Real-world study of ceftazidime-avibactam in the treatment of multidrug-resistant gram-negative bacterial infections / 中国临床药理学与治疗学

AIM: To describe and evaluate the clinical characteristics, treatment management and clinical outcomes of ceftazidime-avibactam (CZA) in the treatment of patients with multidrug-resistant gram-negative bacterial (MDR-GNB) infections. METHODS: A retrospective cohort study was performed on patients hospitalized in the Affiliated Hospital of Xuzhou Medical University from September 2019 to December 2021. Adult patients who received CZA for ≥ 72 hours consecutively were eligible for inclusion. The primary outcome was clinical failure, defined as a composite of 30-day all-cause mortality, microbiological failure and / or failure to resolve or improve signs and symptoms of infection during treatment with CZA. RESULTS: A total of 198 patients with MDR-GNB infections were described and evaluated, including 132 in the carbapenem-resistant Enterobatceriaceae (CRE) cohort and 66 in the Pseudomonas spp. cohort. The main infection sites were lung infection (92.42%), abdominal infection (10.61%), and intracranial infection (10.61%), among which 63 patients (31.82%) were positive for blood culture. Clinical failure, 30-day all-cause mortality and microbiological failure occurred in 61 (30.81%), 33(16.67%) and 11(5.56%) patients, respectively. Body mass index (BMI), acute physiology and chronic health evaluation scoring system (APACHE Ⅱ) and polymicrobial infections were positively associated with clinical outcome failureadjusted OR 1.109, 95%CI 1.017, 1.209; adjusted OR 1.071, 95%CI 1.015, 1.129; adjusted OR 2.844, 95%CI 1.391, 5.814, however, initiation of CZA within 48 hours of admission was protective (adjusted OR 0.424, 95%CI 0.205, 0.879). A total of 15 patients had adverse reactions possibly related to CZA, including 2 cases of rash, 6 cases of nausea and vomiting, and 7 cases of antibiotic-related diarrhea. CONCLUSION: CZA can be used to treat infections caused by a range of MDR-GNB, including Pseudomonas spp. and CRE.

Predictive factors associated with weight response to exenatide in patients with type 2 diabetes mellitus / 中国临床药理学与治疗学

AIM: To explore which variables can predict the weight response to exenatide and to individualize specific therapies for patients with type 2 diabetes mellitus (T2DM) who need treatment with exenatide. METHODS: We performed a study among T2DM patients who were treated with exenatide twice daily for at least 12 months from January 2017 to December 2020. Data of the height, weight, body mass index (BMI) calculated, and HbA1c, fasting plasma glucose (FPG), postprandial plasma glucose (PPG), fasting serum insulin (FINS), postprandial serum insulin (PINS), blood lipids and concurrent diabetic medications at baseline, 3 months, 6 months and 12 months after exenatide initiation were collected. Patients were categorized into two cohorts based on weight loss ≥3%: responders and non-responders. The binary logistic regression analysis was used to identify the major variables of weight response to exenatide. RESULTS: The duration of diabetes in the responder group was shorter than that in patients in the non-responder group (P<0.05). For patients in the responder and non-responder groups, there was a significant decrease in weight, BMI, HbA1c, FPG, PPG, homeostasis model assessment of insulin resistance (HOMA-IR) and increase in homeostasis model assessment for beta cell function (HOMA-B) compared with the prarameters before treatment with exenatide (P<0.001). The baseline weight and baseline HbA1c were associated with weight loss after 6 months of treatment with exenatide (P<0.05). CONCLUSION: Baseline weight and HbA1c improvement were positively correlated with weight loss after 6 months of treatment with exenatide and the major predictors of weight response to exenatide.

Investigation on the utilization of parenteral nutrition preparations in 12 Hospitals of Jiangsu / 中华临床营养杂志

Objective To investigate the use of parenteral nutrition preparations in Jiangsu Province,and to provide reference for the standardized management of parenteral nutrition preparations.Methods 720 cases using parenteral nutrition preparations from January 2017 to June 2017 in the department of general surgery of 12 hospitals in Jiangsu province were selected.The rate of nutritional risk screening,the indications of parenteral nutrition,the way of infusion,the rationality and economy of the prescriptions were retrospectively evaluated.The calorie,amino acid content,non-protein calorie/nitrogen ratio,glycolipid ratio and cation concentration of the patients received total parenteral nutrition were calculated.Results The total costs of parenteral nutrition preparations of 720 cases were 1.614 1 millions,and 346 cases did not have the indications for parenteral nutrition.The results of prescription comment showed that only 16 patients were screened for nutritional risk by Nutritional Risk Screening 2002 tool at admission.544 cases were intravenous dripped with amino acid and fat emulsion from peripheral vein.In the 176 total parenteral nutrition prescriptions,there were 39 non-protein calorie/nitrogen ratio cases,15 glycolipid ratio cases,69 cation concentration cases,61 calorie cases and 32 amino acid content cases failing to comply with the recommendation of the guidelines.Only 31 total parenteral nutrition prescriptions were completely reasonable.Conclusion The costs of parenteral nutrition preparations used in hospitals of Jiangsu are high but the rate of rationality is low.Nutrition support team should be established to regulate the use of parenteral nutrition preparations and save medical resources.

