山楂黄酮抗心肌缺血再灌注损伤的机制研究

目的通过观察山楂叶总黄酮(hawthorn leaf flavonoids,HLF)对大鼠心肌缺血再灌注损伤模型的影响,探讨其对缺血再灌注损伤心肌细胞的保护作用。方法选取Male Wistar大鼠40只,雌雄各半,随机分为正常对照组、模型组及HLF低剂量组、高剂量组,每组各10只;各组均正常饲养,HLF低剂量组、高剂量组分别灌胃给予山楂黄酮0.5 g/kg、1.0 g/kg每日1次,连续7 d;建立大鼠心肌缺血损伤模型,记录V3心电图,比较各组ST段上移、T波升高的幅度及出现心律失常的数量;心电图检查完成后,腹主动脉采血,取血清,测定心肌超氧化物歧化酶(SOD)、肌酸激酶(CK)水平。结果不同剂量的山楂黄酮均可改变实验性大鼠急性心肌缺血的心电图S-T段变化幅度,减少心律失常发生率,提高心肌SOD活力,抑制CK活性。结论 HLF对大鼠心肌缺血再灌注心肌损伤具有保护作用,其机制可能与抑制自由基生成,改善能量代谢等有关。     

染料木素对心肌缺血再灌注损伤的保护作用及机制研究

目的研究染料木素（Gen）对大鼠心肌缺血再灌注损伤的保护作用,并进一步阐明其机制。方法 40只SD大鼠,随机分为模型组、阴性对照组和Gen高剂量组（10 mg/kg）、Gen中剂量组（5 mg/kg）、Gen低剂量组（2.5mg/kg）。持续观察各组标准Ⅱ导联心电图（ECG）T波幅度变化情况,测定血清中乳酸脱氢酶（LDH）,磷酸肌酸激酶（CK）,丙二醛（MDA）及超氧化物歧化酶（SOD）含量,确定心肌损伤程度。免疫组化法检测Bc l-2、Bax、Caspase-3蛋白的表达。结果 Gen能降低大鼠心肌冠脉结扎后T波幅度抬高,降低LDH、CK和MDA水平,升高SOD水平,抑制Bax、Caspase-3的表达而增强Bc l-2的表达,减少心肌细胞凋亡。结论 Gen对冠脉结扎诱发的大鼠心肌缺血再灌注损伤有保护作用,其作用机制可能与抑制脂质过氧化,减少自由基损伤,上调Bc l-2蛋白表达,下调Bax、Caspase-3蛋白表达,抑制心肌细胞凋亡有关。     

银杏内酯B对大鼠心肌缺血再灌注损伤后细胞凋亡及凋亡相关蛋白表达的影响

目的探讨银杏内酯B对大鼠心肌缺血再灌注损伤后细胞凋亡及相关蛋白表达的影响。方法将100只SD大鼠随机分为假手术组、模型组及银杏内酯B低剂量组(15mg/kg)、中剂量组(30mg/kg)、高剂量组(60mg/kg),每组20只。通过夹闭左冠状动脉前降支制作心肌缺血再灌注大鼠模型。监测各组大鼠心电图波动变化;红四氮唑(TTC)染色法测量心肌梗死体积;苏木精-伊红(HE)染色法观察心肌组织病理变化;末端标记法(TUNEL)观察细胞凋亡状况;免疫蛋白印记法测定凋亡相关蛋白(Bcl-2、Bax、激活型Caspase-3)表达。结果与模型组比较,银杏内酯B各剂量组心电图明显改善,其中银杏内酯B高剂量组基本恢复正常;银杏内酯B中剂量组、高剂量组心肌梗死体积显著降低(P<0.05或P<0.01),心肌组织病变明显改善,心肌细胞凋亡指数(AI)显著降低(P<0.01),Bcl-2蛋白表达显著上调(P<0.05或P<0.01),Bax和激活型Caspase-3蛋白表达显著下调(P<0.05或P<0.01),Bcl-2/Bax比值显著升高(P<0.01)。结论银杏内酯B通过调节凋亡相关蛋白表达从而抑制再灌注性损伤后心肌细胞凋亡。     

