内脏利什曼病合并HIV感染患者诊断和治疗研究进展

内脏利什曼病是全球被忽视的传染病之一,危害严重。而利什曼原虫-人类免疫缺陷病毒(human immunodeficiency virus,HIV)合并感染对流行地区造成的威胁更甚。利什曼原虫与HIV存在相互作用,合并感染者在临床表现、诊断及治疗方面具有一定特殊性,其病死率及复发率均高于HIV阴性的内脏利什曼病患者。本文对利什曼原虫-HIV合并感染患者的临床表现、诊断和治疗进展进行综述。     

腹腔脏器损伤210例诊治分析

目的:探讨腹腔脏器损伤的诊治方法。方法：回顾性分析15年间收治的210例腹腔脏器损伤的临床资料。结果：腹腔穿刺阳性率（88.6%）。术前诊断基本准确125例（59.5%）。210例均行手术治疗，治愈190例（90.5%），死亡20例（9.5%）。结论：腹腔多脏器损伤较为常见。腹腔穿刺是可靠的诊断手段，对有剖腹探查指征的病例应积极手术，探查时既要系统全面，防止遗漏，又要避免重复多余的探查。     

高脂饮食诱导的内脏肥胖小鼠模型存在性别差异

目的:比较不同性别BALB/c小鼠采用高脂饮食建立肥胖模型的差异。方法:32只4周龄无特定病原体级BALB/c小鼠（雌雄各半）随机分为雌性对照组、雌性高脂组、雄性对照组和雄性高脂组,每组8只。雌性对照组和雄性对照组采用普通饮食,雌性高脂组和雄性高脂组采用高脂饲料喂养,喂养12周后测量小鼠体重、内脏脂肪比、空腹血糖、葡萄糖耐量、血脂、代谢相关激素水平,并采用16S rRNA测序检测小鼠粪便菌群构成。结果:高脂饮食干预导致雄性小鼠体重和内脏脂肪比明显增加,病理表现为单个脂肪面积明显增大,肝脏脂肪滴堆积,总胆固醇、空腹血糖、口服糖耐量试验时间-血糖曲线下面积以及血清胰岛素水平明显上升（均P<0.05）,并出现明显胰岛素抵抗（P<0.01）。而雌性高脂组体重、内脏脂肪比、血清胰岛素和瘦素水平与雌性对照组差异均无统计学意义（均P>0.05）。高脂干预后小鼠肥胖相关肠道菌群相对丰度显著变化并存在性别差异,其中雄性高脂组肥胖相关菌属（如布劳特菌）相对丰度明显增加,菌群结构变化更明显。结论:高脂饮食喂养12周4周龄BALB/c雄性小鼠可稳定建立以内脏脂肪堆积、代谢功能紊乱和肠道菌群变...     

大鼠三叉神经脊束间质核内内脏神经初级传入终末与NOS阳性投射神经元的联系

目的　探查间质核 (INV)内内脏传入终末与向臂旁核 (PBN)投射的NOS阳性神经元之间的联系。　方法　逆行、跨神经节追踪以及免疫荧光组织化学方法 ,结合激光共聚焦扫描显微镜观察。　结果　PBN内注射四甲基罗丹明 (TMR)后 ,逆行标记细胞主要位于注射侧的INV ,大多属 2 0 μm以下的中、小型细胞。NOS阳性细胞与TMR逆行标记细胞分布区域重叠。NOS TMR双标记细胞分别占NOS阳性细胞总数的 5 4 8% (17 31)和TMR逆行标记细胞总数的 34% (17 4 9)。舌咽和迷走神经内注射生物素化葡聚糖胺 (BDA)跨神经节标记的内脏神经初级传入终末点状膨体贴近双标记细胞胞体 ,呈紧密接触状。　结论　可能存在经INV向PBN投射的内脏伤害性信息传导通路 ,作为神经递质和神经信息分子的NO可能参与其内脏伤害性信息的传递和调控     

Miltefosine (Impavido): the first oral treatment against leishmaniasis

Miltefosine is a novel antileishmanial drug that has significant selectivity in both in vitro and in vivo models. Clinical efficacy was demonstrated for the treatment of visceral leishmaniasis with the advantage of oral administration over the currently recommended antileishmanial drugs that require parenteral administration. Miltefosine produces high cure rates also in patients resistant to the standard antimonial therapy.     

