急性脑梗死患者血清钙、镁含量的变化及其临床意义

目的:探讨急性脑梗死(ACI)患者血清钙、镁(Ca2+、Mg2+)含量的变化与病情及预后的关系。方法:检测37例ACI患者发病早期及治疗2周后血清Ca2+、Mg2+含量,并与31例健康中老年人进行对照。结果:梗死组血清钙、镁含量均低于健康对照组(P<0.01),梗死组中轻、中、重3型比较,其血清Ca2+、Mg2+含量梯度为重型<中型<轻型(P<0.05,P<0.01),治疗2周后,血清Ca2+、Mg2+含量有较大程度回升(P<0.01)。结论:ACI早期血清Ca2+、Mg2+含量均明显降低,病情越重,降低越明显,随病情好转,血清Ca2+、Mg2+含量回升,因此,血清Ca2+、Mg2+含量可作为判断病情及评估预后的指标之一。     

临床药师参与1例丙戊酸钠致重症药疹病例分析

[摘要]目的：通过阐述临床药师参与1例重症药疹患儿治疗过程,优化了重症药疹的治疗方案,实施有效药学监护。方法：通过对该病例中抗癫痫药物与重症药疹因果联系评价,分析发生不良反应的原因,同时参考相关的医学文献,完善与优化治疗方案,为患者提供全程化药学监护,保障患儿抗癫痫方案安全、有效。结果：患儿药疹消除好转出院。结论：临床药师对重症药疹不良反应的判断、治疗有积极意义。     

The effects of phenytoin and sodium valproate on the periodontal health of adult epileptic patients

The periodontal health of 30 adult epileptic patients treated with either sodium valproate or phenytoin was compared with a control group (n = 15) of otherwise healthy patients. The 3 groups were matched for age and sex. Patients on phenytoin therapy showed significantly higher plaque scores (P less than 0.05), gingival index (P less than 0.05) and pocketing (P less than 0.05) than patients in the control group. The % of gingival hyperplasia was significantly higher (P less than 0.05) in the phenytoin-treated patients than those on sodium valproate or in the control group. However, patients on phenytoin therapy had significantly less bone loss than those on sodium valproate (P less than 0.05) or in the control group (P less than 0.01). No significant differences were observed between the sodium valproate group and the control group on any of the parameters assessed. The results from this study would suggest that sodium valproate has no unwanted effects on periodontal health and may be considered a safe alternative, regarding the periodontal aspects, to phenytoin for the treatment of adult onset epilepsy.     

乌拉地尔联合硝苯地平治疗妊娠期高血压对母婴结局及孕妇肾功能的影响

目的 探讨乌拉地尔联合硝苯地平治疗妊娠期高血压对母婴结局、孕妇肾功能的影响。方法 选取我院2019 年2 月至2020 年10 月收诊的妊娠期高血压孕妇100 例为对象,随机数字表法分成对照组50 例（硝苯地平联合常规治疗）和观察组50 例（乌拉地尔、硝苯地平联合常规治疗）,比较两组的治疗总有效率、母婴结局、肾功能指标和药物不良反应发生率。结果 观察组治疗总有效率为92.00%,高于对照组的76.00%,两组比较差异有统计学意义（P＜0.05）;观察组的早产率为6.00%,剖宫产率为26.00%,产后出血率为4.00%,胎儿宫内窘迫率为6.00%,新生儿窒息率为4.00%,均低于对照组的早产率22.00%、剖宫产率46.00%、产后出血率18.00%、胎儿宫内窘迫率20.00%、新生儿窒息率16.00%,两组比较差异有统计学意义（P＜0.05）;观察组新生儿死亡率（0）与对照组（2.00%）比较,差异无统计学意义（P＞0.05）;观察组孕妇治疗7 d 后的24 h 尿蛋白量为（0.89±0.15）g 和24 h 尿肌酐量为（6.87±1.24）mmol/L,均低于对照组的24 h 尿蛋白量（1.56±0.23）g 和24 h 尿肌酐量（8.94±1.45）mmol/L,两组比较差异有统计学意义（P＜0.05）;观察组的药物不良反应总发生率（8.00%）与对照组（12.00%）比较,差异无统计学意义（P＞0.05）。结论 乌拉地尔联合硝苯地平治疗妊娠期高血压综合征疗效肯定,可促进孕妇肾功能改善,改善母婴结局。     

丙戊酸镁与喹硫平联合治疗双向情感障碍的临床观察

目的分析丙戊酸镁与喹硫平联合治疗双向情感障碍(bipolar disorder,BP)的效果。方法选取2017年1月至2020年2月本院收治的150例BP患者,随机分为实验组与对照组,各75例。对照组采用丙戊酸镁治疗,实验组采用丙戊酸镁联合喹硫平治疗,比较两组临床疗效、BRMS、PANSS、HAMD-17、TESS评分。结果实验组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,两组BRMS、PANSS、HAMD-17评分差异有统计学意义(P<0.05)。结论丙戊酸镁联合喹硫平治疗BP患者,能显著改善患者临床症状,减轻患者负面情绪,用药安全性较高,治疗效果显著。     

Effect of valproate on the plasma concentrations of aripiprazole in bipolar patients