灯盏花素对大鼠心肌缺血再灌注损伤心肌细胞凋亡及NF-kB通路信号分子α7nAChR、p65、IkB-α的影响

目的观察灯盏花素对大鼠心肌缺血再灌注损伤心肌细胞凋亡及NF-kB通路信号分子α7nAChR、p65、IkB-α的影响。方法 40只SD大鼠随机均分为假手术组、缺血再灌注组、灯盏花素低剂量组(25 mg/kg·d)和灯盏花素高剂量组(50 mg/kg·d),每组各10只。4组均制备缺血再灌注模型,其中灯盏花素治疗组术前连续1周腹腔注射灯盏花素;假手术组以及缺血再灌注组分别注射等量的生理盐水。随后处死,取出心脏检测心肌组织梗死面积;TUNEL法检测心肌细胞的凋亡指数;蛋白印记法检测α7nAChR、p65、IkB-α蛋白的表达。结果缺血再灌注组较假手术组心肌梗死面积、心肌细胞凋亡指数以及IkB-α蛋白显著增加(P0.01),p65和α7nAChR蛋白显著减少(P0.05);灯盏花素高低剂量组较缺血再灌注组心肌梗死面积、心肌细胞凋亡指数以及IkB-α蛋白显著降低(P0.01),p65和α7nAChR蛋白显著增加(P0.05),并呈现剂量依赖性。结论灯盏花素预处理能有效减少大鼠心肌缺血再灌注损伤以及心肌细胞凋亡,其机制可能为上调α7nAChR,从而通过NF-kB通路抑制心肌细胞的凋亡,发挥心肌保护作用。     

清开灵注射液对大鼠心肌缺血再灌注损伤的保护作用

目的探讨清开灵(QKL)注射液对大鼠实验性缺血/再灌注(I/R)损伤的保护作用及机制。方法 Wistar大鼠40只,随机分为假手术组、模型组、清开灵注射液高剂量组(QKL 40 mg/kg)、清开灵注射液低剂量组(QKL 20 mg/kg),每组10只。结扎大鼠冠状动脉左前降支40 min、再灌120 min制备心肌I/R损伤模型。检测QKL对I/R损伤大鼠血清中LDH、CK、AST、SOD、MDA、NO含量的影响;同时以TTC染色检测心肌梗死面积变化。结果与模型组比较,QKL高剂量组及QKL低剂量组大鼠血清中LDH、CK、AST含量明显降低(P<0.05),SOD活性明显升高(P<0.01),MDA及NO含量降低(P<0.01)。QKL高剂量组及QKL低剂量组心肌梗死面积明显低于模型组(P<0.05)。免疫组化法检测结果显示,QKL高剂量组及QKL低剂量组心肌细胞iNOS表达量低于模型组(P<0.05)。结论 QKL可能通过抑制iNOS,对大鼠心肌I/R损伤具有保护作用。     

曲美他嗪对急性心肌缺血再灌注损伤大鼠的治疗效果及对Bcl_2、Caspase_3蛋白表达的影响

目的探讨曲美他嗪对急性心肌缺血再灌注损伤大鼠的治疗效果及对B细胞淋巴瘤/白血病_2基因(Bcl_2)、天冬氨酸特异性半胱氨酸蛋白酶_3(Caspase_3)表达的影响。方法选取健康成年雄性SD大鼠48只,随机分为假手术组、模型组、低剂量组和高剂量组,每组12只,其中模型组、低剂量组和高剂量组大鼠制备急性心肌缺血再灌注损伤,低剂量组给予10mg/kg曲美他嗪灌胃,高剂量组给予20mg/kg曲美他嗪灌胃,采用全自动生化分析仪检测肌酸激酶(CK)和乳酸脱氢酶(LDH),采用HE染色观察心肌组织,采用DNA原位末端标记(TUNEL)检测心肌细胞凋亡,免疫组化法检测心肌组织Bcl_2和Caspase_3蛋白表达。结果假手术组心肌组织未见明显改变,模型组心肌纤维排列紊乱,细胞严重水肿,低剂量组和高剂量组心肌细胞肿胀减轻;模型组、低剂量组和高剂量组CK、LDH和凋亡指数(AI)值明显高于假手术组(P0.05);高剂量组CK、LDH和AI值分别为(720.02±80.21)U/L、(1642.04±137.72)U/L和(7.89±1.04),明显低于低剂量组和模型组(P0.05);模型组、低剂量组和高剂量组Caspase_2蛋白表达灰度值明显高于假手术组,而Bcl_2蛋白表达灰度值明显低于假手术组(P0.05);高剂量组Caspase_2蛋白表达灰度值为(120.03±24.15),明显低于低剂量组和模型组(P0.05),而Bcl_2蛋白表达灰度值为(155.16±10.10),明显高于低剂量组和模型组。结论高剂量曲美他嗪能抑制急性心肌缺血再灌注损伤大鼠心肌细胞凋亡,与其上调Bcl_2蛋白表达,下调Caspase_2蛋白表达有关。     

