Table of Content

Volume 12 Issue 2
26 February 2007

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Integration of pharmacokinetics and pharmacodynamics in antibiotic drug development and pharmacotherapy

SHI Jun

2007, 12(2):  121-133. 

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Integration of pharmacokinetics (PK)/pharmacodynamics (PD)in antibiotic drug development allows the dosage regimen to be optimized, so that the desired effect can be achieved in a large proportion of the target patient population.In vitro kinetic and in vivo animal models have been extensively used in the evaluation of antibiotics.The value of these pre-clinical models in the PK and PD characterization of antibiotics is critically reviewed.A model based clinical development of antibiotics with integrating MIC distribution, PK parameter distribution, the PD target from animal models of infection, and the protein binding of the test drug, is also reviewed.

Herb-drug interactions in oncology and potential mechanisms

FAN Lan, XIE Hai-tang, ZHOU Hong-hao

2007, 12(2):  134-139. 

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An increasing number of cancer patients are using complementary and alternative medicines (CAM) in combination with their conventional chemotherapeutic treatment.Considering the narrow therapeutic window of oncolytic drugs, this CAM use increases the risk of clinically relevant herb-anticancer drug interactions, therefore leading to substantially more unexpected toxicities of chemotherapeutic drugs and possible undertreatment seen in cancer patients.This review provides information about currently known, clinically relevant PK CAM-drug interactions in oncology and the potential mechanisms.

Overview and research progress of tumorigenesis and related therapies of Uterine leiomyomas

LIU Lin-yan, YUAN Sheng-tao, YU Bo-yang

2007, 12(2):  140-146. 

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Uterine leiomyomas, also called fibroids, are the most common reproductive tract neoplasm in premenopausal women.The discovery and development of medicinal therapies for uterine leiomyoma have been hampered by a lack of understanding in terms of the etiology and molecular mechanisms underlying the development of these lesions.As a reference, this article reviews mechanisms of the tumorigenesis and medicinal therapies, including genes, hormones, growth factors and some other pathways, in order to understand the tumor well and find more promising new drugs.

Advances in study of glucocorticoid receptor induced insulin resistance and its antagonists

LIANG Ying, DING Qi-long

2007, 12(2):  147-151. 

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Glucocorticoids are among those most important hormones that maintain the energy metabolic homeostasis within body.The actions of glucocorticoids on target tissues, such as liver and adipose tissue, are not only dependent on circulating glucocorticoid levels but also on glucocorticoid receptor expression.The elevated level of circulating glucocorticoid caused by exogenous or endogenous reasons may contribute to insulin resistance and the other metabolic syndrome such as dyslipidemia, visceral obesity and hypertension.This review summarizes recent advances in the study of glucocorticoid receptormediated insulin resistance and its antagonists.

Designing method of phase I tolerance trial of several traditional medications for external use in human body

XU Xiao-guo, JIANG Meng, XIONG Ning-ning, ZOU Jian-dong, LIU Fang, GAO Wei-min

2007, 12(2):  152-155. 

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The traditional medications for external use have particularities compared with the common oral administration and the injection.This paper analyses the characteristics of the design for the protocol of phase I tolerance trial which makes nasal cavity spray, skin gel and skin sticking plaster for example.

Protective effects of Artesunate on mice challenged with heat-killed Escherichia coli

ZHANG Rong, LI Bin, ZHANG Le-zhi, LI Jun, DING Guo-fu, HE Sheng-qi, LUO Ping, ZHOU Hong

2007, 12(2):  156-158. 

