胸腺肽和干扰素联合序贯治疗对“标准”干扰素疗法无反应的慢性乙型肝炎

胸腺肽和干扰素联合序贯治疗对“标准”干扰素疗法无反应的慢性乙型肝炎陈如山，徐克成，伦待民抗病毒疗法是慢性乙型肝炎治疗的关键。α干扰素（ＩＦＮ－α）是目前公认对慢性乙型肝炎有效的抗病毒药物。α１胸腺肽（Ｔ－α１）是合成２８肽，相当于胸腺素第５组分，为一...     

苦参素注射液联合胸腺肽治疗慢性乙型肝炎60例

慢性乙型肝炎抗病毒治疗一直是国内外研究的重点。目前公认有效的抗乙型肝炎病毒（HBV）药物为α-干扰素（IFN-α）和拉米夫定。苦参素注射液是植物提取药，我们采用苦参素注射液联合免疫调节剂胸腺肽治疗慢性乙型肝炎，以观察其抗病毒的效果。     

精制人白细胞α-干扰素治疗急性乙型肝炎34例疗效观察

精制人白细胞α－干扰素治疗急性乙型肝炎３４例疗效观察解放军２０１医院传染科（辽阳，１１１０００）张忠文谢晓江刘亚平黄炳全乔世忠１）干扰素作为乙型肝炎治疗的首选药物，多用于慢性活动型肝炎、慢性迁延型肝炎。我们采用精制人白细胞α－干扰素治疗急性乙型肝炎并...     

聚乙二醇干扰素治疗慢性乙型肝炎（上）

目前，在慢性乙型肝炎患中尚缺乏有效根除HBV的抗病毒药物。因此短期治疗目标是：持续地抑制HBV复制、减低肝炎活动度、获得HBeAg血清转换和改善肝纤维化。现今已经被批准用于治疗慢性乙型肝炎的5种药物是：常规干扰素α（IFNα）、拉米夫定、阿德福韦酯、聚乙二醇干扰素α-2a（PEGIFNα-2a）和最新的恩替卡韦。     

慢性乙型肝炎抗病毒治疗进展

本文从干扰素α、核苷（酸）类似物和免疫调节药物三方面论述了慢性乙型肝炎抗病毒的治疗进展，对乙肝治疗颇有帮助。     

α-干扰素联合胸腺肽治疗慢性乙型肝炎62例疗效观察

α-干扰素具有抗病毒与免疫调节作用，是治疗慢性乙型肝炎有效的药物之一。但远期疗效差，为了进一步提高慢性乙型肝炎的疗效，我们应用胸腺肽联合α-干扰素治疗慢性乙型肝炎，现将结果报道如下。     

慢性乙型肝炎患者外周血单个核细胞α干扰素及其受体1的表达与治疗的关系

慢性乙型肝炎是长期影响人类健康的一大难题，全球约有3．5亿人血清中携带乙型肝炎病毒表面抗原。我国的感染情况严重，携带率占总人口的10％以上。目前临床治疗慢性乙型肝炎的主要方法依然是干扰素（IFN）结合核苷类药物，虽然患者对重组IFN的应答率有所增加，但还是不能令人满意。慢性乙型肝炎患者对IFN治疗出现应答差异的原因还不十分清楚。为此，我们检测了慢性乙型肝炎患者外周血单个核细胞（PBMC）诱导抗病毒IFN-α的能力，并分析α干扰素治疗前后不同应答者的α干扰素受体1（IFNAR1）的表达，试图从机体自身的免疫细胞来探讨出现差异的机制。     

乙肝病毒不同基因型的治疗策略（下）

HBV基因型对抗病毒治疗疗效的影响 目前尚没有特效的抗病毒方案能够治愈慢性乙型肝炎病人的HBV感染。短期的治疗目标是控制炎症的活动，使e抗原发生血清转换或HBV复制的持续抑制，使肝脏的坏死性炎症和纤维化程度得到改善。目前有5种药物可以用于治疗慢性乙型肝炎：传统的α-干扰素（IFN），拉米夫定（lamivudine），阿德福韦双脂（adefovir dipivoxil），     

拉米夫定联合干扰素α-1b用于HBeAg阳性慢乙肝患者效果观察

2005年5月-2007年5月，我们采用拉米夫定联合干扰素α-1b对32例HBeAg阳性的慢性乙型肝炎（CHB）行抗病毒治疗，取得较好效果。现报告如下。     

合理应用α干扰素治疗慢性乙型肝炎--2002年α干扰素治疗慢性乙型肝炎专家研讨会会议纪要

20 0 2年 5月 ,国内传染病、肝病领域的二十多位知名专家参加了“2 0 0 2年α干扰素治疗慢性乙型肝炎专家研讨会”。与会专家们一致认为α干扰素在慢性乙型肝炎的抗病毒治疗中仍然占有重要地位 ,并深入地探讨了α干扰素治疗慢性乙型肝炎的临床经验和发展方向 ,这对α干扰素的合理应用具有重要的指导意义。现总结如下 ,供广大临床医生参考。一、α干扰素的适应证和禁忌证α干扰素是被美国食品及药物管理局 (ＦＤＡ)最早批准的用于治疗病毒性肝炎的抗病毒药物 ,而且目前被公认对慢性乙型肝炎具有确切的长期疗效。根据美国肝病学会及亚太肝病学…     

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.