The effects of reboxetine on autonomic and cognitive functions in healthy volunteers

RATIONALE: Though reboxetine, a selective noradrenaline reuptake inhibitor, causes autonomic and cognitive adverse events there is a paucity of appropriately designed studies on the cognitive and autonomic effects of the drug in the literature. OBJECTIVE: To compare the effects of reboxetine on cognitive and autonomic functions with those of placebo in healthy humans. METHOD: A randomised, double-blind, crossover study of 12 healthy male volunteers aged 25 (21-27; median, range) years. Subjects orally received 4 mg reboxetine and placebo twice daily for periods of 14 days each with at least 14 days in between. Vasoconstrictory response of cutaneous vessels (VR) and skin conductance response (SCR) following sudden deep breath were employed as parameters for autonomic function. Quantitative EEG (qEEG) and psychometric tests served as parameters for cognitive function. RESULTS: Reboxetine decreased SCR and prolonged the dilation phase of VR (P<0.05). It did not affect cognitive functions such as flicker fusion frequency, choice reaction, memory and psychomotor coordination but increased slow beta (beta1) power density in the qEEG. Tiredness (n=12), dry mouth (n=9), delayed urination (n=3) and constipation (n=1) were noted with reboxetine. CONCLUSION: Sustained peripheral and/or central sympathetic activation accounts for the prolongation of VR. The decrease of SCR and typical side effects suggest a relevant antimuscarinic drug action. Chronic administration of reboxetine at therapeutic doses causes autonomic dysfunction and subjective sedation but does not impair cognitive and psychomotor abilities in healthy humans.     

中医数学模型

中医五行学说数学模型是完全以中医理论为基础,以《黄帝内经》等古代医学文献为主要的参考资料进行归纳和整理的一种处理中医问题的有效方法。必要的数学假设,精练的数学语言对中医五行学说理论加以描述,并且初步建立起中医数学模型。同时为其他中医理论的数学建模提供了参考依据,从而逐步实现中医与现代科学接轨。     

扇贝裙边糖胺聚糖抗肿瘤作用和对荷瘤小鼠免疫功能的影响

目的：研究扇贝裙边糖胺聚糖（SS-GAG）的抗癌作用及对荷瘤小鼠免疫功能的影响。方法：建立小鼠移植性S180实体瘤模型，观察SS-GAG的抑瘤率以及对荷瘤小鼠的体质量、肝质量、白细胞计数、脾指数、胸腺指数的影响，同时观察SS-GAG对荷瘤小鼠细胞免疫活性的影响。结果：SS-GAG可明显抑制S180实体瘤的生长，SS-GAG与环磷酰胺联用可使化疗药物的抗癌作用增强并能有效提升减少的白细胞；能显著增强荷瘤小鼠腹腔巨噬细胞的吞噬能力和杀伤活性，增强荷瘤小鼠脾淋巴细胞的转化增殖和NK细胞活性。结论：SS-GAG可显著抑制肿瘤生长，与环磷酰胺联用时有减毒增效作用；并能增强荷瘤小鼠的免疫功能。     

颅骨修补对患者神经及认知功能的影响

目的 探讨颅骨修补对患者神经和认知功能的影响.方法 应用NIHSS卒中量表(美国国立卫生研究院卒中量表)对患者手术前后的神经功能进行评价,认知功能的评价采用MMSE量表(简明智能量表),结果进行t检验统计学分析.结果 NIHSS术前为(2.72±3.82),术后为(2.38±3.27),t检验P＜0.01.MMSE术前为(53.09±34.2),术后为(46.84±31.88),t检验P＜0.01.结论 颅骨修补可改善患者的神经功能障碍,提高患者的认知能力.除对开放性、污染伤口去除颅骨后需要延期修补外,对其他颅骨缺损的患者,一旦脑水肿消失,局部组织压力降低后就要考虑颅骨修补手术,以利于患者神经功能和认知能力的恢复.     

