HPLC fingerprint，content determination and transferring patterns of index components of Xintongshu spray / 中国药房

OBJECTIVE To establish the HPLC fingerprint of Xintongshu spray， determine the contents of identified components， and investigate the transferring patterns of the index components of decoction pieces， intermediates and spray， so as to provide scientific reference for technology management and quality control of Xintongshu spray. METHODS HPLC fingerprints of 13 batches of Xintongshu spray were established by the Similarity Evaluation System for Chromatographic Fingerprints of TCM （2012 edition）， and common peaks were identified； the contents of identified components were determined by HPLC. The paeonol in Moutan Cortex and ferulic acid in Chuanxiong Rhizoma were used as index components to investigate the transferring patterns of them in decoction pieces， intermediates and spray. RESULTS There were a total of 33 common peaks in the fingerprints of 13 batches of Xintongshu spray， and the similarities were more than 0.994. Eight components were identified， i.e. gallic acid （peak 5）， oxypaeoniflorin （peak 9）， chlorogenic acid（peak 10）， caffeic acid （peak 14）， paeoniflorin （peak 17）， ferulic acid （peak 21）， senkyunolide Ⅰ （peak 27） and paeonol （peak 31）. The contents of 8 components ranged from 0.590 3- 0.719 7， 0.565 7-0.851 3， 0.279 4-0.368 1， 0.080 6-0.106 1， 1.922 5-3.033 5， 0.151 3-0.191 6， 0.250 6-0.336 0， 3.056 7-4.161 0 mg/mL， respectively. The average transfer rates of paeonol and ferulic acid from decoction pieces to sprays were 63.76% and 38.06%， respectively. It was also found that the process in which the loss of paeonol was more than 30% was the extraction by percolation and negative pressure concentration of Moutan Cortex. The process in which the loss of ferulic acid was more than 50% was the steam distillation extraction process of Chuanxiong Rhizoma. CONCLUSIONS The established HPLC fingerprint and content determination method of Xintongshu spray are reproducible and specific. The key processes that cause a decrease in the average transfer rates of the index components are the extraction by percolation and negative pressure concentration of Moutan Cortex and steam distillation extraction of Chuanxiong Rhizoma.

Content determination and transferring rules of seven components in Angelicae Sinensis Radix and its processed products / 中国中药杂志

A HPLC method was established for simultaneous determination of two organic acids(chlorogenic acid and ferulic acid) and five phthalides(senkyunolide I, senkyunolide H, senkyunolide A, ligustilide, and butylidenephthalide) in Angelicae Sinensis Radix and its processed products to clarify the underlying material transferring rules. The analysis was performed on a Welch Ultimate C_8 column(4.6 mm×250 mm, 5 μm) with acetonitrile(A)-0.085% phosphoric acid water(B) as the mobile phase in a gradient elution mode at the flow rate of 1.1 mL·min~(-1), the column temperature of 25 ℃, the detection wavelength of 280 nm, and the injection volume of 10 μL. Under these conditions, the content of the above-mentioned seven components was analyzed in 15 batches of Angelicae Sinensis Radix and its processed products, and the transfer rate of each compound was calculated. As a result, in the processed products, the average content of chlorogenic acid was slightly decreased and that of ferulic acid was equivalent to the medicinal materials. The content of senkyunolide I, senkyunolide H, senkyunolide A, and butylidenephthalide showed an increasing trend in the processed products as compared with the medicinal materials. The mass fraction of ligustilide in the medicinal materials was above 0.7%(0.94% on average), meeting the requirement of 0.6% in the Hong Kong Chinese Materia Medica Standards, but was 0.47% on average in the processed products, which was decreased by 50% approximately. Further investigation showed that the content of ligustilide in freshly made processed products of Angelicae Sinensis Radix did not change significantly compared with that in the medicinal materials, indicating that the loss of ligustilide in the processed products mainly occurred in the storage. Therefore, Angelicae Sinensis Radix is suitable for storing in the form of medicinal materials and the freshly made processed products should be used except for special cases. Additionally, it is recommended to control the content of volatile oils or ligustilide in medicinal materials and processed products of Angelicae Sinensis Radix to ensure its effectiveness in clinical medication.

