Mechanism of active ingredients in Periploca forrestii compound against rheumatoid arthritis based on integrative metabolomics and network pharmacology / 中国中药杂志

In this study, an ultra-performance liquid chromatography-quadrupole time-of-flight high resolution mass spectrometer(UPLC-Q-TOF-HRMS) was used to investigate the effects of the active ingredients in Periploca forrestii compound on spleen metabolism in rats with collagen-induced arthritis(CIA), and its potential anti-inflammatory mechanism was analyzed by network pharmacology. After the model of CIA was successfully established, the spleen tissues of rats were taken 28 days after administration. UPLC-Q-TOF-HRMS chromatograms were collected and analyzed by principal component analysis(PCA), orthogonal partial least squares discriminant analysis(OPLS-DA), and MetPA. The results showed that as compared with the blank control group, 22 biomarkers in the spleen tissues such as inosine, citicoline, hypoxanthine, and taurine in the model group increased, while 9 biomarkers such as CDP-ethanolamine and phosphorylcholine decreased. As compared with the model group, 21 biomarkers such as inosine, citicoline, CDP-ethanolamine, and phosphorylcholine were reregulated by the active ingredients in P. forrestii. Seventeen metabolic pathways were significantly enriched, including purine metabolism, taurine and hypotaurine metabolism, glycerophospholipid metabolism, and cysteine and methionine metabolism. Network pharmacology analysis found that purine metabolism, glycerophospholipid metabolism, and cysteine and methionine metabolism played important roles in the pathological process of rheumatoid arthritis. This study suggests that active ingredients in P. forrestii compound can delay the occurrence and development of inflammatory reaction by improving the spleen metabolic disorder of rats with CIA. The P. forrestii compound has multi-target and multi-pathway anti-inflammatory mechanism. This study is expected to provide a new explanation for the mechanism of active ingredients in P. forrestii compound against rheumatoid arthritis.

Morphological investigation of protective effects of CDP-choline on liver and small intestine in an experimental sepsis model in rats / Investigación morfológica de los efectos protectores de la CDP-colina en el hígado y el intestino delgado en un modelo experimental de sepsis en ratas

SUMMARY: Fifty male Wistar albino rats were divided into 5 groups; Group 1 as a sham group. Group 2 as a control group, Group 3 as 100 mg/kg CDP-choline administered group, Group as 200 mg/kg CDP-choline administered group, and Group 5 as sepsis group. The sepsis model was performed by ligating and perforating the caecum of rats. Liver and small intestine tissues were assessed either histologically or quantitatively and qualitatively. There was a significant difference between the sepsis and CDP-choline groups for liver and intestinal damage evaluated in tissue samples. (p <0.001). CDP-choline treatment partially improved dose-dependent the clinical parameters of sepsis and septic shock, reversed micro-anatomical damage caused by sepsis.

Cincuenta ratas albinas Wistar macho se dividieron en 5 grupos; Grupo 1 como grupo control simulador, el grupo 2 como grupo de control, el grupo 3 como grupo al que se administró 100 mg/kg de CDP-colina, el grupo 4 como grupo al que se administró 200 mg/kg de CDP-colina y el grupo 5 como grupo con sepsis. El modelo de sepsis se realizó ligando y perforando el intestino ciego de las ratas. Los tejidos del hígado y del intestino delgado se evaluaron histológicamente o cuantitativa y cualitativamente. Hubo una diferencia significativa entre los grupos de sepsis y CDP-colina para el daño hepático e intestinal evaluado en muestras de tejido (p<0,001). El tratamiento con CDP-colina mejoró parcialmente, según la dosis, los parámetros clínicos de sepsis y shock séptico y revirtió el daño micro anatómico causado por la sepsis.

