神经节苷脂联合纳洛酮治疗新生儿缺氧缺血性脑病疗效研究

目的探讨新生儿缺氧缺血性脑病的治疗方法,观察神经节苷脂联合纳洛酮治疗新生儿缺氧缺血性脑病的临床疗效。方法选择新生儿缺氧缺血性脑病患儿56例,随机分为治疗组和对照组各28例,两组均给予常规治疗,对照组在常规治疗的基础上给予纳洛酮治疗,治疗组在常规治疗的基础上给予神经节苷脂联合纳洛酮治疗,观察两组治疗疗效。结果治疗组显效15例,有效11例,无效2例,总有效率92.86%;对照组显效9例,有效14例,无效5例,总有效率82.21%。与对照组相比,治疗组患儿治疗有效率明显升高(P0.05)。结论神经节苷脂联合纳洛酮治疗新生儿缺氧缺血性脑病可以提高治疗疗效,改善预后,建议临床广泛运用。     

纳洛酮联合多巴胺治疗新生儿缺氧缺血性脑病36例

目的 探讨纳洛酮联合多巴胺治疗新生儿缺氧缺血性脑病的临床疗效.方法 将72例新生儿缺氧缺血性脑病患儿随机分为两组:对照组给予对症及支持等常规治疗.治疗组在对照组治疗基础上加用纳洛酮0.1 mg/(kg·d),输液泵维持24 h静脉输注,连用7 d,同时加用多巴胺5 μg/(kg·min),输液泵维持24 h静脉输注,连用7 d.观察两组患儿意识恢复时间,肌张力恢复时间,反射恢复时间和不良反应.结果 治疗组意识恢复时间、反射恢复时间、肌张力恢复时间较对照组明显缩短(P<0.01).治疗组总有效率86.1%,显效率41.7%,对照组总有效率61.1%,显效率16.7%,两组比较均有统计学意义(P<0.05).结论 纳洛酮联合多巴胺治疗新生儿缺氧缺血性脑病疗效满意.     

丹参治疗新生儿缺氧缺血性脑病

目的观察复方丹参注射液治疗新生儿缺氧缺血性脑病（HIE）的疗效。方法治疗组在常规综合治疗基础上加用复方丹参治疗。对照组予以常规治疗。对两组新生儿出生后3d、14d分别行新生儿行为神经测定（NBNA）评分。结果两组患儿NBNA评分情况比较，14d时治疗组≥35分患儿有28例，高于对照组的20例。结论丹参能改善缺氧缺血性脑损伤的预后。     

单唾液酸四己糖神经节苷脂钠注射液治疗新生儿缺氧缺血性脑病疗效分析

目的探讨单唾液酸四己糖神经节苷酯钠注射液治疗新生儿缺氧缺血性脑病的临床效果。方法选择缺氧缺血性脑病新生患儿80例为研究对象,将患儿随机分为观察组和对照组,每组40例。对照组患儿给予降颅内压、抗惊厥等常规治疗;观察组患儿在常规治疗的基础上给予单唾液酸四己糖神经节苷酯钠注射液治疗,20 mg/d,连续治疗14 d。观察比较两组患儿的临床症状恢复情况及新生儿行为神经评分(NBNA)。结果 (1)观察组患儿治疗总疗效率为92.50%,对照组为75.00%,观察组患儿临床疗效优于对照组,差异有统计学意义(P0.05)。(2)治疗前,两组患儿NBNA评分比较差异无统计学意义(P0.05);治疗第7天时,两组患儿的NBNA评分都出现一定程度下降,第14天时又明显上升。治疗第14天时,观察组患儿NBNA评分明显高于治疗前,而对照组患儿明显低于治疗前,两组患儿治疗前后比较差异有统计学意义(P0.05)。治疗第7天、第14天时观察组患儿的NBNA评分均明显高于对照组,差异有统计学意义(P0.01)。结论在常规治疗基础上,加用单唾液酸四己糖神经节苷酯钠注射液治疗缺氧缺血性脑病新生儿效果确切,能有效改善患儿症状和病情,修复受损脑细胞,减轻缺氧缺血脑损伤症状,提高临床治疗效果。     

