Wernicke's encephalopathy misdiagnosed as schizophrenia： a case report / 四川精神卫生

This article presents a case report of Wernicke's encephalopathy misdiagnosed as schizophrenia. The patient was hospitalized and diagnosed with schizophrenia at a local psychiatric hospital over a month ago. Twelve days ago， the patient gradually developed symptoms such as salivation， difficulty in eating， trembling hands， unsteady walking， glossoptosis and so on. The above symptoms were interpreted as drug-induced adverse reactions and managed accordingly， whereas the patient showed a poor response to treatment， and began to experience intermittent consciousness disorder. After referral to our hospital， findings were diagnostic for Wernicke's encephalopathy and peripheral polyneuropathy. Due to the progression of the disease， the family members abandoned further treatment and requested discharge from the hospital， and the patient died outside the hospital. This case report aims to improve the prognosis of Wernicke's encephalopathy in patients with mental disorder by raising the awareness of the disease and enhancing the early prevention.

Ginsenoside Rg1 injection combined with inosine tablets and vitamin B1 for the treatment of primary retinitis pigmentosa / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the effects of ginsenoside Rg1 injection combined with inosine tablets and vitamin B1 on serum brain-derived neurotrophic factor(BDNF), pituitary adenylate cyclase activating polypeptide(PACAP)and clinical efficacy in primary retinitis pigmentosa.METHODS: A total of 50 patients(100 eyes)with primary retinitis pigmentosa who admitted to the Department of Ophthalmology, the Second Affiliated Hospital of Hebei North University from August 2019 to March 2022 were selected as the research object. They were divided into the study group and the control group according to random number table, with 50 eyes in each group. Patients in the control group were treated with inosine tablets and vitamin B1, while patients in the study group were treated with ginsenoside Rg1 injection on the basis of the control group. The expression of BDNF and PACAP in serum, electroretinogram and spectral-domain optical coherence tomography(SD-OCT)were compared before and after treatment, and the retinal thickness(RT), mean deviation(MD), clinical efficacy and safety indexes were compared between the two groups.RESULTS: There were no differences in the MD of the two groups before treatment(t=1.670, P=0.098), while the MD of the study group was significantly lower than that of the control group after treatment(t=3.628, P<0.01). Before treatment, RT with a diameter of 1mm at the circle of macular fovea was compared between the two groups(t=0.108, P=0.914), it was significantly higher than that in the control group after treatment(t=6.125, P<0.01). Before treatment, there was no significant difference in the results of dark adaptation of electroretinogram between the two groups(all P>0.05). After treatment, the results of dark adaptation in the study group were significantly better than those in the control group(all P<0.01). Before treatment, there was no significant difference in the results of electroretinogram adaptation between the two groups(all P>0.05). After treatment, the results of electroretinogram adaptation in the study group were significantly better than those in the control group(all P<0.01). There was no significant difference in BDNF and PACAP between the two groups before treatment(all P>0.05). BDNF and PACAP in the study group were higher than those of the control group after treatment(all P<0.01). After treatment, no adverse reactions were observed in both groups.CONCLUSION: The treatment of patients with primary retinitis pigmentosa with ginsenoside will improve the retinal function and promote the prognosis of the disease by regulating the expression of BDNF and PACAP, and it is highly safe.

New progress in the diagnosis and treatment of thiamine responsive megaloblastic anemia syndrome / 中华实用儿科临床杂志

Thiamine responsive megaloblastic anemia syndrome is a rare autosomal recessive disease caused by mutations of the SLC19A2 gene that encodes the high-affinity thiamine transporter-1.Thiamine responsive megaloblastic anemia syndrome involves extensive organs and systems with various clinical manifestations.The typical triad is megaloblastic anemia, non-autoimmune diabetes, and sensorineural deafness.The diagnosis of thiamine responsive megaloblastic anemia syndrome depends on the detection of the pathogenic gene SLC19A2.Thiamine replacement therapy is the first-line treatment.Blood glucose of patients with thiamine responsive megaloblastic anemia syndrome should be comprehensively managed, and hearing aids and cochlear implants can be used to improve the hearing.

Therapeutic effect of hydrocortisone combined with vitamin C and vitamin B1 on patients with sepsis: a Meta-analysis / 中华危重病急救医学

