Predictive performance of reported vancomycin population pharmacokinetic model in patients with different renal function status, especially those with augmented renal clearance.

BACKGROUND: There is a significant correlation between augmented renal clearance (ARC) and lower serum trough concentrations of vancomycin (VCM) during therapy. There is a need to evaluate the predictive performance of the population pharmacokinetic (PPK) model used for individual calculation of dosage regimens in ARC patients. OBJECTIVE: Our study aimed to estimate the predictive performance differences of the reported VCM PPK software JPKD-vancomycin and SmartDose in patients with varying renal function status, especially those with ARC. METHODS: Patients receiving VCM treatment from May 2014 to December 2019 were enrolled, and divided into the ARC group, the normal renal function (NRF) group, and the impaired renal function (IRF) group. VCM dosage, trough concentration, area under the curve (AUC) and pharmacokinetic parameters were compared among the three groups. The predictive performance of PPK software was expressed using absolute prediction error (APE), sensitivity, specificity, and regression coefficient (r2) of linear regression analysis between the measured VCM trough concentration and the predicted trough concentration. RESULTS: A total of 388 patients were included: 86 patients in the ARC group, 241 patients in the NRF group, and 61 patients in the IRF group. The daily dose of the adjusted regimen in the ARC group was higher than in the NRF group, but the trough concentration was significantly lower than in the NRF group (2.8±0.6 g vs 1.9±0.6 g, p<0.001; 10.5±5.1 mg/L vs 12.9±6.8 mg/L, p=0.030). The percentage of trough concentrations lower than 10 mg/L was 84.9% in the ARC group. Compared with the APE of the initial dosage regimen, the APE of the adjusted regimen calculated by JPKD was lower in the ARC group (p=0.041) and the NRF group (p＜0.001). Specificity of JPKD and SmartDose in the ARC group was higher than in the NRF group (p<0.001; p<0.001). According to the linear regression analysis, the coefficients of determination (r2) were all >0.6 for the initial regimen and adjusted regimen of VCM in the ARC and NRF groups, and the r2 of the adjusted regimen of JPKD was >0.8 in the ARC and NRF groups. In the IRF group, 31.1% of patients had a change in serum creatinine (Scr) level of >50%. The r2 increased from 0.527 to 0.7347 in SmartDose and from 0.55 to 0.7802 in JPKD when using Scr at the sampling time. The ARC group showed a significant decrease in AUC (p<0.001) and an increase in clearance rate (p<0.001) when compared to the NRF group. CONCLUSION: ARC was significantly associated with subtherapeutic serum VCM concentration. The pharmacokinetic parameters of VCM were diverse in patients with different renal function status. The PPK model JPKD and SmartDose had a good predictive performance for predicting VCM trough concentrations of the ARC and NRF patients, especially using JPKD for prediction of the adjusted regimen. The change of Scr is a main factor affecting the accuracy of software prediction.

Effects of Xiangqin Jiere Granules on lipid metabolism and chronic inflammation in different obesity model mice / 中国中药杂志

This paper aims to study the effect of Xiangqin Jiere Granules(XQ) on lipid metabolism and chronic inflammation in different obesity model mice. The monosodium glutamate(MSG) obese mouse model was established by subcutaneous injection of MSG in newborn mice, and the high fat diet(HFD) obese mouse model was established by feeding adult mice with HFD. The normal mice were assigned into the control group; the MSG obese mice were assigned into MSG model group, XQ4.5 group(Xiangqin Jiere Granu-les, 4.5 g·kg~(-1)), XQ22.5 group(Xiangqin Jiere Granules, 22.5 g·kg~(-1)); the HFD obese mice were assigned into HFD model group, XQ4.5 group, and XQ22.5 group. The mice were intragastrically administrated with saline or XQ for 5 weeks. After that, the body weight, visceral fat mass, liver and thymus weight, and the organ indexes in each group were measured. The levels of triglyceride(TG), total cholesterol(TC), and low-density lipoprotein cholesterol(LDL-c) in serum and liver tissue were detected by the kits. The mRNA expression levels of acetyl CoA carboxylase 1(ACC1), fatty acid synthetase(FAS), diacylgycerol acyltransferase 1(DGAT1) and hepatic lipase(HTGL) involved in lipid metabolism in mouse liver tissue were detected by quantitative real-time PCR(qPCR). The protein levels of tumor necrosis factor-α(TNF-α) and interleukin-6(IL-6) in serum were detected by ELISA, and the mRNA levels of TNF-α and IL-6 in liver tissue were detected by qPCR. Compared with the control group, MSG and HFD mice showed increased body weight, abdominal circumference, Lee index and visceral fat mass as well as elevated levels of TG, TC, and LDL-c in serum. The model mice had up-regulated gene levels of ACC1, FAS and DGAT1 while down-regulated gene level of HTGL in the liver. Furthermore, the mRNA and protein levels of IL-6 increased in the model mice. Compared with the model mice, XQ treatment decreased the body weight, abdominal circumference, Lee index, and visceral fat mass, lowered the levels of TG, TC, and LDL-c in se-rum, down-regulated the gene levels of ACC1, FAS, and DGAT1 in liver tissue, up-regulated the gene level of HTGL, and down-regulated the mRNA and protein levels of IL-6. To sum up, XQ has good therapeutic effect on different obesity model mice. It can improve lipid metabolism and reduce fat accumulation in obese mice by regulating the enzymes involved in lipid metabolism, and alleviate obesity-related chronic low-grade inflammation.

