The treatment of hypertension in pregnancy

Maternal deaths from complications of pregnancy; so-called ‘direct deaths’, including hypertensive disorders, are now less than from indirect causes, (medical conditions that may be exacerbated by pregnancy). The direct death rate in the UK has fallen significantly over the past 5 years. The death rate from hypertensive disorders is at its lowest ever: 0.25/100 × 10³ maternities [95%CI 0.09–0.55]. In other words there is one death from hypertensive disorders for every 400,000 maternities. Having been one of the leading direct causes of maternal mortality, it now lags behind thromboembolic disease, haemorrhage and amniotic fluid embolism. This improvement is likely to reflect careful management not a fall in incidence as hypertensive disorders remain one of the commonest complications of pregnancy.The precise trigger for pre-eclampsia has yet to be elucidated but the pathophysiology involves abnormal placentation and an exaggerated inflammatory response causing a multisystem disorder. Raised or rising blood pressure in a pregnant woman should alert the clinician to look for the development of pre-eclampsia. Diagnosis and treatment of hypertensive disorders in pregnancy is vital they are associated with both a worse maternal and fetal outcome. Current recommendations suggest that all pregnant women with a systolic blood pressure greater than 160 mmHg should have immediate antihypertensive therapy and treatment should be initiated at lower pressures if the overall clinical picture suggests rapid deterioration. Regional anaesthesia is recommended for both labour analgesia and operative delivery. In the presence of compromised placental function and intrauterine growth restriction, regional blockade has the beneficial effect of improving placental blood flow.     

Mineral essential elements for nutrition in different chocolate products

In this work, the essential mineral nutritional elements in cocoa beans, in chocolates at different cocoa percentage (60,70,80 and 90%) and in milk chocolate are evaluated. Dark chocolates are confirmed as an excellent source of magnesium (252.2?mg/100?g) and iron (10.9?mg/100?g): in chocolate containing 90% cocoa, their content corresponds to, respectively, 67.0% and 80.3 of Nutrient Reference Values (NRV) in the European Union. The chocolate containing 90% cocoa is also a good source of zinc (3.5?mg/100?g), which is important for the immune system, and selenium (0.1?mg/100?g). Three main components suitable to explain the mineral concentrations are analyzed by factor analysis. The component 1 can be interpreted as the contribution from the cocoa beans, owing to the mineral characteristics of the soil in which they have grown; the component 2 is mainly due to the manipulation and transformation of the cocoa in chocolate, while the component 3 represents the milk powder.     

重型颅脑损伤患者血清镁离子浓度与免疫球蛋白的关联性

目的对重度颅脑损伤患者血清中镁离子浓度以及免疫球蛋白的关联性进行探讨和分析。方法选取2011年3月至2012年3月该院收治的重度颅脑损伤患者46例,作为研究对象,并按照随机数字表法将其分为治疗组和对照组,每组各23例。分别对2组患者1、4、7、15d后的血清镁离子浓度和免疫球蛋白含量进行检测,并进行格拉斯哥昏迷评分（GCS）和格拉斯哥预后分级（GOS）评分,同时分析血清镁离子浓度与免疫球蛋白含量之间的相关性。结果治疗组患者的免疫球蛋白G（IgG）与免疫球蛋白M（IgM）含量在第4天和第7天分别为（10.96±2.55）、（10.22±2.53）和（1.28±0.31）、（1.33±0.35）g/L,均高于对照组患者的IgG与IgM含量,差异有统计学意义（P〈0.05）,2组患者的免疫球蛋白A（IgA）含量差异无统计学意义（P〉0.05）。患者血清镁离子浓度与IgG、IgM含量呈正相关关系,但与IgA含量无相关性,且2组患者15d后病情改善差异无统计学意义（P〉0.05）。结论重型颅脑损伤患者静脉补充硫酸镁可以改善患者免疫机制的抑制状态,但其改善预后的效果并不明显。     

Multiple effects of magnesium isoglycyrrhizinate on the disposition of docetaxel in docetaxel-induced liver injury

1.?Magnesium isoglycyrrhizinate (MgIg) has been extensively used in treating liver injury which is the common adverse reaction of docetaxel (DOC). Due to the narrow therapeutic window, small changes in pharmacokinetic profiles can alter the toxicity and therapeutic efficacy of DOC significantly. The study aimed to explore the effects of MgIg on the disposition of DOC and the potential mechanism in DOC-induced liver injury.

