血管紧张素Ⅱ及其受体在大鼠糖尿病性心肌病发生中的作用

目的 观察心肌局部血管紧张素Ⅱ（ATⅡ）的活性及其受体（ATR）的变化，探讨其在糖尿病性心肌病发生中的作用。方法 实验动物Wistar大鼠被分为3个月对照组（8只）和糖尿病组（8只）6个月对照组（10只）、糖尿病组（10只）和Losartan治疗组（10只），分别于造模后3个月、6个月检测心功能，ATⅡ及其受体的相关参数。结果 糖尿病组动物3个月时首先出现－dp/dtmax减低，血浆ATⅡ增高，6个月时＋dp/dtmax,-dp/dtmax均减低，心脏重量指数持续增加，心肌和血浆ATⅡ明显增高；心肌细胞膜ATⅡ受体亲和力明显增高；治疗组dp/dtmax,-dp/dtmax及心脏重量指数较糖尿病组均有所改善，心肌和血浆ATⅡ变化不明显。结论 ATⅡ及ATR的变化在糖尿病性心肌病发生中起重要作用。     

心功能障碍患者心肌组织及血浆肾素－血管紧张素系统、心钠素改变的临床意义

１９例心功能障碍患者的血浆、心肌血管紧张素Ⅱ（ＡｎｇⅡ）、心钠素（ＡＮＦ）含量高于正常对照组；血浆ＡｎｇⅡ和ＡＮＦ含量增高与心脏指数（ＣＩ）呈显著负相关（ｒ＝－０．５９６８，Ｐ＜０．０５；ｒ＝－０．８９９６，Ｐ＜０．０１），心肌ＡｎｇⅡ含量变化与左室心肌重量（ＬＶＭ）呈显著正相关（ｒ＝０．５７２３，Ｐ＜０．０５）；提示心脏局部肾素－血管紧张素系统（ＲＡＳ）活性增高和ＡＮＦ变化参与心肌细胞增殖及心室重塑的意义较为突出。     

心功能障碍患者心肌组织及血浆肾素—血管紧张素系统,心钠素…

１９例心功能障碍患者的血浆，心肌血管紧张素Ⅱ，心钠素含量高于正常对照组；血浆ＡｎｇⅡ和ＡＮＦ含量增高与心脏指数呈显著负相关，心肌ＡｎｇⅡ含量变化与左室心肌重量呈显著正相关；提示心脏局部肾素－血管紧张素系统活性增高的ＡＮＦ变化参与心肌细胞增殖及心室重塑的意义较为突出。     

糖尿病心肌病早期心肌局部血管紧张素Ⅱ和一氧化氮的变化

目的 :观察糖尿病大鼠心功能改变早期心肌局部血管紧张素Ⅱ (AⅡ )和一氧化氮 (NO)的变化。方法 :实验动物分为 2组 ,对照组 8只 ,链脲左菌素 (STZ)诱导糖尿病大鼠 8只 ,正常饲养 3个月后杀检 ,测心功能、血压、心脏重量指数及AⅡ、血管紧张素转换酶 (ACE)、NO和一氧化氮合酶 (iNOS)表达。结果 :糖尿病 3个月时首先出现心脏舒张功能异常 ,-dp dtmax减低 ,血压无显著改变 ,心脏重量指数增加 ,血浆AⅡ、ACE明显增高 ,心肌局部AⅡ、ACE增高不明显 ,心肌局部NO明显减低 ,iNOS表达增强 ,血浆NO明显减低。结论 :糖尿病心功能改变早期AⅡ、ACE增高和NO的减低可能共同参与了糖尿病心肌病的发生。     

