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Pulmonary Nocardiosis is a rare bacterial infection of lungs, caused by a filamentous bacterium. Immunocompromised people are known to be at danger, but there are other new emerging risk factors to consider. The presentation and clinical course in such patients differ from the previous. Here the present case is aimed to underline the presentation and diagnosis in non-risk individual.
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Objective:To summarize the clinical features and treatment of pneumocystis jirovecii pneumonia(PCP) in children with non-human immunodeficiency virus(HIV) infection.Methods:A retrospective study was performed on seven cases of severe PCP children with non-HIV infection who were admitted to PICU of The University of Hong Kong-Shenzhen Hospital and PICU of Xianyang Rainbow Hospital from May 1, 2015 to May 1, 2021.The risk factors, clinical manifestations, laboratory results, pulmonary radiological features, treatment and outcomes were observed.Results:Seven children with PCP, including four males and three females, aged from 13 months to 85 months[(42.4±26.8) months], were all associated with underlying diseases, and most of which was hematological malignancies.Six children had a history of using TMP-SMX for PCP prevention, but four of them stopped by themselves and infected PCP in 2 to 4 weeks.All children had hypoxic respiratory failure, whose OI was 30.6±3.4, and presented with fever, dry cough, progressive dyspnea but no lung rales in the early stage.LDH[(745.7±317.0) U/L] and β-D-glucan[(513.8±225.0) pg/mL] increased in all patients.Chest CT showed diffused interstitial changes in bilateral lung fields associated with multiple exudative lesions.Among the anti-Pneumocystis Jirovecii treatment regimens, all cases began the treatment in the first three days during the admission, five cases were treated with intravenous TMP-SMX, and two cases were treated with oral TMP-SMX + caspofungin, with a course of 21 days.All children were also treated with glucocorticoid at the same time.Three days after the treatment of PCP, two children were worsened and one of them died, while another one started to recover on the 6th day of the regimen.The remaining five cases began to show clinical improvement after 3~7 days of PCP treatment.Finally six children were cured and one was died.Conclusion:PCP infection of children without HIV has high risk of destruction in immune system.TMP-SMX can prevent PCP effectively.In the severe PCP cases, early commencement of intravenous TMP-SMX can reduce the mortality rate.In the absence of intravenous TMP-SMX, oral TMP-SMX can be used with caspofungin.
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Objective To investigate the preventive effect of highly effective antiretroviral therapy (HARRT) combined with SMZ-TMP on opportunistic infection (OIs) in patients with HIV/AIDS. Methods The 6-month follow-up data of 170 AIDS patients in the Department of Infectious Diseases of Nantong Third People's Hospital were analyzed retrospectively. All patients received HARRT. According to whether SMZ-TMP was used for OIs preventive treatment, the patients were divided into a prevention group (n=47) and a non-prevention group (n=123). The demographic data such as gender, age, occupation and education level of the two groups were collected. The incidence of OIs in the 12-month follow-up period of the two groups was analyzed and compared, and the single factor unconditional logistic regression analysis and multi factor unconditional logistic regression analysis were carried out for AIDS patients taking SMZ-TMP. Results The proportion of prophylactic use of SMZ-TMP in 170 AIDS patients was only 27.65%, and the incidence of OIs in the prevention group was 31.91%, which was significantly lower than that in the non-prevention group (57.72%) (χ2=9.062, P2=7.419, P2=4.473, 4.322, 4.350, 3.982, 5.656, P<0.05). Univariate and multivariate unconditional logistic regression analysis showed that the benefits of SMZ-TMP, doctors' detailed recommendation of SMZ-TMP and higher education level were all influencing factors (95% CI: 135.79-3748.36, 107.43-2954.67, 1.873-25.94). Conclusion Prophylactic use of SMZ-TMP significantly reduced the incidence of AIDS related OIs, but the proportion of SMZ-TMP use was relatively low. It is necessary to take relevant measures according to the influencing factors of taking SMZ-TMP to improve the use rate of SMZ-TMP in AIDS patients.
