冠心病患者甲襞微循环、血液流变性、血脂及血糖的变化

目的: 通过观察冠心病(CHD)患者的甲襞微循环、血液流变学指标、血脂及血糖的变化,为及早诊断、治疗及预后判断提供依据。方法: 确诊为CHD的患者156例进行甲襞微循环、血液流变学、血脂及血糖等进行检测。结果: 与50例正常人相比较,CHD患者甲襞毛细血管数减少、交叉、畸形管襻增多,输入支变细、输出支和乳头下静脉丛扩张、血流速度减慢伴红细胞聚集;全血黏度、血浆黏度、红细胞压积、血沉、纤维蛋白原、血小板黏附性和聚集性增加;总胆固醇、三酰甘油、血糖增高,高密度脂蛋白胆固醇降低;并发有高血压病、糖尿病、高脂血症的CHD患者的甲襞微循环、血液流变性明显异常。结论: CHD患者的甲襞微循环、血液流变性、血脂、血糖明显异常;并发有高血压病、糖尿病、高血脂症的CHD患者甲襞微循环、血液流变性异常更为严重。     

老年心肺疾病患者微循环与血液流变学检查的改变及关系

对２６例老年心血管病患者和２４例老年肺部疾病患者进行了甲襞微循环、血液流变学的检测，并对甲襞微循环和血液流变学改变及两者间的关系进行了分析。结果认为，老年心肺疾病患者的全血粘度、全血还原粘度、血浆粘度均明显增高，红细胞电泳时间缩短；甲襞微循环的清晰度、交叉、畸形、流速、红细胞聚集等也都有明显改变。说明这些疾病患者的血液处于高凝状态，进而引起微循环障碍，二者是相互影响的。     

老年糖尿病合并脑梗死患者血液流变学及血清尿酸检测意义

目的 探讨血清尿酸(UA)和血液流变学指标检测对于确定老年糖尿病患者发生脑梗死的临床意义. 方法 选择87例老年2型糖尿病患者,按照有无并发脑梗死分为合并脑梗死组和糖尿病组,另选择60例正常老年人作为对照组.分别检测各组的血清UA、血液流变学指标,比较各组间的差异.并作血清UA与血液流变学指标在糖尿病患者中的相关性分析. 结果 糖尿病患者全血黏度(高切、低切)、血浆黏度、纤维蛋白原、血小板聚集率、血清UA均显著高于对照组,糖尿病合并脑梗死患者上述指标均高于糖尿病组(P＜0.05).糖尿病患者中UA与全血高切黏度、低切黏度、血浆黏度、纤维蛋白原以及血小板聚集率呈显著正相关(r =0.578、0.641、0.432、0.566、0.493,P均＜0.01). 结论 联合检测糖尿病患者血清UA与血液流变学指标对于预测脑梗死具有一定的临床意义.     

川芎嗪对急性胰腺炎患者血液流变学的影响

背景:急性胰腺炎(AP)作为消化系统常见的急腹症,近年来发病率显著上升。目的:探讨川芎嗪对AP患者血液流变学的影响。方法:纳入2010年8月～2012年2月江苏省海门市人民院医院收治的AP患者62例,随机分为治疗组和对照组。对照组给予AP常规治疗,治疗组在常规治疗的基础上加用川芎嗪。检测患者全血黏度、血浆比黏度、血细胞比容、红细胞沉降率(ESR)、纤维蛋白原、血小板聚集率、外周血白细胞计数、血清淀粉酶含量等。结果:治疗组患者治疗后全血黏度、血浆比黏度、血细胞比容、ESR、纤维蛋白原、血小板聚集率均较治疗前显著下降(P<0.05);对照组患者治疗后全血黏度较治疗前显著下降(P<0.05),其余指标无明显差异(P>0.05);治疗组患者治疗后血浆比黏度、血细胞比容、ESR、纤维蛋白原、血小板聚集率均较对照组患者治疗后显著下降(P<0.05)。治疗组AP病情较对照组明显好转。结论:川芎嗪可显著改善胰腺微循环,缓解AP病情发展。     

灯盏细辛注射液对高血压病病人血液流变学的影响

目的探讨灯盏细辛注射液对高血压病病人血液流变学的影响.方法选取30例1级～2级高血压病病人,给予灯盏细辛注射液20 mL(90 mg)溶于生理盐水250 mL中静脉输注,每日1次,连用10 d,观察用药治疗前后全血高切黏度、低切黏度、红细胞聚集指数、血浆黏度、血小板黏附率及纤维蛋白原的改变情况.结果 30例1级～2级高血压病病人经灯盏细辛注射液20 mL(90 mg)治疗10 d后,全血高切黏度、低切黏度、红细胞聚集指数、血浆黏度、血小板黏附率、纤维蛋白原均有明显改善,治疗前后自身比较有统计学意义.结论灯盏细辛注射液能降低高血压病病人的血液黏滞度,减少心脑血管阻塞事件的发生.     

