I-methylene blue nobuthongo: oko amalingo akubhalileyo, noko kungakhange kulinganiswe mntu

Umgca omnye kwitheyibhile yeziganeko ezingathandekiyo ungowona bungqina bukhulu bobuthongo obukhoyo ngolu sapho lwamachiza. Kwilingo leeveki ezingama-52 lolwabiwo olungenamkhethe kubantu abanesifo sengqondo esixhalabisayo esichaphazela iindawo zangaphambili nezecala zobuchopho, esibonakala ngokutshintsha kokuziphatha, ukuphuthelwa kwaxelwa zizigulana ezi-3 kwezili-110 ezazithatha i-8 mg ngosuku nangabasi-7 kwabali-108 ababethatha i-200 mg ngosuku. Ababhali badwelisa ukuphuthelwa phakathi kweziganeko ezingathandekiyo ezanda ngokwedosi, kunye neanemiya, urhudo, isicaphucaphu, ukuchama okubuhlungu, ukuchama rhoqo nokugabha.

Idosi ephindwe ngamashumi amabini anesihlanu yavelisa ukuphuthelwa okuphantse kuphindwe kabini nesiqingatha. Loo nto luphawu oluncinane kwitheyibhile encinane, yaye ikhomba kwicala elichaseneyo nesizathu sokuba abantu abaninzi baphande ngalo mbandela.

Akukho lingo lolwabiwo olungenamkhethe lwe-methylene blue, okanye lwemo yayo encitshiswe ngokwekhemikhali, i-hydromethylthionine mesylate, olulinganise ubuthongo njengesiphumo. Uphando lweli nqaku alufumananga sifundo sisebenzisa iphepha lemibuzo ngobuthongo, isixhobo sokurekhoda iintshukumo zomzimba ukuze kuhlolwe ubuthongo, okanye ubusuku kwilebhu yobuthongo. Oko kukhoyo yinto isigulana esithe sayixela nengcali yezonyango ethe yayifaka kudidi oluthile, nto leyo esisixhobo esibuthathaka sokuvavanya kunokuba ivakala.

Oko iinkqubo zolwabiwo olungenamkhethe zakubhalayo

Iiseti zedatha ezintathu ziqulethe lonke ungeniso olunxulumene nobuthongo olufunyenweyo. Ezimbini ngamalingo olwabiwo olungenamkhethe lwe-hydromethylthionine, imo encitshiswe ngokwekhemikhali yesiseko esifanayo se-phenothiazine, ezinziswe njengetyuwa. Eyesithathu lulwazi lwase-US lokumiselwa kwemveliso efakwa emthanjeni.

Iinkcukacha ezimbini kumqolo wesibini zibaluleke ngakumbi kunamanani. Okokuqala, iqela lothelekiso lanikwa i-methylthioninium chloride, ikhompawundi efanayo ethengiswa njenge-methylene blue, kwi-4 mg kabini ngeveki, njenge-arhente engasebenziyo yokutshintsha umbala womchamo ukuze abathathi-nxaxheba bangakwazi ukwahlula amaqela amabini ngokujonga isitya sendlu yangasese. Okwesibini, akukho nalinye kwiimeko ezisibhozo zokuphuthelwa kumaqela achiza elisebenzayo elagwetywa ngumphandi njengelinxulumene nechiza. Iimeko ezintathu zokozela kwabasi-332 zagwetywa njalo.

Isiganeko esingathandekiyo asiyomilinganiselo. Yinto athe umntu wayikhankanya, ebhalwe ngesigama esahlukileyo kweso sisetyenziswa ngumfundi, kwiqela labantu abanesifo esonakalisa ngokuthe ngcembe inkqubo yemithambo-luvo, uninzi lwabo oluthatha namachiza okuthomalalisa namachiza okudakumba. Ukufunda “akudweliswanga” kumqolo wesithathu njengokuthi “akuyenzeki” bekuya kuba yimpazamo ngesizathu esichaseneyo: izigulana ezingama-31 ziyisampulu encinane ngokwaneleyo ukuba ingaphoswa phantse yiyo nayiphi na into, yaye ulwazi lokumiselwa lichaza ngokucacileyo ukuba ubudlelwane phakathi kokuvezwa kwichiza nendlela elisabela ngayo umzimba, nobudlelwane phakathi kokuvezwa nokhuseleko, abaziwa.

