维生素D受体基因多态性对肾移植患者术后早期他克莫司浓度的影响

目的 研究维生素D受体(vitamin D receptor,VDR)基因多态性对肾移植术后早期他克莫司浓度的影响。方法 以360例使用他克莫司联合霉酚酸类药物以及糖皮质激素三联抗排异方案的肾移植患者为研究对象,检测患者CYP3A5 (rs776746)、VDR(VDR ApaI rs7975232,VDR BsmI rs1544410,VDR FokI rs2228570和VDR TaqI rs731236)基因型,比较分析不同基因型患者肾移植术后7 d时他克莫司血药浓度(concentration,C)、剂量(dose,D)以及浓度剂量比(ratio of concentration to dose,C/D)的差异。结果 CYP3A5非表达组(GG型)患者他克莫司的C和C/D均显著高于CYP3A5表达组(AA和AG型)(P<0.05)。以CYP3A5基因型进行分层后,在CYP3A5非表达组中VDR ApaI rs7975232 AA型患者C/D显著低于AC和CC型患者(P<0.05),然而在CYP3A5表达组中VDR ApaI rs7975232各基因型的C和C/D差异无统计学意义。此外,无论在CYP3A5表达组还是非表达组中,VDR BsmI rs1544410,VDR TaqI rs731236及VDR FokI rs2228570各基因型之间他克莫司的C、D和C/D差异均无统计学意义。结论 VDR ApaI rs7975232基因多态性与CYP3A5非表达组肾移植患者早期他克莫司血药浓度具有相关性,该基因型检测可能有助于指导肾移植患者他克莫司个体化用药。     

SLCO1B3基因多态性对狼疮性肾炎患者吗替麦考酚酯疗效的影响

目的 探讨有机阴离子转运体1B3(solute carrier organic anion transporter family, member 1B3,SLCO1B3)基因多态性对狼疮性肾炎患者吗替麦考酚酯(mycophenolate mofetil,MMF)药效学的影响。方法 以2019年9月—2021年4月于揭阳市人民医院就诊的新确诊的或既往确诊的狼疮性肾炎患者为研究对象。受试者均使用MMF治疗,且总疗程≥12个月,综合评估MMF的疗效。采用Agena MassARRAY^®方法检测受试者SLCO1B3 334T>G/699G>A (rs4149117/rs7311358)基因型,应用SPSS 25.0软件分析基因多态性与MMF药效学的相关性。结果 SLCO1B3 334T>G/699G>A基因型频率符合Hardy-Weinberg 平衡。334GG/699AA携带者MMF疗效差的几率显著高于334TT/699AA和334TG/699GA携带者(P<0.001);Logistics回归显示334GG/699AA和尿蛋白>2.5 g·(24 h)^-1是MMF疗效差的危险因素[OR=4.038(1.731,9.420),P<0.001;OR=4.157(1.705,10.137),P=0.002]。经过联合分析表明,携带334GG/699AA型且尿蛋白>2.5 g·(24 h)^-1的患者疗效差的风险是非334GG/699AA携带者的8.563倍[(3.301,22.216),P<0.001]。结论 SLCO1B3 334T>G/699G>A与狼疮性肾炎患者MMF疗效有关,334GG/699AA携带者MMF疗效差的可能性更高。     

VKORC1-3673G>A、CYP2C9*3、CYP4F2 rs2108622和CYP2C19*2基因多态性对中国汉族房颤患者华法林维持剂量的影响

目的 探讨VKORC1-3673G>A、CYP2C9^*3、CYP4F2 rs2108622和CYP2C19^*2位点基因多态性对中国汉族房颤患者华法林维持剂量的影响。方法 收集107例服用华法林达维持剂量的汉族房颤患者的血样和临床相关资料,应用PCR-RFLP法检测VKORC1-3673G>A、CYP2C9^*3、CYP4F2 rs2108622和CYP2C19^*2基因型,采用独立样本t检验分析基因型与华法林维持剂量的相关性。多元线性回归建立给药模型,探讨基因多态性对华法林维持剂量的影响。结果 VKORC1-3673G>A、CYP2C9^*3、CYP4F2 rs2108622基因多态性和患者年龄、体质量能解释45.2%的华法林维持剂量差异。CYP2C19^*2基因多态性对本研究人群华法林维持剂量无影响。结论 VKORC1-3673G>A、CYP2C9^*3、CYP4F2 rs2108622基因多态性显著影响中国汉族房颤患者的华法林维持剂量。     