Effect of Recombinant Human Growth Hormone Add on Therapy on Acute Stroke Outcome

Recombinant human growth hormone (rhGH) administration stimulate the secretion of the brain insulin-like growth factor-1 (IGF-1) concentration and IGF-1 is a pleiotropic neurotropic peptide to exert beneficial effect for the injured brain tissues. Citicoline (cytidine-59-diphosphocholine; CDP-choline) is well known to improve neurological outcome in acute stroke. This study aimed to evaluate whether rhGH can potentiate citicoline effect on functional recovery in acute stroke patient. Thirty patients were enrolled. Ten patients were treated with rhGH subcutaneous injection for 6 months on top of citicoline for 6 weeks (GH6 group), and 10 patients for 3 months (GH3 group) with 6 weeks of citicoline treatment as well, and final 10 patients only with citicoline (control group). Functional outcome was determined by Korean modified Barthel Index (K-MBI) and modified Rankin Scale (mRS) at baseline and 6 months after treatment. Seven and 4 patients withdrew from GH6 and GH3 group, respectively. Final 3 patients in GH6 group, 6 patients in GH3 group and 10 patients in control group were analyzed. The K-MBI, and mRS scores from all 3 groups increased in 6 months compared to baseline in intra-group comparison. In inter-group comparison, however, GH6 but not GH3 showed statistically significant improvement compared to control. Administration of rhGH for 6 months on top of 6-week citicoline treatment resulted in further improvement in K-MBI and mRS in acute stroke patients. Further studies in increasing injection dose or injection period is needed.

Neurocirugía endovascular en el abordaje de pacientes con evento cerebrovascular isquémico / Endovascular neurosurgery in the approach of patients with ischemic cerebrovascular event

El evento cerebrovascular isquémico es una de las principales patologías crónicas de mayor prevalencia a nivel mundial, con tasas altas de mortalidad y discapacidad, con impacto significativo en el ámbito laboral, familiar, social, personal y sanitario. El campo de la neurocirugía endovascular se ha incorporado en las últimas décadas al manejo de enfermedades vasculares, siendo una de las opciones más eficientes para el tratamiento de las mismas por el impacto que tiene sobre la vida del paciente. El presente trabajo de revisión tiene como principal objetivo describir el abordaje de la enfermedad cerebrovascular isquémica aguda, desde su enfoque endovascular, basado en evidencia científica actual y lineamientos vigentes. Se realizó un análisis de los resultados obtenidos en estudios clínicos y de los protocolos más recientes publicados en artículos de revisión de bibliotecas virtuales y revistas científicas con rigurosas normas de publicación. Conforme a la revisión realizada, el tratamiento de la enfermedad cerebrovascular isquémica aguda puede abordarse de dos maneras dependiendo del tiempo transcurrido desde el inicio de los síntomas. Si únicamente han transcurrido 4.5 horas desde el inicio de los síntomas y el paciente cumple con criterios bien establecidos, el tratamiento de elección será trombólisis IV (tratamiento estándar). Si han transcurrido más de 4.5 horas (máximo 12 hrs.) o paciente presenta alguna contraindicación para recibir el tratamiento estándar, se deberá manejar con trombólisi intraarterial, trombólisis combinada, trombectomía mecánica o angioplastía con stent (cirugía de precisión); todos ellos definidos como tratamiento endovascular, según sea el caso. El tratamiento endovascular ha permitido ampliar el periodo de atención del evento cerebrovascular isquémico, demostrando su efectividad y reduciendo la discapacidad y mortalidad asociadas...(AU)

The ischemic cerebrovascular event is one of the most important chronic diseases because of its highest prevalence worldwide. It has high rates of mortality and disability, with a significant impact in the labor, family, social, personal and health areas. The field of endovascular neurosurgery has been incorporated in the last decades to the management of vascular diseases; being one of the most efficient options for their treatment because of its effect in patient´s life expectancy. The main objective of this review was to describe the endovascular approach to acute ischemic cerebrovascular disease based on current scientific evidence and guidelines. An analysis of clinical studies and recent protocols was done. According to this review, treatment of acute ischemic cerebrovascular disease can be approached in two ways depending on the time elapsed since the onset of symptoms. If only 4.5 hours have elapsed since the onset of symptoms and the patient meets all inclusion criteria, the treatment of choice will be IV thrombolysis (standard treatment). If more than 4.5 hours have elapsed (maximum 12 hours) or patient has any contraindication to receive standard treatment, it should be treated with intra-arterial thrombolysis, combined thrombolysis, mechanical thrombectomy or angioplasty with stenting; all defined as endovascular treatment. The endovascular treatment has allowed to extend the period of attention of the ischemic cerebrovascular event, demonstrating its effectiveness and reducing the associated disability and mortality...(AU)

Early application of citicoline in the treatment of acute stroke: A meta-analysis of randomized controlled trials / 华中科技大学学报（医学）（英德文版）

