链激酶溶栓治疗急性心肌梗死对左心室功能的改善作用

为评价链激酶溶栓治疗急性心肌梗死（ＡＭＩ）对左心室功能的影响，应用二维超声心动图对２６例接受链激酶溶栓治疗的ＡＭＩ患者和２７例未溶栓的ＡＭＩ患者，分别在急性期及６个月后随访时测量并计算左心室容积（ＥＤＶ和ＥＳＶ），射血分数（ＥＦ）以及室壁运动指数（ＧＷＭＩ和ＲＷＭＩ）。以上各项指标在急性期时比较各组无显著性差异；在随访期再通组ＥＦ值明显高于未通组和未溶栓组，再通组左室容量减小。急性期各组心功能无差     

急性心肌梗塞静脉溶栓治疗改善左心室功能的作用

为评价急性心肌梗塞（ＡＭＩ）静脉溶栓再灌注对左心室功能及重塑的影响，应用二维超声心动图（２ＤＥ）对６１例ＡＭＩ接受静脉溶栓治疗的患者，分别在急性期及６个月后随访时测量并计算左心室容积（ＥＳＶ和ＥＤＶ），射血分数（ＥＦ），左心室内膜弧长（ＡＳＬ和ＰＳＬ）以及室壁运动指数（ＧＷ－ＭＩ和ＲＷＭＩ）。结果显示，以上各项指标急性期时两组比较差异均无显著性，在６个月后的随访中，再通组ＥＦ值明显高于未通组，再通组左室容量减小、变形减轻。急性期两组的心功能无差异，随访时再通组心功能较未通组显著改善。提示溶栓再灌注能明显减轻左心室的扩张及抑制左心室重塑，改善患者的心功能和预后。     

老年急性心肌梗塞溶栓治疗对左心室功能的改善作用

目的 :评价链激酶溶栓治疗老年急性心肌梗塞 (AMI)对左心室功能的影响。方法 :应用二维超声心动图对 2 9例 AMI接受链激酶溶栓治疗和 2 1例未溶栓的 AMI患者 ,分别在急性期及 6个月后随访时测量并计算左心室容积 (EDV和 ESV) ,射血分数 (EF)等参数。结果 :急性各组心功能无差异。随访期再通组 EF值明显增加 ,且明显高于未通组和未溶栓组。结论 :链激酶溶栓能明显减轻老 AMI患者的左心室扩张 ,改善左心室功能和长期预后     

应用心电图记分法评价静脉溶栓对急性心肌梗塞患者梗塞面积的影响

用心电图记分法，分三组对１５５例应用静脉溶栓治疗或常规治疗的急性心肌梗塞（ＡＭＩ）患者的最初和最后梗塞面积、最初和最后左心室射血分数（ＥＦ）进行了统计分析。结果显示：溶栓治疗再通组的最后梗塞面积与对照组相比明显缩小（Ｐ＜０．０５），与溶栓未通组相比亦缩小显著（Ｐ＜０．００１）．溶栓再通组的梗塞心肌存活率明显高于对照组（Ｐ＜０．００１）及溶栓未通用（Ｐ＜０．０５）其心肌挽救达５５％。溶栓再通组最后ＥＦ较未通组及对照组提高明显，其ＥＦ提高的百分比明显高于溶栓未通组及时间组，并具有统计学意义（Ｐ＜０．０５）。而溶栓未通组及对照组最后便塞面积略有缩小、ＥＦ稍有提高，但均无统计学意义（Ｐ＞０．０５）。     

急性心肌梗塞早期冠状动脉再通过左室重塑和收缩功能的影响

目的 评价急性心肌梗塞（ＡＭＩ）早期冠状动脉（冠脉）再通过左室重塑和收缩功能的影响。方法 ８１例首次ＡＭＩ恢复期患者分成前、侧壁和下、后壁心肌梗塞（ＭＩ）的未通和再通各两组，与正常组（２５名）对比分析左室重塑和心功能变化，并对比再通和未通组的结果。结果 （１）前、侧壁和下、后壁ＭＩ未通组左室舒张末容积（ＥＤＶ）、孤长（ＥＤＣ）、短轴（ＥＤＤ）、短／长轴比、圆球容积指数和收缩末容积（ＥＳＶ）均比正常     

