神经节苷脂联合纳洛酮治疗新生儿缺氧缺血性脑病疗效研究

目的探讨新生儿缺氧缺血性脑病的治疗方法,观察神经节苷脂联合纳洛酮治疗新生儿缺氧缺血性脑病的临床疗效。方法选择新生儿缺氧缺血性脑病患儿56例,随机分为治疗组和对照组各28例,两组均给予常规治疗,对照组在常规治疗的基础上给予纳洛酮治疗,治疗组在常规治疗的基础上给予神经节苷脂联合纳洛酮治疗,观察两组治疗疗效。结果治疗组显效15例,有效11例,无效2例,总有效率92.86%;对照组显效9例,有效14例,无效5例,总有效率82.21%。与对照组相比,治疗组患儿治疗有效率明显升高(P0.05)。结论神经节苷脂联合纳洛酮治疗新生儿缺氧缺血性脑病可以提高治疗疗效,改善预后,建议临床广泛运用。     

纳洛酮联合多巴胺治疗新生儿缺氧缺血性脑病36例

目的 探讨纳洛酮联合多巴胺治疗新生儿缺氧缺血性脑病的临床疗效.方法 将72例新生儿缺氧缺血性脑病患儿随机分为两组:对照组给予对症及支持等常规治疗.治疗组在对照组治疗基础上加用纳洛酮0.1 mg/(kg·d),输液泵维持24 h静脉输注,连用7 d,同时加用多巴胺5 μg/(kg·min),输液泵维持24 h静脉输注,连用7 d.观察两组患儿意识恢复时间,肌张力恢复时间,反射恢复时间和不良反应.结果 治疗组意识恢复时间、反射恢复时间、肌张力恢复时间较对照组明显缩短(P<0.01).治疗组总有效率86.1%,显效率41.7%,对照组总有效率61.1%,显效率16.7%,两组比较均有统计学意义(P<0.05).结论 纳洛酮联合多巴胺治疗新生儿缺氧缺血性脑病疗效满意.     

丹参治疗新生儿缺氧缺血性脑病

目的观察复方丹参注射液治疗新生儿缺氧缺血性脑病（HIE）的疗效。方法治疗组在常规综合治疗基础上加用复方丹参治疗。对照组予以常规治疗。对两组新生儿出生后3d、14d分别行新生儿行为神经测定（NBNA）评分。结果两组患儿NBNA评分情况比较，14d时治疗组≥35分患儿有28例，高于对照组的20例。结论丹参能改善缺氧缺血性脑损伤的预后。     

单唾液酸四己糖神经节苷脂钠注射液治疗新生儿缺氧缺血性脑病疗效分析

目的探讨单唾液酸四己糖神经节苷酯钠注射液治疗新生儿缺氧缺血性脑病的临床效果。方法选择缺氧缺血性脑病新生患儿80例为研究对象,将患儿随机分为观察组和对照组,每组40例。对照组患儿给予降颅内压、抗惊厥等常规治疗;观察组患儿在常规治疗的基础上给予单唾液酸四己糖神经节苷酯钠注射液治疗,20 mg/d,连续治疗14 d。观察比较两组患儿的临床症状恢复情况及新生儿行为神经评分(NBNA)。结果 (1)观察组患儿治疗总疗效率为92.50%,对照组为75.00%,观察组患儿临床疗效优于对照组,差异有统计学意义(P0.05)。(2)治疗前,两组患儿NBNA评分比较差异无统计学意义(P0.05);治疗第7天时,两组患儿的NBNA评分都出现一定程度下降,第14天时又明显上升。治疗第14天时,观察组患儿NBNA评分明显高于治疗前,而对照组患儿明显低于治疗前,两组患儿治疗前后比较差异有统计学意义(P0.05)。治疗第7天、第14天时观察组患儿的NBNA评分均明显高于对照组,差异有统计学意义(P0.01)。结论在常规治疗基础上,加用单唾液酸四己糖神经节苷酯钠注射液治疗缺氧缺血性脑病新生儿效果确切,能有效改善患儿症状和病情,修复受损脑细胞,减轻缺氧缺血脑损伤症状,提高临床治疗效果。     

生脉注射液治疗新生儿缺氧缺血性脑病48例疗效观察

新生儿缺氧缺血性脑病(HIE)是新生儿窒息后的严重并发症,可产生永久性神经功能障碍,且病死率高。1998～2000年我们应用生脉注射液治疗HIE患儿48例,疗效满意,现报告如下。 临床资料:选择80例HIE足月新生儿,均在出生后48小时内入院,其诊断均符合1996年杭州会议修订的HIE诊     

