Characteristics of analytically confirmed 3-MMC-related intoxications from the Swedish STRIDA project

Abstract

Background. 3-Methylmethcathinone (3-MMC) is a synthetic cathinone stimulant structurally related to the new psychoactive substance (NPS) mephedrone (4-methylmethcathinone, 4-MMC). We describe a case series of analytically confirmed intoxications involving 3-MMC presented to emergency departments in Sweden and included in the STRIDA project. Study design. Observational case series of consecutive patients with self-reported or suspected use of NPS presenting to hospitals in Sweden between August 2012 and March 2014. Methods. NPS analysis was performed by a liquid chromatography–mass spectrometry (MS)/MS method that is updated with new substances as they appear. Data on clinical features were collected during Poisons Information Centre consultations and retrieved from medical records. Results. 3-MMC was detected in 50 (6.4%) of the 786 cases included in the STRIDA project during the 20-month study period, with the peak occurring in August 2013. The age range of patients testing positive for 3-MMC was 17–49 years (median 24) and 76% of them were men. The 3-MMC concentration in serum ranged between 0.002 and 1.49 μg/mL (median, 0.091) and between 0.007 and 290 μg/mL (median, 3.05) in urine. Co-exposure to other NPS and/or traditional drugs was very common, and 3-MMC mono-intoxication was found in only 4 (8%) cases. The most frequent clinical features were tachycardia (48% of cases) and agitation (42%). Other features included a reduced level of consciousness (32%), dilated pupils (24%), hallucinations (20%), diaphoresis (12%), seizures (8%), and hyperthermia (6%). Most patients (60%) needed hospital care for only 1 day but in 8% for 3 days or longer. Conclusion. The majority of patients with analytically confirmed 3-MMC exposure had sympathomimetic features similar to those associated with mephedrone intoxication. However, the high incidence of co-exposure to other drugs makes the clinical interpretation difficult. Nevertheless, 3-MMC was associated with a high admittance rate to intensive care (30%), and detected in two cases with a fatal outcome, suggesting that 3-MMC is a harmful drug.     

氯吡格雷联合溶栓治疗急性心肌梗死的疗效评价

目的探讨和研究氯吡格雷联合溶栓治疗急性心肌梗死的临床疗效。方法选取2012年1月—2013年5月之间该院收治的50例急性心肌梗死患者作为研究对象,根据入院编号进行随机分组,分为观察组和对照组,各25例,对照组单纯采用重组人组织型纤溶酶原激酶衍生物进行溶栓治疗,观察组患者则在溶栓治疗基础上加用氯吡格雷联合治疗,对比两组患者的疗效及心肌酶谱变化。结果观察组患者总有效率92.0%,显著高于对照组患者的76.0%,差异有统计学意义(P<0.05);治疗前两组患者的肌酸激酶、肌酸激酶同工酶对比差异无统计学意义,治疗后观察组显著低于对照组,差异有统计学意义(P<0.05)。结论氯吡格雷联合溶栓治疗急性心肌梗死的疗效确切,相较于单纯溶栓治疗更具优势,能够有效降低心肌酶水平,提高疗效,值得在临床上推广和应用。     

桂枝中酚类提取物潜在作用靶点的探索

目的?研究桂枝中酚类提取物木脂素的潜在作用靶点。方法?在药效团模型数据库中筛选出与木脂素衍生物匹配值（FitValue）大于0.75的药效团模型;运用反向对接技术,从上述药效团模型所对应的靶点蛋白中挑选出与木脂素衍生物结合能最低的蛋白;以该靶蛋白已报道的抑制剂建立3D-QSAR药效团模型预测木脂素衍生物的活性,同时通过荧光偏振实验测试化合物1与Tankyrase 1蛋白的结合力,通过Western blot实验测试加入化合物1后细胞中Tankyrase 1蛋白的含量变化;最后用分子动力学模拟分析木脂素衍生物与该蛋白的作用模式。结果?与木脂素衍生物匹配值大于0.75的药效团模型有17个,其中4个为神经保护类靶点,占比（24%）最大;反向对接结果显示该化合物与Tankyrase 1蛋白（PDB ID:4TOR）的结合能（E=-66?kcal/mol）最低;预测该化合物的活性为0.61?μmol/L,荧光偏振实验测得化合物1与Tankyrase 1蛋白的结合力Ki=（0.15±0.01）μmol/L,属于中等抑制,Western blot表明在SW480细胞中化合物1使Tankyrase 1蛋白的表达下降;且分子动力学结果显示对接构象与该靶点已报道的抑制剂类似。结论?经过对桂枝中酚类提取物木脂素衍生物的反向找靶,以及活性测试确定其对Tankyrase 1蛋白具有潜在的抑制活性。      

