普乐可复在国内首例亲体小肠移植患者的个体化用药

目的　了解普乐可复 (FK5 0 6 )在亲体小肠移植患者体内药代动力学的规律 ,为临床小肠移植患者制定个体化用药方案 .方法　在患者 FK5 0 6血药浓度达稳态条件下 ,于一个给药周期 (τ)内间隔采集患者全血 11次 ,以微粒子酶免分析法 (MEIA)测定 FK5 0 6全血浓度 ,以 3P97药动学程序拟合求算 FK5 0 6在患者体内的药动学参数 ,以该患者个体的药动学参数为依据 ,为其实施个体化用药 .结果　在患者 poFK5 0 6 (5 mg· 12 h- 1 )稳态时 ,FK5 0 6在该患者体内的处置为一室开放模型 ,其主要的药动学参数 :达峰时间 Tmax、最大全血浓度ρmax、消除相半衰期 t1 / 2 ke、曲线下面积 AUC分别为1.4h,2 5 .1μg· L- 1 ,8.8h和 35 5 .7μg· h- 1 ·L- 1 ,FK5 0 6全血浓度波动差值为 13.7μg· L- 1 .结论　为降低 FK5 0 6全血浓度波动范围 ,采用 8h1次 po FK5 0 6更为适宜 ,同时应加强 FK5 0 6血药浓度监测 ,确保用药安全和有效     

他克莫司药代动力学特点及其在肾移植术后的应用

目的了解肾移植患者体内他克莫司(FK506)药代动力学特征,为临床制定个体化用药方案提供依据.方法采用微粒子酶免分析仪测定3例肾移植患者用药前后不同时间全血中FK506浓度,以3P97药动学程序拟合求算FK506药动学参数.结果在患者口服FK506[0.15mg/(kg·12 h)]达稳定态,FK506在体内处置为一室开放模型.药动力学参数如下:药物半衰期(t1/2)分别为3.9、6.2和8.8 h,峰值浓度(Cmax)分别为75.3、58.2和25.1mg/mL,血药达到峰值浓度时间(Tmax)为1.2、1.5和1.4 h,药物浓度-时间曲线下面积(AUC)为526.6、483.2和355.7 ng·h/mL,全血浓度波动差值为63.4、42.6和13.7ng/mL.结论为降低FK506全血浓度波动范围,采用6～8h一次口服FK506更为适宜,同时应加强FK506血药浓度监测,确保用药安全和有效.     

他克莫司国内首例换脸术患者的个体化用药

目的:研究他克莫司(FK506)在换脸术患者体内药动学特征及规律,并以此为依据制定个体化给药方案,确保免疫抑制剂FK506用药的安全有效.方法:口服FK506达稳态后,给药前和给药后0.25,0.5,0.75,1,1.5,2,2.5,3,4,6,8 和12 h 抽取全血样品,采用MEIA法进行全血药物浓度测定,以DAS2.0药动学软件程序拟合求算FK506在体内药动学参数;基于此临床药动学特征,结合该患者临床疗效和不良反应制定合理安全的给药方案,总结出适合该患者的治疗窗.结果:口服FK506达稳态时,其主要的药动学参数:达峰时间Tmax为1.5 h,最大全血浓度Cmax为51.4 ng/mL,消除半衰期T1/2为13.4 h,曲线下面积AUC0-12为600.58 ng/(mL·h);治疗窗谷浓度范围控制在15～20 ng/mL ,活检检验和实验室检查结果显示FK506的剂量控制在安全的治疗窗内,移植术后未出现严重的排异反应和明显的免疫抑制剂的毒副作用.结论:FK506治疗窗谷浓度范围15～20 ng/mL具有良好的免疫抑制效果,此浓度范围既可满足此患者免疫抑制作用,又可减少FK506的毒副作用.     

