Treatment advice of small molecule antiviral drugs for elderly COVID-19 / 中国药理学通报

COVID-19 has been prevalent for three years. The virulence of SARS-CoV-2 is weaken as it mutates continuously. However, elderly patients, especially those with underlying diseases, are still at high risk of developing severe infections. With the continuous study of the molecular structure and pathogenic mechanism of SARS-CoV-2, antiviral drugs for COVID-19 have been successively marketed, and these anti-SARS-CoV-2 drugs can effectively reduce the severe rate and mortality of elderly patients. This article reviews the mechanism, clinical medication regimens, drug interactions and adverse reactions of five small molecule antiviral drugs currently approved for marketing in China, so as to provide advice for the clinical rational use of anti-SARS-CoV-2 in the elderly.

[Application of bone-retaining femoral stem prosthesis in young patients with Dorr C femoral medullary cavity].

OBJECTIVE: To assess the clinical efficacy of Tri-Lock bio-short prosthesis in artificial total hip arthroplasty(THA) in young patients with Dorr type C femoral medullary cavity. METHODS: From January 2010 to January 2014, 35 young patients(37 hips) with in the chimney-like femoral medullary cavity received Tri-Lock BPS prosthesis of THA, including 18 males(20 hips) and 17 females with an average age of (32.2±3.0) years old ranging from 21.2 to 38.5 years old. There were 16 cases of rheumatoid hip arthritis (17 hips), 8 cases of rheumatoid arthritis (9 hips), and 11 cases of aseptic necrosis of femoral head (11 hips). All cases were complicated with different degrees of osteoporosis. According to Singh index, 26 cases were classified as Grade III and 9 cases as Grade II. Biological prostheses were used for the acetabulum, with ceramic lining and full ceramic femoral head. The proximal femoral medullary cavity was Dorr type C on anteroposterior X-ray. After replacement, X-ray examination was performed to locate the prosthesis stem. Engh and Harris criteria were used to evaluate the stability of bone-prosthesis interface and hip function, respectively. Changes of hip movement pre-operation and at last follow-up were compared. RESULTS: All patients were followed up for 18 to 45 months(means 33.8 months). Harris hip scores in 35 cases (37 hips) increased significantly from preoperative 61.8±3.0 (51.2 to 73.5) to 93.3±6.5 (92.5 to 98.8) points at last follow-up (t=54.745, P<0.01). The hip mobility increased from (46.5±8.0)°(0° to 55°) before surgery to(101.2±10.5)°(85° to 130°) at the last follow-up, the difference was statistically significant(t=133.091, P<0.01). Immediately after surgery, the prostheses were tightly packed with the medullary cavity. At the final follow-up, 17 hips had significant femur cortical bone thickening;12 hips had varying degrees of stress occlusal bone resorption at proximal femoral, including 9 degree I(low femur density, round and blunt) and 3 degree II(involving small rotor) hips. Meanwhile, 15 hips had significant femur cortical bone thickening without thigh pain. CONCLUSIONS: The cone-shaped short Tri-lock biological short-stem can fill Dorr C chimney-like medullary cavity and effectively retain good proximal femoral bone mass. Titanium microporous coating on the surface can effectively increase the friction of the prosthesis. The short-stem end in the medullary cavity can effectively avoid the occurrence of coxa varus.

Effect of Exogenous Nitric Oxide on Plant Hormones and Enzyme Content of Acanthopanax senticosus Seeds / 中国实验方剂学杂志

