声学定量技术评价经皮二尖瓣球囊扩张术对左房、右室功能的影响

用声学定量技术（ＡＱ）对３８例经皮二尖瓣球囊扩张术（ＰＢＭＶ）患者术前与术后的左房、右室功能进行比较，结果表明：与术前比较，术后患者的左房射血分数（ＥＦ）、面积变化率（ＦＡＣ）及高峰充盈率（ＰＦＲ）显著增加．收缩及舒张末期面积（ＥＳＡ、ＥＤＡ）和容积（ＥＳＶ、ＥＤＶ）明显减小，而高峰射血率（ＰＥＲ）及高峰充盈时间（ＴＰＦＲ）则无显著性改变；术后患者的右室ＥＦ、ＦＡＣ、ＰＥＲ、ＰＦＥ均明显升高，ＥＳＡ、ＥＳＶ明显减小，但ＥＤＡ、ＥＤＶ及ＴＰＦＲ却无显著变化。表明：ＰＢＭＶ术后患者的左房、右室收缩及舒张功能均有不同程度的改善。     

放射性核素显像以伴心脏损害的风湿病的检测意义

目的 探讨某些活动期风湿病患者左心室功能改变、心肌损害以及放射性核素显像检测风湿病患者心脏损害的临床应用价值。方法 用放射性核素显像平衡法门电路心血池扫描及心肌断层显像测定２０例正常人和２０例系统性红斑列多发性肌炎（ＰＭ）,６例结节性动脉炎（ＰＡＮ）,５例风湿热患者左心室收缩和舒张功能改变、心肌损害情况。结果 活动期风湿病病人的左室射血分数（ＬＶＥＦ）,高峰射血率（ＰＥＲ）,高峰充盈率（ＰＦＲ）,     

放射性核素显像对伴心脏损害的风湿病的检测意义

目的　探讨某些活动期风湿病患者左心室功能改变、心肌损害以及放射性核素显像检测风湿病患者心脏损害的临床应用价值。方法　用放射性核素显像平衡法门电路心血池扫描及心肌断层显像测定２０ 例正常人和２０ 例系统性红斑狼疮（ＳＬＥ） ,６ 例多发性肌炎（ＰＭ）,６ 例结节性动脉炎（ＰＡＮ）,５ 例风湿热患者左心室收缩和舒张功能改变、心肌损害情况。结果　活动期风湿病病人的左室射血分数（ＬＶＥＦ）,高峰射血率（ＰＥＲ）,高峰充盈率（ＰＦＲ） ,左室相角程（ＳＨ） 均较正常对照有显著差异（ Ｐ＜ ０－０１） ,室壁活动异常的阳性率为４８－６ ％ ,心肌显像阳性率为５７－７ ％ 。结论　活动期风湿病患者左心室功能及心肌明显损害,放射性核素显像可客观评价风湿病患者心脏损害,对临床治疗有指导意义。     

心脏收缩时间间期对经皮冠状动脉腔内成形术后晕厥心肌估价的探讨

动态观察１４例经皮冠状动脉腔内成形术（ＰＴＣＡ）病人手术前后心脏收缩时间间期（ＳＴＩ）变化，估价ＳＴＩ改变时判断晕厥心肌的价值。结果显示:ＰＴＣＡ后３～５ｄ，ＳＴＩ评价左心功能较为敏感的指标射血前时间／左室射血时间（ＰＥＰ／ＬＶＥＴ）比值，由０．３８６±０．６００增加至０．４６０±０．０７０；至７～８ｄ恢复至术前水平。与同期测定的超声心动图左室射血分数（ＬＶＥＦ）相比，变化趋势一致。提示ＰＴＣＡ后，系列测定ＳＴＩ，可动态反映左心功能变化。ＰＥＰ／ＬＶＥＴ比值改变可作为判断晕厥心肌恢复的指标之一。     

核素心室造影对SLE患者心室功能的检测及其临床意义

应用核素心室造影评价３５例系统性红斑狼疮（ＳＬＥ）病人亚临床心脏受累期心功能的变化。结果显示，ＳＬＥ病人左室收缩功能参数如左室射血分分数（ＬＶＥＦ）、峰射血率（ＰＥＲ）、前１／３射血分数（１／３ＥＦ）及峰射血时间（ＴＰＥＲ）均无显著性改变，活动期（ｎ＝２４）和非活动期病人（ｎ＝１１）左室舒张功能参数如峰充盈率（ＰＦＲ）、前１／３充盈分数（１／３ＦＦ）明显降低，活动期更明显。６２．５％的活动期和（Ｐ     

