清热除湿祛腐生肌法配合灌肠治疗活动期溃疡性结肠炎45例

[目的]观察清热除湿、祛腐生肌法配合中药灌肠治疗活动期溃疡性结肠炎(UC)的临床疗效.[方法]将90例UC患者按就诊顺序随机分成2组,各45例,治疗组采用内服清热除湿、祛腐生肌方配合中药灌肠法治疗,对照组口服美沙托嗪片治疗,8周后评价疗效.[结果]2组主要症状(黏液血便、腹痛、腹泻、里急后重)改善情况比较,治疗组优于对照组(P＜0.05),2组疗效比较,治疗组优于对照组(P＜0.01).[结论]清热除湿、祛腐生肌法配合中药灌肠治疗活动期UC疗效明显,无不良反应,值得基层医院临床运用.     

柳氮磺吡啶联合白头翁汤灌肠治疗溃疡性结肠炎32例

[目的]观察柳氮磺毗啶(SASP)联合白头翁汤灌肠治疗溃疡性结肠炎(UC)的临床疗效.[方法]62例UC患者随机分为2组,对照组30例,单用SASP治疗,治疗组32例,采用SASP联合白头翁汤灌肠治疗,治疗9周后,2组均行结肠镜检查,观察比较疗效.[结果]治疗组总有效率为93.75%,对照组66.70%,2组比较差异有统讳学意义(P<0.05).[结论]SASP联合白头翁汤灌肠治疗UC比单用SASP更能控制急性发作,维持缓解,巩固和提高疗效的作用.     

美沙拉嗪口服联合锡类散保留灌肠治疗溃疡性结肠炎40例

[目的]观察口服美沙拉嗪联合锡类散保留灌肠治疗溃疡性结肠炎(UC)疗效.[方法]83例活动期UC患者随机分为2组,治疗组口服美沙拉嗪肠溶片1.0 g,4次/d,八味锡类散1.0 g加入0.9%氯化钠100 ml中,保留灌肠,1次/d;对照组口服美沙拉嗪肠溶片1.0 g,4次/d,疗程均为4周.比较2组的临床疗效及不良反应.[结果]2组患者治疗4周后症状明显改善,治疗组总有效率及临床治愈率分别为100%和95.0%,对照组分别为93.0%和74.4%.2组比较差异均有统计学意义(P＜0.05),2组患者治疗后均未发现严重不良反应.[结论]美沙拉嗪口服联合锡类散保留灌肠治疗UC疗效显著.     

外用溃疡散灌肠联合西药治疗溃疡性结肠炎44例

[目的]观察外用溃疡散灌肠联合西药治疗溃疡性结肠炎(UC)的疗效.[方法]对我院2010年10月～2011年5月住院的84例UC患者随机分为2组,2组均给予美沙拉嗪1.0g,3次/d口服;2％利多卡因20 ml、地塞米松5 mg、0.9％氯化钠30 ml保留灌肠,治疗组在此基础上加用外用溃疡散1.0g保留灌肠,2周后复查肠镜及病理检查,比较2组疗效.[结果]治疗组总有效率93.2％,对照组77.5％,2组比较差异有统计学意义(P＜0.05).[结论]外用溃疡敞灌肠联合西药治疗UC对溃疡愈合有良好效果.     

中西医结合治疗溃疡性结肠炎的疗效观察

[目的]观察口服中药配合柳氮磺胺吡啶（SASP）,联合奥硝唑加康复新液保留灌肠治疗溃疡性结肠炎（UC）的临床疗效。[方法]采用对照试验,治疗组以中西医结合,对照组单纯用西药,2组均采用口服配合灌肠治疗。根据临床症状、大便检查和结肠镜复查结果进行疗效比较。[结果]治疗组总有效率为92．5％,明显优于对照组的77．5％（P〈0．05）。治疗后随访6个月和1年,治疗组复发率明显低于对照组。[结论]中药配合SASP口服,并联合奥硝唑注射液、康复新液保留灌肠治疗UC效果较好,复发率低。     

自拟消溃肠炎散治疗溃疡性结肠炎临床疗效观察

[目的]观察自拟消溃肠炎散治疗溃疡性结肠炎(UC)的疗效.[方法]将80例UC患者随机分为2组,对照组采用口服柳氮磺胺吡啶片4 g/d与甲硝唑100 ml加地塞米松5 mg保留灌肠,治疗组采用自拟消溃肠炎散中药保留灌肠.[结果]总有效率对照组为77.5％,治疗组为97.5％,治疗组疗效优于对照组(P＜0.05).[结论]自拟消溃肠炎散保留灌肠治疗UC疗效明显,有促进溃疡愈合的作用.     