Objective: To investigate the effect of exogenous nitric oxide (NO) on breaking the dormancy of Acanthopanax senticosus seeds and the changes in endogenous hormones and enzymes,and provide a basis for breaking the dormancy as well as artificial cultivation of A. senticosus seeds.Method: Different concentrations (1,5,10,20 mmol·L-1) of sodium nitroprusside (NO donor) were used to treat the A. senticosus seeds, and then thermophilic stratification was conducted. The content changes of endogenous hormones such as gibberellin (GA3), abscisic acid (ABA),indolo acetic acid (IAA),indolo butyric acid (IBA) and salicylic acid (SA) at different stratification time (0, 30, 50, 80, 100,130 d) were tested by high performance liquid chromatography (HPLC). The activity change of its in vivo enzymes[catalase (CAT), superoxide dismutase (SOD), peroxidase (POD), and malondialdehyde (MDA)] were tested by enzyme-labeled instrument.Result: In the seed germination process of A. senticosus,the contents of GA3,IAA,IBA,and SA were increased gradually,while the content of ABA was reduced gradually. The enzyme activities of POD and MDA were significantly reduced,and the enzyme activities of CAT and SOD were increased obviously. Exogenous NO could increase the seed germination rate and shorten the seed germination time. The effect of 20 mmol·L-1 sodium nitroprusside showed the most obvious effect and 10 mmol·L-1 SNP showed the weakest effect in promoting seed germination,showing an obvious "V" shape for changes.Conclusion: Sodium nitroprusside could promote the seed germination effect of A. senticosus, probably by increasing the content of hormones and enzyme in the stage of seed germination and improving the contents of endogenous NO during germination.

General situation and comprehensive utilization of medicinal fungi resources in Heilongjiang province / 中国中药杂志

In order to develop and utilize the macrofungi in Heilongjiang province, numerous literatures have been investigated to make a comprehensive analysis of the number of known species of fungi in Heilongjiang province. There exists a total of 546 species of macrofungus in Heilongjiang province belonging to 53 families and 13 orders of 6 classes and 2 subdivisions. And its application value is classified, summarized and reviewed. Three hundred and twenty kinds of edible fungi, 214 species of fungi with medicinal value, medicinal value in the anti-cancer effects of 167 species of fungi, 141 wood rot fungi, 141 species of ectomycorrhizal fungi, 88 poisonous species, 67 macrofungus which are not clarified whether could be edible or toxic. It shows a broad prospects for development and utilization of macrofungus resources in Heilongjiang province.

Role of sul2 Gene Linked to Transposase in Resistance to Trimethoprim/Sulfamethoxazole Among Stenotrophomonas maltophilia Isolates

No abstract available.

New Delhi Metallo-β-Lactamase-Mediated Carbapenem Resistance: Origin, Diagnosis, Treatment and Public Health Concern / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To review the origin, diagnosis, treatment and public health concern of New Delhi metallo-β-lactamase (NDM)-producing bacteria.</p><p><b>DATA SOURCES</b>We searched database for studies published in English. The database of PubMed from 2007 to 2015 was used to conduct a search using the keyword term "NDM and Acinetobacter or Enterobacteriaceae or Pseudomonas aeruginosa."</p><p><b>STUDY SELECTION</b>We collected data including the relevant articles on international transmission, testing methods and treatment strategies of NDM-positive bacteria. Worldwide NDM cases were reviewed based on 22 case reports.</p><p><b>RESULTS</b>The first documented case of infection caused by bacteria producing NDM-1 occurred in India, in 2008. Since then, 13 blaNDM variants have been reported. The rise of NDM is not only due to its high rate of genetic transfer among unrelated bacterial species, but also to human factors such as travel, sanitation and food production and preparation. With limited treatment options, scientists try to improve available therapies and create new ones.</p><p><b>CONCLUSIONS</b>In order to slow down the spread of these NDM-positive bacteria, a series of measures must be implemented. The creation and transmission of blaNDM are potentially global health issues, which are not issues for one country or one medical community, but for global priorities in general and for individual wound care practitioners specifically.</p>

The Emergence of the 16S rRNA Methyltransferase RmtB in a Multidrug-Resistant Serratia marcescens Isolate in China

No abstract available.

Paroxysmal Supraventricular Tachycardia in an Infant with Hand, Foot, and Mouth Disease

An 11-month-old male infant was admitted to our hospital with fever, fussiness, poor feeding, vomiting, and tachypnea for two days prior. Physical examination revealed sporadic papules and vesicles occurring on his hands, feet, face, and perianal mucosa. Enterovirus 71 was identified from both throat swab and vesicle fluid using virus isolation techniques. The patient's heart rate fluctuated in a very narrow range from 180~210/beats/min regardless of his physiologic state. An electrocardiogram showed P-waves buried within or occurring just after regular, narrow, QRS complexes. The patient was diagnosed as having hand, foot, and mouth disease in combination with paroxysmal supraventricular tachycardia (PSVT). The child recovered well with symptomatic treatment, including intravenous administration of acyclovir, glucocorticoids, immunoglobulin, adenosine, and sotalol. PSVT was terminated within 36 hours of hospitalization. The skin lesions became crusted on the third day, and then proceeded to heal spontaneously. Here we report on this unusual case and review the associated literature.

