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Diabetes, hemoglobin A1c, and cognitive performance in older adults: is there any impact of frailty? Evidence from the ELSI-Brazil study. 老年人的糖尿病、血红蛋白 A1c 和认知能力:虚弱是否有影响?来自巴西 ELSI 研究的证据。
IF 2.3 4区 医学 Q1 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-02-19 eCollection Date: 2024-01-01 DOI: 10.1590/1414-431X2023e12939
J G Souza, D S Farias-Itao, M J R Aliberti, T S Alexandre, C Szlejf, C P Ferri, M F Lima-Costa, C K Suemoto

The aim of this study was to evaluate the association between diabetes and cognitive performance in a nationally representative study in Brazil. We also aimed to investigate the interaction between frailty and diabetes on cognitive performance. A cross-sectional analysis of the Brazilian Longitudinal Study of Aging (ELSI-Brazil) baseline data that included adults aged 50 years and older was conducted. Linear regression models were used to study the association between diabetes and cognitive performance. A total of 8,149 participants were included, and a subgroup analysis was performed in 1,768 with hemoglobin A1c data. Diabetes and hemoglobin A1c levels were not associated with cognitive performance. Interaction of hemoglobin A1c levels with frailty status was found on global cognitive z-score (P-value for interaction=0.038). These results suggested an association between higher hemoglobin A1c levels and lower cognitive performance only in non-frail participants. Additionally, undiagnosed diabetes with higher hemoglobin A1c levels was associated with both poor global cognitive (β=-0.36; 95%CI: -0.62; -0.10, P=0.008) and semantic verbal fluency performance (β=-0.47; 95%CI: -0.73; -0.21, P=0.001). In conclusion, higher hemoglobin A1c levels were associated with lower cognitive performance among non-frail participants. Higher hemoglobin A1c levels without a previous diagnosis of diabetes were also related to poor cognitive performance. Future longitudinal analyses of the ELSI-Brazil study will provide further information on the role of frailty in the association of diabetes and glycemic control with cognitive decline.

本研究旨在通过一项具有全国代表性的巴西研究,评估糖尿病与认知能力之间的关系。我们还旨在研究虚弱与糖尿病对认知能力的交互作用。我们对巴西老龄化纵向研究(ELSI-Brazil)的基线数据进行了横断面分析,其中包括 50 岁及以上的成年人。研究采用线性回归模型来分析糖尿病与认知能力之间的关系。共纳入了 8,149 名参与者,并对 1,768 名有血红蛋白 A1c 数据的参与者进行了亚组分析。糖尿病和血红蛋白 A1c 水平与认知能力无关。血红蛋白 A1c 水平与虚弱状态的交互作用被发现与总体认知 z 评分有关(交互作用的 P 值=0.038)。这些结果表明,只有非虚弱参与者的血红蛋白 A1c 水平越高,认知能力越低。此外,未确诊的糖尿病患者血红蛋白 A1c 水平越高,其整体认知能力(β=-0.36;95%CI:-0.62;-0.10,P=0.008)和语义语言流畅性(β=-0.47;95%CI:-0.73;-0.21,P=0.001)越差。总之,血红蛋白 A1c 水平越高,非体弱者的认知能力越低。既往未确诊糖尿病的血红蛋白 A1c 水平较高也与认知能力较差有关。未来对ELSI-巴西研究的纵向分析将进一步说明虚弱在糖尿病和血糖控制与认知能力下降之间的关系。
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引用次数: 0
Effect of MCH1, a fatty-acid amide hydrolase inhibitor, on the depressive-like behavior and gene expression of endocannabinoid and dopaminergic-signaling system in the mouse nucleus accumbens. 脂肪酸酰胺水解酶抑制剂MCH1对抑郁样行为及小鼠脑核内大麻素和多巴胺能信号系统基因表达的影响
IF 2.3 4区 医学 Q1 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-02-19 eCollection Date: 2024-01-01 DOI: 10.1590/1414-431X2024e12857
C Medina-Saldivar, G V E Pardo, L F Pacheco-Otalora

