A retrospective analysis to estimate trough concentrations of teicoplanin in patients with suspected or documented Gram-positive infections

Abstract Teicoplanin is a glycopeptide antibiotic commonly used to treat Gram-positive bacterial infections in the clinic. The aim of this study was to provide a therapeutic reference for the clinical application and dosage regimen adjustment of teicoplanin by identifying factors associated with its plasma trough concentration (Ctrough). A retrospective study was performed on patients with suspected or documented Gram-positive infections who were hospitalized from November 2017 to January 2020 and treated with teicoplanin while undergoing routine therapeutic drug monitoring (TDM). A total of 112 Ctrough trough measurements were obtained from 72 patients were included in this study. SPSS software was used for correlation analysis and receiver operator characteristic curve (ROC) analysis. The Ctrough for teicoplanin showed statistically significant relationships (P<0.05) with PLT, Scr, CLcr, eGFR, BUN and Cys-C. ROC curve analysis revealed that CLcr and eGFR were more sensitive and specific for Ctrough compared to the other factors. These findings should be considered in the clinical application of teicoplanin and for its dosage adjustment.

Finite element analysis of facet joint between normal and lumbar disc hemiation in adolescents / 解剖学报

Objective To investigate the effect of facet joint asymmetry on lumbar biomechanics in normal and patients with adolescent lumbar disc hemiation (ALDH). Methods Mimics 21.0, 3-Matic Medical 13.0, Geomagic Wrap 2017, HyperMesh 2019 and finite element software ABAQUS 2021 were combined to establish three-dimensional finite element models of nonnal lower lumbar spine and adolescent lumbar disc hemiation. According to the difference between the left and right facet joints, three cases of nonnal and ALDH patients aged 13-18 years old were selected, with a total of 6 cases. The stress of intervertebral disc under different torque loads (neutral position, lateral flexion and rotation) was analyzed and compared. Results 1. Three dimensional finite element models of L3-L, segments were established in 6 male nonnal and adolescent patients with lumbar disc herniation, and the stress and displacement nephogram of lumbar disc hemiation in nonnal neutral position, flexion, extension, lateral flexion and rotation were obtained; 2. The stress of L4_, annulus fibrosus increased when the facet joint angle of nonnal adolescents was symmetrical in the neutral position; 3. The stress of annulus fibrosus was greater than that of nucleus pulposus under different conditions, and the stress of annulus fibrosus was flexion > neutral position > extension; 4. In patients with ALDH, the left side of the facet joint was larger than the right 10 ° model, and the stress in the posterior side of the annulus fibrosus of L4_, segment increased significantly under extension condition. Under lateral flexion condition, the left stress of the left annulus fibrosus was compared with the right stress of the right annulus fibrosus, t = l. 575, P<0. 05, the difference was statistically significant, the right stress of the right annulus fibrosus was greater than the left stress of the left annulus fibrosus. Under the rotating condition, the stress on the left and right sides of the fiber ring was greater than that on the back side. Conclusion 1. Compared with nonnal and patients with ALDH, the stress of intervertebral disc increases under different postures, which ma)' increase the shear load of intervertebral disc and aggravate the process of intervertebral disc degeneration; 2. When the degree of left-right asymmetry of facet joint is more than 10 degrees, the stress on the side with small degree is greater. Facet joint asymmetry can lead to the overload of vertebral bod)' and intervertebral disc, leading to spinal instability; 3. The stress of intervertebral disc in extension is less than that in neutral position and flexion. Extension can relieve the pressure of intervertebral disc and play an auxiliary role in the recovery of patients with ALDH.

Three￣dimensional digital measurement of occipital condyle and foramen magnum in Inner Mongolia / 解剖学报

