Evaluation of alprostadil combined with different doses of mouse nerve growth factor in diabetic peripheral neuropathy / 中国医师进修杂志

Objective:To investigate the application of alprostadil combined with different doses of mouse nerve growth factor in diabetic peripheral neuropathy (DPN) and its effect on motor and sensory nerve conduction and inflammatory factors.Methods:One hundred and fiftypatients with DPN treated in Beihai People′s Hospital from June 2018 to March 2020 were randomly divided into low-dose group and high-dose group, with 75 cases in each group. On the basis of routine treatment, the low-dose group was given alprostadil + mouse nerve growth factor 18 μg/time, once a day. The high-dose group was given alprostadil+mouse nerve growth factor 30 μg/time, once a day, both two groups were treated for 3 weeks. The curative effect, motor and sensory nerve conduction velocity and inflammatory index tumor necrosis factor-α(TNF-α)interleukin-6 (IL-6), high sensitivity C-reactive protein (hs-CRP), white blood cell count (WBC) and cost-effectiveness analysis, adverse reactions between the two groups were compared.Results:There was no significant difference in the total effective rate between the low dose group and the high dose group ( P>0.05). After 1 and 3 weeks of treatment, the levels ofmotor and sensory nerve conduction velocity and TNF-α, IL-6, hs-CRP and WBC in the two groups has no significant differences ( P>0.05). The cost of each unit effect in the low-dose group was 43.11 Yuan, and the cost of each unit effect in the high-dose group was 57.58 Yuan. The high-dose group was higher than that in the low-dose group, and the high-dose group paid 572.56 Yuan more than the low-dose group for each additional unit effect. There was no significant difference in the total incidence of adverse reactions between the two groups ( P>0.05). Conclusions:Alprostadil combined with 18 μg mouse nerve growth factor in the treatment of DPN has a similar improvement effect on clinical symptoms, motor and sensory nerve conduction and inflammatory factors, and has advantages in cost-effectiveness.

Clinical trial of alprostadil combined with metformin in the treatment of diabetic nephropathy / 国际生物医学工程杂志

Objective:To investigate the effect of alprostadil combined with metformin in the treatment of diabetic nephropathy.Methods:50 cases of diabetic nephropathy patients were enrolled and then divided equally into the observation group and the control group. The patients in the control group were treated with conventional therapy and metformin, and the patients in the observation group were treated with alprostadil on the basis of the treatment of the control group. Compare the glycemic index, lipid index, renal function index, inflammatory response index, and oxidative stress response index of the two groups of patients before and after the 4-week treatment. The ratio of the number of effective cases (significant + effective) to the total number of cases, i.e., the total effective rate, was used to characterize the treatment effect.Results:The total effective rate in the observation group was higher than that in the control group (88.00% vs. 60.00%, P<0.05). After the 4-week treatment, no adverse effects occurred in either group. Compared with the control group, patients in the observation group had higher fasting blood glucose (FBG), glycosylated hemoglobin(HbA1c), mean blood glucose(MBG), blood glucose fluctuation rate(BGFR), standard deviation of blood glucose(SDBG), triglyceride(TC), total cholesterol(TG), high-density lipoprotein(HDL), low-density lipoprotein(LDL), serum creatinine(Scr), urinary microalbumin(UmALB), glomerular filtration rate(eGFR), albumin/creatinine ratio(ACR), cyclic adenosine monophosphate(cAMP), renin, protein kinase(PKA), epinephrine (E), angiotensin-converting enzyme inhibitor Ⅱ(ACEI Ⅱ), and norepinephrine(NE) were improved(all P<0.05). Conclusions:The effect of alprostadil combined with metformin in the treatment of diabetic nephropathy is accurate, safe, and reliable.

Effect of alprostadil on acute cerebral infarction in 150 cases / 中国基层医药

Objective:To investigate the clinical efficacy of alprostadil injection in the treatment of acute cerebral infarction.Methods:A total of 300 patients with acute cerebral infarction who received treatment in The First People's Hospital of Jiashan, China between August 2016 and August 2018 were included in this study. They were randomly divided into a control group and an observation group ( n = 150/group). Based on conventional treatment, patients in the control group received Xueshuantong power injection treatment and those in the observation group received alprostadil injection treatment. All patients were treated for 14 days. Clinical efficacy was compared between the control and observation groups. Results:In the observation group, infarct volume, plaque area, lumen area, intima-media thickness of the common carotid artery, Crouse score, recanalization rate, Barthel Index, National Institutes of Health Stroke Scale (NIHSS) score, hematocrit and plasma viscosity in the observation group were (3.16 ± 1.19) cm 3, (0.21 ± 0.05) mm 2, (0.30 ± 0.06) mm 2, (1.05 ± 0.23) mm, (2.18 ± 0.61) points, 98.67% (148/150), (96.38 ± 1.75) points, (6.31 ± 1.08) points, (41.03 ± 4.28)%, (1.12 ± 0.03) mPa/s, respectively, which were superior to those in the control group [ (2.25 ± 1.37) cm 3, (0.68 ± 0.46) mm 2, (0.89 ± 0.54) mm 2, (1.76 ± 0.85) mm, (3.29 ± 0.78) points, 72.00% (108/150), (85.22 ± 1.56) points, (10.18 ± 1.43) points, (50.76 ± 5.31)%, (1.54 ± 0.34) mPa/s, t = 1.869, 1.231, 1.452, 1.326, 2.285, χ2 = 12.528, t = 11.428, 4.28, 17.473, 15.071, all P < 0.05]. Conclusion:Based on conventional treatment, alprostadil injection exhibits good clinical efficacy in the treatment of acute cerebral infarction.

