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Li X, Cheng Y, Zhang B, Chen B, Chen Y, Huang Y, Lin H, Zhou L, Zhang H, Liu M, Que W, Qiu H. A systematic evaluation of population pharmacokinetic models for polymyxin B in patients with liver and/or kidney dysfunction. J Pharmacokinet Pharmacodyn 2024:10.1007/s10928-024-09916-9. [PMID: 38625507 DOI: 10.1007/s10928-024-09916-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 03/21/2024] [Indexed: 04/17/2024]
Abstract
Polymyxin B (PMB) is considered a last-line treatment for multidrug-resistant (MDR) gram-negative bacterial infections. Model-informed precision dosing with population pharmacokinetics (PopPK) models could help to individualize PMB dosing regimens and improve therapy. However, the external prediction ability of the established PopPK models has not been fully elaborated. This study aimed to systemically evaluate eleven PMB PopPK models from ten published literature based on a new independent population, which was divided into four different populations, patients with liver dysfunction, kidney dysfunction, liver and kidney dysfunction, and normal liver and kidney function. The whole data set consisted of 146 patients with 391 PMB concentrations. The prediction- and simulation-based diagnostics and Bayesian forecasting were conducted to evaluate model predictability. In the overall evaluation process, none of the models exhibited satisfactory predictive ability in both prediction- and simulation-based diagnostic simultaneously. However, the evaluation of the models in the subgroup of patients with normal liver and kidney function revealed improved predictive performance compared to those with liver and/or kidney dysfunction. Bayesian forecasting demonstrated enhanced predictability with the incorporation of two to three prior observations. The external evaluation highlighted a lack of consistency between the prediction results of published models and the external validation dataset. Nonetheless, Bayesian forecasting holds promise in improving the predictive performance of the models, and feedback from therapeutic drug monitoring is crucial in optimizing individual dosing regimens.
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Affiliation(s)
- Xueyong Li
- Department of Pharmacy, Fujian Medical University Union Hospital, 29 Xin Quan Rd, Fuzhou, 350001, Fujian, People's Republic of China
- College of Pharmacy, Fujian Medical University, Fuzhou, 350004, People's Republic of China
| | - Yu Cheng
- Department of Pharmacy, Fujian Medical University Union Hospital, 29 Xin Quan Rd, Fuzhou, 350001, Fujian, People's Republic of China
| | - Bingqing Zhang
- Department of Pharmacy, Fujian Medical University Union Hospital, 29 Xin Quan Rd, Fuzhou, 350001, Fujian, People's Republic of China
- College of Pharmacy, Fujian Medical University, Fuzhou, 350004, People's Republic of China
| | - Bo Chen
- College of Pharmacy, Fujian Medical University, Fuzhou, 350004, People's Republic of China
| | - Yiying Chen
- College of Pharmacy, Fujian Medical University, Fuzhou, 350004, People's Republic of China
| | - Yingbing Huang
- College of Pharmacy, Fujian Medical University, Fuzhou, 350004, People's Republic of China
| | - Hailing Lin
- Department of Pharmacy, Fujian Medical University Union Hospital, 29 Xin Quan Rd, Fuzhou, 350001, Fujian, People's Republic of China
| | - Lili Zhou
- Department of Critical Care Medicine, Fujian Medical University Union Hospital, Fuzhou, 350001, People's Republic of China
| | - Hui Zhang
- Department of Critical Care Medicine, Fujian Medical University Union Hospital, Fuzhou, 350001, People's Republic of China
| | - Maobai Liu
- Department of Pharmacy, Fujian Medical University Union Hospital, 29 Xin Quan Rd, Fuzhou, 350001, Fujian, People's Republic of China
| | - Wancai Que
- Department of Pharmacy, Fujian Medical University Union Hospital, 29 Xin Quan Rd, Fuzhou, 350001, Fujian, People's Republic of China.
| | - Hongqiang Qiu
- Department of Pharmacy, Fujian Medical University Union Hospital, 29 Xin Quan Rd, Fuzhou, 350001, Fujian, People's Republic of China.
- College of Pharmacy, Fujian Medical University, Fuzhou, 350004, People's Republic of China.
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Que W, Deng Z, Gao J. Clinical crusade: zosurabalpin's charge against antibiotic resistance. Trends Mol Med 2024:S1471-4914(24)00037-6. [PMID: 38453528 DOI: 10.1016/j.molmed.2024.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 02/19/2024] [Accepted: 02/23/2024] [Indexed: 03/09/2024]
Abstract
In a recent report, Zampaloni et al. describe a novel tethered macrocyclic peptide (MCP) antibiotic, zosurabalpin, that disrupts the essential function of the LptB2FGC complex in Gram-negative bacteria and demonstrates efficacy against carbapenem-resistant Acinetobacter baumannii (CRAB). Its preclinical success suggests a substantial shift in treating antibiotic resistance, pending clinical trials to validate its effectiveness, pharmacokinetics, and resistance management.