This study was to evaluate the efficacy and safety of early application of citicoline in the treatment of patients with acute stroke by meta-analysis. Randomized controlled trials published until May 2015 were electronically searched in MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, WHO International Clinical Trial Registration Platform, Clinical Trial.gov, and China Biology Medicine disc. Two reviewers independently screened the articles and extracted the data based on the inclusion and exclusion criteria. The quality of included articles was evaluated by using Revman5.0, and meta-analysis was performed. The results showed that 1027 articles were obtained in initial retrieval, and finally 7 articles, involving a total of 4039 cases, were included for analysis. The meta-analysis showed that no significant differences were found in the long-term mortality (OR=0.91, 95% CI 0.07 to 1.09, P=0.30), the rate of dependency (OR=1.02, 95% CI 0.87 to 1.24, P=0.85), and the effective rate (OR=0.98, 95% CI 0.84 to 1.14, P=0.82) between citicoline group and control group. The overall rate of adverse events in citicoline group was not significantly different from that in control group (P=0.30). The quality of included articles reached moderate-low level. In conclusion, citicolne cannot reduce long-term mortality and dependence rate in the treatment of acute stroke, and the effective rate of citivoline may be not better than that of controls but with reliable safety.

Metanálisis de estudios clínicos controlados sobre el tratamiento del traumatismo craneoencefálico / Meta-analysis of controlled clinical studies on treating cranioencephalic traumatism

La citicolina es un fármaco neuroprotector-neurorrestaurador que se utiliza en diversos países para el tratamiento de los traumatismos craneales. Tras la publicación del estudio COBRIT, muy controvertido metodológicamente, se ha visto cuestionado el uso de la citicolina en esta indicación, por lo que ha sido necesario realizar una revisión sistemática de cara a evaluar si realmente el tratamiento en fase aguda con citicolina supone algún beneficio al paciente afectado de una lesión cerebral traumática. Métodos: Se realizó una búsqueda sistemática en Medline, En base y la base de datos del Grupo Ferrer para identificar todos los estudios comparativos con citicolina en esta indicación. Resultados: Se encontraron 12 estudios válidos para su inclusión en el metanálisis, con 2 706 pacientes tratados en la fase aguda. Bajo el modelo de efectos aleatorios, el metanálisis demuestra que el uso de citicolina se asocia con una mejor tasa de independencia, valorada con la escala de recuperación de Glasgow o equivalente,con un odds ratio (OR) de 1.815 (IC 95%: 1.302-2.530). Con el uso de la técnica del metanálisis acumulado se pone de manifiesto que el efecto del tratamiento con citicolina se ha podido ir diluyendo a lo largo del tiempo, en paralelo con las mejorías adquiridas en el tratamiento basal estándar de este tipo de pacientes. Conclusión: El metanálisis formal de citicolina para el traumatismo craneo encefálico demuestra un efecto beneficioso del tratamiento, sin que haya que considerar problemas de seguridad asociados...

Combination of citicoline and physiotherapy in children with cerebral palsy

The most common cause of physical disability in children is cerebral palsy. This study was aimed to evaluate the effect of citicoline in combination to physiotherapy versus physiotherapy alone, to improve the functional outcome in pediatric cerebral palsy. The clinical trial was performed on 50 pediatric patients aged 18-75 months with spastic diplegia or quadriplegic cerebral palsy. Patients were assessed in two groups: case group, under treatment, using injection of citicoline [10 mg/kg] every other day for 3 months and physiotherapy. Gross motor function classification system [GMFCS] levels were assessed in all patients before and after treatment. Patient's mean age was 38.7 +/- 17.2 months, and 52% were girls. Differences in the frequency of GMFCS levels between groups were not statistically significant, before [P = 0.09] and after [P = 0.47] treatment. In case group improving in GMFCS, level was occurred in 9/11 with level 2 to level 1, 3/5 with level 3 to other levels and 3/7 with level 4 to other levels. In the control group improving in GMFCS, level was occurred in 3/9 with level 2 to level 1, 3/10 with level 3 to other levels, and 2/4 with level 4 other levels. GMFCS level in 64% of cases was improved, whereas in control group, 32% was improved [P = 0.02]. Results demonstrated that citicoline in combination to physiotherapy appears to be a promising agent to improve gross motor function in patients with cerebral palsy versus physiotherapy alone. Although, further studies are need to be done

