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OBJECTIVE: To evaluate the relationship between serum vancomycin level and efficacy in peritoneal dialysis-related peritonitis(PDRP) patients by analyzing our hospital′s data. METHODS: Forty-six PDRP patients admitted in our hospital from August 2015 to April 2018 were collected, then divided into three groups by different regimens(1 g q3d, 1 g q4d, 1 g q5d), the probability of target attainment of the first trough concentration and those after several administrations, the characteristics of distribution of vancomycin serum level and the relation with efficacy were analyzed. RESULTS: The first trough concentrations of 1 g q3d, 1 g q4d and 1 g q5d were (10.51±2.79), (6.78±1.58) and (6.68±1.68) mg·L-1 respectively, with statistical difference between 1 g q3d regimen and 1 g q4d, 1 g q5d (P0.01). The trough concentration after the 3rd administration of 1 g q3d regimen was (16.15±4.79) mg·L-1, the trough concentration after the 2nd administration of 1 g q4d regimen was (10.20±2.0) mg·L-1, and the trough concentration after the 2nd administration of 1 g q5d regimen was (9.49±3.24) mg·L-1. The serum vancomycin level was increasing after repeated administration with obvious statistical difference among the three regimens(P0.01). There was no significant difference in the efficacy between concentration10 mg·L-1 and that ≥10 mg·L-1 or concentration <15 mg·L-1 and that ≥15 mg·L-1(P0.05). CONCLUSION: There is significant inter-individual differences of serum vancomycin level in PDRP patients after IP administration, and vancomycin is accumulated in body after repeated administration. It is suggested to monitor the serum vancomycin concentration and the trough concentration kept above 10 mg·L-1.
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Township and Village Health Services Integration Management (TVHSIM) is an essential form of China's two-tiered health service integration plan at the township and village level.Its main purpose,also one of the target goals in China's new healthcare reform,is to gradually integrate rural health services and appropriately allocate rural health resources.This study aims to assess the village doctors' satisfaction with the TVHSIM and provide scientific base to further improve TVHSIM.A cross-sectional study was carried out in which 162 village doctors from Qinghai,Inner Mongolia and Xinjiang in western China were interviewed.Descriptive analysis,independent t-test,one-way ANOVA,Spearman rank correlation and multiple linear regression were used to analyze the difference and relevance between village doctors' personal characteristics and their satisfaction with TVHSIM and six subscales.Village doctors with different years of practice,social insurance status and essential medical knowledge level showed statistically significant differences in their satisfaction levels (all P＜0.05).Age (P＜0.05) and years of practice (P＜0.01) were negatively correlated with Drug and Medical Device Management and Financing Management.Essential medical knowledge level (P＜0.05) was negatively correlated with Operations Management as well.However,social insurance status (P＜0.05) was positively correlated with Human Resources Management and Drug and Medical Device management.Gender,age and years of practice respectively had significant influence on village doctors' satisfaction with TVHSIM (P＜0.01).In conclusion,in order to further promote TVHSIM policy in rural China,a well-rounded social insurance model for village doctors is urgently needed.In addition,the development of TVHSIM is regionally imbalanced.Efficient and effective measures aiming at rationalizing gender and age structure and enhancing essential medical training should be carefully considered.
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OBJECTIVE: To provide basis for rational use of biapenem in elderly patients through Monte Carlo simulation. METHODS: A total of 294 strains from five species of Enterobacteriaceae were collected. The MICs of biapenem against the bacteria were measured by double broth dilution method. Six therapeutic regimens (300 mg q24h; 300 mg q12h; 300 mg q8h; 300 mg q6h; 600 mg q24h; 600 mg q12h) were simulated by using Monte Carlo simulation, then the probability of target attainment (PTA) and cumulative fraction of response (CFR) were calculated. RESULTS: In patients at 65-74 years old, only the CFR of 300 mg q24h regimen was 90% for E. coli and E. aerogenes; only the 300 mg q24h regimen had CFRs<90% (89.39% and 88.98%) for K. pneumonia and E. cloacae; for E. aerogenes, all the regimens had CFRs <90%. CONCLUSION: It is suggested that different regimens can be used for target therapy of biapenem on the basis of MICs, while frequency of q12h or higher can be used for experiential therapy of enterobacteriaceae infection in old people in our hospital. Other antimicrobial agents should be chosen for treatment of E. aerogenes.
