生长抑素治疗急性非静脉曲张性上消化道出血疗效观察

目的观察生长抑素治疗非静脉曲张性上消化道出血的疗效。方法将105例非静脉曲张性上消化道出血患者随机分为A组（53例）和B组（52例）,A组为生长抑素联合奥美拉唑组,B组为单用奥美拉唑组,观察两组的止血效果。结果A组止血显效率和总有效率均高于B组,差异有统计学意义（P〈0．05）。结论生长抑素治疗非静脉曲张性上消化道出血有显著疗效,值得推广应用。     

生长抑素联合奥美拉唑对重症胰腺炎患者腹内高压及肠道黏膜屏障功能的影响

目的探讨生长抑素联合奥美拉唑对高龄重症胰腺炎患者腹内高压及肠道黏膜屏障功能的影响。方法 72例高龄重症胰腺炎患者随机分为对照组与观察组各36例。对照组给予常规治疗,观察组在常规治疗基础上加用生长抑素联合奥美拉唑治疗。结果观察组患者总有效率高于对照组(P0.05)。治疗后,观察组腹内高压低于对照组(P0.05)。治疗后,观察组患者D-乳糖及二胺氧化酶水平低于对照组(P0.05)。观察组住院时间、腹痛腹胀缓解时间、肠道恢复时间、尿淀粉酶指数及血淀粉酶指数各项指标均优于对照组(P0.05)。结论采用生长抑素联合奥美拉唑治疗高龄重症胰腺炎患者不仅临床疗效显著,而且能够改善患者腹内高压和肠道黏膜屏障功能。     

生长抑素联合奥美拉唑治疗急性脑卒中应激性溃疡出血的疗效观察

目的观察生长抑素联合奥美拉唑治疗急性脑卒中应激性溃疡出血的疗效。方法选择我院进行急诊的急性脑卒中应激性溃疡出血患者84例,随机分为治疗组与对照组各42例,对照组给予奥美拉唑治疗,治疗组给予生长抑素联合奥美拉唑治疗,两组治疗观察时间为7 d。结果对照组的治疗总有效率为81.0%,明显低于治疗组为95.2%(P0.05)。治疗后治疗组与对照组的血清内源性生长抑素含量为(26.44±4.33)pg/m L和(34.25±3.78)pg/m L,都明显低于治疗前的(68.22±3.13)pg/m L和(68.14±4.09)pg/m L(P0.05),同时治疗后的组间对比差异也有统计学意义(P0.05)。治疗组的止血时间与住院时间分别为(2.56±1.56)h和(6.44±1.34)d,都明显少于对照组的(3.15±1.44)h和(9.24±1.22)d(P0.05)。治疗期间治疗组的恶心、腹胀、头痛、胸闷等不良反应发生率(4.76%)明显少于对照组(35.71%)。结论生长抑素联合奥美拉唑治疗急性脑卒中应激性溃疡出血能抑制内源性生长抑素的表达,安全性佳,从而加快止血速度,提高治疗效果,促进患者康复,值得推广应用。     

大剂量洛赛克联合生长抑素治疗消化性溃疡出血的临床研究

目的研究大剂量洛赛克(注射用奥美拉唑钠)联合生长抑素治疗消化性溃疡出血的临床效果。方法纳入我院收治的消化性溃疡出血患者86例,随机分为两组,各43例。其中43例患者采用生长抑素进行治疗作为对照组,另43例患者在上述基础上联合大剂量注射用奥美拉唑钠治疗作为观察组。观察两组治疗效果、临床症状以及不良反应情况。结果对照组、观察组总有效率分别为86.05%、97.67%,观察组明显较高(P0.05)。观察组止血时间、住院时间以及VAS评分均明显优于对照组(P0.05)。对照组、观察组不良反应发生率分别为13.95%、11.63%,两组对比无明显差异(P0.05)。结论生长抑素联合大剂量注射用奥美拉唑钠治疗消化性溃疡出血患者具有止血快、疗效好、不良反应低等优势,值得临床应用及推广。     