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Introduction: Psoriasis is a group of chronic, inflammatoryand proliferative condition of skin, associated withsystemic manifestations in many organ systems. The mostcharacteristic lesions consist of erythematous, scaly, sharplydemarcated indurated plaques, present particularly over theextensor surfaces and scalp). Phototherapy is one of the mostefficacious treatment options for psoriasis. New, emergingstudies are beginning to define the biological mechanismsby which phototherapy improves psoriasis- with NBUVBand psoralen ultraviolet A (PUVA) as the most widely usedapplications.Material and methods: This prospective study was carriedout on 76 patients attending OPD of Rohilkhand medicalcollege and hospital in one year from November 2017 toOctober 2018. The patients were randomly divided intotwo groups;Systemic PUVA (Trimethylpsoralen+UVA) andNBUVB groups and therapy will be administered thrice perweek on non-consecutive days.Results: The initial mean PASI score was 17.43 and 17.01in group A and group B patients respectively, while posttreatment PASI score was 3.08 and 2.01 in respective groups.The average cumulative dose for 80% clearance with PUVAwas found to be 60.51 J/cm2 while with NBUVB it wasfound to be 6.76 J/cm2. Side effects were observed in 28.94%patients in group A while 5.2% patientsin group B. Amongstgroup A 18.42%, 7.8% and 2.6% patients presented witherythema, burning and vesiculations respectively while undergroup B 2.6% patients in each group presented with erythemaand burning.Conclusion: Both PUVA and NBUVB are effective for thetreatment of psoriasis vulgaris. However, NBUVB has adistinct edge over PUVA in terms of efficacy and lesser sideeffects. The advantages of NBUVB therapy over PUVAtherapy includes lack of psoralen-related side effects and lessmean cumulative dose for clearance and so, good adherence.
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Pneumocystis pneumonia ( PCP) is a disease affecting immunocompromised patients.PCP among these patients is associated with significant morbidity and mortality.In this paper, the prevention crowd of prevention, the effective of prevention and means of prevention are reviewed.
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Aim To develop a HPLC method for the determination of the concentration of 1,8-TMP rhein in rat plasma and study the pharmacokinetics of 1,8-TMP rhein in rat plasma after single dose i. v. administration of 1,8-TMP rhein (2, 4, 8 mg·kg - 1 ). Methods Emodin was used as an internal standard. Plasma sam-ples were extracted with methanol and analyzed by HPLC. The mobile phase was methanol - 0. 1% for-mic acid water (78 ∶ 22, V/ V), with a flow rate of 1. 0 mL·min - 1 and UV 275 nm as the detection wave-length. The plasma concentration of 1,8-TMP rhein in rats was determined by HPLC after single-dose intrave-nous injection in rats with 2,4 and 8 mg·kg - 1 of 1,8-TMP rhein, and the pharmacokinetic parameters were caclulated by DAS 2. 1. Results The result of cali-bration curve was linear over the range of 0. 05 ~ 10. 00 mg·L - 1 (r = 0. 996 2). The lower limit of quantifica-tion was 0. 05 mg · L - 1 . The intra-day and inter-day precision (RSD% ) were both lower than 6% , and the extraction recoveries were higher than 88% , respec-tively. The validated method was successfully applied to a pharmacokinetic study after i. v. administration of 1,8-TMP rhein in rats with a dose of 2,4 and 8 mg· kg - 1 . The T1 / 2 was (68. 35 ± 1. 36), (69. 32 ± 2. 1) and (69. 32 ± 2. 03) min, respectively. The AUC0 - t was ( 101. 03 ± 24. 90 ), ( 144. 79 ± 3. 29 ) and (231. 92 ± 19. 30 ) min · mg · L - 1 , respectively. Conclusion A simple and specific HPLC method for the analysis of 1,8-TMP rhein is successfully developed and applied to a pharmacokinetic study in rat plasma.
