解毒化瘀中药灌肠对溃疡性结肠炎活动期及缓解期炎性反应的影响

[目的]探讨解毒化瘀方灌肠对溃疡性结肠炎（UC）活动期及缓解期炎性反应的影响.[方法]采用家兔结肠黏膜-TNBS/乙醇液的免疫化学法造模,将160只大鼠随机分为4组：正常组、模型组、解毒化瘀方（中药复方）组、奥沙拉秦组,每组40只;检测各组大鼠活动期、缓解期结肠黏膜炎性因子——肿瘤坏死因子（TNF-α）、白细胞介素-8（IL-8）与P-选择素的表达.[结果]活动期,中药复方组、奥沙拉秦组均表现为下调TNF-α、IL-8和P-选择素的高表达状态,且明显低于模型组（P＜0.01）.第1周末,奥沙拉秦组TNF-α、IL-8两指标的改善更明显（P＜0.01）;第2周末,中药复方组、奥沙拉秦组改善两指标的疗效相当（P＞0.05）;第1、2周末中药复方组下调P-选择素的作用均明显优于奥沙拉秦组（P＜0.01）.缓解期,中药复方组、奥沙拉秦组与模型组相比TNF-α、IL-8和P-选择素的表达均显著降低（P＜0.01）.随着时间的推移,中药复方组的疗效更为显著（P＜0.01）,在第4周末,中药复方组大鼠结肠TNF-α、IL-8和P-选择素表达基本接近正常值.[结论]解毒化瘀方、奥沙拉秦均可有效控制UC的炎症反应.奥沙拉秦能更快更早地控制炎症的急性发作,解毒化瘀方则能更有效地改善慢性炎症,且解毒化瘀方在有效抑制血小板活化方面更具优势.     

结肠康泰对溃疡性结肠炎大鼠结肠黏膜细胞增殖及周期的影响

[目的]探讨结肠康泰对溃疡性结肠炎（UC）大鼠模型结肠黏膜细胞增殖及周期的影响。[方法]雌性SD大鼠60只，随机分为正常对照、模型、柳氮磺胺吡啶（SASP）及结肠康泰组，以5％2、4、6，三硝基苯磺酸（TNBs）诱导大鼠形成结肠炎症，免疫组化检测增殖细胞核抗原（PCNA）的表达及流式细胞仪分析细胞周期。[结果]SASP及结肠康泰组大鼠增殖细胞指数（LI）明显增高，G0／1期细胞明显减少而G2／M期细胞增加，与模型组比较差异均有统计学意义（均P〈0．05）。[结论]结肠康泰能增强UC大鼠结肠黏膜细胞的增殖能力。     

益气活血解毒法对溃疡性结肠炎复发患者血浆及结肠组织P－选择素的影响

[目的]探讨益气活血解毒法对溃疡性结肠炎（UC）复发患者血浆及结肠组织P-选择素的影响。[方法]90例UC复发患者随机分为2组,各45例,治疗组给予益气活血解毒法的中药汤剂,对照组给予柳氮磺胺吡啶治疗,治疗前后分别检测血浆及结肠组织P-选择素。[结果]治疗前UC患者血浆及结肠组织P-选择素水平明显高于正常（P〈0．01）;治疗组治疗后及随访时血浆及结肠组织P-选择素水平明显低于对照组（P〈0．01）;复发者水平明显高于未复发者（P〈O．01）。[结论]以益气活血解毒法的中药抗UC复发方,与西药柳氮磺胺吡啶比较,可有效降低血浆及结肠组织P-选择素水平,从而阻抑血小板活化,可能是抗UC复发作用机制之一。     

