幽门螺杆菌与中青年缺铁性贫血关系的临床研究

目的:探讨幽门螺杆菌(HP)感染与缺铁性贫血(IDA)的关系以及HP相关性IDA治疗的有效方法。方法:对132例有上消化道症状的中青年患者进行内镜下组织病理检查,胃黏膜活检标本快速尿素酶试验,同时所有患者作血常规,血清铁(SI),血清铁蛋白(SF),血清HP抗体(HP-IgG)检测。将HP感染伴慢性胃炎的IDA患者(36例)随机分成A,B2组,A组给予铁剂联合HP根治治疗,B组仅给予HP根治治疗,治疗后复查上述血液学指标。结果:HP感染的92例患者中IDA者有52例,IDA的患病率为56.5%;40例无HP感染患者中IDA者有6例,IDA的患病率为15.0%,两者相比差异有统计学意义(P<0.05)。58例IDA患者中,有52例为HP感染,HP感染率为89.7%;74例非IDA患者中,有40例为HP感染,HP感染率为54.1%,两者相比差异有统计学意义(P<0.05)。A,B2组治疗前后其血红蛋白(Hb),SI,SF均有显著性恢复,且A组比B组上述血液学指标差异有统计学意义。结论:HP感染可能为中青年IDA的病因之一,铁剂联合根治HP的治疗能显著提高中青年HP相关性IDA的治疗效果。     

幽门螺杆菌感染与缺铁性贫血的临床分析

目的:观察缺铁性贫血(IDA)伴幽门螺杆菌(Hp)阳性慢性胃炎患者抗Hp加铁剂治疗前后实验室检测指标的变化及疗效,探讨Hp感染与IDA形成的相关性及其临床意义。方法:将62例IDA伴Hp阳性慢性胃炎患者,分为A、B、C、D 4组。A组给予补铁及Hp根除治疗,B组仅Hp根除治疗,C组仅补铁治疗,D组中医辨证治疗胃炎;检测治疗前后其血红蛋白浓度及血清铁、总铁结合力、铁蛋白水平,并对Hp、胃蛋白酶活性、胃酸进行检测。结果:IDA伴慢性胃炎患者Hp感染率较高(82．7％,62／75),补铁联合抗Hp治疗较单纯补铁或抗Hp治疗效果显著(P<0．05)。结论:Hp感染可造成或加重机体铁营养不良,在治疗IDA的过程中应注意清除Hp感染。     

老年缺铁性贫血与幽门螺杆菌感染的临床分析

目的探讨铁剂合并抗幽门螺杆菌(Hp)治疗对老年人缺铁性贫血(IDA)伴Hp阳性慢性胃炎患者的贫血纠正效果,探讨Hp感染与IDA形成的相关性。方法将59例IDA伴Hp阳性慢性胃炎患者,分为A、B2组。A组单纯补铁治疗,B组联合应用补铁及Hp根除治疗;检测治疗前后其血红蛋白及血清铁、总铁结合力、铁蛋白水平,并对Hp进行检测。结果补铁联合抗Hp治疗较单纯补铁治疗效果显著(P<0.05)。结论Hp感染可造成或加重机体铁吸收不良,抗Hp治疗有助于提高IDA伴Hp感染患者的临床疗效。     

缺铁性贫血患者抗幽门螺旋杆菌治疗的价值

目的：了解幽门螺旋杆菌（HP）感染对缺铁性贫血（IDA）发病的影响及抗HP治疗对改善贫血的价值。方法：对116例IDA患者补铁治疗并检测HP感染的情况。分组：A组为给予去除缺铁原因治疗和补铁治疗可以达到IDA痊愈者,B组为无明显缺铁原因但单纯补铁效果不好的IDA患者。对B组患者给予抗HP治疗,观察抗HP治疗前后患者Hb、平均红细胞体积（MCV）、平均红细胞血红蛋白含量（MCH）、血清铁蛋白（SF）的变化。结果：116例IDA患者中,A组74例给予去除缺铁原因治疗和（或）补铁治疗可以达到IDA痊愈,其中HP感染43例,感染率58.1%;B组42例无明显缺铁原因但是单纯补铁效果不好的IDA患者中HP感染者36例,感染率85.7%,2组间HP感染率的差异有统计学意义。对B组中HP阳性者给予抗HP治疗,抗HP治疗有效者Hb、MCV、MCH、SF较治疗前有明显提高。结论：HP感染可能与IDA的发生有关,清除HP的治疗可改善IDA的疗效。     

幽门螺杆菌感染与缺铁性贫血的相关性

采用14C尿素呼气试验检测60例缺铁性贫血（IDA）患者的幽门螺杆菌（HP），并对HP阳性患者行根除HP治疗，观察其血红蛋白上升情况及其他血液学指标的变化。结果显示，HP阳性48例，抗HP治疗后转阴41例，其中38例血红蛋白较治疗前升高（P〈0．05）；治疗后血红蛋白、RBC、血清铁、总铁结合力、铁蛋白与治疗前比较均有统计学差异（P均〈0．05）。认为HP感染和缺铁性贫血关系密切，抗HP治疗有利于血红蛋白的提高。     

