Meropenem （MEM） is one of the important drugs for the treatment of severe infections， but the standard dose is often difficult to achieve an effective therapeutic concentration target. This article reviews the related studies on the population pharmacokinetics of MEM in patients with severe infection. It is found that the apparent volume of distribution （Vd） and clearance rate are the most important factors affecting the dose adjustment， and the factors affecting Vd include serum albumin， age， overall weight， shock status， and chest/abdomen/cerebrospinal fluid drainage. The main factors affecting the clearance rate were renal function， renal replacement therapy treatment mode and combination therapy. For adult patients with severe infections in China， MEM is recommended to be administered in an individualized manner based on glomerular filtration rate， with a dosage range of 500 to 1 500 mg given every 4 to 6 hours， and prolonged infusion is preferred. When the minimum inhibitory concentration （MIC） of the pathogenic bacteria reaches 64 mg/L， therapeutic drug monitoring is required. For therapeutic efficacy， it is essential to ensure that the trough concentration remains above the MIC； to prevent drug resistance， it should be maintained above 4×MIC. Regarding safety， it is recommended that the upper limit of the trough concentration be 32 mg/L， and blood sampling for monitoring can be conducted as early as after 1 to 2 doses of administration.

Background and Aims:Laparoscopic cholecystectomy(LC)is a common surgical method for the treatment of gallbladder diseases.However,some patients experience symptoms such as dyspepsia after surgery,which can affect their quality of life.Compound azinomide enteric-coated tablets,a novel drug,may improve dyspeptic symptoms after LC.This study was conducted to explore the clinical efficacy of compound azinomide enteric-coated tablets in treating post-LC dyspepsia symptoms through a multicenter clinical trial.Methods:A multicenter,superior efficacy,open-label,parallel-controlled design was used.Patients with postoperative dyspepsia were enrolled in 7 centers between January 2023 and May 2024.Patients were randomly assigned to either the observation or control groups using a random number table.The observation group received compound azinomide enteric-coated tablets,while the control group was treated with a combination of oryzae pancreatin tablets and ursodeoxycholic acid tablets.Both groups were treated for 4 weeks.The primary endpoints included gastrointestinal symptom scores and quality of life scores assessed before and at 14 and 28 d after treatment.Additionally,the incidence of adverse reactions and cost-effectiveness ratio(CER)were compared between the groups.Results:A total of 303 patients were included,with 150 in the observation group and 153 in the control group.Baseline characteristics were balanced between the groups before treatment(all P>0.05).After treatment,the observation group showed significantly higher effective rates at 14 d and 28 d than the control group(44.7%vs.29.4%;98.0%vs.73.9%,both P<0.05).The observation group also had significantly lower symptom scores and quality of life scores at both 14 and 28 d,with a significantly higher improvement rate in symptom scores compared to the control group(all P<0.05).Further analysis of the improvement rate and treatment efficacy for individual symptoms revealed that,except for the 14-d improvement in abdominal pain/discomfort,the observation group showed better improvement in all other symptoms at 14 d and in all symptoms at 28 d compared to the control group(all P<0.05).No adverse reactions were observed in either group.The CER for the observation group was 283.78 yuan/efficacy rate at 14 d and 128.57 yuan/efficacy rate at 28 d,while the control group's CER was 729.93 yuan/efficacy rate at 14 d and 290.22 yuan/efficacy rate at 28 d.Conclusion:Compound azinomide enteric-coated tablets demonstrated good clinical efficacy in treating dyspepsia symptoms after LC with excellent safety and high cost-effectiveness.Despite some limitations,the results provide a new treatment option for dyspepsia after LC.Larger-scale randomized controlled trials are needed to validate this study's conclusions further.

