Methylene blue ndi tulo: zimene mayesero analemba, ndi zimene palibe amene anayeza

Mzere umodzi m'tebulo la zochitika zosafunika ndiwo umboni waukulu kwambiri wokhudza tulo umene ulipo pa gulu la mankhwalawa. M'mayesero a masabata 52 ogawa anthu mwachisawawa omwe anali ndi mtundu wa frontotemporal dementia wokhudza khalidwe, kusagona kunanenedwa ndi odwala 3 mwa 110 omwe ankamwa 8 mg patsiku ndi 7 mwa 108 omwe ankamwa 200 mg patsiku. Olembawo anaika kusagona pa mndandanda wa zochitika zosafunika zomwe zinawonjezeka mlingo wa mankhwala ukakwera, pamodzi ndi kuchepa kwa magazi, kutsegula m'mimba, nseru, kupweteka pokodza, kukodza pafupipafupi ndi kusanza.

Mlingo wowirikiza ka makumi awiri ndi kasanu unabweretsa kusagona pafupifupi kowirikiza kawiri ndi theka. Ichi ndi chizindikiro chaching'ono m'tebulo laling'ono, ndipo chikusonyeza zosiyana ndi chifukwa chimene anthu ambiri amafufuzira nkhaniyi.

Palibe mayesero ogawa anthu mwachisawawa a methylene blue, kapena a mtundu wake wochepetsedwa mwa njira ya makemikolo, hydromethylthionine mesylate, amene anayeza tulo monga chotsatira. Kufufuza komwe kunachitika polemba nkhaniyi sikunapeze kafukufuku wogwiritsa ntchito mafunso okhudza tulo, actigraphy, kapena usiku wokhala m'labotale yoyeza tulo. Zomwe zilipo ndi zimene wodwala anangonena ndipo katswiri wa zachipatala anangoziika m'gulu la zolembedwa, zomwe ndi njira yofooka yoyezera kuposa mmene zingamvekere.

Zimene mapulogalamu a mayesero ogawa anthu mwachisawawa analemba

Magulu atatu a deta ali ndi zolembedwa zonse zokhudza tulo zomwe zinapezeka. Awiri ndi mayesero ogawa anthu mwachisawawa a hydromethylthionine, mtundu wochepetsedwa mwa njira ya makemikolo wa maziko omwewo a phenothiazine, wokhazikitsidwa ngati mchere. Lachitatu ndi malangizo a ku US operekera mankhwala olowetsedwa mumtsempha.

Mfundo ziwiri mumzere wachiwiri ndi zofunika kwambiri kuposa manambalawo. Choyamba, gulu loyerekezerapo linalandira methylthioninium chloride, chinthu chomwecho chimene chimagulitsidwa ngati methylene blue, pa 4 mg kawiri pa sabata. Anachipereka ngati chosintha mtundu wa mkodzo chosayembekezeredwa kukhala ndi mphamvu ya chithandizo, kuti otenga nawo mbali asathe kusiyanitsa magulu awiriwo poyang'ana m'mbale ya chimbudzi. Chachiwiri, wofufuzayo sanaone kuti vuto lililonse mwa milandu isanu ndi itatu ya kusagona m'magulu olandira mankhwala omwe ankayesedwa linali logwirizana ndi mankhwalawo. Koma milandu itatu ya tulo tambiri mwa anthu 332 inaonedwa kuti inali yogwirizana nawo.

Chochitika chosafunika si kuyeza. Ndi zimene munthu wina anatchula, zolembedwa ndi mawu osiyana ndi amene wowerenga amagwiritsa ntchito, pakati pa anthu omwe ali ndi matenda owononga mitsempha ya ubongo pang'onopang'ono, ambiri mwa iwo akumwanso mankhwala ofooketsa ndi ochepetsa kuvutika maganizo. Kuwerenga mawu akuti “sizinatchulidwe” mumzere wachitatu ngati akuti “sizimachitika” kungakhale kulakwitsa pa chifukwa china: odwala 31 ndi gulu laling'ono moti zinthu zambiri zingathe kusapezeka, ndipo malangizo operekera mankhwalawo akunena momveka bwino kuti ubale pakati pa kuchuluka kwa mankhwala m'thupi ndi kuyankha kwa thupi, komanso pakati pa kuchulukako ndi chitetezo, sudziwika.