Effects of alprostadil in β-aminopropanitrile induced aortic dissection in a murine model / 中华心血管病杂志

Objective: To investigate the protective role of alprostadil on aortic dissection. Methods: 26 C57BL6 male mice were divided into control group (normal drinking water, n=13) and model group (1 g·kg-1·d-1 BAPN via drinking water, n=13). On day 14, mRNA expression of inflammatory-related genes as well as EP receptor families were detected by RT-PCR (n=6 each) and EP4 protein levels were determined by Western blot (n=7 each). Another 88 mice were divided into 3 groups: control group (n=22), model group (n=33) and treatment group (n=33). The mice in model group and treatment group were applied with BAPN (1 g·kg-1·d-1) via drinking water. The mice in treatment group received additional intraperitoneal injection with alprostadil (80 μg·kg-1·d-1) for 28 days. The mice in the control and model group received equal volume intraperitoneal injection with 0.9% saline respectively. The body weight and systolic blood pressure, the mortality and morbidity were monitored from the beginning until the designed end of the study. On day 28, the mice were sacrificed and aorta were fixed, embedded and sliced, followed by staining with HE and Victoria Blue. The distribution of EP4 was determined by immunohistochemistry in control (n=6) and model group (n=6). Furthermore, the concentration of PGE1 were tested among model (n=3) and treatment group (n=4). EP4 protein expression was determined in model group (n=7) and treatment group (n=6). Results: On day 14, mRNA expression level of MCP-1 ((2.74±1.55) vs. (1.00±0.49),<0.05) and MMP2((1.38±0.42) vs. (1.00±0.27), P<0.05) was significantly upregulated in model group compared with control group. Protein expression of EP4 receptor also increased in aorta in model group compared with control group (1.48±0.51 vs. 1.00±0.19, P<0.05). In the dissection area, the EP4 expression was also enriched compared with non-dissection area, particularly in endothelial cells and inflammatory cells on day 28. BAPN applied in drinking water (model and treatment groups) successfully induced the aortic dissection in mice, some mice died of the rupture. The elastic fibers were fractured, and the infiltrated immune cells were visible in dissected tissue. False lumen was formed. There was no dissection and death in the control group. Compared with control group, the morbidity and mortality rates were significantly increased in the model group (60.6%, 20/33, 30.3%, 10/33) and the treatment group (72.7%, 24/33, 24.2%, 8/33). The mortality and morbidity rates were similar between model and treatment groups. There is no difference in terms of SBP among three groups (P>0.05). Further study showed that after alprostadil injection, the blood concentration of PGE1 was increased in treatment group ((0.540±0.041 vs. 0.436±0.012)μmol/L, P<0.05). Besides, the EP4 receptor expression was downregulated in the treatment group compared to model group (0.60±0.30 vs. 1.00±0.20, P<0.05). Conclusion: EP4 expression is upregulated in BAPN induced aortic dissection mouse model. No protective effects are observed post alprostadil treatment in this model probably due to the reduced expression of EP4.

Therapeutic effect of alprostadil combined with tripterygium glycosides on diabetic nephropathy and its effect on inflammatory factors / 中国基层医药

Objective@#To investigate the efficacy, safety of alprostadil combined with Tripterygium wilfordii polyglycosides in the treatment of patients with diabetic nephropathy and its influence on inflammatory factors.@*Methods@#From December 2015 to June 2018, 100 patients with diabetic nephropathy admitted to Dajiangdong Hospital were randomly divided into two groups according to the digital table, with 50 cases in each group.The control group received oral administration of Tripterygium wilfordii glycosides, the observation group received combined use of alprostadil intravenous infusion.The efficacy, safety and expression of serum TNF- and IL-6 were observed in the two groups.@*Results@#Before treatment, the fasting blood glucose, 2 h postprandial blood glucose and glycosylated hemoglobin of the control group were (8.87±0.65)mmol/L, (12.26±1.57)mmol/L, (8.15±0.56)%, respectively, which of the observation group were (8.69±0.72)mmol/L, (12.41±1.64)mmol/L, (8.12±0.49)%, respectively, and there were no statistically significant differences between the two groups (t=0.78, 0.69, 0.72, all P>0.05). After treatment, the fasting blood glucose, 2 h postprandial blood glucose and glycosylated hemoglobin of the control group were (7.34±0.61)mmol/L, (10.04±1.40)mmol/L, (7.28±0.53)%, respectively, which of the observation group were (6.93±0.39)mmol/L, (8.57±1.33)mmol/L, (6.21±0.44)%, respectively.The blood glucose of the two groups was significantly improved (t=4.13, 5.75, 3.69, 5.25, all P<0.05), and the blood glucose indicators of the observation group were significantly improved compared with the control group(t=3.56, 4.28, 4.12, all P<0.05). Before treatment, the 24-hour urinary protein quantification, urine beta 2-microglobulin in the control group were (0.27±0.05)g/L and (0.12±0.05)mg/L, respectively, which in the observation group were (0.26±0.06)g/L, (0.12±0.04)mg/L, respectively, there were no statistically significant differences between the two groups (t=0.58, 0.63, all P>0.05). After treatment, the 24-hour urinary protein quantification, urine beta 2-microglobulin in the control group were (0.19±0.04)g/L, (0.08±0.04)mg/L, respectively, which in the observation group were (0.14±0.03)g/L, (0.06±0.03)mg/L, respectively, the indicators of proteinuria in both two groups were significantly improved (t=3.97, 4.38, all P<0.05), and the indicators of proteinuria in the observation group were significantly improved compared with the control group (t=3.84, 3.99, all P<0.05). Before treatment, the serum creatinine and urea nitrogen levels in the control group were (150.97±23.82)μmol/L, (13.57±2.24)mmol/L, respectively, which in the observation group were (162.73±21.75)g/L, (14.05±2.31)mmol/L, respectively, there were no statistically significant differences in renal function between the two groups (t=1.02, 0.93, all P>0.05). After treatment, the levels of serum creatinine and urea nitrogen in the control group were (122.38±18.34)μmol/L, (8.72±0.71)mmol/L, respectively, which in the observation group were (101.41±15.64)g/L, (5.11±0.68)mmol/L, respectively, and the indicators of renal function in both two groups were significantly improved(t=5.31, 6.47, 4.92, 6.33, all P<0.05). The indicators of renal function in the observation group were significantly improved compared with the control group (t=4.96, 5.14, all P<0.05). Before treatment, the levels of TNF-α and IL-6 in the control group were (28.28±4.75)ng/L, (17.13±4.46)ng/L, respectively, which in the observation group were (27.87±4.81)ng/L, (16.98±4.27)ng/L, respectively, there were no statistically significant differences in IL-6 and TNF-α levels between the two groups(t=0.86, 0.97, all P>0.05). After treatment, the levels of TNF-α and IL-6 in the control group were (19.72±4.21)ng/L, (14.35±3.25)ng/L, respectively, which in the observation group were (14.61±3.18)ng/L, IL-6 (11.28±3.09)ng/L, respectively, the levels of TNF-α and IL-6 in the two groups were significantly improved (t=5.83, 8.24, 4.66, 7.38, all P<0.05). The levels of TNF-α and IL-6 in the observation group were significantly improved compared with the control group (t=4.32, 3.89, all P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05).@*Conclusion@#Alprostadil combined with Tripterygium wilfordii polyglycosides can significantly improve the clinical efficacy of diabetic nephropathy, with fewer adverse reactions and high safety, which may be related to its ability to regulate the expression of serum TNF-α and IL-6.

