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Combined phenotypic assessment of cyp1A2, cyp2C19, cyp2d6, cyp3A, N-acetyltransferase-2, and xanthine oxidase with the "Cooperstown cocktail"

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CLINICAL pHARMACOLOGY & THERApEUTICS 2000年第4期68卷 375-383页

作者： Streetman, dS Bleakley, JF Kim, JS Nafziger, AN Leeder, JS Gaedigk, A Gotschall, R Kearns, GL Bertino, JS Bassett Healthcare Clin Pharmacol Res Ctr Dept Med Dept Pharm Serv Cooperstown NY USA Childrens Mercy Hosp Div Pediat Clin Pharmacol & Expt Therapeut Kansas City MO 64108 USA Univ Missouri Dept Pediat Kansas City MO 64110 USA Univ Missouri Dept Pharmacol Kansas City MO 64110 USA

Background: Simultaneous administration of several probes enhances the utility of phenotyping, but poor specificity, side effects, and use of drugs not approved by the Food and drug Administration limit the usefulness of prior phenotyping cocktails. Objectives: To evaluate potential drug-drug interactions associated with use of a cocktail of caffeine, omeprazole, dextromethorphan, and midazolam for simultaneous phenotyping of cyp1A2, cyp2C19, cyp2d6, CYT3A, N-acetyltransferase-2, and xanthine oxidase. Methods: Twelve subjects received caffeine + dextromethorphan, omeprazole, and midazolam (each alone), and a cocktail of caffeine + dextromethorphan + omeprazole + midazolam. Blood samples were collected at 120 minutes for omeprazole and 5/-hydroxyomeprazole, and at 0, 5, 30, 60, 120, 240, 300, and 360 minutes for midazolam. Twelve-hour mine samples were collected for analysis of dextromethorphan, caffeine, and metabolites. Results: The median cyp1A2 metabolic ratio after administration of caffeine + dextromethorphan was not significantly different from that obtained with the cocktail (p = .84). Likewise, the median N-acetyltransferase-2, xanthine oxidase, and cyp2d6 metabolic ratios were not significantly different after cocktail administration (p = .977 for each N-acetyltransferase-2;p = .795 for xanthine oxidase;p = .75 for cyp2d6). The median cyp2C19 metabolic ratio after cocktail administration was not significantly different from that obtained after omeprazole administered alone (p = 1.000). Also, midazolam plasma clearance was not significantly different after cocktail administration compared with that after administration of midazolam alone (p = .708). The only side effect was sedation, which was associated with intravenous midazolam and occurred to a similar extent after both individual and cocktail phenotyping. Conclusions: These results indicate no pharmacokinetic or pharmacodynamic interactions that would limit the utility of this phenotyping cocktail for s

关键词：投药口服抗焦虑药/药代动力学抗溃疡病药/药代动力学镇咳药/药代动力学芳基烃羟化酶类芳基胺N-乙酰转移酶/遗传学芳基胺N-乙酰转移酶/代谢咖啡因/投药和剂量咖啡因/药代动力学中枢神经系统刺激剂/药代动力学细胞色素p450cyp1A2/遗传学细胞色素p450cyp1A2/代谢细胞色素p450cyp2d6/遗传学细胞色素p450cyp2d6/代谢细胞色素p-450cyp3A 细胞色素p450酶系统/遗传学细胞色素p450酶系统/代谢右美沙芬/投药和剂量右美沙芬/药代动力学复方合剂药物相互作用基因型催眠药和镇静药/药代动力学咪达唑仑/投药和剂量咪达唑仑/药代动力学混合功能氧化酶类/遗传学混合功能氧化酶类/代谢奥美拉唑/投药和剂量奥美拉唑/药代动力学氧化还原酶类 N-脱甲基/遗传学氧化还原酶类 N-脱甲基/代谢表型聚合酶链反应黄嘌呤氧化酶/遗传学黄嘌呤氧化酶/代谢成年人女(雌)性人类男(雄)性中年人

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Behavioral disturbances of dementia

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JOURNAL OF GERIATRIC pSYCHIATRY ANd NEUROLOGY 1998年第4期11卷 206-212页

