硝苯地平与硫酸镁联用治疗妊娠期高血压疾病的分析

目的：探讨硝苯地平联合硫酸镁用于妊娠期高血压疾病治疗的临床效果。方法将我院收治的妊娠期高血压疾病患者96例随机分成观察组48例（硝苯地平联合硫酸镁治疗）和对照组48例（硫酸镁治疗），对比2组的治疗效果。结果2组治疗有效率相比差异具有显著性（P<0.05）。结论硫酸镁和硝苯地平联合治疗能够在改善患者心肌血氧的同时保护心肌功能，避免并发症的出现，减少高血压发病率，保障孕妇和婴儿的生命健康。     

MR Features of Juxta-Articular Venous Malformations of the Knee to Predict the Clinical Outcome of Sclerotherapy

PurposeTo analyze and correlate preinterventional magnetic resonance (MR) imaging findings with clinical symptoms after percutaneous sclerotherapy of venous malformations (VMs) adjacent to the knee.Materials and MethodsTwenty-five patients (mean age, 24 y; range, 7–55 y; 11 female) with 26 VMs adjacent to the knee undergoing sclerotherapy (direct puncture, diagnostic angiography, sclerosant injection) were identified, and MR imaging findings were analyzed. The VM involved the synovium of the knee joint in 19 of 26 cases (76%). These lesions were associated with joint effusion (3 of 19; 16%), hemarthrosis (4 of 19; 21%), or synovial thickening (16 of 19; 84%). Follow-up ended 6–8 weeks after the first or second sclerotherapy session if complete pain relief was achieved or 3 months after the third sclerotherapy session. Treatment outcomes were categorized as symptom improvement (complete or partial pain relief) or poor response (unchanged or increased pain).ResultsForty-nine percutaneous sclerotherapy sessions were performed. Despite the absence of signs of knee osteoarthritis, patients with a VM involving the synovium (8 of 14; 57%) showed a poor response to sclerotherapy (1 of 8 [13%] pain-free after 1 sclerotherapy session). Among patients with VMs with no associated joint alteration and no synovial involvement (6 of 14; 43%), 5 of 6 (83%) showed improvement of symptoms after 1 sclerotherapy session (P < .05).ConclusionsJuxta-articular VMs of the knee are frequently associated with hemarthrosis and synovial thickening. Patients with signs of osteoarthritis and synovial involvement of the VM on presclerotherapy MR imaging deserve special consideration, as these findings predict worse clinical symptoms after sclerotherapy.     

In vitro and in vivo correlation for lipid-based formulations: Current status and future perspectives

Lipid-based formulations (LBFs) have demonstrated a great potential in enhancing the oral absorption of poorly water-soluble drugs. However, construction of in vitro and in vivo correlations (IVIVCs) for LBFs is quite challenging, owing to a complex in vivo processing of these formulations. In this paper, we start with a brief introduction on the gastrointestinal digestion of lipid/LBFs and its relation to enhanced oral drug absorption; based on the concept of IVIVCs, the current status of in vitro models to establish IVIVCs for LBFs is reviewed, while future perspectives in this field are discussed. In vitro tests, which facilitate the understanding and prediction of the in vivo performance of solid dosage forms, frequently fail to mimic the in vivo processing of LBFs, leading to inconsistent results. In vitro digestion models, which more closely simulate gastrointestinal physiology, are a more promising option. Despite some successes in IVIVC modeling, the accuracy and consistency of these models are yet to be validated, particularly for human data. A reliable IVIVC model can not only reduce the risk, time, and cost of formulation development but can also contribute to the formulation design and optimization, thus promoting the clinical translation of LBFs.     

硫酸镁注射液治疗婴幼儿喘息性疾病的分析

调查分析我院门诊、急诊患儿硫酸镁注射液的应用情况，为临床合理用药和儿科安全用药提供参考依据。对2017年11月门急诊含硫酸镁电子处方进行回顾性分析，内容包括年龄、用法用量、临床诊断、联合用药，使用天数等。共计204例患儿使用硫酸镁注射液，年龄在6个月至1岁之间的患儿最多，共72例，占比35.29%。67.65%的患儿使用剂量是30~50 mg·kg-1·d-1。临床诊断分别为急性喘息性支气管炎（32.35%）、肺炎（29.41%）、支气管炎（23.53%）等。在治疗方案中，硫酸镁常和糖皮质激素合用，其中有58.82%和醋酸甲泼尼龙合用，55.88%和布地奈德合用。目前硫酸镁在婴幼儿喘息性疾病的应用尚无统一、权威标准，可能存在用药风险。临床用药应加以重视、规范管理，保证用药安全。本研究结果对儿科合理使用硫酸镁注射液有参考价值。     

Effects of Mistletoe (Viscum Album L., Loranthaceae) Extracts on Arterial Blood Pressure in Rats Treated with Atropine Sulfate and Hexocycline

