中西医结合根除幽门螺杆菌对萎缩性胃炎核因子-κB表达的影响

[目的]观察以胃舒散为主的三联疗法（胃舒散、呋喃唑酮和克拉霉素）治疗幽门螺杆菌（Hp）阳性慢性萎缩性胃炎（CAG）的临床效果及其对核因子-κB（NF-κB）表达的影响。[方法]41例Hp阳性CAG患者服用胃舒散2．0g，呋喃唑酮0．1g，各3次／d，克拉霉素0．25g，2次／d，1周后再继服胃舒散4周。治疗前及治疗结束1年后行内镜及病理组织学检查，取活检观察病理组织学改变及NF-κB表达变化，采用银染色法、^14C-尿素呼气试验或快速尿素酶试验检测Hp。[结果]三联疗法结束1年后，Hp根除率为85．4％；根除Hp能显著减轻患者胃窦部慢性炎症（P〈0．05）和活动程度（P〈0．01），下调NF-κB表达（P〈0．01），但胃炎的萎缩和肠化生等病理无明显改变。[结论]以胃舒散为主的三联疗法对Hp有较高根除率。根除Hp可抑制NF-κB的表达，减轻活动性炎症，但近期观察对萎缩、肠化生等病理改变无明显作用。     

胃复春联合西药治疗幽门螺杆菌阳性慢性胃炎脾虚兼热型30例

[目的]观察胃复春片联合西药治疗幽门螺杆菌阳性（Hp＋）慢性胃炎脾虚兼热型的临床疗效。[方法]60例Hph慢性胃炎脾虚兼热型患者随机分为2组,各30例。对照组口服泮托拉唑钠肠溶胶囊40mg,2次／d加阿莫西林／克拉维酸钾片0．92g,3次／d加克拉霉素缓释胶囊0．5g,1次／d;治疗组在对照组治疗的基础上加用胃复春片1．44g,3次／d。2组疗程均为14d,停药至少1个月以后复查,观察2组疗效及Hp根除率等情况。[结果]治疗组症状改善明显,总有效率为90．0％,对照组为83．3％（P〈0．05）。治疗组Hp根除率为90．0％,对照组为83．3％（P〈0．05）。2组患者不良反应均轻微。[结论]胃复春片联合西药治疗Hp＋漫性胃炎临床疗效显著,Hp根除率高,不良反应少。     

非溃疡性消化不良患者幽门螺杆菌感染和病理的相关性

[目的]研究非溃疡性消化不良（NUD）患者幽门螺杆菌（Hp）感染的患病率，Hp感染和胃黏膜组织病理的相关性。[方法]入选者为门诊接受胃镜检查的132例临床诊断NUD患者，排除消化性溃疡、胃食管反流病等疾病，胃黏膜组织用Warthin-Starry染色半定量诊断Hp感染，并对胃黏膜组织按慢性炎症、活动性炎症、萎缩、肠化进行病理评价。[结果]NUD患者Hp感染率为54．5％（67／132），Hp感染和病理诊断慢性炎症及活动性炎症有相关性，分别P〈0．001，〈0．048，相关系数分别为0．324和0．167。[结论]NUD患者Hp感染和病理诊断胃黏膜慢性炎症及活动性炎症相关，提示Hp感染在慢性胃炎中的致病作用。     

抗幽门螺杆菌治疗对胃窦部氧自由基的影响

目的观察幽门螺杆菌（Hp）阳性患者治疗后胃窦部粘膜氧自由基的变化．方法对70例Hp（＋）和34例Hp（－）患者胃粘膜采用化学发光法测定氧自由基（OFR），其中30例Hp（＋）溃疡病患者，经抗Hp三联疗法及抗氧化剂治疗3mo，复查内镜，并复查胃粘膜OFR．结果Hp阳性组OFR明显高于Hp阴性组，P＜0．01．分组后球溃疡、胃溃疡和慢性胃炎Hp（＋）OFR均高于Hp（－）组．30例Hp（＋）组经Hp治疗后其OFR值明显低于治疗前，P＜0．01．结论抗Hp治疗后，吸引巨噬细胞的有害因子Hp被去除，OFR值下降，炎症减轻，有利于胃粘膜修复．     

中西医结合治疗幽门螺杆菌相关性慢性胃炎50例

[目的]观察中西医结合疗法治疗幽门螺杆菌（Hp）相关性慢性胃炎的临床疗效。[方法]选择100例Hp相关性慢性胃炎患者,随机分为2组,各50例,治疗组予常规三联西药抗菌及温中健脾中药治疗,对照组仅给予常规三联西药抗菌治疗。疗程结束后观察临床疗效、症状改善、Hp转阴率、胃镜检查的情况。[结果]治疗组总有效率为90．0％,对照组72．0％,治疗组明显优于对照组（P〈0．05）,且治疗组在Hp转阴率及胃镜下胃黏膜改善方面均优于对照组（P〈0．05）。[结论]中西医结合治疗Hp相关性慢性胃炎远期治疗效果好。     