Avela phi amabango ngobuthongo

Phantse lonke inqaku, ividiyo nephepha lemveliso elidibanisa le khompawundi nobuthongo ekugqibeleni libhekisa kwisiphumo esinye. Ngo-2007, u-Oxenkrug noogxa bakhe balinganisa umsebenzi we-monoamine oxidase nee-indole kwidlala lepiniyali leempuku emva kwedosi enye efakwe ngaphantsi kwesikhumba.

I-methylene blue yayisisithinteli esikhuphisanayo esinokubuyiselwa umva se-monoamine oxidase yohlobo A kwi-Ki emalunga ne-180 nanomoles, nesohlobo B malunga ne-1,400 nanomoles, nto leyo ethetha ukukhetha uhlobo A ngokuphindaphindwe phantse kasibhozo. Iimpuku ezintlanu kwiqela ngalinye, i-10 mg/kg ngaphantsi kwesikhumba, amadlala epiniyali asuswa emva kwemizuzu engama-90. I-melatonin yenyuka ukusuka kwi-0.17 ukuya kwi-0.71 nanograms kwidlala ngalinye. I-N-acetylserotonin, isandulela esingqalileyo se-melatonin, yenyuka ukusuka ngaphantsi komda wokubhaqwa ukuya kwi-0.86. I-serotonin yepiniyali yenyuka ukusuka kwi-79 ukuya kwi-118, yaye i-5-HIAA, imveliso yokuchithwa kwayo, yehla ukusuka kwi-10.9 ukuya kwi-4.1.

Ingqiqo elandelayo isekelwe kakuhle kwikhemistri. I-serotonin sisixhobo sokuqala sokwenziwa kwe-melatonin, yaye i-noradrenaline iqhuba inyathelo lokongezwa kweqela le-acetyl eliguqula i-serotonin ibe yi-N-acetylserotonin. Ukuthintela i-enzyme etshabalalisa zombini kwenza idlala lepiniyali libe nesixhobo sokuqala esingakumbi ngexesha lokukhanya, nesandulela esingakumbi esifumanekayo xa kufika ixesha lobumnyama.

Sekunjalo, loo nto ikude kakhulu nomntu olala ngcono. Into elinganisiweyo sisiqulatho sedlala lesilwanyana esifakwe kwisimo sokungaziva ngexesha elinye, yaye akukho nto kuloo ndlela yovavanyo ebhala ukuba impuku ilele ixesha elingakanani, ilale ngokukhawuleza kangakanani, okanye ivakalelwe njani ngentsasa elandelayo. Iphepha labhalwa malunga neendlela zokusebenza zokuchasana nokudakumba, yaye ingxoxo yalo iphakamisa ukuba ukunyusa i-melatonin emini kungalungisa isingqi somjikelo weeyure ezingama-24 esitshintshileyo kwizigulana ezidandathekileyo. Leyo yingcinga ecetywayo kwicandelo lengxoxo, yaye ngumthombo webango ngobuthongo.

Ibango ngamaphupha acacileyo alinawo umthombo opapashiweyo

Uphando lweli nqaku alufumananga ngxelo yemeko, uthotho lweengxelo zeemeko, ungeniso kwilingo, okanye sifundo apho i-methylene blue yayanyaniswa namaphupha acacileyo, amaphupha amabi, okanye utshintsho ekukhumbuleni amaphupha. Eli bango likhona kwimicu yeengxoxo, hayi kwiincwadi zophando.

Ubungqina bodidi lwamachiza bukhomba kwelinye icala ngexesha lonyango. Xa i-clorgyline ne-pargyline, izithinteli ezikhethayo ze-monoamine oxidase yohlobo A no-B, zanikwa iiveki ezine kwizigulana ezineziphazamiso zesimo sengqondo, ubuthongo be-REM bacinezelwa phantse ngokupheleleyo yaye ixesha elipheleleyo lobuthongo lehla. Uphononongo olucwangcisiweyo lwamachiza okudakumba nokuphupha, olwalugubungela izifundo zeklinikhi ezingama-21 neengxelo zeemeko ezingama-25, lwafumanisa ukuba ukukhumbula amaphupha kuyehla xa kusetyenziswa i-phenelzine, isithinteli esiqhelekileyo se-monoamine oxidase. Amaphupha amabi kuloo ncwadi zophando avela xa kuyekiswa ichiza, xa ubuthongo be-REM bubuyela ngamandla, hayi xa ichiza lisathathwa.

