Potencies of Four Stereoisomers of Anisodamine on Muscarinic Receptor

用[3~H]-QNB配体受体结合实验,抗Ach对豚鼠回肠纵肌条收缩效应,抗毛果芸香碱流涎及扩瞳效应为指标,比较山莨菪碱四个立体异构体(A.6S,2′S;B.6S,2′R;C.6R,2′R;D.6R,2′S)与M受体相互作用的构效关系,结果A,B,C,D四个异构体效应分别为:(1)受体结合实验K_i(M)2.69×10^(-7),1.43×10^(-7),1.63×10^(-5),2.15×10^(-6);(2)抗Ach豚鼠回肠纵条收缩:K_6(M)2.98×10^(-8);1.38×10^(-8);1.52×10~5;1.0l×10^(-7);(3)扩瞳:ED_4(mol/kg)1.6×10^(-6),1.9×10^(-6),5.1×10^(-5),3.6×10^(-5);(4)抗毛果芸香碱流涎:ED_(50)(mol/kg)1.5×10^(-6);1.3×10^(-6);2.6×10^(-5);3.1×10^(-5)。以上结果表明四个异构体效应强度为6S,2′R≌6S,2′S>>6R,2′S>6R,2′R。

Anisodamine accelerates spontaneous passage of single symptomatic bile duct stones ≤ 10 mm

AIM:To investigate the rate of spontaneous passage of single and symptomatic common bile duct(CBD)stones≤10 mm in diameter in 4 wk with or without a2-wk course of anisodamine.METHODS:A multicenter,randomized,placebocontrolled trial was undertaken.A total of 197 patients who met the inclusion criteria were enrolled.Ninetyseven patients were assigned randomly to the control group and the other 100 to the anisodamine group.The anisodamine group received intravenous infusions of anisodamine(10 mg every 8 h)for 2 wk.The control group received the same volume of 0.9%isotonic saline for 2 wk.Patients underwent imaging studies and liver-function tests every week for 4 wk.The rate of spontaneous passage of CBD stones was analyzed.RESULTS:The rate of spontaneous passage of CBD stones was significantly higher in the anisodamine group than that in the control group(47.0%vs 22.7%).Most(87.2%,41/47)stone passages in the anisodamine group occurred in the first 2 wk,and passages in the control group occurred at a comparable rate each week.Factors significantly increasing the possibility of spontaneous passage by univariate logistic regression analyses were stone diameter(<5 mm vs≥5 mm and≤10 mm)and anisodamine therapy.Multivariate logistic regression analyses revealed that these two factors were significantly associated with spontaneous passage.CONCLUSION:Two weeks of anisodamine administration can safely accelerate spontaneous passage of single and symptomatic CBD stones≤10 mm in diameter,especially for stones<5 mm.

Effects of anisodamine on altered [Ca^(2+)]i and cerebral cortex ultrastructure following acute cerebral ischemia/reperfusion injury in rabbits