Pharmacy Customers’ Awareness of the Illegality of Transferring Drugs to a Third Party / 医薬品情報学

Background: Although transferring drugs to a third party, even in a personal capacity, is illegal in Japan, many drug transactions are carried out via internet auction sites. Pharmacy consumers might not be aware of the illegality of transferring drugs to others due to various factors. To clarify pharmacy consumers’ awareness of this issue and its covariates, we carried out a questionnaire survey.Methods: A self-completed questionnaire, consisting of yes/no and multiple-choice questions, was used. The adult patients who visited Keio University Pharmacy were asked to fill out the questionnaire.Results and Discussion: One hundred and fifty-one response sheets were effectively collected from 173 responders. The subjects’awareness of the illegality of transferring drugs was significantly affected by the formulation (oral vs. patches) and pharmacological category of the drug, as well as the source of the drug (prescribed vs. over the counter). Patient education about the illegality of personally transferring drugs, especially patches, might be required to avoid illegal drug transfers, including via the internet.

Association of iron metabolism with cognitive function in elderly patients with type 2 diabetes mellitus / 中华内分泌代谢杂志

Objective To investigate the association of iron overload with metabolic changes in hippocampal tissues, and to explore the relationship between iron metabolism abnormality and cognitive function in elderly patients with type 2 diabetes mellitus( T2DM) . Methods A total of 97 elderly inpatients with T2DM were enrolled. According to the Mini-mental state examination ( MMSE) score, the type 2 diabetic patients were divided into mild cognitive impairment ( MCI) and non-mild cognitive impairment ( Non-MCI) groups. A retrospective analysis was performed for their clinical data and laboratory parameters, including serum ferritin, MMSE, Montreal cognitive assessment ( MoCA) , carotid intima-media thickness, ankle brachial index, and the ELISA method was used to detect soluble transferring receptor ( sTfR ) . Proton MR spectroscopy ( 1 H-MRS ) was performed in the hippocampus of 26 patients. Results Compared with Non-MCI group, MCI group revealed higher age(P<0.01), higher incidence of carotid plaque (P<0.01), decreased sTfR(P=0.049) and left hippocampal height(P=0.034). Age, sTfR, and carotid plaque were independent risk factors for MCI in elderly patients with T2DM. Conclusion The abnormal iron metabolism may contribute to the occurrence of MCI in the elderly patients with T2DM.

Unbound Iron Binding Capacity (UIBC) – An Alternative Lab Parameter for Iron Stores?

Introduction:Iron is a component of a number of proteins including haemoglobin, myoglobin, cytochromes and enzymes deficiency of which leads to iron deficiency anemia and excess in iron overload. There is a panel of tests to assess iron status in the body. A low serum iron & ferritin with an elevated TIBC are diagnostic of iron deficiency. While a low serum ferritin is virtually diagnostic of iron deficiency.AS ferritin is an acute phase reactant, it may not be a good marker for iron overload.The objective of the study was to find out whether UIBC is an alternative lab parameter of iron storage/ overload compared to ferritin.Methodology:In a retrospective study conducted, data of 118 patients were collected, who were categorized as iron deficient and those with iron overload. Ferritin, UIBC and serum iron were assayed and remaining parameters were calculated.ROC curves were constructed using SPSS version 16 software.Results:Area under the curve (AUC) for ferritin as a marker of iron storage, AUC for UIBC, serum iron, TIBC and transferrin were 0.108,0.607,0.098,0.098 respectively. In patients with iron depletion, it was observed that AUC was 0.371 and 0.566 respectivelyfor ferritin and UIBC respectively.