CYP3A5和MDR1基因型对尿毒症患者肾移植术后早期他克莫司血药浓度和肌酐水平的影响

目的 评价真实临床实践中CYP3A5(CYP3A5*3,6986A>G)及MDR1(C3435>T,G2677>T/A,C1236>T)基因多态性对尿毒症患者接受肾移植术后早期他克莫司血药浓度的影响及其最佳治疗浓度。方法 以入选2013～2017年单中心的131例首次肾移植术且术后以他克莫司为基础进行三联免疫治疗的患者为对象,开展回顾性研究,考察患者基因多态性对他克莫司的日剂量、血药浓度、血药浓度/剂量比值和肌酐水平的影响。结果 在维持他克莫司靶浓度（10～15 ng/ml）的前提下,肾移植术后4周内基因型为CYP3A5*3/*3(GG)肾移植受者的给药剂量低于基因型CYP3A5*1/*1(AA)和CYP3A5*1/*3(AG)。患者血药浓度在10～13 ng/ml内时,其血肌酐水平最接近正常值。结论 CYP3A5基因多态性影响肾移植受者他克莫司的血药浓度,未发现MDR1基因多态性对他克莫司血药浓度的影响。早期肾移植血药浓度控制在10～13 ng/ml时,患者移植肾功能最接近正常人肾功能水平。     

MDR1基因多态性和单倍体对肾移植术后稳定期患者他克莫司浓度/剂量比值的影响

目的 探讨MDR1 C1236T、G2677T/A和C3435T 基因多态性和单倍体对中国汉族肾移植术后稳定期患者他克莫司浓度/剂量比值的影响,为他克莫司个体化用药提供依据。方法 采用PCR-基因测序法检测104例肾移植术后稳定期患者MDR1 C1236T、G2677T/A和C3435T 的基因多态性,采用均相酶免疫测定方法(EMIT法)测定他克莫司的谷浓度,比较不同基因型患者之间他克莫司血药浓度/(剂量×体质量)(C/D)比值。结果 104例患者中,MDR1 C1236T、G2677T/A和C3435T突变频率分别为56.73%、55.77%和33.17%。MDR1 C3435T、MDR1 TTT单倍体与他克莫司C/D比值具有相关性(P<0.05)。CYP3A5*3*3患者中,MDR1 TTT单倍体与他克莫司C/D比值仍存在显著相关(P<0.05)。MDR1 C1236T、G2677T/A、CGC单倍体与他克莫司C/D比值无显著性差异(P>0.05)。结论 MDR1 C3435T、MDR1 TTT单倍体与中国汉族肾移植术后稳定期患者他克莫司C/D比值具有显著相关性,是影响肾移植患者他克莫司浓度个体化差异的重要因素。     

CYP3A5基因多态性分析指导肾移植术后他克莫司的个体化用药

目的:研究肾移植术患者CYP3A5基因多态性与术后个体化给药剂量的关系。方法:采用等位基因特异扩增法对27例肾移植术后患者进行CYP3A5基因分型。采用酶联免疫法测定他克莫司的血药浓度。比较不同基因型之间的他克莫司的血药浓度与给药剂量(C/D)比值的差异。结果:肾移植患者CYP3A5(A6986G)基因多态性,CYP3A5*3的发生频率为50%,CYP3A5*1/*3基因型与*1/*1基因型患者C/D比值相比差异无显著性(P>0.05),但两者C/D比值均显著低于*3/*3基因型患者(P<0.05)。结论:肾移植患者的CYP3A5基因多态性与他克莫司血药浓度具有相关性,CYP3A5*1/*3基因型和*1/*1基因型患者拟取得相似的血药浓度要比*3/*3型患者需服用更高剂量的他克莫司。分析肾移植患者的CYP3A5基因多态性与血药浓度关系,可指导其术后他克莫司的个体化用药方案。     

