蒿甲醚联合依托泊苷对小细胞肺癌细胞株H446增殖及侵袭的抑制作用

探讨蒿甲醚与依托泊苷联用对小细胞肺癌细胞H446增殖及侵袭能力的抑制作用。采用MTT法检测蒿甲醚、依托泊苷单用及联合作用对H446细胞增殖的影响;采用Annexin V/PI荧光双染法检测蒿甲醚、依托泊苷单用及联合作用对H446细胞凋亡的影响;采用PI单染法检测蒿甲醚、依托泊苷单用及联合作用对H446细胞周期分布的影响。采用基质胶侵袭实验检测蒿甲醚、依托泊苷单用及联合作用对H446侵袭能力的影响。结果表明,蒿甲醚、依托泊苷单用以及联合使用均能有效抑制H446的增殖,且呈剂量依赖性,两药联用具有协同作用。蒿甲醚单用不能明显促进细胞凋亡,但与依托泊苷(300 nmol/L)联用72 h可以比较明显促进H446凋亡,具有统计学意义(P<0.05)。蒿甲醚单用对H446的细胞周期没有显著影响,联合作用48 h对细胞周期G₂期阻滞主要是依托泊苷的作用。单用蒿甲醚、依托泊苷以及二者联合使用都能显著抑制H446的侵袭能力。     

复方蒿甲醚片和苯芴醇两种剂型治疗恶性疟临床对比试验

[目的 ]观察复方蒿甲醚及其组分之一苯芴醇两种剂型对恶性疟的疗效和安全性。 [方法 ]共收治 15 0例恶性疟患者 ,采用双盲 (复方蒿甲醚片组和苯芴醇片组 )、随机、对比方法 ,其中复方蒿甲醚组 (A) 5 1例、苯芴醇片剂组 (B) 5 0例、苯芴醇胶丸组 (C) 4 9例。病人住院后观察 2 8d。 [结果 ]A、B、C3组的平均退热时数分别为 (17.1±8.6 ) h、(34.0± 2 3.2 )和 (2 9.4± 2 4.9) h;平均原虫转阴时间分别为 (2 9.7± 8.9) h、(5 1.6± 14.1) h和 (5 4.7± 17.4) h;3组患者均达到临床治愈 ;观察期间无明显不良反应 ,化验检查亦无明显改变。 [结论 ]复方蒿甲醚和苯芴醇两种剂型对恶性疟均有良好的治疗作用 ,复方蒿甲醚在杀虫速度和控制症状方面明显优于苯芴醇单药     

Synthesis and antimalarial activity of ethylene glycol oligomeric ethers of artemisinin

Objectives The aim of this study was to synthesize a series of ethylene glycol ether derivatives of the antimalarial drug artemisinin, determine their values for selected physicochemical properties and evaluate their antimalarial activity in vitro against Plasmodium falciparum strains. Methods The ethers were synthesized in a one‐step process by coupling ethylene glycol moieties of various chain lengths to carbon C‐10 of artemisinin. The aqueous solubility and log D values were determined in phosphate buffered saline (pH 7.4). The derivatives were screened for antimalarial activity alongside artemether and chloroquine against chloroquine‐sensitive (D10) and moderately chloroquine‐resistant (Dd2) strains of P. falciparum. Key findings The aqueous solubility within each series increased as the ethylene glycol chain lengthened. The IC50 values revealed that all the derivatives were active against both D10 and Dd2 strains. All were less potent than artemether irrespective of the strain. However, they proved to be more potent than chloroquine against the resistant strain. Compound 8 , featuring three ethylene oxide units, was the most active of all the synthesized ethers. Conclusions The conjugation of dihydroartemisinin to ethylene glycol units of various chain lengths through etheral linkage led to water‐soluble derivatives. The strategy did not result in an increase of antimalarial activity compared with artemether. It is nevertheless a promising approach to further investigate and synthesize water‐soluble derivatives of artemisinin that may be more active than artemether by increasing the ethylene glycol chain length.     