Therapeutic effect of alprostadil combined with tripterygium glycosides on diabetic nephropathy and its effect on inflammatory factors / 中国基层医药

Objective To investigate the efficacy,safety of alprostadil combined with Tripterygium wilfordii polyglycosides in the treatment of patients with diabetic nephropathy and its influence on inflammatory factors . Methods From December 2015 to June 2018, 100 patients with diabetic nephropathy admitted to Dajiangdong Hospital were randomly divided into two groups according to the digital table ,with 50 cases in each group.The control group received oral administration of Tripterygium wilfordii glycosides ,the observation group received combined use of alprostadil intravenous infusion.The efficacy,safety and expression of serum TNF －and IL－6 were observed in the two groups.Results Before treatment, the fasting blood glucose,2 h postprandial blood glucose and glycosylated hemoglobin of the control group were (8.87 ±0.65)mmol／L,(12.26 ±1.57)mmol／L,(8.15 ±0.56)%,respectively, which of the observation group were (8.69 ±0.72)mmol／L,(12.41 ±1.64)mmol／L,(8.12 ±0.49)%,respectively, and there were no statistically significant differences between the two groups (t＝0.78,0.69,0.72,all P＞0.05).After treatment,the fasting blood glucose ,2 h postprandial blood glucose and glycosylated hemoglobin of the control group were (7.34 ±0.61) mmol／L,(10.04 ±1.40) mmol／L,(7.28 ±0.53)%,respectively,which of the observation group were (6.93 ±0.39)mmol／L,(8.57 ±1.33)mmol／L,(6.21 ±0.44)%,respectively.The blood glucose of the two groups was significantly improved (t＝4.13,5.75,3.69,5.25,all P＜0.05),and the blood glucose indicators of the observation group were significantly improved compared with the control group ( t ＝3.56,4.28,4.12,all P＜0.05).Before treatment,the 24－hour urinary protein quantification ,urine beta 2－microglobulin in the control group were (0.27 ±0.05)g／L and (0.12 ±0.05)mg／L,respectively,which in the observation group were (0.26 ±0.06)g／L, (0.12 ±0.04)mg／L,respectively,there were no statistically significant differences between the two groups (t＝0.58, 0.63,all P＞0.05).After treatment,the 24－hour urinary protein quantification ,urine beta 2－microglobulin in the control group were (0.19 ±0.04)g／L,(0.08 ±0.04)mg／L,respectively,which in the observation group were (0.14 ± 0.03)g／L,(0.06 ±0.03) mg／L, respectively, the indicators of proteinuria in both two groups were significantly improved (t＝3.97,4.38,all P＜0.05),and the indicators of proteinuria in the observation group were significantly improved compared with the control group (t＝3.84,3.99,all P＜0.05).Before treatment,the serum creatinine and urea nitrogen levels in the control group were (150.97 ±23.82)μmol／L,(13.57 ±2.24) mmol／L,respectively,which in the observation group were (162.73 ±21.75) g／L,(14.05 ±2.31) mmol／L,respectively,there were no statistically significant differences in renal function between the two groups (t＝1.02,0.93,all P＞0.05).After treatment,the levels of serum creatinine and urea nitrogen in the control group were ( 122.38 ±18.34 ) μmol／L, ( 8.72 ± 0.71)mmol／L,respectively,which in the observation group were (101.41 ±15.64) g／L,(5.11 ±0.68) mmol／L, respectively,and the indicators of renal function in both two groups were significantly improved (t＝5.31,6.47,4.92, 6.33,all P＜0.05).The indicators of renal function in the observation group were significantly improved compared with the control group ( t＝4.96,5.14,all P＜0.05).Before treatment,the levels of TNF －αand IL －6 in the control group were (28.28 ±4.75) ng／L,(17.13 ±4.46) ng／L,respectively,which in the observation group were (27.87 ±4.81)ng／L,(16.98 ±4.27) ng／L,respectively,there were no statistically significant differences in IL －6 and TNF－αlevels between the two groups (t＝0.86,0.97,all P＞0.05).After treatment,the levels of TNF－αand IL－6 in the control group were (19.72 ±4.21)ng／L,(14.35 ±3.25) ng／L,respectively,which in the observation group were (14.61 ±3.18)ng／L,IL－6 (11.28 ±3.09)ng／L,respectively,the levels of TNF－αand IL－6 in the two groups were significantly improved (t＝5.83,8.24,4.66,7.38,all P＜0.05).The levels of TNF－αand IL－6 in the observation group were significantly improved compared with the control group (t＝4.32,3.89,all P＜0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups ( P＞0.05).Conclusion Alprostadil combined with Tripterygium wilfordii polyglycosides can significantly improve the clinical efficacy of diabetic nephropathy ,with fewer adverse reactions and high safety ,which may be related to its ability to regulate the expression of serum TNF －αand IL－6.