Telmisartan, ramipril and their combination improve endothelial function in different tissues in a murine model of cholesterol-induced atherosclerosis

BACKGROUND AND PURPOSE

Erectile dysfunction correlates with cardiovascular disease and its common risk factors due to the development of endothelial dysfunction. Positive effects on endothelial and erectile function have been described for substances inhibiting the renin-angiotensin-system. Here, we investigated in an atherosclerosis model, whether telmisartan (angiotensin receptor blocker) and ramipril (angiotensin converting enzyme inhibitor) are equivalent or the combination of both is superior in improving endothelial function in the aorta and the corpus cavernosum and in reducing atherosclerosis.

EXPERIMENTAL APPROACH

Wild-type (WT, C57/B6) and apolipoprotein-E-deficient (ApoE^−/−) mice were treated with a cholesterol-rich diet for 8 weeks. ApoE^−/− mice were supplemented with either telmisartan (20 mg·kg⁻¹·day⁻¹), ramipril (2.5 mg·kg⁻¹·day⁻¹) or the combination thereof.

KEY RESULTS

Systolic blood pressure significantly decreased in treatment groups (P < 0.001), with significantly smaller reduction under ramipril monotherapy (P < 0.05). Endothelial function (assessed by pharmacological stimulation of aortic rings and corpus cavernosum in organ bath chambers) was impaired in ApoE^−/− mice compared to WT animals, which was improved by all three treatments to a comparable extent (P < 0.05). Atherosclerotic lesion size in the ascending aorta and aortic sinus (P < 0.001), the amount of lipid peroxides in cavernosal and aortic tissue (P < 0.05) and free radical load (dihydroethidium-stain) (P < 0.05) were enhanced in untreated ApoE^−/− mice in comparison to WT animals and were significantly reduced by either treatment. In penile tissue, expression of eNOS could be restored by renin-angiotensin-aldosterone system blockade.

CONCLUSIONS AND IMPLICATIONS

Telmisartan and ramipril significantly improved endothelial function of aortic and cavernosal tissues in ApoE^−/− via reduction of oxidative stress. Combination of both agents does not enhance beneficial effects significantly.     

ACEI治疗中老年高血压的疗效观察与分析

目的探讨血管紧张素转换酶抑制剂（ACEI）类药物治疗中老年高血压的临床特点及疗效。方法将确诊为原发性高血压患者118例，观察患者使用ACEI类药物治疗前后的血压、肾脏功能、心功能、代谢功能变化情况。结果ACEI治疗后，患者收缩压和舒张压（P〈0．01），24小时尿蛋白定量（P〈0．05），左室舒张末容积和左室收缩末容积（P〈0．05和P〈0．01）明显降低，左室射血分数和心输出量明显增加（P〈0．05），差异有统计学意义。治疗前后患者的血钾、血肌酐、血糖、血脂无明显变化。结论ACEI在有效降血压的同时，保护心脏、肾脏功能，对糖、脂代谢无影响，是临床理想的降压药物。     

Effects of sertraline on autonomic and cognitive functions in healthy volunteers

Rationale Though sertraline, a selective serotonin reuptake inhibitor (SSRI), causes autonomic and cognitive adverse events such as dry mouth and somnolence, there is a paucity of appropriately designed studies on the cognitive and autonomic effects of the drug in the literature. Objective To compare the effects of sertraline on cognitive and autonomic functions with those of placebo in healthy humans. Method A randomized, double blind, cross over study of 12 healthy male volunteers aged 24 (21– 32; median; range) years. Subjects orally received 50 mg sertraline and placebo once daily for periods of 14 days each with at least 14 days in between. Heart rate variability (HRV), skin conductance level (SCL) and skin conductance response (SCR) following sudden deep respiration were employed as parameters for autonomic function. Quantitative EEG (qEEG) and psychometric tests served as parameters for cognitive function. Measurements were performed repeatedly before the start of drug administration and on the last treatment day. Results Sertraline caused a significant reduction of heart rate and SCL (P<0.05), whereas HRV and SCR were not changed. Cognitive functions such as flicker fusion frequency, memory, choice reaction time and psychomotor performance were not influenced by sertraline but slow and fast beta power density in the qEEG was increased. Conclusion Cognitive and psychomotor performance are not altered in healthy humans receiving multiple dosing with sertraline. The observed decreases in heart rate and SCL may be due to a sympatho-inhibitory effect of sertraline.     

