Rapid Antiretroviral Therapy Initiation for Women in an HIV-1 Prevention Clinical Trial Experiencing Primary HIV-1 Infection during Pregnancy or Breastfeeding

During an HIV-1 prevention clinical trial in East Africa, we observed 16 cases of primary HIV-1 infection in women coincident with pregnancy or breastfeeding. Nine of eleven pregnant women initiated rapid combination antiretroviral therapy (ART), despite having CD4 counts exceeding national criteria for ART initiation; breastfeeding women initiated ART or replacement feeding. Rapid ART initiation during primary HIV-1 infection during pregnancy and breastfeeding is feasible in this setting.     

锌和铜在生长抑素对链佐霉素引起的胰岛B细胞损伤的保护中的作用

我们以前的工作指出,生长抑素可以预防链佐霉素对大鼠胰岛B细胞的损伤。本工作测定给药前后大鼠血清和组织中Zn、Cu含量,以进一步观察链佐霉素破坏大鼠胰岛B细胞后生长抑素预防效应的可能机制。结果为:链佐霉素(STZ)(35mg/kg,ip)注射后24h的大鼠,血清Zn浓度下降,Cu浓度升高,Zn/Cu比值倒置;用生长抑素作预防性注射后,血清Zn浓度与正常对照水平相同,Cu浓度虽稍有升高,但Zn/Cu比值正常。保护组的血清Zn与损伤组比较,差异极为显著。两组的Zn/Cu比值同样也具有显著差异。在给药后72h,血清Zn/Cu比值在各组之间仍呈上述关系,但差异减小。在大鼠胰腺,注射链佐霉素后胰腺组织Zn浓度未见改变,但生长抑素作预防性注射可使组织锌含量增加。上述结果提示,在生长抑素对胰岛B细胞的保护机制中可能有Zn和Cu的参与。预防性注射生长抑素所引起的高Zn状态可能有利于机体细胞含Zn酶类的活性,增强已损伤细胞的修复。     

躯体和内脏传入冲动在大鼠束旁核内的会聚

在麻痹的大鼠上,分别刺激迷走神经、内脏大神经、坐骨神经、腓肠神经、睾丸和副睾,在对侧丘脑束旁核记录到了45个细胞的单位放电。根据诱发反应的潜伏期、时程和放电频谱分布的不同,可将他们分为五种类型,并且认为这些类型和刺激引起的感觉性质有关。在观察到的45单位中,29个的反应具有痛放电的特性,而且对躯体及内脏的传入冲动呈聚合性反应。其中2个单位只对内脏传入冲动产生反应。这项研究的结果表明,束旁核不仅是接受内脏传入的丘脑结构,而且也是一个整合内脏与躯体传入信息的中枢。     

Stroke and coronary heart disease in mild hypertension: risk factors and the value of treatment

Further analyses of the Medical Research Council''s trial of drug treatment of mild hypertension were carried out to provide more detailed information on the benefits associated with treatment in various subgroups. The four main considerations in establishing a rational treatment policy were, firstly, the significant reduction in the stroke rate with active treatment; secondly, the absence of a significant overall treatment effect on myocardial infarction; thirdly, the knowledge that of 100 untreated men in the highest risk group (those aged 55-64 with high systolic pressure at entry who smoked), five would be expected to suffer a stroke and 10 a coronary event within five years; and, fourthly, the cost, in clinical and financial terms, of prolonged treatment. In the high risk group of 100 men treatment with bendrofluazide would result in the prevention of three or four of the five strokes but would have little effect on the expected numbers of myocardial infarctions. Treatment with propranolol in non-smoking men in the highest age and blood pressure categories would lead to a reduction in the number having strokes from three to one or two and might possibly reduce the number experiencing myocardial infarction from seven to four. Smokers treated with propranolol would not be expected to benefit. In women avoiding smoking was particularly important. The considerations for preventing stroke were similar to those in men, but no clear guideline was possible on the effect of lowering blood pressure for preventing myocardial infarction in women.Drug treatment reduces the attack rate of certain events in mild hypertension but should not be prescribed routinely for all patients with the disorder.     

自发性高血压大鼠血管α1肾上腺素受体亚型的改变

本工作在离体与整体条件下比较易卒中型自发性高血压(SHRSP)大鼠与WKY大鼠血管中α_1受体的两种亚型。在离体灌流的主动脉、肾动脉与肠系膜动脉,50μmol/L氯甲基可乐定(CEC)预温育30min可使α_1受体激动时引起的最大收缩张力在SHRSP与WKY大鼠分别降为对照时的31.4±8.3％与35.2±2.9％,68.4±8.2％与80.1±7.3％,68.4±6.3％与55.4±7.0％,两者间均无显著性差别。但10μmol/L硝苯吡啶对α_1受体收缩效应的阻断作用则在SHRSP大鼠大大超过WKY大鼠,最大收缩张力分别降为对照时的3.1±1.5％与56.5±4.8％(P<0.01),9.0±4.1％与23.6±3.5％(P<0.05),5.9±2.5％与28.0±0.8％(P<0.01)。整体动物实验也显示硝苯吡啶的降血压作用及对苯肾上腺素升血压效应的阻断作用在SHRSP大鼠都较WKY大鼠显著增强。离体主动脉a_1受体激动时的快速相与持续相收缩均主要由α_(1B)亚型激动引起,硝苯吡啶对快速相收缩的阻断作用在SHRSP与WKY大鼠无显著性差别,但对持续相收缩的阻断作用则在SHRSP大鼠显著强于WKY大鼠。上述结果提示SHRSP大鼠血管α_1受体两种亚型的分布没有显著改变,但α_(1B)受体激动时继发性细胞外Ca~(2+)进入的途径由非双氢吡啶敏感性钙通道转变为双氢吡啶敏感性钙通道。