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This study established a population pharmacokinetics-pharmacodynamics model of clopidogrel in patients with acute coronary syndrome. Fifty-nine patients were enrolled. The plasma concentration of clopidogrel active metabolite and vasodilator stimulated phosphoprotein platelet reactivity index (VASP-PRI) were selected as the pharmacokinetics index and the pharmacodynamics index, respectively. The covariates including demographic characteristics, laboratory indexes, combined medication, complications and genetic polymorphisms of related enzymes were screened for their influence on the pharmacokinetic and pharmacodynamics parameters. Population pharmacokinetic and pharmacodynamics data analysis was performed using NONMEM software. The general linear model and the indirectly effect model-turnover model for pharmacokinetic and pharmacodynamic analysis were selected as the basic model, respectively. The population typical values of K12, CL/F, V/F, EC50, K(in), and E(max) were 0.259 h(-1), 179 L x h(-1), 632 L, 1.57 ng x mL(-1), 4.29 and 0.664, respectively. CYP2C19 was the covariate in the final pharmacokinetic model, and the model was to design a prior dosage regimen.
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Humans , Acute Coronary Syndrome , Metabolism , Polymorphism, Genetic , Ticlopidine , PharmacokineticsABSTRACT
<p><b>OBJECTIVE</b>To evaluate the results of requesting a second consecutive sperm ejaculate in order to reduce ICSI cycles by PESA or TESE on the day of oocyte pick-up in assisted reproductive technology (ART).</p><p><b>METHODS</b>We collected 68 semen samples as a second consecutive ejaculate from 34 men, compared the semen volume and sperm concentration, motility and total count between the first and the second ejaculation, and analyzed the laboratory results and clinical outcomes of fertilization with the mixed sperm.</p><p><b>RESULTS</b>The 34 males ejaculated twice within 4 hours by masturbation, with an interval of 26-183 (94.9 +/- 39.8) minutes between the first and second ejaculation. The volume of the first ejaculate was (2.0 +/- 1.4) ml, significantly higher than that of the second ([1.5 +/- 0.9] ml) (P = 0.007), although the numbers of motile sperm and grade a + b sperm of the first ([40.8 +/- 25.3]% and [30.9 +/- 22.4]%) were significantly lower than those of the second ([52.2 +/- 21.1]% and [39.9 +/- 17.5]%) (P < 0.05). There were no statistically significant differences in the sperm concentration or total sperm count between the two ejaculates (P > 0.05). The ICSI, IVF + ICSI, and IVF cycles were 3, 3 and 28 respectively among the 34 couples undergoing ART. The number of retrieved oocytes, normal fertilization rate, high quality embryo rate and frozen cycles/fresh transfer cycles ratio were 15.5 +/- 8.7, 57.0% (247/433), 58.7% (145/247) and 20/24 for the IVF cycle, 21.7 +/- 8.3, 61.5% (40/65), 67.5% (27/40) and 3/2 for the ICSI cycle, and 10.0 +/- 2.6, 72.4% (21/29), 66.7% (14/21) and 3/3 for the IVF + ICSI cycle. Fourteen live births were achieved out of the 18 pregnancies, including 6 healthy boys and 9 healthy girls.</p><p><b>CONCLUSION</b>A clinical pregnancy rate of >30% can be achieved by requesting a second consecutive sperm ejaculate on the day of oocyte pick-up in order to collect more sperm and/or increase the total number of motile sperm for ART. And this method can avoid other invasive sperm processing techniques and the need of unnecessary micromanipulative fertilization.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Pregnancy , Young Adult , Ovulation Induction , Reproductive Techniques, Assisted , Sperm RetrievalABSTRACT
