脑缺血再灌注高血压大鼠神经肽Y和超微结构变化

目的观察易卒中型肾血管性高血压大鼠(RHRSP)脑缺血再灌注过程中不同时间点脑组织神经肽Y(NPY)表达和细胞超微结构的动态变化。方法制作RHRSP模型,用线栓法制作左侧大脑中动脉闭塞模型,用放射免疫法、干湿重法、图像分析和透射电镜等技术检测脑缺血6h再灌注6、72、168h时脑组织NPY、水含量、梗死面积百分率和超微结构的动态变化。结果再灌注组脑组织NPY和含水量均明显高于对照组和假手术组(P<0·01),72h达高峰;脑梗死面积百分率显著增高,168h时开始下降,但仍高于对照组和假手术组(P<0·01)。再灌注不同时间点分别出现不同程度的神经元和血管壁超微结构损害。结论NPY可能参与了RHRSP缺血再灌注脑损伤的病理学过程。     

脑缺血再灌注损伤大鼠脑内神经肽Y的动态变化

目的观察神经肽Y(neuropeptideY,NPY)在脑缺血再灌注损伤大鼠脑组织内的动态变化。方法应用环形银夹钳夹SD大鼠的双侧肾动脉,制成易卒中型肾血管性高血压大鼠模型(RHRSP)。在此基础上采用线栓法制成一侧大脑中脉闭塞(MCAO)脑缺血再灌注模型,运用放射免疫法测定缺血6h后再灌注6h、72h1、68h大鼠脑内NPY的动态变化。结果缺血后再灌6h脑内NPY含量〔(108.22±11.48)ng/g〕较正常组〔(78.98±12.53)ng/g〕和假手术组〔(80.52±10.78)ng/g〕明显升高(P<0.01);72h后上升至高峰〔(152.80±11.31)ng/g〕,168h开始下降〔(132.21±10.20)ng/g〕,但仍高于正常组水平,P<0.01。结论NPY参与了脑缺血再灌注神经损伤的发生、发展的病理过程,是引起脑缺血再灌注损伤的可能原因之一。     

环维黄杨星D对高血压大鼠脑缺血再灌注神经肽mRNA表达的影响

目的 观察中药单体环维黄杨星D(cyclovirobuxine D,CVBD)对易脑卒中型肾血管性高血压大鼠 (RHRSP)脑缺血再灌注不同时间点脑组织神经肽Y(NPY)mRNA表达的影响.方法 应用环形银夹钳夹SD大鼠的双侧肾动脉,制成RHRSP 80只,再用线栓法制成一侧大脑中动脉闭塞(MCAO)大鼠模型,并随机分为4组:空白组10只、假手术组10只、治疗组30只和对照组30只,治疗组和对照组分别于脑缺血6 h后,再灌注6 h、3、7天3个时 间点分别给予CVBD和生理盐水腹腔注射.用原位杂交等方法观察CVBD对脑缺血6 h后,再灌注6 h、3、7天大鼠脑组织NPY mRNA表达的影响.结果 治疗组大鼠脑缺血再灌注6 h、3、7天后,脑组织NPY mRNA阳性细胞表达均明显高于空白组和假手术组各相同时间点,但低于对照组同时间点(P<0.05,P<0.01).结论 CVBD对RHRSP脑缺血再灌注细胞损伤的保护作用,可能与其下调NPY mRNA表达等机制有关.     

老年大鼠脑缺血再灌注神经肽的变化及其意义

目的 从内皮素（ET）、降钙素基因相关肽（CGRP）、神经肽Y（NPY）、神经降压素（NT）的变化方面研究老年大鼠脑缺血再灌注损伤的机制。方法 青年（5月龄）和老年（20月龄以上）大鼠均分为模型组和正常对照组，观察大鼠全脑缺血30min再灌注60min后血浆和脑组织中ET、CGRP、NPY、NT含量。结果 老年对照组和青年模型组血浆CGRP低于青年对照组（P＜0．01），老年模型组血浆ET含量高于老年对照组和青年模型组。与青年对照组和老年模型组比较，老年对照组脑组织CGRP含量增高而ET和NPY含量降低。青年对照组血浆中NT高于老年对照组和青年模型组。结论 脑缺血再灌注损伤与CGRP－ET和NPY－NT的平衡失调有关。老年大鼠脑缺血再灌注病理改变血浆中以ET占优势，脑组织中以NPY和ET占优势。     