水飞蓟宾对心肌缺血再灌注损伤大鼠心功能和氧化应激的影响

目的研究水飞蓟宾(silibinin,SIL)对心肌缺血再灌注损伤大鼠的心功能和氧化应激的影响。方法将1()0只实验用SD大鼠随机分为假手术组,模型组和SIL低剂量[100 mg/(kg·d)]预处理组、巾剂量[200 mg/(kg·d)]预处理组、高剂量[400 mg/(kg·d)]预处理组,每组各20只。SIL预处理组术前7 d开始灌胃给药。7 d后结扎大鼠冠状动脉30 min后再通建立心肌缺血再灌注损伤模型,再灌注时间为6 h。通过高分辨率超声影像系统检测舒张末期左室内径(LVIDd)和收缩末期左室内径(LVIDs)、短轴缩短率(FS)、射血分数(EF)及每搏输出量(SV);生化分析法测定血清中心肌酶含量;HE染色法观察心肌组织形态结构改变;比色法测定心肌组织中抗氧化酶活性和丙二醛(MDA)含量;Western blotting法测定心肌组织NF-κB蛋白表达;TUNEL染色法观察心肌细胞凋亡状况。结果与模型组比较,经SIL中、高剂量预处理能够明显降低急性心肌梗死大鼠LVIDd并显著提高FS、EF和SV;可显著降低血清中心肌酶(谷草转氨酶、肌酸磷酸激酶、乳酸脱氢酶)含量,提高心肌组织中抗氧化酶(超氧化物歧化酶、谷胱甘肽过氧化物酶、过氧化氢酶)活性并显著降低MDA含量;此外,还可显著降低NF-κB蛋白表达量,并且明显改善心肌细胞凋亡状况,显著降低凋亡指数(AI),差异均具有统计学意义(P0.05~0.01)。结论 SIL具有改善心肌缺血再灌注损伤大鼠心功能并抑制其氧化应激损伤的作用,表现出对急性心肌梗死具有一定的保护作用。     

水飞蓟宾对大鼠心肌缺血再灌注损伤后心肌细胞凋亡的影响

目的研究水飞蓟宾(Silibinin,SIL)对大鼠心肌缺血再灌注损伤后心肌细胞凋亡的影响及其机制。方法取100只实验用大鼠随机分为假手术组,模型组和SIL低(100mg/(kg·d))、中(200mg/[kg·d))、高(400mg/(kg·d))剂量预处理组(n=20),术前7d开始灌胃给药;采用结扎冠状动脉30min的方法建立大鼠心肌缺血再灌注损伤模型;再灌注6h后,通过高分辨率超声影像系统检测舒张末期左室内径(IVIDd)和收缩末期左室内径(LVIDs)、短轴缩短率(FS)、射血分数(EF)、每搏输出量(SV);TTC染色法计算心肌梗死面积,TUNEL法观察心肌细胞凋亡状况,RT-PCR法测定心肌组织bcl-2 mRNA、Bax mRNA表达,Western blotting法测定心肌组织caspase-3、NF-kB蛋白表达;比色法测定心肌组织中抗氧化酶活性和丙二醛(MDA)含量。结果与模型组比较,发现经SIL中、高剂量预处理能够显著降低急性心肌梗死大鼠LVIDd并显著提高FS、EF和SV,其中SIL高剂量预处理组LVIDs显著降低;显著降低心肌组织梗死面积,明显改善心肌细胞凋亡状况、显著降低心肌细胞凋亡指数(Apoptosis index,AI),显著上调bcl-2 mRNA表达并下调Bax mRNA表达、显著提高‘bcl-2/Bax比值,显著降低caspase-3、NF-kB蛋白表达量,显著提高抗氧化酶(SOD、CAT)活性并显著降低MDA含量,差异均具有统计学意义(P0.05,P0.01)。结论SIL具有抑制心肌缺血再灌注损伤大鼠心肌细胞凋亡的作用,其机制可能与SIL改善心功能、调节凋亡相关基因和蛋白表达以及抑制氧化应激损伤有关。     

