Objective To systematically review the efficacy and safety of non-ergoline dopamine agonists (pramipexole, ropinirole, and rotigotine) and α2δ ligands (pregabalin and gabapentin-enacarbil) in the treatment of restless legs syndrome (RLS). Methods The PubMed, EMbase, The Cochrane Library, CBM, WanFang Data, and CNKI databases were electronically searched for randomized controlled trials (RCTs) assessing different medications for RLS from 2000 to 2021. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. The network meta-analysis was then performed using Stata 16.0 software and R 4.1.0 software. Results A total of 36 RCTs involving 7 666 patients were included. The results of the network meta-analysis showed that gabapentin-enacarbil decreased IRLS scores to the greatest extent among all drugs (MD=−6.42, 95%CI −8.8 to −4.16), was superior to pramipexole (MD=−3.27, 95%CI −6.54 to −0.15), and was associated with the highest CGI-I response rates (RR=1.73, 95%CI 1.52 to 2.00). In terms of tolerance and safety, patients receiving rotigotine presented an increased incidence of withdrawal due to adverse events. Ropinirole had the highest incidence of nausea. Headache was most common side effect in rotigotine, while the incidences of somnolence and dizziness were higher in gabapentin-enacarbil than other treatments. Conclusion Current evidence suggests that gabapentin-enacarbil may be the best treatment for RLS. Rotigotine is associated with the worst tolerance. For safety, nausea is most common in ropinirole, headache is most common for rotigotine, and patients receiving gabapentin-enacarbil show increased incidences of somnolence and dizziness.
Abstract： Objective To use tissue Doppler strain rate imaging to evaluate the impact of low dose dopamine and milrinone on systolic and diastolic function of the left ventricle of patients undergoing heart valve replacement. Methods Forty patients undergoing selective heart valve replacement in West China Hospital of Sichuan University between March and May 2011 were included in this study. All the patients were randomized into 2 groups with 20 patients in each group： milrione group and dopamine group. After anesthesia induction and before cardiopulmonary bypass setup， left ventricular ejection fraction （LVEF） was measured by echocardiography. Tissue Doppler strain rate imaging was used to measure the left ventricular lateral wall and midventricular segment from the four-chamber view， which was compared with Doppler parameters. Results LVEF， ratio of early-diastolic to end-diastolic velocity （E/A） of transmitral flow， ratio of mitral inflow velocity to early diastolic velocity in the annulus （E/Et） of both 2 groups were significantly different between before and after dopamine and milrinone administration （P＜0. 05）. In the milrinone group， 4 segments systolic peak velocity （Vs）， 1 segment early diastolic peak velocity （Ve）， 4 segments late diastolic peak velocity （Va）， 3 segments Ve/Va ratio， 2 segments systolic peak strain rate （SRs）， 2 segments late diastolic peak strain rate （SRa）， and 3 segments early diastolic peak strain rate SRe/SRa ratio after dopamine and milrinone administration were significantly higher than those before dopamine and milrinone administration （P＜0. 05）. In the dopamine group， 4 segments systolic peak velocity （Vs）， 1 segment Ve， 4 segments Va， 1 segment Ve/Va ratio， 2 segments SRs， 1 segment SRe， 1 segment SRa， and 1 segment SRe/SRa ratio after dopamine and milrinone administration were significantly higher than those before dopamine and milrinone administration （P＜0.05）. To compare the milrione group and dopamine group after medication administration， 2 segments Vs， 4 segments Va， 1 segment SRe， 1 segment SRa， 2 segments Ve/Va ratio， and 2 segments SRe/SRa ratio of the milrione group were significantly higher than those of the dopamine group （P＜0.05）， and 1 segment Vs， two segments SRs of the milrione group were significantly lower than those of the dopamine group （P＜0.05）. Conclusion Both milrinone and dopamine can improve left ventricular systolic function of perioperative patients undergoing heart valve replacement assessed by tissue Doppler strain rate imaging， while milrinone can improve the diastolic function of the left ventricle on the long axis more significantly.
1-methyl-6,7-dihydroxy-1,2,3,4-tetrahydroisoquinoline (Sal) is a kind of catechol isoquinoline compound, which mainly exists in mammalian brain and performs a variety of biological functions. Through in vivo metabolism, Sal can be transformed into endogenous neurotoxins and can participate the occurrence of Parkinson’s disease (PD). This has attracted widespread concern of researchers. Recently, many research works have shown that Sal may lead to alcohol addiction and regulate hormone release of the neuroendocrine system, which indicated that it is a potential regulator of dopaminergic neurons. In this paper, we discuss the neural functions of Sal on the above aspects, and wish to provide some theoretical supports for further research on its mechanism.
