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Effect of baclofen combined with neural facilitation technique on the reduction of muscular spasm in patients with spinal cord injury

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Neural Regeneration Research 2007年第8期2卷 510-512页

作者： Shun Li Senxin Xue Zhixiang Li Xiaolan Liu Department of Rehabilitation the Third Affiliated Hospital Guangzhou Medical College Guangzhou 510150 Guangdong Province China

BACKGROUND： Recent researches have demonstrated that baclofen is a commonly central anti-spasm drug. In addition, neural facilitation technique based on nerve development and neurophysiology is widely used for rehabilitation training of motor disorder after central nerve injury. However, whether baclofen combining with neural facilitation technique can relieve muscular spasm after spinal cord injury needs further studies. OBJECTIVE： To observe the effect of baclofen combining with neural facilitation technique on decreasing muscular tension in two lower extremities after spinal cord injury. DESIGN： Randomized controlled study. SETTING- Departments of Rehabilitation and Orthopaedics, the Third Affiliated Hospital of Guangzhou Medical College. PARTICIPANTS： A total of 28 patients with spinal cord injury, including 17 males and 11 females, whose age ranged from 31 to 71 years, were selected from Departments of Rehabilitation and Orthopaedics, the Third Affiliated Hospital of Guangzhou Medical College from March 2005 to September 2006. The illness course ranged from 22 to 54 days and the mean course was （38±8） days. All patients were diagnosed as the fLrst onset and the increase of extensor muscular tension in two lower extremities after thoracic vertebra injury by using spine MR or CT examination. Informed consents were obtained from all the patients. METHODS： All 28 patients who had upper motor neuronal paralysis in two lower extremities after spinal cord injury in thoracic vertebra region were randomly divided into treatment group and control group with 14 cases in each group. Patients in both groups received routine therapy, while those in the treatment group were treated with oral baclofen （the beginning dosage： 5 rag/time; three times per day, 5 mg was increased every three days; the maximal dosage was 60 mg/day; 6 weeks in total）（made in Weicai Pharmaceutical Co., Ltd.; tablet; batch number： HC20040029） combining with neural facilitation technique, which accorded to Rood technique （slight joint extrusion, slo

关键词： baclofen spinal cord injury spasm

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γ-aminobutyric acid B2 receptor:A potential therapeutic target for cholangiocarcinoma in patients with diabetes mellitus

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World Journal of Gastroenterology 2023年第28期29卷 4416-4432页

作者： Charupong Saengboonmee Supannika Sorin Sakkarn Sangkhamanon Surang Chomphoo Somsiri Indramanee Wunchana Seubwai Kanyarat Thithuan Ching-Feng Chiu Seiji Okada Marie-Claude Gingras Sopit Wongkham Department of Biochemistry Faculty of MedicineKhon Kaen UniversityKhon Kaen 40002Thailand Center for Translational Medicine Faculty of MedicineKhon Kaen UniversityKhon Kaen 40002Thailand Cholangiocarcinoma Research Institute Khon Kaen UniversityKhon Kaen 40002Thailand Department of Pathology Faculty of MedicineKhon Kaen UniversityKhon Kaen 40002Thailand Department of Anatomy Faculty of MedicineKhon Kaen UniversityKhon Kaen 40002Thailand Department of Forensic Medicine Faculty of MedicineKhon Kaen UniversityKhon Kaen 40002Thailand Graduate Institute of Metabolism and Obesity Sciences Taipei Medical UniversityTaipei 11031Taiwan Division of Hematopoiesis Joint Research Center for Human Retrovirus InfectionKumamoto UniversityKumamoto 860-0811Japan Human Genome Sequencing Center Department of Human and Molecular GeneticsBaylor College of MedicineHoustonTX 77030United States Michael E.DeBakey Department of Surgery Baylor College of MedicineHoustonTX 77030United States