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AIM: To observe the protective effects of Artesunate (AS) on mice challenged with heat-killed escherichia coli (EC) and its inhibition on the release of cytokines induced by heat-killed EC.METHODS: A total of 48mice of Kunming species were randomly divided into six groups.EC group only received heat-killed EC at 1.2×10¹¹ CFU/kg.In AS group, AS was given by intramuscular injection at a dosage of 45 mg/kg.AS plus EC groups first received AS (5, 15, 45 mg/kg), then heatkilled EC at the same dose.AS was repeatly and intramuscularly injected at 0, 4, 24 and 48 h after heat-killed EC challenge, while the control group received only saline (NS).The mortality was observed within seven days after injection via caudal vein.In vitro, the murine peritoneal macrophages(PMφ) were pre-incubated with various concentration of AS (0.625-10 μg/mL) for 2 h, and the releases of TNF-αand IL-6 in the supernatants induced by heat-killed EC (1.25×10⁶ CFU/mL) were measured by ELISA.RESULTS: AS delayed the death time and decreased the death number of mice challenged with heatkilled EC, and the mortality decreased from 100 % to 50 %(P <0.05).In vitro, AS significantly and dosedependently inhibited the release of TNF-αand IL-6 from PMφinduced by heat-killed EC.MTT results showed AS had no significant influence on the viability of PMφwhen its concentration was under 40 μg/mL (P> 0.05). CONCLUSION: AS significantly protects on mice challenged by heat-killed EC and obviously inhibits the release of cytokines induced by heat-killed EC, suggesting that AS may be an effective drug for the sepsis.

Protective effects of depside salt from salvia miltiorrhiza on temporomandibular joint under +Gz condition

YIN Yin, SUN Zhen-yu, HU Min, LI Dong-xia, CAI Qing, KAN Guang-han, WANG Feng, ZHANG Xia

2007, 12(2):  159-162. 

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AIM: To observe the protective effects of depside salt from salvia miltiorrhiza on temporomandibular joint under repeatedly high sustained +Gz condition. METHODS: 40 male Wistar rats were randomly dividedinto 5 groups.Group 1 was only fixed with rat kept devices for 5min as a negative group.Group 2 was borne +10 Gz for 5min repeatedly 5 times daily, 4 days per week, 3 weeks in total as a positive group.Groups 3-5 were repeatedly exposed +10 Gz same as positive group with depside salt from salvia miltiorrhiza at three different doses (1, 3, 10 mg/kg, i.m.respectively).Every rat was taken in depside salt from salvia miltiorrhiza or 0.9 % sodium chloride solution about 30min prior to the +Gz experiment.The morphological observation and c-fos mRNA expression of jugomaxillary muscle and joint discs were conducted by electronic microscope and RT-PCR technology.RESULTS: Repeatedly high sustained +Gz stresses was able to induce damage of temporomandibular joint, and depside salt from salvia miltiorrhiza could blunt abnormal changes of electronic microscope of temporomandibular joint under +Gz condition and inhibit c-fos mRNA expression.CONCLUSION: Depside salt from salvia miltiorrhiza has a protective effect on the damage of temporomandibular joint induced by repeatedly high sustained +Gz in rats.

Studies on effect of drug concentration on selection of resistant mutants of staphylococcus aureus

LI Zhao-xia, LIU You-ning, WANG Rui, TONG Wei-hang, CHENG Shi-hu

2007, 12(2):  163-167. 

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AIM: To study the effect of levofloxacin, vancomycin, rifampin, azithromycin, tobramycin and chloramphenicol concentration on selection of resistant mutants of staphylococcus aureus ATCC29213.Also to combine minimal inhibitory concentration (MIC), mutant prevention concentration (MPC) and mutant selection window (MSW) with pharmacokinetic parameters and then provide evidence for new strategies for restricting the development of resistance.METHODS: The agar dilution method was carried out on drug-containing agar according to NCCLS guidelines to determine MIC of levofloxacin, vancomycin, rifampin, azithromycin, tobramycin and chloramphenicol against ATCC29213.MPC was determined by the agar dilution according to MIC determining except that ATCC29213 were enriched in broth, and the bacterial concentrations were adjusted to 1010 colony form units per milliliter.Staphylococcus aureus were plated on agar containing various antimicrobial concentrations.The fraction of bacteria recovered curve was traced by colony counting.RESULTS: The MPCs of levofloxacin, vancomycin, rifampin, azithromycin, tobramycin and chloramphenicol for staphylococcus aureus strain ATCC29213 were 1.4, 51.2,>1024, 4.8, 16, and 16 μg/mL;the MICs of them were 0.125, 1.0, 0.002, 0.5, 3.0, and 0.5μg/mL respectively;and the MSW of each antimicrobialstaphylococcus aureus combination was distinct.The MSW of rifampin-staphylococcus aureus was the broadest, and the MSW of chloramphenicol-staphylococcus aureus was the narrowest.The fraction of bacteria recovered curve varied considerably among the bacterium-antimicrobial combinations.CONCLUSION: Antimicrobial concentrations have strong effect on the recovery and selection of resistant colonies.In clinical practice, the selection of resistant mutants could be prevented by choosing antimicrobial concentration and medication in combining MPC with pharmacokinetic parameters.