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OBJECTIVE@#To explore the protective effect and mechanism of Tetramethy1Pyrazine (TMP) on the pancreas function of acute pancreatitis rats.@*METHODS@#A total of 75 SD rats were randomly divided into three groups (A, B, C) with 25 rats in each group. Group A served as sham operation group. In the groups B and C, AP model was prepared as by injecting taurocholic acid sodium. Group B was model group. After modeling, rats were administrated by intraperitoneal injection of normal saline. Group C was TMP treatment group, which was administrated by intraperitoneal injection of 0.6% TMP after modeling. The rat blood specimens in each group were collected with 1 mL/100 g solution after modeling of 2, 6, 12 and 24 h. Levels of amylase (AMS), blood urea nitrogen (BUN), creatinine (CR), TNF-α and IL-6 were detected, and 5 rats were sacrificed. Histopathological examination was performed in he pancreatic tissue specimens of each group to observe pancreatic tissue damage.@*RESULTS@#After modeling in each time point, AMS, BUN, CR, TNF-α and IL-6 in groups B and C were significantly higher than that of in group A (P < 0.05). After modeling of 2 h, AMS, BUN and CR in group B increased significantly and reached the peak value at 6 h. After modeling of 12 h, serum level of TNF-α and IL-6 were significantly lower than that of in control group, while after 24 h of modeling, serum level of AMS, BUN, CR, TNF-α and IL-6 were significantly lower than that of in control group (P < 0.05). The histological observation showed that pancreatic tissue in rats of group A was normal without damage lesions. Massive bleeding, necrosis and serious injury were visible in pancreatic tissue of group B. The rat pancreatic tissue was bleeding in group C with small pieces of necrotic lesions. The degree of inflammatory cell infiltration was lower than group B, and the degree of injury was significantly lower than group B.@*CONCLUSIONS@#TMP can significantly decrease the serum level of TNF-α and IL-6 in AP rats, inhibits inflammatory response of AP, and has significant protective effect on pancreatic tissue and function in AP rats.
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Objective To observe the effect of Salvia TMP on the therapeutic, blood lipids, inflammatory cytokines and cardiac function in treatment of patients with unstable angina pectoris ( UAP) .Methods Eighty cases of patients with UAP treated in the hospital from May 2013 to May 2015 were selected and randomly divided into control group and observation group ,40 patients in each group.The control group received routine medical treatment,observation group supplemented Salvia TMP injection on the basis of conventional therapy.After two weeks for a course of treatment, the difference between the two groups of patients on therapeutic,blood lipid,inflammatory cytokines and cardiac function related indicators were compared. Results Compared with control group post-treatment, the symptom control and ECG effective rate of observation group were significantly higher (χ2 =8.658,P=0.026), the levels of triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C),TC/high-density lipoprotein cholesterol(HDL-C) and LDL-C /HDL-C in observation group were lower(P<0.05),the level of HDL-C was higher(P<0.05), the levels of interleukin-6(IL-6), high-sensitivity C-reactive protein (hs-CRP) and tumor necrosis factor-α(TNF-α) in observation group were significantly lower (P<0.05), the levels of stroke volume (SV), left ventricular systolic pressure (LVSP) and left ventricular ejection fraction (LVEF)were higher(P<0.05), the levels of N-terminal pro-brain natriurelic peptide (NT-proBNP) and cardiac troponin I (cTnI) were lower (P<0.05).Conclusion Salvia TMP injection could effectively regulate blood lipids in patients with UAP,control inflammation cytokines and promote the recovery of cardiac function , which has a good role in improving the symptoms of angina patients,promoting the recovery of disease.