Objective To measure the anatomical structure of the occipital condyle (OC) and the occipital foramen (FM) by three-dimensional reconstruction, and to analyze the morphological characteristics and relative positional relationship of the occipital condyle and occipital foramen, in order to provide anatomical parameters for the imaging diagnosis of the craniocervical junction and the choice of surgical approach. Methods Sixty normal subjects were selected with CT scans of the skull and upper cervical spine, including 30 males and 30 females, aged 20-65 (48. 18±16. 17) years old. The data were imported into the Syngo.via VB10B software, and the skull was reconstructed in three dimensions. To observe the shape of the occipital condyle and occipital foramen, and to measure the occipital condyle length, width, height, condyle inclination angle(CIA), longitudinal diameter, transverse diameter, area of the occipital foramen, the maximum distance between the cranial eyebrow and the posterior cranial point (SML), the crimson eyebrow on the SML line, the distance from the interpoint to the posterior margin of the occipital condyle (GOCP), the vertical distance between the anterior edge of the occipital foramen to the posterior margin of the occipital condyle (AOCP), and the distance from the medial margin of the left and right occipital condyles to the Y axis (OC-M), left and right occipital condyle posterior margin to X axis distance (OC-P); occipital condyle classification index (OCI), occipital condyle relative index of head (SOCI), midpoint on the SML straight line to the occipital condyle Marginal connection distance (COCP,COCP =GOCP-SML/ 2), and determine the type of relative positional relationship between left and right occipital condyles. Results The differences in anatomical length, width and height of the occipital condyle were statistically significant (P<0. 05), and men were larger than women; the occipital foramen area, longitudinal diameter of the occipital foramen, SML, GOCP, AOCP had statistical differences (P<0. 05). The lateral differences of occipital condyle inclination were statistically significant (P<0. 05), and the left side was greater than the right side. The differences in OC-M and OC-P sides were statistically significant (P<0. 05). The former was larger on the right than on the left; the latter was larger on the left than on the right. The longitudinal diameter of the occipital foramen was positively correlated with the area of the occipital foramen and AOCP; OCI classification result were as follows: typeⅠ(OCI<0. 45) had 8 cases (13. 33%), type Ⅱ (0. 45≤OCI<0. 50) had 47 cases (78. 33%), type Ⅲ (OCI≥0. 50) had 5 cases (8. 33%). SOCI classification result were as follows: type Ⅰ (SOCI< 0. 60) had 2 cases (3. 33%), type Ⅱ (0. 60≤SOCI<0. 75) had 54 cases (90. 00%), type Ⅲ (SOCI≥0. 75) had 4 cases (6. 67%). Conclusion The anatomical parameters of the occipital condyle in Inner Mongolia can be implanted with occipital condylar screws. The position of the occipital condyle relative to the foramen magnum and the skull is highly variable.

Comparison of the effect between virtual simulation operation and conventional operation for the treatment of kidney stones / 解剖学报

Objective To provide method for clinical teaching and research, for young doctors to quickly shorten the surgical learning time, a three-dimensional model of the kidney was reconstructed to simulate the effect of percutaneous nephrolithotripsy in virtual and conventional surgery. Methods A total of 30 patients with kidney stones treated in Liangxiang Hospital in Fangshan District of Beijing from December 2017 to February 2019 were randomly selected as the experimental group, while the control group was 30 normal subjects who underwent physical examination in same hospital during the same period. After collecting CT scan data of the two groups of patients, Mimics 16.0 was used. The software was used for image segmentation and fusion to reconstruct the three-dimensional model of the kidney. Observation indexes such as calix puncture, puncture point, puncture depth and channel selection were recorded in the virtual simulation operation. Total hospital stay, average operation time, average amount of blood loss, average postoperative hospital stay and incidence of postoperative complications were recorded. Results Virtual surgery simulation and the actual operation of the puncture point conformity degree was 100%. There was no significant difference of the average length of hospital stay between the two groups (P> 0.05). The average blood loss, the average length of hospital stay and postoperative complications between the two groups were statistically significant (P<0.05). The virtual simulation surgery average blood loss reduced, the average postoperative hospital stay shortened, and the incidence of symptoms decreased. Conclusion Virtual simulation surgery can realize individualized preoperative evaluation and surgical design of kidney stone patients, and provide accurate diagnosis and treatment basis for clinicians.

