One month following carbon monoxide poisoning, a 39 year-old man developed incontinence, memory impairment, disorientation and emotional instability. He was hospitalized 7weeks later, and during hospitalization he exhibited myoclonic movements of the neck and lower limbs. He was given piracetam intravenously for 11 days. The myoclonus was significantly reduced by the third day of treatment and had disappeared by the seventh day. There was no recurrence following cessation of treatment.
Adult ; Carbon Monoxide Poisoning/complications* ; Human ; Male ; Myoclonus/drug therapy ; Myoclonus/etiology* ; Piracetam/therapeutic use* ; Pyrrolidinones/therapeutic use*

OBJECTIVETo observe the clinical efficacy of modified Huanglian Wendan Decoction (HWD) in treating senile mild cognitive impairment (MCI) of turbid-phlegm blocking orifice syndrome.

METHODSWith a block randomized, double-blinded and controlled design adopted, the 64 patients of MCI selected from December 2007 to February 2009 were randomly and equally assigned to two groups. The treatment group was treated with HWD in dose of 200 mL, twice a day; the control group was given Aniracetam 0.2 g (for patients over 70-years-old, 0.1 g) three times a day. And the illusive medicine in dosage-form of capsule/decoction simulated to that used in the opposite group was applied. The medication and observation lasted for three months. Chinese medicine syndrome, cognition capacity (by MMSE), laboratory indexes [acetylcholine (Ach), superoxide dismutase (SOD), malondialdehyde (MDA)] and safety related indexes in patients were observed.

RESULTSAfter treatment, MMSE score increased in both groups, but the increment in the treatment group was significantly higher than that in the control group (P<0.01); Chinese medicine syndrome estimated by scoring showed that after treatment, all scores of syndromes, excepting the expectoration, were improved in the treatment group with the post-treatment scores significantly lower than those in the control group respectively (P<0.05 or P<0.01); while in the control group, lowering of scores only showed in some symptoms such as poor memory, heavy head or dizziness, and heavy sensation in limbs and body. Serum levels of Ach and SOD decreased and MDA increased in both groups after treatment, but the change of Ach was more significant in the treatment group (P<0.01). No obvious adverse reactions were found during the treatment.

CONCLUSIONFor treatment of MCI, HWD shows effects in improving patients' symptoms, cognition capacity and elevating serum Ach content better than that of Aniracetam; and with effects for raising SOD activity and reducing MDA level similar to those of Aniracetam.

Aged ; Aged, 80 and over ; Cognitive Dysfunction ; diagnosis ; drug therapy ; Double-Blind Method ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Pyrrolidinones ; therapeutic use

Animals ; Dementia, Vascular ; drug therapy ; physiopathology ; Hippocampus ; metabolism ; physiopathology ; Learning ; drug effects ; Male ; Memory ; drug effects ; Nootropic Agents ; pharmacology ; therapeutic use ; Proto-Oncogene Proteins c-bcl-2 ; genetics ; metabolism ; Pyrrolidinones ; pharmacology ; therapeutic use ; Rats ; Rats, Sprague-Dawley

