痫愈胶囊联合左乙拉西坦治疗癫痫的临床研究

目的探讨痫愈胶囊联合左乙拉西坦片治疗癫痫的临床疗效。方法选取2017年1月—2017年12月在解放军第452医院就诊的癫痫患者92例为研究对象,按照随机数字表法分为对照组和治疗组,每组各46例。对照组口服左乙拉西坦片,初始剂量0.5 g/次,2次/d,治疗2周后,剂量变为1.0 g/次,2次/d。治疗组在对照组治疗的基础上口服痫愈胶囊,5粒/次,2次/d。两组患者均连续治疗6个月。观察两组的临床疗效,比较两组的认知功能、神经递质水平和癫痫发作频率。结果治疗后,对照组和治疗组的总有效率分别为71.74%、82.61%,两组比较差异有统计学意义(P0.05)。治疗后,两组注意、延迟回忆、定向、Mo CA评分均明显升高,同组治疗前后比较差异有统计学意义(P0.05);且治疗组认知功能指标明显高于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组神经胶质酸性蛋白(GFAP)、髓鞘碱性蛋白(MBP)水平均明显降低,脑源性神经营养因子(BDNF)水平明显升高,同组治疗前后比较差异有统计学意义(P0.05);且治疗组神经递质水平明显优于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组发作频率明显降低,同组治疗前后比较差异有统计学意义(P0.05);且治疗组发作频率明显低于对照组,两组比较差异具有统计学意义(P0.05)。结论痫愈胶囊联合左乙拉西坦片治疗癫痫具有较好的临床疗效,可改善认知功能,减少癫痫发作频率,调节神经递质水平,具有一定的临床推广应用价值。     

二十五味珊瑚丸联合左乙拉西坦治疗癫痫的临床研究

目的探讨二十五味珊瑚丸联合左乙拉西坦片治疗癫痫的临床疗效。方法选取2015年4月至2016年10月中国人民解放军第二五四医院、天津市环湖医院收治的癫痫患者30例为研究对象,按照序列号法将患者随机分为对照组和治疗组,每组各30例。对照组餐后口服左乙拉西坦片,起始剂量500 mg/次,2次/d,一周后加至1 000 mg/次,2次/d。治疗组在对照组治疗基础上口服二十五味珊瑚丸,1 g/次,1次/d。两组患者均连续治疗3个月。观察两组的临床疗效,比较两组的淋巴细胞亚群水平、炎症因子水平、癫痫发作频率。结果治疗后,对照组和治疗组的总有效率分别为73.33%、93.33%,两组比较差异有统计学意义(P0.05)。治疗后,两组CD3~+、CD4~+、CD4~+/CD8~+水平明显升高,同组治疗前后比较差异有统计学意义(P0.05);且治疗组淋巴细胞亚群水平明显高于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组可溶性细胞间黏附分子-1(s ICAM-1)、白细胞介素-6(IL-6)、C反应蛋白(CRP)水平均明显降低,同组治疗前后比较差异有统计学意义(P0.05);且治疗组炎症因子水平明显低于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组癫痫发作频率明显降低,同组治疗前后比较差异有统计学意义(P0.05);且治疗组癫痫发作频率明显低于对照组,两组比较差异具有统计学意义(P0.05)。结论二十五味珊瑚丸联合左乙拉西坦片治疗癫痫具有较好的临床疗效,可减少癫痫发作频率,改善患者免疫功能,减轻炎症反应,具有一定的临床推广应用价值。     