Background and Aims:Laparoscopic cholecystectomy(LC)is a common surgical method for the treatment of gallbladder diseases.However,some patients experience symptoms such as dyspepsia after surgery,which can affect their quality of life.Compound azinomide enteric-coated tablets,a novel drug,may improve dyspeptic symptoms after LC.This study was conducted to explore the clinical efficacy of compound azinomide enteric-coated tablets in treating post-LC dyspepsia symptoms through a multicenter clinical trial.Methods:A multicenter,superior efficacy,open-label,parallel-controlled design was used.Patients with postoperative dyspepsia were enrolled in 7 centers between January 2023 and May 2024.Patients were randomly assigned to either the observation or control groups using a random number table.The observation group received compound azinomide enteric-coated tablets,while the control group was treated with a combination of oryzae pancreatin tablets and ursodeoxycholic acid tablets.Both groups were treated for 4 weeks.The primary endpoints included gastrointestinal symptom scores and quality of life scores assessed before and at 14 and 28 d after treatment.Additionally,the incidence of adverse reactions and cost-effectiveness ratio(CER)were compared between the groups.Results:A total of 303 patients were included,with 150 in the observation group and 153 in the control group.Baseline characteristics were balanced between the groups before treatment(all P>0.05).After treatment,the observation group showed significantly higher effective rates at 14 d and 28 d than the control group(44.7%vs.29.4%;98.0%vs.73.9%,both P<0.05).The observation group also had significantly lower symptom scores and quality of life scores at both 14 and 28 d,with a significantly higher improvement rate in symptom scores compared to the control group(all P<0.05).Further analysis of the improvement rate and treatment efficacy for individual symptoms revealed that,except for the 14-d improvement in abdominal pain/discomfort,the observation group showed better improvement in all other symptoms at 14 d and in all symptoms at 28 d compared to the control group(all P<0.05).No adverse reactions were observed in either group.The CER for the observation group was 283.78 yuan/efficacy rate at 14 d and 128.57 yuan/efficacy rate at 28 d,while the control group's CER was 729.93 yuan/efficacy rate at 14 d and 290.22 yuan/efficacy rate at 28 d.Conclusion:Compound azinomide enteric-coated tablets demonstrated good clinical efficacy in treating dyspepsia symptoms after LC with excellent safety and high cost-effectiveness.Despite some limitations,the results provide a new treatment option for dyspepsia after LC.Larger-scale randomized controlled trials are needed to validate this study's conclusions further.

Objective To analyze the application value of dynamic and static complementary balance theory-based functional exercise combined with stepwise rehabilitation training in postoperative hip function recovery in patients undergoing total hip replacement(THR).Methods The clinical data of 118 inpatients undergoing THR between June 2022 and June 2023 were retrospectively collected.Among the patients,57 were given perioperative stepwise rehabilitation training(the control group),and 61 were given a combination of functional exercise based on static and dynamic complementary balance theory and stepwise rehabilitation training during the perioperative period(the combination group).The postoperative recovery status and the incidence of postoperative complications in the two groups were recorded.During postoperative recovery,the patients were assessed for pain with the visual analogue scale(VAS)and for self-efficacy with the Self-Efficacy for Rehabilitation Outcome Scale(SER).Hip function was measured and compared between the two groups at 2 weeks,4 weeks and 8 weeks after surgery.Results With regard to the primary outcome indicator,the postoperative length-of-stay was(7.63±1.36)d in the combination group,which was shorter than the(8.22±1.48)d in the control group,and the difference was statistically significant(t=2.257,P=0.026).As for the secondary outcome indicators,no statistically significant difference was observed in the incidence of postoperative complications between the two groups(4.92%vs.14.04%)(P＞0.05).The perioperative VAS scores in the two groups showed an interaction effect according to the repeated measurement variance test(P＜0.05).The postoperative VAS scores in both groups declined significantly compared to the preoperative scores(P＜0.05),and the VAS score decreased gradually over time after surgery(P＜0.05).The VAS scores in the combination group at 7 and 14 days after surgery were lower than those in the control group(P＜0.05).At 14 days after surgery,the scores for the coping and the task dimensions and the total score of SER increased in both groups compared with those at 3 days after surgery(P＜0.05),with the combination group showing higher scores than the control group did(P＜0.05).After surgery,the scores for the dimensions of deformity,pain,function,and joint mobility and the total score of the Harris Hip Scale revealed interaction effects in the two groups according to the repeated measurement variance test(P＜0.05),with these scores increasing gradually over time after surgery(P＜0.05),and the scores in the combination group were higher at 4 and 8 weeks after surgery compared to those in the control group(P＜0.05).Conclusion The combination of functional exercise based on dynamic and static complementary balance theory and stepwise rehabilitation training shows an advantage over stepwise rehabilitation training alone in enhancing the self-efficacy of THR patients,relieving the postoperative pain,shortening the length-of-stay,and improving the hip function in patients.