氢溴酸槟榔碱对豚鼠体外胃不同部位肌条作用及其机制

[目的]观察氢溴酸槟榔碱（Ah）对豚鼠体外胃不同部位平滑肌肌条收缩运动的影响，并初步探索其作用机制。[方法]用胃不同部位（6处）平滑肌条置于灌流浴槽，在37℃恒温、通氧和Krebs液灌注条件下，分别记录单独使用Ah和阻断剂孵育后Ah的收缩效应。[结果]①Ah可显著增高各部分体外胃平滑肌条的张力，增大收缩振幅和收缩波曲线下面积，2者均比基础值有显著增高（P〈0．05）。而且其效应强度不同部位有明显差异。纵肌效应：Ah对胃窦纵肌的作用振幅大于胃底、胃体（P〈0．01）；效应曲线下面积大于胃体（P〈0．01）。环肌效应：Ah对胃窦环肌作用振幅大于胃底（P〈0．05）；效应曲线下面积大于胃体和胃底（P〈0．05），对胃体环肌作用的曲线下面积亦大于胃底（P〈0．05）。②阿托品和维拉帕米均能部分阻断Ah的收缩作用，显著降低其振幅（P〈0．01）。[结论]Ah对豚鼠体外胃平滑肌条的收缩活动有明显兴奋作用，推测这种效应部分介导于M-胆碱能受体，L型电压依赖性Ca^2＋通道。     

幽门螺杆菌感染与环氧化酶-2诱导型一氧化氮合酶表达关系的研究

目的研究幽门螺杆菌（H、pylori，Hp）感染与环氧化酶-2（COX-2）、诱导型一氧化氮合酶（iNOS）表达之间的关系，以探讨Hp的致病及可能致癌机制。方法2005年6月至2006年5月，南昌大学第一附属医院消化内科采用免疫组化法检测294例胃黏膜标本中COX-2、iNOS的表达。结果（1）各研究组和对照组间炎症细胞和腺细胞中COX-2阳性积分差异均有显著性（P〈0.01），其中以肠上皮化生与异性增生（IM＋DYS）组最高；且浅表性胃炎（CSG）和IM＋DYS组Hp阳性者炎症细胞中COX-2表达明显高于Hp阴性（P〈0．05）。（2）各研究组和对照组间炎症细胞中iNOS的阳性积分差异有显著性（P〈0．05），其中以CSG组最高，IM＋DYS组次之；在CSG和IM＋DYS组Hp阳性者炎症细胞中iNOS表达明显高于Hp阴性（P〈0．05）。（3）中重度CSG炎症细胞中iNOS表达高于轻度CSG（P〈0．05）。（4）各研究组胃黏膜中COX-2和iNOS的表达呈显著正相关（P〈0．01）。结论（1）Hp感染可能通过诱导COX-2、iNOS的过度表达参与Hp的致病过程，并且Hp可能通过上调COX-2的过度表达参与胃癌发生的早期进程。（2）COX-2、iNOS的表达在Hp的致病过程中相互作用，相互影响。     

肥大细胞在幽门螺杆菌相关性胃炎中的作用

目的探讨肥大细胞（MC）在幽门螺杆菌（Hp）相关性胃炎中的作用。方法选择200例行胃镜检查的慢性胃炎患者,取胃窦黏膜分别行组织病理学HE染色及Hp检查（快速尿素酶、改良Giemsa染色）、改良甲苯胺兰染色,分别计算黏膜及黏膜下的完整和脱颗粒MC数。结果MC计数在Hp阳性和Hp阴性组间无统计学差异（P〉0．05）。但前者黏膜内MC脱颗粒者明显多于后者（P〈0．01）;MC计数在活动性炎症组显著高于非活动性炎症组（P〈0．01）。结论MC可能在Hp相关性胃炎的发生发展中起重要作用。     

幽门螺杆菌感染慢性胃炎患者红细胞免疫功能变化的研究

目的　探讨红细胞免疫在幽门螺杆菌感染慢性胃炎发病机制中的作用。方法　对 91例 Hp(+)慢性胃炎患者 [Hp(+)组 ],给予抗 Hp三联 +胃动力药治疗 2周 ;2 2例 Hp(- )慢性胃炎患者 ,给予胃粘膜保护剂 +胃动力药治疗 2周。治疗前及治疗结束后 2个月分别进行胃镜及 Hp检测 ,并测定两组红细胞免疫功能及胃粘膜屏障功能。结果　治疗前 Hp(+)组与 Hp(- )组红细胞免疫功能比较 ,前者 RBC- C3b RR偏低 ,而 RBC- ICR偏高 ,胃粘膜屏障功能较差 (P<0 .0 5 ) ;治疗后两组间无显著性差异 (P>0 .0 5 )。结论　慢性胃炎患者红细胞免疫功能降低 ,其与 Hp感染存在相关性。     

