国产西尼地平片治疗轻中度原发性高血压

目的观察国产西尼地平治疗轻中度原发性高血压的疗效与安全性。方法采用多中心、随机、双盲双模拟、平行对照的方法,选择门诊轻、中度原发性高血压患者234例,分别给予西尼地平片或氨氯地平片治疗8周,观察其对血压、心率、心电图及实验室检查的影响。结果两组治疗后血压明显下降,与治疗前比较有显著性差异(P<0.01)。西尼地平组平均坐位收缩压及舒张压分别下降(17.9±10.0)和(14.9±5.3)mmHg,氨氯地平组分别下降(19.6±9.6)和(14.9±6.3)mmHg。显效和总有效率试验组分别为85.1%和92.5%,对照组分别为78.0%和87.2%。两药对心率均无明显影响,试验组治疗前后心率分别为74.7和75.2次/min,对照组治疗前后心率分别为75.1和74.7次/min。试验组和对照组不良反应发生率分别为9.7%和8.6%,两组之间无统计学差异。较为常见的是头痛、头胀,面红、潮热和下肢水肿,均较轻微。动态血压监测显示西尼地平收缩压和舒张压的T/P比值分别为0.69和0.65。结论国产西尼地平片治疗轻、中度原发性高血压安全、有效,可作为长效制剂使用。     

氨氯地平与苯那普利对高血压病心、肾功能的影响

A组43例,口服氨氯地平5～10mg,每日1次。B组43例,口服苯那普利5～10mg,每日2次。治疗1年后,A组血压从(153.4±12.6)/(92.7±9.5)降至(135.7±11.8)/(78.8±10.6)mmHg,B组从(154.5±10.2)/(93.5±9.9)降至(132.6±12.2)/(80.2±8.9)mmHg,均P<0.01,且长期稳定在上     

苯磺酸左旋氨氯地平片治疗原发性高血压60例

目的 观察苯磺酸左旋氨氯地平片(施慧达)治疗高血压的降压作用.方法 选择原发性高血压病人60例,予以口服施慧达(2.5～5.0)mg/d,疗程4周,其中26例病人运用24 h动态血压监测.结果 60例病人经治疗4周后,24 h收缩压为(121±11)mmHg,舒张压为(78±6)mmHg,白昼及夜间血压均控制在130/90 mmHg以下.心率无明显变化.无明显毒副反应.结论 施慧达是一种安全有效且服用方便的药物,每日服药一次能有效控制24 h血压及清晨高峰期血压.     

氨氯地平和依那普利对老年纯收缩期高血压患者动态血压的影响

目的　比较氨氯地平和依那普利对老年纯收缩期高血压患者的 2 4h动态血压的影响。方法　将 6 0例轻中度纯收缩期高血压老年患者随机分为两组 ,每组 30例。分别选用氨氯地平片 5mg和依那普利片 10mg ,每日一次 ,共 4周。用药前后进行 2 4h动态血压监测。结果　两组药物治疗第 4周末 2 4h动态血压发现 ,2 4h平均收缩压、脉压、舒张压、平均动脉压均较服药前明显降低 ,统计学上有显著性差异。氨氯地平组治疗后总体收缩压和舒张压分别下降 17.0 3± 8.5 5mmHg和 4 .83± 4 .82mmHg ;平均动脉压下降了 8.86± 4 .76mmHg ,依那普利组治疗后总体收缩压和舒张压分别下降 14 .30± 7.2 6mmHg和 5 .97± 2 .87mmHg ,平均动脉压下降了 8.74± 3.0 7mmHg ,组间比较收缩压下降幅度无差异 (P =0 .187) ,脉压下降幅度有统计学意义 (P =0 .0 0 5 )。氨氯地平组脉压差下降幅度大于依那普利组 (16 .97± 14 .0 6mmHg比 8.33± 7.84mmHg ,P =0 .0 0 5 ) ,两药对舒张压的影响组间比较无统计学差异。两组有效率相似 (76 .7%比 73.3% ,P =0 .76 6 ) ,达标率的差异无统计学意义 (6 6 .7%比 5 6 .7% ,P =0 .4 2 6 )。氨氯地平组发生胫前水肿 2例 ,依那普利组咳嗽 5例。结论　氨氯地平与依那普利对老年纯收缩期高血压均有效 ,尤其     

