Azithromycin concentrations in blood and gingival crevicular fluid after systemic administration

Background: Azithromycin is a macrolide antibiotic that is active against several periodontal pathogens. Macrolides are taken up and concentrated inside gingival fibroblasts, which could influence their pharmacokinetics. This study tests the hypothesis that steady‐state levels of azithromycin are higher and more sustained in gingival crevicular fluid (GCF) than in serum. Methods: Four healthy patients received an initial dose of 500‐mg azithromycin followed by 250‐mg doses on each of the next 2 days. Serum and GCF samples were obtained 2 hours after the last dose on day 2, and on days 4 and 7. GCF samples were collected from maxillary posterior sites with paper strips. The strips were pooled and eluted with high‐purity water. After extraction, the azithromycin content of the serum samples and GCF eluates was determined with an agar diffusion bioassay. Results: On days 2, 4, and 7, the concentrations of azithromycin in blood serum were 0.22 ± 0.02, 0.08 ± 0.02, and 0.04 ± 0.01 μg/mL, respectively. The concentrations in GCF were 8.82 ± 1.25, 7.90 ± 1.72, and 7.38 ± 1.15 μg/mL, respectively. Mean GCF levels were significantly higher than mean serum levels (P ≤0.02; paired t test). Conclusions: The findings demonstrate that the pharmacokinetic profiles of azithromycin are different in GCF and serum. At steady state, azithromycin concentrations in GCF were higher and more sustained than those in serum. Based on previous studies, the levels observed in GCF were above the minimal inhibitory concentration for Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans), Porphyromonas gingivalis, and Prevotella intermedia.     

认知正常与轻度认知障碍老年人海马亚区与序列位置效应关系的研究

目的： 研究认知正常与轻度认知障碍老年人海马亚区与序列位置效应的相关性。 方法： 选择2016年1月至2019年1月就诊于首都医科大学附属复兴医院神经内科门诊的21例轻度认知障碍（mild cognitive impairment,MCI）患者作为MCI组,同期选择体检中心及门诊的39位认知正常（normal cognition,NC）者作为对照组。所有受试者均进行成套神经心理学量表评估与头颅核磁共振检查。应用自动化海马亚区分割软件FreeSurfer计算各亚区体积,采用听觉词语学习测验（auditory verbal learning test,AVLT）记录序列位置效应结果,观察2组人群亚区体积的差异,并分析其与序列位置效应的相关性。 结果： MCI组患者海马各亚区体积均小于对照组,但经多重比较的Bonferroni校正后,仅前下托区差异有统计学意义（P<0.05）。该亚区与AVLT延迟回忆总分及首因分数呈正相关。 结论： 与对照组相比,MCI患者海马亚区体积减少,其中前下托萎缩更显著,与长时记忆损害相关。     

高龄转子间骨折半髋关节置换钢丝捆扎方式探讨

目的探讨人工半髋关节置换术分别联合交叉双环钢丝捆扎和普通环形钢丝捆扎联合关节置换术治疗高龄股骨转子间骨折的临床疗效。 方法选择2013年1月至2017年3月在广州市增城区新塘医院就诊的高龄股骨转子间骨折患者114例作为研究对象。年龄≥75岁、Evans分型Ⅲ型或Ⅳ型的非病理性骨折患者纳入研究,排除病理性骨折、合并重要脏器功能障碍、严重关节炎及神经退行性疾病等。采用随机数字表法将患者分为A组和B组。2组患者均采用人工半髋关节置换术,A组采用常规钢丝捆扎法重建大转子,B组采用交叉双环钢丝捆扎法重建股骨大转子。观察2组手术时间、术中出血量、首次下床行走时间、术后住院时间、术后1月、6月、12月髋关节Harris评分和术后并发症发生率。计量资料采用t检验,组间不同时间点分析采用重复测量数据方差分析,计数资料采用卡方检验。 结果两组手术时间、术中失血量、术后引流量相比较差异均无统计学意义(t＝－0.397、0.943、－0.501,P>0.05);B组术后行走时间、住院时间与A组相比较均显著降低(t＝2.152、2.433,P<0.05)。B组术后1月、术后6月、术后12月时Harris评分与A组相比较均显著升高(t ＝－2.267、－2.396、－2.554,P<0.05)。B组1年内并发症发生率低于A组(χ²＝0.028,P<0.05)。 结论人工半髋关节置换中采用交叉双环钢丝捆扎重建股骨大转子有利于患者早期功能煅炼,可改善患者术后髋关节功能,减少术后并发症发生,值得进一步研究探讨。     

