Single-dose rATG induction at renal transplantation: superior renal function and glucoregulation with less hypomagnesemia

Stevens RB, Lane JT, Boerner BP, Miles CD, Rigley TH, Sandoz JP, Nielsen KJ, Skorupa JY, Skorupa AJ, Kaplan B, Wrenshall LE. Single‐dose rATG induction at renal transplantation: superior renal function and glucoregulation with less hypomagnesemia.
Clin Transplant 2012: 26: 123–132.
© 2011 John Wiley & Sons A/S. Abstract: Background: Rabbit anti‐thymocyte globulin (rATG) induction reduces reperfusion injury and improves renal function in kidney recipients by means of properties unrelated to T‐cell lysis. Here, we analyze intensive rATG induction (single dose, rATG_S, vs. divided dose, rATG_D) for improved renal function and protection against hyperglycemia. Methods: Patients without diabetes (n = 98 of 180) in a prospective randomized trial of intensive rATG induction were followed for six months for the major secondary composite end point of impaired glucose regulation (hyperglycemia and new‐onset diabetes after transplantation, NODAT). Prospectively collected data included fasting blood glucose and HbA_1c. Serum Mg⁺⁺ was routinely collected and retrospectively analyzed. Results: Induction with rATG_S produced less impaired glucose regulation (p = 0.05), delayed NODAT development (p = 0.02), less hyperglycemia (p = 0.02), better renal function (p = 0.04), and less hypomagnesemia (p = 0.02), a factor associated with a lower incidence of NODAT. Generalized linear modeling confirmed that rATG_S protects against a synergistic interaction between tacrolimus and sirolimus that otherwise increased hypomagnesemia (p = 0.008) and hyperglycemia (p = 0.03). Conclusions: rATG_S initiated before renal reperfusion improved early renal function and reduced impaired glucose regulation, an injury by diabetogenic maintenance agents (tacrolimus and sirolimus).     

热性惊厥与血电解质的临床研究

目的：探讨小儿热性惊厥与血电解质变化的关系。方法：对符合诊断标准的89例呼吸道感染合并惊厥和80例单纯呼吸道感染患儿分别进行血电解质测定。观察血清钾、钠、钙、镁含量与惊厥发作之间的关系。结果：观察组患儿血清钠、钙、镁含量与对照组比较差异非常显著性;观察组患儿血清钾含量与对照组比较差异无显著性。观察组中,一次热程中惊厥发作≥2次者,血钠、钙、镁水平与惊厥发作1次者之间差异有显著性。结论：热性惊厥的发作与血清钠、钙、镁含量关系密切,而与血清钾含量无明显的关系。     

牛磺酸镁配合物对豚鼠心室肌细胞钠离子和钙离子通道的影响

目的研究牛磺酸镁配合物(TMC)对正常豚鼠心室肌细胞钠电流(INa)和L-钙电流(ICa,L)的影响,旨在探讨其抗心律失常作用的可能机制。方法酶解法分离豚鼠单个心室肌细胞,全细胞膜片钳技术记录单个心室肌细胞的INa和ICa,L。结果TMC50μmol·L-1不影响INa,而100～200μmol·L-1浓度依赖性地抑制INa;TMC50～200μmol·L-1浓度依赖性地增加ICa,L,使ICa,L的稳态失活曲线右移,对ICa,L的稳态激活曲线无影响。结论TMC对心室肌细胞INa的阻滞可能是其抗心律失常作用的机制之一;对ICa,L的促进可能有利于其发挥正性肌力作用。     

孟鲁司特钠联合硫酸镁治疗老年支气管哮喘的疗效观察

目的：探讨孟鲁司特钠联合硫酸镁治疗老年支气管哮喘的临床疗效。方法选取2012年6月至2013年6月玉林市第二人民医院收治的老年支气管哮喘患者80例,按照随机数字表法分为观察组与对照组各40例。对照组给予吸氧、抗感染、祛痰、β2受体激动剂、糖皮质激素等常规治疗,观察组在对照组的基础上加用孟鲁司特钠片和硫酸镁注射液治疗。观察并比较两组的临床疗效。结果观察组总有效率为97．1％明显高于对照组的77．1％,复发率为5．7％明显低于对照组的28．6％,差异均有统计学意义（ P＜0．05）;观察组喘息、咳嗽及胸闷等症状缓解时间均明显早于对照组,差异有统计学意义（P＜0．05）。两组患者治疗前肺功能指标比较,差异无统计学意义（P＞0．05）;治疗后肺功能指标较治疗前均明显改善,观察组改善程度优于对照组,差异有统计学意义（P＜0．05）。两组均未见呼吸抑制、血压下降等严重不良反应。结论孟鲁司特钠片联合硫酸镁注射液治疗老年支气管哮喘临床疗效显著,症状缓解快,复发率低,安全可靠,值得临床推广。     

