阿卡波糖对老年冠心病患者餐后生理参数的影响

目的 探讨阿卡波糖对冠心病餐后生理参数波动的影响及餐后心肌缺血发作的相关影响因素.方法 选择110例冠心病出现餐后胸闷、心绞痛发作的患者,观察其餐前餐后血压、心率、血糖及血脂变化情况,根据其合并症情况分为单纯冠心病组、合并高血压组、合并糖尿病组,均采用阿卡波糖治疗和常规治疗相结合,分析阿卡波糖对冠心病患者餐后心肌缺血与这些生理参数波动的关系.结果 单纯冠心病组和合并高血压组餐后血压、心率、血糖、血脂明显升高,合并糖尿病组餐后血糖、血脂明显升高,血压、心率明显降低;阿卡波糖治疗后,三组心率、血糖、血压波动幅度明显降低(P<0.05,P<0.01),血脂波动幅度无明显变化(P>0.05).结论 阿卡波糖可有效缓解在单纯冠心病及其合并高血压或糖尿病的患者中,餐后可出现血糖、血脂、血压及心率不同程度的波动,并预防老年冠心病患者心血病事件的发生与发展.     

高血压病和糖尿病患者餐后状态血压及心率变化的研究

目的　研究高血压病 (EH)和 2型糖尿病 (DM)患者餐后状态血压和心率的变化特点。　方法　 187例患者 ,分 3组 :高血压病组 (EH,71例 ) ,2型糖尿病组 (DM,49例 )和 2型糖尿病伴高血压组 (DM EH,6 7例 )。观察各组 2 4h动态血压和心率 ,进标准定量饮食 ,分析进餐前后收缩压(SBP)、舒张压 (DBP)和心率的变化。　结果　 EH组和 DM EH组 2 4h平均收缩压 (2 4h ABPS)和2 4h平均舒张压 (2 4h ABPD)较 DM组明显增高 (P<0 .0 1) ,而 DM组和 DM EH组 2 4h平均心率较 EH组快 (P<0 .0 1) ;EH组在餐后 30 m in至 6 0 min的 SBP、DBP和心率较餐前对应时间点升高(P<0 .0 1) ,餐后 90 m in SBP、DBP和心率恢复至餐前水平。 DM组和 DM EH组在餐后 30 m in至90 min SBP、DBP和心率下降 (P<0 .0 1) ,餐后 12 0 min SBP、DBP和心率恢复至餐前水平。　结论　高血压病和 2型糖尿病患者餐后状态血压和心率的变化有不同的特点 ,表现为高血压病患者餐后血压升高和心率增快 ,而 2型糖尿病或伴高血压病的 2型糖尿病患者餐后血压和心率下降 ,且其血压和心率恢复至餐前水平较单纯高血压病患者慢。     

北京市老年人高同型半胱氨酸血症的患病率调查

目的了解北京地区老年人高同型半胱氨酸血症(HHcy)的患病情况。方法采用分层、分段、随机、整群的抽样方法,通过入户问卷调查、体格检查的方法调查北京城乡60岁及以上老年人1 460例(男638例,女822例),并进行血生化及血浆同型半胱氨酸(Hcy)水平测定,分析HHcy的患病情况。结果北京老年人Hcy水平为21.3μmol/L,男性显著高于女性(P<0.001);农村显著高于城区(P<0.001)。男性HHcy、HHT患病率显著高于女性(P<0.01)。结论北京老年人HHcy患病率较高。     

老年人血小板聚集功能、颗粒膜蛋白及电泳率测定的研究

本文对健康青壮年、老年人血小板功能、颗粒膜蛋白-140及电泳率进行测定,研究老年人血小板功能的变化。结果表明,老年人血小板1、3、5分钟聚集率及最大聚集率明显高于青壮年组(P<0.001),颗粒膜蛋白-140数量显著增多(P<0.05),而老年人血小板电泳率明显降低(P<0.001)。结论认为老年人的上述改变可能与老年人易形成血栓及其并发病的发生有关。     

老年人糖调节受损与心率震荡的相关性研究

目的探讨老年人糖调节受损与心率震荡的相关性。方法选择健康体检者254例,根据口服葡萄糖耐量试验结果和国际糖尿病联盟发布的血糖管理指南,将受试者分为对照组127例、糖调节受损组(受损组)72例及新诊断糖尿病组(糖尿病组)55例。所有受试者均进行24h动态心电图检查,并进行相关分析。结果与对照组比较,受损组及糖尿病组震荡初始及24h室性期前收缩总数升高,震荡斜率及RR间期标准差(SDNN)明显降低(P<0.05);与糖尿病组比较,受损组震荡初始降低,震荡斜率及SDNN明显升高(P<0.05)。Pearson相关分析显示,空腹血糖水平与震荡初始及24h室性期前收缩总数呈正相关(r=0.5347,r=0.3419,P<0.01),与震荡斜率及SDNN呈负相关(r=-0.4633、r=-0.3682,P<0.01)。结论空腹血糖水平与心率震荡相关,老年糖调节受损者已经存在心脏自主神经的功能紊乱。     