Transferring the Aboriginal Australian family wellbeing empowerment Program from a Papua New Guinea University context to broader community settings : A feasibility study

@# This study aims to assess the feasibility of transferring the Aboriginal Family Wellbeing empowerment program (FWB) from a Papua New Guinea (PNG) tertiary setting to broader community contexts to address the problem of endemic interpersonal violence and to generate pilot data to inform future community wellbeing interventions in PNG. Levels of wellbeing among a convenience sample of 100 participants recruited from Bereina station, Kairuku- Hiri District and other parts of the National Capital District and Central Province were assessed using a cross-sectional survey with an anonymous self- administered questionnaire. Follow-up FWB pilot workshops conducted in Bereina station for participants in the wellbeing survey used standardised FWB workshop evaluation questionnaires to obtain community feedback on the relevance of the program. Up to one in four females and over half of males who completed the survey reported being a victim of actual or threatened violence in the last 12 months. In terms of wellbeing, participants were least satisfied with their standards of living and most satisfied with spirituality. Workshop participants could see that FWB has the potential to address community concerns, including interpersonal violence, as it provides a process for identifying basic community needs and introduces skills to address conflict. The challenges and opportunities involved in sustaining such programs at community levels are highlighted.

Iron Deficiency among Pregnant Women Attending Antenatal Clinic at the KNUST Hospital, Kumasi, Ghana.

Background: Pregnant women constitute a high risk group for iron deficiency due to increased iron requirements for foetal and maternal tissues growth. This study sought to find out the prevalence of iron deficiency among Ghanaian pregnant women obtaining antenatal care at the University hospital, Kumasi, Ghana. Methods: The study was conducted between January and May, 2013. A total of 180 women, 150 at various stages of pregnancy and 30 non-pregnant women as control group were recruited for the study. Information on socio-demographic characteristics was obtained from the subjects by means of face-to-face interviews. Using venous blood samples, iron status of subjects was assessed by the determination of haemoglobin, haematocrit, mean cell volume, red cell distribution width, serum ferritin, serum iron, serum transferrin, total iron binding capacity, unoccupied iron binding capacity and percentage saturation of transferrin. Intestinal helminthic infestation was determined by stool examination. Results: Decreasing levels of haemoglobin, serum iron, transferrin, Total iron binding capacity and increasing levels of Mean cell volume and RDW-SD were observed as pregnancy advanced. None of the subjects had helminthic infestation. Anaemia, iron deficiency (ID) and iron deficiency anaemia (IDA) were present in 44.0%, 21.5% and 10.4% of the pregnant women, respectively. These prevalence rates increased as pregnancy advanced to term (15.2%, 51.2%, 56.0% for anaemia; 13.8%, 22.9%, 26.1% for ID and 0%, 12.0%, 17.4% for IDA, respectively for the 1st, 2nd and 3rd trimesters). Conclusions: In spite of iron supplementation in pregnancy, a high percentage of the pregnant women are iron deficient and/or anaemic and this remains a public health problem.

Early lesion of rentanl function in elderly patients with dipper essential hypertension and MBPS,and the value in detection of Hcy and hs-CRP / 安徽医科大学学报

