无水乙醇在大咯血患者支气管动脉栓塞治疗中的应用

目的 评价无水乙醇在支气管动脉栓塞（BAE）治疗大咯血中的栓塞效果.方法 选择31例大咯血患者,随机分为无水乙醇组及对照组,行BAE治疗中分别应用明胶海绵颗粒＋无水乙醇栓塞剂及明胶海绵颗粒栓塞.术后随访6～12个月,对比两组近期、远期栓塞效果及并发症发生情况.结果 两组支气管动脉均得到成功栓塞,无水乙醇组术后近期、远期止血有效率分别为100％、100％,对照组分别为86.7％、73.3％.无水乙醇组复发0例,对照组复发4例,无水乙醇组止血有效率为复发率低于对照组（P均＜0.05）.结论 BAE术中联合应用无水乙醇和明胶海绵颗粒治疗大咯血安全有效,复发率低.     

选择性支气管动脉双重栓塞治疗咯血的远期疗效分析

目的评价不同的材料和操作程序，对支气管动脉栓塞治疗咯血的远期疗效的影响。方法７２例咯血患者，分组接受选择性支气管动脉双重栓塞和单纯明胶海绵栓塞治疗。２９例患者选择支气管动脉双重栓塞时，首程采用明胶微粒（０．５ｍｍ×０．５ｍｍ）、高渗氯化钠和红霉素的混合物栓塞末梢血管，次程以明胶颗粒（１ｍｍ×１ｍｍ）栓塞主干及１～２级分支血管，４３例患者选择单程明胶海绵栓塞治疗。结果两组患者经过治疗后及随访２～４．８年，止血治愈率和总有效率分别为：双重栓塞组８３％、１００％，单纯明胶海绵栓塞组６１％、９５％。两组病例止血治愈率相比较，差异有显著性（Ｐ＜０．０５）。结论选择性支气管动脉双重栓塞能明显提高治疗咯血的远期疗效     

超选择性支气管动脉栓塞术治疗大咯血的临床效果分析

目的探讨超选择性支气管动脉栓塞术治疗大咯血的临床价值。方法 52例大咯血患者经支气管动脉造影明确岀血动脉后行支气管动脉栓塞术,采用明胶海绵颗粒、明胶海绵条或联合弹簧钢圈进行栓塞。所有患者随访3～12月,观察栓塞术后有无再次岀血及并发症的发生。结果 52例患者均顺利完成支气管动脉栓塞术,于一周内咯血症状逐渐消失,其中6例患者分别于术后6月～10月后咯血复发,再次行性支气管动脉栓塞术咯血消失。无严重栓塞术后并发症发生。结论超选择性支气管动脉栓塞术是治疗大咯血安全、有效的治疗方法。     

选择性支气管动脉栓塞治疗大咯血的临床应用

目的研究选择性支气管动脉栓塞治疗大咯血的临床应用。方法对15例大咯血病人行支气管动脉造影后，对异常支气管动脉用明胶海绵进行栓塞。结果10例咯血停止，4例咯血渐止，1例术后复发。结论选择性支气管动脉栓塞对大咯血患者是一种有效、安全、简便的治疗方法。     

急性大咯血责任血管来源的DSA分析及临床栓塞治疗

目的回顾性分析急性大咯血责任血管的来源以及血管内栓塞治疗的有效性及安令性。方法对46例急性大咯血患者进行选择性支气管动脉及相关动脉造影,寻找到咯血的责任血管,对其用明胶海绵（GS）、海藻酸钠微球（KMG）、聚乙烯醇（PVA）、弹簧圈等材料进行栓塞。结果所有患者经动脉栓塞后全部即时止血,术后24h内无活动性出血41例,1例再次明显咯血经手术切除右上肺陈旧性病灶止血,4例少量咯血经内科保守治疗而止血。结论急性大咯血的责任血管来源较为复杂,除主要来源于支气管动脉外,还有相当的病例来源于其他动脉血管,如肋间动脉、隔下动脉、内乳动脉、腋动脉、甲颈干动脉等。急性大咯血血管内栓塞治疗是快速有效的、安全的。对急性大咯血内科治疗效果不佳而又无法耐受外科手术者,应及时行咯血责任血管造影和血管内栓塞治疗。     

