健胃灵合剂防治胃癌癌前病变的临床研究

对经胃镜及病理学确诊的慢性萎缩性胃炎伴肠化和（或）异型增生的患者，随机分为治疗组（健胃灵合剂）６１例，对照组（维酶素胶囊）３１例。治疗６个月后复查，结果临床总效率分别为９１．８％、５４．８％，胃镜疗效分别为８６．９％、５１．６％，病理疗效分别为７７．０％、４１．６％两组比较均提示有非常显著性差异（Ｐ〈０．０１）。     

音乐噪音掩蔽治疗感音神经性耳鸣

对80例感音神经性耳鸣患者随机分成三组进行治疗：A组（20例）给予口服ATP片；B组（30例）给予噪音掩蔽治疗；C组（30例）给予音乐噪音掩蔽治疗。结果：A组痊愈0例，有效8例（40．0％），无效12例（60．0％）；B组分别为3例（10．0％），15例（50．0％），12例（40．0％）；C组分别为5例（16．7％），20例（66．7％），5例（16．6％）。与A、B组比较，C组疗效明显提高（t分别=3．153、2．013，P均〈0．05）。认为音乐噪音掩蔽疗法是治疗感音神经性耳鸣的一种新的有效的方法，患者无痛苦，易于接受，无不良反应发生。     

三皮汤加味治疗溃疡性结肠炎临床疗效观察

[目的]评价三皮汤加味治疗溃疡性结肠炎（UC）的临床疗效和安全性。[方法]采用随机对照观察，将符合人选标准的79例UC患者分为治疗组（49例）、对照组（30例）。治疗组给予三皮汤加味煎剂100ml，4次／d；对照组给予柳氮磺胺吡啶片（SASP）1．0g，4次／d。疗程均为4周。[结果]治疗组和对照组的临床有效率分别为91．8％、76．7％，治疗组显著优于对照组（P〈0．01）；腹泻，腹痛、黏液血便总有效率治疗组分别为91．5％、91．1％、95．0％，对照组分别为80．0％、73．3％、70．8％，治疗组优于对照组（P〈0．05）；结肠镜下疗效观察，治疗组显著优于对照组，其有效率分别为71．6％、46．7％（P〈0．01）。治疗组未见明显不良反应，对照组以恶心、上腹不适为多见（26．7％），白细胞减少次之（20．0％）。[结论]三皮汤加味治疗UC是一个安全、有效配方，可在临床中推广使用。     

埃索美拉唑与奥美拉唑治疗胃溃疡的临床分析

目的对比埃索美拉唑与奥美拉唑治疗胃溃疡的疗效。方法将经胃镜证实的胃溃疡病人随机分为埃索美拉唑组（治疗组60例）与奥美拉唑组（对照组58例）。治疗组应用埃索美拉唑40mg,对照组用奥美拉唑20Ing均睡前服,治疗3周、6周后均复查胃镜,观察溃疡愈合情况。结果治疗3周后治疗组和对照组病人胃镜下胃溃疡的愈合率、显效率、有效率分别是36．7％和17．2％、75．0％和43．1％、95．0％和72．4％,治疗组疗效明显高于对照组,两组差异具有统计学意义（P〈0．05）;治疗6周后治疗组和对照组病人胃镜下胃溃疡的愈合率、显效率、有效率分别是40．0％和37．9％、86．7％和81．0％、98．3％和96．6％,两组比较差异无统计学意义（P〉0．05）。结论埃索美拉唑与奥美拉唑治疗胃溃疡的愈合率、显效率、有效率相当,但埃索美拉唑起效快,治疗时间短,不良反应少,值得在临床上广泛应用。     

多足球囊内放疗装置的研制及其在脑胶质瘤术后^32P内放疗中的应用

160例脑胶质瘤患者均行手术治疗,术后随机分为A、B两组,A组（80例）采用普通球囊法放疗,B组（80例）采用多足球囊法放疗,比较其近、远期疗效及两组治疗前及治疗后6、12个月时的Kamofsky评分。治疗6、12个月时总有效率,A组分别为81．2％、68．8％,B组分别为95．0％、89．9％,两组相比,P〈0．05,P〈0．01。1、3、5a生存率A组分别为70．9％（56／79）、48．1％（38／79）、29．1％（23／79）,B组分别为88．5％（69／78）、70．5％（55／78）、42．3％（33／78）,两组相比,P均〈0．05。两组治疗后Karnofsky评分较治疗前均有好转,其中治疗6个月时两组相比,P〈0．05。认为多足球囊法^32P内放疗治疗脑胶质瘤,较普通球囊法,可明显提高疗效和生存质量。     

膦甲酸钠治疗重度慢性乙型肝炎的临床研究

目的探讨膦甲酸治疗重度慢性乙型病毒性肝炎的疗效和安全性。方法208例患者按1：1随机分为治疗组和对照组，治疗组109例，膦甲酸钠注射液3．0g／250ml静脉点滴，每日2次，疗程4周。对照组为99例，等渗盐水250ml静脉点滴，每日2次，疗程4周，随访24周。结果用药4周时，治疗组和对照组的HBV DNA阴转率分别为12．8％和7．1％，随访24周时分别为5．5％和3．0％，差异无统计学意义。治疗组治疗后HBV DNA≤10）拷贝／ml在用药4周．停药随访24周分别为64．2％（70／109）和40．4％（44／109），对照组分别为30．3％（30／99）和22．2％（22／99），x^2值分别为24．466和8．962，P值均〈0．01，差异有统计学意义。HBeAg转阴率用药4周、随访24周，治疗组分别为17．3％（14／81）、22．0％（11／50）；对照组分别为5．8％（5／87）和5．4％（4／74），P值分别为0．0266和0．0096，差异有统计学意义。HBeAg血清转换率用药4周、随访24周，治疗组分别为12．7％（10／79）和16．7％（8／48）；对照组分别为3．7％（3／82）和1．5％（1／69），P值分别为0．0445和0．0034。差异有统计学意义。治疗结束时，应答率分别为60．6％和21．2％，Z=5．6683，P〈0．05。结论膦甲酸钠注射液治疗重度慢性乙型病毒性肝炎有较好的疗效和安全性。     

