银丹心脑通软胶囊治疗2型糖尿病血瘀证临床观察

目的观察银丹心脑通软胶囊治疗2型糖尿病血瘀证的临床疗效。方法200例患者随机分成两组,银丹心脑通软胶囊联合组（治疗组）100例,口服银丹心脑通软胶囊,肠溶阿司匹林片、双嘧达莫（潘生丁）片。对照组100例,口服肠溶阿司匹林片和潘生丁片。结果银丹心脑通软胶囊治疗组临床症状明显改善,与对照组比较有统计学意义（P〈0.05）。血液流变学指标治疗组治疗前后对比明显改善（P〈0.05）,治疗组与对照组之间也有统计学意义（P〈0.05）。结论应用银丹心脑通软胶囊可改善血黏度,对治疗2型糖尿病血瘀证有明显的疗效。     

松龄血脉康胶囊治疗早期糖尿病足临床分析

将2型糖尿病合并早期足病变的患者86例分为治疗组50例,对照组36例,治疗组口服松龄血脉康胶囊,对照组口服复方丹参片,疗程1～2个月.结果治疗组疗效显著,下肢血管病变症状、血流变学等相关指标改善明显(P＜0.05或P＜0.01).结论松龄血脉康胶囊对糖尿病足的预防和治疗有重要的临床意义.     

松龄血脉康胶囊治疗早期糖尿病足临床分析

将2型糖尿病合并早期足病变的患者86例分为治疗组50例,对照组36例,治疗组口服松龄血脉康胶囊,对照组口服复方丹参片,疗程1-2个月。结果：治疗组疗效显著,下肢血管病变症状、血流变学等相关指标改善明显（P〈0.05或P〈0.01）。结论：松龄血脉康胶囊对糖尿病足的预防和治疗有重要的临床意义。     

糖尿病患者在治疗中的肾功能改变

对79例糖尿病肾病患者分组进行治疗,在糖尿病治疗的基础上,分别给予口服丹参和潘生丁,观察其疗效。结果各组治疗后空腹血糖均明显降低,C_(er)明显升高,尿蛋白阳性率降低,但各组间治疗后空腹血糖下降值、C_(er)上升值和尿蛋白阳性率无显著差异,提示控制高血糖是改善糖尿病肾病的关键,可使早期肾脏功能损害得到明显改善。口服丹参和潘生丁在糖尿病肾病治疗中并不增强其疗效。控制高血压是防治糖尿病肾病的重要措施,有利于肾功能的改善。     

前列地尔注射液治疗糖尿病并发症的疗效观察

目的观察前列地尔注射液治疗糖尿病足、糖尿病周围神经病变的临床疗效。方法选择糖尿病足和糖尿病周围神经病变患者72例,其中糖尿病足患者34例、糖尿病周围神经病变患者38例。随机将糖尿病足患者分为对照组16例、治疗组18例;糖尿病周围神经病变分为对照组17例、治疗组21例。对照组给予常规治疗,治疗组在常规治疗的基础上加用前列地尔注射液。比较各组治疗后临床疗效。结果糖尿病足患者中,治疗组总有效率为89%,对照组为56%,两组总有效率比较P〈0.01;糖尿病周围神经病变中,治疗组总有效率为90%,对照组为53%,两组总有效率比较P〈0.01。结论前列地尔治疗糖尿病足、糖尿病周围神经病变具有良好的临床疗效,值得临床推广应用。     

潘生丁联合喜炎平雾化吸入治疗小儿疱疹性咽峡炎疗效观察

了解潘生丁联合喜炎平雾化对疱疹性咽峡炎的疗效。方法在常规对症处理的基础上治疗组应用潘生丁口服联合喜炎平雾化,对照组应用干扰素雾化。结果潘生丁组与对照组在总有效率上无显著性差异。结论潘生丁联合喜炎平雾化治疗疱疹性咽峡炎疗效满意,值得基层推广。     