Objective To find out early lesion of rentanl function in elderly patients with dipper essential hyperten-sion and morning blood pressure surge( MBPS) , and to find out the value of homocysteine( Hcy) with high-sensitiv-ity C reactive protein ( hs-CRP) in detecting early lesion of rentanl function in hypertensive patients. Methods Totally 168 elderly paritents with dipper essential hypertension were divided into MBPS group( observation group, n=73) and non-MBPS group (control group, n=95) according to the accompanying MBPS or not. The cystatin C ( Cys C) , urinary microcalbumin ( U-mAlb) ,urinary transferring( U-TRF) ,Hcy, hs-CRP,serum creatinine( SCr) , blood urea nitrogen(BUN), blood glucose(Glu),cholesterol(TCH),triglyceride(TG), high density lipoprotein cholesterol( HDL-C) and low density lipoprotein cholesterol( LDL-C) were tested. The differences in Cys C, Hcy, hs-CRP, the U-mAlb positive incidence and the U-TRF positive incidence between the two groups were analyzed. Results There were no statistical concernments in SCr, BUN, GLu, TCH, TG,HDL-C,and LDL-C between the two groups. The amplitude of variation in morning systolic pressure peak was higher in MBPS group than in non-MBPS group(P=0. 000). The obvious varieties in the Cys C, Hcy,and hs-CRP were higher in MBPS group than in non-MBPS group ( P=0. 000 ) . The U-mAlb positive incidence was higher in MBPS group than in non-MBPS group(χ2 =18. 014,P =0. 000). The U-TRF positive incidence was higher in MBPS group than in non-MBPS group(χ2 =19. 694,P=0. 000). Conclusion MBPS has a great effect on Cys C,U-mAlb,U-TRF,Hcy and hs-CRP. MBPS is apt to cause early lesion of rental function in elderly patients with dipper essential hypertension. And Hcy and hs-CRP can be used to diagnose the early renal insufficiency.

Diagnostic value of soluble transferrin receptor detection in non-adult ion deficiency anemia / 国际检验医学杂志

Objective To investigate the diagnostic value of the soluble transferrin receptor (sTfR)in non-adult iron deficiency anemia (IDA)and its differential diagnostic value between IDA and anemia of chronic disease(ACD).Methods 26 cases in the IDA group involved 12 males and 14 females,aged 1 month to 15.5 years;33 cases in the ACD group involved 17 males and 16 females, aged 2 months to 14.0 years;30 cases in the normal control group involved 15 males and 15 females,aged 1 month to 15.5 years. Serum sTfR and ferritin (SF)were detected by the immunonehelomitery,serum iron (SI)was detected by Ferrous Oxazine colori-metric method.Results The gender and age had no statistically significant difference among 3 groups;the SI mean value in the ACD group located between the IDA group′s and the normal control group′s;the SF mean value of the IDA group was significantly lower than that of ACD group (P <0.001)and that of control group (P <0.001),while the sTfR mean value of IDA group was significantly higher than that of the ACD group (P <0.001)and that of the normal control group (P <0.001).The best cutoff of sTfR for the differential diagnosis between IDA and ACD was 3.56 mg/L,its sensitivity,specificity,negative predictive value,posi-tive predictive value and accuracy were 95.12%,93.92%,94.11%,97.53% and 95.50% respectively.Conclusion sTfR has higher sensitivity and specificity for IDA and is conducive to diagnose IDA and differentially diagnose ACD.

Comparative study of adoptively transferring patrilineal lymphocytes and their Exosomes on improving fetation of mice with pregnancy loss / 中国免疫学杂志

Objective:To analyze the protective effects of adoptively transferring different patrilineal lymphocytes and their Exosomes ( Exo) on fetation of mice with pregnancy loss comparatively.Methods: The peripheral blood mononuclear cells ( PBMC) from healthy men and the splenocytes from BALB/c and DBA/2 male mice were induced in vitro ,and their Exo were isolated through sucrose gradient ultra-centrifugation combined with ultrafiltration.The mice of CBA/J (♀) mated with BALB/c (♂) were enrolled as control group of normal pregnancy ,and the CBA/J (♀) mated with DBA/2 (♂) as URSA of pregnancy loss experimental animal model.The mice in URSA group were randomly divided into each group with treatment through adoptively transferring , which were injected intravenously or subcutaneously with splenocytes or splenocytes -derived Exo from mated DBA/2,unmated DBA/2 or unrelated BALB/c,also PBMC-derived Exo from men,respectively.And then,the placenta volumes,rates of fetal absorption and pregnancy loss were calculated to observe the fetation of embryos.Results:Compared with the group of normal pregnancy ,the placenta volumes from URSA group decreased greatly ,and rates of fetal absorption and pregnancy loss elevated greatly ( all P0.05 ).After transferring the Exo derived from either male mice or healthy men,the level of decreased fetal absorption rates were more than that in cellular-therapy groups ( all P<0.05 ).After transferring the Exo derived from men ,the level of decreased pregnancy loss rates were more than that in cellular -therapy groups and mice splenocytes-derived Exo group ( all P<0.05 ).Conclusion:Adoptively transferring patrilineal T lymphocytes and their Exo can greatly improve the fetation.Exo should become a non-cellular bio-remedy,which is expected to replace traditional immunotherapy of adoptively transferring lymphocytes.