Recent advance in mechanism of retinoids in prevention and treatment of Alzheimer's disease / 中华神经医学杂志

Retinoids are a group of natural or synthetic compounds that have similar structures or biological activities as retinoic acid. Previous studies have demonstrated that retinoids can improve the pathophysiology and symptoms of Alzheimer's disease (AD) in a variety of ways. This article reviews the recent advance in mechanism of retinoids in the prevention and treatment of AD, in order to provide some references for selection of clinical treatment direction in AD.

Modification performance and electrochemical characteristics of different groups of modified aptamers applied for label-free electrochemical impedimetric sensors.

Amino and thiolated aptamers are the main aptamers used to construct label-free electrochemical impedimetric aptasensors. In this study, the modification performance and electrochemical properties of amino aptamers and thiolated aptamers were studied in the construction of label-free impedimetric sensors. The results showed that the initial modification density of amino aptamers was higher than that of thiol aptamers. Aptamers can recognize and bind OTA to generate electrical signals. The higher the density of aptamer modification was, the better the electric signals were. If only considering the initial modification density, amino aptamers were more suitable for the preparation of aptasensors than thiolated aptamers. However, the modification density of the amino aptamer decreased with the prolonged immersion time in 1 mM HCl solution, which suggests that the stability of this sensor was poor. However, the thiolated aptamer maintained relatively constant density and could be reused. Thus, the thiolated aptasensor had a wide range and good reproducibility and stability for the determination of ochratoxin A (OTA). In addition, this study proved that gold nanoparticles play an important role in signal amplification by increasing the effective gold surface to fix more aptamers in the process of sensor preparation.

Preliminary development of self-screening questionnaire for somatoform symptoms / 中华行为医学与脑科学杂志

Objective To develop a simple,multi-dimensional self-screening questionnaire for som-atoform symptoms(SQSS). Methods Based on theoretical framework,the study developed the items of the questionnaire. The first draft of the questionnaire was screened through the expert evaluation method. Four groups of 359 subjects were selected to test the reliability and validity of questionnaire. Results The explor-atory factor analysis showed that the four factors(somatic symptoms,negative perception,illness behavior and social function) were extracted and the interpretable percentage of variance was 61. 165%. The correlation between the subscales and the total scales was 0. 740-0. 887,and the correlation coefficient between the sub-scales was 0. 503-0. 625. The Crobanch's α coefficient of the questionnaire was 0. 926,and the Spearman-Brown score of the questionnaire was 0. 868. The retest correlation coefficient of the total scale was 0. 876. A cutoff of 23 points in the SQSS was identified for screening somatoform disorders, and the sensitivity was 0. 880 and the specificity was 0. 606. Conclusion SQSS has good reliability and validity,and can be prelim-inarily used as a self-screening tool for patients with somatoform symptoms or disorders in clinical settings.

Reliability and validity of the Chinese version of illness Attitudes Scale / 中国心理卫生杂志

Objective:To test the psychometric characteristics of the Chinese Version of the Illness Attitudes Scale(IAS-CV).Methods:Totally 297 patients (with somatoform disorders,major depressive disorder,generalized anxiety disorder,panic disorder,and obsessive-compulsive disorder diagnosed with ICD-10) and 212 normal people were assessed with IAS-CV,Beck Depression Inventory-Ⅱ and Beck Anxiety Inventory.Results:The confirmation factor analysis result of the nine-factor model of IAS-CV was x2/df=1.99,GFI =0.86,RMSEA =0.06.The total score of IAS-CV was correlated with BAI scores (r =0.45,P ＜0.01) and BDI-Ⅱ scores(r =0.42,P ＜0.01).Patients with somatoform disorders (62 ± 17) had higher scores than patients with other disorder,such as depression (43 ± 16),anxiety (46 ± 21),obsessive compulsive disorder (46 ± 15),and normal controls (35 ± 13).The Cronbach's α coefficients were 0.91 for IAS-CV and 0.62-0.91 for each subscale.The test-retest coefficients were 0.95 for the total scale and 0.67-0.93 for each subscale (P ＜ 0.01).Split-half coefficient was 0.94.The cut-off score of IAS-CV for screening somatoform disorders was 44.Conclusion:It suggests that the Chinese Version of the Illness Attitudes Scale(IAS-CV) has good psychometric features and could be used in clinical practice and research in China.