Modulation of acute visceral nociception and bladder inflammation by plant triterpene, α, β-amyrin in a mouse model of cystitis: role of tachykinin NK<Subscript>1</Subscript>-receptors,and K<Superscript>+</Superscript><Subscript>ATP</Subscript> channels

Objective and design: We previously described the visceral antinociceptive property of α, β-amyrin in a mouse model of cystitis induced by cyclophosphamide (CPM). This study examined the contribution of vanilloid-1 (TRPV1), peripheral NK1 receptors to CPM-evoked nociceptive behaviors and bladder edema, and its possible modulation by α, β-amyrin. Methods: The effect of α, β-amyrin (10, 30, and 100 mg/kg, p. o.) and N-acetylcysteine (NAC) on CPM (400 mg/kg, i. p.)-induced cystitis was studied in mice. Sensory deafferentation was done by a high dose capsaicin. The parameters analysed were: CPM-evoked noxious behaviors, bladder edema, vascular permeability, and NK₁ immunoreactivity. To assess the role of K⁺ _ATP channels in α, β-amyrin effect, animals were pretreated with glibenclamide. Results: α, β-amyrin (30 and 100 mg/kg) and NAC significantly (p < 0.01) suppressed the visceral pain-related behaviors and NK₁ immunoreactivity, but bladder edema was reduced weakly. Glibenclamide reversed the effects of α, β-amyrin. Sensory deafferentation by capsaicin significantly reduced the nociceptive responses and the NK₁ immunoreactivity to noxious stimulation by CPM. Conclusions: α, β-amyrin attenuates CPM-induced visceral pain and bladder edema by mechanisms that involve, at least in part, a block either of Substance P release or its receptor function, and partly by opening K⁺ _ATP channels. Received 13 February 2007; returned for revision 13 April 2007; accepted by G. Geisslinger 14 May 2007     

The Effects of Discrimination Training on Voluntary Control of Cephalic Vasomotor Activity

The present study was conducted to test Brener's calibration theory of visceral learning. It was hypothesized that training in discrimination of cephalic vasomotor responses would enhance acquisition of voluntary and biofeedback control of cephalic vasomotor response. Four groups were given discrimination training to detect either constriction, dilation, both constriction and dilation, or given false feedback. All groups were then given biofeedback training in constriction. All groups were assessed on discrimination accuracy, acquisition of biofeedback control of constriction, and voluntary control of dilation and constriction. The results indicated that discrimination of cephalic vasomotor responses can be learned and that this skill facilitates the acquisition of biofeedback and voluntary control of vasomotor responses. This facilitation occurs only if discrimination training is given for the specific response to be learned. The data suggest that discrimination of the relevant response is a necessary but not sufficient condition for acquisition of voluntary control in biofeedback learning.     

Effects of the presentation of false heart-rate feedback on the performance of two common heartbeat-detection tasks.

Research has indicated that performance on heartbeat counting tasks may be influenced by beliefs about heart rate. Sixty male subjects were administered the Schandry heartbeat counting task after viewing fast, slow, or no heart rate feedback. Subjects were also administered the Whitehead signal-detection type task. Results indicated that subjects who received fast or no heartbeat feedback performed better on the Schandry task than subjects who received slow feedback. Feedback presentation did not affect performance on the Whitehead task. These results suggest that the Schandry task is influenced by external variables (expectations, beliefs) beyond pure awareness of "discrete" visceral sensations and, thus, may not be as powerful a method for determining awareness of individual heartbeats as some other paradigms.     

Treatment of atypical leishmaniasis with interferon γ resulting in progression of Kaposi's sarcoma in an AIDS patient

Visceral leishmaniasis (kala-azar) affecting HIV-infected patient is being reported in increasing frequency. A 40-year-old German bisexual patient with full-blown AIDS is described who presented with Kaposi's sarcoma, epigastric pain, diarrhea, and weight loss but without fever.Leishmania amastigotes were initially found in biopsies from stomach, duodenum, and a cutaneous Kaposi's sarcoma lesion but were later also recovered from bone marrow and lymph node. The patient received three courses of a combination of pentavalent antimony and interferon-. In addition to the common side effects such as fever, thrombocytopenia, and elevated amylase and lipase, a vivid progression of the Kaposi's sarcoma was noted. Tumor progression was temporally closely associated with treatment with interferon-. Because this phenomemon has also been observed in other patients, we advise caution when using interferon- in patients with Kaposi's sarcoma.Abbreviations AIDS acquired immunodeficiency syndrome - HIV human immunodeficiency virus - KS Kaposi's sarcoma Correspondence to: H. Albrecht     

Prenatal development of transient receptor potential vanilloid 1-expressing primary sensory projections to sacral autonomic preganglionic neurons

The visceral reflexes of the pelvic organs are mediated by connections between primary afferents innervating the pelvic organs and parasympathetic preganglionic neurons in the intermediolateral column of the sacral spinal cord. The present immunohistochemical study revealed many varicosities expressing transient receptor potential vanilloid 1 (TRPV1) that were closely apposed to the preganglionic neuronal perikarya at embryonic day 16 in mice. Many, but not all, varicosities expressing TRPV1 in the intermediolateral column were also immunopositive for calcitonin gene-related peptide. In contrast, no nerve fibers expressing TRPV1 projected to the sympathetic preganglionic cell column in the lumbar spinal cord in prenatal stages. The results of the present study raised the possibility that the primary afferents transmit signals elicited by the activation of TRPV1 receptors to the sacral parasympathetic preganglionic neurons. Thus, the functional circuit for pelvic spinal reflexes, such as micturition induced by urine influx, might develop in the prenatal stages in mice.