AIM:To investigate the effect of lacidipine,thiamine pyrophosphate(TPP)and the combination of lacidipine and TPP against oxidative and inflammatory eye damage induced by bilateral common carotid artery ligation in rat...AIM:To investigate the effect of lacidipine,thiamine pyrophosphate(TPP)and the combination of lacidipine and TPP against oxidative and inflammatory eye damage induced by bilateral common carotid artery ligation in rats.METHODS:Male albino Wistar rats were categorized as those who underwent sham surgery(SG),right and left common carotid cross-clamping and unclamping procedure(CCU),lacidipine+CCU(LCCU),TPP+CCU(TCCU),and combination of lacidipine and TPP(LTC)+CCU(LTCCU).One hour before anesthesia,the LCCU(n=6)received lacidipine(4 mg/kg,orally)and the TCCU(n=6)received TPP(20 mg/kg,intraperitoneally).The SG(n=6)and CCU(n=6)received the same volume of distilled water from the same route.After anesthesia(60 mg/kg ketamine,intraperitoneally),the necks of the rats were opened in the midline.Ischemia was created for 10min by placing clips on the right and left common carotid arteries.Rats in the SG only underwent subcutaneous incision.After 10min,the clips were removed and reperfusion was achieved for six days.Then,the animals were euthanized(120 mg/kg ketamine,intraperitoneally)and the levels of oxidant,antioxidant and proinflammatory cytokines in the eye tissues were determined.The retinal tissue of the eye was also examined histopathologically.RESULTS:Lacidipine,TPP,and LTC significantly prevent the increase in malondialdehyde,tumor necrosis factoralpha,interleukin-1β(IL-1β),and IL-6 levels,decrease in total glutathione levels,superoxide dismutase and catalase activities and histopathological retinal damage in eye tissue induced by bilateral common carotid artery ligation in rats.The impact of these drugs on protection is determined to be LTC>lacidipine>TPP.CONCLUSION:As a result of the study,it is concluded that LTC may be more effective than lacidipine and TPP alone in treating ocular ischemic syndrome.展开更多
Important efforts have been made over the past years to improve the drug acts,which leads to the discovery of novel drug preparations and delivery systems.The optimal design of such processes requires a molecular-leve...Important efforts have been made over the past years to improve the drug acts,which leads to the discovery of novel drug preparations and delivery systems.The optimal design of such processes requires a molecular-level understanding of the interactions between drug molecules and biological membranes.The thermodynamic investigation provides deep and complete knowledge of interactions and the choice of appropriate and suitable production compounds in pharmaceutical fields.Particularly,the analysis of drugs+co-solvents in aqueous media is the central issue in many types of research because they exert their impact by interacting with biological membranes.This work is aimed to measure the density and speed of sound for the thiamine hydrochloride in water+deep eutectic solvents(DESs)mixtures(choline chloride/urea,choline chloride/ethylene glycol and choline chloride/glycerol)at temperature range(293.15-308.15)K.By correlation of the evaluated parameters in some standard relations,the partial molar parameters i.e.apparent molar volumes,Vφ,m,and apparent molar isentropic compression,κ_(s,φ,m),are calculated.In addition,apparent molar isobaric expansion,E^(0)_(φ,m),and Hepler’s constant are computed from the density and speed of sound data.For fitting the experimental Vφ,m andκ_(s,φ,m)the Redlich-Meyer equation was employed that the important quantities;standard partial molar volume,V^(0)_(m),and partial molar isentropic compression,κφ,m0,were obtained.The thermodynamic analysis of the studied system also plays a crucial role in the pharmaceutical industry.展开更多
Growing prevalence of diabetes(type 2 as well as type 1) and its related morbidity due to vascular complications creates a large burden on medical care worldwide. Understanding the molecular pathogenesis of chronic mi...Growing prevalence of diabetes(type 2 as well as type 1) and its related morbidity due to vascular complications creates a large burden on medical care worldwide. Understanding the molecular pathogenesis of chronic micro-, macro- and avascular complications mediated by hyperglycemia is of crucial importance since novel therapeutic targets can be identified and tested. Thiamine(vitamin B1) is an essential cofactor of several enzymes involved in carbohydrate metabolism and published data suggest that thiamine metabolism in diabetes is deficient. This review aims to point out the physiological role of thiamine in metabolism of glucose and amino acids, to present overview of thiamine metabolism and to describe the consequences of thiamine deficiency(either clinically manifest or latent). Furthermore, we want to explain why thiamine demands are increased in diabetes and to summarise data indicating thiamine mishandling in diabetics(by review of the studies mapping the prevalence and the degree ofthiamine deficiency in diabetics). Finally, we would like to summarise the evidence for the beneficial effect of thiamine supplementation in progression of hyperglycemia-related pathology and, therefore, to justify its importance in determining the harmful impact of hyperglycemia in diabetes. Based on the data presented it could be concluded that although experimental studies mostly resulted in beneficial effects, clinical studies of appropriate size and duration focusing on the effect of thiamine supplementation/therapy on hard endpoints are missing at present. Moreover, it is not currently clear which mechanisms contribute to the deficient action of thiamine in diabetes most. Experimental studies on the molecular mechanisms of thiamine deficiency in diabetes are critically needed before clear answer to diabetes community could be given.展开更多
This study aims at evaluating the performance of thiamine as a new eco-friendly shale inhibitor in water-based drilling fluids(WBDFs).The evaluation experiments include sedimentation,bentonite inhibition,filtration,ze...This study aims at evaluating the performance of thiamine as a new eco-friendly shale inhibitor in water-based drilling fluids(WBDFs).The evaluation experiments include sedimentation,bentonite inhibition,filtration,zeta potential,thermal gravimetric analysis,scanning electron microscopy,X-ray diffraction,shale cuttings recovery,linear swelling and Fourier transform infrared spectroscopy(FTIR).The performance of thiamine was compared to potassium chloride.In contrast to deionized water,the aqueous solution of thiamine exhibited greater power to inhibit montmorillonite(Mt)dispersion,much more Mt loading capacity(280 g/L)and fluid loss,lower Mt mass loss,larger aggregated Mt particles,lower interlayer space of the Mt particles,less shale cuttings disintegration and lower linear swelling.Adsorption of thiamine on Mt led to a significant shift in the value of zeta potential(from-17.1 to+8.54 mV).Thiamine demonstrated superior inhibitive performance than potassium chloride.FTIR analysis confirmed that thiamine is adsorbed on Mt particles.The compatibility test revealed the compatibility of thiamine with conventional WBDF additives.It was concluded that the main probable inhibition mechanisms of thiamine are the cation exchange and Mt surface coating.In view of its prominent inhibition capacity and great environmental acceptability,thiamine is a promising inhibitor for drilling in water-sensitive formations.展开更多
