巴马香猪、人和大鼠洛伐他汀体外代谢的比较

目的：体外研究巴马香猪、人和大鼠肝微粒体中洛伐他汀代谢的酶动力学差异，并用人体肝微粒体细胞色素P4503A（CYP3A）酶特异性抑制剂酮康唑（KCZ）进行抑制，观察抑制活性反应的差异，评估巴马香猪作为人体CYP3A酶代谢药物研究实验动物模型的可行性。方法：制备巴马香猪、人和大鼠的肝微粒体，构建肝微粒体与洛伐他汀的反应体系以及抑制剂抑制反应体系。利用RP—HPLC测定洛伐他汀代谢的变化，并对其相应活性值进行比较。结果：巴马香猪肝微粒体代谢洛伐他汀的酶动力学变化比大鼠更为与人体相似。人体CYP3A特异性抑制剂均可以显著抑制三者的代谢，但是巴马香猪代谢速率下降程度与人体接近。结论：巴马香猪与大鼠相比，更适用于作为人CYP3A酶代谢的相关药物研究的良好动物模型。     

单探针与混合探针底物法在细胞色素P450酶底物酶促动力学中的比较研究

[目的] 研究5种细胞色素P450酶亚型的特异性探针底物非那西丁（CYP1A2）、右美沙芬（CYP2D6）、甲苯磺丁脲（CYP2C9）、奥美拉唑（CYP2C19）、咪达唑仑（CYP3A4）在人和大鼠肝微粒体中的酶动力学特征,比较两种探针底物法的适用性。[方法] 5种特异性探针底物分别经人或大鼠的肝微粒体代谢反应后,采用高效液相色谱法测定特异性探针底物的代谢速率,根据底物浓度-代谢速率曲线计算酶动力学常数。[结果] 单探针与混合探针两种方法在人肝微粒体中所得的V_max、K_m值具有一致性;而在大鼠肝微粒体中所得的K_m具有一定差异,表明该混合探针底物法在用于药物对大鼠肝微粒体中的细胞色素P450酶活性评价时可能会出现一定程度的影响。[结论] 在人肝微粒体中,两种探针底物法的V_max、K_m值具有一致性,因而混合探针底物法可代替单探针法用于细胞色素P450酶活性评价;在大鼠肝微粒体中,探针底物混合后可使得部分探针底物的K_m值升高,与酶亲和力下降,在细胞色素P450酶活性评价中可能出现假阴性结果。     

“Cocktail”体外探针法评价补骨脂素对人肝微粒体P450酶亚型活性的影响

[目的]利用Cocktail体外探针法,测定补骨脂有效成分补骨脂素对人肝微粒体多种P450酶亚型活性的影响,为补骨脂临床联合用药安全提供参考。[方法]建立液质联用方法,同时测定人肝微粒体P450酶中各探针代谢产物6α-OH紫杉醇、α-OH咪达唑仑、4-OH甲苯磺丁脲、去甲基右美沙芬、7-OH香豆素、对乙酰氨基酚和6-OH氯唑沙宗的含量。通过Cocktail体外探针实验中补骨脂素对人肝微粒体P450酶各亚型的影响,证明补骨脂对人体肝脏的代谢有影响作用。[结果]所建立的液质联用方法精密可靠,符合生物样品测定要求,可用于人肝微粒体中各P450酶探针的代谢产物的定量分析。与对照组相比,补骨脂素组各底物的转化率均下降,其中香豆素的转化率下降最为显著,补骨脂素对其转化的抑制率为95.84%,而紫杉醇的转化的抑制最不明显,仅为10.39%。补骨脂素对其他几种底物的转化抑制率均在82%～91%之间。[结论]补骨脂素对人肝微粒体的CYP1A2、2A6、2C8、2C9、2D6、2E1和3A4亚型均有抑制,其中对CYP2A6、1A2和2D6 3种亚型的影响较为显著,表明补骨脂素对人肝微粒体P450酶不同亚型影响差异显著,长期给药补骨脂应关注药物联合用药安全。     

