ABSTRACT
OBJECTIVE@#To evaluate whether the efficacy of Getong Tongluo Capsule (, GTC, consisted of total flavone of Radix Puerariae) on improving patients' quality of life and lowering blood pressure are superior to the extract of Ginkgo biloba (EGB) for patients with convalescent-phase ischemic stroke and primary hypertension.@*METHODS@#This randomized, positive-drug- and placebo-controlled, double-blind trial was conducted from September 2015 to October 2017. Totally 477 eligible patients from 18 hospitals in China were randomly assigned in a 2:1:1 ratio to the following interventions, twice a day for 12 weeks: (1) GTC 250 mg plus EGB-matching placebo 40 mg (237 cases, GTC group), (2) EGB 40 mg plus GTC-matching placebo 250 mg (120 cases, EGB group) or (3) GTC-matching placebo 250 mg plus EGB-matching placebo 40 mg (120 cases, placebo group). Moreover, all patients were orally administered aspirin enteric-coated tablets 100 mg, once a day for 12 weeks. The primary outcome was the Barthel Index (BI). The secondary outcomes included the control rate of blood pressure and National Institutes of Health Stroke Scale (NIHSS) scores. The incidence and severity of adverse events (AEs) were calculated and assessed.@*RESULTS@#The BI relative independence rates, the clinical recovery rates of NIHSS, and the total effective rates of NIHSS in the GTC and EGB groups were significantly higher than the placebo group at 12 weeks after treatment (P0.05). The control rate of blood pressure in the GTC group was significantly higher than the EGB and placebo groups at 12, 18 and 24 weeks after treatment (P0.05).@*CONCLUSION@#GTC exhibited significant efficacy in improving patients' quality of life as well as neurological function and controlling hypertension. (Registration No. ChiCTR1800016667).
ABSTRACT
Emerging evidence indicates that microglia activation plays an important role in spinal cord injury (SCI) caused by trauma. Studies have found that inhibiting the Rho/Rho-associated protein kinase (ROCK) signaling pathway can reduce inflammatory cytokine production by microglia. In this study, Western blotting was conducted to detect ROCK2 expression after the SCI; the ROCK Activity Assay kit was used for assay of ROCK pathway activity; microglia morphology was examined using the CD11b antibody; electron microscopy was used to detect microglia phagocytosis; TUNEL was used to detect tissue cell apoptosis; myelin staining was performed using an antibody against myelin basic protein (MBP); behavioral outcomes were evaluated according to the methods of Basso, Beattie, and Bresnahan (BBB). We observed an increase in ROCK activity and microglial activation after SCI. The microglia became larger and rounder and contained myelin-like substances. Furthermore, treatment with fasudil inhibited neuronal cells apoptosis, alleviated demyelination and the formation of cavities, and improved motor recovery. The experimental evidence reveals that the ROCK inhibitor fasudil can regulate microglial activation, promote cell phagocytosis, and improve the SCI microenvironment to promote SCI repair. Thus, fasudil may be useful for the treatment of SCI.
Subject(s)
Animals , Male , Rats , 1-(5-Isoquinolinesulfonyl)-2-Methylpiperazine , Pharmacology , Therapeutic Uses , Apoptosis , Microglia , Metabolism , Myelin Basic Protein , Metabolism , Myelin Sheath , Metabolism , Phagocytosis , Protein Kinase Inhibitors , Pharmacology , Therapeutic Uses , Rats, Sprague-Dawley , Spinal Cord Injuries , Drug Therapy , rho-Associated Kinases , MetabolismABSTRACT
Emerging evidence indicates that microglia activation plays an important role in spinal cord injury (SCI) caused by trauma. Studies have found that inhibiting the Rho/Rho-associated protein kinase (ROCK) signaling pathway can reduce inflammatory cytokine production by microglia. In this study, Western blotting was conducted to detect ROCK2 expression after the SCI; the ROCK Activity Assay kit was used for assay of ROCK pathway activity; microglia morphology was examined using the CD11b antibody; electron microscopy was used to detect microglia phagocytosis; TUNEL was used to detect tissue cell apoptosis; myelin staining was performed using an antibody against myelin basic protein (MBP); behavioral outcomes were evaluated according to the methods of Basso, Beattie, and Bresnahan (BBB). We observed an increase in ROCK activity and microglial activation after SCI. The microglia became larger and rounder and contained myelin-like substances. Furthermore, treatment with fasudil inhibited neuronal cells apoptosis, alleviated demyelination and the formation of cavities, and improved motor recovery. The experimental evidence reveals that the ROCK inhibitor fasudil can regulate microglial activation, promote cell phagocytosis, and improve the SCI microenvironment to promote SCI repair. Thus, fasudil may be useful for the treatment of SCI.