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Affiliation(s)
- Wancai Que
- Key BioAI Synthetica Laboratory for Natural Product Drug Discovery, College of Bee and Biomedical Sciences, Fujian Agriculture and Forestry University, Fuzhou 350002, China
| | - Zixin Deng
- State Key Laboratory of Microbial Metabolism, Joint International Laboratory of Metabolic and Developmental Sciences, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China
| | - Jiangtao Gao
- Key BioAI Synthetica Laboratory for Natural Product Drug Discovery, College of Bee and Biomedical Sciences, Fujian Agriculture and Forestry University, Fuzhou 350002, China.
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Li X, Cheng Y, Chen B, Chen Y, Huang Y, Zhang B, Que W, Liu M, Zhang H, Qiu H. Population pharmacokinetics of polymyxin B in patients with liver dysfunction. Br J Clin Pharmacol 2023; 89:3561-3572. [PMID: 37461291 DOI: 10.1111/bcp.15855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 08/10/2023] Open
Abstract
AIMS Polymyxin B (PMB) is widely used to treat infections caused by multidrug-resistant Gram-negative pathogens. Currently, the pharmacokinetic data of PMB in patients with liver dysfunction are limited. This study aimed to develop a population pharmacokinetic (PopPK) model of PMB in patients with liver dysfunction and identify the factors affecting PMB pharmacokinetics. METHODS We conducted a retrospective pharmacokinetic study involving 136 adults with different levels of liver function. Nonlinear mixed effects modelling was used to develop a PopPK model of PMB. Monte Carlo simulation was used to design PMB dosage schedules across various liver and renal functions. RESULTS PMB pharmacokinetic analyses included 401 steady-state concentrations in 136 adult patients. A one-compartment pharmacokinetic model with first-order absorption and elimination was used to describe the data. The typical population value of PMB clearance was 2.43 L/h and the volume of distribution was 23.11 L. This study revealed that creatinine clearance (CrCL) and Child-Pugh class were significantly associated with PMB pharmacokinetic parameters; however, clinically relevant variations of dose-normalized drug exposure were not significant. For patients with a minimum inhibitory concentration of ≤0.5 mg/L, the appropriate dose was 40-75 mg/12-h. When the dose exceeded 100 mg/12-h, the risk of nephrotoxicity increased significantly. CONCLUSIONS This study provided PMB pharmacokinetic information for patients with liver dysfunction. Patients with renal and liver dysfunctions may not require an initial dose adjustment. Rather than PopPK-guided dose adjustment, therapeutic drug monitoring of PMB plays a more direct role in optimizing dosing regimens based on its therapeutic window.
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Affiliation(s)
- Xueyong Li
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China
- College of Pharmacy, Fujian Medical University, Fuzhou, China
| | - Yu Cheng
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China
| | - Bo Chen
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China
- College of Pharmacy, Fujian Medical University, Fuzhou, China
| | - Yiying Chen
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China
- College of Pharmacy, Fujian Medical University, Fuzhou, China
| | - Yingbin Huang
- College of Pharmacy, Fujian Medical University, Fuzhou, China
| | - Bingqing Zhang
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China
- College of Pharmacy, Fujian Medical University, Fuzhou, China
| | - Wancai Que
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China
| | - Maobai Liu
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China
| | - Hui Zhang
- Department of Critical Care Medicine, Fujian Medical University Union Hospital, Fuzhou, China
| | - Hongqiang Qiu
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China
- College of Pharmacy, Fujian Medical University, Fuzhou, China
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Zhang B, Li X, Chen Y, Chen B, Cheng Y, Lin H, Que W, Liu M, Zhou L, Zhang H, Qiu H, Wu C. Determination of polymyxin B in human plasma and epithelial lining fluid using LC-MS/MS and its clinical application in therapeutic drug monitoring. J Pharm Biomed Anal 2023; 227:115291. [PMID: 36822067 DOI: 10.1016/j.jpba.2023.115291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 02/08/2023] [Accepted: 02/12/2023] [Indexed: 02/15/2023]
Abstract
Polymyxin B (PB) is currently one of the last resort treatment options against carbapenem-resistant gram-negative bacterial pathogens. Pharmacokinetics/pharmacodynamics (PK/PD) guided therapeutic drug monitoring (TDM) of antibiotics is critical for optimizing dosage regimens to maximize efficacy, minimize toxicity, and delay the emergence of resistance. Currently, methods for determining PB in human plasma and epithelial lining fluid (ELF) are limited. In this study, we developed and validated a simple method for PB determination in human plasma and ELF using LC-MS/MS. Protein precipitation of the sample was conducted with 0.1% formic acid-acetonitrile. Polymyxin B1 and B2 were separated on a C18 column and detected within 4 min by the mass spectrometer in the positive mode coupled with multiple reaction monitoring. The calibration curve range was 0.156-10.0 and 0.0156-1.00 μg/mL in the plasma for polymyxin B1 and B2, respectively, and was 0.0625-2.00 and 0.00625-0.200 μg/mL for polymyxin B1 and B2, respectively in bronchoalveolar lavage fluid. The accuracy of the intra- and inter-assay studies ranged from 80.6% to 114.9%, and the coefficients of variation for intra- and inter-day assays were less than 14.8%. Among a considerable number of patients, the average steady-state plasma concentration of PB was suboptimal. Moreover, the exposure to PB in patients with acute kidney injury (AKI) was considerably higher than that in patients without AKI. Meanwhile, a higher concentration of PB in ELF could be achieved than that in plasma after PB nebulization treatment. The established method was proven to be rapid, simple, and suitable for TDM of PB and PK/PD studies in human plasma and ELF.
