解毒软肝片防治鸭乙型肝炎肝纤维化的实验研究

目的观察解毒软肝片对鸭乙型肝炎肝纤维化的防治作用,探讨其抗肝炎肝纤维化的作用机制方法用鸭乙型肝炎病毒(DHBV)阳性血清反复攻击雏鸭复制鸭乙型肝炎肝纤维化动物模型,以秋水仙碱为西药对照,观察解毒软肝片大剂量、小剂量防治组对鸭球结膜微循环,血液流变学指标,肝功能ALb,G,过氧化产物丙二醛(MDA),肝纤维化指标PCⅢ,HA,LN,Hyp含量的影响,观察肝组织光镜及电镜下病理变化.计量资料用t检验,计数资料用Ridit分析.结果DHBV造模组具有明显的球结膜微循环障碍(P<0.01),血液流变学改变(P<0.01),清蛋白(ALb)降低,球蛋白(G)和MDA升高(P<0.01),肝纤维化指标血清PCⅢ,HA,LN和肝组织Hyp含量升高(P<0.01),组织病理可见肝细胞水肿,脂肪变、间质炎性细胞浸润、纤维增生和病毒颗粒.解毒软肝片防治组能降低肝纤维化指标(P<0.01)和减轻组织病理学改变外,小剂量组有降低MDA(P<0.05),改善球结膜微循环作用(P<0.01);大剂量组有升高ALb(P<0.05),降低血清G(P<0.01),MDA(P<0.01)、血液粘度以及改善微循环(P<0.01)等作用.并存在剂量依赖关系.结论解毒软肝片对鸭乙型肝炎肝纤维化有良好的防治作用.     

剔毒护肝方抗鸭乙型肝炎肝纤维化的作用

目的:观察剔毒护肝方抗肝纤维化作用。方法:用鸭乙型肝炎病毒(DHBV)阳性血清反复攻击复制鸭乙型肝炎肝纤维化模型,同时用剔毒护肝方治疗,观察其对肝纤维化指标的影响。结果:剔毒护肝方能提高白蛋白和降低球蛋白含量,且有显著降低透明质酸(HA)、Ⅲ型前胶原(PCⅢ)、肝组织羟脯氨酸(Hyp)的作用,能减轻肝脏胶原纤维增生程度。结论:剔毒护肝方具有抗肝纤维化的作用。     

剔毒护肝方对乙型肝炎肝纤维化麻鸭球结膜微循环和血液流变学的影响

目的 :观察剔毒护肝方对乙型肝炎肝纤维化麻鸭球结膜微循环和血液流变学的影响。方法 :用鸭乙型肝炎病毒 (DHBV)阳性血清反复攻击复制鸭乙型肝炎肝纤维化模型 ,同时用剔毒护肝方治疗 ,观察其对球结膜微循环、肝纤维化指标及血液流变学的影响。结果 :剔毒护肝方能改善肝纤维化麻鸭球结膜微循环 ,提高血清白蛋白 ,降低血清球蛋白含量 ,显著降低透明质酸、层粘蛋白和 型前胶原 ,改善血液流变学。结论 :剔毒护肝方具有防治肝纤维化和改善肝脏血液流变学的作用     

肝纤溶颗粒对肝纤维化大鼠血清TNF-α、IL-6水平的影响

目的 探讨肝纤溶颗粒对肝纤维化大鼠血清TNF-α、1L-6水平的影响。方法：方法应用40% CCl4色拉油溶液复制肝纤维化动物模型，以三种不同剂量的肝纤溶颗粒治疗，对各组的血清TNF-α、IL-6水平变化情况进行比较。血清TNF-α、IL-6水平采用RIA法检测。结果 肝纤溶颗粒对肝纤维化动物模型的TNF-α、IL-6水平有良好的改善作用，随着药物的剂量的增加其疗效更为明显。结论 肝纤溶颗粒可以降低肝纤维化时细胞因子TNF-α、IL-6水平，是一种在阻断并逆转肝纤维化方面极具研究价值及应用前景的中药制剂。     

