OBJECTIVE: To explore the role of antibiotic-eluting absorbable calcium sulfate in treating periprosthetic infection after one-stage revision of knee arthroplasty. METHODS: A retrospective analysis was performed on 36 patients(36 knees)who underwent phaseⅠrevision for periprosthesis infection after total knee arthroplasty from January 2018 to March 2022. All patients were underwent knee cavity puncture before operation and had positive results of aseptic body fluid culture, 21 patients received revision combined with antibiotic loaded calcium sulfate at stageⅠ(calcium sulfate group) during operation, and 15 patients underwent renovation at stageⅠ(revision group). There were 9 males and 12 females in calcium sulfate group, aged from 54 to 76 years old with an average of(67.6±6.2) years old. There were 15 patients in revision group, including 4 males and 11 females, aged from 60 to 75 years old with average of (69.6±4.1) years old. The levels of serum C-reactive protein (CRP), interleukin-6 (IL-6) at 7, 14, 30 and 90 days after operation were compared between two groups, and the rate of end-infection control at follow-up were compared. The systemic antibiotic application time, hospital stay and postoperative complications were observed between two groups. RESULTS: Calcium sulfate group were followed up for 12 to 29 months with an average of(18.9±4.2) months, and the infection control rate was 90.5%;while revision group were followed up 18 to 29 months with average of (21.6±3.7) months, and the infection control rate was 86.7% (13/15). There were no significant differences in follow-up time and infection control rate between two groups(P>0.05). Postoperative levels of CRP and IL-6 at 7, 14 and 30 days in calcium sulfate group were (32.79±11.48), (15.50±6.52), (9.36±3.32) mg·L^-1 and (17.31±6.15) pg·ml^-1, respectively;which were lower than those in revision group (40.65±11.32), (30.15±10.57), (18.97±5.86) mg·L^-1 and (25.54±6.73) pg·ml^-1, had statistical differences(P<0.05). There were no significant differences in IL-6 levels at 7 and 14 days after operation and CRP levels at 90 days after operation between two groups (P>0.05). The hospitalization time and systemic antibiotic application time in calcium sulfate group were (18.4±2.2) and (63.5±21.4) d, respectively;which were better than those in revision group (20.5±2.4) and (82.7±16.9) d, and had statistical differences(P<0.05). No significant wound complications and hypercalcemia were observed in calcium sulfate group. CONCLUSION Antibiotic eluted absorbable calcium sulfate could be used to treat periprosthetic knee infection, significantly reducing CRP levels in the early postoperative period, shortening hospital stay and systemic antibiotic application time, but it does not significantly improve the control rate of revision infection at stageⅠ.
Humans ; Male ; Female ; Aged ; Prosthesis-Related Infections/surgery* ; Middle Aged ; Calcium Sulfate/administration & dosage* ; Arthroplasty, Replacement, Knee/adverse effects* ; Retrospective Studies ; Anti-Bacterial Agents/therapeutic use* ; Interleukin-6/blood* ; C-Reactive Protein/metabolism* ; Reoperation ; Knee Prosthesis/adverse effects*

