ABSTRACT
OBJECTIVE：To investiga te the clinical efficacy and safety of donepezil monotherapy versus donepezil combined with memoriam in the treatment of Alzheimer ’s disease （AD）. METHODS ：Totally 100 patients with moderate and severe AD who received medical care in Sichuan Academy of Medical Sciences & Sichuan Provincial People ’s Hospital （East Hospital ）from March 2018 to March 2020 were enrolled as study subjects ，and then were divided into control group and treatment group randomly. Control group was given donepezil monotherapy treatment （initial dose of 5 mg/d，before bedtime ；after 4 weeks，the dose was changed to 10 mg/d before bedtime ；the total medication time was 6 months）. Treatment group was treated with memantine（initial dose was 5 mg/d，the dose of those without adverse reactions was increased by 5 mg until 20 mg/d，for 6 months）on the basis of the control group ，with 50 patients in each group. Montreal cognitive assessment scale （MoCA）score， MMSE score ，ADL score ，treatment response rate and the occurrence of ADR were compared between 2 groups before and after treatment. RESULTS ：Compared with same group before treatment ，MoCA score ，MMSE score and ADL score of the two groups were significantly improved after treatment （P＜0.05）. After treatment ，compared with control group ，MoCA score ，MMSE score ， ADL score and total response rate in the treatment group were significantly increased （P＜0.05），while the incidence of ADR was decreased significantly （P＜0.05）. CONCLUSIONS ：Donepezil combined with memantine has better clinical efficacy than donepezil monotherapy in the treatment of moderate and severe AD ，and is helpful to improve the neurological function of AD patients，with good safety.
ABSTRACT
Objective To observe the effects of urate-lowering therapy ( ULT) on indexes of inflammation, the frequency of gout flares, compliance of ULT, and the achieved rates of serum uric acid in patients at acute stage. Methods 151 patients with acute gout flares were randomly divided into observation group ( 60 cases with ULT in the acute phase) and control group (91 cases with ULT after 2 weeks of complete remission from acute flares). Visual analogue pain scores (VAS), joint swelling scores, white blood cell counts, erythrocyte sedimentation rates (ESR), as well as high sensitive-C reactive protein (hs-CRP) were measured respectively and compared between two groups. The observation group was treated with 40 mg/d of febuxostat for 12 weeks after effectively achieved inflammation ( VAS<3 points) , while the control group was treated with the same therapy after 2 weeks of symptoms complete remission from acute gout flares. Finally, these indexes were followed and recorded, including the number of gout flares, the compliance of ULT, the changes of liver and kidney function, and the proportion of patients with serum uric acid<360μmol/L. Results There was no statistical difference in the baseline condition, VAS pain scores, joint swelling scores, white blood cell counts, ESR, and hs-CRP between two groups after different ULTs ( all P>0.05) . There was no statistical difference in the frequency of gout flares between two groups during the ULT of 12 weeks ( P=0.658) . At the end of 12 weeks, the serum uric acid in the observation group was significantly lower compared with the control group [(318.38±95.16 vs 398.12±120.13)μmol/L,P<0.01]. The compliance rate of ULT and the rate of reaching the standard of serum uric acid<360μmol/L in the observation group were higher than those in the control group ( both P<0.01) . Conclusion The treatment of ULT with patients after effective achieved of acute gout inflammation has no detrimental effects on VAS pain, joint swelling score, the conversion of inflammation index, and the number of gout flares, while improving the compliance of ULT and the achieved rate of serum uric acid.
ABSTRACT
Objective To investigate the Video?Electroencephalography(VEEG)characteristics and abnormal rate among healthy elderly. Meth?ods According to the age,120 healthy elders were divided into groups A,B,and C. Group A has 57 subjects,aged 60?69 years old;group B has 42 people,aged 70?79 years;group C has 21 individuals,aged≥80 years. Chi square and Rank sum test were used to calculate abnormal rate of VEEG. Additionally,characteristics of alpha、slow wave and Iconic sleep wave were analyzed. Result The total abnormal rate of VEEG was 42.5%, and it was particularly high(76.2%)among elderly over 80s. Frequency,amplitude,reactivity of Alpha wave and alpha index decreased as age in?creased. Theta slow wave increased as age increased,abnormal frontal area theta showed an increase among elderly over 80 s. Each sleep cycle iconic sleep wave was gradually decreased in the elderly. No statistical difference was found about sleep spindles and vertex sharp among different groups . Positive occipital sharp transients of sleep(POSTS)decreased as age increased. There was no POSTS among elderly over 80 s. Conclusion Our re?sults showed that abnormal rate is increased in the elderly,while reactivity variation,slow alpha frequency,alpha amplitude,alpha index are de?creased. In addition,the slow waves in frontal area is increased,. sleep cycles becomes less distinct,and the typical wave are decreased.
