阿昔洛韦联合奥卡西平对单纯性疱疹病毒性脑炎伴癫痫患儿的疗效及安全性

目的探究阿昔洛韦联合奥卡西平对单纯性疱疹病毒性脑炎伴癫痫患儿的临床疗效及安全性。方法将我院2014年7月至2018年9月收治的经临床确诊为单纯性疱疹病毒性脑炎伴癫痫的98例患儿随机分为对照组和观察组,每组49例。对照组给予阿昔洛韦联合左乙拉西坦口服液进行治疗,观察组给予阿昔洛韦联合奥卡西平口服混悬液进行治疗。对比分析两组患儿的临床有效率、血清NSE及炎性因子IL-1β、IL-6和TNF-α的表达、患儿的生活质量改善效果以及后遗症复发率。结果观察组患儿总有效率高于对照组(91.84%vs.65.31%,P<0.05)。观察组患儿治疗后血清NSE及炎性因子IL-1β、IL-6和TNF-α的表达较对照组患儿明显降低,差异有统计学意义(P<0.05)。观察组患儿的日常生活质量评分高于对照组(P<0.05)。此外,观察组患儿出现高热、颅内高压、意识障碍、抽搐和锥体外系反应等后遗症复发率低于对照组(6.12%vs.30.61%,P<0.05)。结论阿昔洛韦联合奥卡西平治疗单纯性疱疹病毒性脑炎伴癫痫患儿具有良好的临床疗效,可显著提升患儿的日常生活质量,降低患儿的后遗症复发率。     

In vivo pharmacological effects of JZP-4, a novel anticonvulsant, in models for anticonvulsant, antimania and antidepressant activity

JZP-4 is a potent calcium and sodium channel blocker, which is currently being evaluated in patients as an anticonvulsant and mood stabilizer. In the current studies, JZP-4 was evaluated in a variety of animal models for anticonvulsant, antimania and antidepressant activity. In the mouse and rat maximal electroshock models, JZP-4 was slightly more potent than LTG. In the mouse pentylenetetrazole induced seizures model, JZP-4 was approximately twice as potent as lamotrigine in prolonging the time to clonus. In the mouse 6-Hz model for drug resistant or refractory epilepsy, JZP-4 had potent anticonvulsant activity at all current intensities, whereas LTG was active at only the lowest current intensity. In the mouse amphetamine-chlordiazepoxide model for antimanic effects, JZP-4, but not LTG, produced dose-related and significant effects at 3 and 10 mg/kg i.p. In the rat forced swim model of antidepressant activity, JZP-4 (30 mg/kg i.p.) produced a significant reduction in immobility and an increase in climbing behavior. LTG (30 mg/kg i.p.) produced similar effects but these effects did not achieve statistical significance. The specificity of this antidepressant response was confirmed in the rat locomotor test. In this test, JZP-4 produced dose-related and significant reductions in locomotor activity, indicating that it was not a CNS stimulant. LTG produced no significant effects in the rat locomotor test. The studies have demonstrated that JZP-4 has greater potency and efficacy than LTG in models of refractory epilepsy, antidepressant activity and antimania activity. The variance between the effects of LTG and JZP-4 may be related to the greater potency at sodium channels or the additional pharmacological actions of JZP-4 on calcium channels.     

mGlu1 and mGlu5 receptor antagonists lack anticonvulsant efficacy in rodent models of difficult-to-treat partial epilepsy

