益母草中阿魏酸对含益母草中成药质量标准影响的探讨

目的：建立HPLC/TQ-MS测定益母草中阿魏酸含量的方法并测定不同产地益母草中阿魏酸含量，评价益母草中阿魏酸对中成药调经止痛片及新生化颗粒的质量影响，为制定含有益母草并以阿魏酸为定量指标的中成药质量标准提供参考。方法：采用薄层色谱法及UPLC-Q/TOF定性鉴别及分析益母草中阿魏酸，采用HPLC/TQ-MS定量分析10批不同产地益母草中阿魏酸含量。基于定量分析结果及处方用量探讨益母草中阿魏酸含量对其中成药质量标准的影响。结果：薄层鉴别及UPLC-Q/TOF定性分析结果显示，10批不同产地益母草中均含有阿魏酸。HPLC/TQ-MS定量分析结果显示，益母草中阿魏酸含量在0.004 2%~0.006 5%之间。结论：益母草与当归、川芎等含有阿魏酸的药材配伍且其用量较大时，益母草中阿魏酸含量会对其质量评价产生一定的影响。     

Investigating the inotropic effect of pyruvic acid on the isolated rat heart and its underlying mechanism

Pyruvic acid is important organic chemical intermediates that plays a role in cardiomyocyte pathophysiology and therapy. This study sought to explore the inotropic effects of pyruvic acid on the function of the isolated rat hearts and investigate its underlying mechanism. Pyruvic acid produced a greater negative inotropic effect compared to HCl and sodium pyruvate in a concentration-dependent pattern in the hearts. The role of low dose of pyruvic acid on heart function was regulated by pyruvic acid molecules and high dose pyruvic acid may be influenced by pyruvic acid molecules and pH. K_v channels may be involved in the pyruvic acid-induced negative inotropic effect. Finally, pyruvic acid markedly increased the level of LDH and CK and reduced the level of Ca²⁺Mg²⁺-ATPase and Na⁺K⁺-ATPase. These results suggest that pyruvic acid may modulate cardiac function at physiological or low doses but can cause damage to cardiomyocytes at high doses.     

Ocular dysfunctions and toxicities induced by antiepileptic medications: Types,pathogenic mechanisms,and treatment strategies

Introduction: Ocular dysfunctions and toxicities induced by antiepileptic drugs (AEDs) are rarely reviewed and not frequently received attention by treating physicians compared to other adverse effects (e.g. endocrinologic, cognitive and metabolic). However, some are frequent and progressive even in therapeutic concentrations or result in permanent blindness. Although some adverse effects are non-specific, others are related to the specific pharmacodynamics of the drug.

Areas covered: This review was written after detailed search in PubMed, EMBASE, ISI web, SciELO, Scopus, and Cochrane Central Register databases (from 1970 to 2019). It summarized the reported ophthalmologic adverse effects of the currently available AEDs; their risks and possible pathogenic mechanisms. They include ocular motility dysfunctions, retinopathy, maculopathy, glaucoma, myopia, optic neuropathy, and impaired retinal vascular autoregulation. In general, ophthalmo-neuro- or retino-toxic adverse effects of AEDs are classified as type A (dose-dependent), type B (host-dependent or idiosyncratic) or type C which is due to the cumulative effect from long-term use.

Expert opinion: Ocular adverse effects of AEDs are rarely reviewed although some are frequent or may result in permanent blindness. Increasing knowledge of their incidence and improving understanding of their risks and pathogenic mechanisms are crucial for monitoring, prevention, and management of patients’ at risk.     

Measuring the appropriateness of carbamazepine and valproic acid prescribing and utilization using a newly implemented online system in the Tabuk Region of Saudi Arabia