银杏黄酮对心肌缺血再灌注损伤大鼠的心肌保护作用及其作用机制研究

目的探讨银杏黄酮对心肌缺血再灌注(MI/R)损伤大鼠的心肌保护作用及其作用机制。方法将80只大鼠随机分为假手术组、模型组、银杏黄酮低剂量组和银杏黄酮高剂量组,各20只。采用左冠状动脉前降支结扎30 min再灌注2 h的方法制备MI/R损伤模型,假手术组开胸但不结扎冠状动脉,腹腔注射等体积1%二甲基亚砜(DMSO);模型组制备MI/R损伤模型,腹腔注射等体积1%DMSO;银杏黄酮低剂量组制备MI/R损伤模型,腹腔注射100 mg/kg银杏黄酮10 ml/kg;银杏黄酮高剂量组制备MI/R损伤模型,腹腔注射200 mg/kg银杏黄酮10 ml/kg。4组大鼠均于术前1周开始给药,1次/d。再灌注成功后处死各组大鼠,并比较4组大鼠心肌梗死面积、心肌组织髓过氧化物酶(MPO)活性及心肌组织核转录因子κB(NF-κB)和细胞间黏附分子-1(ICAM-1)表达情况。结果模型组大鼠心肌梗死面积占心室总面积的百分比高于银杏黄酮低剂量组和银杏黄酮高剂量组(P0.05);银杏黄酮低剂量组和银杏黄酮高剂量组大鼠心肌梗死面积占心室总面积的百分比比较,差异无统计学意义(P0.05)。模型组、银杏黄酮低剂量组和银杏黄酮高剂量组大鼠心肌组织MPO活性高于假手术组,模型组大鼠心肌组织MPO活性高于银杏黄酮低剂量组和银杏黄酮高剂量组(P0.05);银杏黄酮低剂量组和银杏黄酮高剂量组大鼠心肌组织MPO活性比较,差异无统计学意义(P0.05)。模型组、银杏黄酮低剂量组和银杏黄酮高剂量组大鼠心肌组织ICAM-1阳性区面积所占百分比和NF-κB阳性区面积所占百分比高于假手术组,模型组大鼠心肌组织ICAM-1阳性区面积所占百分比和NF-κB阳性区面积所占百分比高于银杏黄酮低剂量组和银杏黄酮高剂量组(P0.05);银杏黄酮低剂量组和银杏黄酮高剂量组大鼠心肌组织ICAM-1阳性区面积所占百分比和NF-κB阳性区面积所占百分比比较,差异无统计学意义(P0.05)。结论银杏黄酮对MI/R损伤大鼠心肌具有保护作用,其作用机制可能与抑制中性粒细胞浸润、下调NF-κB和ICAM-1表达有关,而与银杏黄酮剂量可能无关。     

米诺环素后处理对大鼠缺血再灌注损伤的影响及其机制

目的探讨米诺环素后处理对大鼠心肌缺血再灌注损伤的作用及其可能机制。方法 96只雄性Wistar大鼠随机分为假手术组、缺血再灌注组、低剂量米诺环素组(3 mg/kg)和高剂量米诺环素组(10 mg/kg)。通过结扎大鼠左冠状动脉前降支45 min,再灌注2 h及24 h。再灌注2 h,检测各组心肌缺血危险区、梗死范围;血清、心肌组织TNF-α、IL-1β含量及心肌组织MPO活性;心肌凋亡指数(AI)以及心肌组织形态学改变。再灌注24 h,检测大鼠心脏血流动力学、心肌缺血危险区、梗死范围。结果与缺血再灌注组比较,低剂量、高剂量米诺环素均能降低左心室舒张末压、心肌梗死范围、AI以及血清、心肌组织TNF-α、IL-1β含量及心肌组织MPO活性,同时升高心率、左心室收缩压、±dp/dtmax(P0.05或P0.01)。结论米诺环素后处理能够显著抑制心肌缺血再灌注损伤诱导的大鼠心肌细胞凋亡,减少梗死范围,明显改善心功能,其机制与减少局部与系统的炎症反应有关。     

Calcium channel antagonists part V: Second-generation agents

Summary Second-generation agents include new dihydropyridines, such as amlodipine, felodipine, isradipine, nicardipine, nimodipine, nisoldipine, and nitrendipine. Verapamil-like agents include tiapamil, gallopamil, and anipamil. Among the diphenylalkylamines, bepridil is of special interest. New preparations of existing agents include slow-release formulations of nifedipine, verapamil, and diltiazem. From all these agents will be selected those that are longer-acting and provide higher vascular selectivity.     