BACKGROUND The association between diabetes mellitus(DM)and the increased risk and progression of cholangiocarcinoma(CCA)has been reported with unclear underlying mechanisms.Previous studies showed thatγ-aminobutyric acid(GABA)B2 receptor(GABBR2)was upregulated in CCA cells cultured in high glucose(HG)conditions.Roles of GABA receptors in CCA progression have also been studied,but their association with DM and hyperglycemia in CCA remains unclarified.AIM To investigate the effects of hyperglycemia on GABBR2 expression and the potential use of GABBR2 as a CCA therapeutic target.METHODS CCA cells,KKU-055 and KKU-213A,were cultured in Dulbecco Modified Eagle’s Medium supplemented with 5.6 mmol/L(normal glucose,NG)or 25 mmol/L(HG)glucose and assigned as NG and HG cells,respectively.GABBR2 expression in NG and HG cells was investigated using real-time quantitative polymerase chain reaction and western blot.Expression and localization of GABBR2 in CCA cells were determined using immunocytofluorescence.GABBR2 expression in tumor tissues from CCA patients with and without DM was studied using immunohistochemistry,and the correlations of GABBR2 with the clinicopathological characteristics of patients were analyzed using univariate analysis.Effects of baclofen,a GABA-B receptor agonist,on CCA cell proliferation and clonogenicity were tested using the MTT and clonogenic assays.Phospho-kinases arrays were used to screen the affected signaling pathways after baclofen treatment,and the candidate signaling molecules were validated using the public transcriptomic data and western blot.RESULTS GABBR2 expression in CCA cells was induced by HG in a dose-and time-dependent manner.CCA tissues from patients with DM and hyperglycemia also showed a significantly higher GABBR2 expression compared with tumor tissues from those with euglycemia(P<0.01).High GABBR2 expression was significantly associated with a poorer non-papillary histological subtype but with smaller sizes of CCA tumors(P<0.05).HG cells of both tested CCA cell lines were m

关键词： baclofen Cholangiocarcinoma Diabetes mellitus Drug repurposing Hyperglycemia Gamma-aminobutyric acid

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Therapeutic efficacy of baclofen in refractory gastroesophageal reflux-induced chronic cough

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World Journal of Gastroenterology 2013年第27期19卷 4386-4392页

作者： Xiang-Huai Xu Zhong-Min Yang Qiang Chen Li Yu Si-Wei Liang Han-Jing Lv Zhong-Min Qiu Department of Respiratory Medicine Tongji HospitalTongji University School of Medicine

AIM:To evaluate the efficacy and safety of baclofen for treatment of refractory gastroesophageal reflux-induced chronic cough (GERC) unresponsive to standard anti-reflux therapy. METHODS:Sixteen patients with refractory GERC were given an 8-wk course of baclofen 20 mg three times a day as an add-on therapy to omeprazole. Changes in the cough symptom score, cough threshold to capsaicin, reflux symptom score and possible adverse effects were determined after treatment. The variables of multi-channel intraluminal impedance combined with pH monitoring were compared between responders and non-responders to baclofen. RESULTS:Twelve of 16 patients completed treatment. Cough disappeared or improved in 56.3% (9/16)of patients, including 6 patients with acid refluxinduced cough (66.7%) and 3 patients with non-acid reflux-induced cough (33.3%). With baclofen treatment, the cough symptom score began to decrease at week 2, was clearly decreased at week 6 and reached a minimum at week 8. At the end of therapy, the lowest concentration of capsaicin required for induction of ≥ 2 and ≥ 5 coughs increased from 0.98 (1.46) to 1.95 (6.82) μmol/L (Z = -2.281, P = 0.024) and from 1.95 (7.31) to 7.8 (13.65) μmol/L (Z = -2.433, P = 0.014), respectively, and the reflux symptom score decreased from 8.0 ± 1.6 to 6.8 ± 0.8 (t = 2.454, P = 0.023). The number of acid reflux episodes was significantly lower in responders than in non-responders. The main adverse effects were somnolence, dizziness and fatigue. CONCLUSION:baclofen is a useful, but suboptimal treatment option for refractory GERC.