BACKGROUND： Calcium ion （Ca^2＋） overload plays an important role in cerebral ischemia/reperfusion injury. Anisodamine, a type of alkaloid, can protect the myocardium from ischemia and reperfusion injury by inhibiting intracellular calcium [Ca^2＋]i overload. OBJECTIVE： To investigate effects of anisodamine on [Ca^2＋]i concentration and cortex ultrastructure following acute cerebral ischemia/reperfusion in rabbits. DESIGN, TIME AND SETTING： Randomized and controlled trial was performed at the Department of Emergency, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology from September to December 2006. MATERIALS： Forty healthy rabbits were used to establish models of acute cerebral ischemia/reperfusion. Anisodamine was provided by Lianyungang Dongfeng Pharmaceutical Factory; Fura-2 was purchased from Nanjing Jiancheng Bioengineering Institute; dual-wave length fluorescent spectrophotometry system and DM-300 software were provided by Bio-Rad, USA; OPTON-EM10C transmission electron microscope was product of Siemens, Germany. METHODS： Forty rabbits were randomly divided into the following groups： sham operation, ischemia, ischemia/reperfusion, and anisodamine, with ten rabbits in each group. Models of complete cerebral ischemia injury were established. In addition, blood was collected from the femoral artery of rats in the ischemia/reperfusion and anisodamine groups to induce hypotension and establish repeffusion injury models. The bilateral common carotid artery clamp was removed from the anisodamine group 20 minutes after ischemia, and anisodamine （10 mg/kg body mass） was injected via the femoral vein. Rabbits in the sham operation group underwent only venous cannulation. MAIN OUTCOME MEASURES： [Ca^2＋]i concentration was determined using a dual-wave length fluorescent spectrophotometry system, and cortical ultrastructure was observed following uranyl-lead citrate staining. RESULTS： The levels of [Ca^2＋]i in the ischemia and ischemia/reperfusion groups were significantly increased, compared with the sham operation group （P 〈 0.01）, and the levels of [Ca^2＋]i in the anisodamine group were remarkably less than the ischemia and ischemia/reperfusion groups （P 〈 0.01）. Ultrastructural damage to the cortex was greatly aggravated with increasing levels of [Ca^2＋]i. In the ischemia group, cortical neuronal membranes were fragmentally damaged, including the mitochoudria and endoplasmic reticulum, as well as neufite swelling, and slight chromatin margination. In the ischemia/reperfusion group, the cellular membrane was ruptured with aggravated mitochondrial swelling, increased chromatin margination, obscure neufite structure, and the disappearance of endoplasmic reticulum. However, in the anisodamine group, cellular damage was obviously alleviated. The appearance and structure of cortical neurons was relatively normal, with intact cells. There was slight swelling of the mitochondria and endoplasmic reticulum, as well as mild chromatin margination. CONCLUSION： Cerebral tissue injury was related to increased [Ca^2＋]i levels following ischemia/ reperfusion. Anisodamine exhibited a protective role on acute cerebral ischemia/reperfusion injury by inhibiting the increase in [Ca^2＋]i levels.

THE EFFECT OF ANISODAMINE ON CEREBRAL RESUSCITATION OF RATS IN ACUTE CEREBRAL ISCHEMIA FROM CARDIAC ARREST

In order to investigate the mechanisms of acute cerebral ischemia, and to look for effective drugs on cerebral resuscitation, we made a model of acute complete global brain ischemia, reperfusion and resuscitation on rats according to Garavilla's method.Our results showed that the event of cerebral ischemia and reperfusion injury could resuh in the increase of total brain calcium content, and anisodamine has the same reducing brain calcium contents as diltiazem's, while improving neurological outcome and alleviating injury to neurons.

Observations on the Therapeutic Effects of Anisodamine on Respiratory Distress Syndrome

The animal model of dogs was used to study the pathological evolution ofrespiratory distress syndrome （RDS） and the therapeutic effects of anisodaine on the disease.Atotal of 54 dogs were employed and they were divided into control and experimental groups.RDS was inflicted to the dogs by oleic acid injection.Then the clinical manifestations,theblood gas parameters,the pulmonary arterial pressure,the pulmonary wedge pressure,T3 andTL,blood cell counts,neutrophil aggregation rate,platelet maximum aggregation rate,TXB2,6-keto-PGF1a and hemocoagulagrams were obsenved.On the basis of our observations,it is concluded that the complement activities andneutrophil aggregation induced by TXA2 are likely the initiative factor of RDS,the pathologicalprocess in the lungs is complicated with disseminated intravascular coagulation,and anisodamineexerts certain therapeutic effects on RDS through preventing the cellular membranes andlysosomes from being injured.