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Affiliation(s)
- Bingqing Zhang
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou 350001, People's Republic of China; College of Pharmacy, Fujian Medical University, Fuzhou 350004, People's Republic of China
| | - Xueyong Li
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou 350001, People's Republic of China; College of Pharmacy, Fujian Medical University, Fuzhou 350004, People's Republic of China
| | - Yiying Chen
- College of Pharmacy, Fujian Medical University, Fuzhou 350004, People's Republic of China
| | - Bo Chen
- College of Pharmacy, Fujian Medical University, Fuzhou 350004, People's Republic of China
| | - Yu Cheng
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou 350001, People's Republic of China
| | - Hailing Lin
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou 350001, People's Republic of China
| | - Wancai Que
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou 350001, People's Republic of China
| | - Maobai Liu
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou 350001, People's Republic of China
| | - Lili Zhou
- Department of Critical Care Medicine, Fujian Medical University Union Hospital, Fuzhou 350001, People's Republic of China
| | - Hui Zhang
- Department of Critical Care Medicine, Fujian Medical University Union Hospital, Fuzhou 350001, People's Republic of China
| | - Hongqiang Qiu
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou 350001, People's Republic of China; College of Pharmacy, Fujian Medical University, Fuzhou 350004, People's Republic of China.
| | - Chaoyang Wu
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou 350001, People's Republic of China; College of Pharmacy, Fujian Medical University, Fuzhou 350004, People's Republic of China.
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Wei N, Zheng B, Que W, Zhang J, Liu M. The association between proton pump inhibitor use and systemic anti-tumour therapy on survival outcomes in patients with advanced non-small cell lung cancer: A systematic review and meta-analysis. Br J Clin Pharmacol 2022; 88:3052-3063. [PMID: 35165922 DOI: 10.1111/bcp.15276] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 01/22/2022] [Accepted: 02/01/2022] [Indexed: 11/29/2022] Open
Abstract
AIMS Proton pump inhibitors (PPIs) are often prescribed to prevent or treat gastrointestinal disease. Whether the combination of systemic anti-tumour therapy and PPIs leads to poor outcomes in patients with advanced non-small cell lung cancer (NSCLC) is unclear. This systematic review explored the relationship between PPIs and survival outcomes of patients with advanced NSCLC who are receiving systemic anti-tumour therapy. METHODS We searched studies reporting the overall survival (OS) and/or progression-free survival (PFS) of advanced NSCLC patients who are receiving systemic anti-tumour therapy with or without PPIs on PubMed, EMBASE and the Cochrane Library for literature published prior to 31 August 2021. The meta-analysis used a random effects model to estimate the hazard ratio (HR) with 95% confidence intervals (CI) and I2 to assess statistical heterogeneity. Publication bias and sensitivity analysis were performed. RESULTS Fourteen retrospective studies comprising 13 709 advanced NSCLC patients were identified. Subgroup analyses showed that the use of PPI was correlated with the OS or PFS of patients receiving chemotherapy, targeted therapy, and immunotherapy (PPI users' group vs non-users' group: HR for OS = 1.35, 95% CI = 1.21-1.51, P < .00001; HR for PFS = 1.50, 95% CI = 1.25-1.80, P < .0001). Publication bias and sensitivity analyses confirmed that the results were robust. CONCLUSION Meta-analysis demonstrated that PPI use in advanced NSCLC patients who were undergoing systemic anti-tumour therapy was correlated with increased mortality risk. Until results are further confirmed, caution should be applied when administering PPIs and systemic anti-tumour therapy to advanced NSCLC patients.