Analysis and Study on Academic Influence of National and Provincial Centers for Disease Control and Prevention (CDC) / 医学信息学杂志

The paper analyzes the papers of national and provincial Centers for Disease Control and Prevention (CDC) on the Web of ScienceTM from 2007 to 2016 based on h-index,ESI highly cited papers,ESI hot papers and other bibliometrics indexes,contrasts the academic influence of China CDC and five provincial CDCs with top 5 number of SCI papers,and puts forward the suggestions that China CDC should play the role of an academic leader,and the provincial CDCs should continuously give full play to their advantages in their respective research fields.

[Pollution evaluation and health risk assessment of heavy metals from atmospheric deposition in Lanzhou].

In order to evaluate the contamination and health risk of heavy metals from atmospheric deposition in Lanzhou, samples of atmospheric deposition were collected from 11 sampling sites respectively and their concentrations of heavy metals were determined. The results showed that the average contents of Cu, Pb, Cd, Cr, Ni, Zn and Mn were 82.22, 130.31, 4.34, 88.73, 40.64, 369.23 and 501.49 mg x kg(-1), respectively. There was great difference among different functional areas for all elements except Mn. According to the results, the enrichment factor score of Mn was close to 1, while the enrichment of Zn, Ni, Cu and Cr was more serious, and Pb and Cd were extremely enriched. The assessment results of geoaccumulation index of potential ecological risk indicated that the pollution of Cd in the atmospheric deposition of Lanzhou should be classified as extreme degree, and that of Cu, Ni, Zn, Pb as between slight and extreme degrees, and Cr as practically uncontaminated. Contaminations of atmospheric dust by heavy metals in October to the next March were more serious than those from April to August. Health risk assessment indicated that the heavy metals in atmospheric deposition were mainly ingested by human bodies through hand-mouth ingestion. The non-cancer risk was higher for children than for adults. The order of non-cancer hazard indexes of heavy metals was Pb > Cr > Cd > Cu > Ni > Zn. The non-cancer hazard indexes and carcinogen risks of heavy metals were both lower than their threshold values, suggesting that they will not harm the health.

[Study on ecological risk assessment technology of fluoride pollution from arid oasis soil].

According to translocation regulation of fluoride in the typical oasis soil-plant system under field, an ecological risk assessment model of fluoride was established, and this model was used to assess ecological risk to fluoride pollution from suburban oasis soils in Baiyin City, which was specifically expressed with the potential ecological risk of bioavailability (ER(bc)) model to assess ecological risk of fluoride pollution in oasis regions. Results showed that the ecological risk indices of fluoride pollution from this region were 1.37-24.81, the level of risk at most sites was high to very high, the average ecological risk index was 11.28, belonged to very high risk. This indicated that in the suburb soil of Baiyin City needs to be concerned about the remediation of fluoride pollution.

Traditional Chinese medicine versus western medicine as used in China in the management of rheumatoid arthritis: a randomized, single-blind, 24-week study.

This study is designed to compare the efficacy and safety of traditional Chinese medicine (TCM) with western medicine (WM) in the management of rheumatoid arthritis (RA). This is a 24-week, randomized, multicenter, single-blind study comparing TCM with WM (as used in China) carried out between June 2002 and December 2004 in nine research centers in China, involving 489 patients. Patients were randomized to receive TCM (n = 247), MTX and SSZ (n = 242). MTX was started at a dose of 5 mg to a final dose of 7.5-15 mg weekly. The maintenance dose was 2.5-7.5 mg weekly. The starting dose of SSZ was 0.25 g bid, increasing by 0.25 g a day once a week to a final dose of 0.5-1 g qid. The maintenance dose was 0.5 g tid to qid. Primary end point was the proportion of patients with response according to the American College of Rheumatology 20 % improvement criteria (ACR20) at weeks 24. At 24 weeks, ACR20 responses were 53.0 % in TCM group and 66.5 % in WM group, (P < 0.001) at 24 weeks. ACR 50 responses were 31.6 % of TCM group and 42.6 % in WM group, (P = 0.01). ACR70 responses were 12.6 % in TCM group and 17.4 % in WM group, (P = 0.14). Side effects were observed more frequently in WM group. In this study, ACR20, ACR50 responses at 24 weeks were significantly better in the WM treated group, by intention to treat (ITT) and per protocol analysis. The ACR 70 response showed no significant difference between the two groups. TCM, while effective in treating RA, appears to be less effective than WM in controlling symptoms, but TCM is associated with fewer side effects.