通脉饮治疗糖尿病足早期的临床研究

目的观察通脉饮治疗糖尿病足早期的临床疗效。方法选择2015年10月—2016年10月符合糖尿病足早期患者70例,随机分为治疗组35例和对照组35例,两组均予以一般基础治疗,治疗组口服通脉饮,对照组口服脉管复康片,治疗8周,观察治疗前后症状、动脉血管彩色多普勒变化、踝肱指数(ABI)和肌电图改善情况以及治疗前后血糖、糖化血红蛋白、凝血系列、血脂系列变化情况等指标。结果治疗组与对照组均可改善糖尿病足早期的临床症状体征、动脉血管彩色多普勒、踝肱指数(ABI)、肌电图、血糖、糖化血红蛋白、凝血系列、血脂系列等指标,但治疗组更优于对照组。结论糖尿病足早期治疗干预极为重要,通脉饮治疗糖尿病足早期有较好的临床疗效,可明显降低糖尿病足坏疽的发生率和截肢率,提高了患者的生活质量,符合中医"治未病"的理念。     

阿司匹林和辛伐他汀干预能缓解糖尿病患者颈动脉粥样硬化

目的探讨糖尿病患者在控制血糖的同时,辛伐他汀和肠溶阿司匹林联合用药对颈动脉粥样硬化和心、脑血管事件的干预作用。方法选择158例糖尿病合并颈动脉粥样硬化的患者,将其随机分为药物联合干预组和对照组:干预组80例,在控制血糖的同时应用辛伐他汀(每晚20 mg)和肠溶阿司匹林(每天75 mg)。对照组78例,仅给予控制血糖。共随访3年,分别在干预前及干预后第1、2、3年检测颈动脉内膜—中膜厚度、颈动脉内径、颈动脉内膜—中膜厚度与颈动脉内径的比值、颈动脉斑块积分及血糖、血脂、血小板聚集率和血浆纤维蛋白原等指标。结果干预组在随访后第1年平均颈动脉内膜—中膜厚度和斑块积分分别为1.02±0.11 mm和3.8±2.4,与干预前比较差异无显著性(P>0.05);第2年分别为0.89±0.15 mm和2.7±1.6,第3年分别为0.89±0.14 mm和2.5±1.1,这两年与干预前比较明显降低(P<0.01)。颈动脉内膜—中膜厚度与内径比值在干预后也明显降低。随访结束时,干预组心脑血管病的发生率分别为3.75%和10.00%,与对照组相比明显降低(P<0.05)。结论在有效控制血糖的同时,给予辛伐他汀和肠溶阿司匹林联合干预能延缓和逆转糖尿病患者颈动脉粥样硬化的进展,对降低心、脑血管事件的发生有很好的预防作用。     

小牛血清去蛋白注射液联合甲钴胺注射液治疗DPN疗效观察

目的观察小牛血清去蛋白注射液联合甲钴胺治疗糖尿病周围神经病变的临床疗效。方法将140例DPN患者随机分为观察组和对照组。在饮食、运动,糖尿病教育等基础治疗之上,观察组用小牛血清去蛋白注射液滴注联合甲钴胺注射液治疗,配合口服降糖药或加胰岛素治疗控制血糖。对照组则用甲钴胺注射液配合口服降糖药或加胰岛素治疗控制血糖。疗程2周。观察治疗前后的症状改善情况。结果对照组总有效率为55.6%,显效率为16.7%;治疗组总有效率为88.2%,显效率为44.1%,两组间差异有显著性(P0.01)。结论小牛血清去蛋白注射液联合甲钴胺注射液治疗糖尿病周围神经病变疗效确切,优于单纯甲钴胺治疗方案。     

刺五加注射液治疗脑梗死64例的疗效观察

目的为了解刺五加注射液治疗脑梗死的临床疗效。方法64例脑梗死患者随机分为治疗组和对照组。治疗组用刺五加注射液静脉点滴,疗程为15天,对照组用丹参静脉点滴,疗程30天,两组同时控制血压、血糖、血脂。结果治疗组32例中,有效30例,总有效率为93.75%,对照组32例中,有效24例,总有效率为75%。两者疗效差异具有显著性(P<0.05)。结论刺五加注射液治疗脑梗死安全、有效,适合于基层单位使用。     

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.     

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.