血管紧张素转换酶抑制剂对缺血再灌注心肌细胞内钙超载的拮抗作用

目的：探讨血管紧张素转换酶抑制剂卡托普利和依那普利拉对心肌细胞内游离钙浓度的影响，并观察两药能否对抗缺血再灌注引起的细胞内钙超载作用。方法：Ｗｉｓｔａｒ大鼠心肌细胞培养７２小时后分为对照组、卡托普利组和依那普利拉组。药物于实验前３０分钟加入，终浓度为１０－５ｍｏｌ／Ｌ。Ｉｎｄｏ－１ＡＭ标记后，应用缺血再灌注损伤模型，用粘附式细胞仪连续观察缺血前、缺血及再灌注细胞内游离钙浓度（荧光比率）的变化。测试结果组间采用ｔ检验。结果：缺血前卡托普利组和依那普利拉组细胞内荧光比率均低于对照组（Ｐ＜０．０１～０．０５）；而缺血及再灌注阶段，对照组细胞内荧光比率持续升高，卡托普利组和依那普利拉组均保持相对平稳，显著低于对照组（Ｐ＜０．０１）。结论：血管紧张素转换酶抑制剂可以拮抗缺血再灌注心肌细胞内钙超载，对缺血再灌注心肌细胞具有明显的保护作用。     

缺氧预处理对乳兔心肌细胞缺氧复氧损伤的保护研究

目的：观察预处理（ＰＣ）对乳兔心肌细胞缺氧复氧（Ａ－Ｒ）损伤的影响。方法：采用心肌细胞Ａ－Ｒ模型，用短暂缺氧进行预处理。结果：缺氧预处理能提高Ａ－Ｒ后心肌细胞存活率（７７．２１±３．１０ＶＳＡ－Ｒ组５９．８３±２．１０．Ｐ＜０．０１）．减少ＭＤＡ产生（０．７５±０．０２ＶＳＡ－Ｒ组１．６１±０．０８ｎｍｏｌ／ｍｇｐｒ，Ｐ＜０．０１）及乳酸脱氢酶的漏出（Ｐ＜０．０１）。结论：离体乳兔心肌细胞存在ＰＣ保护现象。     

血管紧张素Ⅱ预处理对乳鼠心肌细胞缺氧复氧损伤的影响

观察血管紧张素Ⅱ预处理（ＡｎｇⅡ）对乳鼠心肌细胞缺氧复氧（Ａ／Ｒ）损伤的影响,并探讨其作用机理。采用心肌细胞Ａ／Ｒ损伤模型,用血管紧张素Ⅱ进行预处理（ＡⅡＰＣ）。ＡⅡＰＣ能提高Ａ／Ｒ损伤后心肌细胞存活率（７６±３％比５２±２％,Ｐ＜０．０１,减少细胞ＭＤＡ产生（０．９５±０．０６比１．７２±０．０７ｎｍｏｌ／ｍｇｐｒ,Ｐ＜０．０１）,减少乳酸脱氢酶漏出（３６．５±７．１比５６．３±９．３Ｕ／Ｌ,Ｐ＜０．０１）,及蛋白漏出（０．３３±０．０４比０．４３±０．０７ｇ／Ｌ,Ｐ＜０．０１）。蛋白激酶Ｃ（ＰＫＣ）抑制剂Ｈ７完全阻断ＡⅡＰＣ的上述保护作用。结果提示ＡⅡＰＣ对乳鼠心肌细胞具有预处理保护作用,其机理是通过ＰＫＣ介导的。     

