Piracetam in acute stroke: a systematic review

We studied whether the administration of piracetam in acute, presumed ischemic stroke affects case fatality and functional outcome. The Cochrane Stroke Group strategy was used to evaluate all randomized controlled trials of patients with presumed ischemic stroke examined within 48 h; death and (when available) functional outcome were used as end points. Three studies were included; the most recent one contributed more than 97% of the data. There were 501 patients treated with piracetam and 501 controls. Piracetam was associated with a nonsignificant 31% increase in the odds of death (95% CI –5% to 81%). This result was due almost completely to the effect of the larger trial, which, however, reported that the difference in case fatality rate between piracetam and control disappeared after correcting for the imbalance in stroke severity between the two groups. Data on functional outcome were available only for the largest study, and no difference was reported. Data obtained from the manufacturer suggested a nonsignificant trend (–10%) towards reduction in dependency with piracetam (CI –33% to 20%); the proportions of patients dead or dependent in the two groups were the same. Relevant adverse effects were not reported. The evidence from this review does not support routine administration of piracetam in patients with acute ischemic stroke; however, since a possible beneficial effect cannot completely be ruled out, further controlled trials are warranted. Received: 31 August 1999/Received in revised form: 3 November 1999/Accepted: 25 November 1999     

短暂性脑缺血发作对后继脑梗死影响的研究

目的:评价短暂性脑缺血发作(T IA)对后继脑梗死是否有保护作用。方法:选择2000~2005年我院老年神经病科及神经内科既往有同侧T IA的脑梗死患者98例,并对有同侧T IA的脑梗死患者根据T IA发作持续时间分为<10m in(26例)、10~20m in(38例)及>20m in(34例),并选择同期住院无T IA的脑梗死患者102例进行病例对照观察。在入院及病程一月时采用改良的爱丁堡-斯堪的那维亚卒中量表进行神经功能缺损评分,病程一月时进行预后评分。结果:两组患者年龄及其他危险因素包括高血压病、糖尿病、高脂血症及冠心病无差异(P>0.05);入院及病程一月时,无T IA的脑梗死患者其神经功能缺损评分及近期预后与T IA持续时间在10~20m in的脑梗死患者有显著性差异(P<0.05),但与T IA持续时间<10m in及>20m in的脑梗死患者无差异(P>0.05),且T IA持续时间在10~20m in之间与<10m in、>20m in比较有显著性差异(P<0.05)。结论:T IA对后继脑梗死有保护作用。     

青黛散抗溃疡性结肠炎的作用研究

目的：探讨青黛散抗实验性溃疡性结肠炎的作用。方法：采用三硝基苯磺酸法制备大鼠溃疡性结肠炎模型，HE染色制作病理切片，对其抗实验性溃疡性结肠炎作用进行评价。结果：病理组织学检查表明青黛散有效改善了溃疡性结肠炎。结论：青黛散可有效对抗实验性结肠性溃疡炎。     

中药内外合治溃疡性结肠炎62例临床观察

[目的]观察中药内服配合灌肠治疗慢性溃疡性结肠炎的疗效。[方法]内服自拟健脾补肾汤配合清热燥湿解毒中药保留灌肠。[结果]62例中痊愈28例,占45·16%;好转27例,占43·55%;无效7例,占11·29%。总有效率为88·71%。[结论]中药内服配合灌肠治疗慢性溃疡性结肠炎的疗效确切,能加速溃疡面愈合并可促进和调整机体的免疫功能。     

针刺为主治疗缺血性视乳头病变临床观察

目的:观察针刺与西药治疗缺血性视乳头病变的疗效差异.方法:31例患者以针刺治疗为主,辅以穴位注射.对于发病2周之内者,局部配合球后注射.记录治疗前后视力、视野的变化.结果:治疗前后视力、视野比较,差异均有极显著性意义(P<0.001).结论:该疗法是改善缺血性视乳头病变患者视功能的有效方法.     

吴茱萸次碱对小鼠溃疡性肠炎的治疗作用

目的:观察吴茱萸次碱治疗小鼠急性结肠炎的药效及对豚鼠肠道平滑肌运动的影响。方法:2,4-二硝基氯苯(DNCB)／乙醇灌肠制作小鼠急性结肠炎模型,经口给予吴茱萸次碱10、30、100 mg·kg-1,观察吴茱萸次碱对小鼠腹泻,组织形态损伤,结肠组织PGE2含量、MPO活力以及对乙酰胆碱、组胺作用下豚鼠离体肠管收缩运动的影响。结果:DNCB诱发结肠炎后,小鼠出现腹泻、充血、溃疡、肠壁增厚等变化。经口给予吴茱萸次碱后,可以显著改善小鼠的腹泻、组织损伤,并且能够降低结肠组织中MPO活性和PGE2的含量,对乙酰胆碱及组胺作用下豚鼠离体肠管收缩亦表现出显著的对抗作用。结论:吴茱萸次碱可以抑制炎性浸润、渗出和组织增生,减轻结肠黏膜的病理损害和抑制肠道平滑肌运动,对实验性动物急性结肠炎有较好的治疗作用。     