作者： pollock, BG Mulsant, BH Univ Pittsburgh Sch Med Dept Psychiat Geriatr Psychopharmacol Program Pittsburgh PA USA

Behavioral disturbances are common in patients with dementia. Medical intervention is needed if, for example, these behaviors threaten a patient's safety or jeopardize his or her ability to perform activities of daily living. Typical antipsychotic agents are associated with troublesome adverse effects in the elderly (e.g., anticholinergic effects, extrapyramidal symptoms). Atypical antipsychotics have reduced potential to cause these types of side effects but are not free from side effects. Recently, there has been a greater focus on the use of antidepressants to treat behavioral disturbances in dementia. Among these, selective serotonin reuptake inhibitors have keen studied more commonly due to their safety profile in the elderly CitaIopram, in particular, has demonstrated efficacy in improving dementia-related behavioral symptoms.

关键词：老年人/生理学抗惊厥药/治疗应用抗精神病药/药代动力学抗精神病药/治疗应用基底神经节疾病/化学诱导基底神经节疾病/遗传学行为症状/药物疗法行为症状/病因学西酞普兰/药理学细胞色素p450cyp2d6/遗传学细胞色素p450cyp2d6/代谢痴呆/并发症痴呆/药物疗法血清素摄取抑制药/药代动力学老年人 80以上女(雌)性人类男(雄)性中年人

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cyp1A2 and cyp2d6 4-hydroxylate propranolol and both reactions exhibit racial differences

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JOURNAL OF pHARMACOLOGY ANd EXpERIMENTAL THERApEUTICS 2000年第3期294卷 1099-1105页

作者： Johnson, JA Herring, VL Wolfe, MS Relling, MV Univ Tennessee Coll Pharm Memphis TN USA Univ Tennessee St Jude Childrens Res Hosp Memphis TN USA

We have previously shown racial differences in propranolol kinetics, with the largest differences appearing to be in its 4-hydroxylation. The purpose of this study was to identify and confirm the cytochrome p450 enzymes (cyp) with propranolol 4-hydroxylase activity, describe their enzyme kinetics, and determine whether there were racial differences in their catalytic activity. Eleven human recombinant, expressed cyps were screened, but only cyp1A2 and cyp2d6 possessed propranolol 4-hydroxylase activity. Subsequent studies were conducted in human liver microsomes, including correlation, inhibition, enzyme kinetics, and racial comparison studies. Significant correlations were noted between propranolol 4-hydroxylation and ethoxyresorufin-O-deethylation (marker of cyp1A2 activity), with marked improvement in the correlations when cyp2d6-mediated propranolol 4-hydroxylation was inhibited with quinidine. Inhibition studies showed that quinidine inhibited approximately 55% of propranolol 4-hydroxylation and furaphylline (cyp1A2-selective inhibitor) inhibited about 45% of propranolol 4-hydroxylation. Median (range) parameter estimates of (S)-4-hydroxypropranolol [(S)-HOp] formation were a V-max value of 307 (165-2397) and 721 (84-1975) pmol/mg of protein/60 min for cyp1A2 and cyp2d6, respectively, and a K-m value of 21.2 (8.9-77.5) and 8.5 (5.9-31.9) mu M for cyp1A2 and cyp2d6, respectively. cyp1A2- and cyp2d6-mediated propranolol 4-hydroxylation was about 70 and 100% higher (p < .05 for both), respectively, in African-Americans compared with Caucasians. In summary, we found that both cyp1A2 and cyp2d6 catalyze formation of 4-hydroxypropranolol and that both enzymes exhibited racial differences in this reaction. The observed racial differences in drug metabolism may have relevance to drug efficacy, toxicity, or carcinogen activation for cyp1A2 or cyp2d6 substrates.

