There are few pharmacologic options for the treatment of cognitive deficits associated with traumatic brain injury in pediatric patients.Acetylcholinesterase inhibitors such as donepezil have been evaluated in adult p...There are few pharmacologic options for the treatment of cognitive deficits associated with traumatic brain injury in pediatric patients.Acetylcholinesterase inhibitors such as donepezil have been evaluated in adult patients after traumatic brain injury,but relatively less is known about the effect in pediatric populations.The goal of this review is to identify knowledge gaps in the efficacy and safety of acetylcholinesterase inhibito rs as a potential a djuvant treatment fo r neurocognitive decline in pediatric patients with traumatic brain injury.Investigators queried PubMed to identify literature published from database inception thro ugh June 2023 desc ribing the use of donepezil in young adult traumatic brain injury and pediatric patients with predefined conditions.Based on preselected search criteria,340 unique papers we re selected for title and abstra ct screening.Thirty-two reco rds were reviewed in full after eliminating preclinical studies and pape rs outside the scope of the project.In adult traumatic brain injury,we review results from 14 papers detailing 227 subjects where evidence suggests donepezil is well tole rated and shows both objective and patient-reported efficacy for reducing cognitive impairment.In children,3 pape rs report on 5 children recovering from traumatic brain injury,showing limited efficacy.An additional 15 pediatric studies conducted in populations at risk for cognitive dysfunction provide a broader look at safety and efficacy in 210 patients in the pediatric age group.Given its promise for efficacy in adults with traumatic brain injury and tole rability in pediatric patients,we believe further study of donepezil for children and adolescents with traumatic brain injury is warranted.展开更多
Background:The current prevalence of Alzheimer’s disease(AD)in the elderly has risen from 1%at 65 to 40%to 50%at 95,and the overall proportion is rising.Emerging evidence suggests that ros-driven oxidative stress is ...Background:The current prevalence of Alzheimer’s disease(AD)in the elderly has risen from 1%at 65 to 40%to 50%at 95,and the overall proportion is rising.Emerging evidence suggests that ros-driven oxidative stress is a crucial mediator of the aging process.Thus,in recent years,oxidative damage and inflammation have become targets for exploring pharmacological strategies for treating age-related diseases.Methods:In C57BL/6J mice,to determine whether the mechanism of action of cerebralcare granule®(CG)combined with donepezil(Don)treatment is better than dementia alone,we constructed a mouse model and treated it with CG in combination with Don.Results:A combination of Don and CG significantly reduces the damage caused by lipid peroxidation in the hippocampus of AD mice,reduces oxidative damage,and reduces inflammation,increases the activity of antioxidant enzymes,which is finally manifested as the improvement effect on the learning and memory impairment of AD mice.Conclusion:CG combined with Don has a better effect on improving cognitive and behavioral deficits caused by D-galactose in AD mice than Don alone.The mechanism may be related to reducing inflammation via the NF-κB pathway,resisting oxidative damage and increasing acetylcholine levels.展开更多