抗幽门螺杆菌对慢性胃炎伴缺铁性贫血患者的疗效研究

目的观察治疗幽门螺杆菌（Helicobacter priori，Hp）对慢性胃炎伴缺铁性贫血（iron deficiency anemia，IDA）患者的疗效。方法对31例有长期IDA病史、病因检查只发现有Hp阳性慢性胃炎的患者，进行根除Hp治疗；同时检测患者的血红蛋白（hemoglobin，Hb）、平均红细胞体积（mean corpuscular volume，MCV）；行快速尿素酶试验、内镜下组织病理检查了解Hp感染情况。结果根除Hp治疗6个月、12个月结束时，74．2％（23／31）和90．3％（28／31）患者的贫血已得到纠正。结论根除Hp治疗可治愈以Hp阳性慢性胃炎作为唯一病因的缺铁性贫血患者的贫血。     

蔗糖铁注射液治疗缺铁性贫血23例临床观察

目的观察蔗糖铁注射液治疗缺铁性贫血（IDA）的疗效和安全性。方法将50例IDA患者随机分为观察组23例和对照组27例,两组均予针对原发病或原发致病因素的治疗,在此基础上观察组予蔗糖铁注射液静滴、对照组予琥珀酸亚铁口服,治疗后2、8周分别测定Hb和血清铁蛋白（SF）以判定疗效,同时观察不良反应发生情况。结果观察组治疗后2周总有效率及治疗后8周治愈率、SF上升幅度均显著高于对照组（P〈0.05、0.001）;无明显不良反应发生。对照组5例发生胃肠道反应。结论蔗糖铁注射液治疗IDA安全、有效,尤适用于因胃肠道疾患导致口服铁剂吸收障碍或胃肠道反应重不耐受口服铁剂治疗而急需改善贫血症状者。     

可溶性转铁蛋白受体在慢性肾衰伴缺铁性贫血诊断及治疗中的应用

贫血是所有慢性。肾功能衰竭（CRF）的必有症状，且相当一部分患者伴有缺铁性贫血（iron deficiency anemia，IDA）。正耐判断CRF患者是否伴有IDA并给予铁剂治疗，具有重要意义本文通过对CRF伴或不伴IDA患者、健康对照者进行可溶性挈铁蛋白受体（sTFR）及其他铁参数的检测，以评价sTFR在CRI伴IDA诊断和治疗中的应用价值。     

四联疗法联合黄芪颗粒根除幽门螺杆菌的临床研究

背景:根除幽门螺杆菌(Hp)是治疗多种胃病的一个重要环节。然而,随着Hp对抗菌药物的耐药性不断升高,传统三联、四联根除疗法的有效率不断下降。目的:探讨四联疗法联合黄芪颗粒根除Hp感染的有效性和安全性。方法:纳入395例经胃镜诊断为慢性胃炎伴消化不良、消化性溃疡并经快速尿素酶试验证实Hp感染的患者,其中慢性胃炎伴消化不良组185例,消化性溃疡组210例,将两种疾病的患者再分别分为试验组和对照组,试验组给予四联疗法+黄芪颗粒,对照组给予四联疗法,疗程均为14 d。治疗结束后4周复查13C-尿素呼气试验以评估根除疗效。结果:358例(90.6%)患者按方案完成治疗。慢性胃炎伴消化不良组中,试验组PP根除率显著高于对照组(P0.05),ITT根除率差异无统计学意义(P0.05)。消化性溃疡组中,试验组PP和ITT根除率与对照组相比差异均无统计学意义(P0.05)。对照组中,消化性溃疡组的PP和ITT根除率显著高于慢性胃炎伴消化不良组(P0.01)。试验组中,慢性胃炎伴消化不良组与消化性溃疡组的PP和ITT根除率差异无统计学意义(P0.05)。慢性胃炎伴消化不良组与消化性溃疡组间以及对照组与试验组间不良反应发生率差异均无统计学意义(P0.05)。结论:四联疗法联合黄芪颗粒能有效提高慢性胃炎伴消化不良患者的Hp根除率,且具有良好的安全性。     

三种新型口服铁剂与硫酸亚铁治疗缺铁性贫血疗效比较

比较了3种新型口服铁剂：右旋糖酥铁片、硫酸亚铁缓释胶囊（Feospan）及硫酸亚铁缓释片（Slow－Fe）与硫酸亚铁片治疗缺铁性贫血（IDA）的疗效，上述3种新型口服铁剂治疗IDA的总有效率均显著高于硫酸亚铁，疗效反应更为迅速，副作用少见。对于贫血严重的IDA患者，以及慢性胃肠道失血及慢性腹泻所致的IDA患者，更适于应用上述新型口服铁剂治疗。此3种新型口服铁剂有推广应用价值。     

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.     

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.     

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.