1.Diuretic effect and renal function impact of dapagliflozin in hospitalized patients with HFrEF.
Shanshan LI ; Youxuan WU ; Xiaolei HU ; Xiaoxiao MAO ; Huijun LIU ; Dai LI ; Pingsheng XU ; Ke XIA
Journal of Central South University(Medical Sciences) 2024;49(11):1732-1740
OBJECTIVES:
Patients with heart failure with reduced ejection fraction (HFrEF) often require diuretics during hospitalization to alleviate fluid retention and improve prognosis. However, the diuretic efficacy and renal impact of dapagliflozin in this population remain unclear. This study aims to investigate the effects of dapagliflozin on diuresis and renal function in hospitalized patients with HFrEF.
METHODS:
This retrospective analysis included clinical data from 200 hospitalized HFrEF patients treated at Xiangya Hospital of Central South University between January 2021 and September 2022. Patients were divided into 2 groups based on whether they received dapagliflozin: a standard treatment group (n=120) and a dapagliflozin treatment group (n=80). The following were compared between the 2 groups during hospitalization: The 24-hour average difference of liquid intake and output during the first 5 days, urine output, cumulative urine output, diuretic efficiency, estimated glomerular filtration rate (eGFR), N-terminal pro B-type natriuretic peptide (NT-proBNP), hospitalization costs, drug costs, and cost-effectiveness ratio (C/E).
RESULTS:
1) Primary outcome: The 24-hour average difference of liquid intake and output during the first 5 days was significantly higher in the dapagliflozin treatment group than in the standard treatment group (P<0.05). 2) Secondary outcomes: The 24-hour average urine volume, cumulative urine volume and diuretic efficiency in the first 5 days of dapagliflozin treatment group were higher than those in the standard treatment group, and the differences were statistically significant (all P<0.05). Among patients with impaired renal function on admission [eGFR between 45 and 90 mL/(min·1.73 m²)], the change in eGFR after treatment was significantly smaller in the dapagliflozin treatment group (P<0.05). For patients with normal renal function on admission [eGFR >90 mL/(min·1.73 m²)], the difference in eGFR changes between 2 groups was not significant (P>0.05). NT-proBNP decreased more in the dapagliflozin treatment group than in the standard treatment group during hospitalization (P<0.05). 3) Other indicators: The length of hospital stay was longer in the dapagliflozin treatment group. However, discharge systolic blood pressure, drug costs, and hospitalization costs were all higher in the standard group, though differences were not statistically significant (all P>0.05). The C/E was more favorable in the dapagliflozin treatment group (425.36 vs. 476.67).
CONCLUSIONS
In hospitalized patients with chronic HFrEF, dapagliflozin treatment increased 24-hour average difference of liquid intake and output and total urine output, reduced NT-proBNP levels, and showed a milder decline in eGFR in those with pre-existing renal impairment. Discharge blood pressure, drug costs, and hospital stay were not significantly affected. While standard therapy may offer better short-term clinical benefits, dapagliflozin demonstrated a superior short-term cost-effectiveness profile.
Humans
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Benzhydryl Compounds/pharmacology*
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Glucosides/pharmacology*
;
Retrospective Studies
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Male
;
Female
;
Heart Failure/physiopathology*
;
Hospitalization
;
Middle Aged
;
Aged
;
Glomerular Filtration Rate/drug effects*
;
Diuretics/therapeutic use*
;
Kidney/drug effects*
;
Natriuretic Peptide, Brain/blood*
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Stroke Volume
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Peptide Fragments/blood*
;
Diuresis/drug effects*
2.Effects of bisphenol A and bisphenol analogs on the nervous system.
Chunxia LI ; Chen SANG ; Shuo ZHANG ; Sai ZHANG ; Hui GAO
Chinese Medical Journal 2023;136(3):295-304
Estrogen impacts neural development; meanwhile, it has a protective effect on the brain. Bisphenols, primarily bisphenol A (BPA), can exert estrogen-like or estrogen-interfering effects by binding with estrogen receptors. Extensive studies have suggested that neurobehavioral problems, such as anxiety and depression, can be caused by exposure to BPA during neural development. Increasing attention has been paid to the effects on learning and memory of BPA exposure at different developmental stages and in adulthood. Further research is required to elucidate whether BPA increases the risk of neurodegenerative diseases and the underlying mechanisms, as well as to assess whether BPA analogs, such as bisphenol S and bisphenol F, influence the nervous system.
