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Objective@#To explore the influence of the 4th revised treatment recommendations in childhood acute lymphoblastic leukemia (ALL) on high dose methotrexate(HD-MTX)-induced nephrotoxicity and MTX blood concentrations.@*Method@#The clinical data from 330 ALL children who received 1 242 courses of HD-MTX therapies from September 2012 to November 2016 was collected. The courses were divided into two groups based on the chemotherapies: original scheme group was treated with the 3rd revised regimen, and new scheme group was treated with the 4th revised regimen. The two groups in acute kidney injury (AKI) and MTX blood concentrations were compared.@*Result@#The incidences of AKI with low risk (LR) and intermediate risk (IR) in new scheme group were significantly lower than those in original scheme group (1.3%(3/229) vs. 7.9%(24/303), 4.9%(10/204) vs. 12.8%(26/203), χ2=11.831 and 7.888 respectively, both P<0.05). There was no significant difference in the incidence of AKI with high risk (HR) in the two groups (15.2%(10/66) vs. 10.5%(25/237), χ2=1.071, P>0.05). The 48h MTX blood concentrations and the interphase from onste to MTX concentrations decreased to the safe level with LR and IR children in new scheme group were significantly lower than those in original scheme group (0.36(0.08-4.00) vs. 0.44(0.06-32.00) μmol/L, 0.49(0.22-33.00) vs. 0.60(0.18-83.00) μmol/L, 3(2-6) vs. 3(2-11) d, 3(2-11) vs. 3(2-19) d, Z=-5.953, -2.658, -4.490 and -4.729 respectively, all P<0.05). The differences with HR were not observed between the two groups (0.61(0.14-36.00) vs. 0.71(0.11-68.00) μmol/L, 3(2-15) vs. 3(2-13) d, Z=-1.465 and -1.179 respectively, both P>0.05).@*Conclusion@#Decreased renal toxicity and acceleration of MTX excretion may occur when childhood ALL with LR and IR were treated with the 4th revised regimen. However, nephrotoxicity and MTX blood concentrations have no significant differences with HR in the two regimens, and close monitoring are necessary.
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Objective:To establish an HPLC method for the determination of paraquat in human serum.Methods:The analytical column was a Kromasil C18column (200mm×4.6mm,5μm).The mobile phase was a mixture of acetonitrile and water ( containing 0.03 mol·L-1sodium heptanesulfonate and 0.24 mol·L-1phosphoric acid) (3 :97,pH was adjusted to 2.0 by triethylamine),the detection wavelength was set at 258 nm,the column temperature was 25℃,the injection volume was 20 μl,and the flow rate was 0.8 ml·min-1.Results:The calibration curve of paraquat was linear within the range of 0.106-10.6 mg·L-1( r =0.999 3),and the lower limit of detection was 0.065 mg·L-1. The absolute recovery of paraquat at low,medium and high concentration was more than 89.4%,and the method recovery was more than 94.4%. The intra-day RSDs were 0.12%-1.74%,and the inter-day RSDs were 0.44%-2.89%.Conclusion:The method is simple,quick,accurate,sensitive and specific,and can be used for detecting paraquat con-centration in human serum.
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Objective To evaluate the effect of comprehensive intervention on perioperative antimicrobial prophy-laxis in clean incision surgery in a hospital.Methods From 2011 ,clean incision surgery cases were performed com-prehensive intervention,antimicrobial use in 2011 -2013 were compared.Results A total of 5 945 cases of clean in-cision surgeries were investigated between 2011 and 2013,3 827 cases (64.37%)received prophylactic use of anti-microbial agents.Prophylactic antimicrobial usage rates in 2011 -2013 were 84.95%,69.99%,and 52.97% re-spectively(χ2 =380.94,P <0.001);the correct rates of medication time were 50.97%,79.99%,and 98.95% re-spectively(χ2 =827.02,P <0.001 );the percentages of prophylactic antimicrobial use ≤24 hours were 24.91 %, 39.96%,and 64.95% respectively(χ2 =422.55,P <0.001 );additional antimicrobial usage rates during surgery were 50.00%,60.00%,and 80.00% respectively(χ2 =59.47,P <0.001 ).Conclusion The implementation of comprehensive intervention measures can standardize antimicrobial use,reduce prophylactic antimicrobial usage rate,improve the correct rate of medication time,shorten the duration of antimicrobial use,and implement addition-al use of antimicrobial agents during surgery.