Acute effects of different extracts of mistletoe stem (Viscum album) were investigated on values of arterial blood pressure in Wistar rats. Arterial blood pressure was registered by direct method in the left carotid artery and the investigated extracts (total ethanol, ether and ethyl acetate) of mistletoe stem were administered into the right jugular vein. The total ethanol extract exhibited the best effect even on the lowest applied concentration (3.33 × 10^?5 mg kg^?1) and significantly decreased the blood pressure after applied concentration 1.00 × 10^?3 mg kg^?1. On the contrary, the ether and ethyl acetate extracts exhibited notable activity only by higher administered doses. Atropine as a nonselective blocker of muscarinic receptors reduced the hypotensive effects of ethanol extract of mistletoe. Hexocycline, a selective blocker of muscarine receptors, significantly raised blood pressure and decreased the hypotensive effect of ethanol extract of mistletoe on arterial blood pressure in rats.     

乙酰肝素酶与相关疾病的研究进展

乙酰肝素酶（HPA）是人体内唯一能降解硫酸肝素蛋白多糖（HSPG）的一种β-D-葡萄糖醛酸内切酶。HSPG是细胞外基质（ECM）的重要组成部分,广泛分布于细胞表面,在正常组织的发育与病理学改变的发展中具有重要作用。HPA能识别 HSPG的硫酸肝素链（HS）并将其降解,进而影响 ECM与上皮细胞及内皮细胞基底膜结构,释放与 HSPG结合的各种细胞因子。除通过降解 HS产生间接生理作用外, HPA还以聚集、脱落、分裂素绑定的方式影响多配体聚糖的生物效应。另外,HPA 可以增强信号级联效应,促进蛋白激酶的磷酸化和基因转录。因此,HPA的激活会引起一些病理生理学改变,包括炎性反应、血管形成、肿瘤转移、胚胎植入等。笔者拟就 HPA与相关疾病的研究进展,进行综述如下。     

PI-88: a novel inhibitor of angiogenesis

Growth factors that stimulate angiogenesis are vital in tumor development and maintenance. Inhibitors of angiogenesis are emerging as key elements in anticancer treatments, and now antibodies and small molecule kinase inhibitors are approved in the treatment of a variety of solid tumors. These have shown modest but statistically significant benefit in colon, breast and lung cancers. PI-88 has a novel mechanism of action compared to the drugs on the market today. By inhibiting heparanase, PI-88 blocks angiogenesis on several different cellular and biological levels. Promising results from Phase I/II trials are being seen with PI-88 in a variety of tumor types including melanoma and hepatocellular carcinoma. However, the development of antibody-induced thrombocytopenia has limited its use in some patients.     

Heparan sulphate,its derivatives and analogues share structural characteristics that can be exploited,particularly in inhibiting microbial attachment

Heparan sulphate (HS) and the related polysaccharide, heparin, exhibit conformational and charge arrangement properties, which provide a degree of redundancy allowing several seemingly distinct sequences to exhibit the same activity. This can also be mimicked by other sulphated polysaccharides, both in overall effect and in the details of interactions and structural consequences of interactions with proteins. Together, these provide a source of active compounds suitable for further development as potential drugs. These polysaccharides also possess considerable size, which bestows upon them an additional useful property: the capability of disrupting processes comprising many individual interactions, such as those characterising the attachment of microbial pathogens to host cells. The range of involvement of HS in microbial attachment is reviewed and examples, which include viral, bacterial and parasitic infections and which, in many cases, are now being investigated as potential targets for intervention, are identified.     

Association between the use of magnesium sulfate as neuroprotector in prematurity and the neonatal hemodynamic effects

Purpose: Cerebral palsy is often associated with prematurity and magnesium sulfate (MgSO₄) has been used as a neuroprotector, with favorable results. However, its mechanism of action has not been fully elucidated. This study aimed to evaluate the association between MgSO₄ at the imminent premature delivery and neonatal hemodynamic effects.

Materials and methods: A cross-sectional study involving 94 newborns (NB) between 24 and 32?weeks at a Brazilian hospital was performed. Bivariate analysis between the use or the non-use of MgSO₄ and hemodynamic characteristics was performed, using the Chi-square test.

Results: NB were evaluated between those who received MgSO₄ (27.7) and those who did not (72.3%). Normal heart rate was verified in 62.8% of NB, normal respiratory rate in 70.2%, and normal temperature in 22.3%. Oxygen saturation higher or equal than 95% was evidenced in 85.1% of NB, normal hemoglucotest in 74.5%, and hemoglobin greater or equal than 16.4?g/dL in 30.9%. Non-invasive ventilation was performed in 48.9% of NB, while 51.1% were submitted to endotracheal ventilation. There was no significance relation detected between the use of MgSO₄ and the hemodynamic characteristics.

Conclusions: MgSO₄ does not appear to influence hemodynamic factors as a cause of the neuroprotection in premature NB.