Analysis of a case of pancytopenia complicated with delayed drug fever induced by vancomycin infusion in a child / 中国药房

OBJECTIVE To accurately identify the rare adverse drug reactions （ADR） of vancomycin-pancytopenia in order to promote its safe use. METHODS Through a case report of a child with suppurative hip arthritis who developed pancytopenia combined with delayed drug fever caused by intravenous infusion of vancomycin，Naranjo score method and related literature were used to summarize the association between the ADR and vancomycin and its possible mechanism， and suggestions for rational use of vancomycin in pediatric patients were put forward. RESULTS & CONCLUSIONS The association of pancytopenia combined with delayed drug fever and vancomycin in this child is “very likely”. In clinical practice， it is difficult to distinguish between pancytopenia combined with delayed drug fever from fever and hematopenia caused by aggravation of infection. Medical staff should increase their awareness of vancomycin rare ADR such as pancytopenia， and pharmacists should assist medical staff in timely screening for ADR. The initial dose of vancomycin infusion for children should start from 60 mg/（kg·d），and the blood concentration should be monitored 48 h after the first infusion and the dose should be adjusted in time to maintain the valley concentration of vancomycin at 5-15 mg/L to prevent the occurrence of ADR caused by excessive blood concentration. For children who have been using vancomycin for more than one week，the blood routine should be rechecked regularly. Once pancytopenia occurs，the drug should be stopped immediately，and symptomatic treatment should be given according to the situation.

Quality Difference Analysis of Raw and Steamed Products of Citri Reticulatae Pericarpium Based on Electronic Eye Technique and Chemical Fingerprint / 中国实验方剂学杂志

ObjectiveTo explore the quality differences between steamed products and raw products of Citri Reticulatae Pericarpium（CRP）. MethodThe color of steamed products and raw products of CRP was determined from the perspective of appearance by electronic eye technique， and the quality differences between them was objectively characterized by the luminous value（L*）， yellow-blue value（b*）， red-green value（a*） and total chromatic value（E*ab）. Based on this， ultra-high performance liquid chromatography（UPLC） was used to establish a fingerprint evaluation method with the mobile phase of acetonitrile（A）-0.1% formic acid aqueous solution（B） for gradient elution（0-5 min， 5%A； 5-30 min， 5%-20%A； 30-60 min， 20%-52%A）， detection wavelength at 270 nm， flow rate of 0.3 mL·min-1 and column temperature of 30 ℃. The quality differences between steamed products and raw products of CRP were compared from the perspective of chemical composition， and correlation analysis was used to reveal the correlation between the difference in appearance color and the difference in internal chemical composition. ResultAfter being steamed， L*， b* and E*ab of CRP showed an overall decreasing trend， indicating that the color of the steamed products darkened and deepened from yellow to blue but still tended to be yellow， while a* showed an overall increasing trend， indicating that the color of the steamed products tended to red. A total of 24 peaks were identified in the fingerprint profiles of raw products and steamed products of CRP， and 13 of the main peaks were identified. The precision， stability and repeatability studies showed that compared with the reference peak （peak 14， hesperidin）， the relative standard deviations（RSDs） of the relative peak area and relative retention time of the remaining peaks were<3.0%.The results of chemometric statistical analysis showed that there were some differences between raw products and steamed products of CRP， and 7 main differential components were identified， among which 5-hydroxymaltol（peak 1） and 5-hydroxymethylfurfural（peak 2） were the characteristic components of steamed products. The correlation analysis results showed that， in addition to the above two characteristic components， four components of peak 4， peak 10 （vicenin-2）， peak 23 （tangeretin） and peak 24 （5-demethylnobiletin） also correlated significantly with the color change （E*ab） of the samples （P<0.05， P<0.01）. ConclusionBefore and after steaming， not only the chemical composition changes， but also the color. Comparing the characteristic peaks of chemical composition difference and color difference before and after steaming of CRP， it is found that 5-hydroxymaltol， 5-hydroxymethylfurfural and peak 4 are common characteristic difference components， which can provide a reference for establishing the characteristic quality control method of steamed products， and quickly evaluating the quality difference between raw products and steamed products of CRP.

A prognostic risk assessment model for pancreatic cancer established based on immune-related lncRNAs / 国际肿瘤学杂志