肥厚心肌组织血管紧张素Ⅱ,醛固酮水平与心肌糜酶样活力改变的关系

目的：探讨在压力负荷性心肌肥厚过程中，肥厚心肌组织血管紧张素、醛固酮水平与糜酶样活性改变及其相关性。　方法：采用缩窄大鼠腹主动脉造成压力负荷性心肌肥厚模型，测定术后 ２、６、１２ 周心肌组织血管紧张素、醛固酮含量及糜酶样活性，并设同期正常对照组。结果：术后２、６、１２ 周心肌肥厚组大鼠心肌组织糜酶样活性较同期正常对照组显著增高（ Ｐ＜ ０．０１）；术后 １２ 周心肌肥厚组大鼠心肌血管紧张素、醛固酮含量较同期正常对照组明显增加（ Ｐ＜ ０．０１）； 心肌组织血管紧张素、醛固酮水平与糜酶样活性呈正相关（ Ｐ＜ ０．０５）。　结论：在压力负荷性心肌肥厚过程中，有心肌组织糜酶样活性因素的参与，并影响局部血管紧张素、醛固酮代谢。     

人尿激肽释放酶(SK-827)对兔心肌缺血/再灌注损伤的保护作用

为探讨人尿激肽释放酶ＳＫ－８２７对心肌缺血再灌注损伤是否具有保护作用，制备了离体家兔心脏灌注模型，利用生物化学技术测定了流出液中肌红蛋白和乳酸脱氢酶含量及心肌组织丙二醛和ＡＴＰ含量。结果发现，ＳＫ－８２７对心肌缺血再灌注损伤具有明显的保护作用：它使冠状动脉流量增加（Ｐ＜０．０１）；细胞内肌红蛋白和乳酸脱氢酶漏出减少（Ｐ＜０．０１）；心肌丙二醛含量减少和心肌ＡＴＰ储备增加。这些结果提示激肽释放酶ＳＫ－８２７对治疗心肌缺血／再灌注损伤具有潜在的应用价值。     

牛磺酸对体外循环手术患者心肌保护作用的基础与临床初步研究

本研究在离体大鼠心肌缺血－再灌注模型上和体外循环心内直视手术病人应用牛磺酸后，观察牛磺酸对体外循环手术病人的血浆内皮素、血管紧张素Ⅱ和脂质过氧化代谢产物丙二醛变化的影响。提示：①动物模型上用牛磺酸组较对照组心律失常发生机会少，ＬＶＥＣ和±ＬＶｄｐ／ｄｔｍａｘ较对照组升高，ＬＶＰＤＰ和ＣＰＰ显著降低，心肌组织内蛋白漏出和丙二醛含量均明显减少；②用牛磺酸组内皮素含量较对照组低（Ｐ＜０．０１）。在体外循环前４个阶段，血管紧张素Ⅱ在两组中的变化规律相似，但术后２４小时，用牛磺酸组血管紧张素Ⅱ较对照组为低；③在用牛磺酸组的各个阶段，丙二醛含量明显较对照组低（Ｐ＜０．０５或Ｐ＜０．０１）。证明牛磺酸对心肌细胞具有保护作用，指出体外循环前后应用牛磺酸是有益处的。     

高血压病左心室肥厚与血管活性物质的关系及依那普利干预

目的：探讨体循环血液中多种血管活性物质在高血压病左心室肥厚（ＬＶＨ）发生和依那普利（ｅｎａｌａｐｒｉｌ）逆转治疗中的作用。方法：测定高血压病患者４５例合并ＬＶＨ、４５例不合并ＬＶＨ及３０例正常人血流动力学和血浆５种血管活性物质，观察２７例高血压病患者合并ＬＶＨ依那普利治疗２４周后各项参数变化。结果：合并ＬＶＨ组收缩压、血浆内皮素、去甲肾上腺素、内源性洋地黄物质（ＥＤＬＳ）和心钠素高于不合并ＬＶＨ组（Ｐ＜０．０５～０．０１），血管紧张素Ⅱ高于正常人（Ｐ＜０．０１）；对１３个相关因素进行逐步回归分析表明，内皮素、血管紧张素Ⅱ和去甲肾上腺素对ＬＶＨ作用显著（复相关系数０．７６９，Ｐ＜０．００１）；内皮素、血管紧张素Ⅱ、去甲肾上腺素、ＥＤＬＳ之间呈正相关（Ｐ＜０．０５～０．０１）；依那普利干预后，ＬＶＨ消退，血压和血管活性物质同步下降（Ｐ＜０．０５～０．０１）。结论：体循环血液中多种血管活性物质含量改变及其相互作用可能共同参与高血压病ＬＶＨ的形成，依那普利消退ＬＶＨ的机制可能与降低这些物质有关。     

