7-取代-1-取代-6,8-二氟-1,4-二氢-4-氧-3-喹啉羧酸化合物的合成及其抗菌活性

目的：研究7－取代－2－取代－6,8二氟－1,4－二氢－4－氧－3－喹啉羧酸的合成,体外抗菌活性及其构效关系。方法：通过缩合,Gould-Jacobs环合,亲核取代得到关键中间体,然后通过反应制得目标化合物,选用临床常见致病菌的标准菌株进行体外抗菌活性测定。结果：设计合成26个化合物,其中20个化合物为首次报道,抗菌活性实验以氟罗沙星为对照Ⅲi,Ⅲj和苯环上无取代的化合物Ⅲb1,Ⅲb2的活性比氟罗沙星稍好,特别是化合物Ⅲb2的活性优于氟罗沙星。结论：合成的26个化合物中有一些化合物显示了较好的抗菌活性。其中化合物Ⅲb2的活性优于氟罗沙星,该类化合物值刘进一步研究。     

135例急性感染性疾病所致肝功能损害临床分析

目的　分析临床急性感染性疾病所致肝功能损害的特点及其恢复时间。方法　对 135例急性感染性疾病患者入院肝功能指标进行分析 ,观察治疗第 2周及第 4周时患者异常肝功能指标恢复情况。结果　除 6例死亡外 ,其余患者异常肝功能指标升高多在正常值上限 3倍以内 ,治疗第 4周异常肝功能指标治愈率分别为 AL T92 .4%、AST91.6 %、GGT75 .6 %、AL P91.3%、 SB10 0 %、 SB’ 10 0 %和 TBA 85 .7% ,HBs Ag ( )携带者与 HBs Ag (- )者治疗第 4周上述指标治愈率无显著差异。第 4周时 GGT仍升高者恢复缓慢或不易恢复正常。结论　急性感染性疾病致肝功能损害多呈轻度及一过性升高 ;HBs Ag ( )携带者肝脏应急储备及修复功能较正常人无明显下降 ;GGT恢复缓慢或不易恢复正常者可能留有持久性的肝内毛细胆管损伤     

Tropheryma whippelii endocarditis confirmed by polymerase chain reaction

This report concerns a patient with cardiac manifestation ofWhipple's disease. For the first time, the gene that encodesthe 16s rRNA of Tropheryma whippelii was identified in a nativeaortic valve by means of a polymerase chain reaction technique.DNA amplification gives evidence of Tropheryma whippelii asa causative organism in infective endocarditis.     

Infective endocarditis in paediatrics

Infective endocarditis is a result of infection of the endocardium, particularly of the heart valves (native or prosthetic valves). The most common causative organisms in the paediatric population are: Streptococci, Staphylococci and Enterococci. The classical signs of infective endocarditis like Roth spots, Janeway lesions, splinter haemorrhages and Osler's nodes are relatively rare in children. A high index of suspicion in a febrile child with a new murmur, detailed history, meticulous examination, repeated blood cultures, and echocardiography are essential in establishing the diagnosis. Management of infective endocarditis involves a prolonged course of antibiotics, at least for 4–6 weeks depending upon the causative organism and underlying heart condition. Complications of infective endocarditis include congestive heart failure resulting from valvular damage/regurgitation, infective emboli leading to abscesses in other organs and abnormal host immunological responses. Prophylactic antibiotics for dental and other medical procedures like genitourinary tract procedures are no longer recommended in the UK. The emphasis should be on educating children and their parents in early recognition of infective endocarditis. Children at high risk of developing endocarditis should be assessed urgently after clinical suspicion.     

氧氟沙星加双黄连注射液静脉滴注致肝损害1例

氧氟沙星 (ｏｆｌｏｘａｃｉｎ)和双黄连 (Ｓｈｕａｎｇｈｕａｎｇｌｉ ａｎ)已成为临床常用的抗菌药 ,但其不良反应亦不可忽视。我们曾遇见 1例用该 2药治疗上呼吸道感染引起严重肝功能损害 ,报道如下。病人男性 ,2 1ａ。主要因咽痛、咯痰、发热 2ｄ入院。病人于入院前 2ｄ出现咽痛、咯黄痰、胸痛、发热 (Ｔ38.9℃ )。诊断为上呼吸道感染。在当地卫生所给予氧氟沙星注射液(四川科伦大药厂生产 ,规格 :1 0 0ｍＬ :0 .2ｇ批号 0 1 30 1 2 )0 .2ｇ(1 0 0ｍＬ) +双黄连注射液 (齐齐哈尔第二制药厂生产 ,规格 :每支 2 0ｍＬ批号 30 0 1 32 ) 2 0…     

药品行政保护品种介绍:抗感染药物(九)(续八)

甲磺酸曲伐沙星及其Ｔｒｏｖａｎ片剂　通用名 :甲磺酸曲伐沙星 (ｔｒｏｖａｆｌｏｘａｃｉｎｍｅｓｙｌａｔｅ) ,商品名 :Ｔｒｏｖａｎ片剂 ,化学名 :(1α,5α ,6α) 7 (6 氨基 3 氮杂双环[3 ,1 ,0 ] 己 3 基 ) 1 (2 ,4 二氟苯基 ) 6 氟 1 ,4 二氢 4 氧 1 ,8 萘啶 3 羧酸单甲磺酸盐 ,结构式见图 1。　　申请日 :1 998年 3月 1 7日。申请人 :美国辉瑞公司。申请号 :Ａ ＵＳ 980 3 1 70 2。授权日 :1 998年1 0月 2 7日 ,授权号 :Ｂ ＵＳ 981 0 2 71 1。法定行政保护期 :自授权之日起 7.5ａ,到 2 0 0 6年 4月 2 7日。专利介绍 :专利号…     

Periodic Protrusion of Right Coronary Cusp into Left Ventricular Outflow Tract Due to Detachment from the Aortic Annulus Complicated with Infective Endocarditis

We describe the imaging of unusual dislocation of right coronary cusp into left ventricular outflow tract (LVOT) due to the infective endocarditis. Although the two‐dimensional echocardiography identified a protruding mass in LVOT, the three‐dimensional echocardiography precisely demonstrated the spatial anatomy of the aortic root, which was confirmed by the surgical operation, implicating the usefulness of three‐dimensional echocardiography in this rare anomaly.     

Long-Term Risk of Infective Endocarditis After Transcatheter Aortic Valve Replacement

Background

Patients undergoing surgical aortic valve replacement (SAVR) are considered at high risk of infective endocarditis (IE). However, data on the risk of IE following transcatheter aortic valve replacement (TAVR) are sparse and limited by the lack of long-term follow-up as well as a direct comparison with patients undergoing SAVR.

Near‐complete aortic mechanical valve dehiscence due to endocarditis reinfection

Prosthetic valve infective endocarditis (IE) is one of the most serious postimplantation complications. Prosthetic aortic valve IE constitutes 1%–6% of all prosthetic valve IE cases. We present a dramatic echocardiographic case of prosthetic aortic valve IE leading to near‐complete valve dehiscence. Echocardiographic evidence of prosthetic aortic valve rocking motion is indicative of significant dehiscence. Aside from IE, other causes and risk factors for prosthetic aortic valve dehiscence include inflammatory and autoimmune vasculitides, concomitant ascending aorta aneurysm, and aortic root calcification.