妇科术后辅助中药灌肠的临床效果观察

目的探讨中药灌肠对妇科术后肠功能恢复的临床研究。方法将妇科手术后24 h不能自行排气,明显腹胀排除机械性肠梗阻患者,给予中药低压保留灌肠。结果低压保留灌肠60例患者,30例用药6 h内,肛门排气,腹胀消失;29例用药24 h内肛门排气,腹胀消失;1例用药24 h仍未排气。结论采用中药低压保留灌肠:1增加肠蠕动,促进排气,解除腹胀,起到预防肠粘连的作用。2可使药液直接渗入病变部位,更有利于发挥药物的作用,达到加速炎症消除,渗出液的吸收,从而使肠壁水肿逐渐减轻,肠功能恢复。     

应用动态心电图分析心脏起搏器功能的价值

目的通过动态心电图（DCG）分析,了解起搏器起搏、感知及特殊功能,评价应用DCG检查在分析起搏器功能中的价值。方法回顾性分析180例次安装永久型心脏起搏器患者DCG检查结果。结果①检出起搏器起搏功能异常5例次,占2.8%。②检出起搏器感知功能异常60例次,占33.3%。③检出起搏器具有特殊功能65例次,占36.1%。④检出与起搏器有关心律失常52例次,占28.9%。结论 DCG检查能了解起搏器起搏、感知功能及起搏器特殊功能,判断与起搏器有关的各种心律失常,为通过体外程控仪调整起搏器技术参数提供参考依据。     

活血通络汤对脑卒中患者凝血功能、内皮功能及氧化应激水平的影响

讨论活血通络汤对脑卒中患者凝血功能、内皮功能及氧化应激水平的影响.选择2017年1月～2019年6月该院收治缺血性脑卒中患者120例,按照治疗方式分成两组,每组60例;对照组采用常规西药治疗,观察组在常规西药治疗的基础上联用活血通络汤治疗;比较两组患者治疗后认知功能、凝血功能、内皮功能以及氧化应激指标变化.治疗后,两组...     

有机磷农药中毒患者肝肾功能变化的研究

目的 探讨急性有机磷农药中毒患者血清肝肾功能的变化。方法 对61例急性有机磷农药中毒患者于中毒后20h内抽取静脉血进行血清肝肾功能及胆碱脂酶（ChE）检测，并与54例治愈组和63例健康对照组进行比较。做统计学分析。结果 急性有机磷农药中毒后轻度中毒患者ChE有明显降低（P〈0．001）；中度中毒总胆红素（TBIL）、直接胆红素（DBIL）、尿素氮（BUN）、天冬氨酸转氨酶（AST）有明显升高而总蛋白（TP）、尿酸（UA）、ChE有明显降低（P均〈0．001）；重度中毒TBIL、DBIL、谷氨酸丙酮酸转氨酶（ALT）、AST、肌酐（Cr）、BUN均有升高明显而TP、UA、白蛋白（ALB）、ChE降低明显（P均〈0．001），有7例心跳停止及6例呼吸肌麻痹各项指标变化最明显者7例死亡。结论 观察血清肝肾功能的变化可以判断有机磷农药中毒患者的中毒程度及预后。     