蒿甲醚伍用伯氨喹治疗恶性疟的研究

目的　观察蒿甲醚伍用伯氨喹治疗恶性疟的疗效和副作用。　方法　在中非共和国选择恶性疟12 1例 ,随机分为两组。伍用组 :口服蒿甲醚 80mg ,qd× 5d ,首日蒿甲醚 16 0mg加服伯氨喹 3片 (含基质 7 5mg ,qd× 3～ 4d)治疗 32例 ;肌注蒿甲醚加服伯氨喹 ,治疗 2 9例 ;对照组 :单用口服蒿甲醚治疗 33例和肌注蒿甲醚治疗 2 7例 ,B组、C组和D组所用剂量与疗程均同A组。上述病例于用药前及后 6、 14、 2 1、及 2 8d各随访1次 ,密切观察病例的临床症状与体征变化。　结果　A组、B组、C组和D组病例的平均退热时间分别为(47 6± 15 7)、 (36 9± 10 7)、 (48 5± 18 4 )和 (42 2± 9 5 )h。其临床治愈率依次为 84 4 %、 10 0 %、 90 1和96 3% ,其复燃率依次为 6 3%、 3 4 %、 2 1 2 %和 18 5 %。 4组药物副作用均轻。　结论　蒿甲醚伍用伯氨喹及单用蒿甲醚 (口服或肌注 )对恶性疟治疗作用均良好 ,但联合使用药物能降低恶性疟的复燃率     

复方蒿甲醚临床治疗恶性疟的效果观察

为了观察复方蒿甲醚治疗恶性疟的临床疗效 ,以显微镜血检恶性疟原虫阳性患者为观察对象 ,复方蒿甲醚口服 ,3天 4次疗法 ,首剂服 4片 ,8、 2 4、 4 8h各服 4片 ,总剂量为 16片 ,服药后按时测量体温和血检原虫 ,并随访 2 8天 ,观察治疗效果。结果显示复方蒿甲醚治疗恶性疟 16 7例 ,平均退热时间为 2 0 . 4±8 4h ,原虫转阴时间为 37. 9± 7 9h ,2 4h原虫平均下降率 97. 4 % ,2 8天治愈率为 94 . 1% ,药后无明显不良反应。可见复方蒿甲醚治疗恶性疟疾具有良好的临床效果。     

蒿甲醚固体分散体缓释制剂的研制及其体外溶出度的观察

本实验以肠溶材料丙烯酸树脂Ⅱ号为载体制成蒿甲醇的固体分散体。X射线衍射实验表明，药物与载体比例为1：2和1：3时，药物在固体分散体中改变了晶型。体外溶出实验说明，固体分散体在pH0．8人工肠液中溶出量较蒿甲醚原粉大为增加。结果表明：蒿甲醚固体分散体缓释制剂既可增加溶解度，提高药物的生物利用度，又达到缓释的目的。     

蒿甲醚对胃癌细胞增殖、侵袭和迁移的抑制作用研究

目的:研究蒿甲醚对胃癌细胞（AGS和SGC-7901）的增殖、侵袭以及迁移的影响并探讨其分子机制。方法:分别利用MTT、集落形成试验检测胃癌细胞的活力和生长;流式细胞技术检测胃癌细胞的凋亡率;利用细胞侵袭和划痕愈合试验检测胃癌细胞的侵袭和迁移;Western blot检测相关蛋白的表达水平。结果:蒿甲醚（0~800 μmol/L）能够浓度和时间依赖性的抑制 AGS和SGC-7901细胞的增殖（P＜0.05）。集落形成试验以及流式细胞术结果显示蒿甲醚（400 和 600 μmol/L）能够抑制AGS和SGC-7901细胞的生长以及促进细胞凋亡（P＜0.05）。细胞侵袭和划痕愈合试验发现蒿甲醚（400 和 600 μmol/L）能够抑制AGS和SGC-7901细胞的侵袭和迁移（P＜0.05）。Western blot结果显示蒿甲醚(400 和 600 μmol/L)能够增加AGS和SGC-7901细胞的cleaved caspase-3,cleaved caspase-9以及Bax的蛋白水平（P＜0.05）;同时能够抑制N-cadherin 和vimentin的蛋白表达并促进E-cadherin蛋白的表达。结论:蒿甲醚可以显著抑制胃癌细胞的增殖、侵袭以及迁移,其机制可能是与促进细胞凋亡以及抑制上皮间质转化有关。     

