Effects of high-dose glucose-insulin-potassium on acute coronary syndrome patients receiving reperfusion therapy:a meta-analysis

BACKGROUND:This meta-analysis aimed to assess the efficacy of high-dose glucose-insulinpotassium(GIK) therapy on clinical outcomes in acute coronary syndrome(ACS) patients receiving reperfusion therapy.METHODS:We searched the PubMed,Web of Science,MEDLINE,Embase,and Cochrane Library databases from inception to April 26,2022,for randomized controlled trials(RCTs) that compared high-dose GIK and placebos in ACS patients receiving reperfusion therapy.The primary endpoint was major adverse cardiovascular events(MACEs).RESULTS:Eleven RCTs with 884 patients were ultimately included.Compared with placebos,high-dose GIK markedly reduced MACEs(risk ratio [RR] 0.57,95% confidence interval [95% CI]:0.35 to 0.94,P=0.03) and the risk of heart failure(RR 0.48,95% CI:0.25 to 0.95,P=0.04) and improved the left ventricular ejection fraction(LVEF)(mean difference [MD] 2.12,95% CI:0.40 to 3.92,P=0.02) at 6 months.However,no difference was observed in all-cause mortality at 30 d or 1 year.Additionally,high-dose GIK was significantly associated with increased incidences of phlebitis(RR 4.78,95% CI:1.36 to 16.76,P=0.01),hyperglycemia(RR 9.06,95% CI:1.74 to 47.29,P=0.009) and hypoglycemia(RR 6.50,95% CI:1.28 to 33.01,P=0.02) but not reinfarction,hyperkalemia or secondary reperfusion.In terms of oxidative stress-lowering function,high-dose GIK markedly reduced superoxide dismutase(SOD) activity but not glutathione peroxidase(GSH-Px) or catalase(CAT) activity.CONCLUSION:Patients with ACS receiving reperfusion therapy exhibited a reduction in MACEs and good oxidative stress-lowering eflcacy in response to high-dose GIK.Moreover,with a higher incidence of complications such as phlebitis,hyperglycemia,and hypoglycemia.Furthermore,there were no observed survival benefits associated with high-dose GIK.More trials with long-term follow-up are still needed.

High-dose vs low-dose proton pump inhibitors for upper gastrointestinal bleeding:A meta-analysis

AIM:To evaluate the efficacy of high-dose proton pump inhibitors(PPIs)vs low-dose PPIs for patients with upper gastrointestinal bleeding.METHODS:PubMed,Embase,the Cochrane Library,and Web of Science were searched to identify relevant randomized controlled trials(RCTs).Eligible trials were RCTs that compared high-dose PPI with low-dose PPI following endoscopic hemostasis.The primary endpoint was rebleeding;secondary endpoints were patient numbers that needed surgery,and mortality.The meta-analysis was performed with a fixed effects model or random effects model.RESULTS:Nine eligible RCTs including 1342 patients were retrieved.The results showed that high-dose intravenous PPI was not superior to low-dose intra-venous PPI in reducing rebleeding[odds ratio(OR)= 1.091,95%confidential interval(CI):0.777-1.532],need for surgery(OR=1.522,95%CI:0.643-3.605) and mortality(OR=1.022,95%CI:0.476-2.196).Subgroup analysis according to different region revealed no difference in rebleeding rate between Asian patients(OR=0.831,95%CI,0.467-1.480)and European patients(OR=1.263,95%CI:0.827-1.929).CONCLUSION:Low-dose intravenous PPI can achieve the same efficacy as high-dose PPI following endoscopic hemostasis.