老年突发性耳聋患者血液流变学指标变化及其与病情转归的关系

目的 探讨老年突发性耳聋患者血液流变学指标变化及其与病情转归的关系。方法 选取丽水市人民医院2018年6月至2020年6月收治的122例老年突发性耳聋患者为耳聋组,同期在本院体检且年龄匹配的110名健康志愿者为对照组。比较两组对象血液流变学指标（包括高切全血黏度、低切全血黏度、血浆黏度、血小板聚集率、红细胞压积等）,以及耳聋组不同听力曲线类型患者血液流变学指标;比较突发性耳聋患者好转组与恶化组临床资料,采用多因素logistic回归分析影响老年突发性耳聋患者病情转归的独立危险因素。结果 突发性耳聋患者病情恶化50例,病情好转72例。耳聋组患者各项血液流变学指标均明显高于对照组（均P<0.05）。耳聋组不同听力曲线类型患者各项血液流变学指标比较,差异均有统计学意义（均P<0.05）。恶化组患者吸烟、饮酒、重度听力受损、听力曲线类型为全聋型以及合并高血压、高血脂、糖尿病的比例均明显高于好转组,高切全血黏度、低切全血黏度、血浆黏度、血小板聚集率、红细胞压积等血液流变学指标均明显高于好转组,差异均有统计学意义（均P<0.05）。吸烟、饮酒、重度听力受损、全聋型、高血压、高血脂...     

长春西汀注射液对老年腔隙性脑梗死患者微循环和血液流变学的影响

目的探讨长春西汀注射液对老年腔隙性脑梗死患者微循环和血液流变学的影响。方法选择老年腔隙性脑梗死患者80例,按照随机数字表法分为对照组和观察组,各40例。两组患者均给予常规基础治疗,包括降压、降脂、降糖等,两组患者均口服拜阿司匹林、阿伐他汀钙。观察组在此基础上静点长春西汀注射液,每日1次,7 d为1个疗程,两组患者均治疗2个疗程。观察两组患者治疗前后血液流变学指标、炎性反应指标,采用积分评价两组患者治疗前后甲襞微循环指标(管袢形态、管袢流态、袢周状态)。结果治疗后,两组患者全血低切黏度、高切黏度、血浆黏度、红细胞聚集指数、血浆纤维蛋白原、血小板1 min聚集率、血小板3 min聚集率较治疗前均有显著改善(均P<0.05),且观察组改善显著优于对照组(均P<0.05)。治疗后,两组患者红细胞沉降率(ESR)、C反应蛋白(CRP)均较治疗前有所改善(P<0.05),且观察组改善情况显著优于对照组(P<0.05)。治疗后,两组患者管袢形态、管袢流态及袢周状态积分较治疗前均有所改善(P<0.05),且观察组改善情况显著优于对照组(P<0.05)。结论长春西汀注射液可以改善老年腔隙性梗死患者血液流变学和微循环状态,并具有一定抗感染作用。     

心可舒片对冠心病血液黏度和血小板的影响

目的 观察268例住院冠心痛患者应用心可舒片治疗后血液流变学指标的变化.方法 住院患者先常规治疗1个月,再加服,心可舒片1个月后自身前后对比.结果 心可舒片对全血黏度高切值、全血黏度低切值、红细胞聚集指数、红细胞变形能力、纤维蛋白原、血小板1 min聚集率、血小板5 min聚集率及血小板最大聚集率都有明显的降低作用(P<0.01);对红细胞压积和血浆黏度也有一定的降低作用(P<0.05).结论 心可舒片对冠心病尤其伴有血液流变学指标明显异常者有肯定的治疗效果.     

高血压病患者血浆纤维蛋白原与血小板聚集功能的变化及降压治疗的影响

为了探讨高血压病患者血浆纤维蛋白原和血小板聚集功能的改变及降压治疗对其影响，本文采用免疫比浊法，比浊法测定15例正常人及53例高血压病患者血浆纤维蛋白原、血小板聚集率，并对高血压病患者分别以氯压定（赖诺普利）或圣通平（缓释硝苯吡啶）降压治疗12周。结果表明，高血压病患者血浆纤维蛋白原水平升高，血小板聚集增强，且纤维蛋白原与血小板聚集率呈正相关。氯压定及圣通平降压治疗均使血小板聚集下降、氯压定还降低纤维蛋白原，而圣通平无此作用，提示血管紧张素转换酶抑制剂在防治高血压病缺血性心、脑并发症方面更有益。     