左氨氯地平与依那普利联合治疗糖尿病合并高血压的疗效观察

目的 观察左氨氯地平与依那普利联合治疗糖尿病合并高血压的疗效.方法 选择糖尿病合并高血压病人60例,随机分为左氨氯地平组、依那普利组、联合治疗组,每组20例,均治疗4周,治疗前后监测收缩压、舒张压、空腹血糖,对比分析治疗前后上述指标差异.结果 治疗4周后3组血压均下降,左氨氯地平组与依那普利组治疗效果接近,左氨氯地平组收缩压为(145±12)mmHg,舒张压为(90±7)mmHg;依那普利组为(142±11)mmHg、(89±6)mmHg,组内自身治疗前后比较均有统计学意义(P＜0.01).联合治疗组降压幅度低于以上两组,分别为(131±10)mmHg、(85±7)mmHg,与治疗前比较有统计学意义(P＜0.01),与左氨氯地平组、依那普利组比较有统计学意义.结论 左氨氯地平与依那普利联合应用降压幅度较大.     

国产西尼地平片治疗轻中度原发性高血压

目的 观察国产西尼地平治疗轻中度原发性高血压的疗效与安全性.方法 采用多中心、随机、双盲双模拟、平行对照的方法,选择门诊轻、中度原发性高血压患者234例,分别给予西尼地平片或氨氯地平片治疗8周,观察其对血压、心率、心电图及实验室检查的影响.结果 两组治疗后血压明显下降,与治疗前比较有显著性差异(P＜0.01).西尼地平组平均坐位收缩压及舒张压分别下降(17.9±10.0)和(14.9±5.3)mm Hg,氨氯地平组分别下降(19.6±9.6)和(14.9±6.3)mm Hg.显效和总有效率试验组分别为85.1%和92.5%,对照组分别为78.0%和87.2%.两药对心率均无明显影响,试验组治疗前后心率分别为74.7和75.2次/min,对照组治疗前后心率分别为75.1和74.7次/min.试验组和对照组不良反应发生率分别为9.7%和8.6%,两组之间无统计学差异.较为常见的是头痛、头胀,面红、潮热和下肢水肿,均较轻微.动态血压监测显示西尼地平收缩压和舒张压的T/P比值分别为0.69和0.65.结论 国产西尼地平片治疗轻、中度原发性高血压安全、有效,可作为长效制剂使用.     

替米沙坦治疗超重/肥胖高血压患者的效果

目的探讨替米沙坦对超重/肥胖高血压患者血压的影响。方法原发性高血压1~2级伴有超重/肥胖患者75例,治疗组(n=45)口服替米沙坦,对照组(n=30)服用缬沙坦或厄贝沙坦或贝那普利,高血压1级者单药治疗,高血压2级者联合用药于前述药物基础上加氨氯地平。观察降压疗效6周。结果替米沙坦组舒张压下降幅度(9.96±2.13)mmHg明显优于对照组(8.13±2.42)mmHg(P<0.05)。两组收缩压下降明显,但两组间无明显差异。结论替米沙坦能更有效控制超重/肥胖高血压患者的血压,可能通过激活过氧化物酶体增殖物激活受体-γ(PPAR-γ)等多途径实现了降压效果。     

