肺炎链球菌红霉素相关耐药基因与耐药表型的关系

目的:了解肺炎链球菌(Streptococcuspneum oniae,SP)临床分离株红霉素耐药基因的流行状况及和耐药表型的关系。方法:对住院儿童分离到的43株肺炎链球菌进行红霉素药敏试验,并用PCR法检测与红霉素耐药相关的红霉素核糖体甲基化酶基因(ermB)、主动外排转运基因(mefA)。结果:43株肺炎链球菌红霉素药敏试验40株耐药(占93%),3株敏感。红霉素ermB基因总检出率为76.7%(33/43),mefA基因总检出率为23.3%(10/43)。3株红霉素敏感的肺炎链球菌均未检出ermB基因和mefA基因;40株红霉素耐药肺炎链球菌ermB基因和mefA基因的PCR检出率分别为82.5%(33/40)和25%(10/40)。共有35株肺炎链球菌检出ermB基因或/和mefA基因,其中单独携带ermB基因的耐药表型为25株(占71.4%);单独携带mefA基因的耐药表型2株(占5.7%);同时携带ermB基因和mefA基因的耐药表型8株(占22.9)%。结论:ermB基因和mefA基因同时表达或单独表达均可导致红霉素耐药,ermB基因表达是儿童肺炎链球菌对红霉素耐药的主要原因,mefA基因表达是造成对红霉素耐药的次要原因。红霉素已不是治疗肺炎链球菌的有效药物。     

Co2+对红霉素生物合成过程的影响

研究了红霉素生物合成过程中糖代谢相关的关键酶:己糖激酶、6-磷酸葡萄糖脱氢酶、磷酸果糖激酶和异柠檬酸脱氢酶,以及合成红霉内酯环前体甲基丙二酰CoA相关的酶:甲基丙二酰CoA异构酶和甲基丙二酰CoA羧基转移酶的时序变化,并测定了过程中有机酸的含量变化。实验表明:Co2 能大幅提高红霉素效价。这可能与Co2 能明显提高甲基丙二酰CoA异构酶与甲基丙二酰CoA羧基转移酶的比活,并在一定程度上促进糖代谢有关。     

小剂量红霉素治疗早产儿喂养不耐受的疗效观察

目的:观察小剂量红霉素治疗早产儿喂养困难的临床疗效。方法:收集2007年1至12月的42例喂养不耐受的早产儿,随机分为治疗组21例和对照组21例。治疗组采用少食多餐、体位疗法等非药物治疗基础上,静脉滴注3~5μg/(kg.m in)的小剂量红霉素进行干预,对照组予少食多餐、体位疗法等非药物治疗,比较患儿在呕吐,体重增长,及胃潴留量的情况。结果:治疗组在治疗呕吐,体重增长,及减少胃潴留总有效率分别为85.7%,80.9%,76.2%,对照组总有效率为14.3%,9.5%,及9.5%,两组比较差异有非常显著性。结论:小剂量红霉素治疗早产儿喂养不耐受有效。     

Pharmacokinetics of trimethylamine in rats,including the effects of a synthetic diet

1. The pharmacokinetic profile of trimethylamine (TMA) was examined in the male Wistar rat and the effects of a synthetic diet on TMA pharmacokinetics were also evaluated. 2. The concentrations of TMA and its N -oxide in blood were analysed by a sensitive headspace gas chromatographic assay. 3. The pharmacokinetics of TMA were essentially linear for intravenous (i.v.) bolus doses of 10-40?mg kg -1. Over the range of administered i.v. doses, the concentrations of TMA in blood declined approximately monoexponentially with half-lives of 2.03-2.48?h. The V d of TMA ranged from 3.2 to 4.39?l kg -1 and clearance ranged from 18.78 to 23.92ml?min -1 kg -1. The peak concentration of TMA in blood occurred at 1?h after oral administration of a 20?mg kg -1 dose and the bioavailability for the oral dose averaged 81%. 4. Peak concentrations of trimethylamine N -oxide (TMAO) in blood were attained at 0.75 and 1?h after i.v and oral administration of TMA (20mg kg -1), respectively. 5. Feeding the male Wistar rat with a synthetic diet resulted in a twofold decrease in the clearance of TMA. Furthermore, the concentration of TMAO in blood after i.v. administration of TMA peaked at 1.25?h in rat placed on the synthetic diet as opposed to 0.75?h in rat placed on normal laboratory rat chow. The altered pharmacokinetic profile of TMA and its N -oxide suggest a diminished drug-elimination capacity in rat placed on the synthetic diet. 6. Dietary modulation of flavin-containing monooxygenase (FMO) activity may explain the effects of diet on the pharmacokinetics of TMA and its N -oxide.     

红霉素眼膏微生物限度检查方法的研究

建立红霉素眼膏微生物限度检查方法.利用红霉素在碱性条件下易分解失效的特点,采取在一定温度下调节pH值,对培养基进行稀释的方法建立红霉素眼膏微生物限度检查方法.红霉素眼膏的抗菌活性灭活后可有效检出污染菌.该方法可行性强,能有效地对红霉素眼膏进行微生物限度的测定.     

