丁苯酞软胶囊联合神经节苷脂治疗急性分水岭脑梗死的临床研究

目的探讨丁苯酞软胶囊联合注射用单唾液酸四己糖神经节苷脂钠治疗急性分水岭脑梗死的临床疗效。方法选取2016年1月—2017年10月郑州市第九人民医院收治的急性分水岭脑梗死患者76例作为研究对象,根据随机数字表法将所有患者分为对照组和治疗组,每组各38例。对照组静脉滴注注射用单唾液酸四己糖神经节苷脂钠,100 mg加入到0.9%氯化钠注射液250 m L中,1次/d。治疗组在对照组治疗的基础上口服丁苯酞软胶囊,0.2 g/次,3次/d。两组患者均连续治疗2周。观察两组的临床疗效,比较两组的美国国立卫生研究院卒中量表(NIHSS)评分、Barthel指数(BI)评分、促血栓形成因子和血液流变学指标。结果治疗后,对照组和治疗组的总有效率分别为71.05%、89.47%,两组比较差异有统计学意义(P0.05)。治疗后,两组NIHSS评分显著降低,BI评分明显升高,同组治疗前后比较差异有统计学意义(P0.05);且治疗组NIHSS评分和BI评分明显优于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组抗凝血酶Ⅲ(ATⅢ)水平明显升高,血小板聚集率(PAG)、纤维蛋白原(FIB)、D-二聚体(DD)水平明显降低,同组治疗前后比较差异有统计学意义(P0.05);且治疗组促血栓形成因子水平明显优于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组血浆黏度(PV)、全血高切黏度(HBV)、全血低切黏度(LBV)、红细胞聚集指数(Arbc)水平显著降低,同组治疗前后比较差异有统计学意义(P0.05);且治疗组血液流变学指标水平明显低于对照组,两组比较差异具有统计学意义(P0.05)。结论丁苯酞软胶囊联合注射用单唾液酸四己糖神经节苷脂钠治疗急性分水岭脑梗死具有较好的临床疗效,可调节促血栓形成因子和血液流变学指标,改善神经功能,提升日常生活能力,具有一定的临床推广应用价值。     

单唾液酸四己糖神经节苷脂钠联合脑蛋白水解物治疗帕金森病的疗效观察

目的探讨单唾液酸四己糖神经节苷脂钠联合脑蛋白水解物治疗帕金森病的疗效。方法按照随机数字表法将86例帕金森病患者均分为实验组和对照组,对照组患者单用单唾液酸四己糖神经节苷脂钠注射液治疗,实验组患者采取单唾液酸四己糖神经节苷脂钠注射液联合注射用脑蛋白水解物治疗,比较两组患者治疗效果。结果两组患者治疗后UPDRS总评分均显著下降,与治疗前比较,差异具有统计学意义(P0.05);实验组患者UPDRS总评分显著低于对照组,总有效率显著高于对照组,差异具有统计学意义(P0.05);两组患者不良反应发生率比较,差异无统计学意义(P0.05)。结论单唾液酸四己糖神经节苷脂钠联合脑蛋白水解物能够显著改善帕金森病患者UPDRS评分,临床疗效显著。     

丁苯酞联合单唾液酸四己糖神经节苷脂钠治疗急性进展型脑梗死的疗效分析

目的探讨丁苯酞联合单唾液酸四己糖神经节苷脂钠治疗进展型脑梗死的临床疗效和安全性。方法40例急性进展性脑梗死患者,随机分为实验组和对照组,各20例。实验组给予丁苯酞联合单唾液酸四己糖神经节苷脂钠治疗,对照组给予单唾液酸四己糖神经节苷脂钠治疗。观察比较两组患者在治疗前治疗后美国国立卫生研究院卒中量表(NIHSS)评分、临床疗效、不良反应发生情况。结果入院当日,两组NIHSS评分比较差异无统计学意义(P>0.05);治疗第15天,两组NIHSS评分均低于入院当日,且实验组低于对照组,差异有统计学意义(P<0.05)。实验组临床治疗有效率为90.0%,对照组治疗有效率为60.0%;实验组临床治疗有效率明显高于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论丁苯酞联合单唾液酸四己糖神经节苷脂钠能明显改善进展性脑梗死患者的神经缺损症状,且安全有效。     