应用丝裂霉素—葡聚糖微球栓塞支气管动脉治疗老年人肺癌

对２１例老年人肺癌进行了选择性支气管动脉灌注（ＢＡＩ）化疗＋ＭＭＣ－葡聚糖微球栓塞支气管动脉治疗，其中ＣＲ７例，ＰＲ１０例，总有效率为８０．９０％（１７／２１）；本组总体中数生存期为１６．２９个月，１年生存率为７６．２％（１６／２１）。对照分析表明，这种介入性治疗肺癌的方法明显优于ＢＡＩ化疗＋明胶海绵栓塞，是一种很有前途的治癌方法。     

双重栓塞支气管动脉治疗大咯血的远期疗效分析

目的评价不同操作程序和材料对栓塞支气管动脉治疗大咯血远期疗效的影响。方法157例大咯血患者,分组采用三步双重栓塞支气管动脉和单纯明胶海绵颗粒栓塞治疗。121例选择经高温处理的明胶海绵微粒、真丝线段、明胶海绵条分三步双重逐级栓塞支气管动脉远端细小分支、小分支及大分子血管,36例患者选择明胶海绵颗粒栓塞治疗。结果两组患者经治疗后随访1~8年,远期止血率为:三步双重栓塞组89.3%,单纯明胶海绵栓塞组72.2%,两组比较有显著性差异(χ2=6.439,P<0.02)。结论采用支气管动脉三步双重栓塞法能明显提高治疗大咯血的远期疗效。     

聚乙烯醇和明胶海绵联合栓塞治疗急性大咯血

目的 探讨聚乙烯醇(PVA)和明胶海绵(GS)联合栓塞支气管动脉治疗急性大咯血临床疗效。方法 采用Seldinger法，对内科治疗无效的47例患者，在电镜引导下经支气管动脉进行栓塞，GS组21例，PVA GS组26例，并随访2年。结果 随访1个月GS组有效率(19／21)90．5％，PVA GS组有效率(23／26)88．5％；随访6个月GS组有效率(12／21)57．1％，PVA GS组有效率(20／26)76．9％；随访2年GS组有效率(5／21)23．8％，PVA GS组有效率(17／26)65．4％。结论：PVA GS联合栓塞支气管动脉治疗急性大咯血疗效好，复发率低。     

同轴微导管栓塞支气管动脉治疗大咯血的临床应用

近年来 ,我们采用同轴微导管系统超选择性进入支气管动脉远段 ,并改进栓塞制剂和栓塞程序 ,达到避免并发症和迅速止血的目的 ,明显提高了长期反复咯血的止血成功率。临床资料　 48例大咯血患者 ,男 31例 ,女 1 7例 ,年龄2 3～ 68岁。基础病为支气管扩张 30例 ,Ⅲ型肺结核 7例 ,Ⅳ型肺结核 5例 ,毁损肺 2例 ,肺癌 2例 ,不明原因咯血 (隐原性咯血 ) 2例 ,病程 0 .8～ 2 5年 ,平均 5 .7年。治疗方法 :(1 ) 2 6例单纯明胶海绵栓塞 (单纯栓塞组 ) :将 1ｍｍ× 1ｍｍ大小明胶海绵颗粒注入支气管动脉内 ,直至重复造影显示支气管动脉主干仅残存 2～ …     

支气管动脉栓塞治疗支气管扩张大咯血28例

目的回顾性分析支气管动脉栓塞治疗支气管扩张大咯血。方法对28例支气管扩张大咯血患者进行选择性支气管动脉造影，用明胶海绵颗粒等材料进行栓塞。结果左支气管动脉栓塞10例，右支气管动脉栓塞12例，左右支气管动脉共干6例。确定出血血管栓塞后，28例患者咯血停止，27例3日内未再咯血，有1例仍有咯血，1周后再行栓塞术后，咯血停止。结论支气管扩张大咯血进行内科保守治疗效果不佳而又无法耐受外科手术者，应及时行支气管动脉造影并栓塞治疗。     

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.