丹红注射液治疗慢性肺源性心脏病临床观察

目的观察丹红注射液治疗慢性肺源性心脏病的临床疗效。方法选择我院肺心病患者86例，随机分为治疗组46例，对照组40例，两组患者均给予适当的抗生素抗感染，低流量吸氧，通畅气道等治疗。治疗组患者在此基础上加用丹红注射液40ml加入5％葡萄糖注射液250ml中静点，1次／d，疗程均为14d。结果两组患者疗效间差异有显著性意义（P〈0．05）。治疗组患者治疗前、后红细胞比客、红细胞计数、血红蛋白、血小板计数间差异有显著性意义（P〈0．01），两组患者治疗后上述指标间比较差异亦均有显著性意义（P〈0．05）。结论丹红对慢性肺心病有良好的疗效。     

无创通气对慢性肺源性心脏病心肺功能的影响

目的观察无创通气对慢性肺源性心脏病心肺功能失代偿期患者的影响。方法将67例慢性肺源性心脏病失代偿期患者随机分为对照组和实验组，两组常规治疗相同，实验组除常规治疗外还予以BiPAP呼吸机治疗，疗程7-10d。比较两组治疗前后症状，体征，动脉血气（Pa02、PaC02）、心输出量（CO）、肺动脉收缩压（SPAP）和肺功能指标（FEVI和FVC）的改善程度。结果治疗后实验组和对照组临床症状和体征改善率分别为86％和75％（P〈O．01）；实验组动脉血PaO2、PaCO2、SPAP和FVE较对照组明显改善（P〈0．05），而CO和FEV1与对照组相比无明显差异（P均〉0．05）。结论无创通气能降低肺心病心肺功能失代偿期患者的肺动脉压，显著改善临床症状和肺功能，对左心功能无明显影响。     

低分子肝素钙治疗慢性肺源性心脏病急性发作期64例疗效观察

目的评价低分子肝素钙治疗慢性肺源性心脏病（肺心病）急性发作期的疗效及安全性。方法选择我院慢性肺心病急性发作患者124例，随机分为两组，两组患者均根据药物敏感试验选择有效性抗生素，扩血管、强心利尿，止咳化痰，低流量持续吸氧，维持水电解质平衡等常规治疗，治疗组患者在此基础上加用低分子肝素钙4100U，2次／d，腹部皮下注射，疗程均为7d。观察两组患者的临床疗效及有无出血、药物过敏等不良反应。结果两组患者的临床疗效间差异有非常显著性意义（P〈0．01）。治疗组患者治疗前、后血浆黏度、全血黏度低切间差异均有显著性意义（P〈0．05），且无严重不良反应。结论低分子肝素钙治疗肺心病急性发作期安全有效。     

丹红注射液治疗慢性肺心病急性发作临床观察

目的观察丹红注射液治疗慢性肺源性心脏病急性发作的疗效。方法将88例患者随机分为治疗组（45例）和对照组（43例）,两组均予常规对症治疗（包括吸氧、抗炎、解痉、化痰、强心、利尿、扩血管等）,治疗组在上述基础上加用丹红注射液30ml＋5％葡萄糖针250ml静滴,1次／d,疗程14d。结果治疗组临床疗效的总有效率优于对照组（P〈0．01）;治疗组血液流变学各项指标明显改善（P〈0．01）。结论丹红注射液能有效降低慢性肺心病患者的血液黏稠度,降低肺循环阻力,从而改善心肺功能,缩短住院时间,值得推广。     

生脉注射液治疗慢性阻塞性肺疾病合并慢性肺源性心脏病的效果分析

目的分析生脉注射液治疗慢性阻塞性肺疾病合并慢性肺源性心脏病(肺心病)的效果。方法将我院收治的40例慢性阻塞性肺疾病合并慢性肺心病患者随机分为对照组和观察组,对照组依据常规进行康复治疗并加强营养支持;观察组在常规康复治疗的基础上给予生脉注射液静脉滴注,共治疗28d,治疗后观察两组患者的治疗效果。结果治疗后观察组患者肺通气功能、血气分析指标均优于对照组,差异有统计学意义(P<0.05)。结论临床应用生脉注射液治疗慢性阻塞性肺疾病合并慢性心肺病,效果显著,值得临床推广应用。     