System model for transfer and application of the appropriate health technologies in rural areas / 中华医学科研管理杂志

Considering the core concept of the system theory,the author describes the conception,components and main functions of the subjects,the objects and behavioral factors for the popularization and application of appropriate health technologies.This theoretically built up the system model for transfer and application of the appropriate health technologies in Chinese rural areas.

The Role of Pyruvate Dehydrogenase Kinase in Diabetes and Obesity

The pyruvate dehydrogenase complex (PDC) is an emerging target for the treatment of metabolic syndrome. To maintain a steady-state concentration of adenosine triphosphate during the feed-fast cycle, cells require efficient utilization of fatty acid and glucose, which is controlled by the PDC. The PDC converts pyruvate, coenzyme A (CoA), and oxidized nicotinamide adenine dinucleotide (NAD+) into acetyl-CoA, reduced form of nicotinamide adenine dinucleotide (NADH), and carbon dioxide. The activity of the PDC is up- and down-regulated by pyruvate dehydrogenase kinase and pyruvate dehydrogenase phosphatase, respectively. In addition, pyruvate is a key intermediate of glucose oxidation and an important precursor for the synthesis of glucose, glycerol, fatty acids, and nonessential amino acids.

Clinical features and electron transfer flavoprotein dehydrogenase gene mutation analysis in 35 Chinese patients with lipid storage myopathy / 中华神经科杂志

Objective To investigate the clinical features and electron transfer flavoprotein dehydrogenase (ETFDH) gene mutations in 35 Chinese patients with lipid storage myopathy. Methods The clinical data of 35 cases with lipid storage myopathy confirmed by muscle biopsy were collected. The sequences of all 13 exons of ETFDH were analyzed. Results All 35 patients showed proximal weakness. Ten of them demonstrated masseter weakness and 28 of them showed weakness in neck flexion. Twenty-nine of 32 patients who were followed up showed improvement after treatment with VitB2 and CoQ10. Mutations of ETFDH were found in 30 of 35 patients,which included 8 homozygosises,20 compound heterozygosises and 2 single heterozygosises. Fourteen novel mutations were found, including 9 missense mutations ( c. 3G > C, c. 152G>A, c. 191G > A, c.349G>C, c.433G>C, c. 949C > A, c. 1454C > G, c. 1744A >T and c. 1763A>G), 1 nonsense mutation(c. 172G>T), 2 deletions(c. 1282_1283del and 1773_1774del) and 2 splice mutations (c. 405 + 1G > T and c. 1691 -3C > G). Nine of them showed c. 250G > A mutation and 6 of them showed c. 770A > G mutation. Conclusions Lipid storage myopathy is presented as proximal weakness. Multiple acyl-CoA dehydrogenase deficiency caused by mutations of ETFDH is the major cause of lipid storage disease in this group. ETFDH c. 250G > A and c. 770A > G mutations show a high frequency.

