[The mid-term effect of corneal collagen cross-linking for progressive keratoconus and the changes in rigid gas permeable contact lens fitting parameters].

Objective: To investigate the effect of corneal collagen cross-linking (CXL) for progressive keratoconus and to evaluate changes in the parameters of rigid gas permeable contact lens (RGPCL) fitting after surgery. Methods: It was a prospective cohort study. Fifty-three eyes of 41 keratoconus patients received accelerated CXL in Qingdao Eye Hospital of Shandong First Medical University from May to December 2018. There were 31 males and 10 females, aged (20.46±4.15) years. According to the corneal thickness, de-epithelial CXL (33 eyes) or trans-epithelial CXL (20 eyes) was performed. The best spectacle-corrected visual acuity, refractive power and the thinnest corneal thickness at baseline and at 6 weeks were compared. Corneal topography was performed at baseline and at 6 weeks, 3, 6 and 12 months postoperatively. Rose K RGPCLs were used before and 6 weeks after surgery, and the fitting status was monitored until 12 months after surgery. The t test was performed to analyze the difference before and after the operation. Results: The best spectacle-corrected visual acuity, refractive power, and the thinnest corneal thickness were not significantly changed over 6 weeks of follow-up, but the Kf, Ks and Kmax values were significantly increased in all patients (all P<0.05). In the de-epithelial group, the Kmax values before the operation, at 3, 6 and 12 months after the operation were (55.00±5.51) diopters (D), (54.73±5.34) D, (54.58±6.15) D and (54.20±5.49) D, respectively, and the decrease at 12 months was significant [(0.80±2.05) D; t=2.25, P=0.001]. In the trans-epithelial group, the Kmax values were (59.43±8.98) D, (57.97±8.79) D, (58.19±8.37) D and (56.94±7.19) D at the four time points, respectively, and the decreases at 3, 6 and 12 months were all significant [(1.46±2.09) D, (1.25±1.82) D, (2.49±3.64) D; t=3.12, 3.06, 3.50; P=0.006, 0.006, 0.007]. The best RGPCL-corrected visual acuity, the diameter and the average diopters of RGPCLs showed no significant change in both groups. The RGPCL base curve decreased by 0.07 mm in the de-epithelial group and by 0.13 mm in the trans-epithelial group (both P<0.05). The design of edge lifting was used in 10 eyes postoperatively in the de-epithelial group compared with 8 eyes preoperatively, and in 4 eyes postopratively in the trans-epithelial group compared with 7 eyes preoperatively. The number of eyes using the toric peripheral design of the lens was increased to 3 compared with 2 preoperatively in the de-epithelial group and from 1 to 4 in the trans-epithelial group. The acceptance rate of RGPCL fitting in both groups increased at 6 and 12 months after surgery compared to 6 weeks after surgery. Conclusions: The corneal curvature became steep slightly at 6 weeks after CXL and gradually recovered and flattened. The Kmax in the trans-epithelial group decreased earlier and more than that in the de-epithelial group. The base curve of the RGPCLs was slightly reduced after 6 weeks, and the toric peripheral design was increasingly needed, but the requirement for the design of the lifted edge was different between the two groups. A good RGPCL fitting can be achieved within 1 year after CXL.

Stereoisomers of N-[1-hydroxy-(2-phenylethyl)-3-methyl-4-piperidyl]- N-phenylpropanamide: synthesis, stereochemistry, analgesic activity, and opioid receptor binding characteristics.

N-[1-(2-Hydroxy-2-phenylethyl)-3-methyl-4-piperidyl]-N-phenylpropanamide (ohmefentanyl,1) is an extremely potent analgesic agent with high affinity and selectivity for opioid mu receptors. There are three chiral carbons in 1, so eight optically active isomers are possible. Respective reaction of optically active 3-methyl-N-phenyl-4 -piperidinamines (5a-d) with (R)- or (S)-styrene oxide produced eight optically active intermediates which were subsequently converted to eight optically active isomers of 1 (1a-h). The absolute configurations of 1a-h were determined by X-ray analysis of (3R,4S,2'R)-(-)-cis-1a and (3R,4R,2'S)-(-)-trans-1g. The analgesic activity (mice, ip, hot plate) revealed their extreme stereodifferences; the ED50 values of (3R,4S,2'R)-(-)-cis-1a and (3R,4S,2'S)-(+)-cis-1b, which are the most potent isomers among eight isomers, were 0.004 65 (2990 times that of morphine) and 0.001 06 mg/kg (13 100 times that of morphine), respectively, while the corresponding antipodes 1d,c were the least potent compounds among the eight isomers. In agreement with pharmacological results, both 1a,b also had the highest receptor affinity and selectivity for the opioid mu receptor. The ratio of K(i)(DPDPE)&K(i)(DAMGO) was 22 800 for 1a and 22 500 for 1b. All isomers except 1c,d strongly inhibited the electrically evoked smooth muscle contraction of GPI and MVD but not that of RVD, and the inhibitory effects could be reversed by naloxone, which indicated that these compounds were potent mu agonists in GPI and MVD. There was a good linear correlation between the analgesic potencies (ED50) and the receptor affinities (K(i)(DAMGO)) or inhibitory effects (IC50) to GPI and MVD. These results suggested that the analgesic effects of ohmefentanyl are mediated by interaction between the agents and opioid mu receptors in the central nervous system and the 3R,4S configuration at the piperidine 3- and 4-carbon atoms and the S configuration at the phenylethyl 2-carbon atom are beneficial for analgesic potency and inhibitory effects in GPI and MVD and the same for an S or R configuration at the phenylethyl 2-carbon atom besides the 3R,4S configuration for receptor mu affinity and selectivity.