Therapeutic effect of insulin pump combined alprostadil on diabetic peripheral neuropathy in aged pa-tients / 心血管康复医学杂志

Objective :To explore therapeutic effect of insulin pump combined alprostadil on diabetic peripheral neu-ropathy (DPN) in aged patients .Methods : A total of 134 aged DPN patients treated in our hospital were selected and randomly , equally divided into routine treatment group and combined treatment group (received insulin pump combined alprostadil based on routine treatment ) ,both groups were treated for two weeks .Therapeutic effect ,lev-els of blood lipids ,serum superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) before and after treat-ment were compared between two groups .Results : After treatment , total effective rate of combined treatment group was significantly higher than that of routine treatment group (92-5% 比74-6%, P＝0-005).Compared with routine treatment group after treatment ,there were significant rise in serum levels of SOD [ (78-54 ± 9-48) nU／ml vs.(88-29 ± 9-08) nU／ml] ,GSH-Px [(486-53 ± 32-84) U／L vs.(552-31 ± 89-86) U／L] and high density lipopro-tein cholesterol [HDL-C ,(5-88 ± 1-48) mmol／L vs.(6-59 ± 1-63) mmol／L] ,and significant reductions in serum levels of triglyceride [TG ,(2-05 ± 0-34) mmol／L vs.(1-35 ± 0-26) mmol／L] and low density lipoprotein choles-terol [LDL-C ,(3-48 ± 0-48 ) mmol／L vs.(2-48 ± 0-88 ) mmol／L ] in combined treatment group , P＝ 0-001 all. Conclusion : Insulin pump combined alprostadil possess significant therapeutic effect on aged DPN patients .It can significantly improve blood lipid levels ,and relieve oxidative stress state ,which is worth extending .

Therapeutic effect of Rhodiola grandiflora combined alprostadil on acute coronary syndrome and its in‐fluence on blood lipid levels／ / 心血管康复医学杂志

Objective :To study therapeutic effect of Rhodiola grandiflora combined alprostadil on acute coronary syn‐drome (ACS) and its influence on blood lipid levels .Methods : A total of 104 ACS patients ,who were treated in our hospital from Jul 2016 to Sep 2017 ,were selected ,randomly and equally divided into alprostadil group (received al‐prostadil injection based on routine treatment ) and combined treatment group (received Rhodiola grandiflora injec‐tion based on alprostadil group ) ,both groups were treated for two weeks .LVEDd ,LVEF ,levels of blood lipid :TC ,TG ,HDL‐C ,LDL‐C ,serum high sensitive C reactive protein (hsCRP ) ,interleukin 6 (IL‐6) and monocyte chemoattractant protein‐1 (MCP‐1) before and after treatment ,total effective rate and incidence of adverse reac‐tions were observed and compared between two groups .Results : After two‐week treatment ,total effective rate of combined treatment group was significantly higher than that of alprostadil group (94.23% vs .78. 85%) , P＝0.022. Compared with before treatment ,after two‐week treatment ,there were significant reductions in LVEDd , levels of TC ,TG ,LDL‐C ,serum hsCRP ,IL‐6 and MCP‐1 ,and significant rise in LVEF and HDL‐C level in two groups , P＜0.05 or ＜0. 01. Compared with alprostadil group after two‐week treatment ,there were significant re‐ductions in LVEDd [ (58.07 ± 6. 14) mm vs.(55.12 ± 5. 06) mm] ,levels of TC [ (5.63 ± 0.94) mmol／L vs.(4. 75 ± 0.81) mmol／L] , TG [ (2. 78 ± 0.54) mmol／L vs.(2. 16 ± 0.47) mmol／L] , LDL‐C [ (3. 28 ± 0.57) mmol／L vs.(2.56 ± 0. 42) mmol／L] ,serum hsCRP [ (6.27 ± 1. 14) mg／L vs .(5. 39 ± 0. 96) mg／L] , IL‐6 [ (7.85 ± 1. 47) ng／L vs .(6. 82 ± 1. 30) ng／L] and MCP‐1 [ (113.74 ± 19.62) ng／L vs.(94.36 ± 16.58) ng／L] ,and significant rise in LVEF [(45.74 ± 8.48)% vs.(50.78 ± 8.34)%] and HDL‐Clevel [(2.36 ± 0. 52) mmol／L vs.(2. 93 ± 0. 57) mmol／L] in combined treatment group , P＜0.01 all.During treatment ,there was no significant difference in inci‐dence rate of adverse reactions between two groups , P＝0. 539. Conclusion :Rhodiola grandiflora combined alpros‐tadil possesses significant therapeutic effect on ACS .It can significantly improve cardiac function ,regulate blood lipid metabolism and reduce inflammation with low incidence of adverse reactions ,which is worth extending .

Effect of alprostadil on myocardial microcirculation and hemorheology in patients with coronary heart disease / 中国基层医药

