普罗布考联合阿托伐他汀对脑梗死颈动脉粥样硬化斑块稳定性的影响

目的探讨普罗布考联合阿托伐他汀治疗对脑梗死颈动脉粥样硬化的干预作用。方法急性脑梗死患者120例,入院查颈动脉彩超提示存在动脉粥样硬化斑块,其中男68例,女52例,年龄74±15岁,随机分为两组:阿托伐他汀组男35例,女25例,年龄73±16岁,予阿托伐他汀(20 mg/d)治疗;联合治疗组男33例,女27例,年龄76±18岁,予阿托伐他汀(20 mg/d)和普罗布考(500 mg/d)联合治疗。两组患者分别于治疗前、治疗后6个月、12个月及24个月检测血清脂蛋白相关性磷脂酶A2活性、颈动脉粥样硬化斑块情况,并进行分组分析。结果阿托伐他汀组和联合治疗组治疗前脂蛋白相关性磷脂酶A2活性分别为18.43±8.01 mmol/(min.L)和18.65±8.12 mmol/(min.L),无显著性差异;治疗6个月脂蛋白相关性磷脂酶A2活性分别为14.98±4.21 mmol/(min.L)和12.68±2.04 mmol/(min.L),明显下降,联合治疗组下降更显著;治疗12个月两组脂蛋白相关性磷脂酶A2活性分别为11.57±1.62 mmol/(min.L)和11.98±1.43 mmol/(min.L),进一步明显下降;治疗24个月脂蛋白相关性磷脂酶A2活性分别为12.06±1.68 mmol/(min.L)和11.34±1.61 mmol/(min.L),继续保持12个月时水平,但联合治疗组较阿托伐他汀组下降更明显(P0.05)。阿托伐他汀组治疗前、治疗后6个月、12个月及24个月稳定性斑块积分分别为2.73±0.31、2.68±0.46、3.92±0.28及3.84±0.35,6个月时积分有所减少,但无统计学意义,12个月、24个月时积分较前两时间点明显增高(P0.05);不稳定性斑块积分分别为6.82±0.37、4.38±0.42、3.02±0.43、3.28±0.29,6个月时积分较治疗前明显减少(P0.05),且12个月、24个月时积分进一步较少(P0.01)。联合治疗组治疗前、治疗后6个月、12个月及24个月稳定性斑块积分分别为2.68±0.34、2.73±0.50、3.01±0.44及2.89±0.42,各时间点间无显著性差异;不稳定性斑块积分分别为7.08±0.39、4.92±0.33、3.11±0.46及2.28±0.41,各时间点间均有显著性差异。两组治疗前积分无显著性差异;对于稳定性斑块,阿托伐他汀组在治疗后12个月、24个月较联合治疗组斑块积分有所提高(P0.05);对于不稳定性斑块,两组治疗后斑块积分均明显降低,但联合治疗组于12个月、24个月时较阿托伐他汀组降低更明显(P0.01)。结论稳定斑块是治疗脑梗死动脉粥样硬化的重要策略,普罗布考联合阿托伐他汀可分别从降低低密度脂蛋白、抑制氧化型低密度脂蛋白的形成,降低血液循环中脂蛋白相关性磷脂酶A2活性,尤其是抑制巨噬细胞分泌脂蛋白相关性磷脂酶A2等途径多方位、多靶点地起到抗动脉粥样硬化作用。     