关键词：非洲大陆世系人群芳基烃羟化酶类细胞色素p450cyp1A2/拮抗剂和抑制剂细胞色素p450cyp1A2/代谢细胞色素p450cyp2d6/拮抗剂和抑制剂细胞色素p450cyp2d6/代谢细胞色素p450酶系统/代谢酶抑制剂/药理学欧洲大陆世系人群羟基化动力学微粒体肝/酶学微粒体肝/代谢混合功能氧化酶类/代谢普萘洛尔/化学普萘洛尔/代谢奎尼丁/药理学重组蛋白质类/代谢立体异构现象女(雌)性人类男(雄)性

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In vivo modulation of cyp enzymes by quinidine and rifampin

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CLINICAL pHARMACOLOGY & THERApEUTICS 2000年第4期68卷 401-411页

作者： Branch, RA Adedoyin, A Frye, RF Wilson, JW Romkes, M Univ Pittsburgh Med Ctr Ctr Clin Pharmacol Pittsburgh PA 15213 USA Univ Pittsburgh Dept Pharmaceut Sci Pittsburgh PA 15213 USA Zeneca Pharmaceut Dept Drug Disposit & Metab Wilmington DE USA

Background: The metabolism of drugs and other xenobiotics is mediated by enzymes whose activities can be modulated by different compounds. The activities of these modulators have the potential to be used to optimize drug action, prevent toxicity, or identify the enzymes involved in a reaction. This approach requires that selective agents be used for specific enzymes. However, selectivity of action has been poorly characterized in vivo. Methods: This study investigated the effect of 3 and 28 days of treatment with quinidine (200 mg daily) and rifampin (INN, rifampicin) (600 mg daily) on the activities of four cytochrome p450 enzymes and N-acetyltransferase in 28 healthy young male volunteers divided into three groups with a cocktail of drug probes used, including caffeine, mephenytoin, debrisoquin (INN, debrisoquine), and dapsone. Results: Quinidine selectively and almost completely inhibited the activity of cyp2d6 from day 3 through day 28 without affecting any other enzymes. Rifampin showed evidence of time-dependent induction of the activities of all measured oxidative routes of metabolism but decreased the acetylation ratio in fast acetylators. The quinidine/rifampin combination resulted in selective cyp2d6 inhibition and induction of all other enzymes evaluated over this time period, suggesting that predictable complex interactions occur with the drug combination. Conclusions: These observations illustrate the value of simultaneous assessment of the effect of modulators on the activities of multiple specific enzymes with the drug cocktail approach.

关键词：乙酰化作用/药物作用投药口服肾上腺素能α拮抗剂/投药和剂量肾上腺素能α拮抗剂/药理学抗心律失常药/药理学抗生素类抗结核/药理学抗惊厥药/药理学芳基烃羟化酶类咖啡因/药理学中枢神经系统刺激剂/药理学细胞色素p450cyp1A2/代谢细胞色素p450cyp2d6/代谢细胞色素p450cyp2E1/代谢细胞色素p450酶系统/拮抗剂和抑制剂细胞色素p450酶系统/代谢氨苯砜/药理学异喹胍/药理学用药计划表酶抑制剂/投药和剂量酶抑制剂/药理学美芬妥英/药理学混合功能氧化酶类/代谢奎尼丁/投药和剂量奎尼丁/药理学参考值利福平/投药和剂量利福平/药理学类固醇16-α-羟化酶甾类羟化酶类/代谢茶碱/药理学成年人人类男(雄)性

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polymorphisms of the cyp2d6 gene increase susceptibility to ankylosing spondylitis

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HUMAN MOLECULAR GENETICS 2000年第11期9卷 1563-1566页

作者： Brown, MA Edwards, S Hoyle, E Campbell, S Laval, S daly, AK pile, Kd Calin, A Ebringer, A Weeks, dE Wordsworth, Bp Wellcome Trust Ctr Human Genet Headington OX3 7BN Oxon England Univ Newcastle Upon Tyne Dept Pharmacol Sci Newcastle Upon Tyne NE1 7RU Tyne & Wear England Queen Elizabeth Hosp Adelaide SA Australia Royal Natl Hosp Rheumat Dis Bath BA1 1RL Avon England Univ London Kings Coll Div Life Sci London W8 7AH England Univ Pittsburgh Dept Human Genet Pittsburgh PA USA