Effect of anisodamine on changes of blood-brain barrier permeability following brain injury in rabbits

The changes of blood-brain barrier(BBB)permeability following brain injury werestudied quantitatively by using colloidal gold(CG)particles of various sizes as tracers in 57 rab-bits.In addition,water content in brain tissues was determined.The brain-injured rabbits re-ceived intravenous injection of anisodamine in a dose of 0.3 mg/kg BW at 5rain or 3h after braininjury,and the effect of anisodamine on aherations of BBB permeability and water content of thebrain tissue after brain injury was investigated.The results indicated that an increase of BBBpermeability began at 30min after injury with only a few of 5nm CG tracers present in the endo-cytic pits and endothelial microvilli,and there were 10nm CG tracers passing through the BBB at3 h after brain injury.The increase of BBB permeability reached its peak at 6 h after brain in-jury.More 15nm CG tracers penetrated the BBB by way of pinocytotic vesicule transportationand opening of tight junctions between endothelial cells.The water content in the brain tissueincreased,which was closely correlated to the above-mentioned EBB permeability and giving ad-vantages to the treatment of traumatic brain edema in the present study.

Effects of labor analgesia on maternal and neonatal outcome by epidural low concentration of bupivacaine combined with anisodamine

Objective To observe the effects of labor analgesia on maternal and neonatal outcome by epidural application of 0.125% bupivacaine combined with anisodamine on the labor stage, and modes of delivery and neonatal Apgar’s score. Methods A total of 220 primiparaes with full-term pregnancy, monocyesis and fetal head presentation without any obstetrical or systematic complications were chosen and divided into analgesic group and control group (110 in each group). The mixture of bupivacaine and anisodamine was injected into the epidural space of the parturients in the analgesic group while those patients in the control group did not receive any analgesics. Results The analgesic effect was satisfactory (91.8%), and no side effects occurred in the second stage of labor. The instrument delivery rate was lower in the analgesic group, and there was no significant difference between the two groups in neonatal Apgar’s score. Conclusion The method is feasible in clinic for labor pain relief without increasing the rate of dystocia and complications of delivery.

Anisodamine Inhibits Endotoxin-induced Tissue Factor Expression in Human Endothelial Cells

By study on the effect of anisodamine on lipopolysaccharide- induced expression of tissue factor(TF) in vascular endothelial cells(EC) ,the mechanism of anisodam ine antithrom bosis,as well as in the treatm ent of bacteraemic shock was investigated.Human umbilical vein endothelial cells (HUVECs) were cultured by trypsin digestion m ethod.TF activity was measured in the lysates of HUVEC by using a single step clotting assay.Specific m RNA expression was detected by Northern blotting.In order to evaluate a possible contribution of the nuclear factor (NF) -κB pathway on the effects observed,electrophoretic mobility shift assays(EMSA) were performed using nuclear extracts from HU VECs and NF- κB- binding oligonucleotides.The results showed that treatment of HUVEC with L PS resulted in a significant increase in TF activity.Anisodamine dose- dependently inhibited L PS- induced upregulation of TF.These effects was also confirm ed on the level of specific TF m RNA expression by Northern blotting.Furtherm ore,EMSA showed that anisodamine com pletely abolished L PS- induced NF-κB DNA binding activity in nuclear ex- tracts from HUVECs treated with L PS together with anisodamine.The results suggest thataniso- damine counteracts endothelial cell activation by inhibiting L PS- induced TF expression in these cells.Its interference with the NF- κB pathway might- at least in part- contribute to this effect. The ability of anisodamine to counteract L PS effect on endothelial cells m ight be one underlying m echanism explaining its antithrombosis and efficacy in the treatment of bacteraemic shock.