Drugs and pesticide residues in broiler feed can compromise the therapeutic and production benefits of antibiotic (ANT) application and affect gene expression. In this study, we analyzed the expression of 13 key pancreatic genes and blood physiology parameters after administering one maximum residue limit of herbicide glyphosate (GLY), two ANTs, and one anticoccidial drug (AD). A total of 260 Ross 308 broilers aged 1‍-‍40 d were divided into the following four groups of 65 birds each: control group, which was fed the main diet (MD), and three experimental groups, which were fed MD supplemented with GLY, GLY+ANTs (enrofloxacin and colistin methanesulfonate), and GLY+AD (ammonium maduramicin), respectively. The results showed that the addition of GLY, GLY+ANTs, and GLY+AD caused significant changes in the expression of several genes of physiological and economic importance. In particular, genes related to inflammation and apoptosis (interleukin 6 (IL6), prostaglandin-endoperoxide synthase 2 (PTGS2), and caspase 6 (CASP6)) were downregulated by up to 99.1%, and those related to antioxidant protection (catalase (CAT), superoxide dismutase 1 (SOD1) and peroxiredoxin 6 (PRDX6)) by up to 98.6%, compared to controls. There was also a significant decline in the values of immunological characteristics in the blood serum observed in the experimental groups, and certain changes in gene expression were concordant with changes in the functioning of the pancreas and blood. The changes revealed in gene expression and blood indices in response to GLY, ANTs, and AD provide insights into the possible mechanisms of action of these agents at the molecular level. Specifically, these changes may be indicative of physiological mechanisms to overcome the negative effects of GLY, GLY+ANTs, and GLY+AD in broilers.
Animals ; Glyphosate ; Glycine/administration & dosage* ; Chickens/blood* ; Pancreas/metabolism* ; Anti-Bacterial Agents/pharmacology* ; Animal Feed ; Gene Expression/drug effects* ; Herbicides

OBJECTIVES: Bloodstream infections in emergency patients have a high incidence, severe disease progression, and rapid deterioration. Early administration of appropriate antimicrobial agents is crucial for improving patient outcomes. This study aims to investigate the incidence, pathogen distribution, and antimicrobial resistance patterns of bloodstream infections in emergency patients, providing a reference for rational antibiotic use in clinical practice. METHODS: Medical records of patients diagnosed with bloodstream infections in the emergency department of a hospital in Hunan Province between January 2018 and October 2022 were retrospectively collected. Clinical characteristics of bloodstream infection patients were analyzed, and the distribution trends and antimicrobial susceptibility of clinical isolates were examined. RESULTS: During the study period, 2 215 blood culture samples were submitted from the emergency department, with a positivity rate of 13.27%. After excluding eight cases with missing data or suspected contamination, 286 patients with bloodstream infections were included, with community-acquired infections accounting for the majority (85.66%). The most common primary infection site was the urinary tract (24.48%), followed by respiratory tract infections (20.28%) and biliary and intra-abdominal infections (17.13%). The 30-day mortality rate of bloodstream infections was 16.08%. A total of 286 pathogens were isolated, including 181 (63.29%) Gram-negative bacteria, primarily Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa; 101 (35.31%) Gram-positive bacteria, mainly Staphylococcus aureus, Staphylococcus epidermidis, and Streptococcus pneumoniae; and only 4 (1.40%) fungal isolates. Antimicrobial susceptibility testing showed that the key Enterobacteriaceae strains exhibited resistance rates of 2.4% to carbapenems, 16.3% to piperacillin sodium and tazobactam sodium, and 15.3% to ceftazidime, with no detected resistance to tigecycline or polymyxins. The main non-fermentative bacteria showed resistance rates of 29.6% to piperacillin sodium and tazobactam sodium, 13.3% to cefoperazone sodium and sulbactam sodium, and 27.1% to quinolones. Among Gram-negative bacteria, multidrug-resistant strains accounted for 40.9% (74/181), with carbapenem-resistant Escherichia coli and Klebsiella pneumoniae detected in 5.4% (5/92) and 13.6% (6/44) of cases, respectively. No carbapenem-resistant Pseudomonas aeruginosa was identified. Among Gram-positive bacteria, resistance rates to penicillin G, rifampicin, and cefoxitin were 74.7%, 4.2%, and 50%, respectively, with only 3 cases of resistant to glycopeptide antibiotics. CONCLUSIONS Bloodstream infections in emergency patients are predominantly community-acquired, with Gram-negative bacteria being the most common pathogens. The isolated pathogens exhibited relatively low resistance rates to commonly used clinical antibiotics.
Retrospective Studies ; Emergency Service, Hospital/statistics & numerical data* ; Drug Resistance, Bacterial ; Anti-Bacterial Agents/therapeutic use* ; Incidence ; Microbial Sensitivity Tests/statistics & numerical data* ; Bacteremia/microbiology* ; Community-Acquired Infections/microbiology* ; Gram-Negative Bacteria/isolation & purification* ; Blood Culture/statistics & numerical data* ; Humans ; Male ; Female ; Adolescent ; Young Adult ; Adult ; Middle Aged ; Aged ; Aged, 80 and over ; China/epidemiology*