氯沙坦对糖尿病心肌微血管的保护作用

目的：观察糖尿病大鼠血肌血管活性物质的动态变化及应用氯沙坦（Losartan)对心肌微血管的保护作用。方法：建立3,6个月糖尿病大鼠模型,测定血浆及心肌血管紧张素Ⅱ（AⅡ）,血管紧张素转换酶（ACE）及一氧化氮（NO）含量,心肌微血管形态学观察,并与正常组,Losartan干预组相比较,结果：糖尿病组心肌AⅡ,ACE6个明显增高,血浆AⅡ,ACE3,6个月持续增高;血浆及心肌NO含量3,6个月时明显减低,并呈进行性下降;6个月时糖尿病组心肌微血管基膜明显增厚,干预组心肌和血浆AⅡ糖尿病组变化不明显,ACE明显减低,NO含量较糖尿病组增高,微血管基膜增厚减轻。结论：Losartan可以通过阻断AII的缩血管作用,增加NO的扩血管作用,部分改善心肌微血管的功能。     

培哚普利对糖尿病大鼠心肌保护作用的研究

糖尿病性心肌病是糖尿病的慢性并发症之一 ,其病因复杂 ,机制未明。近来研究发现 ,心脏局部组织肾素血管紧张素系统 (ＲＡＳ)与糖尿病心肌损害有关[1] 。本研究通过观察不同病程链脲菌素 (ＳＴＺ)糖尿病大鼠局部心肌血管紧张素Ⅱ(ＡｎｇⅡ )、左室重量指数 (ＬＶＭＩ)心肌超微结构改变及培哚普利治疗后的变化 ,探讨培哚普利对糖尿病大鼠心脏的作用。一、材料和方法1 模型的建立与分组 :雄性ＳＤ大鼠 4 8只 (购自ＢＫ公司 )体重 180～ 2 0 0ｇ ,随机分为 ( 1)正常对照组 (ＮＣ) 18例 ,( 2 )糖尿病组 3 0例。糖尿病模型以一次性腹腔注射ＳＴＺ…     

氯沙坦对SHR血浆及心血管组织中血管紧张素Ⅱ水平的影响

目的：观察氯沙坦对自发性高血压大鼠（ＳＨＲ）血浆、左室及主动脉组织中血管紧张素Ⅱ（ＡｎｇⅡ）水平的影响，并探讨其降压和逆转心血管肥厚的作用与心血管局部组织中ＡｎｇⅡ的关系。方法：将１６ 周龄的ＳＨＲ随机分成ＳＨＲ－Ｌ（氯沙坦治疗）组与ＳＨＲ－Ｃ（非治疗对照）组，另设同源正常血压大鼠ＷＫＹ组。饲养时间共六周。大鼠的收缩压和心率用尾套法测量，实验前及实验开始后每两周测一次。左室重量指数（ＬＶⅠ）及主动脉中膜与内径比率在第六周实验结束前测量。血浆、心肌和主动脉ＡｎｇⅡ含量用放免法测量。以ＳＨＲ－Ｃ组做直线相关分析。结果：氯沙坦能显著降低ＳＨＲ的收缩压，在４ 周后降至最低水平，对心率无影响。ＳＨＲ－Ｌ与ＳＨＲ－Ｃ组比较ＬＶⅠ及主动脉中膜与内径比值下降，但未降至ＷＫＹ水平。左室及主动脉ＡｎｇⅡＳＨＲ－Ｃ组高于ＷＫＹ组，且分别与ＬＶⅠ及主动脉中膜与内径比值呈正相关。ＳＨＬ－Ｌ组ＡｎｇⅡ水平均高于ＳＨＲ－Ｃ组，且以血浆升高最明显。结论：ＳＨＲ左室及主动脉组织中ＡｎｇⅡ升高是造成左室及主动脉肥厚的重要因素。氯沙坦通过阻断ＡＴ１受体产生降压及逆转心血管肥厚的作用     

