Nano carriers for drug transport across the blood–brain barrier

Effective therapy lies in achieving a therapeutic amount of drug to the proper site in the body and then maintaining the desired drug concentration for a sufficient time interval to be clinically effective for treatment. The blood–brain barrier (BBB) hinders most drugs from entering the central nervous system (CNS) from the blood stream, leading to the difficulty of delivering drugs to the brain via the circulatory system for the treatment, diagnosis and prevention of brain diseases. Several brain drug delivery approaches have been developed, such as intracerebral and intracerebroventricular administration, intranasal delivery and blood-to-brain delivery, as a result of transient BBB disruption induced by biological, chemical or physical stimuli such as zonula occludens toxin, mannitol, magnetic heating and ultrasound, but these approaches showed disadvantages of being dangerous, high cost and unsuitability for most brain diseases and drugs. The strategy of vector-mediated blood-to-brain delivery, which involves improving BBB permeability of the drug–carrier conjugate, can minimize side effects, such as being submicrometre objects that behave as a whole unit in terms of their transport and properties, nanomaterials, are promising carrier vehicles for direct drug transport across the intact BBB as a result of their potential to enter the brain capillary endothelial cells by means of normal endocytosis and transcytosis due to their small size, as well as their possibility of being functionalized with multiple copies of the drug molecule of interest. This review provids a concise discussion of nano carriers for drug transport across the intact BBB, various forms of nanomaterials including inorganic/solid lipid/polymeric nanoparticles, nanoemulsions, quantum dots, nanogels, liposomes, micelles, dendrimers, polymersomes and exosomes are critically evaluated, their mechanisms for drug transport across the BBB are reviewed, and the future directions of this area are fully discussed.     

Association of admission blood glucose level and clinical outcomes in elderly community‐acquired pneumonia patients with or without diabetes

IntroductionCommunity‐acquired pneumonia (CAP) is the major cause of infection‐related mortality worldwide. Patients with CAP frequently present with admission hyperglycemia.ObjectivesThe aim of this study was to evaluate the association between admission blood glucose (ABG) level and clinical outcomes in elderly CAP patients (≥80 years of age) with or without diabetes.MethodsIn this single center retrospective study, 290 elderly patients diagnosed with CAP were included. Demographic and clinical information were collected and compared. The associations between admission blood glucose level and the 30‐day mortality as well as intensive care unit (ICU) admission and invasive mechanical ventilation (IMV) in elderly CAP patients with or without diabetes were assessed.ResultsOf the 290 eligible patients with CAP, 159 (66.5%) patients were male, and 64 (22.1%) had a known history of diabetes at hospital admission. After adjusting for age and sex, the logistic regression analysis had identified several risk factors that might be associated with clinical outcomes in elderly patients with CAP. Multivariable logistic regression analysis revealed that admission glucose level > 11.1 mmol/L was significant associated with ICU admission, IMV, and 30‐day mortality both in non‐diabetic and diabetic patients. Furthermore, Kaplan–Meier analysis indicated that patients with higher admission glucose level were correlated statistically significantly with 30‐day mortality in patients with CAP (P < 0.001).ConclusionAdmission blood glucose is correlated with 30‐day hospital mortality, ICU admission, and IMV of CAP in elderly patients with and without diabetes. Specially, admission glucose > 11.1 mmol/L was a significant risk factor for 30‐day hospital mortality.     

通调督脉化瘀排毒法治疗尿毒症晚期患者92例临床研究

目的观察应用通调督脉化瘀排毒法治疗尿毒症晚期的临床疗效。方法将92例尿毒症晚期患者随机分为两组,治疗组48例,除一般治疗外,加用海洋生命平衡超导治疗仪,将中药干粉剂作用于督脉、足太阳膀胱经的五脏六腑之俞穴,每日3次,每次1小时;对照组44例,给予一般治疗。结果治疗组总有效率及生化指标与对照组比较均有显著改善(P<0.05)。结论应用调督通脉化瘀排毒法,能提高尿毒症晚期患者的临床疗效。     

人参皂苷Rb1和罗格列酮联合用药对2型糖尿病痴呆小鼠记忆功能的影响及机制

目的: 研究人参皂苷Rb₁和罗格列酮联合用药对2型糖尿病记忆障碍小鼠动物学习记忆能力及胰岛素信号通路的影响. 方法: 雄性10周龄C57BL小鼠16只为正常组(N组),雄性10周龄Kkay小鼠64只为模型组,高糖高脂饲料喂养6周后,检测随机血糖≥13.9 mmol·L^-1后随机分为模型组(M组)、阳性组(P组)、联合给药高、中、低剂量组(C1,C2,C3组).P组每天用马来酸罗格列酮片按3.0 mg·kg^-1灌胃,C组每天用马来酸罗格列酮片(3.0 mg·kg^-1)和人参皂苷Rb₁(60,30,15 mg·kg^-1)灌胃,N组和M组每天用等体积生理盐水灌胃,持续42 d.给药前后分别进行1次Morris水迷宫试验,记录结果并做比较.水迷宫后及时于冰上开颅取海马.采用酶联免疫吸附剂测定(ELISA)小鼠血浆胰岛素水平;半定量反转录-聚合酶链反应(RT-PCR)检测小鼠大脑海马中1-磷脂酰肌醇-3激酶亚基p85(PI-3K/p85)的信使核糖核酸(mRNA)表达水平. 结果: 与正常组相比,模型组在水迷宫试验中寻找平台的时间及错误率明显偏高(P<0.05),血浆胰岛素水平和PI-3K/p85水平均明显升高(P<0.05);与模型组相比,罗格列酮组与之各项指标差异均不明显,复合给药组平台潜伏期均明显降低(P<0.05),血浆胰岛素水平和PI-3K/p85水平均明显降低(P<0.05). 结论: 人参皂苷Rb₁能在改善血浆胰岛素水平的基础上,有效提高胰岛素抵抗型糖尿病记忆障碍小鼠学习、记忆能力,其可能的作用机制为通过降低PI-3K/p85表达水平改善大脑海马胰岛素信号传导通路.     