ABSTRACT
With the development of the medicine industry and the expansion of global commu-nication and cooperation , more and more Chinese higher vocational college students who major in pharmaceutical management and administration are aware of the demands and are trying to master English for Specific Purpose (ESP) for their better future development. The necessity, course orienta-tion, curriculum design and teaching method for opening ESP course in pharmaceutical management and administration major of higher vocational college were studied in this paper.
ABSTRACT
Objective To investigate the effects of oxytocin on hemodynamies in patients under epidural block.Methods Twenty-six selective myomectomy patients were randomly divided into epidural block group(E) and general anesthesia group(G) with 13 cases each.Epidural anesthesia with 2 % lidocaine was performed with the blocking plane of T_6-T_8.Group G was given general anesthesia with propofol,fentanyl,remifentanyl and vecuroniurn.Oxytocin 5 U was injected in 30 s when hysteromyoma was removed and the hemodynamics was stable.MAP and HR were recorded before and after oxytocin injection.Results Compared to those before,MAP was decreased and HR was increased after oxytocin injection in both groups(P<0.05 or P<0.01).The decrease of MAP was slower but lasted for a longer period in group E than those in group G(P<0.05 or P<0.01).Conclusion Epidural blockade may aggravate the hypotensive effect of oxytocin and inhibit oxytocin-induced HR increasise.
ABSTRACT
Objective To study the role of atrial natriuretic peptide (ANP) and renin-angiotensin-aldosterone system (RAAS) in the pathogenesis of salt-sensitive (SS) hypertension and mechanism of the hypotensive effect of benazepril and ANP in patients with SS essential hypertension. Methods Sixty-four patients with essential hypertension were divided into SS (n=30) and non-salt-sensitive (NSS, n=34) groups by modified Sulliran's method. Plasma ANP, angiotensin Ⅱ (AⅡ) and aldosterone (ALD) were determined before and during the period of salt loading test. Thirty healthy subjects as controls were also enrolled. A self-comparative study of benazepril with the placebo was performed in SS group. Before and after the placebo and benazepril therapy, blood pressure (BP) and plasma ANP were determined. Results (1)Basal plasma ANP level in the SS group was significantly lower than that in the NSS group. Basal plasma ANP level in the NSS group was also significantly lower than that in the control group [(110.28±15.40) pmol/L vs NSS (145.52±26.53) pmol/L and control (197.74±26.20) pmol/L]. Plasma ANP in both SS and NSS groups [(133.56±34.03) pmol/L and (169.20±35.91) pmol/L respectively, both P<0.05 vs control]. Percentage of increase of plasma ANP in SS and NSS groups was of no difference (P>0.05) . (2) No significant difference of basal plasma AⅡ and ALD levels were found between SS and NSS groups (P>0.05). There were no significant changes of plasma AⅡ and ALD during salt loading in both SS and NSS groups ( both P>0.05). (3) After the benazepril treatment, plasma ANP was increased significantly [(146.74±31.86) pmol/L , P<0.01]; both systolic and diastolic BP were reduced significantly in SS group. (4) Basal plasma ANP level was negatively correlated with the magnitude of increase of mean arterial pressure (MAP) by salt loading (b=-0.06, P<0.05). Conclusion Deficiency of circulating endogenous ANP may play an important role in the pathogenesis of SS hypertension. Benazepril could reduce BP and increase plasma ANP significantly in patients with SS hypertension.
