糖尿病并发冠心病患者血中TXB_2、6—Keto—PGF_(1α)和LPO的含量变化及其临床意义

应用放射免疫法和硫代巴比妥酸荧光法测定了52例糖尿病并发冠心病患者血中TXB_26—keto—PGF_(1α)和LPO的含量,并与37例非糖尿病性冠心病患者作了对比分析。结果发现:糖尿病并发冠心病患者血中TXB_2、LPO含量和TXB_2/6—Keto—PGF_(1α)比值明显增高,6—Keto—PGF_(12)含量无明显变化。提示糖尿病并发冠心病患者体内TXA_2/PGF_(1α)比例失衡和氧自由基的氧化损伤反应较无糖尿病的冠心病患者严重。这可能是糖尿病患者冠心病发病率高、起病早、发展快、病情重、预后差的重要原因之一。     

Long-term Effectiveness and Tolerability of Topiramate in Children with Epilepsy under the Age of 2 Years: 4-Year Follow-up

This is a long-term, open label, observational study aimed to broaden our clinical experiences in managing infants and toddlers with epilepsy. The long-term retention rate and side effects of topiramate (TPM) in them were evaluated and compared with carbamazepine (CBZ). A total of 146 children were involved in the study (TPM=41, CBZ=105). The retention rates at 24 , 36, and 48 months were 46.3%, 34.1%, 26.8% for TPM and 36.2%, 23.8%, 13.3% for CBZ, respectively. At 6 months after starting antiepileptic drugs (AED), the seizure freedom or clinical efficacy (seizure reduction rate more than 50 percent) were 73.2% for TPM and 62.9% for CBZ. The major side effects led to discontinuation included psychomotor slowing, poor oral intake from TPM and sleepiness and skin rash from CBZ. TPM was discontinued due to side effects in one case (2.4%) and lack of efficacy in five cases (12.2%), whereas CBZ was discontinued due to lack of efficacy (22.9%) and side effects (6.7%). As compared with CBZ, TPM showed the same long-term retention rate in children under the age of 2 yr, and no serious side effects. It is therefore concluded that TPM can be considered as a major AED for treating children with epilepsy under the age of 2 yr.     

双波长法测定强力治癫散中卡马西平的含量

目的应用双波长光谱测定强力治癫散中卡马西平的含量。方法在碱性条件下,选择波长280 nm为测定波长,270 nm为参比波长,消除中药成分的干扰,对卡马西平在两波长处有不同的紫外吸收光谱,测得吸收度差值(ΔA)为定量依据。结果平均回收率98.54%,RSD为0.86%。结论双波长紫外分光光度法可以作为强力治癫散中卡马西平的含量测定,其方法简单、准确。     

卡马西平固体脂质纳米粒的包封率测定

目的:建立以高效液相色谱法测定卡马西平固体脂质纳米粒含量并计算包封率的方法。方法:色谱柱为KromasilC18,流动相为甲醇-水(6∶4,含0.1%三乙胺),流速为1.0mL·min-1,检测波长为285nm,进样量为20μL。结果:卡马西平检测浓度的线性范围为0.525～21.0μg·mL-1(r=0.9998);平均回收率为100.1%(RSD=1.42%);平均包封率为73.1%。结论:本方法简便、快速、重现性好,可用于该制剂的质量控制。     

高—低钠序贯透析预防急性并发症的临床护理研究

目的观察高—低钠序贯透析预防血液透析急性并发症的效果。方法将30例维持性血透患者(MHD)共400例次血透治疗,分单次治疗为实验组,双次治疗为对照组,实验组采用高—低钠序贯透析,对照组采用常规血液透析。结果实验组透析治疗中发生急性并发症有14例次,对照组46例次,两组比较,差异有统计学意义(P<0.05);血透后血浆钠浓度无显著性差异(P>0.05)。结论高—低钠序贯透析可减少血透过程中急性并发症的发生。     

复康片对卡马西平胃粘膜损伤的预防作用

目的：探讨复康片对卡马西平（carbamazepine，CBZ）胃粘膜损伤的预防作用。方法：将48只大鼠随机分为正常对照组、模型对照组、复康片低剂量组、复康片高剂量组共4组，每组12只。实验第90天，处死所有大鼠。取胃组织在光镜下观察胃粘膜病理学变化。结果：与正常对照组比较，模型对照组胃粘膜萎缩、腺体减少、胃粘膜上皮细胞水肿，粘膜下层组织水肿，毛细血管扩张充血。炎细胞浸润，浅表渍疡形成。部分腺体发生肠上皮化生。中药复康片低剂量组表现胃粘膜上皮细胞轻微水肿，偶见浅表溃疡形成，并可见粘膜下层组织轻微水肿，毛细血管扩张充血，粘膜固有层和粘膜下层可见炎细胞浸润。中药复康片高剂量组表现胃粘膜上皮细胞轻微水肿，未见浅表溃疡形成，粘膜下层组织轻微水肿，毛细血管无扩张充血。仅粘膜固有层见少量炎细胞浸润。结果表明高剂量组的效果要好于低剂量组。结论：复康片可预防卡马西平对胃粘膜的损害。     

Stable carbamazepine colloidal systems using the cosolvent technique

The aim of this paper was to prepare stable carbamazepine nanosuspensions containing 10 mg/ml drug concentration by screening different polymers. Stable formulations were created by the cosolvent technique with polyethylene glycol (PEG-300) and water as the cosolvents. Rapid growth of long needle shaped CBZ crystals was observed in the absence of polymer. The presence of hydroxypropyl methylcellulose (HPMC) or methylcellulose (MC) inhibited crystal growth and the mean particle sizes were in the range 10–20 nm. Simultaneous presence of HPMC and polyvinylpyrrolidon (PVP PF17) polymers in CBZ suspensions enhanced the overall stability of the formulations. The additional stability improvement was attributed to the interaction between the polymers by the formation of hydrogen bonds. Suspension stability was evaluated over 5 months where the particle size remained constant. FT-Raman studies showed the existence of form I within the stable CBZ suspensions.     