研究丙戊酸钠联合左乙拉西坦治疗脑卒中后癫痫的疗效

目的分析临床采用丙戊酸钠联合左乙拉西坦治疗脑卒中后癫痫实际效果。方法80例脑卒中后癫痫患者,采用数字随机分配方式分为对照组与观察组,各40例。两组患者均接受常规治疗,对照组采用单一丙戊酸钠治疗,观察组患者在对照组患者治疗基础上加用左乙拉西坦治疗。对比两组患者的临床治疗效果、癫痫持续发作时间、癫痫发作次数以及用药不良反应发生情况。结果治疗后,对照组患者治疗总有效率为80.0%,观察组患者治疗总有效率为97.5%,观察组患者的治疗总有效率显著高于的对照组,差异具有统计学意义(P<0.05)。治疗后,对照组患者的癫痫发作持续时间为(3.19±0.21)min,癫痫发作次数为(1.39±0.23)次;观察组患者的癫痫发作持续时间为(2.06±0.15)min,癫痫发作次数为(0.39±0.06)次;观察组患者的癫痫发作持续时间短于对照组,癫痫发作次数少于对照组,差异具有统计学意义(P<0.05)。两组患者用药不良反应发生率比较差异无统计学意义(P>0.05)。结论脑卒中后癫痫患者采用丙戊酸钠联合左乙拉西坦治疗效果显著,可有效降低患者发病次数,同时可有效控制用药不良反应,患者治疗安全性高,值得临床推广使用。     

左乙拉西坦治疗癫痫的临床效果研究

目的分析左乙拉西坦治疗癫痫的临床效果。方法60例癫痫患者,依据随机数字表法分为对照组与观察组,每组30例。对照组患者给予丙戊酸钠治疗,观察组患者在该基础上增加左乙拉西坦治疗。比较两组癫痫发作消失时间,住院时间,治疗前后患者癫痫每次发作持续时间、痫样放电情况、神经元特异性烯醇化酶、白细胞介素-2以及肿瘤坏死因子-α,治疗效果,不良反应发生情况。结果观察组癫痫发作消失时间、住院时间分别为(6.21±1.24)、(8.21±2.51)d,均短于对照组的(9.51±2.44)、(11.11±3.12)d,差异具有统计学意义(P<0.05)。治疗后,两组患者癫痫每次发作持续时间、痫样放电情况、神经元特异性烯醇化酶、白细胞介素-2以及肿瘤坏死因子-α水平均低于本组治疗前,且观察组低于对照组,差异均具有统计学意义(P<0.05)。观察组总有效率为96.67%高于对照组的73.33%,差异具有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论常规治疗基础上联合左乙拉西坦对于癫痫的治疗效果确切,可更好改善患者的癫痫症状,并改善患者的血清学指标,未增加不良反应,安全性高。     

左乙拉西坦单药或添加治疗癫痫的临床观察

目的研究分析左乙拉西坦单药或添加治疗癫痫的临床效果。方法随机挑选我院2016年8月至2017年8月接收的84癫痫患者。根据患者入院时间的先后将所有患者均分对照组和观察组。对照组患者应用左乙拉西坦单药治疗,观察组患者则使用左乙拉西坦添加治疗。比较并分析两组患者的临床效率。结果对照组患者治疗有效率78.6%,观察组患者治疗有效率为97.6%,两组患者临床治疗有效率差异显著(P <0.05);经有效治疗后,所有患者BMI、瘦素/脂联素、胰岛素抵抗指数均明显改善,且观察组患者改善效果要显著于对照组,具有统计学意义(P <0.05)。结论癫痫患者接受治疗期间,应用左乙拉西坦添加治疗效果更明显,促进患者康复,可在临床上推广应用。     

醒脑静静脉注射联合左乙拉西坦治疗癫痫患者的疗效观察及对甲状腺功能的影响

目的 探讨醒脑静静脉注射联合左乙拉西坦治疗癫痫患者的疗效及对甲状腺功能的影响.方法 76例癫痫患者随机分为联合组与对照组,各38例.联合组采用醒脑静静脉注射联合左乙拉西坦治疗,对照组仅采用左乙拉西坦治疗.对比分析两组治疗总有效率,治疗前后血清NSE、MMP-9、甲状腺功能指标及不良反应.结果 联合组治疗总有效率(94.73％)明显高于对照组(78.95％)(P＜0.05);联合组和对照组治疗后血清NSE和MMP-9水平明显低于治疗前,且联合组治疗后血清NSE和MMP-9水平低于对照组,差异有统计学意义(P＜0.05);两组治疗前后甲状腺功能指标水平变化比较差异无统计学意义(P＞0.05);两组均未见严重不良反应.结论 醒脑静静脉注射联合左乙拉西坦对癫痫患者疗效显著,但对甲状腺功能无明显影响,可明显降低患者血清NSE和MMP-9表达.     

