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Objective:To observe the changing characteristics of pharmacokinetic and pharmacodynamic (PK-PD) parameters of vancomycin in critical patients under different drug regimens and to further explore the influencing factors.Methods:The clinical data of patients who treated with vancomycin and recorded by steady-state through concentration (C min) admitted to intensive care unit (ICU) of Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2011 to December 2018 were analyzed retrospectively. The patients were divided into three groups according to the dosing interval (groups of q12 h, q8 h and q6 h respectively) and C min was collected. The serum concentration of vancomycin before (0 hour) and 1, 2, 4, 6, 8, 12 and 24 hours after administration were estimated by JPKD Ver 3.1. Area under the curve (AUC 0-24 h) was estimated by trapezoidal area method. Minimum inhibitory concentration (MIC) of pathogenic microorganisms in the same period was retrieved, thus AUC 0-24 h/MIC was calculated. Results:285 patients with 529 records of C min were enrolled in the study, including 375 data in q12 h group, 121 data in q8 h group and 33 data in q6 h group. After unifying daily dose by JPKD Ver 3.1, the C min (10-20 mg/L) reaching rate of q12 h group, q8 h group, q6 h group were 35.7%, 43.8% and 60.6%, respectively, while only q12 h group was statistically significant compared with q6 h group ( P < 0.01). q6 h group and q8 h group showed higher C min than q12 h group (mg/L: 13.8±5.2, 13.5±7.3 vs. 11.4±7.9, both P < 0.05) and lower peak concentration (C max) than q12 h group (mg/L: 19.4±5.3, 21.5±7.3 vs. 23.9±8.1, both P < 0.05). However, there was no significant difference in terms of percentage of PD target (AUC 0-24 h/MIC≥400) among the three groups (q12 h group, q8 h group, q6 h group were 38.1%, 41.3%, 45.5%, P > 0.05). Multiple linear regression analysis showed that creatinine clearance (CCr) and vancomycin clearance (CLvancomycin) were the main influencing factors of vancomycin PD parameters such as C min and AUC 0-24 h/MIC ( r values of CCr were -0.391, -0.424, and rvalues of CLvancomycin were -0.673, -0.663, all P < 0.01), and were negatively correlated with age ( r values were -0.432 and -0.488, respectively, both P < 0.01). Conclusions:At the same daily dose, C min can be increased and C max can be decreased by increasing the frequency of vancomycin administration, thus minimize the fluctuation of vancomycin serum concentration, but AUC 0-24 h/MIC is not affected. Vancomycin administration regimen in severe patients should be optimized according to CCr, CLvancomycin and age.
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Objective This study was aimed to investigate the effects of Ginger combined with Rhubarb on hyperuricemia in mice. Methods The mice hyperuricemic model was made by orally administering yeast extract, The mice were randomly divided into 7 groups,includinglow,middle and high dose of Ginger combined with Rhubarb group, Rhubarb group, and allopurinol group was given corresponding drugs respectively by gavage, and the uric acid (uA), creatinine (Cr), urea nitrogen (BUN) level in blood and XOD activity in liver were observed for all mice in each group. Results Compared to hyperuricaemia model control group,UA level and XOD activity in liver of mice of the three doses of Ginger combined with Rhubarb groups received dose-dependent decrease. Conclusion Ginger combined with Rhubarb can reduce UA level and XOD activity in liver in hyperuricaemia mice model.
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[Objective] To observe analgesic action produced by electvoacupuncture (EA) of different intensity in adjuvant arthritis (AA) rats. [Methods] AA rat models were induced and the rats were randomized into 3 groups: group A, group B and group C. Group A and group B were treated with EA on points of Kunlun (BL60) and Yangtingquan (GB34) at the same wave type and wave frequency but at different electric current (3.5mA and 5.5mA respectively). Group C was performed with mimic EA. Pain threshold (PT) in the three groups before and after EA was observed. [Results] After EA, PT of the affected limb in group A and group B was increased (P0.05). [Conclusion] Analgesic action of EA at the same wave type and wave frequency while at different electric current is different: analgesic action at middle-intensity current is superior to that at large-intensity current; its possible mechanism is related to the participation of central nervous system.