Visual evoked potentials (VEP) and visual acuity improvement after cytidine 52 -diphosphocholine (CDP-Choline) therapy in amblyopic patient / Melhora do potencial evocado visual (PEV) e da acuidade visual em paciente amblíope tratado com citidina difosfato colina

Citicoline may be used in many neurological disorders. Combined treatment of citicoline with patching in amblyopia has previously been researched. The purpose of this paper is to illustrate the effect of citicoline in non-patching amblyopic patient. A 11-year-old amblyopic boy underwent complete ophthalmological examinations, including VEP with flash and pattern stimulus. Two averages of 100 sweep were performed for flash stimulus. Pattern reversal stimulus obtained with high contrast was performed with 60', 30' and 15' checks stimuli. The VEP was repeated 90 days later after a therapy with citicoline and vitamin and the results compared with the responses of the previous recording session. The visual acuity (VA) was 0,7 in the RE and 1,0 in the LE. The VEP pattern amplitude was normal in both eyes. Delayed in latency was detected for all spatial frequency stimulus (SFS) in the RE. Delay in latency was detected only for high SFS in the LE. After the treatment, the VA was 1,0 in both eyes. The latency was normalized with low SFS on the RE and with high SFS on the LE. The flash VEP was normal before and after the therapy. In conclusion, the citicoline demonstrated that it was effective in the treatment of amblyopic eye without patching. The VA and the VEP latency improvement demonstrated that the citicoline enhance the transmission of the electric impulse from retina to visual cortex. Further research is required to understand the immediate and long-term effect of coline treatment in amblyopic patients.

A citicolina pode ser utilizada em vários problemas neurológicos. O tratamento combinado de citicolina e oclusão na ambliopia já foi previamente relatado. O objetivo deste estudo é ilustrar o efeito da citicolina em paciente amblíope sem o tratamento oclusivo. Um menino de 11 anos de idade foi submetido a um exame oftalmológico completo incluindo PEV do tipo flash e do tipo padrão reverso. Para o PEV tipo flash, foram analisadas duas médias de 100 estímulos cada uma. Para o PEV do tipo padrão reverso, foram utilizados estímulos de alto contraste de 60', 30' e 15'. O PEV foi repetido 90 dias depois do tratamento com citicolina e vitaminas e os resultados comparados com os exames antes do tratamento. A acuidade visual era de 0,7 no olho direito e 1,0 no olho esquerdo. A amplitude do PEV era normal em ambos os olhos. Era presente um aumento da latência a todas as frequências espaciais de estimulação (FEE) no olho direito e somente à alta FEE no olho esquerdo. Após o tratamento, a acuidade visual era de 1,0 em ambos os olhos. A latência se normalizou à baixa FSS no olho direito e à alta FSS no olho esquerdo. O PEV tipo flash era normal antes e depois do tratamento. Em conclusão, a citicolina demonstrou ser eficaz no tratamento de olhos amblíopes sem oclusão. A melhora da acuidade visual e da latência do PEV demonstraram que a citicolina restaura a transmissão elétrica do impulso da retina ao cortex visual. Pesquisas futuras são necessárias para entender o efeito imediato e a longo prazo da citicolina no tratamento de pacientes amblíopes.

Citicoline Protects Against Cognitive Impairment in a Rat Model of Chronic Cerebral Hypoperfusion