疏血通联合辛伐他汀辅助治疗慢性肺心病急性发作46例疗效观察

目的 观察疏血通联合辛伐他汀治疗慢性肺心病急性发作期患者的临床疗效。方法将90例慢性肺心病急性发作期患者随机分为观察组46例和对照组44例，两组均予吸氧、抗感染、解除支气管痉挛、强心利尿等常规综合治疗，在此基础上观察组加用疏血通、辛伐他汀治疗，疗程均为10d。观察两组治疗前后临床表现、血液流变学指标、高敏-C反应蛋白（hsCRP）水平、血气分析、肺动脉压变化并据以判定临床疗效；测定凝血功能指标。结果观察组总有效率显著高于对照组，且各项凝血功能指标改善情况优于对照组（P〈0．05）。结论疏血通联合辛伐他汀辅助治疗慢性肺心病急性发作患者近期疗效确切，且可改善凝血功能。     

阿魏酸钠治疗慢性肺源性心脏病急性加重期疗效观察

目的观察阿魏酸钠治疗慢性肺源性心脏病(肺心病)急性加重期的临床疗效。方法80例慢性肺心病急性加重期患者随机分为两组。对照组采用常规治疗,治疗组在常规治疗基础上加用阿魏酸钠治疗15 d后。结果治疗组总有效率为90.0%,对照组总有效率为82.5%,两组比较差异有统计学意义(P<0.05)。结论在常规治疗基础上加用阿魏酸钠治疗慢性肺心病可明显改善患者的心肺功能。     

复方强心康治疗慢性肺源性心脏病心力衰竭的疗效观察

目的观察复方强心康治疗慢性肺源性心脏病心力衰竭的疗效。方法选择慢性肺源性心脏病心力衰竭患者60例。随机将患者分为治疗组（30例）与对照组（30例）。两组患者均给予吸氧,抗感染,支气管扩张剂,减轻心脏前后负荷等综合治疗,治疗组加用复方强心康治疗,30d为1个疗程。对比两组治疗后的临床症状、心脏彩超及血气分析等。结果治疗1个疗程后治疗组总有效率为90％,明显高于对照组（P〈0．05）;心脏彩超检查右心室形态改变及血气分析的改善程度均优于对照组（P〈0．05）。结论复方强心康可改善微循环,降低血液黏度,降低肺动脉高压,改善患者缺氧和高碳酸血症,改善心肺功能,治疗慢性肺源性心脏病心力衰竭有确切疗效。     

76例老年慢性肺心病合并心衰患者加强护理的效果

目的：探讨加强护理对老年慢性肺源性心脏病合并心力衰竭患者心肺功能和生活质量的影响。方法：76例慢性肺心病合并心力衰竭住院患者,随机分为常规护理组（28例,给予常规治疗、护理）与加强护理组（48例,在常规治疗基础上,加强针对性护理,指导肺功能锻炼）,比较两组患者治疗前后的心肺功能和生活质量变化。结果：两组治疗后心肺功能及生活质量均较治疗前有显著改善（P〈0．05或〈0．01）;与常规护理组比较,加强护理组治疗后生活质量评分[（49．93±8．43）分比（39．30±5．01）分]显著减少（改善）;左室射血分数[LVEF（53．42±5．45）％比（61．33±5．97）％]、第一秒用力呼气量FFEVl,（53．4±5．2）％比（58．2±4．7）％]、6min步行距离F6MWD,（196±10．6）m比（203．4±9．1）m3显著增加（P〈0．05）。结论：加强针对性护理可增强老年慢性肺源性心脏病合并心力衰竭患者的心肺功能,改善生活质量。     

慢性肺心病急性加重期患者川芎嗪注射液的应用研究

目的研究慢性肺心病急性加重期患者应用川芎嗪注射液对其临床疗效及血管活性物质的影响。方法采取随机、对照试验方法,将60例慢性肺心病急性加重期患者随机分为川芎嗪治疗组和对照组,观察两组患者治疗前后临床疗效和血一氧化氮（NO）、内皮素-1（ET-1）的变化。结果川芎嗪治疗组临床疗效优于对照组。川芎嗪治疗组治疗后血NO升高、ET-1降低更为显著,与对照组治疗后比较有显著性差异（P〈0．05）。结论川芎嗪治疗慢性肺心病急性加重期安全有效。其机制可能是通过选择性作用于肺血管,抑制ET-1而增加NO的合成与释放,从而降低肺动脉高压,改善患者心肺功能。     

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.