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Affiliation(s)
- Na Wei
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China
| | - Bin Zheng
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China
| | - Wancai Que
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China
| | - Jin Zhang
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China
| | - Maobai Liu
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China
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Cheng Y, Que W, Zhang B, Chen M, Zhao Z, Li B, Qiu H. YouTube as an educational resource for medication poisoning: a systematic review. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-020-01464-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
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Cheng Y, Chen M, Zhang B, Lin H, Li X, Cai Y, Zhang H, Que W, Liu M, Qiu H. Rapid, simple, and economical LC-MS/MS method for simultaneous determination of ceftazidime and avibactam in human plasma and its application in therapeutic drug monitoring. J Clin Pharm Ther 2022; 47:1426-1437. [PMID: 35633089 DOI: 10.1111/jcpt.13693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 04/11/2022] [Accepted: 05/04/2022] [Indexed: 11/29/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Carbapenem-resistant Gram-negative bacterial pathogens continue to threaten public health. Avibactam (AVI), a novel non-β-lactam β-lactamase inhibitor, has been approved for use with ceftazidime (CAZ) mainly against carbapenem-resistant Enterobacteriaceae. Therapeutic drug monitoring (TDM) is urgently needed to optimize dosage regimens to maximize efficacy, minimize toxicity, and delay the emergence of resistance. This study aims to develop and validate a rapid, simple, and economical LC-MS/MS method for simultaneous determination of CAZ/AVI in human plasma. METHODS Samples were processed by simple protein precipitation, and gradient elution strategy was applied to separate CAZ and AVI on a reverse-phase C18 column; with subsequent detection by the mass spectrometer in a positive and negative ion switching mode. Plasma samples from patients were analysed. RESULTS AND DISCUSSION A 4-min run of LC-MS/MS was developed. The precision, trueness, matrix effect, extraction recovery, carry-over, dilution integrity, and stability were all acceptable for a bioanalytical method. The method was successfully applied to the determination of CAZ and AVI in patients, and a considerable PK variability of CAZ/AVI was observed among patients. WHAT IS NEW AND CONCLUSION A robust, rapid, simple, and economical LC-MS/MS method for the simultaneous determination of CAZ and AVI was developed. The considerable PK variability of CAZ/AVI among patients demonstrates the clinical significance of TDM.
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Affiliation(s)
- Yu Cheng
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China.,College of Pharmacy, Fujian Medical University, Fuzhou, People's Republic of China.,Department of Pharmacy, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China
| | - Maohua Chen
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China
| | - Bingqing Zhang
- College of Pharmacy, Fujian Medical University, Fuzhou, People's Republic of China
| | - Hailin Lin
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China
| | - Xueyong Li
- College of Pharmacy, Fujian Medical University, Fuzhou, People's Republic of China
| | - Yipeng Cai
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China
| | - Hui Zhang
- Department of Critical Care Medicine, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China
| | - Wancai Que
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China
| | - Maobai Liu
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China
| | - Hongqiang Qiu
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, People's Republic of China.,College of Pharmacy, Fujian Medical University, Fuzhou, People's Republic of China
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Que W, Wu Z, Chen M, Zhang B, You C, Lin H, Zhao Z, Liu M, Qiu H, Cheng Y. Molecular Mechanism of Gelsemium elegans (Gardner and Champ.) Benth. Against Neuropathic Pain Based on Network Pharmacology and Experimental Evidence. Front Pharmacol 2022; 12:792932. [PMID: 35046814 PMCID: PMC8762237 DOI: 10.3389/fphar.2021.792932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 12/13/2021] [Indexed: 11/13/2022] Open
Abstract
Gelsemium elegans (Gardner and Champ.) Benth. (Gelsemiaceae) (GEB) is a toxic plant indigenous to Southeast Asia especially China, and has long been used as Chinese folk medicine for the treatment of various types of pain, including neuropathic pain (NPP). Nevertheless, limited data are available on the understanding of the interactions between ingredients-targets-pathways. The present study integrated network pharmacology and experimental evidence to decipher molecular mechanisms of GEB against NPP. The candidate ingredients of GEB were collected from the published literature and online databases. Potentially active targets of GEB were predicted using the SwissTargetPrediction database. NPP-associated targets were retrieved from GeneCards, Therapeutic Target database, and DrugBank. Then the protein-protein interaction network was constructed. The DAVID database was applied to Gene Ontology and Kyoto Encyclopedia of Genes and Genome pathway enrichment analysis. Molecular docking was employed to validate the interaction between ingredients and targets. Subsequently, a 50 ns molecular dynamics simulation was performed to analyze the conformational stability of the protein-ligand complex. Furthermore, the potential anti-NPP mechanisms of GEB were evaluated in the rat chronic constriction injury model. A total of 47 alkaloids and 52 core targets were successfully identified for GEB in the treatment of NPP. Functional enrichment analysis showed that GEB was mainly involved in phosphorylation reactions and nitric oxide synthesis processes. It also participated in 73 pathways in the pathogenesis of NPP, including the neuroactive ligand-receptor interaction signaling pathway, calcium signaling pathway, and MAPK signaling pathway. Interestingly, 11-Hydroxyrankinidin well matched the active pockets of crucial targets, such as EGFR, JAK1, and AKT1. The 11-hydroxyrankinidin-EGFR complex was stable throughout the entire molecular dynamics simulation. Besides, the expression of EGFR and JAK1 could be regulated by koumine to achieve the anti-NPP action. These findings revealed the complex network relationship of GEB in the "multi-ingredient, multi-target, multi-pathway" mode, and explained the synergistic regulatory effect of each complex ingredient of GEB based on the holistic view of traditional Chinese medicine. The present study would provide a scientific approach and strategy for further studies of GEB in the treatment of NPP in the future.
