50例肺移植术后心房颤动分析

目的 研究肺移植术后心房颤动（房颤）的发生率与术前相关危险因素.方法 收集无锡市人民医院2002年至2009年50例肺移植患者的临床资料,根据住院期间是否出现房颤持续5 min以上分为房颤组和非房颤组,分析两组患者的超声心动图检查指标及术前一般临床资料.结果 术后13例患者（26.0%）发生房颤,房颤组术前左心房内径（37.38±6.79）mm大于非房颤组中术前左心房内径（32.70±7.22）mm,两者间差异有统计学意义（P＜0.05）.术前左心房内径≥40 mm的患者高于非房颤组[50.0%（8例）对23.5%（8例）,x2=5.329,P=0.021],房颤组与非房颤组在性别、年龄、肺移植种类、原发疾病、术前左心室舒张末内径、肺动脉收缩压、右心房内径、右心室内径、室间隔厚度、左心室后壁厚度、左心室舒张功能之间差异无统计学意义（P＞0.05）.COX分析发现术前左心房内径≥40 mm是肺移植术后发生房颤的独立危险因素,风险系数为4.622.结论 房颤是肺移植术后常见的心律失常,其发生率为26.0%,左心房扩大是肺移植患者术后发生房颤的独立危险因素.     

心脏瓣膜手术同期房颤射频消融的疗效及影响因素

目的 回顾性分析心脏瓣膜手术同期心房颤动（房颤）射频消融的疗效及影响术后窦性心律转复的因素。 方法 选取2016年1月至2019年6月在我院行心脏瓣膜手术同期射频消融（Cox Maze Ⅳ）的患者182例。其中男性50例、女性132例,平均年龄（56.16±9.27）岁,术后随访3个月至4年,获取术后3个月、6个月、1年及以后每年的心电图、超声心动图等检查结果和并发症发生情况,评价手术效果及窦性心律转复情况。以术后1年心电图是否为窦律分为A、B两组进行比较,对可能影响射频消融术后窦性心律转复的因素进行分析。结果 术后痊愈出院179例,死亡3例,2例患者在术后2、6天死于低心排出量综合征,1例死于多器官功能衰竭。术后并发症主要为因出血二次手术、永久起搏器置入、恶性心律失常、急性肾衰竭等。出院时及术后3个月、6个月、1年的窦性心律转复率分别为58.7%、70.2%、68.3%、69.0%,术后1年维持窦性心律的患者左心房和左心室内径明显减小,心脏功能和生活质量明显提高。A、B两组患者在年龄[（54.96±9.15）岁 vs（58.51±9.05）岁,P=0.032]、体重[（58.51±9.55）kg vs（63.24±13.13）kg,P=0.016]、心功能（P=0.012）、术前左心房横径[（52.19±9.15）mm vs（63.09±14.49）mm,P＜0.05]及瓣膜风湿性病变比例[(55/45) vs (34/11),P=0.019]差异有明显统计学意义。Logistic多因素分析显示,年龄（OR=0.934,95%CI 0.891~0.980,P=0.006）、体重（OR=0.956,95%CI 0.924~0.989,P=0.010）、术前左心房横径（OR=0.909,95%CI 0.872~0.947,P<0.05）和瓣膜风湿性病变（OR=0.424,95%CI 0.193~0.935,P=0.033）与术后窦性心律转复存在显著相关性。结论 心脏瓣膜手术同期房颤射频消融治疗是安全、有效的,对于改善患者心脏功能和心肌重塑有重要意义,年龄、体重、术前左心房横径和瓣膜风湿性病变是影响术后远期疗效的独立危险因素。     