Predictors of post-treatment stenosis in cervical esophageal cancer undergoing high-dose radiotherapy

AIM To evaluate toxicity and treatment outcome of highdose radiotherapy(RT) for cervical esophageal cancer(CEC).METHODS We reviewed a total of 62 consecutive patients who received definitive RT for stage Ⅰ to Ⅲ cervical esophageal cancer between 2001 and 2015. Patients who received < 45 Gy, treated for lesions below sternal notch, treated with palliative aim, treated with subsequent surgical resection, or diagnosed with synchronous hypopharyngeal cancer were excluded. Treatment failures were divided into local(occurring within the RT field), outfield-esophageal, and regional [occurring in regional lymph node(s)] failures. Factors predictive of esophageal stenosis requiring endoscopic dilation were analyzed.RESULTS Grade 1, 2, and 3 esophagitis occurred in 19(30.6%), 39(62.9%), and 4 patients(6.5%), respectively, without grade ≥ 4 toxicities. Sixteen patients(25.8%) developed post-RT stenosis, of which 7 cases(43.8%) were malignant. Four patients(6.5%) developed tracheoesophageal fistula(TEF), of which 3(75%) cases were malignant. Factors significantly correlated with post-RT stenosis were stage T3/4(P = 0.001), complete circumference involvement(P < 0.0001), stenosis at diagnosis(P = 0.024), and endoscopic complete response(P = 0.017) in univariate analysis, while complete circumference involvement was significant in multivariate analysis(P = 0.003). A higher dose(≥ 60 Gy) was not associated with occurrence of postRT stenosis or TEF. With a median follow-up of 24.3(range, 3.4-152) mo, the 2 y local control, outfield esophageal control, progression-free survival, and overall survival(OS) rates were 78.9%, 90.2%, 49.6%, and 57.3%, respectively. Factors significantly correlated with OS were complete circumference involvement(P = 0.023), stenosis at diagnosis(P < 0.0001), and occurrence of post-RT stenosis or TEF(P < 0.001) in univariate analysis, while stenosis at diagnosis(P = 0.004) and occurrence of post-RT stenosis or TEF(P = 0.023) were significant in multivariate analysis. CONCLUSION Chemoradiation for CEC was well tolerated, and a higher dose was not associated with stenosis. Patients with complete circumferential involvement require close follow-up.

High-dose interferon-α2b induction therapy in combination with ribavirin for treatment of chronic hepatitis C in patients with non-response or relapse after interferon-a monotherapy

AIM： To evaluate the daily high-dose induction therapy with interferon-α2b （IFN-α2b） in combination with ribavirin for the treatment of patients who failed with interferon monotherapy and had a relapse, based on the assumption that the viral burden would decline faster, thus increasing the likelihood of higher response rates in this difficult-totreat patient group. METHODS： Seventy patients were enrolled in this study. Treatment was started with 10 NU IFN-α2b daily for 3 wk, followed by IFN-α2b 5 NU/TIW in combination with ribavirin （1 000-1 200 mg/d） for 21 wk. In case of a negative HCV RNA PCR, treatment was continued until wk 48 （IFN-α2b 3MU/TIW＋1000-1200 mg ribavirin/daily）. RESULTS： The dose of IFN-α2b or ribavirin was reduced in 16% of patients because of hematologic side effects, and treatment was discontinued in 7% of patients. An early viral response （EVR） was achieved in 60% of patients. Fifty percent of all patients achieved an end-oftreatment response （EOT） and d0% obtained a sustained viral response （SVR）. Patients with no response had a significantly lower response rate than those with a former relapse （SVR 30% vs 53%; P=0.049）. Furthermore, lower response rates were observed in patients infected with genotype la/b than in patients with non-1-genotype （SVR 28% vs7d%; P=0.001）. As a significant predictive factor for a sustained response, a rapid initial decline of HCV RNA could be identified. No patient achieving a negative HCV-RNA PCR at wk 18 or later eventually eliminated the virus. CONCLUSION： Daily high-dose induction therapy with interferon-α2b is well tolerated and effective for the treatment of non-responders and relapsers, when interferon monotherapy fails. A fast decline of viral load during the first 12 wk is strongly associated with a sustained viral response.