Modulation of metabotropic glutamate (mGlu) receptors represents an interesting new approach for the treatment of a range of neurological and psychiatric disorders. Several lines of evidence suggest that functional blockade of group I (mGlu1 and mGlu5) receptors may be beneficial for treatment of epileptic seizures. This study was conducted to investigate whether mGlu1 or mGlu5 receptor antagonists have the potential to block partial or secondarily generalized seizures as occurring in partial epilepsy, the most common and difficult-to-treat type of epilepsy in patients. For this purpose, we systemically administered novel highly selective and brain penetrable group I mGlu receptor antagonists, i.e., the mGlu1 receptor antagonist EMQMCM [3-ethyl-2-methyl-quinolin-6-yl-(4-methoxy-cyclohexyl)-methanone methanesulfonate] and the mGlu5 receptor antagonist MTEP ([(2-methyl-1,3-thiazol-4-yl) ethynyl] pyridine), at doses appropriate for mGlu1 or mGlu5 receptor-mediated effects in rodent models of partial seizures. Two models were used: the 6-Hz electroshock model of partial seizures in mice and the amygdala-kindling model in rats. Clinically established antiepileptic drugs were included in the experiments for comparison. Antiepileptic drugs exerted significant anticonvulsant effects in both models, while EMQMCM and MTEP were ineffective in this regard, although both compounds were administered up to doses associated with essentially full receptor occupancy and with typical mGlu receptor-mediated effects in rodent models of anxiety or pain. Brain microdialysis for determining extracellular levels of MTEP following i.p. administration in rats substantiated that effective brain concentrations were reached at times of our experiments in seizure models. The present results do not support a significant anticonvulsant potential of group I mGlu receptor antagonists in rodent models of difficult-to-treat partial epilepsy.     

Postsynaptic actions of substance P on rat periaqueductal grey neurons in vitro

The postsynaptic actions of substance P on rat midbrain periaqueductal grey (PAG) neurons were examined using whole-cell patch-clamp recordings in brain slices. Substance P produced an inward current in a subpopulation (60%) of PAG neurons. The substance P induced current was concentration dependent (EC50=27 nM) and was reduced by the NK1, NK2 and NK3 antagonists L-732,138 (20 microM), GR 159897 (3 microM) and SB 218795 (3 microM). The selective NK1, NK2 and NK3 agonists [Sar9,Met(O2)11]-Substance P (100 nM), GR 64349 (300-500 nM) and senktide (300 nM) also produced inward currents in subpopulations of neurons. A greater proportion of substance P-sensitive neurons (70%) than substance P-insensitive neurons (31%) responded to the mu/delta opioid agonist met-enkephalin (10 microM). Substance P reduced the outward current produced by met-enkephalin. The reversal potential of the substance P induced current varied from -5 mV to below -140 mV in the absence of met-enkephalin, and was -105 mV in the presence of met-enkephalin. These results indicate that substance P acts via NK1, NK2 and NK3 receptors to excite subpopulations of opioid-sensitive and insensitive PAG neurons by increasing a non-selective cation conductance and by reducing a K+ current. In addition, substance P has anti-opioid actions that are largely mediated by a reduction in the opioid induced K+ current.     

Cardioprotective actions of human superoxide dismutase in two reperfusion models of myocardial ischaemia in the rat.

1. In rats under ether anaesthesia, the left coronary artery was ligated and reperfused after 10 min of ischaemia. Forty-eight hours later the myocardium was analyzed for creatine kinase (CK) activity. 2. Human superoxide dismutase (h-SOD) given 1 min after occlusion and again 6 h later significantly improved survival and retarded the loss of myocardial CK. 3. In rat isolated hearts perfused at 15% of normal flow for 30 min followed by re-establishment of normal flow for 20 min, perfusion pressure increased by 72% and myocardial CK decreased by 44%. No significant changes occurred in wet-to-dry heart weight ratio. 4. Administration of h-SOD at 2.5 or 5.0 mg, significantly attenuated the elevated post-ischaemic perfusion pressure and the loss of myocardial CK activity in rat perfused hearts. 5. h-SOD appears to be an effective anti-ischaemic agent in the intact animal as well as the isolated perfused heart of the rat subjected to low flow followed by reperfusion at normal flow. The mechanism of this cardioprotective effect is not totally dependent upon the formed elements of the blood, but may be partially due to a direct cytoprotective effect.     