拉米夫定联合苦参素抗肝纤维化的临床观察

乙型肝炎病毒（HBV）DNA在肝细胞内复制引起肝细胞病理损伤是肝纤维化形成的启动因素，拉米夫定通过抑制HBVDNA复制而间接阻断肝纤维化形成，苦参素（氧化苦参碱）有抗肝纤维化作用。我们对139例HBV复制的不同肝病患者采用联合治疗（拉米夫定联合苦参素）／单一拉米夫定治疗6个月后血清肝纤维化指标的含量变化，并初步探讨其抗肝纤维化的临床疗效。     

IH764—3抗肝纤维化作用的实验研究

目的：研究IH764-3的抗肝纤维化作用，为临床应用提供实验依据。方法：①用四氯化碳复制大鼠肝纤维化模型，观察IH764—3的防治作用；②分离、培养大鼠贮脂细胞，观察IH764—3对其增殖和胶原合成的影响。结果：①IH764-3可显著抑制大鼠肝纤维化程度,能明显降低肝脏羟脯氨酸和Ⅰ、Ⅲ型前胶原mRNA含量，降低血清透明质酸、层粘连蛋白水平，改善肝功能。组织学检查亦显示其具有抗肝纤维化作用；②IH764—3可显著抑制大鼠贮脂细胞增殖和胶原的合成，并呈时间、剂量依赖性关系。结论：IH764-3在体内外均具有抗肝纤维化作用，它对于防治肝纤维化可能具有临床应用前景。     

鸭乙型肝炎肝纤维化模型的研制(摘要)

目的:采用鸭乙型肝炎病毒(DHBV)阳性血清反复攻击雏鸭建立鸭乙型肝炎肝纤维化动物模型。方法:用DHBV阳性血清0.1ml/只,从胫静脉注射1日龄樱桃谷鸭,每周1次,从第10周剂量加大为     

不同剂量清热解毒化浊片对大鼠免疫性肝损伤治疗作用的对比研究

目的:研究不同剂量清热解毒化浊片对大鼠免疫性肝损伤的治疗作用.方法:用BSA(牛血清白蛋白)复制大鼠免疫性肝损伤模型,应用不同剂量清热解毒化浊片进行治疗,观察大鼠肝组织形态改变、肝功能及肝纤维化血清学指标.结果:大剂量的清热解毒化浊片可降低大鼠血清PCⅢ、CG、ALT的水平,升高TP、Alb水平;小剂量的清热解毒化浊片仅可降低CG、ALT值.结论:大、剂量清热解毒化浊片均能有效改善肝功能,保护肝细胞.采用大剂量的清热解毒化浊片治疗大鼠肝纤维化,其疗效优于小剂量的清热解毒化浊片.     

桑黄治疗大鼠肝纤维化实验研究

目的:研究桑黄对肝纤维化的治疗作用。方法:采用四氯化碳诱导大鼠肝纤维化模型,实验分正常对照组、模型对照组、桑黄高、中剂量组,观察血清酶学,血清胶原成分含量及肝组织病理变化。结果:桑黄高、中、低剂量对肝纤维化有明显的治疗作用,能显著降低血清氨基转移酶水平和胶原成分含量,抑制肝组织内胶原纤维增生。结论:桑黄可用于治疗肝纤维化,且疗效与剂量呈正相关。     

生理剂量的雌激素对雌、雄性大鼠肝纤维化形成的影响

目的 探讨生理剂量的β-Est对雌、雄性大鼠肝纤维化形成的影响.方法 采用皮下注射CCl4制作大鼠肝纤维化模型,观察β-Est(0.02 mg·kg-1·d-1)对完整或去势雌、雄性大鼠肝纤维化形成的影响.6周后收集肝组织和血清标本,以标准酶法、ELISA、RIA分别测定血清肝功能、ECM及性激素水平;VG染色观察肝脏组织学改变,结合图像分析计算胶原面积.结果 在相同剂量CCl4作用下雄性大鼠肝纤维化反应较雌性大鼠强烈;补充生理剂量β-Est能改善雌性、去势肝纤维化大鼠肝功能,降低其ECM分泌及肝组织纤维化程度;去势加重雌性大鼠肝纤维化反应;而生理剂量β-Est或去势对雄性大鼠肝纤维化形成无影响.结论 内源性雌激素能抑制CCl4诱导的大鼠肝纤维化,而不同性别对雌激素反应各不相同,这可能是导致肝纤维化形成具有性别差异性的原因之一.     