Dose-individualization Efficiently Maintains Sufficient Exposure to Methotrexate without Additional Toxicity in High-dose Methotrexate Regimens for Pediatric Acute Lymphoblastic Leukemia

Objective:Methotrexate(MTX)can be safely administered to most patients but may cause severe toxicity in others.This study aimed to summarize the characteristics of high-dose methotrexate(HD-MTX)chemotherapy and to evaluate whether the modified dose-adjustment program was able to improve the maintenance of sufficient MTX exposure levels while minimizing toxicities.Methods:We evaluated 1172 cycles of high-dose MTX chemotherapy from 294 patients who were treated according to the CCCG-ALL-2015 protocol(clinical trial number:ChiCTR-IPR-14005706)and analyzed the data of actual MTX dosage,MTX concentration,toxicity,and prognosis.We compared data between the dose-adjustment Program 1(fixed 20%reduction in dose)and the dose-adjustment Program 2(dose-individualization based on reassessment of the creatine clearance rate and the MTX concentration-monitoring point at 16 h),which were applied if the MTX clearance was delayed in the previous cycle.Results:The patients who used Program 2 had higher actual MTX infusion doses and infusion rates and were able to better maintain the MTX concentration at 44 h at the established target value than those on Program 1(P<0.001).No significant differences in toxicities were found between these two programs except that abnormal serum potassium levels and prolonged myelosuppression in intermediate-risk/high-risk patients were more frequently observed in patients using Program 2(P<0.001).No significant correlations were observed between the MTX dose,dose-adjustment programs,or MTX concentrations and relapse-free survival.Conclusion:Adjusting the MTX dose using Program 2 is more efficient for maintaining sufficient MTX exposure without significantly increasing the toxicity.

The Experience of Pain and Anxiety in Cervical Cancer Patients Undergoing Multiple Fraction High-Dose Rate Brachytherapy: A Prospective Observational Study

Purpose: To evaluate the anxiety and pain levels of cervical cancer patients undergoing intracavitary multifraction high-dose rate (HDR) brachytherapy, as part of a process to develop guidelines for quality patient-centered care. Methods: Cervical cancer patients (n = 31) undergoingmultiple fraction HDR brachytherapy treatment at the National Institute of Oncology in Rabat (Morocco) completed ratings of pain and anxiety intensity using 11-point verbal analog scales, at 6 key time points over 2 brachytherapy insertion procedures and 4 brachytherapy fractions. Women were evaluated for psychological status at baseline before starting the brachytherapy process using the Hospital Anxiety and Depression Scale (HADS). Scores were grouped as follows: 0 - 7 = normal, 8 - 10 = borderline, 11 - 21 = abnormal. Factors that could affect anxiety levels such as education level, relationship status, number of pregnancies and prior surgical history were documented. Results: Between July and August 2020, 31 women with a median age of 49.6 years were evaluated (range: 27 - 70). The HADS score identified depression in 5 patients (16.1%) and anxiety in 12 patients (38.7%). Throughout both treatment procedures, anticipatory anxiety was reported, with a maximum intensity in the operating room during spinal anesthesia (3.23 ± 1.7) and during applicator insertion (2.97 ± 2.4). Moderate-to-severe anxiety scores were reported in 25.8% and 22.6% of patients respectively. Level of education showed a significant correlation with anxiety scores (p = 0.027). Pain increased significantly during the procedure (p ± 1.4) and applicator removal (4.74 ± 1.5) turned out to be the most painful parts of the procedure. No correlation was found between pain and anxiety levels. Conclusion: Intracavitary multifraction high-dose rate brachytherapy is associated with mild to moderate levels of pain and anxiety, although a subset of patients reported more severe symptoms and may require additional medical and psychological support, with particular emphasis on bed-rest duration and applicator removal. The development of effective interventions (both pharmacological and non-pharmacological) is needed to improve women’s experiences of brachytherapy for locally advanced cervical cancer.

Very-high-dose olanzapine for treatment-resistant schizophrenia

Treatment-resistant schizophrenia has an extremely negative impact on mental health and social life. If clozapine, the gold standard treatment, fails, there are very few options left. The literature suggests that high-dose olanzapine (20 - 60 mg/day) is a possible alternative. We report two cases in which very high doses of olanzapine were administered, with significant clinical improvements above 60 mg/day. Clinical, metabolic and cardiac tolerance was good. This report highlights the usefulness of very-high-dose olanzapine in treatment-resistant schizophrenia. The main hypotheses concerning the psychopharmacological mechanisms of very-high-dose olanzapine are discussed.

