红细胞分布宽度与急性胰腺炎严重程度的研究

目的研究外周血红细胞分布宽度(RDW)对急性胰腺炎AP严重程度评估的价值。方法收集2017年1月-2019年3月在首都医科大学大兴医院收治的急性胰腺炎(AP)患者266例,按疾病严重程度分为重症急性胰腺炎(SAP)组、中重症急性胰腺炎(MSAP)组、轻症急性胰腺炎(MAP),并纳入相同例数的健康体检者作为对照组,收集患者的一般资料及RDW进行统计分析。结果急性胰腺炎(AP)组与对照组之间RDW差异具有有统计学意义(P<0.05);SAP患者的RDW水平明显高于非SAP患者;RDW(P <0.05,OR=3.378)是急性胰腺炎的一项独立危险因素;ROC曲线预测AP及SAP曲线下面积分别为0.712及0.840。结论 RDW水平是评估急性胰腺炎严重程度及预后的一项有效指标。     

The impact of a total knee arthroplasty on jaw movements,upper body posture,plantar pressure distribution,and postural control

ABSTRACT

Objective: The purpose of this study was to examine the influence of a total knee arthroplasty (TKA) on linked cranial and caudal structures.

Methods: Thirty-five (14f/21m) subjects participated in this study: 15 subjects (9f, 6m) pre- and post- TKA and a control group of 20 subjects (5f, 15m). The measurements included: jaw condyle position and movement, back scan, plantar pressure distribution, and body sway.

Results: There were no significant differences in electronic position analysis of the jaw; however, the protrusion of the TKA group improved (p = 0.001). The test group had a more anteriorly inclined thoracic spine and a less pronounced lumbar lordosis. Before and after surgery, the body sway in the test group was larger.

Conclusion: The TKA affected most prominently the static mechanisms of the postural control and the spine position. The trajectories of the mandible during protrusion also changed slightly.     

Regional Spread of Ebola Virus,West Africa, 2014

To explain the spread of the 2014 Ebola epidemic in West Africa, and thus help with response planning, we analyzed publicly available data. We found that the risk for infection in an area can be predicted by case counts, population data, and distances between affected and nonaffected areas.     

Ecotoxicological effects of bisphenol A and nonylphenol on the freshwater cladocerans Ceriodaphnia silvestrii and Daphnia similis

Toxicities of bisphenol A (BPA) and nonylphenol (NP) to the neotropical freshwater cladocerans Ceriodaphnia silvestrii and Daphnia similis were studied under laboratory conditions. Acute exposures to BPA generated mean 48-h EC₅₀ values of 14.44 (6.02–22.85) mg L^?1 for C. silvestrii and 12.05 (1.73–22.37) mg L^?1 for D. similis. When the organisms were exposed to acute doses of NP, mean 48-h EC₅₀ values were 0.055 (0.047–0.064) mg L^?1 (C. silvestrii) and 0.133 (0.067–0.200) mg L^?1 (D. similis). Ceriodaphnia silvestrii was also tested in chronic bioassays, which resulted in mean 8-d IC₂₅ values of 2.43 (2.16–2.69) mg L^?1 BPA [no observed effect concentration (NOEC): 1.38?mg L^?1] and 0.020 (0.015–0.026) mg L^?1 NP (NOEC: 0.015?mg L^?1). These laboratory tests are valuable to broaden the understanding of the environmental threat posed by BPA and NP in aquatic ecosystems, and to increase the knowledge about the sensitivity of neotropical indigenous species to these contaminants. In addition to the laboratory bioassays, species sensitivity distributions were used to suggest protective concentrations of BPA and NP to prevent adverse effects on freshwater organisms. According to the obtained results, concentrations lower than 36.47?µg L^?1 BPA and 1.39?µg L^?1 NP are not expected to adversely impact aquatic organisms in natural ecosystems.     

Suitability of the AUC Ratio as an Indicator of the Pharmacokinetic Advantage in HIPEC

The purpose of this study was to evaluate the area under the concentration-time curve (AUC) ratio as an optimal indicator of the pharmacokinetic advantage during hyperthermic intraperitoneal perioperative chemotherapy. The impact on the AUC ratio on the variables related to the calculation of systemic drug exposure, instillation time, and peripheral drug distribution was evaluated through simulations as well as through a retrospective analysis of studies published in the literature. Both model simulations and the retrospective analysis showed that the 3 variables evaluated had an impact on the AUC ratio value if the complete systemic exposure was not fully considered. However, when that complete systemic exposure was considered, none of these variables affected the AUC ratio value. AUC ratio is not a characteristic parameter of a drug if the calculated systemic drug exposure is not complete. Thus, AUC ratio is not valid for comparing the pharmacokinetic advantage of 2 drugs, and it should not be employed to prove whether a drug can be used in hyperthermic intraperitoneal perioperative chemotherapy safely with regard to toxicity. As an alternative, the study of the absorption rate constant and the bioavailability are proposed as the true and independent parameters that reflect the amount of drug absorbed.     

