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OBJECTIVE To investigate the treatment plan for az treonam-resistant metallo- β-lactamase（MBL）-producing Enterobacteriaceae infection in pediatric solid organ transplant recipients. METHODS The clinical data of aztreonam-resistant MBL-producing Klebsiella pneumoniae caused intra-abdominal infection of an infant after liver transplantation were retrospectively analyzed. Abdominal infection occurred after operation. The pathogenic bacterium was MBL-producing K. pneumoniae . The drug sensitivity results showed that the infant was resistant to aztreonam. Based on the results of sensitivity test ，polymyxin B combined with tigecycline were selected as initial regimen. The treatment effect was poor ，with recurrent disease and shock spots. The clinical pharmacist assisted the clinician to formulate treatment regimen of ceftazidime avibactam 0.5 g，q8 h combined with aztreonam 0.18 g，q6 h. Relevant domestic and foreign literature were reviewed ，and the treatment plan of MBL-producing Enterobacteriaceae infection after solid organ transplantation was summarized. RESULTS & CONCLUSIONS The infant was finally cured and discharged with ceftazidime avibatan combined and aztreonam. Several foreign literature reported that ceftazidime avibactam combined with aztreonam could effectively treat the infection caused by aztreonam-resistant MBL-producing Enterobacteriaceae infection in patients with organ transplantation. It is expected to be an effective treatment for aztreonam-resistant MBL-producing Enterobacteriaceae infection in pediatric solid organ transplant recipients.
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OBJECTIVE: To investigate the relationship of the function and gene polymorphism of insulin receptor substrate (IRS) with type 2 diabetes mellitus (T2DM), and to provide a new perspective for T2DM drug development. METHODS: Relevant literatures included in CNKI, Wanfang, VIP, PubMed, SpringerLink and other databases from Jan. 1991 to Nov. 2017 were retrieved by using "Insulin receptor substrate" "Type 2 diabetes" "Insulin resistance" "Polymorphism" as Chinese keywords, and "Insulin receptor substrate" "IRS" "Type 2 diabetes" "Insulin resistance" "Polymorphism" as English keywords. The relationship of the function and gene polymorphism of IRS family with T2DM was reviewed. RESULTS & CONCLUSIONS: A total of 328 literatures were retrieved, of which there were 38 valid literatures. At present, IRS family has six members (IRS-1 to IRS-6). The dysfunction of IRS-1 and IRS-2 will lead to insulin resistance and induce T2DM. The relationship of IRS-3 and IRS-4 with T2DM remains controversial. IRS-5 and IRS-6 were newly found and their functions are not clear. The Gly972Arg mutation of IRS-1 is positively correlated with the pathogenesis of T2DM. Gly1057Asp mutation of IRS-2 combined with obesity can induce insulin resistance, but there is controversy. The mutation types of IRS family other members include Ala94Thr, Ala512Pro and Ser892Gly mutation of IRS-1, ACC, Ala157Thr and Leu647Val mutation of IRS-2. The relationship between these types of mutation and T2DM has not yet been fully supported. Multiracial and large-scale studies are required. Some achievements have been made in the present study, but the study is not yet comprehensive. Relationship of IRS family members and their mutation sites with T2DM still needs to be further tested in the expanded population.
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OBJECTIVE:To establish an HPLC method for the determination of Stillbene glycoside (THPG) in Zhipingk-ang misture.METHODS:The chromatographic column was Hypersil C18(250 mm?4.6 mm,5 ?m).The mobile phase consisted of acetonitribl-water(25∶75) at a flow rate of 1.0 mL?min-1 with detection wavelength set at 320 nm. RESULTS: There was a good linear relationship within the concentration range of 0.5～8.0 ?g for THPG. The average recovery of THPG was 100.03%(RSD=1.07, n=6).CONCLUSION: The adoptd method is accurate, reproducible and suitable for the quality con-trol of Zhipingkang misture.
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OBJECTIVE:To evaluate the drug use status of Chinese materia medica injection(CMMI)in our hospital.METHODS:Chinese materia medica injection(CMMI)used in our hospital from2002to2004was analyzed statistically in terms of consumption sum,defined daily dose(DDDs)and the average daily consumption sum(DDDc).RESULTS:The consumption sum of CMMI in3years increased year by year with annual increase rates of29.7%and32.3%,respectively.The cardio-cerebral vascular CMMI steadily dominated the first place in terms of consumption sum and DDDs in3years with a steady increase year by year from a high starting point.The DDDc of antitumor CMMI ranked the toppest.As for the consumption sum for single variety,xuesaitiong steadily ranked the first place in3years.CONCLUSION:The fast increase of the consumption of CMMI shows that it has a great market demand.