Comparison of High-Dose Dexamethasone and Prednisone for Initial Treatment of Adult Primary Immune Thrombocytopenia

Prednisone is the most common first-line treatment for adult primary immune thrombocytopenia (ITP). However, the best initial therapeutic approach is still a matter of debate. Prior studies have shown that high-dose dexamethasone (HD-DXM) produces a high sustained efficacy not achieved by conventional prednisone therapy. However, the definition of response widely differs between individual reports, and this heterogeneity makes comparison of the efficacy difficult. The aim of our study was to compare the therapeutic outcomes of a conventional dose of prednisone with HD-DXM for adult ITP patients as initial therapy. Thirty patients treated with prednisone and 22 patients treated HD-DXM were retrospectively analyzed. No significant differences between the HD-DXM and prednisone groups were observed for the rates of complete response (68% vs. 70%) and response (18% vs. 17%). However, 1 year probability of sustained response was significantly greater in the HD-DXM group than in the prednisone group (78% vs. 38%;P = 0.008). No adverse events necessitating discontinuation of treatment were observed in either group. Our retrospective analysis showed that initial treatment with HD-DXM produced longer response duration compared to a conventional dose of prednisone. Randomized clinical trials are warranted to establish the optimal initial steroid therapy for adult ITP.

A New Variant of Combined Pulmonary Fibrosis and Emphysema from Long-Term High-Dose of Glucocorticoid Therapy: A Case Report

Recent studies have described the combination of both pulmonary emphysema and idiopathic interstitial lung disease (ILDs) by means of high-resolution computed axial tomography (HRCT). Definition of this syndrome was first named by Cottin as combined pulmonary fibrosis and emphysema (CPFE). Functional and radiological findings have showed that these patients are suffering from severe breathlessness, but whose pulmonary functional tests revealed no signs of obstruction, normal static lung volumes, and depressed DLco, most with a history of smoking [1] [2]. The radiological and endoscopic studies especially show that these patients have both areas of upper-lobe predominant emphysema and lesions compatible with fibrosis in both lung bases [3]. No prior research has reported any cases of such condition in person with no prior history of smoking as well as long-term high-dose of glucocorticoid therapy. In this case report, we discuss the presentation, diagnosis, and management of a 53-year-old non-smoker with increasing shortness of breath with a long-term high-dose of glucocorticoid therapy discovered to have an abnormal variant or presentation of CPFE. The cause of disease was attributed to a certain history of smoking in most studies;other potential risk factors have yet to be properly analyzed. This clinical report features a special case about the problem and solution surrounding this issue.

模拟胃液环境下谷维素清除亚硝酸钠及阻断亚硝胺的作用

为降低人体内亚硝胺类化合物含量,采用模拟胃液结合液质联用的方法研究谷维素清除亚硝酸钠及阻断亚硝胺的作用。结果表明:在模拟胃液条件下,谷维素能有效清除亚硝酸钠,且亚硝酸钠的清除率与谷维素液添加量呈正相关关系;在膳食样品中添加谷维素能有效降低N-亚硝基-N-乙基苯胺、N-亚硝基二乙基胺、N-亚硝基吡咯烷的含量,其阻断率分别为100%、100%和24.4%。谷维素在模拟胃液条件下能通过降低亚硝酸钠含量减少内源性亚硝胺合成的反应底物,从而阻断亚硝胺的合成。