OBJECTIVE: The objective of this study was to investigate the clinical efficacy and safety of treating sepsis patients with Xuebijing injection (XBJI). METHODS: We conducted a retrospective analysis of 418 patients who experienced severe infections and were treated with XBJI from June 2018 to June 2021. Propensity score matching was used to match the patient cases. The study population included 209 pairs of cases (418 individuals), and the analysis included data from before and after a 14-day course of treatment with carbapenem alone, or carbapenem with XBJI. RESULTS: There were no significant differences in the 14-day mortality or length of hospital stay (P > 0.05) between the two groups. The combined treatment group had more patients with C-reactive protein that returned to normal levels (compared to baseline) than the non-combined treatment group (14.4% vs 8.1%; odds ratio [OR]: 0.528; 95% confidence interval [CI]: 0.282-0.991; P = 0.026). Similarly, the combined treatment group had higher procalcitonin attainment rate (55.0% vs 39.7%; OR: 0.513; 95% CI: 0.346-0.759; P = 0.001) than the non-combined treatment group. Further, more patients in the combined treatment group achieved normal creatinine levels than in the non-combined treatment group (64.1% vs 54.1%; OR: 0.659; 95% CI: 0.445-0.975; P = 0.037). CONCLUSION The combination of XBJI with carbapenem did not reduce the 14-day mortality rate of patients with severe infection, but it was able to reduce the level of inflammatory factors in patients with sepsis, and had a protective effect on liver and kidney function. Please cite this article as: Gong ZT, Yang HX, Zhu BB, Liu HH, Siri GL. Clinical efficacy of Xuebijing injection for the treatment of sepsis: A retrospective cohort study. J Integr Med. 2024; 22(6): 645-651.
Humans ; Drugs, Chinese Herbal/administration & dosage* ; Sepsis/mortality* ; Retrospective Studies ; Male ; Female ; Middle Aged ; Aged ; Treatment Outcome ; Anti-Bacterial Agents/administration & dosage* ; C-Reactive Protein/analysis* ; Carbapenems/therapeutic use* ; Length of Stay ; Injections ; Adult ; Drug Therapy, Combination ; Procalcitonin/blood*

Platelets not only have hemostatic function, but can also directly or indirectly recognize pathogenic microorganisms and the signals they produce to capture and destroy them through membrane receptors. They can collaborate with various components of the body's immune system by releasing of intraplatelet particulate matter, cytokines and chemokines to perform bactericidal functions. And it can also play a bactericidal role by swallowing pathogens, releasing antimicrobial proteins and chemokines and activating and enhancing other specialized anti-inflammatory cells bactericidal effect, such as leukocytes and so on. However, the bacteriostatic composition and bacteriostatic mechanism of platelets remain unclear, so attention should be paid to the immune mechanism and bacteriostatic effect of platelets.
Blood Platelets ; Anti-Bacterial Agents/pharmacology* ; Cytokines ; Leukocytes ; Particulate Matter

At present, effective antibiotics and comprehensive symptomatic/supportive treatment as early as possible are mainly used for the treatment of severe pertussis in clinical practice. However, some children with severe pertussis have unsatisfactory response to commonly used drugs and treatment measures in the intensive care unit and thus have a high risk of death. Studies have shown that certain treatment measures given in the early stage, such as exchange transfusion, may help reduce deaths, but there is still a lack of uniform implementation norms. How to determine the treatment regimen for severe pertussis and improve treatment ability remains a difficult issue in clinical practice. This article reviews the advances in the treatment of severe pertussis, in order to provide a reference for clinical treatment and research.
Anti-Bacterial Agents ; Child ; Exchange Transfusion, Whole Blood ; Humans ; Whooping Cough/drug therapy*

