多索茶碱对AECOPD患者血清IL-8、TNF-α、IL-10的影响

目的探讨对慢性阻塞性肺疾病急性发作期(AECOPD)患者应用多索茶碱后患者血清IL-8、TNF-α、IL-10变化情况。方法将120例AECOPD患者随机分为观察组和对照组,观察组应用多索茶碱,对照组应用氨茶碱,比较两组治疗前后肺功能及血清IL-8、TNF-α、IL-10。结果 1治疗后,两组PaO2、FEV1、FVC、FEV1/FVC升高,Pa CO2降低(P0.05);且观察组改善更明显(P0.05);2治疗后,两组IL-10升高,IL-8、TNF-α降低,且观察组改善更明显(P0.05);3AECOPD患者FEV1/FVC与IL-8、IL-10成负相关,与IL-10成正相关(P0.05)。结论血清IL-8、TNF-α、IL-10与AECOPD患者气道功能具有相关性,多索茶碱能有效的抑制IL-8、TNF-α水平,提升IL-10水平。     

雾化吸入糖皮质激素治疗慢性阻塞性肺疾病急性加重期患者的疗效

目的 探讨雾化吸入糖皮质激素治疗慢性阻塞性肺疾病急性加重期患者的疗效,并进一步探讨慢性阻塞性肺疾病的发病机制.方法 分别测定对照组、非吸入组和吸入组治疗前后的肺功能指标、血清及诱导痰中IL-8和TNF-α的水平.采用SPSS13.0软件包对数据进行统计学分析.结果 治疗后肺功能指标与治疗前比较均明显升高,吸入组升高更明显,但仍低于对照组(P＜0.05);治疗前非吸入组和吸入组患者血清中IL-8、TNF-α水平明显高于对照组,且与FEV1和FEV1占预计值百分比呈负相关(P＜0.05);治疗后血清和痰液中IL-8、TNF-α水平较治疗前明显下降,且吸入组与非吸入组比较痰液中IL-8和TNF-α下降更为显著(P＜0.05),但治疗后两组患者血清中IL-8、TNF-α水平无统计学差异(P＞0.05).结论 糖皮质激素吸入疗法可以有效地改善肺功能,降低诱导痰中炎症介质IL-8、TNF-α的水平,进而减轻全身、尤其气道和肺组织的炎症反应.     

慢性阻塞性肺疾病急性加重期患者治疗前后肺功能、SIRS评分及血清炎症因子水平变化与预后的相关性研究

目的:探究慢性阻塞性肺疾病急性加重期(AECOPD)患者治疗前后肺功能、全身性炎症反应综合征(SIRS)评分、血清炎症因子水平变化及其预后的相关性。方法:通过肺功能检测仪检测109例AECOPD患者治疗前后肺功能指标[第1秒用力呼气容量占用力肺活量比值(FEV1/FVC)、FEV1占预计值百分比(FEV1%)],酶联免疫吸附法(ELISA)测定血清炎症因子[白介素-6(IL-6)、白介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、降钙素原(PCT]指标。对AECOPD患者治疗前后行SIRS评分,并分析上述指标与患者预后的相关性。结果:患者治疗后FEV1/FVC、FEV1%较治疗前均显著上升,IL-6、IL-8、TNF-α、PCT水平、SIRS评分显著下降,差异有统计学意义(P0.05);AECOPD存活组患者入院时FEV1/FVC、FEV1%水平均显著高于死亡组,血清IL-6、IL-8、TNF-α、PCT水平、SIRS评分均显著低于死亡组,差异有统计学意义(P0.05);FEV1/FVC、FEV1%与患者预后正相关(P0.05),IL-8、TNF-α、SIRS评分与预后负相关(P0.05)。结论:肺功能、血清炎症因子、SIRS评分对AECOPD诊断、疗效判断有重要意义,肺功能下降、IL-8、TNF-α水平上升、SIRS评分高为患者死亡的危险因素。     