BACKGROUND AND PURPOSE: Cerebral white matter (WM) lesions are frequently observed in human cerebrovascular diseases, and are believed to be responsible for cognitive impairment. Various neuroprotective agents can suppress this type of WM or neuronal damage. In this study, we investigated whether citicoline, a drug used to treat acute ischemic stroke, can attenuate WM lesions and cognitive decline caused by chronic hypoperfusion in the rat. METHODS: Animals were divided into immediate- and delayed-treatment groups. Those in the immediate-treatment group received a sham operation, citicoline (500 mg/kg/day), or phosphate buffered saline (PBS) treatment. Citicoline or PBS was administered intraperitoneally for 21 days after occluding the bilateral common carotid arteries. Rats in the delayed-treatment group were intraperitoneally administered with either 500 mg/kg/day citicoline or PBS for 21 days beginning on the 8th day after the operation. From the 17th day of administration, the rats were placed in an eight-arm radial maze to examine their cognitive abilities. After completing the administration, tissues were isolated for Kluver-Barrera and the terminal deoxynucleotidyl transferase biotin-dUTP nick end labelling (TUNEL) staining. RESULTS: In the immediate-treatment group, cognitive functions were preserved in the citicoline-treated group, and WM damage and TUNEL-positive cells differed significantly between the citicoline- and PBS-treated animals. In the delayed-treatment group, there was no decrease in WM damage and TUNEL-positive cells, but cognitive improvement was evident for citicoline treatment relative to PBS treatment. CONCLUSIONS: These results show that citicoline can prevent WM damage and aid cognitive improvement, even after a certain extent of disease progression. Citicoline might be useful in patients with acute ischemic stroke as well as in chronic stroke accompanied with cognitive impairment.

Clinical effect of ligustrazine combined with citicoline for treatment of diabetic peripheral neuropathy / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To assess the clinical efficacy of the therapeutic schema for treatment of diabetic peripheral neuropathy (DPN) with ligustrazine and citicoline injection in combination.</p><p><b>METHODS</b>Adopting double-centered randomized controlled trial, 300 patients were randomly assigned to 3 groups, who were treated respectively by ligustrazine plus citicoline (group A), ligustrazine alone (group B) and citicoline alone (group C). Clinical efficacy, symptomatic integral (SI), electromyogram ( EMG), blood sugar and blood lipids were assessed 4 weeks after treatment, and the clinical efficacy and SI were assessed at the end of 3-month follow-up.</p><p><b>RESULTS</b>After 4-week treatment, improvements of blood sugar and blood lipids were seen in all the three groups, showing insignificant difference among them (P > 0.05). But the clinical efficacy, improvement of SI and EMG in group A were superior to those in group B and C (P < 0.05), while the difference between group B and C was insignificant. No severe adverse reaction was found. Results at the end of 3-month follow-up showed that the clinical efficacy in group A was still better than in the other two groups, so did the SI (6.39 +/- 2.04 vs 8.36 +/- 1.17 and 8.05 +/- 1.34, P < 0.05).</p><p><b>CONCLUSION</b>The therapeutic schema of using ligustrazine and citicoline in combination is effective and safe for improving DPN, and worthy of clinical spreading.</p>

Efectividad y tolerabilidad de la citicolina en el ictus isquémico agudo, estudio aleatorizado, doble ciego comparado con placebo / Effectiveness and tolerabilidad of the citicolina in the sharp ischemic ictus, I study randomized, blind double compared with placebo

Estudios previos sugieren que la CDP colina reduce los síntomas neurológicos en pacientes con isquemia cerebral. Acelerando la recuperación de los síntomas motores, la conciencia y disminuyendo el volumen del infarto. Evaluar la efectividad de Citicolina en el Ictus agudo. Métodos: Estudio prospectivo, aleatorizado, doble ciego de grupos paralelos. Un grupo recibió adicionalmente al tratamiento convencional citicolina 1000 mg endovenoso cada 12h. por 3 días, luego 2g VO por 6 semanas y otro placebo. Se evaluaron: NIHSS, BARTHEL y RANKIN, neuroimagen a través de Tomografía Helicoidal Cerebral, a las 3 y 6 semanas. Participaron 77 pacientes, 65 ingresaron a análisis. BARTHEL. Con un punto de corte de 50, en el grupo citicolina al final del tratamiento, el 55 por ciento fueron independientes y en el grupo que recibió placebo, 43.3 por ciento pacientes fueron independientes (P: 0.52). RANKIN: El punto de corte es menor de 3. Al final del tratamiento tuvieron un escore menor de 3 puntos, 33.3 por ciento pacientes en el grupo placebo y 45 por ciento en el grupo que recibió Citicolina (P 0.002). El volumen final del infarto fue inferior en el grupo que recibió citicolina (P 0.057). Tolerancia: Un paciente en el grupo activo con antecedente de ulcus gástrico, sangró; no se reportaron efectos adversos en el grupo placebo. La citicolina fue superior a placebo para mejorar el porcentaje de pacientes independientes después de un episodio de ictus, producido por la oclusión de la cerebral media.

