BACKGROUNDAs a time-dependent antibiotic, the time of cefazedone concentration exceeds the minimum inhibitory concentration (MIC) is the key pharmacokinetic-pharmacodynamic (PK-PD) variable associated with the killing of pathogens. The purpose of the study was to evaluate the clinical regimen rationality of intravenous cefazedone sodium in the treatment of community-acquired pneumonia (CAP) by PK/PD study.

METHODSTen patients with mild to moderate CAP were enrolled to receive intravenous cefazedone sodium (2 g q12 h) for 7-14 days. Blood samples were collected in any day during day 5-7. Sputum specimens were collected before treatment for bacteria isolated, and susceptibility to cefazedone determined. PK-PD analysis was performed using the noncompartmental analysis of Phoenix WinNolin software (version 6.1, Pharsight Corporation, CA, USA). The maximal time above MIC (ƒT > MIC) was calculated, and its correlation with clinical efficacy was analyzed.

RESULTSAll 10 patients completed the study and 8 of them were cured. Six strains were isolated from patients before treatment (one for each patient) and all susceptible to cefazedone. Five patients of six in culture positive group were cured. All pathogens were cleared at the end of therapy. The MICs were between 0.25 and 1 mg/L. The main PK parameters were C max 175.22 ± 36.28 mg/L; T½ 1.52 ± 0.23 h; AUC (0-∞) 280.51 ± 68.17 mg·L -1·h -1 ; CL 7.37 ± 1.84 L/h; Vd 16.06 ± 4.42 L. The average ƒT > MIC was 55.45 ± 8.12%.

CONCLUSIONSIntravenous injection of cefazodone sodium with 2 g q12 h dosage regimen is used in the treatment of CAP caused by sensitive bacteria, either ƒT > MIC or clinical efficacy shows that such dosing regimen is reasonable.

Administration, Intravenous ; Adolescent ; Adult ; Aged ; Anti-Bacterial Agents ; administration & dosage ; pharmacokinetics ; therapeutic use ; Cefazolin ; administration & dosage ; analogs & derivatives ; pharmacokinetics ; therapeutic use ; Community-Acquired Infections ; drug therapy ; metabolism ; Female ; Humans ; Male ; Microbial Sensitivity Tests ; Middle Aged ; Young Adult

BACKGROUNDThe aim of this study was to assess the performance of apparent diffusion coefficient (ADC) measurement obtained with diffusion-weighted magnetic resonance imaging (DW-MRI) to distinguish renal cell carcinomas (RCCs) from small benign solid renal tumors (≤ 4 cm).

METHODSIn this cross-sectional study, 49 consecutive patients with histopathologically confirmed small solid renal tumors, and seven healthy volunteers were imaged using nonenhanced MRI and DW-MRI. The ADC map was calculated using the b values of 0, 50, 400, and 600 s/mm 2 and values compared via the Kruskal-Wallis and Mann-Whitney tests. The utility of ADC for differentiating RCCs and benign lesions was assessed using a receiver operating characteristic curve. Multiple nonenhanced MRI features were analyzed by Logistic regression.

RESULTSThe tumors consisted of 33 cases of clear-cell RCCs (ccRCCs) and 16 cases of benign tumors, including 14 cases of minimal fat angiomyolipomas and 2 cases of oncocytomas. The ADCs showed significant differences among benign tumors ([0.90 ± 0.52] × 10-3 mm 2 /s), ccRCCs ([1.53 ± 0.31] × 10-3 mm 2 /s) and the normal renal parenchyma ([2.22 ± 0.12] × 10-3 mm 2 /s) (P < 0.001). Moreover, there was statistically significant difference between high and low-grade ccRCCs (P = 0.004). Using a cut-off ADC of 1.36 × 10-3 mm 2 /s, DW-MRI resulted in an area under the curve (AUC), sensitivity, and specificity equal to 0.839, 75.8%, and 87.5%, respectively. Nonenhanced MRI alone and the combination of imaging methods led to an AUC, sensitivity and specificity equal to 0.919, 93.9%, and 81.2%, 0.998, 97%, and 100%, respectively. The Logistic regression showed that the location of the center of the tumor (inside the contour of the kidney) and appearance of stiff blood vessel were significantly helpful for diagnosing ccRCCs.

CONCLUSIONSDW-MRI has potential in distinguishing ccRCCs from benign lesions in human small solid renal tumors (≤ 4 cm), and in increasing the accuracy for diagnosing ccRCCs when combined with nonenhanced MRI.