Objective:To systematically evaluate the effect of hydrocortisone combined with vitamin C and vitamin B1 on the efficacy of patients with sepsis or septic shock.Methods:Databases including CNKI, Sino Med, VIP, Wanfang, PubMed, the Cochrane Library, and Embase were searched from inception to January 2021 for the randomized controlled trial (RCT) about hydrocortisone combined with vitamin C and vitamin B1 to treat sepsis or septic shock. The experimental group was given intravenous injection of hydrocortisone, vitamin B1 and vitamin C based on conventional treatment; the control group was given conventional treatment or placebo/hydrocortisone/hydrocortisone+vitamin B1 based on conventional treatment. Outcome indicators included sequential organ failure assessment (SOFA), mortality, the duration of vasoactive drugs, new acute kidney injury (AKI) patients, length of stay in intensive care unit (ICU) and in hospital. Two researchers independently screened the literature, extracted data, and evaluated the risk of bias in the included studies. RevMan 5.3 software was then used to perform Meta-analysis. Funnel plot was used to test publication bias.Results:A total of 6 articles involving 816 patients were included, with 411 patients in the experimental group and 405 patients in the control group. The Meta-analysis results showed that the duration of vasoactive drugs in the experimental group was significantly shorter than that in the control group [mean difference ( MD) = -24.02, 95% confidence interval (95% CI) was -32.36 to -15.68, P < 0.000 01]. However, there were no significant differences in SOFA, mortality, new AKI patients, the length of ICU stay and hospital stay between the two groups [SOFA: MD = -0.14, 95% CI was -1.15 to 0.87, P = 0.79; mortality: relative risk ( RR) = 0.99, 95% CI was 0.81 to 1.21, P = 0.92; new AKI patients: RR = 1.10, 95% CI was 0.42 to 2.87, P = 0.84; length of ICU stay: MD = 1.33, 95% CI was -2.22 to 4.89, P = 0.46; length of hospital stay: MD = 1.02, 95% CI was -0.66 to 2.69, P = 0.23]. The funnel plot showed that most of the points were symmetrical and showed an inverted funnel shape, suggesting that the publication bias among the studies was small. There was no significant publication bias on this Meta-analysis. Conclusions:Hydrocortisone combined with vitamin C and vitamin B1 can shorten the duration of vasoactive drugs in patients with sepsis or septic shock, but it cannot effectively reduce the SOFA score, mortality, new AKI patients, length of stay in ICU and in hospital. Limited by the number and quality of the included studies, further large-scale, multi-center, blinded, RCT are still needed for verification.

Ácido fólico em excesso: efeitos sobre o metabolismo das vitaminas B2 e B6, o catabolismo do triptofano e a resposta imune / Folic acid excess: effects on vitamin B2 and B6 metabolism, tryptophan catabolism and immune response

Introdução: A suplementação com ácido fólico (AF) é recomendada em algumas condições para evitar a deficiência de folato, como para mulheres no período periconcepcional e durante a gestação. Atualmente, existe uma preocupação quanto ao consumo excessivo de AF pela população pelo uso de suplementos com altas doses dessa vitamina. As vitaminas B6 e B2 agem como cofatores no metabolismo de um carbono, e o uso de altas doses de AF pode influenciar o metabolismo de ambas vitaminas e, consequentemente, interferir em metabolismos importantes das quais elas participam, como a via das quinureninas, e no sistema imune. Objetivo: Avaliar os efeitos da intervenção diária com uma alta dose de AF (5 mg) por 90 dias sobre marcadores do estado das vitaminas do complexo B, e as consequências sobre os metabólitos da via das quinureninas e o sistema imune em adultos saudáveis. Material e Métodos: 64 indivíduos saudáveis foram submetidos à intervenção diária com 5 mg de AF por 90 dias. Coletas de sangue foram realizadas antes (baseline) e após 45 e 90 dias de intervenção. As concentrações séricas de folato e vitamina B12 foram avaliadas por métodos microbiológicos. As concentrações séricas das vitaminas B6 (piridoxal 5'-fosfato (PLP), piridoxal (PL) e ácido 4-piridóxico (PA)), B2 (riboflavina e flavina mononucleotídeo (FMN)), B1 (tiamina e tiamina monofosfato (TMP)) e B3 (ácido nicotínico, nicotinamida e N1-metilnicotinamida), bem como de triptofano, quinurenina e metabólitos, foram avaliadas por LC-MS/MS. A proteína C-reativa ultrassensível (PCRus) foi determinada por imunoturbidimetria, e as concentrações séricas de interleucina (IL)-6, IL-8, IL-10, interferon gama (IFN-γ) e fator de necrose tumoral alfa (TNF-α) foram avaliadas por ensaio multiplex. A expressão de RNAm de DHFR (dihidrofolato redutase), MTHFR (metilenotetrahidrofolato redutase), IL8, TNFA e IFNG em leucócitos mononucleares (PBMC) foram avaliadas por PCR em tempo real. O número de células T regulatórias (Treg) (CD3+, CD4+, CD25high, FoxP3+, CD127-) foi avaliado após incubação dos PBMC com PMA e ionomicina ou veículo por 18h, por imunofenotipagem. Resultados: Houve um grande aumento das concentrações de folato sérico após 45 e 90 dias de intervenção com AF. Não houve diferença nas concentrações de vitamina B12 antes e após a intervenção. As concentrações séricas de PLP foram semelhantes antes e após a intervenção, entretanto, um aumento de PL sérico foi observado após 45 e 90 dias, e de PA após 45 dias, quando comparado ao baseline. Riboflavina e FMN foram maiores após 45 e 90 dias em relação ao baseline. A tiamina sérica foi menor após 45 dias, e as concentrações de TMP foram maiores após 90 dias quando comparados aos períodos anteriores. Não houve diferença nas concentrações de vitamina B3 antes e após a intervenção. Dentre os metabólitos da via das quinureninas, apenas o ácido antranílico apresentou aumento após 45 e 90 dias, enquanto o ácido picolínico diminuiu após 90 dias. PCRus, IL-6, IL-8, IL-10, IFN-γ e TNF-α séricos foram semelhantes no baseline e após a intervenção. Um aumento da expressão de RNAm de DHFR e TNFA foi observado após, respectivamente, 90 dias e 45 e 90 dias de intervenção. Após 90 dias de intervenção com AF, foi observada diminuição do número de células Treg após estímulo com PMA e ionomicina. Conclusão: O uso diário de 5 mg de AF foi associado a alterações nas concentrações séricas de marcadores do estado de vitaminas do complexo B e da via das quinureninas, bem como a diminuição do número de células Treg

