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OBJECTIVE To explore potential proarrhythmic effect and underlying mechanism of azithromycin (AZM) and Shengmai injection (SM) used clinically.METHODS ① In vivo guinea pig ECG recordings were made to analyze effects of jugular intravenous(iv) injection of AZM [38.2 mg· kg-1,one time (clinically relevant dose,CRD)],or SM (4.6 mL· kg-1,one time CRD) or their combination.②In vitro ECG recordings were made to analyze effects of AZM,SM or AZM + SM on ECG in isolated hearts of guinea pigs.AZM [one,five and ten times (clinically relevant concentrations,CRC)] was perfused in this order:41.5 →207.5 → 415 mg· L-1 and SM (one,five and ten times CRC) in this order:5 →25 →50 mL· L-1.Also,AZM (41.5 mg· L-1,one time CRC) +SM (5 mL· L-1,one time CRC) was perfused to isolated hearts of guinea pigs.③ Enzymatically isolated cardiomyocytes from guinea pig left ventricles were perfused in this order:AZM 41.5 mg· L-1 →AZM 41.5 mg· L-1+SM 5 mL· L-1 for action potential,L-type Ca2+ and Na+ current recordings,respectively.RESULTS ① Neither AZM 38.2 mg· kg-1,nor SM 4.6 mL· kg-1 significantly changed the in vivo ECG.However,AZM 38.2 mg· kg-1 +SM 4.6 mL · kg-1 significantly reduced heart rate (P＜0.05) and prolonged the P-R (P＜0.05) and QRS (P＜0.05) intervals.②AZM 41.5,207.5 and 415 mg· L-1 reduced heart rate (P＜0.05) and prolonged the P-R (P＜0.05) and QRS (P＜0.05) intervals in a concentration-dependent manner.AZM 415 mg·L-1 also prolonged QTc (P＜0.05) interval.SM 5,25 and 50 mL· L-1 reduced heart rate (P＜0.05) and prolonged the P-R interval (P＜0.05) in a concentration-dependent manner.SM had no effect on QRS or QTc intervals.Washout partially recovered the above changes.Moreover,AZM 41.5 mg· L-1 + SM 5 mg·L-1 significantly reduced heart rate (P＜0.05) and prolonged the P-R (P＜0.05) and QRS intervals.③ AZM 41.5 mg·L-1 did not significantly change the action potential amplitude (APA),action potential durations at 50％ (APD50) and 90％ (APD90) repolarization levels,or L-type Ca2+ and Na+ currents.However,AZM+SM 5 mg· L-1 significantly reduced APA (P＜0.05),shortened APD50 (P＜0.05) and APD90 (P＜0.05) and inhibited the L-type Ca2+ (P＜0.05) and Na+ (P＜0.05) currents.CONCLUSION AZM and SM has potential prorrhythmic risks.The combined use might cause higher risk of arrhythmia.The underlying mechanism for proarrhythmia is mediated by inhibition of the L-type Ca2+ and Na+ currents.
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Objective To explore the associated rules between western medicine and traditional Chinese medicine (TCM) on urinary tract infection (UTI) with text mining technique.Methods The data set on UTI was downloaded from CBM database.The regularities of Chinese patent medicines (CPM),western medicines and the combination of CPM and western medicines on UTI were mined out by data slicing algorithm.The results were showed visually with Cytoscape2.8 software.Results The main function of CPM was focused on clearing heat and removing toxicity,promoting diuresis and relieving stranguria.For western medicine,antibacterial agents was often used and it was also frequently used together with CPM such as Sanjinpian.Conclusions Text mining approach provides an important method in the summary of the application regularity for disease in both TCM and western medicine.
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Objective To investigate the effects of acarbose versus fenofibrate on insulin secretion and insulin resistance in the subjects with impaired glucose tolerance (IGT) and hypertriglyceridemia. Methods Eighty subjects were allocated to acarbose group (28 cases),fenofibrate group (30 cases),and control group (22 cases) without intervention for 3 months,and also divided into elderly (46 cases) and younger groups (34 cases). Fasting blood samples were collected for measuring fasting plasma glucose and lipid.Oral glucose tolerance test (OGTT) were carried out with measurement of plasma insulin and glucose before ad after treatment.Early insulin secretion indexes(△I30/△G30),insulin secretion indexes (HOMA -β) and insulin resistance indexes (HOMA-IR)were calculated. Results After 3-months of treatment,the lipid profile was evidently improved in fenofibrate group. Levels of triglyceride (TG) and total cholesterol (TC) were significantly reduced ( both P ＜ 0.01 ),△I30/△G30 was significantly increased (P ＜ 0.05) and HOMA-IR was decreased (P＜＜0.01).In acarbose group,levels of fasting plasma glucose (FPG),2hours postprandial plasma glucose (2 hPG) and HOMA-IR were reduced (all P＜0.01),△I30/△G30 and HOMA-β were enhanced (P＜0.01 or P＜0.05).No change of above indicators was found in the control group.Compared with fenofibrate group,acarbose group had higher △ I30/△G30 (P＜ 0.05),HOMA-β (P＜ 0.01 ) and lower HOMA-IR ( P ＜ 0.01 ).The improvement of △△I30/△G30 was correlated with the decreasing of plasma FPG,2 hPG and TG(r=0.5812,0.6327,0.3872,P＜0.01),while HOMA-1R was related with the decreasing of plasma 2 hPG,TG and TC(r=0.8126,0.4671,0.2895,P＜ 0.01). HOMA-IR,△I30/△G30 and HOMA-β were lower (P＜0.01) and acarbose improved insulin resistance better (P＜0.05) in the elderly than in the younger with type 2 diabetes. Conclusions Pancreatic β-cell function declines gradually with aging,acarbose may have advantage over fenofibrate in improving early insulin secretion and resistance which was more relieved by diminishing glucotoxity in comparison with lipotoxity.
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OBJECTIVE:To study the general pattern and characteristics of the ADRs associated with Houttuynia cordata injection(HCI).METHODS:An analysis was conducted on55cases of ADRs induced by HCI reported in domestic medical jou_ rnals in recent years.RESULTS:The ADRs of HCI were not related to the dosage given.The onset of ADRs was commonly within30min during infusion.The ADRs mostly occurred in groups of patients under age20and from30to59years of age.The ADRs could involve multiple organs and systems,and the clinical manifestations were varying,of which allergic reaction was the commonest one including anaphylactic shock.CONCLUSION:The mechanism of allergic reaction induced by HCI remains to be further studied.Clinical physicians,nurses and pharmacists should pay more attention to the ADRs of HCI.