Adult ; Aged ; Carcinoma, Renal Cell ; diagnosis ; Cross-Sectional Studies ; Diffusion Magnetic Resonance Imaging ; methods ; Female ; Humans ; Kidney Neoplasms ; diagnosis ; Male ; Middle Aged ; Young Adult

The effective exploitation of natural products is of great significance. Herein the essential oil from Herba Artimisiae Sieversianae in growth period and flower/ fruit bearing period was extracted by ethanol extraction method. The optimal extraction condition was determined by orthogonal experiment, including extracting 3 times, soaking for 90 min, and the ratios of liquid to solid for Herba Artimisiae Sieversianae in growth period and flower/ fruit bearing period were 10 mL : 1 g and 8 mL : 1 g, respectively. The main components of the products were confirmed by FT-IR and GC-MS, which were cineole, camphor, d-borneol, caryophyllene, cadina-1, 4-diene, calamenene, ethyl palmitate, etc. in herba artimisiae sieversianae in growth period, and camphor, caryophyllene, borneol, neryl formate, etc. in Herba Artimisiae Sieversianae in flower/ fruit bearing period. The radical scavenging activity of the products was determined. The results showed that the IC50 values of the essential oil from Herba Artimisiae Sieversianae in growth period and flower/fruit bearing period for 0. 05 mmol/ L DPPH solution were 0. 40 mg / mL and 1. 66 mg / mL, respectively. The essential oil extracted by ethanol from Herba Artimisiae Sieversianae was confirmed to possess good antioxidant activity.

Objective VATER/VACTERL-like association is associated with adverse pregnancy outcomes.Genetic evidence of this disorder is sporadic.In this study,we aimed to provide genetic insights to improve the diagnosis of VACTERL. Methods We have described a Chinese family in which four members were affected by renal defects or agenesis,anal atresia,and anovaginal fistula,which is consistent with the diagnosis of a VACTERL-like association.Pedigree and genetic analyses were conducted using genome and exome sequencing. Results Segregation analysis revealed the presence of a recessive X-linked microdeletion in two living affected individuals,harboring a 196-380 kb microdeletion on Xq27.1,which was identified by familial exome sequencing.Genome sequencing was performed on the affected male,confirming a-196 kb microdeletion in Xq27.1,which included a 28%loss of the CDR-1 gene.Four family members were included in the co-segregation analysis,and only VACTERL-like cases with microdeletions were reported in X27.1. Conclusion These results suggest that the 196-380 kb microdeletion in Xq27.1 could be a possible cause of the VATER/VACTERL-like association.However,further genetic and functional analyses are required to confirm or rule out genetic background as the definitive cause of the VACTERL association.

OBJECTIVETo further investigate the risk factors of cubitus varus in humeral condylar fracture after conservative treatment in children through Logistic regression analysis, so as to guide the clinical treatment.

METHODSChildren with humeral condylar fracture who were treated by manipulative reduction and plaster fixation in our hospital from March 2008 to December 2014 were studied. The clinical data including age, gender, BMI, time from injury to reduction, direction of displacement, rotation displacement, fixed position, and epiphyseal injury were collected. First, preliminary screen the risk factors through univariate analysis of the above data, then determine the risk factors of cubitus varus through multivariate Logistic regression analysis of the significant factors from univariate analysis.

RESULTSUnivariate analysis showed that time from injury to reduction, direction of displacement, rotation displacement and epiphyseal injury were significantly correlated with the cubitus varus. Multivariate Logistic regression analysis showed that time from injury to reduction which was longer than 8 h [=0.017, OR=3.303(1.243-8.774)], ulnar displacement [=0.001,=11.951(2.895-49.335)], rotation displacement [=0.003, OR=4.190(1.643-10.685)]and epiphyseal injury [=0.000,=7.092(2.557-19.671)] were independent risk factors of cubitus varus.

CONCLUSIONSTime from injury to reduction, ulnar displacement, rotation displacement and epiphyseal injury are independent risk factors of cubitus varus. So it need corresponding treatment according to different risk factors.

Objective:To observe the effect of polyphyllin Ⅰ on the expressions of forkhead box Q1（FOXQ1）and epithelial-mesenchymal transition (EMT)-related factors, in order to explore the possible mechanism of polyphyllin Ⅰ in inhibiting the metastasis of colon cancer. Method:After the treatment with 1.25，2.50 μmol·L^-1 polyphyllin Ⅰ on HCT116 cells, Western blot and Real-time PCR were used to detect the expressions of FOXQ1，E-cadherin，Vimentin protein and mRNA. Result:Compared with the blank group, relative expressions of FOXQ1 protein and mRNA in low-concentration polyphyllin Ⅰ group were decreased, while relative expression of E-cadherin mRNA was increased, the differences were not statistically significant, and relative expressions of Vimentin protein and mRNA in low-concentration polyphyllin Ⅰ group were decreased (P<0.05)， and relative expression of E-cadherin protein in low-concentration polyphyllin Ⅰ group was increased (P<0.01). Compared with the blank group, relative expressions of FOXQ1, Vimentin protein and mRNA in high-concentration polyphyllin Ⅰ group were decreased，while relative expressions of E-cadherin protein and mRNA were increased (P<0.05, P<0.01). Compared with low-concentration polyphyllin Ⅰ group, relative expressions of Vimentin protein and mRNA in high-concentration polyphyllin Ⅰ group were decreased, but the difference was not statistically significant, relative expressions of E-cadherin protein and mRNA in high-concentration polyphyllin Ⅰ group were increased, whereas relative expressions of FOXQ1 protein and mRNA were decreased (P<0.05, P<0.01). Conclusion:Mechanism of polyphyllin Ⅰ inhibiting the metastasis of colon cancer may be related to the decrease of FOXQ1 and Vimentin expressions, and the up-regulation of E-cadherin.