Immune protecting on tumor-bearing mouse of C21 sterols in Baishouwu

WANG Dong-yan, LI Xin, ZHANG Hong-quan

2007, 12(2):  168-172. 

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AIM: To investigate the anti-tumor effect of the C21 mono-glucosides sterols and its immunity mechanism.METHODS: The models of Heps tumor transplanted in mice were established.The tumor growth inhibition rate (1R) was calculated, and tumor tissue samples were taken and examined by light microscopy.Spleen and thymus were taken to get spleen index (SI) and thymus index (TI).The phagocytic ability of peritoneal macrophage to neutral red and the amount of NO were detected to reflect holistic cellular immune level.The T and B lymphocyte transformation capacity were tested by MTT assay.The secretion of interleukin-2 (IL-2) and tumor necrosis factor-alpha (TNF-α) were detected with ABCELISA.RESULTS: After treatment of the C21 steroidal,inhibitory effect on the transplanted Heps was observed in the tuner-bearing mice.The inhibitory rates were 34.79 %, 47.08 % and 50.23 %, respectively.We found the morphology of tumor tissues in C21 groups had typical characters of necrosis under the light microscope. Spleen indices were decreased and thymus indices rose in C21 groups.The C21 steroidal could significantly augment the peritoneal macrophage phagocytic ability.T and B cells proliferation was increased to normal level.IL-2 and TNF-αwere elevated when compared with model group. CONCLUSION: The C21 steroidal could improve the specific and non-specific cellular immunity and promote anti-tumor cytokines secretion.

Experimental study of antiviral effect of compound Chaihu capsule on mice infected with influenza virus

ZHANG Bo, HUANG Fang, DAI Yue, MI Jing-yu

2007, 12(2):  173-176. 

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AIM: To observe the effect of anti-influenza of compound Chaihu capsule.METHODS: We designed compound Chaihu capsule curative effect experiments to the mice which were infected with influenza virus. In vivo, the impacts on lung index and death rate of mice were observed in the mice infected with influenza virus.RESULTS: Experiments in vivo showed that compound Chaihu capsule markedly inhibited the lung consolidation of mice pneumonia caused by the infection of influenza virus, and prolonged the survival time of mice infected with influenza virus.CONCLUSION: Compound Chaihu capsule is markedly effective for treatment of infection with influenza virus.

Protective effect of baicalin on myocardial ischemia in isolated rat heart

ZHANG Xiao-dan, WU Xiao-dong

2007, 12(2):  177-181. 

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AIM: To study the protectective effect of bacalin on myocardial ischemia in isolated rat heart and its mechanism.METHODS: Thirty six Sprague-Dawley rats were randomly divided into 3 groups.The heart of rats in control group (n=12) were perfused for 1 h and 50 min incessantly.The heart of rats in ischemia group (n=12) received 25min of perfusion first and then subjected to 25 min of global ischemia followed by 1 h reperfusion.The heart of rats in baicalin group (n=12) received 5 min perfusion of 5 mg/L) baicalin before ischemia while other procession was the same as ischemia group.The hemodynamic measurement and the coronary flow were recorded.The levels of CK and LDH in the coronary effluent were detected.The expression of p38mapk, NF-κB and the levels of TNF-ê and IL-6 in myocardium were respectively detected by immumohisto- chemical technique and ELISA.RESULT: The function of hearts treated with baicalin was improved significantly, and the level of LDH and CK of coronary effluent were decreased significantly compared with ischemia group. The level of TNF-ê and IL-6 and the expression of p38mapk and NF-κB in myocardium also decreased observably compared with ischemia group.CONCLUSION: Baicalin has a protective effect on myocardial ischemia of isolated rat heart and the effect may be due to the decrease of TNF-ê and IL-6 induced by the reduction of the expression of p38mapk and NF-κB.