Efectividad y tolerabilidad de la citicolina (somazina®): en el tratameinto de pacientes con deterioro cognitivo tipo demencia / Effectiveness and tolerabilidad of the citicolina (somazina®) in the treatment of patient with deterioration cognitivo type insanity

Evaluar la citicolina administrada a dosis de 1000 mg diarios durante 12 semanas en pacientes con criterios de demencia según Mini Mental State Test. (MMST) < 24 puntos, con el fin de observar los cambios en el MMST y en la calidad de vida. Se realizó un estudio, fase IV, prospectivo, abierto, multicéntrico, donde incluyeron pacientes de ambos sexos con edades comprendidas entre 45 y 85 años con deterioro de la función mental por: deterioro mental del anciano o trastornos vasculares crónicos, con un Score en MMST entre 12 y 23, a los cuales se suministró Citicolina (CDP.colina) en gotas a una dosis de 1000 mg., 10 cc (2 cucharaditas) diarias durante 3 meses. La efectividad fue evaluada mediante los cambios en los scores de: Mini Mental State Test, Escala de Calidad de Vida de Barthel, opinión del paciente o cuidador, opinión del médico a los tiempos: 0 días; 1,5 y 3 meses de tratamiento. Ingresaron al estudio 55 pacientes. La mayoría tomaban otro tipo de medicamentos y estos se mantuvieron sin cambios desde el inicio hasta el final del estudio. Se presentó un descenso discreto en las presiones arteriales sistólicas en ambas posiciones y en la presión arterial diastólica en la posición sentada entre el inicio y la 6ta semana sin modificaciones posteriores. Hubo un incremento importante en los promedios del MMST, el 92 por ciento de los pacientes mejoraron los resultados, en el 32 por ciento el cambio fue mayor de 5 puntos y el 18 por ciento tuvo resultados normales al final. Dos de tres pacientes con demencia severa pasaron a demencia moderada (10 a 16 ptos y 10 a 15 ptos). Diez de diecinueve pasaron de demencia moderada a leve y nueve pacientes pasaron de demencia moderada a un puntaje normal. Siete pacientes presentaron efectos adversos: mareos, inquietud, náuseas, diarrea, insomnio, epigastralgia, empeoramiento motor, ira, dos pacientes suspendieron (mareos, ataques de ira) y dos necesitaron tratamiento (mareos: cimnarizina; ira: alprazolan).

Effect of citicoline on spatial learning and memory of rats after focal cerebral ischemia / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effects of citicoline on spatial learning and memory of rats after focal cerebral ischemia.</p><p><b>METHODS</b>The rats were randomly divided into sham-operation group, ischemia control group and citicoline group. In the later two groups, focal cerebral ischemia model was established by introducing an intraluminal filament into the left middle cerebral artery, and citicoline (500 mg/kg) or 0.9% NaCl was administered intraperitoneally once a day for 2 weeks after the operation. The rats in the sham-operation group were not subjected to middle cerebral artery occlusion (MCAO) with intraluminal filament. The spatial learning and memory functions of the rats were evaluated by Morris water maze test 15 days after MCAO for 5 days.</p><p><b>RESULTS</b>The rats in ischemia control group exhibited serious spatial learning and memory deficits in both place navigation test and spatial probe test. In the former test, the mean escape latency of citicoline-treated rats were significantly shorter than that of ischemia control rats (P<0.01), and in the latter test significant diffidence was noted between citicoline and ischemia control groups in the percentage time spent in the former platform quadrant and frequency of crossing the former platform (P<0.05).</p><p><b>CONCLUSION</b>Citicoline can improve the spatial learning and memory function of rats after focal cerebral ischemia.</p>

Effect of Xuesaitong soft capsule on hemorrheology and in auxiliarily treating patients with acute cerebral infarction / 中国结合医学杂志