Introduction: Folic acid (FA) supplementation is recommended in some conditions to avoid folate deficiency, as women during periconceptional period and pregnancy. Currently, there is a concern about the excessive consumption of FA by population by using supplements with high doses of this vitamin. Vitamins B6 and B2 are cofactors of enzymes of one carbon metabolism and, consequently, may disturb key metabolism in which they participate, as kynurenine pathway, and the immune system. Aim: To assess the effects of a daily intervention with high dose of FA (5 mg) for 90 days on biomarkers of complex B vitamins status and its outcomes in kynurenine pathway metabolites and immune system in healthy adults. Material and Methods: 64 healthy individuals were submitted to a daily intervention with 5 mg of FA for 90 days. Blood samples were collected before (baseline) and after 45 and 90 days of intervention. Serum folate and vitamin B12 were assessed by microbiological assays. Serum vitamin B6 (pyridoxal 5'-phosphate (PLP), pyridoxal (PL) and 4-pyridoxic acid (PA)), vitamin B2 (riboflavin and flavin mononucleotide (FMN)), vitamin B1 (thiamin and thiamin monophosphate)) and vitamin B3 (nicotinic acid, nicotinamide and N1-methylnicotinamide), as well as tryptophan, kynurenine and metabolites, were assessed by LC-MS/MS. C-reactive protein (hs-CPR) was assessed by immunoturbidimetry, and serum interleukin (IL)-6, IL-8, IL-10, interferon gamma (IFN-γ) and tumor necrosis factor alpha (TNF-α) were assessed by multiplex assay. Mononuclear leukocytes mRNA expression of DHFR (dihydrofolate reductase), MTHFR (methylenetetrahydrofolate reductase), IL8, TNFA and IFNG were assessed by real time PCR. Regulatory T Cell (Treg) number (CD3+, CD4+, CD25high, FoxP3+, CD127-) was determined after mononuclear leukocytes incubation with PMA and ionomycin or vehicle for 18h, by immunophenotyping. Results: A great increase on serum folate was observed after 45 and 90 days of FA intervention. No differences in serum vitamin B12 were observed before and after intervention. Serum PLP was similar before and after intervention, however, an increase in serum PL was observed after 45 and 90 days, and in PA after 45 days, when compared to baseline. Riboflavin and FMN were increased after 45 and 90 days than in baseline. Serum thiamine was decreased after 45 days than in baseline. Serum TMP was increased after 90 days when compared with previous timepoints. No differences in vitamin B3 were observed after and before FA intervention. Among kynurenine pathway metabolites, anthranilic acid was increased after 45 and 90 days, while picolinic acid was decreased after 90 days. hs-CPR, serum IL-6, IL-8, IL-10, IFN-γ and TNF-α were similar at baseline and after intervention. An increase on mRNA expression of DHFR and TNFA was observed after, respectively, 90 days and 45 and 90 days of intervention. After 90 days of FA intervention, it was observed a decrease on Treg cell number after PMA and ionomycin stimulation. Conclusion: Daily use of 5 mg of FA was associated with changes in serum markers of B-complex vitamins status and kynurenine pathway, as well as decreased number of Treg cells

The effects of intramuscular injections of vitamin B1 and B12 on pain, salivary components and taste in patients with burning mouth syndrome / 口腔疾病防治