MCH1 is a synthetic macamide that has shown in vitro inhibitory activity on fatty acid amide hydrolase (FAAH), an enzyme responsible for endocannabinoid metabolism. This inhibition can modulate endocannabinoid and dopamine signaling in the nucleus accumbens (NAc), potentially having an antidepressant-like effect. The present study aimed to evaluate the effect of the in vivo administration of MCH1 (3, 10, and 30 mg/kg, ip) in 2-month-old BALB/c male mice (n=97) on forced swimming test (FST), light-dark box (LDB), and open field test (OFT) and on early gene expression changes 2 h after drug injection related to the endocannabinoid system (Cnr1 and Faah) and dopaminergic signaling (Drd1 and Drd2) in the NAc core. We found that the 10 mg/kg MCH1 dose reduced the immobility time compared to the vehicle group in the FST with no effect on anxiety-like behaviors measured in the LDB or OFT. However, a 10 mg/kg MCH1 dose increased locomotor activity in the OFT compared to the vehicle. Moreover, RT-qPCR results showed that the 30 mg/kg MCH1 dose increased Faah gene expression by 2.8-fold, and 10 mg/kg MCH1 increased the Cnr1 gene expression by 4.3-fold compared to the vehicle. No changes were observed in the expression of the Drd1 and Drd2 genes in the NAc at either MCH1 dose. These results indicated that MCH1 might have an antidepressant-like effect without an anxiogenic effect and induces significant changes in endocannabinoid-related genes but not in genes of the dopaminergic signaling system in the NAc of mice.

MCH1 是一种人工合成的大酰胺,在体外对脂肪酸酰胺水解酶(FAAH)具有抑制活性,FAAH 是一种负责内源性大麻素代谢的酶。这种抑制作用可调节内源性大麻素和多巴胺在脑核(NAc)中的信号传导,从而可能产生类似抗抑郁的效果。本研究旨在评估给2个月大的BALB/c雄性小鼠(97只)体内注射MCH1(3、10和30 mg/kg,ip)对强迫游泳试验(FST)、光暗箱试验(LDB)和开阔地试验(OFT)的影响,以及注射药物2小时后对NAc核内与内源性大麻素系统(Cnr1和Faah)和多巴胺能信号转导(Drd1和Drd2)相关的早期基因表达变化的影响。我们发现,与载体组相比,10 毫克/千克 MCH1 剂量减少了 FST 中的不动时间,但对 LDB 或 OFT 中测得的焦虑样行为没有影响。然而,与车辆组相比,10 毫克/千克 MCH1 剂量增加了 OFT 的运动活动。此外,RT-qPCR结果显示,与药物相比,30 mg/kg MCH1剂量可使Faah基因表达量增加2.8倍,10 mg/kg MCH1剂量可使Cnr1基因表达量增加4.3倍。两种剂量的MCH1均未观察到NAc中Drd1和Drd2基因的表达发生变化。这些结果表明,MCH1可能具有类似抗抑郁剂的作用,但没有致焦虑作用,并且能诱导小鼠NAc中与内源性大麻素相关的基因发生显著变化,而多巴胺能信号系统的基因则没有变化。
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引用次数: 0
Puerarin protects the fatty liver from ischemia-reperfusion injury by regulating the PI3K/AKT signaling pathway. 葛根素通过调节 PI3K/AKT 信号通路保护脂肪肝免受缺血再灌注损伤。
IF 2.3 4区 医学 Q1 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-02-19 eCollection Date: 2024-01-01 DOI: 10.1590/1414-431X2024e13229
Faji Yang, Hengjun Gao, Zheyu Niu, Qingqiang Ni, Huaqiang Zhu, Jianlu Wang, Jun Lu

The incidence of non-alcoholic fatty liver (NAFLD) remains high, and many NAFLD patients suffer from severe ischemia-reperfusion injury (IRI). Currently, no practical approach can be used to treat IRI. Puerarin plays a vital role in treating multiple diseases, such as NAFLD, stroke, diabetes, and high blood pressure. However, its role in the IRI of the fatty liver is still unclear. We aimed to explore whether puerarin could protect the fatty liver from IRI. C57BL/6J mice were fed with a high-fat diet (HFD) followed by ischemia reperfusion injury. We showed that hepatic IRI was more severe in the fatty liver compared with the normal liver, and puerarin could significantly protect the fatty liver against IRI and alleviate oxidative stress. The PI3K-AKT signaling pathway was activated during IRI, while liver steatosis decreased the level of activation. Puerarin significantly protected the fatty liver from IRI by reactivating the PI3K-AKT signaling pathway. However, LY294002, a PI3K-AKT inhibitor, attenuated the protective effect of puerarin. In conclusion, puerarin could significantly protect the fatty liver against IRI by activating the PI3K-AKT signaling pathway.