Komwe zonena zokhudza tulo zimachokera

Pafupifupi nkhani, kanema ndi tsamba lililonse la malonda lomwe limagwirizanitsa chinthuchi ndi tulo pamapeto pake limaloza ku chotsatira chimodzi. Mu 2007, Oxenkrug ndi anzake anayeza ntchito ya monoamine oxidase ndi ma indole a chithokomiro cha pineal cha makoswe pambuyo pa mlingo umodzi wobayidwa pansi pa khungu.

Methylene blue inaletsa monoamine oxidase ya mtundu A m'njira yopikisana yomwe imatha kubwerera m'mbuyo, pa Ki ya pafupifupi 180 nanomoles, ndipo inaletsa mtundu B pa pafupifupi 1,400 nanomoles. Izi zinali zokonda mtundu A pafupifupi mowirikiza kasanu ndi katatu. Makoswe asanu pagulu lililonse, 10 mg/kg pansi pa khungu, ndipo zithokomiro za pineal zinachotsedwa patatha mphindi 90. Melatonin inakwera kuchokera pa 0.17 kufika pa 0.71 nanograms pa chithokomiro chilichonse. N-acetylserotonin, yomwe imasandulika mwachindunji kukhala melatonin, inachoka pa mlingo wotsika kuposa womwe zida zingathe kupeza kufika pa 0.86. Serotonin ya mu pineal inakwera kuchokera pa 79 kufika pa 118, ndipo 5-HIAA, chinthu chotuluka serotonin ikawonongeka, inatsika kuchokera pa 10.9 kufika pa 4.1.

Kufotokoza komwe kumatsatira n'kogwirizana ndi sayansi ya makemikolo. Serotonin ndi chinthu choyambira popanga melatonin, ndipo noradrenaline imayendetsa gawo la acetylation lomwe limasandutsa serotonin kukhala N-acetylserotonin. Mukaletsa enzyme yomwe imawononga zonsezi, pineal imakhala ndi zinthu zambiri zoyambira nthawi ya kuwala komanso zinthu zambiri zomwe zingasanduke melatonin nthawi ya mdima ikafika.

Koma zimenezi n'zosiyana kwambiri ndi munthu kugona bwino. Zomwe zinayesedwa ndi zinthu zomwe zinali m'chithokomiro cha nyama yomwe inapatsidwa mankhwala oletsa kumva pa nthawi imodzi yokha. Palibe m'kapangidwe ka kuyesaku chimene chinalemba kuti khoswe anagona nthawi yaitali bwanji, anagona mofulumira bwanji, kapena anamva bwanji m'mawa wotsatira. Pepalalo linalembedwa za njira zomwe mankhwala ochepetsa kuvutika maganizo amagwirira ntchito, ndipo gawo lake la zokambirana limapereka lingaliro lakuti kuwonjezera melatonin masana kungakonze kayendedwe ka thupi ka usana ndi usiku komwe kasuntha mwa odwala ovutika maganizo. Limenelo ndi lingaliro m'gawo la zokambirana, ndipo ndi lomwe linayambitsa zonena zokhudza tulo.

Zonena za maloto omveka bwino zilibe gwero lofalitsidwa

Kufufuza komwe kunachitika polemba nkhaniyi sikunapeze lipoti la wodwala m'modzi, malipoti a odwala angapo, cholembedwa cha mayesero, kapena kafukufuku amene anagwirizanitsa methylene blue ndi maloto omveka bwino, maloto owopsa, kapena kusintha kwa kukumbukira maloto. Zonenazi zilipo m'makambirano a pa intaneti, osati m'mabuku a kafukufuku.

Umboni wa gulu la mankhwalawa umasonyeza zosiyana panthawi ya chithandizo. Pamene clorgyline ndi pargyline, zomwe zimaletsa mwapadera monoamine oxidase ya mitundu A ndi B, zinaperekedwa kwa masabata anayi kwa odwala omwe anali ndi matenda okhudza mmene amamvera m'maganizo, tulo ta REM tinaponderezedwa pafupifupi kotheratu ndipo nthawi yonse yogona inachepa. Kuwunika mwadongosolo kafukufuku wokhudza mankhwala ochepetsa kuvutika maganizo ndi kulota, komwe kunaphatikiza kafukufuku 21 wa odwala ndi malipoti 25 a odwala payekha, kunapeza kuti kukumbukira maloto kumachepa munthu akamamwa phenelzine, mankhwala odziwika oletsa monoamine oxidase. Maloto owopsa m'mabuku amenewo amaoneka munthu akasiya mankhwalawo, pamene tulo ta REM timabwereranso mwamphamvu, osati pamene akumwabe mankhwalawo.

