探析普瑞巴林联合硫辛酸在痛性糖尿病神经病变安全性观察

目的对普瑞巴林联合硫辛酸治疗痛性糖尿病神经病变患者的临床效果进行分析。方法选择2013年12月—2014年12月前来该院进行治疗的96例痛性糖尿病神经病变患者作为研究对象,经过患者同意后,把患者随机分为3组,一组采用普瑞巴林药物进行治疗,一组采用硫辛酸药物进行治疗,一组采用普瑞巴林联合硫辛酸药物进行治疗,对比3组糖尿病神经病变患者的临床治疗效果。结果经过一段时间的治疗后,普瑞巴林联合硫辛酸组显示的总有效率为(96.8%),普瑞巴林组显示的总有效率为(81.25%),奥美拉唑组显示的总有效率为(68.75%)。3组间的数据对比差异有统计学意义(P0.05)。结论采用普瑞巴林联合硫辛酸治疗痛性糖尿病神经病变患者的临床效果最好,同时安全性非常高。     

硫辛酸联合普瑞巴林对老年患者2型糖尿病周围神经病变的临床疗效

目的探讨硫辛酸联合普瑞巴林对老年患者2型糖尿病周围神经病变的临床疗效。方法选取2019年1月—2020年12月该科病房收治的老年2型糖尿病合并周围神经病变患者,随机分为两组,对照组采用一般治疗及硫辛酸方案,联合组在对照组基础上加用普瑞巴林方案,1周为1个疗程,观察2个疗程。对比正中神经SNCV、MNCV及腓总神经SNCV、MNCV及MDNS、VAS得分。结果正中神经SNCV、MNCV及腓总神经SNCV、MNCV两组患者治疗前对比,差异无统计学意义(P0.05),两组治疗前后对比,差异有统计学意义(P0.05);治疗后联合组与对照组相比,差异有统计学意义(P0.05)。两组治疗前MDNS、VAS得分对比,差异无统计学意义(P0.05),两组治疗前后对比,差异有统计学意义(P0.05);治疗后联合组与对照组相比,差异有统计学意义(P0.05)。结论硫辛酸联合普瑞巴林对老年患者2型糖尿病周围神经病变具有一定疗效。     

糖尿病周围神经病变采用α-硫辛酸联合甲钴胺治疗的效果探究

目的探讨糖尿病周围神经病变采用α-硫辛酸联合甲钴胺治疗的效果。方法该院100例2017年1月—2018年12月糖尿病周围神经病变患者。随机分组,甲钴胺治疗组对于糖尿病周围神经病变患者采取甲钴胺治疗,α-硫辛酸联合甲钴胺组则对于糖尿病周围神经病变患者采取α-硫辛酸+甲钴胺治疗。比较两组糖尿病周围神经病变疗效;疼痛感觉消失的时间、麻木消失的时间、烧灼感消失的时间;治疗前后患者正中神经传导的速度;不良反应发生率。结果α-硫辛酸联合甲钴胺组疗效比甲钴胺治疗组高(P0.05)。其中,甲钴胺治疗组治疗后显效16例,治疗后有效24例,治疗后无效10例,总有效率80.00%;α-硫辛酸联合甲钴胺组治疗后显效34例,治疗后有效16例,治疗后无效0例,总有效率100.00%。治疗前甲钴胺治疗组、α-硫辛酸联合甲钴胺组正中神经传导的速度相近(P0.05);治疗后α-硫辛酸联合甲钴胺组正中神经传导的速度变化幅度更大(P0.05)。α-硫辛酸联合甲钴胺组疼痛感觉消失的时间、麻木消失的时间、烧灼感消失的时间短于甲钴胺治疗组疼痛感觉消失的时间、麻木消失的时间、烧灼感消失的时间(P0.05)。α-硫辛酸联合甲钴胺组和甲钴胺治疗组不良反应发生率相似(P0.05)。结论α-硫辛酸+甲钴胺治疗糖尿病周围神经病变效果确切,可有效改善临床症状和神经传导速度,且无明显不良反应,安全性高。     