非酒精性脂肪肝(NAFLD)的发病率居高不下,许多非酒精性脂肪肝患者患有严重的缺血再灌注损伤(IRI)。目前,还没有切实可行的方法来治疗 IRI。葛根素在治疗非酒精性脂肪肝、中风、糖尿病和高血压等多种疾病方面发挥着重要作用。然而,它在脂肪肝 IRI 中的作用仍不明确。我们旨在探讨葛根素是否能保护脂肪肝免受IRI的影响。用高脂饮食(HFD)喂养 C57BL/6J 小鼠,然后进行缺血再灌注损伤。结果表明,与正常肝脏相比,脂肪肝的肝脏IRI更为严重,而葛根素能显著保护脂肪肝免受IRI,并减轻氧化应激。PI3K-AKT信号通路在IRI过程中被激活,而肝脂肪变性则降低了激活水平。葛根素通过重新激活PI3K-AKT信号通路,明显保护脂肪肝免受IRI的影响。然而,PI3K-AKT 抑制剂 LY294002 削弱了葛根素的保护作用。总之,葛根素能通过激活PI3K-AKT信号通路显著保护脂肪肝免受IRI的影响。
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引用次数: 0
Inhibition of anlotinib-induced autophagy attenuates invasion and migration by regulating epithelial-mesenchymal transition and cytoskeletal rearrangement through ATG5 in human osteosarcoma cells. 通过ATG5调节人骨肉瘤细胞的上皮-间质转化和细胞骨架重排,抑制安罗替尼诱导的自噬可减轻侵袭和迁移。
IF 2.3 4区 医学 Q1 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-02-19 eCollection Date: 2024-01-01 DOI: 10.1590/1414-431X2023e13152
Bingxin Zheng, Xiangchen Sun, Li Zhang, Guojian Qu, Chongmin Ren, Peng Yan, Chuanli Zhou, Bin Yue

The cure rates for osteosarcoma have remained unchanged in the past three decades, especially for patients with pulmonary metastasis. Thus, a new and effective treatment for metastatic osteosarcoma is urgently needed. Anlotinib has been reported to have antitumor effects on advanced osteosarcoma. However, both the effect of anlotinib on autophagy in osteosarcoma and the mechanism of anlotinib-mediated autophagy in pulmonary metastasis are unclear. The effect of anlotinib treatment on the metastasis of osteosarcoma was investigated by transwell assays, wound healing assays, and animal experiments. Related proteins were detected by western blotting after anlotinib treatment, ATG5 silencing, or ATG5 overexpression. Immunofluorescence staining and transmission electron microscopy were used to detect alterations in autophagy and the cytoskeleton. Anlotinib inhibited the migration and invasion of osteosarcoma cells but promoted autophagy and increased ATG5 expression. Furthermore, the decreases in invasion and migration induced by anlotinib treatment were enhanced by ATG5 silencing. In addition, Y-27632 inhibited cytoskeletal rearrangement, which was rescued by ATG5 overexpression. ATG5 overexpression enhanced epithelial-mesenchymal transition (EMT). Mechanistically, anlotinib-induced autophagy promoted migration and invasion by activating EMT and cytoskeletal rearrangement through ATG5 both in vitro and in vivo. Our results demonstrated that anlotinib can induce protective autophagy in osteosarcoma cells and that inhibition of anlotinib-induced autophagy enhanced the inhibitory effects of anlotinib on osteosarcoma metastasis. Thus, the therapeutic effect of anlotinib treatment can be improved by combination treatment with autophagy inhibitors, which provides a new direction for the treatment of metastatic osteosarcoma.