SLCO1B1基因多态性与阿托伐他汀的安全性及有效性相关性分析

目的 研究高脂血症患者SLCO1B1基因多态性与阿托伐他汀安全性及有效性的相关性。方法 收集金华市人民医院2017年4月—2018年4月在门诊确诊为高脂血症患者的基本资料,测定纳入患者的SLCO1B1 c.388A>G和c.521T>C的基因多态性,定期随访受试者,并定期测定其甘油三酯、胆固醇、低密度脂蛋白胆固醇及肌酸激酶等相关实验室检查指标。结果 纳入患者SLCO1B1 c.388A>G和c.521T>C等位基因频率分别为72.8%和15.9%。随访期结束后不同基因型患者的血清血脂指标变化率无明显差异。SLCO1B1 c.521T>C基因多态性与阿托伐他汀的安全性有相关性（P=0.005）。结论 SLCO1B1c.388A>G基因多态性对阿托伐他汀降脂疗效及安全性无影响。SLCO1B1 c.521T>C基因多态性与阿托伐他汀的降脂疗效无相关性,但对其安全性有一定影响。     

CYP3A基因多态性与他克莫司血药浓度的相关性研究

目的:探讨肾移植术后口服免疫抑制剂他克莫司的剂量及其全血谷浓度个体差异的原因。方法:用基质辅助激光解吸电离飞行时间质谱技术对60例肾移植稳定期患者的CYP3AP1、CYP3A5*3的基因型进行检测,并分析各项临床指标对他克莫司血药浓度的影响。结果:60例肾移植患者中,性别、年龄、体质量、身高、激素剂量、血清肌酐对他克莫司浓度/(剂量×体表面积)比值并没有显著影响(P>0.05),术后时间和CYP3AP1、CYP3A5*3是主要影响因素(P<0.05)。CYP3AP1他克莫司浓度/(剂量×体表面积)比值高低依次为GG组相似文献   

VKORC1-1639 G/A、CYP2C93*基因多态性对华法林使用剂量的影响

目的 基于VKORC1-1639 G/A及CYP2C93^*的基因多态性初步探讨华法林的使用剂量。方法 收集2016年10月-2018年2月进行华法林用药指导相关基因检测的100例患者,记录患者基本信息（身高、体质量等）。采用数字荧光分子杂交检测VKORC1-1639 G/A,CYP2C93^*的基因型分布,并结合患者年龄、身高、体质量等,根据国际华法林药物基因组学联合会（IWPC）公式计算患者华法林理论剂量。结果 VKORC1-1639 G/A AA、AG、GG基因型实际频率分别为84%,15%,1%;等位基因A,G频率分别为91.5%,8.5%。CYP2C9 3^* AA型、AC型、CC型实际频数分别为91%,9%,0%;等位基因A,C频率分别为95.5%,4.5%。不同VKORC1-1639 G/A、CYP2C93^*基因型华法林理论用量不同,VKORC1-1639 G/A AA型并CYP2C93^* AA型和VKORC1-1639 G/A AG型并CYP2C93^* AA型患者华法林剂量均高于VKORC1-1639 G/A AA型并CYP2C93^* AC型患者;VKORC1-1639 G/A AG型并CYP2C93^* AA型患者华法林用量高于VKORC1-1639 G/A AA型并CYP2C93^* AA型患者,3组间两两比较,差异有统计学意义（P<0.05）。结论 华法林代谢相关基因的基因多态性为VKORC1-1639 G/A AA及CYP2C93^* AA型占多数,表明VKORC1-1639 G/A基因突变率高,CYP2C93^*基因突变率较低,且两者多态性影响个体间华法林的理论剂量。     

CYP3A5、UGT1A1、UGT2B7基因多态性与肾移植受者 他克莫司血药浓度的相关性研究

目的:探讨CYP3A5、UGT1A1、UGT2B7基因多态性与肾移植受者他克莫司血药浓度的相关性.方法:共纳入124例肾移植术后采用他克莫司十霉酚酸酯+泼尼松三联治疗方案的患者.采用酶放大免疫测定法(Emit)检测他克莫司血药浓度;采用实时荧光定量PCR方法和Taqman基因分型技术测定CYP3A5*3、UGT1A1*6、UGT2B7*3、UGT1A1*28、UGT2B7*2基因多态性;应用Kruskal-Wallis H检验法分析5个SNPs基因多态性与他克莫司血药浓度的相关性.结果:CYP3A5*3突变型的他克莫司血药浓度GG/AG(7.75±2.56)/(6.75±1.85) ng· mL-1显著高于野生型AA (5.00±1.81)ng·mL-1 (P＜0.01);UGT1A1*6基因型GG/AG的血药浓度分别为(7.15±2.72)/(6.74±1.81)ng·mL-1,显著高于基因型AA(4.45±0.49)ng·mL-1(P=0.022).UGT2B7*3基因型GG/GT的血药浓度分别为(7.00±1.95)、(7.48±2.22)ng·mL-1,显著高于基因型TT(6.78+3.00)ng·mL-1(P=0.014).UGT1A1*28与UGT2B7*2基因多态性与他克莫司血药浓度无显著相关性(P＞0.05).结论:他克莫司血药浓度与CYP3A5*3、UGT1A1*6、UGT2B7*3基因多态性相关.     

