巨噬细胞移动抑制因子基因多态性与冠心病关联性研究新进展

冠心病是一种环境和遗传因素相互作用的疾病。从基因方面对冠心病的发生进行阐明,将会使冠心病的预防、诊治进入一个新的领域。巨噬细胞移动抑制因子目前被认为是冠心病发生发展中的关键因素。因此,现从巨噬细胞抑制因子的基因多态性与冠心病的相关性进行综述。     

血清胆红素与冠心病关系的研究进展

血清胆红素作为冠心病非传统危险因素,是体内一种内源性抗氧化剂。流行病学研究提出,血清总胆红素水平与冠心病发病率呈负相关。目前关于血清胆红素与冠心病预后关系和从血清胆红素水平、基因水平预测冠心病发病风险的研究,有望为冠心病防治提供新思路。     

"五脏之伤,穷必及肾"在冠心病中的指导应用

"五脏之伤,穷必及肾"这一治疗要则指出,疾病日久必然会导致肾的损伤.冠心病是中老年人的常见病、多发病,从中医角度纵观其危险因素,多与肾虚有密切关系.在临床上,补肾疗法在冠心病的治疗中也取得了一定的进展,从补肾入手预防冠心病的发生,也是一个有效可行的治疗方法.本文对冠心病从肾论治的理论依据、临床应用做了论述,并对冠心病从肾论治的疗效与新方向作了展望.     

抑郁与冠心病的研究进展

冠心病和抑郁均严重威胁人类健康,两者关系密切,互相影响,共同使患者病情恶化。近年来随着社会医学模式的转变,抑郁与冠心病越来越引起国内外学者的关注。本文将从抑郁对冠心病患者的危害、抑郁导致冠心病发生和发展的可能机制、冠心病患者抑郁的筛选以及治疗等方面进行综述。     

早发冠心病发病机制相关基因多态性研究进展

早发冠心病是指发病年龄男性≤55岁、女性≤65岁，发生于青年的冠心病，多伴有家族史，遗传因素的影响更为重要。随着基因检测技术的进步，人们试图从基因多态性的角度揭示早发冠心病的发生，为其预防和治疗提供依据。目前对早发冠心病致病基因的寻找大多集中在内皮损伤、炎性反应、脂质代谢异常、血栓形成等主要发病机制，现基于国内外研究进展，拟从发病机制的角度论述多种类型的基因多态性与早发冠心病风险之间的关系。     

心肺运动试验在冠心病治疗及康复中的研究进展

从心肺运动试验在冠心病诊断筛查、指导治疗、康复指导等方面进行综述,为临床诊治冠心病提供新思路。     

更年期女性抑郁症与冠心病

冠心病是人类主要死亡原因之一.抑郁症与冠心痛之间存在密切联系.抑郁症被认为是冠心病的一种重要危险因素,而冠心病患者又是抑郁症的高危人群.现从合并有更年期女性抑郁症的冠心病患者的概况、临床表现、可能机制、治疗等方面,探讨更年期女性抑郁症与冠心病的关系以及更年期女性抑郁症对冠心痛预后的影响,说明在合并有更年期抑郁症的女性冠心病患者中,抗抑郁治疗和冠心病二级治疗同等重要.     

尿酸与冠心病的关系及研究的进展

近年来,相关研究及荟萃分析都显示尿酸水平升高是冠心病的独立危险因素。本文从高尿酸水平导致冠心病的机制、与冠心病的关系及与预后的关系进行阐述,表明积极控制尿酸水平,有助于改善冠心病的预后。     

清热解毒中药与冠心病证治

从中医角度阐明冠心病发病的病因及机制。重点论述清热解毒类中药在治疗冠心病方面的药理研究、作用机制及其临床应用，并提出了清热解毒类中药治疗冠心病的展望。     

冠心病与焦虑症

焦虑症是常见的精神障碍之一.在一般人群中,其患病率为4.1%～6.6%.而在冠心病病人当中,其患病率约为40%～70%.可见焦虑症与冠心病的关系密切.现从冠心病合并焦虑症的现状及临床表现、发病机制、治疗等方面,探讨冠心病与焦虑症的关系.说明在冠心病合并焦虑症的患者中,抗焦虑治疗和冠心病二级预防治疗同等重要.     

