让我们把果实分享

春天来了,樱桃树结满了鲜艳的果实,树枝都被压弯了。红艳艳的果实吸引了穿梭在密林中的小鸟,它们从四面八方飞来,享受着樱桃的盛宴。很快,樱桃树上的红樱桃就被鸟们啄食一空。假花生树看着樱桃树,叹了口气,你辛辛苦苦结的果实,都被鸟吃光了,自己什么也没留下,多可惜啊。樱桃树笑笑,能让这些可爱的小鸟填饱肚皮,在春天里飞翔,这是多么开心的一件事啊。盛夏刚过,山核桃树就迫不及待地开花结果了,它的果实毛茸茸的,一点也不好看,还裹着一层厚厚的外壳。小鸟们飞来了,啄不动,又飞走了。一个迷路的山民,路过山核桃树下,又饿又累的他,看见山核桃树上挂满的果实,忍不住摘下一颗,敲开,尝尝,虽然有点苦涩,但味道还不错。他想,如果摘回去,炒熟了吃,味道一定更好。于是,他解下行囊,摘了满满一袋子,背回了     

足月宫角妊娠并胎盘植入2例报告

病例1:女,29岁,因停经37周 4,腹痛10个多小时于2003年3月22日以妊娠37周 4,孕2产0,头位,潜伏期入院.患者曾于孕近3个月及孕6个多月时出现阴道少量流血,经治疗后症状消失.入院当日自然分娩一女性活婴,脐带绕颈1周,体质量2 250 g.30 min后胎盘仍无剥离迹象,于无菌操作下检查宫腔,见胎盘位于左侧宫角内,剥离3～4个小叶后,宫腔光滑,脐带位于左侧宫角内,未触及其余胎盘组织,无法剥离,亦无出血现象.     

《中国实用内科杂志》首届终身成就奖

评委点评:医界泰斗,品德端行,救死扶伤,悬壶济世,辛勤耕耘,不懈求索,领圣贤之蕴,率一代风范。您视《中国实用内科杂志》如己出,悉心栽培,提携呵护,为杂志的发展做出卓越的贡献!获奖者于润江中国医科大学附属第一医院     

《中国实用内科杂志》首届终身成就奖

评委点评:医界泰斗,品德端行,救死扶伤,悬壶济世,辛勤耕耘,不懈求索,领圣贤之蕴,率一代风范。您视《中国实用内科杂志》如己出,悉心栽培,提携呵护,为杂志的发展做出卓越的贡献!     

《世界华人消化杂志》栏目设置

本刊讯本刊栏目设置包括述评,基础研究,临床研究,焦点论坛,文献综述,研究快报,临床经验,病例报告,会议纪要.文稿应具科学性、先进性、可读性及实用性,重点突出,文字简练,数据可靠,写作规范,表达准确.     

《世界华人消化杂志》栏目设置

本刊讯本刊栏目设置包括述评,基础研究,临床研究,焦点论坛,文献综述,研究快报,临床经验,病例报告,会议纪要.文稿应具科学性、先进性、可读性及实用性,重点突出,文字简练,数据可靠,写作规范,表达准确.     

《世界华人消化杂志》栏目设置

本刊讯本刊栏目设置包括述评,基础研究,临床研究,焦点论坛,文献综述,研究快报,临床经验,病例报告,会议纪要.文稿应具科学性、先进性、可读性及实用性,重点突出,文字简练,数据可靠,写作规范,表达准确.     

《世界华人消化杂志》栏目设置

本刊讯本刊栏目设置包括述评,基础研究,临床研究,焦点论坛,文献综述,研究快报,临床经验,病例报告,会议纪要.文稿应具科学性、先进性、可读性及实用性,重点突出,文字简练,数据可靠,写作规范,表达准确.     

重型破伤风12例救治体会

我科1993年2月-2003年10月共收治重型破伤风12例,有11例治愈,1例好转出院,现报道如下. 1临床资料 1.1一般资料本组男9例,女3例,男女比例为3:1,年龄28～64岁,平均43.5岁.11例为农民,1例为城镇居民.受伤原因分别为:树枝刺伤3例,烟花爆炸伤1例,烫伤1例,足趾感染后继续下田劳动者3例,刀刺伤2例,上肢皮肤裂伤后刮竹茹贴敷1例,足被石头砸伤1例.潜伏期2～7d,平均3.5d.全部病例均有典型苦笑面容,牙关紧闭,全身肌强直,吞咽及呼吸困难,频繁抽搐,抽搐时呈强直性角弓反张,抽搐次数平均21/h,抽搐持续时间长达3min,其中1例入院时合并肺部感染.     

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.