包公藤甲素类似物的合成

包公藤甲素(简称包甲素)系从包公藤茎中分离的一个新生物碱,其结构为2β-羟基-6β-乙酰氧基-N-去甲托品烷(1),为一强效M-胆碱受体激动剂,已用于青光眼治疗。项中等已报道了不同的合成方法,合成品为外消旋体,合成步骤长、收率很低。     

EFFECTS OF 2-GUANIDINE-4-METHYLQUINAZOLINE ON GASTRIC ACID SECRETION IN RATS

In this study 2-guanidine-4-methylquinazoline (2-GMQ) appeared to decrease basal and stimulated gastric acid secretion, while structurally related compounds as dimethyl- biguanide, cyanoguanidine and 2-cyanoamino-4-methylpyrymidine did not. Thus, there is an antisecretory effect when the biguanide group is associated with a lipophilic structure. The antisecretive effects exerted by 2-GMQ are associated with anti H₂-histamine activity.The anti H₂-histamine nature of the effects of 2-GMQ was confirmed by the capacity of this compound of depressing the chronotropic activity of the isolated guinea pig auricle increased by histamine, as well as relaxant activity in rat uterus contracted by histamine, since both preparations are rich in H₂-histamine receptors.     

Synthesis and evaluation of 2,6-piperidinedione derivatives as potentially novel compounds with analgesic and other CNS activities

New 2,6-piperidinediones 2_a–g and 4_a–d were prepared by initial condensation of aromatic aldehydes or cycloalkanones with cyanoacetamide to give α-cyanocinnamides l_a–g or cycloalkylidenes 3_a,b which underwent Michae1 addition with ethyl cyanoacetate or diethylmalonate. Compounds 4_a–d were alkylated by various alkyl halides to produce the N-alkylated 2,6-piperidinedione derivatives 5_a–m. Some new selected compounds 2_a–c,f, 4_a–d & 5_e,h,j were pharmacologically evaluated for potential anticonvulsant, sedative and analgesic activities. These compounds exhibited significant anticonvulsant and analgesic effects after a single I.P. administration 100 mg/kg b.wt. . On the other hand all the investigated compounds induced hypnotic activity and prolonged the phenobarbital sodium- induced sleep as compared with the control group and the most potent compound was found to be 2_f.     

Investigation of the prevalence of tetQ, tetX and tetX1 genes in Bacteroides strains with elevated tigecycline minimum inhibitory concentrations

In this study, the antibiotic susceptibilities to tigecycline and tetracycline of 35 selected Bacteroides fragilis group strains were determined by Etest, and the presence of tetQ, tetX, tetX1 and ermF genes was investigated by polymerase chain reaction (PCR). tetQ was detected in all 12 B. fragilis group isolates (100%) exhibiting elevated tigecycline minimum inhibitory concentrations (MICs) (≥8 μg/mL) as well as the 8 strains (100%) with a tigecycline MIC of 4 μg/mL, whilst tetX and tetX1 were present in 15% and 75% of these strains, respectively. All of these strains were fully resistant to tetracycline (MIC ≥ 16 μg/mL). On the other hand, amongst the group of strains with tigecycline MICs < 4 μg/mL (15 isolates), tetQ, tetX and tetX1 were found less frequently (73.3%, 13.3% and 46.7%, respectively). All but two strains harbouring the tetQ gene in this group were non-susceptible to tetracycline, with a MIC > 4 μg/mL. These data suggest that in most cases tigecycline overcomes the tetracycline resistance mechanisms frequently observed in Bacteroides strains. However, the presence of tetX and tetX1 genes in some of the strains exhibiting elevated MICs for tigecycline draws attention to the possible development and spread of resistance to this antibiotic agent amongst Bacteroides strains. The common occurrence of ermF, tetX, tetX1 and tetQ genes together predicted the presence of the CTnDOT-like Bacteroides conjugative transposon in this collection of Bacteroides strains.     