生脉注射液治疗新生儿缺氧缺血性脑病48例疗效观察

新生儿缺氧缺血性脑病(HIE)是新生儿窒息后的严重并发症,可产生永久性神经功能障碍,且病死率高。1998～2000年我们应用生脉注射液治疗HIE患儿48例,疗效满意,现报告如下。 临床资料:选择80例HIE足月新生儿,均在出生后48小时内入院,其诊断均符合1996年杭州会议修订的HIE诊     

脑活素治疗新生儿缺氧缺血性脑病40例疗效分析

1992～1998年,我们对40例缺氧缺血性脑病患儿在常规治疗的基础上加用脑活素治疗,取得一定疗效,现报告如下。资料与方法:将88例患儿分为对照组和治疗组。两组患儿均有明显的围产期缺氧窒息史,生后出现意识障碍、过度兴奋、嗜睡、昏迷、惊厥、肌张力改变及原始反射消失等。其中34例头颅CT检查显示程度不一的多灶性低密度区,9例合并颅内出血。两组一般情况比较见表1。所有患儿均按制定的新生儿缺氧缺血性脑病标准诊断及分度,对照组给予常规治疗,包括降颅压、镇静、止痉、能量合剂及吸氧等;治疗组在上述基础上加用脑活素5ml静注,10～15天为一疗…     

复方丹参与大剂量维生素C治疗新生儿缺氧缺血性脑病

1994～1997年,我们应用复方丹参与大剂量维生素C治疗新生儿缺氧缺血性脑病26例,取得较满意疗效。现报告如下。临床资料:治疗组26例,男21例、女5例,生后1～72小时,生后1分钟Apgar评分0～3分12例,4～7分14例。对照组28例,男210例、女8例,生后0.5～72小时,生后1分钟Apgar评分0～3分12例、4～7分16例。两组患儿均按1998年济南会议制定的新生儿缺氧缺血性脑病诊断标准诊断。治疗组轻型7例,中型12例,重型7例;对照组轻型9例,中型12例,重型7例。治疗方法:对照组采用吸氧、激素、20%甘露醇及对症支持等常规治疗。治疗组在此基础上加用复方丹参注射…     

生脉注射液联合黄芪注射液治疗慢性心力衰竭疗效观察

目的观察生脉注射液联合黄芪注射液治疗慢性心力衰竭的疗效。方法将58例心力衰竭患者随机分为两组。对照组28例,采用常规治疗;治疗组30例,在常规治疗基础上加用生脉注射液与黄芪注射液。结果治疗组总有效率93．3％,对照组总有效率75．0％,治疗组优于对照组（P〈0．01）。结论生脉注射液联合黄芪注射液治疗慢性心力衰竭优于常规治疗。     

谷氨酸钠联合醒脑静、纳洛酮注射液治疗肝性脑病36例疗效观察

目的观察谷氨酸钠联合醒脑静、纳洛酮注射液治疗肝性脑病疗效。方法将36例患者随机分为观察组与对照组,观察组采用谷氨酸钠加醒脑静、纳洛酮,对照组仅用谷氨酸钠治疗,两组其他基础治疗相同。结果观察组较对照组昏迷时间缩短,清醒人数明显增多;观察组总有效率高于对照组。结论谷氨酸钠联合醒脑静、纳洛酮治疗肝性脑病有缩短昏迷时间,促进清醒的作用。疗效确切。     

高压氧联合川芎嗪对重度缺氧缺血性脑病NSE和MBP水平变化的调节

目的 探讨高压氧联合川芎嗪对重度缺氧缺血性脑病（HIE）患儿神经元特异性烯醇化酶（NSE）和髓鞘碱性蛋白（加3P）水平变化的调节。方法 HIE患儿90例，随机分为川芎嗪治疗组（30例）、高压氧和川芎嗪联合治疗组（30例）和常规治疗组（30例），同时以30名正常新生儿组作对照。在治疗前后分别用酶联免疫分析法检测血清NSE、MBP水平。结果 3组重度缺氧缺血性脑病患儿NSE、MBP水平明显高于正常对照组（P〈0．05）；常规治疗组患儿NSE、MBP水平明显高于川芎嗪治疗组和联合治疗组（P〈0．05）；联合治疗组NSE、MBP水平显著低于川芎嗪治疗组（P〈0.05）。结论 NSE及加BP水平是反映脑组织损伤和修复的生化指标，临床上早期用高压氧联合川芎嗪治疗重度HIE有较好的疗效。     

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.