Ankylosing spondylitis (AS) is a common and highly familial rheumatic disorder, The sibling recurrence risk ratio for the disease is 63 and heritability assessed in twins >90%. Although MHC genes, including HLA-B27, contribute only 20-50% of the genetic risk for the disease, no non-MHC gene has yet been convincingly demonstrated to influence either susceptibility to the disease or its phenotypic expression. previous linkage and association studies have suggested the presence of a susceptibility gene for AS close to, or within, the cytochrome p450 2d6 gene (cyp2d6, debrisoquine hydroxylase) located at chromosome 22q13.1. We performed a linkage study of chromosome 22 in 200 families with AS affected sibling-pairs. Association of alleles of the cyp2d6 gene was examined by both case-control and within-family means. For case-control studies, 617 unrelated individuals with AS (361 probands from sibling-pair and parent-case trio families and 256 unrelated non-familial sporadic cases) and 402 healthy ethnically matched controls were employed. For within-family association studies, 361 families including 161 parent-case trios and 200 affected sibling-pair families were employed. Homozygosity for poor metabolizer alleles was found to be associated with AS. Heterozygosity for the most frequent poor metabolizer allele (cyp2d6*4) was not associated with increased susceptibility to AS. Significant within-family association of cyp2d6*4 alleles and AS was demonstrated. Weak linkage was also demonstrated between cyp2d6 and AS, We postulate that altered metabolism of a natural toxin or antigen by the cyp2d6 gene may increase susceptibility to AS.

关键词：等位基因病例对照研究细胞色素p450cyp2d6/遗传学细胞色素p450cyp2d6/代谢 dNA/遗传学家庭卫生疾病遗传易感性基因型连锁(遗传学) 优势对数记分法核型家庭多态现象遗传脊柱炎强直性/遗传学脊柱炎强直性/病理学女(雌)性人类男(雄)性

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Quinidine as a probe for cyp3A4 activity: Intrasubject variability and lack of correlation with probe-based assays for cyp1A2, cyp2C9, cyp2C19, and cyp2d6

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CLINICAL pHARMACOLOGY & THERApEUTICS 2000年第2期68卷 199-209页

作者： damkier, p Brosen, K Odense Univ Univ So Denmark Inst Publ Hlth DK-5000 Odense Denmark

Background: In vitro studies have shown that the formation of 3-hydroxyquinidine from quinidine is catalyzed almost exclusively by cyp3A4, In vivo this result has been supported in various interaction studies, and the use of this reaction as an in vivo biomarker reaction of cyp3A4 activity has been suggested, We studied the possible correlation of the formation clearance of 3-hydroxyquinidine with probe-based assays for cyp1A2, cyp2C9, cyp2C19, and cyp2d6. descriptive analyses of the outcome of various biomarker reactions were performed. Methods: Forty-two healthy, young male volunteers participated in an open study consisting of two identical test periods separated by a 12- to 14-week washout period. In each period biomarker reactions of cyp1A2 (caffeine), cyp2C9 (tolbutamide), cyp2C19 (mephenytoin), cyp2d6 (sparteine), cyp3A4 (urinary excretion of 6 beta-hydroxycortisol), as well as the pharmacokinetics of quinidine after a 200-mg single oral dose of quinidine sulfate were studied. Results: The median formation clearance of 3-hydroxyquinidine were 2.40 and 2.33 L/h in the two test periods. As measured by the formation clearance of 3-hydroxyquinidine, the intraindividual coefficient of variation for cyp3A4 activity was 18%, whereas the interindividual activity varied fourfold. The formation clearance of 3-hydroxyquinidine did not correlate with the outcome of indexes for activities of cyp1A2, cyp2C9, cyp2C19, or cyp2d6 or the urinary excretion of 6 beta-hydroxycortisol, The formation clearance of 3-hydroxyquinidine correlated well to point values of 3-hydroxyquinidine to quinidine ratios in plasma and urine. Conclusion: The formation clearance of 3-hydroxyquinidine after a single oral dose of 200 mg quinidine sulfate may represent a useful index of cyp3A4 activity in vivo.