关键词： baclofen Cough Esophageal pH monitoring Gastroesophageal reflux Proton pump inhibitors

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baclofen对慢性神经痛大鼠镇痛效果的影响

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临床麻醉学杂志 2003年第5期19卷 291-294页

作者：杜冬萍陈志峰徐惠芳上海市第六人民医院麻醉科疼痛诊疗中心 200233

目的　研究GABAB 受体激动剂baclofen对慢性神经痛大鼠痛阈的影响以及对脊髓c fos表达的影响 ,探讨脊髓GABA能系统在神经痛调节中的可能机制。方法　结扎大鼠左侧L5脊神经根建立慢性神经痛模型。SD大鼠 2 4只随机等分成 (1)假手术 +bacl... 详细信息

目的　研究GABAB 受体激动剂baclofen对慢性神经痛大鼠痛阈的影响以及对脊髓c fos表达的影响 ,探讨脊髓GABA能系统在神经痛调节中的可能机制。方法　结扎大鼠左侧L5脊神经根建立慢性神经痛模型。SD大鼠 2 4只随机等分成 (1)假手术 +baclofen组 :大鼠背部假手术而未行神经根结扎 ,术后 2 8至 34d每天腹腔注射baclofen 10mg/kg两次 ;(2 )假手术组 :背部假手术后2 8至 34d每天腹腔注射 0 9%NaCl 2ml两次 ;(3)L5结扎 +baclofen组 :实施L5神经根结扎 ,术后2 8至 34d每天腹腔注射baclofen 10mg/kg两次 ;(4)L5结扎组 :实施L5神经根结扎 ,术后 2 8至 34d每天腹腔注射 0 9%NaCl 2ml两次。术后 1、3、7、10、14、2 1、2 8、35d测大鼠双后肢光热刺激性痛阈。术后 35d处死大鼠取出腰段脊髓 ,冰冻切片 ,免疫组化法检测c fos免疫阳性细胞。结果　 (1)术后 7～ 2 8d ,左L5脊神经结扎大鼠较假手术大鼠痛阈明显降低 (P baclofen大鼠的假手术大鼠左后肢痛阈无显著变化 (P >0 0 5 ) ,双侧脊髓深层 (Ⅲ Ⅹ层 )FLI细胞无显著差异 (P >0 0 5 ) ;(2 )术后 35d ,使用baclofen的L5结扎大鼠的左后肢痛觉显著低于未使用baclofen的L5结扎大鼠 (P <0 0 1) ,前者脊髓深层 (Ⅲ Ⅹ层 )FLI细胞显著?

关键词： baclofen 慢性神经痛大鼠镇痛神经损伤 FLI细胞 c-fos

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Comparison of baclofen and Tizanidine in Reducing Spasticity in Cerebral Palsy: A Randomized Control Trial

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Open Journal of Pediatrics 2020年第4期10卷 617-625页

作者： Nazmul Haque Narayan Saha Tahmina Ahmed Bithi Debnath Abid Hossain Mollah Ekhlasur Rahman Department of Paediatric Neurology National Institute of Neurosciences & Hospital Dhaka Bangladesh Infertility Unit Department Of Obstetrics and Gynecology Dhaka Medical College Hospital Dhaka Bangladesh Department of Paediatrics BIRDEM General Hospital Dhaka Bangladesh Department of Paediatrics Anwar Khan Modern Medical College and Hospital Dhaka Bangladesh

Background: Cerebral palsy is the most common chronic motor disability that begins in childhood with the predominant motor abnormality that is spasticity. Objective: The purpose of the present study was to compare the efficacy of oral baclofen and oral tizanidine in reducing spasticity in cerebral palsy patients. Methodology: This randomized controlled trial was conducted from January 2010 to December 2011 and it was carried out in the Out Patient Department (OPD) of Pediatrics at Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh and Center for Neurodevelopment and Autism in Children (CNAC) of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. Results: A total number of 70 cerebral palsy children were recruited for this study of which 35 patients were in Tizanidine group and 35 patients were in baclofen group. Furthermore,

关键词： Cerebral Palsy Spasticity baclofen Tizanidine

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baclofen对大鼠脊髓薄片胶状质神经元的抑制作用

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中国神经科学杂志 2001年第1期17卷 7-10页

作者：闫励杨鲲冯宇鹏赵华李云庆第四军医大学解剖学教研室暨梁銶琚脑研究中心陕西西安710032 白求恩医科大学生理学教研室吉林长春130021

用脊髓薄片全细胞电压钳法观察激活γ 氨基丁酸B亚型受体 (GABABR)对大鼠脊髓背角胶状质(SG)神经元活动的影响。选择性GABABR激动剂baclofen减少所有被记录SG神经元 (n =15)的微小兴奋性突触后电流 (mEPSCs)的发放频率 ,同时引起一缓慢... 详细信息