血凝酶及生长抑素联合奥美拉唑治疗急性上消化道出血的临床疗效及安全性

[目的]探究与分析血凝酶及生长抑素联合奥美拉唑治疗急性上消化道出血的临床疗效及安全性。[方法]选取我院2013年4月~2015年4月收治的60例急性上消化道出血患者,采取随机数字表法分为对照组与试验组,每组各30例,对照组仅给予奥美拉唑治疗,试验组在其基础上加用血凝酶及生长抑素治疗,对比2组患者的临床疗效、平均止血时间、再出血率及不良反应。[结果]对照组总有效率为70.00%,试验组总有效率为93.33%,组间比较差异有统计学意义(P0.05)。对照组平均止血时间为(31.5±7.6)h、试验组平均止血时间为(18.4±4.7)h,组间比较差异有统计学意义(P0.05)。对照组再出血率为20.00%,并发症发生率为33.33%,试验组再出血率为6.67%,并发症发生率为10.00%,组间比较差异有统计学意义(P0.05)。[结论]在奥美拉唑常规治疗急性上消化道出血基础上加用血凝酶联合生长抑素可显著提高临床疗效,缩短止血时间,降低再出血率,不良反应发生率较低,安全性较高,可有效改善患者生活质量,值得推广。     

国产生长抑素治疗肝硬化食管胃底静脉曲张急性出血56例疗效观察

目的:观察国产生长抑素注射液治疗肝硬化门静脉高压食管胃底静脉曲张急性出血的疗效.方法:选择104例肝硬化食管胃底静脉曲张急性出血患者,随机分成2组,治疗组56例,给予生长抑素(双鹭药业)治疗,对照组48例,给予善宁治疗,2组均配合给予奥美拉唑静脉滴注辅助治疗.结果:2组治疗后生命体征如心率、收缩压、舒张压、尿量以及患者...     

两种联合药物方案治疗急性上消化道曲张静脉破裂出血临床对比研究

[目的]研究奥曲肽与生长抑素联合奥美拉唑2种不同的联合药物方案对急性上消化道曲张静脉破裂出血患者的临床疗效的影响。[方法]选取2013年1月~2016年12月我院收治的急性上消化道曲张静脉破裂出血患者130例为研究对象,用随机数表法分为对照组和试验组,每组各65例。对照组患者采用生长抑素联合奥美拉唑,试验组患者应用奥曲肽联合奥美拉唑,2组患者均治疗7d。观察比较2组患者治疗效果、输血量、止血时间、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、1周内再出血率及不良反应发生率。[结果]2组患者在年龄、性别、pH值等方面差异无统计学意义。2组患者临床疗效有效率分别为76.92%及92.31%,差异有统计学意义(P0.05)。观察组患者在输血量、止血时间、PT、APTT均低于对照组,且观察组1周内再出血率为4.62%,明显低于对照组的再出血率的15.38%,2组患者在输血量、止血时间、PT、APTT、1周内再出血率差异均有统计学意义(P0.05)。观察组出现3例头痛,6例恶心呕吐,2例腹痛,4例腹泻,不良反应发生率为23.08%,对照组出现2例头痛,8例恶心呕吐,3例腹痛,3例腹泻,不良反应发生率为24.62%,2组差异无统计学意义。[结论]奥曲肽联合奥美拉唑相较于生长抑素联合奥美拉唑,在治疗上消化道曲张静脉破裂出血具有较好的临床效果,能减少输血量、止血时间,降低再出血率、凝血酶原时间、活化部分凝血活酶时间,但两者不良反应发生率并无明显差异。     

生长抑素（14肽）治疗食管胃底静脉曲张破裂出血的疗效观察

目的观察生长抑素（14肽）治疗食管胃底静脉曲张破裂出血的疗效及其不良反应。方法选择2006年2月-2008年10月我院住院患者111例,随机分为两组,对照组63例,常规给予奥美拉唑、止血药,垂体后叶素等治疗。治疗组48例,在对照组基础上首先缓慢静脉推注0．25mg生长抑素（14肽）作为负荷剂量,而后立即以0．25mg／h持续静脉滴注。出血停止后,继续用药48—72h。结果治疗组止血率明显优于对照组,差异有显著性（P〈0．01）,治疗组死亡率明显低于对照组（P〈0．05）,治疗组有4例出现恶心、呕吐、腹胀,停药后缓解。结论生长抑素（14肽）对食管胃底静脉曲张破裂出血有较好的疗效,止血率高,减少了输血量,降低了死亡率。且由于生长抑素（14肽）较奥曲肽（8肽）与生长抑素受体（SSIR1—5）亲和力强,故止血效果优于常规剂量的奥曲肽。     