脑血疏口服液联合神经节苷脂治疗急性脑出血的疗效观察

目的观察脑血疏口服液联合神经节苷脂治疗急性脑出血的临床疗效。方法选取2012年1月—2015年12月在连云港市赣榆区人民医院接受急性脑出血治疗的患者82例,随机分成对照组和治疗组,每组各41例。对照组患者根据出血情况静脉滴注单唾液酸四己糖神经节苷脂钠注射液,50~80 m L加入到250 m L生理盐水中,1次/d,两周之后根据患者情况减量,维持20~40 m L/d。治疗组患者在对照组的基础上口服脑血疏口服液,10 m L/次,3次/d。两组患者均连续治疗1个月。比较两组患者临床疗效、脑血肿和脑水肿量减少量、神经功能缺损程度(NIHSS)评分、改良Barthel指数(BI)评分以及日常生活能力(ADL)评分变化。结果治疗后,对照组和治疗组总有效率分别为78.05%和92.68%,两组总有效率比较差异具有统计学意义(P0.05)。治疗后,两组患者脑血肿和脑水肿减少量均比治疗前明显减少(P0.05);且治疗后治疗组脑血肿和脑水肿减少量比对照组的更明显(P0.05)。治疗后,两组患者NIHSS评分比治疗前明显降低,BI和ADL评分比治疗前明显升高,同组治疗前后比较差异具有统计学意义(P0.05);且治疗组患者上述指标评分改善程度优于对照组,两组比较差异具有统计学意义(P0.05)。结论脑血疏口服液联合神经节苷脂治疗急性脑出血能有效减少患者脑血肿和脑水肿量,降低神经功能缺损程度,提高改良BI,增强日常生活能力,具有一定的临床推广应用价值。     

三七通舒胶囊联合神经节苷脂治疗急性脑梗死的临床研究

目的研究三七通舒胶囊联合单唾液酸四己糖神经节苷脂钠注射液治疗急性脑梗死的临床疗效。方法选取2016年8月—2018年8月延安大学咸阳医院收治的85例急性脑梗死患者为研究对象,将所有患者随机分为对照组(42例)和治疗组(43例)。对照组患者静脉滴注单唾液酸四己糖神经节苷脂钠注射液,40 mg加入到0.9%氯化钠注射液250 mL中,1次/d;治疗组在对照组基础上口服三七通舒胶囊,1粒/次,3次/d。两组患者持续治疗4周。观察两组的临床疗效,比较两组的美国国立卫生研究院卒中量表(NHISS)评分,以及丙二醛(MDA)、神经元特异性烯醇化酶(NSE)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、脑源性神经营养因子(BDNF)和谷胱甘肽过氧化物酶(GSH-Px)水平。结果治疗后,对照组和治疗组的总有效率分别为83.33%、95.35%,两组比较差异有统计学意义(P0.05)。治疗后,两组MDA、NSE、TNF-α、IL-6水平均显著降低,同组治疗前后比较差异有统计学意义(P0.05);并且治疗组MDA、NSE、TNF-α、IL-6水平明显低于对照组,两组比较差异有统计学意义(P0.05)。治疗后,两组患者NIHSS评分显著降低,同组治疗前后比较差异有统计学意义(P0.05);并且治疗组患者NIHSS评分明显低于对照组,两组比较差异有统计学意义(P0.05)。治疗后,两组患者BDNF和GSH-Px水平均显著升高,同组治疗前后比较差异有统计学意义(P0.05);并且治疗组患者BDNF和GSH-Px水平明显高于对照组,两组比较差异有统计学意义(P0.05)。结论三七通舒胶囊联合单唾液酸四己糖神经节苷脂钠注射液治疗急性脑梗死具有较好的临床疗效,能改善神经功能缺损情况,调节MDA、NSE、TNF-α、IL-6、BDNF和GSH-Px水平,具有一定的临床推广应用价值。     