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Objective:To explore the protective effect and mechanism of Tetramethy1Pyrazine (TMP) on the pancreas function of acute pancreatitis rats. Methods:A total of 75 SD rats were randomly divided into three groups (A, B, C) with 25 rats in each group. Group A served as sham operation group. In the groups B and C, AP model was prepared as by injecting taurocholic acid sodium. Group B was model group. After modeling, rats were administrated by intraperitoneal injection of normal saline. Group C was TMP treatment group, which was administrated by intraperitoneal injection of 0.6%TMP after modeling. The rat blood specimens in each group were collected with 1 mL/100 g solution after modeling of 2, 6, 12 and 24 h. Levels of amylase (AMS), blood urea nitrogen (BUN), creatinine (CR), TNF-α and IL-6 were detected, and 5 rats were sacrificed. Histopathological examination was performed in he pancreatic tissue specimens of each group to observe pancreatic tissue damage. Results:After modeling in each time point, AMS, BUN, CR, TNF-α and IL-6 in groups B and C were significantly higher than that of in group A (P<0.05). After modeling of 2 h, AMS, BUN and CR in group B increased significantly and reached the peak value at 6 h. After modeling of 12 h, serum level of TNF-α and IL-6 were significantly lower than that of in control group, while after 24 h of modeling, serum level of AMS, BUN, CR, TNF-α and IL-6 were significantly lower than that of in control group (P<0.05). The histological observation showed that pancreatic tissue in rats of group A was normal without damage lesions. Massive bleeding, necrosis and serious injury were visible in pancreatic tissue of group B. The rat pancreatic tissue was bleeding in group C with small pieces of necrotic lesions. The degree of inflammatory cell infiltration was lower than group B, and the degree of injury was significantly lower than group B. Conclusions:TMP can significantly decrease the serum level of TNF-α and IL-6 in AP rats, inhibits inflammatory response of AP, and has significant protective effect on pancreatic tissue and function in AP rats.
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Objective: To explore the protective effect and mechanism of Tetramethy1Pyrazine (TMP) on the pancreas function of acute pancreatitis rats. Methods: A total of 75 SD rats were randomly divided into three groups (A, B, C) with 25 rats in each group. Group A served as sham operation group. In the groups B and C, AP model was prepared as by injecting taurocholic acid sodium. Group B was model group. After modeling, rats were administrated by intraperitoneal injection of normal saline. Group C was TMP treatment group, which was administrated by intraperitoneal injection of 0.6% TMP after modeling. The rat blood specimens in each group were collected with 1mL/100g solution after modeling of 2, 6, 12 and 24h. Levels of amylase (AMS), blood urea nitrogen (BUN), creatinine (CR), TNF-α and IL-6 were detected, and 5 rats were sacrificed. Histopathological examination was performed in he pancreatic tissue specimens of each group to observe pancreatic tissue damage. Results: After modeling in each time point, AMS, BUN, CR, TNF-α and IL-6 in groups B and C were significantly higher than that of in group A (P<0.05). After modeling of 2h, AMS, BUN and CR in group B increased significantly and reached the peak value at 6h. After modeling of 12h, serum level of TNF-α and IL-6 were significantly lower than that of in control group, while after 24h of modeling, serum level of AMS, BUN, CR, TNF-α and IL-6 were significantly lower than that of in control group (P<0.05). The histological observation showed that pancreatic tissue in rats of group A was normal without damage lesions. Massive bleeding, necrosis and serious injury were visible in pancreatic tissue of group B. The rat pancreatic tissue was bleeding in group C with small pieces of necrotic lesions. The degree of inflammatory cell infiltration was lower than group B, and the degree of injury was significantly lower than group B. Conclusions: TMP can significantly decrease the serum level of TNF-α and IL-6 in AP rats, inhibits inflammatory response of AP, and has significant protective effect on pancreatic tissue and function in AP rats.
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Objective To explore the effects of ligustrazine (TMP) on acute drug -induced free radical for-mation in guinea pig cochlear ,and to explore possible mechanisms of TMP on gentamycin(GM)-induced ototoxici-ty .Methods Sixty guinea pigs were randomly divided into four groups ,control group ,GM group ,TMP group and TMP+GM group .GM group were injected with GM 120 mg/kg per day .TMP group were injected with TMP 40 mg/kg per day .TMP+GM group were injected with GM and TMP at the same dosage .Control group were injected with normal saline .All groups were injected for consecutive 10 days .Before injection and one day after the last injec-tion ,ABR thresholds were measured .Biochemical assays of Superoxide Dismutase (SOD1 ,SOD2 ,T -SOD) activity and ma1ondia1dehyde(MDA) content in guinea pig cochlear were detected by TBA .Results After the injection , ABR thresholds in GM group were significantly increased compared with those of in control group (P0 .05) .SOD activity was significantly decreased while MDA content was increased in cochlear tissues after GM injection (P<0 .05) .Co -treatment with TMP evidently enhanced SOD activity and decreased MDA content (P<0 .05) .Conclusion TMP may enhance SOD activity and prevent lipid per-oxidation ,thus alleviate GM ototoxicity ,and improve auditory function .