Sepsis and septic shock remain a major cause of morbidity and mortality among patients admitted in the intensive care unit.Diabetes is a major risk factor for the development of sepsis.The global mortality of sepsis r...Sepsis and septic shock remain a major cause of morbidity and mortality among patients admitted in the intensive care unit.Diabetes is a major risk factor for the development of sepsis.The global mortality of sepsis remains high,despite significant interventions and guidelines.It has been known for decades that patients with sepsis have reduced levels of antioxidants,most notably vitamin C.Furthermore,experimental data has demonstrated multiple beneficial effects of vitamin C in sepsis.In addition,corticosteroids and thiamine may have synergistic biological effects together with vitamin C.Preliminary data suggests that therapy with hydrocortisone,ascorbic acid and thiamine improves the outcome of patients with sepsis with the potential to save millions of lives.However,this intervention has met with much resistance and has not been widely adopted.Ultimately,we await the final jury verdict on this simple,safe and cheap intervention.展开更多
Objective To estimate the association between three B-vitamin intakes and sociodemographic factors among adults in China.Methods We derived our data from the China Health and Nutrition Survey(CHNS) among 12,241 indivi...Objective To estimate the association between three B-vitamin intakes and sociodemographic factors among adults in China.Methods We derived our data from the China Health and Nutrition Survey(CHNS) among 12,241 individuals aged 18–64 years. Log binomial regression was used to estimate adjusted prevalence ratios for factors associated with the inadequate intake of B-vitamins.Results Females with low incomes and living in the north had a higher prevalence of inadequate riboflavin intake than those with high incomes and living in the south. Both males and females living in a village had a higher prevalence of inadequate riboflavin intake than adults living in a city. Adults with low income, low education, and living in the north or in a village had a higher prevalence of inadequate niacin intake than adults with a high income, high education, and living in the south or in a city.Conclusion We found that income, region, and area of residence were associated with riboflavin intake. Education, income, region, and area of residence were associated with niacin intake. Welltailored strategies and policies are needed to improve nutritional status in China.展开更多
Myotonic dystrophy type 1,also known as Steinert's disease,is an autosomal dominant disorder with multisystemic clinical features affecting the skeletal and cardiac muscles,the eyes,and the endocrine system.Thiami...Myotonic dystrophy type 1,also known as Steinert's disease,is an autosomal dominant disorder with multisystemic clinical features affecting the skeletal and cardiac muscles,the eyes,and the endocrine system.Thiamine(vitamin B1) is a cofactor of fundamental enzymes involved in the energetic cell metabolism; recent studies described its role in oxidative stress,protein processing,peroxisomal function,and gene expression.Thiamine deficiency is critical mainly in the central and peripheral nervous system,as well as in the muscular cells.Our aim was to investigate the potential therapeutical effects of long-term treatment with thiamine in myotonic dystrophy type 1 in an observational open-label pilot study.We described two patients with myotonic dystrophy type 1 treated with intramuscular thiamine 100 mg twice a week for 12 or 11 months.We evaluated the patients using the grading of muscle strength according to Medical Research Council(MRC),the Muscular Impairment Rating Scale(MIRS),and the Modified Barthel index.High-dose thiamine treatment was well tolerated and effective in improving the motor symptomatology,particularly the muscle strength evaluated with the MRC scale,and the patients' activities of daily living using the Modified Barthel Index.At the end of treatment,the MRC score was 5 in the proximal muscles and 2–4 in the distal muscles(the MRC score before the treatment was 3–4 and 1–3,respectively).The MIRS grade improved by 25% compared to baseline for both patients.In patient #1,the Modified Barthel Index improved by 44%,and in patient #2 by 29%.These findings suggest that clinical outcomes are improved by long-term thiamine treatment.展开更多
AIM: To compare the effects of thiamine pyrophosphate(TPP) and thiamine(TM) in oxidative optic neuropathy in rats induced by ethambutol.METHODS: The animals were divided into four groups:a control group(CG),an ethambu...AIM: To compare the effects of thiamine pyrophosphate(TPP) and thiamine(TM) in oxidative optic neuropathy in rats induced by ethambutol.METHODS: The animals were divided into four groups:a control group(CG),an ethambutol control(ETC) group,TM plus ethambutol group(TMG),and TPP plus ethambutol group(TPPG).One hour after intraperitoneal administration of TM 20 mg/kg to the TMG group and TPP 20 mg/kg to TPPG group,30 mg/kg ethambutol was given via gavage to all the groups but the CG.This procedure was repeated once daily for 90 d.After that period,all rats were exposed to high levels of anaesthesia in order to investigate the gene expression of malondialdehyde and glutathione in removed optic nerve tissue and histopathologically to examine these tissues. RESULTS: Malondialdehyde gene expression significantly increased,whereas glutathione gene expression significantly decreased in the ETC group compared to the CG.TM could not prevent the increase of malondialdehyde gene expression and the decrease of glutathione,while TPP significantly could suppress.Histopathologically,significant vacuolization in the opticnerve,single-cell necrosis in the glial cells,and a decrease in oligodendrocytes were observed in the ETC group.Vacuolization in the optic nerve,a decrease in oligodendrocytes and single-cell necrosis were found in the TMG group,while no pathological finding was observed in the TPPG group except for mild vacuolization.CONCLUSION: TPP protects the optic nerve against the ethambutol-induced toxicity but TM does not.TPP can be beneficial in prophilaxis of optic neuropathy in ethambutol therapy.展开更多
The present data show a fast and efficient biological sample processing method for the extraction of thiamine (vitamin B1) and its mono-(TMP) and di-(TDP) phosphate esters from hippocampus, thalamus and prefrontal cor...The present data show a fast and efficient biological sample processing method for the extraction of thiamine (vitamin B1) and its mono-(TMP) and di-(TDP) phosphate esters from hippocampus, thalamus and prefrontal cortex (PFC) and blood sample of the rodents. In addition, using the hippocampus and standards of these three compounds we validated an isocratic fluorescence HPLC procedure for a simultaneous detection of them in a single chromatogram within a total run time of about 12 min. Reproducibility for TDP, TMP and B1 was 2.66%, 4.50% and 7.43% (intraday) and 37.54%, 25.39% and 25.87% (interday), respectively. Recovery assays were between 96.0% and 101.7%. The calibration curves were linear and the concentrations of the three compounds, all in nanomolar range, were determined in the brain areas and in the blood samples. When compared to the current methods in the literature, this new method provides information on essential variables, such as linearity range and limit of detection, reproducibility and stability of thiamine, TMP and TDP in rat brain samples. The present data on sample processing and B1 and its phosphate ester level determinations are the first to be validated using hippocampus samples of rats.展开更多