Effect of oregano monomers against Trichomonas vaginalis in vitro

CHI Xiu-ling, YANG Qiu-lin, ZHU Bing-yang, YAN Yu-zhen, WEN Shu-guang, LI Lian, YAN Tao, ZHANG Hai-qiang, ZHONG Chao, TAN Hai-ping, YAN Feng-xiang

2007, 12(2):  182-186. 

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AIM: To study the effect of four monomers (thymol, cavacrol, rosmarinic acid and caffeic acid) extracted from oregano against Trichomonas vaginalis. MERHODS: The morphologic change, survival rate and MEC of the monomers on Trichomonas vaginalis were observed in different times and at different concentrations in vitro.RESULTS: The initial effect of Thymol and Cavacrol(5 mmol/L)against Trichomonas vaginalis was one time quicker than metronidazole.The MEC of thymol and cavacrol was 1.25, 2.5 mmol/L respectively at 24 h, which was respectively one and two times weaker than metronidazole.The effect of rosmarinic acid and caffeic acid on Trichomonas vaginalis was weak.CONCLUSIONS: Thymol and cavacrol have stronger effect against Trichomonas vaginalis.

Experimental study of a new small peptide purifing from agkitrodon acutus venom on antitumor activities

LI Ying-xin, LEI Dan-qing, ZHOU Xian-guo

2007, 12(2):  187-190. 

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AIM: To isolate and purify a new small peptide from Guangxi agkitrodon acutus venom, then investigating its antitumor activity in vitro.METHODS: Small peptide was separated from the snake venom by gel filtration chromatography on superdex 75, ultrafiltration and DEAE-Sepharose CL-6B ionexchange.The inhibition on the cultured tumor cells was tested by MTT assay.RESULTS: The peptide purified from Guangxi agkitrodon acutus venom strongly inhibited the proliferation of human ovarian carcimona cell, human gastric cancer cell and mouse breast cancer cell in a dose-dependent manner. The IC50 for 24 h was 0.264, 0.648, 0.173 μg/mL, respectively.CONCLUSION: A peptide can be obtained by gel filtration, ultrafiltration and ionexchange, which exhibits strong effect on inhibiting the proliferation of cultural tumor cells line in vitro.

Leptin level change during acute myocardial infarction in rats

XU Tong-tong, YANG Yue-zhong

2007, 12(2):  191-194. 

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AIM: Experiments were carried out to explore the variation of leptin level during acute myocardial infarction of SD rats and the inter-relationship between leptin change and AMI progress.METHODS: Sixty Sprague-Dawlaw rats were randomized into 2 groups, 40 rats as the AMI group and 20 rats as the sham-operation group.AMIwas experimentally established by ligating/Left coronary artery anterior descending branch.Leptin level in serum and myocardium was measured at 1st, 2nd, 3rd and 4th week after ligation, respectively.Further, myocardial function and death area, as well as the left ventricle weight index were detected.RESULTS: The leptin level of the AMI group varied during the AMI process, experiencing a period with increasing/Leptin level at first and then a period with decreasing/Leptin level.The leptin level of the AMI group is significantly higher than that of the sham-operation group.The myocardial death area for the AMI group did not correlate with serum and myocardial leptin concentrations with a P value>0.05, while the left ventricle weight index correlated with both leptin concentrations in the early phase of AMI with P <0.05. Leptin concentration correlated well with SBP, DBP, LVESP, and +dp/dt_max, with P <0.05, while the correlations of leptin concentration with both LVEDP and-dpdt/_max were not significant, with P>0.05.CONCLUSION: Leptin is involved in the progress of AMI in the experimental SD rats.An increase in leptin level during AMI may signify myocardial deterioration.

Evaluation of anti-inflammatory effects of luteolin and underlying mechanisems

TANG Ning, LI Zi-yan, ZHOU Yong-mei, LIU Bao-lin

2007, 12(2):  195-199. 