p-Cymene Modulates In Vitro and In Vivo Cytokine Production by Inhibiting MAPK and NF-κB Activation

The present study was designed to investigate the effects of p-cymene on lipopolysaccharide (LPS)-induced inflammatory cytokine production both in vitro and in vivo. The production of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), interleukin-6 (IL-6), and interleukin-10 (IL-10) in LPS-stimulated RAW 264.7 cells and C57BL/6 mice was evaluated by sandwich ELISA. Meanwhile, the mRNA levels of cytokine genes were examined in vitro by semiquantitative RT-PCR. In a further study, we analyzed the activation of nuclear factor-κB (NF-κB) and mitogen-activated protein kinase (MAPK) signaling pathways by western blotting. We found that p-cymene significantly regulated TNF-α, IL-1β, and IL-6 production in LPS-stimulated RAW 264.7 cells. Furthermore, the levels of relative mRNAs were also found to be downregulated. In in vivo trail, p-cymene markedly suppressed the production of TNF-α and IL-1β and increased IL-10 secretion. We also found that p-cymene inhibited LPS-induced activation of extracellular signal receptor-activated kinase 1/2, p38, c-Jun N-terminal kinase, and IκBα. These results suggest that p-cymene may have a potential anti-inflammatory action on cytokine production by blocking NF-κB and MAPK signaling pathways.     

瞬时弹性成像技术、APRI及FIB-4对胆道闭锁患儿肝纤维化程度的诊断价值

目的探讨肝脏瞬时弹性成像技术检测肝脏硬度(LSM)、AST-PLT比值指数(APRI)、基于4因子的肝纤维化指数(FIB-4)对胆道闭锁患儿肝纤维化程度的诊断价值。方法选取2016年1月1日-2018年12月31日于湖南省儿童医院新生儿外科行Kasai术的胆道闭锁患儿110例。收集患儿术中肝脏病理活检标本及术前1周内血常规、肝功能、瞬时弹性成像检查结果。计数资料组间比较采用χ2检验,非正态分布的计量资料多组间比较采用Kruskal-Wallis H秩和检验。采用MedCalc软件绘制受试者工作特征曲线(ROC曲线),通过ROC曲线评估瞬时弹性成像技术、APRI和FIB-4对胆道闭锁患儿肝纤维化程度的诊断效能。采用Spearman相关法进行相关性分析。结果ROC曲线分析显示,LSM、APRI、FIB-4用于判断胆道闭锁明显肝纤维化(F≥2)的临界值分别为9.250 kPa、0.680、0.047,ROC曲线下面积(AUC)分别为0.874[95%可信区间(95%CI):0.778~0.970]、0.636(95%CI:0.362~0.911)、0.622(95%CI:0.363~0.880);LSM、APRI、FIB-4用于判断胆道闭锁进展性肝纤维化(F≥3)的临界值分别为10.75 kPa、0.70、0.05,AUC分别为0.781(95%CI:0.689~0.873)、0.519(95%CI:0.401~0.636)、0.506(95%CI:0.389~0.623);LSM、APRI、FIB-4用于判断胆道闭锁肝硬化(F≥4)的临界值分别为11.85 kPa、0.82、0.09,AUC分别为0.855(95%CI:0.769~0.942)、0.701(95%CI:0.599~0.803)、0.717(95%CI:0.609~0.825)。相关性分析结果显示,LSM值与AST水平呈正相关(r=0.258,P=0.007),与PLT水平呈负相关(r=-0.248,P=0.009)。结论瞬时弹性成像技术对于胆道闭锁患儿肝纤维化分级具有较高的准确性,其诊断肝纤维化程度的临床价值高于APRI、FIB-4。     