香砂六君颗粒与丸剂对脾虚胃肠动力及胃肠激素影响的对比观察

[目的]观察香砂六君颗粒和香砂六君丸对脾虚胃病患者胃肠动力和胃肠激素的影响,探讨香砂六君颗粒治疗脾虚胃病的机制。[方法]将患者随机分为香砂六君颗粒（颗粒）组和香砂六君丸（对照）组,分别于治疗前后以B超检测胃半排空时间,以放免法测血浆胃动素（MOT）、生长抑素（SS）和血清促胃液素（GAS）水平,同时观察症状积分情况。[结果]2组分别与治疗前比较,症状积分改善、胃半排空时间缩短（均P〈0．01）,MOT、GAS升高,SS降低（P〈0．01,〈0．05）;颗粒组与对照组比较,症状积分降低（P〈0．01）,胃半排空时间缩短,MOT升高（P〈0．05）,2组间GAS、SS差异无统计学意义。[结论]香砂六君颗粒通过调节胃肠激素水平可明显促进胃排空,减慢小肠蠕动,改善脾虚症状,且优于香砂六君丸。     

Three layer functional model and energy exchange concept of aging process

Relying on a certain degree of abstraction, we can propose that no particular distinction exists between animate or living matter and inanimate matter. While focusing attention on some specifics, the dividing line between the two can be drawn. The most apparent distinction is in the level of structural and functional organization with the dissimilar streams of ‘energy flow’ between the observed entity and the surrounding environment. In essence, living matter is created from inanimate matter which is organized to contain internal intense energy processes and maintain lower intensity energy exchange processes with the environment. Taking internal and external energy processes into account, we contend in this paper that living matter can be referred to as matter of dissipative structure, with this structure assumed to be a common quality of all living creatures and living matter in general. Interruption of internal energy conversion processes and terminating the controlled energy exchange with the environment leads to degeneration of dissipative structure and reduction of the same to inanimate matter, (gas, liquid and/or solid inanimate substances), and ultimately what can be called ‘death.’ This concept of what we call dissipative nature can be extended from living organisms to social groups of animals, to mankind. An analogy based on the organization of matter provides a basis for a functional model of living entities. The models relies on the parallels among the three central structures of any cell (nucleus, cytoplasm and outer membrane) and the human body (central organs, body fluids along with the connective tissues, and external skin integument). This three-part structural organization may be observed almost universally in nature. It can be observed from the atomic structure to the planetary and intergalactic organizations. This similarity is corroborated by the membrane theory applied to living organisms. According to the energy nature of living matter and the proposed functional model, the decreased integrity of a human body's external envelope membrane is a first cause of the structural degradation and aging of the entire organism. The aging process than progresses externally to internally, as in single cell organisms, suggesting that much of the efforts towards the restoration and maintenance of the mechanisms responsible for structural development should be focused accordingly, on the membrane, i.e., the skin. Numerous reports indicate that all parts of the human body, like: bones, blood with blood vessels, muscles, skin, and so on, have some ability for restoration. Therefore, actual revival of not only aging tissue of the human body's membrane, but the entire human body enclosed within, with all internal organs, might be expected. We assess several aging theories within the context of our model and provide suggestions on how to activate the body's own anti-aging mechanisms and increase longevity. This paper presents some analogies and some distinctions that exist between the living dissipative structure matter and inanimate matter, discusses the aging process and proposes certain aging reversal solutions.     

Unusual responses of nocturnal pineal melatonin synthesis and secretion to swimming: Attempts to define mechanisms

Abstract: The effect of swimming at night on rat pineal melatonin synthesis was compared with that of light exposure at night. Rats were forced to swim at 0030 hr (lights out at 2000 hr) and sacrificed by decapitation 15 and 30 min later, immediately after swimming. Other groups of animals were exposed to white light (650μW/cm²) for 15 and 30 min at same time. Swimming caused a rapid and highly significant drop in the melatonin content in the pineal gland; however, the activity of N-acetyltransferase (NAT), the supposed rate limiting enzyme in the melatonin production, was not changed. Despite the drop in pineal melatonin levels, serum concentrations of the indole remained elevated in the rats that swam. In contrast, melatonin levels in the pineal and serum of light exposed rats fell precipitously, accompanied by a significant suppression of NAT activity. Since we anticipated that the strenuous exercise associated with swimming may induce release of artrial natriuretic peptide (ANP) from the heart, which in turn could cause the release of pineal melatonin, in a second study we injected physiological saline intravenously to stretch the cardiac muscle and release ANP. Three milliliters of normal saline was injected during the day into the jugular vein of anesthetized rats that were pretreated with isoproterenol to stimulate pineal melatonin production. Animals were killed 15 min after the saline injection, and pineal NAT activity and pineal melatonin levels were measured. The saline injections caused no alteration in the elevated levels of either NAT or melatonin. These data suggest that the disparity in pineal NAT activity (which was high) and pineal melatonin (which was low), in animals swum at night, may not be caused by ANP which is released during strenuous exercise such as swimming.     