外科手术和血管内治疗颅内动脉瘤的术后疗效分析

目的探讨外科手术和血管内栓塞治疗颅内动脉瘤患者的术后疗效。方法282例（337个）颅内动脉瘤患者，剔除55例采用联合手术（7例）或未经手术治疗（48例）的患者后，对其中的128例（45．4％）行血管内治疗，99例（35．1％）行外科手术治疗。回顾性分析两种治疗方法的术后并发症、住院时间和出院时的GOS评分。结果血管内治疗组和外科手术组预后良好率分别为91．4％和79．8％（x^2=6．380，P=0．012）；预后不良率分别为8．8％和20．2％（x^2=6．380，P=0．012）；两组的病死率分别为4．7％和5．1％（x^2=0．016，P=0．899），术后并发症发生率分别为36．36％和17．19％（x^2=10．791，P=0．001）。结论经过选择的颅内动脉瘤病例，血管内治疗优于外科手术治疗。     

头孢他啶联合奈替米星或左氧氟沙星治疗老年医院获得性肺炎的对照观察

目的 观察头孢他啶联合奈替米星治疗老年医院获得性肺炎（Hospital acquired pneumonia）的疗效。方法 将42例病人随机分为两组，治疗组22例，予头孢他啶2．0g静滴，每日2次；同时予奈替米星0．2～0．3g静滴，每日11次。对照组20例予头孢他啶2．0g静滴，每日2次；同时予左氧氟沙星0．5g静滴，每日1次。疗程均为7-14d。结果 治疗组与对照纽的有效率分别为81．8％和80％；两组的细菌清除率分别为84．6％和83．3％；药物不良反应发生率分别为13、6％和10％，两组比较均无统计学意义（P〉0．05）。结论 头孢他啶联合奈替米星治疗老年医院获得性肺炎安全、有效。     

康心胶囊治疗冠心病稳定型心绞痛的临床研究

目的观察康心胶囊治疗冠心痛稳定型心绞痛的有效性和安全性。方法采用随机分组对照试验方法，观察康心胶囊治疗冠心痛稳定型心绞痛（48例）病人的疗效，井与复方丹参片对照组（48例）比较疗效。结果治疗组与对照组改善心绞痛症状的总有效率分别为91．7％和70．8％。减少冠心痛心绞痛发作次数的总有效率分别为93．8％和68．8％；心电图的总有效率分别为68．8％和47．9％。两组总有效率比较均有统计学意义（P〈0．05），平板运动试验显示总运动时间、最大代谢当量明显增加。峰运动ST段平均下移明显下降。两组比较均有统计学意义（P〈0．05）。结论康心胶囊疗效明显优于复方丹参片，两者都未发现明显的不良反应和毒副反应。     

爱通立静脉溶栓治疗急性心肌梗死46例临床观察

将98例急性心肌梗死（AMI）患者随机分为观察组46例和对照组52例．分别应用小剂量（50mg）爱通立（rT—PA）和尿激酶（UK）静脉溶栓治疗。结果冠状动脉总再通率观察组为82．6％、对照组为50．0％．发病后6h内静脉溶栓治疗再通率分别为89．29％、60％，两组比较P均〈0．01；5周病死率分别为6．5％和9．6％；P〉0．05。认为小剂量rT—PA静脉溶栓治疗AMI疗效优于UK,发病后6h内治疗效果更佳，且并发症少。     

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.     

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.     

Variabilité des concentrations plasmatiques de l’angiotensinogène et risque d’hypertension artérielle chez le rat transgénique

Aim

Genetic polymorphisms of the human angiotensinogen gene are frequent and may induce up to 30% increase of plasma angiotensinogen concentrations with a blood pressure increase of up to 5 mmHg. Their role for the pathogenesis of human arterial hypertension remains unclear. High plasma angiotensinogen levels could increase the sensitivity to other blood pressure stressors.

Methods

Male transgenic rats with a 9-fold increase of plasma angiotensinogen concentrations and male non-transgenic rats aged 10 weeks were treated or not with NG-Nitro-L-arginine-methyl ester for 3 weeks in their drinking water (n = 3/group). Systolic blood pressure and body weight were measured at baseline and at the end of the study when left ventricular weight and ventricular expression of angiotensin I-converting enzyme and procollagen Iα1 were determined (polymerase chain reaction).

Results

At baseline, transgenic rats had +18 mmHg higher bood pressure and –8% lower body weight compared to non-transgenic rats (P < 0.05) without significant changes for the vehicle groups throughout the study (P > 0.05). NG-Nitro-L-arginine-methyl ester increased blood pressure, left ventricular weight and left ventricular weight indexed for body weight by +41%, +17.6% and +18.6% (P < 0.05) in transgenic and +25%, +5.3% and +6.7% (P > 0.05) in non-transgenic rats compared to untreated animals, respectively. Cardiac gene expression showed no differences between groups (P > 0.05).

Conclusion

Increased plasma angiotensinogen levels may sensitize to additional blood pressure stressors. Our preliminary results point towards an independent role of angiotensinogen in the pathogenesis of human hypertension and associated end-organ damage.