复方儿茶胶囊治疗消化性溃疡疗效观察

目的;观察复方儿茶胶囊对消化性溃疡的近期和远期疗效。方法;经胃镜确诊的消化性溃疡２６１例,随机分为西米替丁组８７例（西米替丁０．２ｇ,每天３次口服,睡前加服０．４ｇ）,丽珠得乐组８７例（丽珠得乐１１０ｍｇ,每天４次口服）,复方儿茶胶囊组８７例（复方儿茶胶囊０．５１５ｇ,每天３次口服）。治疗前,治疗８周后１年后距幽门５ｃｍ以内取胃组织,用快速尿素酶法测定幽门螺杆菌。     

止溃灭幽汤治疗幽门螺杆菌阳性活动期十二指肠溃疡的临床观察

目的探讨止溃灭幽汤治疗幽门螺杆菌(HP)阳性活动期十二指肠溃疡的近期疗效。方法自拟止溃灭幽汤治疗HP阳性活动性十二指肠溃疡64例,并与雷尼替丁、丽珠得乐组对照．治疗6周结束时进行胃镜复查。结果两组6周溃疡愈合率分别为87．2％和92．9％。两组的溃疡愈合率、HP转阴率和疼痛缓解率均无显著性差异,未发现严重的副作用。结论止溃灭幽疡是治疗HP阳性活动期十二指肠溃疡较为理想的方药。     

中西医结合治疗幽门螺杆菌阳性消化性溃疡的临床研究

将幽门螺杆菌（HP）阳性消化性溃疡62例随机分为3组，分别用灭幽丸、抗生素三联和中西药联合进行治疗。结果显示，中药组（灭幽丸）溃疡愈合率为80．95％，HP根除率76.19％；西药组（丽珠得乐＋甲硝唑＋四环素）溃疡愈合率75．00％，HP根除率90．00％；联合组（灭幽丸＋西药组用药）愈合率90．48％，HP根除率95．24％。活动性胃炎消失率中药组（23．80％）和联合组（28．57％）优于西药组（15.00％）。中药组和联合组副作用亦明显少于西药组。     

丽珠胃三联治疗海员消化性溃疡46例

[目的]观察丽珠胃三联治疗海员消化性溃疡的疗效及幽门螺杆菌（Hp）根除率。[方法]Hp阳性的海员消化性溃疡86例，随机分2组：治疗组46例，给予丽珠胃三联，即枸橼酸铋钾110mg，4次／d，替硝唑0．5g，2次／d，克拉霉素0．25g，2次／d；对照组40例，给予达克普隆30mg，阿莫西林1．0g，甲硝唑400mg，均2次／d。2组均连续治疗。7d停药4周后复查电子胃镜及^14C-尿素呼气试验检测其Hp阴转率。[结果]治疗组和对照组溃疡治疗有效率分别为89．1％及90．0％；Hp根除率为87．0％和90．0％；疼痛缓解率为84．7％和85．0％；2组差异均无统计学意义（P〉0．05）。治疗组的腹痛消失时间、症状消失率较对照组快，但差异均无统计学意义（P〉005）。[结论]丽珠胃三联能有效根除Hp，对海员消化性溃疡有较高的治愈率和症状缓解率，服用方便，不良反应小。     

雷尼替丁维持治疗对幽门螺杆菌相关性溃疡四联法治疗后意义的探讨

目的：观察以洛赛克为核心的两种四联疗法的幽门螺杆菌（HP）根除率和溃疡治愈率以及HP相关性胃十二指肠溃疡治愈后是否仍需应用抑酸剂维持治疗。方法：（1）196例病人（HP相关性胃炎40例,HP相关性溃疡156例）随机分两,分别给予洛赛克＋灭滴灵＋瑞贝克（庆大霉素混悬剂）＋四环素（A组）和洛赛克＋灭滴灵＋丽珠得乐＋四环素（B组）口服2周。十二指肠溃疡者继续应用洛赛克6周。胃溃疡和复合性溃疡者则继续用10周后查复查胃镜。（2）对溃疡愈合者将A与B两组各分为雷尼替丁维持组和对照组（AR^ 、AR^－、BR^ 、BR^－组）,对溃疡已愈合但HP未能根除者加用2周四联疗法后再用上述方法处理,1年后复查胃镜记录其溃疡愈合情况。结果：A组与B组的HP根除率分别为92．60％和92％和92．16（P≥0．05）,12周溃疡愈合率分别为90．54％和92．68％（P≥0．05）;AR^ 组与AR^－组组1年后溃疡持久事率分别为91．67％和58．06％（P≤0．01）,BR^ 组和BR^－组的溃疡持久愈合率分别为90．91％和53．13％（P≤0．001）,结论：（1）以洛赛克为核心的两种四联疗法均具有极高的HP根除率和极好的治疗溃疡作用。（2）HP相关性溃疡在HP根除和溃疡短期治愈后仍需用抑酸剂维持治疗。     