鼠神经生长因子联合神经节苷脂治疗新生儿脑损伤的临床研究

目的探讨注射用鼠神经生长因子联合单唾液酸四己糖神经节苷脂钠注射液治疗新生儿脑损伤的临床疗效。方法选取2017年1月—2018年3月郑州大学第三附属医院收治的脑损伤患儿178例为研究对象,根据治疗方案分为对照组(98例)和治疗组(80例)。对照组静脉输注单唾液酸四己糖神经节苷脂钠注射液,20 mg/次,1次/d。治疗组在对照组治疗的基础上肌内注射注射用鼠神经生长因子,18μg加入到生理盐水2 mL中,1次/d。两组均治疗10 d后停用20 d,30 d为1个疗程,连续治疗3个疗程。观察两组的临床疗效,比较两组的神经损伤指标、脑干听觉诱发电位和智力情况。结果治疗后,对照组和治疗组的总有效率分别为83.67%、93.75%,两组比较差异有统计学意义(P0.05)。治疗后,两组神经元特异性烯醇化酶(NSE)、髓鞘碱性蛋白(MBP)、S100β蛋白水平均显著下降,同组治疗前后比较差异有统计学意义(P0.05);且治疗组神经损伤指标明显低于对照组,两组比较差异有统计学意义(P0.05)。治疗后,两组潜伏期(PL)、峰间期(IPL)各级均显著下降,同组治疗前后比较差异有统计学意义(P0.05);且治疗组脑干听觉诱发电位指标明显低于对照组,两组比较差异有统计学意义(P0.05)。治疗3月后,两组盖泽尔发育量表适应性发育商(DQ)评分均明显升高,同组治疗前后比较差异有统计学意义(P0.05);且治疗组DQ评分明显高于对照组,两组比较差异有统计学意义(P0.05)。结论注射用鼠神经生长因子联合单唾液酸四己糖神经节苷脂钠注射液治疗新生儿脑损伤具有较好的临床疗效,能改善其智力和神经损伤程度,并缩短患儿脑干听觉诱发电位时长,具有一定的临床推广应用价值。     

叶酸联合单唾液酸四己糖神经节苷脂钠治疗急性脑梗死的疗效及对同型半胱氨酸的影响

目的探讨叶酸联合单唾液酸四己糖神经节苷脂钠治疗急性脑梗死的疗效及对同型半胱氨酸的影响。方法60例急性脑梗死患者,随机分为实验组及对照组,各30例。两组患者入院后均给予以常规药物治疗,实验组给予叶酸联合单唾液酸四己糖神经节苷脂钠治疗,对照组给予单唾液酸四己糖神经节苷脂钠治疗。比较两组患者入院当日及治疗第15天美国国立卫生研究院卒中量表(NIHSS)评分和同型半胱氨酸水平,治疗后临床疗效,不良反应发生情况。结果入院当日,两组患者的NIHSS评分比较,差异无统计学意义(P>0.05);治疗第15天,两组患者的NIHSS评分均低于本组入院当日,且实验组明显低于对照组,差异均具有统计学意义(P<0.05)。入院当日,两组患者的同型半胱氨酸水平比较,差异无统计学意义(P>0.05);治疗第15天,两组患者的同型半胱氨酸水平均低于本组入院当日,且实验组明显低于对照组,差异均具有统计学意义(P<0.05)。实验组临床治疗有效率为86.7%,对照组治疗有效率为63.3%,实验组治疗有效率明显高于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论叶酸联合单唾液酸四己糖神经节苷脂钠能明显改善急性脑梗死患者的神经功能缺损情况,降低同型半胱氨酸水平,安全有效。     

血栓心脉宁胶囊联合单唾液酸四己糖神经节苷脂治疗脑梗死的临床研究

目的探讨血栓心脉宁胶囊联合单唾液酸四己糖神经节苷脂治疗脑梗死的临床效果。方法收集2015年9月—2016年9月在重庆市长寿区人民医院进行治疗的脑梗死患者98例,根据治疗方案的差别分为对照组(49例)和治疗组(49例)。对照组患者静脉滴注单唾液酸四己糖神经节苷脂钠注射液,60 mg加入生理盐水250 m L中,1次/d。治疗组在对照组的基础上口服血栓心脉宁胶囊,4粒/次,3次/d。两组患者均连续治疗4周。比较治疗前后两组患者临床疗效、神经功能缺损评分和神经功能指标差异。结果治疗后,对照组患者的总有效率为79.59%,显著低于治疗组的95.92%,两组比较差异有统计学意义(P0.05)。治疗后,两组患者神经功能缺损评分均明显降低,同组治疗前后比较差异具有统计学意义(P0.05);且治疗组上述评分改善情况显著好于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组血清神经元特异性烯醇化酶(NSE)、血红素氧合酶-1(HO1)、S100β水平均明显降低,胰岛素样生长因子-1(IGF-1)水平升高,同组治疗前后比较差异具有统计学意义(P0.05);且治疗组患者上述指标比对照组改善更显著,两组比较差异具有统计学意义(P0.05)。结论血栓心脉宁胶囊联合单唾液酸四己糖神经节苷脂治疗脑梗死效果显著,可明显改善患者神经功能,具有一定的临床推广应用价值。     