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Affiliation(s)
- Wancai Que
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China.,College of Pharmacy, Fujian Medical University, Fuzhou, China
| | - Zhaoyang Wu
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China.,College of Pharmacy, Fujian Medical University, Fuzhou, China
| | - Maohua Chen
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China
| | - Binqing Zhang
- College of Pharmacy, Fujian Medical University, Fuzhou, China
| | - Chuihuai You
- College of Agriculture, Fujian Agriculture and Forestry University, Fuzhou, China
| | - Hailing Lin
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China
| | - Zhichang Zhao
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China.,College of Pharmacy, Fujian Medical University, Fuzhou, China
| | - Maobai Liu
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China.,College of Pharmacy, Fujian Medical University, Fuzhou, China
| | - Hongqiang Qiu
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China.,College of Pharmacy, Fujian Medical University, Fuzhou, China
| | - Yu Cheng
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China.,College of Pharmacy, Fujian Medical University, Fuzhou, China.,Department of Pharmacy, Shengjing Hospital of China Medical University, Shenyang, China
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Lin H, Qiu H, Cheng Y, Liu M, Chen M, Que Y, Que W. Gelsemium elegans Benth: Chemical Components, Pharmacological Effects, and Toxicity Mechanisms. Molecules 2021; 26:molecules26237145. [PMID: 34885727 PMCID: PMC8659130 DOI: 10.3390/molecules26237145] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/20/2021] [Accepted: 11/20/2021] [Indexed: 11/16/2022] Open
Abstract
Gelsemium elegans Benth (GEB), also known as heartbreak grass, is a highly poisonous plant belonging to the family Loganiaceae and genus Gelsemium that has broad application prospects in medicine. This article reviews its chemical components, pharmacological effects, toxicity mechanisms, and research progress in clinical applications in recent years. Indole alkaloids are the main active components of GEB and have a variety of pharmacological and biological functions. They have anti-tumor, anti-inflammatory, analgesic, and immunomodulation properties, with the therapeutic dose being close to the toxic dose. Application of small-dose indole alkaloids fails to work effectively, while high-dose usage is prone to poisoning, aggravating the patient’s conditions. Special caution is needed, especially to observe the changes in the disease condition of the patients in clinical practice. In-depth research on the chemical components and mechanisms of GEB is essential to the development of promising lead compounds and lays the foundation for extensive clinical application and safe usage of GEB in the future.
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Affiliation(s)
- Hailing Lin
- Department of Pharmacy, Fujian Medical University Union Hospital, 29 Xin Quan Rd, Gulou, Fuzhou 350001, China; (H.L.); (H.Q.); (Y.C.); (M.L.); (M.C.)
| | - Hongqiang Qiu
- Department of Pharmacy, Fujian Medical University Union Hospital, 29 Xin Quan Rd, Gulou, Fuzhou 350001, China; (H.L.); (H.Q.); (Y.C.); (M.L.); (M.C.)
| | - Yu Cheng
- Department of Pharmacy, Fujian Medical University Union Hospital, 29 Xin Quan Rd, Gulou, Fuzhou 350001, China; (H.L.); (H.Q.); (Y.C.); (M.L.); (M.C.)
| | - Maobai Liu
- Department of Pharmacy, Fujian Medical University Union Hospital, 29 Xin Quan Rd, Gulou, Fuzhou 350001, China; (H.L.); (H.Q.); (Y.C.); (M.L.); (M.C.)
| | - Maohua Chen
- Department of Pharmacy, Fujian Medical University Union Hospital, 29 Xin Quan Rd, Gulou, Fuzhou 350001, China; (H.L.); (H.Q.); (Y.C.); (M.L.); (M.C.)
| | - Youxiong Que
- College of Agriculture, Fujian Agriculture and Forestry University, Fuzhou 350002, China
- Correspondence: (Y.Q.); (W.Q.)
| | - Wancai Que
- Department of Pharmacy, Fujian Medical University Union Hospital, 29 Xin Quan Rd, Gulou, Fuzhou 350001, China; (H.L.); (H.Q.); (Y.C.); (M.L.); (M.C.)
- Correspondence: (Y.Q.); (W.Q.)