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.     

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.     

N-acetyl-L-cysteine combined with mesalamine in the treatment of ulcerative colitis： Randomized,placebo-controlled pilot study

AIM： To evaluate the effectiveness and safety of oral N-acetyl-L-cysteine （NAC） co-administration with mesalamine in ulcerative colitis （UC） patients.
METHODS： Thirty seven patients with mild to moderate UC were randomized to receive a four-wk course of oral mesalamine （2.4 g/d） plus N-acetyl-L-cysteine （0.8 g/d） （group A） or mesalamine plus placebo （group B）. Patients were monitored using the Modified Truelove-Witts Severity Index （MTWSI）. The primary endpoint was clinical remission （MTWSI ≤ 2） at 4 wk. Secondary endpoints were clinical response （defined as a reduction from baseline in the MTWSI of ≥ 2 points） and drug safety. The serum TNF-α, interleukin-6, interleukin-8 and MCP-1 were evaluated at baseline and at 4 wk of treatment. RESULTS： Analysis per-protocol criteria showed clinical remission rates of 63% and 50% after 4 wk treatment with mesalamine plus N-acetyl-L-cysteine （group A） and mesalamine plus placebo （group B） respectively （OR = 1.71; 95% CI： 0.46 to 6.36; P = 0.19; NNT = 7.7）. Analysis of variance （ANOVA） of data indicated a significant reduction of MTWSI in group A （P = 0.046） with respect to basal condition without significant changes in the group B （P = 0.735） during treatment. Clinical responses were 66% （group A） vs 44% （group B） after 4 wk of treatment （OR = 2.5; 95% CI： 0.64 to 9.65; P = 0.11; NNT = 4.5）. Clinical improvement in group A correlated with a decrease of IL-8 and MCP-1. Rates of adverse events did not differ significantly between both groups.
CONCLUSION： In group A （oral NAC combined with mesalamine） contrarily to group B （mesalamine alone）, the clinical improvement correlates with a decrease of chemokines such as MCP-1 and IL-8. NAC addition not produced any side effects.     

Delorme's transrectal excision for internal rectal prolapse

Surgical therapy of functional outlet obstruction in patients with internal rectal intussusception may include abdominal, perineal, or transrectal procedures. Because abdominal procedures often result in significant physiologic impact but unrelieved constipation, the authors have elected Delorme's transrectal excision for management of these patients. Since a short-term placebo effect attends many therapies, this report describes results of transrectal excision only after a threeyear postoperative period. Delorme's transrectal excision of internal intussusception accomplished sustained symptomatic relief in over 70 percent of otherwise refractory constipated patients. The association of internal intussusception with other abnormalities underscores the importance of defining both anatomic and functional components when selecting patients whose constipation may require surgical therapy. Critical technical elements, surgical pitfalls, and potential complications of the procedure are discussed.Poster presentation at the meeting of The American Society of Colon and Rectal Surgeons, Toronto, Canada, June 11 to 16, 1989.     

The oral glucose tolerance test: A comparison of the time points on the basis of limit values,normal dispersion,and reproducibility

Summary Time points in the glucose tolerance test (GTT) are compared on the basis of limit values, dispersion within a reference population, and reproducibility. We suggest using the distance between a limit value and the median reference value as a measure of the magnitude of abnormality. The distance between 140 mg/100 ml and the median fasting plasma glucose value is chosen as a standard distance and limits for other points in the GTT are calculated to equal this standard distance of abnormality. We suggest that the probability of correctly interpreting an inividual result is directly related to the reproducibility of the test and inversely related to the percentage of the total range of values which is dispersed among the normal population. The ratio of reproducibility to percentage normal dispersion is proposed as an index of the probability of correctly interpreting an individual result. According to this index, the probability of correct interpretation varies in order: fasting plasma glucose concentration>3-h>2-h>0.5-h>1-h plasma glucose concentration.