阿奇霉素联合乙酰半胱氨酸治疗稳定期慢性阻塞性肺疾病患者的效果观察

目的探讨阿奇霉素联合乙酰半胱氨酸治疗稳定期慢性阻塞性肺疾病患者的临床效果。方法选取2017年1月至2017年12月在我院呼吸科门诊就诊的稳定期慢性阻塞性肺疾病患者100例,随机分为观察组和对照组,每组50例。对照组患者进行常规治疗,观察组在常规治疗的基础上加用阿奇霉素及乙酰半胱氨酸治疗,疗程36周。比较两组患者治疗前、治疗12周、24周和36周后肺功能的变化情况以及血清TNF-α、IL-8、IL-18水平。结果两组患者治疗前、治疗12周、24周后的FEV1%和FEV1/FVC%比较,差异无统计学意义(P0.05);治疗36周后观察组患者的FEV1%和FEV1/FVC%均显著高于对照组,差异有统计学意义(P0.01)。治疗前两组患者血清TNF-α、IL-8、IL-18水平比较差异无统计学意义(P0.05);治疗12周、24周、36周后观察组患者血清TNF-α、IL-8、IL-18水平显著低于对照组,差异有统计学意义(P0.05或0.01)。结论在常规治疗的基础上阿奇霉素联合乙酰半胱氨酸治疗稳定期慢性阻塞性肺疾病患者,能够显著改善患者的肺功能,降低肺内炎症反应,减缓恶化进程,值得推广应用。     

肿瘤坏死因子α和白介素8对慢性阻塞性肺疾病急性加重期的诊断价值

目的分析肿瘤坏死因子α(4-α)和白介素8(IL-8)对慢性阻塞性肺疾病急性加重期(AECOPD)的诊断价值。方法选取2015年1月—2016年5月佛山市中医院收治的AECOPD患者40例作为A组,慢性阻塞性肺疾病(COPD)稳定期患者40例作为B组,健康体检者40例作为C组。比较3组受检者诱导痰和血清TNF-α、IL-8水平,分析血清TNF-α及IL-8水平对AECOPD的诊断价值,并比较A组患者治疗前后血清TNF-α、IL-8水平及动脉血氧分压(Pa O2)、动脉血二氧化碳分压(Pa CO2)。结果 A组患者诱导痰和血清TNF-α、IL-8水平均高于B组和C组,B组患者诱导痰和血清TNF-α、IL-8水平均高于C组(P0.05)。血清TNF-α水平诊断AECOPD的灵敏度为90.0%,特异度为80.0%;血清IL-8水平诊断AECOPD的灵敏度为87.5%,特异度为82.5%;血清TNF-α水平联合血清IL-8水平诊断AECOPD的灵敏度为95.0%,特异度为90.0%。治疗后A组患者血清TNF-α、IL-8水平及Pa CO2低于治疗前,Pa O2高于治疗前(P0.05)。结论 TNF-α和IL-8对AECOPD具有一定的诊断价值,可作为AECOPD的早期诊断指标。     

慢性阻塞性肺疾病稳定期患者下呼吸道细菌定植及对血清TNF-α、IL-8的影响

目的 探讨慢性阻塞性肺疾病(COPD)稳定期患者下呼吸道细菌定植(LABC)与炎症反应的关系.方法 选择62例COPD稳定期患者,留取痰液标本并进行培养,检测患者血清肿瘤坏死因子α(TNF-α)、白介素8(IL-8)水平,对患者进行肺功能测定.结果 62例患者中有18例(29.03％)患者存在LABC,存在LABC患者血清TNF α、IL-8水平高于无LABC者(P＜0.05);存在LABC者肺功能FEV1％ pred、FEV1/FVC低于无LABC者,吸烟指数≥400的比例大于无LABC者,差异均有统计学意义(P ＜0.05);LABC定量培养结果与TNF-α及IL-8水平呈正相关(P＜0.05).结论 部分COPD稳定期患者存在LABC,而LABC可加重患者炎症反应,加剧肺功能的损害.     

AECOPD患者炎症相关指标检测及临床意义

目的 探讨慢性阻塞性肺疾病急性加重期（AECOPD）患者CRP、IL-6、IL-8、TNF-α等相关炎症指标的变化及临床意义.方法 选取AECOPD患者及稳定期患者各60例,检测血清及诱导痰液中CRP、IL-6、IL-8、TNF-α水平.结果 AECOPD患者外周血WBC计数、血清CRP、IL-6、IL-8、TNF-α,诱导痰液中IL-6、IL-8、TNF-α,浓度明显高于稳定期患者（P〈0.05）;AECOPD患者治疗后WBC、血清CRP、IL-6、IL-8、TNF-α浓度与治疗前比较明显下降（P〈0.05）.结论 AECOPD患者血清及诱导痰液中的IL-6、IL-8、TNF-α,血清WBC及CRP,均较稳定期患者明显升高,检测相关炎症指标有助于判断患者病情变化及预后.     