γ-谷维素对淀粉酯-磷脂纳米乳液氧化稳定性的影响机制

抗氧化剂的添加能有效提高纳米乳液氧化稳定性。该研究探索γ-谷维素(γ-oryzanol,GO)添加量对以辛烯基琥珀酸淀粉酯(octenyl succinic anhydride modified starch,OSAS)-磷脂(phosphatidylcholine,PC)为乳化剂的纳米乳液性质的影响。结果表明,与未添加GO的纳米乳液(46.12 m V)相比,GO质量浓度为37.5 mg/L的纳米乳液ζ-电位绝对值增加至49.47 m V,所有乳液贮藏4周后未出现分层、絮凝等现象。在25℃贮藏4周的过程中,与未添加GO的纳米乳液相比,含GO的纳米乳液的过氧化值增长较慢,表现出较强的氧化稳定性。分子动力学模拟结果显示,PC-GO(-1.67×10^(5)k J/mol)和甘油三酯(triacylglycerol,TAG)-GO(-1.66×10^(5)k J/mol)的结合能显著低于OSAS-GO的结合能(-1.56×10^(5)k J/mol),表明GO倾向分布于水包油纳米乳液的分散相且靠近界面处。当GO数量由1增至3时,GO与TAG间的结合能由-1.66×10^(5)k J/mol减小至-4.94×10^(5)k J/mol,说明GO的数量影响着其与TAG的结合强度。该研究从实验和理论计算的角度阐明了GO对OSAS-PC纳米乳液的氧化稳定性有着重要影响,有望拓展GO等抗氧化剂提高纳米乳液稳定性方面的基础研究,为开发新式功能乳液产品提供借鉴。

姜黄素和γ-谷维素提高麦醇溶蛋白乳液的理化稳定性

为提高基于麦醇溶蛋白(gliadin,Gli)的O/W乳液的理化稳定性,以姜黄素(curcumin,Cur)和γ-谷维素(gamma oryzanol,GO)分别与Gli制备复合物,并采用实验和理论计算联合的方法探究Gli与Cur、Gli与GO之间的相互作用及其对乳液稳定性的影响。与Gli(接触角θ_(ow)为62.43°)相比,Gli-Cur复合物和Gli-GO复合物具有更好的表面润湿性(θ_(ow)分别为71.94°和89.45°),其稳定的乳液表面平均直径分别降低16.46%和29.22%,而弹性和黏度则有所提高。此外,Gli-Cur复合物和Gli-GO复合物稳定的乳液过氧化值比Gli稳定的乳液过氧化值分别低1.92、1.74 mmol/kg,表现出较高的氧化稳定性。红外光谱、分子对接和分子动力学模拟的结果表明,Gli与Cur、Gli与GO之间存在氢键、疏水相互作用和静电相互作用,其中静电相互作用主导了Gli-Cur和GliGO复合物的形成;Gli-Cur的结合能(-2.11×10^(5)k J/mol)低于Gli-GO的结合能(-1.89×10^(5)k J/mol),表明Gli和Cur的结合强度更大,这可能更利于增强Gli-Cur复合物乳液的凝胶网络结构强度。该研究从实验和理论计算角度阐明了Gli-Cur复合物和Gli-GO复合物对乳液稳定性的影响机制,为提高Gli基乳液稳定性提供一定参考。

基于植物甾醇与γ-谷维素的牡丹/葵花籽油凝胶的制备及其物理特性研究

凝胶剂的含量和比例、植物油基质是影响油凝胶结晶特性和加工功能的重要因素。该研究以植物甾醇和γ-谷维素为凝胶剂,牡丹籽油和葵花籽油为基质油制备高含量α-亚麻酸油凝胶,探讨了植物甾醇与γ-谷维素的质量比以及基质油对油凝胶外观、硬度、黏度、微观结构、流变和热力学性质的影响。结果表明,在4℃下,当m(植物甾醇)∶m(γ-谷维素)=40∶60,添加量为8%(质量分数)时,油凝胶形成的速度最快,硬度和黏度最大,熔点也最高;与葵花籽油凝胶相比,此条件下牡丹籽油凝胶的硬度更大(210.70 N),凝胶时间更短(0.5 h),熔点更高(55.22℃)。油凝胶制备时,可通过调整植物甾醇与γ-谷维素的比例来获得所需的晶型和凝胶网络结构,并由此获得理想的硬度、黏度、熔点和透明度等,以适应特定食品加工的需求。该研究为后续基于油凝胶的新型功能黄油和功能奶油的制备提供了理论基础。