Choncho njira yogwirira ntchito yomwe nthawi zambiri imatchulidwa ngati chifukwa cha maloto omveka bwino imaneneratu tulo ta REM tochepa ndi kukumbukira maloto kochepa m'mikhalidwe yanthawi zonse, ndi kubwereranso kosasangalatsa mankhwalawo akasiya. Sizinayesedwe ngati methylene blue imachita chilichonse mwa zimenezi mwa munthu. Kuletsa kwake kumatha kubwerera m'mbuyo, ndi mankhwala ofooka kwambiri poletsa kuposa phenelzine, ndipo kafukufuku wa anthu amene angayankhe funsoli sanachitike.

Zonena za kusokonezeka kwa tulo chifukwa cha kusintha kwa nthawi paulendo zili ndi gwero lenileni

Pepala limodzi ndi lomwe linayambitsa zonenazi. Oxenkrug ndi Requintina anapanga chitsanzo cha kusokonezeka kwa tulo chifukwa cha kusintha kwa nthawi paulendo mwa makoswe posintha nthawi ya kuwala, kenako anayeza serotonin, N-acetylserotonin ndi melatonin za mu pineal pogwiritsa ntchito high-performance liquid chromatography yokhala ndi kuzindikira kwa fluorescence.

Ananena zotsatira ziwiri. Majekeseni a melatonin kumayambiriro kwa nthawi yatsopano ya mdima anafulumizitsa kubwereranso kwa kayendedwe ka N-acetylserotonin ndi melatonin. Ndipo N-acetylserotonin ndi methylene blue, yomwe pepalalo linaitchula kuti yoletsa monoamine oxidase A, zinachepetsa kusokonekera kwa N-acetylserotonin koyambitsidwa ndi kuwala, koma osati kwa melatonin.

Werengani zimenezi mosamala. M'chitsanzo cha nyama cha mkhalidwe weniweni womwe zonenazi zikukhudza, methylene blue inasintha chizindikiro chimodzi cha chinthu choyambira kupanga melatonin koma sinasinthe kayendedwe ka melatonin. Zomaliza za pepalalo lokha zikukhudza nthawi yabwino yofikira paulendo wa ndege wopita kum'mawa komanso nthawi yoyenera kupereka melatonin. Silipereka methylene blue ngati chithandizo cha kusokonezeka kwa tulo chifukwa cha kusintha kwa nthawi paulendo, ndipo palibe kafukufuku wa anthu amene waiyesa ngati chithandizo choterocho.

Kulepheretsa mbewa kugona si kuyeza tulo

Kuyesa komwe kumatchulidwa nthawi zambiri ngati umboni wakuti methylene blue imathandiza pakusagona sikunayeze tulo. Marzabadi ndi anzake anaika mbewa zazimuna 60 za BALB/c mu dongosolo losinthidwa la nsanja zingapo, momwe nyama yoikidwa pa nsanja yopapatiza imakakamizika kukhala yosagona. Anayerekeza gulu lokhala pa nsanja yotakata ndi nyama zolepheretsedwa kugona, methylene blue yokha, laser ya 810-nanometre yotulutsa kuwala m'zigawo yokha, ndi kuphatikiza ziwirizo.

Methylene blue inabayidwa pa 0.5 mg/kg masiku khumi otsatizana kusanakhale kulepheretsa kugona, ndipo laser inagwiritsidwa ntchito tsiku lina lililonse. Kuphunzira ndi kukumbukira zinapatsidwa mfundo pogwiritsa ntchito njira ya T-maze, kuyesa kucheza ndi zina, ndi bokosi la shuttle box, ndipo pambuyo pake milingo ya PSD-95, GAP-43 ndi synaptophysin mu hippocampus inayesedwa.

