Effect of papaverine combined with tirofiban intracoronary injection on the degree of myocardial injury in patients with no reflow during PCI

Objective:To study the effect of papaverine combined with tirofiban intracoronary injection on the degree of myocardial injury in patients with no reflow during percutaneous coronary intervention (PCI).Methods: Patients who underwent PCI in Ankang Central Hospital between March 2014 and May 2017 were retrospectively studied and divided into two groups according to the intravascular drugs they received during PCI, combined group received papaverine combined with tirofiban intracoronary injection and control group received tirofiban intracoronary injection. The changes in myocardial injury indexes, platelet activation indexes and inflammatory molecules were measured before PCI as well as 24 h and 48 h after PCI.Results:Serum CK-MB, cTnI, MYO, IMA, CD62p, GPIIb/IIIa, MIP-1α, sICAM-1 and HMGB-1 levels as well as peripheral blood Lp-PLA2, PAF, P-selectin, ERK and NF-κB fluorescence intensity of both groups 24 h and 48 h after PCI were significantly lower than those before PCI, and serum CK-MB, cTnI, MYO, IMA, CD62p, GPIIb/IIIa, MIP-1α, sICAM-1 and HMGB-1 levels as well as peripheral blood Lp-PLA2, PAF, P-selectin, ERK and NF-κB fluorescence intensity of combined group 24 h and 48 h after PCI were significantly lower than those of control group.Conclusion: papaverine combined with tirofiban intracoronary injection for PCI can reduce the degree of myocardial injury.

Opening blood-brain-barrier by intracarotid infusion of papaverine in treatment of malignant cerebral glioma

Abstract: Objective To find an effective method for the treatment of malignant cerebral glioma by opening the bloodbrainbarrier (BBB).Methods The concentration of methotrexate (MTX) in tumor was measured in 18 patients with cerebral glioma, and 155 patients with malignant glioma were treated by intracarotid infusion of papaverine and Bischloronitrosourea (BCNU).Results After intracarotid infusion of papaverine for reversible opening of BBB, the MTX concentration in tumor tissue was 1810±380 ng/g, higher than that in patients without papaverine infusion (997±126 ng/g). Eightynine patients with glioblastoma and 66 patients with anaplastic astrocytoma received intracarotid infusion of papaverine and BCNU (250 mg) for an [CM(23*6/8]average of 2.14 times. The mean survival time of thesepatients was 114.5 weeks, median survival time was 140 weeks, and fiveyear survival rate was 22.97%.Conclusion The combined chemotherapy with papaverine and BCNU through intraarterial infusion is simple, safe and effective in treating malignant cerebral glioma so long as the tumor is sensitive to the drugs.

苄基异喹啉生物碱Neolitacumonine、Mollinedine和Papaverine的全合成

研究了苄基异喹啉生物碱的一条新的通用合成路线.其关键步骤为1-苄基-3,4-二氢异喹啉的铜催化氧化芳构化串联反应.以胡椒醛或3,4-二甲氧基苯甲醛为起始原料,经8步反应,分别以42%、37%和37%的总收率实现了三个苄基异喹啉生物碱Neolitacumonine、Mollinedine和Papaverine的全合成.

Pupillary Changes after Papaverine Application During Intracranial Aneurysm Surgeries

Background: The goal of this paper is to summarize the pupillary changes after papaverine application in intracranial aneurysms surgeries. Methods: We retrospectively analyzed the clinical data of six intracranial aneurysm patients who were treated with papaverine application during surgery. Results: Two cases of ipsilateral papillary dilation, two cases of contralateral pupillary dilation, one case of bilateral pupillary dilation, and one case of asymmetric pupils were observed after craniotomy. All of these pupillary changes resolved in one-half to three hours without neurological deficits. Conclusions: Pupillary changes after the use of papaverine in intracranial aneurysm surgeries may be an instantaneous reaction to papaverine. Most cases can return to normal after close observation.

Long-term treatment with intracavernosal injections in diabetic men with erectile dysfunction

Aim： To assess the behavior of patients with diabetes mellitus （DM） and erectile dysfunction （ED） during 10 consecutive years of treatment with self-injection of vasoactive drugs. Methods： Thirty-eight diabetic men, including 12 with type Ⅰ and 26 with type Ⅱ diabetes, were followed up regularly for 10 years after they began self-injecting for severe ED. Real time rigidity assessment was used for the objective determination of the initial dosage and then doses were regulated in order to introduce an erection suitable for penetration and maintenance of erection for approximately 30 min. Patients were followed up every two months, and doses were increased only when the treatment response was not satisfactory. Results： The number of injections used per year by the patients was reduced each year （mean numbers： 50 in the first year and 22.5 in the 10th） and treatment shifted towards stronger therapeutic modalities （mixtures of vasoactive drugs instead of prostaglandin E1 alone）. Type Ⅰ diabetic men were standardized to a level of treatment as early as 5 years after the initiation of treatment. That level was finally reached by type Ⅱ patients after another 4-5 years. Conclusion： Treatment with self-injections of vasoactive drugs in diabetic men with severe El） is a safe and effective alternative in the long term. Diabetic men of both types show the same preferences in quality and quantity of treatment after 10 years. The key point for maintenance in treatment is the adjustment of the therapeutic method and dosage to optimal levels for satisfactory erections. （Asian J Androl 2006 Mar; 8： 219-224）

