对六轴系统法诊断左前分支阻滞的评价

为了对新的六轴系统法（ＨＳＡ）诊断左前分支阻滞（ＡＤＢ）进行评价,１２０例电轴在－９０°～＋３０°之间的住院病人按电轴水平－９０°≤Ａ＜－３０°、－３０°≤Ｂ≤０°、０°＜Ｃ≤＋３０°标准划分为Ａ、Ｂ、Ｃ三组,各组均４０例。应用ＨＳＡ和１９８５年世界卫生组织和国际心脏病学会与联合会（ＷＨＯ／ＩＳＦＣ）诊断ＡＤＢ的标准分别对三组病例进行诊断。应用ＨＳＡ诊断Ａ、Ｂ、Ｃ三组ＡＤＢ的阳性率分别为７５．０％、３０．０％和１５．０％,Ａ组阳性率明显高于Ｂ、Ｃ两组,Ｐ均＜０．００１;而应用ＷＨＯ／ＩＳＦＣ标准三组阳性率分别为７０．０％、０、０。两种方法诊断Ａ组中ＡＤＢ的阳性率比较,差异无显著性（７５．０％ｖｓ７０．０％）。Ａ、Ｂ、Ｃ三组中合并右束支阻滞（ＲＢＢＢ）分别为３０％、７．５％和２．５％,Ａ组明显高于Ｂ、Ｃ两组（Ｐ＜０．０１和０．００１）,依据ＨＳＡ诊断的ＡＤＢ中,三组合并ＲＢＢＢ分别占４０．０％、８．３％和０;Ａ组高于Ｂ组,Ｐ＜０．０５。Ａ、Ｂ、Ｃ三组及依据ＨＳＡ方法诊断ＡＤＢ阳性的三组间合并器质性心脏病,左、右室肥大均无差异（Ｐ均＜０．０５）。结果表明：采用ＨＳＡ诊断ＡＤＢ具有简单易行,可能不受电轴及左、右室?     

冠状动脉旁路移植术对心室晚电位的影响

对８例陈旧性心肌梗死（ＯＭＩ）患者于冠状动脉旁路移植术（ＣＡＢＧ）前、后分别检测信号平均心电图（ＳＡ－ＥＣＧ），观察ＣＡＢＧ后，即晚期再灌注对心室晚电位（ＶＬＰ）的影响。发现ＣＡＢＧ后滤波后ＱＲＳ波群时限明显缩短（９５．０±１０．２ｍｓｖｓ１０５．０±１６．７ｍｓ，Ｐ＜０．０５）。８例中３例ＶＬＰ阳性，ＣＡＢＧ后１例ＶＬＰ转为阴性。提示晚期再灌注可能对改善冠心病患者预后有一定作用。     

冠状动脉造影确诊冠心病与非冠心病患者的血脂比较

目的　通过比较和分析冠状动脉造影（ＣＡＧ）确诊为冠心病（ＣＨＤ） 和冠状动脉基本正常者的血脂代谢改变情况,了解血脂代谢紊乱与ＣＨＤ 之间的关系。方法　对３７１ 名住院病人进行ＣＡＧ 并根据狭窄程度分为三组：Ａ 组（ＣＡＧ 基本正常,冠状动脉狭窄＜ ３０％ ,ｎ ＝ １１１ 例） ,Ｂ 组（ＣＡＧ证实至少有一支冠状动脉内径狭窄≥５０％ ,ｎ ＝ ２０３例） ,Ｃ组（ 急性心肌梗死患者,ｎ＝ ５７ 例）,除外糖尿病、瓣膜病及先天性心脏病患者。结果　血清ＴＣ：Ａ组（５－２２±１．１２）ｍｍｏｌ／Ｌ（２００．８ ±４３．１） ｍｇ／ｄＬ,Ｂ 组（５－５８ ±１－２６） ｍｍｏｌ／Ｌ,（２１４－６ ±４８－５） ｍｇ／ｄＬ,Ｃ 组（５－０９ ±１－１２） ｍｍｏｌ／Ｌ（１９５－８ ±４３－１） ｍｇ／ｄＬ,（ Ｐ＝ ０－０３１ ７） ;ＬＤＬ－ Ｃ：Ａ 组（３－１３±１－１４）ｍｍｏｌ／Ｌ（１２０．４ ±４３．８） ｍｇ／ｄＬ,Ｂ 组（３－６９ ±１－０９） ｍｍｏｌ／Ｌ（１４１－９ ±４１－９） ｍｇ／ｄＬ,Ｃ组（３－２３±１－１５）ｍｍｏｌ／Ｌ（１２４－４ ±４４－２） ｍｇ／ｄＬ,（Ｐ＝ ０－０２７ ４） ;ＨＤＬ－ Ｃ：Ａ 组（１－１８ ±０－４１） ｍｍｏｌ／     

