Population pharmacokinetics of mycophenolic acid in pediatric patients with primary IgA nephropathy / 中国药房

OBJECTIVE To develop a population pharmacokinetic （PPK） model for mycophenolate mofetil active metabolite mycophenolic acid （MPA） in children with primary IgA nephropathy， explore the factors affecting the pharmacokinetic parameters of MPA， and provide a basis for clinical individualized therapy. METHODS Retrospective collection was conducted on 636 concentrations and clinical data from 47 pediatric patients with primary IgA nephropathy. PPK analysis was carried out by using the nonlinear mixed-effects model； the covariates were tested with a stepwise method. Goodness-of-fit plots， Bootstrap and visual predictive check were employed to evaluate the final model. RESULTS The pharmacokinetics of MPA in children with IgA nephropathy in vivo conformed to the first-order absorption and elimination two-compartment model （objective function value of 3 276.31）. Covariate analysis suggested that body weight and albumin （ALB） levels were significant influencing factors on apparent clearance rate and apparent distribution volume. The typical values of PPK parameters of MPA in the final model were as follows： the central room had a distributed volume of 5.79 L， the clearance rate was 4.06 L/h， the volume of peripheral ventricular distribution was 430.93 L， the clearance rate between compartments was 15.40 L/h， the oral absorption rate constant was 1.29 h－1. After verification， most of the predicted corrected observed concentration points were within the 90% confidence interval of the predicted corrected simulated concentration， indicating that the MPA final model had good predictive performance. CONCLUSIONS The PPK model of MPA in children with primary IgA nephropathy is established in this study， identifying body weight and ALB levels are significant factors affecting MPA metabolism.

Analysis of SALL1 gene variant in a boy with Townes-Brocks syndrome without anal atresia / 中华医学遗传学杂志

OBJECTIVE@#To explore the genetic basis for a child presented with renal failure and multi-cystic dysplastic kidney without anal atresia.@*METHODS@#Peripheral blood sample of the child and his parents were collected and subjected to whole exome sequencing. Candidate variant was verified by Sanger sequencing.@*RESULTS@#The 40-day-old infant had presented with vomiting brown matter in a 7 days neonate and was transferred for kidney failure. Clinical examination has discovered renal failure, polycystic renal dysplasia, congenital hypothyroidism, bilateral thumb polydactyly, sensorineural hearing loss and preauricular dermatophyte. Genetic testing revealed that he has harbored a previously unreported c.824delT, p.L275Yfs*10 frameshift variant of SALL1 gene, which was confirmed by Sanger sequencing as de novo.@*CONCLUSION@#The patient was diagnosed with Townes-Brocks syndrome due to the novel de novo variant of SALL1 gene. Townes-Brocks syndrome without anal atresia is rare. Above finding has also enriched the mutational spectrum of the SALL1 gene.

Seroprevalence of Toxoplasma gondii in wild birds in Northeast China by modified agglutination test / 中国人兽共患病学报

We detected the seroprevalence of Toxoplasma gondii (T.gondii) in the wild birds in northeast China.The wild bird's blood was collected from the cutaneous ulnar vein and the serum was isolated and used for detection of anti T.gondii antibody by modified agglutination test (MAT).Results showed that totally 179 birds' serum samples were collected.Twenty serum samples (11.17％) were positive with T.gondii antibody,which belonged to 9 orders,17 families and 31 species.The seroprevalence against T.gondii was about 5.26％ (1/19) in Columbiformes,9.09％ (9/99) in Passeriformes,14.29％ (3/21) in Falconiformes,15.00％ (5/22) in Piciformes,16.67％ (1/6) in Coraciiformes,and 25.00％ (1/4) in Anseriformes.Based on their feeding behavior,the seroprevalence was 12.00％ (3/25) in carnivorous wild birds,10.60％ (15/141) in omnivorous wild birds,and 15.38％ (2/13) in the wild birds feeding on aquatic animals or plants.These wild birds also can be sorted as migratory and sedentary (non-migratory) according to their migration habits,and the serum positivity was 11.67％ (14/120),and 10.71％ (6/59) respectively.The seroprevalence against Toxoplasma gondii in wild birds in northeast China is about 11.17％,which indicates a common infection of Toxoplasma gondii in wild birds.