Multi-angle plane-wave beamforming algorithm is the basis of ultra-fast ultrasonic imaging. It can be used to improve the imaging frame rate and resolution of traditional focused ultrasound. However, the existing multi-angle plane-wave technology can not satisfy the real-time imaging requirements due to the huge amount of computation required by CPU. In this paper, We proposed a parallel processing method to reduce the computation time based on compute unified device architecture(CUDA). Simulation analysis and contrast experiment were conducted to verify its performance. Experimental results show that the execution time based on GPU is much less than that based on CPU, thus the computational speed is accelerated significantly to satisfy the demand of ultrafast imaging.

Animals ; B7-H1 Antigen ; immunology ; Cell Line, Tumor ; Gene Expression Regulation, Neoplastic ; immunology ; Humans ; Interferons ; immunology ; Mice ; Neoplasm Proteins ; immunology ; Neoplasms ; immunology ; Up-Regulation ; immunology

Objective To investigate the protective effect of retigabine (a M-type potassium channel opener) on brains and its mechanism in male mice after acute cerebral ischemia reperfusion(I/R)injury.Methods Seventy male C57BL/6J mice were randomly divided sham-operated group (n=10),middle cerebral artery occlusion (MCAO) group (n=10) and prevention group (n=50) according to the random number table method;mice in the prevention group were then divided into XE991 (a M-type potassium channel blocker) group,RTG-treatment 0 h group,RTG-treatment 1 h group,RTG-treatment 3 h group,and RTG-treatment 6 h group (n=10).The MCAO models were established by suture method,and reperfusion was performed 90 min after cerebral ischemia.In RTG-treatment groups,a single dose of 10.5 mg/kg RTG was injected at the designated varying time points (0,1,3 and 6 h after the reperfusion);in XE991 group,a single dose of 3.0 mg/kg XE991 was injected after the reperfusion;mice in the sham-operated group and MCAO group received the same volume of saline.Twenty-four h after model making,infarct size was measured by TTC staining.HE staining was used to observe the morphological changes of neurons in hippocampal CA1 regions.The apoptotic neurons level and membrane protein CD40L expression in the ischemic penumbra were detected by TUNEL staining and Western blotting.Results In the sham-operated group,brain tissues had no obvious change,no infarction was observed,there was no CD40L expression,and TUNEL staining positive neurons were hardly found.(1) Cerebral artery territory infarction was visible in the MCAO group and intervention group;however,the infarction volume of the RTG-treatment groups was significantly lower than that in the MCAO group (P＜0.05);the infarction volume of the RTG-treatment 6 h group was increased as compared with that of the RTG-treatment 0 h group,RTG-treatment 1 h group,and RTG-treatment 3 h group,without significant difference (P＞0.05).(2) HE staining showed that hippocampal neurons were obviously swollen and necrotic in the MCAO group and XE991 group,while the pathological damages such as brain edema and neuron necrosis were ameliorated significantly in the RTG-treatment groups.(3) As compared with those in the MCAO group,the number of TUNEL staining positive neurons in the RTG-treatment 0 h group,RTG-treatrnent 1 h group,and RTG-treatment 3 h group and CD40L number in the RTG-treatment 0 h group and RTG-treatment 3 h group were decreased significantly (P＜0.05);as compared with that in the MCAO group,the number of TUNEL staining positive neurons increased significantly in the XE991 group (P＜0.05).Conclusion RTG has protective effect on cerebral I/R,and its mechanism might relate to reducing cell excitability and inflammation,thereby inhibiting cell apoptosis;these protection would be less effective when RTG is used outside a defined critical period of time.

OBJECTIVETo investigate the effect of phenylhexyl isothiocyanate (PHI) on histone acetylation and apoptosis in hepatocellular carcinoma cell line (SMMC-7721) in vitro.

METHODSThe viability of SMMC-7721 cells was determined by trypan blue exclusion. Apoptotic cells were assessed by TUNEL assay. The proteins of Bcl-2, Procaspase-9, Procaspase-8, Procaspase-3, caspase-9, caspase-3, histone acetylated H3 and H4 were detected by Western blot.