阿托伐他汀治疗非酒精性脂肪性肝病的疗效观察

目的 观察阿托伐他汀治疗非酒精性脂肪性肝病(NAFLD)的疗效及安全性.方法 选择72例非酒精性脂肪性肝病患者,共68例患者按规定要求完成试验.所有患者基线丙氨酸转氨酶(ALT)及总胆固醇(TC)水平均高于正常值.随机分为治疗组38例、对照组30例.予治疗组患者阿托伐他汀10 mg/d(TC≤6.5 mmol/L)或20 mg/d(TC＞6.5 mmol/L)口服.对照组患者则不予给药.记录两组患者基线水平及治疗6个月时的症状积分、体重指数(BMI)、血TC水平、ALT水平及B超测量肝密度.结果 治疗组基线期和6个月时的症状积分分别为11.05±1.29和6.08±0.87,差异有统计学意义(t=1.96,P＜0.05).经6个月治疗.治疗组中11例患者ALT水平恢复正常,对照组中仅2例患者ALT水平恢复正常,差异有统计学意义(P＜0.05).治疗组基线及6个月时的TC水平分别为(6.65±0.5)和(5.4±0.5)mmol/L,两者间差异有统计学意义(t=1.72,P＜0.05).治疗组基线及6个月时的BMl分别为(26.8±2.9)和(26.4±2.8)kg/m~2,对照组则分别为(26.5±2.3)和(26.4±2.2)kg/m~2,两者间差异均无统计学意义(P值均＞0.05).治疗组及对照组基线及6个月时的B超肝密度分级差异亦无统计学意义(P值均＞0.05).试验中未观察到明显不良反应.结论 NAFLD患者经阿托伐他汀治疗后,血清ALT水平及TC水平均显著下降.合并高胆固醇血症的NAFLD患者选用阿托伐他汀治疗安全有效.     

多重危险因素干预与老年颈动脉粥样硬化斑块关系的研究

目的 探讨多重危险因素干预与老年人颈动脉粥样硬化和斑块的关系,评估强化他汀降脂治疗重要性、安全性、有效性及达标剂量. 方法 入组181例经彩色颈动脉超声检查确诊为颈总动脉内中膜(IMT)增厚和颈动脉粥样硬化斑块伴有多重危险因素患者.数字抽签随机分为2组给予综合控制血脂、血压、血糖等,常规治疗组阿托伐他汀10 mg,强化治疗组阿托伐他汀20 mg,治疗24个月. 结果 两组患者干预后的血压、血脂、血糖、微量白蛋白尿(MAU)及超高敏C反应蛋白(hs-CRP)较治疗前均有改善(P％0.05或P＜0.01);强化治疗组总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)及hs-CRP差值分别为(0.9±0.6) mmol/L,(1.3±0.7)mmol/L、(3.9±3.0) mg/L,常规治疗组分别为(0.3±0.3) mmol/L、(1.0±0.6) mmol/L、(2.9±1.9) mg/L,差异有统计学意义(均P＜0.01).强化治疗组颈动脉IMT、颈动脉斑块的性质改善(P＜0.01);斑块个数两组均减少,强化治疗组的变化趋势更显著(P＜0.01);强化治疗组颈动脉双侧斑块面积均改善(P＜0.05). 结论 多重危险因素综合干预治疗,可稳定、延缓颈动脉粥样硬化及斑块,老年人常规剂量他汀治疗可使LDLC达到目标值.     

阿托伐他汀联合依折麦布治疗急性冠状动脉综合征临床观察

目的观察联合应用阿托伐他汀和依折麦布治疗急性冠状动脉综合征的疗效。方法 306例急性冠状动脉综合征患者随机分为他汀常规剂量组(n=98,阿托伐他汀20 mg/d),他汀加倍剂量组(n=103,阿托伐他汀40 mg/d),联合治疗组(n=105,阿托伐他汀20 mg/d+依折麦布组10 mg/d)。治疗前和治疗24周后检测患者血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDLC)、甘油三酯(TG)水平,并观察各治疗组不良反应和心血管事件的发生情况。结果经24周治疗后,各组TC、TG、LDLC低于治疗前,联合治疗组治疗后TC(2.51±0.51 mmol/L比3.22±0.53 mmol/L和3.10±0.63 mmol/L,P0.05)、LDLC(1.58±0.27 mmol/L比2.11±0.33 mmol/L和2.01±0.31mmol/L,P0.05)、TG(1.12±0.30 mmol/L比1.67±0.39 mmol/L和1.53±0.27 mmol/L,P0.05)下降较他汀常规剂量组、他汀加倍剂量组更明显。联合治疗组LDLC降低达标率(69.5%)明显优于他汀常规剂量组(43.9%)和他汀加倍剂量组(48.5%,P0.05)。联合治疗组不良反应发生率较他汀加倍剂量组低(P0.05),心血管事件(再发心绞痛、急性心肌梗死)发生率也低于其他两组(P0.05)。结论应用阿托伐他汀联合依折麦布治疗急性冠状动脉综合征较单用阿托伐他汀能更显著改善血脂水平,减少心血管事件,并具有良好的安全性。     