Objective@#To determine differences in pain, salivary components and taste between burning mouth syn⁃ drome (BMS) patients and the normal population and to study the effects of intramuscular injections of vitamin B1 (VitB1) and vitamin B12 (VitB12) on BMS. @*Methods@#Before treatment: We observed and compared differences in un⁃ stimulated salivary flow rate (USFR); stimulated salivary flow rate (SSFR); salivary amylase, cortisol, and secretory im⁃ munoglobulin A (SIgA) concentrations; and taste levels between BMS patients and normal controls. After treatment: The treatment group received an intramuscular injection of 100 mg VitB1 and 0.5 mg VitB12 in the buttocks once per day for 10 days. The above indexes were recorded before and after treatment and compared. A visual analog scale (VAS) score was used to assess the degree of pain relief in patients and as a clinical evaluation index. @*Results@#Before treat⁃ ment: SSFR, salivary amylase levels and bitter taste levels of the treatment group were significantly lower than those of the control group (P < 0.05). The concentration of SIgA was significantly higher than that of the control group (P < 0.05), and the USFR and the cortisol concentration were not significant different from the those of the control group (P > 0.05). After treatment: The total effective rate of VitB1 and VitB12 on BMS was up to 70%. USFR was increased signifi⁃ cantly after treatment (P < 0.05), and the concentration of SIgA decreased (P < 0.05). There were no significant differ⁃ ences in the SSFR or the cortisol and salivary amylase concentrations (P > 0.05). Taste levels improved by varying de⁃ grees. @*Conclusions @#The abnormal decreases in SSFR, salivary amylase levels, and taste sensitivity and the abnormal increase in SIgA levels seen in BMS patients may be sensitive salivary indicators for the diagnosis of BMS. A VitB1 and VitB12 intramuscular injection is an effective treatment for patients with BMS, who showed pain relief. Changes in SIgA levels may be used as an indicator during follow⁃up and for the prognosis of BMS patients.

Simultaneous Determination of Five Vitamins in Complex Vitamin B Tablets by HPLC / 中国药师

Objective:To develop an HPLC method for the simultaneous determination of vitamin B 1(thiamine), vitamin B2(ribo-flavin), vitamin B3(niacinamide), vitamin B5(pantothenic acid) and vitamin B6(pyridoxine) in complex vitamin B tablets.Meth-ods:An Alltima C18 column (250 mm ×4.6 mm, 5μm) was used for the separation , and 50 mmol· L-1 ammonium dihydrogen phos-phate ( adjusting pH to 3.0 with H3 PO4 ) and acetonitrile were used as the mobile phase with gradient elution at the flow rate of 0.5 ml · min-1 .The detection wavelength was set at 275 nm for vitamin B1 , vitamin B2 , vitamin B3 and vitamin B6 , and 210 nm for vitamin B5 .The column temperature was 30℃and the injection volume was 5μl.Results:The linear range of vitamin B 1 , B2 , B3 , B5 and B6 was 39.48-197.40, 40.16-200.80, 39.36-196.80, 38.80-194.00 and 41.76-208.80 μg · ml-1(r≥0.9999).The average recov-ery was 98.70％, 99.91％, 99.04％, 99.63％and 98.75％, and the RSDs were 0.40％, 0.27％, 0.40％, 0.92％ and 0.39％(n =9), respectively.Conclusion:The established method is accurate , simple and rapid, and can be utilized for the simultaneous determination of vitamin B 1 , B2 , B3 , B5 and B6 in complex vitamin B tablets .

Simultaneous Determination of Dihydralazine Sulfate and Three Vitamins in Compound Apocynum venetum Tablets I by HPLC / 中国药房

OBJECTIVE: To establish a method for simultaneous determination of vitamin B1, dihydralazine sulfate, vitamin B6 and vitamin B5 in Compound Apocynum venetum tablets I.METHODS: HPLC method was used for content determination of 8 batches of samples from 2 enterprises. The determination was performed on Waters XBridge C18 column with mobile phase consisted of acetonitrile-0. 2％ phosphoric acid (gradient elution) at the flow rate of 0. 5 mL/min. The detection wavelengths were set at 285 nm (vitamin Bi, dihydralazine sulfate, vitamin B6) and 210 nm (vitamin B5). The column temperature was 30 ℃, and sample size was 10 μL. RESULTS: The linear ranges of vitamin Bi, dihydralazine sulfate, vitamin B6 and vitamin B5 were 41. 66-208. 3 μg/mL (r=0. 999 9), 127. 0-635. 0 μg/mL (r=0. 999 9), 40. 74-203. 7 μg/mL (r=0. 999 9) and 22. 72-113. 6 μg/mL (r= 0. 999 9), respectively. The limits of quantitation were 0. 267, 0. 274, 0. 062, 0. 124 μg/mL, respectively. The limits of detection were 0. 095, 0. 088, 0. 021, 0. 039 μg/mL, respectively. RSDs of precision, stability and reproducibility tests were all lower than 2. 0％ (n=6). The average recoveries were 98. 70％ (RSD=0. 69％, n=9),99. 74％ (RSD=1. 2％, n=9), 99. 89％ (RSD= 1. 0％, n=9), 99. 25％ (RSD=1. 2％, n=9), respectively. Among 8 batches of samples, the contents of vitamin B1, dihydralazine sulfate, vitamin B6 and vitamin B5 were 91. 44％-98. 74％, 36. 68％-95. 23％, 92. 42％-97. 90％, 91. 36％-99. 48％ of labelled amount, respectively. The contents of dihydralazine sulfate were significantly different and differed by 2. 6 times between the lowest and the highest threshold value. CONCLUSIONS: The method is accurate, reliable, simple and can be used for simultaneous determination of the above 4 components in Compound A. venetum tablets I.