进口青霉素V钾片在健康人体的药物动力学

目的 :研究进口青霉素V钾片在健康人体的药物动力学。方法 :12名健康男性受试者 ,空腹单剂口服进口青霉素V钾片 15 0 0mg ,采用微生物法测定不同时间血清中药物浓度 ,用 3P87软件经微机处理血药浓度 -时间数据。结果 :用药后体内过程符合二房室开放模型 ,其主要药动学参数如下 ,达峰时间 (Tmax)为 (0 70± 0 .11)h ,峰浓度 (Cmax)为 (12 86± 2 2 6 )mg/L ,消除半衰期 (t1/ 2 β)为 (1 2 7± 0 2 4)h ,药时曲线下面积 (AUC)为 (2 0 30±2 90 )mg·h·L-1。结论 :进口青霉素V钾片药动学特点可为临床用药提供参数依据。     

HPLC法测定人唾液中卡马西平浓度及其药代动力学

目的 :利用HPLC法测定人唾液中卡马西平浓度 ,并观察其药代动力学特征 .方法 :采用Shim packCLC ODSC1 8色谱分析柱 (1 5 0mm× 6mm ,5 μm) ,以甲醇 水 (5 3∶4 7)为流动相 ,流速为 1 .0mL·min-1 ,检测波长为 2 1 2nm ,柱温为室温 ,进样量 5 0 μL .根据唾液药物浓度求算 6名健康受试者单剂量口服卡马西平片剂的药代动力学参数 .结果 :本测定方法线形范围为 0 .4 0～ 4 .32mg·L-1 ,相关系数r =0 .999,最低检出浓度为 30 μg·L-1 (按S/N≥ 3计 ) ,方法平均回收率为99.1 7% - 1 0 4 . 80 % ;日内RSD、日间RSD分别在2 .6 % - 4 .9%和 3.0 % - 8.6 % .药动学参数表明 ,卡马西平人体内过程符合单室开放模型 ,Tmax,Cmax,ke,T1 / 2 ,AUC(0～inf) 分别为 (4 .5 0± 3.1 5 )h ,(1 .5 2± 0 .2 2 )mg·L-1 ,(0 .0 0 90± 0 .0 0 0 6 )h-1 ,(77.1 6± 5 .2 6 )h ,(1 32 .1 8± 8.82 )mg·h·L-1 .单次给药后 ,CBZ唾液浓度 时间曲线出现多峰现象 .结论 :该法简便、快速、专一性强 ,适用于卡马西平唾液药物浓度测定及药代动力学研究之用     

肾移植术后FK506血药谷浓度的临床观察

目的 :建立FK5 0 6理想治疗窗谷浓度范围 ,初步了解影响FK5 0 6谷浓度的因素以及FK5 0 6谷浓度与急性排斥反应和肾中毒的关系 .方法 :78例同种尸肾移植受者应用FK5 0 6 +骁悉 (MMF) +强的松 (Pred)三联免疫抑制治疗 ,采用竞争性酶联免疫吸附法 (ELISA)测定服药 12h后FK5 0 6的全血浓度 (即谷浓度 ) ,对术后不同时期的FK5 0 6血药浓度进行分析 .结果 :FK5 0 6的全血谷浓度 ,正常组术后 1mo内(13.1± 2 .6 ) μg·L-1,2mo (10 .9± 2 .4 ) μg·L-1,3mo (10 .6± 1.9) μg·L-1,4 / 6mo (8.2± 1.2 ) μg·L-1,7mo以后 (6 .6± 1.1) μg·L-1.抗痨组术后 3mo内FK5 0 6谷浓度显著低于正常组 ,肝功损害组术后各时期的FK5 0 6谷浓度显著高于正常组 .急性排斥反应 1例 ,FK5 0 6谷浓度为 3.2 μg·L-1.急性肾中毒 6例 ,平均谷浓度为 18.7μg·L-1.结论 :FK5 0 6理想的全血谷浓度治疗窗范围为 :术后 1mo内 10～ 15 μg·L-1,术后 2～ 3mo 9～ 12 μg·L-1,4～ 6mo 7～ 10 μg·L-1,7mo以后5～ 8μg·L-1.肝损害可显著提高FK5 0 6血药浓度 ,利福平显著降低FK5 0 6血药浓度 .FK5 0 6低浓度易致急性排斥反应 ,高浓度可致急性肾中毒     