In the two decades since AZT was first approved for clinical use in 1987, 24 additional antiretroviral agents have been approved. They include 7 nucleoside analogs, a nucleotide analog and 4 non-nucleoside reverse transcriptase inhibitors, 10 protease inhibitors, 2 entry inhibitors and an integrase inhibitor. More than 20 investigational agents are currently being studied in clinical trials. Highly active antiretroviral therapy (HAART), which involves a combination of anti-HIV-1 drugs, is extremely effective in suppressing HIV-1 replication and increasing CD4+ number and results in substantial reductions in HIV-1-related morbidity and mortality. In last 20 years, much has been learned about resistance to antiretroviral drugs, drug interactions and metabolic complications of antiviral drug use. Drugs are now selected on the basis of resistance tests and on the risk of specific drug complications in individual patients. As a result, decisions about the therapy of HIV/AIDS have become personalized and are made on a patient-by-patient basis. With appropriate medical management, a person with HIV-1 now has the possibility of a nearly normal life expectancy.
Anti-HIV Agents ; adverse effects ; pharmacology ; therapeutic use ; Antiretroviral Therapy, Highly Active ; Cyclohexanes ; chemistry ; pharmacology ; therapeutic use ; Drug Resistance, Viral ; HIV Envelope Protein gp41 ; chemistry ; therapeutic use ; HIV Fusion Inhibitors ; chemistry ; pharmacology ; therapeutic use ; HIV Infections ; drug therapy ; HIV Integrase Inhibitors ; chemistry ; pharmacology ; therapeutic use ; HIV Protease Inhibitors ; chemistry ; pharmacology ; therapeutic use ; HIV Reverse Transcriptase ; chemistry ; pharmacology ; therapeutic use ; HIV-1 ; drug effects ; physiology ; Humans ; Molecular Structure ; Peptide Fragments ; chemistry ; therapeutic use ; Pyrrolidinones ; chemistry ; pharmacology ; therapeutic use ; Raltegravir Potassium ; Saquinavir ; chemistry ; pharmacology ; therapeutic use ; Triazoles ; chemistry ; pharmacology ; therapeutic use ; Virus Replication ; drug effects ; Zidovudine ; chemistry ; pharmacology ; therapeutic use

OBJECTIVETo observe the effects of the scalp acupuncture at Baihui (DU20) through Qubin (GB7) on the expressions of glial cell line-derived neurotrophic factor (GDNF) and vascular endothelial growth factor (VEGF) in the brain tissue of rats with acute intracerebral hemorrhage (AICH).

METHODSTotally 150 healthy male Wistar rats were used to prepare the intracerebral hemorrhage (ICH) model. They were randomly divided into the model group, the acupuncture group, and the Western medicine group, 50 in each group. Rats in each group were then randomly divided into five subgroups, i. e., 6 h, day 1, day 2, day 3, and day 7, 10 in each subgroup. Another 10 normal rats were recruited as the blank control group. Rats in the acupuncture group were acupunctured at Baihui (DU20) through Qubin (GB7) on the lesion side. Rats in the Western medicine group were administered with aniracetam diluent 1 mL by gastrogavage, 3 times daily. Rats in the model group were bound the same way as those in the acupuncture group 30 min daily, and then administered with normal saline 1 mL by gastrogavage, 3 times daily. The expressions of GDNF and VEGF in the brain tissue of the rats in each group were detected using in situ hybridization and immunohistochemical methods.

RESULTSCompared with the blank control group, the number of GDNF positive cells in the model group increased at 6 h-3 days, and the number of VEGF positive cells in the model group increased at each time point, showing statistical difference (P<0.01). The numbers of GDNF positive cells increased in the acupuncture group at each time point, showing statistical difference when compared with those of the model group and the Western medicine group (P<0.01). There was no statistical difference between the model group and the Western medicine group at each time point (P>0.05). Compared with the model group, the number of VEGF positive cells in the acupuncture group decreased at 6 h -3 days. The VEGF positive cells increased at day 7 and were higher than that of the Western medicine group, showing statistical difference (P<0.01).

CONCLUSIONSThe scalp acupuncture at Baihui (DU20) through Qubin (GB7) played the role of nerves remodeling in AICH possibly through promoting the expression of endogenous GDNF and early inhibiting the expression of VEGF in the AICH. This method possibly had favorable bidirectional regulation effects in AICH. Its therapeutic effects were superior to Aniracetam.

Acupuncture Points ; Acupuncture Therapy ; Animals ; Brain ; metabolism ; Cerebral Hemorrhage ; metabolism ; therapy ; Glial Cell Line-Derived Neurotrophic Factor ; metabolism ; Male ; Pyrrolidinones ; therapeutic use ; Rats ; Rats, Wistar ; Vascular Endothelial Growth Factor A ; metabolism