Ginkgo biloba Extract (EGb 761) Pretreatment Limits Free Radical Oxidative Stress in Patients Undergoing Coronary Bypass Surgery

A growing body of evidence supports the trigger role of free radicals in the delayed functional and metabolic myocardial recovery following cardiopulmonary bypass (CPB) in humans, thus opening the field to specific therapies. This clinical study was designed to evaluate, in 15 patients undergoing aortic valve replacement, whether the extent of CPB- and reperfusion-induced lipid peroxidation, ascorbate depletion, tissue necrosis, and cardiac dysfunction is reduced by orally administered EGb 761, a Ginkgo biloba extract withpotent in vitro antiradical properties. Patients received either EGb 761 (Tanakan, 320 mg/day, n = 8) or a matching placebo (n = 7) for 5 days before surgical intervention. Plasma samples were obtained from the peripheral circulation and the coronary sinus at crucial stages of the operation (i.e., before incision, during ischemia, and within the first 30 minutes post-unclamping), and up to 8 days postoperatively. Upon aortic unclamping, EGb 761 inhibited the transcardiac release of thiobarbituric acid species (p ` 0.05), as assessed by high-performance liquid chromatography, and attenuated the early (5–10 minute) decrease in dimethylsulfoxide/ascorbyl free radical levels, an electron spin resonance index of the plasma ascorbate pool (p ` 0.05). EGb 761 also significantly reduced the more delayed leakage of myoglobin (p = 0.007) and had an almost significant effect on ventricular myosin leakage (p = 0.053, 6 days postoperatively). The clinical outcome of recovery of treated patients was improved, but not significantly, compared with untreated patients. Our results demonstrate the usefulness of adjuvant EGb 761 therapy in limiting oxidative stress in cardiovascular surgery and suggest the possible role of highly bioavailable terpene constituents of the drug.     

Ivermectin for the chemotherapy of bancroftian filariasis: a meta-analysis of the effect of single treatment

Summary The efficacy and safety of ivermectin in the treatment of filariasis due to Wuchereria bancrofti was assessed by a meta-analysis of the results from 15 published clinical trials. Seven hundred and forty-eight microfilaraemic patients were enrolled in 7 dose-finding and 8 comparative studies. Administered as a single dose, ivermectin induced nearly complete clearance of microfilariae from the blood from the first day to 30 days post-treatment, followed by gradual recurrence of microfilaraemia and increase in its intensity. Higher doses of ivermectin showed greater clearance effects and maintained lower microfilaraemia levels for a longer time. The adverse reactions caused by the drug were flu-like, transient, generally mild and well tolerated by patients. The frequency and intensity of adverse reactions were strongly associated with pretreatment microfilaria counts in the blood, but independent of dose. The findings of the meta-analysis suggest that ivermectin given at a single annual dose of 200 μg/kg body weight or higher, whether or not in combination with DEC, has great potential for therapeutic strategies to control bancroftian filariasis.     

胰岛素抵抗与高血压病冠心病糖尿病的关系

目的探讨中老年人高血压、冠心病、糖尿病胰岛素抵抗的状况及相关因素。方法按中老年高血压病、冠心病、糖尿病、高血压合并冠心病等类别分组、并设对照组，计体重指数、测血脂、血糖、胰岛素及胰岛素抗体浓度，并根据血糖、血胰岛素浓度计算胰岛素敏感性．结果胰岛素抵抗在冠心病、高血压病、高血压合并冠心病及糖尿病中依次递增．设对照组胰岛素相对敏感性为１，则上述各病分别为０８３、０．７９、０６１、０．３２．与之相伴随的是糖及脂质代谢紊乱及体重指数的增加。结论高血压、冠心病、糖尿病多存在胰岛素抵抗，并可能是心血管疾病的危险因子。     

Down-regulation of rat β-adrenoceptors by clenbuterol or desipramine does not require chronic treatment: [H]CGP-12177 binding reveals rapid (24 hour) modulation

Desipramine (DMI, 15 mg/kg, s.c.) decreased [³H]CGP-12177-labelled cortical β-adrenoceptor density (B_max) by 30% upon chronic (14 day) treatment. However, even a single dose (in mg/kg) of DMI (15) or the β-adrenoceptor agonist, clenbuterol (20), induced a rapid (24 hour) and significant reduction of β-adrenoceptor B_max (−15%; p<0.01). Acute treatment with amitryptiline (10), clorgyline (1), fluoxetine (10), nomifensine (10) or maprotiline (20) had no significant effect on [³H]CGP-12177-labelled β-adrenoceptors, suggesting that rapid down-regulation may not be a general property of antidepressant drugs. None of the antidepressants altered the B_max of [³H]ketanserin-labelled 5-HT_2A receptors on acute treatment. These results show that β-adrenoceptor down-regulation by clenbuterol and DMI is not dependent on chronic treatment and may, therefore, be a poor correlate of the gradual onset of therapeutic efficacy seen clinically with antidepressant drugs.     