过去三十年来,骨肉瘤的治愈率一直未变,尤其是肺转移患者。因此,转移性骨肉瘤迫切需要一种新的有效治疗方法。据报道,安罗替尼对晚期骨肉瘤有抗肿瘤作用。然而,安罗替尼对骨肉瘤自噬的影响以及安罗替尼介导肺转移自噬的机制尚不清楚。本研究通过跨孔实验、伤口愈合实验和动物实验研究了安罗替尼治疗对骨肉瘤转移的影响。在安罗替尼治疗、ATG5沉默或ATG5过表达后,通过Western印迹检测相关蛋白。免疫荧光染色和透射电子显微镜用于检测自噬和细胞骨架的变化。安罗替尼抑制了骨肉瘤细胞的迁移和侵袭,但促进了自噬并增加了ATG5的表达。此外,ATG5沉默可增强安罗替尼治疗诱导的侵袭和迁移的减少。此外,Y-27632可抑制细胞骨架重排,而ATG5的过表达可挽救细胞骨架重排。ATG5过表达增强了上皮-间质转化(EMT)。从机制上讲,安罗替尼诱导的自噬通过ATG5激活EMT和细胞骨架重排,从而促进了体外和体内的迁移和侵袭。我们的研究结果表明,安罗替尼可诱导骨肉瘤细胞发生保护性自噬,抑制安罗替尼诱导的自噬可增强安罗替尼对骨肉瘤转移的抑制作用。因此,与自噬抑制剂联合治疗可以提高安罗替尼的治疗效果,为转移性骨肉瘤的治疗提供了新的方向。
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引用次数: 0
Correlation analysis between peripheral blood dendritic cell subsets and PD-1 in patients with peritoneal adenocarcinoma. 腹膜腺癌患者外周血树突状细胞亚群与 PD-1 的相关性分析
IF 2.3 4区 医学 Q1 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-02-19 eCollection Date: 2024-01-01 DOI: 10.1590/1414-431X2023e13192
Huihui Hu, Man Zhang

The aim of this study was to explore the association between differential percentages of dendritic cell (DC) subsets in peripheral blood and malignancy (grade and lymph node metastasis) of peritoneal adenocarcinoma patients and the frequencies of dendritic cell subsets in the normal controls. The peripheral blood of 30 patients with peritoneal adenocarcinoma and 12 healthy controls were collected for multicolor flow cytometry analysis. Peritoneal adenocarcinoma patients were grouped according to the malignant degree (grade and lymph node metastasis). Percentages of myeloid DCs (mDCs) and its subsets MDC1 and MDC2 in DCs were lower in peripheral blood of patients with peritoneal adenocarcinoma than in normal controls. The percentages of plasmacytoid dendritic cells (pDCs) and CD16+mDCs in DCs were higher than in normal controls. Compared with poor differentiation grade, patients with well/moderate differentiation grade had an increased percentage of CD16+mDCs. Contrary to CD16+mDCs, the percentage of MDC1 was lower in the well/moderate differentiation grade group. In patients with no lymph node metastasis, pDCs and CD16+mDCs levels were higher compared with patients with lymph node metastasis. mDCs and MDC1 levels had opposite results. pDCs were positively correlated with CD16+mDCs in peripheral blood of peritoneal patients, as was mDCs and MDC1. CD16+mDCs were negatively correlated with MDC1. The percentages of pDCs and CD16+mDCs in DCs were positively correlated with CD3+CD8+T cells, and pDCs also positively correlated with CD8+PD-1+T cells. Our results revealed that DCs subsets correlated with peritoneal adenocarcinoma malignancy. Dendritic cells play an independent role in the immune function of peritoneal adenocarcinoma.

本研究旨在探讨腹膜腺癌患者外周血中树突状细胞(DC)亚群的不同百分比与恶性程度(分级和淋巴结转移)之间的关系,以及正常对照组中树突状细胞亚群的频率。采集 30 名腹膜腺癌患者和 12 名健康对照者的外周血,进行多色流式细胞术分析。腹膜腺癌患者按恶性程度(分级和淋巴结转移)分组。腹膜腺癌患者外周血中髓样 DCs(mDCs)及其亚群 MDC1 和 MDC2 的百分比低于正常对照组。质体树突状细胞(pDCs)和CD16+mDCs在DCs中的比例高于正常对照组。与分化等级较差的患者相比,分化等级良好/中等的患者 CD16+mDCs 的比例更高。与 CD16+mDCs 相反,良好/中等分化等级组中 MDC1 的比例较低。在没有淋巴结转移的患者中,pDCs 和 CD16+mDCs 的水平高于有淋巴结转移的患者,而 mDCs 和 MDC1 的水平则相反。CD16+mDCs 与 MDC1 呈负相关。DCs中pDCs和CD16+mDCs的百分比与CD3+CD8+T细胞呈正相关,pDCs与CD8+PD-1+T细胞也呈正相关。我们的研究结果表明,DCs亚群与腹膜腺癌的恶性程度相关。树突状细胞在腹膜腺癌的免疫功能中发挥着独立作用。
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引用次数: 0
Factors associated with non-treatment of hypertension and gender differences at baseline in the ELSA-Brasil cohort. ELSA-Brasil 队列中未治疗高血压的相关因素和基线时的性别差异。
IF 2.3 4区 医学 Q1 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-02-09 eCollection Date: 2024-01-01 DOI: 10.1590/1414-431X2023e12937
A K M Néri, R M F Xavier, S M A Matos, M C C Almeida, R M Ladeira, A A Lopes, D O C Lino, A P P Lázaro, R V B M Cairutas, J H Silva Júnior, J M O Lima, M C Chaves, R P Silva, G B Silva Júnior