Ngoko indlela yokusebenza edla ngokukhankanywa njengesizathu samaphupha acacileyo iqikelela ubuthongo be-REM obuncinane nokukhumbula amaphupha okuncinane kwimeko eqhelekileyo, nokubuyela ngamandla okungathandekiyo xa kuyekwa. Akukavavanywa ukuba i-methylene blue iyayenza na enye kwezi emntwini. Ukuthintela kwayo kunokubuyiselwa umva, isisithinteli esibuthathaka kakhulu kune-phenelzine, yaye izifundo kubantu ezinokuphendula lo mbuzo azizange zenziwe.

Ibango ngokuphazamiseka ngenxa yokutshintsha kwemimandla yexesha linayo imvelaphi yokwenene

Lisekelwe kwiphepha elinye. U-Oxenkrug no-Requintina benza imodeli kwiimpuku yokuphazamiseka okubangelwa kukutshintsha kwemimandla yexesha ngokutshintsha umjikelo wokukhanya, baza balinganisa i-serotonin, i-N-acetylserotonin ne-melatonin yepiniyali ngekromatografi yolwelo esebenza kakhulu, esebenzisa ukubhaqwa kokukhanya kwe-fluorescence.

Kwaxelwa iziphumo ezimbini. Izitofu ze-melatonin ekuqaleni kwexesha elitsha lobumnyama zakhawulezisa ukubuyela kwezingqi ze-N-acetylserotonin ne-melatonin. Yaye i-N-acetylserotonin ne-methylene blue, echazwe kwiphepha njengesithinteli se-monoamine oxidase A, zanciphisa ukuphazamiseka kwe-N-acetylserotonin okubangelwa kukukhanya, kodwa hayi okwe-melatonin.

Funda oko ngononophelo. Kwimodeli yezilwanyana yemeko kanye eli bango lithetha ngayo, i-methylene blue yatshintsha isalathisi esinye sesandulela yaza ayasitshintsha isingqi se-melatonin. Izigqibo zephepha ngokwalo zithetha ngexesha elifanelekileyo lokufika kuhambo ngenqwelo-moya oluya ngasempuma nangendlela ekufanele kubekwe ngayo ixesha le-melatonin. Alicebisi i-methylene blue njengonyango lokuphazamiseka okubangelwa kukutshintsha kwemimandla yexesha, yaye akukho sifundo kubantu siyivavanye ngaloo njongo.

Ukuthintelwa kobuthongo kwiimpuku ezincinane akuyomilinganiselo yobuthongo

Uvavanyo oludla ngokukhankanywa njengobungqina bokuba i-methylene blue iyanceda xa kuthintelwe ubuthongo aluzange lulinganise ubuthongo. U-Marzabadi noogxa bakhe bafaka iimpuku ezincinane ezingamadoda ezingama-60 zohlobo lwe-BALB/c kwinkqubo ehlengahlengisiweyo yamaqonga amaninzi, apho isilwanyana esibekwe kwiqonga elimxinwa sinyanzelwa ukuba sihlale siphaphile, baza bathelekisa iqela lothelekiso elikwiqonga elibanzi nezilwanyana ezithintelwe ubuthongo, i-methylene blue yodwa, i-laser ekhupha ukukhanya ngemithontsi ye-810 nanometres yodwa, nezi zimbini zidibeneyo.

I-methylene blue yafakwa ngesitofu kwi-0.5 mg/kg ngeentsuku ezilishumi ezilandelelanayo ngaphambi kokuba kuqale ukuthintelwa kobuthongo, i-laser isetyenziswa yonke imihla yesibini. Ukufunda nenkumbulo zanikwa amanqaku kusetyenziswa imaze emile njengo-T, uvavanyo lonxibelelwano lwentlalo nebhokisi yokuhamba phakathi kwamacala amabini, yaye amanqanaba e-PSD-95, i-GAP-43 ne-synaptophysin kwi-hippocampus alinganiswa emva koko.

