OBJECTIVE:To systematically evaluate the efficacy and safety of modified infusion(2-4 h infusion or continuous 24 h infusion)versus traditional infusion(0.5-1 h infusion)of meropenem in the treatment of severe infectious,and to provide evi-dence-based reference for clinic treatment. METHODS:Retrieved from Medline,CJFD,VIP database and Wanfang database, modified infusion(test group)versus traditional infusion(control group)of meropenem in the treatment of severe infections were collected,and Mata-analysis was performed by using Rev Man 5.0 statistical software after extracting data and evaluating quality. RESULTS:A total of 13 studies were included,involving 1 012 patients. Results of Meta-analysis showed the effective rate [RR=1.25,95%CI(1.10,1.43),P<0.001] and bacterial eradication rate [RR=1.25,95%CI(1.05,1.48),P=0.01] in test groups were sig-nificantly higher than those of control group,and there were no significant differences in the mortality rate [RR=0.74,95%CI (0.46,1.18),P=0.21] and incidence of adverse reactions [RR=0.81,95%CI(0.48,1.39),P=0.45]. CONCLUSIONS:Compared with traditional infusion of meropenem,extended or continuous infusion can improve efficacy in the treatment of severe infections, with similar safety. Due to methodology limit of included studies,large-scale and high quality RCT are required for further valida-tion of the conclusions.

Objective:To evaluate the early predictive value of serum procalcitonin (PCT) , C-reactive protein (CRP) , and white blood cell count (WBC) levels for pancreatic fistula after pancreaticoduodenectomy (PD) .Methods:Data of 93 patients undergoing PD in Department of Pancreatic Surgery at the First Affiliated Hospital of Xinjiang Medical University from Jan. 2017 to Nov. 2019 were retrospectively analyzed. The general information of patients before surgery and postoperative pancreatic fistula were recorded. The levels of serum PCT, CRP, and WBC before surgery and 1st, 3rd, and 5th days after operation were recorded. Patients were divided into pancreatic fistula group (63 cases) and non-pancreatic fistula group (30 cases) . The preoperative data were compared between the two groups. Box plot and the receiver operating characteristic curve (ROC) were drawn. The area under the ROC curve (AUC) was calculated. The sensitivity and specificity of PCT, CRP, and WBC levels in predicting pancreatic fistula alone and jointly were calculated.Results:There were no statistically significant differences in the age, gender, presence or absence of diabetes, total bilirubin, preoperative albumin, surgical time, or intraoperative bleeding in the general information of the pancreatic fistula group and the non-pancreatic fistula group. The difference in index (BMI) was statistically significant. The value of PCT, CRP, and WBC before operation and the value of PCT on the first day after operation were not statistically significant between the two groups ( P=0.424, 0.819, 0.484, and 0.072, respectively) . The PCT values on the 3rd and 5th days after surgery, the values of CRP and WBC on the 1st, 3rd, and 5th days after surgery were all statistically significant (all P values were<0.05) . The area under the ROC curve was jointly predicted by the three at the 3rd and 5th days after operation (AUC=0.792, 0.812) , and the sensitivity (62.9%, 71.4%) and specificity (83.3%, 80%) were better than the three alone. Conclusion:PCT, CRP, and WBC values on the 1st, 3rd, and 5th days after surgery alone have certain limitations in predicting pancreatic fistula, and the combined prediction of the three is more valuable.

In this work, retinal penetration of fluorescein was achieved in vitro by covalent attachment of taurine to fluorescein, yielding the F-Tau conjugate. Nuclear magnetic resonance (NMR) and high resolution mass spectrometry (HRMS) were used to confirm the successful synthesis of F-Tau. The cellular uptake of F-Tau in adult retinal pigment epithelial cells (ARPE-19) and human retinal microvascular endothelial cells (hRMECs) was visualized via confocal scanning microscopy. The results indicated an improvement of solubility and a reduction of logP of F-Tau compared with fluorescein. As compared with fluorescein, F-Tau showed little toxicity, and was retained longer by cells in uptake experiments. F-Tau also displayed higher transepithelial permeabilities than fluorescein in ARPE-19 and hRMECs monolayer cells (P<0.05). These results showed that taurine may be a useful ligand for targeting small-molecule hydrophobic pharmaceuticals into the retina.