Sulfato de magnesio para neuroprotección fetal: revisión de la literatura / Magnesium sulphate for foetal neuroprotection: review of the literature

Objetivo: revisar la evidencia disponible acerca de la efectividad y seguridad del sulfato de magnesio como neuroprotector en fetos pretérmino.Materiales y métodos: se realizó una búsqueda de la literatura en las bases de datos, Medline, SciELO, Embase y ScienceDirect y Cochrane, utilizando los términos de búsqueda: "premature birth, cerebral palsy, magnesium sulfate", restringida a los siguientes tipos de estudios: metaanálisis, revisiones sistemáticas, guías de práctica clínica y ensayos clínicos controlados, entre el 2000 y el 2013.Resultados: la búsqueda en las bases de datos electrónicas arrojó 31 títulos, de los cuales se excluyeron 19 estudios debido a que no respondían a la pregunta inicial, eran artículos de revisión narrativa, doble publicación, incluían estudios observacionales o se trataba de protocolos de investigación. Finalmente, se seleccionaron 12 artículos que corresponden a 5 revisiones sistemáticas, 5 ensayos clínicos controlados y 2 guías de práctica clínica. El sulfato de magnesio disminuye el riesgo de parálisis cerebral en alrededor del 30 % y de disfunción motora gruesa en un 40 %. No tiene impacto significativo en otros desenlaces como mortalidad perinatal, leucomalacia periventricular o hemorragia intraventricular. Este efecto protector es mayor en edades gestacionales más tempranas. Los eventos adversos maternos y neonatales son generalmente leves.Conclusiones: el sulfato de magnesio utilizado en pacientes con trabajo de parto pretérmino, fase activa antes de semana 32, es un tratamiento efectivo y seguro en la prevención de la parálisis cerebral en fetos prematuros.

Objective: To review the existing evidence about the effectiveness and safety of magnesium sulphate used for neuroprotection in preterm foetuses.Materials and methods: A search of the literature was conducted in the Medline, SciELO, Embase and ScienceDirect and Cochrane databases, using the terms "premature birth, cerebral palsy, magnesium sulphate" limited to the following types of studies: meta-analyses, systematic reviews, clinical practice guidelines and controlled clinical trials, between 2000 and 2013.Results: The search in the electronic databases resulted in 31 titles. Of these, 19 studies were excluded because they did not answer the initial question, they were narrative review papers, double publication, included observational studies, or they were research protocols. Finally, 12 articles were selected, including 5 systematic reviews, 5 controlled clinical trials and 2 clinical practice guidelines. Magnesium sulphate reduces the risk of cerebral palsy by approximately 30 %, and of gross motor dysfunction by 40 %; however, it does not have significant impact on other outcomes such as perinatal mortality, periventricular leukomalacia or intraventricular haemorrhage. This protective effect is greater in earlier gestational ages. Maternal and neonatal adverse events are generally mild.Conclusions: Magnesium sulphate used in women in preterm labour or in active phase before 32 weeks is an effective and safe treatment for the prevention of cerebral palsy in premature babies.

Experimental study on the effect of Ginsenoside Rg1 on the pathological changes of rat optic nerve injury / 中国基层医药

ObjectiveTo study the effect of ginsenoside Rg1 on the pathological changes of rat optic nerve injury. MethodsThe model of rat optic nerve injury was established, the rats were divided into the experimental group and control group,intraperitonealiy injected ginsenosides Rgl (10mg/kg) to experimental group of rats for 20days ,meanwhile intraperitonealiy injected the same volume of saline to the control group,took eyeball and optic nerve from the optic nerve injury eye and the normal eye in both groups ,HE staining,SABC immunohistochemical staining of Bcl-2, neurocan were analyzed. ResultsHE staining results showed the morphological difference on optic nerve cells from control group and the optic nerve injury group. Immunohistochemistry showed the neuronal cell apoptosis was significantly increased after optic nerve injury. The intraperitoneal injection of ginsenoside Rg1 could significantly improve the situation of cell apoptosis. The significant increment of fiber protein may be partly related to the improvement of cell apoptosis, but the principle was not clear. ConclusionGinsenoside Rg1 had protective effect on rat optic nerve injury.