RESULTSCompared with the vehicle control, PHI at 5, 10, 20, 40 and 80 µmol/L reduced the cell viability of SMMC-7721 cells in a concentration-dependent manner. PHI induced apoptosis in SMMC-7721 cells. An increased amount of apoptotic cells was detected after 7 hours exposure to PHI at 10, 20, and 40 µmol/L, 6.9% ± 2.4%, 17.5% ± 4.2% and 54.5% ± 5.4%, respectively, while that of the vehicle control was 4.5% ± 2.3% (P < 0.05). Along with the prolongation of time and increase of dose, the expressions of bcl-2, procaspase-9, procaspase-3 were decreased, that of caspase-9 and caspase-3 was increased. In contrast, alteration of procaspase-8 was not significant at those concentrations. PHI accumulated acetylated histone H3 and H4. After 3 hours exposure to PHI at 10, 20 and 40 µmol/L, the level of histone acetylated H3 was 1.87-, 2.43-, 3.67-fold increased and histone acetylated H4 was 1.29-, 1.45-, and 2.25-fold increased, compared with that of the vehicle control. The protein of histone acetylated H3 and H4 was significantly accumulated after 7 hours exposure.

CONCLUSIONPHI is a new histone deacetylation inhibitor. It may induce accumulation of histone acetylation H3 and H4, inhibit cell growth and induce apoptosis in SMMC-7721 cells via the mitochondrial pathway.

Acetylation ; drug effects ; Apoptosis ; drug effects ; Carcinoma, Hepatocellular ; metabolism ; pathology ; Caspase 3 ; metabolism ; Caspase 8 ; metabolism ; Caspase 9 ; metabolism ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Dose-Response Relationship, Drug ; Histone Deacetylase Inhibitors ; administration & dosage ; pharmacology ; Histones ; metabolism ; Humans ; Isothiocyanates ; administration & dosage ; pharmacology ; Liver Neoplasms ; metabolism ; pathology ; Proto-Oncogene Proteins c-bcl-2 ; metabolism

To get information in the sexual and contraceptive behaviors in Chinese female college students, a randomized cluster sampling was conducted in colleges and universities in Wuhan Area, China, in terms of types of colleges, subjects (literature, sciences, medicines, art etc), and grades etc. A total number of 2450 questionnaires were distributed, with 2365 questionnaires returned being valid. The return rate of valid questionnaires was 96.6%. The questionnaire investigation was conducted on a multiple-choice and anonymous basis. Data were input into computer and SPSS12.0 software package was employed for statistical analysis. Among the female students, 1196 had the experiences of hugging and kissing (50.57%) and 423 (17.89%) had sexual experiences (sexual intercourse). The first sexual intercourse took place at the age of 19.23+/-1.74 y. There were significant differences in the sexual experiences among the majors of different subjects, with the rate of sexual experiences in art majors (43.17%) and high-grade students (34.31%) being the highest. The causes of the first sexual intercourse included sexual impulse, curiosity, intention to strengthen the relationship or to show loyalty to boyfriend and sometimes violence. While the motives of the sexual intercourse within the past one year before the investigation were to satisfy the sexual needs and to strengthen the relation with their boyfriends. With both first intercourse and sexual experiences within last one year, the partners of the sexual intercourse were mainly their boyfriends (95.7% and 97.3% respectively), but the partners also included acquaintances, "one night stand" partners and customers of sex trade. Some of them had multiple sexual partners, with the highest number of the sexual partners being 11. In the first sexual intercourse of the subjects, 44.0 % of them did not take any contraceptive measures; only 16.4% of them used condoms. In the sexual intercourse within the last one year, only 44.6% took contraceptive measures every time they had sexual intercourse. Among those who took contraceptive measures, 64.4% used condoms. Among those who had sexual intercourse, 101 persons got pregnant, with a rate of pregnancy being 4.3%, accounting for 23.9% of all who had sexual intercourse. Among those who got pregnant, 78 persons got pregnant once; the others became pregnant more than two times, the highest being 5 times. There were 122 persons who had inflammation of reproductive system, mostly vaginitis. Other conditions included venereal warts and herpes genitalis. It is concluded that the rate of sexual behaviors is high in female college students and there exist promiscuity, unexpected pregnancy and transmission of STD in the students.