阿托伐他汀对维持性血液透析患者心血管的保护作用

目的 观察阿托伐他汀对维持性血液透析患者心血管的保护作用.方法 新导入维持性血液透析患者100例,随机分成阿托伐他组50例和对照组50例.常规方法检测两组患者研究前后血色素、血脂、肝肾功能、心肌损伤标志物和动态血压的变化,64排螺旋CT冠状血管成像分析两组患者研究前后冠状动脉血管狭窄程度和钙化的变化,同时比较分析两组患者心血管事件的发生率.结果 阿托伐他汀组在研究后冠状动脉小血管狭窄≥50％的血管数、狭窄＜50％的血管数和未见狭窄的血管数与研究前比较差异均无统计学意义(P＞0.05);对照组在研究后冠状动脉小血管狭窄＞50％的血管数和狭窄＜50％的血管数均显著多于研究前(P＜0.05),未见狭窄的血管教则显著少于研究前(P＜0.05).两组患者冠状动脉钙化积分在研究前差异无统计学意义(P＞0.05),阿托伐他汀组研究后冠状动脉钙化积分与研究前比较无显著性增加(P＞0.05),但对照组研究后冠状动脉钙化积分与研究前比较显著增加,与阿托伐他汀组研究前、研究后比较差异有统计学意义(P＜0.05).心肌损伤标志物在阿托伐他汀组研究后水平也显著低于研究前、且显著低于对照组研究后水平(P＜0.05),同时,对照组患者心血管事件的发生率显著高于阿托伐他汀组患者(P＜0.05).结论 阿托伐他汀可能通过抑制冠状动脉血管钙化和/或降低血脂对新导入维持性血液透析患者的心血管产生保护作用.     

阿托伐他汀联合肠溶阿司匹林对颈动脉粥样硬化患者斑块稳定性及脑血管事件的影响

目的 观察标准剂量阿托伐他汀联合肠溶阿司匹林对颈动脉粥样硬化患者斑块稳定性及脑血管事件的影响. 方法 将67例颈动脉粥样硬化患者随机分成2组,治疗组34例,对照组33例,治疗组口服阿托伐他汀(10 mg/d)和肠溶阿司匹林(100 mg/d),对照组仅口服肠溶阿司匹林(100 mg/d).观察2组患者在治疗6月、12月后颈动脉粥样硬化斑块缩小程度及脑血管事件的发生率.结果 治疗6月后2组颈动脉斑块大小及脑血管事件的发生率变化无统计学差异(P＞0.05),但治疗组稳定性斑块数目增加,与治疗前比较差异有统计学意义(P＜0.01).治疗12月后2组斑块大小、稳定性斑块数目及脑血管事件的发生率与治疗前比较均有统计学差异(P＜0.01),2组间也存在显著性差异(P＜0.05).结论 阿托伐他汀联合阿司匹林治疗可通过调节颈动脉粥样硬化患者炎性细胞因子,抑制血小板活化,缩小或稳定颈动脉粥样硬化斑块,长时间服用可降低脑血管事件的发生率.     