贝凡洛尔治疗原发性高血压的疗效和安全性评价

目的随机、开放、平行对照的比较评价两种选择性β1受体阻断剂(贝凡洛尔/美托洛尔)治疗原发性高血压的疗效和安全性.方法选择原发性高血压患者136例,随机分为两组服用贝凡洛尔100 mg～200 mg/d或美托洛尔100 mg～150 mg/d,每日分二次治疗共8周,根据需要4周末调整剂量.分别比较两组药前、后第2、4、6、8周末坐位血压和心率的变化.结果口服盐酸贝凡洛尔(100～200 mg/d,分两次)治疗原发性高血压,药后2、4、6、8周平均SeDBP降低值分别为8.9±6.4 mmHg、7.9±7.1 mmHg、10.0±8.2 mmHg、11.00±8.2 mmHg;平均SeSBP降低值分别为8.8±11.4 mmHg、10.6±12.0 mmHg、8.6±14.2 mmHg、10.3±14.8 mmHg.美托洛尔组(100～150 mg/d,分两次).药后2、4、6、8周平均SeDBP降低值分别为8.1±9.2 mmHg、7.7±8.6 mmHg、10.4±7.9 mmHg、10.7±8.4 mmHg;平均SeSBP降低值分别为7.1±13.9 mmHg、7.5±13.3 mmHg、10.9±13.2 mmHg、11.3±13.9 mmHg.服药前后降压值两组内比较均P=0.00,组间比较无统计学差异.贝凡洛尔单药治疗原发性高血压病患者70.97%需要服用200 mg/d.两组治疗后心率均较基线下降,贝凡洛尔组于治疗4周后心率下降幅度有统计学差异,美托洛尔组于治疗2周后心率下降幅度有统计学差异 .两组药后24小时内平均心率变化趋向降低.两药治疗4、8周后心电图窦性心率与QT、RR和PP等相关的指标在临床允许范围有变化.对血脂、血糖的代谢影响与其它β受体阻滞剂相似.贝凡洛尔组不良反应发生率10.29% (7/68例),美托洛尔组不良反应发生率23.53% (16/68例),两组不良反应发生率有显著性差异(P=0.04).美托洛尔组出现窦性心动过缓5例,窦性停搏1例,2例因窦性心动过缓退出研究.贝凡洛尔组无心律失常的发生.两药均未发现对房室传导的影响.结论贝凡洛尔治疗原发性高血压的疗效肯定,耐受性较好.     

国产坎地沙坦酯片治疗轻中度原发性高血压的疗效和安全性

目的评价坎地沙坦酯片治疗轻中度原发性高血压的疗效和安全性.方法随机、双盲、双模拟、阳性药物(氯沙坦)平行对照.61例轻、中度原发性高血压服用坎地沙坦酯片或氯沙坦片各1片,1次/d,必要时增加剂量1次.总疗程8周.结果氯沙坦组治疗前的血压为(146.2±11.6)/(100.3±3.3)mm Hg,治疗后的血压为(130.3±9.8)/(85.7±8.0)mm Hg,血压下降幅度为(16.0±11.8)/(14.6±6.8)mm Hg;坎地沙坦酯组治疗前的血压为(143.4±11.2)/(100.6±4.1)mm Hg,治疗后的血压为(130.4±11.2)/(86.3±8.0)mm Hg,血压下降幅度为(13.0±8.7)/(14.3±6.5) mm Hg.两组治疗后血压降低幅度均有统计学意义,主要降幅均在前2周.组间无差异.治疗前后心率无明显变化.坎地沙坦酯和氯沙坦降压显效率分别为60.7%和60.0%,总有效率分别为82.1%和76.7%,组间无差别.不良事件坎地沙坦酯和氯沙坦组为头晕各2例和1例,血生化等实验室指标无异常改变.结论国产坎地沙坦酯片治疗轻中度原发性高血压不良反应发生率很低,本文无1例出现咳嗽,耐受性良好,适用于长期治疗.     

左旋氨氯地平联合缬沙坦治疗高血压患者血压晨峰的临床观察

目的观察左旋氨氯地平联合缬沙坦治疗高血压患者血压晨峰的疗效。方法采用动态血压监测技术筛选出有血压晨峰的高血压患者80例,给予左旋氨氯地平2.5 mg~5 mg,晨服,每日1次,缬沙坦40 mg~80 mg,每日晚上服用1次,观察2个月。结果治疗8周末,24 h、白天、夜间平均收缩压/舒张压与治疗前相比分别降低(10.4±2.5)/(7.8±2.6)mmHg(、11.2±1.8)/(7.5±2.8)mmHg(、9.6±1.5)/(7.5±2.0)mmHg,治疗前后相比,差异有统计学意义(P<0.01)。晨峰程度降低(14±2)/(11±3)mmHg,血压峰值异常控制率84.4%,24 h动态血压达标率86.5%。结论左旋氨氯地平联合缬沙坦治疗不仅有效降低24 h血压,而且能降低晨峰程度,有效控制血压晨峰的发生。     

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.