清肠化湿法治疗87例活动期溃疡性结肠炎的临床研究

[目的]观察清肠化湿法加减治疗活动期溃疡性结肠炎(UC)的疗效。[方法]将符合纳入标准的UC活动期87个病例,应用随机数字表法将87例患者分为治疗组44例与对照组43例,中药组予清肠化湿法组方加减口服加灌肠联合口服美沙拉嗪肠溶片;对照组给予口服美沙拉嗪肠溶片。口服药物连续8周。灌肠连续2周。将2组的临床症状、症状疗效评价、证候疗效评价和肠镜等级的改善进行比较。[结果]经过8周治疗后,清肠化湿法组方,对本病的主要症状(腹泻、腹痛、黏液脓血便、里急后重)及其总积分具有较好的改善作用(P0.05、0.01),且上述指标在治疗组中均优于对照组(P0.05)。随访过程中,治疗组对改善腹泻、腹痛、里急后重、总积分要优于对照组(P0.05)。总体疗效比较治疗组95.45%优于对照组83.72%(P0.05)总有效率比较治疗组97.72%优于对照组86.04%(P0.05)。治疗后肠镜等级改变治疗组优于对照组(P0.05)。[结论]清肠化湿法对活动期UC的治疗具有较好疗效。     

肠愈宁治疗活动期溃疡性结肠炎疗效观察

[目的]观察肠愈宁颗粒治疗活动期溃疡性结肠炎(UC)的临床疗效.[方法]60例患者随机分为2组各30例,治疗组予以中药肠愈宁颗粒口服,10g,早晚分服;对照组予口服美沙拉嗪1.0 g/次,4次/d.8周为1个疗程.观察2组患者治疗后主要临床症状、结肠镜下黏膜改善情况及临床疗效.[结果]治疗组总有效率为93.3％,对照组90.0％,2组比较差异无统计学意义(P＞0.05).临床症状改善情况2组比较差异亦无统计学意义(P＞0.05).[结论]肠愈宁颗粒治疗活动期UC疗效显著,与西药美沙拉嗪相当,值得临床推广应用.     

自拟健脾清热化瘀汤治疗溃疡性结肠炎45例

[目的]观察自拟健脾清热化瘀汤治疗溃疡性结肠炎(UC)的临床疗效.[方法]选取90例UC患者,随机分为2组,治疗组45例给予自拟健脾清热化瘀汤口服并灌肠,对照组45例给予柳氮磺吡啶口服,6周后观察2组临床、内镜下治疗效果.[结果]治疗组临床总有效率为93.3％,明显优于对照组的73.3％ (P＜0.05).治疗后治疗组肠镜下黏膜评分0.32±0.84,明显优于对照组肠镜下黏膜评分0.95±0.93(P＜0.05).治疗后随访3个月和6个月,治疗组复发率明显低于对照组.[结论]自拟健脾清热化瘀汤治疗UC疗效显著,复发率低.     

奥沙拉嗪联合地塞米松保留灌肠治疗溃疡性结肠炎的疗效评价

[目的]评价奥沙拉嗪联合地塞米松保留灌肠治疗溃疡性结肠炎(ulcerative colitis,UC)的疗效及安全性.[方法]50例UC患者随机分为观察组(26例,采用奥沙拉嗪联合地塞米松保留灌肠)、对照组(24例,采用柳氮磺嘧啶联合地塞米松保留灌肠),比较2组治疗前及治疗1个月、2个月后患者疾病活动指数(disease activity index,DAI),治疗2个月后总有效率及不良反应发生情况.[结果]2组患者治疗前DAI差异无统计学意义(P＞0.05);治疗1个月后,2组患者DAI均较治疗前降低(P＜0.05),而2组间比较差异无统计学意义(P＞0.05);治疗2个月后,2组DAI均较治疗前下降显著(P＜0.01),观察组优于对照组,差异有统计学意义(P＜0.05).治疗2个月后,观察组总有效率为92.3％,对照组为75.0％,2组比较差异有统计学意义(P＜0.05).[结论]奥沙拉嗪联合地塞米松保留灌肠治疗UC患者安全有效,值得临床推广.     

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.     

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.     

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.     

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.