Objective To investigate the clinical effect of alprostadil in the treatment of coronary heart disease and its effect on myocardial microcirculation and hemorheology.Methods From January 2015 to October 2017,100 patients with coronary heart disease admitted to the First People's Hospital of Wenling were randomly divided into two groups according to the digital table,with 50 cases in each group.The control group was treated with routine therapy.The observation group was treated with alprostadil on the basis of routine treatment.The clinical efficacy,myocardial microcirculation index and hemorheology index were compared between the two groups.Results The total effective rate of the observation group was 96％ (48/50),which was higher than 82％ (41/50) of the control group,and the difference between the two groups was statistically significant (x2 =5.005,P ＜ 0.05).After treatment,the cardiac troponin Ⅰ and myocardial troponin T in the observation group were (0.023 ±0.014)μg/L,(0.012 ±0.006)μg/L,respectively,which in the control group were (0.037 ± 0.015) μg/L,(0.019 ± 0.008) μg/L,respectively,the differences between the two groups were statistically significant (t =4.825,4.950,all P ＜ 0.05).The erythrocyte hematocrit,plasma viscosity,erythrocyte sedimentation rate,erythrocyte electrophoresis time in the observation group were (25.69 ± 3.87) ％,(293.42 ± 12.73) s,(15.21 ± 4.59) mm/h,(1.29 ± 0.37) mp/s,respectively,which in the control group were (32.54 ± 4.52) ％,(326.17 ± 18.65) s,(21.85 ± 5.93) mm/h,(1.76 ± 0.43) mp/s,respectively,the differences between the two groups were statistically significant (t =8.140,10.256,6.261,10.256,all P ＜ 0.05).Conclusion Alprostadil in the treatment of coronary heart disease can improve the clinical efficacy and improve the patients'myocardial microcirculation and hemorheological indicators.

Alprostadil attenuates myocardial ischemia/reperfusion injury by promoting antioxidant activity and eNOS activation in rats

Abstract Purpose: To investigate the effect of alprostadil on myocardial ischemia/reperfusion (I/R) in rats. Methods: Rats were subjected to myocardial ischemia for 30 min followed by 24h reperfusion. Alprostadil (4 or 8 μg/kg) was intravenously administered at the time of reperfusion and myocardial infarct size, levels of troponin T, and the activity of creatine kinase-MB (CK-MB) and lactate dehydrogenase (LDH) in the serum were measured. Antioxidative parameters, nitric oxide (NO) content and phosphorylated endothelial nitric oxide synthase 3 (p-eNOS) expression in the left ventricles were also measured. Histopathological examinations of the left ventricles were also performed. Results: Alprostadil treatment significantly reduced myocardial infarct size, serum troponin T levels, and CK-MB and LDH activity (P<0.05). Furthermore, treatment with alprostadil significantly decreased malondialdehyde (MDA) content (P<0.05) and markedly reduced myonecrosis, edema and infiltration of inflammatory cells. Superoxide dismutase and catalase activities (P<0.05), NO level (P<0.01) and p-eNOS (P<0.05) were significantly increased in rats treated with alprostadil compared with control rats. Conclusion: These results indicate that alprostadil protects against myocardial I/R injury and that these protective effects are achieved, at least in part, via the promotion of antioxidant activity and activation of eNOS.

The protective effect of Papaverine and Alprostadil in rat testes after ischemia and reperfusion injury

ABSTRACT Objective: To investigate the effect of papaverine and alprostadil on testicular torsion-detorsion injury in rats. Materials and Methods: A total of 40 male Wistar-Albino rats were used in this study. Four hours of right testicular torsion was applied to each group, excluding sham oper- ated group. The torsion-detorsion (T/D), T/D + papaverine and T/D + alprostadil groups received saline, papaverine and alprostadil at the same time as surgical detorsion, respectively. At 14 days after the surgical detorsion, ischaemic changes and the degree of damage were evaluated with Cosentino scoring and the Johnson tubular biopsy score (JTBS). Results: JTBS was determined as 8.8±2.7 in the Sham group, 5.08±1.9 in the T/D+papaverine group, 5.29±2.3 in the T/D +alprostadil group and 2.86±1.9 in the TD group. The JTBS was determined to be statistically significantly high in both the T/D + papaverine group and the T/D + alprostadil group compared to the T/D group (p=0.01, p=0.009). In the T/D + papaverine group, 3 (43%) testes were classified as Cosentino 2, 3 (43%) as Cosentino 3 and 1 (14%) as Cosentino 4. In the T/D +alprostadil group, 5 (50 %) testes were classified as Cosentino 2, 3 (30 %) as Cosentino 3 and 2 (20%) as Cosentino 4. Conclusion: The present study indicated that spermatic cord administration of alprostadil and papaverine showed a protective effect against ischemia/reperfusion injury after right-side testes torsion and histological changes were decreased after testicular ischemia reperfusion injury.

Alprostadil Combined with Bailing Capsule in the Treatment of 46 Case of Early Stage Chronic Kidney Disease / 医药导报

Objective To explore the efficacy of alprostadil combined with Bailing capsule in the treatment of early chronic kidney disease. Methods A total of 94 early stage chronic kidney disease patients were selected and divided into treatment group(n=46) and control group(n=48).The patients in control group were treated with Bailing capsule,5 capsules, tid,po.The patients in treatment group were treated with Bailing capsule combined with 2 mL alprostadil in 20 mL 0.9% sodium chloride injection,intravenous injection,qd.The patients were treated for 4 weeks as a course of treatment in both groups.After 2 courses of treatment,the improvement of renal function,the changes in cytokine levels including NK cells and T cell subsets CD+3, CD+4,CD+8,adverse reactions of two groups were observed. Results The effective rates of the control group and the treatment group were 60.42%,91.30%,respectively(P<0.05).The renal function index 24 h urine protein were(1.15± 0.35) g,serum creatinine were(78.52±10.63) μmol·L-1,urea nitrogen were(8.23±1.65) mmol·L-1,all of which were decreased significantly (P<0.05).The levels of NK cells were(21.89±2.73)%,T cell subsets CD+3were(71.02±5.61)%,CD+4were(38.84±3.52)%, CD+4/CD+8were(1.28 ± 0.14),which were increased significantly,while the level of CD+8were(30.21± 3.03)% was decreased significantly(P<0.05).There was no significant difference between two groups in the adverse reactions(P>0.05). Conclusion The combination of alprostadil and Bailing capsule is effective to early stage chronic kidney disease by improving the renal function and regulating the level of cytokines.