复方丹参与大剂量维生素C治疗新生儿缺氧缺血性脑病

1994～1997年,我们应用复方丹参与大剂量维生素C治疗新生儿缺氧缺血性脑病26例,取得较满意疗效。现报告如下。临床资料:治疗组26例,男21例、女5例,生后1～72小时,生后1分钟Apgar评分0～3分12例,4～7分14例。对照组28例,男210例、女8例,生后0.5～72小时,生后1分钟Apgar评分0～3分12例、4～7分16例。两组患儿均按1998年济南会议制定的新生儿缺氧缺血性脑病诊断标准诊断。治疗组轻型7例,中型12例,重型7例;对照组轻型9例,中型12例,重型7例。治疗方法:对照组采用吸氧、激素、20%甘露醇及对症支持等常规治疗。治疗组在此基础上加用复方丹参注射…     

脑活素治疗新生儿缺氧缺血性脑病40例疗效分析

1992～1998年,我们对40例缺氧缺血性脑病患儿在常规治疗的基础上加用脑活素治疗,取得一定疗效,现报告如下。资料与方法:将88例患儿分为对照组和治疗组。两组患儿均有明显的围产期缺氧窒息史,生后出现意识障碍、过度兴奋、嗜睡、昏迷、惊厥、肌张力改变及原始反射消失等。其中34例头颅CT检查显示程度不一的多灶性低密度区,9例合并颅内出血。两组一般情况比较见表1。所有患儿均按制定的新生儿缺氧缺血性脑病标准诊断及分度,对照组给予常规治疗,包括降颅压、镇静、止痉、能量合剂及吸氧等;治疗组在上述基础上加用脑活素5ml静注,10～15天为一疗…     

谷氨酸钠联合醒脑静、纳洛酮注射液治疗肝性脑病36例疗效观察

目的观察谷氨酸钠联合醒脑静、纳洛酮注射液治疗肝性脑病疗效。方法将36例患者随机分为观察组与对照组,观察组采用谷氨酸钠加醒脑静、纳洛酮,对照组仅用谷氨酸钠治疗,两组其他基础治疗相同。结果观察组较对照组昏迷时间缩短,清醒人数明显增多;观察组总有效率高于对照组。结论谷氨酸钠联合醒脑静、纳洛酮治疗肝性脑病有缩短昏迷时间,促进清醒的作用。疗效确切。     

生脉注射液联合黄芪注射液治疗慢性心力衰竭疗效观察

目的观察生脉注射液联合黄芪注射液治疗慢性心力衰竭的疗效。方法将58例心力衰竭患者随机分为两组。对照组28例,采用常规治疗;治疗组30例,在常规治疗基础上加用生脉注射液与黄芪注射液。结果治疗组总有效率93．3％,对照组总有效率75．0％,治疗组优于对照组（P〈0．01）。结论生脉注射液联合黄芪注射液治疗慢性心力衰竭优于常规治疗。     

高压氧联合川芎嗪对重度缺氧缺血性脑病NSE和MBP水平变化的调节

目的 探讨高压氧联合川芎嗪对重度缺氧缺血性脑病（HIE）患儿神经元特异性烯醇化酶（NSE）和髓鞘碱性蛋白（加3P）水平变化的调节。方法 HIE患儿90例，随机分为川芎嗪治疗组（30例）、高压氧和川芎嗪联合治疗组（30例）和常规治疗组（30例），同时以30名正常新生儿组作对照。在治疗前后分别用酶联免疫分析法检测血清NSE、MBP水平。结果 3组重度缺氧缺血性脑病患儿NSE、MBP水平明显高于正常对照组（P〈0．05）；常规治疗组患儿NSE、MBP水平明显高于川芎嗪治疗组和联合治疗组（P〈0．05）；联合治疗组NSE、MBP水平显著低于川芎嗪治疗组（P〈0.05）。结论 NSE及加BP水平是反映脑组织损伤和修复的生化指标，临床上早期用高压氧联合川芎嗪治疗重度HIE有较好的疗效。     

Three layer functional model and energy exchange concept of aging process

Relying on a certain degree of abstraction, we can propose that no particular distinction exists between animate or living matter and inanimate matter. While focusing attention on some specifics, the dividing line between the two can be drawn. The most apparent distinction is in the level of structural and functional organization with the dissimilar streams of ‘energy flow’ between the observed entity and the surrounding environment. In essence, living matter is created from inanimate matter which is organized to contain internal intense energy processes and maintain lower intensity energy exchange processes with the environment. Taking internal and external energy processes into account, we contend in this paper that living matter can be referred to as matter of dissipative structure, with this structure assumed to be a common quality of all living creatures and living matter in general. Interruption of internal energy conversion processes and terminating the controlled energy exchange with the environment leads to degeneration of dissipative structure and reduction of the same to inanimate matter, (gas, liquid and/or solid inanimate substances), and ultimately what can be called ‘death.’ This concept of what we call dissipative nature can be extended from living organisms to social groups of animals, to mankind. An analogy based on the organization of matter provides a basis for a functional model of living entities. The models relies on the parallels among the three central structures of any cell (nucleus, cytoplasm and outer membrane) and the human body (central organs, body fluids along with the connective tissues, and external skin integument). This three-part structural organization may be observed almost universally in nature. It can be observed from the atomic structure to the planetary and intergalactic organizations. This similarity is corroborated by the membrane theory applied to living organisms. According to the energy nature of living matter and the proposed functional model, the decreased integrity of a human body's external envelope membrane is a first cause of the structural degradation and aging of the entire organism. The aging process than progresses externally to internally, as in single cell organisms, suggesting that much of the efforts towards the restoration and maintenance of the mechanisms responsible for structural development should be focused accordingly, on the membrane, i.e., the skin. Numerous reports indicate that all parts of the human body, like: bones, blood with blood vessels, muscles, skin, and so on, have some ability for restoration. Therefore, actual revival of not only aging tissue of the human body's membrane, but the entire human body enclosed within, with all internal organs, might be expected. We assess several aging theories within the context of our model and provide suggestions on how to activate the body's own anti-aging mechanisms and increase longevity. This paper presents some analogies and some distinctions that exist between the living dissipative structure matter and inanimate matter, discusses the aging process and proposes certain aging reversal solutions.     