房室结传导的加速性、疲劳性对房室结功能不应期的影响

房室结传导的加速性、疲劳性对心室免于各种类型的室上性心动过速包括心房颤动的影响起决定作用，但对房室结功能不应期（ＡＶＮ－ＦＲＰ）的影响不明。旨在通过对离体兔心施以多种方案电生理刺激以阐明两者的相互关系。实验结果表明：①房室结传导的加速性使ＡＶＮ－ＦＲＰ缩短（Ｂ方案１４６±３．３ｍｓｖｓＡ方案１５９±３．５ｍｓ，Ｐ＜０．０１，ｎ＝６），疲劳性使ＡＶＮ－ＦＲＰ延长（Ｃ方案１８７±４．９ｍｓｖｓＡ方案１５９±３．５ｍｓ，Ｐ＜０．０１，ｎ＝６）；②加速性和疲劳性诱导的ＡＶＮ－ＦＲＰ的变化是在１１房室传导范围内产生的，并在快速频率下达到它的最大效应（１００％频率下，Ｂ方案１５４±６．０ｍｓ、Ｃ方案１８７±８．３ｍｓ分别与Ａ方案１６８±６．９ｍｓ相比，Ｐ均＜０．０１，ｎ＝６）。结论：ＡＶＮ－ＦＲＰ受房室结传导之加速性、疲劳性相互作用的共同影响，ＡＶＮ－ＦＲＰ的变化可以用来反映房室结的传导功能     

长效二氢奎尼丁、普罗帕酮、美托洛尔对心室晚电位影响的临床研究

通过短期观察信号平均心电图（ＳＡ－ＥＣＧ）的重复性及比较心室晚电位（ＶＬＰ）阳性患者服药前后ＳＡ－ＥＣＧ指标变化，以了解长效二氢奎尼丁（ｓéｒéｃｏｒ）、普罗帕酮、美托洛尔对ＶＬＰ阳性患者ＳＡ－ＥＣＧ指标的影响，及是否具有逆转ＶＬＰ的作用，结果表明：（１）ＳＡ－ＥＣＧ各定量指标的重复性良好，ＶＬＰ阳性组自然转阴率仅为７．７％。（２）ｓｅｒｅｃｏｒ不能逆转ＶＬＰ，而具有选择性延长ＱＲＳ终末部４０μＶ的低振幅信号持续时间（ＬＡＳ）的作用。（３）普罗帕酮不能逆转ＶＬＰ，仅延长滤波后ＱＲＳ－时限（ＱＲＳ－Ｄ）。（４）美托洛尔显著逆转ＶＬＰ，使ＱＲＳ－Ｄ、ＬＡＳ缩短，综合导联滤波的ＱＲＳ终末４０ｍｓ处综合向量电压（ＲＭＳ_（４０））增加。讨论了三种抗心律失常药物对ＶＬＰ影响的不同效应。     