中西医结合疗法治疗幽门螺杆菌阳性消化性溃疡的远期疗效观察

目的：探讨中药、中西医结合疗法治疗幽门螺杆菌（Hp）阳性消化性溃疡的远期疗效。方法：将Hp阳性消化性溃疡用中药方剂（益胃片）、西药三联（丽珠得乐加甲硝唑加羟氨苄青霉素）、中西医结合疗法（益胃片加西药组用药）治疗根除Hp后,分别随访3年,共94例,观察Hp和溃疡的复发率,并进行比较。结果：西药组Hp和溃疡复发率均为26．67％;中药组Hp复发率为9．38％,溃疡复发率为12．50％;中西医结合组Hp复发率和溃疡的复发率均为6．25％。中西医结合组与西药组比较,差异有显著性意义（P＜0．05）。结论：中药方剂益胃片和中西医结合疗法治疗Hp阳性消化性溃疡既有很好的Hp根除率,又有很好的溃疡愈合率,Hp和溃疡的复发率也很低,不失为一种较好的治疗Hp阳性消化性溃疡的有效方法。     

潘托拉唑三联疗法与奥美拉唑三联疗法治疗幽门螺杆菌相关性消化性溃疡

目的：研究潘托拉唑治疗消化性溃疡及根除幽门螺杆菌（HP）的疗效和安全性。方法：将经过胃镜和病理学检查证实了的消化性溃疡患者随机分成潘托拉唑组（治疗组）和奥美拉唑组（对照组）。其中治疗组60例,应用潘托拉唑、羟氨苄青霉素和甲硝唑治疗;对照组57例,应用奥美 拉唑、羟氨苄青霉素和甲硝唑治疗。停药后均复查胃镜观察溃疡愈合情况以及HP根除情况。结果：两组胃溃疡的愈合率分别为92．3％和95．4％,HP根除率分别为92．3％和90．9％;十二指肠溃疡的愈合率分别为97．1％和94．3％,HP根除率分别为91．2％和94．3％,两组比较差异无显著性（P＞0．01）,各项症状的改善情况两组相似（P＞0．1）。治疗期间两组均有良好的耐受性。结论：潘托拉唑对消化性溃疡有很高的治愈率,以它为主的三联疗法可达到很高的HP根除率,对消化性溃疡的疗效与奥美拉唑相当,不良反应极少,患者耐受性,依从性好,是一种有广泛应用前景的新型质子泵抑制剂。     

中西医结合疗法治疗幽门螺杆菌阳性

目的探讨中药、中西医结合疗法治疗幽门螺杆菌(Hp)阳性消化性溃疡的远期疗效。方法将Hp阳性消化性溃疡用中药方剂(益胃片)、西药三联(丽珠得乐加甲硝唑加羟氨苄青霉素)、中西医结合疗法(益胃片加西药组用药)治疗根除Hp后,分别随访3年,共94例,观察Hp和溃疡的复发率,并进行比较。结果西药组Hp和溃疡复发率均为26.67%;中药组Hp复发率为9.38%,溃疡复发率为12.50%;中西医结合组Hp复发率和溃疡的复发率均为6.25%。中西医结合组与西药组比较,差异有显著性意义(P＜0.05)。结论中药方剂益胃片和中西医结合疗法治疗Hp阳性消化性溃疡既有很好的Hp根除率,又有很好的溃疡愈合率,Hp和溃疡的复发率也很低,不失为一种较好的治疗Hp阳性消化性溃疡的有效方法。     

舒威、阿莫西林、痢特灵治疗幽门螺杆菌阳性消化性溃疡的疗效

目的 探索幽门螺杆菌（Hp）阳性感染的理想治疗方案。方法 随机将84例幽门螺杆菌阳性十二指肠溃疡病人分为治疗组和对照组，即舒威（枸橼酸铋雷尼替丁）、阿莫西林、痢特灵三联组（n=42），丽珠胃三联组（n=42），进行为期7d的临床治疗观察，疗程结束后1个月复查。结果 舒威三联组与丽珠胃三联组溃疡治愈率分别85．72％和88．1％，Hp根除率分别为90．4％和92.8％，统计学差异无显著性（P〉0．05）。结论 舒威三联组疗效好、费用低，是消化性溃疡最经济的治疗方案。     

四联疗法治疗小儿伴HP感染的消化性溃疡41例效果观察

目的观察四联疗法治疗小儿伴幽门螺杆菌（HP）感染的消化性溃疡的疗效及安全性。方法将同期收治的82 HP感染消化性溃疡患儿随机分为观察组和对照组各41例,前者采用洛赛克＋铋剂＋四环素＋替硝唑四联疗法,后者采用奥美拉唑＋阿莫西林＋克拉霉素三联疗法,观察两组溃疡灶愈合率、HP根除率及不良反应发生情况。结果观察组溃疡愈合率和HP根除率分别为98.7%、98.2%,对照组分别为79.7%、81.9%,组间比较P均〈0.05;观察组和对照组不良反应发生率分别为14.6%、41.5%（P〈0.05）。结论四联疗法治疗小儿伴HP感染的消化性溃疡效果确切、患者耐受性好。     

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.