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Objective:To determine the content of notoginsenoside R1 , ginsenoside Rg1 and Rb1 in Shuxuening capsules. Meth-ods:The three constituents were determined on a Hypersil ODS-2 C18 column (250 mm × 4. 6 mm, 5 μm) with gradient elution using acetonitrile (A) -aqueous solution (B) (0-8 min, 20%A→20%A, 8-40 min, 20%A→30%A, 40-60 min, 30%A→45%A) at the detection wavelength of 203 nm with a flow rate of 1. 0 ml·min-1 . The column temperature was 25℃ and the injection volume was 20μl. Results:The calibration curve showed good linearity within the concentration range of 0. 05-0. 50 mg·ml-1 for notogisenoside R1 , and 0.20-2.00 mg·ml-1 for ginsenoside Rg1 and Rb1(r =0.999 9). The average relative recovery was 98.79%, 98.42% and 98. 89% for each constituent(RSD=0. 85%, 0. 97% and 0. 74%, respectively, n=6). The intra-day RSD was 0. 49%, 0. 20% and 0. 39%, and the inter-day RSD was 0. 75%, 0. 56% and 0. 51%, respectively. The RSDs of stability test and repeatability test were less than 1%. Conclusion:The method is simple with good accuracy and repeatability, which can be used for the determination of no-toginsenoside R1 , ginsenoside Rg1 and Rb1 in Shuxuening capsules.
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Objective To investigate the clinical efficiency of serum cystatin C as a marker of renal function to predict serum trough concentrations of vancomycin. Methods Data on trough concentrations of vancomycin(Cmea ),serum creatinine (Scr)concentrations,cystatin C( Cys C) concentrations were collected from 81 hospitalized patients who received vancomycin therapy. Predicted vancomycin trough concentrations(Cpre )were calculated based on Scr or Cys C concentrations associating with Bayesian forecasting method through NONMEM software. Finally,the correlations and distinctions between Cpre and Cmea were comparatively analyzed. Results There were both correlation between Cpre and Cmea in relation to Scr or Cys C(r = 0. 678,P<0. 01;r=0. 727,P<0. 01). Besides,the errors of mean predictive error(ME),mean absolute error(MAE)and root-mean-square error(RMSE)for Scr was - 5. 79,6. 86,9. 86 μg · mL-1 , respectively, where as the errors for Cys C was - 0. 82,5. 42, 7. 74 μg·mL-1 ,respectively. Conclusion Cystatin C is a good marker of renal function available for predicting serum vancomycin concentrations.
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Objective To study paraquat adsorbability of different field soils in Guangxi province of China. Methods HPLC method was adopted to measure the peak area of paraquat in three different media of four types of soils. Chromatographic column was Kromasil C18 column (4. 6 mm×200 mm, 5 μm); mobile phase was acetonitrile-water (including 0. 03 mol·L-1 sodium heptanesulfonate and 0. 24 mol·L-1 phosphoric acid) at a ratio of 397 (pH adjusted to 2. 0 by triethylamine). Detection wave length was 258 nm; column temperature was 25 ℃; the injection volume was 20 μL; flow rate was 0. 8 mL·min-1 . The peak areas of paraquat before and after being adsorbed were compared to calculate the adsorption rate of paraquat in different soils. Results All tested soil samples possessed the adsorption rate of paraquat over 99. 0%. Conclusion Four common field soils in Guangxi province can be used as temporary effective absorbents for the first-aid of paraquat poisoning.
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Aim To investigate the effects of emodin isolated from Guangxi P.multiflorum Thunb on the expression of KU70/KU80 in hypoxic nasopharyngeal cancer CNE-1 cells and reveal the relationship between radiosensitization of emodin monomer and DNA repair genes.Methods The expression of hypoxia inducible factor-1?(HIF-1?)and DNA double-strand break repair genes(KU70/KU80)between the experimental groups and the control group under hypoxic condition was detected by the real-time fluorescence quantitative RT-PCR.Results Expression of HIF-1? was significantly increased under hypoxia condition.HIF-1? had no change after treatment with emodin alone.The expression level of KU70/KU80 was induced by radiation.Compared with radiation alone group,radiation combined hypoxia group obviously enhanced the expression of KU70/KU80.KU70/KU80 mRNA expression significantly reduced after radiation combined with emodin under hypoxic condition.Conclusion In the hypoxic environment,emodin combined with radiotherapy can effectively inhibit the expression of HIF-1 ? and DNA double-strand break repair genes(KU70/KU80),which may be its mechanism of radiosensitization.