1.1 Los ntawm kev kho cell membrane mus rau Cerebrovascular kev cai

Txij li thaum Citicoline tau tsim thawj zaug los ntawm Takeda Pharmaceutical ntawm Nyij Pooj xyoo 1956, nws daim ntawv thov keeb kwm tuaj yeem suav tias yog keeb kwm ntawm kev txawj ntse kho dua tshiab:

• Xyoo 1980:Tsuas yog siv los ua cov tshuaj kho cell membrane tom qab mob stroke

• Xyoo 2010:Nws tau pom tias nws tuaj yeem ua rau cov ntshav cerebral perfusion (PET-CT pom tau tias nce 23% ntawm cov ntshav ntws mus rau hauv lub cev)

• Hauv xyoo 2024,NIH ntawm Tebchaws Meskas tau teev tseg tias nws yog ib qho tseem ceeb ntawm kev tswj hwm cov tshuaj "neurovascular coupling"

1.2 Kev loj hlob tawg ntawm kev lag luam thoob ntiaj teb

Raws li cov ntaub ntawv ntawm Evaluate Pharma:

Kev muag khoom thoob ntiaj teb tau txog 4.7 billion US las hauv 2024 (CAGR 12.3%)

Kev siv tshuaj hauv cov tsev kho mob hauv Suav teb tau nce 400% hauv peb xyoos

Indications tau nthuav dav rau:

Vascular dementia (MMSE tau qhab nia zoo dua los ntawm 2.1 cov ntsiab lus)

Kev puas hlwb raug mob (GOS prognostic scale nce los ntawm 1.5 qib)

Tshooj Ob: Black-box Cracking ntawm Mechanism of Action

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2.1 Triple action pathways

Cov txiaj ntsig pov thawj qib: Phosphatidylcholine synthesis kho neuronal membrane kev ncaj ncees Class I: Acetylcholine precursors txhim khu kev xa cov neurotransmitter Class IIA: Nitric oxide synthase regulation txhim kho microvascular dilation (inch nce 18%) Class IIB

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2.2 Clinical golden window lub sij hawm

Ib txoj kev tshawb fawb 2024 los ntawm Thawj Tsev Kho Mob ntawm Sun Yat-sen University qhia:

Kev txhaj tshuaj ntawm 1000mg hauv 6 teev tom qab cerebral infarction tuaj yeem txuag thaj tsam ntawm ischemic penumbra txog li 7.2cm.3

Txawm li cas los xij, tsis muaj qhov sib txawv tseem ceeb thaum kev tswj hwm tau tshaj 72 teev (p = 0.34).

Tshooj 3: Lub Vortex ntawm Controversy

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3.1 Tsis ntseeg txog kev siv tau

UK NICE Cov Lus Qhia: Nws tau txiav txim siab tias cov ntaub ntawv pov thawj uas twb muaj lawm tsis txaus los txhawb kev pov hwm kev noj qab haus huv (tus nqi-zoo piv ￡ 45,000 / QALY)

Lancet Neurology ** 2025 Meta-analysis: Tsis muaj qhov sib txawv tseem ceeb ntawm cov placebo hauv cov pab pawg me me kev paub tsis meej (p = 0.21)

3.2 Chaos hauv Kev Tshaj Tawm Kev Lag Luam

National Medical Products Administration's 2024 ceeb toom:

Kaum ob lub lag luam exaggerated cov indications (txhawb "adjuvant therapy" li "reversing dementia")

Kev ntsuam xyuas ntawm qee qhov kev lag luam e-lag luam qhia tau tias cov ntsiab lus tiag tiag ntawm 32% ntawm kev npaj qhov ncauj yog tsawg dua 70% ntawm cov ntawv sau npe

Tshooj Plaub: Frontiers of Technological Breakthroughs

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4.1 Kev xa tshuaj tshiab

Ntshav-hlwb barrier penetrating peptide hloov liposomes (Patent ntawm Peking University Team, CN202410123456.7)

Teb-tso tawm microneedles (Kev sim tsiaj hauv Seoul National University hauv Kaus Lim Qab Teb qhia qhov nce peb zaug hauv bioavailability)

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4.2 Kaj ntug ntawm Cov Tshuaj Kho Mob Tus Kheej

Bgi txoj kev tshawb fawb sib koom tau pom tias:

Cov nyhuv tshuaj ntawm CDP-cholinesterase gene polymorphic cov pej xeem (siv rau 31% ntawm cov neeg Esxias) tau nce 47%

Tshooj 5 Cov ntaub ntawv tiag tiag ntawm cov neeg mob

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5.1 Cov neeg tau txais txiaj ntsig

Ib cov ntaub ntawv los ntawm lub tsev kho mob tertiary hauv Hangzhou: Tom qab kev kho mob ua ke, cerebral blood flow reserve muaj peev xwm ntawm tus neeg mob hnub nyoog 62 xyoo uas muaj kev puas hlwb rov qab los ntawm 32% mus rau 89%

5.2 Cov lus hais tus kheej ntawm tog tsis raug

"Nyob rau ib nrab ib xyoos tsis tu ncua, tus nqi ib hlis ntawm 300 yuan tsuas yog ua rau lub plab tsis xis nyob" - cov ntaub ntawv sib tham ntawm Ms. Li, tus neeg mob los ntawm Beijing