格列齐特片健康人体药物动力学及相对生物利用度

目的　研究格列齐特片的健康人体药物动力学及相对生物利用度。方法　 8例健康受试者单剂量交叉口服格列齐特片标准参比制剂和被试制剂 80mg后 ,用高效液色谱法测定血浆中格列齐特片浓度。结果　两药体内过程均符合一房室开放模型 ,Tmax分别为 (5 5 0± 0 5 3)h和 (5 0 0± 0 5 3)h ,Cmax为 (2 95± 0 4 1)mg·L-1和 (3 0 2± 0 31)mg·L-1,AUC为 (45 79± 5 99)mg·h·L-1和 (42 99± 6 93)mg·h·L-1,被试制剂的相对生物利用度为 (10 2 9± 8 2 ) %。两种制剂的药动学参数无显著性差异。结论　两种制剂具有生物等效性。     

用唾液和血液比较研究得理多的药代动力学

目的　用唾液法和血液法比较得理多 (Tegretol)在人体内的药代动力学特征 ,动态观察唾液和血液药物浓度的相关性 .方法　以 HPL C法测定 8名健康志愿者口服 2 0 0 mgTegretol后的唾液和血液浓度 ,分别计算其药代动力学参数并进行统计学比较 .结果　唾液和血液中的 Tegretol药 -时曲线可用一室开放模型拟合 ,其峰浓度 (Cmax)分别为 (1.45± 0 .2 1)、(4 .2 1± 0 .85 ) mg· L- 1 ;达峰时间 (Tmax)分别为(6.2 5± 4.88)、(7.75± 1.75 ) h,吸收半衰期 (T1 / 2 ka)为 (1.45± 1.2 1)、(1.69± 1.18) h,消除半衰期 (T1 / 2 ke)为 (5 2 .43±19.90 )、(5 1.5 8± 9.5 7) h,曲线下面积 AU C为 (135 .91±16.81)、(34 1.86± 48.10 ) h· mg· L- 1 ,清除率 (CL /F)为(0 .0 15± 0 .0 0 5 )、(0 .0 13± 0 .0 0 2 ) (mg· kg- 1 ) /(mg· L- 1 ) ,唾液和血液药动学参数中的 Tmax,T1 / 2 ka,T1 / 2 ke和 CL /F无显著性差异 (P>0 .0 5 ) .Tegretol的唾液 /血液浓度比值 (S/P)平均为 0 .367± 0 .0 5 6,吸收相略高于消除相 ;服药 3～ 144 h的 Tegretol唾液和血液浓度的相关系数 (r)平均为 0 .90 5 .结论　 Tegretol的唾液和血液浓度在用药 3～ 144 h具有较高的相关性 ,这种相关性存在动态的平行关系 ;除 Cmax和AU     

檀香对广枣中原儿茶酸和没食子酸的药代动力学影响

目的 建立大鼠体内的没食子酸和原儿茶酸的反相高效液相色谱分析方法,研究檀香对广枣中没食子酸、原儿茶酸在大鼠体内药代动力学的影响。方法 给SD大鼠灌服广枣水提液和广枣-檀香水提液,采用反相高效液相色谱法测定大鼠给药后不同时间血浆中原儿茶酸和没食子酸的浓度,DAS2.0药动学软件拟合房室模型,计算药动学参数。结果 广枣水提液组没食子酸的主要药动学参数Cmax为 (0.112±0.008) mg·L-1,CL/F (0.132±0.016) L·min-1·kg-1;Tmax (45.0±0) min,t1/2β (69.3±0) min;原儿茶酸的主要药动学参数Cmax为 (0.550±0.028) mg·L-1, Tmax (52.0±0) min,CL/F (0.078±0.011) L·min-1·kg-1,t1/2β (60.7±1.1) min。广枣-檀香水提液组没食子酸的主要药动学参数Cmax为 (0.187±0.010) mg·L-1,CL/F (0.094±0.017) L·min-1·kg-1,Tmax (30.0±0) min,t1/2β (69.3±3.3) min;原儿茶酸的主要药动学参数Cmax为(1.080±0.066) mg·L-1,Tmax (45.0±0) min,T1/2β (69.3±0.2) min,CL/F (0.011±0.001) L·min-1·kg-1。 结论 广枣-檀香水提液组没食子酸和原儿茶酸的达峰时间提前,清除率降低,半衰期延长,提示檀香可促进广枣中酚酸类物质吸收,延缓其消除。     

