通心络胶囊对动脉粥样硬化斑块影响的临床研究

目的研究通心络胶囊对动脉粥样硬化斑块的治疗作用.方法对80例经体外血管超声检查确诊颈动脉粥样硬化斑块的病人双盲随机分成对照组和治疗组,对照组行常规治疗,治疗组在常规治疗的基础上,加服通心络胶囊,观察用药前后病人血脂的变化及斑块声学密度的变化.结果治疗后,治疗组血脂水平较治疗前明显降低,组间比较有统计学意义(P＜0.0 5或0.01),治疗后治疗组软斑块声学密度水平高于对照组(P＜0.05),与治疗前相比,治疗组软斑块声学密度明显升高(P＜0.05或0.01).结论 通心络可以降低血脂,改善软斑块组织学构成,增加斑块密度,从而稳定斑块.     

通心络胶囊对高血压患者血清超敏C反应蛋白及血脂水平的影响

目的 观察通心络胶囊对高血压患者超敏C反应蛋白(hs-CRP)和血脂的影响.方法 选取住院高血压患者72例,随机分为两组,治疗组在钙拮抗剂降压治疗基础上加服通心络胶囊,对照组服用钙拮抗剂常规有效降压治疗.用药1个月后复查hs-CRP及血脂等的变化.结果 治疗组治疗1个月后hs-CRP、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)水平较治疗前显著下降(P＜0.05),与对照组治疗后比较,治疗组hs-CRP、TC、LDL-C明显降低(P＜0.05).结论 通心络胶囊可显著降低高血压患者hs-CRP及血脂水平.提示通心络胶囊能改善高血压患者存在的炎症状态,抑制炎性因子的表达,从而减少心血管事件的发生.     

通心络对动脉粥样硬化斑块消退作用的临床研究

目的探讨用彩色多谱勒超声技术测定颈动脉内膜-中层厚度和斑块大小的方法,监测、观察及评价通心络胶囊对动脉粥样硬化斑块的消退作用.方法采用彩色多谱勒超声技术从高脂血症病人中检测出127例颈动脉内膜-中层增厚与斑块形成的病人,随机分成对照组(62例)和治疗组(65例),治疗组采用辛伐他汀20mg/d口服,通心络胶囊每次3粒,每日3次,口服;对照组采用辛伐他汀20 mg/d、维生素E胶囊0.3 g/d口服,疗程均为16周.治疗期间观察增厚的内膜-中层与斑块消退的变化、血脂变化、心脑血管重要事件的发生率、再住院率及上述药物的不良反应.结果两组病人颈动脉增厚与斑块均有消退,血脂LDL-C均有明显降低.但以治疗组更为显著(P<0.05),同时治疗组HDL-C升高、TG降低,心脑血管事件发生和再住院次数的降低均较对照组有统计学意义.两组无明显不良反应.结论通心络胶囊和辛伐他汀合用可消退动脉粥样硬化和斑块形成,同时,有效调控血脂,降低心脑血管事件的发生.     

通心络对急性冠状动脉综合征病人血管细胞黏附分子-1水平影响的研究

目的观察通心络治疗急性冠状动脉综合征病人2周后血清血管细胞黏附分子-1(VCAM-1)等水平的变化,以了解短期通心络治疗对斑块稳定性的影响.方法 32例急性冠状动脉综合征病人随机分为常规治疗组(未服用通心络及任何调脂药物,19例)和通心络组(760 mg,每天3次,13例)治疗,测定治疗前后病人血清VCAM-1和血脂水平的变化.结果两组间治疗前后血脂各组成分的变化差异均无统计学意义.通心络组治疗后血清VCAM-1水平降低13.5%,与治疗前比较有统计学意义(P＜0.05).结论急性冠状动脉综合征早期予通心络短期治疗,可明显降低血清VCAM-1的水平,可能具有一定的增加斑块稳定性的作用.     

通心络对颈动脉粥样硬化斑块的作用研究

目的观察通心络胶囊对颈动脉粥样硬化斑块的影响。方法符合入选标准的80例患者随机分为两组,每组40例。对照组为常规治疗组,通心络治疗组在常规治疗组的基础上加用通心络胶囊3粒,3次/d,疗程均为6个月。治疗3、6个月后两组以彩色多普勒超声检测颈动脉斑块性数目和积分,同时记录不良事件情况。结果两组治疗3、6个月后在斑块数目及积分等方面差异有统计学意义(P0.05)。结论通心络能有效地干预颈动脉粥样硬化斑块中软斑块的发生发展并降低心脑血管疾病事件发生。     