糖尿病患者血液流变学、血小板聚集功能及血脂检测的意义

目的:分析2型糖尿病患者血液流变学、血小板聚集功能及血脂水平的变化及临床意义。方法:比较70例2型糖尿病患者和50名正常人空腹静脉血的血液流变学、血小板聚集功能及血脂水平。结果:2型糖尿病患者与正常对照组比较,全血黏度、血浆黏度、血小板最大聚集率、血脂水平均有明显增高,且血胆固醇、甘油三酯水平与血小板最大聚集力、全血黏度、血浆黏度均呈正相关。结论:在治疗2型糖尿病的同时,积极改善血液流变学、血小板聚集功能及血脂水平可能有益于综合控制糖尿病病情。     

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.     

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.     

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.     

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.     

N-acetyl-L-cysteine combined with mesalamine in the treatment of ulcerative colitis： Randomized,placebo-controlled pilot study

AIM： To evaluate the effectiveness and safety of oral N-acetyl-L-cysteine （NAC） co-administration with mesalamine in ulcerative colitis （UC） patients.
METHODS： Thirty seven patients with mild to moderate UC were randomized to receive a four-wk course of oral mesalamine （2.4 g/d） plus N-acetyl-L-cysteine （0.8 g/d） （group A） or mesalamine plus placebo （group B）. Patients were monitored using the Modified Truelove-Witts Severity Index （MTWSI）. The primary endpoint was clinical remission （MTWSI ≤ 2） at 4 wk. Secondary endpoints were clinical response （defined as a reduction from baseline in the MTWSI of ≥ 2 points） and drug safety. The serum TNF-α, interleukin-6, interleukin-8 and MCP-1 were evaluated at baseline and at 4 wk of treatment. RESULTS： Analysis per-protocol criteria showed clinical remission rates of 63% and 50% after 4 wk treatment with mesalamine plus N-acetyl-L-cysteine （group A） and mesalamine plus placebo （group B） respectively （OR = 1.71; 95% CI： 0.46 to 6.36; P = 0.19; NNT = 7.7）. Analysis of variance （ANOVA） of data indicated a significant reduction of MTWSI in group A （P = 0.046） with respect to basal condition without significant changes in the group B （P = 0.735） during treatment. Clinical responses were 66% （group A） vs 44% （group B） after 4 wk of treatment （OR = 2.5; 95% CI： 0.64 to 9.65; P = 0.11; NNT = 4.5）. Clinical improvement in group A correlated with a decrease of IL-8 and MCP-1. Rates of adverse events did not differ significantly between both groups.
CONCLUSION： In group A （oral NAC combined with mesalamine） contrarily to group B （mesalamine alone）, the clinical improvement correlates with a decrease of chemokines such as MCP-1 and IL-8. NAC addition not produced any side effects.     

Delorme's transrectal excision for internal rectal prolapse

Surgical therapy of functional outlet obstruction in patients with internal rectal intussusception may include abdominal, perineal, or transrectal procedures. Because abdominal procedures often result in significant physiologic impact but unrelieved constipation, the authors have elected Delorme's transrectal excision for management of these patients. Since a short-term placebo effect attends many therapies, this report describes results of transrectal excision only after a threeyear postoperative period. Delorme's transrectal excision of internal intussusception accomplished sustained symptomatic relief in over 70 percent of otherwise refractory constipated patients. The association of internal intussusception with other abnormalities underscores the importance of defining both anatomic and functional components when selecting patients whose constipation may require surgical therapy. Critical technical elements, surgical pitfalls, and potential complications of the procedure are discussed.Poster presentation at the meeting of The American Society of Colon and Rectal Surgeons, Toronto, Canada, June 11 to 16, 1989.     

The oral glucose tolerance test: A comparison of the time points on the basis of limit values,normal dispersion,and reproducibility

Summary Time points in the glucose tolerance test (GTT) are compared on the basis of limit values, dispersion within a reference population, and reproducibility. We suggest using the distance between a limit value and the median reference value as a measure of the magnitude of abnormality. The distance between 140 mg/100 ml and the median fasting plasma glucose value is chosen as a standard distance and limits for other points in the GTT are calculated to equal this standard distance of abnormality. We suggest that the probability of correctly interpreting an inividual result is directly related to the reproducibility of the test and inversely related to the percentage of the total range of values which is dispersed among the normal population. The ratio of reproducibility to percentage normal dispersion is proposed as an index of the probability of correctly interpreting an individual result. According to this index, the probability of correct interpretation varies in order: fasting plasma glucose concentration>3-h>2-h>0.5-h>1-h plasma glucose concentration.