左乙拉西坦与卡马西平治疗高血压脑出血后癫痫的疗效对比分析

目的:通过对左乙拉西坦与卡马西平治疗高血压脑出血后癫痫的疗效对比分析,评价两者疗效的差异.方法:选取在本院门诊和住院部治疗的148例患者,分为左乙拉西坦组和卡马西平组,随访半年后观察两组癫痫发作控制情况;同时行动态脑电图检查了解放电情况.结果:左乙拉西坦组治疗总有效率为92.86%;卡马西平组治疗总有效率为80.77%,左乙拉西坦组治疗总有效率显著优于卡马西平组(X2=4.177,P=0.043,P<0.05);左乙拉西坦组动态脑电图检查异常率明显低于卡马西平组,差异有统计学意义(X2=4.255,P=0.041,P<0.05).结论:左乙拉西坦对于高血压脑出血后癫痫控制率明显高于卡马西平,治疗后异常放电率更低,值得临床推广.     

卡马西平与左乙拉西坦治疗成人癫痫的效果及对认知功能和骨密度的影响分析

目的探究卡马西平与左乙拉西坦治疗成人癫痫的效果及对认知功能、骨密度的影响。方法92例成人癫痫患者作为研究对象,随机分为左乙拉西坦组与卡马西平组,各46例。左乙拉西坦组采用左乙拉西坦治疗,卡马西平组采用卡马西平治疗。比较两组患者治疗前及治疗6个月后认知功能[语言智商(VIQ)、操作智商(PIQ)、总智商(FIQ)]评分、骨密度(腰椎、股骨大转子、股骨颈)变化情况。结果治疗6个月后,两组患者VIQ、PIQ、FIQ评分均较治疗前显著提升,且左乙拉西坦组患者VIQ评分(101.2±3.1)分、PIQ评分(108.1±2.3)分、FIQ评分(105.2±1.8)分均明显高于卡马西平组的(95.1±2.8)、(94.1±2.0)、(93.5±1.6)分,差异有统计学意义(P<0.05)。治疗6个月后,卡马西平组患者腰椎、股骨大转子、股骨颈骨密度均较治疗前显著下降,且明显低于卡马西平组,差异有统计学意义(P<0.05);左乙拉西坦组治疗6个月后腰椎、股骨大转子、股骨颈骨密度与治疗前比较差异无统计学意义(P>0.05)。结论左乙拉西坦与卡马西平治疗成人癫痫,左乙拉西坦更能明显提升患者认知功能,且对患者骨密度无影响。     

左乙拉西坦对癫痫患儿骨代谢与认知功能的影响

目的 研究左乙拉西坦对癫痫患儿骨代谢与认知功能的影响.方法 选取于我院接受过癫痫治疗的患儿68例,随机分为观察组和对照组各34例,观察组采取左乙拉西坦进行治疗,对照组的患者采取丙戊酸治疗对其治疗,分别对患者治疗前后的神经认知功能进行测评,同时对其骨代谢指标进行检查,并分析疗效情况及检测结果.结果 治疗后,观察组认知功能中的语言智商(VIQ)、操作智商(PIQ)及短时视觉记忆与对照组相比均有明显好转,两组相比差异具有统计学意义(P<0.05),另外观察组患者治疗后的复杂部分性发作、简单部分发作、强直阵挛发作、肌阵挛发作都要明显低于对照组患者的情况,两组差异具有统计学意义(P<0.05);且观察组治疗后的血磷离子、血钙离子、甲状腺激素、碱性磷酸酶与对照组相比具有统计学意义(P<0.05).结论 左乙拉西坦对患儿的骨代谢影响极小,且有助于提高患者的认知功能及改善患者的生活质量.     

