初发性和复发性生殖器疱疹患者尿道和宫颈排毒的临床研究

目的应用降落PCR法检测初发性和复发性生殖器疱疹患者尿道和宫颈HSV排放情况。方法对每位初发性和复发性生殖器疱疹患者均取1个拭子,采用降落聚合酶链式反应(TD-PCR)对临床标本进行鉴定。结果共检测38例生殖器疱疹患者,男性尿道口标本28个,初发性7个,复发性21个;女性宫颈管标本10个,初发性和复发性各5个。经降落PCR方法鉴定,均为HSV-Ⅱ。初发病例与复发病例的HSV-PCR阳性率分别为83%(10/12)和46.2%(12/26)(χ2=4.66,P<0.05),有显著性差异。结论初发性和复发性生殖器疱疹患者尿道和宫颈HSV排放的情况不同,初发性生殖器疱疹的排毒率高于复发性生殖器疱疹。     

泛昔洛韦单日疗法治疗复发性生殖器疱疹的临床对照研究

目的探讨泛昔洛韦单日疗法治疗复发性生殖器疱疹的疗效及安全性。方法采用随机、对照临床实验,比较泛昔洛韦单日疗法(1 000mg,2次/日,共1日)与传统的阿昔洛韦五日疗法(400mg,3次/日,共5日)的疗效及安全性。结果 136例复发性生殖器疱疹患者参加试验。试验组与对照组疗效比较,皮损愈合时间、症状消退时间、总病愈时间分别为(4.00±0.63)天vs.(3.85±0.90)天(t=1.13,P=0.26),(3.32±0.55)天vs.(3.18±0.77)天(t=1.22,P=0.22),(4.53±0.65)天vs.(4.45±0.95)天(t=0.57,P=0.57)。皮损顿挫比率分别为32.4%vs.26.8%(χ2=0.58,P=0.31),差异均无统计学意义。两种治疗方案不良反应发生率相近(28.0%vs.19.1%)(χ2=0.91,P=0.34),表现以头痛为主。结论泛昔洛韦单日疗法治疗复发性生殖器疱疹有效、安全,运用方便。     

伐昔洛韦长期抑制疗法对频繁复发的生殖器疱疹患者心理及性生活质量的影响

目的探讨伐昔洛韦长期抑制疗法对频繁复发的生殖器疱疹患者心理及性生活质量的影响。方法通过比较复发性生殖器疱疹患者在运用伐昔洛韦长期抑制疗法前后其心理及性生活质量的改变情况,探讨伐昔洛韦长期抑制疗法对复发性生殖器疱疹患者心理及性生活质量的影响。结果 130例复发性生殖器疱疹患者,经过6个月的伐昔洛韦长期抑制疗法,治疗的总有效率为62.31%。其中存在不同程度心理障碍的患者由治疗前的86.15%降低为治疗后的43.08%,其差异具有统计学意义(P0.05);而性生活质量低下的患者也由治疗前的79.23%降低为治疗后的33.85%,差异有统计学意义(P0.05)。结论伐昔洛韦长期抑制疗法对频繁复发的生殖器疱疹患者心理及性生活质量均有明显改善,值得临床推荐。     

中西药抑制疗法治疗复发性生殖器疱疹

2001年10-2002年11月,我科采用中西药疗法治疗30例复发性生殖器疱疹(GH)患者,取得较好疗效,报告如下: 1 临床资料 1.1 一般资料 30例GH患者病情均为反复发作,病程6个月～2年,复发间隔20～40d不等。以往均曾口服或静滴阿昔洛韦治疗,其中6人曾注射过γ-干扰素100万U,隔日1次,连用10～20d,但均未控制复发。     

重组人干扰素α-2b预防生殖器疱疹复发的临床观察

目的观察重组人干扰素α-2b局部注射联合口服伐昔洛韦对生殖器疱疹复发的预防作用。方法实验组采用重组人干扰素α-2b局部注射联合口服伐昔洛韦治疗生殖器疱疹,对照组单独采用口服伐昔洛韦治疗,比较两者的临床复发率。结果治疗后观察1年内复发次数,实验组明显低于对照组,两组复发率相比差异具有统计学极显著意义(P0.01)。结论重组人干扰素α-2b局部注射,可显著降低生殖器疱疹复发率。     