Receptors, Estrogen/metabolism*
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Estrogens
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Benzhydryl Compounds/pharmacology*
;
Nervous System/metabolism*
3.Bisphenol A alters glucose metabolism in rat Sertoli cells in vitro.
Wei HUANG ; Hong-mei HUANG ; Hong WANG ; Ji-cun ZHAO ; Mian-zhou LI ; Hong-qiang WANG ; Xin-sheng WANG ; Pei-tao WANG
National Journal of Andrology 2015;21(2):119-123
OBJECTIVETo observe the influence of different concentrations of bisphenol A (BPA) on glucose metabolism and lactate dehydrogenase (LDH) expression in rat Sertoli cells in vitro and investigate the mechanisms of BPA inducing male infertility.
METHODSUsing two-step enzyme digestion, we isolated Sertoli cells from male Wistar rats and constructed a primary Sertoli cell system, followed by immunohistochemical FasL staining. We randomly divided the Sertoli cells into a control group to be cultured in the serum-free minimal essential medium (MEM) plus dimethyl sulfoxide (DMSO) and three experimental groups to be treated with 100 nmol/L, 10 μmol/L, and 1 mmol/L BPA, respectively, in the MEM plus DMSO. After 48 hours of treatment, we measured the proliferation of the cells by CCK-8 assay, determined the concentrations of metabolites by NMR spectroscopy, and detected the expression of LDH in the Sertoli cells by RT-PCR and Western blot.
RESULTSThe purity of the isolated Sertoli cells was (96.05 ± 1.28)% (n = 10). Compared with the control group, the 100 nmol/L, 10 μmol/L, and 1 mmol/L BPA groups showed no remarkable changes in the proliferation of Sertoli cells ([98 ± 8]%, [96 ± 3]%, and [95 ± 3]%, P >0.05), but the 10 μmol/L and 1 mmol/L of BPA groups exhibited significantly decreased concentrations of intracellular glucose ([3.89 ± 0.07] vs [3.36 ± 0.24] and [3.04 ± 0.21] pmol/cell, P <0.05) and lactate ([0.43 ± 0.06] vs [0.29 ± 0.05] and [0.20 ± 0.03] pmol/cell, P <0.05). The expression of LDH mRNA was decreased with the increased concentration of BPA, while that of LDH protein reduced only in the 1 mmol/L BPA group (P <0.05).
CONCLUSIONHigh-concentration BPA decreases the expression of LDH and alters glucose metabolism in Sertoli cells, and therefore may reduce the provision of lactate for germ cells and impair spermatogenesis.
Animals ; Benzhydryl Compounds ; administration & dosage ; pharmacology ; Cell Proliferation ; drug effects ; Cells, Cultured ; Culture Media, Serum-Free ; Dimethyl Sulfoxide ; pharmacology ; Glucose ; metabolism ; In Vitro Techniques ; Infertility, Male ; chemically induced ; L-Lactate Dehydrogenase ; metabolism ; Male ; Phenols ; administration & dosage ; pharmacology ; RNA, Messenger ; metabolism ; Random Allocation ; Rats ; Rats, Wistar ; Sertoli Cells ; drug effects ; metabolism ; Spermatogenesis ; drug effects
4.NGF and HB-EGF: Potential Biomarkers that Reflect the Effects of Fesoterodine in Patients with Overactive Bladder Syndrome.