Melatonin and photoperiodic time measurement: Seasonal breeding in the sheep

Abstract: Well-established circadian physiology supports the view that photoperiodic time measurement utilizes the coincidence between the presence of light and a photosensitive phase of a 'biological clock' to alter reproductive status—the so-called external coincidence model of seasonal breeding. In this review, we examine the mechanism whereby photoperiod interacts with presumed suprachiasmatic nuclei activity to allow endogenous melatonin to normally synchronize reproductive activity to the optimal time of year. The Romney Marsh sheep is particularly explored as an experimental model. It is suggested that the on/off activity of seasonal reproduction may be a robust mechanism able to be predictably manipulated by the judicious use of the light/dark cycle and exogenous melatonin, but firmly based on circadian principles.     

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.     

Serological survey of HIV and syphilis in pregnant women in Madagascar

Objectives Peripartal transmission of human immunodeficiency virus (HIV) and Treponema pallidum, the causative agent of syphilis, leads to severe consequences for newborns. Preventive measures require awareness of the maternal infection. Although HIV and syphilis testing in Madagascar could be theoretically carried out within the framework of the national pregnancy follow‐up scheme, the required test kits are rarely available at peripheral health centres. In this study, we screened blood samples of pregnant Madagascan women for HIV and syphilis seroprevalence to estimate the demand for systemic screening in pregnancy. Methods Retrospective anonymous serological analysis for HIV and syphilis was performed in plasma samples from 1232 pregnant women that were taken between May and July 2010 in Ambositra, Ifanadiana, Manakara, Mananjary, Moramanga and Tsiroanomandidy (Madagascar) during pregnancy follow‐up. Screening was based on Treponema pallidum haemagglutination tests for syphilis and rapid tests for HIV, with confirmation of positive screening results on line assays. Results Out of 1232 pregnant women, none were seropositive for HIV and 37 (3%) were seropositive for Treponema pallidum. Conclusions Our findings are in line with previous studies that describe considerable syphilis prevalence in the rural Madagascan population. The results suggest a need for screening to prevent peripartal Treponema pallidum transmission, while HIV is still rare. If they are known, Treponema pallidum infections can be easily, safely and inexpensively treated even in pregnancy to reduce the risk of transmission.     

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.     

Variabilité des concentrations plasmatiques de l’angiotensinogène et risque d’hypertension artérielle chez le rat transgénique

Aim

Genetic polymorphisms of the human angiotensinogen gene are frequent and may induce up to 30% increase of plasma angiotensinogen concentrations with a blood pressure increase of up to 5 mmHg. Their role for the pathogenesis of human arterial hypertension remains unclear. High plasma angiotensinogen levels could increase the sensitivity to other blood pressure stressors.

Methods

Male transgenic rats with a 9-fold increase of plasma angiotensinogen concentrations and male non-transgenic rats aged 10 weeks were treated or not with NG-Nitro-L-arginine-methyl ester for 3 weeks in their drinking water (n = 3/group). Systolic blood pressure and body weight were measured at baseline and at the end of the study when left ventricular weight and ventricular expression of angiotensin I-converting enzyme and procollagen Iα1 were determined (polymerase chain reaction).

Results

At baseline, transgenic rats had +18 mmHg higher bood pressure and –8% lower body weight compared to non-transgenic rats (P < 0.05) without significant changes for the vehicle groups throughout the study (P > 0.05). NG-Nitro-L-arginine-methyl ester increased blood pressure, left ventricular weight and left ventricular weight indexed for body weight by +41%, +17.6% and +18.6% (P < 0.05) in transgenic and +25%, +5.3% and +6.7% (P > 0.05) in non-transgenic rats compared to untreated animals, respectively. Cardiac gene expression showed no differences between groups (P > 0.05).

Conclusion

Increased plasma angiotensinogen levels may sensitize to additional blood pressure stressors. Our preliminary results point towards an independent role of angiotensinogen in the pathogenesis of human hypertension and associated end-organ damage.