PURPOSE: Fungal periprosthetic joint infection (PJI) is a rare but devastating complication following total knee arthroplasty (TKA). On the other hand, a standardized procedure regarding an accurate treatment of this serious complication of knee arthroplasty is lacking. The clinical progress of staged reimplantation in patients who had fungus-related PJI after TKA was reviewed retrospectively. MATERIALS AND METHODS: Ten patients who had a fungal related PJI after TKA between 2006 and 2017 using staged reimplantation surgery were reviewed. These patients were compared with 119 patients who had a PJI in the same period. The failure rate of infection control, intravenous antimicrobial using the period, and the clinical results were evaluated by comparing the range of motion and Korean knee score (KKS) between pre-staged reimplantation and the last follow-up. RESULTS: In the fungal infection group, 7 out of 10 cases (70.0%) had failed in infection control using staged reimplantation and in the non-fungal group, 7 out of 119 cases (5.9%) had failed (p=0.04). In the non-fungal group, the mean duration of antibiotics was 6.2 weeks. In the fungus group, the mean duration of antibiotics was 15.3 weeks, which was 9.1 weeks longer (p < 0.001). The range of motion of the knee was increased in the two groups (p=0.265). At the last follow-up, the KKS was 71.01 points in the non-fungal group and 61.3 points in the fungal group (p=0.012). Erythrocyte sedimentation rate and C-reactive protein (CRP) decreased in the two groups, but the CRP was significantly different in the two groups (p=0.007). CONCLUSION: The treatment of fungus-related PJIs using staged reimplantation showed uneven clinical progress and unsatisfactory clinical improvements compared to non-fungal PJI. Therefore, it is necessary to consider the use of an antifungal mixed cement spacer at resection arthroplasty and oral antifungal agent after reimplantation.
Anti-Bacterial Agents ; Arthroplasty ; Arthroplasty, Replacement, Knee ; Blood Sedimentation ; C-Reactive Protein ; Follow-Up Studies ; Fungi ; Hand ; Humans ; Infection Control ; Joints ; Knee ; Range of Motion, Articular ; Replantation ; Retrospective Studies

To investigate the effect of Fuyanshu Capsules combined with Western medicine antibiotics on symptoms and inflammatory factors IL-10 and IL-1β in patients with pelvic inflammatory disease and its possible mechanism. Totally 112 patients with pelvic inflammatory disease of damp-heat stagnation treated since April 2017 to April 2018 were randomly divided into treatment group( group A,57 cases) and control group( group B,55 cases). The treatment group was given Fuyanshu Capsules for 56 d,and levofloxacin hydrochloride tablets and metronidazole tablets for 14 d. The control group was given Fuyanshu Capsules as its analogue. The curative rate,effective rate and inefficiency,serum IL-10 and IL-1β levels were compared between the two groups. The curative effect was evaluated with McCormack score and traditional Chinese medicine( TCM) syndrome score. The recurrence rate and chronic pelvic pain were followed up after one menstrual cycle. It was found that the curative rate and effective rate of group A were higher than those of group B after treatment. After 28 d of treatment,there was a difference in the effective rate of TCM syndrome score between group A and group B( 62. 71% vs 8. 47%,P < 0. 01). After 56 d of treatment,serum IL-10 increased,while IL-1β decreased in group A,which was significantly different from that in group B( P<0. 01). The recurrence rate of PID and chronic pelvic pain in group A were significantly lower than those in group B( P<0. 01). The results showed that Fuyanshu Capsules combined with levofloxacin and metronidazole could alleviate the clinical symptoms and signs of chronic pelvic inflammation of damp-heat stagnation type,reduce the recurrence rate of pelvic inflammation,relieve pelvic pain,and alleviate the inflammation status of patients by regulating the expression of IL-10 and IL-1β in peripheral serum.
Anti-Bacterial Agents ; therapeutic use ; Capsules ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Interleukin-10 ; blood ; Interleukin-1beta ; blood ; Levofloxacin ; Medicine, Chinese Traditional ; Metronidazole ; Pelvic Inflammatory Disease ; drug therapy