硬膜外阻滞治疗糖尿病周围神经病变的疗效观察

目的探讨分析硬膜外阻滞治疗糖尿病周围神经病变的临床疗效。方法选取该院2011年1月—2013年8月收治的62例糖尿病周围神经病变患者为研究对象,将其随机分成两组,观察组42例患者给予普瑞巴林联合0.6%利多卡因连续硬膜外阻滞治疗。对照组40例患者给予普瑞巴林治疗,观察两组临床效果。结果治疗2周后,观察组患者下肢神经传导速度改善情况显著优于对照组,差异有统计学意义(P<0.05);两组患者不良反应发生率比较小明显,差异无统计学意义(P>0.05)。结论硬膜外阻滞治疗糖尿病周围神经病变的临床疗效较显著,能有效改善患者下肢神经传导速度,值得应用推广。     

硫辛酸注射液治疗痛性糖尿病神经病变临床疗效观察

目的探讨硫辛酸注射液治疗痛性糖尿病神经病变临床治疗效果。方法选取2012年3月—2013年4月来该院进行治疗的痛性糖尿病神经病变患者30例,按照治疗方式的不同平均分为对照组和观察组,每组患者各15例。对照组患者使用甲钴胺进行治疗,观察组患者使用硫辛酸注射液进行治疗,观察两组患者治疗前后运动神经传导速度和感觉神经传导速度的变化情况,比较两组患者治疗的总有效率。结果两组患者在治疗之前临床的基本情况差异无统计学意义,经过治疗后,痛性糖尿病神经病变的症状均有明显的改善,但是,观察组患者治疗的结果明显优于对照组患者。在治疗的总有效率方面,对照组患者6例患者出现不良反应情况,治疗无效,治疗的总有效率为60%;观察组患者仅有1例患者出现不良反应情况,治疗的总有效率为93.33%,差异有统计学意义(P0.05)。结论硫辛酸注射液在治疗痛性糖尿病神经病变方面具有极强的效果,安全性能较高,这一发现具有极强的临床推广价值,值得推广应用。     

普瑞巴林治疗糖尿病痛性周围神经病变的疗效观察

目的 评价普瑞巴林治疗糖尿病痛性周围神经病变的疗效和安全性. 方法 入选T2DM患者60例,随机分为普瑞巴林组和阿米替林组,每组各30例.共观察4周.治疗开始和4周时测定血生化及周围神经传导速度,每日行疼痛强度数字分级法（NRS）评估,并记录药物不良反应.计算两组治疗4周时疼痛缓解≥50％的发生率. 结果 治疗后两组FPG、LDL-C较治疗前下降（P＜0.05）,但两组间比较差异无统计学意义.治疗前后主要终点指标NRS评分,普瑞巴林组为（5.2±1.4）vs（1.3±1.2）分;阿米替林组为（4.9±0.9）vs（2.2±1.3）分（P均＜0.01）.4周时普瑞巴林组NRS低于阿米替林组（P＜0.05）.普瑞巴林组和阿米替林组疼痛缓解≥50％的发生率为75.9％ vs 50.0％（P＜0.05）.普瑞巴林组头痛1例,心悸1例;阿米替林组头晕1例,嗜睡5例,便秘1例,水肿1例. 结论 普瑞巴林和阿米替林均可缓解糖尿病痛性周围神经病变,且普瑞巴林更有效、起效更快.     