异莲心碱对大鼠CYP3A酶活性的影响

目的:探讨异莲心碱对CYP3A酶活性的影响,以了解异莲心碱与CYP3A酶底物合用药时可能产生的相互作用.方法:①建立体外肝微粒体混合酶代谢体系;②以睾酮作为底物探针,用HPLC建立检测CYP3A酶代谢活性的方法,考察体外代谢体系的最佳孵育条件;③将不同浓度异莲心碱分别与睾酮共同孵育于肝微粒体代谢体系中,测定在有或无异莲心碱存在下睾酮的减少量,以评估异莲心碱对CYP3A酶代谢的影响.结果:在肝微粒体孵育体系中,睾酮体外代谢的最佳孵育条件为底物浓度200μmol/L,代谢时间210 min.异莲心碱对CYP3A酶抑制作用较弱,IC50＞1 000 μmol/L.结论:异莲心碱对CYP3A酶无显著影响,可以与其底物联合用药.     

紫杉醇对食蟹猴和人CYP1A2、CYP3A4及CYP2A6酶代谢的影响

目的探讨紫杉醇对食蟹猴和人肝微粒体CYP1A2、CYP2A6和CYP3A4酶活性的影响。方法采用食蟹猴和人肝脏微粒体,分别以非那西汀、睾丸酮和香豆素分别作为CYP1A2、CYP2A6、CYP3A4的底物,建立CYP1A2、CYP2A6和CYP3A4体外代谢体系。采用不同浓度的紫杉醇分别与上述3种底物共同孵育于肝微粒体代谢体系中。用HPLC法分别测定各底物的代谢产物扑热息痛、6β-羟基睾丸酮、7-羟基香豆素的产生量,计算IC50值,以评估紫杉醇对CYP1A2、CYP2A6和CYP3A4代谢的影响。结果紫杉醇对食蟹猴肝微粒体3种酶的IC50值分别为570±5.9μmol/L、140±2.9μmol/L和无影响;紫杉醇对人肝微粒体3种酶的IC50值分别为193±6.6μmol/L、253±3.6μmol/L和24±1.6μmol/L。结论紫杉醇对食蟹猴肝微粒体CYP1A2和CYP3A4活性具有一定的抑制作用,但对CYP2A6酶的活性几乎没有影响。紫杉醇对人肝微粒体CYP1A2和CYP3A4活性的抑制作用较弱,但对CYP2A6酶的活性抑制作用较强,提示临床上紫杉醇与作为上述酶底物的药物联合用药时应慎重,以避免因中西药物相互作用所导致的不良反应发生。     

异莲心碱对大鼠CYP3A酶活性的影响

目的:探讨异莲心碱对CYP3A酶活性的影响,以了解异莲心碱与CYP3A酶底物合用药时可能产生的相互作用。方法:①建立体外肝微粒体混合酶代谢体系;②以睾酮作为底物探针,用HPLC建立检测CYP3A酶代谢活性的方法,考察体外代谢体系的最佳孵育条件;③将不同浓度异莲心碱分别与睾酮共同孵育于肝微粒体代谢体系中,测定在有或无异莲心碱存在下睾酮的减少量,以评估异莲心碱对CYP3A酶代谢的影响。结果:在肝微粒体孵育体系中,睾酮体外代谢的最佳孵育条件为底物浓度200μmol/L,代谢时间210 min。异莲心碱对CYP3A酶抑制作用较弱,IC50>1 000μmol/L。结论:异莲心碱对CYP3A酶无显著影响,可以与其底物联合用药。     

丹参酮对大鼠细胞色素P-450酶系和谷胱甘肽转移酶的作用

目的探讨丹参有效成分丹参酮 (Tan)对大鼠肝、肾组织内的细胞色素P 450酶 (cytochromeP 450,CYP)系和谷胱甘肽转移酶(GT)的影响。方法给予SD雄性大鼠丹参酮 (100mg·kg-1 )灌胃,每日 1次,连续10天后,选用CYP1A1、1A2、2B1、2E1及 3A特异性代谢底物,检测它们在肝和肾微粒体中的活性,同时检测肝、肾微粒体中的GT水平变化。结果实验表明,丹参酮可诱导肝微粒体内的CYP1A1、CYP1A2和CYP2B1活性显著升高(均P<0. 01),同时显著抑制CYP2E1的活性 (P<0. 01),也可诱导肝微粒体中GT的活性升高 (P<0.05)。结论丹参酮对CYP亚型的不同调节作用可能会影响与其合用药物在体内的代谢消除,丹参酮对GT的影响也具有一定的临床意义。     