Research on the effect and mechanism of hepatoma cells HepG2 exosome on its own methylation / 医学研究生学报

ObjectiveThe prognosis of patients with advanced liver cancer is poor and there is no effective treatment so far. This paper observed the effect of hepatoma cells HepG2 exosomes on its own methylation and attempted to explore its mechanism.MethodsThere was experimental group and control group in the research. The medium has been changed when the cells grow to 60% in a DMEM culture dish with 10% serum. Cells in the control group were cultured in serum-free DMEM medium while the experimental group were cultured in serum-free DMEM medium added 100 L (0.5mg/mL) exosomes, and the supernatant was retained after incubation for 48h. HepG2 cells were cultured and exosomes were extracted by overspeed differential centrifugation, and identified by particle size analysis, transmission electron microscopy, Western blot and other methods. The effect of exosomes of hepatocellular carcinoma cells HepG2 on cell proliferation was analyzed by scratch test. Fluorescence antibody staining was used to observe the change of automethylation level. Fluorescence quantitative PCR was used to detect mRNA expression levels of methyltransferase-related genes DNMT3A, DNMT3B, DNMT1, and apoptosis-related genes Bax and BcI2.ResultsUnder inverted fluorescence microscope, red fluorescent exosomes could be seen entering the cell, surrounding the blue fluorescent nucleus or on the nucleus, indicating that DiI entered the cell membrane or cytoplasm. The area ratio of 6 and 12 h in the experimental group [(57.25±2.06, 83.92±3.17) %] was significantly higher than that in the control group [(28.32±1.22, 40.03±1.74) %] (P<0.05). The genes expressions of Bax, DNMT3A and DNMT3B in the experimental group were higher than those in the control group (P<0.05). The expression of BcI2 was lower than that of the control group (P<0.05).ConclusionThe exosomes of hepatoma cell HepG2 can enhance DNA methylation level by changing the transcriptional expression of DNMT3A, DNMT3B and other genes to affect the expression of apoptose-related genes Bax and BcI2, and to promote the proliferation and growth capacity of hepatoma cell HepG2.

Digital measurement of anatomical parameters of normal Mongolian young college students' ears / 解剖学报

Objective: To proform the digital three-dimensional reconstruction and measurement analysis of the normal Mongolian young students' digital anatomical features so to provide anatomical parameters for auricle reconstruction surgery, data measurement for traumatic ear defects, and provide basic data for forensic disability identification. Methods: A total of 32 Mongolian college students used the Artec Spider 3D scanner to perform a three-dimensional scan of the auricle. The 59 sides (28 cases on the left side and 31 cases on the right side) were screened out. Using software measurement according to anthropometry, the ear length and width of the ear, the length and width of the ear, the length and width of the earlobe, and the correlation analysis were carried out. Results: Fifty-nine cases of normal auricle were obtained. The results were as follows: morphological ear length was(25. 72±2. 64) mm, morphological ear width(49. 73± 5. 18)mm, physiognomic ear length(60. 06±4. 89) mm, physiognomic ear width(28. 68±3. 25) mm, earlobe length(15. 71± 2. 67) mm, lobe width(20. 45±2. 92) mm, the morphological ear index was 194. 98±26. 03, and the physiognomic ear index was 47. 91±5. 36. The morphological ear index was calculated to be 194. 98±26. 03, and the physiognomic index was 47. 91 ±5. 36. Conclusion: The symmetry of the auricle is good, and there is a gender difference in the appearance and ear length of the auricle (P<0. 05). There is a difference between the Mongolian nationality and the Han nationality in different regions (P<0. 05). The feature ear length of the Mongolian young college students is similar to that of the Sichuan Han nationality in northwest China. Male physiognomic ear of Han nationality in Henan province between 20 and 29 years old is longer than male physiognomic ear length of 20 to 22 years old in this paper. Male physiognomic ear length of Mongolian young college students are as those of Han Chinese men in northwest China. The features and ear length of Mongolian young college students are similar to that of the southern Han nationality at the age of 20. Male physiognomic ear of Han nationality in Tunpu, Guizhou province is longer in this study (20-22 years old). Both male and female Mongolian college students have longer ears than those in Northwestern India. Caucasian male appearance ear is longer than those in Mongolian young male college students' appearance ear.

