法舒地尔联合依达拉奉对颅内破裂动脉瘤术后脑血管痉挛患者的影响研究

目的 探究法舒地尔联合依达拉奉治疗颅内破裂动脉瘤术后脑血管痉挛患者的临床效果。方法 100例颅内破裂动脉瘤术后脑血管痉挛患者,随机分为实验组和对照组,每组50例。对照组患者采用依达拉奉治疗,实验组患者采用法舒地尔联合依达拉奉治疗。比较两组患者症状性血管痉挛和迟发性脑梗死发生情况,治疗前后可溶性细胞间黏附分子1(SICAM-1)、天冬氨酸特异性半胱氨酸蛋白酶-3(Caspase-3)水平及大脑中动脉(MCA)平均血流速度。结果 实验组症状性血管痉挛和迟发性脑梗死发生率分别为10.0%、8.0%,均低于对照组的30.0%、24.0%,差异均具有统计学意义(P<0.05)。治疗后,两组患者SICAM-1、Caspase-3水平均低于治疗前,且实验组患者SICAM-1水平(295.24±86.46)μg/L、Caspase-3水平(156.35±50.06)μg/L均低于对照组的(383.26±79.67)、(312.53±66.57)μg/L,差异均具有统计学意义(P<0.05)。两组患者MCA平均血流速度均高于治疗前,且实验组MCA平均血流速度(141.62±34.17)cm/s高于对照组的(122.11±26.42)cm/s,差异均具有统计学意义(P<0.05)。结论 法舒地尔联合依达拉奉对颅内破裂动脉瘤术后脑血管痉挛的效果显著,值得在临床上广泛推广。     

丹参注射液联合依达拉奉预防颅内动脉瘤术后脑血管痉挛的临床疗效观察

目的观察丹参注射液联合依达拉奉预防颅内动脉瘤术后脑血管痉挛的的临床效果及安全性。方法将2012年6月至2013年1月在我院神经内科住院治疗的64例颅内动脉瘤患者随机分成两组,通过显微外科手术夹闭及介入治疗后,对照组接受常规治疗（尼莫地平注射液,长春西汀等）,治疗组在常规治疗的基础上使用丹参注射液联合依达拉奉治疗,2周后进行疗效评定。结果两组治疗后7、14天,MCA的平均流速与治疗前相比均显著降低,（P〈0．05）;治疗后第7天,治疗组MCA的平均流速显著低于对照组（P〈0．05）;治疗后第14天,两组MCA平均流速的差异无统计学意义（P〉0．05）,脑血管痉挛发生率的差异有统计学意义（P〈0．05）,脑梗死发生率、死亡率及不良反应发生率的差异均无统计学意义（P〉0．05）。结论丹参注射液联合依达拉奉预防颅内动脉瘤术后脑血管痉挛的的临床效果显著,副作用小,可以作为预防颅内动脉瘤术后脑血管痉挛的联合方案。     

法舒地尔防治蛛网膜下腔出血并发脑血管痉挛临床疗效分析

目的 探讨法舒地尔防治动脉瘤破裂蛛网膜下腔出血后脑血管痉挛的临床疗效.方法 采用回顾性分析的方法,动脉瘤破裂蛛网膜下腔出血后脑血管痉挛患者临床资料,依据治疗方式不同分为观察组和对照组.结果 观察组患者治疗后GCS评分明显优于对照组;观察组患者治疗后大脑中动脉平均血流速度明显低于对照组（P＜0.05）.观察组患者治疗后致残率、病死率均低于对照组（P＜0.05）.结论 法舒地尔联合常规治疗动脉瘤破裂蛛网膜下腔出血后脑血管痉挛临床疗效明显,预后良好,值得临床推广应用.     

依达拉奉联合高压氧治疗颅内动脉瘤术后脑血管痉挛的临床疗效

目的　观察依达拉奉联合高压氧（HBO）治疗颅内动脉瘤术后脑血管痉挛的临床疗效和安全性。方法　选取我院收治的52 例颅内动脉瘤蛛网膜下腔出血的术后患者，随机分为观察组和对照组，每组26 例。对照组采用依达拉奉常规治疗，观察组在对照组治疗的基础上联合HBO 治疗。治疗前和治疗后4 周，经颅多谱勒超声（Transcraninal Doppler，TCD）测量大脑中动脉平均血流速度评价血管痉挛程度，采用NIHSS 评价神经功能缺损程度，MBI 评价日常生活活动能力，并观察和比较两组患者不良反应的发生情况。结果　治疗4 周后，观察组大脑中动脉平均血流速度较对照组显著降低（P<0.05），脑血管痉挛的发生率显著低于对照组（P<0.05），MBI 评分显著高于对照组，NIHSS 评分较对照组明显降低（P<0.05）。两组患者的脑梗死发生率、死亡率以及不良反应的发生率比较均无显著差异（P>0.05）。结论　依达拉奉联合HBO 可以更有效地缓解颅内动脉瘤术后患者的脑血管痉挛，改善神经功能缺损程度，提高日常生活活动能力。     

