乙肝后肝硬化患者血清胃泌素的变化及其与幽门螺杆菌感染的关系

为了探讨乙肝后肝硬化患者血清胃泌素变化的意义及其与幽门螺杆菌(Hp)感染的关系,检测46例乙肝后肝硬化患者血清胃泌素及Hp感染的变化,并以20例门诊健康体检者胃泌素的变化为对照,结果显示:肝硬化患者空腹血清胃泌素浓度为159.3±42.1ng/L,对照组为96.8±32.4ng/L,两组比较差异有显著性(P<0.05)。Child-Pugh分级A、     

重症肺心病消化道出血时血清胃泌素的变化

目的　探讨重症肺心病时胃泌素变化与消化道出血的关系。方法　检测 5 6例重症肺心病患者和 2 0 0例对照组血清胃泌素的水平。结果　 5 6例重症肺心病患者胃泌素的浓度明显增高 ,平均值为 (4 87.91± 3 .0 2 )ng/L ,而对照组的平均值为 (2 5 .0 0± 19,6)ng/L ,两组比较差异有非常显著性 (P <0 .0 1)。血清胃泌素 >5 0 0ng/L重症肺心病患者 ,均并发消化道明显出血。结论　血清胃泌素的水平可作为重症肺心病易并发消化道出血的标志     

贲门癌组织中胃泌素型癌细胞与血清胃泌素水平的关系

应用免疫组织化学方法观察64例贲门癌组织中的胃泌素型癌细胞,并测定了血清胃泌素浓度.结果显示:21.88%(14/64)的贲门癌组织中存在胃泌素型癌细胞;贲门癌患者术前血清胃泌素浓度较正常人为高(P<0.01).术后继续升高,4周达顶峰,8周恢复正常水平.作者对癌组织中胃泌素型癌细胞与血清胃泌素水平之间关系进行了探讨,胃泌素型癌细胞阳性者贲门癌血清胃泌素水平为196.08±69.50ng/L,胃泌素型癌细胞阴性者为168.92±59.74ng/L(P>0.05).结果提示;胃泌素型癌细胞不影响贲门癌的血清胃泌素浓度.     

腹部推拿对老年胃轻瘫患者胃肠激素的影响

目的观察腹部推拿法对老年胃轻瘫患者血清胃动素、血清胃泌素的影响。方法纳入老年胃轻瘫患者10例,观察腹部推拿治疗前后患者胃轻瘫基本症状指数(GCSI)和外周静脉血中血清胃动素、血清胃泌素含量的变化情况。结果 10例老年胃轻瘫患者腹部推拿治疗后GCSI总分明显降低(P0.05),其中早饱评分、胃胀评分、食后饱胀评分、食欲不振评分等4各单项均有显著改善(P0.05,P0.01);血清胃动素、血清胃泌素含量经腹部推拿后均显著增加,治疗前后比较其含量差异有统计学意义。结论腹部推拿对老年胃轻瘫患者的治疗作用可能是通过调节胃肠激素的分泌而发生作用。     

肺癌患者手术前后血清胃泌素水平的连续研究

研究目的了解肺癌患者手术前后血清胃泌素水平的动力学改变,根治性手术与血清胃泌素的关系,以便估价其临床应用的可能性。患者与方法肺癌患者58(男52,女61)例,27～71岁;胸部非癌性病变患者40(男22、女18)例,16～61岁;健康对照组151(男83、女68)例,26～57岁。所有患者均于手术前和手术后第1、7和14天测定血清胃泌素,30例肺癌患者手术后第180、360和540天重新进行了监测。结果不同人群血清胃泌素的平均水平(ng/L)和阳性(>50ng/L)率分别为:正常人29.37±1.10,阳性6例(3.97%);非癌性病患者29.99±1.73,阳     

连续性血液净化治疗Ⅰ型心肾综合征患者的疗效分析

目的 探讨连续性血液净化治疗(CBP)对Ⅰ型心肾综合征(CRS)的临床疗效. 方法 收集2012年1月至2014年6月武汉市中心医院重症医学科42例使用CBP治疗Ⅰ型CRS患者的临床资料,记录患者CBP治疗前及治疗5d后平均动脉压、心率、呼吸频率、急性生理与慢性健康状况评分Ⅱ (APACHEⅡ)、尿量的变化;同步观察患者的肾功能监测指标、心功能监测指标的变化;治疗过程中使用PICCO plus监测患者心指数、胸腔内血容积指数、全心舒张末期容积指数、中心静脉压、血管外肺水指数等指标变化;比较患者治疗前后左心室射血分数变化. 结果 42例Ⅰ型CRS患者在CBP治疗过程中循环稳定,平均动脉压差异无统计学意义(P=0.08).治疗5d后,其心动过速、呼吸急促症状较治疗前缓解(均P＜0.05),尿量增加、APACHEⅡ评分下降(均P＜0.05);同时治疗前后患者的肌酐(413.6±126.1)μmol/L比(126.8±68.3) μmol/L、血清胱抑素C(4.1±1.1)g/L比(1.1±0.8)g/L、肌钙蛋白(3.5±0.7)μg/L比(2.6±0.4)μg/L、B型利钠多肽(3300.3±567.6)ng/L比(807.6±427.7)ng/L(均P＜0.05).CBP治疗后患者心肌收缩力、容量前负荷、肺相关参数均改善(P＜0.05). 结论 CBP治疗能缓解Ⅰ型CRS患者的临床症状,改善心、肾功能.     