<p><b>OBJECTIVE</b>To observe the therapeutic effect of Xuesaitong soft capsule (XST) and its effect on platelet counts, coagulation factor 1 (CF1) as well as hemorrheologic indexes in treating patients with acute cerebral infarction (ACI).</p><p><b>METHODS</b>Two hundred and four patients with ACI were assigned into two groups, the control group (n = 96) and the treated group (n = 108). They were all treated with conventional Western medicines, including mannitol, troxerutin, citicoline, piracetam and aspirin, while to the treated group, XST was given additionally through oral intake, twice a day, 2 capsules each time for 8 successive weeks. The clinical efficacy was evaluated according to the nerve function deficits scoring and the changes of platelet count. CF1 and hemorrheological indexes were measured before and after treatment.</p><p><b>RESULTS</b>The total effective rate was 87.0% in the treated group, and 87.5% in the control group, respectively, showing insignificant difference between them. But the markedly effective rate in the treated group (66.7%) was significantly higher than that in the control group (27.1%, P < 0.01). The count of platelet was not changed significantly in both groups after treatment, while CF1 in them evidently lowered at the end of the 4th and 8th weeks of treatment, but showed insignificant difference between the two groups. The hematocrit, whole blood viscosity and plasma viscosity in both groups were all improved significantly after treatment, but also showed insignificant difference in comparison of the two groups.</p><p><b>CONCLUSION</b>XST has good efficacy in auxiliary treatment of patients with ACI, though its mechanism remains to be further explored.</p>

Neuroprotective Effect of Citicoline on Retinal Cell Damage Induced by Kainic Acid in Rats

PURPOSE: To examine whether citicoline has a neuroprotective effect on kainic acid (KA) -induced retinal damage. METHODS: KA (6 nmol) was injected into the vitreous of rat eyes. Citicoline (500mg/kg, i.p.) was administered to the rats once before and twice a day after KA-injection for 3- and 7-day intervals. The neuroprotective effects of citicoline were estimated by measuring the thickness of the various retinal layers using hematoxylin-eosin (H and E) staining. In addition, immunohistochemistry was conducted to elucidate the expression of endothelial nitric oxide synthase (eNOS) and neuronal nitric oxide synthase (nNOS). RESULTS: Morphometric analysis of retinal damage in KA-injected eyes showed significant cell loss in the inner nuclear layer (INL) and inner plexiform layer (IPL) of the retinas at 3 and 7 days after KA injection, but not in the outer nuclear layer (ONL). At 3 days after citicoline treatment, no significant changes were detected in the retinal thickness and immunoreactivities of eNOS and nNOS. The immunoreactivities of eNOS and nNOS increased in the retina at 7 days after the KA injection. However, prolonged treatment for 7 days significantly attenuated the immunoreactivities and the reduction of thickness. CONCLUSIONS: The results indicate that citicoline has a neuroprotective effect on KA-induced neurotoxicity in the retina.

Efficacy of citicoline in ischemic stroke as a supportive therapy

To study the efficacy of Citicoline in ischemic stroke as a supportive therapy. An open randomized trial to study the efficacy and tolerance of Citicoline. Setting: District Headquarters Hospital, Dera Ghazi Khan, Pakistan. Forty patients [22 males and 18 females] between the ages of 35$ 5 years, selected over a period of eight months suffering from acute ischemic stroke within twenty four hours. Thirtysix out of 40 patients [Hemiplegia 16, Hemiparesis 20] completed the study. Diabetes, hypertension and heart failure were the concomitant diseases seen in some patients. In the Hemiplegia group, 5 patients [31.25%] showed complete recovery, 8 patients [50%] partial recovery while There was no response in 3 patients [18.75°10]. In the Hemiparesis group, the results showed complete recovery in 16 patients [80%], partial recovery in 4 patients [20%] with no failure. Tolerance in both groups was good and did not necessitate cessation of therapy. When both groups are combined and taken as acute ischemic stroke, results show 58.3% complete recovery 33.3% partial recovery and 8.3% as nonresponders. Citicoline limits the size of infarct leading towards early recovery of motor and cognitive functions. As such, it can be used effectively in the management of ischemic stroke as supportive therapy

Influence of cyclic AMP on the biosynthesis of phosphatidylcholine in Microsporum gypseum.

The influence of intracellular cAMP on phosphatidylcholine biosynthesis in Microsporum gypseum has been examined using radiolabelled precursors. The incorporation of labelled choline, methionine and ethanolamine into total lipids, phospholipids and choline containing phospholipids increased in aminophylline and decreased in atropine grown cells as a result of rise and fall in cAMP levels in these cells. The enhanced uptake of labelled methionine and ethanolamine in comparison to labelled choline in choline containing phospholipids in aminophylline grown cells suggests that methylation pathway is more influenced by cAMP than CDP-choline pathway.