用脊髓薄片全细胞电压钳法观察激活γ 氨基丁酸B亚型受体 (GABABR)对大鼠脊髓背角胶状质(SG)神经元活动的影响。选择性GABABR激动剂baclofen减少所有被记录SG神经元 (n =15)的微小兴奋性突触后电流 (mEPSCs)的发放频率 ,同时引起一缓慢的抑制性 (外向 )膜电流并伴有膜电导增加。细胞内电泳G蛋白偶联受体抑制剂 (GDP β S)抑制被钳制神经元的G蛋白偶联受体后 ,baclofen引起的缓慢外向电流被抑制 ,但对mEPSC频率的减低作用依然存在。结果提示脊髓内baclofen敏感的GABAB

关键词： baclofen 胶状质神经元脊髓薄片全细胞电压钳记录大鼠

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The Importance of Adjuvant Agents in Acute Intrathecal baclofen Withdrawal: Case Report and Review of the Literature

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Open Journal of Anesthesiology 2012年第4期2卷 102-106页

作者： Christopher M. Wang Susan E. Opper Department of Anesthesiology University of Missouri – Kansas City School of Medicine Kansas City Missouri USA.

Objective: baclofen (β-p-chlorophenyl-GABA) selectively activates the GABAB subtype of γ-aminobutyric acid (GABA) receptors, a group of receptors known to provide inhibitory neurotransmission in the central nervous system. Available for over thirty years in oral form for the treatment of skeletal muscle spasticity, its availability now includes continuous intrathecal infusion via an internally implanted pump. While ideal for long-term attenuation of symptoms, this treatment modality can also become disastrous should the pump empty and withdrawal subsequently ensue. Case Report: A 48-year-old male with a past medical history of T8 spinal cord injury from a motor vehicle crash originally presented with altered mental status. Because of resultant paraplegia and spasticity from his injuries, a neurosurgeon implanted an intrathecal baclofen pump three years prior to presentation with symptomatic relief. Further exploration revealed that he had missed his scheduled pump refill appointment and interrogation of his pump confirmed a completely empty reservoir. The patient endured a protracted hospital course that included rhabdomyolysis, acute renal failure, lactic acidosis, respiratory failure, and systemic inflammatory response syndrome. Treatment included benzodiazepines, dantrolene, aggressive hydration, opiates, and refill of his intrathecal baclofen pump. His mentation and ventilatory status improved with recovery from his critical illness and eventual discharge. Conclusions: Treatment of intrathecal baclofen withdrawal should focus on restoration of previous intrathecal baclofen levels by refill of the intrathecal pump. Adjuvant medications such as benzodiazepines, propofol, cyproheptadine, dantrolene, tizanidine, and opiates may prove crucial in helping with muscle spasticity while these levels are reestablished. A high index of suspicion, leading to timely initiation of proper treatment, may serve as the most important factor in successful recovery from this life-threatening syndrome.

关键词： baclofen GABA GABAB Intrathecal Implantable Infusion Pump Chronic Pain Pain Management Spasticity Spinal Cord Injury Neurosurgery Withdrawal Analgesia

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Intrathecal baclofen Facilitated Postanesthetic Tracheal Extubation in a Dystonic Patient Associated with Neurodegeneration of Brain Iron Accumulation (Hallervorden-Spatz Disease)

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Neuroscience & Medicine 2011年第4期2卷 351-354页

作者： Chien-Ching Lee Ya-Chun Chu Chia-Chun Chuang Chih-Yang Chen Mei-Yung Tsou Kwok-Hon Chan 不详