氯沙坦对心力衰竭患者肿瘤坏死因子α和血管内皮依赖性舒张功能的影响

目的　观察氯沙坦对慢性心力衰竭 (chronicheartfailure ,CHF)患者肿瘤坏死因子α(TNF α)与血管内皮依赖性舒张功能 (endothelialdependentdiastolicfunction ,EDD)的影响。 方法测定 4 9例CHF患者 (CHF组 )和 38例无慢性心力衰竭患者 (无CHF组 )TNF α水平。 4 9例CHF患者随机分为氯沙坦组和常规治疗组。治疗前和治疗 4周后测定TNF α水平及用彩色多普勒血流仪测定肱动脉内径和反应性充血后的内径。结果　CHF组TNF α水平明显高于无CHF组 [( 10 7 4±4 7 2 )比 ( 76 2± 35 4 )ng/L ,P <0 0 1]。治疗 4周后 ,氯沙坦组TNF α水平比治疗前明显降低[( 10 8 5± 12 1)比 ( 91 3± 11 4 )ng/L ,P <0 0 5 ];而反应性充血后血管内径及其变化百分比明显升高 [( 4 9± 8 4 )比 ( 5 5± 7 7)mm ,P <0 0 5 ;( 2 9 2± 4 2 )比 ( 38 9± 5 9) % ,P <0 0 5 ];氯沙坦组的TNF α水平与反应性充血后血管内径及其变化百分比呈负相关 (r =- 0 5 2 ,P <0 0 5 ;r =- 0 6 4 ,P <0 0 5 )。结论　慢性心力衰竭患者的血管内皮功能受损 ,TNF α是引起这一损害的主要因素 ,氯沙坦治疗不仅可以控制心力衰竭症状 ,而且可以有效地改善血管内皮功能     

舒肝解郁胶囊治疗进展期胃癌并发抑郁症的临床研究

目的探讨舒肝解郁胶囊治疗进展期胃癌并发抑郁症的临床疗效。方法明确诊断的82例胃癌晚期患者在化疗基础上分为治疗组41例(给予舒肝解郁胶囊治疗)和对照组41例(给予姑息治疗),两组患者使用汉密顿抑郁量表(HAMD)评定患者的抑郁状态及其舒肝解郁胶囊治疗抑郁的疗效。结果经6周治疗后,两组患者临床症状均获改善,且总有效率比较有显著性差异(P0.05),治疗组抑郁症疗效明显优于对照组(χ2=7.68,P0.01),两组治疗前后HAMD评分比较有显著性差异(P0.01)。结论舒肝解郁胶囊治疗进展期胃癌并发抑郁症,临床疗效较好。     

血清胃泌素水平与舌象及其相关因素的研究

以双盲法对随机收集的113例患者进行了血清胃泌素水平与舌象及其相关因素的临床研究。结果舌体胖大、有齿痕，舌质淡红、红与暗红，苔薄黄、黄厚、白厚以及腻苦的检出率，高胃泌素血症者明显低于正常者（P＜0．05，＜0．01），提示正常或低胃泌素血症利于上述舌象形成。此外，中年患者、血瘀化热型、老年病和溃疡病者血清胃泌素多正常（P＜0．05，＜0．01）。胃窦炎、肾结石者以低胃泌素血症居多，且具显著或极显著性差异（P＜0．05＜0．01），表明与各自的胃泌素释放或抑制状态有关。认为血清胃泌素水平与舌象及其相关因素有一定内在联系，但其机制有待进一步研究。     

西米替丁对急性胰腺炎的影响及机制探讨

目的:探讨西米替丁治疗急性胰腺炎的利弊及其机制。方法:对156例急性水肿型胰腺炎患者进行传统疗法与传统疗法加西米替丁的治疗对照研究,并检测了50例消化性溃疡患者服用西米替丁前后的血清胃泌素及24例急性胰腺炎患者急性发病期的血清胃泌素。结果西米替丁组腹痛消失时间、血尿淀粉酶下降时间、住院时间均较对照组明显延长。另有40.16％(51/127)的患者出现病情反复。溃疡病患者服用西米替丁后血清胃泌素明显升高。急性胰腺炎发病期血清胃泌素明显高于正常,发病当日超过正常值4～10余倍。结论:急性胰腺炎的发病可能与血清胃泌素过高有关,西米替丁虽能降低胃酸,但因反馈性升高血清胃泌素而不利于急性胰腺炎的恢复。     

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.