[Synthesis of pyrido [1,2-a] pyrimidinone series of compounds, potential agents on the nervous system].

In an effort to modify the structure of edulinine so to seek compounds exhibiting higher potency toward inhibition of central nervous system, we designed and synthesized several analogous compounds: 2-methoxy-3-(3-methyl-2-butenyl)-4-oxo-4 H-pyrido [1,2-a] pyrimidine (IV), 3-methoxy-3-(3-methyl-2-butenyl)-2-oxo-2H-pyrido[1,2-a]pyrimidine (V), 2-methoxy-3-(2,3-dihydroxy-3-methyl-1-butyl)-4-oxo-4H-pyrido[1,2-a] pyrimidine (VI), and 4-methoxy-3-(2,3-dihydroxy-3-methyl-1-butyl)-2-oxo-2H-pyrido[1,2-a] pyrimidine (VII). Animal experiments revealed that compound (IV) has anticonvulsant activity, compounds (V) and (VI) have far lower activity than compound (IV).

[Synthesis of (+/-)-edulinine analogues].

The natural product, edulinine (I), possesses analgesic, anaesthetic and anticonvulsant activities on the central nervous system. In this paper we report that a series of edulinine analogues IV, V were synthesized and screened in mice according to methods of Topliss and Austel quantitative drug design. In preliminary pharmacological tests a number of synthesized compounds showed central depressant activities stronger than edulinine.

[Stereoisomers of 3-methylfentanyl: synthesis, absolute configuration and analgesic activity].

Fractional crystallization of fumarate salt and oxalate salt of the mixture of cis- and trans-N-(3-methyl-4-piperidyl)-aniline (6) gave pure cis-6 x fumarate salt and trans-6 x oxalate salt respectively. Four optically pure 6 were obtained via resolution of cis-6 and trans-6 with D- and L-tartaric acid. Respective reaction of the optically pure 6 with phenylethyl bromide following propionylation gave optically active 3-methylfentanyl (2). The absolute configuration was confirmed: cis-(+)-2 as (3R,4S), cis-(-)-2 as (3S,4R), trans-(+)-2 as (3S,4S), trans-(-)-2 as (3R,4R). Pharmacological results showed that the configuration of two chiral centers in 2 was very important for analgesic potency. The median effective dose (ED50) of cis-(+)-2, which is the most potent among the four isomers, was found to be 0.00767 mg/kg (in mice, ip., hot plate) with 2600 times as potent as morphine while 119 and 1.5 times as potent as cis-(-)-2 and cis-(+/-)-2 respectively. The potency ratio between trans-(+)-2 and morphine was calculated as 450:1, while that between trans-(+)-2 and trans-(-)-2 as 4:1.

A study on configuration-activity relationship of diamminedichloroplatinum (II) by the pseudopotential valence electron-only ab initio calculation method.

We investigated the cis- and trans-isomers of Pt(NH3)2Cl2 and [Pt(NH3)2]2+ using a quantum chemical non-empirical calculation method, the pseudopotential valence electron-only ab initio method. The electronic structure and electrostatic potential counter maps were in turn determined through the wave functions so obtained. There was a sharp difference between the dipole moments of the cis- and trans-isomers. The electrostatic counter maps of the isomers also had remarkably different features. Based on the interaction between the platinum (II) coordination compound and the base pairs of nucleic acid, the difference in antitumour activity of the isomeric compounds was discussed. It is pointed out that the key factor for antitumour activity is that the platinum (II) coordination compound must be mutually complementary with the target acceptor in both configuration and bonding activity. This mutual-complementary requirement includes a bonding ability of the platinum complex with two negative centers in DNA, so as to form an intrastrand crosslink with two neighbouring guanines.

Molecular modeling of interactions between tetrahydroprotoberberines and dopamine receptors.

AIM: To build up the structure models of dopamine receptors, then combined with the receptor models, to investigate the action mechanism of tetrahydroprotoberberines (THPB) on dopamine receptors at the molecular level. METHODS: Using the three-dimensional structure of bacteriorhodopsin as a template, we have constructed dopamine D1 and D2 receptor models on computer. l-Stepholidine was selected as the leading compound of THPB and docked into D1 and D2 receptor active sites. RESULTS: After manual adjustment and energy minimization, the ligand-receptor interaction models were achieved. Based on these models, the possible action mechanism of THPB on dopamine receptors was suggested that the protonated N atom of THPB form electrostatic interaction and hydrogen-bonding interaction with residue Asp in TM3 of the receptor, the two substituents in D ring of THPB form hydrogen-bonding interactions with two Ser residues in TM5 of the receptor, and the aryl groups form pi-pi interactions with some aryl residues of the receptor around ligand. CONCLUSION: Our ligand-receptor interaction models should be helpful for rational design of more potent drugs.