ABSTRACT
To probe the genetic background and immunopathogenesis of dilated cardiomyopathy (DCM) 77 patients with DCM, HLA-DRB1 gene polymorphism were analyzed by using the polymerase chain reaction/sequence specific primer (PCR/SSP) technique and autoantibody against myocardial mitochondria ADP/ATP carrier were examined by using the Immunoblot analysis. The frequency of HLA-DRB1*0901 allele was significantly higher in DCM patients in which autoantibody against ADP/ATP carrier of myocardial mitochondria is positive in contrast with those in which the autoantibody is negative (25.46% vs 3.45%, P < 0.05), the relative risk (RR) being 9.56. The other frequencies of HLA-DRB1 alleles have no significant difference in the antibody positive group and negative group. It is possible that a subset of DCM patients may exist in which autoimmunity is associated with genetic factors.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Autoantibodies , Allergy and Immunology , Cardiomyopathy, Dilated , Genetics , Allergy and Immunology , HLA-DR Antigens , Genetics , Allergy and Immunology , HLA-DRB1 Chains , Mitochondria, Heart , Allergy and Immunology , Mitochondrial ADP, ATP Translocases , Allergy and ImmunologyABSTRACT
Objective: To evaluate the prognostic value of serum troponin Ⅰ (cTnI) in unstable angina pectoris (UA). Methods: Serum cTnI, creatine kinase isoenzyme MB (CK－MB) were simultaneously measured in 25 healthy subjects, 96 UA patients, routine treatment was administered and cardiac events were observed closely within two weeks. Results: Thirteen of 28 UA patients whose cTnI was≥0.3μg/L developed cardiac events, only 3 of 68 UA patients whose cTnI was ＜0. 3 μg/L developed cardiac events within two weeks, there was a significant difference (P＜0. 05). Conclusion: There is a clinical value of serum cTnI measurement in identifying the high risk patients of UA. The patients whose cTnI was≥0. 3μg/L indicate a poor prognosis.
ABSTRACT
The relationship between hyperhomocysteinemia and coronary artery disease (CAD) was investigated and the influence of environmental factors (Folate, VitB12) and genetic factors ［N5,N10-methylenetetrahydrofolate reductase gene (MTHFR) or MTHFR gene mutation］ on plasma homocysteine (Hcy) levels and the risk of CAD observed. Fifty-one CAD patients and 30 CAD-free subjects were recruited in the study. The polymorphisms of MTHFR gene were analyzed by PCR-RFLP and plasma total Hcy levels were measured by high performance liquid chromatography with fluorescence detection. Plasma folate and vitamin B12 concentrations were measured by an automated chemiluminescence method. It was found that mean total plasma Hcy concentrations were significantly higher in CAD patients than in CAD-free subjects (P<0.01). The differences were also apparent among the three genotypes of MTHFR gene in CAD group (P<0.05). There was no significant difference in the genotype distributions and allele frequencies between the two groups. A strong inverse correlation was found between folate or vitamin B12 and plasma Hcy levels according to MTHFR genotype (P<0.01). It was concluded that hyperhomocysteinemia is a new independent risk factor for CAD. However, MTHFR gene mutation alone does not relate significantly to the morbidity of CAD since hyperhomocysteinemia and its influence on the risk of CAD are decided by both environmental and genetic factors. Supplementary treatment with vitamins B can effectively lower the plasma levels of Hcy, thus maybe reduceing the risk of CAD.
ABSTRACT
The relationship between hyperhomocysteinemia and coronary artery disease (CAD) was investigated and the influence of environmental factors (Folate, VitB12) and genetic factors ［N5,N10-methylenetetrahydrofolate reductase gene (MTHFR) or MTHFR gene mutation］ on plasma homocysteine (Hcy) levels and the risk of CAD observed. Fifty-one CAD patients and 30 CAD-free subjects were recruited in the study. The polymorphisms of MTHFR gene were analyzed by PCR-RFLP and plasma total Hcy levels were measured by high performance liquid chromatography with fluorescence detection. Plasma folate and vitamin B12 concentrations were measured by an automated chemiluminescence method. It was found that mean total plasma Hcy concentrations were significantly higher in CAD patients than in CAD-free subjects (P<0.01). The differences were also apparent among the three genotypes of MTHFR gene in CAD group (P<0.05). There was no significant difference in the genotype distributions and allele frequencies between the two groups. A strong inverse correlation was found between folate or vitamin B12 and plasma Hcy levels according to MTHFR genotype (P<0.01). It was concluded that hyperhomocysteinemia is a new independent risk factor for CAD. However, MTHFR gene mutation alone does not relate significantly to the morbidity of CAD since hyperhomocysteinemia and its influence on the risk of CAD are decided by both environmental and genetic factors. Supplementary treatment with vitamins B can effectively lower the plasma levels of Hcy, thus maybe reduceing the risk of CAD.