Effect of dexamethasone,anisodamine and rhubarb therapy on rats with acute pancreatitis

Objective:To investigate the therapeutic effects of dexamethasone,anisodamine and rhubarb(DAR) on endotoxin,tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),and pancreatic damage in rat models of acute pancreatitis(AP).Methods:The AP rat models were prepared and randomly assigned to AP group(n=10) and DAR group(n=10),while other healthy rats were assigned to the sham-operated group(n=10).The rats were euthanized at 6 h after operation,and then the serum levels of endotoxin,TNF-α,IL-6 and histology of pancreas were determined as the indexes of therapeutic effects.Results:At 6 h after operation,serum levels of endotoxin,TNF-α and IL-6,and pancreatic damage were significantly increased in AP group compared with those in sham-operated group(P<0.01).Compared with the AP group,DAR therapy remarkably attenuated the endotoxin,TNF-α,IL-6 levels and reduced pancreatic damage(P<0.05).Conclusion:The inhibition of pancreatic damage by DAR in rats with AP might contribute,in part at least,to the amelioration of pancreatic inflammation.The present study provides beneficial evidence that DAR may be useful in the treatment of AP model of rats.

Effects of anisodamine on pulmonary α_1-adrenergic receptor and phospholipase A, in acute lung injury

Objective: To imastigate the effects of anisodamine on pulmonary α1- adrenergic receptor andphospholipase A, in acute lung injurg. Methods: Change of α1--adrenergic receptor (al AR ) in lung tissllesduring endotoxin--induced rat acute lung injury was measured with radioligand biding assay. The effects ofanisodamine on pulmonary α1--AR and phospholipase A2 (PLA2 ) were observed. Results: 1. 4 h after theendotoxin injection, there was a significant decrease in the maximal binding capacity of α1--AR by 34% ascompared with the control group. meanwhile elevated activity of PLA2 in rat lung and reduction of thephospholipids content of cell membrane was found. 2. Anisodamine could attenuate endotoxin--induced acutelung injury in rats. Conclusion: This effect might be related to anisodamine’s blockage of α1--AR andsuppression of PLA2, prevention of membranous phospholipids from degradation. and the reduction ofarachidonic acid release.

THE EFFECT OF ANISODAMINE ON THE MICROVASCULAR PERMEABILITY OF THE LUNGS DURING ARDS

The rats model with ARDS (Adult Respiratory Distress Syndrome)was produced by the way of injecting Eschericbia coli, the effect of anisodamine onthe microvascular permeability of lungs in the rats with ARDS was studied with themethod of Albumin labeled 125I. The experimental results shown that the microvascular permeability of lung in rat with ARDS increased distinctly,but it recovered tothe control arter injecting anisodamine into rat. The function of anisodamine thatrecovered the microvascular Permeability of lungs in rats with ARDS to the controlmay be one of the main principles of anisodamine for curerability of ARDS. It isshown that the anisodamine has profound value for some of diseases with increasingmicrovascular permeability or tissues or organs in clinic.

Anisodamine augments mucosal blood flow during gut ischemia/reperfusion

Objective;To determine if anisodamine is able to augment mucosal perfusion during gut ischemia-reper-fusion (I/R).Methods;A jejunal sac was formed in Sprague Dawley rat.A Laser Doppler probe and a tonometerwere inserted into the sac which was filled with saline.The superior mesenteric artery was occluded (SMAO) for 60minutes followed by 90 minutes of reperfusion.At the end of 60 minutes of SMAO,either 0.2mg/kg of anisodmineor dobutamine was injected into the jejunal sac.Laser Doppler mucosal blood flow ...