探讨卡马西平、托吡酯和左乙拉西坦联合治疗创伤性难治性癫痫的效果

目的探究创伤性难治性癫痫患者治疗中卡马西平、托吡酯和左乙拉西坦联合治疗的应用效果。方法88例创伤性难治性癫痫患者,随机分为对照组和研究组,各44例。对照组采用卡马西平联合托吡酯治疗,研究组采用卡马西平、托吡酯和左乙拉西坦联合治疗。对比两组患者的治疗效果;治疗前后癫痫发作次数及每次持续时间;治疗前后简易精神状态量表(MMSE)评分;不良反应发生情况。结果研究组患者治疗总有效率为90.91%,高于对照组的72.73%,差异有统计学意义(P<0.05)。研究组患者治疗后1个月癫痫发作次数为(2.62±1.03)次,少于对照组的(4.06±1.14)次,每次癫痫持续时间(1.21±0.49)h短于对照组的(1.98±0.51)h,差异均具有统计学意义(P<0.05)。研究组患者治疗后MMSE评分为(26.84±3.59)分,高于对照组的(22.42±3.48)分,差异有统计学意义(P<0.05)。两组患者治疗后不良反应发生率比较差异无统计学意义(P>0.05)。结论创伤性难治性癫痫患者治疗中采用卡马西平、托吡酯和左乙拉西坦联合治疗的效果显著,能够有效改善患者临床症状,提升癫痫控制效果,改善其精神状态,且不会加重患者的不良反应,建议推广实施。     

Synthesis,Cytotoxicity and Antileishmanial Activity of Some N-(2-(indol-3-yl)ethyl)-7-chloroquinolin-4-amines

We report herein the condensation of 4,7-dichloroquinoline (1) with tryptamine (2) and D-tryptophan methyl ester (3) . Hydrolysis of the methyl ester adduct (5) yielded the free acid (6) . The compounds were evaluated in vitro for activity against four different species of Leishmania promastigote forms and for cytotoxic activity against Kb and Vero cells. Compound (5) showed good activity against the Leishmania species tested, while all three compounds displayed moderate activity in both Kb and Vero cells.     

Lung disease and PKCs

The lung offers a rich opportunity for development of therapeutic strategies focused on isozymes of protein kinase C (PKCs). PKCs are important in many cellular responses in the lung, and existing therapies for pulmonary disorders are inadequate. The lung poses unique challenges as it interfaces with air and blood, contains a pulmonary and systemic circulation, and consists of many cell types. Key structures are bronchial and pulmonary vessels, branching airways, and distal air sacs defined by alveolar walls containing capillaries and interstitial space. The cellular composition of each vessel, airway, and alveolar wall is heterogeneous. Injurious environmental stimuli signal through PKCs and cause a variety of disorders. Edema formation and pulmonary hypertension (PHTN) result from derangements in endothelial, smooth muscle (SM), and/or adventitial fibroblast cell phenotype. Asthma, chronic obstructive pulmonary disease (COPD), and lung cancer are characterized by distinctive pathological changes in airway epithelial, SM, and mucous-generating cells. Acute and chronic pneumonitis and fibrosis occur in the alveolar space and interstitium with type 2 pneumocytes and interstitial fibroblasts/myofibroblasts playing a prominent role. At each site, inflammatory, immune, and vascular progenitor cells contribute to the injury and repair process. Many strategies have been used to investigate PKCs in lung injury. Isolated organ preparations and whole animal studies are powerful approaches especially when genetically engineered mice are used. More analysis of PKC isozymes in normal and diseased human lung tissue and cells is needed to complement this work. Since opposing or counter-regulatory effects of selected PKCs in the same cell or tissue have been found, it may be desirable to target more than one PKC isozyme and potentially in different directions. Because multiple signaling pathways contribute to the key cellular responses important in lung biology, therapeutic strategies targeting PKCs may be more effective if combined with inhibitors of other pathways for additive or synergistic effect. Mechanisms that regulate PKC activity, including phosphorylation and interaction with isozyme-specific binding proteins, are also potential therapeutic targets. Key isotypes of PKC involved in lung pathophysiology are summarized and current and evolving therapeutic approaches to target them are identified.     