溃疡性结肠炎患者P-选择素和血小板参数分析

背景：研究发现凝血机制活化在炎症性肠病（IBD）的进展过程中起重要作用。P-选择素（CD62P）参与介导凝血和炎症反应时中性粒细胞和单核细胞与活化的血小板或内皮细胞的黏附。目的：探讨血小板活化标记物P．选择素以及血小板计数（PLT）、平均血小板体积（MPV）用于溃疡性结肠炎（UC）疾病活动度评估的价值。方法：纳入65例活动期UC患者、31例缓解期UC患者和60例健康对照者。流式细胞术测定外周血P-选择素阳性率,血细胞分析仪测定PLT、MPV,分析三者与UC活动度的相关性。结果：UC患者外周血CD62P阳性率、PLT显著高于对照组（P〈0．01）,MPV显著低于对照组（P〈0．01）;活动期UC患者三项指标的变化均较缓解期UC患者更为显著,组间差异有统计学意义（P〈0．05）。外周血CD62P、PLT与UC活动度呈正相关（P〈0．05）,MPV与UC活动度呈负相关（P〈0．05）。结论：UC患者的机体处于高凝状态。P-选择素、PLT、MPV能反映UC疾病活动度,对病情评估和治疗方案的制定有一定参考价值。     

三七提取物对三硝基苯磺酸诱导溃疡性结肠炎大鼠结肠血管生成的研究

[目的]从血管生成角度研究三七提取物促进结肠溃疡愈合的作用机制。[方法]制备三硝基苯磺酸（TNBS）诱导溃疡性结肠炎（UC）大鼠，分为三七提取物低、中、高剂量组，柳氮磺胺吡啶（SASP）组，模型对照组，模型组和正常对照（正常）组。其中模型组于造模3d时处死，其余6组均在给药处理7d（即造模10d）时处死。取大鼠结肠病变部位标本，进行组织学评价；运用免疫组化染色法检测血管内皮生长因子（VEGF）、fms样酪氨酸激酶受体（FLT-1）和含有激酶插入区域的受体（KDR）、低氧诱导因子（HIF-1）蛋白表达；用RT-PCR法检测VEGF、FLT-1和KDR、HIF-1的mRNA表达。[结果]与模型对照组和SASP组比较，三七提取物低、中和高剂量组大鼠结肠黏膜炎症明显消除和溃疡愈合，杯状细胞数量及黏液增加，VEGF、FLT-1和KDR、HIF-1表达显著增加。[结论]血管生成在TNBS诱导大鼠UC形成和愈合过程中起重要作用。用药后VEGF、KDR、FLT-1和HIF-1表达增加。三七提取物通过上调VEGF、KDR、FLT-1和HIF-1表达促进血管生成，是其治疗UC的主要作用机制之一。     

乌梅丸对溃疡性结肠炎大鼠肠组织核转录因子-κB及细胞间黏附分子1的影响

[目的]探讨乌梅丸对大鼠溃疡性结肠炎（UC）结肠组织核转录因子-κB（NF-κB）及细胞间黏附分子1（ICAM-1）表达的影响机制。[方法]采用2，4-二硝基氯苯（DNCB）加醋酸复合法制备大鼠UC模型。84只SD大鼠随机分为正常对照（正常）组、模型组、柳氮磺胺吡啶（SASP）组和乌梅丸大、中、小剂量组。采用免疫组织化学染色法检测结肠组织NF-κB、ICAM-1的表达。[结果]与正常组相比，模型组大鼠结肠组织中NF-κB、ICAM-1表达显著增高（P〈0．01），而乌梅丸各剂量组、SASP组较模型组明显降低（P〈O．01）。[结论]NF-κB、ICAM-1可能参与了UC的发生、发展。乌梅丸可能通过抑制NF-κB、ICAM-1的表达，从而起到治疗UC的作用。     

