Clinical characteristics and change trend of patients with Crohn′s disease at different onset times of perianal lesions / 中华消化杂志

Objective:To investigate the clinical characteristics and change trend of patients with perianal lesions before or after Crohn′s disease (CD) diagnosed.Methods:From January 2008 to September 2018, at The Tenth People′s Hospital Affiliated to Tongji University, the clinical data of 747 hospitalized CD patients were retrospectively collected, 293 patients were PCD patients. The clinical characteristics of PCD patients before or after CD diagnosed were analyzed and the change trend was followed. T test, Mann-Whitney U test, and Chi-square test were performed for statistical analysis. Multivariate logistic regression analysis was used to analyze factors associated with perianal lesions onset time. Spearman correlation analysis was used to analyze the change trend of clinical characteristics. Results:Before CD diagnosis, 86.3% (253/293) PCD patients had perianal lesions. The median follow-up time (range) was 72 months (36 to 108 months). Compared with the patients presented with perianal lesions after CD diagnosis, the onset age of patients with perianal lesions before CD diagnosis was younger ((36.0±12.6) years vs. (24.2±10.2) years), and the rates of male (62.5%, 25/40 vs. 77.9%, 197/253), non-structuring and non-penetrating type (32.5%, 13/40 vs. 56.9%, 144/253) and perianal surgery (55.0%, 22/40 vs.76.7%, 194/253) were high, but low rate of abdominal surgery (37.5%, 15/40 vs. 13.0%, 33/253), and the differences were statistically significant ( t=2.630, χ2=4.442, 8.379, 8.379 and 15.081; all P<0.05). The results of logistic multivariate analysis showed that before CD diagnosis, non-structuring and non-penetrating type was more common than structuring type (odds ratio ( OR)=0.447, 95% confidence interval ( CI) 0.207 to 0.962, P=0.039) and penetrating type ( OR=0.264, 95% CI 0.089 to 0.780, P=0.016). The short disease duration of CD ( OR=0.981, 95% CI 0.968 to 0.995, P=0.008), structuring type ( OR=2.239, 95% CI 1.040 to 4.822, P=0.039) and penetrating type ( OR=3.788, 95% CI 1.281 to 11.198, P=0.016) were the risk factors of perianal lesions after CD diagnosed. The number of PCD patients ( r=0.964, P<0.01) and the proportion of biological agents ( r=0.879, P<0.01) increased with years, while PCD duration ( r=-0.828, P<0.01) and the rate of abdominal surgery significantly decreased with years ( r=-0.882, P<0.01). The proportion of biological agents was negatively correlated with the rate of abdominal surgery ( r=-0.770, P=0.006). Conclusions:The perianal lesions should be closely monitored in adult CD patients with short disease duration, structuring type and penetrating type for early diagnosis and treatment. Biological agents can improve the clinical outcomes of PCD.

Analysis of invalid detections in nucleic acid detection systems / 中国输血杂志

Objective To analyze the reasons of invalid detections occurred in using three kinds of nucleic acid detection systems in our laboratory since 2016.Methods Analyze the numbers and types of invalid detections,for Roche Cobas S201 system from January to December 2016,Procleix Tigris system from January to September 2016,and Procleix Panther system from September 2016 to March 2017,respectively.Results The invalidation rates of Cobas s201,Tigris,and Panther systems were 0.90％ (402/44 838),4.01％ (2 960/73 835),and 1.34％ (1 093/81 741),respectively,and there were statistically significant differences between the three detection systems (P＜0.05).Except for the differences between Roche Cobas s201 and Panther 1404,there were statistically significant differences between instruments (P＜0.05).Failure of instruments,invalid detection of reagent calibrators,fault operation and sample quality are the causes of invalid detection.Conelusion The main reason of invalidation is instrument failure and reagent calibrator failmre.Invalid detections of nucleic acid screening is related on different detection systems.

Optimization of initial antibacterial drug regimens for treating common staphylococcal infection in ICU / 重庆医学

Objective To optimize the antibacterial drug regimen in ICU common staphylococcal infection.Methods The pharmacokinetic and pharmacodynamic parameters of antibacterial drugs were collected in combination with the hospital ICU anti-microbial drug resistance monitoring reports from the national antimicrobial resistance investigation net (Mohnarin)of the Ministry of Health and the performance standards for antimicrobial susceptibility testing (2013)issued by the clinical and laboratory stand-ards institute (CLSI),the minimum inhibitory concentration (MIC)of staphylococci was set by using the discrete uniform distribu-tion method and 16 kinds of administration regimens with 6 antimicrobial agents were worked out.The best initially antimicrobial regimen was optimized by using the pharmacokinetic and pharmacodynamic models and Monte Carlo simulations of cumulative frac-tion of response (CFR)from 5 000 patients.Results The alternative initially drug regimens to the infectious bacteria were:linezolid 0.40 g twice daily and vancomycin 0.75 g twice daily for staphylococcus aureus;amikacin 0.60 g once daily and linezolid 0.40 g twice daily,and vancomycin 0.75 g twice daily for hemolytic staphylococci and staphylococcus epidermidis;linezolid 0.40 g twice daily and vancomycin 0.75 g twice daily for methicillin-resistant Staphylococcus aureus;ampicillin/sulbactam 1.50 g 4 times daily, cefuroxime 0.75 g 4 times daily,amikacin 0.60 g once daily,moxifloxacin 0.40 g once daily for methicillin-sensitive staphylococcus aureus.Conclusion In the Staphylococcus aureus infection occurred in ICU,if which being methicillin-sensitive could be deter-mined,ampicillin/sulbactam,cefuroxime,amikacin and moxifloxacin could be selected for treatment,and linezolid or vancomycin could be selected for treating possible methicillin-resistant Staphylococcus aureus infection or undetermined whether being methicil-lin-resistant Staphylococcus aureus infection.