术后新发心房颤动对单纯改良扩大Morrow手术治疗肥厚型梗阻性心肌病患者长期预后的影响

目的：观察术后新发房颤（POAF）对单纯改良扩大Morrow手术治疗肥厚型梗阻性心肌病（HOCM）患者长期预后的影响。方法：回顾性分析我院2012年1月-2017年12月328例HOCM患者行单纯改良扩大Morrow手术治疗的患者。根据住院期间是否发生POAF分为POAF患者（79例）和非POAF患者（249例）。通过查阅病历记录患者一般资料、临床病史、手术情况及住院并发症情况。电话或门诊随访患者的生命状态及临床表现。主要研究终点是远期房颤、术后脑卒中和血栓事件。采用Kaplan-Meier法绘制生存曲线,单因素及多因素Cox回归分析确定影响患者预后的危险因素。结果：患者平均随访时间为2.36±1.35年。随访期间共39例（11.89%）患者出现主要或次要终点事件。POAF患者在远期房颤（P=0.007）、因心力衰竭住院治疗（P=0.010）等的发生率上高于非POAF患者。术后1年、3年和5年的总的生存率为99.38%、98.77%和98.17%。多因素Cox回归分析结果表明：体外循环时间增加（HR=12.832,95%CI=1.812～90.896,P=0.011）术后心血管死亡的独立危险因素;POAF（HR=12.163,95%CI=1.470-100.608,P=0.02）和ICU时间延长（HR=11.235,95%CI=1.157-109.099,P=0.037）是术后脑卒中和血栓事件的独立危险因素;POAF（HR=6.658,95%CI=1.578-28.098,P=0.01）是术后远期房颤的独立危险因素;POAF（HR=5.116,95%CI=1.457-17.966,P=0.011）和术后左心房直径增加（HR=12.187,95%CI=2.875-51.661）是术后心力衰竭再住院的独立危险因素。生存分析表明POAF患者在无远期房颤（P=0.002）生存率、无脑卒中和血栓事件（P=0.027）生存率和无心力衰竭再住院（P=0.006）生存率上均较非POAF患者低;远期无心血管死亡的生存率上两组患者无明显差异（P=0.737）。结论： POAF是术后远期房颤、脑卒中和血栓事件、心力衰竭再住院的独立危险因素,POAF能预测HOCM患者单纯改良扩大Morrow术后长期预后。     

肥厚型梗阻性心肌病经皮经腔间隔心肌消融术与室间隔心肌切除术疗效比较

目的应用超声心动图比较肥厚型梗阻性心肌病患者经皮经腔间隔心肌消融术与室间隔心肌切除术的疗效。方法分别于经皮经腔间隔心肌消融术及室间隔心肌切除术前、后测量肥厚型梗阻性心肌病患者左室流出道压差,比较术前及术后压差。结果肥厚型梗阻性心肌病患者在进行经皮经腔间隔心肌消融术与室间隔心肌切除术后,左室流出道压差均较术前明显减低。经皮经腔间隔心肌消融术肥厚型心肌病患者术前左室流出道压差(99±19)mm Hg(1 mm Hg=0.133 kPa),术后降至(36±20) mm Hg(P<0.05)。进行室间隔心肌切除术肥厚型心肌病患者术前左室流出道压差(117±32) mm Hg,术后降至(28±17) mm Hg(P<0.05)。经皮经腔间隔心肌消融术与室间隔心肌切除术患者术后左室流出道压差差异无统计学意义[(36±20)mm Hg比(28±17)mm Hg]。结论经皮经腔间隔心肌消融术可以明显减低肥厚型梗阻性心肌病患者左室流出道压差,且与室间隔心肌切除术疗效相似。     

