Teicoplanin trough concentrations following different loading doses in critically ill patients / 中国感染控制杂志

Objective To understand serum trough concentrations (Cmin) of teicoplanin and target concentration achieved in severely infected patients after three days treatment with different loading doses of teicoplanin,and find out optimal loading dose.Methods Severely infected patients who admitted to the intensive care unit(ICU) of a hospital from February 1,2016 to February 28,2017 were enrolled in the study.According to different drug loading doses (teicoplanin standard dose:6mg/kg;high dose:10mg/kg) and different creatinine clearance rates (Ccr:50mL/min as standard value),patients were divided into four subgroups:group of standard dose and normal Ccr (GsD1),group of standard dose and low Ccr (GSD2),group of high dose and normal Ccr (GHD1),group of high dose and low Ccr(GHD2).Serum Cmin,percentage of achieving target concentration,and adverse reactions of teicoplanin in different groups were compared.Results A total of 49 patients were enrolled in the study,17 patients were in GSD group,Cmin on 4th day before administration was (5.98 ± 2.67)mg/L;32 patients were in GHD group,Cmin on 4th day before administration was (9.05 ± 4.25)mg/L;Cmin in GHD group was higher than that in GsD group,and there was statistical difference between two groups(t=3.10,P=0.003).Values of Cmin in GSD1,GSD2,GHD1,and GHD2 groups were (5.78±2.72),(6.34±2.78),(8.21 ±3.77),and (12.07±4.81) mg/L respectively,differences among four groups were statistically significant(F =4.766,P =0.006).The Cmin in GHD2 group was higher than those in GHD1,GSD2,and GsD1 groups,percentage of achieving the target concentration were 9.09％ (1/11),16.67％ (1/6),28.00％(7/25),and 71.43％ (5/7) respectively,differences were statistically significant(x2=8.766,P=0.033).Complications associated with teicoplanin such as rash,damage to hepatic and renal function were not observed in all patients during the treatment course.Conclusion Whether the Ccr is normal or not,target Cmin can not be achieved early in patients given teicoplanin with standard loading dose;in patients with low Ccr,given high loading dose,target Cmin can be achieved early;while in patients with normal Ccr,higher loading dose may be needed.

Application of multi-function anti-reflux drainage connector in prevention from catheter-associated urinary infection / 中华护理杂志

Objective To evaluate the effects of a self-designed multi-function anti-reflux drainage connector on preventing catheter-associated urinary infection in patients with long-term indwelling catheters.Methods A total of 100 elderly males with indwelling catheters from 10 nursing homes in our city were selected and randomly divided into the control group (n=50) and the experimental group (n=50) from January 2013 to December 2015.The patients in the control group were indwelled with Foley catheters and connected with an ordinary disposable drainage bags;the patients in the experimental group were indwelled the same catheters and connected to disposable drainage bags with an multi-function anti-reflux drainage connector.Patients' urine in catheters and drainage bags from two groups were collected for urine culture on 7th,14th,21st,28th days.The cases of catheter plugging on the 7th,14th,21st,28th days and the cases of catheter encrustation on 28th day in two groups were recorded.Results The cases of bacteriuria on the 7th,14th,21st,28th days in the experimental group were significantly less than those in the control group (P＜0.05),and were also significantly less than those in the drainage bags in the same group (P＜0.05).The cases of catheter plugging on the 7th,14th,21st,28th days were not significantly different between two groups(P＞0.05).The cases of catheter encrustation on the 28th day in the experimental group were significantly less than those in the control group (P＜0.05).Conclusion Multi-function anti-reflux drainage connector can safely and effectively prevent catheter-associated urinary infection,reducing bacteria ascending with reflux of urine as well as catheter encrustation.

Effects of bacterial biofilm on hearing restoration with titanium partial ossicular prosthesis replacement / 医用生物力学

Objective To study effects of the bacterial biofilm at different growth stages on dynamic behavior of the titanium partial ossicular replacement prosthesis (PORP), so as to provide theoretical references for clinical treatment of diseases such as secretory otitis media. Methods Based on the CT scan images of normal human right ear and combined with the self compiling program, a 3D finite element model of the ear was reconstructed for dynamic analysis on sound conduction, and compared with the experimental data. The model was computed by harmonic response analysis method, and the sound conduction effect of bacterial biofilm grown on PORP at different growth stages was analyzed. Results The simulated amplitude of umbo and stapes footplate was in accordance with experimental measurements, which confirmed the validity of this numerical model. The existence of biofilm would cause 0-1.6 dB hearing loss at low frequencies. The growth of biofilm in the radial direction of PORP would cause 0-12 dB hearing loss at intermediate and high frequencies, especially at 8 kHz, and the hearing loss could be as high as 11.2 dB. Conclusions The bacterial biofilm has an impact on hearing by reducing the hearing at low frequencies while raising a little at high frequencies. The biofilm grown in the radial direction of PORP will reduce hearing, and affect the working efficiency of PORP on hearing restoration.