冠心病与颈动脉粥样硬化的相关性及应用阿托伐他汀干预的疗效

目的探讨颈动脉粥样硬化与冠心病的相关性及应用阿托伐他汀治疗颈动脉斑块的疗效。方法选取冠心病患者80例,根据患者是否使用阿托伐他汀治疗分为他汀组及非他汀组,各40例,选取非冠心病者30例作为对照组。应用超声测量患者颈动脉内中层厚度(CIMT)并计算斑块积分,比较三组患者治疗3、6个月后CIMT及斑块积分变化情况以及斑块检出率。结果冠心病患者CIMT及斑块积分[(1.16±0.15)mm,8.12±5.18]明显高于对照组[(0.85±0.20)mm,2.65±1.68,P<0.05],冠状动脉重度狭窄者[(1.18±0.13)mm,9.27±3.26]与中度狭窄者[(1.12±0.15)mm,7.69±4.52],中度狭窄者与轻度狭窄者[(1.01±0.13)mm,5.28±4.39]差异均有统计学意义(均P<0.05)。他汀组及非他汀组CIMT[(1.16±0.14),(1.15±0.16)mm]及斑块积分(8.45±4.35,7.85±5.26)明显高于对照组(P<0.05)。他汀组在应用阿托伐他汀治疗3个月后,CIMT及斑块积分[(1.13±0.16)mm,6.88±3.58]虽低于治疗前及同期非他汀组[(1.14±0.15)mm,7.18±4.59],但差异均无统计学差异(均P>0.05);在应用阿托伐他汀治疗6个月后,CIMT[(1.06±0.16)mm]及斑块积分(4.39±4.12)明显低于治疗3个月及治疗前(P<0.05),也明显低于同期非他汀组[(1.14±0.13)mm,6.89±4.73,P<0.05]。非他汀组及对照组在相关治疗3、6个月后CIMT及斑块积分差异无统计学意义(P>0.05)。结论颈动脉粥样硬化程度与冠状动脉粥样硬化程度息息相关,是冠心病高危预测因素之一。长期应用阿托伐他汀可以有效逆转血管狭窄,减少心血管事件发生。     

阿托伐他汀联合非诺贝特对冠心病并糖尿病患者的疗效与安全性

目的：探讨阿托伐他汀联合非诺贝特治疗冠心病合并糖尿病患者的调脂疗效与安全性。方法：选择100例确诊冠心病合并糖尿病的患者为研究对象,在常规治疗基础上按1∶1随机分为两组：（1）他汀组（50例,给予阿托伐他汀20mg,每晚1次）;（2）联合治疗组（50例,给予阿托伐他汀20mg 每晚1次,非诺贝特200mg 每日1次治疗）。分别于治疗前、治疗6周和12周后检测血清总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）和高密度脂蛋白胆固醇（HDL-C）水平,观察治疗前后上述血脂水平的变化、达标率,并记录不良反应及临床事件。结果：治疗6周后,两组血清 TC、TG、LDL-C 水平均明显低于用药前,治疗12周后降低更为明显（P ＜0.05～＜0.01）,且12周后与他汀组比较,联合治疗组 TC [（4.35±0.71）mmol/L 比（4.09±0.56）mmol/L],TG [（2.35±0.62）mmol/L 比（1.65±0.49）mmol/L]和 LDL-C 水平[（2.01±0.39）mmol/L 比（1.85±0.22）mmol/L]降低更显著（P＜0.05或＜0.01）;两组治疗后 HDL-C 水平均升高,12周后升高更明显但两组比较无统计学差异（P ＞0.05）。治疗12周后,联合治疗组 LDL-C、TG、HDL-C 各项指标达标率、3项血脂指标均达标和非 HDL-C 的达标率（分别为70％、68％、80％、58％、70％）均明显高于他汀组（分别为50％、46％、48％、10％、48％）（P ＜0.05或＜0.01）。治疗期间两组均未观察到严重不良反应。结论：阿托伐他汀联合非诺贝特治疗冠心病合并糖尿病患者较单用阿托伐他汀更有效,能更全面地改善各项血脂水平,有助于血脂的全面达标,且具有更良好的安全性和耐受性。     