大鼠脑缺血-再灌注后下丘脑室旁核促肾上腺皮质激素的表达

目的 探讨大鼠脑缺血-再灌注后，不同时期中枢下丘脑室旁核促肾上腺皮质激素样阳性免疫物的表达。方法 取雄性Wislar大鼠70只，随机分成对照组（10只）、假手术对照组（30只）及脑缺血-再灌注组（30只）以颈动脉引流法行全脑缺血-再灌注造模，术后分6、24、72h3个时间段取脑，釆用免疫细胞化学技术，用图像分析系统行下丘脑室旁核促肾上腺皮质激素样阳性免疫反应面积、平均吸光度值检测。结果 显微镜下观察示，促肾上腺皮质激素样阳性免疫物呈深棕色，胞核深染，并广泛分布于中枢各脑区，核仁清晰可辨、在丘脑及下丘脑区域有散在分布“串珠”状阳性纤维。图像分析结果显示，假手术对照组、脑缺血-再灌注组大鼠的阳性免疫面积和平均吸光度值呈同步变化：从术后6h开始，假手术对照组、脑缺血-再灌注组大鼠均较正常对照组显着升高，术后24h达高峰（P〈0．05），然后逐渐回落。在3个不同时间段，3组间差异均有显着意义（P〈0．05），术后6及24h为：脑缺血-再灌注组，假手术对照组，正常对照组；术后72h为：假手术对照组〉正常对照组〉脑缺血-再灌注组。结论 在脑缺血-再灌注不同时间段，下丘脑室旁核神经元促肾上腺皮质激素样阳性免疫物表达呈现明显的时间规律；促肾上腺皮质激素可能在神经元功能调控，中枢内环境控制及脑缺血-再灌注损伤过程中发挥着重要作用。     

苯妥英对局灶性脑缺血——再灌注后脑组织自由基含量的影响

目的观察大鼠局灶性脑缺血-再灌注后脑组织自由基的变化及苯妥英（PHT）对其改善的影响．并探讨其保护作用机制。方法将雄性成年Wistar大鼠随机分为4组：即假手术组、缺血-再灌注组、PHT低剂量治疗组和PHT高剂量治疗组。采用线栓法制成大脑中动脉闭塞模型，每组均于手术后6h、12h、24h三个时间点测定脑组织超氧化物歧化酶（SOD）活力和丙二醛（MDA）水平的改变。结果缺血-再灌注组各时点SOD活力显著低于假手术组相应时点SOD活力（P〈0．05），PHT低剂量治疗组和高剂量治疗组SOD活力明显高于缺血-再灌注组各时点SOD活力（P〈0.05），PHT高剂量治疗组各时点SOD活力又明显高于低剂量治疗组，且具有显著性差异（P〈0．05）；缺血-再灌注组MDA水平显著高于假手术组相应时点MDA水平（P〈0.05），PHT低剂量治疗组和高剂量治疗组MDA水平与缺血-再灌注组各相应时间点比较明显降低（P〈0．05），PHT高剂量治疗组MDA水平与PHT低剂量治疗组各相应时间点比较明显降低（P〈0.05）。结论脑缺血-再灌注后，缺血大鼠脑组织内的MDA的水平升高，SOD活力降低，说明自由基参与了脑缺血-再灌注损伤的病理生理过程。PHT可降低MDA的水平，增加SOD的活性，从而对脑缺血-再灌注损伤具有保护作用。     

环维黄杨星D对脑缺血再灌注大鼠生长相关蛋白-43 mRNA表达的影响

目的观察易卒中型肾血管性高血压大鼠（RHRSP）脑缺血-复流脑组织大鼠脑缺血生长相关蛋白-43（GAP-43）mRNA表达情况及中药单体环维黄杨星D（CVBD）的影响。方法采用环形银夹使SD大鼠的双侧肾动脉狭窄，制成RHRSP，将大鼠随机分为空白组、假手术组、模型组及CVBD组．再用线栓法制成一侧大脑中动脉闭塞（MCAO）脑缺血再灌注模型，用原位杂交观测脑缺血2h后再灌注1d、7d、14d、30d不同时间点大鼠的GAP-43 mRNA表达。结果脑缺血再灌注2h后，缺血区周围及海马1d后可见GAP-43 mRNA表达。7d明显增多，14d开始下降，CVB—D组在上述区域各时间点较对照组显著增加。结论CVB-D上调实验性脑缺血再灌注大鼠脑GAP-43 mRNA的表达，可能与促进轴突的再生有关．     