LC-MS/MS assay of methylphenidate: stability and pharmacokinetics in human / 药学学报

The study aims to solve the instability problem of methylphenidate (MPH) in plasma, and establish a LC-MS/MS method for simultaneous determining of MPH in human plasma. The stabilities of MPH in different media were studied, and the degradation characteristics of MPH in these media were also investigated by HPLC and LC-MS/MS. To a 200 microL aliquot of freshly collected plasma sample, 10 microL 2% formic acid was added immediately to prevent the hydrolysis of MPH in human plasma samples. Chromatographic separation was performed on a Sapphire C18 column using the mobile phase of methanol - 5 mmol.L-1 ammonium acetate buffer solution containing 0.1% formic acid (46 : 54). MPH was quantified by tandem mass spectrometry operating in positive electrospray ionization mode with multiple reaction monitoring. The detection used the transitions of protonated molecules at m/z 234.2-->84.1 for MPH and m/z 260.3-->183.1 for propranolol (IS), separately. The intra- and inter-assay precisions were all below 5.0%. The accuracies were all in standard ranges. The linear calibration curve was obtained in the concentration range of 0.035-40 ng.mL-1. The methods fulfilled the demand. The method was used to determine the concentration of MPH in human plasma after a single dose of 36 mg MPH tablet to 6 healthy Chinese volunteers. The method is suitable for the precisely determination of MPH and for pharmacokinetic study of MPH in human plasma.

Investigation on the behavior problems of children aged 3 to 5 years in Changsha and comparison of the norm of Conners Parent Symptom Questionnaire in Chinese and American urban children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the behavior problems of children aged 3 to 5 years in Changsha and to compare the differences of the results detected by the norm of Conners Parent Symptom Questionnaire (PSQ) in Chinese and American urban children.</p><p><b>METHODS</b>A total of 854 children aged 3 to 5 years were randomly sampled from 5 districts in Changsha City and their parents completed the Conners PSQ.</p><p><b>RESULTS</b>The assessment by the norm of PSQ in American urban children demonstrated that the average prevalence of behavior problems was 20.4%, with 28.1% for boys and 12.4% for girls. There were significant differences between boys and girls (P<0.01). The factor score of anxiety in girls was markedly higher than that in boys (P<0.01). Learning and psychosomatic problems were the main problems in the children. The prevalences of conduct problems and impulse-restlessness, and abnormal restlessness index detected by the norm of PSQ in Chinese urban children were higher than those detected by the American norm. The prevalences of conduct problems and psychosomatic problems in boys by the norm of PSQ in Chinese urban children were significantly lower than those detected by the American norm, while the total prevalence of behavior problems was higher than that detected by American norm. There was a poor consistency in the assessment results of most factors of the PSQ and the total prevalence of behavior problems detected by the Chinese and American norms (KappP<0.4).</p><p><b>CONCLUSIONS</b>The prevalence of behavior problems especially learning problems and psychosomatic problems in children aged 3 to 5 years is higher in Changsha. The consistency of assessment results is poor between the norms of China and America. It is recommended to use the China norm of PSQ in Chinese children aged 3 to 5 years because the Chinese norm is in line with China's national conditions and cultural background.</p>

Metabolic footprint in conditioned culture medium of placental explants: a comparison between early-onset and late-onset severe preeclampsia / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the differences of metabolic footprint in the conditioned culture medium of placental explants between early-onset and late-onset severe preeclampsia.</p><p><b>METHODS</b>In 13 cases of early-onset severe preeclampsia and 14 cases of late-onset severe preeclampsia, the placentas were sampled at the surface of the maternal placenta. High performance liquid chromatography-mass spectrometry (HPLC-MS) was used to determine the differences in the metabolites in the conditioned culture medium of the placental villous explants cultured in 6% atmospheric O(2) for 96 h. Standard samples were used to establish the tryptophan and kynurenine chromatography library by HPLC-MS to analyze the concentration of tryptophan and kynurenine in the conditioned culture medium.</p><p><b>RESULTS</b>Thirty-six metabolites showed statistically significant differences between early-onset and late-onset severe preeclampsia (P<0.05). The concentration of kynurenine was significantly higher in early-onset severe preeclampsia than in late-onset severe preeclampsia (P<0.05).</p><p><b>CONCLUSION</b>Early-onset and late-onset severe preeclampsia may have different pathogeneses. By detecting the concentration of metabolites, metabolomic strategies provide a new means for predicting the onset time of severe preeclampsia.</p>