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Objective Class 1 integrase(intI 1),qacE△1-sul1 and sul2 genes were detected in trimethoprim-sulfamethoxazole resistant Stenotrophomonas maltophilia by PCR to assess the relationship between the antibiotic resistance mechanism for trimethoprim-sulfamethoxazole (TMP-SMZ)and these genes distribution.Methods S.maltophilia isolates were collected from patients treated in Affilitated hospital of Nanjing University of TCM during January to May in 2013,DNA was ab-stracted by boiling method and genes were detected by polymerase chain reaction.Results intI 1 genes were observed posi-tive in 25 of 28 strains resistant for TMP-SMZ,qacE△1-sul1 genes were positive in 21 while sul2 genes positive in 15,the positive rates of intI 1,qacE△1-sul1 and sul2 genes were 89.29%,75% and 53.57%;in 18 trimethoprim-sulfamethoxazole sensitive strains,5 were intI 1 positive,4 were qacE△1-sul1 positive while sul2 were none,the positive rates of intI1 and qacE△1-sul1 were 27.78% and 22.22%.Conclusion Most of stenotrophomonas maltophilia resisted trimethoprim-sulfa-methoxazole had intI 1,qacEΔ1-sul 1 and sul2 genes.
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Many of the opportunistic infections that occur at this late stage can be fatal and since that Pneumocystis carinii pneumonia (PCP) is a leading opportunistic infection found among immunocompromised (CD4 cell < 200) patients worldwide. DHFR is responsible for the growth and maturation of sporozoites stage (life cycle) in Pneumocystis as reported. Currently, 13 million chemical compounds are available for virtual screening in ZINC database. The biological information of four known drug molecules like TMP/SMX, Dapsone, Atovaquone and Pentamidine were collected from the PubChem compound database. Q-Site Finder online tool was used to determine the active site of DHFR in P. jiroveci. LogP values of chemical compounds were identified with the Atom-additive method. Since, existing drugs are synthetic chemicals that give more side effects in Pneumocystis affected patients. Polar surface area value of oxamide (86.18) was predicted to be in the ranges of existing drug values. Pentamidine was proved to be a more efficient ligand based on the dock score of -26.3398 still could not be considered as the natural compound oxamide also was highly comparable with the value of -20.3173. The binding affinity of the selected molecule was analyzed through Pose View and LigPlot.
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Tetramethylpyrazine(TMP)is a main active alkaloid ingredient of Traditional Chinese Medicine Ligusticum chuanqiong Hort. The article reviews the protection of TMP against pathological damage and nervous retardation disease in central nervous and peripheral nervous system and summarizes the mechanisms in basic research,clinical practice and so on.
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Objective To study the potential antidepressive-like effect of tetramethylpyrazine (TMP). Methods Forced-swimming and chronic mild stress (CMS) tests were performed to assess the antidepressant-like activity of TMP. Male Sprague-Dawley (SD) strain rats were divided into six matched groups (n= 13 or 14 in each group) based on their sucrose consumption:control, CMS, CMS + fluoxetine, and CMS + TMP groups. The rats except control were housed separately in different rooms, and the rat model of depression was established by exposing to an unpredictable sequence of stressors for 28 days; the rats in CMS + fluoxetine were exposed to CMS and received administration of FLU (2.0 mg· kg-1·d-1 ,ig) for 28 days; the rats in CMS + TMP groups were exposed to CMS and received administration of TMP (10,20,40 mg·kg-1·d-1 ,ig) , respectively, for 28 days. The rats in control group were given ordinary daily care and received ig administration of normal saline simultaneously. The body weight, food intake and fluid consumption were measured, and the behaviors were examined by open field during the duration of the stress procedure, and forced-swimming test was performed 1 day after last unpredictable stressor. Results Acute administration of TMP markedly decreased the duration of immobility during forced-swimming test((89.0 ±37.0)s vs (117.1 ±32. 1)s, P<0.05) . Chronic administration of TMP partially countered the effects of CMS on consumption of sucrose solution and locomotion and exploration behavior, and potently shortened the immobility time during forced-swimming test following CMS in rats. The results showed that long-term administration of TMP partially reversed the effects of CMS on the body weight gain,the consumption of sucrose solution,the squares crossing in open field test and the immobility time during forced-swimming test in rats ((91.9 ±31.5) vs (124.4±27.0)s,P<0.05).Conclusion TMP shows obvious antidepressant-like activity.