咪达唑仑对交感神经元电压门控性钾电流的影响

目的 :观察不同浓度咪达唑仑对交感神经元电压门控钾通道电流的影响 ,探讨临床浓度咪达唑仑对钾电流的作用是否与抑制交感神经系统有关。方法 :用酶消化法获得急性分离的SD大鼠 (7～1 0d)颈上交感神经节细胞 ,应用膜片钳技术记录不同浓度的咪达唑仑对电压门控钾电流的影响。结果 :在钳制电位 (Vh) -80mV ,刺激电压 (Vt) -1 0 0mV～ 3 0mV ,时程 1 60ms条件下 ,不同浓度的咪达唑仑对电压门控钾电流均有抑制作用 ,且呈浓度依赖性。临床相关浓度的咪达唑仑(0 .3 μmol·L-1)使钾通道电流峰值下降3 .89% (P =0 .88)。5 0 %钾通道电流峰值受抑制时的咪达唑仑浓度(IC50 )约为 70 .0 6μmol·L-1。结论 :咪达唑仑对交感神经元电压门控钾电流具浓度依赖性抑制作用 ,但临床浓度咪达唑仑对钾电流影响较小。     

Diuretic and hypotensive actions of torasemide in hypertensive models of rat

The diuretic and the antihypertensive actions of torasemide were examined in renal and genetic hypertensive rats and compared to the effects of furosemide. Oral administration of torasemide (1 and 3 mg/kg) elicited a dose-dependent increase in the excretion of urine and electrolytes and elevated the urinary Na/K ratio in both renal and genetic hypertensive rats. Torasemide and furosemide had a similar maximum diuretic effect in the normotensive Wistar rat and the spontaneously hypertensive rat (SHR). However, the diuretic activity of furosemide was weaker in the renal hypertensive rat (RHR). Torasemide showed approximately 30 times greater diuretic potency than furosemide. Torasemide and furosemide demonstrated hypotensive action in hypertensive rat models, but not in the normotensive Wistar rat. Especially in the RHR, torasemide exhibited a more potent hypotensive action than furosemide. These results show that the diuretic and antihypertensive activities of torasemide are effective in various rat models of hypertension, while the diuretic activity of furosemide is weak in certain hypertensive rat models. © 1992 Wiley-Liss, Inc.     

Effect of methamphetamine on potassium and L-type calcium currents in rat ventricular myocytes

The mechanisms of cardiac toxicity caused by methamphetamine (MA) are poorly understood at present. This study was designed to investigate the effects of MA on ionic currents in myocardial cells. The effects of MA on transient outward potassium current (I_to), inward rectifying potassium current (I_K1), and L-type calcium current (I_Ca-L) in isolated rat ventricular myocytes were studied using the whole-cell patch clamp technique. It was demonstrated that MA inhibited the I_to, I_K1, and I_Ca-L in the rat ventricular myocytes concentration-dependently. MA shifted left the I_to steady-state inactivation curve and shifted down the recovery curve, but had no influence on the steady-state activation curve. MA did not affect the I_Ca-L steady-state activation curve or steady-state inactivation curve, but shifted down the recovery curve. We concluded that MA had inhibitory effects on the I_to, I_K1, and I_Ca-L in ventricular myocytes, which might be one of the possible electrophysiological mechanisms of cardiac damage caused by MA.     

苄基四氢巴马汀对豚鼠和大鼠心室肌细胞钾电流的作用

目的:研究苄基四氢巴马汀(BTHP)对心室肌细胞快激活(I_(Kr))和慢激活(I_(Ks))延迟整流钾电流、内向整流钾电流(I_(Kl))和瞬时外向钾电流(I_(to))的作用.方法:采用全细胞膜片箝技术记录豚鼠及大鼠心室肌细胞钾电流.结果:BTHP在 1-100 μmol/L的范围内以浓度依赖性方式阻滞I_(Kr)和I_(Ks),其中对I_(Kr)的IC_(50)为 13.5 μmol/L(95％可信限:11.2-15.8 μmol/L)而对 I_(Ks)的 IC_(50)则为 9.3 μmol/L(95％可信限:7.8-11.8 μmol/L).BTHP 30μmol/L时可使 I_(Kr)及I_(Kr,tail)分别降低31％±4％和36％±5％(n=6,P<0.01);使I_(Ks)及I_(Ks,tail)分别降低40％±6％和45％±15％(n=7,P<0.01);BTHP 5μmol/L可抑制大鼠心室肌细胞I_(to)电流,使电流幅值降低63％±6％(n=6,P<0.01),BTHP1-100μmol/L以浓度依赖性方式阻滞入I_(to),其 IC_(50)为 3.6 μmol/L(95％可信限:2.9-4.3μmol/L).但BTHP 200 μpmol/L对I_(Kl)基本无影响.结论:BTHP对I_(Kr)、I_(Ks)、I_(to)均有抑制作用,且其阻滞作用呈现出浓度依赖性特征.     