自发性高血压大鼠高血压形成前期血管平滑肌细胞增殖和肾素-血管紧张素系统的关系

通过体外培养３周龄自发性高血压大鼠（ＳＨＲ）胸主动脉血管平滑肌细胞（ＡＳＭＣ），探讨ＳＨＲ高血压形成前期ＡＳＭＣ是否存在异常增殖，以及与循环、血管局部血管紧张素Ⅱ（ＡｎｇⅡ）、血管紧张素转换酶（ＡＣＥ）的关系。结果表明：３周龄ＳＨＲＡＳＭＣ肾素－血管紧张素系统（ＲＡＳ）处于高功能状态，合成ＡｎｇⅡ、ＡＣＥ，分泌ＡｎｇⅡ的量比ＷＫＹ高（Ｐ＜０．０５），并呈现异常增殖，３Ｈ－ＴｄＲ参入增加，倍增时间（ＤＴ）缩短（Ｐ＜０．０１）。血管紧张素转换酶抑制剂（ＡＣＥＩ）卡托普利、ＡｎｇⅡ受体拮抗剂Ｓａｒａｌａｓｉｎ长期干预可通过抑制ＳＨＲＡＳＭＣＡｎｇⅡ生成或阻断ＡｎｇⅡ的作用进而抑制其异常增殖。而ＷＫＹ血浆ＡｎｇⅡ、ＡＣＥ活性反比ＳＨＲ高（Ｐ＜０．０１）。说明：血管局部ＲＡＳ处于高功能状态对ＳＨＲ高血压前期ＡＳＭＣ异常增殖起重要作用，而循环ＲＡＳ则不起作用。     

卡托普利对冠心病患者内源性纤溶功能的影响

目的：冠状动脉粥样硬化性心脏病（冠心病）患者内源性纤溶功能紊乱与肾素—血管紧张素系统激活有关，但转换酶抑制剂能否改善这种功能紊乱尚不十分清楚，本文目的是研究此作用。方法：符合世界卫生组织冠心病不稳定性心绞痛诊断标准，６５％经选择性冠状动脉造影确定冠状动脉狭窄≥５０％的患者３４例，单盲随机分为卡托普利治疗组（１８例）及安慰剂对照组（１６例），４周治疗前、后检测血浆肾素活性、血管紧张素Ｉ、组织型纤溶酶原激活剂（ｔ－ＰＡ）及纤溶酶原激活剂抑制物（ＰＡＩ）含量与活性，两组间的参数比较采用ｔ检验。结果：４周后，治疗组的血浆血管紧张素Ｉ及ｔ－ＰＡ含量、ＰＡＩ活性均显著低于对照组（Ｐ＜０．０５或Ｐ＜０．０１，而ｔ－ＰＡ活性及纤溶活力则显著高于对照组（Ｐ＜０．０５或Ｐ＜０．０１）。结论：卡托普利可通过降低血浆血管紧张素Ｉ水平，改善冠心病患者内源性纤溶功能紊乱。本结果对预防冠状动脉内血栓形成有意义     

卡托普利与美托洛尔治疗轻、中度高血压疗效比较

本文比较了血管紧张素转换酶抑制剂卡托普利（开搏通）与选择性β１受体阻滞剂美托洛尔（倍他乐克）治疗轻中度高血压即时和短程疗效。眼药后１ｈ，卡托普利组收缩压和舒张压明显下降（Ｐ＜０．０１），而美托洛尔组仅收缩压下降（Ｐ＜０．０５）。服药后３ｈ，两药均达最大降压疗效，两组降压比较无统计学差异。服药后１２ｈ美托洛尔组收缩压和舒张压仍有降压作用（Ｐ＜０．０５），而卡托普利仅对舒张压有作用（Ｐ＜０．０５）。服药后２１天，卡托普利和美托洛尔组总有效率分别是８７．５％和８３．３％（ｘ２＝４．２２，Ｐ＞０．０５）。     

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.