血吸虫病肝纤维化患者转化生长因子β_1mRNA的水平及其临床意义

目的：研究血吸虫病患者 Ｔ Ｇ Ｆ β１ ｍ Ｒ Ｎ Ａ 水平及其临床意义。方法：用 Ｒ Ｔ Ｐ Ｃ Ｒ 加 ｄｏｔｂｌｏｔ法测定血吸虫病患者 Ｐ Ｂ Ｍ Ｃ中 Ｔ Ｇ Ｆ β１ ｍ Ｒ Ｎ Ａ 水平,与肝硬变和肝癌患者作比较,并研究了部分肝脏组织（肝癌患者１６ 例,肝血管瘤患者正常肝组织 ５ 例）中 Ｔ Ｇ Ｆ β１ ｍ Ｒ Ｎ Ａ 水平与 Ｐ Ｂ Ｍ Ｃ中水平的关系。同时,测定血清中 Ｈ Ａ、 Ｌ Ｎ、 Ｃｏｌ ⅠⅤ和 Ｐ ＣⅢ水平,作为衡量肝纤维化活动与否的指标。结果： Ｐ Ｂ Ｍ Ｃ内 Ｔ Ｇ Ｆ β１ ｍ Ｒ Ｎ Ａ 水平在晚期血吸虫病患者组（ｎ＝ ２１,１２６±０１４）,肝硬变患者组（ｎ＝ １５,２０５±０８１）和肝癌患者组（ｎ＝ ２５,１８３±１２９）均显著高于正常对照组（ｎ＝ １６,０６２±０４０）（ Ｐ＜ ００５）。其中晚期血吸虫病患者组又显著低于肝硬变患者组或肝癌患者组（ Ｐ＜ ００５）,后两组差异无显著性（ Ｐ＞ ００５）。肝组织与 Ｐ Ｂ Ｍ Ｃ内 Ｔ Ｇ Ｆ β１ ｍ Ｒ Ｎ Ａ 水平差别无统计学意义（ Ｐ＞ ００５）。血清 Ｈ Ａ、 Ｃｏｌ Ⅳ和 Ｌ Ｎ 异常组的 Ｔ Ｇ Ｆ β１ ｍ Ｒ Ｎ Ａ 水平显著高于正常组（ Ｐ＜ ００５）。结论： Ｐ     

重型乙型肝炎患者血浆与外周血单个核细胞培养上清液中sIL－2R的检测及意义

以双单克隆抗体夹心ＥＬＩＳＡ法，对４５例重型乙型肝炎（ＳＨＢ）患者（其中急性１０例，亚急性１５例，慢性２０例）检测了血浆与外周血单个核细胞（ＰＢＭＣ）培养上清液中的可溶性白细胞介素２受体（ｓＩＬ－２Ｒ）。结果显示，各型ＳＨ一Ｂ患者血浆ｓＩＬ－２Ｒ水平均明显高于正常对照（Ｐ均＜Ｏ０ｌ）。而不同类型ＳＨ一Ｂ之间，ＨＢｅＡｇ与抗－ＨＢｅ阳性组之间血浆ｓｌＬ－２Ｒ水平及ＳＨ－Ｂ患者与正常对照组之间ＰＢＭＣ培养上清液中的ｓＩＬ－２Ｒ水平皆无显著性差异（Ｐ均＞Ｏ．０５）。提示不同类型ＳＨ一Ｂ患者都存在免疫效应细胞的过度活化而其ＰＢＭＣ体外释放ｓＩＬ－２Ｒ的功能似乎无异常，血浆ｓＪＬ－２Ｒ水平高低似乎与ＨＢＶ复制状态无关。     

红花总黄素抑制血小板激活因子所致毛细血管通透性增加的研究

本文研究了红花总黄素（ＳＹ） 拮抗血小板激活因子（ＰＡＦ） 诱导的小鼠毛细血管通透性增加的作用。小鼠随机分为正常动物空白对照组（Ａ）,模型动物对照组（Ｂ） ,模型动物大剂量（Ｃ） ,中剂量（Ｄ） ,低剂量（Ｅ） 药物组共五组（ｎ ＝ １２） 。Ａ,Ｂ组腹注ＮＳ,Ｃ,Ｄ,Ｅ组腹腔注射ＳＹ;３０ｍｉｎ 后,各组尾静脉注射伊文斯蓝;尾注后３０ｍｉｎ,Ａ组腿部肌肉注射ＮＳ,Ｂ,Ｃ,Ｄ,Ｅ组肌注ＰＡＦ造模;肌注３０ｍｉｎ 后处死小鼠。提取腿部肌肉中的染料,测定提取液６２０ｎｍ 的吸收度反映毛细血管通透性。比色结果：Ａ 组０－０８０ ±０－０４５ ,Ｂ组０－４５６ ±０－１５６（ 与Ａ组比较,Ｐ＜ ０－０１） ,Ｃ 组（１００ｍｇ／ｋｇ ＳＹ）０－２２２ ±０－０７１ ,Ｄ 组（７０ｍｇ／ｋｇ ＳＹ）０－３２２ ±０－１３５ ,Ｅ 组（５０ｍｇ／ｋｇ ＳＹ）０－３４２ ±０－１２９ ,（Ｃ,Ｄ,Ｅ,组与Ｂ 组比较依次为,Ｐ＜ ０－０１ ,０－０５ ,０－０５） ,提示ＳＹ 具有明显抑制ＰＡＦ诱发的小鼠毛细血管通透性增加的作用,并且这种作用随着ＳＹ 剂量增加而加强     