Rationale:Prolonged undernutrition may arise out of depression and lead to Wernicke's encephalopathy if timely diagnosis and intervention are missed.Wernicke's encephalopathy is potentially treatable,and appro...Rationale:Prolonged undernutrition may arise out of depression and lead to Wernicke's encephalopathy if timely diagnosis and intervention are missed.Wernicke's encephalopathy is potentially treatable,and appropriate treatment may revert clinical depression and cognitive dysfunction to some extent.Patient's concern:A 69-year-old female who had been taking escitalopram for one year developed tremor,ophthalmoplegia,ataxia,progressive cognitive decline,and convulsions.Diagnosis:Non-alcoholic Wernicke's encephalopathy and hypomagnesemia due to psychogenic anorexia.Interventions:High dose intravenous thiamine and magnesium were supplemented.Outcomes:The patient showed remarkable improvement in neurological complications and even in depressive features.Lessons:Wernicke's encephalopathy should not be ignored in the treatment of depression.展开更多
Our previous studies showed that 17β-estradiol (E2) modulated dopamine D2 receptor in regulating body weight set-point. The aim of this study was to understand whether thiamine deficiency influenced the E2 modulation...Our previous studies showed that 17β-estradiol (E2) modulated dopamine D2 receptor in regulating body weight set-point. The aim of this study was to understand whether thiamine deficiency influenced the E2 modulation on dopamine D2 receptors, using bromocriptine mesylate (BR) and sulpiride (SUL) as selective central dopamine-D2 receptors agonist and antagonist respectively. We studied the E2-dopamine D2 receptors interferences in a 10-day thiamine-deficient female rats for which consumptions of water, sugar, alcohol and food were daily-recorded and their consequences on body weights assessed. Our results showed that the volume of water daily ingested doubled in thiamine-deficient female rats (OXT), while sugar and alcohol consumptions collapsed with decreased weight and food consumption. On the one hand, thiamine potentiated D2/BR activity (bromocriptine-activated D2 receptors) to induce sugar intake and inhibited the same D2/BR receptors to induce water intake. On the other hand, thiamine promoted D2/SUL receptors (sulpiride-inhibited D2 receptors) for enhanced alcohol intake, increased food consumption and weight gain. Taking together, thiamine modulated the actions of 17β-estradiol on both D2/BR and D2/SUL receptors activities.展开更多
We discuss the safety and controversy regarding the administration of glucose before thiamine with regards to precipitation of Wernicke’s Encephalopathy in the severely malnourished and alcoholic patient population. ...We discuss the safety and controversy regarding the administration of glucose before thiamine with regards to precipitation of Wernicke’s Encephalopathy in the severely malnourished and alcoholic patient population. Herein we review clinical features, pathophysiology and the relevant literature to provide an evidenced-based recommendation that thiamine replacement should not delay glucose administration acutely in the malnourished patient population.展开更多
Objective: Patients with generalized anxiety disorder (GAD) are fearful. They constantly worried about minor matters, and they anticipate the worst. The GAD is diagnosed when a patient experiences excessive anxiety an...Objective: Patients with generalized anxiety disorder (GAD) are fearful. They constantly worried about minor matters, and they anticipate the worst. The GAD is diagnosed when a patient experiences excessive anxiety and worry for at least 6 months. The cause of GAD is unknown. In the present paper, we discuss patients with GAD who have low levels of thiamine in their bloods. We also discuss the role of thiamine in the pathogenesis and treatment of GAD. Methods: We examined 9 patients (6 males and 3 females) who met the DSM-IV-TR diagnostic criteria for GAD. These patients had no history of alcoholism. Their ages ranged from 57 to 83 years old (mean age –72.8 ± 2.9 years). All of the patients had low blood thiamine levels (mean –25.1 nmol/L ± 6.0 nmol/L;normal level—70 nmol/L - 180 nmol/L). Participants completed the Hamilton Anxiety Rating Scale (HARS) for anxiety before and after thiamine treatments. All of the patients received daily thiamine 100 mg intramuscularly. Results: Thiamine supplementation significantly improved HARS scores, increased both appetite and general well-being, and reduced fatigue in patients with GAD. Interestingly, these patients were able to discontinue taking anxiolytic and β-blocker medications. Conclusion: Parental thiamine significantly affects patients with GAD.展开更多
Background This study aimed to conduct a systematic review and meta-analysis of the efficacy of hydrocortisone,vitamin C,and thiamine(HVT)in patients with sepsis or septic shock.Methods A literature search was perform...Background This study aimed to conduct a systematic review and meta-analysis of the efficacy of hydrocortisone,vitamin C,and thiamine(HVT)in patients with sepsis or septic shock.Methods A literature search was performed in PubMed,Embase,Cochrane Library,and Web of Science from their inception to April 2021.Search terms included hydrocortisone,thiamine,vitamin C,sepsis,and septic shock.Only randomized controlled trials on HVT in treating sepsis and septic shock were analyzed.Risk ratio(RR)was generated using Review Manager 5.3 to evaluate binary variants,whereas mean±standard deviation(MD)was generated to assess continuous variants.Results A total of 7 randomized controlled trials,with 1233 patients,were included in this meta-analysis.There was no significant difference in long-term mortality(35.3%vs 33.2%;RR:1.07;95%confidence interval[95%CI]:0.90-1.27;P=0.45;I^(2)=0%),intensive care unit(ICU)mortality(17.4%vs 17.5%;RR:0.99;95%CI:0.75-1.30;P=0.95;I^(2)=0%),in-hospital mortality(27.4%vs 25.8%;RR:1.06;95%CI:0.84-1.34;P=0.63;I^(2)=0%),and acute kidney injury morbidity(RR:1.04;95%CI:0.91-1.18;P=0.60;I^(2)=0%)between HVT and control groups.For continuous variables,there was no significant effect of HVT therapy on delta Sequential Organ Failure Assessment(△SOFA)score(MD:−0.44;95%CI:−1.00 to 0.12;P=0.12;I^(2)=49%),length of ICU stay(MD:0.43;95%CI:−0.27 to 1.14;P=0.23;I^(2)=0%),and length of hospital stay(MD:0.80;95%CI:−0.38 to 1.97;P=0.18;I^(2)=0%).Only vasopressor duration was significantly reduced in the HVT group(MD:−17.75;95%CI:−25.56 to−9.94;P<0.00001;I^(2)=38%).Vasopressor duration refers to the time to shock reversal.Alternatively,it is the amount of time(in hours)required for patients to withdraw all vasoactive medication support.Neither HVT nor control△SOFA reached statistical significance.Conclusion Hydrocortisone,vitamin C,and thiamine use was not associated with improved mortality,lower acute kidney injury incidence,lower△SOFA,and shorter ICU and in-hospital stays among patients with sepsis and septic shock.However,the use of vasopressors decreased significantly.Further direct head-to-head studies are needed.展开更多