酮咯酸氨丁三醇与氢溴酸山莨菪碱在输尿管结石导致的急性肾绞痛患者中的应用效果比较

目的 比较酮咯酸氨丁三醇与氢溴酸山莨菪碱在输尿管结石导致的急性肾绞痛患者中的应用效果。方法 回顾性分析2020年1月至2022年1月于北京市海淀医院急诊外科就诊的166例输尿管结石导致的急性肾绞痛患者的临床资料,采用随机数字法将研究对象分为对照组(肌内注射氢溴酸山莨菪碱,81例)和观察组(肌内注射酮咯酸氨丁三醇,85例)。比较分析两组患者用药前以及用药后30 min、1 h、4 h的疼痛程度,用药后30 min的临床疗效,用药期间的不良反应发生情况。结果 与用药前比较,两组患者用药后30 min、1 h、4 h的视觉模拟评分法(VAS)评分均降低,差异均有统计学意义(P<0.05)。用药前,两组患者的VAS评分比较差异无统计学意义(P>0.05);用药后30 min、1 h、4 h,观察组患者的VAS评分均低于对照组,差异均有统计学意义(P<0.05)。用药后30 min,观察组患者的总有效率高于对照组,差异有统计学意义(P<0.05)。观察组患者用药期间的不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论 在输尿管结石导致的急性肾绞痛患者中,与肌内注射氢溴酸山莨菪碱比较,肌内注射酮咯酸氨丁三醇的镇痛效果更好,且不良反应更少。

氢溴酸山莨菪碱及盐酸消旋山莨菪碱对八种离体平滑肌解痉作用的对比研究

目的:通过离体平滑肌张力实验,研究并比较氢溴酸山莨菪碱(654-1)和盐酸消旋山莨菪碱(654-2)对大鼠、小鼠和豚鼠八种离体平滑肌的解痉作用。方法:SD大鼠,随机分组后,采用生理信号测量系统分别记录乙酰胆碱(Ach)刺激大肠、小肠及胃平滑肌的收缩值及给药后的舒张值,计算解痉率。英国种豚鼠,同法研究药物对胆囊、膀胱、气管、子宫平滑肌的影响。KM小鼠,同法研究药物对冠脉平滑肌的影响。结果:给药后(10^(-5)-10^(-4)mol·L^(-1)),Ach刺激的大鼠离体大肠、小肠、胃平滑肌,豚鼠离体胆囊、膀胱、气管平滑肌显著舒张(p<0.05);仅654-1高剂量组对离体大肠平滑肌的效果显著优于654-2(p<0.05)。给药后(10^(-5)-10^(-4)mol·L^(-1)),缩宫素刺激的豚鼠离体子宫未舒张,部分样本收缩增强。给药后(10^(-4)-10^(-3)mol·L^(-1)),高K+溶液刺激的小鼠离体冠脉平滑肌舒张(p<0.05),见效时间较长。结论:在所研究的八种离体平滑肌中,两种药物对刺激后的豚鼠离体子宫无解痉作用,其余均有效,且对小鼠离体冠脉平滑肌的起效缓慢。整体而言654-1解痉率较654-2略优,但两者并无统计学差异。

氢溴酸山莨菪碱对脓毒症相关凝血障碍患者凝血功能及预后的影响研究

目的探讨氢溴酸山莨菪碱对脓毒症相关凝血障碍患者凝血功能及预后的影响及其可能的作用机制。方法前瞻性选取2022年4月至2023年10月川北医学院附属医院急诊医学科收治的72例脓毒症相关凝血障碍患者为研究对象,采用随机数字表法分为对照组和治疗组,每组36例。两组患者均予以脓毒症常规治疗,治疗组在常规治疗基础上加用氢溴酸山莨菪碱。收集所有患者入组时的性别、年龄、感染部位、脓毒症相关凝血障碍评分,统计两组患者ICU住院天数、总住院天数及28 d死亡率,记录两组患者治疗前及治疗第3、5、7天急性生理学和慢性健康状况评价Ⅱ(APACHEⅡ)评分及凝血功能指标[包括PT、APTT、Fib、PLT和D-二聚体(D-D)],并在相同时间采集两组患者的血液样本,采用ELISA法检测血浆多配体蛋白聚糖-1(SDC-1)水平。比较两组上述指标。结果治疗组患者ICU住院天数和总住院天数均少于对照组,差异均有统计学意义(均P<0.05);两组患者28 d死亡率比较差异无统计学意义(P>0.05)。治疗组患者治疗第3、5、7天APACHEⅡ评分、血浆SDC-1水平均低于对照组,PLT均高于对照组,治疗第5、7天D-D均低于对照组,差异均有统计学意义(均P<0.05);而两组患者治疗第3、5、7天PT、APTT和Fib比较差异均无统计学意义(均P>0.05)。结论氢溴酸山莨菪碱可以改善脓毒症相关凝血障碍患者的凝血功能及预后,其机制可能与减轻内皮损伤有关。