加巴喷丁联合α-硫辛酸治疗糖尿病痛性神经病变的疗效观察

目的探讨加巴喷丁联合α-硫辛酸治疗糖尿病痛性神经病变的临床疗效。方法以40例于2015年6月—2018年5月期间进入该院的糖尿病痛性神经病变患者作对象,以不同疗法作分组依据,对照组20例行硫辛酸治疗,研究组20例行加巴喷丁联合硫辛酸治疗,对比分析两组的临床疗效和疼痛症状评分。结果研究组治疗总有效率高达95.00%(19/20),显著高于对照组的75.00%(15/20)(P0.05);且治疗后两组患者疼痛症状评分显著降低(P0.05),且研究组的疼痛症状评分低于对照组(P0.05)。结论在治疗糖尿病痛性神经病变患者中,给予加巴喷丁联合α-硫辛酸治疗,能够保证治疗效果,缓解患者的疼痛症状,值得推广。     

评价硫辛酸注射液在治疗痛性糖尿病神经病变中的疗效

目的评价硫辛酸注射液在治疗痛性糖尿病神经病变中的疗效。方法该次调查时间为2014年1—12月;调查对象为在该院接受治疗的100例痛性糖尿病神经病变患者;以随机分配法对患者进行分组处理,组间人数均等,一般资料无统计学差异。其中对照组患者以甲钴胺进行治疗,观察组患者以硫辛酸注射液进行治疗,分析比较两组患者临床疗效。结果统计学处理后得知,观察组总有效率为90%,高于对照组52%,组间比较P0.05。观察指标分析,在正中神经、尺神经和胫神经的运动传导速度(MNCV)和腓浅神经、正中神经感觉传导速度(SNCV)等指标上,观察组改善优于对照组(P0.05)。结论硫辛酸注射液治疗痛性糖尿病神经病变具有较好的治疗效果,对改善患者预后具有积极作用。因此临床上可选择以硫辛酸注射液作为痛性糖尿病神经病变患者的主要治疗药物。     

硫辛酸注射液治疗老年2型糖尿病周围神经病变的临床观察

目的观察硫辛酸注射液治疗老年2型糖尿病周围神经病变的临床疗效。方法选择陆军总医院2013年12月~2015年2月收治的60例老年2型糖尿病周围神经病变患者,随机分为观察组和对照组,每组各30例。观察组应用硫辛酸注射液联合腺苷钴胺和丹红注射液进行治疗,对照组应用腺苷钴胺联合丹红注射液治疗,疗程均为3周。比较两组治疗前后的临床疗效、神经传导速度(包括运动神经传导速度和感觉神经传导速度)的变化及不良反应情况。结果观察组的总有效率显著高于对照组(P0.05),两组神经传导速度较治疗前均有显著提高(P0.05),且观察组正中神经的改善效果明显优于对照组(P0.05),但两组腓总神经的改善无明显差异(P0.05)。两组患者均未见明显不良反应。结论硫辛酸注射液治疗老年2型糖尿病周围神经病变安全有效,有较好的临床应用前景。     

α-硫辛酸联合腺苷钴铵治疗糖尿病周围神经病变的疗效观察

目的 探讨了α-硫辛酸联合腺苷钴铵治疗糖尿病周围神经病变的疗效观察.方法 回顾性分析该院2012年2月-2013年1月2型糖尿病合并周围神经病变患者90例患者的临床资料,随机分为对照组和治疗组,对照组采取腺苷钴铵治疗,治疗组采取α-硫辛酸联合腺苷钴铵治疗,比较两组患者的临床疗效,神经传导速度及其不良反应.结果 对照组总有效率为75.56％,治疗组总有效率为95.56％,治疗组临床疗效显著优于对照组,差异有显著性(P＜0.05).两组患者治疗后神经传导速度显著优于治疗前,差异有显著性(P＜0.05);治疗组神经传导速度改善显著优于对照组,差异有显著性(P＜0.05).两组治疗后血常规、肝肾功能等无异常变化,无明显不良反应.结论 糖尿病周围神经病变治疗方案中,通过α-硫辛酸联合腺苷钴铵实施治疗,病患的临床症状缓解效果明显,下肢神经传导功能的恢复效果明显,值得推广.     

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.