Hot spot mutations in electron transfer flavoprotein dehydrogenase gene of riboflavin responsive lipid storage myopathy in 20 Chinese families / 中华神经科杂志

Objective To report the spectrum of electron transfer flavoprotein dehydrogenase (ETFDH)gene mutations in 20 Chinese RR-LsM families.Methods Twenty-four RR-LSM patients in the First Hospital of Peking University from January 2003 to May 2010 were collected and the clinical characteristics were analyzed.These patients came from 20 families in North Mainland China.Sixteen families had 1 patient each.and the other 4 families had 2 patients.ETFDH gene analysis was performed in all patients,11 family members and 100 healthy controls.Results The mean onset age was(27.9±9.9)years.The main symptoms were limb weakness(21,87.5%),dysmasesia(15,62.5%),neck weakness (14,58.3%)and myalgia(14,58.3%).Eighteen patients had high level of acyleamitine.Fifteen of 17patients had glutaric aciduria.Seventeen ETFDH mutations,including 13 missense mutations,2 splice mutations,and 2 nonsense mutations,were identified in 19 families:c.998A>G,c.1450T>C,c.1703T>C,c.1717C>T,c.821G>A,c.643G>A,c.251C>T,c.1763A>T,c.IVS7+2T>C and c.IVS6+1G>A were Hovel mutations which were not found in 100 healthy controls.Nine families had the mutation of c.770A>G(P.Y257C)and 5 families had the mutation of c.1227A>C(P.L409F).Conclusions The numerous novel mutations in ETFDH gene indicate that Chinese RR-LSM might have special mutation pattern.c.770A>G(P.Y257C)and c.1227A>C(p.L409F)may be hot spot mutations in North Mainland China.

Prognostic Significance of Glycolytic Metabolic Change Related to HIF-1alpha in Oral Squamous Cell Carcinomas

BACKGROUND: Growing tumors adapt to a hypoxic environment and increase anaerobic glycolysis. This metabolic switch is related to aggressive behavior. We investigated the relationship between glycolytic metabolism biomarkers associated with hypoxia-inducible factor (HIF)-1alpha and prognosis. METHODS: We performed immunohistochemical staining of HIF-1alpha, pyruvate dehydrogenase kinase (PDK) 1 and lactate dehydrogenase (LDH) 5 in 74 patients with oral squamous cell carcinoma (SCC) who had received curative radical resection. RESULTS: High reactivity of HIF-1alpha, PDK 1 and LDH 5 was observed in 29 (39.2%), 32 (43.2%) and 54 (73.0%) patients, respectively. Expression levels of the three biomarkers were significantly correlated. All three markers were highly expressed in 16 (21.6%) patients. Elevated expression of the three markers was associated with increased invasiveness (p = 0.043) and recurrence (p = 0.017) of tumors. In survival analysis, upregulation of the three markers was additionally associated with shorter disease free survival (DFS, p = 0.001) and overall survival (OS, p = 0.002). High expression of all three markers was a strong independent prognostic factor for DFS (p = 0.030) and OS (p = 0.026). CONCLUSIONS: Oral SCC with altered glycolytic metabolism exhibits a more invasive and aggressive phenotype. Our results indicate that glycolytic metabolism biomarkers related to HIF-1alpha may be independent prognostic factors in patients with oral SCC.

Differentially expressed genes in a flock of Chinese local-breed chickens infected with a subgroup J avian leukosis virus using suppression subtractive hybridization

Avian leukosis virus subgroup J (ALV-J) is a new type of virus that mainly induces myeloid leukosis (ML) in chickens. To further elucidate the pathogenesis of ALV-J infection and tumor development, expression profiles from the bone marrow tissue of 15 infected and 18 non-infected birds from a local-breed poultry-farm under naturally infected conditions, were analyzed by suppression-subtractive hybridization. The birds were diagnosed as ML+ (or ML-) by specific ALV-J detection methods, involving serological tests for antigens and antibodies, and RT-PCR to detect viral RNA. A total of 59 partial gene sequences were revealed by differential screening of 496 forward and 384 reverse subtracted cDNA clones. Of these, 22 identified genes, including 8 up-regulated and 14 down-regulated, were related to immune functions, these genes being, MHC B-G antigen, translationally-controlled tumor protein (TPT1/TPTC), transferrin and ferritin, hemoglobin and Carbonic anhydrase. Four of the down-regulated genes were selected for further analysis, in view of their predicted roles in infection and immunity by real-time qRT-PCR, using RNA collected from the same birds as those used for SSH. The four genes were expressed at significantly lower levels (p < 0.001) in ALV-J infected birds than in non-infected ones.