红花黄色素对急性血瘀大鼠微循环及血液流变学部分指标的影响

目的观察红花黄色素(saffioryellow,SY)对血瘀大鼠微循环和血液流变性的影响。方法通过皮下注射肾上腺素注射液0.07ml/(kg     

牛蒡子苷元现代药理作用研究进展

ARC-G（牛蒡子苷元）为中药牛蒡子中常见的主要活性物质,通过众多学者的潜心钻研,使得ARC-G在药用方面的作用逐渐凸显出来。目前对其药理作用的研究比较深入,有抗炎及增强免疫力、抵御病毒、抗白血病、抑制肿瘤细胞活性和调节血糖等作用。已进行初步研究的药理活性包括抗菌、抵御血小板活化因子（PAF）受体、调节血压稳定以及对于心脏病的调节。本文综述了近几年关于牛蒡子苷元药理作用的文献,以期为更深入地研究ARC-G药理作用以及扩大其临床应用提供参考。     

痰湿证睡眠呼吸暂停患者CPAP压力水平研究

目的:对痰湿证睡眠呼吸暂停(OSA)患者运用持续正压通气(CPAP)治疗,探讨呼吸机压力水平和BMI、颈围、最低血氧、AHI、鼾声指数的关系,推导相关压力值计算公式,方便临床应用。方法:对54例痰湿证OSA患者行呼吸机压力滴定,分析呼吸机压力水平和BMI、颈围、最低血氧、AHI、鼾声指数的相关性,得出平均压力的多元线性回归方程,用于临床参考。结果:(1)CPAP治疗前后AHI指数和鼾声指数有显著差异(P0.01),CPAP治疗疗效显著。(2)BMI、颈围、最低血氧、AHI、鼾声指数均和平均压力直线相关(P0.01)。(3)根据多元线性逐步回归,得出平均压力=0.220×颈围+0.036×AHI+0.001×鼾声指数-3.746。结论:OSA患者BMI、颈围、最低血氧、AHI、鼾声指数均与CPAP平均压力显著相关,通过回归方程计算得出相关压力水平。     

理血类中药在治疗寻常型银屑病中的应用

银屑病俗称为"牛皮癣",属于中医"白疕"的范畴,是一种常见的、慢性且反复发作的,以红斑、脱屑、斑块为主要皮损的皮肤病,其病程缠绵反复,顽固难愈,为临床常见病、难治病。古代医学将寻常型银屑病的病机总结为风、湿、热、燥、毒等范畴,临床辨证分型主要以血热、血瘀、血燥常见,治则主要有清热凉血解毒、活血化瘀、养血润燥,临床用药以凉血、养血及活血类等理血中药为主。本文主要对理血中药及临床中常用的几味理血中药在银屑病治疗中的作用综述如下。     

祛瘀化痰、散结消瘢中药复方对肾小球系膜细胞增殖及ECM的影响

目的：探讨祛瘀化痰、散结消瘕中药复方对肾小球系膜细胞增殖及ECM合成调控系统的影响。方法：以脂多糖为刺激因子,作用于体外培养的大鼠肾小球系膜细胞,设立空白对照组、川芎组、川芎＋鳖甲组、川芎＋海藻组、川芎＋鳖甲＋海藻组（高、中、低剂量组）,以MTT比色法观察各组肾小球系膜细胞增殖情况,ELIsA法观测细胞上清中FN水平的变化。结果：川芎组、川芎＋鳖甲组、川芎＋鳖甲＋海藻（高、中剂量）组均能不同程度地抑制肾小球系膜细胞增殖,减少FN的含量,中以川芎＋鳖甲＋海藻组（高剂量）作用最明显,且随着用药浓度增加,作用增强。结论：祛瘀化痰、散结消瘢中药复方具有干预肾小球硬化的作用,而这一作用可能与有效抑制系膜细胞增殖、下调系膜细胞上清中FN水平,减少EcM合成有关。     

刺血疗法联合紫外线照射治疗带状疱疹

目的:评价刺血疗法联合紫外线照射治疗带状疱疹的临床疗效和安全性.方法:将130例患者随机分为观察组(65例)、对照组(65例).观察组采用刺血疗法联合紫外线照射,先用梅花针重叩病变局部,再拔罐,取罐后采用体表分野法对皮损区及脊椎旁相应的神经根区进行紫外线照射治疗;对照组采用阿昔洛韦等西药治疗,两组疗程均为7天,观察疗效及不良反应.结果:治疗7天后观察组痊愈率和总有效率分别为76.9%和90.8%,均显著优于对照组的38.5%、66.2%(均P<0.01),观察组后遗神经痛发生率为3.1%,明显低于对照组的12.3%(P<0.05);两组疼痛、皮损、睡眠积分较治疗前明显降低(均P<0.01),且组间比较观察组各项积分下降更为显著(P<0.01,P<0.05);痊愈患者中观察组带状疱疹止痛、止疱、结痂及痊愈时间均显著低于对照组(P<0.01,P<0.05).结论:刺血疗法联合紫外线照射治疗带状疱疹起效快,并且能有效缩短病程,降低后遗神经痛的发生率,是高效安全的治疗方案.