Kulepheretsa kugona kunachepetsa kuchuluka kwa kusinthana posankha njira, kuchezeka, chidwi pa nyama yatsopano yocheza nayo, ndi chizindikiro cha kukumbukira. Palibe chithandizo chimodzi chokha chomwe chinabwezeretsa miyeso yambiri imeneyo. Kuphatikiza ziwirizo kunatero, ndipo kunawonjezera zizindikiro zonse zitatu za malo olumikizirana maselo a mitsempha. Chotsatira chake ndi chakuti kuphatikiza chithandizo chisanachitike kulepheretsa kugona kunateteza kukumbukira mwa nyama zomwe tulo tawo tinasokonezedwa. Mu kapangidwe ka kuyesako, kulepheretsa kugona ndi kuvulaza komwe kunayambitsidwa, osati chotsatira chomwe chinayesedwa. Palibe nthawi yotengera kuti nyama igone, nthawi yonse yogona, kapena dongosolo la magawo a tulo zomwe zinalembedwa. Kuwerenga pepalalo ngati umboni wa mmene munthu amagona bwino kumatembenuza tanthauzo la zomwe linayeza.

M'mawa kapena usiku: manambala sapereka yankho

Malangizo okhudza nthawi yomwa amabwerezedwa molimba mtima koma sanayesedwepo. Palibe mayesero amene anayerekeza kupereka mankhwala m'mawa ndi madzulo, m'gulu lililonse la anthu, kuti awone chotsatira chilichonse chokhudza tulo.

Chomwe chayesedwa ndi mmene chinthuchi chimayendera pang'onopang'ono m'thupi. Mu kafukufuku wa mlingo umodzi mwa anthu athanzi odzipereka, 200 mg yomwedwa pambuyo pokonzekera matumbo inabweretsa milingo m'magazi yomwe inakwera kwa maola khumi ndi awiri, ndipo nthawi yapakati yofikira pa mlingo wapamwamba kwambiri inali maola 16. Nthawi yomwe kuchuluka kwake kunachepa kufika pa theka inali pakati pa maola 14 ndi 27 pa mlingo umenewo, ndi pakati pa maola 6 ndi 26 pa 400 mg. Mankhwala olowetsedwa mumtsempha omwe ali m'malangizo operekera mankhwala ali ndi nthawi yochepera kufika pa theka ya pafupifupi maola 24, ndipo pafupifupi 40% imatuluka mu mkodzo isanasinthe, pomwe kuchuluka kwake m'thupi kumakwera kwambiri impso zikamagwira ntchito movutikira.

Choncho mlingo womwedwa pa chakudya cham'mawa umafika pa mlingo wake wapamwamba kwambiri woyezedwa pafupifupi pakati pausiku. Mfundo imeneyi ndi yoyenera kuiganizira bwino, chifukwa malangizo awiri omwe amafalitsidwa kwambiri amadalira kuti isakhale yoona. “Imwani m'mawa kuti isasokoneze tulo” kumaganiza kuti mphamvu yake imakhala itatha nthawi yogona ikafika. “Imwani usiku chifukwa mphamvu yake imatha msanga” kumaganiza zosiyana. Kafukufuku umodzi wokha wopezeka wa mmene mankhwalawa amayendera m'thupi la munthu sukuthandizira lingaliro la mphamvu yokhalitsa kwa nthawi yochepa madzulo. Ndipo kuyesa kwa makoswe komwe kunayambitsa nkhani ya melatonin kumapereka chifukwa choperekera mankhwala kumayambiriro kwa nthawi ya kuwala pa chifukwa chosiyana kotheratu: kuwonjezera masana chinthu choyambira kupanga melatonin. Pali kalozera wina wa nthawi yomwe chinthuchi chimakhala m'thupi ngati mwabwera kudzafufuza manambala okhudza kuchotsedwa kwake m'thupi.

Yankho loona pa funso la nthawi yomwa ndi lakuti palibe amene akudziwa, ndipo milingo yoyezedwa imatsutsa kunamizira kuti pali amene akudziwa.

Lipoti limodzi la munthu yemwe vuto lake la tulo linasintha

Pali chofalitsidwa chimodzi chokha chokhudza munthu chomwe chinapezeka, momwe methylene blue inaperekedwa kwa munthu wokhala ndi vuto la tulo, ndipo ndi nkhani ya wodwala m'modzi.