Calcium channel antagonists part V: Second-generation agents

Summary Second-generation agents include new dihydropyridines, such as amlodipine, felodipine, isradipine, nicardipine, nimodipine, nisoldipine, and nitrendipine. Verapamil-like agents include tiapamil, gallopamil, and anipamil. Among the diphenylalkylamines, bepridil is of special interest. New preparations of existing agents include slow-release formulations of nifedipine, verapamil, and diltiazem. From all these agents will be selected those that are longeracting and provide higher vascular selectivity.[This article appeared in Cardiovascular Drugs and Therapy, 2:191–203, 1988.]     

Les atteintes rénales au cours des hémopathies malignes. Stratégie diagnostique

Kidney involvement is frequent in hematologic malignancies. It is associated with adverse outcome and treatment difficulties. It can affect every area of the renal parenchyma (tubules, interstitium, glomerulus, vessels). Various mechanisms could be implicated: deposits of immunoglobulin fractions or crystals, renal infiltration by malignant cells, urinary tract obstruction, paraneoplastic or storage glomerulopathies… Diagnostic strategy relies on the clinical presentation: acute renal failure, chronic kidney disease, glomerular proteinuria with or without nephrotic syndrome, tubular proteinuria, hydroelectrolytic disorders. In this review, we detail the diagnostic tests that are needed for the detection and the follow-up of renal involvement in hematologic malignancies, and clarify the indications of renal biopsy. We propose diagnostic strategies of renal involvement in myeloma, Waldenström's disease, high grade lymphomas and acute leukemias, low grade lymphomas and chronic leukemias. The adverse effects of treatments (chemotherapy, radiotherapy, stem cell graft …) are not addressed in this review.     

Cinedefecography and electromyography in the diagnosis of nonrelaxing puborectalis syndrome

A prospective study was undertaken to assess the correlation between electromyography (EMG) and cinedefecography (CD) for the diagnosis of nonrelaxing puborectalis syndrome (NRPR). Clinical criteria for NRPR included straining, incomplete evacuation, tenesmus, and the need for enemas, suppositories, or digitation. EMG criteria included failure to achieve a significant decrease in electrical activity of the puborectalis (PR) during attempted evacuation. CD criteria included either paradoxical contraction or failure of relaxation of the PR along with incomplete evacuation. In addition, other etiologies for incomplete evacuation, such as rectoanal intussusception or nonemptying rectocele, were excluded by proctoscopy and defecography in all cases. One hundred twelve patients with constipation, 81 females and 31 males, with a mean age of 59 (range, 12–83) years were studied by routine office evaluation, CD, and EMG. Forty-two patients (37 percent) had evidence of NRPR on CD (rectal emptying: none, 24; incomplete, 18). Twenty-eight of these patients (67 percent) also had evidence of NRPR on EMG. EMG findings of NRPR were present in 12 of 70 patients (17 percent) with normal rectal emptying. Conversely, 14 of 72 patients (19 percent) with normal PR relaxation on EMG had an NRPR pattern on CD. The sensitivity and specificity for the EMG diagnosis of NRPR were 67 percent and 83 percent, and the positive and negative predictive values were 70 percent and 80 percent, respectively. Conversely, if EMG is considered as the ideal test for the diagnosis of NRPR, CD had a sensitivity of 70 percent, a specificity of 80 percent, and positive and negative predictive values of 66 percent and 82 percent, respectively. In summary, sensitivity, specificity, and predictive values of EMG and CD are suboptimal. Therefore, a combination of these two tests is suggested for the diagnosis of NRPR.Poster presentation at the meeting of The American Society of Colon and Rectal Surgeons, San Francisco, California, June 7 to 12, 1992.Dr. Ger was a visiting colorectal surgeon from the Section of Colon and Rectal Surgery, Department of Surgery, National Defense Medical Center and Tri-Service General Hospital, Taipei, Taiwan, R.O.C.     