力量训练对老年代谢综合征患者空腹和摄糖后自主神经功能调节的影响

目的探讨8 w力量训练对老年代谢综合征(MS)患者空腹和摄糖后自主神经功能的调节作用。方法 24例老年MS患者随机分为运动组(n=12)和对照组(n=12),运动组进行8 w力量训练,对照组保持日常生活习惯。分别于实验前后测定空腹和口服葡萄糖耐量试验(OGTT)后的心率变异性(HRV)和血压变异性(BPV)。结果空腹状态下,两组实验前后HRV、BPV参数均无统计学差异(P>0.05)。OGTT状态下,两组实验前及实验后标准化低频功率(LFn)、LFn/标准化变频功率(HFn)、收缩压的低频功率(LFSBP)均较本组空腹状态时明显增加(P<0.05),运动组实验后OGTT状态下LFn、LFn/HFn、LFSBP较实验前OGTT状态下也明显增加(P<0.05)。而对照组实验前后OGTT状态下各指标无统计学差异(P>0.05)。结论力量训练提高了老年MS患者摄糖后的交感反应(包括心交感调制和交感缩血管调制),但对空腹时的自主神经功能无明显影响。     

老年糖尿病患者脂肪餐后甘油三酯的变化及其对血管内皮功能的影响

目的观察老年糖尿病患者脂肪餐后甘油三酯(TG)的变化,及其对血管内皮功能的影响。方法检测35例老年糖尿病患者脂肪餐前和餐后2、4、6 h时血清TG表达水平,并采用超声检测空腹颈动脉内中膜厚度(IMT)及脂餐前后血管内皮依赖性舒张功能(FMD),同期选择35例门诊健康体检者作为对照组。结果老年糖尿病患者脂肪餐后2 h、4 h及6 h时的血清TG表达水平明显高于餐前(P<0.05),且均明显高于同时间点对照组的血清TG表达水平(P<0.05),对照组脂肪餐后2、4 h明显高于餐前(P<0.05),但餐后6 h血清TG表达水平恢复至餐前水平;糖尿病组患者空腹状态时C-IMT明显高于对照组(P<0.05),而FMD明显低于对照组(P<0.05),两组餐后4 h时C-IMT比较无显著差异(P>0.05),而FMD较空腹均明显降低(P<0.05),且糖尿病组餐后4 h时FMD明显低于对照组(P<0.05),而ΔFMD明显高于对照组(P<0.05)。结论老年糖尿病患者脂肪餐后血清TG表达水平明显升高,对血管内皮功能造成一定损害,可促进糖尿病合并心血管病变的发生。     

贵阳市城区老年人记忆减退现况研究

目的探讨影响老年人记忆减退的部分因素。方法采用多阶段抽样的方法,抽取贵阳市城区5个办事处的26个社区为调查点,对3229名60岁以上的老年人采用问卷调查,了解一般情况及相关健康问题;用简易智力状态检查量表(MMSE)中的记忆问题对短时记忆和瞬时记忆进行检测。资料统计采用χ2检验。结果老年人短时记忆障碍的发生率为26.9%,瞬时记忆障碍的发生率为9.7%。随着增龄老年人的记忆普遍下降(短时记忆:χ2=195.64,P<0.001;瞬时记忆:χ2=283.67,P<0.001),随文化程度的降低,老年人的记忆力有减退趋势(短时记忆:χ2=174.27,P<0.001;瞬时记忆:χ2=280.79,P<0.001),男性记忆力好于女性,两者差异有显著性(短时记忆:χ2=15.48,P<0.01;瞬时记忆:χ2=15.86,P<0.01),不同职业的老年人记忆力有一定的差别(短时记忆:χ2=32.76,P<0.001;瞬时记忆:χ2=48.83,P<0.001)。结论贵阳市老年人记忆减退发生率较高,记忆受性别、年龄、教育程度和职业因素不同程度的影响。     

老年人餐后高血糖与颈动脉粥样硬化的相关性

目的探讨老年人餐后高血糖的水平与颈动脉粥样硬化程度的相关性。方法做糖耐量试验(OGTT)入选老年人餐后高血糖123例,应用高频多普勒超声检测老年患者的颈动脉内膜中层厚度(IMT)及斑块程度,测定总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDLC)和低密度脂蛋白胆固醇(LDL-C)。观察分析老年人餐后高血糖与颈动脉IMT及斑块的关系。结果本组老年人住院病例餐后高血糖四分位组分析显示,随分位数增加,老年人颈动脉IMT及斑块严重程度增加。老年人餐后高血糖颈动脉斑块发生率是67.48%。老年人餐后高血糖与颈动脉IMT和斑块严重程度的相关性独立于年龄、性别、血压、TC、TG和LDL-C。结论老年人餐后高血糖水平与颈动脉IMT密切相关。餐后高血糖是老年人颈动脉粥样硬化和斑块形成独立危险因素。     

2014～2017年广州市某医院老年人伤害流行病学特征

目的了解广州市某哨点医院老年人伤害流行病学特征,为制定老年人伤害防控措施提供科学依据。方法收集某哨点医院2014～2017年≥60岁人群的首诊伤害资料,分析伤害特征及相关影响因素。结果 2014～2017年共监测≥60岁的首诊伤害病例5 399例,男2 257例(41.8%),女3 142例(58.2%);伤害主要发生在家中(76.20%),以跌倒坠落(57.31%)、头部伤害(31.43%)、挫伤擦伤(35.36%)、非故意伤害(97.81%)、轻度伤害(71.38%)为主,伤害发生时主要从事休闲活动(38.49%),伤害结局以治疗后回家(74.16%)为主;老年人伤害基本特征和伤害临床信息存在不同程度的性别差异;伤害的严重程度(r=0.256,P<0.001)、伤害结局均与年龄呈正相关(r=0.273,P<0.001)。结论根据老年人的伤害特征及性别差异开展针对性健康教育和健康促进可降低老年人伤害的发生率。     

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.     

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.