热处理条件下米糠油中谷维素的损失规律研究

旨在为米糠油的精准适度加工及其在食品工业中的应用提供科学指导,研究了常压和充氮加热(60~260℃)处理0~12 h条件下米糠油中谷维素及其4种主要组分[环木菠萝烯醇阿魏酸酯(CAFA)、24-亚甲基环木菠萝烯醇阿魏酸酯(24-MCAFA)、菜油甾醇阿魏酸酯(CampFA)及β-谷甾醇阿魏酸酯(SitoFA)]的损失规律。结果表明:两种加热方式下谷维素及其4种主要组分的损失率随加热时间的延长均呈线性上升趋势(R^(2)>0.90),损失速率随着加热温度升高而升高;在常压加热条件下,当温度达到220℃时谷维素开始快速损失,260℃下加热12 h时谷维素总量损失率最高(74.14%);谷维素4种主要组分在两种热处理过程中热稳定性相似,即不高于140℃时各组分之间热稳定性总体无显著差异,不低于180℃时各组分热稳定性大小顺序为CampFA>CAFA>24-MCAFA>SitoFA;充氮加热下谷维素损失率变化趋势与常压加热下相似,但其损失率显著低于常压加热(除140℃和60℃),在220℃下加热12 h时两者相差最大(32.34百分点)。综上,米糠油应采用适度加工工艺及在食品工业应用中应合理控制加热条件以减少谷维素的损失,提高米糠油的营养品质。

马来酸曲美布汀联合谷维素治疗肠功能紊乱的疗效分析

目的 分析马来酸曲美布汀联合谷维素治疗肠功能紊乱的疗效。方法 非随机选取2022年8月—2023年9月寿光市人民医院收治的70例肠功能紊乱患者为研究对象,并根据治疗方法不同分为常规组与研究组,各35例。将马来酸曲美布汀应用于常规组,研究组以常规组为基础,给予谷维素治疗,分析对比两组治疗效果、肠道改善情况、胃肠功能指标、炎症因子水平。结果 研究组治疗总有效率为97.14%(34/35),高于常规组的82.86%(29/35),差异有统计学意义(χ^(2)=3.968,P<0.05)。研究组腹痛次数、大便次数、便血次数、肠鸣音次数均少于常规组,差异有统计学意义(P均<0.05)。治疗后研究组血清胃泌素和促胃动素水平均高于常规组,差异有统计学意义(P均<0.05)。治疗后研究组炎症因子水平均低于常规组,差异有统计学意义(P均<0.05)。结论 肠功能紊乱患者采取马来酸曲美布汀联合谷维素治疗可提高治疗有效率,改善胃肠功能、减轻炎症反应。

稻米油及其γ-谷维素营养的研究进展

我国稻米资源丰富,其加工产物稻米油(RBO)不仅脂肪酸组成均衡,还富含γ-谷维素、植物甾醇、维生素E等脂质伴随物,对人体健康十分有益。对稻米油及其γ-谷维素营养研究进展进行检索分析,阐述了稻米油及其γ-谷维素在血脂、血糖、情绪/睡眠、肌肉力量/运动表现、免疫调节等方面的营养功效及潜在机制,其中关于RBO对血脂影响的临床研究最多,食用RBO可能有效改善成人受试者的脂质参数,降低血脂异常/高脂血症风险,以预防和控制心血管疾病。为整体了解稻米油及γ-谷维素营养特性及潜在应用价值,未来需进一步探索RBO在不同人群中健康效应及作用机制。

Nutritional management and autism spectrum disorder:A systematic review

BACKGROUND Autism spectrum disorder(ASD)presents unique challenges related to feeding and nutritional management.Children with ASD often experience feeding difficulties,including food selectivity,refusal,and gastrointestinal issues.Various interventions have been explored to address these challenges,including dietary modifications,vitamin supplementation,feeding therapy,and behavioral interventions.AIM To provide a comprehensive overview of the current evidence on nutritional management in ASD.We examine the effectiveness of dietary interventions,vitamin supplements,feeding therapy,behavioral interventions,and mealtime practices in addressing the feeding challenges and nutritional needs of children with ASD.METHODS We systematically searched relevant literature up to June 2024,using databases such as PubMed,PsycINFO,and Scopus.Studies were included if they investigated dietary interventions,nutritional supplements,or behavioral strategies to improve feeding behaviors in children with ASD.We assessed the quality of the studies and synthesized findings on the impact of various interventions on feeding difficulties and nutritional outcomes.Data extraction focused on intervention types,study designs,participant characteristics,outcomes measured,and intervention effectiveness.RESULTS The review identified 316 studies that met the inclusion criteria.The evidence indicates that while dietary interventions and nutritional supplements may offer benefits in managing specific symptoms or deficiencies,the effectiveness of these approaches varies.Feeding therapy and behavioral interventions,including gradual exposure and positive reinforcement,promise to improve food acceptance and mealtime behaviors.The findings also highlight the importance of creating supportive mealtime environments tailored to the sensory and behavioral needs of children with ASD.CONCLUSION Nutritional management for children with ASD requires a multifaceted approach that includes dietary modifications,supplementation,feeding therapy,and behavioral strategies.The review underscores the need for personalized interventions and further research to refine treatment protocols and improve outcomes.Collaborative efforts among healthcare providers,educators,and families are essential to optimize this population's nutritional health and feeding practices.Enhancing our understanding of intervention sustainability and long-term outcomes is essential for optimizing care and improving the quality of life for children with ASD and their families.