Mate-analysis of risk factors of postoperative delirium in ICU patients / 现代临床护理

Objective To explore the risk factors of postoperative delirium among ICU patients. Methods Meta analysis was done by retrieving POD-relevant literature through electronic databases.The included papers by quality assessment were analyzed by Revman 5.3. Results 14 papers,10 English and 4 Chinese,were included for the analysis,involving 5,661 patients.Meta-analysis showed that the alcoholism, renal function impairment, mechanical ventilation, stroke, hypertension and diabetes, LVEF<50% and emergency operation were the risk factors of postoperative delirium(all P<0.05). Conclusions The risk factors of postoperative POD in ICU patients include alcoholism,renal function impairment,mechanical ventilation,stroke,hypertension and diabetes,LVEF<50% and emergency operation. Medical staffs should pay more attentions to the intervention into those risk factors in order to reduce the incidence rate of POD and improve the quality of clinic treatment.

Discuss on model organism and model for geoherbs' study / 中国中药杂志

The scientific essence of geoherbs bases on the attribute of matter. The phenotype of geoherbs from biological point view includes medicinal character, tissue structure, content and composition of the effective components and the therapeutic effect. The forming of geoherb is resulted from the interaction of genotype and environment. It can be expressed by the formula: phenotype = genotype + environmental modification. In order to prove this hypothesis, the authors discussed the model organism and model for geoherbs' study based on Salvia miltiorrhiza.

Protection on myocardial ischemia and reperfusion injury by Salvia miltiorrhiza hairy root in isolated Langendorff rat hearts / 中国中药杂志

<p><b>OBJECTIVE</b>Protection by Salvia miltiorrhiza hairy root on myocardial ischemia and reperfusion injury in isolated Langendorff rat hearts was observed.</p><p><b>METHOD</b>Isolated rat hearts were perfused with 14, 28, 56 mg x L(-1) for 10 min followed by a 10 min washout period before the induction of 30 min normothermic global ischemia and 60 min of reperfusion.</p><p><b>RESULT</b>Our results showed that S. miltiorrhiza hairy root reduced the incidence of reperfusion-induced VF and VT and delayed the onset time of VF and VT. The increased aortic flow and content of SOD with decreased release of LDH and MDA were found.</p><p><b>CONCLUSION</b>Our results show that S. miltiorrhiza hairy root can prevent postischmic abnormalities in reperfusion arrhythmias, aortic flow and myocardium metabolism, which was similar to actions of S. miltiorrhiza.</p>

Determination of Cytarabine and Uracil Arabinoside in Tissues of Rats by RP-HPLC / 中国药房

0.998 8).The minimum detection limit were 0.1～0.4 mg?L-1.The average recovery rates were no less than 96%(RSD≤7.19%).There were significant difference among the concentration of Ara-C and Ara-U in plasma,cerebrospinal fluid and testicular tissue.Ara-C in plasma hadn't been determined in low-dose group and medium-dose group except for Ara-U.CONCLUSIONS: The method is simple,rapid,accurate and reproducible for plasma concentration monitoring and pharmacokinetic study of Ara-C and Ara-U.

Optimization of the Extract Technology of the Total Flavonoids from Herba Epimedii by Orthogonal Experiment / 中国药房

OBJECTIVE:To optimize the extracting process of the total flavonoids from Herba Epimedii.METHODS: The extract technology of the total flavonoids from Herba Epimedii was optimized by orthogonal experiment with the yield of total flavonoids from Herba Epimedii as index and with the extraction temperature,extraction time,the ratio of solid to liquid and the concentration of ethanol as factors.RESULTS:The optimum extracting conditions for the total flavonoids from Herba Epimedii were as follows:the reflux extraction was conducted twice(1 hour/time) at 80 ℃ with 60% ethanol as solvent,and the ratio of solid to solution was 1∶10.CONCLUSION:The optimum extracting technology is simple and reasonable,and it serves as a good reference for the extracting process of the total flavonoids from Herba Epimedii.

Determination of Main Component in Ciprofloxacin Lactate Chitosan Nasal Drop by RP-HPLC / 中国药房

OBJECTIVE: To determine the content of ciprofloxacin in ciprofloxacin lactate chitosan nasal drops by RP-HPLC.METHODS: The sample was separated on XTerra RP18 chromatographic column with 0.05 moL?L-1 citric acid-acetonitrile(80∶20) as mobile phase at a flow rate of 0.8 mL?min-1.The detective wavelength was set at 277 nm;The sensitivity was 2.000 AUFS;The column temperature was maintained at 30 ℃ and the sample size was 10 ?L.RESULTS: The linear ranges of ciprofloxacin lactate was 10～200 ?g?mL-1(r=0.999 9) and its average recovery rate was 99.46%(RSD=1.13%).CONCLUSION: This method is rapid,accurate and suitable for the determination of the content of ciprofloxacin in ciprofloxacin lactate chitosan nasal drops.