Soo Rim KIM ; Yeo Jung MOON ; Sei Kwang KIM ; Sang Wook BAI
Yonsei Medical Journal 2015;56(1):204-211
PURPOSE: To determine whether levels of nerve growth factor (NGF) and heparin-binding epidermal growth factor-like growth factor (HB-EGF) can be used to objectively assess overactive bladder syndrome (OAB) treatment outcome and to evaluate the effects of fixed-dose fesoterodine on OAB symptoms. MATERIALS AND METHODS: This study included 124 participants (62 patients with OAB and 62 controls) in Severance Hospital between 2010 and 2012. In patients with OAB, 4 mg fesoterodine was administered once daily. Repeated evaluations of putative biomarker levels, urine creatinine (Cr) levels, and questionnaire responses, including the Overactive Bladder Symptom Score (OABSS) and the Overactive Bladder Questionnaire (OAB q), were performed from baseline to 16 weeks. RESULTS: Urinary levels of NGF/Cr (OAB: 1.13+/-0.9 pg/mg; control: 0.5+/-0.29 pg/mg) and HB-EGF/Cr (OAB: 8.73+/-6.55 pg/mg; control: 4.45+/-2.93 pg/mg) were significantly higher in subjects with OAB than in controls (p<0.001). After 16 weeks of fixed-dose fesoterodine treatment, urinary NGF/Cr levels (baseline: 1.13+/-0.08 pg/mg; 16 weeks: 0.60+/-0.4 pg/mg; p=0.02) and HB-EGF/Cr levels significantly decreased (baseline: 8.73+/-6.55 pg/mg; 16 weeks: 4.72+/-2.69 pg/mg; p=0.03, respectively). Both the OABSS and OAB q scores improved (p<0.001). However, there were no a statistically significant correlations between these urinary markers and symptomatic scores. CONCLUSION: Urinary levels of NGF and HB-EGF may be potential biomarkers for evaluating outcome of OAB treatment. Fixed-dose fesoterodine improved OAB symptoms. Future studies are needed to further examine the significance of urinary NGF and HB-EGF levels as therapeutic markers for OAB.
Adult
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Benzhydryl Compounds/pharmacology/*therapeutic use
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Biological Markers/urine
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Case-Control Studies
;
Creatinine/urine
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Female
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Heparin-binding EGF-like Growth Factor/*urine
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Humans
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Male
;
Middle Aged
;
Nerve Growth Factor/*urine
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Questionnaires
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Treatment Outcome
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Urinary Bladder, Overactive/*drug therapy/physiopathology/*urine
;
Urodynamics
5.Influence of Genista tinctoria L. or methylparaben on subchronic toxicity of bisphenol A in rats.
Daniela-Saveta POPA ; Pompei BOLFA ; Bela KISS ; Laurian VLASE ; Ramona PĂLTINEAN ; Anca POP ; Cornel CĂTOI ; Gianina CRIŞAN ; Felicia LOGHIN
Biomedical and Environmental Sciences 2014;27(2):85-96
OBJECTIVETo evaluate the influence of an extract of Genista tinctoria L. herba (GT) or methylparaben (MP) on histopathological changes and 2 biomarkers of oxidative stress in rats subchronicly exposed to bisphenol A (BPA).
METHODSAdult female Wistar rats were orally exposed for 90 d to BPA (50 mg/kg), BPA+GT (35 mg isoflavones/kg) or BPA+MP (250 mg/kg). Plasma and tissue samples were taken from liver, kidney, thyroid, uterus, ovary, and mammary gland after 30, 60, and 90 d of exposure respectively. Lipid peroxidation and in vivo hydroxyl radical production were evaluated by histological analysis along with malondialdehyde and 2,3-dihydroxybenzoic acid detection.
RESULTSThe severity of histopathological changes in liver and kidneys was lower after GT treatment than after BPA or BPA+MP treatment. A minimal thyroid receptor antagonist effect was only observed after BPA+MP treatment. The abnormal folliculogenesis increased in a time-dependent manner, and the number of corpus luteum decreased. No significant histological alterations were found in the uterus. The mammary gland displayed specific estrogen stimulation changes at all periods. Both MP and GT revealed antioxidant properties reducing lipid peroxidation and BPA-induced hydroxyl radical generation.
CONCLUSIONGT L. extract ameliorates the toxic effects of BPA and is proved to have antioxidant potential and antitoxic effect. MP has antioxidant properties, but has either no effect or exacerbates the BPA-induced histopathological changes.
Animals ; Benzhydryl Compounds ; toxicity ; Chemical and Drug Induced Liver Injury ; pathology ; prevention & control ; Endocrine Disruptors ; toxicity ; Female ; Genista ; Hydroxyl Radical ; blood ; Lipid Peroxidation ; drug effects ; Liver ; pathology ; Oxidative Stress ; drug effects ; Parabens ; toxicity ; Phenols ; toxicity ; Phytotherapy ; Plant Extracts ; pharmacology ; therapeutic use ; Rats ; Rats, Wistar
6.Effects of bisphenol-A on blastocyst development and implantation.
Pei-pei YAN ; Xiao-yan PAN ; Hong-he WANG ; Zhi-xin LI ; Xue-nan WANG ; Qin LAI ; Wen-jing SONG ; Hua-yi ZHAO ; Zhao-hua DOU
Acta Academiae Medicinae Sinicae 2014;36(4):351-356
OBJECTIVETo determine the effects of bisphenol-A (BPA) on blastocyst development and implantation.
