高血压患者依那普利、阿罗洛尔治疗前后血浆内皮素、心钠素的变化

目的:探讨内皮素(ET)与心钠素(ANP)在高血压发病和治疗学中的意义. 方法:60例原发性高血压(EH)患者口服依那普例5～10 mg/d或阿罗洛尔20～30 mg/d,疗程为6周,放免法测定治疗前后血浆ET和ANP水平. 结果:EH患者血ET、ANP水平明显高于对照组(P＜0.05),Ⅱ期高血压患者血ET水平高于Ⅰ期(P＜0.01),ANP的变化与分期无关(P＞0.05).治疗后,两组患者血压明显下降(P＜0.01).依那普利组患者血ET、ANP水平均下降,阿罗洛尔组血ET水平没有变化(P＞0.05),而ANP水平升高(P＜0.01). 结论:ET、ANP在高血压发病中起重要作用,二者的变化及相互作用对降压药物作用的发挥有重要作用.     

高血压患者依那普利、阿罗洛尔治疗前后血浆心钠素的变化

<正> 本研究测定了60例原发性高血压(EH)患者的血浆心钠素(ANP)含量及口服依那普利和阿罗洛尔对其的影响.1.对象和方法门诊轻、中度EH患者60例,舒张庄(DBP)95-114mmHg,收缩压(SBP)<200mmHg(1mmHg=0.133kPa),继发性高血压除外.其中,男33例,女14例,年龄18～65岁.平均(52.6±13.8)岁,随机分为依那普利组和阿罗洛尔组,每组各30例,两组间患者基础情况、血压、心率无显著差异.停用降压药物两周后分别口服依那普利片(悦宁定,杭州默沙东公司,5mg/片),5-10mg/d,每日一次;阿罗洛尔片(阿尔马尔,日本住友株式会社,10mg/片),10-20mg/d,每日两次,均治疗六周.治疗前后分别测血压并留取血标本.正常对照组30例,为体检健康人员.以放射免疫法测定血浆ANP水平(药盒购自解放军总医院东亚免疫研究所).统计方法用t检验.     

老年高血压病患者肾素系统和血管活性肽的变化

目的 :探讨老年原发性高血压 （EH ）患者肾素 （RA） -血管紧张素 （AT） -醛固酮 （AL D）系统 （RAAS）及心房钠尿肽 （ANP）、内皮素 （ET）、降钙素基因相关肽 （CGRP）等血管活性肽的变化。方法 :放射免疫方法检测 96例健康老年人和 10 4例老年 EH患者血浆肾素活性 （PRA） ,AT ,AL D,ANP,ET,CGRP浓度。结果 :1两组 PRA,AT ,AL D浓度均随年龄增长而降低 （P<0 .0 5或 P <0 .0 1） ,但老年 EH患者明显高于健康老年人 （P<0 .0 5或 P<0 .0 1） ;2健康老年人各年龄组的 ANP,ET和 CGRP无明显差异 （P>0 .0 5 ） ;老年 EH患者血浆 ANP,ET浓度随年龄增长而明显增高 （P<0 .0 5或 P<0 .0 1） ,CGRP浓度随年龄增长而明显减低 （P<0 .0 1） ;各年龄组老年 EH患者血浆 ANP,ET均明显高于健康老年人 （P<0 .0 5或 P<0 .0 1） ,CGRP浓度均明显低于健康老年人 （P<0 .0 5或P<0 .0 1）。 3老年 EH患者血浆 AT 与 ANP,ET呈正相关 （r=0 .6 0 ,0 .79,P<0 .0 1） ,与 CGRP呈负相关 （r=-0 .5 9,P<0 .0 1）。结论 :老年人随着年龄的增长 ,在生理状态下传统的 RAAS的作用减弱 ,更多的是血管活性肽（ANP,ET,CGRP）参与心血管活性的调节 ,老年 EH患者缩血管肽 ET的活性增高、舒血管肽 CGRP活性减弱。     

阿罗洛尔及咪唑普利对高血压病患者利钾尿肽与心钠素比值的影响

目的　探讨利钾尿肽 (KP)与心钠素 (ANP)比值在老年高血压病治疗中的作用。方法将 60例老年高血压病患者随机分为两组 ,分别给予阿罗洛尔 (2 0～ 30mg/d)、咪唑普利 (5～ 1 0mg/d)治疗 6周 ,并检测治疗前后血浆中KP与ANP的浓度。结果　治疗前与对照组比较 ,高血压病患者血浆KP、ANP水平升高 ,KP/ANP比值降低 (P <0 0 0 1 )。治疗后两组患者血压均明显下降 (P <0 0 0 1 ) ,组间差异无显著性 (P >0 0 5)。阿罗洛尔组血浆KP、ANP水平升高 ,咪唑普利组下降 ,两组KP/ANP比值均升高 (P <0 0 0 1 )。结论　KP含量及KP/ANP比值的改变 ,在老年高血压病治疗中起着一定的作用。     