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Phosphorus and nitrogen are the important eutrophication nutrients. They were removed in the anaerobic/anoxic/oxic (A2/O) system through biologically. The use of pilot scale A2/O systems with immersed membranes in removing nutrients phosphorus and nitrogen were investigated over a period of 150 days. The A2/O membrane bio reactor (MBR) was operated at a flux of 17 LMH. The designed flux was increased stepwise over a period of one week. The reactor was operated with the mixed liquid suspended solids (MLSS) concentrations in the range of 7000-8000 mg l-1. The phosphorus removal was found to be in the range of 74-84%. The ammonification was completed in the aerobic zone and the ammonia concentration was almost nil. Nitrate concentration in the anoxic zone was found to be in the range of 0.3-1.6 mg l-1 indicating efficient denitrification. The nitrogen removal efficiency of the A2/O-MBR system was in the range of 68 to 75%. The chemical oxygen demand (COD) in the effluent was in the range of 8-5 mgl-1 indicating the efficiency of membrane. During the period of reactor operation transmembrane pressure (TMP) of the reactor increased slowly from 0 to 6 -cmHg over a period of 150 days.
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Objective To study the reverse roles of reverse effect of tetramethylpyrazine on the resistance to adriamycin in human ovarian carcinoma cell line A2780/ADM.Methods The drug sensitivity of A2780/ADM cells was measured by MTT assay.The intracellular concentration of ADM was determined by fluorescent spectrophotometry.The changes of cell apoptosis percentage of A2780/ADM was demonstrated by flow cytometry.Results The IC50 value of TMP in A2780/ADM cell line was significantly decreased by the non-cytotoxic dose or low-cytotoxic dose of TMP.The resistance reversing effect comparing with the IC50 value of ADM cells was respectively 2.07 folds.The intracellular ADM concentration in A2780/ADM cells was significantly elevated by TMP at the same dose and the cell apoptosis percentage was significantly increased by TMP.The expression of P-gp was reduced significantly by TMP.Conclusion TMP could reverse the resistance of human ovarian carcinoma of A2780/ADM cell line to ADM,which may be related to the increased intracellular.
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OBJECTIVE: To explore the general pattern and characteristics of adverse drug reactions (ADRs) induced by Tetramethylpyrazine(TMP) so as to provide references for clinical rational drug use. METHODS: A statistical analysis was conducted on 30 TMP-induced ADR cases reported in domestic medical journals. RESULTS: ADRs of TMP were independent of patient's sex, and which were more often seen in patients aged above 50. The ADRs could occur at any time after medication and involve multiple organs and systems. The clinical manifestations were various and manifested as allergic reaction or even allergic shock in severe cases. CONCLUSION: Doctors and pharmacists should master the pattern and characteristics of ADRs induced by TMP, and strengthen monitoring on the use of TMP to reduce the incidence of ADRs induced by TMP.
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Aim To study the effect of tetramethylpyrazine(TMP) on binding of 125I-VEGF to VEGF receptor. Methods The mice sera were collected after peritoneal injection with big-dose TMP,low-dose TMP,protamine and NS. A reversed-phase high performance liquid chromatography(RP-HPLC) method was used to determine the TMP in mice serum. The culture medium of ECV304 was treated with the mice sera in different groups. Radioligand binding assay(RBA) of receptor and Scatchard pot were performed to observe the changes of the maximum binding capacity(B_ max) and dissociation constant(K_d).Results The sera of big-dose TMP inhibited 125I-VEGF binding to its receptor, K_d=343.30?36.64 pmol?L-1,B_ max=46.26?5.85 fmol/2?10~5 cells(P0.05),but B_ max decreased(P
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0.05). It was established that both TMP and LPS had less cytotoxic property in this condition. LPS could inhibit the NOS activity (P