Compliance with a 2 day course of artemether-mefloquine in an area of highly multi-drug resistant Plasmodium falciparum malaria

Aims Multi-drug resistant Plasmodium falciparum malaria is a rapidly increasing problem in the world, particularly Thailand. Practical antimalarial regimens which are highly effective against multi-drug resistant parasites with short-term course of administration are needed. In this study, we assessed the patient compliance of a short course regimen using artemether-mefloquine.
Methods Clinical effectiveness (efficacy, tolerability and patient compliance) of a 2-day regimen of artemether-mefloquine was evaluated in 126 patients with acute uncomplicated falciparum malaria who were attending the two malaria clinics in an area of highly multi-drug resistant P. falciparum malaria (Thai-Myanmar border). Patients were treated with a single oral dose of 300  mg artemether on the day of attendance. Two additional doses of mefloquine were given for home treatment on the following day (750 and 500  mg after breakfast and lunch, respectively).
Results The combination regimen was effective, with a cure rate of 92.6%. Based upon the concentrations of whole blood mefloquine on day-2, compliance for this 2 day regimen of artemether-mefloquine was 98.1% (full compliance 86.8%, partial compliance 11.3%, non-compliance 1.9%).
Conclusions We conclude that the 2 day regimen of artemether-mefloquine is, at present, a good alternative regimen for the treatment of uncomplicated multi-drug resistant falciparum malaria.     

复方蒿甲醚临床研究：选择剂量比例和治疗方案

目的：选择复方蒿甲醚的最佳剂量配比和治疗方案。方法与结果：蒿甲醚与本芴醇按１：６或１：５的剂量配比制成２种复方片剂，各治疗恶性疟２０例，均达临床治愈。观察２８ｄ，前者（１：６）无一复燃，治愈率１００％；后者（１：５）复燃４例，治愈率８０．０％。进而以１：６的片剂，设２ｄ４次，３ｄ３次和３ｄ４次给药３种疗法，比较其临床疗效，观察２８ｄ，治愈率分别为８０．０％，７２．７％和９５．９％，其中３ｄ４次疗法     

氨基蝶呤修饰的蒿甲醚脂质体的制备工艺研究

目的优选氨基蝶呤修饰的蒿甲醚脂质体的最佳处方配比和制备工艺,并进行理化性质评价。方法以包封率为指标,优选氨基蝶呤修饰蒿甲醚脂质体的制备方法,并通过正交试验优化其处方及工艺;采用激光粒度仪、透射电镜评价脂质体的粒径、Zeta电位及外观形态;利用透析法研究脂质体的体外释放。结果制备的氨基蝶呤修饰的蒿甲醚脂质体的最优处方为卵磷脂-胆固醇-TPGS物质的量比95∶0.5∶3,5%氨基蝶呤修饰率,蒿甲醚与脂材的比例为1∶20,30℃下旋转成膜,水化后,探头超声8 min。所得的氨基蝶呤修饰蒿甲醚脂质体的粒径为(99.97±1.67)nm;多分散度为0.185±0.021;Zeta电位为(-0.023±0.080)m V。透射电镜结果显示蒿甲醚脂质体形态圆整;包封率为(90.06±1.15)%;在模拟血液中,蒿甲醚脂质体的48 h累积释放率为(57.07±6.09)%。结论正交试验优选的氨基蝶呤修饰的蒿甲醚脂质体形态圆整、粒径小且均一、药物包封率较高、具有很好的缓释效果。