非那雄胺在慢性中心性浆液性脉络膜视网膜病变患者中的应用

目的评估非那雄胺治疗慢性中心性浆液性脉络膜视网膜病变(central serous chorioretinopathy,CSC)的有效性及安全性。方法选取2017年3月至2019年6月在本院确诊的慢性CSC患者31例40眼,采用单臂试验对患者进行非那雄胺治疗。使用非那雄胺治疗后6个月,对患者的视网膜神经上皮层(retinal neuroepithelial layer,RNL)下积液状况,ETDRS视力以及黄斑中心凹视网膜厚度(central foveal thickness,CFT)进行检查。结果非那雄胺治疗后1个月,有10眼(25.0%)RNL下积液完全消退。持续治疗2个月、3个月、4个月、5个月、6个月,分别有7眼(17.5%)、6眼(15.0%)、7眼(17.5%)、3眼(7.5%)及3眼(7.5%)RNL下积液消退,仅有4眼(10.0%)在治疗后6个月RNL下积液仍存在。患眼EDTRS视力非那雄胺治疗后1个月为(50.00±16.11)个字母,与治疗前(46.16±16.67)个字母差异无统计学意义(P=0.2213);治疗后2个月(53.39±14.67)个字母,较治疗前显著升高(P=0.0003);治疗后3个月、4个月、5个月、6个月,分别为(57.39±12.76)个字母、(58.52±12.39)个字母、(59.13±10.76)个字母及(60.42±10.96)个字母,与治疗前相比差异均有统计学意义(均为P<0.0001)。而患眼CFT自治疗后1个月、2个月、3个月、4个月、5个月、6个月分别为(274.10±22.74)μm、(273.00±17.22)μm、(263.50±12.81)μm、(263.90±10.62)μm、(259.70±12.48)μm及(252.60±11.00)μm,与治疗前(296.60±35.41)μm相比,差异均有统计学意义(均为P<0.05)。所有患者均无服药后身体不适或并发症发生。结论非那雄胺对于慢性CSC的治疗安全且有效,有望成为慢性CSC的治疗选择。     

抗生素联合非那雄胺治疗血精症的临床观察

目的探讨及评价抗生素联合非那雄胺选择性治疗炎症性血精症的有效性。方法选择炎症性血精症50例,随机分2组;其中28例联合用药组采用抗生素联合非那雄胺治疗3个月,22例对照组仅用抗生素治疗3个月。结果联合用药组26例血精消失(26/28,92.9%),对照组15例血精消失(15/22,68.2%),两组比较差异有显著性。对照组中7例血精复发,加用非那雄胺治疗3个月后,5例血精消失(5/7,71.4%)。结论血精症主要是下尿路生殖道的炎症,尤其是精囊和前列腺炎引起,联合抗生素和非那雄胺治疗是治疗炎症性血精症的有效方法。     

非那雄胺片的人体生物等效性研究

目的:研究国产与进口非那雄胺片的人体生物等效性。方法:采用高效液相色谱法测定18名健康男性志愿者随机交叉单剂量口服非那雄胺片10mg后血清中的药物浓度,计算药动学参数和相对生物利用度,并进行生物等效性评价。结果:国产及进口非那雄胺片的AUC0～t 分别为(990 .80±302. 80)、(1007 .46±333. 65) (μg·h)/L ,Cmax 分别为(119. 22±18. 48)、(114. 08±22 .97) μg/L ,tmax 分别为(2. 89±1. 02)h、(2. 64±0. 54)h ,国产制剂相对于进口制剂的人体生物利用度为(103. 35±29 .75) %。结论:国产与进口非那雄胺片具有生物等效性。     

非那雄胺联合坦洛新术前应用对经尿道前列腺切除术中出血及手术时间的影响

目的：探讨术前非那雄胺、盐酸坦洛新缓释片联合口服对经尿道前列腺切除术（TURP）术中出血及手术时间的影响。方法：回顾分析2009年8月-2012年5月76例行经尿道前列腺切除术的患者临床资料。根据术前是否联合服用非那雄胺、盐酸坦洛新缓释片随机分成两组,实验组38例术前联合服用非那雄胺、盐酸坦洛新缓释片,对照组38例术前不用非那雄胺、盐酸坦洛新缓释片。比较两组术中出血总量、术中每克切除组织出血量、术中每分钟出血量,并进行两组手术时长对比。结果：实验组术中出血总量、术中每克切除组织出血量、每分钟出血量、手术时长均较对照组减少,差异具有统计学意义（P〈0．05）。两组患者年龄、前列腺体积和切除组织重量之间的差异均无统计学意义（P〉0．05）。结论：术前短期联合服用非那雄胺、盐酸坦洛新缓释片可以减少TURP术中出血、缩短手术时间,对减少TURP手术创伤有一定的积极作用。     

