呼吸肌康复锻炼对COPD患者肺功能的影响

目的观察呼吸肌康复锻炼对慢性阻塞性肺病(COPD)患者肺功能及生活质量的影响。方法 67例COPD患者随机分为两组,对照组(n=32例)给予常规对症支持治疗,观察组(n=35例)在对照组治疗基础上加用呼吸肌康复锻炼,两组疗程均为3个月。比较两组患者治疗前后肺功能(FVC、FEV1、FEV1/FVC)及生活质量变化。结果治疗后观察组患者肺功能及生存质量较对照组均明显改善(P0.05)。结论呼吸肌康复锻炼可改善COPD患者的肺功能和提高生活质量。     

小剂量阿奇霉素治疗对慢性阻塞性肺疾病稳定期老年患者肺功能和炎症因子的影响

目的探讨小剂量阿奇霉素治疗对慢性阻塞性肺疾病(COPD)稳定期老年患者肺功能和炎症因子的影响。方法回顾性收集98例COPD稳定期老年患者,根据治疗方法的不同分为观察组(n=46)和对照组(n=52),两组患者均给予COPD常规治疗,观察组患者在此基础上给予口服小剂量阿奇霉素治疗,两组均给予6个月连续治疗,治疗前、后分别检测两组患者肺功能指标,包括1 s用力呼气容积(FEV1)、FEV1占预计值百分比(FEV1%)、1 s率(FEV1/FVC%)和炎症因子肿瘤坏死因子(TNF)-α、白细胞介素(IL)-8及C-反应蛋白(CRP)变化。结果治疗后,观察组FEV1、FEV1%和FEV1/FVC%分别为(1.60±0.38)L、47.30±3.77和43.76±3.93,较治疗前和对照组治疗后显著增加(P0.05);治疗后,观察组TNF-α、IL-8和CRP分别为(10.65±3.66)pg/ml、(28.46±4.08)pg/ml和(4.06±1.47)mg/L,较治疗前和对照组治疗后显著降低(P0.05)。结论小剂量阿奇霉素治疗可以显著改善COPD稳定期老年患者肺功能,降低气道炎症反应,具有积极的临床意义。     

老年COPD患者血清PCT、hs-CRP的表达与肺功能指标、生活质量的相关性

目的探讨老年慢性阻塞性肺疾病(COPD)患者血清降钙素原(PCT)、超敏C反应蛋白(hs-CRP)的表达与肺功能指标、生活质量的相关性。方法老年COPD急性加重期(AECOPD)患者42例为AECOPD组,老年COPD稳定期患者38例为稳定期COPD组,另选取同期体检健康者30例作为对照组,分别检测三组受试者血清PCT、hs-CRP水平,检测AECOPD组和稳定期COPD组的第1秒用力呼气容积与用力肺活量的比值(FEV1/FVC)、FEV1占预计值的百分比(FEV1%),同时用圣乔治呼吸问卷(SGRQ)评估两组患者的生活质量,分析PCT、hs-CRP与FEV1/FVC、FEV1%、SGRQ评分的相关性。结果 AECOPD组患者血清PCT、hs-CRP水平均高于稳定期COPD组和对照组,稳定期COPD组上述指标高于对照组(P0.05)。AECOPD组FEV1/FVC及FEV1%均低于稳定期COPD组,而SGRQ评分高于稳定期COPD组(P0.05)。相关性分析显示血清PCT、hs-CRP水平与FEV1/FVC和FEV1%呈负相关,与SGRQ评分正相关(均P0.05)。结论 COPD患者血清PCT、hs-CRP呈现高表达,且肺功能和生活质量均下降。COPD患者血清PCT、hs-CRP水平与FEV1/FVC、FEV1%和生活质量呈负相关。     

温和灸治疗慢性阻塞性肺疾病稳定期患者的疗效观察

目的探讨温和灸对COPD稳定期患者的疗效,以期为指导临床提供依据。方法 80例稳定期慢性阻塞性肺疾病患者被随机分为治疗组和对照组,各40例。对照组接受中西医药物治疗,治疗组在其基础上运用温和灸治疗,治疗2个疗程后,对两组患者肺功能、呼吸困难情况、生活质量及疗效进行比较分析。结果两组患者治疗后,肺功能指标(FVC、FEV1及FEV1/FVC)、改良呼吸困难指数(mMRC)、生活质量评分(CAT)均有明显改善(P0.05);但相比对照组,治疗组以上各指标改善更显著(P0.05);治疗组总有效率明显高于对照组(P0.05)。结论温和灸能够明显提高稳定期慢性阻塞性肺疾病患者的临床疗效,增强肺功能,改善呼吸困难情况,提高生活质量。     