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<p><b>OBJECTIVE</b>To compare the efficacy of midazolam and diazepam for treatment of acute seizures in children.</p><p><b>METHODS</b>One hundred and twenty children with acute seizures were randomly divided into two groups: midazolam (0.1-0.3 mg/kg) and diazepam treatment (0.3-0.5 mg/kg) (n=60 each). In cases with seizure recurrence or statural convulsivus, a maintenance dose of midazolam (1-8 mg/kg per hour) and a maintenance dose of diazepam (0.5-1 mg/kg per hour) or along with phenobarbital sodium were given in the midazolam and diazepam treatment groups, respectively. The therapeutic effects were compared between the two groups.</p><p><b>RESULTS</b>The seizures were relieved in all cases from the two groups 10 minutes after administration of midazolam or diazepam. There were no significant differences in the average time of seizure control between the two groups. Five children in the midazolam group had seizure recurrence or statural convulsivus after 10 minutes compared with 13 children in the diazepan group (P<0.05). The time of seizure control averaged 40+/-32 minutes in the midazolam group compared with 69+/-24 minutes in the diazepam group after maintenance treatment (P<0.05). No midazolam and diazepam treatment related adverse events were observed.</p><p><b>CONCLUSIONS</b>Midazolam is safe and effective in the treatment of acute seizures in children. Midazolam appears to be a better option in the treatment of recurrent seizures or statural convulsivus than diazepam.</p>
Subject(s)
Child , Child, Preschool , Female , Humans , Male , Acute Disease , Anticonvulsants , Therapeutic Uses , Diazepam , Therapeutic Uses , Midazolam , Therapeutic Uses , Seizures , Drug TherapyABSTRACT
<p><b>BACKGROUND</b>Carbon disulfide (CS(2)) is a commonly used organic solvent. Many epidemiological investigations and animal experiments have indicated that learning and memory ability can be affected to different degrees after long-term exposure to CS(2), but the mechanisms are still unclear. The aim of this study was to explore the possible mechanisms of CS(2)-related impairment of the learning and memory ability of rats, by investigating the effects of CS(2) on nitric oxide synthase (NOS) activity and NOS mRNA expression in rat hippocampus.</p><p><b>METHODS</b>Rat models of toxicity were generated by inhalation of various doses of CS(2). After two months of inhaling intoxication, the activities of constitutive NOS (cNOS) and induced NOS (iNOS) in the hippocampus were measured. The levels of neuronal NOS (nNOS) mRNA and iNOS mRNA were measured by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR).</p><p><b>RESULTS</b>cNOS activity was significantly decreased compared with controls, while iNOS activity was changed only slightly. CS(2) treatment significantly decreased nNOS mRNA levels. iNOS mRNA levels were significantly increased only at higher doses of CS(2).</p><p><b>CONCLUSION</b>The effect of CS2 on learning and memory ability in rats is related to the activity of NOS and the expression of nNOS in the hippocampus.</p>
Subject(s)
Animals , Rats , Carbon Disulfide , Pharmacology , Gene Expression Regulation, Enzymologic , Hippocampus , Metabolism , Nitric Oxide Synthase , Genetics , Metabolism , RNA, Messenger , Random Allocation , Rats, Wistar , Reverse Transcriptase Polymerase Chain Reaction , SpectrophotometryABSTRACT
Objective To compare tbe efficacy of conventional therapy,psychotherapy,serotonin reuptake in- hibitor,and psychotherapy combined with serotonin reuptake inhibitor in rehabilitating nerve function in the treatment of post-stroke depression.Methods One hundred and twenty patients with post-stroke depression were divided into a control group(A),a group treated with serotonin reuptake inhibitor (B),a psychotherapy group (C) and a group in which psychotherapy was combined with serotonin rcuptake inhibitor(D).These groups were graded with the SDS for the degree of their depression and with the MESSS for their muscle strength before andafter treatment.Results The anti-depression therapies showed significantly different effects in improving depression.After eight weeks,group D showed significantly less depression than the others.However,muscle strength did not show statistically significant differences until twelve weeks,when group D again showed better progress than the others.Conclusion Psychothera- py combined with serotonin reuptake inhibitor can promote the rehabilitation of nervous function-after stroke.