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10
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Que W, Chen M, Yang L, Zhang B, Zhao Z, Liu M, Cheng Y, Qiu H. A network pharmacology-based investigation on the bioactive ingredients and molecular mechanisms of Gelsemium elegans Benth against colorectal cancer. BMC Complement Med Ther 2021; 21:99. [PMID: 33743701 PMCID: PMC7981997 DOI: 10.1186/s12906-021-03273-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 03/11/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Colorectal cancer (CRC) remains one of the leading causes of cancer-related death worldwide. Gelsemium elegans Benth (GEB) is a traditional Chinese medicine commonly used for treatment for gastrointestinal cancer, including CRC. However, the underlying active ingredients and mechanism remain unknown. This study aims to explore the active components and the functional mechanisms of GEB in treating CRC by network pharmacology-based approaches. METHODS Candidate compounds of GEB were collected from the Traditional Chinese Medicine@Taiwan, Traditional Chinese Medicines Integrated Database, Bioinformatics Analysis Tool for Molecular mechanism of Traditional Chinese Medicine, and published literature. Potentially active targets of compounds in GEB were retrieved from SwissTargetPrediction databases. Keywords "colorectal cancer", "rectal cancer" and "colon cancer" were used as keywords to search for related targets of CRC from the GeneCards database, then the overlapped targets of compounds and CRC were further intersected with CRC related genes from the TCGA database. The Cytoscape was applied to construct a graph of visualized compound-target and pathway networks. Protein-protein interaction networks were constructed by using STRING database. The DAVID tool was applied to carry out Gene Ontology and Kyoto Encyclopedia of Genes and Genome pathway enrichment analysis of final targets. Molecular docking was employed to validate the interaction between compounds and targets. AutoDockTools was used to construct docking grid box for each target. Docking and molecular dynamics simulation were performed by Autodock Vina and Gromacs software, respectively. RESULTS Fifty-three bioactive compounds were successfully identified, corresponding to 136 targets that were screened out for the treatment of CRC. Functional enrichment analysis suggested that GEB exerted its pharmacological effects against CRC via modulating multiple pathways, such as pathways in cancer, cell cycle, and colorectal cancer. Molecular docking analysis showed that the representative compounds had good affinity with the key targets. Molecular dynamics simulation indicated that the best hit molecules formed a stable protein-ligand complex. CONCLUSION This network pharmacology study revealed the multiple ingredients, targets, and pathways synergistically involved in the anti-CRC effect of GEB, which will enhance our understanding of the potential molecular mechanism of GEB in treatment for CRC and lay a foundation for further experimental research.
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Affiliation(s)
- Wancai Que
- Department of Pharmacy, Fujian Medical University Union Hospital, 29 Xin Quan Rd, Gulou, Fuzhou, 350001, Fujian, People's Republic of China
| | - Maohua Chen
- Department of Pharmacy, Fujian Medical University Union Hospital, 29 Xin Quan Rd, Gulou, Fuzhou, 350001, Fujian, People's Republic of China
| | - Ling Yang
- Department of Pharmacy, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Bingqing Zhang
- College of Pharmacy, Fujian Medical University, Fuzhou, 350004, People's Republic of China
| | - Zhichang Zhao
- Department of Pharmacy, Fujian Medical University Union Hospital, 29 Xin Quan Rd, Gulou, Fuzhou, 350001, Fujian, People's Republic of China
| | - Maobai Liu
- Department of Pharmacy, Fujian Medical University Union Hospital, 29 Xin Quan Rd, Gulou, Fuzhou, 350001, Fujian, People's Republic of China
| | - Yu Cheng
- Department of Pharmacy, Fujian Medical University Union Hospital, 29 Xin Quan Rd, Gulou, Fuzhou, 350001, Fujian, People's Republic of China.
| | - Hongqiang Qiu
- Department of Pharmacy, Fujian Medical University Union Hospital, 29 Xin Quan Rd, Gulou, Fuzhou, 350001, Fujian, People's Republic of China. .,College of Pharmacy, Fujian Medical University, Fuzhou, 350004, People's Republic of China.
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Zhai Y, Neumeyer C, Dellas J, Greenough N, Kalish M, Petrella J, Que W, Raftopoulos S. Prototype Coil Evaluation for NSTX-U Replacement Inner Poloidal Field Coils. Fusion Science and Technology 2019. [DOI: 10.1080/15361055.2019.1610314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Y. Zhai
- Princeton Plasma Physics Laboratory, P.O. Box 451, Princeton, New Jersey
| | - C. Neumeyer
- Princeton Plasma Physics Laboratory, P.O. Box 451, Princeton, New Jersey
| | - J. Dellas
- Princeton Plasma Physics Laboratory, P.O. Box 451, Princeton, New Jersey
| | - N. Greenough
- Princeton Plasma Physics Laboratory, P.O. Box 451, Princeton, New Jersey
| | - M. Kalish
- Princeton Plasma Physics Laboratory, P.O. Box 451, Princeton, New Jersey
| | - J. Petrella
- Princeton Plasma Physics Laboratory, P.O. Box 451, Princeton, New Jersey
| | - W. Que
- Princeton Plasma Physics Laboratory, P.O. Box 451, Princeton, New Jersey
| | - S. Raftopoulos
- Princeton Plasma Physics Laboratory, P.O. Box 451, Princeton, New Jersey
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Qiu H, Yu C, Cheng Y, Que W, Zeng X, Wang H, Liu M. Simultaneous Determination of Koumine and Gelsemine in Human Plasma Using HPLC-UV Assay and Its Clinical Application. CURR PHARM ANAL 2019. [DOI: 10.2174/1573412915666190222161942] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Of two main alkaloids extracted from Gelsemium, koumine was shown to be a
promising analgesic, while gelsemine proved to be deleterious. Many patients suspected to be poisoned
by Gelsemium cannot be timely diagnosed due to the lack of UPLC-MS/MS. Additionally, the
concentration of alkaloids in humans has never been reported. The aim of this study was to establish a
more economical and accessible method using HPLC-UV for diagnosis and quantitative analysis of
Gelsemium poisoning.