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AIM: To investigate anti-inflammatory effects of luteolin and underlying mechanisems.METHODS: Three typical inflammatory models, carrageenaninduced paw edema, cotton pellet granuloma and air cyst were used to investigate anti-inflammatory effect of luteolin in vivo.Meanwhile, effects of luteolin on mitogen-induced splenocyte proliferation and cyclooxygenase (COX) activities in vitro were also studied.RESULTS: Luteolin reduced the carrageenan-induced paw edema and effectively inhibited the inflammatory process in the cotton pellet granuloma model.Luteolin significantly inhibited leukocytes influx and reduced elevated levels of PGE2 and 6-keto-PGF1αin the exude induced by carrageenan injection.ConA stimulated splenocyte to proliferate, and the response was effectively suppressed by luteolin.In the whole blood assay, luteolin demonstrated selective inhibition of COX-2 activity.CONCLUSION: Luteolin effectively suppresses inflammatory responses in vivo, and the anti-inflammatory activity is associated with its selective inhibition of COX-2.

Synthesis and cytotoxic T lymphocyte response in vivo of therapeutic vaccine against cervical cancer

XU Dao-hua, ZHOU Chen-hui, XIA Yong-peng, QIU Zong-yin, JIA Zheng-cai, ZHOU Wei

2007, 12(2):  200-203. 

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AIM: To design and synthesize the therapeutic vaccine against human cervical cancer and study its immunological effect.METHODS: The peptides were synthesized with solid phase strategies, purified with reverse phase HPLC and identified with mass spectrometry. Their immunological effects inducing(CTL) response were investigated in HLA-A2 transgenic mice, and the activity of specific CTL was measured by using a standard 4 h⁵¹Cr release assay.RESULTS: The purities of peptides were 86.5 %, 81.8 % and 98.5 %, respectively.Their molecular weights were 3 121, 2 580 and 815 respectively, which was the same as expected molecular mass.The therapeutic vaccine could induce strong specific CTL activity in HLA-A2 transgenic mice.CONCLUSION: The synthetical products are the target peptides.The combination of CTL and T helper epitope and lipid molecule can remarkably improve the immunogenicity of CTL peptide.

Estimation of sample size in individual bioequivalence

LU Jing-jing, CHEN Feng, CUI Yong-chun, WANG Shou-cang, ZHANG Ai-min, LI Ren-peng, XU Jin-ke

2007, 12(2):  204-207. 

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AIM: To compare efficacy of two designs and three test approaches in individual bioequivalence and estimate sample size.METHODS: Monte-Carlo simulation research was applied.RESULTS: Sample size under 2×4 cross-over design is less than that under 2×3 crossover design.When, estimation method is feasible in estimating sample size.Whereas is close to 0.2,we can use test method to determine sample size.Then, either method is chosen to determine sample size.Consequently, we are able to choose appropriate method to estimate sample size.CONCLUSION: Sample size of individual bioequivalence is different as σWR, σD and designs are changed.

Genetic polymorphism analysis of cytochrome P450 2C19 among gender,age and body mass index in Chinese Han population

ZHOU Jian, LV Hong, KANG Xi-xiong

2007, 12(2):  208-213. 

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AIM: To identify the distribution feature of cytochrome P450 2C19 (CYP2C19)gene, and assess the effects of gender, age (18-80 years old)and body weight on genetic polymorphism of CYP2C19 in a Chinese Han population.METHODS: Two hundred and eightthree unrelated, healthy Chinese Han population subjects (126 males and 157 females, aged from 18 to 80)were genotyped for CYP2C19 to identify the wild-type (CYP2C19 *1)gene and two mutations (CYP2C19 *2 CYP2C19 *3) by PCR and DNA sequencing.RESULTS: Six different allelic variants of CYP2C19 gene were observed in this study.42.4 %(120 of the 283 subjects) were homozygous for the wild type CYP2C19 *1 * 1 in total by the genotyping analysis.The frequencies of the CYP2C19 *2 and *3 alleles were 29.2 % and 6.7 % respectively.14.2 % (40 of 283 subjects)were genotypically identified as PMs of CYP2C19.Of 126 genotyped male subjects, the CYP2C19 *2 and *3 allele frequencies were 28.2 %and 5.2 %.And among the 157 female subjects, the frequencies of the two alleles were 29.9 % and 8.0 %.The frequencies of CYP2C19 *2 and CYP2C19 *3 alleles in different ages were 29.9 % and 6.8 % (18 to 45 years old)versus 28.1 % and 6.6 % (no less than 45 years old).Body mass index (BMI)is an optimal way to examine obesity rather than actual body weight.BMI>25 indicates the individual is overweight. The frequencies of the CYP2C19 *2 and *3 alleles were 31.1 % and 6.6 %in BMI <25 group versus 22.7 %and 7 % in BMI>25 group.CONCLUSION: There are no statistically significant difference in the occurrence of CYP2C19 *2 and CYP2C19 *3 among gender (P>0.05), age (P>0.05)and BMI (P>0.05).So gender, age and BMI may have no significant effect on genetic polymorphism of CYP2C19.