Objective:To identify and screen out immune-related long non-coding RNAs (lncRNAs) in pancreatic cancer, and construct a prognostic risk assessment model to predict the prognostic factors of patients with pancreatic cancer.Methods:RNA-Seq data and corresponding clinicopathological and follow-up information of 177 pancreatic cancer patients were downloaded from The Cancer Genome Atlas (TCGA) database. The 177 pancreatic cancer samples were randomly divided into discovery cohort ( n=89) and validation cohort ( n=88) using random number table method. Immune-related lncRNAs were identified by Pearson correlation coefficient analysis. Univariate and multivariate Cox analysis were used to select prognosis-related lncRNAs and construct the risk score formula based on the data of discovery cohort. The conclusion generated from discovery cohort would be verified in the validation cohort. Results:A total of 788 immune-related lncRNAs were screened out using Pearson correlation coefficient calculation formula, and 5 lncRNAs (AC006237.1, AC025154.2, RASSF8-AS1, AL122010.1 and AC073896.3) were selected by univariate and multivariate Cox analysis to build the risk score formula based on the discovery cohort. Based on the above risk score formula, pancreatic cancer patients from the discovery cohort were divided into high-risk group ( n=44) and low-risk group ( n=45). Survival analysis indicated that the median survival time of high-risk group (1.09 years) was significantly shorter than that of low-risk group (4.11 years; χ2=26.016, P<0.001). The validation cohort was also divided into high-risk group ( n=44) and low-risk group ( n=44) based on the above risk score formula. Survival analysis showed that the median survival time of high-risk group (1.28 years) was also significantly shorter than that of low-risk group (1.90 years; χ2=4.422, P=0.035). Besides, univariate and multivariate analyses suggested that the prognostic risk assessment model could effectively predict the prognosis of patients with pancreatic cancer, and could be used as an independent prognostic prediction model ( HR=2.618, 95% CI: 1.285-5.332, P=0.008). The predictive efficiency of this model was better than that of common clinicopathological information such as age, gender and tumor histopathological grade [1-year area under curve (AUC)=0.687, 3-year AUC=0.725 and 5-year AUC=0.782]. The expression levels of AC025154.2, AC073896.3, AL122010.1 and RASSF8-AS1 were significantly different in various clinical characteristics of pancreatic cancer (all P<0.05), and might serve as potential new targets for diagnosis and treatment in pancreatic cancer. Interferon α, mammalian target of rapamycin complex 1 (mTORC1), MYC regulatory genes and transforming growth factor-β (TGF-β) signaling pathways were significantly activated, and myogenesis and pancreas β cells signaling pathways were significantly suppressed in the high-risk group, which may explain the underlying molecular mechanisms of the prognostic risk assessment model. Conclusion:The prognostic risk assessment model based on 5 immune-related lncRNAs can effectively predict the prognosis of pancreatic cancer patients. Besides, the above immune-related lncRNAs may serve as new biomarkers in the diagnosis and therapy in pancreatic cancer.

Preparation and properties of calcium silicate-phosphate composite bone cements / 生物医学工程学杂志

In this paper, alpha-tricalcium phosphate (alpha-TCP) and tetracalcium phosphate (TTCP) respectively were chosen as basic compositions of phosphate bone cements. Other auxiliary materials such as hydroxyapatite (HAP), dicalcium phosphate dihydrate (DCPD), calcium carbonate (CaCO3), calcium oxide (CaO) and amorphous calcium silicate (CaSiO3) were added in the cements. Six kinds of composite bone cements were decided with 1.50 as their Ca/P ratio. Then the primary properties of them were studied. Ringer's simulated body fluid (SBF) tests were carried out for the samples. The changes of pH value in SBF and the compressive strength of the samples with the immersion time were studied. The results showed: the mixing liquid 0.25 M K2HPO4/KH2PO4 and amorphous CaSiO3 were effective for accelerating the setting of the cements; the initial setting time (It) was about 4-5.5 min and the final setting time (Ft) was about 18-19. 5 min. Amorphous calcium silicate can increase the compressive strength of the bone cements remarkably; the compressive strength of the alpha-TCP bone cement with the addition of suitable amount amorphous CaSiO3 reached 45.3 MPa after immersion in SBF for 14 days.

Microstructure and adhesion of HAP-glass-alumina composite gradient bioceramics coating / 生物医学工程学杂志

HAP-Glass-alpha-Al2O3 gradient coating on alumina ceramics substrate was prepared by multi-layer slurry-dipping and sintering process, effects of the composition of the coating on the microstructure and adhesion strength of the gradient coating were studied. R2O-Al2O3-B2O3-SiO2 system glass with low softening temperature and thermal expansion was used in the gradient coating. The composition of the coating was varied from interface to surface layer, i.e. the HAP concentration increased and glass concentration decreased gradually from the under layer to the surface layer. A suitable amount superfine alpha-Al2O3 was added in the gradient coating to reinforce the bonding strength between the coating and substrate. The results show that the use of R2O-Al2O3-B2O3-SiO2 system glass is propitious to sintering the coating at low temperature and to combination between the coating and substrate. The addition of superfine alpha-Al2O3 can reinforce the bonding strength between the coating and substrate, the highest bonding strength is about 48.2 MPa.

Influences of R2O-Al2O3-B2O3-SiO2 system glass and superfine alpha-Al2O3 on the sintering and phase transition of hydroxyapatite ceramics / 生物医学工程学杂志

The effects of R2O-Al2O3-B2O3-SiO2 system glass and superfine alpha-Al2O3 on the sintering and phase transition of hydroxyapatite (HAP) ceramics were assessed. The results showed that alpha-Al2O3 impeded the sintering of HAP and raised the sintering temperature. When glass and alpha-Al2O3 were used together to reinforce HAP ceramics, better results could be obtained; the bending strength of multiphase HAP ceramics approached 106 MPa when 10% (wt) alpha-Al2O3 and 20%(wt) glass were used and sintered at 1200 for 1 h.

Application and Maintenance of RT-2100C Micro-plate Reader / 医疗卫生装备

The application and maintenance of RT-2100C micro-plate reader are introduced systematically.Common faults and effective solutions are pointed out.Experiences in teaching and clinical application of micro-plate reader are summarized.It gives a valuable reference to ensure medical equipment stable and improve diagnostic level.