ADA试剂对镁离子测定结果干扰的评价

目的：探讨腺苷脱氨酶（ADA）试剂对全自动生化分析仪镁离子测定的影响。方法测定ADA 试剂中的镁离子浓度;单独比较测定混合血清中的镁离子和先测定ADA再测定镁离子的检测结果;将不同浓度ADA 试剂加入标本中测定其镁离子浓度的变化。结果 ADA试剂中镁离子含量为0．739 mmol/L。单独测镁离子与先测ADA 再测镁离子的结果比较差异有统计学意义（P＜0．05）。镁离子结果增加的幅度与ADA试剂的量呈直线相关。结论 ADA试剂对镁离子测定有正干扰。     

Magnesium ions and opioid agonists in vincristine-induced neuropathy

Neuropathic pain is difficult to treat. Classic analgesics (i.e., opioid receptor agonists) usually possess low activity. Therefore other agents such as antidepressants, anticonvulsants, and corticosteroids are used. It is commonly known that NMDA antagonists increase analgesic activity of opioids. Unfortunately, clinical use of NMDA antagonists is limited because of the relatively frequent occurrence of adverse effects e.g., memory impairment, psychomimetic effects, ataxia and motor in-coordination. Magnesium ions (Mg²⁺) are NMDA receptor blockers in physiological conditions. Therefore, in this study the effect of opioid receptor agonists and the influence of Mg²⁺ on the action of opioid agonists in vincristine-induced hyperalgesia were examined. Opioid agonists such as morphine (5 mg/kg, ip), and fentanyl (0.0625 mg/kg, ip), as well as the partial agonist buprenorphine (0.075 mg/kg, ip) administered alone on 5 consecutives days did not modify the hyperalgesia in vincristine rats. In contrast, pretreatment with a low dose of magnesium sulfate (30 mg/kg, ip) resulted in a progressive increase of the analgesic action of all three investigated opioids. After discontinuation of drug administration, the effect persisted for several days.     

Adolescent brain maturation,the endogenous cannabinoid system and the neurobiology of cannabis-induced schizophrenia

Cannabis use during adolescence increases the risk of developing psychotic disorders later in life. However, the neurobiological processes underlying this relationship are unknown. This review reports the results of a literature search comprising various neurobiological disciplines, ultimately converging into a model that might explain the neurobiology of cannabis-induced schizophrenia. The article briefly reviews current insights into brain development during adolescence. In particular, the role of the excitatory neurotransmitter glutamate in experience-dependent maturation of specific cortical circuitries is examined. The review also covers recent hypotheses regarding disturbances in strengthening and pruning of synaptic connections in the prefrontal cortex, and the link with latent psychotic disorders. In the present model, cannabis-induced schizophrenia is considered to be a distortion of normal late postnatal brain maturation. Distortion of glutamatergic transmission during critical periods may disturb prefrontal neurocircuitry in specific brain areas. Our model postulates that adolescent exposure to Δ9-tetrahydrocannabinol (THC), the primary psychoactive substance in cannabis, transiently disturbs physiological control of the endogenous cannabinoid system over glutamate and GABA release. As a result, THC may adversely affect adolescent experience-dependent maturation of neural circuitries within prefrontal cortical areas. Depending on dose, exact time window and duration of exposure, this may ultimately lead to the development of psychosis or schizophrenia. The proposed model provides testable hypotheses which can be addressed in future studies, including animal experiments, reanalysis of existing epidemiological data, and prospective epidemiological studies in which the role of the dose–time–effect relationship should be central.     

微核试验评价含磷酸氢钙涂层纯镁材料的致突变性

目的通过微核实验检测纯镁微弧氧化（MAO）、二水磷酸氢钙（DCPD）涂层对小鼠的致突变性以评价其生物相容性。方法 30只小鼠,随机分为5组,阴性对照和实验组按50m l/kg分别腹腔注射生理盐水、三种材料浸提液,阳性对照组腹腔注射环磷酰胺（CP）（40mg/kg）,二次注射后6h处死小鼠,取其股骨制备骨髓涂片,观察P/N值,计算微核率。结果各实验组微核率均小于5‰,实验组与阴性对照组无显著差异,与阳性对照组有显著差异。结论涂层后的纯镁对小鼠无潜在的致突变性。