左心房内径与高龄心房颤动并缺血性卒中的相关性分析

目的 左心房内径与高龄心房颤动并缺血性卒中的相关性。方法 选取2015.01~2018.08在南部战区总医院干部病房住院的高龄患者共524例,房颤患者264例,其中持续性房颤132例(25.2%),阵发性房颤132例(25.2%),非房颤患者260例(49.6%)。通过病历资料,调取超声心动图检查结果,比较左心房内径在房颤组与非房颤组之间、房颤卒中组与非房颤卒中组之间是否存在差异。结果 与非房颤组相比,房颤组左心房左右内径(43.87±8.20mm vs 38.06±4.50mm, P=0.001)、左心房前后内径(37.96±7.24mm vs 33.54±4.51mm, P=0.001)、左心房上下内径(44.98±7.25mm vs 43.00±7.59mm, P=0.001)、右心房前后内径(53.09±6.65mm vs 48.71±7.14mm, P=0.001)、肌酐(124.42±88.20umol/L vs 110.01±48.39umol/L, P=0.023)、胱抑素C(1.97±1.22mgl/L vs 1.63±0.62mgl/L, P=0.001)、尿酸(400.13±121.34umol/L vs 378.71±118.47umol/L, P=0.043)、同型半胱氨酸(16.80±11.58umol/L vs 14.87±5.84umol/L, P=0.017)、低密度脂蛋白(1.79±0.65mmol/L vs 2.01±0.76mmol/L, P=0.001)、甘油三酯(3.38±0.88mmol/L vs 3.66±0.99mmol/L, P=0.001)、缺血性卒中(136/128 vs 78/182, P=0.001)、慢性心力衰竭(141/123 vs 69/191, P=0.001)等指标在两组之间差异有统计学意义。房颤卒中组尿酸(385.65±122.37umol/L vs 415.28±118.83umol/L, P=0.047)、左心房左右内径(44.71±7.83mm vs 42.72±8.47mm, P=0.049)、左心房上下内径(45.45±6.87mm vs 43.18±7.69mm, P=0.012)、慢性心力衰竭(81/55 vs 60/68, P=0.048)等指标与非房颤卒中组比较,差异有统计学意义。通过Logistic回归分析发现,左心房左右内径、左心房上下径、慢性心力衰竭可能与高龄房颤并缺血性卒中存在关联性,左心房左右内径、左心房上下径可作为高龄房颤并缺血性卒中的预测因子,ROC曲线下面积分别为0.596、0.588。结论 左心房内径不仅与高龄房颤并发缺血性卒中存在关联性,也可作为高龄房颤并发缺血性卒中的预测因子。     

1335例心房颤动住院患者病因(或相关因素)分析

目的探讨心房颤动(房颤)住院患者的病因(或相关因素)。方法对我院2000年1月~2005年12月出院时诊断为房颤的1335例患者的临床资料进行回顾性分析。结果(1)入选患者1335例,年龄为19~101(68.7±11.9)岁,男女比例为1.31∶1,阵发性、持续性、永久性房颤分别为54.7%、10.6%、34.7%。(2)房颤病因(或相关因素)统计:老年70%,高血压57.3%,冠心病26.3%,风湿性心脏病12.8%,糖尿病19.8%,贫血18.6%。54.1%合并有心房扩大,12.6%有左心室射血分数下降。<45岁年龄组的首位病因(或相关因素)为风心病,而≥45岁年龄组为高血压。(3)随着高血压病程延长,房颤发生增加,但左心房内径无进一步增加。(4)房颤患者左心房前后径为阵发性房颤<持续性房颤<永久性房颤[(38.81±7.69)mm<(43.55±8.05)mm<(48.05±10.33)mm,P<0.05]。(5)随着房颤病程的延长左心房前后径增加[<5年:(39.98±8.05)mm,5~10年:(44.18±10.84)mm,>10年:(46.17±10.63)mm,P<0.05]。结论老年和高血压是房颤最常见的病因(或相关因素),应积极控制高血压,减少或延缓房颤的发生、发展。     

体外循环下冠状动脉旁路移植术后新发房颤的危险因素分析

【摘要】 目的 探讨体外循环下冠状动脉旁路移植（on-pump coronary artery bypass grafting，ONCAB）术后新发房颤的危险因素，为ONCAB术后新发房颤的预防和治疗提供参考。方法 收集我院心脏外科2015年1月至2016年5月间357例单纯ONCAB患者的临床资料，根据术后是否发生新发房颤而分为房颤组和非房颤组。对两组患者围术期的临床参数进行统计分析，从而筛选术后新发房颤的独立危险因素。结果 ONCAB术后新发房颤的发生率为23.8%（85例）。单因素分析结果显示，年龄≥65岁（P=0.02）、慢性阻塞性肺疾病病史（P=0.03）及术前左心房内径≥38 mm（P<0.001）与ONCAB术后新发房颤相关。logistic多因素回归分析显示，年龄≥65岁(OR=1.720, P=0.039)、慢性阻塞性肺疾病病史(OR=11.924, P=0.032)及左心房内径≥38 mm(OR=2.735, P<0.001)是ONCAB术后患者发生新发房颤的独立危险因素。结论 高龄（≥65岁）、慢性阻塞性肺疾病病史及左心房内径增大（≥38 mm）与ONCAB术后新发房颤相关，是潜在的预测因子。     