The treatment of arterial hypertension (AH) contributes to the reduction of morbidity and mortality. Gender differences are likely to play a role, as non-treatment is associated with clinical and sociodemographic aspects. The aim of this study was to investigate the factors associated with non-treatment of AH and gender differences in hypertensive individuals from the ELSA-Brasil cohort. The study was conducted with 5,743 baseline hypertensive cohort participants. AH was considered if there was a previous diagnosis or if systolic blood pressure (SBP) was ≥140 and/or diastolic BP (DBP) was ≥90 mmHg. Sociodemographic and anthropometric data, lifestyle, comorbidities, and use of antihypertensive medications were evaluated through interviews and in-person measurements. Treatment with renin-angiotensin-aldosterone system inhibitors (RAASi) or other antihypertensive medications and non-treatment were evaluated with multivariate logistic regression. Non-treatment was observed in 32.8% of hypertensive individuals. Of the 67.7% treated individuals, 41.1% received RAASi. Non-treatment was associated with alcohol consumption in women (OR=1.41; 95%CI: 1.15-1.73; P=0.001), lowest schooling level in men (OR=1.70; 95%CI: 1.32-2.19; P<0.001), and younger age groups in men and women (strongest association in males aged 35-44 years: OR=4.58, 95%CI: 3.17-6.6, P<0.001). Among those using RAASi, a higher proportion of white, older individuals, and with more comorbidities was observed. The high percentage of non-treatment, even in this civil servant population, indicated the need to improve the treatment cascade for AH. Public health policies should consider giving special attention to gender roles in groups at higher risk of non-treatment to reduce inequities related to AH in Brazil.

动脉高血压(AH)的治疗有助于降低发病率和死亡率。由于不治疗与临床和社会人口学方面有关,因此性别差异很可能在其中发挥作用。本研究旨在调查 ELSA-Brasil 队列中高血压患者不治疗 AH 的相关因素和性别差异。研究对象为 5743 名基线高血压队列参与者。如果既往确诊或收缩压(SBP)≥140 和/或舒张压(DBP)≥90 mmHg,则视为高血压。社会人口学和人体测量数据、生活方式、合并症以及降压药物的使用情况均通过访谈和现场测量进行了评估。使用肾素-血管紧张素-醛固酮系统抑制剂(RAASi)或其他抗高血压药物治疗和不治疗的情况通过多变量逻辑回归进行评估。32.8%的高血压患者未接受治疗。在 67.7% 接受治疗的患者中,41.1% 接受了 RAASi 治疗。女性未接受治疗与饮酒有关(OR=1.41;95%CI:1.15-1.73;P=0.001),男性未接受治疗与受教育程度最低有关(OR=1.70;95%CI:1.32-2.19;P=0.001)。
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引用次数: 0
Protective effect of sterubin against neurochemical and behavioral impairments in rotenone-induced Parkinson's disease. 甾体黄酮对鱼藤酮诱导的帕金森病的神经化学和行为损伤的保护作用
IF 2.3 4区 医学 Q1 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-02-09 eCollection Date: 2024-01-01 DOI: 10.1590/1414-431X2023e12829
M M Alqurashi, F A Al-Abbasi, M Afzal, A M Alghamdi, M Zeyadi, R A Sheikh, S Alshehri, S S Imam, N Sayyed, I Kazmi

