氨氯地平治疗老年肥胖高血压患者高胰岛素血症的临床观察

目的:探讨氨氯地平对老年肥胖高血压(EH)患者胰岛素敏感性的干预作用.方法:30例老年肥胖高血压患者氨氯地平治疗前及治疗半年后,分别进行口服葡萄糖耐量试验(OGTT),并测定治疗前后的血糖、血浆胰岛素,计算血浆胰岛素的敏感指数(血糖/胰岛素),与30例年龄,性别,体重指数相当的正常人进行比较.结果:两组空腹血糖水平差异无显著性,均正常.EH组患者OGTT后血糖、血浆胰岛素水平显著升高,胰岛素敏感指数显著下降(P均<0.05);氨氯地平治疗半年后,OGTT后血糖、血浆胰岛素水平显著降低,胰岛素敏感指数显著上升(P均<0.05).结论:老年肥胖高血压患者胰岛素敏感指数下降,血糖、血浆胰岛素水平显著升高(P均<0.05),氨氯地平长期治疗后,在稳定降压的同时高胰岛素抵抗也得到明显改善.     

氨氯地平治疗老年肥胖高血压患者高胰岛素症的临床观察

目的:探讨氨氯地平对老年肥胖高血压(EH)患者胰岛素敏感性的干预作用。方法:30例老年肥胖高血压患者氨氯地平治疗前及治疗半年后,分别进行口服葡萄糖耐量试验(OGTT),并测定治疗前后的血糖、血浆胰岛素,计算血浆胰岛素的敏感指数(血糖/胰岛素),与30例年龄,性别,体重指数相当的正常人进行比较。结果:两组空腹血糖水平差异无显著性,均正常。EH组患者OGTT后血糖、血浆胰岛素水平显著升高,胰岛素敏感指数显著下降(P均<0.05);氨氯地平治疗半年后,OGTT后血糖、血浆胰岛素水平显著降低,胰岛素敏感指数显著上升(P均<0.05)。结论:老年肥胖高血压患者胰岛素敏感指数下降,血糖、血浆胰岛素水平显著升高(P均<0.05),氨氯地平长期治疗后,在稳定降压的同时高胰岛素抵抗也得到明显改善。     

氨氯地平联合缬沙坦治疗老年原发性高血压合并糖尿病的疗效观察

目的观察氨氯地平联合缬沙坦治疗老年原发高血压合并糖尿病的疗效。方法选取100例在我院就诊的原发性高血压合并糖尿病老年病人,随机分为对照组和观察组,各50例。对照组给予5mg/d氨氯地平,观察组给予5mg/d氨氯地平联合80mg/d缬沙坦。治疗1个月后对两组病人的血压、血糖、胰岛素水平、肾功能等进行对比。结果观察组血压(收缩压与舒张压)下降幅度均明显大于对照组,差异具有统计学意义(P0.05)。两组病人治疗前后空腹血糖、餐后2h血糖、空腹血清胰岛素及胰岛素敏感性指数比较,差异无统计学意义(P0.05)。治疗前两组肾功能水平比较,差异无统计学意义(P0.05)。治疗后,两组病人微量尿白蛋白排泄率(UAER)及24h尿蛋白定量均低于治疗前(P0.05)。观察组UAER及24h尿蛋白定量低于对照组(P0.05)。两组不良反应发生情况比较差异无统计学意义(P0.05)。结论氨氯地平联合缬沙坦对老年原发高血压合并糖尿病病人有良好的治疗效果。     

缬沙坦联合氨氯地平治疗社区老年原发高血压合并糖尿病的效果评价

2017年8月至2018年5月抽选80例社区老年原发高血压合并糖尿病患者,随机法平分为对照组接受缬沙坦治疗,观察组联合氨氯地平治疗。结果:观察组健康调查量表评分明显高于对照组,其舒张压、收缩压、空腹血糖及餐后2h血糖空腹胰岛素水平低于对照组,P 0.05。结论:联合治疗老年原发高血压合并糖尿病的疗效显著。     

氨氯地平对高血压病人胰岛素敏感性的影响

为探讨氨氯地平对高血压病人胰岛素敏感性的干预作用。我们测定２２例高血压病人，２２例正常血压者胰岛素敏感性以及高血压病患者氨氯地平治疗后的胰岛素敏感性变化。以正常血糖胰岛素钳夹技术测定葡萄糖代谢率作为胰鸟敏感性指标。     

特拉唑嗪治疗老年原发性高血压临床研究

60例老年原发性高血压患者随机分为观察组和对照组，观察组采用氨氯地平与特拉唑嗪联合治疗，对照组仅用氨氯地平治疗。疗程结束后，观察组临床效果明显优于对照组。提示氨氯地平与特拉唑嗪联合治疗老年原发性高血压效果显著，不良反应少，值得在临床推广。     

氨氯地平与依那普利对老年高血压疗效比较

目的评价氨氯地平治疗老年高血压病的疗效和安全性并与依那普利比较。方法４６例老年高血压患者，采用随机单盲自身交叉法试验。氨氯地平组与依那普利组各有９例行动态血压监测。氨氯地平５～１０ｍｇ／ｄ，依那普利５～２０ｍｇ／ｄ，疗程４周。结果氨氯地平或依那普利治疗后，偶测血压比治疗前有显著降低，组间比较差异无显著性。动态血压显示氨氯地平控制２４ｈ血压明显较依那普利为优。不良反应的发生率氨氯地平较依那普利为少。结论氨氯地平是治疗老年高血压安全、有效的降压药物。     

氨氯地平治疗老年高血压的临床研究

目的观察氨氯地平对老年高血压的治疗效果。方法本研究采用２４小时动态血压、超声心动图和平板运动检查,评价了氨氯地平对老年高血压患者左室肥厚和运动血压的影响。３６例按ＷＨＯ标准确诊为老年高血压者,排除继发性病因,停用降压药２周后给予氨氯地平５ｍｇ～７．５ｍｇ／ｄ,治疗四月。治疗前后行２４小时动态血压、超声心动图和平板运动试验检查。结果氨氯地平治疗后２４小时收缩压、舒张压及白昼、夜间收缩压、舒张压均明显低于治疗前;左室重量、室间隔厚度及左室后壁厚度亦明显减少;治疗后运动高峰时收缩压、运动停止后３分钟收缩压亦明显降低。结论氨氯地平能有效地降低老年高血压患者２４小时收缩压、舒张压,逆转心室肥厚,并明显降低患者运动时收缩压,但对运动时舒张压及血压昼夜节律无明显影响     

缬沙坦氨氯地平治疗老年高血压的依从性及药物经济学优势

目的探讨缬沙坦氨氯地平治疗老年高血压的依从性及药物经济学优势。方法采用调查问卷,对219例老年高血压患者进行依从性的追踪、随访调查,并运用成本-效果分析方法进行评价。结果缬沙坦氨氯地平依从性比例达到52.94%,而缬沙坦组、苯磺酸氨氯地平组、缬沙坦联合氨氯地平组依从性比例分别为31.91%、35.71%、35.40%。且缬沙坦氨氯地平组的成本-效果比最低。结论缬沙坦氨氯地平治疗高血压的依从性好,且具有药物经济学优势。     

苯磺酸左旋氨氯地平治疗老年高血压60例疗效观察

为观察苯磺酸左旋氨氯地平片治疗老年原发性高血压的临床疗效，2007年6月至2007年12月，我们应用苯磺酸左旋氨氯地平（施慧达，2．5mg／片，吉林天风制药有限公司生产）治疗老年原发性高血压患者60例，现报告如下。     

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.     

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.     

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.     

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.