先天性非溶血性黄疸

先天性非溶血性黄疸通常包括间接胆红素增高症（Gilbert syndrome，GS）、直接胆红素增高症Ⅰ型（Dubin-Johnson syndrome）、直接胆红素增高症Ⅱ型（Rotor syndrome）和新生儿非溶血性家族性黄疸（Crigler—Najjar syndrome）。是常染色体遗传性疾病造成胆红素的代谢障碍，临床主要表现为黄疸。     

先天性非溶血性黄疸的核素显像二例报告

先天性非溶血性黄疸的核素显像二例报告王光莹（河南医科大学一附院郑州４５００５２）先天性非溶血性黄疸为罕见之胆红素代谢功能缺陷，除黄疸外，无论是临床、实验室、Ｂ超、ＣＴ、ＭＲＩ甚至肝穿活检都可无特殊表现。９９ｍＴｃ－ＥＨＩＤＡ肝胆显像，则可反映胆红素代...     

中西医结合治疗新生儿黄疸

中西医结合治疗新生儿黄疸太原重型机器厂职工医院（０３００２４）张丽川太原化工厂职工医院孙杰英我们于１９８７年１月至１９９３年１月，治疗新生儿黄疸，取得较好疗效。－、临床资料凡新生儿黄疸，血清胆红素大于２０．４μｍｏｌ／Ｌ，早产儿血清胆红素大于２２．５...     

肝前性黄疸的诊断与治疗

正本文仅对肝前性黄疸的诊断和治疗作一总结。1黄疸的定义黄疸是由于各种原因引起血清胆红素升高、出现巩膜、黏膜和皮肤黄染,是临床上常见的症状和体征。血清总胆红素的正常值为1.7~17.1μmol/L(0.1~1mg/dl)。当胆红素在17.1~34.2μmol/L(1~2 mg/dl)时,肉眼难以发现,称为隐性黄疸或亚临床黄疸;当血清胆红素超过34.2μmol/L(2 mg/dl)时,     

C反应蛋白和甲胎蛋白在新生儿黄疸中表达的意义

正新生儿黄疸为临床多见病症之一,主要是指新生儿时期胆红素代谢异常导致血中胆红素水平升高的一种临床综合征,主要症状为皮肤、巩膜及粘膜黄染,若不及时治疗,易使患儿出现胆红素脑病,严重威胁新生儿健康。本研究分析C反应蛋白(CRP)和甲胎蛋白(AFP)在新生儿黄疸中表达的意义。1资料与方法1.1一般资料选本院2012年10月至2015年12月治疗的80例黄疸新生儿(观察组)及同期40例健康     

慢性充血性心力衰竭所致的重度高胆红素血症和昏迷

慢性充血性心力衰竭可造成肝脏组织学和肝功能的严重紊乱,可以发生黄疸,但胆红素浓度通常低于3mg/dl,且以非结合胆红素为主。本文报道1例慢性充血性心力衰竭所致的以结合胆红素为主的重度胆红素血症,临床类似阻塞性黄疸。     

加味茵陈蒿汤治疗新生儿高胆红素血症94例临床疗效分析

新生儿高胆红素血症可引起高胆红素血症脑病，即核黄疸，严重者可遗留后遗症甚至致死，临床需积极治疗。2002年1月～2006年10月，我们应用加味茵陈蒿汤治疗新生儿高胆红素血症94例，效果显著。现报告如下。     

乙肝残留黄疸的发病机制及中西医治疗

在慢性乙型肝炎临床诊疗过程中,部分患者黄疸下降到一定程度就持久不退,总胆红素为100～150μmol/L,病程超过3个月,谓之残留黄疸,又称顽固性黄疸、难治性黄疸.此类患者血中胆红素长期升高,肝脏负担重,发生肝硬化的概率比常人明显增高,给患者带来精神痛苦和经济负担,迅速消退黄疸是控制病情、改善预后的关键.     

球形红细胞增多症误诊为Gilbert综合征2例

<正>黄疸是由于血清胆红素升高(>17.1 μmol/L)导致皮肤、巩膜、尿液等发黄的一系列症状和体征，众多疾病均可导致黄疸升高。黄疸的鉴别诊断是临床医师尤其是肝病科医师经常碰到的。临床中黄疸按病因学可分为溶血性黄疸、胆汁淤积性黄疸、肝细胞性黄疸和先天性非溶血性黄疸，各种黄疸疾病临床表现存在交叉，甚至存在2种黄疸均升高的混合型黄疸的情形[1]。临床诊疗上极易出现误诊、漏诊等，黄疸的鉴别诊断是临床医生需要不断学习与总结的内容。     

口服茵栀黄颗粒及蓝光照射治疗新生儿病理性黄疸的研究进展

新生儿病理性黄疸又称新生儿高胆红素血症,是新生儿期最常见的临床症状,是由于血液中胆红素高,尤其是未结合胆红素,导致皮肤黏膜黄染。病理性黄疸分为：高间接胆红素血症和高直接胆红素血症。病因复杂,其中新生儿溶血、红细胞酶缺乏、感染、窒息、缺氧、酸中毒、胆红素肝肠循环及新生儿早期肠道缺乏细菌等,     

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.     

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.     

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.     

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.     

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.     

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.