高血压病患者血浆内皮素的改变及其临床意义

目的　探讨内皮素 ( ET)与高血压的发病关系及其临床意义。方法　采用放射免疫法检测高血压病 ( EH )患者血浆 ET水平 ,同时与健康人作对照分析。结果　 ( 1) EH患者血浆 ET浓度为 ( 59.71± 2 2 .77) ng/L ,明显高于正常组 ( 37.36± 13.2 7) ng/L ( P <0 .0 1) ;经治疗后 EH患者的 ET浓度明显降低 ,但仍高于正常组 ( P <0 .0 1)。 ( 2 ) 1级高血压病患者血浆 ET浓度最低 ,2级居中 ,3级最高 ,各级之间比较 ,差异有显著性 ( P<0 .0 1)。 ( 3)高血压并发心力衰竭组血浆 ET浓度明显高于无心力衰竭组 ( P<0 .0 1)。结论　 ET参与高血压的发生和发展 ,并与病情有关 ;检测血浆 ET浓度可作为判断 EH患者病情的指标     

厄贝沙坦对老年高血压患者内皮素及心钠素的影响

目的:探讨厄贝沙坦对老年高血压患者血浆内皮素(ET)及心钠素(ANP)的影响。方法:随机开放选择,采用放射免疫法测定37例老年高血压患者服用厄贝沙坦前、后ET及ANP水平的变化。结果:与对照组比较,高血压组患者ET、ANP水平明显升高(P<0.01),厄贝沙坦治疗后ET、ANP水平显著降低(P<0.01)。结论:高血压患者血浆ET、及ANP水平明显升高,厄贝沙坦对老年高血压患者不但有较好的降压作用,还能够降低ET及ANP水平,可能有较好的血管内皮保护功能。     

高血压患者血管内皮功能的改变及氯沙坦的影响

目的:评价高血压患者血管内皮功能的改变及氯沙坦的影响。方法:随机选择原发性高血压患者40例,检测其内皮素(ET)、心钠素(ANP)和一氧化氮(NO)水平的变化。结果:与正常对照组比较,高血压组患者ET、ANP水平上升明显(P均<0.05),NO水平明显下降(P<0.05),氯沙坦治疗后ET水平无明显变化,ANP下降明显(P<0.05),NO水平上升明显(P<0.05)。结论:高血压患者血管内皮功能有明显变化.氯沙坦不仅有较好的降压作用,可能也有较好的血管内皮保护功能。     

老年血液透析患者血浆中利钾尿肽与心钠素的变化

目的　探讨行血液透析的老年患者血浆中利钾尿肽 (KP)与心钠素 (ANP)的变化。方法　选择 2 0 0 1年我科收治的伴有高血压的终末期肾病 (ESRD)行血液透析的老年患者 8例 ;选择同期老年原发性高血压病 (EH) 1～ 3级高危患者而肾功能正常者 2 5例为对照组。应用超声心动图仪测量室间隔、左室后壁厚度、左室舒张末内径并计算出左室心肌重量 (L VM) ;监测 2 4 h动态血压 ,测出平均收缩压 (SBP)及舒张压 (DBP) ;同时测定血浆中的 KP与 ANP、血肌酐、尿素氮。结果　 ESRD组左室心肌重量 (LVM)高于 EH组 (P<0 .0 5) ,且 KP及 ANP亦高于 EH组 ,尤其 KP更有明显差异 (P<0 .0 0 1 )。血透结束时收缩压升高 (P<0 .0 0 1 ) ,KP、ANP也高于血透前。结论　老年 ESRD血透患者血浆中 KP、ANP升高可能与伴发高血压有关。     

原发性高血压患者c-myc基因表达及其与血管紧张素Ⅱ和内皮素的关系

目的 :研究原癌基因 c- m yc在原发性高血压 ( EH)患者外周淋巴细胞中的表达及与血浆中血管紧张素 ( Ang )和内皮素 ( ET)之间的关系。方法 :采用 PCR技术检测 EH患者 5 5例 ( EH组 , 期 17例 , 期 2 4例 , 期 14例 ) ,正常对照组 2 4例淋巴细胞中的原癌基因 c- m yc的表达水平 ,采用放射免疫法测定各组血浆中Ang 、ET含量。结果 :EH组 c- m yc的表达水平明显高于对照组 ( P <0 .0 1) , 、 期较 期增高 ( P <0 .0 1)。EH组血浆 Ang 、ET高于对照组 (分别 P <0 .0 5和 <0 .0 1) ,EH组 3期之间相比差异无显著性意义 ( P >0 .0 5 ) ;EH患者原癌基因 c- m yc的表达程度与血浆中 Ang 、ET含量呈正相关 ( r =0 .86,P <0 .0 1)。结论 :从分子水平探讨 EH的发病与 c- m yc基因表达增高有关。c- myc的表达水平与血浆中 Ang 、ET含量呈正相关     

抗高血压药物对神经内分泌因子的干预作用

目的观察降压药物对高血压患者血中心钠索（ANP）、内源性类洋地黄物质（EDLS）、内皮素（ET）、一氧化氮（NO）等的干预作用，探讨神经内分泌因子与降压疗效的关系。方法将90例高血压病患者采用随机法分为三组，分别给予阿罗涪尔、睬矬普利及依那普利治疗6周，并检测治疗前后上述四种神经内分泌因子的血浓度。结果治疗后，三组诊室血压均明显下降（P〈0．001），组间差异无显著性（P〉0．05）．阿罗洛尔组治疗后ANP显著升高（P〈0.001），ET、NO无变化（P〉0．05）；眯唑普利组与依那普利组ANP、ET降低，NO升高（P〈0.05）。三组EDLS水平均降低（P〈0．05）。结论三种药物均可有效降低血压，其疗效与上述神经内分泌因子的变化有关。     

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.     

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.     

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.     

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.