目的 探讨单光子计算机断层扫描仪(SPECT)对抑郁症的疗效评估价值。 方法 2006年5月-2007年12月，选取32例未经治疗的原发性中、重度抑郁症患者，给予氟西汀治疗10周。治疗后根据临床疗效总评量表和汉密尔顿抑郁量表(HAMD)减分率作为疗效评定指标，将患者分为有效组21例，无效组11例。对所有患者于治疗前和治疗后分别进行99m锝-双半胱乙酯(99mTc-ECD)脑灌注显像。静脉注射99mTc-ECD 1 110 MBq，30 min后行脑断层显像，对显像结果分别进行目测及半定量分析两种方法进行判断。 结果 抑郁症患者出现的脑血流灌注减低区主要集中在前额叶、扣带回，经过治疗后好转的抑郁症患者脑血流灌注明显改善。可通过脑血流灌注显像评估抗抑郁治疗的疗效，左前额叶血流灌注越低，对氟西汀治疗效果越好。 结论 SPECT显像技术可视性较好，可用于评估抗抑郁治疗的疗效。
The aim of this study is to investigate the protective effect of idebenone (IDE) combined with borneol (BO) against Parkinson’s disease (PD). In this study, wild-type AB zebrafish and transgenic Tg (vmat2: GFP) zebrafish with green fluorescence labeled dopamine neurons were used to establish the PD model with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine hydrochloride (MPTP). Following drug treatment, the behavioral performance and dopamine neuron morphology of zebrafish were evaluated, and regulation of dopamine signaling pathway-related genes was determined using RT-qPCR. The results showed that IDE combined with BO improved the behavioral disorders of zebrafish such as bradykinesia and shortening movement distance, also effectively reversed the damage of MPTP-induced dopaminergic neurons. At the same time, the expression of dopamine synthesis and transportation-related genes was up-regulated, and the normal function of the signal transduction pathway was restored. The combination showed a better therapeutic effect compared to the IDE monotherapy group. This study reveals the protective mechanism of IDE combined with BO on the central nervous system for the first time, which provides an important experimental basis and theoretical reference for clinical combination strategy in PD treatment.
ObjectiveTo study the effect of rotenone on rat substantia nigra dopamine (DA) in the nervous system and oxidative stress parameters (malondialdehyde and glutathione), the influence of rotenone on DA neurons toxic effect and its pathogenesis. MethodsThis study applied back subcutaneous injection of rotenone in rats [1.0 mg/(kg·d)], and used immunocytochemistry technique to detect changes in the expression of tyrosine kinase (TH) in 10 rats of the control group and 10 rats of the experimental group. Spectrophotometry was used to detect the change of oxidative stress parameters in rats (malondialdehyde and glutathione). ResultsDA neurons in rats had various degrees of damage. The TH immune response strength of rats in the substantia nigra and striatum decreased significantly. The number of immune response nigra TH positive neurons was significantly less in the experimental group than in the control group (P< 0.01). Spectrophotometer method was used to detect the midbrain nigra of glutathione, which was significantly less in the experimental group than in the control group (P<0.01). Malondialdehyde in the experimental group was significantly higher (P<0.01). ConclusionRotenone has obvious neurotoxicity, and can lead to the damage of DA neurons and obvious oxidative stress injury in rats, which provides an experimental basis for the pathogenesis of Parkinson's disease, and at the same time provides new targets for the treatment.
Ｉｎ ｔｈｅ ａｃｕｔｅ ｈｅｍｏｒｒｈａｇｉｃ ｎｅｃｒｏｔｉｚｉｎｇ ｐａｎｃｒｅａｔｉｔｉｓ（ＡＨＮＰ）ｍｏｄｅｌ ｏｆ ｒａｔｓ ｉｎｄｕｃｅｄ ｂｙ ５％ ｓｏｄｉｕｍ ｔａｕｒｏｃｈｏｌａｔｅ，ａｆｔｅｒ ｔｒｅａｔｅｄ ｗｉｔｈ ｌｏｗ ｄｏｓｅ ｄｏｐａｍｉｎｅ〔５μｇ／（ｋｇ·ｍｉｎ）〕，ｔｈｅ ａｌｔｅｒｎａｔｉｏｎｓ ｏｆ ｍｅａｎ ａｒｔｅｒｉａｌ ｐｒｅｓｓｕｒｅ，ｐａｎｃｒｅａｔｉｃ ｍｉｃｒｏｆｌｏｗ，ｓｅｒｕｍ ａｍｙｌａｓｅ ａｎｄ ｌｉｐａｓｅ，ａｎｄ ｐａｎｃｒｅａｔｉｃ ｐａｔｈｏｈｉｓｔｏｌｏｇｙ ｗｅｒｅ ｓｔｕｄｉｅｄ．Ｔｈｅ ｒｅｓｕｌｔｓ ｓｈｏｗｅｄ ｔｈａｔ ｌｏｗ ｄｏｓｅ ｄｏｐａｍｉｎｅ ｃｏｕｌｄ ｉｎｃｒｅａｓｅ ｐａｎｃｒｅａｔｉｃ ｍｉｃｒｏｆｌｏｗ ｓｉｇｎｉｆｉｃａｎｔｌｙ ｗｈｉｌｅ ｍｅａｎ ａｒｔｅｒｉａｌ ｐｒｅｓｓｕｒｅ ｒｅｍａｉｎｅｄ ｓｔａｂｌｅ ｉｎ ｔｈｅ ｅａｒｌｙ ｓｔａｇｅ ｏｆ ＡＨＮＰ，ｉｔ ｃｏｕｌｄ ａｌｓｏ ｒｅｄｕｃｅ ｔｈｅ ｌｅｖｅｌｓ ｏｆ ｓｅｒｕｍ ａｍｙｌａｓｅ ａｎｄ ｌｉｐａｓｅ，ａｎｄ ａｍｅｌｉｏｒａｔｅ ｔｈｅ ｐａｔｈｏｌｏｇｉｃ ｓｅｖｅｒｉｔｙ ｏｆ ｐａｎｃｒｅａｔｉｔｉｓ．Ｔｈｅｓｅ ｓｕｇｇｅｓｔ ｔｈａｔ ｌｏｗ ｄｏｓｅ ｄｏｐａｍｉｎｅ ｃｏｕｌｄ ｂｅ ｕｓｅｄ ｔｏ ｔｒｅａｔ ｐａｎｃｒｅａｔｉｔｉｓ ｂｙ ｉｍｐｒｏｖｉｎｇ ｐａｎｃｒｅａｔｉｃ ｍｉｃｒｏｆｌｏｗ．