Encefalopatía de Wernicke en gestante con hiperemesis gravídica grave / Wernicke's encephalopathy associated with gravidarum hypermesis

Resumen ANTECEDENTES: la encefalopatía de Wernicke se origina por el déficit de vitamina B1 y sus características sobresalientes son: triada de confusión, ataxia y oftalmoplejia. Cuando hay déficit de memoria o aprendizaje se denomina síndrome de Wernicke-Korsakoff. CASO CLÍNICO: se comunica el caso de una paciente en su primer embarazo, de 18 semanas de gestación, con varios ingresos al hospital por hiperemesis gravídica; acudió al servicio de Urgencias por un cuadro de pérdida progresiva de fuerza en las extremidades inferiores. A los cinco días del ingreso tuvo empeoramiento del estado general. A la exploración física se identificó nistagmus horizonto-rotatorio, bilateral, espontáneo, tetraparesia flácida de predominio proximal, con arreflexia global de predominio en EEII y pérdida de tono de los esfínteres. La paciente se encontraba confusa, desorientada y repetitiva en su discurso. Se inició tratamiento con tiamina parenteral, por sospecha de polineuropatía metabólica por déficit de tiamina; el nistagmus y el cuadro de confusión disminuyeron. Un mes más tarde se programó para tratamiento intensivo de rehabilitación. La evolución del embarazo trascurrió con normalidad y continuó en tratamiento con tiamina y antieméticos, con estabilidad y control del cuadro. CONCLUSIÓN: la encefalopatía de Wernicke es una padecimiento de frecuencia excepcional, pero de consecuencias muy graves; de ahí la importancia de tenerlo en mente en pacientes embarazadas susceptibles de padecerlo y poner en práctica las medidas de profilaxis adecuada que eviten su aparición y las secuelas.

Abstract BACKGROUND: Wernicke's encephalopathy, caused by vitamin B1 deficiency, is characterised by the triad of confusion, ataxia and ophthalmoplegia. If memory or learning deficits appear simultaneously, it is known as Wernicke-Korsakoff syndrome. CLINICAL CASE: We present the case of a primigravida in her 18th week of pregnancy who had been suffering from hyperemesis gravidarum. She came to the emergency unit because of progressive loss of strength in her lower limbs. Five days after her admission, a deterioration of her general condition was observed. The examination revealed bilateral spontaneous horizontal-rotatory nystagmus, flaccid tetraparesis with proximal predominance, global areflexia predominantly in the lower limbs and loss of sphincters tone. The patient was confused, disoriented and repetitive in her speech. Parenteral vitamin B1 was initiated as a metabolic polineuropathy due to thiamine insufficiency was suspected. As a result the symptoms of nystagmus and confusion subsided. Intensive physical therapy was programmed in a rehabilitation unit 1 month later. Pregnancy developed normally and she continued with thiamine and antiemetic therapy. CONCLUSIONS: Wernicke's encephalopathy is an infrequent pathology, but its consequences may be really serious. This is the reason why it is paramount to take into account this entity in pregnant women liable to develop it and to carry out adequate prophylaxis to prevent its appearance and development of posterior sequels.

Preparation of Vitamin B1 Sustained-release Tablets / 中国药师

Objective: To screen the optimal formula and preparation process of vitamin B1 ( VB1 ) sustained-release tablets. Methods:The single-factor tests were used to investigate the type of filler, type and amount of matrix material hydroxypropyl methycel-lulose(HPMC), type and amount of retarder, tablet weight and core hardness. The orthogonal tests were used to investigate the amount of HPMC and ethyl cellulose( EC) and the core hardness. Results:The optimum formula was as follows:HPMC accounted for 50% of the tablet weight, EC accounted for 20%, the filler was lactose, the tablet weight was 200 mg and the tablet core hardness was 50 N. Conclusion:The prepared sustained-release tablets have significant controlled-release property, which provides reference for the devel-opment of new dosage form for VB1 .

Effect of Multi-trace Elements Injection (Ⅱ) on the Stability of Compound Trivitamin B for Injection (Ⅱ) / 中国药师

Objective:To study the stability of thiamine nitrate ( VB1 ) and pyridoxine hydrochloride ( VB6 ) in total parenteral nu-trition ( TPN) solution containing multi-trace elements injection (Ⅱ) . Methods:HPLC was used to determine the contents of VB1 and VB6 in different prescriptions in 0, 2, 4, 6, 8 and 24 h. Meanwhile, the pH value was determined and the appearance of the solution was observed. Results:The contents of VB1 and VB6 in 5% glucose solution containing multi-trace elements injection (Ⅱ) were changed mithin the range of 10%. In the TPN solution, containing multi-trace elements injection (Ⅱ) , the content of VB1 decreased by 12% in 8 h, and the content of VB6 was changed within the range of 10%. The solutions containing multi-trace elements injection (Ⅱ) were all light yellow, while the solutions without multi-trace elements injection (Ⅱ) were colorless and transparent. The pH val-ue showed no significant change in each group. Conclusion: The TPN solution containing multi-trace elements injection (Ⅱ) and compound trivitamin B for injection (Ⅱ) is recommended to be used in 8 hours.