Effect of alprostadil on wound healing of scalded rats and the mechanism / 中华烧伤杂志

Objective@#To explore effect of alprostadil on wound healing of scalded rats and the mechanism.@*Methods@#According to random number table method, forty-eight Sprague Dawley rats were divided into sham scald group, simple scald group, lithium chloride group, and alprostadil group, with 12 rats in each group. Rats in sham injury group were sham injured on the back, and rats in the other three groups were inflicted with 30% total body surface area deep partial thickness scald on the back.Immediately after scald, rats in sham scald group and simple scald group were injected with 1 mL saline through caudal vein, and rats in lithium chloride group and alprostadil group were injected respectively with 1 mL lithium chloride and alprostadil through caudal vein. Saline, lithium chloride, and alprostadil were injected once in a day and lasted for 14 days. General wound appearance and wound healing rate on post scald day (PSD) 7, 10, 14 were observed and calculated. Expressions of protein and mRNA of Wnt1 and β-catenin on PSD 14 were detected. Data were processed with analysis of variance of factorial design, one-way analysis of variance, Student Newman Keuls q test, t test, and Bonferroni correction.@*Results@#(1) On PSD 7, wounds of scalded rats in each group formed dry eschar and had little exudation. On PSD 10, wounds of rats in simple scald group were covered with eschar, with little exudation, and wounds of rats in lithium chloride group were covered with eschar, and partial wounds healed under the eschar. On PSD 10, partial eschar of rats in alprostadil group desquamated; partial wounds healed; newly burned skin was ruddy. On PSD 14, partial wounds of rats in simple scald group were healed under eschar with little exudation. On PSD 14, most of the eschar of rats in lithium chloride group were desquamated with patial wounds healed and little exudation. On PSD 14, wounds of rats in alprostadil group were basically healed with vigorously growing hair on the back. (2) On PSD 7, the wound healing rates of rats in simple scald group, lithium chloride group, and alprostadil group were close (F=0.41, P>0.05). On PSD 10 and 14, wound healing rate of rats in lithium chloride group and alprostadil group were significantly higher than that in simple scald group (q=5.73, 17.45, 26.30, 11.28, P<0.05), and wound healing rate of rats in alprostadil group was significantly higher than that in lithium chloride group (q=32.03, 28.73, P<0.05). (3) On PSD 14, the mRNA expressions of Wnt1 and β-catenin of rats in lithium chloride group and alprostadil group were significantly higher than those in simple scald group (q=65.40, 19.16, 66.79, 18.41, P<0.05), and the mRNA expressions of Wnt1 and β-catenin of rats in simple scald group was significantly higher than those in sham scald group (t=14.86, 4.46, P<0.05). (4) On PSD 14, the protein expressions of Wnt1 and β-catenin of rats in lithium chloride group and alprostadil group were 0.98±0.05, 0.98±0.06, 0.97±0.06, and 1.00±0.06, which were significantly higher than 0.49±0.04 and 0.66±0.04 of rats in simple scald group (q=34.62, 22.38, 33.61, 23.47, P<0.05). On PSD 14, the protein expressions of Wnt1 and β-catenin of rats in simple scald group was significantly higher than 0.29±0.03 and 0.31±0.03 of rats in sham scald group (q=14.73, 23.88, P<0.05).@*Conclusions@#Alprostadil can accelerate wound healing through activating Wnt/β-catenin signal pathway and upregulating the expressions of Wnt1 and β-catenin.

Effects of Alprostadil Dried Emulsion for Injection Combined with Butylphthalide Soft Capsules on Nerve Function,Inflammatory Factor and Coagulation Function of Patients with Severe Ischemic Stroke / 中国药房

OBJECTIVE:To observe the effects of Alprostadil dried emulsion for injection combined with Butylphthalide soft capsules on nerve function,inflammatory factor and coagulation function of patients with severe ischemic stroke. METHODS:A total of 66 patients with severe ischemic stroke selected from our hospital during Jun. 2015-Oct. 2017 were divided into control group and observation group according to random number table,with 33 cases in each group. On the basis of routine treatment, control group was additionally given Butyphthalide soft capsules 0.2 g/time,orally at fasting state,tid. On the basis of control group,observation group was additionally given Alprostadil dried emulsion for injection 10 μg added into 0.9% Sodium chloride injection 10 mL,via slow infusion or slow dripping with pipkin,qd. Both groups were treated for 14 days. NIHSS and Barthel index scores,the levels of serum inflammatory factors(CRP,PCT)and coagulation function indexes(D-D,TT,PT,APTT, FIB)were observed in 2 groups before and after treatment,and the occurrence of ADR was also recorded. RESULTS:Before treatment,there was no statistical significance in above indexes between 2 groups(P>0.05).After treatment,NIHSS scores,the levels of CRP,PCT,D-D and FIB in 2 groups were deceased significantly,while Barthel index scores were increased significantly,TT,PT,APTT were prolonged significantly;observation group was significantly better than control group,with statistical significance(P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Alprostadil dried emulsion for injection combined with Butylphthalide soft capsules can effectively improve nerve function and coagulation function of patients with severe ischemic stroke,and reduce the levels of inflammatory factor with good safety.

Therapeutic effect of creatine phosphate sodium combined alprostadil injection on acute-exacerbation CHF and its influence on serum NT-proBNP level / 心血管康复医学杂志

