ABSTRACT
OBJECTIVE:To investigate the effects of different diuretic regimens on related indicatora in hepatocellular carcino-ma patients after hepatic resection. METHODS:A total of 60 hepatocellular carcinoma patients undergoing hepatic resection were randomly divided into study group (30 cases) and control group (30 cases). After surgery,study group was given Spironolactone tablet 100 mg+Furosemide tablet 40 mg,qd,after breakfast;Control group was given Spironolactone tablet 100 mg orally,bid,af-ter breakfast and at 16:00+Furosemide tablet 20 mg,qd,after breakfast. Electrolyte,liver and renal function of 2 groups were re-checked every 3 days;diuretic regimen was adjusted according to body weight and volume of liquid intake and output. The effec-tiveness indexes of diuretic treatment were observed in 2 groups,such as the decrease of body weight,case number of effective di-uretic treatment,frequency of intravenous dieresis,frequency of hydroxyethl starch use,frequency of night arination,postoperative hospitalization stay,the time of ascites extinction;serum sodium,serum potassium,serum creatinine,blood urea nitrogen,serum al-bumin,ALT,AST,GGT,the occurrence of ADR were observed before and after treatment. RESULTS:The nocturnal micturition frequency of study group was significantly lower than that of control group,with statistical significance (P<0.05). There was no significant difference in the decrease of body weight,response rate of diuretic treatment,frequency of intravenous dieresis,frequen-cy of hydroxyethyl starch use,postoperative hospitalization stay or the time of ascites extinction between 2 groups(P>0.05). After treatment,the levels of serum sodium and serum albumin in 2 groups were decreased significantly,compared to before treatment;the levels of blood urea nitrogen,serum potassium and ALT,AST,GGT in 2 groups were significantly higher than before treat-ment,with statistical significance(P<0.05). There was no statistical significance in the levels of serum sodium,serum potassium, blood urea nitrogen,serum albumin or ALT,AST,GGT between 2 groups(P>0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Both two diuretic regimens can effectively avoid the occurrence of postoperative ascites formation and related complication in patients hepatocellular carcinoma after hepatic resection. The drug regi-mens of spironolactore 100 mg,qd+furosemide 40 mg,qd after breakfast can significantly reduce nocturnal micturition frequency and improve medication compliance.
ABSTRACT
Aim To determine the effective compo-nents of Semen Ziziphi Spinosae for sedative-hypnotic and its mechanism. Methods The extraction of Se-men Ziziphi Spinosae and the rat brain homogenates were prepared. High concentrations of Diazepam com-petitively replaced the ligand compounds of Semen Ziz-iphi Spinosae combining BDZ receptor in brain tissue, and all the compounds with sedative and hypnotic effects were collected and identified by HPLC and LC-MS technique, as the compounds extracted from the brain tissue were administered with Semen Ziziphi Spi-nosae. The brain tissue was administered with Diaze-pam, and with Semen Ziziphi Spinosae and Diazepam. Results The HPLC chromatograms show that the peak time of BDZ receptor ligand compounds was 2. 71 min and 46. 87min, when compared with Diazepam. And the LC-MS chromatograms display the relative molecu-lar weight of the ligand compounds was 274. 28 m/z, 453. 34 m/z,496. 34 m/z and 608. 38 m/z respective-ly. According to the fingerprint of Semen Ziziphi Spi-nosae, these compounds may be fatty acid substances and lupine pill triterpene compounds. Conclusions On the basis of the principle of receptor ligand bind-ing, we established a way to quickly analyze and iden-tify the role of natural products in the same drug target compounds. The method not only can clearly define the effective components of natural products, but also clar-ify the mechanism of action of the compounds. The ac-tive ingredient of calm hypnosis in Semen Ziziphi Spi-nosae may be fatty acid substances Palmitic acid ( C16 H32 O2 ) and lupine pill triterpene compounds Alphitolic acid( C30 H48 O4 ) and Spinosin( C28 H32 O15 ) . They exert their sedative and hypnotic effects by combining with BDZ receptor, and the research has laid a theoretical foundation for the further study about mechanism of Se-men Ziziphi Spinosae.