氯沙坦与苯那普利单独和联合治疗高血压对血管紧张素Ⅱ的影响

目的：评价氯沙坦治疗高血压病的有效性和安全性及其对ＡｎｇⅡ的影响。方法：９０ 例高血压病患者, ３０ 例接受氯沙坦（ＬＯＳ）治疗, ３０例接受苯那普利（Ｂｅｎ）治疗,３０ 例接受氯沙坦与苯那普利联合（Ｃｏｍ ）治疗,均为口服片剂,对照观察６ 周。结果：Ｌｏｓ与Ｂｅｎ 组总有效率分别为９０％ 、８６．６％ ,Ｃｏｍ 组总有效率为９６．６％ , 优于Ｌｏｓ组和Ｂｅｎ 组, 但差异无显著性（Ｐ＞ ０．０５）。氯沙坦使ＡｎｇⅡ增高, 苯那普利使ＡｎｇⅡ下降, 分别与治疗前对照均有显著差异（Ｐ＜ ０．０１）。不良反应发生率Ｌｏｓ组为１２．５％ , Ｂｅｎ 组为２３．３％ ,Ｃｏｍ 组为１３．３％ 。Ｂｅｎ 组与Ｌｏｓ组和Ｃｏｍ 组分别对照均有显著差异（Ｐ＜ ０．０１）。结论： 氯沙坦治疗高血压病安全有效,耐受性良好,与苯那普利有协同作用     

卡托普利与贝那普利对糖尿病大鼠心肌间质重构的影响

目的通过观察卡托普利与贝那普利对糖尿病大鼠心脏指数、心肌局部血管紧张素Ⅱ（AngⅡ）、Caspase-3蛋白阳性染色指数、心肌细胞凋亡指数（AI）的影响，探讨二者对糖尿病大鼠心肌病的可能保护机制。方法将60只大鼠随机分成正常对照组和糖尿病组，采用链脲佐菌素（STZ）腹腔注射制作糖尿病模型，然后将糖尿病组随机分成糖尿病对照组、卡托普利治疗组（A组）和贝那普利治疗组（B组）。9周后处死大鼠，测定心肌AngⅡ含量、Caspase-3蛋白阳性染色指数及I、Ⅲ型胶原含量。结果与正常对照组比较，糖尿病组心脏指数均显著增大，AngⅡ含量、AI、Caspase-3蛋白阳性染色指数均明显增高（P均〈0.05）；A、B组治疗后上述指标均显著改善，A组较B组心脏指数、I、Ⅲ型胶原含量改善更为明显（P均〈0.05）。结论糖尿病心肌病中心肌间质有重构现象发生，卡托普利与贝那普利均可以通过降低AngⅡ、Caspase-3阳性蛋白指数来改善心脏的功能，而且两组相比稍有差别。     

高血压大鼠心脏肥厚过程中心肌细胞凋亡心肌纤维化动态观察

目的 探讨SHR心脏肥厚进展阶段心肌细胞凋亡、心肌纤维化及左室重构特点及其相互关系。方法 分别采用末端脱氧核糖核苷酸转移酶介导dUTP缺口末端标记（TUNEL）、放射免疫测定及病理检查方法对16周、24周龄、32周龄SHR心肌细胞凋亡指数（APOI）、心肌胶原容积分数（VF）和心肌血管周围胶原面积（PVCA）、血浆和组织血管紧张素Ⅱ检测,并以同龄Wister大鼠作对照。结果 与同龄正常血压Wistar大鼠比较,SHR各周龄组收缩压明显增高、心脏肥厚指标心脏重量（HW）、左室重量（LVW）、左室重量指数（LVW/BW) 显著增加;各周龄组SHR心肌细胞APOI显著增加,各周龄组间无显著性差异;各周龄组SHR大鼠血浆、心肌组织Ang Ⅱ明显增高;24、32周龄SHR的CVF和PVCA显著增加;SHR心肌组织Ang Ⅱ分别与APOI、CVF呈显著正相关,APOI与CVF呈显著正相关。结论 心肌细胞凋亡与心肌纤维化参与SHR代偿性心脏肥厚阶段心脏重构病理过程,组织Ang Ⅱ是导致SHR代偿性心脏肥厚阶段心肌细胞凋亡与心肌纤维化的重要机制之一。     

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.