Objective. There is very limited documentation available on the effects of valproate co-medication on the pharmacokinetics of aripiprazole in a naturalistic setting. The aim of the present study was to investigate the effect of co-medication with valproate on serum concentrations of aripiprazole in bipolar disorder patients in a clinical setting. Method. Plasma samples of bipolar disorder patients (n = 69) on a stable dose of aripiprazole 20 mg/day were analyzed by a liquid chromatography-mass spectrometry method in a routine therapeutic drug monitoring setting. Therapeutic drug monitoring was done for the entire study group before and after valproate co-administration. Results. We observed a statistically significant difference between the aripiprazole monotherapy and aripiprazole-valproate combination with respect to total aripiprazole plasma levels (p < 0.01). However, no statistically significant differences were noted in aripiprazole levels between the first week and the second week of valproate co-administration. Conclusion. In conclusion, concurrent treatment with valproate resulted in changes in the total aripiprazole plasma levels by 23%. But a lower total aripiprazole concentration during co-medication with valproate, caused by protein binding displacement, is reported being clinically insignificant in previous studies. The results from these studies are important in order to clarify clinical safety and efficacy.     

Magnesium vs. machined surfaced titanium - osteoblast and osteoclast differentiation

PURPOSE

This study focused on in vitro cell differentiation and surface characteristics in a magnesium coated titanium surface implanted on using a plasma ion source.

MATERIALS AND METHODS

40 commercially made pure titanium discs were prepared to produce Ti oxide machined surface (M) and Mg-incorporated Ti oxide machined surface (MM). Surface properties were analyzed using a scanning electron microscopy (SEM). On each surface, alkaline phosphatase (ALP) activity, alizarin red S staining for mineralization of MC3T3-E1 cells, and quantitative analysis of osteoblastic gene expression, were evaluated. Actin ring formation assay and gene expression analysis of TRAP and GAPDH performing RT-PCR were performed to characterize osteoclast differentiation on mouse bone marrow-derived macrophages (BMMs).

RESULTS

MM showed similar surface morphology and surface roughness with M, but was slightly smoother after ion implantation at the micron scale. M was more hydrophobic than MM. No significant difference between surfaces on ALP activity at 7 and 14 days were observed. Real-time PCR analyses showed similar levels of mRNA expression of the osteoblast phenotype genes; osteopontin (OPN), osteocalcin (OCN), bone sialoprotein (BSP), and collagen 1 (Col 1) in cell grown on MM at 7, 14 and 21 days. Alizarin red S staining at 21 days showed no significant difference. BMMs differentiation increased in M and MM. Actin ring formation assay and gene expression analysis of TRAP showed osteoclast differentiation to be more active on MM.

CONCLUSION

Both M and MM have a good effect on osteoblastic cell differentiation, but MM may speed the bone remodeling process by activating on osteoclast differentiation.     

镁合金对骨髓间充质干细胞增殖及成骨分化的影响研究

目的：探讨镁合金对人骨髓间充质干细胞（BMSCs）增殖及成骨分化的影响。方法抽取人骨BMSCs并予以鉴定;采用AZ31B镁合金浸提液培养人BMSCs 1、3、5、7 d,以普通培养基为对照组,CCK-8法检测细胞增殖活性;应用浸提液培养人BMSCs,诱导分化后检测成骨分化相关基因（COLⅠ、ALP、OPN）的表达。另设置调节pH值AZ31B组（pH-AZ31B组）,以观察pH值变化对实验结果的影响。结果 BMSCs表达CD34（-）、CD45（-）、CD44（＋）、CD73（＋）、CD90（＋）、CD105（＋）。浸提液培养1、3、5、7 d,AZ31B组细胞相对增殖率低于对照组（P＜0.05）,毒性评级为2级;对照组和pH-AZ31B组细胞活性较好,两组细胞相对增殖率比较,差异无统计学意义（P ＞0.05）。AZ31B组COLⅠ基因表达量与对照组比较,差异无统计学意义（P ＞0.05）;AZ31B组ALP基因表达量较低（P＜0.05）,pH-AZ31B组与对照组无显著差异（P＞0.05）;AZ31B组OPN基因表达量在诱导分化后6 d、12 d显著高于对照组（P＜0.05）,pH-AZ31B组与对照组无显著差异（P＞0.05）。结论镁合金对BMSCs增殖及成骨分化无不良影响,其影响可能与浸提液pH值的变化有关。     

冰片对丙戊酸钠透过血脑屏障的影响

目的探讨冰片对丙戊酸钠在家兔体内透过血脑屏障的影响。方法12只家兔随机分为对照组和冰片组，每组6只。两组动物均静脉滴注丙戊酸钠达稳态，之后冰片组予冰片灌胃给药。采用荧光偏振免疫分析法检测家兔血浆和脑脊液丙戊酸钠的浓度，计算药代动力学参数。结果与对照组相比，冰片组家兔脑脊液平均药物浓度升高，曲线下面积增加（P〈0．05），稳态脑脊液药物浓度出现峰值时间为6h，脑血浓度比亦升高（P〈0．05），但血药浓度并未升高。结论冰片可提高血脑屏障对丙戊酸钠的通透性，但对血药浓度影响较小。