ABSTRACT
OBJECTIVE：To investigate the r ole of clinical pharmacists on the therapy for human herpesvirus 7（HHV-7） infection in central nervous system. METHODS ：The clinical pharmacists participated in the treatment process of the hospitalized patient who was a 15-year-old patient with central nervous system infection. The doctor initially gave Levetiracetam tablets （500 mg，bid，po）to control epilepsy symptoms ，and Acyclovir for injection （500 mg，q8 h，ivgtt）for antiviral treatment. According to the large red wheal scattered rubella on the limbs and back of the patient ，clinical pharmacists recommended to give Dexamethasone sodium phosphate injection （10 mg，qd，iv）and Loratadine tablets （10 mg，qd，po）for anti-allergy treatment ；in view of involuntary shaking of limbs in the patient ，clinical pharmacists recommended to continue to give Dexamethasone sodium phosphate injection intravenously to control inflammation and Xingnaojing injection （20 mL，qd，ivgtt） to improve the convulsion. For HHV- 7 infection，based on consulting the relevant guidelines and existing treatment experience ，the clinical pharmacists recommended discontinuation of acyclovir ， dexamethasone combined with Human immunoglobulin （pH 0278）（17.5 g，qd，ivgtt）for impact therapy should be used and adverse drug reactions and therapeutic effects should be monitored at the same time. RESULTS ： The physiciansaccepted the suggestions of clinical pharmacists. The patient was improved and discharged from the hospital after 18 days of treatment. CONCLUSIONS ： During the treatment of ineffective case of clinic rare central nervous system infectious diseases with routine a ntiviral drugs ，clinical pharmacists assisted physicians to improve their treatment plan and ensure the effectiveness and safety of patient ’s medication.
ABSTRACT
Objective To evaluate the safety, performability and long-term clinical efficacy of stenting angioplasty for treating symptomatic internal carotid artery (ICA) stenosis in the origin part in elderly patients. Methods Stenting angioplasty was performed on 29 patients with symptomatic ICA stenosis in the origin part. Results 29 stents were placed in 29 patients. Operations were performed 100%successfully. After an average 24 months of follow-up visits, restenoses were detected in 2cases reexamined by DSA 6 months after stenting, both presented with less than 50% stenoses. 1 case was found not regularly taking statins and antiplatelet drugs after stenting, severe restenosis occurred 6 months later, stent implantation performed again, no recurrence of transient ischemic attack (TIA) was noted during 2 years′follow-up visit. Cerebral ischemic strokes occurred in 2 cases , and both of them had balloon dilatation after stenting. 1 case was completely recovered after treatment and 1 was left with weakness in right extremities, unabling to walk. No cases of posterior circulation ischemia, death and myocardial infarction were detected. Conclusions Stenting angioplasty can be performed in treating symptomatic internal carotid artery stenosis in elderly patients. It showed a relatively good mid-long-term clinical effects and can be a secondary prevention option.
ABSTRACT
Objective To observe the effect of β-amyloid42 (Aβ42) on stimulating the inflammatory factors production by BV-2 microglia, including interleukin-1β (IL-1β), IL-10 and nitric oxide (NO), and to contrast the inhibitory action of anti-Aβ42 antibody in serum of Alzheimer's patients and the artificially synthesized anti-Aβ42 antibody. Methods The anti-Aβ42 antibodies were extracted from the serum of Alzheimer's patients. And the BV-2 microglia cells in murine were cultured as in vitro cell model. The cells were stimulated by Aβ42 and the two different anti-Aβ42antibodies to analyze the impact of stimulants on the cell activity. The Aβ42 of 5 μmol/L was added to the culture separately or in mixture with each of the two different anti-Aβ42 antibodies. Each antibody was mixed with Aβ42 of 5 μmol/L at final anti-Aβ42 antibody titre of 5 μg/ml, 1 μg/ml and 0.2 μg/ml,respectively. Then clear supernatant was collected from each tube respectively at 6 h, 12 h, and 24 h after culture, and the concentrations of IL-1β, IL-10 and NO were determined. Results The Aβ42,artificially synthesized anti-Aβ42 antibody and anti-Aβ42 antibody from Alzheimer's patients had no effects on the activities of BV-2 cells, the cell survival rates were (98. 6±5.8)%, (101.9±2.8)%and (98. 4±6.0)%, with no significant differences as compared with normal control group (F=0. 407, P＞0. 05). The inflammatory factors releasing from BV-2 cells stimulated by Aβ42 reached the peak level at 12 h, the concentrations of IL-1β, IL-10 and NO were (69.0±12.7) pg/ml, (24.1 ±4. 0) pg/ml and (128. 2±8. 7) μmol/L, the concentrations of IL-1β and NO were significantly higher at 12 h than at 6 h and 24 h (F= 15. 470 and 242. 107, P＜0.05), there was no significant difference in the concentration of IL-10 among 12 h, 6 h and 24 h (F=1. 852, P＞0.05). The two different antiAβ42 antibodies of different titre remarkably inhibited Aβ42 stimulated BV-2 cells to release inflammatory factors. At high titre of 5 μg/ml, the two different antibodies showed no significant difference in the inhibitory effects (P＞0.05), while at the titre of 0. 2 μg/ml, anti-Aβ42 antibody from Alzheimer's patients showed a significantly lower inhibitory effect than artificially synthesized antibodies, the concentrations of NO were (35.4 ± 2. 5) μoml/L and ( 19. 2 ± 3.3) μoml/L,respectively (P ＜ 0.05). Conclusions The Aβ42 can stimulate BV-2 microglia cells to release inflammatory factors. Anti-Aβ42 antibody from Alzheimer's patients has a lower inhibitory effect on Aβ42 in stimulating microglia to release inflammatory factors.