ABSTRACT
OBJECTIVE To establish the estimation model for the exposure of mycophenolic acid （MPA） in early renal transplant recipients [calculated by the area under the plasma concentration-time curve with 12 h （AUC0－12 h）]. METHODS Twenty kidney transplant recipients， who received triple immunosuppressive therapy of mycophenolate mofetil （MMF）+tacrolimus+ methylprednisolone， were selected and given MMF dispersible tablets （750 mg， q12 h） on the 15th day after the operation； the blood samples were collected from the patients before and 0.5， 1.0， 1.5， 2.0， 3.0， 4.0， 6.0， 8.0， 12.0 hours after the administration， respectively. The blood concentration of MPA was determined， and the pharmacokinetic parameters of MPA were calculated. The multivariate linear stepwise regression analysis method was used to fit an estimation formula for the finite sampling method suitable for MPA-AUC0－12 h of the recipients. Bland-Altman analysis was used to evaluate the agreement between the estimation formula and the classical pharmacokinetic method. RESULTS The main pharmacokinetic parameters of MPA in 20 renal transplant recipients： c0 was （1.53±0.84） μg/mL， cmax was （12.07±5.97） μg/mL， t1/2 was （5.41±3.67） h， tmax was （1.58±0.75） h， and the average AUC0－12 h calculated by the classical pharmacokinetic method was （33.95±13.40） μg·h/mL. MPA-AUC0－12 h was estimated with sampling points of “4.0， 8.0， 12.0 h”； the simplified calculation formula was AUC0－12 h＝12.058+2.819c4.0+7.045c8.0+ 3.879c12.0 （R 2＝0.934）. The predicted value had a good correlation and consistency with the measured value， and 95.0% of predicted values did not exceed the x±1.96SD （standard deviation） range. CONCLUSIONS The estimation model is established successfully for the exposure of MPA in early renal transplant recipients； the model has better prediction accuracy and fewer sampling points.
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Objective To evaluate the feasibility of optic nerve subarachnoid space in non?invasive qualitatively diagnosis of intracranial hypertension. Methods In this retrospective study, patients who received lumbar puncture from October 2009 to June 2015 were enrolled and divided into normal intracranial pressure group (41 cases) and intracranial hypertension group (39 cases). Optic nerve subarachnoid space width (SASW) behind ocular 3 mm (SASW?3),9 mm (SASW?9),and 15 mm (SASW?15) were measured on MRI and compared between groups. Chi?square test, t test and ROC analyses were used. Results SASW?3,SASW?9,and SASW?15 were (1.16±0.21), (0.98±0.21) and (0.92±0.17) mm in normal group and (1.46 ± 0.20), (1.29 ± 0.19) and (1.17 ± 0.20) mm in intracranial hypertension group, respectively. According to independent samples t test,SASW?3,SASW?9,and SASW?15 of intracranial hypertension group was significant larger than those at the same measured site of normal group (P<0.01). According to MedCalc analysis,Receive operating characteristic (ROC) area was 0.849 in SASW?3 and when the cut?off value was fixes as 1.19 mm,the sensibility and specificity were 94.9% and 63.4%,respectively. ROC area was 0.849 in SASW?9 and when the cut?off value was fixes as 1.10 mm, the sensibility and specificity were 84.6% and 78.0%,respectively. ROC area was 0.824 in SASW?15 and when the cut?off value was fixes as 1.06 mm,the sensibility and specificity were 69.2% and 80.5%,respectively. Conclusion SASW?9 can be used to screen and monitor the intracranial hypertension as a non?invasive tool.
ABSTRACT
Objective To study the chemical constituents of Epimedium brevicornum.Methods Compounds were isolated with various chromatographic techniques,their structures were elucidated by physicochemical methods and spectral analysis.Results Ten compounds were obtained and identified as p-nitroethylphenol(Ⅰ),salidroside(Ⅱ),5,7,4'-trihydroxy-8,3'-diprenylflavone(Ⅲ),kaempferol-3-O-?-L-dirhamnoside(Ⅳ),baohuoside-Ⅰ(Ⅴ),sagittatoside B(Ⅵ),2″-O-rhamnosylicariside Ⅱ(Ⅶ),7,3',4',5'-tetrahydroxyflavanol(Ⅷ),desmethylicaritin(Ⅸ),and 1-O-?-glucopyransosyl-1,4-dihydroxy-2-(3'-hydroxy-3'-methylbutyl)benzene(Ⅹ).Conclusion Compounds Ⅰ,Ⅱ,Ⅳ,and Ⅹ are isolated and identified from the plants of Epimedium L.for the first time and compound Ⅵ is isolated from the title plant for the first time.