Lipoti la wodwala la 2021 mu Cureus limafotokoza mnyamata wa zaka 15 wokhala ndi Kleine-Levin syndrome, vuto losowa limene limabweretsa nthawi zobwerezabwereza za kugona kochuluka zomwe zimakhala kwa masiku mpaka masabata, pamodzi ndi kusokonezeka maganizo, kumva ngati zinthu zozungulira si zenizeni, ndi kusintha kwa khalidwe. Anali atalandira chithandizo cha lithium kwa zaka zitatu, ndipo modafinil, methylprednisolone, mankhwala amtundu watsopano ochepetsa matenda osokoneza maganizo, ndi amantadine sizinabweretse kusintha kwabwino. Ali ndi zaka 18 anayamba nthawi ya vutoli yomwe inatenga pafupifupi miyezi isanu ndi umodzi. Makolo ake atavomereza, anapatsidwa 10 mg ya methylene blue yakumwa ola limodzi asanalandire kuwala kofiira kwa 633 nanometres mkati mwa mphuno kwa mphindi 25 usiku uliwonse, pa 11.4 joules pa square centimetre. Pasanathe sabata, kugona kochuluka ndi zizindikiro za khalidwe zinatha. Patatha zaka ziwiri vutolo linali lisanabwererenso ndipo sankamwa mankhwala ena aliwonse.

Olembawo amanena okha malire a lipotilo: munthu m'modzi, osati kafukufuku wotsatira nthawi yayitali, ndipo zimadziwika kuti nthawi za Kleine-Levin zimayamba kuchepa pafupipafupi zaka zikamadutsa. Izi zimapangitsa kuti kusatheke kunena kuti kutha kwa zizindikiro kunachitika chifukwa cha chithandizocho. Pali malire achiwiri omwe sanawatsindike. Munthuyo analandira njira ziwiri za chithandizo nthawi imodzi, ndipo imodzi inali kuwala kofiira koperekedwa mkati mwa mphuno pamodzi ndi chinthu chomwe kugwiritsidwa ntchito kwake konse kwa photodynamic kumadalira kuwala kuti kuchiyambitse kugwira ntchito. Wowerenga sangathe kusiyanitsa mphamvu ya utoto ndi ya kuwala kapena ya kupita kwa nthawi, ndipo lipotilo si chifukwa choyesera methylene blue pa vuto la tulo.

Chomwe chili ndi deta ya anthu ndi kufooketsa munthu ndi mankhwala

Pamene miyeso ya dongosolo lapakati la mitsempha mwa anthu ilipo, yambiri imaloza ku kufooketsa munthu ndi mankhwala m'malo momupangitsa kukhala tcheru.

Kafukufuku wa 2008 mu Anaesthesia anayerekeza odwala 11 omwe anapatsidwa methylene blue pasadakhale ndi odwala 11 ofanana nawo m'gulu loyerekezerapo, pamene ankayamba kupatsidwa mankhwala oletsa kumva komanso pa opaleshoni. Anagwiritsa ntchito Bispectral index ndi kulowetsa propofol koyendetsedwa kuti kufikire mlingo womwe ankafuna. Pa mlingo wa propofol woyerekezedwa kuti uli pamalo ogwirira ntchito wa 2 micrograms pa millilitre, mfundo zoyeza kufooketsedwa ndi mankhwala ndi milingo ya index zinali zotsika kwambiri m'gulu lomwe linalandira methylene blue. Pa nthawi yonse ya opaleshoni, odwala omwe anapatsidwa mankhwalawo pasadakhale ankafunikira propofol yochepera ndi 50% pa avareji kuti afikire kuya komweko kwa kuletsa kumva. Pepalalo limayamba ndi kutchula kuti kuchedwa kudzuka pambuyo pa mankhwala oletsa kumva ndi kusokonezeka kwa ntchito ya mitsempha zinali zitanenedwa kale mwa odwala opaleshoni ya parathyroid omwe analandira methylene blue pasadakhale. Limamaliza ndi kulangiza kuti mlingo usinthidwe mosamala nthawi iliyonse mankhwalawa akulowetsedwa pafupi ndi nthawi ya opaleshoni.

Malangizo operekera mankhwalawo amanena zomwezo ndi mawu ena. Chithandizo chingayambitse kusokonezeka maganizo, chizungulire ndi kusokonezeka kwa kuona, ndipo odwala amalangizidwa kupewa kuyendetsa galimoto kapena makina owopsa mpaka mavutowo atatha. Malangizowa alibe ubale woonekeratu ndi chinthu chogulitsidwa ngati chothandiza kugona.

Palinso kugwiritsidwa ntchito komwe kumachiza mkhalidwe wofanana ndi tulo. Ifosfamide, mankhwala a chemotherapy, angayambitse encephalopathy yomwe zizindikiro zake zazikulu ndi tulo tambiri kwambiri, kusakhazikika ndi kusokonezeka maganizo, zomwe zingapitirire mpaka chikomokere. Methylene blue ndi imodzi mwa njira za chithandizo zoperekedwa pa vutoli. Mu kuwunika milandu 24 ku MD Anderson Cancer Center, odwala 20 analandira methylene blue ndipo zizindikiro zinatha mwa 19. Vutolo linabwereranso mwa atatu mwa asanu omwe pambuyo pake anapatsidwanso ifosfamide pamene ankalandira methylene blue yopewa vutolo.