脂质体携载前列腺素E1对心力衰竭内皮功能和心室舒张功能的影响

目的 :探讨脂质体携载前列腺素E1(Lipo -PGE1)在治疗心力衰竭 (CHF)中对血管内皮功能以及左室舒张功能的影响。方法 :随机将76例住院心力衰竭患者分为两组 ,治疗组39例在CHF常规治疗基础上 ,加用Lipo -PGE1 10μg/天 ,共两周 ;对照组仅接受CHF常规治疗。分别观察两组在治疗前后及其期间心功能、内皮功能指标 (ET、NO、TXB2、6 -keto -PGF1α)以及超声心动图的变化。结果 :两组治疗后心功能有不同程度的改善 ,其中收缩功能的变化无显著差异 ,而治疗组在治疗后内皮功能指标、左室舒张功能的改善则差异具有显著性 (P<0.05)。结论 :在CHF常规治疗基础上 ,加用脂质体携载前列腺素E1 更能有效地改善血管内皮功能和左室舒张功能     

Assessment of endothelial function in atrial fibrillation: utility of peripheral arterial tonometry

Endothelial function is an independent predictor of adverse cardiovascular outcomes. The evaluation of endothelial function via changes in vessel diameter or blood flow may be inaccurate during atrial fibrillation (AF) because of non-uniform stroke volumes. Using peripheral arterial tonometry, 50 patients with AF (25 in AF, 25 in sinus rhythm) had digital pulse amplitudes assessed at baseline and during reactive hyperaemia. Hyperaemic responses were compared over varying measurement durations (5, 10 and 15beats; 30s; and 1-10min) to determine optimal measurement duration. Endothelial responses were significantly decreased (indicating endothelial dysfunction) in patients in AF compared with patients in sinus rhythm (1.48±0.60 vs 2.05±1.13, respectively; P=0.03). Beat-to-beat pulse amplitude was highly variable during AF; although coefficients of variation (CV) for short measurement durations were large, these decreased with longer measurement durations. Bland-Altman plots revealed that limits of agreement for short measurement durations were poor. Limits of agreement became consistently narrower when measurement durations of at least 1min were used. In contrast, limits of agreement and CV for short measurement durations during sinus rhythm were significantly narrower and smaller, respectively, than during AF over similar measurement durations. Pulse amplitudes are highly variable owing to the non-uniform stroke volumes in AF. Our results suggest that methods of determining endothelial function via vessel diameters or blood flow during reactive hyperaemia should use measurement durations of at least 1min to ensure accurate and reproducible results.     

氯沙坦对原发性高血压患者血管内皮功能及肾功能的保护作用

目的:观察氯沙坦对原发性高血压患者血管内皮功能及肾功能的保护作用。方法:对40例轻、中度原发性高血压患者(观察组),予以氯沙坦片50mg,qd,口服,血压下降不理想增加至100mg,qd,连用16周。观察治疗前、后患者血压变化,并检测肱动脉内皮舒张功能(FMD)及尿微量白蛋白(U-MALB)、β2-微球蛋白(β2-MG)含量的变化和不良反应。另选30例健康体检者作为对照组。结果:治疗前,观察组患者肱动脉FMD较对照组明显降低,尿U-MALB和β2-MG含量均较对照组明显升高(均P<0.01);经氯沙坦治疗16周后,观察组患者收缩压和舒张压均控制正常,肱动脉FMD较治疗前明显升高,尿U-MALB和β2-MG含量均较治疗前明显降低(均P<0.01)。但与对照组比较,差异仍有统计学意义(P<0.05)。治疗过程中未见明显不良反应发生。结论:原发性高血压患者存在血管内皮功能障碍和肾脏功能损害,氯沙坦具有良好降压效果,有改善原发性高血压患者内皮功能和保护肾功能作用。     