胸腺素β4对大鼠局灶性脑缺血再灌注损伤后血脑屏障的影响

目的：观察胸腺素β4对大鼠局灶性脑缺血再灌注损伤后血脑屏障的影响,并探讨其作用机制。方法将72只SD大鼠随机分为假手术组、对照组、胸腺素β4组各24只。采用线栓法制作大鼠大脑中动脉闭塞局灶性脑缺血再灌注模型,再灌注24 h后,采用干湿重法测定缺血脑组织含水量,通过检测伊文蓝渗透到缺血侧脑组织的含量观察血脑屏障的通透性,应用RT-PCR法检测缺血脑组织紧密连接蛋白5（ Claudin-5）和基质金属蛋白酶-9（MMP-9） mRNA表达。结果脑缺血再灌注损伤24 h后,与假手术组比较,对照组缺血侧脑含水量、伊文蓝含量、MMP-9 mRNA表达明显增加,Claudin-5 mRNA表达显著减少（ P均＜0．01）;与对照组比较,胸腺素β4组缺血侧脑组织含水量、缺血侧伊文蓝含量、MMP-9 mRNA明显降低,Claudin-5 mRNA表达明显升高（P均＜0．01）。结论胸腺素β4对大鼠脑缺血再灌注损伤后的血脑屏障具有保护作用,其作用机制可能是通过促进Claudin-5 mRNA表达和抑制MMP-9 mRNA表达实现的。     

尼莫通对大鼠急性脑缺血再灌注损伤后缺血半暗带神经元Na+-K+-ATP酶活性影响的研究

目的研究尼莫通对大鼠急性脑缺血再灌注损伤后缺血半暗带神经元Na＋-K＋-ATP活性的影响。方法选取450只雄性Wistar大鼠随机分为3组（对照组、尼莫通组、假手术组）,每组大鼠根据缺血后再灌注不同时间又分为缺血2 h再灌注6 h、24 h、48 h、72 h、7 d五个亚组（30只/亚组）。采用线栓法制备大鼠缺血2 h再灌注模型,仅尼莫通组采用药物进行干预。分别于再灌注6 h、24 h、48 h、72 h及7d断头取脑,观察缺血半暗带脑组织Na＋-K＋-ATP酶活性、脑组织水肿程度、脑梗死范围及神经症状评分的变化。结果三组间和不同时间点之间各项观察指标比较差异均有统计学意义（P〈0.01）;尼莫通组24 h、48 h、72 h各时间点Na＋-K＋-ATP酶活性及脑组织含水量与对照组相应时间点比较差异有统计学意义（P〈0.05）,尼莫通组24 h、48 h、72 h、7 d各时间点脑梗死面积及神经症状评分较对照组相应时间点显著降低,差异有统计学意义（P〈0.05）。对照组大鼠脑缺血半暗带神经元Na＋-K＋-ATP酶活性于6 h开始降低,48 h达最低值,72 h稍有回升,7 d趋于稳定。结论尼莫通对大鼠急性脑缺血再灌注损伤后缺血半暗带神经元具有保护作用,其机制不仅与拮抗Ca2＋超载有关,同时还可能与改善能量代谢有关。     

辛伐他汀预处理对大鼠局灶性脑缺血再灌注时间窗的影响

目的研究辛伐他汀预处理对大鼠局灶性脑缺血不同灌注时间窗的脑保护作用;探讨药物干预再灌注时间窗的可行性。方法线栓法制作大鼠缺血再灌注损伤模型,实验随机分为假手术组（A组）、缺血组（B组）、缺血/再灌注组（C组）、缺血/再灌注组加辛伐他汀组（D组）。C组、D组又各分为MCAO术后2h、4h、6h再灌注组。在完成预定操作后进行神经功能评分优于B组,测梗死体积,脑组织病理变化情况。结果D组各时间点神经功能评分优于B组,梗死体积小于B组（P〈0.05或P〈0.01）,脑组织病理变化改善。结论辛伐他汀预处理可改善神经功能评分,缩小梗死体积,改善脑组织病理变化,延长再灌注时间窗。     

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.     

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.     

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.