The anticonvulsant retigabine attenuates nociceptive behaviours in rat models of persistent and neuropathic pain

We have tested for anti-nociceptive effects of the anticonvulsant KCNQ channel opener, N-(2-amino-4-(4-fluorobenzylamino)-phenyl)carbamic acid ethyl ester (retigabine), in rat models of experimental pain. In the chronic constriction injury and spared nerve models of neuropathic pain, injection of retigabine (5 and 20 mg/kg, p.o.) significantly attenuated (P<0.05) mechanical hypersensitivity in response to pin prick stimulation of the injured hindpaw. In contrast, retigabine had no effect on mechanical hypersensitivity to von Frey stimulation of the injured hindpaw in either model. Cold sensitivity in response to ethyl chloride was only attenuated (P<0.05) in the chronic constriction injury model. In the formalin test, retigabine (20 mg/kg, p.o.) attenuated flinching behaviour in the second phase compared with vehicle (P<0.05), and this effect was completely reversed by the KCNQ channel blocker 10,10-bis(4-pyridinylmethyl)-9(10H)-anthracenone (XE-991; 3 mg/kg, i.p.). Neither retigabine nor XE-991 administration affected the latency to respond to noxious thermal stimulation of the tail in control animals. These results suggest that retigabine may prove to be effective in the treatment of neuropathic pain.     

胺碘酮对大鼠心肌梗死后重构心肌细胞钾电流的作用

目的观察胺碘酮对大鼠心肌梗死后重构心肌钾通道的作用,探讨胺碘酮对心肌梗死后电重构的影响。方法采用脂肪乳灌胃方法建立大鼠高脂血症模型后结扎冠状动脉左前降支建立急性心肌梗死动物模型,应用全细胞膜片钳技术记录急性心肌梗死模型大鼠胺碘酮灌胃1wk后重构区心室肌细胞内向整流钾电流(Ik1)、瞬时外向钾电流(Ito)的变化。结果在实验电压-120mV时,模型组大鼠心室肌细胞Ik1为(-15.66±1.40)PA/PF,较正常组(-21.02±1.95)PA/PF降低(n=4,P<0.01),胺碘酮组(-11.07±1.11)PA/PF,较模型组明显降低(n=4,P<0.05)。在实验电压+50mV时,模型组大鼠心室肌细胞内Ito为(7.29±1.02)PA/PF,较正常组(13.24±1.16)PA/PF降低(n=4,P<0.01),胺碘酮组(4.12±1.01)PA/PF,较模型组降低(n=4,P<0.05)。结论胺碘酮抑制心梗后重构心肌细胞的Ik1、Ito,影响动作电位的复极过程。     

Contributions of peripheral and central opioid receptors to antinociception in rat muscle pain models

Administration of hypertonic saline (HS) is an accepted model to study muscular pain. HS-induced nociceptive responses were tested in masseter, already described, and in two new pain models of spinally innervated muscles (gastrocnemius and triceps) developed in rats at our laboratory. HS administration in the masseter induced vigorous hindpaw shaking and in the gastrocnemius or triceps, paw withdrawal or flexing. Participation of the central and peripheral opioid receptors in HS-induced pain is compared in these muscles: masseter, innervated by trigeminal nerve, and gastrocnemius and triceps by spinal nerves. Morphine and loperamide were used to reveal peripheral and central components of opioid analgesia. Both agonists reduced HS-induced nociceptive behaviours in the masseter and were antagonised by the opioid antagonist naloxone and by naloxone methiodide, an opioid receptor antagonist that poorly penetrates the blood-brain barrier. Unexpectedly, in the gastrocnemius and triceps, morphine, but not loperamide, decreased the nociceptive behaviour and this effect was only reversed by naloxone. So, peripheral opioid receptors seem to participate in HS-induced masseter pain, whereas only central opioid receptors reduced the nociception in gastrocnemius and triceps. Our results suggest that the use of peripheral opioids can be more advantageous than central opioids for treatment of orofacial muscular pain.     