Biomimetic nanocarriers are emerging as efficient vehicles to facilitate dietary absorption of biomacromolecules. In this study, two vitamins, thiamine and niacin, are employed to decorate liposomes loaded with insuli...Biomimetic nanocarriers are emerging as efficient vehicles to facilitate dietary absorption of biomacromolecules. In this study, two vitamins, thiamine and niacin, are employed to decorate liposomes loaded with insulin, thus facilitating oral absorption via vitamin ligand–receptor interactions. Both vitamins are conjugated with stearamine, which works to anchor the ligands to the surface of liposomes.Liposomes prepared under optimum conditions have a mean particle size of 125–150 nm and an insulin entrapment efficiency of approximately 30%–36%. Encapsulation into liposomes helps to stabilize insulin due to improved resistance against enzymatic disruption, with 60% and 80% of the insulin left after 4 h when incubated in simulated gastric and intestinal fluids, respectively, whereas non-encapsulated insulin is broken down completely at 0.5 h. Preservation of insulin bioactivity against preparative stresses is validated by intra-peritoneal injection of insulin after release from various liposomes using the surfactant Triton X-100. In a diabetic rat model chemically induced by streptozotocin, both thiamine-and niacindecorated liposomes showed a comparable and sustained mild hypoglycemic effect. The superiority of decorated liposomes over conventional liposomes highlights the contribution of vitamin ligands. It is concluded that decoration of liposomes with thiamine or niacin facilitates interactions with gastrointestinal vitamin receptors and thereby facilitates oral absorption of insulin-loaded liposomes.展开更多
Background:The objective of this study was to evaluate the clinical efficacy of thiamine and vitamin C with or without hydrocortisone coadministration on the treatment of sepsis and septic shock.Methods:MEDLINE,EMBASE...Background:The objective of this study was to evaluate the clinical efficacy of thiamine and vitamin C with or without hydrocortisone coadministration on the treatment of sepsis and septic shock.Methods:MEDLINE,EMBASE and CENTRAL databases were searched for randomized controlled trials(RCTs)that made a comparative study between the combination therapy of vitamin C and thiamine with or without hydrocortisone and the administration of placebo in patients with sepsis or septic shock.Two reviewers independently performed study selection,data extraction and quality assessment.Both short-term mortality and change in the sequential organ failure assessment(SOFA)score from baseline(delta SOFA)were set as the primary outcomes.Secondary endpoints included intensive care unit(ICU)mortality,new onset of acute kidney injury,total adverse events,ICU and hospital length of stay,duration of vasopressor usage and ventilator-free days.Meanwhile,trial sequential analysis was conducted for primary outcomes.Results:Eight RCTs with 1428 patients were included in the current study.The results showed no significant reduction of short-term mortality in sepsis and septic shock patients who received combination therapy of vitamin C and thiamine with or without hydrocortisone compared to those with placebo{risk ratio(RR),1.02[95%confidence interval(CI),0.87 to 1.20],p=0.81,I2=0%;risk difference(RD),0[95%CI,−0.04 to 0.05]}.Nevertheless,the combination therapy was associated with significant reduction in SOFA score[mean difference(MD),−0.63,(95%CI,−0.96 to−0.29,p<0.001,I^(2)=0%]and vasopressors duration(MD,−22.11[95%CI,−30.46 to−13.77],p<0.001,I2=6%).Additionally,there were no statistical differences in the pooled estimate for other outcomes.Conclusions:In the current meta-analysis,the combination therapy of vitamin C and thiamine,with or without hydrocortisone had no impact on short-term mortality when compared with placebo,but was associated with significant reduction in SOFA score among patients with sepsis and septic shock.展开更多
Background:Supplementation of corticosteroid,ascorbic acid and thiamine in adult septic patients remains controversial.We aimed to evaluate the efficacy and safety of hydrocortisone,ascorbic acid and thiamine(HAT)in a...Background:Supplementation of corticosteroid,ascorbic acid and thiamine in adult septic patients remains controversial.We aimed to evaluate the efficacy and safety of hydrocortisone,ascorbic acid and thiamine(HAT)in adult septic patients.Methods:Data search included Pumbed,EMBASE,and the Cochrane Library from inception to Sep,2021.Only studies with classifications of sepsis and intravenous HAT treatment were included.Adult patients with sepsis(aged≥18 years)were divided into 2 groups.The treatment group received HAT therapy,whereas the control group received standard care and/or intravenous hydrocortisone.The primary outcome was hospital mortality.Results:Eleven studies including 4579 patients who fulfilled the predefined criteria were analyzed(6 randomized controlled trials[RCTs]and 5 clinical cohort studies).No hospital mortality reduction was demonstrated in patients treated with HAT when compared to the reference(OR:0.99;95%CI:0.77 to 1.27;I^(2)=39%)group.Sequential organ failure assessment(SOFA)score decrement at 72hours was more significant in HAT-treated patients(mean difference[MD]:–1.23;95%CI:–1.94 to–0.53;I^(2)=81%).There was no difference in the duration of vasopressor use between HAT-treated patients and controls(MD:–4.92;95%CI:–24.38 to 14.53;I^(2)=97%).Statistical heterogeneity was noted with no sign of significant publication bias.Conclusion:In adult sepsis and septic shock patients,HAT treatment failed to reduce mortality or shorten vasopressor duration,but reduced SOFA scores.展开更多
Wernicke encephalopathy(WE) is an acute neurological disorder resulting from vitamin B1 deficiency, which is common in chronic alcoholism and is rare in acute liver failure. So far, there are 2 cases of WE reported af...Wernicke encephalopathy(WE) is an acute neurological disorder resulting from vitamin B1 deficiency, which is common in chronic alcoholism and is rare in acute liver failure. So far, there are 2 cases of WE reported after liver transplantation. Here, we report a case of a 45-year-old nonalcoholic male patient who developed psychiatric and neurological disturbance 15 d after receiving orthotopic liver transplantation because of hepatitis B-related cirrhosis and portal hypertension. Brain magnetic resonance imaging(MRI) showed symmetric high-signal intensities in the periaqueductal area. The patient was diagnosed with WE and given intravenous high-dose vitamin B1 immediately. His neurological disturbance resolved in 7 d after receiving the vitamin B1. Brain MRI after 5 mo showed nearly complete recovery. Most WE cases may be misdiagnosed in patients after liver transplantation, and we should pay more attention to its onset.展开更多