Application research in business process reengineering in transferring of inpatients for check-up / 中国实用护理杂志

Objective To explore the clinical value of application research in business process reengineering in transferring of inpatients for check-up. Methods We reorganized transferring of inpatients for check-up and service tache by introducing the Systematic Redesign method from the therory of Business Process Reengineering. The reengineered process was adopted and applied in the transferring processes. We randomly selected patients for check-up(126 cases for electrocardiogram,130 cases for Xrayand 128 cases for CT examination)and investigated the time cost for check-up and patients satisfaction rate. The above results were compared with those patients(112 cases for electrocardiogram,112 cases for Xrayand 120 cases for CT examination)before use of reengineered process. Results The time cost for the above mentioned check-up was shorter and patients satisfaction rate were alleviated compared with those before use of reengineered process(U=14.55,12.26,13.57;x2=17.37,14.65,10.75,P＜0.01).Conclusion Application of business process reengineering in the transferring process of inpatients for check-up proved pivotal important in that it could shorten time cost for transferring process and improve patients satisfaction rate.It possessed realistic significance for increasing benefit and competitions for hospitals.

Nursing about the transferring of peduncle island skin flap in foot / 中国实用护理杂志

Objective To investigate the nursing methods of transferring peduncle island skin flap in foot. Methods Nursing about 19 patients who have undergone the transferring of peduncle island skin flaps because of soft tissue injury in foot. The preoperative nursing included skin nursing, individual psycho-behavior guidance, room allocation. Postoperative nursing included placement of limbs correctly, nursing about the transferring district flaps, observation and nursing the vescular crisis, correct using anticoagulant and functional exercises of ankle-joint. Results There were 18 flaps survived completely, 1 flaps in distal end had partly necrosis, but flap had recovered well afterⅡ-period skin grafting. Conclusion Overall elaborate clinical nursing can guarantee the survival of the graft peduncle island skin flaps in foot.

Progress in the vector-mediated drug delivery system to the brain / 中国药理学通报

The blood-brain barrier(BBB) is formed by the brain capillary endothelium and excludes from the brain approximately 100% of large-molecule neurotherapeutics and more than 98% of all small-molecule drugs.There are three routines to increase drug transport into brain,ie,neurosurgical,pharmaceutical chemical,and physiological ways and the later is most hopeful.The receptor-mediated transcytosis system on the brain capillary endothelium could be used as multifunctional vectors for drug active transport into brain.This provides the platform for CNS drug delivery programs.

Study on the efficacy tolerability of topiramate in transferring monotherapy for the patients with partial seizures / 临床神经病学杂志

Objective To observe the possibility and efficacy tolerability of topiramate(TPM) in transferring monotherapy for the patients with partial seizures with or without secondary general seizure,as well as to find out the optimum way of the transferring.Methods After TPM add on therapy 64 patients with seizures reduced ≥50%, it reduced about 1/4 of AEDs or one drug each time according to every two weeks until gradually to stop fully and transferring monotherapy.Results 18 patients were successful with TPM monotherapy (28.13%), 35 patients were half success(54.69%), 11 cases for failure (17.19%). The less AEDs combined, the higher possibility of transferring monotherapy would be. The rate of success for cabamazepine seemed higher than valproate.Conclusion It was possible to transfer monotherapy by TPM. The rate of success was 28.13%. It was easier to reduce cabamazepine than valproate. In the transferring monotherapy it was better to reduce one after another, in principle the one of the little dose was reduced first,and then the hepatic enzyme inducing agents was reduced. Even if the transferring was half success,the kinds of concomitant AEDs could be reduced at least, it was in line with the policy of medicine application.