睾丸切除联合非那雄胺治疗前列腺增生的临床效果观察

目的：探讨睾丸切除联合非那雄胺治疗前列腺增生(BPH)的临床效果。方法选取2010年4月~2014年11月在本院治疗的120例BPH患者,随机进行分组,对照组采取睾丸切除术治疗,观察组采取睾丸切除联合非那雄胺治疗,对比两组患者治疗前后的最大尿流率(MFR)、残余尿量(Ur)、前列腺体积(Vp)、国际前列腺症状评分(IPSS)及生活质量(QOL)评分。结果两组患者治疗后的MFR、Ur、Vp、IPSS及QOL评分均有所改善,与治疗前比较差异有统计学意义(P<0.05);观察组治疗后的MFR、Ur、Vp、IPSS及QOL评分改善程度较对照组明显,差异有统计学意义(P<0.05)。结论睾丸切除联合非那雄胺可显著改善BPH的临床症状,其临床疗效优于睾丸切除,值得推广应用。     

Effect of acute ethanol administration and acute allopregnanolone administration on spontaneous hippocampal pyramidal cell neural activity

We investigated the effect of acute ethanol administration and acute allopregnanolone administration on spontaneous hippocampal pyramidal cell neural activity. Both agents produced significant reductions in spontaneous firing rate of hippocampal pyramidal neurons at a medium and high doses. Furthermore, blockade of allopregnanolone biosynthesis by preadministration of finasteride, a 5alpha-reductase blocker, prevented ethanol-induced inhibition on hippocampal pyramidal neural activity. The results further demonstrate similar effects of allopregnanolone and ethanol on hippocampal neurophysiology and that allopregnanolone plays a key role in producing ethanol-induced inhibition of hippocampal neural activity.     

Neuroactive steroid 3 alpha-hydroxy-5 alpha-pregnan-20-one modulates ethanol-induced loss of righting reflex in rats

Systemic ethanol administration elevates plasma and brain levels of GABAergic neuroactive steroids, including 3alpha-hydroxy-5alpha-pregnan-20-one (3alpha,5alpha-THP) that contribute to specific behavioral actions of ethanol. The present study determined the effect of adrenalectomy and 5alpha-reductase type-1/type-2 enzyme inhibition, known to reduce neuroactive steroids, on ethanol-induced increases in cerebral cortical levels of 3alpha,5alpha-THP and hypnotic effects in male rats. Systemic ethanol administration to male rats increases plasma levels of progesterone and corticosterone similar to acute stress, indicating release of these steroids from adrenal glands. Adrenalectomy markedly reduced the elevation of cerebral cortical 3alpha,5alpha-THP and plasma progesterone levels and reduced the duration of ethanol-induced loss of righting reflex. Prior systemic administration of 5alpha-dihydroprogesterone (10 or 15 mg/kg, i.p.), an immediate precursor of 3alpha,5alpha-THP, to adrenalectomized rats not only restored the ethanol-induced increases in cerebral cortical 3alpha,5alpha-THP levels but also reversed the effect of adrenalectomy on ethanol-induced loss of righting reflex. Prior administration of the 5alpha-reductase inhibitor finasteride (2 x 25, 2 x 75 or 2 x 150 mg/kg, s.c.) and the 5alpha-reductase type-1 inhibitor SKF-105,111 (50 mg/kg, i.p.) did not reduce ethanol-induced increases in the cerebral cortical levels of 3alpha,5alpha-THP at hypnotic doses of ethanol. Furthermore, these drugs did not alter the duration of loss of righting reflex. However, significant correlations between cerebral cortical 3alpha,5alpha-THP levels and the duration of loss of righting reflex were obtained regardless of finasteride administration. These results demonstrate the contributory role of neuroactive steroids in the ethanol-induced loss of righting reflex and the source of ethanol-induced elevation of GABAergic neuroactive steroids. Ethanol-induced increases in neurosteroids could be pertinent to the etiology of sleep-related disorders associated with alcoholism.     

非那雄胺与多沙唑嗪联用对鼠前列腺增生模型的影响

目的:探讨非那雄胺与多沙唑嗪联用对鼠前列腺增生模型的影响。方法:将34只雄性W istar大鼠,随机分为模型组(28只)、假手术组(6只)。造模成功后将24只模型鼠随机分为非那雄胺与多沙唑嗪联用、非那雄胺、多沙唑嗪组、阴性对照组,继续予皮下注射丙酸睾酮4mg/d.kg造模,连续4周;假手术组继续予皮下注射等量橄榄油4周。各组实验鼠分别于注射4周后处死,取出前列腺,光镜下观察其形态学变化,计算各实验组前列腺指数(PI)。免疫组化检测bax、fas、bcl-2蛋白表达情况。结果:与阴性对照组相比,给药4周后非那雄胺与多沙唑嗪联用、非那雄胺组PI、bcl-2表达下降(P<0.05),bax、fas表达增加(P<0.05)。结论:两种药物联用显著地降低了鼠前列腺增生的进展,有望成为临床治疗前列腺增生的新方法。     

HPLC-MS法测定血浆中苦参素浓度

目的:建立测定人体血浆中苦参素的HPLC-MS快速测定方法。方法:血样经乙腈沉淀蛋白后取上清液进样,乙腈: 10 mmol·L-1醋酸铵(含0．08％甲酸)(65:35)为流动相,Nucleodurfe CN柱分离后进入质谱,采用电喷雾电离源正离子模式(ESI )选择性离子监测(SIR)准分子离子峰。结果:苦参素浓度在12．5-2000 ng·ml-1范围线性良好(r=0．999 1),日内日间RSD均小于5％,回收率大于95％。结论:该法操作简便、快速、准确。