<p><b>OBJECTIVE</b>To compare the clinical and radiologic effect in treating degenerative lumbar instability with single or double carbon fiber cages.</p><p><b>METHODS</b>From November 2005 to October 2006, 97 patients of degenerative lumbar instability were followed up more than two years. All cases underwent pedicle screw fixation. Meanwhile, 41 of them, named group A, were applied with single carbon fiber cage, with 23 males and 18 females, aged for 35-70 years, including 38 cases with single vertebral instability and 3 cases with existing L4.5 and L5S1 intervertebral instability. The other 56 cases, named group B, were treated with two carbon fiber cages, with 32 males and 24 females, aged for 33-72 years, including 53 cases with single vertebral instability and 3 cases existing L4.5 and L5S1 intervertebral instability. The clinical effect, intervertebral fusion ratio and lost intervertebral height were compared between two groups.</p><p><b>RESULTS</b>All patients were followed up for 24-35 months, with an average of 28 months. Clinical effects (including symptom, sign, daily action and bladder function) were evaluated according to JOA 29 score. In group A: the JOA score improve from 10.11 +/- 2.40 preoperative to 24.88 +/- 2.30 at final follow-up, 25 cases obtained excellent results, 12 good, 4 fair; 39 cases obtained fusion with the fusion ratio of 95.1% (39/41). In group B: the JOA score from 9.62 +/- 2.60 preoperative to 25.19 +/- 2.40 at final follow-up, 37 cases obtained excellent results, 13 good, 6 fair; 53 cases obtained fusion with the fusion ratio of 94.6% (53/56). In the 7th day after operation, the average intervertebral height in group A was (11.2 +/- 1.2) mm,and that of group B was (11.3 +/- 1.4) mm. Two years later, the average intervertebral height in group A was (11.0 +/- 1.4) mm, while that of group B was (11.1 +/- 1.4) mm. There was no significant difference between two groups in clinical effect, intervertebral fusion ratio and lost intervertebral height (P > 0.05).</p><p><b>CONCLUSION</b>Pedicle screw fixation and single or double carbon fiber cages in treating degenerative lumbar instability both can obtain satisfactory curative effect. Single carbon fiber cage has advantages such as minimally trauma, simply operation, retentively posterior column structure, cheaply price than double carbon fiber cages.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Follow-Up Studies , Fracture Fixation, Internal , Internal Fixators , Lumbar Vertebrae , General Surgery , Neurodegenerative Diseases , General Surgery , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To investigate the chemical constituents of the brown alga D. divaricata, and to test cytotoxicities of the purified compounds.</p><p><b>METHOD</b>Compounds were isolated by normal phase silica gel, Sephadex LH-20 chromatography and reverse phase HPLC techniques. Their structures were elucidated by spectroscopic methods including IR, MS and NMR. Cytotoxicities were tested by MTT method.</p><p><b>RESULT</b>Eight compounds were isolated from ethanolic extract of the brown alga D. divaricata and their structures were identified as (-)-torreyol (I), 4beta, 5alpha-dihydroxycubenol (II), 3-farnesyl-p-hydroxybenzioc acid (III), chromazonarol (IV), fucosterol (V), phenyl acetylamine (VI), 4-hydroxybenzoic acid (VII) and n-hexadecanoic acid (VIII).</p><p><b>CONCLUSION</b>Compound II and IV were obtained from this alga for the first time. The others were isolated from the Dictyotaceae algae for the first time. All compounds were inactive (IC50 > 10 microg x mL(-1)) against human tumor cell lines KB, Bel-7402, PC-3M, Ketr 3 and MCF-7.</p>
Subject(s)
Humans , Cell Line, Tumor , Parabens , Chemistry , Pharmacology , Phaeophyceae , Chemistry , Stigmasterol , Chemistry , Pharmacology , Terpenes , Chemistry , Pharmacology , Xanthenes , Chemistry , PharmacologyABSTRACT
<p><b>OBJECTIVE</b>To investigate the chemical constituents of the brown alga Leathesia nana.</p><p><b>METHOD</b>Compounds were isolated by normal phase silica gel, Sephadex LH-20 chromatography and reverse phase HPLC techniques. Their structures were elucidated with spectroscopic methods including IR, MS and NMR.</p><p><b>RESULT</b>Six compounds were isolated from ethanolic extract of the brown alga L. nana and their structures were identified as 2,2',3,3'-tetrabromo-4,4',5,5'-tetrahydroxydiphenyl methane, 2,2',3-tribromo-3', 4,4', 5-tetrahydroxy-6'-ethyloxymethyldiphenyl methane, 2,3-dibromo-4,5-dihydroxybenzyl alcohol, 2,3-dibromo-4,5-dihydroxybenzyl methyl ether, 3-bromo-4-hydroxybenzoic acid and 2-bromo-4,5-dihydroxybenzaldehyde.</p><p><b>CONCLUSION</b>All these compounds were obtained from this species for the first time.</p>