尼莫地平联合依达拉奉治疗外伤性蛛网膜下腔出血后脑血管痉挛预后分析

目的:探究尼莫地平与依达拉奉联合使用在外伤性蛛网膜下腔出血(tSAH)后脑血管痉挛患者中的应用效果,以便为该疾病的治疗和改善预后提供指导.方法:选取2019年8月—2020年4月就诊于我院的84例tSAH患者,根据就诊日期不同分为对照组(42例)和观察组(42例),对照组应用尼莫地平治疗,观察组在此基础上应用依达拉奉,两组均治疗4周.比较两组治疗前后炎症指标与预后情况.结果:治疗4周,两组肿瘤坏死因子α(TNF-α)、白细胞介素-6(IL-6)水平均低于治疗前,且观察组变化较大(P<0.05);随访3个月,与对照组相比,观察组预后良好率明显更高(P<0.05).结论:尼莫地平与依达拉奉联用可改善tSAH后脑血管痉挛患者预后,抑制炎症因子水平,值得推广应用.     

依达拉奉联合马来酸桂哌齐特治疗动脉瘤性蛛网膜下腔出血后脑血管痉挛的临床观察

目的:观察依达拉奉联合马来酸桂哌齐特治疗动脉瘤性蛛网膜下腔出血后脑血管痉挛的临床疗效及安全性。方法:选择动脉瘤性蛛网膜下腔出血后脑血管痉挛患者66例,采用随机数字表法分为对照组和治疗组,各33例。在常规治疗基础上,对照组患者给予马来酸桂哌齐特注射液320 mg加入0.9%氯化钠注射液500 m L中,ivgtt,qd;治疗组患者在对照组基础上加用依达拉奉注射液30 mg加入0.9%氯化钠注射液100 m L中,ivgtt,bid。两组患者均治疗14 d。比较两组患者治疗前后炎症因子[白细胞介素6(IL-6)和肿瘤坏死因子α(TNF-α)]水平、大脑中动脉收缩峰流速(MCA Vp)、临床疗效及不良反应发生情况。结果:治疗前,两组患者IL-6、TNF-α、MCA Vp水平比较,差异均无统计学意义(P>0.05);治疗后,两组患者IL-6、TNF-α水平和MCA Vp显著降低,且治疗组显著低于对照组,差异均有统计学意义(P<0.05)。治疗组患者临床总有效率为90.91%,显著高于对照组的63.64%,差异有统计学意义(P<0.05)。两组患者均未见明显不良反应发生。结论:依达拉奉联合马来酸桂哌齐特治疗动脉瘤性蛛网膜下腔出血后脑血管痉挛疗效显著,能有效降低患者的MCA Vp,减轻炎症反应,且安全性较好。     

盐酸法舒地尔防治颅内动脉瘤栓塞术后脑血管痉挛24例临床研究

目的 观察盐酸法舒地尔防治颅内动脉瘤破裂介入栓塞术后脑血管痉挛(CVS)的疗效.方法 48例脑动脉瘤破裂介入栓塞术后患者随机分成两组,各24例;对照组给予尼莫地平注射液治疗;治疗组给予盐酸法舒地尔注射液治疗.结果 治疗组:治愈13例,总有效率87.50%;对照组治愈10例,总有效率66.67%.两组比较,差异有统计学意义(P<0.05).结论 盐酸法舒地尔能有效防治颅内破裂动脉瘤破裂介入栓塞术后CVS的发生,值得借鉴.     

法舒地尔防治动脉瘤性蛛网膜下腔出血后出现脑血管痉挛的疗效

目的探讨法舒地尔防治动脉瘤性蛛网膜下腔出血后脑血管痉挛的疗效。方法分析116例动脉瘤性蛛网膜下腔出血患者的临床资料,分为观察组和对照组,两组均绝对卧床,止血、脱水等对症治疗,急诊开颅夹闭手术治疗。观察组加用法舒地尔静滴,对照组应用尼莫地平静脉泵入,观察两组患者脑血管痉挛率及病死率。结果术后2周内,观察组脑血管痉挛发生率及病死率显著低于对照组,差异具有统计学意义(P<0.05)。结论法舒地尔能够明显缓解动脉瘤性蛛网膜下腔出血后脑血管痉挛,降低脑血管痉挛的发生率,不增加动脉瘤的再出血风险。     

依达拉奉联合维脑路通治疗脑梗死的疗效观察

目的 观察依达拉奉联合维脑路通治疗脑梗死的临床疗效.方法 将103例缺血性脑梗死患者随机分为治疗组54例和对照组49例.治疗组给予依达拉奉30mg+0.9%氯化钠注射液100ml静脉滴注,每天2次;维脑路通400mg+0.9%氯化钠注射液500ml或5%葡萄糖注射液500ml静脉滴注,每天1次.对照组给予复方丹参30ml+0.9%氯化钠注射液500ml或5%葡萄糖注射液500ml静脉滴注;维脑路通400mg+0.9%氯化钠注射液500ml或5%葡萄糖注射液500ml静脉滴注,每天1次,疗程均为3周.2组辅助治疗相同.治疗后比较2组疗效及神经功能缺损评分.结果 治疗组显效率为53.7%高于对照组的32.7%,差异有统计学意义(P＜0.05).2组治疗后神经功能缺损评分均减少(P＜0.01),且治疗后神经功能缺损评分少于对照组,差异均有统计学意义(P＜0.01).结论 依达拉奉联合维脑路通治疗脑梗死疗效显著,无明显不良反应,值得推广应用.     