The Influence of In Vivo Metabolic Modifications on ADMET Properties of Green Tea Catechins–In Silico Analysis

The health effects of green tea are associated with catechins: (?)-epigallocatechin-3-O-gallate (EGCG), (?)-epigallocatechin, (?)-epicatechin-3-O-gallate, and (?)-epicatechin. An understanding of compound absorption, distribution, metabolism, excretion, and toxicity characteristics is essential for explaining its biological activities. Herein, absorption, distribution, metabolism, excretion, and toxicity properties of in vivo detected metabolites of green tea catechins (GTCs) have been analyzed in silico. The influence of metabolic transformations on absorption, distribution, metabolism, and excretion profiles of GTCs corresponds to the effects of size, charge, and lipophilicity, as already observed for other small molecules. Mutagenic, carcinogenic, or liver toxic effects were predicted only for a few metabolites. Similar to galloylated GTCs EGCG and (--)-epicatechin-3-O-gallate, the sulfo-conjugates were predicted to bind at the warfarin binding site. The low free plasma concentration of these derivatives may be consequential to their serum albumin binding. The activity cliff detected for methylated conjugates of EGCG indicates that GTCs' pro-oxidative activity in bound state comes primarily from free hydroxyl groups of the pyrogallol ring B.     

Pharmacokinetics and tissue distribution of crotonoside

1.?Crotonoside is a bioactive ingredient from Croton Herba with a strong antitumour activity. This study aimed to develop a highly sensitive and selective high-performance liquid chromatography (HPLC) method to quantify crotonoside in biological samples for pharmacokinetics and distribution studies.

2.?Protein precipitation by perchloric acid was used to separate crotonoside from the biological samples, and the recovery rates for crotonoside and the internal standard (luteoloside) were >80%. All calibration curves examining the crotonoside levels in plasma and tissues were linear (all correlation coefficients >?0.99).

3.?The response to crotonoside appeared to be dose disproportional to the maximum plasma concentration and the area under the time–concentration curve in plasma over the range of 12.5–50.0?mg/kg, and crotonoside was highly distributed in tissues after intravenous administration. The highest crotonoside level was detected in the liver (28.79?±?14.96?μg/g), whereas crotonoside was undetected in the brain.     

204株耐碳青霉烯铜绿假单胞菌的临床特点和耐药性分析

摘要： 目的 分析204株耐碳青霉烯铜绿假单胞菌的临床分布、 患者因素和耐药性, 为临床合理有效使用抗菌药物提供科学依据。方法 采取VITEK-2 Compact全自动微生物分析系统对2017年1月—12月我院分离的204株耐碳青霉烯铜绿假单胞菌进行鉴定及药敏试验, 分析临床分布、 标本来源。比较患者不同因素对耐碳青霉烯铜绿假单胞菌检出率的影响。比较呼吸道与非呼吸道分离株、 ICU与普通病房分离株的耐药性差异。结果 204株耐碳青霉烯铜绿假单胞菌分布于ICU 97株、 普通病房107株。标本来源以呼吸道为主, 共169株, 占82.84%; 非呼吸道35株,占17.16%。有基础疾病、 近90 d使用抗菌药物、 进行侵入性操作以及菌株检出时间距入院时间＞48 h的患者耐碳青霉烯铜绿假单胞菌的检出率均分别高于无基础疾病、 近90 d未使用抗菌药物、 未进行侵入性操作以及菌株检出时间距入院时间≤48 h的患者 （P＜0.01）。呼吸道标本组对头孢他啶、 环丙沙星的耐药率显著低于非呼吸道标本组 （P＜ 0.05）, 余12种抗菌药物耐药率差异无统计学意义 （P＞0.05）。普通病房分离株对替卡西林/克拉维酸、 头孢哌酮/舒巴坦、 阿米卡星、 头孢吡肟、 庆大霉素耐药率显著低于ICU病房 （P＜0.05）, 余9种抗菌药物耐药率差异无统计学意义（P＞0.05）。204株耐碳青霉烯铜绿假单胞菌对亚胺培南、 美罗培南耐药率差异无统计学意义 （P＞0.05）。结论 耐碳青霉烯铜绿假单胞菌感染多发生于院内, 在ICU、 普通病房, 呼吸道、 非呼吸道的耐药形势已同样严峻, 应引起临床高度重视。     

碳青霉烯耐药肠杆菌科细菌临床分布及耐药特征分析

目的 分析综合性三甲医院住院患者临床标本分离碳青霉烯耐药肠杆菌科细菌（CRE）的临床分布及耐药特征,为临床抗感染治疗及院感防控提供参考。方法 收集2015年7月至2017年6月安徽医科大学第二附属医院住院患者临床标本分离CRE药敏数据及相关临床资料,应用WHONET 5.6软件统计分析CRE临床分布及耐药率,药敏折点参照CLSI 2016版标准。结果 2015年7月至2017年6月期间,自住院患者临床标本共分离CRE 82株,由肺炎克雷伯菌（42株,51.22%）、大肠埃希菌（23株,28.05%）、阴沟肠杆菌（9株,10.98%）、黏质沙雷菌（5株,6.10%）、弗劳地枸橼酸杆菌（2株,2.44%）及产酸克雷伯菌（1株,1.22%）构成。临床标本以痰标本（29株,35.37%）,分泌物/脓液标本（20株,24.39%）及尿液标本（14株,17.07%）为主。CRE分布广泛,检出的临床科室包括ICU（14株,17.07%）、呼吸内科（10株,12.20%）等。CRE菌株对临床常用抗菌药物耐药性较高,仅对阿米卡星较为敏感,耐药率为23.17%。结论 CRE菌株临床分布广泛且对常用抗菌药物耐药率高,临床科室应积极送检病原学检验并根据药敏结果合理选择抗菌药物。医院感控部门应联合微生物实验加强对CRE菌株的监测与防控。