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OBJECTIVE:To investigate the characteristics and causes of cardiac ADR induced by quinolones,and to provide reference for clinical treatment. METHODS:Three thousaud two hundred and eighty-eighe 8 patients receiving common quinolones were selected from clinical departments in Zhengzhou Central Hospital of Zhengzhou University during Mar. 2012-Mar. 2016. Retro-spective analysis was conducted in terms of patients’age and gender,clinical departments,main clinical manifestations,route of administration,underlying disease,drug combination. The reasons for cardiac ADR were analyzed. RESULTS:Among 3 288 pa-tients,there were 34 patients(1.03%)with cardiac ADR. Among them,the incidence of cardiac ADR in patients over 50 years old was as high as 76.47%;patients with cardiac ADR were mainly in the respiration department,gastroenterology department and urology department,accounting for 76.47%;most of patients were from gastroenterology department(29.41%). In cardiac ADR, the main clinical manifestations were QTc interval prolongation torsadesde poiutes(TdP)and TdP,accounting for 58.82%. Among them,patients with QTc interval prolongation TdP occupied the highest proportion,there was no statistical significance compared to TdP(P>0.05);there was statistical significance in the difference with other clinical manifestations(P<0.05). Among common-ly used quinolones,levofloxacin(32.35%)and ciprofloxacin(41.18%)caused large proportion of cardiac ADR,there was statisti-cal significance compared to norfloxacin,moxifloxacin and other quinolones(P<0.05). The proportion of cardiac ADR induced by intravenous dripping(91.18%)was much higher than oral administration(8.82%),with statistical significance(P<0.05). Among patients with cardiac ADR,the patients with underlying disease (94.12%) and drug combination (91.18%) occupied the higher proportion,there was statistical significance compared to the patients without underlying disease and drug combination(P<0.01). Among drug combination,the patients receiving amiodarone (29.41%) and salbutamol (20.59%) occupied the large proportion, there was statistical significance compared to other types of drug combination(P<0.05). CONCLUSIONS:Cardiac ADR induced by quinolones in our hospital mostly occurs in respiration department,gastroenterology department and urology department,and mainly manifests as QTc interval prolongation TdP and TdP. The incidence of cardiac ADR may be greatly increased in elderly pa-tients,patients with underlying diseases,and drug combination as well as intravenous infusion. Therefore,clinicians should select suitable quinolones,and make reasonable individualized dosage regimen.
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Objective To compare the effects of telmisartan and (or) amlodipine on the reversal left ventricular re-modeling in two-kidney one clip hypertensive rats. Methods A total of 50 healthy male SD rats were randomly divided into 5 groups (n=10):two-kidney one clip renal hypertensive (2KIC) model group, sham group, telmisartan (10 mg/kg) group, am-lodipine (2.5 mg/kg) group and telmisartan (10 mg/kg)+amlodipine(2.5 mg/kg) group. The model of two-kidney one clip re-nal hypertensive rats was established. The tail arterial blood pressure was detected once a week. After 20 weeks, rats were sacrificed and specimens were collected. The left ventricular mass index (LVMI) was assessed. The myocardial ultrastructur-al changes were observed by electron microscope. Values of plasma renin activity (PRA), angiotensionⅡ(AngⅡ) and atrial natriuretic peptide (ANP) were measured by enzyme linked immunosorbent assay (ELISA).Results Compared with sham group, the levels of systolic blood pressure (SBP), LVMI, PRA, AngⅡand ANP were significantly higher in 2KIC group (P＜0.01). Compared with 2KIC group, values of SBP, LVMI, PRA and ANP were significantly lower in telmisartan group and am-lodipine group (P＜0.01), but the value of AngⅡwas significantly higher (P＜0.01). The levels of SBP, LVMI, AngⅡand ANP were significantly lower in combined medication group than those of single drug medication group (P＜0.01). There was no significant difference in the plasma PRA level between those groups (P>0.05). Results of myocardial electron microsco-py showed that the left ventricular remodeling was significantly improved in combined treatment group. Conclusion Telmisartan and amlodipine can effectively improve the left ventricular remodeling induced by hypertension. There was more effective therapy using both medications together.
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AIMTo investigate the effects of prostaglandin E 1 on apoptosis induced by hypoxia/reoxygenation in cultured neonatal rat cardiomyocy tes. METHODSThe models of hypoxia/reoxygenation were made with t he first generation of cultured cardiomyocytes. Hypoxia/reoxygenation apoptosis in cultured neonatal rat cardiomyocytes was studied by agarose gel electrophores is and Tdt-mediated dUTP nick end labeling(TUNEL). Bcl-2 and bax mRNA were det ected by in situ hybridization. RESULTSThe results of DNA electr ophoresis in the H/R group showed the typical DNA ladder. And the DNA ladder decreased gradually corresponding to the increased dose of PGE 1. The TUNEL staining showed that the total number of apo ptotic cells in the H/R group was much biger than that in PGE 1(0 127 ?mol?L -1 ) group. The results of in situ hybridization showed that the conten t of bcl-2 mRNA in H/R group was lower than control. And the content of bax mRN A showed a reverse result as bcl-2 mRNA. Compared with H/R group, the content o f bcl-2 mRNA was significantly higher after treatment with PGE 1(0 014 ?mol ?L -1 , 0 042 ?mol?L -1 , 0 127 ?mol?L -1 ). But the content of bax mRNA in PGE 1(0 014 ?mol?L -1 , 0 042 ?mol?L -1 , 0 127 ?mol?L -1 )groups was significantly lower than H/R group. CONCLUSI ONH/R injury can induce cardiomyocyte apoptosis. PGE 1 has obvious an ti-apoptotic effects on cardiomyocyte and the mechanisms are possibly by inhibi ting the expression of bax and increasing the expression of bcl-2.hein creaseddoseofPGE1 .TheTUNELstainingshowedthatthetotalnumberofapoptoticcellsintheH