,治疗组患者肝功能生化学指标改善明显好于对照组,两组相比差异有显著性意义(P＜0.05);治疗组HBeAg转阴率为48.2％,HBeAg/HBeAb血清转换率为42.9％,HBV DNA转阴率为78.57％,对照组HBeAg转阴率为39.3％,HBeAg/HBeAb血清转换率为32.1％,HBV DNA转阴率为64.29％,两组相比差异有显著性意义(P＜0.05).结论:参灵肝康胶囊联合阿德福韦酯治疗CHB安全有效,具有较好的持久恢复肝功能和抗病毒的疗效.     

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.     

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.     

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.