Shoshin syndrome is a rare fulminating heart failure caused by thiamine deficiency. In Japanese 'sho' means acute damage and 'shin' means heart. It consists of a rare and hyperacute manifestation of be...Shoshin syndrome is a rare fulminating heart failure caused by thiamine deficiency. In Japanese 'sho' means acute damage and 'shin' means heart. It consists of a rare and hyperacute manifestation of beriberi that was first described in polished white rice-eating communities in various locations across Asia including China, Japan and Indonesia. In a totally different context, ‘Shoshin’ is a word from Zen Buddhism meaning 'beginner's mind', which is considered the necessary attitude to approach the Zen practice. This case report is a prime example of clinical manifestations of thiamine deficiency for the presence of both cardiological and neurological disorders, for hyperacute onset of cardiac failure (shoshin syndrome), for the simultaneous involvement of peripheral and central nervous system, and for the dramatic global recovery after thiamine replacement therapy. We therefore explain why the physician should adopt a beginner’s mind in clinical practice.展开更多
文摘AIM:To investigate the effect of lacidipine,thiamine pyrophosphate(TPP)and the combination of lacidipine and TPP against oxidative and inflammatory eye damage induced by bilateral common carotid artery ligation in rats.METHODS:Male albino Wistar rats were categorized as those who underwent sham surgery(SG),right and left common carotid cross-clamping and unclamping procedure(CCU),lacidipine+CCU(LCCU),TPP+CCU(TCCU),and combination of lacidipine and TPP(LTC)+CCU(LTCCU).One hour before anesthesia,the LCCU(n=6)received lacidipine(4 mg/kg,orally)and the TCCU(n=6)received TPP(20 mg/kg,intraperitoneally).The SG(n=6)and CCU(n=6)received the same volume of distilled water from the same route.After anesthesia(60 mg/kg ketamine,intraperitoneally),the necks of the rats were opened in the midline.Ischemia was created for 10min by placing clips on the right and left common carotid arteries.Rats in the SG only underwent subcutaneous incision.After 10min,the clips were removed and reperfusion was achieved for six days.Then,the animals were euthanized(120 mg/kg ketamine,intraperitoneally)and the levels of oxidant,antioxidant and proinflammatory cytokines in the eye tissues were determined.The retinal tissue of the eye was also examined histopathologically.RESULTS:Lacidipine,TPP,and LTC significantly prevent the increase in malondialdehyde,tumor necrosis factoralpha,interleukin-1β(IL-1β),and IL-6 levels,decrease in total glutathione levels,superoxide dismutase and catalase activities and histopathological retinal damage in eye tissue induced by bilateral common carotid artery ligation in rats.The impact of these drugs on protection is determined to be LTC>lacidipine>TPP.CONCLUSION:As a result of the study,it is concluded that LTC may be more effective than lacidipine and TPP alone in treating ocular ischemic syndrome.
基金financial support from the graduate council of the University of Tabriz,Tabriz,Iran.
文摘Important efforts have been made over the past years to improve the drug acts,which leads to the discovery of novel drug preparations and delivery systems.The optimal design of such processes requires a molecular-level understanding of the interactions between drug molecules and biological membranes.The thermodynamic investigation provides deep and complete knowledge of interactions and the choice of appropriate and suitable production compounds in pharmaceutical fields.Particularly,the analysis of drugs+co-solvents in aqueous media is the central issue in many types of research because they exert their impact by interacting with biological membranes.This work is aimed to measure the density and speed of sound for the thiamine hydrochloride in water+deep eutectic solvents(DESs)mixtures(choline chloride/urea,choline chloride/ethylene glycol and choline chloride/glycerol)at temperature range(293.15-308.15)K.By correlation of the evaluated parameters in some standard relations,the partial molar parameters i.e.apparent molar volumes,Vφ,m,and apparent molar isentropic compression,κ_(s,φ,m),are calculated.In addition,apparent molar isobaric expansion,E^(0)_(φ,m),and Hepler’s constant are computed from the density and speed of sound data.For fitting the experimental Vφ,m andκ_(s,φ,m)the Redlich-Meyer equation was employed that the important quantities;standard partial molar volume,V^(0)_(m),and partial molar isentropic compression,κφ,m0,were obtained.The thermodynamic analysis of the studied system also plays a crucial role in the pharmaceutical industry.
基金Supported by The Grant from the Ministry of Health of Czech Republic,No.NT13198
文摘Growing prevalence of diabetes(type 2 as well as type 1) and its related morbidity due to vascular complications creates a large burden on medical care worldwide. Understanding the molecular pathogenesis of chronic micro-, macro- and avascular complications mediated by hyperglycemia is of crucial importance since novel therapeutic targets can be identified and tested. Thiamine(vitamin B1) is an essential cofactor of several enzymes involved in carbohydrate metabolism and published data suggest that thiamine metabolism in diabetes is deficient. This review aims to point out the physiological role of thiamine in metabolism of glucose and amino acids, to present overview of thiamine metabolism and to describe the consequences of thiamine deficiency(either clinically manifest or latent). Furthermore, we want to explain why thiamine demands are increased in diabetes and to summarise data indicating thiamine mishandling in diabetics(by review of the studies mapping the prevalence and the degree ofthiamine deficiency in diabetics). Finally, we would like to summarise the evidence for the beneficial effect of thiamine supplementation in progression of hyperglycemia-related pathology and, therefore, to justify its importance in determining the harmful impact of hyperglycemia in diabetes. Based on the data presented it could be concluded that although experimental studies mostly resulted in beneficial effects, clinical studies of appropriate size and duration focusing on the effect of thiamine supplementation/therapy on hard endpoints are missing at present. Moreover, it is not currently clear which mechanisms contribute to the deficient action of thiamine in diabetes most. Experimental studies on the molecular mechanisms of thiamine deficiency in diabetes are critically needed before clear answer to diabetes community could be given.
文摘This study aims at evaluating the performance of thiamine as a new eco-friendly shale inhibitor in water-based drilling fluids(WBDFs).The evaluation experiments include sedimentation,bentonite inhibition,filtration,zeta potential,thermal gravimetric analysis,scanning electron microscopy,X-ray diffraction,shale cuttings recovery,linear swelling and Fourier transform infrared spectroscopy(FTIR).The performance of thiamine was compared to potassium chloride.In contrast to deionized water,the aqueous solution of thiamine exhibited greater power to inhibit montmorillonite(Mt)dispersion,much more Mt loading capacity(280 g/L)and fluid loss,lower Mt mass loss,larger aggregated Mt particles,lower interlayer space of the Mt particles,less shale cuttings disintegration and lower linear swelling.Adsorption of thiamine on Mt led to a significant shift in the value of zeta potential(from-17.1 to+8.54 mV).Thiamine demonstrated superior inhibitive performance than potassium chloride.FTIR analysis confirmed that thiamine is adsorbed on Mt particles.The compatibility test revealed the compatibility of thiamine with conventional WBDF additives.It was concluded that the main probable inhibition mechanisms of thiamine are the cation exchange and Mt surface coating.In view of its prominent inhibition capacity and great environmental acceptability,thiamine is a promising inhibitor for drilling in water-sensitive formations.