Effect of intracoronary administration of anisodamine on slow reflow phenomenon following primary percutaneous coronary intervention in patients with acute myocardial infarction

Background Many basic and clinical studies have proved that anisodamine can produce significant effect on relieving microvascular spasm, improving and dredging the coronary microcirculation. It may be beneficial to the improvement of slow-reflow phenomenon （SRP） following percutaneous coronary intervention （PCI） for acute myocardial infarction （AMI）. So we investigated the effect of intracoronary administration of anisodamine on SRP of infarct related artery （IRA） following primary PCI in patients with ST segment elevated acute myocardial infarction （STEAMI）. Methods Twenty-one patients with SRP from a total of 148 STEAMI patients accepted primary PCI were enrolled into this study from September 2004 to December 2005. When SRP happened, nitroglycerin （200 μg） was ＂bolus＂ injected firstly into IRA to exclude the spasm of epicardial artery and identify SRP as well as a baseline and self-control agent following PCI. Ten minutes later, 1000 μg of anisodamine was injected into IRA with SRP at 200 μg/s, while the coronary angiography （CAG） was taken before and at 1st, 3rd and 10th minute after administration of nitroglycerin or anisodamine, respectively. The corrected TIMI frame count （cTFC）, TIMI myocardial perfusion grade （TMPG） and the diameter of IRA were calculated and analyzed by Gibson＇s TIMI frame count method using quantitative computer angiography （QCA） system to evaluate the influence of anisodamine on coronary flow and vessel lumen. In the meantime the invasive hemodynamic parameters of intracoronary and systemic artery （systolic, diastolic and mean pressure） and electrocardiogram （ECG） were measured and monitored. The changes of ventricular performance parameters and the adverse reaction were evaluated and followed-up at 1 month post-PCI. Results No significant changes in cTFCs and TMPGs were found at 1st, 3rd and 10th minute after intracoronary administration of nitroglycerin as compared with the baseline control （P〉0.05）. cTFCs were decreased by 58.3%, 56.2% and 54.6%, respectively （P〈0.001）, and TMPGs were increased from 1.13±0.21 grade to 2.03±0.32, 2.65±0.45 and 2.51±0.57 grades （P〈0.05） at 1st, 3rd and 10th minute after intracoronary administration of anisodamine as compared with those after intracoronary administration of nitroglycerine, respectively. The average coronary blood flow of TIMI grade was improved from 1.76±0.43 to 2.71±0.46 （P〈0.05） while the diameter of middle segment in re-patented coronary artery was slightly increased from （3.20±0.40） mm to （3.40±0.50） mm at the 3rd minute after intracoronary administration of anisodamine （P〉0.05） as compared with those of nitroglycerine control. The systolic, diastolic and mean pressures of intracoronary artery after intracoronary administration of anisodamine increased from 115 to 123, 75 to 84, 88 to 95 mmHg （P〈0.05）, respectively, along with the rise of heart rate from 68 to 84 beats per minute （P〈0.05）. There were no significant changes in intervals of PR, QT and QRS （P〉0.05） and no any severe fast arrhythmia after intracoronary administration of anisodamine. The ventricular performance parameters were significantly improved and no major adverse cardiovascular events （MACE） were found during follow-up at 1 month post-PCI. Conclusions Intracoronary administration of 1000 μg anisodamine is effictive in reversing SRP following PCI in STEAMI patients, especially it is suitable for SRP patients with bradycardia or hypotension.