慢性阻塞性肺疾病患者血清IL-18、TNF-α、IL-8的水平变化与肺功能的相关性分析

目的 探讨慢性阻塞性肺疾病(COPD)患者血清白介素18(IL-18)、肿瘤坏死因子α(TNF-α)和白介素8(IL-8)的水平变化与肺功能的相关性,及其在COPD发病机制中的作用及意义.方法 采用双抗体夹心酶联免疫吸附法(ELISA),对36例COPD急性加重期患者治疗前、后血清中IL-18、TNF-α和IL-8进行检测,与12名正常健康人作比较.结果 COPD组治疗前和治疗后血清IL-18、TNF-α和IL-8水平均高于对照组(P＜0.05);COPD组治疗前和治疗后血清IL-18、TNF-α和IL-8水平差异有统计学意义;COPD组治疗前血清IL-18、TNF-α和IL-8水平与同期肺功能呈负相关.结论 过多的IL-18、TNF-α和IL-8可能参与了COPD发病机制,细胞因子浓度的增高可能与肺功能损害程度有关.     

加味麻杏石甘汤配合穴位贴敷治疗老年慢性阻塞性肺病急性加重期患者的效果及对肺功能和肿瘤坏死因子-α、白细胞介素-8表达的影响

目的探讨加味麻杏石甘汤配合穴位贴敷治疗慢性阻塞性肺疾病急性加重期(AECOPD)的临床疗效及其对肺功能和肿瘤坏死因子(TNF)-α、白细胞介素(IL)-8表达的影响。方法 130例老年AECOPD患者随机分为对照组和观察组,对照组采用穴位贴敷治疗,治疗组在对照组的基础上加用加味麻杏石甘汤,治疗2 w后,观察两组治疗效果,肺功能及血清IL-8和TNF-α表达水平。结果观察组总有效率(93.33%)显著高于对照组(77.78%)(χ~2=4.406,P=0.036)。两组肺功能均较治疗前改善,观察组好转幅度大于对照组(P<0.01)。两组血清TNF-α、IL-8炎性因子水平表达均降低,且观察组低于对照组(P<0.05)。结论加味麻杏石甘汤配合穴位贴敷治疗AECOPD的临床疗效确切,可有效改善肺功能,降低血清TNF-α、IL-8炎性因子表达。     

伴焦虑抑郁障碍的慢性阻塞性肺疾病急性加重期患者白介素8、肿瘤坏死因子α的临床研究

目的 探讨伴有焦虑抑郁障碍的慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)患者血清中自介素8(interukin-8,IL-8)、肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)水平变化的关系.方法 1999年3月至2004年3月在解放军第454医院呼吸科住院和门诊的患者,诊断为AECOPD患者35例,依照就诊的症状分组入选病例及随机分为两组,其中男21例,女14例;分别为焦虑抑郁障碍组和对照组(无焦虑抑郁障碍),两组分别为18例和17例.共观察2周.人院后及出院时观察咳嗽、咳痰、气喘、呼吸困难、胸闷、焦虑、抑郁障碍等症状,肺功能:第1秒用力呼气容积(FEV1)、FEV1占预计值百分比(FEV1pred%)测定及空腹静脉抽血用放射免疫法检测IL-8及TNF-α的含量.结果 组间症状入院第1天(前)相比无明显差异,咳嗽、咳痰、呼吸困难、胸闷、焦虑、抑郁症状前与入院第14天(后)相比较,差异有统计学意义.两组治疗前后肺功能:FEV1、FEV1pred%指标前后差异无统计学意义.焦虑抑郁组前与后相比TNF-α含量降低差异有统计学意义,IL-8含量降低差异无统计学意义.结论 伴有抑郁焦虑障碍AECOPD患者血清中IL-8及TNF-α含量增高,可能焦虑抑郁障碍是AECOPD的危险因素之一,与病变过程中炎症因子的溢出有关,其机制有待进一步研究.     

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.