脑心通胶囊联合神经节苷脂治疗急性脑梗死的临床研究

目的探讨脑心通胶囊联合单唾液酸四己糖神经节苷脂钠注射液治疗急性脑梗死的临床疗效。方法选取2016年4月—2017年12月在荆门市中医医院接受治疗的急性脑梗死患者128例为研究对象,将所有患者根据随机数字表法分为对照组和治疗组,每组各64例。对照组静脉滴注单唾液酸四己糖神经节苷脂钠注射液,40 mg加入到0.9%氯化钠溶液250 mL中,1次/d;治疗组在对照组治疗的基础上口服脑心通胶囊,4粒/次,3次/d。两组患者均连续治疗2周。观察两组的临床疗效,比较两组的NIHSS评分、血液流变学指标和血清学指标同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)、S100β蛋白、血管内皮生长因子(VEGF)水平。结果治疗后,对照组和治疗组的总有效率分别为75.00%、90.63%,两组比较差异有统计学意义(P0.05)。治疗后,两组患者NIHSS评分均明显降低,同组治疗前后比较差异有统计学意义(P0.05);且治疗组NIHSS评分明显低于对照组,两组比较差异有统计学意义(P0.05)。治疗后,两组患者全血高切黏度、全血低切黏度、HCT、FIB和红细胞聚集指数均显著降低,同组治疗前后比较差异有统计学意义(P0.05);且治疗组血液流变学指标显著低于对照组,两组比较差异有统计学意义(P0.05)。治疗后,两组患者血清Hcy、hs-CRP、S100β蛋白水平均明显降低,VEGF水平明显升高,同组治疗前后比较差异有统计学意义(P0.05);且治疗组上述指标明显优于对照组,两组比较差异有统计学意义(P0.05)。结论脑心通胶囊联合单唾液酸四己糖神经节苷脂钠注射液治疗急性脑梗死的疗效显著,可改善血液流变学指标,减轻炎症反应,抑制血栓形成,促进患者神经功能的恢复,具有一定的临床推广应用价值。     

神经节苷脂联合血塞通注射液治疗脑梗死的临床研究

目的考察单唾液酸四己糖神经节苷脂钠注射液联合血塞通注射液治疗脑梗死的临床疗效。方法选择2016年1月—2017年1月上海市第四康复医院治疗的92例脑梗死患者作为研究对象,将患者随机分为对照组和治疗组,每组各46例。对照组患者静脉滴注血塞通注射液,600 mg加入到生理盐水250 mL中,1次/d。治疗组在对照组治疗的基础上给予静脉滴注单唾液酸四己糖神经节苷脂钠注射液,100 mg加入到生理盐水250 mL中,1次/d。两组患者均连续治疗14 d。观察两组患者的临床疗效,同时比较两组治疗前后的神经功能缺损评分、生活质量评分和炎症因子水平。结果治疗后,治疗组的总有效率为76.1%,显著高于对照组的60.8%,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者的生理功能、生理职能、情感职能、社会功能、活力、躯体疼痛、精神健康、总体健康评分和总分均显著升高,同组治疗前后比较差异具有统计学意义(P0.05);且治疗后治疗组生活质量各项评分和总分均明显高于对照组,两组比较差异有统计学意义(P0.05)。治疗后,两组患者NIHSS评分显著降低,同组治疗前后比较差异具有统计学意义(P0.05);治疗后治疗组NIHSS评分显著低于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者的血浆C反应蛋白(CRP)和纤维蛋白原(Fg)水平均显著降低,同组治疗前后比较差异具有统计学意义(P0.05);且治疗后治疗组血浆CRP和Fg水平均明显低于对照组,两组比较差异具有统计学意义(P0.05)。结论单唾液酸四己糖神经节苷脂钠注射液联合血塞通注射液治疗脑梗死具有较好的临床疗效,可显著改善患者的神经功能和生活质量,能降低炎症因子水平,具有一定的临床推广应用价值。     

Interindividual variability in metabolic activation in humans in vivo

In assessing interindividual variability in metabolic activation, the toxic metabolite is often too unstable for conventional analysis. Possible alternatives include a stable product of the reactive metabolite e.g. cysteinyl derivatives of N-acetyl-4-benzoquinoneimine, the toxic metabolite of paracetamol, adducts with DNA or protein, and indirect measurement of the activity of the enzyme(s) producing the active metabolite. An example of the last approach is the use of furafylline, a highly specific inhibitor of human CYP1A2, to determine the extent of the metabolic activation of the cooked food mutagens PhIP and MeIQx. The extent of inhibition, determined from levels of unchanged amine in urine, is an indirect measure of the activity of the activation pathway. Further refinement of this approach, allied to improved measures of the biological process of interest should prove of value in evaluating interindividual variability and its role in the risk assessment process.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg.kg) or i.p. (50 mg.kg) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) l.h. kg in the male rat and 10.6 (95% CI: 7.5, 15.0) l.h. kg in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p 0.001) in plasma obtained from the male (8.8 2.0%) compared with the female rat (11.7 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Theophylline kinetics in peripheral tissues in vivo in humans