乌灵胶囊联合谷维素片治疗脑卒中后抑郁患者的效果及安全性分析

目的 分析乌灵胶囊联合谷维素片治疗脑卒中后抑郁患者的效果及安全性。方法 选取2020年2月—2023年5月广东医科大学附属第二医院就诊的脑卒中后抑郁患者94例,采用随机数字表法分为研究组和对照组,每组47例。患者均接受常规治疗,对照组在该基础上采用谷维素片治疗,研究组在对照组的基础上采用乌灵胶囊治疗,持续治疗8周。对比两组神经功能、抑郁程度、临床疗效、睡眠质量、日常活动能力、炎症信号蛋白通路、神经递质、神经细胞因子及安全性。结果 研究组治疗前后的美国国立卫生研究院卒中量表评分、汉密尔顿抑郁量表评分的差值高于对照组(P <0.05)。研究组总有效率高于对照组(P <0.05)。研究组治疗前后匹茨堡睡眠质量指数评分、改良Barthel指数评分的差值均高于对照组(P <0.05)。研究组治疗前后的PI3K、Akt蛋白的差值均高于对照组(P <0.05)。研究组治疗前后的5-羟色胺、神经生长因子、脑源性神经营养因子、多巴胺、去甲肾上腺素的差值均高于对照组(P <0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论乌灵胶囊联合谷维素片可改善脑卒中后抑郁患者抑郁程度、神经功能、睡眠质量、日常活动能力,调节神经递质与神经细胞因子表达,疗效显著,可能与调节PI3K/Akt信号通路有关,且安全可靠。

γ-谷维素对稻米煎炸油品质的影响研究

以添加γ-谷维素的稻米油为煎炸用油,研究γ-谷维素对稻米煎炸油品质的影响,并分析低场核磁共振技术(LF-NMR)检测的稻米煎炸油弛豫特性与理化指标之间的相关性。结果表明:γ-谷维素能显著提高稻米油的氧化稳定性和煎炸稳定性,且当添加量为5 g/kg时效果最好;添加5 g/kg的γ-谷维素能有效抑制稻米油中饱和脂肪酸和单不饱和脂肪酸的增长,且对多不饱和脂肪酸的保护作用也比较突出;LF-NMR检测参数S_(21)与极性组分含量、酸价、碘值之间具有良好的相关性,R^(2)分别为0.9149、0.8572和0.7600,但与过氧化值和茴香胺值之间无明显相关性,可为LF-NMR在煎炸油品质检测方面的应用提供理论支撑。

谷维素片的质量分析与评价

目的:对谷维素片进行质量分析与评价。方法:通过法定标准检验结合探索性研究的方式,对山东省内药品质量风险监测抽样的43批次谷维素片进行分析检验,分析不同企业产品的质量差异。结果:通过法定标准检验,43批次谷维素片均符合规定,但仍然存在同一企业产品批间差异大,含量接近限度等问题;探索性研究中,HPLC法测定含量,部分样品含量测定结果低于法定标准限度要求。结论:目前谷维素片总体质量较好,但仍存在一定问题,建议企业加强内部质控管理,优化工艺参数,提高制剂工艺稳定性。