Preventive effects of anisodamine against contrast-induced nephropathy in type 2 diabetics with renal insufficiency undergoing coronary angiography or angioplasty

Background Anisodamine is widely used in therapy for treating acute glomerulonephritis and diabetic nephropathy because it can improve renal microcirculation. We performed a study to evaluate the preventive effects of anisodamine against contrast-induced nephropathy （CIN） in type 2 diabetics with renal insufficiency undergoing coronary angiography or angioplasty. Methods A total of 260 patients with type 2 diabetes and an estimated glomerular filtration rate （eGFR） of 60 ml^-1 - min^-1·1.73 m^-2 or less, who were undergoing coronary angiography or angioplasty, were randomly assigned to receive an infusion of either sodium chloride （control group, n=128） or anisodamine （treatment group, n=132）. Patients in the treatment group received an infusion of anisodamine at a rate of 0.2 μg · kg^-1 · min^-1 from 12 hours before to 12 hours after coronary angiography or angioplasty, while patients in the control group received an infusion of sodium chloride with the same volume as the treatment group. All patients received intravenous sodium chloride hydration. CIN was defined as a 25% increase in serum creatinine from baseline or an absolute increase of 〉0.5 mg/dl within three days after contrast exposure. The primary end point was the incidence of CIN. The secondary end point was a 25% or greater reduction in eGFR. Results There were no significant differences between the two groups with regard to age, gender, risk factors, laboratory results, medications and interventions. The incidence of CIN was 9.8% （13/132） in the treatment group and 20.3% （26/128） in the control group （P 〈0.05）. The secondary end point was 6.0% （8/132） in the treatment group and 16.4% （21/128） in the control group （P〈0.05）. Conclusion These results indicate the preventive effects of anisodamine against CIN in type 2 diabetics with renal insufficiency who are undergoing coronary angiography or angioplasty.

Effects of anisodamine on the expressions of vascular endothelial growth factor and intercellular adhesion molecule 1 in experimental infusion phlebitis

Background Infusion phlebitis is the most common side effect of clinical intravenous drug therapy and several clinical studies have demonstrated that anisodamine can effectively prevent the occurrence of infusion phlebitis.This study was designed to investigate effects of anisodamine on the expressions of vascular endothelial growth factor （VEGF） and intercellular adhesion molecule 1 （ICAM-1） in a rabbit model of infusion phlebitis and to analyze the mechanisms of anisodamine effect on the prevention and treatment of experimental infusion phlebitis.Methods Twenty-four specific pathogen-free male Japanese white rabbits were randomly assigned to the control group,the model group,the magnesium sulfate group and the anisodamine group.The rabbit model of infusion phlebitis,induced by intravenous administration,was established and expressions of VEGF and ICAM-1 were determined and contrasted with the control group treated with normal saline.We evaluated expression by histopathology,immunohistochemistry,reverse transcription-polymerase chain reaction,and Western blotting assay.Results Pathohistological changes of the model group were observed,such as loss of venous endothelial cells,inflammatory cell infiltration,edema and thrombus.The magnesium sulfate group and the anisodamine group showed significant protective effects on vascular congestion,inflammatory cell infiltration,proliferation,swelling of endothelium and perivascular hemorrhage.The model group showed the highest expressions of VEGF and ICAM-1 of the four groups （P〈0.01）.On the contrary,anisodamine alleviated the inflammatory damage by significantly reducing the expressions of VEGF and ICAM-1 compared with the model group （P 〈0.01）.There was no significant difference in the expressions of VEGF and ICAM-1 between the magnesium sulfate group and the anisodamine group （P 〉0.05）.Conclusion Anisodamine alleviates inflammatory damage by significantly reducing the expressions of VEGF and ICAM-1,and shows significant protective effects

Safety and efficacy of anisodamine on prevention of contrast induced nephropathy in patients with acute coronary syndrome