老年人红细胞膜唾液酸含量与红细胞免疫功能的相关性

目的探讨老年人红细胞膜唾液酸（ＲＢＣｍ－ＳＡ）与红细胞免疫功能的相关性。方法采用Ｂｉａｌｓｃｈｅ试剂法检测ＲＢＣｍ－ＳＡ，Ｆ－８８３６化学比色法检测血浆唾液酸（Ｐ－ＳＡ），红细胞免疫粘附试验观察红细胞Ｃ３ｂ受体花环率（ＲＲＣＦ）。结果老年急性心肌梗死（ＡＭＩ）组和脑梗塞（ＡＣＩ）组的ＲＢＣｍ－ＳＡ分别为３０．８±４．３和３１．３±４．４μｇＮＡＮＡ／ｍｇ膜蛋白，ＲＲＣＦ分别为１６．７％±３．５％和１６．０％±３．６％，均低于老年对照组（Ｐ＜０．０１或０．０５），老年对照组均低于非老年对照组（均为Ｐ＜０．０５）；ＡＭＩ和ＡＣＩ患者的Ｐ－ＳＡ分别为２．４±０．４和２．４±０．３ｍｍｏｌ／Ｌ，均高于老年对照组（均为Ｐ＜０．０５），老年对照组则高于非老年对照组（Ｐ＜０．０５）。老年患者和老年对照组的ＲＢＣｍ－ＳＡ与ＲＲＣＦ均呈正相关，而ＲＢＣｍ－ＳＡ与Ｐ－ＳＡ均呈负相关。结论老年人红细胞Ｃ３ｂ受体花环率降低与ＲＢＣｍ－ＳＡ代谢障碍有关。     

拉米夫定治疗2年时乙肝病毒的YMDD变异情况

观察核苷类似物拉米夫定治疗慢性乙肝病人２年时ＹＭＤＤ变异情况及其与血清ＨＢＶＤＮＡ，ＡＬＴ水平等指标的关系。第一阶段（１－１２周）为随机、双盲、安慰剂对照研究，７２名ＨＢｓＡｇ．ＨＢｅＡｇ阳性至少６个月，ＨＢＶ－ＤＮＡ阳性的慢性乙肝患者分别口服拉米夫定１００ｍｇ／ｄ（ｎ＝５４）或安慰剂（ｎ＝１８）；第二阶段（１３－１０４周）所有患者均服用拉米夫定 １００ｇ／ｄ。５２周和 １０４周检查病毒的 ＹＭＤＤ变异．其总变异率分别为 １３．７％（８／５８）和 ３９．７％（２３／５８）。１０４周时变异组血清 ＨＢＶＤＮＡ，ＡＬＴ水平高于无变异组（３９４．９±７２７．９比 １６．３±５０．９，Ｐ＝０．００４８；６２．７±５７．９比２６ ４±２７．５，Ｐ＝０．００３），ＨＢＶＤＮＡ阴转率低于未变异组（１７．４％比４８．６％，Ｐ＜０．０５）；服用拉米夫定的慢性乙肝患者的ＹＭＤＤ发生率与服药时间长短有关，血清ＨＢＶＤＮＡ及ＡＬＴ水平与ＹＭＤＤ相关。     

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.