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Objective To investigate clinical efficacy and safety of the memantine and donepezil in the treatment of moderate to severe Alzheimer's disease,in order to provide the basis for clinical treatment.Methods One hundred and twelve cases of moderate to severe Alzheimer's disease patients were given memantine plus donepezil(observation group) ,and single use of memantine treatment(control group), and the treatment for 24 weeks.Respectively before and after treatment, Mini Mental State Scale (MMSE), Alzheimer' s disease assessment scale (ADAS-cog), Alzheimer' s disease collaborative learning, daily life ability questionnaire (ADCS-ADL) ,and neuropsychological questionnaire (NPI) score, and adverse reactions were observed in the process of two kinds of therapy, the efficacy and safety of two kinds of treatment methods were evaluated.Results After treatment, the patients in observation group with MMSE, ADAS-cog, ADL and NPI evaluation results were (12.1 ± 2.1), (32.9 ± 8.3), (33.4 ± 5.0), (6.1 ± 3.1) scores, significantly improved compared with scoring (9.9±2.8), (46.2±7.6), (42.1±6.0), (10.5±2.9) scores before treatment,and the differences were statistically significant (t =2.138,-2.411,2.398, 2.107 respectively, P ＜ 0.05).The control group after treatment in patients with MMSE, ADAS-cog, ADL and NPI evaluation results were (12.3±2.6), (33.1 ±7.2), (35.1 ±6.6), (6.7 ± 2.9) scores, significantly improved compared with scoring 11.0 ± 2.5,44.9 ± 6.9,42.2 ±6.6,10.9 ± 3.5 before treatment, and the difference had statistical significanc (t =2.101,-2.033,2.105, 2.400 respectively, P＜0.05).After treatment, the difference of patients in the two groups of MMSE, NPI score had statistical significance(t =2.553,2.176, P＜0.05).The adverse reactions in two group respectively were 32.14％ (18/56) and 26.79％ (15/56), less difference was no statistical significance (P＞0.05).Vital signs checks,regular laboratory examination and ECG examination showed no obvious abnormalities.Conclusion Memantine combined with donepezil in the treatment of moderate and severe AD patients is superior to the singleeffect of memantine, and long-term use will not increase the risk of adverse reactions, which is safe and effective in the combined application.
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Objective To observe how ox-LDL impacts the mRNA expressions of MMP-9 and LOX-1 of human umbilical endothelial cells (HUEVC) and how LOX-1 acts as in inflamation course.Methods HUVEC were incubated in vitro.mRNA Expressions of MMP-9 and LOX-1 were determined by reverse transcription polymerase chain reaction (RT-PCR).Results Compared to the control group(0.252±0.032;0.279 ±0.041 ),ox-LDL significantly increased the mRNA expressions of MMP-9 and LOX-1 (25 ng/group 0.486 ± 0.012,0.586 ± 0.02;50 ng/L group 0.668 ± 0.011,0.739 ± 0.014; 100 ng/group 0.817 ±0.030,0.872 ±0.003,P ＜0.01 ).Those expressions were increased by ox-LDL( 1.020 ±0.039)in a concentration-and time-dependent manner.MMP-9 mRNA(0.872 ±0.046) was reduced when LOX-1 was inhibited by polyinosinic acid ( P ＜ 0.01 ).Conclusions The mRNA expressions of MMP-9 and LOX-1 were induced by ox-LDL in HUVEC.Inhibition of LOX-1 may decrease the expression of MMP-9.Those data demonstrate that LOX-1 is involved in the process of ox-LDL-induced MMP-9 expression.
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Objective To study the effects of repetitive transeranial magnetic stimulation (rTMS) on depression behavior and hippocampus neuron regeneration in rats with chronic stress depression and to explore the therapeutic mechanism of rTMS on depressive disorder.Methods Thirty-sixth rats were divided into a control group, a model group and a rTMS group randomly, with 12 rats in each group.The depression model of rat was established by exerting long-term unpredictable moderate stress on the animals.Rats in rTMS group were given rTMS treatment after stress, while those in the control group were not given rTMS treatment.Open-field test was performed to test depression behavior of rats in each group before and after 2 weeks of rTMS treatment.Immunohistochemistry technique was used to detect expression of nestin, a marker of dentate gyrus (DG) neural precursor cells.Neuron regeneration was observed by use of 5-bromodeoxyuridine(5-BrdU).The expression of brain-derived neurotrophic factor (BDNF) in hippocampus was detected through western blot.Results There observed neural precursor cells in DG area of rats in control group and some of them were proliferating.Compared with control group, the number of DG progenitor cells and proliferating ability of DG progenitor cells decreased in model group.The expression level of BDNF in model group was lower than that in model group as well.After rTMS treatment, depression behavior of rats in rTMS group improved significantly, number of DG progenitor cells increased and proliferating ability of DG progenitor cells elevated significantly.The expression level of BDNF in rTMS group was higher than that in model group as well.Conclusion rTMS therapy could ameliorate depressive behavior of depression rat.The therapeutic mechanism may be associated with rTMS promoting expression of BDNF in hippocampus, which increasing number of neural precursor cells in DG and promoting the proliferation DG neurons as results.