氟康唑胶囊在健康人体中的药动学和相对生物利用度研究

目的　研究氟康唑胶囊对健康人体的药动学和相对生物利用度。方法　采用高效液相色谱法 (HPLC) ,测定 2 0名男性健康受试者单剂量交叉口服 30 0mg两种氟康唑胶囊后 ,不同时间血浆中的药物浓度。结果　两制剂的药时曲线均符合一房室模型 ,被试制剂和参比制剂的主要药动学参数如下 :Cmax分别为 (6 .2 2± 0 .6 9)mg·L-1和(6 .2 6± 0 .6 2 )mg·L-1;Tmax分别为 (1.78± 0 .93)h和 (1.78± 0 .75 )h ;T1/2ke分别 (2 5 .99± 4 .81)h和 (2 6 .2 0± 3.13)h ;AUCt0 分别为 (2 0 2 .2 2± 37.37)mg·h·L-1和 (2 0 9.98± 34.4 1)mg·h·L-1;AUC∞0 分别为 (2 2 1.77± 5 0 .71)mg·h·L-1和(2 2 6 .73± 37.78)mg·h·L-1;对试制剂的相对利用度F10 与F∞0 分别为 (97.74± 17.39) %和 (98.4 2± 19.4 6 ) %。结论　方差分析和双单侧t检验证明 2种制剂具有生物等效性     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

A preliminary screening study on the associated proteins in human psoriasis vulgaris by serum proteomics technologies

Objective：To investigate the optimum screening conditions of associated proteins in human psoriasis vulgaris by serum proteomics technique, and to screen the different expression proteins related with psoriasis vulgaris. Methods：Serum samples of peripheral blood were collected from newly diagnosed psoriasis vulgaris patients in the clinic, and 20 matched healthy persons. Serum albumin IgG was removed by filtering with ProteoExtract Albumin/IgG. After comparative proteomics analysis the different protein spots were identified using 2-DE and MS. Results ：Electrophoresis figures with high resolution and reproducibility were obtained. Three different expression proteins were found only in the serum from psoriasis vulgaris patients, while nine other different proteins expressing from healthy volunteers. Conclusion：The protein expression was different in the serum between the psoriasis vulgaris patients and healthy volunteers. It was hoped that we could find the biomarkers related to psoriasis vulgaris by using proteomics.     

A CASE OF HUGE GASTRIC DISOPYROBEZOAR

PYTOBEZOARS are common bezoars in gastrontestinal tract, commonly seen in stomach and mall intestine,1but huge disopyrobezoars are     

Acupuncture Treatment of Chest Bi Syndrome

CASE HISTORY A male,a retired officer of 61 years old,paid his first visit on May 12,2006.The patient stated that 2 weeks before he suddenly got paroxysmal precordial choking pain,with irregular attacks.Each attack would last several seconds to several minutes.The attack was accompanied with heavy oppressed sensation in the precordial region,palpitation,lassitude,and in severe cases,sweating,which was once diagnosed by a hospital as'coronary heart disease'.Recalling the case history,the patient said that several days before he got angry with others because of some affairs in work,and he was not so used to the life pattern since he had just retired from his busy working post.At usual times,he was quick tempered and peevish.In recent days,he had poor appetite,and loose stool.     

Instructions to Contributors

The English edition of Chinese Journal of Integrative Medicine is edited and published by the Chinese Journal of Integrated Traditional and Western Medicine Press.Original scientific papers of advanced clinical and experimental medicine in the field of complementary/alternative medicine or integrative medicine are expected.