ASSESSMENT OF CORONARY FLOW RESERVE IN PATIENTS WITH ANGINA PECTORIS

Coronary flow reserve was assessed by a computer-assisted method after intracoronary injection of papaverine in patients with angina pectoris. Compared with control group (n=26), patients with coronary artery disease (n=45) had decreased proximal diameter, cross-sectional area, blood velocity, flow and flow reserve of the left anterior descending and right coronary arteries. The blood velocity, flow and flow reserve of these two coronary arteries were lower in patients with syndrome X (n=16), but proximal diameter and cross-sectional area were similar. The study indicates that coronary flow reserve is reduced in patients with coronary artery disearse and syndrome X,which may be related to abnormal changes at different levels of the coronary vasculature.

Effects of Taohong Siwu Decoction on coagulation function and PI3K/AKT/mTOR pathway after femoral artery anastomosis in rabbits

Objective:To observe the effect of Taohong Siyu Decoction on the coagulation function and the signaling pathway of PI3K(phosphatidylinositol 3-kinase)/AKT(protein kinase B)/mTOR(mammalian target of rapamycin)after femoral artery anastomosis in rabbits.Methods:30 New Zealand white rabbits were divided into blank control group,model control group,papavine hydrochloride injection group and low,medium and high dose groups of Taohong Siwu decoction by random number table method,with 5 rabbits in each group.The rabbits in the model control group,papavine hydrochloride injection group and low,medium and high dose groups of Taohong Siwu decoction were treated with the femoral artery simple intermittent end-to-end suture model.After the successful modeling,the low,medium and high dose groups of Taohong Siwu decoction were given the Taohong Siwu decoction,while the model control group,the blank control group and papavine hydrochloride injection group were given the same amount of normal saline.APTT(activated partial thromboplastin time),FIB(fibrinogen)and PI3K/AKT/mTOR concentrations were measured in aural venous blood samples from six groups of rabbits 30min before operation and 1d,2D,3D and 7d after operation,respectively.Statistical analysis was conducted on the data of the six groups.Results:Compared with blank control group,APTT of model control group was significantly shortened 1d to 7d after operation(P<0.05),FIB values were significantly increased from 1d to 7d after operation(P<0.05);Compared with model control group,APTT in Taohong Siwu decoction low-dose,medium-dose and high-dose groups were significantly prolonged 1d to 7d after operation(P<0.05),FIB value of Taohong Siwu decoction medium and high dose groups decreased significantly from 1d to 7d after operation(P<0.05),the FIB value of Taohong Siwu decoction low-dose group was significantly decreased from 2d to 7d after surgery(P<0.05);Compared with papaverine hydrochloride injection group,APTT in Taohong Siwu decoction medium dose group was significantly prolonged 2d to 7d after surgery(P<0.05),APTT of Taohong Siwu decoction high-dose group was significantly prolonged on 1d to 7d after operation(P<0.05).FIB in Taohong Siwu decoction medium and high dose groups decreased significantly 1d to 7d after operation(P<0.05);Compared with the blank control group,the expression concentrations of PI3K,Akt and mTOR in serum of the model control group were significantly increased from 1d to 7d after surgery(P<0.05);Compared with the model control group,the expression levels of PI3K,Akt and mTOR in serum were significantly increased in the low dose group of Taohong Siwu decoction and Papaverine Hydrochloride Injection group on postoperative 7 days(P<0.05),Taohong Siwu decoction high-dose group was significantly increased from 1d to 7d after surgery(P<0.05),the expression concentrations of PI3K and Akt in Taohong Siwu decoction medium dose group were significantly increased from 2d to 7d after operation(P<0.05),mTOR expression levels were significantly increased from 3d to 7d after operation(P<0.05);Compared with papaverine hydrochloride injection group,the expression concentrations of PI3K,Akt and mTOR in serum of Taohong Siwu decoction medium dose group were significantly increased from 3d to 7d after operation(P<0.05),the expression concentrations of PI3K and mTOR in Taohong Siwu decoction high-dose group were significantly increased from 1d to 7d after operation(P<0.05),and the expression concentration of Akt increased significantly from 3d to 7d after operation(P<0.05).Conclusion:The Taohong Siwu decoction can improve the coagulation function of rabbit femoral artery anastomosis,prevent thrombosis,activate PI3K/Akt/mTOR signaling pathway,promote angiogenesis,and improve tissue ischemia after artery anastomosis.