Ukuthintelwa kobuthongo kwanciphisa amazinga okutshintshana, ukuthanda ukunxulumana, umdla kubantu abangaziwayo nesalathisi senkumbulo. Akukho nalunye kunyango ngalunye olulodwa olwabuyisela umva uninzi lwaloo milinganiselo. Indibaniselwano yakwenza oko, yaza yanyusa zontathu izalathisi zonxibelelwano phakathi kweeseli zemithambo-luvo. Isiphumo sesokuba indibaniselwano yonyango olunikwe kwangaphambili yakhusela inkumbulo kwizilwanyana ezaziphazanyiswe ubuthongo. Ukuthintelwa kobuthongo kukwenzakala kuyilo lovavanyo, hayi isiphumo esilinganisiweyo. Akuzange kubhalwe ixesha elithathiweyo ngaphambi kokulala, ixesha lobuthongo okanye ukulandelelana kwezigaba zobuthongo, yaye ukufunda eli phepha njengobungqina bokuba umntu ulala kakuhle kangakanani kukuguqula intsingiselo yoko likulinganisileyo.

Kusasa okanye ebusuku: amanani awayisombululi loo nto

Ingcebiso ngexesha lokuthatha ichiza iphindaphindwa ngokuzithemba, kodwa ayizange ivavanywe. Akukho lingo luthelekise ukuthatha idosi kusasa nokuyithatha ngokuhlwa, kulo naliphi na iqela labantu, nangasiphi na isiphumo sobuthongo.

Into elinganisiweyo kukuba le khompawundi ihamba kancinane kangakanani. Kwisifundo sedosi enye kumavolontiya asempilweni, i-200 mg ethathwe ngomlomo emva kokulungiswa kwamathumbu yavelisa amanqanaba egazini anyuka iiyure ezilishumi elinesibini aza afikelela kwincopho ngexesha eliphakathi leeyure ezili-16. Ixesha lokuncipha kwesiqingatha sobungakanani laliphakathi kweeyure ezili-14 nezingama-27 kuloo dosi, naphakathi kweeyure ezi-6 nezingama-26 kwi-400 mg. Imveliso efakwa emthanjeni ekulwazi lokumiselwa inexesha lokuncipha kwesiqingatha elimalunga neeyure ezingama-24, yaye malunga ne-40% ikhutshwa ingatshintshanga kumchamo, ukuvezwa kuyo kunyuka kakhulu xa ukusebenza kwezintso kuphazamisekile.

Ngoko idosi ethathwe ngomlomo ngesidlo sakusasa ifikelela kwincopho yayo elinganisiweyo malunga nobusuku phakathi. Kubalulekile ukucingisisa ngaloo nto, kuba iingcebiso ezimbini ezixhaphakileyo zixhomekeke ekubeni loo nto ingabi yinyaniso. “Yithathe kusasa ukuze ingaphazamisi ubuthongo” icinga ukuba isiphumo sayo siphelile xa kufika ixesha lokulala. “Yithathe ebusuku kuba iphela ngokukhawuleza” icinga okuchaseneyo. Isifundo esinye esikhoyo kubantu sendlela ichiza elingena, lisasazeke neliphuma ngayo emzimbeni asixhasi isiphumo esifutshane sangokuhlwa, yaye uvavanyo lweempuku olusemva kwebali le-melatonin luxhasa ukuthatha idosi ekuqaleni kwexesha lokukhanya ngesizathu esahluke ngokupheleleyo, sokunyusa isandulela se-melatonin emini. Kukho isikhokelo esahlukileyo sokuba le khompawundi ihlala ixesha elingakanani emzimbeni ukuba uzele amanani okukhutshwa kwayo.

Impendulo enyanisekileyo kumbuzo wexesha lokuyithatha kukuba akukho mntu waziyo, yaye amanqanaba alinganisiweyo aphikisana nokwenza ngathi kukho umntu owaziyo.

Ingxelo enye kubantu yokutshintsha kwesiphazamiso sobuthongo

Kufunyenwe upapasho olunye kuphela kubantu apho i-methylene blue yanikwa umntu onesiphazamiso sobuthongo, yaye yimeko yomntu omnye.