Background Previous studies have proved the renal protective effects of anisodamine in patients with septic shock. The aim of this study was to investigate anisodamine for the prevention of contrast induced nephropathy （CIN） in patients with acute coronary syndrome （ACS）. Methods Consecutive ACS patients undergoing elective percutaneous coronary intervention （PCI） were randomly assigned to one of two groups： patients in the anisodamine group （ANI group） were assigned to receive intravenous infusions of anisodamine by an adjusted-dose （0.1-0.2 μg·kg^-1·min^-1） from the PCI procedure to 24 hours after PCI, and the control group （CON group） received 0.9% isotonic saline of the same volume. All patients were hydrated for 6 to 12 hours before and 12 hours after PCI. Blood samples were taken on the day of PCI and at 24, 48 and 72 hours after PCI to measure the serum creatinine （SCr）. Results A total of 177 patients were involved in the study, 88 in the ANI group and 89 in the CON group. In both groups, the SCr concentrations significantly increased after PCI, with the peak value occurring at 48 hours. At 72 hours, the SCr concentration in the ANI group retuned to the baseline level （P 〉0.05）, but the SCr concentration in CON group was still higher than baseline level （P 〈0.01）. The SCr concentrations at 48 and 72 hours after PCI were much lower in the ANI group than those in the CON group （both P 〈0.01）. The estimated glomerular filtration rate （eGFR） significantly decreased after PCI, the lowest value occurred at 48 hours. In the ANI group, the eGFR at 72 hours was similar to the baseline level. In the CON group, the eGFR failed to return to baseline at 72 hours （P〈0.01）. The eGFR at 24, 48 and 72 hours after PCI were higher in the ANI group （all P 〈0.05）. The incidence of CIN in the ANI group was lower than that in the CON group within 72 hours after PCI （P〈0.05）. The results of multiple Logistic regression proved that both diabetes and left ventricular ejection fraction （LVEF） were independent predictors of CIN, and treatment with anisodamine was an independent preventive factor of CIN （OR 0.369 and 95% Cl 0.171 to 0.794, P=0.011）. No serious side effects were found in the ANI group. Conclusion Intravenous infusion of anisodamine during and after elective PCI may safely prevent the occurrence of CIN in ACS patients.

倍他司汀联合氢溴酸山莨菪碱治疗眩晕症的疗效

目的研究倍他司汀联合氢溴酸山莨菪碱治疗眩晕症患者的疗效、安全性以及对患者血流动力学、血清血小板活化因子(platelet activated factor,PAF)和血栓素B(2 thromboxane B2,TXB2)的影响。方法将80例眩晕症患者用随机数字表法分为倍他司汀组和对照组,各40例。对照组采用氢溴酸山莨菪碱治疗,倍他司汀组在对照组治疗的基础上加用倍他司汀治疗,治疗周期为14 d。治疗后通过眩晕症状评分简化量表(vertigo symptom score-short form,VSS-SF)和眩晕残障程度评定量表(dizziness handicap inventory,DHI)评估患者的眩晕程度;通过经颅多普勒(transcranial doppler,TCD)结果评价患者左椎动脉、右椎动脉和椎基底动脉的血流情况;测定患者血清PAF和TXB2水平;统计治疗后总有效率;观察2组患者不良反应(呕吐、过敏反应、睡眠障碍、肝功能异常和凝血功能异常)的发生情况。结果治疗后,倍他司汀组患者的总有效率高于对照组(P<0.05);倍他司汀组的VSS-SF、DHI量表评分均低于对照组(P<0.05),患者左椎动脉、右椎动脉和椎基底动脉血流情况均优于对照组(P<0.05),患者PAF、TXB2水平均低于对照组(P<0.05);2组不良反应发生率比较差异无统计学意义。结论倍他司汀联合氢溴酸山莨菪碱治疗眩晕症有较好的临床效果,可以改善患者的眩晕症状及眩晕程度,降低患者的炎性因子水平,对于患者脑部血流动力学有较好的改善作用。