白头翁汤灌肠治疗溃疡性结肠炎患者的疗效及对T细胞亚群的影响

目的 观察白头翁汤灌肠治疗溃疡性结肠炎（UC）的疗效及对患者T细胞亚群的影响。方法 将我院2014年1月-2018年3月收治的124例UC患者随机分为对照组和观察组,2组均给予美沙拉嗪治疗,观察组另给予白头翁汤灌肠治疗。30 d后对比2组患者治疗有效率、肠镜评分、住院时间、UC活动度、T细胞亚群变化、不良反应发生率。结果 治疗30 d时,观察组治疗有效率（93.5%）明显高于对照组（72.6%）, P <0.05;观察组住院时间明显低于对照组（ P <0.05）;观察组DAI评分明显低于对照组（ P <0.05）;2组外周血中CD3+与CD8+均出现下降趋势,而CD4+与CD4+/CD8+均出现上升趋势,且观察组变化幅度明显大于对照组（ P <0.05）;观察组不良反应发生率为9.7%,对照组不良反应发生率为8.1%,差异不明显（ P >0.05）。结论 白头翁汤灌肠能够有效提高UC疗效,降低患者UC活动指数及住院时间,同时改善患者免疫功能,值得临床进一步推广应用。      

缺血预处理对肝硬化大鼠肝脏缺血再灌注损伤保护作用的研究

目的探讨缺血预处理(IP)对硬化肝脏缺血再灌注损伤的保护作用及其可能机制。方法Wistar雄性大鼠制成肝硬化模型。分两组:IP组离断肝周韧带,消除侧枝循环,用Pringle's法阻断肝门15min,然后恢复血供,关腹;C组只予以开、关腹。48 h后,再次Pringle's法阻断肝门30 min,恢复血供。用Western blotting法测IP后6、24、48 h肝组织中热休克蛋白70(HSP70)表达的水平;测再灌注1、3 h血清生化酶(ALT、AST、LDH)及再灌注3h肝组织中谷胱苷肽(GSH)水平;行病理学观察。结果IP后6 h,两组均有微量HSP70表达,至24-48hIP组HSP70表达显著增强,呈高水平;而C组中在各时点HSP70均无表达增强。再灌注1h,IP组的ALT、AST、LDH水平显著低于C组(P<0.01或P<0.05);再灌注3h,IP组的ALT、AST水平明显低于C组(P<0.01)而其肝组织中的GSH水平明显高于C组(P<0.05)。术后一周生存率IP组(93.10%)明显高于C组(73.33%)(P<0.05)。缺血再灌注后1、3h,IP组的肝细胞损伤明显轻于C组。结论在硬化大鼠肝脏中,IP启动内源性保护机制,诱导HSP70的大量表达,而HSP70通过增加或提高GSH的产生及其活性,清除自由基,减轻硬化肝脏缺血再灌注损伤。     

Long-lasting renal dysfunction following tacrolimus induction therapy in ulcerative colitis patients

Although tacrolimus (TAC) has remarkable effects in ulcerative colitis (UC) patients when given as remission induction therapy, some can develop renal dysfunction during TAC administration, resulting in withdrawal, though related details remain poorly understood. This study was conducted to determine the impact of oral TAC on renal function for remission induction therapy in UC patients. Fifty-five patients (10 elderly, 45 non-elderly) with UC and treated with oral TAC at our hospital were retrospectively evaluated. Renal function was assessed using estimated glomerular filtration rate (eGFR). Although a high clinical response to TAC was seen in both elderly and non-elderly, a decline in eGFR was noted in nearly all patients regardless of age, with a maximum change of −34.4% from the baseline value at week 11. Furthermore, eGFR decline recovered quickly after TAC discontinuation, though did not return to the baseline at two years following cessation. The rate of eGFR change at week 12 was significantly associated with patient age (β = −0.3242, p = 0.0103) and peak serum trough level during TAC treatment (β = 0.3563, p = 0.0051). Furthermore, the rate of decline in eGFR was significantly greater during treatment with TAC in the elderly as compared to non-elderly, with a large difference in eGFR decline rate between those groups also noted at two years after withdrawal of treatment. Careful attention to renal function when administering oral TAC for UC is important and changes in eGFR should be monitored closely in elderly patients even after treatment cessation.     

The Alleviation of Gut Microbiota-Induced Depression and Colitis in Mice by Anti-Inflammatory Probiotics NK151, NK173, and NK175

Gut microbiota dysbiosis is strongly associated with psychiatric disorders and inflammatory bowel disease (IBD). Herein, we examined whether the fecal microbiota of IBD patients with depression (IBDD) and their gut microbiota culture (iGm) could cause depression and colitis in mice and anti-inflammatory probiotics could mitigate depression in iGm-transplanted or immobilization stress (IS)-exposed mice. Fecal microbiota transplantation (FMT) from IBDD patients, which exhibited Enterobacteriaceae-rich gut microbiota, and its gut microbiota culture (iGm) increased depression-like behaviors in mice. Their treatments heightened the blood lipopolysaccharide (LPS) level and colonic IL-1β and IL-6 expression. However, FMT from healthy volunteers or sulfasalazine treatment alleviated cGm-induced depressive-like behaviors and hippocampal and colonic inflammation in mice. Moreover, oral administration of Lactobacillus plantarum NK151, Bifidobacterium longum NK173, and Bifidobacterium bifidum NK175, which inhibited LPS-induced IL-6 expression in macrophages, alleviated cGm-induced depression-like behaviors, hippocampal NF-κB⁺Iba1⁺ cell numbers and IL-1β and IL-6 expression, blood LPS, IL-6, and creatinine levels, and colonic NF-κB⁺CD11c⁺ number and IL-1β and IL-6 expression in mice. Treatment with NK151, NK173, or NK175 mitigated immobilization stress (IS)-induced depressive-like behaviors, neuroinflammation, and gut inflammation in mice. NK151, NK173, or NK175 also decreased IS-induced blood LPS, IL-6, and creatinine levels. The transplantation of Enterobacteriaceae-rich gut microbiota can cause depression and colitis, as IS exposure, and anti-inflammatory NK151, NK173, and NK175, may alleviate stress-induced fatigue, depression, and colitis by regulating the expression of proinflammatory and anti-inflammatory cytokines through the suppression of gut bacterial LPS.