This study was conducted to evaluate how sterubin affects rotenone-induced Parkinson's disease (PD) in rats. A total of 24 rats were distributed into 4 equal groups: normal saline control and rotenone control were administered saline or rotenone (ROT), respectively, orally; sterubin 10 received ROT + sterubin 10 mg/kg po; and sterubin alone was administered to the test group (10 mg/kg). Rats of the normal saline and sterubin alone groups received sunflower oil injection (sc) daily, 1 h after receiving the treatments cited above, while rats of the other groups received rotenone injection (0.5 mg/kg, sc). The treatment was continued over the course of 28 days daily. On the 29th day, catalepsy and akinesia were assessed. The rats were then euthanized, and the brain was extracted for estimation of endogenous antioxidants (MDA: malondialdehyde, GSH: reduced glutathione, CAT: catalase, SOD: superoxide dismutase), nitrative (nitrite) stress markers, neuroinflammatory cytokines, and neurotransmitter levels and their metabolites (3,4-dihydroxyphenylacetic acid (DOPAC), dopamine (DA), norepinephrine (NE), serotonin (5-HT), 5-hydroxyindoleacetic acid (5-HIAA), and homovanillic acid (HVA)). Akinesia and catatonia caused by ROT reduced the levels of endogenous antioxidants (GSH, CAT, and SOD), elevated the MDA level, and altered the levels of nitrites, neurotransmitters, and their metabolites. Sterubin restored the neurobehavioral deficits, oxidative stress, and metabolites of altered neurotransmitters caused by ROT. Results demonstrated the anti-Parkinson's activities of sterubin in ROT-treated rats.

本研究旨在评估固醇比如何影响鱼藤酮诱导的帕金森病(PD)大鼠。研究人员将 24 只大鼠平均分为 4 组:正常生理盐水对照组和鱼藤酮对照组分别口服生理盐水或鱼藤酮(ROT);固醇素 10 组口服 ROT + 固醇素 10 毫克/千克;试验组口服固醇素(10 毫克/千克)。正常生理盐水组和单纯固醇霉素组的大鼠在接受上述治疗 1 小时后,每天接受葵花籽油注射(sc),而其他组的大鼠则接受鱼藤酮注射(0.5 毫克/千克,sc)。每天持续治疗 28 天。第 29 天,对催眠和运动障碍进行评估。然后对大鼠实施安乐死,并提取大脑以估算内源性抗氧化剂(MDA:丙二醛;GSH:还原型谷胱甘肽;CAT:过氧化氢酶;SOD:超氧化物歧化酶)、抗氧化剂(MDA:丙二醛;GSH:还原型谷胱甘肽;CAT:过氧化氢酶;SOD:超氧化物歧化酶提取大脑中的内源性抗氧化剂(MDA:丙二醛;GSH:还原型谷胱甘肽;CAT:过氧化氢歧化酶;SOD:超氧化物歧化酶)、硝化(亚硝酸盐)应激标记物、神经炎症细胞因子、神经递质水平及其代谢物(3,4-二羟基苯乙酸(DOPAC)、多巴胺(DA)、去甲肾上腺素(NE)、5-羟色胺(5-HT)、5-羟基吲哚乙酸(5-HIAA)和高钒酸(HVA))。ROT 引起的肌动不安和紧张症降低了内源性抗氧化剂(GSH、CAT 和 SOD)的水平,提高了 MDA 的水平,并改变了亚硝酸盐、神经递质及其代谢物的水平。Sterubin 可修复 ROT 引起的神经行为缺陷、氧化应激和神经递质代谢物的改变。结果表明,固醇黄素对 ROT 治疗大鼠具有抗帕金森氏症活性。
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引用次数: 0
"Penumbra sign" in knee pain: a case of distal femur osteomyelitis. 膝关节疼痛的 "半影征":一例股骨远端骨髓炎病例。
IF 2.3 4区 医学 Q1 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-02-09 eCollection Date: 2024-01-01 DOI: 10.1590/1414-431X2023e12976
Hakan Koray Tosyali, Adem Çakir

"Penumbra sign" is a characteristic finding in magnetic resonance imaging (MRI) of Brodie's abscess, a rare variant of subacute osteomyelitis. We aimed to discuss the imaging finding penumbra sign that will help in the diagnosis of osteomyelitis and may be useful to clinicians in differential diagnosis. A 26-year-old male patient presented to the emergency department with complaints of pain and limping in the right knee that did not go away. He had a history of arthroscopic debridement and percutaneous fixation surgery due to osteochondral fragment 3 years ago. There were no additional findings in the patient's vital parameters, physical examination, and medical history. X-ray imaging revealed two screws in the distal femur and a well-defined sclerotic rim surrounding a radiolucent lesion anterior to the screws. MRI revealed a lesion in the distal femoral metaphysis with low-density fluid and hyperintense granulation tissue surrounding it. After surgical abscess drainage and local debridement, bone cement was placed in the resulting cavity. Teicoplanin treatment was started. The patient was discharged and complete recovery was achieved in the second month. The diagnosis of osteomyelitis is often missed or confused with bone tumors in non-traumatic cases presenting with persistent bone pain. MRI imaging is frequently used in differential diagnosis, and detection of characteristic imaging signs such as the penumbra sign accelerates the diagnosis. In this context, emergency department clinicians, in particular, should be cautious and not forget that early treatment can be started by recognizing these signs.

