用生命科学眼光看两种医疗模式

糖脂病是世界卫生组织对三高四病的统称。三高即高血脂、高血黏、高血糖,四病是高血压病、冠心病、脑中风、糖尿病。据世界卫生组织统计,全世界约十亿人患糖脂病,中老年人约50%死于糖脂病。而我国60%以上的中老年人死于糖脂病。糖脂病危害巨大,病因是长期较多地摄入主食肉食,超过了自身的需要,患者可能数病并发。糖脂病患者病在血浆和细胞内外糖类     

四国专家呼吁关注烟雾病的规范治疗

解放军307医院段炼教授是国内最早开展烟雾病治疗的专家之一,并一直致力于烟雾病推广工作。他最早在2005年主办首届国内烟雾病研讨会,随后先后举办了2届国内烟雾病研讨会,承办了4届天坛国际脑血管病会烟雾病论坛,主办了3届烟雾病国际研讨会。为了总结以往烟雾病治疗经验,探索烟雾病未来的方向,段炼主任发起并主办了第四届烟雾病国际研讨会,会议于2014年6月28日在京召开,以“新进展、新成果与新趋势”为主题,共同对烟雾病领域的热点难点进行研讨。     

临床医生应重视老年共病

<正>老年患者共病问题普遍存在,不仅影响患者的功能状态及生活质量,还增加疾病的临床管理难度。目前国内关于共病的研究较少,临床医生对共病的认识不足。本文对共病的定义、流行病学、不良影响、评估工具及共病管理面临的问题及共病管理策略做一简要概述,旨在加强临床医生对共病的认识。1共病的定义及流行病学     

共病状态评估工具的临床应用及研究进展

随着人口老龄化发展,共病问题日显突出。共病影响患者生活质量、增加疾病不良预后风险。共病状态的研究和证据有限,临床决策复杂困难,如何对共病状态进行评估并指导临床实践成为急需解决的问题。本文对现有共病状态评估的工具及应用进行综述,旨在为今后共病评估方法及共病管理的研究提供依据。     

空间统计学方法在棘球蚴病研究中的应用

空间统计学方法在棘球蚴病空间流行病学研究中发挥着重要的作用。在棘球蚴病空间流行病学研究方面,空间统计学方法可用于描述棘球蚴病的空间分布情况,对未抽样地区棘球蚴病患病率进行预测,分析棘球蚴病的影响因素。明确棘球蚴病的空间分布对于开展棘球蚴病的防控工作具有重要的意义。     

遗传性胃肠道息肉病和非息肉病综合征

胃肠道息肉病和非息肉病综合征 散发性结肠癌占所有结肠癌的90％以上,此类癌多数起自于腺瘤性息肉的癌前期。遗传性息肉病综合征可分为腺瘤性息肉病和错构瘤性息肉病综合征,每年发生率约占结肠癌的1％。遗传性非息肉性结直肠癌综合征也称Lynch或家族性癌综合征,占每年结肠癌发生率的5％～10％。 腺瘤性息肉病 家族性腺瘤性息内病家族性腺瘤性息肉病为常染色体显性遗传病,以腺瘤性息肉病综合征最为常见,据估测其基因发生率为1/     

恙虫病东方体感染免疫及其疫苗研究进展

恙虫病东方体是恙虫病的病原体,机体对恙虫病的免疫机制主要是细胞免疫,抗体在恙虫病免疫中也起一定作用,目前尚无预防恙虫病的理想疫苗。     

人舌形虫病的研究进展

人舌形虫病是由舌形虫引起的由食物传播或水传播的人兽共患寄生虫病。近20年来人舌形虫病的研究取得较大突破。传统的内脏舌形虫病可分成两个亚型:成囊内脏舌形虫病和脱囊内脏舌形虫病。迄今全球已知致病舌形虫10种和舌形虫病11种。尖吻蝮蛇舌状虫病、串珠蛇舌状虫病和台湾孔头舌虫病在中国的发现,首例眼舌形虫病分别在以色列和厄瓜多尔查见,以及在伊朗报道数例鼻咽舌形虫病,表明新疫源地的存在和流行区的扩大。该文对人舌形虫病的病原学、病理学和致病机制、临床表现、诊断、流行病学、控制和预防的研究进展作了综述。     

微量元素硒与克山病

目的分析克山病发病原因,指导克山病防治工作。方法查阅历年克山病病情资料,并对资料进行分析,探讨微量元素硒与克山病发病关系。结果微量元素硒与克山病发病关系密切相关,克山病病区内、外环境硒水平明显低于非病区,微量元素硒预防克山病收到了确切的效果。结论微量元素硒是克山病发病的重要因素,深入探讨微量元素硒与克山病发病的关系,对阐明克山病病因有重要意义。     

低血钾软病

低血钾软病是主要发生于广大农村的,具有流行性的,以低血钾、瘫痪为主要临床特征的疾患。本病各地名称不同,如软病、麻病、软麻病、湖口病、低血钾症、低血钾麻痹症、软瘫病、软脚病等。现暂按临床主要特征和习惯用语,统称低血钾软病。该病     

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.