老年不稳定心绞痛合并抑郁及其治疗

目的：观察抗抑郁治疗对老年不稳定心绞痛伴抑郁患者近期预后的影响。方法：68例老年不稳定心绞痛伴抑郁患者被随机分为抗抑郁治疗组和心绞痛对照组，各34例。在常规心绞痛药物治疗基础上，治疗组给予心理治疗及抗抑郁药物左洛复（舍曲林）50mg／d，顿服，疗程8周。结果：治疗组与对照组比较，心绞痛复发率及急性心肌梗死率明显降低，心肌缺血明显改善，P均〈0．05。结论：抗抑郁治疗能明显改善老年不稳定心绞痛患者的近期预后。     

抗抑郁治疗对老年不稳定型心绞痛伴抑郁患者近期预后的影响

目的：观察抗抑郁治疗对老年不稳定型心绞痛伴抑郁患者近期预后的影响。方法：将老年不稳定型心绞痛伴抑郁的患者随机分为抗抑郁治疗组和对照组各31例，治疗组在堂仙心脏病药物治疗基础上给予心理治疗及加服抗抑郁药盐酸含曲林（左洛复）50mg/d，共12周；对照组给予单纯常规心脏病药物治疗。结果：治疗组心肌缺血明显改善，心绞痛复发率及发生急性心肌梗死比率低，与对照组比较，有显著性差异（P＜0．05）。结论：抗抑郁治疗能明显改善不稳定型心绞痛伴抑郁患者的近期预后。     

抗抑郁治疗对老年不稳定型心绞痛伴抑郁患者近期预后的影响

目的观察抗抑郁治疗对老年不稳定型心绞痛伴抑郁患者近期预后的影响.方法将老年不稳定型心绞痛伴抑郁的患者随机分为抗抑郁治疗组和对照组各31例,治疗组在常规心脏病药物治疗基础上给予心理治疗及加服抗抑郁药盐酸舍曲林(左洛复)50mg/d,共12周;对照组给予单纯常规心脏病药物治疗.结果治疗组心肌缺血明显改善,心绞痛复发率及发生急性心肌梗死比率低,与对照组比较,有显著性差异(P＜0.05).结论抗抑郁治疗能明显改善不稳定型心绞痛伴抑郁患者的近期预后.     

不稳定型心绞痛伴抑郁患者抗抑郁治疗对其预后的影响

目的　观察不稳定型心绞痛伴抑郁患者抗抑郁治疗对其预后的影响。方法　将 42例不稳定型心绞痛伴抑郁患者随机分为抗抑郁治疗组和对照组各 2 1例 ,治疗组在常规药物治疗基础上予心理治疗及加服抗抑郁药氟西汀(百忧解 ,美国礼来药厂 ) 2 0mg/d ,疗程为 12周。结果　治疗组心肌缺血明显改善 ,心绞痛复发率及发生急性心肌梗死比例低 ,与对照组比较 ,有显著差异 (P <0 .0 5 )。结论　抗抑郁治疗能明显改善不稳定型心绞痛伴抑郁患者的近期预后     

丹红注射液治疗冠心病不稳定型心绞痛合并抑郁状态的临床观察

目的：观察中成药丹红注射液治疗冠心病不稳定型心绞痛患者合并抑郁状态的临床疗效,探讨活血化瘀法对双心治疗的有效性。方法选取冠心病不稳定型心绞痛合并抑郁状态患者60例,随机分为治疗组和对照组,各30例。治疗组在常规抗心肌缺血治疗及心理疏导的基础上给予丹红注射液治疗,对照组采用常规抗心肌缺血治疗及心理疏导,连续3周后对两组患者疗效进行比较。结果治疗3周后,治疗组总有效率为96.7%,对照组总有效率为63.3%,治疗组优于对照组（P〈0.05）。治疗组治疗后汉密尔顿抑郁量表（HAMD）评分较治疗前及对照组治疗后明显降低,差异有统计学意义（P〈0.01）。结论丹红注射液治疗冠心病不稳定型心绞痛合并抑郁状态疗效显著。     