Clinical role of dietary thiamine on regulation of renal response to metabolic acidosis in adult rats / Papel clínico de tiamina na dieta sobre a regulação da resposta renal de acidose metabólica em ratos adultos

Kidney plays a central role in maintaining the composition of body fluids by regulating water, NaCl, acid base, and solute reabsorption and excretion, respectively. The study was done to investigate the physiological role of thiamine in regulation of renal response to metabolic acidosis induced by NH4Cl in adult male rats. For this experiment, fifty rats were used. They were divided into five groups. Control rats received basal diet; rats fed on basal diet mixed with NH4Cl (4g NH4Cl/100g diet) to induce severe metabolic acidosis, rats fed on basal supplemented diet with thiamine (600 mg/kg diet), and rats fed on basal supplemented diet with thiamine before and after induction of metabolic acidosis by NH4Cl for 14 days. The results showed that the plasma levels of chloride, urea, and creatinine were significantly elevated in metabolic acidosis induced by NH4Cl. Thiamine supplementation at high dose before or after induction improved the chloride values. Feeding diets supplemented with thiamine modulated the plasma sodium and bicarbonate values. Supplementation with vitamin B1 as preventive agent significantly restored these changes to near control value and when used as curative agent improved plasma creatinine and urea levels. Urinary pH and potassium levels were decreased significantly in metabolic acidotic rats when compared to all experimental groups. Urinary ammonia and aldosterone levels were decreased by thiamine supplementation as protective agent. Supplementation with vitamin B1 as preventive and curative agents, restored the affected parameters and regulate the response of kidney to metabolic acidosis induced by ammonium chloride.

O rim desempenha um papel central na manutenção da composição de fluidos corporais através do controlo de água, NaCl, ácido-base, e reabsorção do soluto e excreção, respectivamente. O estudo foi realizado para investigar o papel fisiológico de tiamina na regulação da resposta renal à acidose metabólica induzida por NH4Cl em ratos machos adultos. Para esta experiência, foram utilizados cinquenta ratos. Eles foram divididos em cinco grupos. Os ratos de controlo receberam dieta basal; os ratos alimentados com dieta basal misturado com NH 4 Cl (4 g NH 4 Cl / 100 g de dieta) para induzir uma grande taxa de acidose metabólica , os ratos alimentados com dieta suplementada basal com tiamina (600 mg / kg de ração), e ratos alimentados com dieta suplementada basal com tiamina antes e após a indução de acidose metabólica por NH4Cl durante 14 dias. Os resultados mostraram que os níveis plasmáticos de cloreto, ureia e creatinina foram significativamente elevados em acidose metabólica induzida por NH4Cl. A suplementação de tiamina em doses elevadas antes ou após a indução aumentou os valores de cloreto. O fornecimento de dietas suplementadas com valores de tiamina modulado o sódio plasmático e bicarbonato. A suplementação com vitamina B1 como agente preventivo restaurou significativamente estas alterações para aproximar o valor de controle e, quando utilizado como agente curativo melhorou os níveis de creatinina e uréia plasmática. Os níveis de pH e de potássio na urina foram reduzidos significativamente em ratos acidóticos metabólicos, quando comparado com todos os grupos experimentais. os níveis de amônia e de aldosterona urinário foram reduzidos pela suplementação de tiamina como agente de proteção. A suplementação com vitamina B1 como agentes preventivos e curativos, restaurou os parâmetros afetados e regulou a resposta do rim a acidose metabólica induzida por cloreto de amónio.

Content Determination of Vitamin B1 and Vitamin B2 in Trivitamin and Calcium Gluconate,Calcium Hydro-gen Phosphate Chewable Tablets by HPLC / 中国药房

OBJECTIVE:To establish a method for the content determination of vitamin B1 and vitamin B2 in Trivitamin and calci-um gluconate,calcium hydrogen phosphate chewable tablets. METHODS:HPLC was conducted. The column was Inertsil C18 with the mobile phase of 1%triethylamine contained 0.02 mol/L of sodium heptane solution(pH was adjusted to 5.5 by phosphate)-methanol (74∶26,V/V)at the flow rate of 1.0 ml/min,the detection wavelength was 260 nm,temperature was 30℃and the volume was 20μl. RESULTS:There was a good linear relationship between the quality concentration of vitamin B1 and peak area in the range of 0.22-1.10μg/ml(r=0.999 8)and vitamin B2 was in the range of 0.22-1.09μg/ml(r=0.999 7). The RSDs of precision,reproducibility and stabil-ity tests were all less than 1%;the average recovery was respectively 99.66%(RSD=0.96%,n=9)and 100.31%(RSD=0.92%,n=9). CONCLUSIONS:The method is simple,accurate,sensitive and reliable and suitable for the content determination of vitamin B1 and vitamin B2 in Trivitamin and calcium gluconate,calcium hydrogen phosphate chewable tablets.