奥拉西坦联合依达拉奉治疗急性脑梗死的临床疗效

目的 探讨奥拉西坦联合依达拉奉对急性脑梗死的保护作用.方法 88例急性脑梗死患者分为治疗组和对照组,均给予阿托伐他仃、阿司匹林,奥拉西坦治疗.治疗组在此基础上加用依达拉奉.于治疗前及治疗后第1、3、7、14天,分别进行临床神经功能缺损评分和疗效评定.结果 治疗组总有效率90.7％,明显高于对照组的59.1％(P＜0.05).生活能力评定治疗组独立及轻度依赖率72.7％,明显高于对照组的40.9％(P＜0.05).两组均无明显不良反应.结论 奥拉西坦联合依达拉奉治疗脑梗死,安全有效.     

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.     

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 x kg(-1)) or i.p. (50 mg x kg(-1)) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) 1 x h(-1) x kg(-1) in the male rat and 10.6 (95% CI: 7.5, 15.0) 1 x h(-1) x kg(-1) in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was approximately 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.     

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.     

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。     

Changes in angiopoietin expression in glomeruli involved in glomerulosclerosis in rats with daunorubicin-induced nephrosis

AIM: To study the potential pathological role of endogenous angiopoietins in daunorubicin-induced progressive glomerulosclerosis in rats. METHODS: Seventy male Wistar rats were allocated randomly into a daunorubicin group (DRB; n=40) or a control group (n=30). The rats in the DRB group were injected with DRB (15 mg/kg), in their tails. Subsequently, at intervals of 1, 2, 4, 6, 8, and 12 weeks, 5 male Wistar rats in each group were chosen randomly for 24 h urinary protein quantitative measurements (24 h UPQM), and determination of plasma tumor necrosis factor alpha (TNF-alpha), angiopoietin-1 (Ang1), and angiopoietin-2 (Ang2) levels. Kidney sections were examined by electron microscopy, Periodic Acid Schiff (PAS) staining, immunohistochemical staining and in situ hybridization histochemistry. RESULTS: As glomerulosclerosis progressed in the DRB group, expression of Ang1 mRNA and protein in glomeruli decreased and expression of TNF-alpha protein, Ang2 mRNA and protein in glomeruli increased. Expression of Ang1 mRNA and protein in glomeruli were negatively correlated with 24 h UPQM, Fn protein expression, and mean area of extracellular matrix (MAECM). In comparison, expression of Ang2 mRNA and protein in glomeruli were positively correlated with 24 h UPQM, Fn protein expression and MAECM; furthermore, there was a positive correlation between plasma Ang2 and 24 h UPQM. Plasma TNF-alpha and expression of TNF-alpha in glomeruli were positively correlated with expression of Ang2 mRNA and protein in glomeruli. There was a negative correlation between Ang1 protein expression and Ang2 protein expression in glomeruli. CONCLUSION: During DRB-induced glomerulosclerosis, podocyte injury led to a shift in the balance of Ang1 and Ang2 in glomeruli. Increased TNF-alpha in plasma and glomeruli may upregulate Ang2 expression in glomeruli. Elevated Ang2 in both plasma and glomeruli may mediate protein permeability through the glomerular filtration barrier. Moreover, local expression of Ang2 may facilitate the progress of glomerulosclerosis by upregulating a component expression of extracellular matrix.     

Deoxynivalenol in cereals in Russia

A survey of the occurrence of deoxynivalenol (DON) and zearalenone (ZEN) in wheat, rye, barley and maize harvested in 1989-2001 in several regions of Russia has been conducted. A total of 5652 samples of cereals were analysed for DON and ZEN by using TLC and normal-phase HPLC with UV-detector. DON was detected in 69% of 2166 samples from Krasnodar region which is considered to be the major Fusarium endemic region of Russia. The contamination levels ranged from 0.1 till 8.6 ppm, MTEL was exceeded in 37% of these samples. The positive correlation between DON concentration and a percentage of Fusaria-damaged wheat kernels has been shown. DON occurrence and contamination levels were much lower that for wheat. Based on the results of monitoring and the data of average actual consumption of wheat products in Russia, the estimated daily intake of DON per 1 kg of body weight (EDI)was calculated. EDI varied from 0.07 ug in 1990-1991 till 1.40 ug in 1992. Although average EDI were lower than adopted tolerable daily intake (TDI, 3 ug/kg body weight) EDIs for the North-Caucasian region in some cases exceeded TDI.