文摘Sepsis and septic shock remain a major cause of morbidity and mortality among patients admitted in the intensive care unit.Diabetes is a major risk factor for the development of sepsis.The global mortality of sepsis remains high,despite significant interventions and guidelines.It has been known for decades that patients with sepsis have reduced levels of antioxidants,most notably vitamin C.Furthermore,experimental data has demonstrated multiple beneficial effects of vitamin C in sepsis.In addition,corticosteroids and thiamine may have synergistic biological effects together with vitamin C.Preliminary data suggests that therapy with hydrocortisone,ascorbic acid and thiamine improves the outcome of patients with sepsis with the potential to save millions of lives.However,this intervention has met with much resistance and has not been widely adopted.Ultimately,we await the final jury verdict on this simple,safe and cheap intervention.
基金The National Institute for Nutrition and Health,China Center for Disease Control and Prevention,Carolina Population Center[P2C HD050924,T32 HD007168]the University of North Carolina at Chapel Hill,the NIH[R01-HD30880,DK056350,R24 HD050924,and R01-HD38700]+3 种基金the NIH Fogarty International Center[D43 TW009077,D43 TW007709]the China-Japan Friendship Hospitalthe Chinese Ministry of HealthBeijing Municipal Center for Disease Prevention and Control and Chinese Nutrition Society(CNS)Nutrition Research Foundation-DSM Research Fund[No.CNS2015075B].
文摘Objective To estimate the association between three B-vitamin intakes and sociodemographic factors among adults in China.Methods We derived our data from the China Health and Nutrition Survey(CHNS) among 12,241 individuals aged 18–64 years. Log binomial regression was used to estimate adjusted prevalence ratios for factors associated with the inadequate intake of B-vitamins.Results Females with low incomes and living in the north had a higher prevalence of inadequate riboflavin intake than those with high incomes and living in the south. Both males and females living in a village had a higher prevalence of inadequate riboflavin intake than adults living in a city. Adults with low income, low education, and living in the north or in a village had a higher prevalence of inadequate niacin intake than adults with a high income, high education, and living in the south or in a city.Conclusion We found that income, region, and area of residence were associated with riboflavin intake. Education, income, region, and area of residence were associated with niacin intake. Welltailored strategies and policies are needed to improve nutritional status in China.
文摘Myotonic dystrophy type 1,also known as Steinert's disease,is an autosomal dominant disorder with multisystemic clinical features affecting the skeletal and cardiac muscles,the eyes,and the endocrine system.Thiamine(vitamin B1) is a cofactor of fundamental enzymes involved in the energetic cell metabolism; recent studies described its role in oxidative stress,protein processing,peroxisomal function,and gene expression.Thiamine deficiency is critical mainly in the central and peripheral nervous system,as well as in the muscular cells.Our aim was to investigate the potential therapeutical effects of long-term treatment with thiamine in myotonic dystrophy type 1 in an observational open-label pilot study.We described two patients with myotonic dystrophy type 1 treated with intramuscular thiamine 100 mg twice a week for 12 or 11 months.We evaluated the patients using the grading of muscle strength according to Medical Research Council(MRC),the Muscular Impairment Rating Scale(MIRS),and the Modified Barthel index.High-dose thiamine treatment was well tolerated and effective in improving the motor symptomatology,particularly the muscle strength evaluated with the MRC scale,and the patients' activities of daily living using the Modified Barthel Index.At the end of treatment,the MRC score was 5 in the proximal muscles and 2–4 in the distal muscles(the MRC score before the treatment was 3–4 and 1–3,respectively).The MIRS grade improved by 25% compared to baseline for both patients.In patient #1,the Modified Barthel Index improved by 44%,and in patient #2 by 29%.These findings suggest that clinical outcomes are improved by long-term thiamine treatment.
文摘AIM: To compare the effects of thiamine pyrophosphate(TPP) and thiamine(TM) in oxidative optic neuropathy in rats induced by ethambutol.METHODS: The animals were divided into four groups:a control group(CG),an ethambutol control(ETC) group,TM plus ethambutol group(TMG),and TPP plus ethambutol group(TPPG).One hour after intraperitoneal administration of TM 20 mg/kg to the TMG group and TPP 20 mg/kg to TPPG group,30 mg/kg ethambutol was given via gavage to all the groups but the CG.This procedure was repeated once daily for 90 d.After that period,all rats were exposed to high levels of anaesthesia in order to investigate the gene expression of malondialdehyde and glutathione in removed optic nerve tissue and histopathologically to examine these tissues. RESULTS: Malondialdehyde gene expression significantly increased,whereas glutathione gene expression significantly decreased in the ETC group compared to the CG.TM could not prevent the increase of malondialdehyde gene expression and the decrease of glutathione,while TPP significantly could suppress.Histopathologically,significant vacuolization in the opticnerve,single-cell necrosis in the glial cells,and a decrease in oligodendrocytes were observed in the ETC group.Vacuolization in the optic nerve,a decrease in oligodendrocytes and single-cell necrosis were found in the TMG group,while no pathological finding was observed in the TPPG group except for mild vacuolization.CONCLUSION: TPP protects the optic nerve against the ethambutol-induced toxicity but TM does not.TPP can be beneficial in prophilaxis of optic neuropathy in ethambutol therapy.
文摘The present data show a fast and efficient biological sample processing method for the extraction of thiamine (vitamin B1) and its mono-(TMP) and di-(TDP) phosphate esters from hippocampus, thalamus and prefrontal cortex (PFC) and blood sample of the rodents. In addition, using the hippocampus and standards of these three compounds we validated an isocratic fluorescence HPLC procedure for a simultaneous detection of them in a single chromatogram within a total run time of about 12 min. Reproducibility for TDP, TMP and B1 was 2.66%, 4.50% and 7.43% (intraday) and 37.54%, 25.39% and 25.87% (interday), respectively. Recovery assays were between 96.0% and 101.7%. The calibration curves were linear and the concentrations of the three compounds, all in nanomolar range, were determined in the brain areas and in the blood samples. When compared to the current methods in the literature, this new method provides information on essential variables, such as linearity range and limit of detection, reproducibility and stability of thiamine, TMP and TDP in rat brain samples. The present data on sample processing and B1 and its phosphate ester level determinations are the first to be validated using hippocampus samples of rats.