QRS记分法评价老年心肌梗塞患者的左室功能

为评估常规心电图ＱＲＳ记分法评价老年心肌梗塞患者的左室收缩及舒张功能的价值，将常规心电图测得的老年急性心肌梗塞（ｎ＝６７）及陈旧性心肌梗塞（ｎ＝３２）的ＱＲＳ记分与９９ｍＴｃＭＩＢＩＳＰＥＣＴ心肌显像检测的心肌坏死、心肌疤痕节段数及平衡法核素心血池显像测得的左室射血分数（ＬＶＥＦ）、高峰射血率（ＰＥＲ）、１／３射血分数（１／３ＥＦ）、１／３充盈率（１／３ＦＲ）、高峰充盈率（ＰＦＲ）、１／３射血率（１／３ＥＲ）、１／３充盈分数（１／３ＦＦ）进行相关分析。发现ＱＲＳ记分与急性心肌梗塞者心肌坏死节段数及陈旧性心肌梗塞者的心肌疤痕节段数显著相关，ｒ分别为０．７８，０．６６，Ｐ均＜０．０００１；与反映收缩功能的ＬＶＥＦ、ＰＥＲ、１／３ＥＦ、１／３ＥＲ呈明显负相关，ｒ分别为－０．７３和－０．８６，－０．５５和－０．７３，－０．３６和－０．５５，－０．６５和－０．７７，Ｐ均＜０．０５；与反映舒张功能的ＰＦＲ、１／３ＦＲ、１／３ＦＦ亦呈明显相关，ｒ分别为－０．４５和０．４１，－０．４９和－０．５２，－０．３８和－０．３６，Ｐ均＜０．０５。说明ＱＲＳ记分可用于估测心肌梗塞面积、左室收缩及舒张功能。     

核心脏技术在稳定期慢性阻塞性肺疾病患者左心功能研究 …

目的 了解慢性阻塞性肺疾病（ＣＯＰＤ）患者稳定期左心功能的状况。方法 采用多门电路血池平衡法素心血管造影（ＭＧＢＰ）技术对４３例不同程度的ＣＯＰＤ患者及名肺功能正常者左室收缩功能和舒张功能进行综合评价。结果 左室射血分数（ＬＶＥＦ） 率（ＰＥＲ）、收缩期前１／３射血分数、１／３射血率;舒张末期到收缩末期的时间（ＴＥＳ）、收缩末期到高峰充盈时间（ＴＰＥ）、高峰充盈率（ＰＦＲ）、前１／３充盈分数、前１     

超声心动图对保留后瓣、腱索和乳头肌的二尖瓣替换术后左室功能的评价

本文对１８例二尖瓣替换术保留二尖瓣后叶、腱索和乳头肌（Ｐ组）和１６例常规切除瓣膜及瓣下结构（Ｃ组）术后左室功能进行对照分析。结果发现，Ｐ组术后的心功能明显优于Ｃ组。Ｐ组左室射血分数（ＥＦ）、左室短轴缩短率（ＦＳ）较术前有显著提高（Ｐ＜０．０５及Ｐ＜０．０１）；左室收缩末期容量、左室舒张末期容量降低（Ｐ＜０．０１）。而Ｃ组术后则ＥＦ、ＦＳ较术前降低（Ｐ＜０．０１），绝大多数患者术后出现室间隔矛盾运动。提示二尖瓣装置对维持心肌的收缩功能有重要作用。     

老年冠心病患者心功能改变的特点

对２３例老年冠心病患者，１９例非老年冠心病患者及１４例正常老年人，１７例正常非老年人进行了核素心血池显像。结果发现老年冠心病组左室高峰充盈率（ＰＦＲ）、左室射血分数（ＬＶＥＦ）、左室高峰射血率（ＰＥＲ）较老年正常组明显降低，相角程明显增大。老年冠心病组较非老年冠心病组ＰＦＲ明显降低，相角程和ＰＦＲ异常的比例明显增大。相关分析证实年龄与ＰＦＲ、ＬＶＥＦ、ＰＥＲ、相角程明显相关。提示老年冠心病患者存在着更为普遍和严重的舒张功能减退，影响舒张功能受损的主要原因有年龄因素、心室运动协调障碍等。     

非胰岛素依赖型糖尿病病人心脏功能的改变

经静注潘生丁锝－９９ｍ标记的甲氧基异丁基异腈心肌断层显像术筛选后，用核素心室造影术评价非胰岛素依赖型糖尿病（ＮＩＤＤＭ）病人组１８例及对照组１６例在静息及极量运动状况下的心脏收缩功能变化；以多普勒超声心动图评价静息时心脏舒张功能改变。结果：静息状态下ＮＩＤ－ＤＭ组心率虽快于对照组，射血分数（ＥＦ）、峰射血率（ＰＥＲ）与对照组无差异；极量运动时则ＰＥＲ有统计学意义地明显低于对照组，且有４例ＥＦ较运动前降低＞５％，对照组无此现象，此差异接近显著意义（Ｐ＝０．０６５）．静息时ＮＩＤＤＭ组的Ｅ／Ａ比值降低，等容舒张时间延长，揭示ＮＩＤＤＭ病人心室收缩贮备功能降低，舒张功能在静息时已异常。     

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.