Effects of flunarizine on spontaneous synaptic currents in rat neocortex

Flunarizine, a non-selective blocker of voltage-dependent Ca²⁺ and Na⁺ channels, is clinically effective against several neurological disorders, including epilepsy, migraine, and alternating hemiplegia of childhood. We examined the effects of flunarizine on spontaneous post-synaptic currents in acute brain slices maintained in vitro using patch-clamp electrophysiology. Flunarizine significantly attenuated the amplitude of spontaneous currents in pyramidal neurons from juvenile rat neocortex. Flunarizine had no effect on miniature spontaneous events recorded in the presence of tetrodotoxin, a blocker of voltage-dependent sodium channels. In high (9 mM) extracellular potassium, flunarizine reduced the amplitude and frequency of the spontaneous currents. Additionally, dimethyl sulfoxide, the solvent used in our experiments, reduced the amplitude of spontaneous currents, but only in high extracellular potassium. Our data suggest that the clinical activity of flunarizine may in part be a consequence of reducing spontaneous synaptic currents in the neocortex, especially under conditions of heightened neuronal activity.     

N-甲基小檗胺对大鼠肠系膜动脉平滑肌细胞钙激活钾电流的作用

目的研究N-甲基小檗胺对大鼠肠系膜阻力血管平滑肌细胞钙激活钾电流(IK·Ca)的作用,以阐明其降血压的离子机制。方法膜片钳技术全细胞记录模式记录IK·Ca。结果指令电位为+60mV时,N-甲基小檗胺0·1,1,10μmol·L-1使IK·Ca幅值分别由给药前的(33·6±2·0)pA·pF-1增至给药后的(35·7±1·9),(42·9±2·7)和(59·4±1·4)pA·pF-1(n=6,P<0·01)。结论N-甲基小檗胺可以增加大鼠肠系膜阻力血管平滑肌细胞钙激活钾电流,这可能是其降压机制之一。     

Aldosterone and the autocrine modulation of potassium currents and oxidative stress in the diabetic rat heart

BACKGROUND AND PURPOSE: Aldosterone plays a major role in cardiac pathology. This study was designed to investigate the role of cardiac aldosterone in modulating K(+) currents and oxidative stress in the streptozotocin-induced diabetic rat heart. EXPERIMENTAL APPROACH: Transient and sustained K(+) currents were measured in ventricular myocytes by voltage clamp. Plasma and cellular aldosterone were measured by ELISA. Fluorescent dihydroethidium (DHE) was used to assess superoxide ions as markers of oxidative stress. KEY RESULTS: The mineralocorticoid antagonist spironolactone (1 microM, 5-9 h) significantly augmented both K(+) currents in diabetic males, with a concomitant shortening of the action potential but had no effect in myocytes from control males or from diabetic females. Effects of spironolactone were restored in ovariectomized diabetic females and abolished in orchidectomized diabetic males. The aldosterone synthase inhibitor FAD286 (1 microM, 5-9 h) significantly augmented K(+) currents in cells from diabetic males, but not females. Spironolactone and FAD286 significantly reduced oxidative stress in cells from diabetic males. Plasma aldosterone content was elevated in diabetic males (relative to control), but not in females. Cellular aldosterone was also elevated, but not significantly. The elevation in aldosterone was only partly dependent on a concomitant increase in cellular angiotensin II. CONCLUSIONS AND IMPLICATIONS: A gender-related, sex-hormone-dependent elevation in plasma and cardiac cell aldosterone contributed to oxidative stress and to attenuation of K(+) currents in diabetic male rats. Aldosterone may thus contribute to diabetes-associated cardiac arrhythmias. Aldosterone elevation was partly related to levels of angiotensin II, but residual, angiotensin II-independent, aldosterone maintains functional relevance.     

