稳心颗粒联合胺碘酮治疗充血性心力衰竭并发室性心律失常128例

目的观察稳心颗粒联合胺碘酮治疗充血性心力衰竭合并室性心律失常疗效。方法选择2002年2月—2005年2月充血性心力衰竭合并室性心律失常病人128例,给予口服稳心颗粒1包,每日3次,疗程为4周;胺碘酮0.2g,每日3次,疗程为4周。结果治疗两周后总有效率为60%,28例阵发性室性心动过速(PVT)也被终止,QT离散度(QTd)由(66.05±11.32)ms减至(42.35±10.08)ms(P<0.01)。治疗4周后观察总有效率为86%,QTd由(66.05±11.32)ms减至(30.65±6.28)ms(P<0.01)。结论稳心颗粒联合胺碘酮是治疗充血性心力衰竭合并室性心律失常有效的药物。     

稳心颗粒与胺碘酮联合应用对QTc离散度的影响、

目的 探讨稳心颗粒与胺碘酮联合应用治疗心律失常对患者QTc离散度(QTcd)的影响.方法 将136例心律失常患者随机分为两组,67例为胺碘酮组,69例为联合治疗组,比较治疗前后及组间QTcd.结果 两组患者治疗后QTcd水平较治疗前差异均有统计学意义(P<0.05),胺碘酮组治疗前QTcd水平较联合治疗组差异无统计学意义(P>0.05),治疗后差异有统计学意义(P<0.01).结论 稳心颗粒与胺碘酮联合应用更能明显降低QTcd.     

稳心颗粒对急性冠脉综合征室性心律失常的影响及机制

目的观察稳心颗粒对急性冠脉综合征(ACS)患者室性心律失常及QT离散度(QTd)的影响。方法64例ACS患者随机分为常规治疗组和稳心颗粒组各32例,第1天(治疗前)及第28天(治疗后)常规行12导联心电图和Holter检查。常规治疗组采用常规治疗,稳心颗粒组加用稳心颗粒,9g/次,3次/d,疗程均为4周。结果两组患者室性心律失常疗效间差异有统计学意义(P<0.05)。两组患者QTd治疗前差异无统计学意义(P>0.05),治疗后差异有统计学意义(P<0.05)。结论稳心颗粒能减少ACS患者室性心律失常的发生和有效缓解临床症状,QTd的缩短可能是其治疗机制之一。     

稳心颗粒冲剂治疗充血性心力衰竭伴室性心律失常疗效观察

目的 :观察稳心颗粒冲剂对充血性心力衰竭合并室性心律失常病人的疗效。方法 :充血性心力衰竭心功能Ⅲ级～Ⅳ级合并室性心律失常病人 5 8例随机分为稳心颗粒冲剂组 (A组 )和对照组 (B组 ) ,治疗 4周后 ,复查超声心动图、动态心电图。结果 :经治疗后A组与B组相比 ,心功能改善、室性心律失常改善均有统计学意义 (P <0 .0 5 )。结论 :稳心颗粒冲剂对充血性心力衰竭伴室性心律失常病人 ,在改善心功能、控制室性心律失常方面有较好的疗效。     

稳心颗粒联合胺碘酮治疗冠心病室性心律失常疗效评价

目的分析稳心颗粒联合胺碘酮治疗冠心病室性心律失常的疗效。方法选择2014年9月~2016年3月本院收治的80例冠心病室性心律失常病人,随机分为两组,对照组给予胺碘酮口服;观察组在对照组基础上给予稳心颗粒治疗,比较两组患者治疗前后心电图及血脂指标变化,治疗后1月的临床疗效及不良反应情况。结果治疗1月后,观察组ST段下移程度小于对照组;观察组治疗总有效率90.0%,对照组为72.5%,差异均有统计学意义(P0.05);观察组不良反应率5.0%,对照组12.5%,两组差异有统计学意义(P0.05)。结论稳心颗粒联合胺碘酮治疗冠心病室性心律失常较胺碘酮单独治疗效果更显著,且用药相对安全,值得推广。     