Correlation of snoring with attention deficit and hyperactivity-impulsivity in school age children from Changsha City / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the prevalence of snoring in school age children from Changsha City, and study the correlation of snoring with attention deficit and hyperactivity-impulsivity.</p><p><b>METHODS</b>A total of 1 736 children aged 6 to 12 years were randomly sampled from five districts in Changsha City. Their parents completed the questionnaires about children's sleep conditions and the Attention Deficit Hyperactivity Disorder Diagnostic Scale-Parent Version.</p><p><b>RESULTS</b>The total incidence rate of frequent snoring was 5.7%. Boys had higher incidence of frequent snoring than girls (7.5% vs 3.8%; x2=18.782, p<0.01). The incidence of snoring in the 6-to 9-year-old group was higher than that of the 10-to 12-year-old group (x2=9.666, P<0.01). The incidence of daytime sleepiness in the snoring group was higher than that in the non-snoring group (31.5% vs 25.9%; x2=6.678, p<0.01). The incidences of larynx choking, sleep apnea, mouth breathing, hyperhidrosis, and awaking for unknown reasons or awaking by choke in the frequent snoring group were significantly higher than in the occasional snoring and the non-snoring groups (x2=37.035, 27.745, 51.341, 30.975, 45.972 respectively; all P<0.01). The incidences of attention deficit (31.3%) and hyperactivity-impulsivity (18.2%) in the frequent snoring group were the highest, followed by the occasional snoring (16.2% and 9.9% respectively) and the non-snoring groups (13.9% and 8.8% respectively). There were significant differences in the incidence of both attention deficit (x2=20.592, p<0.01) and hyperactivity-impulsivity (x2=9.067, p<0.05) between groups.</p><p><b>CONCLUSIONS</b>There is a high incidence of snoring in school age children from Changsha City. Snoring is correlated to attention deficit and hyperactivity-impulsivity. It is essential to pay attention to the mental growth and behavioral problems in children with sleep snoring.</p>

Relationship between impulsivity and sleep disorders in children aged 6 to 12 years / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the relationship between impulsivity and sleep disorders in children.</p><p><b>METHODS</b>A total of 1 736 children at ages of 6 to 12 years were randomly sampled from five districts of Changsha. Their parents completed the questionnaires about children's sleep conditions and behaviors (using Barratt Impulsiveness Scale 11th version).</p><p><b>RESULTS</b>Five hundred and fifty-four children (31.9%) had sleep disorders. The incidence of sleep disorders in boys was significantly higher than that in girls (35.4% vs 28.3%; P<0.01). The scores of attentional, motor, and non-planning impulsiveness factors as well as the total score of Barratt Impulsiveness Scale in children with sleep disorders were significantly higher than those in children without (P<0.01). The incidence of daytime sleepiness (35.9%) in children with sleep disorders was significantly higher than that in children without (24.7%; P<0.01). The scores of attentional, motor, and non-planning impulsiveness factors increased with the grade of sleep disorders, and reached a peak at the fifth grade. The children with frequent sleep snoring showed higher scores of above three impulsiveness factors than children without sleep snoring or having rare snoring (P<0.01).</p><p><b>CONCLUSIONS</b>Sleep disorders are associated with impulsivity in children. It is thus essential to pay close attentions to children's sleep for children with relatively high impulsiveness.</p>

Epidemiological investigation of sleep disorders for children at ages of 2-12 years in Changsha City / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the sleep time and the prevalence of sleep disorders in children at ages of 2-12 years in Changsha City.</p><p><b>METHODS</b>A total of 3756 children at ages of 2-12 years were randomly sampled from five districts of Changsha City from June 2006 to April 2007. A questionnaire survey was performed on their parents.</p><p><b>RESULTS</b>The average daily sleep time in the subjects was 10.60 hrs. The average daily sleep time among different age groups (1 year as a group separation) was different. It was 12.26, 11.57, 11.33, 11.26, 10.95, 10.64, 10.62, 10.45, 10.28, 9.83 and 9.61 hrs respectively in the 11 age groups of 2 to 12 years of age. The prevalence of sleep disorders in children at ages of 2-12 years was 40.9%, including frequent sleep snoring (8.2%), choke/gargling (1.5%), sleep apnea (0.8 %), sleep inquietude (7.6%), mouth breathing (4.9%), hyperhidrosis (22.6%), limbs spasm (3.2 %), sleep teeth grinding (9.5 %), sleep talking (5.5 %), sleep walking (0.9 %), nocturnal enuresis (2.5%), waking up by choke (1.9%), remaining wakefulness in the night due to too much daytime sleep time (1.5%), going to sleep too early (2.1%), night awakenings (1.6%), and screeching or crying during sleep (1.8%). The prevalence of different sleep disorders was different in children between boys and girls and among different age groups.</p><p><b>CONCLUSIONS</b>The average sleep time in children at ages of 2-5 years is less than the reference value recommended by the domestic child health care textbook. There is a higher prevalence rate of sleep disorders in children at ages of 2-12 years in Changsha City than the reported data in other cities.</p>