红霉素致小鼠肝脏毒性效应的基因表达谱变化

目的 利用小鼠毒理基因芯片观察红霉素致balb/c小鼠肝脏毒性效应的基因表达谱变化.方法 建立红霉素致balb/c小鼠肝毒性效应模型,利用本室构建的小鼠毒理基因芯片检测1、3、7d小鼠肝脏基因表达谱变化,结合层次聚类和生物信息数据库检索对差异表达基因进行初步信息分析.结果 各时相组共发现239个差异表达基因,其基本表达模式分为4群,结合功能分析涉及脂肪分解代谢、蛋白质合成与降解、氧化应激、炎症发生、凋亡相关信号转导等多方面机制.结论 毒理芯片的检测展示了红霉素致肝脏毒性效应的基因表达谱变化基本轮廓,为进一步阐明其肝毒性机制提供了众多线索.     

Correlation between midazolam and lignocaine pharmacokinetics and MEGX formation in healthy volunteers

AIMS: The objectives of the present investigation were: (a) to determine the correlation between lignocaine and midazolam pharmacokinetics following intravenous administration in healthy volunteers, (b) to determine the effects of treatment with an inhibitor of CYP3A4 (erythromycin) on this correlation and (c) to assess the precision of the MEGX-test as a sole predictor of lignocaine and midazolam pharmacokinetics. METHODS: The study was conducted in four male and four female healthy volunteers, aged between 21 and 26 years, who received 1 mg kg-1 lignocaine HCl i.v. on days 1, 3, 5, 9 and 10 of the investigation. On days 5 and 10 they also received midazolam, 0.075 mg kg-1 i.v. and from days 6-10 they took erythromycin 500 mg orally, four times daily. Following administration of lignocaine and midazolam, frequent venous blood samples were obtained for determination of the concentrations of lignocaine, MEGX and midazolam. RESULTS: In the absence of erythromycin a statistically significant linear correlation was observed between the clearance of lignocaine and midazolam (CL(midazolam)= 0.41 x CL(lignocaine)+ 1.2; r(2) = 0.857; P < 0.001). Erythromycin cotreatment resulted in a loss of the correlation between the two clearances (r(2) = 0.39; P = 0.1). Erythromycin caused a statistically significant reduction in midazolam clearance from the original value of 3.8 to 2.5 (95% CI for the difference -2.27, -0.35) ml kg-1 min-1. Interestingly there was no significant change in the clearance of lignocaine (6.4 vs 5.8 (95% CI for the difference -2.74, -1.51) ml kg-1 min-1). Furthermore no correlation at all was observed between the MEGX-test and lignocaine or midazolam clearances. Considering the data on day 1, 3 and 5 the intra-individual coefficient of variation in the MEGX-test was 45.3% at 15 min and 23.5% at 30 min, respectively. CONCLUSIONS: It is concluded that there is a significant correlation between lignocaine and midazolam clearances but this correlation is lost after CYP3A4 inhibition by erythromycin. The MEGX-test is of no value in assessing intra- and inter-individual variability in midazolam clearance.     

司丙红霉素安全性药理学研究

目的:观察司丙红霉素对大鼠心血管、呼吸系统和小鼠中枢神经系统的影响。方法:健康SD大鼠分别按体重随机分为低、中、高3个剂量组和溶媒对照组。给药组分别从十二脂肠给予司丙红霉素75,150,300 mg·kg~(-1),对血压、心电图(ECG)、呼吸频率及呼吸幅度进行观察。小鼠实验分低、中、高3个剂量组及溶媒对照共4个组,分别灌胃给予司丙红霉素75,150,300 mg·kg~(-1),对动物一般活动和睡眠时间进行观察。结果:司丙红霉素300 mg·kg~(-1)剂量组使大鼠心率下降,对舒张压、收缩压、ECG之QRS时间、ST段、T波、QT间期、呼吸频率及呼吸幅度无明显的影响;对小鼠一般活动和睡眠时间无明显影响。75,150 mg·kg~(-1)剂量组对大鼠、小鼠各项指标无明显影响。结论:司丙红霉素300 mg·kg~(-1)对心血管系统有一定影响,可使大鼠心率下降。     

Hepatic Disposition of Fexofenadine: Influence of the Transport Inhibitors Erythromycin and Dibromosulphothalein

Purpose. To examine the disposition of fexofenadine in the isolated perfused rat liver and the influence of erythromycin and dibromosulphthalein (DBSP) on the hepatic uptake and biliary excretion of fexofenadine. Methods. Livers from four groups of rats were perfused in a recirculatory manner with fexofenadine HCl added as a bolus (125, 250, 500, or 1000 g) to perfusate. Livers from another three groups of rats were perfused with 250 g of fexofenadine HCl. With one group as control, erythromycin (4.0 g/ml) or DBSP (136 g/ml) was added to the perfusate of the other groups. In all experiments, perfusate and bile were collected for 60 min; in addition, livers from the second experiment were retained for assay. Fexofenadine was determined in perfusate, bile, and homogenized liver by HPLC. Results. The area under the curve (AUC) of fexofenadine was linearly related to concentration. It was unchanged from control (12,800 ± 200 ng·h/ml) by erythromycin (14,400 ± 2000 ng·h/ml), but was increased 95% by DBSP (25,000 ± 2600 ng·h/ml, P <0.001). The ratios of the concentrations of fexofenadine in liver/perfusate were decreased significantly by DBSP; those for bile/liver were increased by erythromycin. Conclusions. Erythromycin reduced the canalicular transport of fexofenadine into bile, whereas DBSP reduced uptake across the sinusoidal membrane.