关键词：抗疟药/血液抗疟药/代谢抗疟药/尿芳基烃羟化酶类细胞色素p450cyp1A2/代谢细胞色素p450cyp2d6/代谢细胞色素p-450cyp3A 细胞色素p450酶系统/代谢混合功能氧化酶类/代谢奎尼丁/类似物和衍生物奎尼丁/血液奎尼丁/代谢奎尼丁/尿类固醇16-α-羟化酶甾类羟化酶类/代谢青少年成年人人类男(雄)性

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design, synthesis, and characterization of 7-methoxy-4-(aminomethyl)coumarin as a novel and selective cytochrome p450 2d6 substrate suitable for high-throughput screening

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CHEMICAL RESEARCH IN TOXICOLOGY 1999年第7期12卷 555-559页

作者： Onderwater, RCA Venhorst, J Commandeur, JNM Vermeulen, NpE Free Univ Amsterdam Dept Pharmacochem Div Mol Toxicol Leiden Amsterdam Ctr Drug Res NL-1081 HV Amsterdam Netherlands

In this study, a selective substrate for cytochrome p450 2d6 was designed using a small molecule model developed by M. J. de Groot et al. [(1997) Chem. Res. Toxicol. 10, 41-48]. The substrate, 7-methoxy-4-(aminomethyl)coumarin (MAMC), and its putative O-demethylated metabolite 7-hydroxy-4-(aminomethyl)coumarin (HAMC) were synthesized, and their respective fluorescence properties were characterized. The selectivity of MAMC for p450 2d6 was characterized using microsomes containing single human p450 isoenzymes and human liver microsomes. Formation of the metabolic product HAMC was easily assessed in real time with fluorescence spectroscopy, since MAMC and HAMC excitation and emission wavelengths differed significantly. HpLC analysis confirmed that HAMC was the single metabolic product of MAMC and that HAMC formation accounts for the total increase in fluorescence. It was found that, in microsomes from yeast or lymphoblastoid cells selectively expressing p450 isoenzymes, MAMC was selective for p450 2d6 at a concentration of 25 mu M with only p450 1A2 contributing significantly to the formation of HAMC. p450s 2A6, 2B6, 2C8, 2C9, 2C19, 2E1, 3A4, and 3A5 were shown not to metabolize MAMC at a concentration of 25 mu M. K-m and v(max) values of MAMC for p450 2d6 were found to be 26.2 +/- 2.8 mu M and 2.9 +/- 0.07 min(-1), respectively. For p450 1A2, MAMC was found to have a K-m value of 29.7 +/- 6.2 mu M and a v(max) of 0.57 +/- 0.07 min(-1). Formation of HAMC in human liver microsomes could be completely inhibited by quinidine, at a concentration of 0.5 mu M selective for p450 2d6, and furafylline, at a concentration of 30 mu M selective for p450 1A2. In conclusion, O-demethylation of 7-methoxy-4-(aminomethyl)coumarin is a rapid and easily determined parameter for p450 2d6 activity and, due to the fluorescent properties of the metabolite formed, may be a valuable new tool for high-throughput screening purposes.

关键词：细胞系色谱法高压液相香豆素类/化学合成香豆素类/化学香豆素类/代谢细胞色素p450cyp2d6/代谢动力学微粒体肝/酶学模型分子光谱法荧光底物特异性人类

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Competition between cytochrome p-450 isozymes for NAdpH-cytochrome p-450 oxidoreductase affects drug metabolism

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JOURNAL OF pHARMACOLOGY ANd EXpERIMENTAL THERApEUTICS 1999年第2期289卷 661-667页

作者： Li, dN pritchard, Mp Hanlon, Sp Burchell, B Wolf, CR Friedberg, T Univ Dundee Ninewells Hosp & Med Sch Biomed Res Ctr Dundee DD1 9SY Scotland Univ Dundee Ninewells Hosp & Med Sch Dept Mol & Cellular Pathol Dundee DD1 9SY Scotland

