非酒精性脂肪性肝病的中医证治研究

非酒精性脂肪性肝病在各型脂肪肝中占有较大的比例，已成为我国第二大肝病。流行病学调查显示，有20％～30％的中国城市人口肝脏超声检查发现脂肪肝（FLD）。上海市成人脂肪肝患病率为17．29％，非酒精性脂肪性肝病（NAFLD）患病率为15．35％；广东省农村成人脂肪肝标化率为13．81％（NAFLD的标化率为10．95％）。无论其成因如何，均有部分脂肪肝患者（约占25％）可发展为肝纤维化，甚至肝硬化，因此可以认为，脂肪肝是肝纤维化和肝硬化的前期病变。     

中医药防治非酒精性脂肪性肝病的研究

非酒精性脂肪性肝病（NAFLD）是指除外酒精和其他损肝因素所致的，以弥漫性肝细胞大泡性脂肪变为主要特征的临床病理综合征．包括非酒精性单纯性脂肪肝（NAFL）、非酒精性脂肪性肝炎（NASH）、非酒精性脂肪性肝硬化三种主要类型。NAFLD在西方普通人群中的发病率接近20％～30％。其中约10％的病人会发展成NASH．后者近30％的病人可进展为肝硬化．甚至发生终末期的肝功能衰竭。我国脂肪肝在一般人群中的患病率为10％～16％，在肥胖患者中，脂肪肝的检出率高达38％。     

葫芦巴总皂昔对大鼠酒精性脂肪肝的治疗作用

据不完全统计,我国部分地区成人脂肪性肝病的发病率已高达10%～20%；脂肪性肝病已经不再被认为是良性静止性病变,其纤维化的发生率高达25%,且约1．5%～8．0%的患者可发展为肝硬化,已成为较严重的医学和社会问题。本研究通过构建大鼠酒精性脂肪肝模型,研究葫芦巴总皂苷(TFGs)对酒精     

隔药饼灸联合药物治疗非酒精性单纯性脂肪肝81例

非酒精性单纯性脂肪肝（简称脂肪肝）是非酒精性脂肪性肝病（nonalcoholic fatty liver disease，NAFLD）的一种临床类型，是中医内科常见的一种疾病。脂肪肝虽通常被认为是一种良性的病变，但也可在较短时间内发展为不可逆的肝损害，其肝纤维化的发生率高达25％，且有1．5％-8．0％患者可进展为肝硬化。故积极防治脂肪肝对阻止慢性肝病进展和改善患者预后具有十分重要意义。脂肪肝患者虽然临床表现不明显，肝功能也基本正常，但是如果不加以干预，可进展为脂肪性肝炎，脂肪性肝纤维化和肝硬化。     

重视非酒精性脂肪性肝病的基础和临床研究

目前，非酒精性脂肪性肝病（nonalcoholic fatty liver diseases，NAFLD）是指除外酒精和其他明确损肝因素所致的、以弥漫性肝细胞大泡性脂肪变为主要特征的临床病理综合征，包括单纯性脂肪肝以及由其演变的脂肪性肝炎和肝硬化．胰岛素抵抗（insulin resistance,IR）和遗传易感性与其发病关系密切。流行病学显示，本病平均累及世界人口的10％～24％，在肥胖人群中的患病率高达57％～74％，明显超过乙型肝炎、丙型肝炎及酒精性肝病的患病率，已成为最常见的肝病。近年来我国及亚太地区的NAFLD患病率逐年上升，已与西方国家接近，     

脂肪性肝病与肝癌

脂肪性肝病（FLD）系由多种病因引起的肝脏脂质代谢紊乱及动态平衡失调，以致肝细胞内脂质蓄积，肝细胞脂肪变性，从而产生的一系列临床病理综合征。FLD包括单纯性脂肪肝、脂肪性肝炎、脂肪性肝硬化3种类型。在西方发达国家脂肪肝的发病率为10％～24％。近年来，随着人们生活水平和饮食结构的变化，我国FLD的发病率也日趋增高，已成为居病毒性肝炎之后的第二大肝病。FLD根据病因可分为酒精性脂肪性肝病（AFLD）和非酒精性脂肪性肝病（NAFLD）两大类。FLD不再仅被认为是良性病变，单纯性脂肪肝可发展为脂肪性肝炎、肝硬化。许多学者报道FLD与肝细胞癌（HCC）关系密切。     

安络化纤丸联合辛伐他丁治疗非酒精性脂肪肝30例

近年来，非酒精性脂肪性肝病（non-alcoholic fatty liver disease，NAFLD）的发病率有逐年升高的趋势。据统计，其中约有1．5％-8％非酒精性脂肪性肝病患者发生肝硬化。NAFLD包括单纯性非酒精性脂肪肝、非酒精性脂肪性肝炎、脂肪性肝纤维化和肝硬化。及早治疗对阻断病情的发展具有重要意义。笔者采用安络化纤丸联合辛伐他丁治疗NAFLD，并与凯茜莱作对照，现报告如下。     

酒精性脂肪肝与非酒精性单纯性脂肪肝中药新药临床研究有关问题的思考

酒精性肝病（ALD）与非酒精性脂肪性肝病（NAFLD）近年来在中国的发病率逐年上升，成为仅次于病毒性肝炎的最常见的肝病。临床常见为酒精性脂肪肝与非酒精性单纯性脂肪肝。目前，相关中药新药研究也多针对酒精性脂肪肝与非酒精性单纯性脂肪肝。     

酒精性肝病分子发病机制的研究进展

长期饮酒会造成各种肝脏疾病。在我国广东省，社区中脂肪肝的发病率是14．5％，其中酒精性肝病为0．5％，疑似酒精性肝病2．3％。香港酒精性肝病发病率为1．7％。浙江省香山县岛民兼有肥胖和5年以上饮酒史的人群中脂肪肝的患病率高达71．52％，而在非肥胖的长期饮酒者中这一比例也达56．78％。作为乙醇高消耗地区的东欧，一般人均多消耗1升乙醇，男性肝硬化死亡病例增加3～4／10万，女性肝硬化死亡病例仅增加1／10万。因此，酒精性肝病的研究，对指导本病的防治和提高人们的生活质量具有重要意义。     

非酒精性脂肪性肝病营养治疗

非酒精性脂肪性肝病（nonalcoholic fatty liver disease,NAFLD）是一种无过量饮酒史、以肝实质细胞脂肪变性和脂肪贮积为特征的临床综合征，疾病谱随病程进展而表现不一，主要包括单纯性脂肪肝、非酒精性脂肪性肝炎（nonalcoholic steatohepatitis,NASH）、脂肪性肝纤维化和肝硬化。美国成人NAFLD发病率接近20％。日本为21.8％，韩国为24．6％，我国成人NAFLD发病率为12.6％～25％。美国12～18岁青少年NASH发病率为3．0％，     

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.