熊果酸衍生物对糖尿病骨质疏松骨重塑的影响

目的 探讨熊果酸衍生物(ursolic acid derivatives,UAD)对糖尿病骨质疏松骨重塑的影响。方法 将小鼠随机分为对照组、STZ组与US组三组,取胫骨进行基因和蛋白表达测定以及组织形态学分析,测定骨体积/总体积(BV/TV)、骨小梁数(Tb.N)、小梁厚度(Tb.Th)和骨密度/总体积(BMD／TV)等各项骨形态参数,分别检测骨保护素/核因子-κΒ受体活化剂(OPG/RANKL)比值与骨代谢关键调控因子mRNA的表达。结果 STZ组与对照组相比,OPG/RANKL比值和OPG显著降低且RANKL升高;US组显著增加OPG/RANKL比值。STZ组MMP9和CAII mRNA表达显著高于对照组,而STZ组Runx2和TGF-β的mRNA表达显著低于对照组。US组同时逆转糖尿病小鼠MMP9、CAII、RUNX2和TGF-β mRNA的表达。结论 UAD通过促进成骨细胞分化、新生骨形成及抑制破骨细胞骨吸收功能来逆转STZ诱导的骨小梁损伤作用进行骨重塑。     

利福霉素类抗生素的晶型与血（尿）药浓度

目的：探讨利福霉素类抗生素的衍生物（利福平,利福定,利福喷丁）的晶型与血（尿）药浓度的关系。方法：通过正常人空腹口服各不同型晶粉,定时收集血、尿标本,用杯碟法测定血、尿药含量。结果：同一药物的不同晶型粉,显示出各自不同的结构图形、溶解度及生物有效度的特性。结论：凡是稳定的晶型均具恒定的结构及生物有效度,利福霉素类药物的含水量,对其晶型的稳定性至关重要,干燥失重,不是越低越好。     

8-硝基白杨素诱导结肠癌HT-29细胞凋亡

目的:观察8-硝基白杨素(NOChR)诱导人结肠癌HT-29细胞凋亡作用。方法:MTT比色法测定细胞增殖活性;流式细胞分析术检测细胞凋亡率;琼脂糖凝胶电泳观察DNA梯形条带。结果:NOChR抑制HT-29细胞活性,呈浓度依赖性,其IC50值为1.78μM;NOChR具有诱导HT-29细胞凋亡作用;PPARγ特异性阻断剂GW 9662能部分拮抗NOChR诱导HT-29细胞凋亡。结论:NOChR诱导HT-29细胞凋亡作用与其活化PPARγ相关。     

阿维菌素B_(1a)衍生物合成研究

目的高效率合成几种阿维菌素B_(1a)衍生物。方法通过5-O-三苯硅基阿维菌素B_(1a)与羧酸在4-二甲氨基吡啶(DMAP)等存在下发生酯化反应合成得到数种目标衍生物。结果反应以较好的收率得到3种阿维菌素B_(1a)衍生物。结论生物活性试验结果表明,这些不同取代基团对化合物的杀虫活性有不同的影响,其中部分化合物具有较好的杀虫、杀螨活性。     

丹皮酚肟衍生物的设计、合成及抗血小板聚集活性

以丹皮酚为起始原料,经结构修饰得到25个新的丹皮酚肟类衍生物4a ~ 4y,其结构经过高分辨质谱、核磁共振氢谱确证。所合成的目标化合物对二磷酸腺苷（ADP）和胶原诱导的血小板聚集均具有一定的抑制活性,其中化合物4h、4j对两种诱导剂诱导的血小板聚集优于阳性对照药阿司匹林,且化合物4h具有较好的水溶性和类药性,可作为新的抗血小板活性化合物进一步研究。