目的分析轻中度老年痴呆患者采用针刺飞腾八法穴位联合多奈哌齐治疗的效果。方法选取2022年12月—2023年12月广州中医药大学第一附属医院收治的100例轻中度老年痴呆患者,按治疗方法不同分为多奈哌齐组(50例,多奈哌齐治疗)和针刺飞腾组(5...目的分析轻中度老年痴呆患者采用针刺飞腾八法穴位联合多奈哌齐治疗的效果。方法选取2022年12月—2023年12月广州中医药大学第一附属医院收治的100例轻中度老年痴呆患者,按治疗方法不同分为多奈哌齐组(50例,多奈哌齐治疗)和针刺飞腾组(50例,多奈哌齐联合针刺飞腾八法穴位治疗)。比较两组中医证候积分、简易智能精神状态检查量表(Mini-mental State Examination,MMES)评分、巴塞尔指数、脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)、同型半胱氨酸(homocysteine,Hcy)。结果治疗后,针刺飞腾组中医证候积分、MMES评分、巴塞尔指数均高于多奈哌齐组,差异有统计学意义(P均<0.05)。治疗后,针刺飞腾组血清BDNF及Hcy水平[(15.55±0.24)pg/mL,(15.48±0.16)μmol/L]显著优于多奈哌齐组[(13.92±0.16)pg/mL、(19.74±0.33)μmol/L],差异有统计学意义(t=18.534、82.136,P均<0.05)。结论与单纯多奈哌齐治疗比较,对轻中度老年痴呆患者施行针刺飞腾八法穴位联合多奈哌齐治疗效果明显,能够改善患者的中医证候积分、MMES评分、巴塞尔指数、血清BDNF及Hcy。展开更多
目的探究银杏叶提取物注射液联合多奈哌齐对脑梗死后认知障碍患者血管内皮功能、氧化应激反应及认知水平的影响。方法选取收治的126例脑梗死后认知障碍患者为研究对象,用随机数字表法分为对照组和观察组,各63例。2组均行常规治疗,在此...目的探究银杏叶提取物注射液联合多奈哌齐对脑梗死后认知障碍患者血管内皮功能、氧化应激反应及认知水平的影响。方法选取收治的126例脑梗死后认知障碍患者为研究对象,用随机数字表法分为对照组和观察组,各63例。2组均行常规治疗,在此基础上对照组给予多奈哌齐治疗,观察组给予银杏叶提取物注射液联合多奈哌齐治疗,比较2组美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分、血管内皮功能[内皮素(endothelin,ET)-1、一氧化氮]、氧化应激反应[干扰素-γ(interferon-γ,INF-γ)、超氧化物歧化酶(superoxide dismutase,SOD)和丙二醛(malondialdehyde,MDA)]和特利尔认知评估量表(Montreal cognitive assessment,MoCA)评分,以及不良反应的发生情况。结果治疗前,2组NIHSS评分比较差异无统计学意义(P>0.05),治疗后2组上述评分均下降,且观察组较对照组更低(P<0.05);治疗前2组血清ET-1、一氧化氮、INF-γ、SOD和MDA水平比较差异无统计学意义,治疗后2组ET-1、INF-γ、MDA水平均下降,一氧化氮、SOD水平均升高,且观察组均优于对照组(P<0.05);治疗前2组MoCA评分比较差异无统计学意义(P>0.05),治疗后2组上述评分均升高,且观察组较对照组更高(P<0.05);2组不良反应总发生率比较差异无统计学意义(P>0.05)。结论脑梗死后认知障碍患者应用银杏叶提取物注射液联合多奈哌齐治疗,可有效改善神经功能、血管内皮功能,拮抗氧化应激水平,从而提高认知水平,且安全性良好。展开更多
基金Division of Neurology,Cincinnati Children’s Hospital Medical Center(as a Medical Student Scholars Program award to ALM)。
文摘There are few pharmacologic options for the treatment of cognitive deficits associated with traumatic brain injury in pediatric patients.Acetylcholinesterase inhibitors such as donepezil have been evaluated in adult patients after traumatic brain injury,but relatively less is known about the effect in pediatric populations.The goal of this review is to identify knowledge gaps in the efficacy and safety of acetylcholinesterase inhibito rs as a potential a djuvant treatment fo r neurocognitive decline in pediatric patients with traumatic brain injury.Investigators queried PubMed to identify literature published from database inception thro ugh June 2023 desc ribing the use of donepezil in young adult traumatic brain injury and pediatric patients with predefined conditions.Based on preselected search criteria,340 unique papers we re selected for title and abstra ct screening.Thirty-two reco rds were reviewed in full after eliminating preclinical studies and pape rs outside the scope of the project.In adult traumatic brain injury,we review results from 14 papers detailing 227 subjects where evidence suggests donepezil is well tole rated and shows both objective and patient-reported efficacy for reducing cognitive impairment.In children,3 pape rs report on 5 children recovering from traumatic brain injury,showing limited efficacy.An additional 15 pediatric studies conducted in populations at risk for cognitive dysfunction provide a broader look at safety and efficacy in 210 patients in the pediatric age group.Given its promise for efficacy in adults with traumatic brain injury and tole rability in pediatric patients,we believe further study of donepezil for children and adolescents with traumatic brain injury is warranted.
基金supported by the Innovation Team and Talents Cultivation Program of the National Administration of Traditional Chinese Medicine[grant numbers ZYYCXTD-D-202005]the Key Project at Central Government Level[grant numbers 2060302]the Special Project for Transformation of Scientific and Technological Achievements in Qinghai Province[grant numbers 2021-SF-150].