NAdpH-cytochrome p-450 oxidoreductase (CpR) is essential for the catalytic activity of cytochrome p-450 (p-450), On a molar basis, the amount of p-450 exceeds that of CpR in human liver. In this study, we investigated whether drug-drug interactions can occur as a result of competition between p-450 isozymes for this ancillary protein. For this purpose, combinations of p-450 isozymes were coexpressed together with p-450 reductase in Escherichia coli. We show that testosterone inhibited the cyp2d6-mediated bufuralol 1'-hydroxylase activity in bacterial membranes containing both cyp2d6 and cyp3A4 but not in membranes containing cyp2d6 alone. Conversely, bufuralol inhibited the cyp3A4-medjated testosterone Gp-hydroxylase activity in bacterial membranes containing both cyp3A4 and cyp2d6 but not in membranes containing only cyp3A4. In each case, inhibition was seen even at a p-450 to p-450 reductase ratio of 1.9:1, which is more favorable than the ratio of 4 reported for human liver. The physiological significance of this mechanism was demonstrated by the observation that testosterone inhibited several prototypical p-450 enzyme activities, such as bufuralol 1'-hydroxylase, coumarin 7-hydroxylase, and 7-ethoxyresorufin O-dealkylase, in human liver microsomes, but not if tested against a panel of bacterial membranes containing the human p-450 isozymes that mainly catalyze these reactions.

关键词：芳基烃羟化酶类细胞色素p450cyp1A1/拮抗剂和抑制剂细胞色素p450cyp1A1/代谢细胞色素p450cyp2d6/生物合成细胞色素p450cyp2d6/遗传学细胞色素p450cyp2d6/代谢细胞色素p-450cyp3A 细胞色素p450酶系统/生物合成细胞色素p450酶系统/遗传学细胞色素p450酶系统/代谢药物相互作用酶抑制剂/代谢酶抑制剂/药理学大肠杆菌/酶学大肠杆菌/遗传学乙醇胺类/代谢同工酶类/拮抗剂和抑制剂同工酶类/生物合成同工酶类/遗传学同工酶类/代谢膜微粒体肝/药物作用微粒体肝/酶学混合功能氧化酶类/拮抗剂和抑制剂混合功能氧化酶类/生物合成混合功能氧化酶类/遗传学混合功能氧化酶类/代谢 NAdpH高铁血红素蛋白还原酶/拮抗剂和抑制剂 NAdpH高铁血红素蛋白还原酶/生物合成 NAdpH高铁血红素蛋白还原酶/遗传学 NAdpH高铁血红素蛋白还原酶/代谢质粒重组蛋白质类/拮抗剂和抑制剂重组蛋白质类/生物合成重组蛋白质类/遗传学重组蛋白质类/代谢甾类羟化酶类/拮抗剂和抑制剂甾类羟化酶类/代谢睾酮/代谢睾酮/药理学人类

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Involvement of cyp3A4 in the metabolism of bromperidol in vitro

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pHARMACOLOGY & TOXICOLOGY 2000年第3期86卷 145-148页

作者： Sato, S Someya, T Shioiri, T Koitabashi, T Inoue, Y Niigata Univ Sch Med Dept Psychiat Niigata 9518510 Japan Natl Saigata Hosp Dept Psychiat Niigata Japan Yoshitomi Pharmaceut Ind Ltd Div Pharmaceut Res Kyushu Labs Pharmacokinet Fukuoka Japan

In this study, human cytochrome p450 isoenzymes (cyp1A2, cyp2C19, cyp2d6, and cyp3A4) expressed in a cell line were used to elucidate their roles in the metabolism of bromperidol. We found that cyp3A4 catalyzes the N-dealkylation of bromperidol and its metabolite, reduced bromperidol. cyp3A4 also catalyzes the dehydration of bromperidol to bromperidol 1,2,3,6-tetrahydropyridine, metabolizes bromperidol to bromperidol pyridinium, and catalyzes the oxidation of reduced bromperidol back to bromperidol. cyp1A2, cyp2C19, and cyp2d6 do not catalyze these reactions.

关键词：芳基烃羟化酶类细胞分级分离细胞系/酶学色谱法高压液相细胞色素p450cyp1A2/代谢细胞色素p450cyp2d6/代谢细胞色素p-450cyp3A 细胞色素p450酶系统/代谢氟哌啶醇/类似物和衍生物氟哌啶醇/代谢微粒体/酶学混合功能氧化酶类/代谢人类

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Terbinafine and potential drug interactions

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JOURNAL OF THE AMERICAN ACAdEMY OF dERMATOLOGY 2000年第5期43卷 882-882页

作者： Kaplan, dL Adult & Pediatric Dermatology 4601 W 109th St Suite 116 Overland Park KS 66211

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