Multiple vaginal deliveries increase the risk of permanent incontinence of flatus and urine in normal premenopausal women

PURPOSE: This study was undertaken to evaluate the risk of permanent flatus or urinary incontinence after repeated vaginal deliveries. METHODS: In 1989 a questionnaire on obstetric history and urinary and fecal incontinence was sent to a sample of 304 women selected from the birth records from 1976 to 1988; 242 responded (80 percent). RESULTS: Participants had one, two, or three vaginal deliveries, all without an obstetric tear of the anal sphincter. After the first, second, and third deliveries, 1.2, 1.5, and 8.3 percent developed permanent flatus incontinence. The risk was significantly increased after the third delivery compared with the first and second deliveries (odds ratio, 6.6; confidence interval, 2.4–18.3). Permanent urinary incontinence after the first, second, and third delivery developed in 3.3, 1.0, and 6.8 percent. The risk was significantly increased after the third delivery compared with the first and second (odds ratio, 3.2; confidence interval, 1.1–9.1). CONCLUSION: These results indicate that repeated vaginal deliveries increase the risk of minor anal and urinary incontinence, which were found to be a common problem in premenopausal women.Supported by a grant from the Danish Medical Research Council. Read at the meeting of The American Society of Colon and Rectal Surgeons, Chicago, Illinois, May 2 to 7, 1993, and at the Tripartite Meeting, Sydney, Australia, October 17 to 20, 1993.     

Neuropeptide evolution: neurohormones and neuropeptides predicted from the genomes of Capitella teleta and Helobdella robusta

Genes encoding neurohormones and neuropeptide precursors were identified in the genomes of two annelids, the leech Helobdella robusta and the polychaete worm Capitella teleta. Although no neuropeptides have been identified from these two species and relatively few neuropeptides from annelids in general, 43 and 35 such genes were found in Capitella and Helobdella, respectively. The predicted peptidomes of these two species are similar to one another and also similar to those of mollusks, particular in the case of Capitella. Helobdella seems to have less neuropeptide genes than Capitella and it lacks the glycoprotein hormones bursicon and GPA2/GPB5; in both cases the genes coding the two subunits as well as the genes coding their receptors are absent from its genome. In Helobdella several neuropeptide genes are duplicated, thus it has five NPY genes, including one pseudogene, as well as four genes coding Wwamides (allatostatin B). Genes coding achatin, allatotropin, allatostatin C, conopressin, FFamide, FLamide, FMRFamide, GGRFamide, GnRH, myomodulin, NPY, pedal peptides, RGWamide (a likely APGWamide homolog), RXDLamide, VR(F/I)amide, WWamide were found in both species, while genes coding cerebrin, elevenin, GGNG, LFRWamide, LRFYamide, luqin, lymnokinin and tachykinin were only found in Capitella.     

Evaluation of enzyme-linked immunosorbent assay (ELISA) and enzyme-linked immunoelectrotransfer blot (EITB) for immunodiagnosis of hydatid diseases in sheep

This study was undertaken to investigate antigenic characteristics of hydatid cyst fluid in sheep by SDS-PAGE method, to evaluate sensitivity and specificity of Enzyme-linked immunosorbent assay (ELISA) and Enzyme-linked immunoelectrotransfer blot (EITB) assay for diagnosis of sheep hydatidosis, and to determine seroprevalance of hydatidosis in sheep population in Elazig, Turkey. SDS-PAGE analysis of hydatid cyst fluids indicated that 6 specific-protein bands were detected at molecular weights of 29, 45, 58, 68, 98 and 116 kDa. EITB analysis showed presence of 29, 38, 42, 58, 62, 68, 98, 116, 120, 150 and 205 kDa bands in positive sheep sera, while 38, 58, 62, 68, 116 and 205 kDa bands were detected in negative sheep sera. Therefore, it was concluded that the 116 kDa band was specific for diagnosis of sheep hydatid disease by EITB assay. Sensitivity and specificity of EITB assay were determined as 88% and 84%, respectively, whereas corresponding rates for ELISA were 60% and 94%, respectively. Sensitivity of ELISA was 47.3% in hepatic cysts, 60% in pulmonary cysts, 69.2% in hepato-pulmonar cysts. Sensitivity ratios of ELISA were 67.8%, 75%, and 38.4% for fertile, sterile, and under-growth cysts, respectively. Sensitivity of EITB was found 84.2% in hepatic cysts, 80% in pulmonary cysts, and 92.3% in hepato-pulmonar cysts. Corresponding ratios for sensitivity of EITB for fertile, sterile, calcified, and under growth cysts were 92.8%, 75%, 100%, and 84.6%, respectively. In addition, seroprevalance of hydatidosis in sheep was found as 62% by ELISA and 66.4% by EITB in Elazig, Turkey and seroprevalance increased by age.     