Ingxelo yemeko ka-2021 kwi-Cureus ichaza inkwenkwe eneminyaka eli-15 eyayine-Kleine-Levin syndrome, imeko enqabileyo eneziqendu eziphindaphindayo zobuthongo obugqithisileyo ezihlala iintsuku ukuya kwiiveki, zihamba nokudideka, ukuva ngathi izinto ezingqongileyo aziyonyani nokutshintsha kokuziphatha. Yayinyangwe nge-lithium iminyaka emithathu, yaye i-modafinil, i-methylprednisolone, amachiza angengawo awesiqhelo okuthomalalisa iziphazamiso zengqondo ne-amantadine ayengavelisanga phuculo. Xa yayineminyaka eli-18 yaqalisa isiqendu esathatha phantse iinyanga ezintandathu. Ngemvume yabazali, yanikwa i-10 mg ye-methylene blue ngomlomo iyure enye ngaphambi kwemizuzu engama-25 yokukhanya okubomvu okufakwa empumlweni ubusuku ngabunye kwi-633 nanometres, i-11.4 joules kwi-square centimetre nganye. Kwisithuba seveki, ubuthongo obugqithisileyo neempawu zokuziphatha zaphela. Kwiminyaka emibini kamva yayingabuyelwanga yimeko yaye yayingathathi naliphi na elinye iyeza.

Ababhali bawuchaza ngokwabo umda wengxelo: umntu omnye, ingelulo uphando olulandelela abantu ekuhambeni kwexesha, yaye iziqendu ze-Kleine-Levin ziyaziwa ngokuncipha ngokuhamba kweminyaka, nto leyo eyenza kungabi nakwenzeka ukunxulumanisa ukuphela kweempawu nonyango. Kukho nomda wesibini abangawugxininisiyo. Kwakusetyenziswa iindlela ezimbini zonyango ngaxeshanye, yaye enye yazo yayikukukhanya okubomvu okufakwa kumngxuma wempumlo kunye nekhompawundi ekusetyenzisweni kwayo ngokufotodayinamiki ixhomekeke ngokupheleleyo ekubeni ukukhanya kuyivuselele. Umfundi akanakwahlula idayi ekukhanyeni nasekuhambeni kwexesha, yaye le ngxelo ayisosizathu sokuzama i-methylene blue kwingxaki yobuthongo.

Icala elinayo idatha kubantu kukuthomalaliswa

Apho kukho imilinganiselo kubantu yenkqubo yemithambo-luvo esembindini, ubukhulu becala ikhomba ekuthomalalisweni kunokuphapha.

Isifundo sika-2008 kwi-Anaesthesia sathelekisa izigulana ezili-11 ezazinikwe i-methylene blue kwangaphambili nezigulana ezili-11 zothelekiso ezineempawu ezifanayo, ngexesha lokuqaliswa kwesimo sokungaziva notyando, sisebenzisa isalathisi se-Bispectral nokufakwa kwe-propofol okulawulwa ngokwenqanaba ekujoliswe kulo. Kwinqanaba le-propofol eliqikelelweyo lendawo esebenza kuyo eliyi-2 micrograms kwi-millilitre nganye, amanqaku okuthomalaliswa namaxabiso esalathisi ayephantsi kakhulu ngokobalo-manani kwiqela elanyangwayo. Kulo lonke utyando, izigulana ezazinikwe ichiza kwangaphambili zafuna ngokomndilili i-propofol engaphantsi nge-50% ukuze zifikelele kubunzulu obufanayo bokungaziva. Iphepha liqala ngokuqaphela ukuba ukulibaziseka kokuvuka kwisimo sokungaziva nokuphazamiseka kwemithambo-luvo kwakusele kuxeliwe kwizigulana ezazityandwa amadlala e-parathyroid ezazifumene i-methylene blue kwangaphambili, lize liqukumbele ngokucebisa uhlengahlengiso olucokisekileyo lwedosi nanini na ichiza lifakwa malunga nexesha lotyando.

Ulwazi lokumiselwa luthetha into efanayo ngamanye amazwi. Unyango lunokubangela ukudideka, isiyezi nokuphazamiseka kokubona, yaye izigulana ziyacetyiswa ukuba zikuphephe ukuqhuba okanye ukusebenzisa oomatshini abayingozi de ezi zinto ziphele, umyalelo ongenabudlelwane bucacileyo nekhompawundi ethengiswa njengesincedisi sobuthongo.