Unusual responses of nocturnal pineal melatonin synthesis and secretion to swimming: Attempts to define mechanisms

Abstract: The effect of swimming at night on rat pineal melatonin synthesis was compared with that of light exposure at night. Rats were forced to swim at 0030 hr (lights out at 2000 hr) and sacrificed by decapitation 15 and 30 min later, immediately after swimming. Other groups of animals were exposed to white light (650μW/cm²) for 15 and 30 min at same time. Swimming caused a rapid and highly significant drop in the melatonin content in the pineal gland; however, the activity of N-acetyltransferase (NAT), the supposed rate limiting enzyme in the melatonin production, was not changed. Despite the drop in pineal melatonin levels, serum concentrations of the indole remained elevated in the rats that swam. In contrast, melatonin levels in the pineal and serum of light exposed rats fell precipitously, accompanied by a significant suppression of NAT activity. Since we anticipated that the strenuous exercise associated with swimming may induce release of artrial natriuretic peptide (ANP) from the heart, which in turn could cause the release of pineal melatonin, in a second study we injected physiological saline intravenously to stretch the cardiac muscle and release ANP. Three milliliters of normal saline was injected during the day into the jugular vein of anesthetized rats that were pretreated with isoproterenol to stimulate pineal melatonin production. Animals were killed 15 min after the saline injection, and pineal NAT activity and pineal melatonin levels were measured. The saline injections caused no alteration in the elevated levels of either NAT or melatonin. These data suggest that the disparity in pineal NAT activity (which was high) and pineal melatonin (which was low), in animals swum at night, may not be caused by ANP which is released during strenuous exercise such as swimming.     

Melatonin and photoperiodic time measurement: Seasonal breeding in the sheep

Abstract: Well-established circadian physiology supports the view that photoperiodic time measurement utilizes the coincidence between the presence of light and a photosensitive phase of a 'biological clock' to alter reproductive status—the so-called external coincidence model of seasonal breeding. In this review, we examine the mechanism whereby photoperiod interacts with presumed suprachiasmatic nuclei activity to allow endogenous melatonin to normally synchronize reproductive activity to the optimal time of year. The Romney Marsh sheep is particularly explored as an experimental model. It is suggested that the on/off activity of seasonal reproduction may be a robust mechanism able to be predictably manipulated by the judicious use of the light/dark cycle and exogenous melatonin, but firmly based on circadian principles.     

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.     

Serological survey of HIV and syphilis in pregnant women in Madagascar

Objectives Peripartal transmission of human immunodeficiency virus (HIV) and Treponema pallidum, the causative agent of syphilis, leads to severe consequences for newborns. Preventive measures require awareness of the maternal infection. Although HIV and syphilis testing in Madagascar could be theoretically carried out within the framework of the national pregnancy follow‐up scheme, the required test kits are rarely available at peripheral health centres. In this study, we screened blood samples of pregnant Madagascan women for HIV and syphilis seroprevalence to estimate the demand for systemic screening in pregnancy. Methods Retrospective anonymous serological analysis for HIV and syphilis was performed in plasma samples from 1232 pregnant women that were taken between May and July 2010 in Ambositra, Ifanadiana, Manakara, Mananjary, Moramanga and Tsiroanomandidy (Madagascar) during pregnancy follow‐up. Screening was based on Treponema pallidum haemagglutination tests for syphilis and rapid tests for HIV, with confirmation of positive screening results on line assays. Results Out of 1232 pregnant women, none were seropositive for HIV and 37 (3%) were seropositive for Treponema pallidum. Conclusions Our findings are in line with previous studies that describe considerable syphilis prevalence in the rural Madagascan population. The results suggest a need for screening to prevent peripartal Treponema pallidum transmission, while HIV is still rare. If they are known, Treponema pallidum infections can be easily, safely and inexpensively treated even in pregnancy to reduce the risk of transmission.     

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.