步长稳心颗粒与胺碘酮治疗慢性心力衰竭室性期前收缩的疗效观察

目的观察步长稳心颗粒与胺碘酮治疗慢性心力衰竭室性期前收缩患者的疗效。方法将慢性心力衰竭室性期前收缩患者分为两组,治疗组在常规治疗基础上加用步长稳心颗粒、胺碘酮;对照组在常规治疗基础上加用普罗帕酮,观察两组患者临床症状、心电图变化。结果治疗组临床症状改善总有效率为90%,对照组临床症状改善总有效率为70%,两组比较差异有统计学意义(P0.05)。结论步长稳心颗粒与胺碘酮治疗慢性心力衰竭室性期前收缩疗效确切。     

胺碘酮对慢性充血性心力衰竭并室性心律失常的疗效及QT离散度的影响

目的 观察胺碘酮对慢性充血性心力衰竭(CCHF)并室性心律失常的疗效及QT离散度的影响.方法 42例CCHF并室性心律失常患者常规治疗心力衰竭的同时,给予口服胺碘酮治疗8周,观察其疗效及治疗前后(校正)QT离散度(QTcd)的变化.结果 观察组患者治疗前的QTcd显著大于正常对照组(t=5.6767,P＜0.01).治疗8周后观察组控制室性心律失常的总有效率为90.5％;观察组患者治疗后的心率、LVESV、QTcd显著低于治疗前(t=11.698、2.5248、3.1841,P＜0.01或P＜0.05),LVEF显著高于治疗前(t=2.5780,P＜0.05);观察组患者治疗后的QTcd仍显著高于正常对照组(t=2.7499,P＜0.01).结论 胺碘酮能改善慢性充血性心力衰竭患者的心功能,降低QTcd,减少室性心律失常,可安全用于治疗慢性充血性心力衰竭并室性心律失常.     

稳心颗粒治疗慢性心力衰竭合并心律失常的临床观察

目的 观察稳心颗粒对慢性心衰合并心律失常的治疗效果.方法 将慢性心衰合并心律失常患者120例随机分成两组,对照组给予常规抗心衰药物+胺碘酮治疗,治疗组在观察组治疗基础上加用稳心颗粒治疗,观察4周.比较治疗前后患者的临床症状、实验室检查、超声心动图、静息心电图及动态心电图的变化.结果 治疗4周后,治疗组改善心律失常、心力衰竭总有效率均优于对照组,差异均有统计学意义(P＜0.05).两组不良反应发生率无统计学意义.结论 稳心颗粒可改善心衰症状,具有较强的抗心律失常作用.     

步长稳心颗粒与胺碘酮治疗室性期前收缩的对比观察

目的比较步长稳心颗粒和胺碘酮治疗室性期前收缩的疗效及安全性。方法90例室性期前收缩患者随机分为稳心颗粒组(45例)和胺碘酮组(45例)。稳心颗粒组患者给予稳心颗粒治疗,胺碘酮组患者给予胺碘酮治疗,均治疗4周。观察用药前后两组患者的临床症状、期前收缩次数及不良反应情况。结果稳心颗粒组患者治疗后总有效率为82.2%,胺碘酮组为80.2%,两组患者治疗后总有效率间差异无统计学意义(P<0.05)。结论稳心颗粒对室性期前收缩的疗效与胺碘酮相当,但不良反应少。     

稳心颗粒对老年性心律失常的疗效研究

目的观察步长稳心颗粒治疗老年人心律失常的疗效。方法选取87例心律失常患者随机分为疗治组和对照组,疗治组44例,用步长稳心颗粒治疗;对照组43例,口服胺碘酮,疗程均为4周,一疗程后复查动态心电图并观察疗效。结果疗治组有效率90.9%,对照组有效率79.1%,两组治疗效果差异有统计学意义（P〈0.05）。结论步长稳心颗粒是一种有效治疗老年心律失常的药物,能有效抑制室性及室上性心律失常,改善心功能,对伴随症状疗效也较好。     

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.