Kukwakho nokusetyenziswa kwayo okunyanga imeko efana nobuthongo. I-ifosfamide, ichiza lekhemotherapi, inokubangela ukuphazamiseka kobuchopho okuneempawu eziphambili zokozela kakhulu, ukuxhalaba nokungazinzi, nokudideka, kuze kufikelele kwikoma. I-methylene blue lolunye lonyango olunikwayo kule meko. Kuphononongo lweemeko ezingama-24 kwi-MD Anderson Cancer Center, izigulana ezingama-20 zafumana i-methylene blue yaye iimpawu zaphela kwezili-19, zaphinda zavela kwabathathu kwabahlanu abaphinda banikwa i-ifosfamide kamva ngoxa babefumana i-methylene blue ukuthintela ezo mpawu.

Ichiza elenza nzulu isimo sokungaziva, elibangela isiyezi nokudideka, nelisetyenziswa ukubuyisela umva imeko yokozela okugqithisileyo okubangelwa yikhemotherapi alibonakali ngokucacileyo njengesincedisi sobuthongo. Lichiza elineziphumo zokwenene kwinkqubo yemithambo-luvo esembindini, icala lezo ziphumo lixhomekeke koko sele kukhona emzimbeni.

Amayeza asebusuku, nokuphefumla ebusuku

Amangeniso amabini kulwazi lokumiselwa afanele ukuqwalaselwa nguye nabani na othatha i-methylene blue ngokuhlwa kunye nenye into.

Elokuqala luluhlu lokunxibelelana kwamachiza. Ileyibhile ikhankanya ii-SSRI, ii-SNRI, ii-MAOI, i-bupropion, i-buspirone, i-clomipramine, i-mirtazapine, i-linezolid, ii-opioid ne-dextromethorphan, yaye icebisa ukuba kungathathwa naliphi na ichiza elichaphazela i-serotonin kwiiyure ezingama-72 emva kwedosi yokugqibela. Ezimbini kwezo zihlala kwiitafile ezisecaleni kweebhedi. I-mirtazapine lichiza lokudakumba elithomalalisayo elidla ngokuthathwa ebusuku. I-dextromethorphan sisithinteli sokukhohlela esikumayeza engqele asebusuku, yaye ithengiswa ngaphandle komyalelo kagqirha. Akukho nanye kwezi ndibaniselwano eyingcinga nje: ileyibhile ibhala iimeko ze-serotonin syndrome ezivela kwiimveliso zodidi lwe-methylene blue, yaye ezinye zazo zabangela ukufa. Ingxelo epapashiweyo yemeko enxulumene notyando ichaza indoda eneminyaka engama-67 ukuxhalaba nokungazinzi kwayo, ukuxhuzula kwezihlunu okuphindaphindayo nobushushu bomzimba obugqithisileyo okwabonakala kuphela xa yayivuka kwisimo sokungaziva ngokubanzi, emva kokuba inikwe i-methylene blue ngexesha lotyando.

I-melatonin, ii-benzodiazepine, amachiza ohlobo lwe-z afana ne-zopiclone, ne-diphenhydramine azichaphazeli i-serotonin ngale ndlela, ngoko inkxalabo apho ayiyo-serotonin syndrome. Yileyo yalinganiswa sisifundo sokungaziva, kukuthi kukuthomalaliswa okongezelelekileyo kwidosi engekho mntu uyichazileyo.

Ungeniso lwesibini luphathelele ekuphefumleni. Phakathi kweziphumo ezingathandekiyo ezixeliweyo kwiimveliso zodidi lwe-methylene blue, ulwazi lokumiselwa ludwelisa ukuvaleka kwempumlo, intlungu emlonyeni nasemqaleni, ukuvuza kwempumlo nokuthimla. Ezi ziingxelo ezenziwe ngokuzenzekelayo ezingenamanani obuninzi bazo nendlela yokufakwa kwechiza echaziweyo, yaye ziluhlobo lotshintsho olunokubonakala ngokuvuka unomlomo owomileyo nemvakalelo yokuba uphefumle ngeempumlo ngendlela eyahlukileyo ebusuku. Ingxelo yomfundi omnye yotshintsho ngesiquphe ukuya ekuphefumleni ngomlomo ngexesha lobuthongo ikhona kumcu wengxoxo yeforam ngaphandle kovavanyo, imbali yamayeza okanye nawuphi na umlinganiselo, nto leyo eqinisekisa kuphela ukuba ingxelo yenziwa, kungekho nto ingaphezulu.