糖尿病无症状性心肌缺血的临床特点及诊治原则

冠心病是糖尿病（DM）的重要并发症，约43％～50％的糖尿病患者合并冠心病，合并急性心肌梗死（AMI）的病死率较非糖尿病高2～3倍。而糖尿病合并心肌缺血时以无症状性常见，且AMI、猝死等发生率高。故对糖尿病无症状性心肌缺血（SMI）进行全面了解有重要意义。     

抗抑郁治疗对老年不稳定型心绞痛伴抑郁患者近期预后的影响

目的观察抗抑郁治疗对老年不稳定型心绞痛伴抑郁患者近期预后的影响.方法将老年不稳定型心绞痛伴抑郁的患者随机分为抗郁治疗组和对照组各38例,治疗组在常规心脏药物治疗基础上予心理治疗及加服抗抑郁药氟西汀20 mg 1/d,共12周;对照组只给予单纯常规心脏药物治疗.结果治疗组心肌缺血明显改善,心绞痛复发率及发生急性心肌梗死比例低,与对照组比较,差异有显著性(P＜0.05).结论抗抑郁治疗能明显改善不稳定型心绞痛伴抑郁患者的近期预后.     

冠心病介入治疗后抗抑郁焦虑治疗356例临床观察

目的观察冠心病介入治疗（PCI）后症状再次出现的患者抗抑郁焦虑治疗对冠心病治疗效果的影响。方法选取接受PCI完全血运重建治疗后症状复发、经汉密尔顿量表确定为抑郁焦虑的356例冠心病患者,予以盐酸舍曲林抗抑郁治疗,观察患者临床症状的改善情况。结果356例患者入院后复查冠状动脉造影未见明显异常。盐酸舍曲林治疗4周后356例患者的心绞痛症状及抑郁焦虑症状明显改善,并未出现明显的副作用。结论对于合并抑郁焦虑的冠心病患者给予抗抑郁焦虑治疗,可以进一步改善症状,提高冠心病的治疗疗效。     

心肌缺血后适应对急性心肌梗死（AMI）合并糖尿病患者临床及预后的影晌

目的观察心肌缺血后适应对急性心肌梗死（AMI）合并糖尿病患者临床及预后的影响。方法选取我院从2010年9月-2013年9月我院所收治的首次ST段抬高性急性心梗合并糖尿病患者20例作为观察组对象，同时选取采用常规PCI治疗患者20例作为对照组对象，两组患者均采用常规方法进行经皮腔内冠脉成形术（PTCA），观察组患者采用心肌缺血后适应治疗，并评定患者疗效和预后。结果观察组患者在CPK、CK-MB和cTnT峰值浓度均低于对照组患者，术后三个月LVEF值明显高于对照组。差异均有统计学意义（P〈0．05）。观察组患者在梗死后心绞痛、严重心律失常的发生率均低于对照组患者，差异有统计学意义（P〈0．05）。而心源性死亡的发生率与对照组比较则无统计学意义（P〉0．05）。结论PCI治疗中加用缺血后适应治疗，可以改善AMI合并糖尿病患者预后，且无需额外产生治疗费用，不会造成患者经济负担，适合在今后临床治疗中推广使用。     

抗抑郁治疗对老年高血压降压疗效的影响

该文探讨抗抑郁治疗对老年高血压患者降压疗效的影响。方法：对138例老年高血压合并抑郁的患者随机分为A、B组，并设老年高血压患者对照组103例，3组均给予氢氯噻嗪12．5mg／d和硝苯地平控释片30mg／d口服，A组在此基础上加服氟西汀（百优解）20mg／d口服，共12周；B组给予阿米三嗪（都可喜）1片和谷维素20mg，3次／d，共12周。结果：A组与治疗前及B组相比，其坐位血压、24h动态血压监测昼夜收缩压和舒张压均明显下降，差异有非常显著意义（P〈0.01）。结论：抗抑郁治疗有利于老年高血压合并抑郁患者的血压控制。     

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.