OBJECTIVE: To investigate the effect of clinical factors on the pathogen culture results in the patients with pyogenic spondylitis, and to find out clinical controllable factors which could increase the positive rate of the pathogen culture. METHODS: A retrospective study reviewed 40 patients who were diagnosed with pyogenic spondylitis in Peking University First Hospital from January 2011 to July 2017. The patients were divided into two groups depending on the culture results, culture negative or culture positive. The influence of clinical uncontrollable factors [the patient's age, gender, predisposing factors, infection site except spine, visual analogue score (VAS), course of disease, spinal segment, white blood cell (WBC), (neutrophilic granulocyte)% (NE%), the incidence of systemic inflammatory response syndrome (SIRS), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), the incidence of paravertebral abscess] and controllable factors (prior antibiotics exposure within 2 weeks, tissue homogenate, surgical approach) on pathogen culture results were analyzed. RESULTS: Of the 40 patients, 18 patients were female and 22 patients were male. Causative germ was identified in 24/40 patients (60.00%) and dominant by gram positive cocci (68.00%). For clinical uncontrollable factors, there was no significant difference between the two groups in the patient's age, gender, predisposing factors, infection site except spine, VAS, course of disease, spinal segment, WBC, NE% and the incidence of SIRS. ESR [(94.38±6.91) mm/h, P=0.023)], CRP [(64.74±13.51) mg/L, P=0.040], and the incidence of paravertebral abscess (75%, P=0.018) in culture negative group were lower in contrast to culture positive group. For clinical controllable factors, prior antibiotics exposure within 2 weeks (P=0.058, OR=4.030, 95%CI: 0.956-16.993) and tissue homogenate (P=0.014, OR=0.171, 95%CI: 0.042-0.695) were significantly associated with the pathogen culture result. Surgical approach was not significantly associated with pathogen culture result. CONCLUSION Patients with high level of ESR, CRP, and paravertebral abscess, would have high positive rate of pathogenic culture. Prior antibiotics exposure was associated with lower positive pathogen culture rate. Culture with tissue homogenate was more likely to find the causative germ, especially for patients without paravertebral abscess who had low level of ESR, CRP and prior antibiotics exposure.
Abscess ; Anti-Bacterial Agents ; Blood Sedimentation ; C-Reactive Protein ; Female ; Humans ; Male ; Retrospective Studies ; Spondylitis

Panax notoginseng saponins (PNS) are the major components of Panax notoginseng, with multiple pharmacological activities but poor oral bioavailability. PNS could be metabolized by gut microbiota in vitro, while the exact role of gut microbiota of PNS metabolism in vivo remains poorly understood. In this study, pseudo germ-free rat models were constructed by using broad-spectrum antibiotics to validate the gut microbiota-mediated transformation of PNS in vivo. Moreover, a high performance liquid chromatography-electrospray ionization tandem mass spectrometry (HPLC-ESI-MS/MS) was developed for quantitative analysis of four metabolites of PNS, including ginsenoside F1 (GF1), ginsenoside Rh2 (GRh2), ginsenoside compound K (GCK) and protopanaxatriol (PPT). The results showed that the four metabolites could be detected in the control rat plasma, while they could not be determined in pseudo germ-free rat plasma. The results implied that PNS could not be biotransformed effectively when gut microbiota was disrupted. In conclusion, gut microbiota plays an important role in biotransformation of PNS into metabolites in vivo.
Animals ; Anti-Bacterial Agents ; pharmacology ; Biotransformation ; Chromatography, High Pressure Liquid ; Feces ; microbiology ; Gastrointestinal Microbiome ; drug effects ; physiology ; Ginsenosides ; blood ; Male ; Panax notoginseng ; chemistry ; Rats, Sprague-Dawley ; Sapogenins ; blood ; Saponins ; administration & dosage ; metabolism ; Tandem Mass Spectrometry