"半影征 "是布罗迪脓肿(一种亚急性骨髓炎的罕见变体)磁共振成像(MRI)的特征性发现。我们旨在讨论有助于骨髓炎诊断的影像学发现 "半影征",它可能对临床医生的鉴别诊断有用。一名 26 岁的男性患者因主诉右膝疼痛和跛行而到急诊科就诊。3 年前,他曾因骨软骨碎片接受过关节镜清创和经皮固定手术。患者的生命体征、体格检查和病史均无其他发现。X光成像显示,股骨远端有两颗螺钉,螺钉前方的放射状病变周围有清晰的硬化边缘。核磁共振成像显示股骨远端干骺端有病变,周围有低密度液体和高密度肉芽组织。经过手术排脓和局部清创后,在形成的空腔中植入了骨水泥。开始了替考拉宁治疗。患者出院后第二个月就完全康复了。在出现持续性骨痛的非创伤性病例中,骨髓炎的诊断常常被漏诊或与骨肿瘤混淆。核磁共振成像经常被用于鉴别诊断,发现特征性成像征象(如半影征)可加快诊断。在这种情况下,急诊科的临床医生尤其要谨慎,不要忘记通过识别这些体征可以开始早期治疗。
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引用次数: 0
Safety of a 90-min duration of intravenous infusion of obinutuzumab in patients with B-cell non-Hodgkin's lymphoma in a tertiary hospital in China: a prospective, open-label, exploratory clinical trial. 中国某三甲医院对B细胞非霍奇金淋巴瘤患者静脉输注奥比妥珠单抗90分钟的安全性:一项前瞻性、开放标签、探索性临床试验。
IF 2.3 4区 医学 Q1 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-02-09 eCollection Date: 2024-01-01 DOI: 10.1590/1414-431X2023e13284
Shuangshuang Xing, Yiqin Pu, Xiaoqian Zhao, Yan Hu, Feiyan Zhang, Zejuan Gu, Wei Xu, Lei Fan, Yi Miao, Jianyong Li

This study aimed to analyze the safety and applicability of a 90-min duration of infusion (SDI) of obinutuzumab in patients with B-cell non-Hodgkin's lymphoma (NHL) in a tertiary hospital in China. This exploratory clinical trial was performed at Jiangsu Province Hospital. All patients were treated with the standard infusion regimen for the first infusion. If no grade ≥3 infusion-related reactions (IRRs) occurred, the subsequent infusions were given as SDI. The primary endpoint was the incidence of IRR during the standard infusion (3-4 h) and 90-min SDI regimens. This study enrolled 208 patients and all completed cycle 1. Forty-one patients (19.71%) had IRRs: five (2.40%) with grade 1, twenty-eight (13.46%) with grade 2, and eight (3.85%) with grade 3. The 41 patients had 71 IRRs, mainly fever (40.85%), chest pain/tightness (12.68%), and dyspnea (9.86%). The occurrence of IRRs in the first infusion was significantly lower in patients who received oral acetaminophen prophylaxis than those who did not (10.72% vs 30.21%, P<0.001). For the subsequent cycles with 90-min SDI, only two (0.25%) IRRs occurred among 814 infusions (one grade 1 hand numbness and one grade 2 chill/fever). The 90-min obinutuzumab SDI might be safe and feasible in patients with B-cell NHL in China.