Patients with Hallervorden-Spatz disease may be confronted by invasive procedure, like gastrostomy and thalamotomy for care of the status of extreme dystonia and rigidity. This rare disorder possesses potential perioperative risks, such as difficult airway management, aspiration pneumonia, hyperpyrexia, dehydration, acute renal failure, and postoperative pulmonary insufficiency. As patients were usually in the state of uncontrollable dystonia and rigidity, delayed endotracheal extubation had been suggested by several previous case reports. We report the anesthetic management of a 34-year-old Hallervorden-Spatz disease woman scheduled for intrathecal baclofen pump implantation under general anesthesia. Preoperatively she had suffered from severe dystonia, confusion and repeated attacks of respiratory insufficiency and pneumonia requiring mechanical ventilation and critical care. Anesthesia was induced uneventfully and the catheter of the pump reached the CSF via T2 interspace. Intraoperative intrathecal baclofen injection mildly relieved her severe dystonia and rigidity. Hemodynamics and arterial blood gas were improved than preoperative. She was extubated after consciousness was regained. Postanesthetic visit demonstrated a fair outcome. Whether this treatment applies to every case confronted by general anesthesia needs to be elucidated. Nevertheless, we suggest intrathecal baclofen may help postanesthetic pulmonary care by attenuating dystonia and rigidity and can be an adjuvant for anesthesia care in patients with Hallervorden-Spatz disease.

关键词： Anesthesia Hallervorden-Spatz Disease Intrathecal baclofen Pneumonia

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baclofen治疗脊髓损伤后痉挛的疗效观察

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中国康复理论与实践 2008年第1期14卷 77-78页

作者：刘根林李建军周红俊郑樱郝春霞汪家琮首都医科大学康复医学院

目的观察脊髓损伤性痉挛患者口服baclofen的解痉效果。方法136例患者连续服药2个月。采用改良Ashworth评分进行评定。结果改良Ashworth评分降低超过1级的131例(96.3%)。结论该药对不同年龄、性别、损伤部位、损伤程度和损伤时间的患者... 详细信息

目的观察脊髓损伤性痉挛患者口服baclofen的解痉效果。方法136例患者连续服药2个月。采用改良Ashworth评分进行评定。结果改良Ashworth评分降低超过1级的131例(96.3%)。结论该药对不同年龄、性别、损伤部位、损伤程度和损伤时间的患者均有明显的解痉效果,长期服药对肝肾功能无影响。

关键词：脊髓损伤痉挛 baclofen 康复

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COVID-19 presenting with persistent hiccup and myocardial infarction in a peritoneal dialysis patient:A case report

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World Journal of Virology 2022年第4期11卷 198-203页

作者： Dimitra Bacharaki Panagiotis Giannakopoulos Konstantinos Markakis Christos Papas Aikaterini Theodorou Vasiliki Zoi Georgios Tsivgoulis Sophia Lionaki Department of Nephrology Attikon University HospitalChaidari 12462Greece Department of Internal Medicine Attikon University HospitalChaidari 12462Greece Department of Cardiology Attikon University HospitalChaidari 12462Greece Second Department of Neurology National and Kapodistrian University of AthensAttikon University HospitalAthensGreece

BACKGROUND Persistent hiccups,lasting more than 48 h,have been described as an atypical presentation of coronavirus disease 19(COVID-19)in the general population.To the best of our knowledge,this is the first report of persistent hiccups and non-ST elevation myocardial injury(NSTEMI)as an atypical presentation of COVID-19 in a peritoneal dialysis(PD)patient.CASE SUMMARY A 70-year old man,who had been on PD for 3 years with a history of ischemic heart failure and reduced ejection fraction,presented for a scheduled radionuclide myocardial scan.Upon arrival,he complained of anorexia,nausea for 5 d,and unremitting hiccups for the previous 48 h.Clinical and laboratory examinations revealed an NSTEMI plus a positive nasopharyngeal reverse transcriptase polymerase chain reaction testing for severe acute respiratory syndrome coronavirus 2.COVID-19 lung involvement was mild and was resolved without specific treatment.Myocardial injury was managed by coronary catheterization and stenting,while hiccups responded only to baclofen per os.CONCLUSION Persistent hiccups and NSTEMI can be atypical presentations of COVID-19 in peritoneal dialysis patients,which may be due to involvement of the central nervous system and myocardial injuries.

关键词： COVID-19 Peritoneal dialysis Atypical presentation Hiccup Myocardial infarction baclofen Case report

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