Health-related quality of life under six months' treatment of migraine—an open clinic-based longitudinal study

Health-related quality of life (HQL) assessment in the clinical setting have distinguished subjective perceptions (e.g. well-being), signssymptoms of the disease, and functional capacity as three major components. The impact of short-term treatment for migraine attacks on these variables was evaluated in an open prospective 6-month study at the Gothenburg Migraine Clinic. Socio-economic factors, subjective symptoms, and general well-beingquality of life were evaluated by self-administered questionnaires in 99 patients with migraine with or without aura in accordance with the classification of the International Headache Society. Short-term treatment comprising conventional therapy or subcutaneous sumatriptan reduced number of days per month with migraine and absenteeism from work, migraine-associated symptoms, but did not significantly improve general well-being between attacks. Future assessment of the patients' HQL in accordance with this approach would enable us to consider all the advantages and disadvantages of current therapies of particular interest in the field of migraine.     

乙胺碘呋酮对加速性交界性自主节律转复治疗

本文对心室率较快、持续时间转长,因而影响心功,或使原发病加重的二例加速性交界性自主节律病人,试以口服乙胺碘呋酮进行转复治疗,均恢复了窦性节律。在心电图监护过程中,除出现轻度Q—Tc延长外,无其他不良反应,因此作者等认为,对某些需要治疗的加速性交界性自主节律,乙胺碘呋酮系一较为安全而有效的治疗药物,值得在临床上进一步推广试用。     

产褥期脑病62例临床分析

目的研究产褥期脑病的临床特征、治疗方法及预后。方法选择62例产褥期突发精神症状并有全脑受累体征病人的临床资料进行回顾性分析。结果发现产褥期脑病的临床表现酷似病毒性脑炎,但病前无明显感染灶,病程较长,疗效和预后较差。结论对产褥期精神异常病人应进行神经病学方面检查,尽早诊治。病初要控制和缩短脑水肿期,防止和减轻脑细胞的变性和脱鞘;恢复期要耐心而持久地进行各种康复治疗,以便病人恢复到最佳健康水平。     

硝酸甘油、米力农和尼卡地平缓解桡动脉痉挛作用的比较

目的：比较硝酸甘油、米力农和尼卡地平3种药物对桡动脉的解痉作用。方法：收集手术后多余的人体桡动脉标本，采用器官浴槽方法，比较上述3种药物对预收缩的离体桡动脉的解痉作用。结果：米力农和硝酸甘油对预收缩的桡动脉的舒张作用明显强于尼卡地平；米力农和硝酸甘油的疗效相似。结论：米力农和硝酸甘油更适用于缓解冠状动脉旁路移植术中桡动脉的痉挛。     

莪术油治疗毛细支气管炎60例疗效观察

目的　评价莪术油治疗毛细支气管炎的疗效。方法　毛细支气管炎患儿 110例 ,随机分为治疗组 6 0例和对照组 5 0例 ,6d为 1疗程 ,比较两组治愈率 ,临床指标对比观察 (咳喘 ,肺部罗音消失时间 ,住院时间 )。结果　总治愈率治疗组 96 .7% ,对照组 80 % ,两组比较有显著性差异 (P <0 .0 5 )。结论　莪术油治疗毛细支气管炎疗效满意。     

Microalbuminuria and nerve conduction velocity in type-I diabetics during conventional therapy and during continuous I.V. insulin infusion

Summary The objective of this study was to follow the development of microalbuminuria and nerve conduction velocity under continuous i.v. insulin therapy over a limited period of 4 months. For this purpose, 8 labile type I diabetics were selected (age 33±8 years, duration of diabetes 16±9 years) and treated conventionally with two insulin injections daily over 4 months. Afterwards, the same patients were treated with continuous i.v. insulin infusion and finally again with two injections daily over 4 months each. This procedure allowed each diabetic to serve as his own control. HbA₁, microalbuminuria, nerve conduction velocity and relative refractory period of the ulnar nerve were checked at montly intervals. During the continuous i.v. infusion over 4 months, blood sugar values were significantly lower, glucosuria had disappeared almost completely and the glycosylated hemoglobin had fallen to near normal values. The mean rate of albumin excretion was 16±5 μg/min at rest and 76±26 μg/min during exercise (normal: 3.9±0.4 and 4.8±1.2 μg/min, respectively) and did not change significantly. Nerve conduction velocity in the ulnar nerve rose significantly under i.v. insulin therapy from 47.9±0.6 m/sec to 52±0.6 m/sec. Similarly, the relative refractory period of the same nerve fell significantly from 3.7±0.2 to 1.9±0.1 msec (i.e. to within normal range). It is concluded that functional disturbances of peripheral nerve can regress by improved blood sugar control with continuous i.v. insulin infusion over 4 months. On the other hand, incipient microangiopathy measured as microalbuminuria remains unchanged over the same period of time. If an improvement is at all possible, considerably longer periods of euglycemia are likely to be necessary. Supported by Grant No. 3.964-0.80 from the Swiss National Science Foundation.