步长稳心颗粒治疗心律失常型冠心病的疗效观察

目的 观察步长稳心颗粒对心律失常型冠心病患者临床疗效、心电图心室率、降钙素基因相关肽水平的影响.方法 将在我院心内科就诊的60例收缩性心力衰竭患者随机分为两组,分别给予常规西药治疗(对照组)和常规西药基础上加服步长稳心颗粒(治疗组).治疗前后做常规心电图及24h动态心电图检测.结果 两组患者治疗后心悸、胸闷症状、心电图ST-T变化及期前收缩总数,治疗组均优于对照组.结论 步长稳心颗粒能明显改善患者心悸、胸闷症状及心电图ST-T变化及期前收缩总数.     

步长稳心颗粒与胺碘酮治疗慢性心力衰竭室性期前收缩的疗效观察

目的观察步长稳心颗粒与胺碘酮治疗慢性心力衰竭室性期前收缩患者的疗效。方法将慢性心力衰竭室性期前收缩患者分为两组,治疗组在常规治疗基础上加用步长稳心颗粒、胺碘酮;对照组在常规治疗基础上加用普罗帕酮,观察两组患者临床症状、心电图变化。结果治疗组临床症状改善总有效率为90%,对照组临床症状改善总有效率为70%,两组比较差异有统计学意义(P0.05)。结论步长稳心颗粒与胺碘酮治疗慢性心力衰竭室性期前收缩疗效确切。     

稳心颗粒治疗心室率缓慢且合并频发期前收缩患者临床观察

目的观察稳心颗粒治疗心室率缓慢且合并频发期前收缩患者的临床疗效。方法将基础心室率缓慢合并频发期前收缩患者随机分为两组,对照组38例采用常规治疗,治疗组40例在常规治疗基础上加用稳心颗粒。观察治疗前后患者临床症状及24h动态心电图期前收缩情况。结果治疗组心电图疗效总有效率为87.5%,临床症状疗效总有效率为92.5%;对照组心电图疗效总有效率为57.9%,临床症状疗效总有效率为68.4%。两组总有效率比较有统计学意义(P0.01)。结论稳心颗粒治疗基础心率缓慢且存在频发期前收缩患者的疗效优于常规治疗。     

稳心颗粒与美托洛尔对室性期前收缩自觉症状缓解情况的影响

目的观察稳心颗粒与美托洛尔治疗老年性室性期前收缩(室性早搏)的疗效和自觉症状缓解率。方法选取81例室性期前收缩病人,随机分为治疗组(41例)和对照组(40例),治疗组给予稳心颗粒,每次9g,每日3次口服。对照组给予美托洛尔每次25mg,每日2次口服,用药4周后观察室性期前收缩次数、临床自觉症状及不良反应。结果稳心颗粒对老年性室性期前收缩总有效率为88%,美托洛尔对老年性室性期前收缩的总有效率为85%,两者差异无统计学意义(P>0.05);稳心颗粒对病人自觉症状的缓解率为90%,优于美托洛尔的82%(P<0.05)。结论稳心颗粒及美托洛尔治疗老年性室性期前收缩的疗效相当,但对自觉症状的改善稳心颗粒明显优于美托洛尔。     

稳心颗粒联用参松养心胶囊治疗室性期前收缩

目的观察稳心颗粒联用参松养心胶囊治疗室性期前收缩的临床疗效及安全性。方法120例室性期前收缩病人随机分为两组,对照组口服稳心颗粒1包(9g),3次/日,治疗组在对照组基础上加用参松养心胶囊1.6g,3次/日。治疗4周后,观察两组病人的动态心电图与临床症状等。结果治疗组室性期前收缩总有效率为92.3%,临床症状总有效率为95.4%,优于对照组的76.4%与83.6%(P<0.05)。结论稳心颗粒联用参松养心胶囊治疗室性期前收缩具有较好的疗效。     