LC-MS/MS法研究苯环喹溴铵对大鼠肝微粒体CYP450酶的抑制作用

建立同时测定大鼠肝微粒体中7种特异性底物对应代谢产物（对乙酰氨基酚、4″-羟基美芬妥英、右啡烷、4-羟基甲苯磺丁脲、6-羟基氯唑沙宗、1-羟基咪达唑仑和6β-羟基睾酮）的LC-MS/MS法,并应用探针底物法研究苯环喹溴铵对大鼠肝微粒体CYP450酶的抑制作用。将CYP450酶6种亚型的7种特异性探针底物非那西丁（CYP1A2）、S-美芬妥英（CYP2C11）、右美沙芬（CYP2D1/2）、甲苯磺丁脲（CYP2C6）、氯唑沙宗（CYP2E1）、咪达唑仑（CYP3A1/2）和睾酮（CYP3A1/2）分别与大鼠肝微粒体及系列浓度的苯环喹溴铵溶液进行温孵反应,合并处理后的微粒体溶液,采用LC-MS/MS法同时测定对应底物代谢产物的含量,计算相应的IC₅₀,评价是否有抑制作用。并应用已知抑制剂对所建立的探针底物法进行验证。在大鼠肝微粒体温孵体系中,苯环喹溴铵对CYP1A2,CYP2C11,CYP2C6,CYP2E1和CYP3A1/2的IC₅₀均大于100 μmol/L,对CYP2D1/2的IC₅₀为（2.16±0.22）μmol/L。结果表明,苯环喹溴铵对CYP2D1/2可能有抑制作用,对CYP450酶的其他亚型无抑制作用。     

探针药物法评价柚皮苷对人肝微粒体CYP2E1酶代谢活性的影响

目的：考察柚皮苷对CYP2E1酶代谢活性的影响,以探讨与其它以CYP2E1为主要代谢酶的药物联用时,是否可能产生潜在的相互作用.方法：在人肝微粒体代谢体系中,以氯唑沙宗作为底物探针,建立表征CYP2E1酶代谢活性的HPLC检测方法,分别考察体外代谢体系的最适宜底物浓度、代谢时间、pH值以及孵育温度.在确定的条件下,将柚皮苷稀释成不同浓度,分别与氯唑沙宗共同孵育于人肝微粒体代谢体系中,测定在有或无柚皮苷存在下氯唑沙宗的剩余量,以评估柚皮苷对CYP2E1酶代谢的影响.结果：在人肝微粒体孵育体系中,氯唑沙宗代谢最适宜的体外代谢条件为底物浓度2.4 g/L,代谢时间3.5h,pH7.5,孵育温度37℃.柚皮苷对CYP2E1酶代谢活性有一定的抑制作用,IC50为10.07 μmol/L.结论：柚皮苷对经CYP2E1酶代谢的药物可能会产生微弱的药物相互作用.     

灯盏生脉胶囊有效组分对大鼠细胞色素P450酶同工酶作用的体外研究

目的 探讨灯盏生脉胶囊6种有效组分对细胞色素P450酶(CYP450酶)4种主要亚型(同工酶)的作用.方法 采用大鼠肝微粒体体外孵育的方法和液质联用(LC/MS/MS)技术,通过体外cocktail高通量筛选,选择不同的CYP450酶同工酶特异性探针底物与灯盏生脉有效组分共同孵育,比较灯盏生脉有效组分对大鼠肝微粒体中CYP450酶同工酶抑制作用.结果 五味子甲素对大鼠肝微粒体CYP3A1、2C6及2C11有弱抑制作用,五味子酯甲对CYP3A1及2C11有弱抑制作用,IC50值均在10～50 μmol/L之间.结论 本研究初步界定参与灯盏生脉胶囊有效组分代谢的大鼠CYP450酶同工酶,及其有效组分对大鼠CYP450酶同工酶的抑制作用,为灯盏生脉胶囊与其他药物的联合使用提供科学依据.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…