A Case of Acute Incomitant Esotropia Associated with Wernike's Encephalopathy

PURPOSE: We report a case of an acute incomitant esotropia with Wernike's encephalopathy. CASE SUMMARY: A 64-year-old male visited our hospital because of diplopia lasting a week. He was a chronic alcoholic drinking two bottles of makgeolli daily and eating little for a month. He showed -2 underaction of bilateral lateral rectus muscles and 45 prism diopters of esotropia at the primary position at the first visit. He had ataxia and mild cognitive impairment. There were high signal intensities in the periaqueductal area and mammillary bodies in the brain fluid attenuated inversion recovery magnetic resonance image. He was diagnosed with Wernike's encephalopathy clinically and was immediately treated with intravenous thiamine. He showed -0.5 underaction of bilateral lateral muscles and 8 prism diopters of esotropia at the primary position 3 days after thiamine treatment. CONCLUSIONS: Wernicke's encephalopathy is a medical emergency. If diagnosis and treatment are delayed, patients may have neurological sequelae that can lead to death. Esotropia and diplopia can be the presenting manifestations in Wernike's syndrome without other symptoms. In taking patient histories, physicians should ask about alcohol consumption and low food intake because of the possibility of acute incomitant esotropia associated with Wernicke's encephalopathy.

Detection of Serum Folate and Vitamin B1 2 in the Role of Gigantic Young Cell Anemia Diagnosis and Treatment / 现代检验医学杂志

Objective To explore the serum folic acid (FOL)and vitamin B12 (Vit B12)levels in gigantic young cell anemia (MA)in the diagnosis and treatment effect.Methods Select in March 2010 to March 2013,examined with clear cell mor-phology in the diagnosis of 50 patients with gigantic young cell anemia as observation group.Another selection during the same period to hospital for a medical 52 cases of healthy people as control group,observation group treated with FOL and Vit B1 2 8~1 5 d,with SIEMENS SIEMENS ADVIA Centaur CP automatic chemiluminescence immune analyzer to observe group before and after treatment and the control group was used to detect the serum FOL and Vit B1 2 levels,respectively, for all the test results were analyzed.Results Observation group before treatment serum FOL and Vit B12 levels (2.23± 0.11 ng/ml and 125.21±94.14 pg/ml)significantly lower than the control group (5.49± 3.91 ng/ml and 356.70±185.46 pg/ml),differences were statistically significant (t=5.89,P0.05;t=1.51,P>0.05).Conclusion The detection of serum FOL and Vit B12 levels,can be used as a gigantic young cell anemia is the effective means to the diagnosis and treatment effect monitoring.

Serum concentration of B vitamins and their correlation to epilepsy / 中华临床营养杂志

Objective To investigate the correlation of serum concentration of B vitamins B1,B6,B12) with the incidence of epilepsy.Methods We recruited 50 newly diagnosed patients with epilepsy (not receiving antiepileptic drugs) and 50 patients without epilepsy.Serum concentrations of B vitamins (B1,B6,and B12) in both groups were detected with a LK3000V vitamin detector.Results The concentrations of vitamin B1 and B12 in epileptic patients were (132.81 ±7.3l) nmol/L and (221.41 ±26.09) pg/ml,respectively,not significantly different from those in non-epileptic patients [(130.44 ± 5.12) nmol/L,P =0.095 ;(197.87 ± 19.36) pg/ml,P =0.077].The concentration of vitamin B6 in epileptic children was (44.61 ±2.49) μmol/L,significantly lower than that in non-epileptic children [(64.63 ± 5.71) μmol/L,P =0.031].Conclusion Though serum concentrations of vitamin B1 and B12 may not be associated with epilepsy,lower concentration of vitamin B6 in serum may increase the risk of epilepsy.