2.?Pharmacokinetics and tissues distribution behaviors showed that there was no significant difference between DOC group (DOCG) and MgIg?+?DOC group (MDOCG). The mRNA and protein levels of cytochrome P450 3A1 (CYP3A1) in liver, intestine, and kidney were significantly upregulated, and the P-glycoprotein (P-gp) was obviously downregulated in MDOCG when compared with DOCG.

3.?Immunoglobulin M (IgM), CD₈⁺ were upregulated in DOCG; while in MDOCG, IgM, CD₈⁺ recovered to normal levels and complement C₃; CD₄^+? were upregulated.

4.?MgIg had no significant effects on the disposition of DOC in docetaxel-induced liver injury. Additional, potential drug–drug interaction may happen if MgIg co-administered with antitumor drugs which are the substrates of CYP3A4 or P-gp. Hepatoprotective mechanism of MgIg perhaps was through upregulation of C₃, CD₄⁺ and downregulation of IgM, CD₈⁺.     

N-Myc-induced up-regulation of TRPM6/TRPM7 channels promotes neuroblastoma cell proliferation

Intracellular levels of the divalent cations Ca²⁺ and Mg²⁺ are important regulators of cell cycle and proliferation. However, the precise mechanisms by which they are regulated in cancer remain incompletely understood. The channel kinases TRPM6 and TRPM7 are gatekeepers of human Ca²⁺/Mg²⁺ metabolism. Here, we investigated the human neuroblastoma cell line SHEP-21N in which the MYCN oncogene (encoding N-Myc) can be reversibly expressed under control of an inducible repressor. We report that N-Myc expression increases cell growth and up-regulates both TRPM6 and TRPM7 expression. Membrane current analyses reveal that endogenous TRPM6/TRPM7 currents exhibit reduced Mg·ATP suppression, increased Mg²⁺ sensitivity, and diminished sensitivity to 2-APB inhibition. These properties are consistent with N-Myc-induced increase of heteromeric TRPM7/TRPM6 channels promoting Ca²⁺ and Mg²⁺ uptake. Genetic suppression of TRPM6/TRPM7 through siRNA inhibits cell proliferation, suggesting that N-Myc can promote neuroblastoma cell proliferation through up-regulation of divalent cation-transporting channels.     

Preparation and Characterization of Hydroxyapatite Coating on AZ31 Magnesium Alloy Induced by Carboxymethyl Cellulose-Dopamine

Magnesium and its alloys have become potential implant materials in the future because of light weight, mechanical properties similar to natural bone, good biocompatibility, and degradability in physiological environment. However, due to the rapid corrosion and degradation of magnesium alloys in vivo, especially in the environment containing chloride ions, the application of magnesium alloys as implant materials has been limited. Therefore, improving the corrosion resistance of magnesium alloy and ensuring good biocompatibility is the main focus of the current research. In this study, hydroxyapatite coating was prepared on magnesium alloy surface using carboxymethyl cellulose-dopamine hydrogel as inducer to improve corrosion resistance and biocompatibility. Surface characterization techniques (scanning electron microscopy, Fourier-transformed infrared spectroscopy, energy dispersive X-ray spectroscopy- and X-ray diffraction) confirmed the formation of hydroxyapatite on the surface of AZ31 alloy. Corrosion resistance tests have proved the protective effect of Carboxymethyl cellulose-Dopamine/hydroxyapatite (CMC-DA/HA) coating on the surface of AZ31 alloy. According to MC3T3-E1 cell viability and Live/Dead staining, the coating also showed good biocompatibility. The results will provide new ideas for the biological application of magnesium alloys.