ABSTRACT
A 24-year female with abdominal pain and fever for 4 days was admitted. The blood culture showed Leuconostoc growth, and sputum culture showed positive Acinetobacterbaumannii. The diagnosis Leuconostoclactis bacteremia following small intestinal perforation was confirmed; surgical treatment was performed and the infection was controlled by piperacillin sodium and tazobactam combined with tegacycline. Wanfang database, CNKI, PubMed and Embase database up to September 2020 were searched with the keywords of " Leuconostoc lactis" "infection" "bacteraemia" for relevant literature. A total of 32 cases were reported in the literature, of whom 13 (39.4%) were infants, 17 (51.5%) had catheter-related bloodstream infection, and one healthy adult male had bacteremia through gastrointestinal perforation. In 20 patients treated with penicillins-based antibiotics, 18 were cured with an effective rate of 90.0%. The results suggest that Leuconostoc infection is likely to occur in the infants, but adults can still get community-acquired Leuconostoc infection. Most β-lactams are susceptible to Leuconostoc, but some exhibit resistance, so it is recommended to select antimicrobial agents based on drug susceptibility.
ABSTRACT
OBJECTIVE：To systematicall y review the pharmacoeconomics of anticoagulants for the prevention and therapy of venous thromboembolism （VTE）in cancer patients. METHODS ：Retrieved from PubMed ，Embase，Cochrane library ，CNKI， Wanfang database ，VIP，SinoMed，The NHS Economic Evaluation Database ，The Healthy Technology Assessment Database and EconLit，supplemented by manual retrieval ，the economic evaluation studies on the prevention and therapy of VTE in cancer patients with different anticoagulants were collected. The retrieval time was from the inception to Nov. 12th，2020. After screening and extracting ，the Consolidated Health Economic Evaluation Reporting Standards （CHEERS）was used to evaluate the quality of the included literatures. The basic characteristics of the included literatures were summarized by descriptive methods ，and the economic results were summarized according to medication purpose and different intervention grouping. RESULTS ：A total of 15 literatures were included. Three literatures were of excellent quality ；ten were of good quality ；and the other two were of moderate quality. Included studies were widely conducted in countries of different economic levels ，including China （1 piece），the United States（7 pieces），Canada（3 pieces），France（2 pieces），the Netherlands （1 piece），Brazil（1 piece）and Austria （1 piece）. For preventing VTE in cancer patients ，the economic evaluation results of warfarin and low-molecular-weight heparin （LMWH）needed to be updated. Novel oral anticoagulants （NOACs）for the prevention of VTE were less cost-effective among cancer patients with medium- and high-risk venous thrombosis in China than in the United States ，but the economic advantage increased among the high-risk patients. Compared to enoxaparin ，aspirin was absolutely dominant to preventing VTE in patients with myeloma. For the treatment of VTE in cancer patients ，LMWH was not cost-effective ，compared to warfarin in the United States ；but it was cost-effective in Canada and some countries of Northern Europe. Compared with LMWH ，NOACs could save total cost ，but the incremental utility in the United States and Brazil were opposite. Sensitivity analysis showed that economic results were sensitive to drug prices ，the baseline rate of thrombosis risk ，and the risk of adverse events （thrombosis recurrence ，major bleeding and death ） of different interventions ，the first two of which could reverse the conclusions. CONCLUSIONS ：For the prevention of VTE in cancer patients ，compared with no intervention or placebo ，the economic advantages of NOACs were different in different countries or for patients with different thrombosis risk ；the economics of warfarin and LMWH were not yet clear. Aspirin had obvious economic advantages compared with enoxaparin. For the treatment of VTE in cancer patients ，LMWH had different economic advantages compared with warfarin in different countries ；NOACs could save costs compared with LMWH. Economic strategies are greatly affected by the risk of diseases ，medical systems ，drug price ，patient preferences and values ，economic levels ，cost-utility threshold standards in different countries. Therefore ，the final economic strategies need to be based on the contexts of different countries.
ABSTRACT
Salvianolic acid A (Sal A) is one of the most effective compounds isolated from the root of Salvia miltiorrhiza. Up to now, several studies regarding the pharmacokinetic profiles of Sal A have been reported, however there is no such study reported in monkeys, the species which is more similar to human. The aim of this study is to develop a LC-MS method for the determination of Sal A in monkey plasma and apply it to the pharmacokinetic studies of monkeys. After single intravenous administration of Sal A, the plasma concentration-time curves were observed and the main pharmacokinetic parameters were calculated. The plasma concentration at 2 min (C2 (min)) values were (28.343 ± 6.426), (45.679 ± 12.301) and (113.293 ± 24.360) mg x L(-1) for Rhesus monkeys treated with Sal A at 2.5, 5 and 10 mg x kg(-1). The area under the concentration-time curve (AUC(0-∞)) values were (3.316 ± 0.871), (5.754 ± 2.150) and (13.761 ± 2.825) μg x L(-1) x h, respectively. Furthermore, this method was improved and applied to the simultaneous determination of Sal A, Sal B and Sal C, which provided useful information for preclinical studies and clinical trials of Sal A, Sal B and Sal C.
ABSTRACT
A sensitive, specific and rapid LC-MS method was developed and validated for the determination of salvianolic acid D (SalD) in rat plasma. This method used a single quadrupole mass spectrometer with an electrospray ionization (ESI) source. A single ion monitoring scanning (SIM) mode was employed. It showed good linearity over the concentration range from 3.3 to 666.7 ng/mL for the determination of SalD. The R.S.D.% of intra-day and inter-day precision values were no more than 7.69%, and the accuracy was within 91%-104% at all quality control levels. This LC-MS method was applied to the pharmacokinetic study of SalD in rats. A two-compartmental model analysis was employed. The plasma concentrations at 2 min (C 2min) were 5756.06±719.61, 11,073.01±1783.46 and 21,077.58±5581.97 μg/L for 0.25, 0.5 and 1 mg/kg intravenous injection, respectively. The peak plasma concentration (C max) was 333.08±61.21 μg/L for 4 mg/kg oral administration. The area under curve (AUC0-t ) was 14,384.379±8443.184, 22,813.369±11,860.823, 46,406.122±27,592.645 and 8201.740±4711.961 μg/L·h for intravenous injection (0.25, 0.5 and 1 mg/kg) and oral administration (4 mg/kg), respectively. The bioavailability of SalD was calculated to be 4.159%±0.517%.