文摘Background:The current prevalence of Alzheimer’s disease(AD)in the elderly has risen from 1%at 65 to 40%to 50%at 95,and the overall proportion is rising.Emerging evidence suggests that ros-driven oxidative stress is a crucial mediator of the aging process.Thus,in recent years,oxidative damage and inflammation have become targets for exploring pharmacological strategies for treating age-related diseases.Methods:In C57BL/6J mice,to determine whether the mechanism of action of cerebralcare granule®(CG)combined with donepezil(Don)treatment is better than dementia alone,we constructed a mouse model and treated it with CG in combination with Don.Results:A combination of Don and CG significantly reduces the damage caused by lipid peroxidation in the hippocampus of AD mice,reduces oxidative damage,and reduces inflammation,increases the activity of antioxidant enzymes,which is finally manifested as the improvement effect on the learning and memory impairment of AD mice.Conclusion:CG combined with Don has a better effect on improving cognitive and behavioral deficits caused by D-galactose in AD mice than Don alone.The mechanism may be related to reducing inflammation via the NF-κB pathway,resisting oxidative damage and increasing acetylcholine levels.
文摘目的分析轻中度老年痴呆患者采用针刺飞腾八法穴位联合多奈哌齐治疗的效果。方法选取2022年12月—2023年12月广州中医药大学第一附属医院收治的100例轻中度老年痴呆患者,按治疗方法不同分为多奈哌齐组(50例,多奈哌齐治疗)和针刺飞腾组(50例,多奈哌齐联合针刺飞腾八法穴位治疗)。比较两组中医证候积分、简易智能精神状态检查量表(Mini-mental State Examination,MMES)评分、巴塞尔指数、脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)、同型半胱氨酸(homocysteine,Hcy)。结果治疗后,针刺飞腾组中医证候积分、MMES评分、巴塞尔指数均高于多奈哌齐组,差异有统计学意义(P均<0.05)。治疗后,针刺飞腾组血清BDNF及Hcy水平[(15.55±0.24)pg/mL,(15.48±0.16)μmol/L]显著优于多奈哌齐组[(13.92±0.16)pg/mL、(19.74±0.33)μmol/L],差异有统计学意义(t=18.534、82.136,P均<0.05)。结论与单纯多奈哌齐治疗比较,对轻中度老年痴呆患者施行针刺飞腾八法穴位联合多奈哌齐治疗效果明显,能够改善患者的中医证候积分、MMES评分、巴塞尔指数、血清BDNF及Hcy。
文摘目的探究银杏叶提取物注射液联合多奈哌齐对脑梗死后认知障碍患者血管内皮功能、氧化应激反应及认知水平的影响。方法选取收治的126例脑梗死后认知障碍患者为研究对象,用随机数字表法分为对照组和观察组,各63例。2组均行常规治疗,在此基础上对照组给予多奈哌齐治疗,观察组给予银杏叶提取物注射液联合多奈哌齐治疗,比较2组美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分、血管内皮功能[内皮素(endothelin,ET)-1、一氧化氮]、氧化应激反应[干扰素-γ(interferon-γ,INF-γ)、超氧化物歧化酶(superoxide dismutase,SOD)和丙二醛(malondialdehyde,MDA)]和特利尔认知评估量表(Montreal cognitive assessment,MoCA)评分,以及不良反应的发生情况。结果治疗前,2组NIHSS评分比较差异无统计学意义(P>0.05),治疗后2组上述评分均下降,且观察组较对照组更低(P<0.05);治疗前2组血清ET-1、一氧化氮、INF-γ、SOD和MDA水平比较差异无统计学意义,治疗后2组ET-1、INF-γ、MDA水平均下降,一氧化氮、SOD水平均升高,且观察组均优于对照组(P<0.05);治疗前2组MoCA评分比较差异无统计学意义(P>0.05),治疗后2组上述评分均升高,且观察组较对照组更高(P<0.05);2组不良反应总发生率比较差异无统计学意义(P>0.05)。结论脑梗死后认知障碍患者应用银杏叶提取物注射液联合多奈哌齐治疗,可有效改善神经功能、血管内皮功能,拮抗氧化应激水平,从而提高认知水平,且安全性良好。