Pharmacokinetics and bioequivalence of epinastine hydrochloride,a histamine H₁ receptor antagonist, in healthy Chinese volunteers

SHI Shao-jun, LI Zhong-fang, CHEN Hua-ting, ZENG Fan-dian

2007, 12(2):  214-218. 

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AIM: To determine the pharmacokinetics and bioequivalence of epinastine (EPN) hydrochloride, a promising histamine H₁ receptor antagonist, in healthy Chinese volunteers under fasting conditions.METHODS: EPN hydrochloride test and reference tablets were administered as a single dose on two treatment days separated by a 1-week washout period.After dosing, serial blood samples were collected for a period of 36 h, and plasma EPN hydrochloride concentrations were determined by a validated reversed-phase HPLC method and pharmacokinetic parameters were calculated with DAS software.RESULTS: Plasma concentration-time profiles were adequately described by a two-compartment open model.The compound was rapidly absorbed and cleared slowly from plasma with a half-life of approximately 10 h.The main pharmacokinetic parameters of EPN hydrochloride test and reference tablets were as follow:t_max were (2.2 ±0.5) and (2.0 ±0.4) h, C_max were (66 ±16) and (68 ±13) μg/L, t1 2 were (10.1 ±1.3) and (10.4 ±2.4) h, AUC0-36 were (592 ±88) and (601 ±94) μg·h·L^-1, respectively.The relative bioavailability of test tablets was (99 ±13) %.CONCLUSION: The results indicate that the two formulations of EPN hydrochloride tablets are bioequivalent in the rate and extent of absorption.

Recent advance in association between genetic polymorphisms in CYP2C9 and pharmacokinetics and pharmacodynamics of sulphonylureas

HUANG Zuo-jun, LI Yue-ling, HUANG Min

2007, 12(2):  219-223. 

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Sulphonylureas are the initial and most commonly used therapy for type 2 diabetes mellitus.Sulphonylureas are metabolized by CYP2C9, and the CYP2C9 gene has several mutant alleles leading to genetic polymorphisms in humans.The variation of metabolism abilities of different CYP2C9 genotype is one of the reasons why the type 2 diabetes mellitus patients need different doses of sulphonylureas.To offer a guidance for individualizing administration of sulphonylureas, we specify the relationship between genetic polymorphisms in CYP2C9 and the pharmacokinetics and pharmacodynamics of sulphonylureas.

Effects of hyperventilation on propofol anesthesia

ZHANG Yi-long, MI Wei-dong

2007, 12(2):  224-227. 

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AIM: To study the effects of hyperventilation on propofol anesthesia by measuring Bispectral index (BIS).METHODS: Twenty patients (ASA Ⅰ-Ⅱ) undergoing/Lower limbs surgeries were enrolled in this study.Anesthesia was maintained with target controlled infusion (TCI) propofol and remifentanyl intravenously. The target concentration of propofol and remifentanyl were 2-5 μg/mL and 2-6 ng/mL, respectively.During the period of anesthesia, BIS values were recorded when the end-tidal pressure of CO2 (PetCO2) was kept to 35 mm/Hg, 30 mm Hg and 25 mm Hg respectively for 30min by changing the ventilation rate and the tidal volume.Also, the BIS values and the time required were recorded following bolus intravenous injection of propofol at 1 mg/kg at above three PetCO2 levels.RESULTS: The BIS values kept stable when ventilation was adjusted to PetCO2 at 35 mm/Hg, 30mm Hg and 25mm Hg for 30 min respectively.Propofol injected at 1 mg/kg intravenously made the BIS values a significant decrease at the three PetCO2 levels. However, the decreasing extent of the BIS and the time when BIS began reducing were different between groups.The BIS values showed a less decrease and slower reacting time at the deep hyperventilation with PetCO2 descending (P <0.05).CONCLUSION: Hyperventilation or low PaCO2 can affect the anesthesia effects of propofol and slower action time when propofol injected at bolus.This effect may be related to the physiological reaction of CBF to CO2.