消化性溃疡并因生长抑素治疗研究

目的 观察生长抑素（ＳＳ）对出血性十二指肠溃疡２４ｈ胃内ｐＨ的影响及其对消化性溃疡出血的治疗效果。方法 （１）十二指肠溃疡出血１６例随机分ＳＳ组（２５０μｇ．ｉ．ｖ，后２５０μｇ／ｈ静滴）和奥美拉唑组（４０ｍｇ．ｉ．ｖ，后８ｍｇ／ｈ静滴）行２４ｈ胃内ｐＨ监测；（２）消化性溃疡活动性出血（渗血或并血管显露）随机分为治疗组３７例（ＳＳ同上，用药到出血停止后４８ｈ）和对照组４６例（奥美拉唑４０ｍｇ．ｉ．     

生长抑素及质子泵抑制剂对大鼠胰腺腺泡细胞慢活化电压依赖性钾离子通道的影响

目的 通过检测慢活化电压依赖性外向钾离子通道电流(Iks)的变化,探讨生长抑素及质子泵抑制剂(PPI)对胰腺腺泡细胞慢活化电压依赖性钾离子通道及胰腺外分泌的影响.方法 分离SD大鼠胰腺组织,取得胰腺腺泡细胞悬液,用EPC10膜片钳放大器记录电压钳制下的不同组别胰腺腺泡细胞Iks的电流值并比较其间差异.分组如下:冲洗液处理为对照组,5μmol/L和20μmol/L 293B组,5 nmol/L促胰液素组,5 nmol/L促胰液素+100 nmol/L或10 nmol/L或1 nmol/L生长抑素组,0.3 mmol/L 8溴—环单磷酸腺苷(8Br-cAMP)组,0.3 mmol/L 8Br-cAMP+100 nmol/L生长抑素组,1 μmol/L乙酰胆碱(Ach)组,1μmol/L Ach+100 nmol/L生长抑素组,5 nmol/L促胰液素+10-5mol/L或10-6mol/L或10-7mol/L奥美拉唑组,1μmol/L Ach+10-5 mol/L或10-6 mol/L或10-7 mol/L奥美拉唑组.组间比较采用单因素方差分析,P＜0.05为差异有统计学意义.结果 大鼠胰腺腺泡细胞静息膜电位为(-40±0.8)mV,当去极化至+10 mV时,对照组的Iks为(420.0±3.2) pA.经5 μmol/L和20 μmol/L 293B作用后,大鼠胰腺腺泡细胞Iks减少为对照组的(60.4±4.2)％和(30.2±3.1)％(F=6.87,P＜0.05).5 nmol/L促胰液素刺激后,Iks增加为(823.0±2.2)pA,分别加入100 nmol/L、10 nmol/L和1 nmol/L生长抑素,Iks降低至(510.0±3.2)pA,(584.0±2.8)pA和(789.0±6.9)pA(F=5.67,P＜0.05);分别加入10-5 mol/L、10-6 mol/L和10-7mol/L奥美拉唑后,Iks峰值未见明显变化,分别为(806.5±3.6)pA,(814.8±3.2) pA和(816.3±2.9) pA (P＞0.05).1 μmol/L Ach刺激后,Iks的峰值为(966.0±3.2) pA;加入100 nmol/L生长抑素后,Iks峰值为(942.0±6.3)pA;分别加入10-5 mol/L,10-6 mol/L和10-7 mol/L奥美拉唑后,其Iks峰值未见明显变化,分别为(956.3±10.3) pA,(957.5±8.6)pA和(960.0±8.4)pA (P＞0.05).结论 生长抑素能抑制胰腺腺泡细胞慢活化电压依赖性钾离子通道的开放,PPI对该通道没有明显抑制作用.     

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.     

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.