国产醋酸甲地孕酮的质量研究:6-羟基-6-甲基-17α-乙酰氧基黄体酮差向异构体的分离与鉴定

用柱层析及薄层层析对国产醋酸甲地孕酮的杂质进行了分析,共分离出7个杂质点:Ⅰ₁,Ⅰ₂,Ⅰ₃,Ⅰ₄,Ⅰ₅,Ⅰ₆,Ⅰ₇,并对其中Ⅰ₃和Ⅰ₄进行分离纯制及光谱分析,确定其结构为6β-羟基-6α-甲基-17α-乙酰氧基黄体酮及其差向异构体6α-羟基-6β-甲基-17α-乙酰氧基黄体酮。本文报道了薄层层析条件(硅胶GF₂₅₄,展开剂:醋酸乙酯-甲苯=7:3)以及光谱鉴别的依据。     

NEURAMIDE STIMULATES ADRENOCORTICOTROPIN BUT NOT PROLACTIN RELEASE FROM RAT PITUITARY

Neuramide (NMD), a substance found in crude preparations of porcine stomach extract, is a viral inhibitor that also has putative immunostimulatory effects. The effects of NMD on stress-hormone (ACTH and prolactin—PRL) release were assessed inin vivoandin vitrostudies. In the former, blood levels of corticosterone and PRL were measured in NMD-treated male rats.In vitroexperiments were performed to evaluate the effects of NMD and three of its fractions (obtained with high performance liquid chromatography) on ACTH and PRL release from perfused rat pituitary slices. NMD increased plasma corticosterone levelsin vivoand produced dose-dependent increases inin vitropituitary release of ACTH. No effects on PRL secretion were observedin vivoorin vitro. The stimulatory effects on ACTH release were caused by the NMD fraction with a molecular weight of >5000<10000Da.     

7α-和7β-甲基-10β,17β-二乙酰氧基-△4-雌甾烯-3酮的抗早孕作用

7α-和7β-甲基-10β,17β-二乙酰氧基-△⁴-雌甾烯-3酮(简称7α-和7β-甲-乙氧雌酮)对小鼠抗早孕ED₅₀分别为1.6和5.5 mg/kg。7α-甲-乙氧雌酮在大鼠也有抗早孕作用并使血浆孕酮浓度降低,应用10 μg/ml浓度能抑制离体妊娠大鼠卵巢孕酮合成。7α-和7β-甲-乙氧雌酮与兔子宫胞浆雌二醇受体的相对结合亲和力(RBA)分别为10.8和1.5,与孕酮受体的RBA均<1.7α-和7β-甲-乙氧雌酮都有较弱的雌激素和抗雌激素活性。     

EFFECT OF POLICOSANOL SUCCESSIVE DOSE INCREASES ON PLATELET AGGREGATION IN HEALTHY VOLUNTEERS

Policosanol is a cholesterol-lowering drug with hypocholesterolemic effects demonstrated in experimental models, healthy volunteers and type II hypercholesterolemic patients. In addition, antiplatelet effects of policosanol have been shown in experimental models and healthy volunteers. The effect of successively increasing doses of policosanol on platelet aggregation was investigated in a randomized, placebo-controlled, double-blind study conducted in 37 healthy volunteers. The volunteers were on a placebo-baseline period (two tablets per day) for 7 days and thereafter they received randomly, under double-blind conditions, placebo or policosanol (10mgday⁻¹) for 7 days. After this period dosage was doubled to 20mgday⁻¹for the next 7 days and then again doubled to 40mgday⁻¹, while the control group received placebo tablets all the time. Platelet aggregation as well as coagulation time was measured at baseline and after each dosing step. Results showed that antiplatelet effects of policosanol were successfully enhanced throughout the study, thus suggesting a dose-dependent relationship. No significant effect was reached during the first dosing period, but significant reductions of epinephrine and ADP-induced platelet aggregation were observed after the second one. Finally, a significant inhibition of platelet aggregation induced by all the agonists was observed at the last dosing step. Coagulation time remained unchanged during the trial.     

7α和7β-甲基-10β,17β-二乙酰氧基-4-雌甾烯-3-酮的合成

由于7α-甲基或10β-乙酰氧基4(5)烯-3-酮雌(雄)甾化合物具有显著的抗着床或抗蜕膜活性,我们合成了既具有7α-甲基或7β-甲基又具有10β-乙酰氧基的两个新甾族化合物(1_a)和(1_b)。经药理试验表明(1_a)和(1_b)对孕鼠均有抗早孕作用。