Methods:
Plasma spiked with an internal standard, oxcarbazepine, was prepared with solid-phase extraction.
Koumine and gelsemine were separated on a C18 column using a mobile phase consisting of
methanol, water, and di-n-butylamine (58:42:0.01) pumped at a flow rate of 1.00 mL/min. The detection
wavelength was set at 263 nm. Plasma concentrations of two different times were determined for the
patients.
Results:
The calibration curves for both monomers possessed good linearity from 0.05-50 mg/L
(r=0.9997 and 0.9999, respectively). The extraction recoveries were greater than 88.5 %. Variation for
intraday and interday assays of koumine and gelsemine were less than 8.3% and 7.7%, respectively. The
concentrations of the two alkaloids were identified in 5 patients with Gelsemium poisoning by using the
established method.
Conclusion:
The established method by using HPLC-UV is applicable for diagnosis and quantitative
analysis of Gelsemium poisoning in such cases. TDM of koumine and gelsemine in patients with Gelsemium
poisoning may provide additional information for the clinic to improve rescue strategy.
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Affiliation(s)
- Hongqiang Qiu
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China
| | - Changxi Yu
- Department of Pharmacology, College of Pharmacy, Fujian Medical University, Fuzhou, China
| | - Yu Cheng
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China
| | - Wancai Que
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China
| | - Xiaofang Zeng
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China
| | - Hui Wang
- Department of Critical Care Medicine, Fujian Medical University Union Hospital, Fuzhou, China
| | - Maobai Liu
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China
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Gerhardt SP, Erickson K, Kaita R, Lawson J, Mozulay R, Mueller D, Que W, Rahman N, Schneider H, Smalley G, Tresemer K. Magnetic diagnostics for equilibrium reconstruction and realtime plasma control in NSTX-Upgrade. Rev Sci Instrum 2014; 85:11E807. [PMID: 25430372 DOI: 10.1063/1.4889781] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This paper describes aspects of magnetic diagnostics for realtime control in National Spherical Torus Experiment-Upgrade (NSTX-U). The sensor arrangement on the upgraded center column is described. New analog and digital circuitry for processing the plasma current Rogowski data are presented. An improved algorithm for estimating the plasma vertical velocity for feedback control is presented.
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Affiliation(s)
- S P Gerhardt
- Princeton Plasma Physics Laboratory, Princeton, New Jersey 08543, USA
| | - K Erickson
- Princeton Plasma Physics Laboratory, Princeton, New Jersey 08543, USA
| | - R Kaita
- Princeton Plasma Physics Laboratory, Princeton, New Jersey 08543, USA
| | - J Lawson
- Princeton Plasma Physics Laboratory, Princeton, New Jersey 08543, USA
| | - R Mozulay
- Princeton Plasma Physics Laboratory, Princeton, New Jersey 08543, USA
| | - D Mueller
- Princeton Plasma Physics Laboratory, Princeton, New Jersey 08543, USA
| | - W Que
- Princeton Plasma Physics Laboratory, Princeton, New Jersey 08543, USA
| | - N Rahman
- Princeton Plasma Physics Laboratory, Princeton, New Jersey 08543, USA
| | - H Schneider
- Princeton Plasma Physics Laboratory, Princeton, New Jersey 08543, USA
| | - G Smalley
- Princeton Plasma Physics Laboratory, Princeton, New Jersey 08543, USA
| | - K Tresemer
- Princeton Plasma Physics Laboratory, Princeton, New Jersey 08543, USA
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Pignol J, Keller B, Rakovitch E, Sankreacha R, Que W. Immediate Tolerance of Permanent Breast 103-Pd Seed Implant (PBSI) as the Sole Adjuvant Treatment of Early Stage Breast Cancer. Int J Radiat Oncol Biol Phys 2005. [DOI: 10.1016/j.ijrobp.2005.07.313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Pignol JP, Keller B, Rakovitch E, Sankracha R, Que W. 76 Permanent breast seed implant using 103pd as the sole adjuvant radiation treatment for early stage breast cancer: Interim analysis of an ongoing phase I/II trial. Radiother Oncol 2005. [DOI: 10.1016/s0167-8140(05)80237-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Abstract
The 'tongue-and-groove problem' in step-and-shoot delivery of intensity modulated radiotherapy is investigated. A 'tongue-and-groove' index (TGI) is introduced to quantify the 'tongue-and-groove' effect in step-and-shoot delivery. Four different types of leaf sequencing methods are compared. The sliding window method and the reducing level method use the same number of field segments to deliver the same intensity map, but the TGI is much less for the reducing level method. The leaf synchronization method of Van Santvoort and Heijmen fails in step-and-shoot delivery, but a new method inspired by the method of Van Santvoort and Heijmen is shown to eliminate 'tongue-and-groove' underdosage completely.