Nabani na onengxaki yobuthongo ekukurhona, ukunqumama kokuphefumla okubonwe ngomnye umntu, okanye ukozela emini kakhulu ngokwaneleyo ukuba alale ngoxa eqhuba, ufanele ajonge umba wokunqumama kokuphefumla ebuthongweni kunokuba ajonge isongezelelo. Ukunqumama kokuphefumla kunokuxilongwa, kunokunyangwa, yaye akukho bungqina bungasentla buthetha ngako.

Into esetyenziswayo nayo ingumba oguquguqukayo apha

Iidosi kuzo zonke izifundo ezingasentla yayizizixa ezilinganisiweyo zekhompawundi echaziweyo evela kumenzi wamayeza, ixhaswa sisiqinisekiso sohlalutyo. Ibhotile evela kumthengisi ongakhange aqinisekiswe ayifani naloo nto, yaye umahluko awungowenkangeleko nje. Uphawu lwe-USP ngumgangatho umthengi anokuwujonga, yaye into engahambelaniyo nawo isenokuba yeyomgangatho wokudaya amalaphu, enokuthwala ukungcola kwezinto eziphilayo njenge-Azure B, iintsalela zezinyibilikisi nezinyithi ezinzima kumanqanaba ancitshiswa yimigangatho yamayeza.

Uninzi lwabathengisi abachaza imveliso njengevavanywe ngumntu wesithathu luvavanya izinyithi ezinzima kuphela luze lubonise loo paneli inye njengokuhambelana ngokupheleleyo nemigangatho. I-Blupreme ivavanya yonke imigangatho ye-USP: isazisi, ubunyulu, ukungcola kwezinto eziphilayo, iintsalela zezinyibilikisi, ukungcola kwee-elementi, intsalela emva kokutshiswa, imida yeentsholongwane nee-endotoxin zebhaktiriya. Ibhetshi nganye ithunyelwa kunye nesiqinisekiso sohlalutyo, yaye ukusifunda ngokuchanekileyo kuthetha ukuthelekisa inombolo yebhetshi nelebhu nebhotile esesandleni sakho.

Akukho nanye kwezo zinto idala inzuzo yobuthongo, yaye ayisosizathu sokuthatha le khompawundi. Ukuba uyayithatha nangona kunjalo, ukwazi oko kukwikhepsuli yeyona nto isisiseko, yaye ireferensi yokhuseleko kunye nesikhokelo sokunxibelelana kwamachiza zigubungela imibuzo ekufuneka iza ngaphambi kwayo nayiphi na ingxoxo yexesha lokuyithatha.

Isishwankathelo

Akukho lingo lolwabiwo olungenamkhethe olulinganise ubuthongo ngexesha lonyango lwe-methylene blue. Amangeniso kuphela ngobuthongo kwirekhodi yamalingo olwabiwo olungenamkhethe yimigca yeziganeko ezingathandekiyo, yaye kolona thelekiso lukhulu lweedosi olufumanekayo izinga lokuphuthelwa laliyi-2.7% kwi-8 mg ngosuku xa lithelekiswa ne-6.5% kwi-200 mg ngosuku.

Ibango ngamaphupha acacileyo alinawo umthombo opapashiweyo, yaye iincwadi zophando nge-monoamine oxidase ziqikelela okuchaseneyo ngexesha lonyango. Umbuzo wokuthatha kusasa xa kuthelekiswa nasebusuku awuzange uvavanywe, yaye idosi ethathwe ngomlomo ifikelela kwincopho egazini ngexesha eliphakathi leeyure ezili-16, elisondele kubusuku phakathi kunexesha lesidlo sasemini kuye nabani na othatha idosi ngesidlo sakusasa. Uvavanyo lokuthintelwa kobuthongo olusasazwa njengobungqina sisifundo senkumbulo apho kungazange kubhalwe buthongo, yaye ingxelo enye kubantu yokuphucuka kwesiphazamiso sobuthongo yeyomntu omnye owayesazi ukuba ufumana luphi unyango, efumana iindlela ezimbini zonyango ngaxeshanye.

Isishwankathelo sobungqina kubantu siqokelela oko la malingo akuqinisekisayo, uphononongo lwenkumbulo nokugxila luhlalutya iziphumo zokuqonda ezisondele kakhulu kubuthongo kwezi zifundo zifanayo, yaye ithala lophando lidwelisa amaphepha axhasa ibango ngalinye kweli phepha.