Anti-inflammatory effects of medications used for viral infection-induced respiratory diseases

Respiratory viruses like rhinovirus, influenza virus, respiratory syncytial virus, and coronavirus cause several respiratory diseases, such as bronchitis, pneumonia, pulmonary fibrosis, and coronavirus disease 2019, and exacerbate bronchial asthma, chronic obstructive pulmonary disease, bronchiectasis, and diffuse panbronchiolitis. The production of inflammatory mediators and mucin and the accumulation of inflammatory cells have been reported in patients with viral infection-induced respiratory diseases. Interleukin (IL)-1β, IL-6, IL-8, tumor necrosis factor-α, granulocyte-macrophage colony-stimulating factor, and regulated on activation normal T-cell expressed and secreted are produced in the cells, including human airway and alveolar epithelial cells, partly through the activation of toll-like receptors, nuclear factor kappa B and p44/42 mitogen-activated protein kinase. These mediators are associated with the development of viral infection-induced respiratory diseases through the induction of inflammation and injury in the airway and lung, airway remodeling and hyperresponsiveness, and mucus secretion. Medications used to treat respiratory diseases, including corticosteroids, long-acting β₂-agonists, long-acting muscarinic antagonists, mucolytic agents, antiviral drugs for severe acute respiratory syndrome coronavirus 2 and influenza virus, macrolides, and Kampo medicines, reduce the production of viral infection-induced mediators, including cytokines and mucin, as determined in clinical, in vivo, or in vitro studies. These results suggest that the anti-inflammatory effects of these medications on viral infection-induced respiratory diseases may be associated with clinical benefits, such as improvements in symptoms, quality of life, and mortality rate, and can prevent hospitalization and the exacerbation of chronic obstructive pulmonary disease, bronchial asthma, bronchiectasis, and diffuse panbronchiolitis.     

Étiologies et orientation diagnostique devant un flush

The flush is a transient and recurrent erythema of the upper region of the body, due to a sudden arterial dilatation. First, physicians should confirm the flush and ascertain the location and timing of skin manifestations. The rapid onset and location of the skin rash to the face and anterior chest are the main characteristics of flush. In most of the cases, the flush is emotional, but this should remain a diagnosis of exclusion, as flush may be the presenting manifestation of many systemic or neoplastic disorders. Therefore, a comprehensive diagnostic work-up is necessary, including clinical, biological, and imaging testing. Neoplastic and endocrine causes of flush include VIPoma, carcinoid syndrome, medullary thyroid cancer, mastocytosis, renal cell carcinoma, and pheochromocytoma. Mast cell activation syndrome has been recently described, but it remains a diagnosis of exclusion. This review will first present the different causes of flush, and then will propose a diagnostic algorithm for the physician.     

Polypharmacy prevalence among older adults based on the survey of health,ageing and retirement in Europe

Polypharmacy, a common condition among the elderly, is associated with adverse outcomes, including increased healthcare costs, due to higher mortality, falls and hospitalizations rates, adverse drug reactions, drug–drug reactions and medication nonadherence. This study aims to evaluate the prevalence and factors related to polypharmacy in older adults across 17 European countries, plus Israel.In this cross-sectional analysis, we used data from participants aged 65 or more years from Wave 6 of the Survey of Health, Ageing, and Retirement in Europe (SHARE) database. Polypharmacy was defined as the concurrent use of five or more medications. Age, gender, education, physical inactivity, number of limitations with activities of daily living, network satisfaction, quality of life, depression, number of chronic diseases and difficulty taking medication variables were found to be associated with polypharmacy.Our results showed a prevalence of polypharmacy ranging from 26.3 to 39.9%. Switzerland, Croatia and Slovenia were the countries with the lowest prevalence, whereas Portugal, Israel and the Czech Republic were the countries where the prevalence of polypharmacy was the highest. Age, gender, number of limitations with activities of daily living, number of chronic diseases, quality of life, depression, physical inactivity, network satisfaction, difficulty in taking medications, years of education and shortage of money were significant variables associated with polypharmacy.Polypharmacy is a highly prevalent condition in the elderly population. Identification of variables associated with polypharmacy, such as those identified in this study, is important to identify and monitor elderly groups, which are most vulnerable to polypharmacy.