单次冷冻球囊消融治疗心房颤动长期随访效果

目的：分析冷冻球囊消融（CBA）治疗心房颤动（房颤）患者的单中心长期随访效果,探讨影响其疗效的相关临床因素。方法回顾性分析2009年1月至2013年4月接受CBA治疗的房颤患者的住院病历资料、手术记录和门诊随访资料。术前经胸超声测量左心房内径（LAD）。术后3个月后出现的房颤、心房扑动（房扑）、房性心动过速（房速）发作判定为CBA治疗失败。结果199例房颤接受CBA治疗,术中并发膈神经麻痹3例（1.5％）,术后发生心包积液1例（0.5％）、短暂性脑缺血发作1例（0.5％）,均自行缓解。在平均（23±14）个月随访中152例患者完成随访,其中65例（42.8％）治疗成功,失败患者中75例（86.2％）为术后12个月内复发。失败患者年龄较大[（62±7）比（52±10）,P=0.0379]、LAD较大[（47±7）mm比（43±6）mm,P＜0.0001],持续性房颤患者治疗成功率（29.5%）明显低于阵发性房颤患者（48.1％）。Logistic回归分析显示年龄[OR=1.037（1.000,1.076）,P=0.0488]和LAD[OR=0.896（0.842,0.953）,P=0.005]能独立预测初次CBA治疗效果。结论 CBA治疗房颤安全有效,长期随访效果较好。房性心律失常复发主要发生在术后12个月内。年龄和LAD是预测术后复发的独立危险因素。     

心脏再同步化治疗慢性心力衰竭伴持续性心房颤动的疗效观察

目的评价心脏再同步化治疗(CRT)慢性心力衰竭(心衰)合并持续性心房颤动(房颤)患者的临床疗效。方法选择慢性心衰患者23例,其中13例窦性心律患者及4例房颤患者(房颤CRT患者)接受双心室起搏治疗,另6例房颤患者(药物治疗患者)继续服用抗心衰药物治疗。术后3个月进行随访,观察患者的心功能分级(NYHA),6 min步行距离,超声心动图测定各房室腔内径大小、LVEF、二尖瓣反流以及速度向量成像超声评价同步性参数的变化。结果 17例患者三腔起搏器置入术均取得成功。术后3个月随访,房颤CRT患者心功能分级[(3.00±0.00)级vs(2.25±0.50)级]、左心房内径[(52.75±3.50)mm vs (45.25±3.50)mm,P<0.05]、LVEF[(36.25±4.79)% vs (42.00±5.16)%]及二尖瓣反流(3.25±0.50 vs 1.50±0.58,P<0.01)较术前均有明显改善,速度向量成像超声结果显示,室内不同步较术前有明显改善。与药物治疗患者比较,房颤CRT患者LVEF、左心房内径、二尖瓣反流明显改善。结论对于慢性心衰合并持续性房颤患者,在有效控制心室率的基础上行CRT明显优于药物保守治疗,与窦性心律患者一样可以改善心功能。     

P波离散度对经皮球囊二尖瓣扩张术后心房纤颤发作的预测价值

目的 探讨P波离散度预测经皮球囊二尖瓣扩张术(PBMV)后心房纤颤发作的价值.方法 选择风湿性心脏病,二尖瓣狭窄并成功行PBMV术,术前为窦性心律者,共95例.所有患者均测量PBMV前12导联同步心电图P波宽度,计算最宽P波(Pmax)、最窄P波(Pmin)并取两者差的平均值,即为P波离散度(Pd),Pd=Pmax-Pmin.结果PBMV术后59例患者维持窦性心律(对照组),男8例,女51例,年龄24～57岁(36.8±8.3岁);36例患者出现心房纤颤(房颤组).男13例,女23例,年龄18～56岁(38.1±7.8岁).两组患者在年龄、心率、左室舒张期内径、右室舒张期内径和左室射血分数无统计学差异.房颤组左房内径(46.63±2.36mm)比对照组(43.51±2.51mm)显著增大(P<0.05).房颤组Pmax(121.67±14.64ms)、Pd(37.50±9.37ms)比对照组Pmax(106.38±12.24ms)、Pd(23.97±12.70ms)显著延长(P<0.01).以Pmax≥110ms预测心房纤颤的敏感性80.55%,特异性50.85%,准确性61.05%.以Pd≥40ms预测心房纤颤的敏感性69.44%,特异性32.20%,准确性68.42%.结论 Pd作为一项无创性心电学指标,对PBMV术后发作心房纤颤的预测有一定临床价值.     

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.     

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.