急性心肌梗死溶栓治疗后心脏收缩功能的改善

为观察急性心肌梗死（ＡＭＩ）患者，静脉溶栓疗效与心脏收缩功能之关系。选８８例接受静脉溶栓治疗的ＡＭＩ患者，分为两组:溶栓再通组６６例及未溶通组２２例。以Ｋｉｌｉｐ分级判定临床心功能，超声心动图测定左室射血分数（ＬＶＥＦ）。结果显示:①重度左心功能不全（即ＫｉｌｉｐⅢ级）患者，溶通组明显少于未溶通组（１０．６％比３１．８％）；②室壁瘤出现率，溶通组明显少于未溶通组（９．１％比３６．４％）；③ＬＶＥＦ值，溶通组明显高于未溶通组（５８．３±１０．５比５０．９±１１．９）。以上比较的Ｐ值均＜０．０１。可认为经静脉溶栓使梗死相关血管再灌注后的ＡＭＩ患者，左心室收缩功能一定程度上得以保护。     

急性心肌梗塞溶栓再灌注的临床评价

为评价急性心肌梗塞（ＡＭＩ）溶栓再灌注的临床价值，对７６例ＡＭＩ病人进行尿激酶静脉溶栓治疗。溶栓后有再灌注的４７例病人作为再通组，无再灌注的２９例为未通组。结果显示，在梗塞的急性期，再通组的严重心脏事件的发生率明显低于未通组，而且无一例死亡，未通组死亡２例。再通组的外周血白细胞计数、心电图的ＱＲＳ记分和ＮＹＨＡ心功能分级均明显低于未通组。溶栓后４周及６个月再通组的左室射血分数均显著高于未通组，室壁瘤的发生率显著低于未通组。提示ＡＭＩ早期成功溶栓可显著改善临床预后及左心功能。     

急性心肌梗死溶栓治疗后心脏收缩功能的改善

为观察急性心肌梗死（ＡＭＩ）患者，静脉溶栓疗效与心脏收缩功能之关系。选８８例接受静脉溶栓治疗的ＡＭＩ患者，分为两组：溶栓再通组６６例及未溶通组２２例。以Ｋｉｌｉｐ分级判定临床心功能，超声心动衅测定左室射血分数（ＬＶＥＦ）。结果显示：①重度左心功能不全（即ＫｉｌｌｉｐⅢ级）患者，溶通组明显少于未溶通组（１０．６％比３１．８％）；②室壁瘤出现率，溶通组明显少于未溶通组（９．１％比３６．４％）；③ＬＶＥ     

急性心肌梗死早期溶栓治疗对QT离散度及恶性室性心律失常的影响

研究急性心肌梗死（ＡＭＩ）后溶栓治疗对ＱＴ离散度（ＱＴｄ）及恶性室性心律失常（ＭＶＡ）事件的影响。回顾性选择分析ＡＭＩ患者７５例（溶栓治疗组４３例、未溶栓组３２例）,通过测量入院时及入院后２４ｈ常规心电图计算ＱＴｄ、校正ＱＴｃ（ＱＴｃｄ）,并在入院后一周内心电监护观察ＭＶＡ事件发生情况。溶栓再通组ＱＴｄ、ＱＴｃｄ较溶栓前显著缩短（４２．６±１４．３ｍｓｖｓ７１．７±１６．９ｍｓ,４５．９±１７．４ｍｓｖｓ７４．８±１８．５ｍｓ,Ｐ均＜０．０１）;溶栓未通组、未溶栓组入院２４ｈ期间ＱＴｄ、ＱＴｃｄ无明显变化（Ｐ＞０．０５）。ＱＴｄ、ＱＴｃｄ≥９０ｍｓ者ＭＶＡ事件明显高于＜９０ｍｓ者（７０．６％ｖｓ１０．２％,Ｐ＜０．０１）,溶栓再通组ＭＶＡ事件与溶栓未通组比较趋于减少（１１％ｖｓ２８％）。结论：ＡＭＩ后成功的溶栓治疗可以缩短心室复极的ＱＴｄ,从而可能减少ＡＭＩ后早期ＭＶＡ的发生;无效的溶栓治疗对ＡＭＩ近期预后无任何影响。     

急性心肌梗塞患者静脉溶栓治疗前后QT离散度变化分析

目的探讨急性心肌梗塞（ＡＭＩ）患者静脉溶栓治疗前后ＱＴ间期离散度（ＱＴｄ）变化及对预后的影响。方法１５３例ＡＭＩ患者分为溶栓再通组,未通组及非溶栓组,测定其溶栓前后的ＱＴｄ,并与非溶栓组ＱＴｄ比较。结果溶栓治疗再通后ＱＴｄ明显减小,而未通组及非溶栓组ＱＴｄ增大,且后两组间ＱＴｄ比较差异无显著性（Ｐ＞０．０５）。ＱＴｄ增大者发生室性快速心律失常比率增大。结论ＡＭＩ患者ＱＴｄ明显增大,但静脉溶栓再通后,随心肌缺血改善,ＱＴｄ明显减小,同时室性快速心律失常发生率降低。     

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.     

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.     

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.