依那普利加强异舒吉抗心绞痛作用的研究

目的：观察异舒吉(isoket)与依那普利联合治疗不稳定型心绞痛(UAP)的临床疗效。方法：将60例不稳定型心绞痛病人随机分为两组，治疗组30例给异舒吉，每天30mg，依那普利每次5mg--10mg口服，每日2次；对照组30例单用异舒吉。两组基础治疗相同，14d为一疗程。观察治疗后心绞痛的发作频率、程度、维持时间、心率、血压和心电图变化。结果：异舒吉联合依那普利治疗UAP临床总有效率为93．3％，心电图改善总有效率为76．6％，与对照组比较有统计学意义(P＜0．05)。结论：依那普利能加强异舒吉的抗心绞痛及抗心肌缺血作用，延缓或防止耐药性产生，降低UAP的病死率及AMI发生率。     

综合用药治疗冠心病疗效观察

应用硝酸甘油、极化液、能量合剂、精制蝮蛇抗栓酶（ｓｖａｔｅ）静滴交替用药治疗冠心病心绞痛、心肌梗塞。并与单纯应用ｓｖａｔｅ静滴治疗患者作对比观察，结果显示：综合用药组心绞痛减少总有效率为９７．５％，心电图恢复正常或改善总有效率为９０％，心功能提高Ⅰ至Ⅱ级的总有效率为９７．５％。对照组心绞痛减少总有效率为６５％，心电图改善总有效率为４５％，心功能改善总有效率为６０％。两组疗效对比有显著差异（Ｐ＜０．０５）。     

参麦注射液治疗心绞痛的临床研究及其对一氧化氮的影响

４０例正常对照组及５８例ＣＨＤ心绞痛组均测血清ＮＯ，心绞痛组患者给予参麦注射液４０ｍｌ＋５％葡萄糖５００ｍｌ静点，每日１次，共２ｗ，于第２周重复做心电图及血清ＮＯ测定，同组治疗前后配对资料用ｔ检验。心绞痛组在治疗后症状改善的总有效率为９６．５％；心电图改善的总有效率为７７．４％；与对照组比较，心绞痛组治疗前血清ＮＯ水平显著减低（Ｐ＜０．０１）；与治疗前比较，心绞痛组治疗后血清ＮＯ水平显著升高（Ｐ＜０．０１）。结果提示参麦注射液能明显缓解心绞痛，改善缺血心电图，同时能提高冠心病患者血清ＮＯ水平。     

比索洛尔和依那普利对高血压病治疗的比较观察

对１４５例原发性高血压患者分组应用比索洛尔（Ｂｉｓｏｐｒｏｌｏｌ）与依那普利（Ｅｎａｌａｐｒｉｌ）治疗，以观察各自疗效。结果显示：①比素洛尔总有效率８７．５％，依那普利总有效率７８．７％，两者疗效有明显差异。②对心率、血脂、血糖、血清电解质、血像和肝肾功能观察期间均无不良影响。③比索洛尔每晨只服１次即可维持疗效，使用方便，副作用小，耐受性好。     

非洛地平治疗冠心病心绞痛的临床疗效

本总结了非洛地平治疗冠心病心绞痛的临床疗效。方法：冠心病心绞痛病人４８例，男性２９例，女性１９年龄（５８±７）岁。应用非洛地平５ｍｇ，口服，每天一次，连续４周。结果：治疗心绞痛的临床总有效率为８５．４％，心电图改善总有效率为７１．９％；治疗后每搏时，每分输出量及射血分数值均增加；同时有明显的降压作用，副作用小。     

肝素治疗不稳定心绞痛临床观察

对１８０例不稳定心绞痛随机单盲分为常规治疗（对照组）及常规＋肝素治疗（肝素组）。结果显示，肝素组１周显效率４４．８％，总有效率６７．８％；２周总有效率９３．２％，高于对照组（Ｐ＜０．０５）。２周显效率８７．３％，明显高于对照组（Ｐ＜０，０１）。住院期间心肌梗塞发生率：肝素组３．５％，对照组７．５％（Ｐ＞０．０５）。在院期间病死率：肝素组２．３％，对照组３．２％（Ｐ＞０．０５）。肝素治疗未见明显不良反应。认为肝素与常规药物并用治疗不稳定心绞痛，能迅速控制心绞痛，对降低心肌梗塞发生可能有益。     

鹿红方治疗充血性心力衰竭合并心绞痛的临床研究

目的观察鹿红方（复方鹿红强心扩脉颗粒）治疗充血性心力衰竭合并心绞痛的临床疗效。方法将50例充血性心力衰竭合并心绞痛的病人随机分为两组，其中鹿红方治疗组（治疗组）27例和培哚普利（雅施达）对照组（对照组）23例。结果治疗组心功能疗效总有效率为33．33％。心绞痛症状疗效总有效率为62．96％，中医心绞痛证候疗效总有效率为44．44％，中医心力衰竭证候疗效总有效率为48．15％，与对照组比较均有统计学意义（19〈0．05）。治疗组心电图疗效总有效率33．33％，心绞痛疾病疗效总有效率25．93％。与对照组比较无统计学意义（P〉0．05）。两组病人治疗前后心肌耗氧量及体重改变无明显差异（P〉0．05）。结论鹿红方治疗充血性心力衰竭合并心绞痛。可以缓解心力衰竭、心绞痛中西医各项症状，在一定程度上可以改善病人的生活质量。     

益气化痰通瘀法治疗冠心病心绞痛44例疗效观察

对４４例冠心病心绞痛患者，采用益气化痰通瘀法作前瞻性临床观察。结果：心绞痛缓解总有效率为８４．０９％，心电图改善总有效率为５２．３８％。表明本法是治疗冠心病心绞痛的有效途径之一。     

心通胶囊治疗不稳定型心绞痛的临床观察

目的观察心通胶囊治疗冠心病不稳定型心绞痛的临床疗效。方法将确诊为冠心病不稳定型心绞痛的患者60例随机分为治疗组和对照组各30例。治疗组口服心通胶囊治疗。对照组口服复方丹参片治疗。结果治疗组心绞痛疗效总有效率为90.00％,心电图疗效总有效率为86．67％,对照纽心绞痛疗效总有效率为73．33％,心电图疗效总有效率为60．00％。两组比较有统计学意义（P〈0．05）。结论心通胶囊治疗冠心病不稳定型心绞痛疗效优于复方丹参片。     

新通注射液治疗冠心病心绞痛的临床观察

目的观察新通注射液治疗冠心病心绞痛的临床疗效。方法108例冠心病患者，双盲随机分为新通治疗组（73例）和对照组（35例），以新通注射液12ml加入5％葡萄糖液500ml静滴治疗为治疗组，以复方丹参针12ml加入5％葡萄糖液250ml静滴治疗为治疗组（有糖尿病者改用生理盐水稀释）。平均每日1次，连续治疗2周，观察前后心绞痛症状、心电图的变化。结果心绞痛症状疗效：治疗组总有效率94．4％，对照组总有效率80．0％，两组比较差异有非常显著性（P〈0．01）；心电图疗效：治疗组总有效率69．9％，对照组总有效率37．1％，两组比较差异有非常显著性（P〈0．01）。结论新通注射液治疗冠心病心绞痛安全有效。     

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.     

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.     

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.     

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.