METHODSAccording to completely randomized grouping method, 90 pregnant mice were divided into 100, 300, and 600 mg/(kg·d)BPA groups and control group. BPA-treated pregnant mice were orally administered with BPA at concentrations of 100, 300 and 600 mg/(kg·d) from day 0.5 to day 3.5 of their pregnancy. Blastocyst implantation and development were studied.
RESULTSIn the 300 mg/(kg·d) BPA group, the number of implantation sites and implantation rate were significantly decreased. In the 600 mg/(kg·d) group, no implantation sites were observed among pregnant mice and BPA inhibited embryo implantation. Blastocyst development on day 4 was examined, and findings showed that the development rate and total numbers of blastocysts in BPA treatment groups had no significant difference from the control group. However, BPA at 300 and 600 mg/(kg·d) significantly reduced blastocyst hatching rate and dramatically increased the number of blastocyst apoptotic cells when compared with those in the control group.
CONCLUSIONBPA at a high concentration damages the blastocyst development before implantation and inhibits embryo implantation.
Animals ; Benzhydryl Compounds ; pharmacology ; Blastocyst ; drug effects ; Embryo Implantation ; Female ; Male ; Mice ; Phenols ; pharmacology ; Pregnancy
7.Ventrolateral periaqueductal gray metabotropic glutamate receptor subtypes 7 and 8 mediate opposite effects on cardiosomatic motor reflex in rats.
Na SUN ; Lingheng KONG ; Ligang NIU ; Juanxia ZHU ; Yan XU ; Jianqing DU
Journal of Southern Medical University 2014;34(1):8-13
OBJECTIVETo investigate the role of ventrolateral periaqueductal gray (VL-PAG) metabotropic glutamate receptors subtype 7 and 8 (mGluR 7/8) in descending modulation of cardiosomatic motor reflex (CMR) in rats.
METHODSAMN082 (agonist of mGluR 7) and DCPG (agonist of mGluR 8) were injected into the VL-PAG of a rat model of CMR to observe their effects in modulating CMR. The raphe magnus nucleus (NRM) or the gigantocellular reticular nucleus (Gi) was then damaged, and the changes in VL-PAG descending modulation were observed.
RESULTSSelective activation of mGluR 7 of the VL-PAG by AMN082 obviously facilitated capsaicin (CAP)-induced CMR (P<0.05), which was suppressed by DCPG-induced mGluR 8 activation (P<0.05). These facilitatory or inhibitory effects were completely reversed by group III mGluR antagonist MSOP. Damaging the NRM of VL-PAG main relay nucleus did not significantly affect the facilitatory effect produced by AMN082 microinjection (P>0.05), but partially attenuated the inhibitory effect of DCPG microinjection (P<0.05). Both the facilitatory effect of AMN082 and the inhibitory effect of DCPG were reduced obviously after bilateral Gi damage (P<0.05).
CONCLUSIONVL-PAG mGluR 7 and mGluR 8 mediate biphasic regulation of CMR in rats probably through activation of different sub-nuclei and different neurons in the rostroventral medulla.
Animals ; Benzhydryl Compounds ; pharmacology ; Benzoates ; pharmacology ; Glycine ; analogs & derivatives ; pharmacology ; Male ; Medulla Oblongata ; metabolism ; Periaqueductal Gray ; metabolism ; Physical Conditioning, Animal ; Rats ; Rats, Sprague-Dawley ; Receptors, Metabotropic Glutamate ; agonists ; metabolism ; Reflex ; physiology
8.Synthesis and biological evaluation of novel diphenyl methane sulfinyl and diphenylthio-acetamide derivatives.
Xiong ZHU ; Yan TANG ; Cong GAO ; Liu-Quan ZHANG ; Wen-Long HUANG
Acta Pharmaceutica Sinica 2013;48(3):372-376
According to the structure-activity relationships (SARs) of modafinil, a therapeutic drug of hypnolepsy, we designed and synthesized two series of compounds 2-[(diphenylmethane)sulfinyl] acetamides and 2-[(diphenylmethyl)thio] acetamides, and measured their biological activities. The target compounds (6a-6o) were synthesized beginning with diphenyl carbinol by substitution, oxidation, acylation and so on. Their structures were confirmed by ESI-MS, 1H NMR and elemental analysis. The central stimulatory effects of the target compounds were determined by the independent activity assay on mice. Compounds 6c, 6f and 6n have considerable activities, while the central stimulative effect of 6h is slightly better than the positive control modafinil.