有氧康复训练对稳定期慢性阻塞性肺疾病患者的康复疗效

目的:探讨有氧康复训练对慢性阻塞性肺疾病患者运动功能、肺功能及生存质量的影响。方法:选择108例慢性阻塞性肺疾病患者,按数字表将其随机分为试验组(54例)和对照组(54例),对照组给予常规康复训练,试验组在此基础上增加有氧康复训练。训练4周,分别测评训练前后两组患者的运动功能指标、肺功能指标和生存质量指标。结果:训练前后比较,两组患者运动功能、肺功能和生存质量均有明显改善(P<0.5);训练后组间比较,试验组运动功能指标中m MRC明显低于对照组,6MWT明显高于对照组(P<0.05);试验组肺功能指标FVC、FEV1及FEV1/FVC均高于对照组(P<0.05);日常生活因子、社会活动因子、抑郁因子及焦虑因子均低于对照组(P<0.05)。结论:有氧康复训练能够改善稳定期慢性阻塞性肺疾病(COPD)患者的运动功能和肺功能,提高生存质量。     

舒利迭改善COPD合并尘肺病患者肺功能研究

目的研究舒利迭对COPD合并尘肺病患者肺功能影响的机制。方法选择我院肺功能Ⅱ～Ⅲ组稳定期COPD合并尘肺病和COPD患者各28例,给予舒利迭吸入治疗4周,检测治疗前后两组FEV1、FVC、FEV1%和FEV1/FVC等指标,比较两组肺功能改善程度。结果两组治疗后FEV1、FVC、FEV1%和FEV1/FVC均较治疗前显著提高(P<0.05)。治疗后COPD合并尘肺病组的FEV1%低于COPD组(P<0.05);两组FEV1/FVC差异无显著性(P>0.05)。结论舒利迭吸入治疗能显著改善COPD患者和COPD合并尘肺患者的肺功能,但合并尘肺病使舒利迭对COPD患者的疗效减弱。     

利金颗粒治疗慢性阻塞性肺疾病稳定期35例疗效分析

目的观察利金颗粒对慢性阻塞性肺疾病(COPD)稳定期肺气虚证患者的临床疗效及肺功能的影响。方法将70例COPD患者随机分为治疗组和对照组;对照组予氨茶碱治疗,治疗组予利金颗粒治疗,疗程均为2个月;比较两组临床疗效及肺功能的变化。结果治疗组疗效优于对照组(P<0.05),治疗组治疗后肺功能指标FEV1、FVC、FEV1﹪均明显提高,与对照组治疗后比较差异有显著性(P<0.05)。结论利金颗粒对COPD稳定期肺气虚证患者有较好疗效,且对肺功能有改善作用。     

肺功能锻炼联合营养支持在COPD稳定期康复中的应用价值

目的评价肺功能康复锻炼联合营养支持在慢性阻塞性肺疾病(COPD)稳定期康复中的应用价值。方法将85例COPD稳定期患者随机分为两组,对照组(n=43)给予常规护理和常规饮食,观察组(n=42)在对照组基础上加肺功能康复锻炼和营养支持;治疗2月后比较两组患者的康复情况。结果治疗后观察组患者在MMRC评分、BMI、FEV1/FVC以及6MWT评分均显著优于对照组(P0.05)。结论肺功能康复锻炼联合营养支持可以显著缓解COPD患者的呼吸困难情况,增强患者运动能力,利于康复。     

乙酰半胱氨酸对稳定期慢性阻塞性肺疾病患者急性加重率及生活质量的影响研究

目的观察乙酰半胱氨酸对稳定期慢性阻塞性肺疾病(COPD)患者急性加重率及生活质量的影响。方法选择2012年4月—2013年8月在鄂尔多斯市中心医院门诊就诊的稳定期COPD患者86例,随机分为治疗组43例和对照组43例。对照组给予常规治疗,治疗组在常规治疗的基础上加用乙酰半胱氨酸。观察两组患者肺功能指标、急性加重情况,并采用中文版COPD评估测试(CAT)问卷评价其生活质量。结果两组患者治疗前及治疗后6、12个月第一秒用力呼气容积(FEV1)、FEV1占预计值百分比(FEV1%)、FEV1/用力肺活量(FVC)比较,差异均无统计学意义(P0.05)。治疗前,两组患者中文版CAT问卷总分比较,差异无统计学意义(P0.05);治疗后6、12个月,治疗组患者中文版CAT问卷总分低于对照组,差异均有统计学意义(P0.05)。治疗前及治疗6个月后,两组患者急性加重率比较,差异均无统计学意义(P0.05);治疗12个月后,治疗组急性加重率低于对照组,差异有统计学意义(P0.05)。结论长期口服乙酰半胱氨酸可减少COPD患者急性加重率,改善其生活质量。     

布地奈德福莫特罗对稳定期COPD患者临床疗效及血清IL-13的影响

目的 观察布地奈德福莫特罗对稳定期慢性阻塞性肺疾病(COPD)患者的临床疗效及血清白介素-13(IL-13)水平的影响.方法 60例稳定期COPD患者随机分为治疗组和对照组各30例,对照组予常规治疗,治疗组加用布地奈德福莫特罗粉吸入剂吸入,3个月为一疗程.测定两组患者治疗前后肺功能、血清IL-13水平.结果 一个疗程后,与治疗前及治疗后的对照组相比,治疗组患者肺功能指标(FEV1/预计值％、FEV1/FVC、PEF)明显改善(P＜0.01),治疗组患者血清中IL-13水平显著下降(P＜0.01).结论 布地奈德福莫特罗可明显改善稳定期COPD患者的肺功能,降低COPD患者全身炎症反应.     

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.