文摘Rationale:Prolonged undernutrition may arise out of depression and lead to Wernicke's encephalopathy if timely diagnosis and intervention are missed.Wernicke's encephalopathy is potentially treatable,and appropriate treatment may revert clinical depression and cognitive dysfunction to some extent.Patient's concern:A 69-year-old female who had been taking escitalopram for one year developed tremor,ophthalmoplegia,ataxia,progressive cognitive decline,and convulsions.Diagnosis:Non-alcoholic Wernicke's encephalopathy and hypomagnesemia due to psychogenic anorexia.Interventions:High dose intravenous thiamine and magnesium were supplemented.Outcomes:The patient showed remarkable improvement in neurological complications and even in depressive features.Lessons:Wernicke's encephalopathy should not be ignored in the treatment of depression.
文摘Our previous studies showed that 17β-estradiol (E2) modulated dopamine D2 receptor in regulating body weight set-point. The aim of this study was to understand whether thiamine deficiency influenced the E2 modulation on dopamine D2 receptors, using bromocriptine mesylate (BR) and sulpiride (SUL) as selective central dopamine-D2 receptors agonist and antagonist respectively. We studied the E2-dopamine D2 receptors interferences in a 10-day thiamine-deficient female rats for which consumptions of water, sugar, alcohol and food were daily-recorded and their consequences on body weights assessed. Our results showed that the volume of water daily ingested doubled in thiamine-deficient female rats (OXT), while sugar and alcohol consumptions collapsed with decreased weight and food consumption. On the one hand, thiamine potentiated D2/BR activity (bromocriptine-activated D2 receptors) to induce sugar intake and inhibited the same D2/BR receptors to induce water intake. On the other hand, thiamine promoted D2/SUL receptors (sulpiride-inhibited D2 receptors) for enhanced alcohol intake, increased food consumption and weight gain. Taking together, thiamine modulated the actions of 17β-estradiol on both D2/BR and D2/SUL receptors activities.
文摘We discuss the safety and controversy regarding the administration of glucose before thiamine with regards to precipitation of Wernicke’s Encephalopathy in the severely malnourished and alcoholic patient population. Herein we review clinical features, pathophysiology and the relevant literature to provide an evidenced-based recommendation that thiamine replacement should not delay glucose administration acutely in the malnourished patient population.
文摘Objective: Patients with generalized anxiety disorder (GAD) are fearful. They constantly worried about minor matters, and they anticipate the worst. The GAD is diagnosed when a patient experiences excessive anxiety and worry for at least 6 months. The cause of GAD is unknown. In the present paper, we discuss patients with GAD who have low levels of thiamine in their bloods. We also discuss the role of thiamine in the pathogenesis and treatment of GAD. Methods: We examined 9 patients (6 males and 3 females) who met the DSM-IV-TR diagnostic criteria for GAD. These patients had no history of alcoholism. Their ages ranged from 57 to 83 years old (mean age –72.8 ± 2.9 years). All of the patients had low blood thiamine levels (mean –25.1 nmol/L ± 6.0 nmol/L;normal level—70 nmol/L - 180 nmol/L). Participants completed the Hamilton Anxiety Rating Scale (HARS) for anxiety before and after thiamine treatments. All of the patients received daily thiamine 100 mg intramuscularly. Results: Thiamine supplementation significantly improved HARS scores, increased both appetite and general well-being, and reduced fatigue in patients with GAD. Interestingly, these patients were able to discontinue taking anxiolytic and β-blocker medications. Conclusion: Parental thiamine significantly affects patients with GAD.
基金This project was supported by the Scientific Research Fund of Wannan Medical College(no.JXYY202109).
文摘Background This study aimed to conduct a systematic review and meta-analysis of the efficacy of hydrocortisone,vitamin C,and thiamine(HVT)in patients with sepsis or septic shock.Methods A literature search was performed in PubMed,Embase,Cochrane Library,and Web of Science from their inception to April 2021.Search terms included hydrocortisone,thiamine,vitamin C,sepsis,and septic shock.Only randomized controlled trials on HVT in treating sepsis and septic shock were analyzed.Risk ratio(RR)was generated using Review Manager 5.3 to evaluate binary variants,whereas mean±standard deviation(MD)was generated to assess continuous variants.Results A total of 7 randomized controlled trials,with 1233 patients,were included in this meta-analysis.There was no significant difference in long-term mortality(35.3%vs 33.2%;RR:1.07;95%confidence interval[95%CI]:0.90-1.27;P=0.45;I^(2)=0%),intensive care unit(ICU)mortality(17.4%vs 17.5%;RR:0.99;95%CI:0.75-1.30;P=0.95;I^(2)=0%),in-hospital mortality(27.4%vs 25.8%;RR:1.06;95%CI:0.84-1.34;P=0.63;I^(2)=0%),and acute kidney injury morbidity(RR:1.04;95%CI:0.91-1.18;P=0.60;I^(2)=0%)between HVT and control groups.For continuous variables,there was no significant effect of HVT therapy on delta Sequential Organ Failure Assessment(△SOFA)score(MD:−0.44;95%CI:−1.00 to 0.12;P=0.12;I^(2)=49%),length of ICU stay(MD:0.43;95%CI:−0.27 to 1.14;P=0.23;I^(2)=0%),and length of hospital stay(MD:0.80;95%CI:−0.38 to 1.97;P=0.18;I^(2)=0%).Only vasopressor duration was significantly reduced in the HVT group(MD:−17.75;95%CI:−25.56 to−9.94;P<0.00001;I^(2)=38%).Vasopressor duration refers to the time to shock reversal.Alternatively,it is the amount of time(in hours)required for patients to withdraw all vasoactive medication support.Neither HVT nor control△SOFA reached statistical significance.Conclusion Hydrocortisone,vitamin C,and thiamine use was not associated with improved mortality,lower acute kidney injury incidence,lower△SOFA,and shorter ICU and in-hospital stays among patients with sepsis and septic shock.However,the use of vasopressors decreased significantly.Further direct head-to-head studies are needed.