阿托伐他汀钙与瑞舒伐他汀钙治疗颈动脉粥样硬化斑块的疗效及降脂作用观察

目的探讨阿托伐他汀钙及瑞舒伐他汀钙对颈动脉粥样硬化患者降血脂效果及抗动脉粥样硬化的疗效。方法 110例颈动脉粥样硬化斑块患者随机分为阿托伐他汀组、瑞舒伐他汀组及对照组,比较每组治疗前后(3和6个月)的血清脂质指标变化、颈动脉粥样硬化斑块的稳定数量变化、治疗有效率及不良反应。结果和对照组相比,瑞舒伐他汀组治疗3、6个月甘油三酯(TG)水平明显降低(P0.05),治疗3个月低密度脂蛋白胆固醇(LDL-C)水平明显降低(P0.05)。和对照组相比,阿托伐他汀组治疗3、6个月TG水平明显降低(P0.05),治疗6个月总胆固醇(TC)、LDL-C水平明显降低(P0.05)。和瑞舒伐他汀组相比,阿托伐他汀组治疗6个月TC、TG、LDL-C明显降低(P0.05)。和瑞舒伐他汀组相比,阿托伐他汀组治疗3个月LDL-C明显升高(P0.05)。各组高密度脂蛋白胆固醇(HDL-C)各时间点无明显差异(P0.05)。与对照组相比,阿托伐他汀组、瑞舒伐他汀组治疗6个月斑块治疗有效率有统计学差异(P0.05),但阿托伐他汀组和瑞舒伐他汀组无统计学差异(P0.05)。结论瑞舒伐他汀钙在短期内降血脂效果明显,阿托伐他汀钙在长期内降血脂效果明显,在抗动脉硬化稳定斑块方面,均有良好治疗效果。     

阿托伐他汀联合非诺贝特治疗老年混合型高脂血症临床疗效观察

目的 探讨中等剂量阿托伐他汀片剂和非诺贝特胶囊联合应用治疗混合性高脂血症的临床疗效及安全性.方法 混合性高脂血症患者226例,随机分为：阿托伐他汀组112例,阿托伐他汀（20 mg/d）治疗;联合治疗组114例,阿托伐他汀（20 mg/d）和非诺贝特胶囊（200 mg/d）共治疗3个月.观察治疗前、后各项血脂参数的变化、达标率及不良反应.结果 除阿托伐他汀组高密度脂蛋白胆固醇（HDL-C）水平与治疗前相比无明显改善[（0.99±0.27）mmol/L比（0.95±0.24）mmol/L,P＞0.05]外,两组患者各项血脂参数如血清总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）和甘油三酯（TG）水平与治疗前相比均有不同程度的改善[阿托伐他汀组：（4.22±0.46）mmol/L比（7.18±0.52）mmol/L,（2.76±0.34）mmol/L比（4.46±0.43）mmol/L,（3.05±0.44）mmol/L比（3.81±0.48）mmol/L;联合治疗组：（3.43±0.42）mmol/L比（7.15±0.50）mmol/L,（2.18±0.31）mmol/L比（4.44±0.42）mmol/L,（1.62±0.31）mmol/L比（3.85±0.51）mmol/L;P均＜0.05],但联合治疗组TG、TC、LDL-C降低的幅度和HDL-C升高幅度较大[（3.05±0.44）mmol/L比（1.62±0.31）mmol/L,（4.22±0.46）mmol/L比（3.43±0.42）mmol/L,（2.76±0.34）mmol/L比（2.18±0.31）mmol/L,（1.23±0.30）mmol/L比（0.99±0.27）mmol/L,P均＜0.05],达标率更高（69.6%比13.4%,83.3%比71.4%,80.7%比67.9%,49.1%比9.8%,P均＜0.05）,明显优于阿托伐他汀组,两组患者不良反应的发生率相比差异无统计学意义（P＞0.05）.结论 中等剂量阿托伐他汀（20 mg/d）和非诺贝特胶囊（200 mg/d）联合应用对混合性高脂血症患者具有良好的安全性和有效性,值得临床推广应用.     

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.