Efficacy observation of acupuncture and tapping therapy in the treatment of type 2 diabetes of yin deficiency pattern combined with stasis in the patients / 中国针灸

<p><b>OBJECTIVE</b>To explore the clinical efficacy and mechanism of acupuncture and tapping therapy in the treatment of type 2 diabetes of yin deficiency pattern combined with stasis in the patients.</p><p><b>METHODS</b>One hundred and twelve patients were treated with acupuncture, followed by tapping method. The reinforcing method with lifting, thrusting and rotating needle technique was used at Taixi (KI 3), Shenmen (HT 7), Taibai (SP 3), Taiyuan (LU 9), Sanyinjiao (SP 6) and Zusanli (ST 36); and the even-needling technique was used at Taichong (LR 3), Hegu (LI 4), Xuehai (SP 10) and Fenglong (ST 40). The needles were remained for 30 min. After needle removal, the tapping method with plum-blossom needle was applied to Geshu (BL 17), Yishu (EX-B 3), Ganshu (BL 18), Shenshu (BL 23) and Pishu (BL 20), once every two days. The treatment of 3 months was required. The changes were observed before and after treatment in the relevant indices of fat-islet axis such as fasting plasma glucose (FPG), fasting leptin (FLP), fasting insulin (FINS), insulin sensitivity index (ISI), insulin resistance (Homa IR), insulin secretion index (Homa-beta) and the indices of obesity and blood lipids in the patients.</p><p><b>RESULTS</b>After treatment, the total effective rate was 84.8% (95/112), in which the efficacy on the stasis predominated syndrome was better than that of yin deficiency predominated syndrome [92.9% (52/56) vs 76.8% (43/56), P < 0.05]. Before treatment, FPG, FLP, FINS, Homa-IR, total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), body mass, body mass index (BMI), fat percentage (F%) and obesity degree in the patients were higher obviously than those in the normal group (all P < 0.01); high-density lipoprotein cholesterol (HDL-C) and ISI were lower than those in the normal group (both P < 0.01). After treatment, FPG, FLP, FINS, Homa-IR, TC, TG, LDL-C, body mass, BMI, F% and obesity degree were all reduced obviously as compared with those before treatment (all P < 0.01). ISI and HDL-C were increased apparently (both P < 0.01). The efficacy on mild obesity was superior to that on moderate and severe obesity, and the efficacy in the young patients was better than that in the elderly, the efficacy in the males was better than that in the females, but the differences were not significant (all P > 0.05). The efficacy in the cases with 10 years duration of sickness was superior to those with over 10 years duration of sickness (P < 0. 01).</p><p><b>CONCLUSION</b>Acupuncture and tapping therapy achieves the significant efficacy on type 2 diabetes of yin deficiency pattern combined with stasis and its effect mechanism is related to the positive regulation of glucose, lipid metabolism and fat-islet axis.</p>

GPI-PLD gene exon14 polymorphisms of leucocyte in peripheral blood from healthy persons and leukemia patients / 中南大学学报(医学版)

OBJECTIVE@#To analyze the polymorphisms of glycosylphosphatidylinositol-specific phospholipase D (GPI-PLD) gene exon 14, GPI-PLD activity of leucocyte in the peripheral blood,and the relationship in leukemia patients of Han nationality in Hunan.@*METHODS@#Both 96 leukemia patients and 96 healthy persons of Han nationality in Hunan were researched [including 48 acute non-lymphocytic leukaemia (ANLL) patients as group A, 31 acute lymphoblastic leukaemia (ALL) patients as group B, 12 chronic granulocytic leukaemia (CML) patients as group C, 5 chronic lymphocytic leukaemia (CLL) patients as group D]. The polymorphisms were analyzed by PCR-SSCP and sequencing;. and GPI-PLD activities were determined by GPI-anchored placental alkaline phosphatase (PLAP) as substrate and triton-X114 partioning.@*RESULTS@#There were four variations in the coverage of GPI-PLD gene exon 14 of leukemia patients and healthy persons. The codons of variation were: 1257 C-->T, 1298 T-->C, 1218 C-->A, 1257 C-->A. The total various frequency in leukemia patient and healthy person, which was determined by SSCP, was 28.12% and 20.83%. On the basis of the percentage of GPI-anchored PLAP conversion, the leucocyte GPI-PLD activities of the 96 leukemia patients were measured. Compared with the 96 healthy controls, the leukocyte GPI-PLD activites of ANLL and CLL patients were significantly increased; the acticities of ALL and CML patients were significantly reduced.@*CONCLUSION@#Leukocyte GPI-PLD gene in the peripheral blood, which belongs to healthy persons and leukemia patients of Han nationality in Hunan, is polymorphism. The leukocyte GPI-PLD activities in the four groups are remarkable.