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Affiliation(s)
- W Que
- MPCS, Ryerson University, 350 Victoria Street, Toronto, Ontario, M5B 2K3, Canada
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Abstract
Radiation exposure to the public is estimated if the body of an I-125 prostate implant patient is cremated. Precautions regarding the handling of cremated remains are suggested. Cremation can be performed safely at any time.
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Affiliation(s)
- W Que
- MPCS, Ryerson University, 350 Victoria Street, Toronto, Ontario, Canada M5B 2K3
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Abstract
In the "stop and shoot" method of intensity modulated radiation therapy, it is desirable to use an efficient multileaf collimator (MLC) field segmentation algorithm in the sense that it translates beam intensity maps into the least number of MLC field segments. In this work, we compare the performance of eight different algorithms, including the ones by Bortfeld et al., Galvin et al., Xia and Verhey, the Siemens IMFAST algorithm, and four other algorithms which have not been studied before. We find that the algorithm of Xia and Verhey is most frequently the algorithm that needs the least MLC field segments. However, no single algorithm is the most efficient for all clinical cases or intensity maps. This suggests that it is desirable to have multiple algorithms available in a clinical treatment planning system which will search through all algorithms automatically and find the most efficient delivery sequence for a given treatment. Each intensity map in a treatment could be delivered by a different algorithm, whichever is the most efficient for that map. It is pointed out that when the background intensity level is not zero, it is not always efficient to deliver a segment to bring the background level down to zero.
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Affiliation(s)
- W Que
- Department of Medical Biophysics, University of Toronto, Toronto Sunnybrook Regional Cancer Center, Ontario, Canada.
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Que W, Rowlands JA. X-ray photogeneration in amorphous selenium: Geminate versus columnar recombination. Phys Rev B Condens Matter 1995; 51:10500-10507. [PMID: 9977744 DOI: 10.1103/physrevb.51.10500] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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Abstract
This is a theoretical study of the inherent spatial resolution of the latent image on the surface of an amorphous selenium (a-Se) plate used for diagnostic x-ray imaging. The following effects are considered: (A) ranges of primary photoelectrons; (B) reabsorption of K fluorescence; (C) reabsorption of Compton scattered photons; (D) diffusion; (E) the geometric effect due to oblique incidence of x rays; (F) electrostatic effect; and (G) the space charge effect. The modulation transfer function of a-Se in the diagnostic x-ray energy range has been estimated. In conclusion, (A) and (E) are the main factors limiting the resolution, and for diagnostic x rays, the inherent spatial resolution of a-Se plates is much better than that of CsI layers used in x-ray image intensifiers.
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Affiliation(s)
- W Que
- Sunnybrook Health Science Centre, University of Toronto, Ontario, Canada
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Walker MB, Buyers WJ, Tun Z, Que W, Menovsky AA, Garrett JD. Nature of the order parameter in the heavy-fermion system URu2Si2. Phys Rev Lett 1993; 71:2630-2633. [PMID: 10054730 DOI: 10.1103/physrevlett.71.2630] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Que W, Walker MB. Generalized Frenkel-Kontorova model for structural modulations in bismuth high-Tc superconductors and related compounds. Phys Rev B Condens Matter 1992; 46:14772-14778. [PMID: 10003575 DOI: 10.1103/physrevb.46.14772] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Walker MB, Que W. Structural model for the incommensurate bismuth high-Tc superconductors. Phys Rev B Condens Matter 1992; 45:8085-8090. [PMID: 10000619 DOI: 10.1103/physrevb.45.8085] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Que W, Kirczenow G, Castao E. Nonlocal theory of collective excitations in quantum-dot arrays. Phys Rev B Condens Matter 1991; 43:14079-14090. [PMID: 9997277 DOI: 10.1103/physrevb.43.14079] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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Que W. Quantum theory of plasmons in lateral multiwire superlattices: Intrasubband plasmons and their coupling to intersubband plasmons. Phys Rev B Condens Matter 1991; 43:7127-7135. [PMID: 9998176 DOI: 10.1103/physrevb.43.7127] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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