乌梅丸对溃疡性结肠炎大鼠结肠组织白细胞介素8及13表达的影响

[目的]探讨乌梅丸对大鼠溃疡性结肠炎（UC）结肠组织白细胞介素8（IL-8）及白细胞介素13（IL-13）表达的影响。[方法]采用2,4-二硝基氯苯（DNCB）加醋酸复合法制备大鼠UC模型。动物随机分为正常对照组、模型组、柳氮磺胺吡啶（SASP）组和乌梅丸大、中、小剂量组6组。采用免疫组织化学染色法检测结肠组织IL-8、IL-13的表达。[结果]与正常组相比,模型组大鼠结肠组织中IL-8的阳性表达显著增高（P〈0.01）,而乌梅丸各剂量组、SASP组则较模型组明显降低（P〈0.01）。与正常组相比,模型组大鼠结肠组织中IL-13的阳性表达显著降低（P〈0.01）,而乌梅丸各剂量组、SASP组则较模型组明显升高（P〈0.01）。[结论]IL-8I、L-13参与了UC的发生。乌梅丸可能是通过下调IL-8,上调IL-13达到治疗UC的目的。     

健脾解毒化瘀方对大鼠实验性溃疡性结肠炎细胞因子的影响

[目的]探讨以益气健脾、清热解毒、活血化瘀为原则组成方剂对溃疡性结肠炎(UC)大鼠细胞因子的影响,探讨其治疗UC的机制.[方法]除15只大鼠作为正常组外,其他大鼠采用TNBS复制UC模型后随机分成模型组、对照组、柳氮磺胺吡啶(SASP)组、中药组,肉眼及镜下观察各组大鼠的组织学损伤,并检测血清中细胞因子的含量.[结果]中药组、SASP组在减轻肉眼及镜下的组织学损伤方面和改善细胞因子方面较模型组、对照组均具有明显效果(P＜0.05);中药组较SASP组疗效更明显(P＜0.05).[结论]以益气健脾、清热解毒、活血化瘀为原则组成方剂对UC治疗有效,其机制可能是提高抗炎因子的含量,降低炎症因子的含量,维持细胞因子之间的平衡,进而调节免疫炎症反应.     

理肠汤灌胃结合溃疡灵灌肠治疗大鼠溃疡性结肠炎实验研究

[目的]观察理肠汤灌胃结合溃疡灵灌肠治疗大鼠实验性溃疡性结肠炎(UC)的疗效。[方法]将动物随机分为正常对照(正常)组、模型组、中药治疗小剂量(小剂量)组、中药治疗大剂量(大剂量)组、柳氮磺吡啶(SASP)组。其中除正常组外,其余4组均采用2,4,6-三硝基苯磺酸(TNBS)溶液制作大鼠模型,成功后大、小剂量组分别予大、小剂量理肠汤灌胃及溃疡灵灌肠;SASP组予SASP溶液灌胃,各组灌药时间均为14 d。[结果]大剂量组肠黏膜组织学损伤评分显著低于模型组(P0.01);小剂量组、SASP组肠黏膜组织学损伤评分亦低于模型组(P0.05),但小剂量组和SASP组疗效相近(P0.05)。[结论]理肠汤灌胃结合溃疡灵灌肠治疗大鼠实验性UC有明显疗效。     

健脾清肠方对溃疡性结肠炎的临床疗效及对Fas／FasL的影响

[目的]观察健脾清肠方对溃疡性结肠炎（UC）患者的临床疗效及对免疫细胞载脂蛋白及其配体（Fas／FasL）的影响。[方法]将60例UC患者，随机分为健脾清肠方（中药）组和柳氮磺胺吡啶（SASP）组各30例。治疗8周后，观察临床症状、结肠镜下黏膜改变以及治疗前后Fas／FasL表达。[结果]中药组症状改善和结肠镜下黏膜炎症修复情况均优于SASP组（P〈0．05）。2组治疗前后肠上皮Fas的表达率均有不同程度下降，其中中药组下调Fas及FasL蛋白表达的作用更强，效果亦优于SASP组（P〈0．05）。[结论]健脾清肠方治疗UC疗效显著；Fas／FasL表达异常可能在UC发病中作为病理因子而导致患者肠上皮的损害，降低其表达可能是治疗UC的机制之一。     

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.