稳心颗粒对心肌梗死后房室性期前收缩的疗效观察

目的观察步长稳心颗粒对心肌梗死后房、室性期前收缩的疗效。方法将心肌梗死后出现房、室性期前收缩的患者随机分为两组,对照组给予常规治疗,治疗组在常规治疗基础上口服步长稳心颗粒,观察两组患者临床症状、心电图、血液流变学等方面的变化。结果对房、室性期前收缩有效率治疗组为88%,对照组为65%,两组比较差异有统计学意义(P0.05);严重心律失常发生率治疗组为8%,对照组为21%,两组比较差异有统计学意义(P0.05);治疗组全血黏度、血浆黏度均有改善。结论步长稳心颗粒治疗心肌梗死后房、室性期前收缩有较好的疗效。     

稳心颗粒联合美托洛尔治疗风湿性心脏病换瓣术后频发性室性期前收缩

目的评价美托洛尔联合稳心颗粒治疗风湿性心脏病换瓣术后频发室性期前收缩的临床疗效及安全性。方法将风湿性心脏病换瓣术后频发室性期前收缩患者68例,随机分为两组。两组患者均常规口服美托洛尔,治疗组加服稳心颗粒,每次9g,每日3次,2周为1个疗程。观察两组患者临床症状、24h动态心电图、华法林用量、凝血酶原时间(PT)及国际化标准比值(INR)变化。结果治疗1个疗程后,两组症状及室性期前收缩明显减少。治疗组临床疗效总有效率91.18%,明显高于对照组79.41%(P<0.05),24h室性期前收缩减少总有效率88.23%,明显高于对照组82.35%(P<0.05),且未见严重不良反应。两组治疗前后华法林用量、PT及INR无明显差异(P>0.05)。结论稳心颗粒联合美托洛尔治疗风湿性心脏病术后室性频发早搏疗效明显,优于单用美托洛尔,且对华法林抗凝治疗无明显影响。     

稳心颗粒治疗老年人冠心病室性期前收缩的临床疗效

目的观察稳心颗粒对老年人冠心病合并室性期前收缩的临床疗效。方法将120例病人随机分为两组,治疗组口服稳心颗粒,对照组口服普罗帕酮(心律平)。4周为1个疗程。两组病人治疗前后各做心电图、Holter、血尿常规、肝肾功能1次。结果治疗组治疗后心电图总有效率为73.33%,显效率53.33%;对照组心电图总有效率为71.67%,显效率为51.67%,两组心电图疗效相近(P>0.05)。Holter改变情况:治疗组总有效率为66.67%,显效率为30.00%;对照组总有效率为65.00%,显效率为31.67%,两组比较无统计学意义(P>0.05)。治疗组临床症状改善总有效率为86.67%,显效率为51.67%;对照组总有效率为73.33%,显效率为41.67%。结论稳心颗粒抗老年人室性期前收缩的作用与心律平相当,还可改善冠心病临床症状。     

稳心颗粒治疗室性期前收缩疗效观察

目的观察中药稳心颗粒与西药慢心律治疗室性期前收缩的疗效与安全性。方法将80例室性期前收缩病人随机分为两组,治疗组口服稳心颗粒9g,3次/日;对照组口服慢心律150mg,3次/日,疗程4周。结果治疗组临床症状总有效率为87.5%,对照组总有效率为67.5%。两组比较差异有统计学意义(P0.05)。结论稳心颗粒与慢心律有相近的治疗室性期前收缩作用,且不良反应少。     

步长稳心颗粒与胺碘酮治疗室性期前收缩的对比观察

目的比较步长稳心颗粒和胺碘酮治疗室性期前收缩的疗效及安全性。方法90例室性期前收缩患者随机分为稳心颗粒组(45例)和胺碘酮组(45例)。稳心颗粒组患者给予稳心颗粒治疗,胺碘酮组患者给予胺碘酮治疗,均治疗4周。观察用药前后两组患者的临床症状、期前收缩次数及不良反应情况。结果稳心颗粒组患者治疗后总有效率为82.2%,胺碘酮组为80.2%,两组患者治疗后总有效率间差异无统计学意义(P<0.05)。结论稳心颗粒对室性期前收缩的疗效与胺碘酮相当,但不良反应少。     

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.     

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.     

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.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.