单支架术在冠状动脉左主干病变治疗中的应用评价

目的 评价冠状动脉左主干(LMCA)病变病人接受单支架术的治疗效果及预后。方法 收集2007年1月至2014年3月在苏州大学附属第二医院接受经皮冠状动脉介入治疗(PCI)的53例LMCA病变病人的临床资料,所有入选病人均完成了冠状动脉单支架植入术。随访病人术后1年、术后2年时主要不良心脑血管事件(MACCE)发生情况。结果 手术成功率100%。23例在PCI术后1—12月行冠状动脉造影复查,2例发生支架内再狭窄,再狭窄率为8.7%。术后1年、术后2年时总体MACCE发生率分别为7.5%、9.4%。PCI术后1年、2年,SYNTAX积分低、中分组(≤32)和高分组(≥33)间无MACCE生存率比较,差异无统计学意义(分别为90.5%、100.0%,P=0.297;90.5%、90.9%,P=0.931)。结论 对经选择的LMCA病变病人,包括部分无保护左主干病变及分叉病变病人,单支架术成功率高,中远期预后良好。     

GnRH-a延长给药间隔周期治疗子宫内膜异位症的临床研究

目的 探讨GnRH-a延长给药间隔周期治疗子宫内膜异位症患者对临床疗效的影响。方法 选取2017年9月～2018年9月凉山彝族自治州第一人民医院和成都中医药大学附属医院进行子宫内膜异位症治疗的114例患者为研究对象,随机分为常规组与延长组,每组57例。两组患者均采用曲普瑞林治疗,常规组给药间隔为4周,延长组给药间隔为6周。比较两组患者治疗前后痛经程度、子宫体积、血清性激素水平及治疗后月经恢复时间、总有效率、并发症及复发情况。结果 治疗后,延长组患者痛经程度、子宫体积显著优于常规组（均P＜0.05）;两组患者LH、FSH及E-2水平显著降低,但两组无显著差异（P＞0.05）。治疗后,延长组患者月经恢复时间显著优于常规组（P＜0.05）;延长组与常规组治疗总有效率分别为89.47%及91.23%,两组无显著差异（P＞0.05）;延长组患者各项并发症发生几率显著低于常规组（均P＜0.05）。随访1年,两组患者复发情况无显著差异（P＞0.05）。结论 GnRH-a延长给药时间间隔、减少给药次数治疗治疗子宫内膜异位症,患者不良反应明显减少,复发率降低,临床有效率无明显降低,且能减少患者治疗费用,可在临床推广应用。     

Modulation of LPS-Stimulated Pulmonary Inflammation by Borneol in Murine Acute Lung Injury Model

The object of our study is to investigate the protective effects of Borneol on lipopolysaccharide (LPS)-induced acute lung injury (ALI) in mice. To determine the effects of Borneol on the histopathological changes in mice with ALI, inflammatory cell count in bronchoalveolar lavage fluid (BALF) and lung wet/dry weight ratio were measured in LPS-challenged mice, and lung histopathologic changes observed via paraffin section were assessed. Next, cytokine production induced by LPS in BALF and RAW 264.7 cells was measured by enzyme-linked imunosorbent assay (ELISA). To further study the mechanism of Borneol-protective effects on ALI, nuclear factor-kappaB (NF-κB) and mitogen-activated protein kinases (MAPKs) pathways were investigated. In the present study, Borneol obviously alleviated pulmonary inflammation by reducing inflammatory infiltration, histopathological changes, descended cytokine production, and pulmonary edema initiated by LPS. Furthermore, Borneol significantly suppressed phosphorylation of NF-κB/P65, IκBa, p38, JNK, and ERK. Taken together, our results suggest that Borneol suppressed inflammatory responses in LPS-induced acute lung injury through inhibition of the NF-κB and MAPKs signaling pathways. Borneol may be a promising potential preventive agent for acute lung injury treatment.