Objective: To explore therapeutic effect of creatine phosphate sodium (CP) injection combined alprostadil injection on acute-exacerbation chronic congestive heart failure (CHF) and its influence on serum level of N terminal pro B-type natriuretic peptide (NT-proBNP). Methods: A total of 120 acute-exacerbation CHF patients treated in our hospital were selected. According to random number table, they were randomly and equally divided into CP group (received CP injection based on routine treatment) and combined treatment group (received alprostadil injection based on CP group), and both groups were treated for two weeks. Cardiac output (CO), stroke volume (SV), left ventricular ejection fraction (LVEF), left ventricular end-diastolic dimension (LVEDd) and serum NT-proBNP level before and after treatment, total effective rate and incidence rate of adverse reactions were measured and compared between two groups. Results: Compared with before treatment, after two-week treatment, there were significant rise in CO, SV and LVEF, and significant reduction in LVEDd in two groups except CO of CP group (P=0. 001 all); compared with CP group, after two-week treatment, there were significant rise in CO [(4. 9±1. 5) L vs. (5. 6±1. 6) L], SV [(70. 6±7. 5) ml vs. (79. 2±7. 6) ml]and LVEF [(42. 9±7. 6) ％ vs. (49. 3±8. 6) ％], and significant reduction in LVEDd [(58. 4±5. 3) mm vs. (43. 6±5. 5) mm]in combined treatment group, P＜0. 05 or＜0. 01. Compared with before treatment, there was significant reduction in serum NT-proBNP level in two groups on one and two weeks after treatment, and those of after two weeks were significantly lower than those of after one week, P=0. 001 all. Compared with CP group, after one-week and two-week treatment, there was significant reduction in serum NT-proBNP level [after one week: (708. 6±137. 6) ng/L vs. (611. 4±121. 4) ng/L, after two weeks: (573. 9±132. 9) ng/L vs. (359. 1±114. 2) ng/L]in combined treatment group, P=0. 001 all. Total effective rate of combined treatment group was significantly higher than that of CP group (95. 0％ vs. 81. 7％), P=0. 023. There was no significant difference in incidence rate of adverse reactions between two groups, P=0. 675. Conclusion: CP combined alprostadil can significantly improve cardiac function and total effective rate in acute-exacerbation CHF patients, which is worth extending.

Effects of alprostadil on oxidative stress in contrast-induced nephropathy in patients with chronic kidney disease / 实用放射学杂志

Objective To investigate the anti-oxidative effects of alprostadil on contrast-induced nephropathy(CIN)after percuteous coronary intervention (PCI)in patients with chronic kidney disease(CKD).Methods A total of 200 patients with CKD were enrolled in our hospital.According to the random number table was divided into alprostadil 100 cases,100 cases of conventional treatment group.The levels of serum creatinine (Scr),creatinine clearance (eGFR),serum cystatin C (ScysC)and 8-hydroxy-deoxyguanine (8-OHdG)were observed before and after operation at 72 h and 7 d after operation.Results The incidence of CIN in the alprostadil group was significantly lower than that in the conventional treatment group (6% vs 12%,P<0.05).There was no significant difference in the level of Scr,eGFR,ScysC and 8-OHdG between the alprostadil group and the conventional treatment group (P>0.05).The level of Scr in the alprostadil group was significantly lower than that in the conventional treatment group at 72 h and 7 d after operation.The level of eGFR was significantly higher than that of the conventional treatment group (P<0.05).The levels of ScysC and 8-OHdG in the two groups were significantly higher than those before operation at 72 h and 7 d(P>0.05).The levels of ScysC and 8-OHdG in the alprostadil group were significantly lower than those in the conventional treatment group at 72 h and 7 d after PCI(P<0.05).Conclusion Alprostadil may improve the oxidative stress in patients with CKD and provide a preventive effect on CIN.

Effect of alprostadil on microcirculation after the resuscitation in patients with septic shock / 解放军医学杂志

Objective To evaluate the effect of alprostadil on the microcirculation and mortality after the fluid resuscitation in patients with septic shock.Methods The patients who met the criteria of septic shock admitted to our hospital from March 2015 to September 2016 were selected as the subjects.After the shock resuscitation reached the standard,they were randomly divided into control group and alprostadil group.Control group was given a standard treatment.On the basis of standard treatment,alprostadil group was given alprostadil 10μg/d plus tube.The heart rate,mean arterial pressure (MAP),central venous pressure (CVP),lactic acid (Lac) and urine volume were recorded at 0,1,3 and 7 days.The microcirculation index under the tongue including small vessel density (TvDs),perfused small microvessel density (PvDs),small vessel perfusion ratio (PPVs),microvascular flow index (MFI) and heterogeneity index (HI) were recorded at 0,6,24 and 72h.The patients' hospitalization time in ICU,total hospitalization time and mortality rate of follow-up 28 days were recorded.Results Forty-eight patients were enrolled in this study,of which 23 were in control group and 25 in alprostadil group.The heart rate and MAP had no significant changes in alprostadil group,but the CVP decreased significantly compared with control group (P＜0.05) at 1,3,7 days after the treatment,and urine volume increased at 3 and 7 days in the alprostadil group (P＜0.05);but TvDs did not increase at 6 and 24h in the two groups,while PvDs,PPVs,MFI,HI increased at 6,24 and 72h in the two groups,with a higher value at 24 and 72h than the 6h.The 72-h indexes were significantly higher in alprostadil group than in control group (P＜0.05).The mechanical ventilation (MV) was significantly lower in alprostadil group than in control group (P＜0.05);ICU hospitalization time and total hospitalization time was significantly shorter in alprostadil group than in control group (P＜0.05).The hospital mortality and 28-day mortality were lower in alprostadil group than in control group (P＜0.05).Conclusions Alprostadil could significantly improve the microcirculation and urine volume in the patients after resuscitation for septic shock,with little effect on systemic circulation,effectively improve the prognosis of patients,and shortening the mechanical ventilation time,ICU stay time and total hospitalization time,thus reducing the mortality rate.