基金financially supported by Shanghai Commission of Science and Technology (15ZR1403000)National Natural Science Foundation of China (81573363, 81690263, and 21372063)
文摘Biomimetic nanocarriers are emerging as efficient vehicles to facilitate dietary absorption of biomacromolecules. In this study, two vitamins, thiamine and niacin, are employed to decorate liposomes loaded with insulin, thus facilitating oral absorption via vitamin ligand–receptor interactions. Both vitamins are conjugated with stearamine, which works to anchor the ligands to the surface of liposomes.Liposomes prepared under optimum conditions have a mean particle size of 125–150 nm and an insulin entrapment efficiency of approximately 30%–36%. Encapsulation into liposomes helps to stabilize insulin due to improved resistance against enzymatic disruption, with 60% and 80% of the insulin left after 4 h when incubated in simulated gastric and intestinal fluids, respectively, whereas non-encapsulated insulin is broken down completely at 0.5 h. Preservation of insulin bioactivity against preparative stresses is validated by intra-peritoneal injection of insulin after release from various liposomes using the surfactant Triton X-100. In a diabetic rat model chemically induced by streptozotocin, both thiamine-and niacindecorated liposomes showed a comparable and sustained mild hypoglycemic effect. The superiority of decorated liposomes over conventional liposomes highlights the contribution of vitamin ligands. It is concluded that decoration of liposomes with thiamine or niacin facilitates interactions with gastrointestinal vitamin receptors and thereby facilitates oral absorption of insulin-loaded liposomes.
基金supported by grants from the National Natural Science Foundation of China(Nos.81730057,81801935,82002071)the Key Project of Military Medical Innovation Program of Chinese PLA(No.18CXZ026)+3 种基金the National Key Research and Development Program of China(No.2017YFC1103302)CAMS Innovation Fund for Medical Sciences(2019-I2M-5-076)Achievements Supportive Fund(2018-CGPZ-B03)Chinese Postdoctoral Science Foundation Grant(2019 M664003).
文摘Background:The objective of this study was to evaluate the clinical efficacy of thiamine and vitamin C with or without hydrocortisone coadministration on the treatment of sepsis and septic shock.Methods:MEDLINE,EMBASE and CENTRAL databases were searched for randomized controlled trials(RCTs)that made a comparative study between the combination therapy of vitamin C and thiamine with or without hydrocortisone and the administration of placebo in patients with sepsis or septic shock.Two reviewers independently performed study selection,data extraction and quality assessment.Both short-term mortality and change in the sequential organ failure assessment(SOFA)score from baseline(delta SOFA)were set as the primary outcomes.Secondary endpoints included intensive care unit(ICU)mortality,new onset of acute kidney injury,total adverse events,ICU and hospital length of stay,duration of vasopressor usage and ventilator-free days.Meanwhile,trial sequential analysis was conducted for primary outcomes.Results:Eight RCTs with 1428 patients were included in the current study.The results showed no significant reduction of short-term mortality in sepsis and septic shock patients who received combination therapy of vitamin C and thiamine with or without hydrocortisone compared to those with placebo{risk ratio(RR),1.02[95%confidence interval(CI),0.87 to 1.20],p=0.81,I2=0%;risk difference(RD),0[95%CI,−0.04 to 0.05]}.Nevertheless,the combination therapy was associated with significant reduction in SOFA score[mean difference(MD),−0.63,(95%CI,−0.96 to−0.29,p<0.001,I^(2)=0%]and vasopressors duration(MD,−22.11[95%CI,−30.46 to−13.77],p<0.001,I2=6%).Additionally,there were no statistical differences in the pooled estimate for other outcomes.Conclusions:In the current meta-analysis,the combination therapy of vitamin C and thiamine,with or without hydrocortisone had no impact on short-term mortality when compared with placebo,but was associated with significant reduction in SOFA score among patients with sepsis and septic shock.
文摘Background:Supplementation of corticosteroid,ascorbic acid and thiamine in adult septic patients remains controversial.We aimed to evaluate the efficacy and safety of hydrocortisone,ascorbic acid and thiamine(HAT)in adult septic patients.Methods:Data search included Pumbed,EMBASE,and the Cochrane Library from inception to Sep,2021.Only studies with classifications of sepsis and intravenous HAT treatment were included.Adult patients with sepsis(aged≥18 years)were divided into 2 groups.The treatment group received HAT therapy,whereas the control group received standard care and/or intravenous hydrocortisone.The primary outcome was hospital mortality.Results:Eleven studies including 4579 patients who fulfilled the predefined criteria were analyzed(6 randomized controlled trials[RCTs]and 5 clinical cohort studies).No hospital mortality reduction was demonstrated in patients treated with HAT when compared to the reference(OR:0.99;95%CI:0.77 to 1.27;I^(2)=39%)group.Sequential organ failure assessment(SOFA)score decrement at 72hours was more significant in HAT-treated patients(mean difference[MD]:–1.23;95%CI:–1.94 to–0.53;I^(2)=81%).There was no difference in the duration of vasopressor use between HAT-treated patients and controls(MD:–4.92;95%CI:–24.38 to 14.53;I^(2)=97%).Statistical heterogeneity was noted with no sign of significant publication bias.Conclusion:In adult sepsis and septic shock patients,HAT treatment failed to reduce mortality or shorten vasopressor duration,but reduced SOFA scores.
基金Supported by National Natural Science Foundation of China,No.81200326Natural Science Foundation of Hunan Province,No.2016JJ3165
文摘Wernicke encephalopathy(WE) is an acute neurological disorder resulting from vitamin B1 deficiency, which is common in chronic alcoholism and is rare in acute liver failure. So far, there are 2 cases of WE reported after liver transplantation. Here, we report a case of a 45-year-old nonalcoholic male patient who developed psychiatric and neurological disturbance 15 d after receiving orthotopic liver transplantation because of hepatitis B-related cirrhosis and portal hypertension. Brain magnetic resonance imaging(MRI) showed symmetric high-signal intensities in the periaqueductal area. The patient was diagnosed with WE and given intravenous high-dose vitamin B1 immediately. His neurological disturbance resolved in 7 d after receiving the vitamin B1. Brain MRI after 5 mo showed nearly complete recovery. Most WE cases may be misdiagnosed in patients after liver transplantation, and we should pay more attention to its onset.
文摘Shoshin syndrome is a rare fulminating heart failure caused by thiamine deficiency. In Japanese 'sho' means acute damage and 'shin' means heart. It consists of a rare and hyperacute manifestation of beriberi that was first described in polished white rice-eating communities in various locations across Asia including China, Japan and Indonesia. In a totally different context, ‘Shoshin’ is a word from Zen Buddhism meaning 'beginner's mind', which is considered the necessary attitude to approach the Zen practice. This case report is a prime example of clinical manifestations of thiamine deficiency for the presence of both cardiological and neurological disorders, for hyperacute onset of cardiac failure (shoshin syndrome), for the simultaneous involvement of peripheral and central nervous system, and for the dramatic global recovery after thiamine replacement therapy. We therefore explain why the physician should adopt a beginner’s mind in clinical practice.