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.     

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.     

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.     

Language of CTO interventions – Focus on hardware

The knowledge of variety of chronic total occlusion (CTO) hardware and the ability to use them represents the key to success of any CTO interventions. However, the multiplicity of CTO hardware and their physical character and the terminology used by experts create confusion in the mind of an average interventional cardiologist, particularly a beginner in this field. This knowledge is available but is scattered. We aim to classify and compare the currently used devices based on their properties focusing on how physical character of each device can be utilized in a specific situation, thus clarifying and simplifying the technical discourse.     

High prevalence of distal sensory polyneuropathy in antiretroviral-treated and untreated people with HIV in Tanzania

Objectives To describe the prevalence of distal sensory polyneuropathy (DSP), a complication of both advanced HIV disease and of antiretroviral therapy (ART), amongst Tanzanians with HIV, on and off ART (including stavudine) with CD4 counts above and below 200 cells/μl. Methods We recruited participants attending ART clinic into four groups: >6 months ART exposure and (i) CD4 < 200 cells/μl or (ii) CD4 > 200 cells/μl (ART/CD4 < 200 and ART/CD4 > 200, respectively); ART‐naïve and (iii) CD4 < 200 cells/μl or iv)CD4 > 200 cells/μl (noART/CD4 < 200 and noART/CD4 > 200, respectively). Primary outcome was DSP, as defined by presence of at least one symptom and one sign. Results Of 326 evaluable participants, 81 (32 men, median age 38 years, median CD4 142 cells/μl) were enrolled in the ART/CD4 < 200 group, 78 (17 men, median age 37 years, median CD4 345 cells/μl) in ART/CD4 > 200, 81 (30 men, median age 37 years, median CD4 128 cells/μl) in noART/CD4 < 200 and 86 (22 men, median age 33 years, median CD4 446 cells/μl) in noART/CD4 > 200. Numbness was the most commonly reported symptom. DSP prevalence ranged from 43.2% in ART/CD4 < 200 to 20.9% in noART/CD4 > 200. DSP was more common among men (adjusted odds ratio [aOR] 1.9, 95% confidence interval [CI] 1.2–3.3) and older participants (aOR 2.7, 95% CI 1.1–6.2 for age 40 + vs. <30 years). Conclusion Distal sensory polyneuropathy is common amongst those attending this clinic, even those with no ART exposure and a CD4 count above 200 cells/μl. Stavudine and didanosine expose HIV‐infected patients to an additional avoidable risk of DSP. Access to non‐neurotoxic ART regimes as well as earlier HIV diagnosis and initiation of ART is needed.     

Prise en charge d’un paragangliome rétropéritonéal

Paragangliomas are rare tumors arising from extraadrenal chromaffin cells. We report a 43-year-old man who presented with abdominal pain. An abdominal computed tomography scan revealed a large retroperitoneal mass. During an endoscopic biopsy of this tumor, the patient experienced marked hemodynamic fluctuations with tachycardia and high blood pressure, and an extraadrenal pheochromocytoma was suspected. Measurements of plasma and urinary catecholamines and urinary total metanephrines ruled in the diagnosis. Echocardiography disclosed acute myocardial dysfunction that returned to normal after surgical resection of the paraganglioma. This report also underlines the importance of the anesthetic preparation and monitoring around the surgical procedure and the need of a long-term follow-up to detect malignant paraganglioma in the absence of histological criteria of benign tumor.