Clinical research of ropivacaine supplemented with midazolam for sacral block in pediatric operation

SHI Qi-qing, XIONG Bo, ZHANG Xue-feng

2007, 12(2):  228-231. 

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AIM: To observe the efficacy and safety of ropivacaine supplemented with midazolam for sacral block in pediatric operation.METHODS: 40 cases of patients aged 1-6 years old, who were going to be operated in hypogastrium, perineum and lower limb, were randomly and double-blindly divided into four groups with ten cases each:control group (bupivacaine 2.5 mg/kg), low dosage group (ropivacaine 2.5 mg/kg), middle dosage group (ropivacaine 3.5 mg/kg) and high dosage group (ropivacaine 5.0 mg/kg).Sacral block was performed after induction of inhalation anaesthesia with sevoflurane.Sedation was induced by midazolam (0.2mg/kg) administered through mainline 5 min before the surgical procedure.RESULTS: In a certain dosage range, ropivacaine supplemented with midazolam anesthesia for sacral block showed a slight influence on diastolic blood pressure, mean arterial pressure, heart rate and pulse oxygen saturation. Those parameters remained in the physiological normal range, though they dropped slightly during the operative period.Compared with bupivacaine group, the postoperative analgesic period was similar in the high and middle ropivacaine groups, while it was shorter in lowr opivacaine group.There was no significant adverse effect in all groups except for operative stretch reflex and postoperative vomiting in individual patients.CONCLUSION: Ropivacaine supplemented with midazolam anesthesia for sacral block has a slight influence on emodynamics, prolongs the postoperative analgesic period, and shows less adverse effect.

Clinical observation of parenteral nutrition in premature infants

GUO Ben-biao, ZHOU Ming-xiong

2007, 12(2):  232-235. 

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AIM: To observe the effect of parenteral nutrition (PN) in the feeding of premature infants. METHODS: Seventy five premature infants were randomly assigned into three groups.The control group supplied glucose combined with minimal enteral nutrition and assisted with nonutrition sucking.In treatment groups:the no-fat emulsion PN group supplied amino acids and glucose combined with minimal enteral nutrition and assisted with nonutrition sucking, and the fat emulsion PN group supplied fat emulsion, amino acids and glucose combined with minimal enteral nutrition and assisted with nonutrition sucking.After 1 week, the weight, the state correlated biochemical indicator and complications were detected.RESULTS: Both of the no-fat emulsion PN therapy and the fat emulsion PN therapy could promote weight gain and lessen complications, and the clinical application was comparatively safe.CONCLUSION: The PN can improve growth and development of premature infants and elevate the clinical therapeutic efficacy.

Therapeutic observation of chitosan gynecologic suppository for candida vaginitis and mycotic vaginitis

GUO Lin

2007, 12(2):  236-240. 

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AIM: To observe the clinical therapeutic effect of chitosan gynecologic suppository in the treatment of candidal vaginitis and bacteroidal vagina disease. METHODS: One hundred cases of candidal vaginitis were randomly divided into observation group (n=50) treated with chitosan gynecologic suppository and control group (n=50)treated with Daktarin suppository.Similarly, another one hundred cases of bacteroidal vaginitis were randomly divided into observation group (n=50) treated with chitosan gynecologic suppository and control group (n=50)treated with metronidazole suppository.The syndrome, physical sign and laboratory examination were compared before and after the treatment.RESULTS: The effective rates of the chitosan gynecologic suppository were 93.6 % and 79.1 % for candidal vaginitis and bacteroidal vagina disease, respectively.There was no statistical difference in the effect between Daktarin suppository and metronidazole suppository (P>0.05).CONCLUSION: Chitosan gynecologic suppository is safe, effective and more receptive for the patients, and the resistance is not easily produced for treatment of candida vaginitis and bacteroidal vagina disease.Its advantage is that the patients can be treated without complete laboratory examination.