Analysis of drug resistance and risk factors of Enterobacteriaceae in burn units / 中华烧伤杂志

<p><b>OBJECTIVE</b>To study the risk factors of infection of extended-spectrum beta-lactamases (ESBL)-producing strains and drug resistance of Enterobacteriaceae that infected burn patients.</p><p><b>METHODS</b>A retrospective study was performed on clinical information of 92 patients with Enterobacteriaceae infection in our burn unit from January 2001 to December 2008. The distribution and drug resistance of Enterobacteriaceae, and the detection rate, drug resistance of ESBL-producing strains, and its risk factors of nosocomial infection were analyzed. Data were processed with Chi-square test.</p><p><b>RESULTS</b>One hundred and nine strains of Enterobacteriaceae were isolated, with 38 (34.9%) strains of Enterobacter cloacae, 25 (22.9%) strains of Escherichia coli, 22 (20.2%) strains of Klebsiella pneumoniae, 13 (11.9%) strains of Proteus mirabilis, and 11 (10.1%) other strains of Enterobacteriaceae. Enterobacteriaceae were moderately or highly resistant to antibiotics except imipenem, resistance rate of which was less than 8.0%. ESBL-producing strains accounted for 44.0% in Escherichia coli, and 77.3% in Klebsiella pneumoniae. Drug-resistance rate of ESBL-producing strains to antibiotics was obviously higher than that of non ESBL-producing strains. Length of hospital stay longer than 20 days, and use of the third-generation cephalosporin longer than 5 days, quinolone antibiotics longer than 7 days, and topical antibiotics longer than 5 days were the risk factors of nosocomial infection caused by ESBL-producing strains, comparing with non ESBL-producing strains, the difference was statistically significant (with chi2 value respectively 5.491, 4.441, 15.186, 4.938, P values all below 0.05).</p><p><b>CONCLUSIONS</b>Enterobacteriaceae strains in burn unit of our hospital are highly drug resistant, with high lactamase-producing rates, calling for intense monitor to control the risk factors that predispose the infection of ESBL-producing strains in order to lower the infection rate.</p>

Identification of plasmid-mediated AmpC ?-lactamase in Escherichia coli / 中华检验医学杂志

Objective To investigate genotypes and antibiotic resistance of Escherichia coli producing plasmid-mediated AmpC ?-lactamase in Anhui province.Methods A total of 407 clinical isolates of nonrepeated Escherichia coli were collected from different cities in Anhui province.AmpC ?-lactamase producing isolates were identified by cefoxitin three-dimensional test and antibiotic susceptibility was identified by agar dilution test.Plasmid extraction,PCR amplication of corresponding group was performed, followed by sequencing.Results The positive rate of cefoxitin three-dimensional test was 8.1% (33/407), and the prevalence of plasmid-mediated AmpC ?-lactamase was 3.0% (12/407).bla_(CMY-2) gene,bla_(DHA-1) gene and bla_(ACT-2) gene were identified by PCR amplification and confirmed by sequencing in 5 strains,4 strains and 2 strains,respectively.A new CMY genotype was identified,with its sequence revealed 97% identity to the deduced amino acid sequence with previous CMY-2.This is also the first report on ACT-2 genotype in China.The susceptibility test showed that all strains were resistant to cephamycins and piperacillin,and susceptible to imipenem.Two strains of Escherichia coli producing DHA-1 were resistant to fourth-generation cephalosporin.Conclusions CMY-2,DHA-1 and ACT-2 are the most common genotypes in plasmid-mediated AmpC ?-lactamase produced by clinical Escherichia coli isolates in Anhui province. Carbapenems could be the first choice for the treatment of infection caused by AmpC ?-lactamase producers.