Acetamides
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chemical synthesis
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chemistry
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pharmacology
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Animals
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Behavior, Animal
;
drug effects
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Benzhydryl Compounds
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chemistry
;
pharmacology
;
Biphenyl Compounds
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chemical synthesis
;
chemistry
;
pharmacology
;
Methane
;
chemical synthesis
;
chemistry
;
pharmacology
;
Mice
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Mice, Inbred ICR
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Random Allocation
;
Structure-Activity Relationship
;
Wakefulness-Promoting Agents
;
chemical synthesis
;
chemistry
;
pharmacology
9.Research progress of sodium-glucose co-transporter 2 inhibitors for treatment of type 2 diabetes.
Acta Pharmaceutica Sinica 2012;47(6):716-724
Sodium-glucose co-transporters are a family of glucose transporter found in the intestinal mucosa of the small intestine (SGLT-2) and the proximal tubule of the nephron (SGLT-1 and SGLT-2). They contribute to renal glucose reabsorption and most of renal glucose (about 90%) is reabsorbed by SGLT-2 located in the proximal renal tubule. Selectively inhibiting activity of SGLT-2 is an innovative therapeutic strategy for treatment of type 2 diabetes by enhancing urinary glucose excretion from the body. Therefore SGLT-2 inhibitors are considered to be potential antidiabetic drugs with an unique mechanism. This review will highlight some recent advances and structure-activity relationships in the discovery and development of SGLT-2 inhibitors including O-glycoside, C-glycoside, C, O-spiro glycoside and non glycosides.
Animals
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Benzhydryl Compounds
;
chemical synthesis
;
chemistry
;
pharmacology
;
Diabetes Mellitus, Type 2
;
drug therapy
;
Glucosides
;
chemical synthesis
;
chemistry
;
pharmacology
;
Humans
;
Hypoglycemic Agents
;
chemical synthesis
;
chemistry
;
pharmacology
;
Molecular Structure
;
Monosaccharides
;
chemical synthesis
;
chemistry
;
pharmacology
;
Sodium-Glucose Transporter 1
;
metabolism
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Sodium-Glucose Transporter 2
;
antagonists & inhibitors
;
metabolism
;
Structure-Activity Relationship
10.Pharmacokinetics--pharmacodynamics of modafinil in mice.
Zhang-Qing MA ; Zong-Yuan HONG ; Wu-San WANG ; Fang TAO
Acta Pharmaceutica Sinica 2012;47(1):101-104
To guide the reasonable clinical application of modafinil (MOD), pharmacokinetics and pharmacodynamics of MOD in mice and the correlation between them were investigated. Male mice (Kunming strain) were given a single oral dose of MOD (120 mg x kg(-1)). The plasma concentration of MOD was measured by HPLC and the pharmacokinetic parameters were calculated with DAS 3.0 software. For another batch of male Kunming strain mice, their locomotor activities were recorded by an infrared ray passive sensor after a same oral dose of MOD, and the synchronization and correlation between the changes of MOD plasma concentration and the locomotor activity induced by MOD were compared and analyzed. The results showed that the plasma concentration-time curve of MOD was fitted to two-compartment open model with a first order absorption. The main pharmacokinetic parameters t1/2alpha, t1/2beta, t(max), C(max) and AUC(0-inifinity) were 0.42 h, 3.10 h, 1.00 h, 41.34 mg x L(-1) and 142.22 mg x L(-1) x h, respectively. MOD significantly increased locomotor activity and the effect lasted for about 4 h. The changes of MOD plasma concentration and the locomotor activity induced by MOD were synchronous. In conclusion, there is a significant correlation between the effect of MOD and its plasma concentration after administration of 120 mg x kg(-1) in mice.
Administration, Oral
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Animals
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Area Under Curve
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Benzhydryl Compounds
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administration & dosage
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blood
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pharmacokinetics
;
pharmacology
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Central Nervous System Stimulants
;
administration & dosage
;
blood
;
pharmacokinetics
;
pharmacology
;
Chromatography, High Pressure Liquid
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Dose-Response Relationship, Drug
;
Male
;
Mice
;
Motor Activity
;
drug effects

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