通心络胶囊联合辛伐他汀对颈动脉粥样斑块形成的干预作用研究

目的 观察通心络胶囊联合辛伐他汀对颈动脉粥样斑块形成的干预作用.方法 选择116例门诊颈动脉粥样斑块患者并随机分为3组.通心络胶囊组(39例)在常规治疗的基础上加通心络胶囊2粒,每日3次1辛伐他汀组(39例)在常规治疗基础上加辛伐他汀40 mg,每晚1次;联合治疗组(38例)在常规治疗基础上,应用通心络胶囊2粒,每日3次,辛伐他汀40 mg,每晚1次.患者均连续服药6个月,并均于服药前和服药后第6个月接受颈动脉超声检查,现察比较各组患者用药前后颈动脉粥样斑块的变化.结果 3组患者用药后颈动脉粥样硬化斑块明显减轻甚或消退.用药前后通心络胶囊组与辛伐他汀组之间无统计学意义(P＞0.05),但用药后与通心络胶囊组和辛伐他汀组相比,联合治疗组患者颈动脉粥样硬化斑块减轻更明显(P＜0.05).各组均未见明显的不良反应.结论 通心络胶囊和辛伐他汀对颈动脉粥样硬化斑块有明显的抑制作用,两药联合效果更佳,且患者无明显的不良反应.     

不同剂量阿托伐他汀治疗颈动脉粥样硬化斑块的临床观察

目的 观察不同剂量阿托伐他汀对老年男性患者颈动脉粥样硬化斑块的消退作用及降脂疗效.方法 采用彩色多普勒超声检出颈动脉粥样硬化斑块形成者90例,随机分为两组,分别口服阿托伐他汀10 mg、20 mg,共16周,观察治疗前后颈动脉内膜中层厚度(IMT)、胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)的变化.结果 阿托伐他汀10 mg、20 mg均能明显消退颈动脉粥样硬化斑块[IMT:10 mg组:治疗后(1.23 0.19)mm比治疗前(1.48 0.26)mm,P＜0.05;20 mg组:治疗后(1.03 0.2)mm比治疗前(1.46 0.23)mm,P＜0.05],降低TC、TG、LDL-C水平(P＜0.05),升高HDL-C水平.与10 mg阿托伐他汀组比较,20 mg阿托伐他汀能更进一步降低TC、LDL-C和升高HDL-C水平(P＜0.05).结论 阿托伐他汀可消退颈动脉粥样硬化斑块,有效降低血脂水平.     

阿托伐他汀和通心络胶囊治疗冠状动脉粥样硬化疗效的血管内超声评价

目的 探讨血管内超声（IVUS）对阿托伐他汀和通心络胶囊治疗冠状动脉粥样硬化疗效的评价作用.方法 选取冠心病患者63例,随机分为观察组31例和对照组32例;对照组给予常规药物＋阿托伐他汀钙片,观察组给予常规药物＋通心络胶囊.治疗12个月后两组复查血脂及CAG,靶病变冠脉复查IVUS.结果 与治疗前比较,治疗12个月两组血脂、IVUS参数均明显改善（P均＜0.05）;治疗12个月两组间比较血脂、IVUS参数无统计学差异（P均＞0.05）.结论 通心络和阿托伐他汀对冠心病均有良好疗效,IVUS对评价药物治疗后冠状动脉粥样硬化斑块变化有重要作用.     

通心络胶囊对阿尔茨海默病患者血脂及内皮功能的影响

目的 观察通心络胶囊对阿尔茨海默病伴高脂血症患者血脂、内皮素、一氧化氮(NO)的影响.方法 将4JD例阿尔茨海默病伴高脂血症患者随机分为通心络组(20例)和对照组(20例),两组基础治疗相同,通心络组在对照组基础治疗上加服通心络胶囊,治疗四周后观察两组患者血脂、内皮素、NO及临床症状的变化.结果 与对照组比较,通心络组在降低总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL.C)、内皮素和升高NO方面疗效更为显著,两组升高高密度脂蛋白胆固醇(HDL-C)的疗效相似.结论 通心络胶囊可有效调节阿尔茨海默病伴高脂血症患者血脂水平,改善内皮功能.     

通心络联合阿托伐他汀治疗H型高血压颈动脉粥样硬化疗效观察

目的 观察通心络联合阿托伐他汀治疗H型高血压颈动脉粥样硬化(CAS)的疗效.方法 132例H型高血压伴CAS患者,随机分为通心络组69例和对照组63例,两组均给予阿托伐他汀治疗,通心络组在此基础上加用通心络(3次/d,3粒/次)治疗,疗程均为12个月;两组采用相同的方法治疗高血压至达标.治疗前后分别检测颈动脉内膜—中膜厚度(IMT)、血清同型半胱氨酸(Hcy)值、血脂和血压等.结果 通心络组与对照组治疗后的IMT值较治疗前均有所下降(P均＜0.05),但通心络组更为明显,治疗后两组比较P＜0.05.两组治疗后Hcy值、血脂、血压比较,差异无统计学意义.结论 通心络联合阿托伐他汀较单用阿托伐他汀对H型高血压的CAS有更好的临床疗效,且不依赖血脂和Hcy水平的进一步降低.     

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.