Paranasal sinus mucormycosis in an immunologically competent host

A case of paranasal sinus mucormycosis in an immunocompetent patient is reported. After an extensive evaluation, no evidence of either diabetes mellitus or underlying immunologic abnormality was found. The combination of excisional surgery and amphotericin B therapy resulted in an excellent response. High-resolution axial and coronal computed tomography was useful in both planning treatment and monitoring the response to therapy.     

Changes in thyroid function tests induced by 2 month carbamazepine treatment in l-thyroxine-substituted hypothyroid children

In five l-thyroxine-substituted hypothyroid children with partial epilepsy serum total thyroxine (T₄) and free T₄ (FT₄) significantly (P<0.01) decreased following 2 months of carbamazepine (CBZ) administration (20 mg/kg per BW per day) from mean (±SD) values of 12.7±1.1 g/dl and 15.5±1.8 pg/ml to mean values of 7.5±2.3 and 10.1±1.7, respectively. In all but one patient important changes in both serum total and free triiodothyronine (T₃, FT₃) were not observed; consequently T₃T₄ and FT₃FT₄ ratios significantly (P<0.05) increased in the whole series. Three subjects had post-treatment serum TSH that rose to hypothyroid levels parallel to a T₄ decrease. The negligible thyroid hormone secretion and the unmodified T₃-uptake (T₃U) or T₄-binding globulin (TBG) exclude direct effects of CBZ on thyroid gland and on carrier serum proteins, respectively. The findings observed, instead, might be due to accelerated T₄ metabolic clearance together with augmented T₄ to T₃ conversion rate, as previously demonstrated for diphenylydantoin. The sharp reduction in T₄ and FT₃ concentrations is the peripheral display of this event, which is associated with a decompensation of the metabolic status, as indicated by serum TSH enhancement. In all cases a supplement of l-thyroxine by itself was able to restore euthyroid TSH serum concentrations, suggesting that hypothyroidism in patients with partial epilepsy to whom CBZ had been administered requires a higher l-T₄ substitutive regimen.Abbreviations CBZ carbamazepine - DPH phentoin - T₄ thyroxine - T₃ triiodothyronine - TSH thyrotropin - FT₄ free T₄ - FT₃ free T₃ - rT₃ reverse T₃ - TBG thyroxine binding globulin - T₃U T₃ uptake - RIA radioimmunoassay Presented in part at the 23rd Annual Meeting of the European Society for Pediatric Endocrinology (Heidelberg, September 2–5, 1984) [5]     

Effects of valproic acid,carbamazepine, and phenobarbitone on the fatty acid composition of erythrocyte membranes in children

PURPOSE: To investigate a possible relation between antiepileptic drugs (AEDs) and the fatty acid composition of membranes. METHODS: Fatty acid (FA) composition of erythrocytes was studied in children with epilepsy receiving AED monotherapy. Children taking valproate (VPA, n = 28), carbamazepine (CBZ, n = 17), or phenobarbitone (PB, n = 14) were compared with healthy controls (n = 25). FAs were measured by capillary-gas chromatography (GC-FID). RESULTS: Significant changes (p < 0.05) in the FA composition of membranes were found. In children treated with VPA, C13:0 was decreased (8.2 +/- 2% vs. 10.7 +/- 4% in controls) and C14:0 increased (1.4 +/- 0.5% vs.1 +/- 0.5% in controls). C17:0 again was reduced (9.9 +/- 4% vs. 13.2 +/- 6% in controls), whereas the long-chained acids were enhanced: C18:2n-6 (6 +/- 2.4% vs. 3.9 +/- 2.5% in controls), and C20:4n-6 (1.9 +/- 1.7% vs. 1.4 +/- 0.5% in controls). The nonidentified FAs also increased with VPA therapy: 2.5 +/- 0.8% versus 1.7 +/- 0.9% in controls. Children treated with CBZ showed only minimal changes of FA composition: C13:0 was decreased compared with controls (8 +/- 2% vs. 10.7 +/- 4%). No changes were seen in patients taking PB. The mean corpuscular volume (MCV) showed important differences between the study groups: MCV was 84.7 +/- 6.0 fl during VPA therapy (p < 0.001) and 85.7 +/- 4.1 fl with CBZ (p < 0.001). During PB, the MCV increased to 82.87 +/- 3.29 fl compared with controls (78.73 +/- 4.92 fl; p < 0.01). CONCLUSIONS: VPA therapy is associated with changes of the FA composition of membranes, which is not the case with PB therapy. The implications of this finding remain to be established.