Several biochemical and cellular effects have been described for methylxanthines under in vitro conditions. However, it is unknown, whether threshold concentrations required to exert these effects are attained in target tissues in vivo. We therefore employed the microdialysis technique for measuring theophylline concentrations in peripheral tissues under in vivo conditions.Following in vitro and in vivo calibration, microdialysis probes were inserted into the medial vastus muscle and into the periumbilical subcutaneous adipose layer of healthy volunteers. Following single oral dose administration of 300 mg or i.v. infusion of 240 mg theophylline, in vivo time courses of theophylline concentrations were monitored in tissues and plasma. Major pharmacokinetic parameters (c_max, t_max, AUC) were calculated for plasma and tissue time courses. The mean AUC_tissue /AUC_plasma-ratio was 0.56 (p.o.) and 0.55 (i.v.) for muscle and 0.55 (p.o.) and 0.72 (i.v.) for subcutaneous adipose tissue.We conclude that microdialysis provides important information on the distribution and the tissue pharmacokinetics of theophylline.Abbreviations FPIA Fluorescence polarisation immuno assay - AUC Area under the curve - t_max Time to peak concentration - c_max Peak concentration     

休克时血中氧自由基的变化

本实验测定10名休克患者血浆和红细胞的丙二醛(MDA)、血浆总抗的氧化活性(AOA)的含量。结果表明:休克病人红细胞膜和血浆 MDA 含量(4.298±0.722;5.348±0.834)与对照组(3.235±0.682;4.356±1.081)比较明显增高(P<0.05);血浆 AOA(39.65±7.858)与对照组(48.21±10.81)比较明显降低(P<0.01)。提示:休克时,患者机体内自由基反应增强是引起组织细胞损伤的原因之一。     

Polymorphisms in genes involved in neurotransmission in relation to smoking

Smoking behavior is influenced by both genetic and environmental factors. The genetic contribution to smoking behavior is at least as great as its contribution to alcoholism. Much progress has been achieved in genomic research related to cigarette-smoking within recent years. Linkage studies indicate that there are several loci linked to smoking, and candidate genes that are related to neurotransmission have been examined. Possible associated genes include cytochrome P450 subfamily polypeptide 6 (CYP2A6), dopamine D₁, D₂, and D₄ receptors, dopamine transporter, and serotonin transporter genes. There are other important candidate genes but studies evaluating the link with smoking have not been reported. These include genes encoding the dopamine D₃ and D₅ receptors, serotonin receptors, tyrosine hydroxylase, trytophan 2,3-dioxygenase, opioid receptors, and cannabinoid receptors. Since smoking-related factors are extremely complex, studies of diverse populations and of many aspects of smoking behavior including initiation, maintenance, cessation, relapse, and influence of environmental factors are needed to identify smoking-associated genes. We now review genetic polymorphisms reported to be involved in neurotransmission in relation to smoking.     

Tramadol concentrations in blood and in cerebrospinal fluid in a neonate

Based on blood and cerebrospinal fluid samples collected in a full-term neonate, the penetration of tramadol in the central nervous system is described. Following intravenous administration of tramadol, a lag time of about 4 h was observed until full blood–brain equilibration was achieved. This pharmacokinetic observation is in line with a recent pharmacodynamic evaluation of the central opioid effects of tramadol in adults.     

Disease control in asthmatic children seen in private practice in Switzerland

ABSTRACT

Background: Asthma is the most common chronic childhood disease in Switzerland with a prevalence of 10%. Asthma has a high economic burden accounting for high medical costs. Assessment of disease control is likely to be of help in the implementation of strategies to improve asthma. Therefore, we aimed to evaluate asthma control and therapy regimens among children in private practice.

Methods: We assessed asthma control as well as therapy regimens in 575 asthmatic children in an experience programme in Switzerland by using an abbreviated questionnaire based on the asthma control questionnaire and the child health questionnaire on Visit 1 and Visit 2.

Results: Good asthma control at Visit 1 was only present in 25.7% of asthmatic children. Occasional asthma symptoms, limitation of physical activity, nocturnal awakening and anxiety of the parent was present in 80.5%, 41.2%, 46.8% and 57% of the children, respectively. After adjustment of therapy regimens at Visit 1, mainly by adding a leukotriene receptor antagonist, asthma control was reported to be much better in 53.4% of the children at Visit 2.

Conclusions: As asthma control is inadequately achieved within a major portion of asthmatic children, it is imperative to find measures to improve asthma control and hence, to reduce the burden of disease.