本研究旨在分析在中国一家三甲医院对B细胞非霍奇金淋巴瘤(NHL)患者进行90分钟输注(SDI)的安全性和适用性。这项探索性临床试验在江苏省立医院进行。所有患者首次输注均采用标准输注方案。如果没有发生≥3级的输液相关反应(IRR),则后续输液按SDI进行。主要终点是标准输注(3-4 小时)和 90 分钟 SDI 方案中 IRR 的发生率。这项研究共招募了 208 名患者,所有患者都完成了第一周期的治疗。41例患者(19.71%)出现了IRR:5例(2.40%)为1级,28例(13.46%)为2级,8例(3.85%)为3级。41 名患者共出现 71 次 IRR,主要是发热(40.85%)、胸痛/胸闷(12.68%)和呼吸困难(9.86%)。接受口服对乙酰氨基酚预防治疗的患者在首次输液时发生 IRR 的比例明显低于未接受口服对乙酰氨基酚预防治疗的患者(10.72% vs 30.21%,P<0.05)。
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引用次数: 0
Assessing the reaction to and efficacy of the Screener drug discovery and development board game as a pedagogical tool in postgraduate courses 评估 "筛选器 "药物发现和开发棋盘游戏作为研究生课程教学工具的反应和功效
IF 2.3 4区 医学 Q1 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-01-22 DOI: 10.1590/1414-431X2023e13258
F. Noël, G. Xexéo, M.A. Martins, E.J.R. Silva, A.S. Pupo, P.J.C. Magalhães, R.C.P. Lima-Júnior, K.K.L. Gadelha, K. Lima-Silva, J.M. Raimundo, P.C. Ghedini, M.E. Crespo-Lopez, G.P. Arrifano, J. Ferreira, R.D. Prediger, G.C.G. Militão, R.B. Oliveira, A.W. Hollais, L.C.M. Rodrigues, D.T. Carvalho, S.K.P. Costa, D.T.O. Martins
Screener, a board game supplemented with online resources, was introduced and distributed by the Brazilian Society of Pharmacology and Experimental Therapeutics to postgraduate programs as an instructional tool for the process of drug discovery and development (DDD). In this study, we provided a comprehensive analysis of five critical aspects for evaluating the quality of educational games, namely: 1) description of the intervention; 2) underlying pedagogical theory; 3) identification of local educational gaps; 4) impact on diverse stakeholders; and 5) elucidation of iterative quality enhancement processes. We also present qualitative and quantitative assessments of the effectiveness of this game in 11 postgraduate courses. We employed the MEEGA+ online survey, comprising thirty-three close-ended unipolar items with 5-point Likert-type response scales, to assess student perceptions of the quality and utility of Screener. Based on 115 responses, the results indicated a highly positive outlook among students. In addition, we performed a preliminary evaluation of learning outcomes in two courses involving 28 students. Pre- and post-quizzes were applied, each consisting of 20 True/False questions directly aligned with the game's content. The analysis revealed significant improvement in students' performance following engagement with the game, with scores rising from 8.4 to 13.3 (P<0.0001, paired t-test) and 9.7 to 12.7 (P<0.0001, paired t-test). These findings underscore the utility of Screener as an enjoyable and effective tool for facilitating a positive learning experience in the DDD process. Notably, the game can also reduce the educational disparities across different regions of our continental country.
巴西药理学与实验治疗学学会向研究生课程引入并分发了一款棋盘游戏--Screener,并辅以在线资源,作为药物发现与开发(DDD)过程的教学工具。在这项研究中,我们对评估教育游戏质量的五个关键方面进行了全面分析,这五个方面分别是1) 对干预措施的描述;2) 基本的教学理论;3) 确定当地的教育差距;4) 对不同利益相关者的影响;5) 阐明迭代质量提升过程。我们还对该游戏在 11 门研究生课程中的有效性进行了定性和定量评估。我们采用了 MEEGA+ 在线调查,包括 33 个封闭式单极项目和 5 点李克特类型的回答量表,以评估学生对 Screener 的质量和实用性的看法。根据 115 份回复,结果显示学生们对筛查器的看法非常积极。此外,我们还对 28 名学生参与的两门课程的学习成果进行了初步评估。我们进行了课前和课后测验,每个测验包括 20 道与游戏内容直接相关的真/假问题。分析结果显示,学生在参与游戏后成绩有了明显提高,分数从 8.4 分提高到 13.3 分(P<0.0001,配对 t 检验),从 9.7 分提高到 12.7 分(P<0.0001,配对 t 检验)。这些发现强调了 "筛选器 "的实用性,它是一种愉悦而有效的工具,可在定向行走过程中促进积极的学习体验。值得注意的是,该游戏还能缩小我国大陆不同地区之间的教育差距。
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引用次数: 0
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Brazilian Journal of Medical and Biological Research
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