浆细胞样树突状细胞对频繁复发的生殖器疱疹的免疫作用

目的探索浆细胞样树突状细胞(plasmacytoid dendritic cells,p DCs)对频繁复发的生殖器疱疹的免疫作用。方法选取确诊复发性生殖器疱疹患者10例,于静息期、复发早期及后期抽取外周血,通过梯度离心法分离白细胞,流式细胞术检测p DCs百分比,白细胞体外原代培养,ELISA法检测血清以及白细胞培养上清液干扰素(interferon,IFN)α和IFNγ,并与对照组比较。结果生殖器疱疹复发后期外周血p DCs百分比相较对照组、静息期及复发早期显著减低(P均0.05);患者血清IFNα水平高于对照组,复发早期显著升高,后期降低(P均0.05);患者IFNγ水平在疾病各期呈依次升高,差异均有统计学意义,静息期略低于正常参考值,发病早期和后期均高于正常参考值。IFNα、单纯疱疹病毒(herpes simplex virus,HSV)-2和寡聚脱氧核苷酸(Cp G-oligodeoxynueleotide,Cp G ODN)均可诱导外周血白细胞产生IFNγ,患者IFNγ水平显著低于对照组(P均0.05)。BDCA-2抗体可抑制HSV-2和Cp G ODN的诱导作用。结论 p DCs参与了复发性生殖器疱疹的免疫反应,频繁复发的生殖器疱疹存在Th1淋巴细胞对p DCs介导的免疫反应减低。     

胸腺肽治疗对复发性生殖器疱疹患者T细胞亚群的影响

目的探讨胸腺肽治疗对复发性生殖器疱疹(RGH)患者T细胞亚群的影响。方法50例RGH患者随机分为2组:治疗组28例,对照组22例。对照组口服阿昔洛韦片治疗;治疗组除口服阿昔洛韦片外,还接受胸腺肽注射液治疗。另设30名健康体检者为正常对照组。所有患者在治疗前后均采用流式细胞仪检测T细胞亚群。结果(1)RGH组与正常对照组比较,CD4 T细胞数及CD4 /CD8 比值均明显下降(P<0.001),CD8 T细胞数升高(P<0.01)。(2)治疗组治疗后CD4 T细胞数及CD4 /CD8 比值均明显升高,CD8 T细胞数明显下降,与治疗前及对照组相比差异均具有显著的统计学意义(P均<0.05)。(3)经胸腺肽治疗后RGH复发频率明显下降,与对照组相比差异有显著的统计学意义(P<0.001)。结论RGH患者存在细胞免疫功能异常,细胞免疫在RGH的发病中起重要作用。胸腺肽对其具有调节作用,治疗RGH可获得较好疗效。     

更昔洛韦胶囊治疗复发性生殖器疱疹的临床观察

近年来,生殖器疱疹患者日渐增多,且具有反复发作难于根治的特点,目前还没有一种药物可以彻底治愈生殖器疱疹.更昔洛韦是一种合成的核苷类抗病毒新药,注射针剂自临床应用以来,治愈了许多病毒感染的患者,但未见更昔洛韦胶囊剂治疗复发性生殖器疱疹的临床报道.我科用该药治疗复发性生殖器疱疹患者35例,现将结果报告如下.     

英夫利西单抗治疗难治性白塞病葡萄膜炎的疗效及安全性

目的探讨英夫利西单抗(infliximab, IFX)治疗难治性白塞病葡萄膜炎(Behcet's disease uveitis, BDU)的疗效与安全性。方法对2014年7月至2018年7月北京协和医院风湿免疫科和眼科门诊收治的8例难治性复发性BDU患者给予IFX治疗。在糖皮质激素和/或免疫抑制剂治疗基础上,IFX剂量为5 mg/kg。主要观察指标是BDU患者视力改善及复发减少;次要观察指标是激素和免疫抑制剂的节约效应,以及IFX不良反应。结果 8例患者均男性,BD发病年龄平均(27.8±7.9)岁,均为难治性复发性全葡萄膜炎伴视网膜血管炎,4例(50%)出现黄斑水肿。经过IFX治疗,BDU复发中位次数由治疗前2.5(范围1～4)次/6个月减少至用药第6个月的1(范围0～1)次/6个月(P=0.003),第12个月时继续减少为0次/6个月(与基线相比P0.000 1,与第6个月相比P=0.008)。受累眼视力由治疗前的0.15(范围0.01～0.60)提高到IFX治疗后0.50(范围0.06～0.10)(P0.000 1)。口服激素剂量由IFX治疗前的中位数26.25(范围20～35)mg/d,减量为第6个月时的15(范围10～20)mg/d (P0.000 1),第12个月时10 (范围0～15) mg/d(与基线相比P0.000 1,与第6个月相比P=0.035);同时联合应用的免疫抑制剂种类由3(范围1～4)种减少为1(范围0～1)种(P=0.001)。应用IFX后,2例(25%)出现轻度感染,抗感染治疗后好转。结论在糖皮质激素和免疫抑制剂治疗的基础上,IFX可以有效减少难治性BDU复发次数,改善患者视力,不良反应少,且具有一定的激素和免疫抑制剂节约效应。     