Mankhwala omwe amawonjezera kuya kwa kuletsa kumva, omwe amayambitsa chizungulire ndi kusokonezeka maganizo, ndipo omwe amagwiritsidwa ntchito pobwezeretsa mkhalidwe wa tulo tochuluka woyambitsidwa ndi chemotherapy, si oonekeratu kuti ndi othandiza kugona. Ndi mankhwala okhala ndi mphamvu zenizeni pa dongosolo lapakati la mitsempha, ndipo mmene mphamvu zake zimayendera zimadalira zinthu zina zomwe zili m'thupi.

Mankhwala a usiku, ndi kupuma usiku

Mfundo ziwiri m'malangizo operekera mankhwalawo ziyenera kuganiziridwa ndi aliyense amene amamwa methylene blue madzulo pamodzi ndi chinthu china.

Yoyamba ndi mndandanda wa mankhwala omwe angakhudzane nayo. Zolembedwazo zimatchula SSRIs, SNRIs, MAOIs, bupropion, buspirone, clomipramine, mirtazapine, linezolid, opioids ndi dextromethorphan, ndipo zimalangiza kusamwa mankhwala aliwonse okhudza serotonin mkati mwa maola 72 pambuyo pa mlingo womaliza. Ziwiri mwa zimenezi zimapezeka pamatebulo a m'zipinda zogona. Mirtazapine ndi mankhwala ochepetsa kuvutika maganizo omwe amafooketsa munthu ndipo nthawi zambiri amamwedwa usiku. Dextromethorphan ndi yoletsa chifuwa yomwe ili m'mankhwala a chimfine a usiku, ndipo imagulitsidwa popanda chilolezo cha dokotala. Zowopsa za kuphatikiza kulikonse mwa zimenezi si zongoganiziridwa: zolembedwazo zimanena milandu ya serotonin syndrome yochokera ku mankhwala a gulu la methylene blue, ndipo ina inaphetsa anthu. Lipoti lofalitsidwa la vuto pafupi ndi nthawi ya opaleshoni limafotokoza mwamuna wa zaka 67 amene kusakhazikika, kukokana kwa minofu mobwerezabwereza ndi kutentha kwambiri kwa thupi zinayamba kuoneka pokhapokha akudzuka kuchokera ku kuletsa kumva kwa thupi lonse, methylene blue itaperekedwa pa opaleshoniyo.

Melatonin, benzodiazepines, z-drugs monga zopiclone, ndi diphenhydramine sizigwira ntchito kudzera mu serotonin, choncho nkhawa pa zimenezi si serotonin syndrome. Ndi imene kafukufuku wa kuletsa kumva anayeza: kuwonjezerana kwa kufooketsa munthu ndi mankhwala pa mlingo womwe palibe amene wafotokoza bwino.

Mfundo yachiwiri ndi ya kupuma. Pa mavuto osafunika omwe ananenedwa okhudza mankhwala a gulu la methylene blue, malangizo operekera mankhwalawo amatchula kutsekeka kwa mphuno, kupweteka m'kamwa ndi m'khosi, kutuluka mamina ndi kuyetsemula. Amenewa ndi malipoti odziperekera okha, opanda manambala a kuchuluka kwa zochitikazo komanso opanda njira yoperekera mankhwala yotchulidwa. Ndi mtundu wa kusintha komwe kungawonekere ngati kudzuka mkamwa muli mouma ndi kumva kuti munthu wapuma kudzera m'mphuno mosiyana usiku. Nkhani ya wowerenga m'modzi ya kusintha mwadzidzidzi n'kuyamba kupuma pakamwa akagona ilipo m'makambirano a pa intaneti, popanda kumuyesa, mbiri ya mankhwala ake kapena kuyeza kulikonse. Izi zimangotsimikizira kuti lipoti linaperekedwa, osati china chilichonse.