右美托咪定联合缺血预处理对心脏疾病患者非心脏手术心肌和肾损伤的保护作用

目的探讨右美托咪定联合缺血预处理对心脏疾病患者非心脏手术心肌和肾损伤的保护作用。方法选取2017年5月至2019年1月在我院拟行手术治疗的86例伴有心脏疾病的患者,采用随机数表法分为观察组(43例)及对照组(43例),所有患者均使用静吸复合全麻,观察组采用右美托咪定联合缺血预处理,对照组使用生理盐水。比较两组术中不良心血管事件的发生率,围手术期肌钙蛋白(cTnI)和肌酐(CR)水平,术后心肾不良反应发生率。结果两组术中低血压、高血压、心动过缓的发生率比较差异无统计学意义(P>0.05),观察组心动过速(2.33%vs.18.60%,χ^2=6.08,P=0.02)及心肌缺血(11.63%vs.53.49%,χ^2=17.16,P<0.01)的发生率低于对照组。入室时两组cTnI及Cr水平比较差异无统计学意义(P>0.05),术后两组cTnI及Cr水平均较入室时显著提高(P<0.05);观察组在术后1 h、8 h、24 h的cTnI水平显著低于对照组(P<0.05或P<0.01),在术后8 h、24 h的Cr水平低于对照组(P<0.01)。观察组术后急性肾损伤(AKI)(20.93%vs.44.19%)及室性心律失常(39.53%vs.83.72%)的发生率显著低于对照组,差异有统计学意义(P<0.05)。结论右美托咪定联合缺血预处理可有效保护心脏患者非心脏手术中的心肾功能。     

参芪益肺糖浆对大鼠免疫和造血功能的影响

目的观察参芪益肺糖浆对大鼠免疫和造血功能的影响。方法用注射环磷酰胺的方法建立大鼠白细胞减少症模型。90只大鼠随机分为正常组、模型组、鲨肝醇组和参芪益肺糖浆大、中、小剂量组,观察外周血白细胞、骨髓有核细胞数、淋巴细胞转化指数以及白细胞介素-6（IL-6）指标的变化。结果与模型组比较,参芪益肺糖浆各剂量组均可促进大鼠外周血白细胞、骨髓有核细胞数、淋巴细胞转化指数、IL-6活性指标的恢复及升高（P〈0.05或P〈0.01）。结论参芪益肺糖浆有显著改善机体免疫功能和刺激骨髓造血功能的作用。     

Effects of Different Monoamine Oxidase Inhibitors on Respiratory Activity in Rats with Chronically Impaired Central Serotonergic Function

Abstract: Resting and CO₂ stimulated respiration were measured by means of a whole-body plethysmograph in rats lightly anaesthetized with halothane. Rats pretreated neonatally with intracisternal 5,7-dihydroxytryptamine (5,7-DHT) to destruct permanently central serotonergic neurones had significantly lower resting and CO₂ stimulated respiratory frequency (RF) and minute volume (V_M) than naive rats. In the 5,7-DHT pretreated rats, but not in naive rats, the monoamine oxidase inhibitors clorgyline and pargyline further reduced both resting and CO₂ stimulated RF and Vm, whereas 1-deprenyl stimulated respiration. The results provide additional evidence that monoaminergic mechanisms are involved in central modulation of respiration in which activation of a serotonergic neuronal system depresses, and dopaminergic activation stimulates respiration.     

竹荪深层发酵菌丝体对小鼠免疫功能的影响及其抗肿瘤作用

过对食药用真菌──竹荪深层发酵菌丝体提取液对小鼠免疫功能及S－180肿瘤细胞的作用观察，表明其发酵菌丝体可明显提高小鼠腹腔巨噬细胞的吞噬功能（P＜0．01），并显著增加免疫器官的重量（P＜0．05）；对小鼠S－180肿瘤的抑瘤率为40．63％。     

Graves病的免疫学监测

本文对４６例未治疗的Ｇｒａｖｅｓ’病（ＧＤ）患者的外周血采用ＯＫＴ４、ＯＫＴ３单元隆抗抗体法进行Ｔ细胞亚群测定的同时，还检测了其Ｂ细胞、红细胞免疫及一些非特异性免疫功能。