抗CD20+单克隆抗体联合CHOP方案治疗复发性或耐药性恶性淋巴瘤7例报告

我院自 2 0 0 0年 6～ 1 1月使用抗ＣＤ2 0 + 单克隆抗体 (商品名 :美罗华 )治疗 7例复发性淋巴瘤 ,现将结果报告如下。1 　 资料与方法1 .1 　 病例选择7例患者均系住院患者。男 6例 ,女 1例 ,年龄2 2～ 86岁 ,平均 5 3岁。病程 0 .5～ 1 5年。诊断标准和疗效标准参照文献〔1〕。和以下标准选择患者 :① 7例恶性淋巴瘤患者均使用过联合化疗 (包括ＣＨＯＰ、ＣＨＯＰ加Ｂｌｅｏ、ＣＨＯＰ加ＶＰ 1 6等 ) ;②化疗后复发 1次 3例 ,复发 2次以上 4例 ;③病理组织学 (包括淋巴结或活体组织 )证实为非霍奇金淋巴瘤 ,且为ＣＤ2 0 + 者。详细临床资…     

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.     

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.     

Variabilité des concentrations plasmatiques de l’angiotensinogène et risque d’hypertension artérielle chez le rat transgénique

Aim

Genetic polymorphisms of the human angiotensinogen gene are frequent and may induce up to 30% increase of plasma angiotensinogen concentrations with a blood pressure increase of up to 5 mmHg. Their role for the pathogenesis of human arterial hypertension remains unclear. High plasma angiotensinogen levels could increase the sensitivity to other blood pressure stressors.

Methods

Male transgenic rats with a 9-fold increase of plasma angiotensinogen concentrations and male non-transgenic rats aged 10 weeks were treated or not with NG-Nitro-L-arginine-methyl ester for 3 weeks in their drinking water (n = 3/group). Systolic blood pressure and body weight were measured at baseline and at the end of the study when left ventricular weight and ventricular expression of angiotensin I-converting enzyme and procollagen Iα1 were determined (polymerase chain reaction).

Results

At baseline, transgenic rats had +18 mmHg higher bood pressure and –8% lower body weight compared to non-transgenic rats (P < 0.05) without significant changes for the vehicle groups throughout the study (P > 0.05). NG-Nitro-L-arginine-methyl ester increased blood pressure, left ventricular weight and left ventricular weight indexed for body weight by +41%, +17.6% and +18.6% (P < 0.05) in transgenic and +25%, +5.3% and +6.7% (P > 0.05) in non-transgenic rats compared to untreated animals, respectively. Cardiac gene expression showed no differences between groups (P > 0.05).

Conclusion

Increased plasma angiotensinogen levels may sensitize to additional blood pressure stressors. Our preliminary results point towards an independent role of angiotensinogen in the pathogenesis of human hypertension and associated end-organ damage.     

Morphological and immunocytochemical heterogeneity of cultured pinealocytes from one-week-and two-month-old rats: Planimetric and densitometric investigations

Abstract: In vitro preparations of rat pinealocytes are widely used for biochemical analyses of signal transduction processes. This paper deals with morphological and immunocytochemical features of such preparations. Special attention was paid to the problems of whether pinealocytes represent a heterogeneous cell population and how such heterogeneity may develop during ontogeny. The investigations were performed with cells which were obtained from the pineal organ of one-week-and two-month-old rats, attached to synthetic peptide-coated coverslips or tissue culture chamber slides, and maintained under in vitro conditions overnight. The attached cells were then fixed with paraformaldehyde. These preparations yielded monolayers of spherical cells of different sizes; most cells were isolated, but some of them were aggregated and formed small clusters. On the average, the cells from the one-week-old animals were smaller than the cells from the two-month-old animals. Immunocytochemical demonstration of S-antigen, a pinealocyte-specific marker, showed that the majority of the cells from two-month-old animals were intensely or moderately labelled. Pinealocytes from one-week-old animals were less S-antigen immunoreactive. Only very few cells (less than 1% displayed glial fibrillary acidic protein (GFAP)-immunoreactivity. Planimetric investigations of the cell size and semiquantitative densitometric investigations of the intensity of the S-antigen immunoreaction revealed that (i) pinealocytes kept in vitro form a heterogeneous cell population, and that (ii) this heterogeneity increases during postnatal development from one-week-old to two-month-old animals. Two groups of pinealocytes can be distinguished based on their developmental fate: pinealocytes of one group grow dramatically, but show only a moderate increase in S-antigen immunoreactivity, and pinealocytes of the other group retain their size, but display a distinct increment in S-antigen immunoreacti vitv.     

MUTATION FREQUENCY IN NURSES AND PHARMACISTS WORKING WITH CYTOTOXIC DRUGS

Individuals occupationally exposed to cytotoxic drugs may be at risk owing to the effects of these agents on DNA. As an index of DNA damage, in vivo mutations were measured in lymphocytes from 24 oncology nurses or pharmacists and 24 matched controls. Mutation frequency was significantly increased in exposed individuals and appeared to be related to duration of exposure. However, the overall magnitude of the increase was small and its biological significance remains to be determined.