Drug delivery of sinomenine hydrochloride floating and pulsatile release tablet / 中成药

AIM : To prepare a phase-specific drug delivery system withfloating and pulsatile release of sinome-nine hydrochloride and evaluate in vitro drug release behavior. METHODS: The floating and pulsatile-release of coat-core tablets were prepared by press-coated technics. The effects of factors influencing release characteristic of the drug were investigated by dissolution test, and to elucidate the mechanism of drug releaseof the tablets with erosion and water-uptake test. RESULTS: The tablets had typical floating and pulsatile release properties with a lag time rapid release. The lag-time was shortened with the increase of expansion ratio of tablet core and rotation speed of stirrer. The lag-time was prolonged with the increase of pH and ionic strength of dissolution media.CONCLUSION: The tablet could float and rapidly release drug at the predetermined time.

Preparation of gastric retenting and chronopharmacologic drug delivery tablets of sinomenine hydrochloride / 中国中药杂志

<p><b>OBJECTIVE</b>To prepare the gastric retenting and chronopharmacologic drug delivery tablets containing sinomenine hydrochloride as a model drug, evaluate the effects of the coating layers formulation and technics on drug release behavior, and to elucidate the mechanism of drug release based on obtained results.</p><p><b>METHOD</b>The gastric retenting and chronopharmacologic drug delivery tablets were prepared by press-coated technics. The types of disintegrants were chosen according to the expanding rate and the lag-time. The effects of formulation and technics of coating layer on the release characteristic of the drug were investigated by dissolution testing. The mechanism of drug release was proved by erosion test.</p><p><b>RESULT</b>The tablets had typical chronopharmacologic drug delivery properties with a lag time followed by a rapid release phase. CMS-Na was selected as the disintegrant. The lag-time was prolonged with the increase of the ratio of HPMC/carrrageenan and the amount of matrix material in coating layer. The compressing pressure and preparation method of coat material had minor influence on the lag-time of the tablets. Coating layer erosion and tablet core swelling were involved in the mechanism of drug release.</p><p><b>CONCLUSION</b>The tablets had typical chronopharmacologic drug delivery properties. A suitable lag-time can be achieved by adjusting formulation of coating layer to meet the requirement of chronotherapy.</p>

The molecular genetics basis for ABw07 phenotype of ABO subtype / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To analyze the molecular genetic basis for a case of ABw07 phenotype of ABO subtype.</p><p><b>METHODS</b>The ABO group antigens on red blood cells of the proband were identified by monoclonal antibodies and the ABO antibody in serum was detected by the standard A, B and O cells. The exons 6 and 7 of the ABO gene was amplified by PCR and the PCR product was sequenced directly after enzyme digestion. The amplified product was also cloned by TOPO TA cloning sequencing kit to split the two alleles apart, chosen colonies were sequenced bidirectionally. The samples of the parents and one sister of the proband were collected, then the blood group serological test and sequence analysis for exon 6 to 7 of ABO gene were performed.</p><p><b>RESULTS</b>Both A and B antigen were detected on red blood cells of the proband and there was anti-B antibody in the serum. There was no 261G deletion. And the 297A/G, 467C/T, 526C/G, 657C/T, 703G/A, 796C/A, 803G/C, 930G/A, 1055G/A and 1096A/G loci were heterozygotes by direct DNA sequencing, which can be assigned for A102Bw07 genotype. After cloning and sequencing, two alleles of A102 and Bw07 were obtained. The Bw07 has one nucleotide change of G to A at nucleotide 1055 compared with B101, which results in an amino acid change from Arg to Gln at nucleotide 352. The Bw07 in the proband was inherited from his mother, and the serological characteristic of the ABO blood group and the sequence of exons 6 and 7 of the mother were the same as that of the proband.</p><p><b>CONCLUSION</b>The G to A at nucleotide 1055 of alpha -1, 3 galactosyltransferase gene (B gene) can result in BW7 phenotype, with anti-B antibody in serum.</p>

Drug delivery of sinomenine hydrochloride floating and pulsatile release tablet / 中成药

AIM: To prepare a phase-specific drug delivery system with floating and pulsatile release of sinomenine hydrochloride and evaluate in vitro drug release behavior. METHODS: The floating and pulsatile-release of coat-core tablets were prepared by press-coated technics.The effects of factors influencing release characteristic of the drug were investigated by dissolution test,and to elucidate the mechanism of drug release of the tablets with erosion and water-uptake test. RESULTS: The tablets had typical floating and pulsatile release properties with a lag time rapid release.The lag-time was shortened with the increase of expansion ratio of tablet core and rotation speed of stirrer.The lag-time was prolonged with the increase of pH and ionic strength of dissolution media. CONCLUSION: The tablet could float and rapidly release drug at the predetermined time.