Levcromakalim-induced modulation of membrane potassium currents,intracellular calcium and mechanical activity in rat mesenteric artery

In freshly-dispersed cells from rat mesenteric artery, levcromakalim (1 and 10 M) induced a non-inactivating potassium current (I_KCO), an event which was associated with increased current noise. I_KCO was fully inhibited in the presence of 10 M glibenclamide. Stationary fluctuation analysis of the current noise associated with I_KCO induced by levcromakalim at a holding potential of –10 mV indicated that the unitary conductance of the underlying K-channels was 10.2 pS at 0 mV under the quasi-physiological conditions of the experiment.In isolated arterioles both levcromakalim (10 nM - 10 M) and nifedipine (10 nM - 10 M) each elicted full, concentration-dependent, parallel reductions of the increases in [Ca²⁺]_i (assessed using fura-2) and tension induced by 10 M noradrenaline. However, the effects of both drugs on KCl-induced increases in tension and in [Ca²⁺]_i, did not follow a simple relationship. Levcromakalim relaxed KCl- and noradrenaline-induced sustained contractions with a similar potency. This was in contrast to nifedipine which was approximately 20 times more potent against KCl-induced contractions.It is concluded that levcromakalim relaxes rat mesenteric arterioles primarily by the opening of a small conductance, glibenclamide-sensitive K-channel. An additional action of levcromakalim is suggested by its relative inability to suppress the increase in [Ca²⁺]_i produced by 30 mM K⁺-PSS. Correspondence to: A. H. Weston at the above address     

N-甲基小檗胺对大鼠肠系膜阻力血管平滑肌细胞钙激活钾电流的作用(英文)

目的　研究N 甲基小檗胺对大鼠肠系膜阻力血管平滑肌细胞钙激活钾电流 (IK·Ca)的作用 ,以阐明其降血压的离子机制。方法　膜片钳技术全细胞记录模式记录IK·Ca。结果　指令电位为 +6 0mV时 ,N 甲基小檗胺 0 .1,1,10 μmol·L- 1使IK·Ca幅值分别由给药前的 ( 33.6± 2 .0 )pA·pF- 1增至给药后的( 35 .7± 1.9) ,( 42 .9± 2 .7)和 ( 5 9.4± 1.4 )pA·pF- 1(n =6 ,P <0 .0 1)。结论　N 甲基小檗胺可以增加大鼠肠系膜阻力血管平滑肌细胞IK·Ca,这可能是其降血压机制之一。     

他克林对培养大鼠海马神经元延迟整流钾电流和瞬间外向钾电流的影响

目的研究他克林对培养大鼠海马神经元上延迟整流钾电流(I_K)和瞬间外向钾电流(I_A)的影响。方法 大鼠海马神经元原代培养,全细胞膜片钳记录培养大鼠海马神经元上电压依赖性外向钾电流和瞬间外向钾电流变化。结果他克林明显抑制海马神经元延迟整流钾电流和瞬间外向钾电流,呈浓度依赖性,对延迟整流钾电流的敏感性高于瞬间外向钾电流。30 μmol·L^-1他克林显著影响I_K和I_A稳态激活曲线,使所有电流的V_1/2左移。结论他克林明显抑制延迟整流钾电流和瞬间外向钾电流,对延迟整流钾电流的敏感性高于瞬间外向钾电流。     

Dose-dependent proconvulsant and anticonvulsant actions of the alpha 2 adrenergic agonist, xylazine, on kindled seizures in the rat

The effects of the alpha 2 adrenergic agonist, xylazine, was evaluated on kindling acquisition and on kindled seizure expression in rats. Dose-dependent proconvulsant and anticonvulsant properties were found. The proconvulsant effects were observed at low (0.3 mg/kg) doses. In previously kindled rats these consisted of a decrease in afterdischarge threshold and an increase in the length and severity of the accompanying seizure. This dose also facilitated the rate of kindling in naive subjects. The anticonvulsant effects were observed at higher dose levels (3-20 mg/kg) which also produced sedation and ataxia. If these effects upon kindling are related to the adrenergic actions of xylazine, then it is proposed that the proconvulsant effects are associated with alpha 2 receptor activation and the anticonvulsant effects with alpha 1 receptor activation.