Gender-related symptoms and correlates of alcohol dependence among men and women with a lifetime diagnosis of alcohol use disorders

This study explored gender-related symptoms and correlates of alcohol dependence in a crosssectional study of 150 men and 150 women with a lifetime diagnosis of alcohol use disorders (AUD). Participants were recruited in equal numbers from treatment settings, correctional centres and the general community. Standardized measures were used to determine participants' use of substances, history of psychiatric disorders and psychosocial stress, their sensation seeking and family history of substance use and mental health disorders. Multivariate analyses were used to detect patterns of variables associated with gender and the lifetime severity of AUD. Men had a longer history of severe AUD than women. Women had similar levels of alcohol dependence and medical and psychological sequelae as men, despite 6 fewer years of AUD. More women than men had a history of severe psychosocial stress, severe dependence on other substances and antecedent mental health problems, especially mood and anxiety disorders. There were differences in family history of alcohol-related problems approximating same-gender aggregation. The severity of a lifetime AUD was predicted by its earlier age at onset and the occurrence of other disorders, especially anxiety, among both men and women. The limitations in the generalizability of these findings due to sample idiosyncrasies are discussed.     

Biochemical and molecular characterisation of cubozoan protein toxins

Class Cubozoa includes several species of box jellyfish that are harmful to humans. The venoms of box jellyfish are stored and discharged by nematocysts and contain a variety of bioactive proteins that are cytolytic, cytotoxic, inflammatory or lethal. Although cubozoan venoms generally share similar biological activities, the diverse range and severity of effects caused by different species indicate that their venoms vary in protein composition, activity and potency. To date, few individual venom proteins have been thoroughly characterised, however, accumulating evidence suggests that cubozoan jellyfish produce at least one group of homologous bioactive proteins that are labile, basic, haemolytic and similar in molecular mass (42-46 kDa). The novel box jellyfish toxins are also potentially lethal and the cause of cutaneous pain, inflammation and necrosis, similar to that observed in envenomed humans. Secondary structure analysis and remote protein homology predictions suggest that the box jellyfish toxins may act as α-pore-forming toxins. However, more research is required to elucidate their structures and investigate their mechanism(s) of action. The biological, biochemical and molecular characteristics of cubozoan venoms and their bioactive protein components are reviewed, with particular focus on cubozoan cytolysins and the newly emerging family of box jellyfish toxins.     

Dose tolerability of chronically inhaled voriconazole solution in rodents

Invasive pulmonary aspergillosis (IPA) is a fungal disease of the lung associated with high mortality rates in immunosuppressed patients despite treatment. Targeted drug delivery of aqueous voriconazole solutions has been shown in previous studies to produce high tissue and plasma drug concentrations as well as improved survival in a murine model of IPA. In the present study, rats were exposed to 20 min nebulizations of normal saline (control group) or aerosolized aqueous solutions of voriconazole at 15.625 mg (low dose group) or 31.25 mg (high dose group). Peak voriconazole concentrations in rat lung tissue and plasma after 3 days of twice daily dosing in the high dose group were 0.85 ± 0.63 μg/g wet lung weight and 0.58 ± 0.30 μg/mL, with low dose group lung and plasma concentrations of 0.38 ± 0.01 μg/g wet lung weight and 0.09 ± 0.06 μg/mL, respectively. Trough plasma concentrations were low but demonstrated some drug accumulation over 21 days of inhaled voriconazole administered twice daily. Following multiple inhaled doses, statistically significant but clinically irrelevant abnormalities in laboratory values were observed. Histopathology also revealed an increase in the number of alveolar macrophages but without inflammation or ulceration of the airway, interstitial changes, or edema. Inhaled voriconazole was well tolerated in a rat model of drug inhalation.