Epilepsy is a common neurologic disorder, which is efficiently treated with carbamazepine and valproic acid. Moreover, Saudi Ministry of Health implemented a new E-system for Poison Control Centers called Awtar to enhance technology utilization in ensuring patients’ satisfaction and to improve treatment outcomes. Therefore, we conducted this study to assess appropriateness of indication of requests and therapeutic levels of carbamazepine and valproic acid in Tabuk area, North West Saudi Arabia. This is a retrospective observational study conducted in Poison Control & Forensic Chemistry Center, Tabuk, Saudi Arabia. Patients’ data were obtained for years 2018 and 2019. The blood levels of carbamazepine and valproic acid were measured by Therapeutic Drug Monitoring (TDM) Unit. We selected patients treated with either valproic acid or carbamazepine alone without any history of drug allergy. Data of 264 patients were extracted from Awtar E-system. Serum carbamazepine levels were within therapeutic range in 114 patients (75.50%), above-therapeutic range in 13 patients (8.61%) and sub-therapeutic levels in 24 patients (15.89%). Regarding serum valproic acid, it is within therapeutic range in 62 patients (54.87%), above-therapeutic range in 11 patients (9.73%) and sub-therapeutic levels in 40 patients (35.40%). In conclusion, this study gives information about partial appropriateness of usage of carbamazepine and low level of appropriateness of valproic acid. However, more efforts are needed to improve results of appropriateness of indication of antiepileptic drugs.     

PARP7 negatively regulates the type I interferon response in cancer cells and its inhibition triggers antitumor immunity

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Magnetic resonance imaging accurately tracks kidney pathology and heterogeneity in the transition from acute kidney injury to chronic kidney disease

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Comparison of the protective effects of curcumin and caffeic acid phenethyl ester against doxorubicin-induced testicular toxicity

Whether testicular toxicity is mediated by matrix metalloproteinases (MMPs) is an important question that has not been examined. This study investigated the suppressive effect of curcumin and caffeic acid phenethyl ester (CAPE) on oxidative stress, apoptosis, and whether MMPs mediate doxorubicin (DOX)-induced testicular injury. Male rats were randomly divided into eight groups (n = 8 per group). The groups were as follows: sham, dimethyl sulphoxide (100 µL), DOX (3 mg/kg), CAPE (2.68 mg/kg), curcumin (30 mg/kg), DOX+CAPE (3 mg/kg DOX and 2.68 mg/kg CAPE), DOX+curcumin (3 mg/kg DOX and 30 mg/kg curcumin) and DOX+CAPE+curcumin (3 mg/kg DOX, 2.68 mg/kg CAPE and 30 mg/kg curcumin). Injections were administered daily for 21 days. The oxidative stress, MMPs, proinflammatory cytokines and apoptotic markers in the DOX group were higher than the sham group (p < .05); these measures were lower in the groups treated with CAPE and curcumin together with DOX compared with the DOX group (p < .05). The results showed that MMPs mediated DOX-induced testicular injury, but CAPE and especially curcumin suppressed testis injury and cell apoptosis by suppressing DOX-induced increases in MMPs, oxidative stress and proinflammatory cytokines. However, curcumin exhibited more pronounced effects than CAPE in terms of all studied parameters.     

基于一项“多中心、随机对照、双盲”的临床研究探讨影响肾功能进展的因素＊

目的 基于一项前瞻性、多中心、随机、安慰剂对照、双盲的临床试验结果，探索影响肾功能进展的因素。方法 选择343例慢性肾脏病3期的患者，将入组的患者随机分为治疗组和对照组，治疗组给予中药颗粒剂口服，对照组给予安慰剂口服。两组患者均给予基础治疗，疗程24周。评估两组患者肾功能变化情况。治疗结束后，根据患者肾功能情况，以CKD3期为界限，将病情好转者定为A组，该组患者血肌酐下降至CKD2期或CKD1期；病情恶化者为B组，该组患者血肌酐上升至CKD4期或CKD5期；病情稳定者为C组，该组患者血肌酐稳定，仍处于CKD3期，分析各组患者指标的差异。结果 经过24周观察，比较两组患者的血肌酐（Scr）水平，治疗组130.78 ± 32.55 μmol·L^-1，对照组149.12 ± 41.27 μmol·L^-1，两组比较，差异有统计学意义（P < 0.05）。eGFR水平比较，治疗组55.74 ± 50.82 mL/min/1.73 m²，对照组44.46 ± 12.60 mL/min/1.73 m²，差异有统计学意义（P < 0.05）。研究结束后，A组患者血尿酸水平明显低于B组和C组的患者，A组患者血红蛋白水平明显高于B组和C组的患者，A组患者的血磷水平明显低于B组和C组的患者。结论 中药颗粒剂在24周内可以明显改善肾功能，患者的血尿酸水平、血红蛋白及血磷水平对肾功能有一定的影响。