Determination of Methionine,Vitamin B1 and Vitamin B2 in Lingzhi Erwei Methionine Capsules by HPLC / 中国药师

Objective:To establish an HPLC method for the simultaneous determination of methionine, vitamin B1 and vitamin B2 in Lingzhi Erwei methionine capsules. Methods:The determination was performed on a Ultimate? AQ-C18 column(250 mm × 4. 6 mm, 5 μm,Welch Inc. ) with the detection wavelength at 220 nm. The mobile phase was composed of methanol and 0. 07 mol·L-1 sodium heptanesulfonate solution (14 ml triethylamine diluted with water to1 000ml, adjusting pH to 3. 5 with diluted orthophosphoric acid) with gradient elution, and the flow rate was 1. 0 ml·min-1. Results: Methionine, vitamin B1 and vitamin B2 was in good linearity within the range of 0.527 0-1.510 0 mg·ml-1 - (r =0.999 9), 0.045 52-0.136 56 mg·ml-1 (r =0.999 9) and 0.010 10-0. 060 58 mg·ml-1(r=0. 999 9), respectively. The mean recovery was 100. 5%, 97. 7% and 101. 5% with RSD of 0. 5%, 1. 0%and 1. 4%(n=9) accordingly. Conclusion:The method is simple, accurate, reliable and appropriate in the simultaneous determina-tion of methionine,vitamin B1 and vitamin B2 in Lingzhi Erwei methionine capsules.

Analysis on correlation of vitamin B1 level with progression of diabetic nephropathy / 吉林大学学报(医学版)

Objective To measure the vitamin B1 levels in plasma,erythrocytes and urine of the patients with type 2 diabetes,and to analyze the correlation of vitamin B1 level with the progression of diabetic nephropathy,and to clarify the metabolism of nutrtion mechanism of type 2 diabetic nephropathy.Methods Total 90 patients with type 2 diabetes and 30 healthy volunteers were recruited.According to the levels of microalbuminuria,the patients with type 2 diabetes were divided into non diabetic nephropathy (NDN)group,early diabetic nephropathy (EDN)group and clinical diabetic nephropathy (CDN)group (n=30);the healthy people was used as normal control (NC) group.The vitamin B1 levels in the plasma,erythrocytes and urine were examined with high performance liquid chromatography (HPLC). The correlation of microalbuminuria with the plasma viamin B1 level was analyzed. Results The level of vitamin B1 in plasma of the patients in NC group was (7.1±3.3)μg·L-1,while it was (4.0±2.3)μg·L-1 in NDN group,(3.1±1.0)μg·L-1 in EDN group and (2.3±0.6)μg·L-1 in CDN group. Compared with NC group,the vitamin B1 levels in the plasma in NDN,EDN and CDN groups dropped 43.7%, 56.3%,and 67.6%,respectively (P<0.05). The excretion of vitamin B1 in urine were (2.9 ± 0.8),(9.0 ± 4.7),(11.7±3.9),and (15.6±5.0)μg·L-1 in NC group,NDN group,EDN group and CDN group, respectively.Compared with NC group,the vitamin B1 levels in the urine in NDN,EDN and CDN groups were increased by 2,3 and 4 times,respectively (P<0.05).A negative correlation was found between the level of microalbuminuria and the level of vitamin B1 in plasma (r=-0.62,P=0.013).Conclusion Vitamin B1 deficiency can be observed in the early stage of diabetic nephropathy,and the level of vitamin B1 is closely correlated with the progression of diabetic nephropathy.

Effect of Drug Injection in Muscle Motor Points on Spastic Cerebral Palsy / 中国康复理论与实践

Objective To explore the effect of drug injection in muscle motor points on children with spastic cerebral palsy. Methods 230 children with spastic cerebral palsy were divided into control group and observation group, with 115 cases in each group. The control group received comprehensive rehabilitation including functional training, physical therapy and medicine, while the observation group re-ceived injection of vitamin B1 and vitamin B12 in muscle motor points in addition. They were assessed with Gross Motor Function Measure (GMFM), modified Ashworth Scale (MAS), mental development index (MDI) and psychomoter developmental index (PDI) of CDCC Infant Me Ntal Development Scale. Results The gross motor function improved, MAS score decreased, the scores of MDI and PDI increased after treatment (P<0.01) in both groups, which were better in the observation group than in the control group (P<0.05). Conclusion Drug injec-tion in muscle motor points can improve the gross motor function, relieve spasm, and improve intelligence development of children with spastic cerebral palsy.

Effect of Drug Injection in Muscle Motor Points on Spastic Cerebral Palsy / 中国康复理论与实践

@#Objective To explore the effect of drug injection in muscle motor points on children with spastic cerebral palsy. Methods 230 children with spastic cerebral palsy were divided into control group and observation group, with 115 cases in each group. The control group received comprehensive rehabilitation including functional training, physical therapy and medicine, while the observation group received injection of vitamin B1 and vitamin B12 in muscle motor points in addition. They were assessed with Gross Motor Function Measure (GMFM), modified Ashworth Scale (MAS), mental development index (MDI) and psychomoter developmental index (PDI) of CDCC Infant Me Ntal Development Scale. Results The gross motor function improved, MAS score decreased, the scores of MDI and PDI increased after treatment (P<0.01) in both groups, which were better in the observation group than in the control group (P<0.05). Conclusion Drug injection in muscle motor points can improve the gross motor function, relieve spasm, and improve intelligence development of children with spastic cerebral palsy.