Effect of prostaglandin E1 on propofol-induced neuroapoptosis in hippocampus of newborn rats / 中华麻醉学杂志

Objective To evaluate the effect of prostaglandin E1 (PGE1) on propofol-induced neuroapoptosis in hippocampus of newborn rats.Methods Thirty-six clean-grade healthy newborn SpragueDawley rats,aged 7 days,weighing 11-16 g,were divided into 3 groups (n=12 each) using a random number table method:control group (group C),propofol group (group P) and group PGE1.Propofol 75 mg/kg was intraperitoneally injected once every other day for 7 consecutive days in P and PGE1 groups.PGE1 10 μg/kg was injected via the tail vein at 30 min before each injection of propofol in group PGE1.Normal saline 3 ml/kg was intraperitoneally injected once every other day for 7 consecutive days in group C.The rats were sacrificed at 60 min after emergence from the last injection.The hippocampi were harvested for determination of neuroapoptosis (by TUNEL),expression of caspase-3,Bcl-2 and Bax (by Western blot),and contents of intedeukin-1bota (IL-1β),IL-6 and tumor necrosis factor-alpha (TNF-α) (by enzyme-linked immunosorbont assay).Results Compared with group C,the contents of hippocampal IL-1β,IL-6 and TNF-α were significantly increased,apoptosis index was increased,the expression of caspase-3 and Bax was up-regulated,and the expression of Bcl-2 was down-regulated in P and PGE1 groups (P＜0.05).Compared with group P,the contents of hippocampal IL-1β,IL-6 and TNF-α were significantly decreased,apoptosis index was decreased,the expression of caspase-3 and Bax was down-regulated,and the expression of Bcl-2 was up-regulated in group PGE1 (P＜0.05).Conclusion PGE1 can reduce propofol-induced neuroapoptosis in hippocampus of newborn rats,and the mechanism may be related to inhibiting inflammatory responses of the hippocampus.

Clinical effect of alprostadil combined with Kudiezi injection in the treatment of posterior circulation ischemic vertigo and its effect on levels of Iysophosphatidic acid, acidic phospholipid / 中国基层医药

Objective To explore the clinical effect of alprostadil combined with Kudiezi injection in the treatment of posterior circulation ischemic vertigo,and its effect on levels of lysophosphatidic acid (LPA),acidic phospholipid (AP).Methods From October 2015 to October 2017,92 cases of posterior circulation ischemia in the Affiliated Hospital of Medical College were selected and randomly divided into observation group(n =46) and control group(n =46) according to the digital table.The control group was treated with Kudiezi injection,while the observation group was treated with alprostadil combined with Kudianzi injection.The clinical efficacy and LPA,AP levels before and after treatment were compared between the two groups.Results After treatment,the total effective rate in the observation group was 95.65％,which in the control group was 82.61％,there was statistically significant difference between the two groups(x2 =8.622,P ＜0.05).After treatment,Vm and Vs of bilateral vertebrobasilar artery in both two groups were increased more rapidly than those before treatment(observation group:t =14.041,11.124,11.207,10.057,10.925,11.920;control group:t =7.204,7.057,8.145,6.572,6.581,5.481,all P ＜ 0.05).Compared with the control group,the Vm [(34.24 ± 3.04) cm/s,(30.54 ± 3.33) cm/s,(35.42 ± 3.46) cm/s] and Vs[(40.09 ± 5.14) cm/s,(40.24 ± 5.02) cm/s,(43.14 ± 4.97) cm/s] of bilateral vertebrobasilar artery in the observation group were significantly higher (t =7.825,4.581,8.610,7.256,7.017,5.824,all P ＜ 0.05).After treatment,the levels of LPA and AP in the two groups were significantly lower than those before treatment(observation group:t =18.054,17.259;control group:t =17.651,14.254,all P ＜ 0.05).The levels of LPA and AP in the control group [(1.75 ± 0.52) μmol/L,(2.42 ± 0.51) μmol/L] were significantly higher than those in the observation group [[(1.05 ± 0.28) μmol/L,(1.84 ± 0.48) μmol/L] (t =8.571,7.224,all P ＜ 0.05).Before treatment,the number of white blood cells in two groups were (6.23 ±0.54) × 109/L,(6.68 ±0.57) × 109/L,respectively,which after treatment were (6.57 ±0.61) × 109/L,(6.42 ±0.64) × 109/L,respectively,there was no statistically significant difference in leukocyte count between the two groups before and after treatment(all P ＜ 0.05).During the treatment,there was no obvious adverse reaction in the two groups.Conclusion Alprostadil combined with Kudiezi injection in the treatment of circulatory ischemic vertigo has excellent clinical effect,there are no adverse reactions such as leukopenia occurred and the safety is good.

Effect of alprostadil on serum bone morphogenetic protein 7 and transforming growth factor-β1 in patients with diabetic nephropathy / 中国基层医药

Objective To investigate the clinical efficacy of alprostadil in the treatment of diabetic nephropathy,and its effect on serum bone morphogenetic protein 7(BMP-7)and transforming growth factor-β1(TGF-β1)levels in patients.Methods From January 2014 to January 2016,120 cases of diabetic nephropathy in the People's Hospital of Beilun District were selected in the study.According to different treatment methods,the patients were divided into study group and control group,with 60 cases in each group.The two groups were treated with basic treatment,the study group was treated with alprostadil for 8 weeks.The clinical efficacy and serum levels of BMP-7 and TGF-β1 were compared between the two groups.Results There were no significant differences in serum BMP-7 and TGF-β1 between the two groups before treatment(P>0.05).After treatment,the serum BMP-7[(17.54 ±3.90)pg/mL]in the study group was higher than that in the control group [(15.20 ±2.96)pg/mL](t=3.607,P<0.05),the level of TGF-β1[(7786.3 ±1951.2)pg/mL]was lower than that of the control group [(10021.5 ±2109.7)pg/mL](t=6.025,P<0.05).There were no significant differences in the levels of fasting blood glucose(FBG),total cholesterol(TC),triglyceride(TG)and glycosylated hemoglobin(HbA1c)between the two groups(all P >0.05).After treatment,the levels of UAER,Hcy,Scr,BUN in the study group were(89.62 ±17.74)g/min,(23.55 ±4.17)mol/L,(64.2 ±8.5)mol/L,(6.70 ±0.96)mmol/L,which were significantly lower than those in the control group [(118.50 ± 21.18)g/min,(29.69 ±4.82)mol/L,(74.7 ±9)mol/L,(7.52 ±0.89)mmol/L](t=8.097,7.462,6.57,4.852,all P<0.05).Conclusion Alprostadil has better clinical effect on diabetic nephropathy,and can significantly improve serum BMP-7 and TGF-β1 levels.