Aliyense amene vuto lake la tulo ndi kukoroma, kuima kwa kupuma komwe munthu wina waona, kapena tulo ta masana tochuluka moti angagone akuyendetsa galimoto, ayenera kufufuza funso la kuima kwa kupuma pogona m'malo mofufuza chowonjezera. Kuima kwa kupuma pogona kungadziwike mwa kuyesa ndipo kungachiritsidwe, koma palibe umboni uliwonse pamwambapa umene umakukhudza.

Mtundu wa chinthu chomwe chikugwiritsidwa ntchito umasiyananso pano

Milingo ya kafukufuku aliyense pamwambapa inali kuchuluka koyezedwa kwa chinthu chodziwika bwino chochokera kwa wopanga mankhwala, chothandizidwa ndi satifiketi ya kusanthula. Botolo lochokera kwa wogulitsa wosatsimikiziridwa silili choncho, ndipo kusiyana kwake si kwa maonekedwe chabe. Chizindikiro cha USP ndi muyezo umene wogula angayang'ane. Chinthu chosagwirizana ndi muyezowo chingakhale cha mtundu wopangira nsalu, chomwe chingakhale ndi zonyansa za organic monga Azure B, zotsalira za zosungunulira ndi zitsulo zolemera pa milingo yomwe zofunikira za mankhwala zimachepetsa.

Ogulitsa ambiri omwe amanena kuti chinthu chawo chayesedwa ndi gulu lina lodziyimira pawokha amangoyeza zitsulo zolemera zokha ndipo amapereka mayeso amodziwo ngati kutsatira zofunikira zonse. Blupreme imayesa zofunikira zonse za USP: kutsimikizira kuti ndi chinthu choyenera, kuyera kwake, zonyansa za organic, zotsalira za zosungunulira, zonyansa za ma element, zotsalira pambuyo powotcha, malire a tizilombo ndi endotoxin za mabakiteriya. Gulu lililonse lopangidwa limatumizidwa ndi satifiketi ya kusanthula, ndipo kuiwerenga molondola kumatanthauza kufananitsa nambala ya gululo ndi labotale ndi botolo lomwe muli nalo m'manja.

Palibe mwa zimenezo chimene chimapanga phindu la tulo, ndipo si chifukwa chomwera chinthuchi. Ngati mukumwabe, kudziwa zimene zili mu kapisozi ndi chinthu chochepa kwambiri chofunika. Cholozera cha chitetezo ndi kalozera wa kukhudzana ndi mankhwala ena amafotokoza mafunso omwe ayenera kubwera musanayambe kukambirana za nthawi yomwa.

Mfundo yomaliza

Palibe mayesero ogawa anthu mwachisawawa amene anayeza tulo pa nthawi ya chithandizo cha methylene blue. Zolembedwa zokhudza tulo zokha zomwe zili m'mayesero ogawa anthu mwachisawawa ndi mizere ya zochitika zosafunika. Ndipo pakuyerekeza kwakukulu kwambiri kwa milingo komwe kulipo, kuchuluka kwa kusagona kunali 2.7% pa 8 mg patsiku poyerekeza ndi 6.5% pa 200 mg patsiku.

Zonena za maloto omveka bwino zilibe gwero lofalitsidwa, ndipo mabuku a monoamine oxidase amaneneratu zosiyana panthawi ya chithandizo. Funso la m'mawa poyerekeza ndi usiku silinayesedwepo, ndipo mlingo womwedwa umafika pachimake m'magazi pa nthawi yapakati ya maola 16. Kwa aliyense womwa pa chakudya cham'mawa, nthawi imeneyi ili pafupi kwambiri ndi pakati pausiku kuposa ndi nthawi ya nkhomaliro. Kuyesa kwa kulepheretsa kugona komwe kumafalitsidwa ngati umboni ndi kafukufuku wa kukumbukira momwe palibe tulo tinalembedwa. Ndipo lipoti limodzi la munthu amene vuto lake la tulo linasintha kukhala bwino ndi la wodwala m'modzi amene ankadziwa chithandizo chimene ankalandira, ndipo ankalandira njira ziwiri za chithandizo nthawi imodzi.

Chidule cha umboni wa anthu chimasonkhanitsa zimene mayeserowa amatsimikizira, kuwunika kwa kukumbukira ndi kuika maganizo pa chinthu kumafotokoza zotsatira za luso la kuganiza zomwe zili pafupi kwambiri ndi tulo m'maphunziro omwewo, ndipo laibulale ya kafukufuku ili ndi mndandanda wa mapepala omwe ali kumbuyo kwa zonena zonse patsamba lino.