Objective To summarize the clinical experience of the first case of sulbactam-durlobactam treatment for extensively drug-resistant Acinetobacter baumannii infection after lung transplantation in China.Methods A retrospective analysis was conducted on a case of a patient with severe chronic obstructive pulmonary disease who received sulbactam-durlobactam treatment after lung transplantation.Results A 68-year-old male patient with a history of drug-resistant Acinetobacter baumannii infection before surgery,experienced worsening infection and impaired renal function after lung transplantation,with sputum culture showing extensively drug-resistant Acinetobacter baumannii.After receiving combination treatment with sulbactam-durlobactam and meropenem,the infection was controlled,and the function of the transplanted lung was restored.Conclusions Sulbactam-durlobactam has potential therapeutic value for extensively drug-resistant Acinetobacter baumannii infection after lung transplantation and provides a new strategy for clinical practice.

Objective To summarize the clinical experience of the first case of sulbactam-durlobactam treatment for extensively drug-resistant Acinetobacter baumannii infection after lung transplantation in China.Methods A retrospective analysis was conducted on a case of a patient with severe chronic obstructive pulmonary disease who received sulbactam-durlobactam treatment after lung transplantation.Results A 68-year-old male patient with a history of drug-resistant Acinetobacter baumannii infection before surgery,experienced worsening infection and impaired renal function after lung transplantation,with sputum culture showing extensively drug-resistant Acinetobacter baumannii.After receiving combination treatment with sulbactam-durlobactam and meropenem,the infection was controlled,and the function of the transplanted lung was restored.Conclusions Sulbactam-durlobactam has potential therapeutic value for extensively drug-resistant Acinetobacter baumannii infection after lung transplantation and provides a new strategy for clinical practice.

OBJECTIVE To develop a population pharmacokinetic （PPK） model for mycophenolate mofetil active metabolite mycophenolic acid （MPA） in children with primary IgA nephropathy， explore the factors affecting the pharmacokinetic parameters of MPA， and provide a basis for clinical individualized therapy. METHODS Retrospective collection was conducted on 636 concentrations and clinical data from 47 pediatric patients with primary IgA nephropathy. PPK analysis was carried out by using the nonlinear mixed-effects model； the covariates were tested with a stepwise method. Goodness-of-fit plots， Bootstrap and visual predictive check were employed to evaluate the final model. RESULTS The pharmacokinetics of MPA in children with IgA nephropathy in vivo conformed to the first-order absorption and elimination two-compartment model （objective function value of 3 276.31）. Covariate analysis suggested that body weight and albumin （ALB） levels were significant influencing factors on apparent clearance rate and apparent distribution volume. The typical values of PPK parameters of MPA in the final model were as follows： the central room had a distributed volume of 5.79 L， the clearance rate was 4.06 L/h， the volume of peripheral ventricular distribution was 430.93 L， the clearance rate between compartments was 15.40 L/h， the oral absorption rate constant was 1.29 h－1. After verification， most of the predicted corrected observed concentration points were within the 90% confidence interval of the predicted corrected simulated concentration， indicating that the MPA final model had good predictive performance. CONCLUSIONS The PPK model of MPA in children with primary IgA nephropathy is established in this study， identifying body weight and ALB levels are significant factors affecting MPA metabolism.

This study aims to investigate the function of two SNPs (rs8904C > T and rs696G >A) in 3' untranslated region (3'UTR) of NFKBIA gene by constructing luciferase reporter gene. A patient's genomic DNA with rs8904 CC and rs696 GA genotype was used as the PCR template. Full-length 3'UTR of NFKBIA gene was amplified by different primers. After sequencing validation, these fragments were inserted to the luciferase reporter vector, pGL3-promoter to construct recombinant plasmids containing four kinds of haplotypes, pGL3-rs8904C/rs696G, pGL3-rs8904C/rs696A, pGL3-rs8904T/rs696G and pGL3-rs8904T/rs696A. Then these plasmids were transfected into LS174T cells and the luciferase activity was detected. Compared with pGL3-vector transfected cells (negative control), the luciferase activity of the four kinds of recombinant plasmids was significantly decreased (P < 0.001). For rs696G > A, the luciferase activity of the recombinant plasmids containing A allele (pGL3-rs8904C/rs696A and pGL3-rs8904T/rs696A) was about 45.1% (P < 0.05) and 56.1% (P < 0.001) lower than those containing G allele (pGL3-rs8904C/rs696G and pGL3-rs8904T/rs696G), respectively. For rs8904C > T, there were no significant differences in the luciferase activity between the recombinant plasmids containing T allele and those with C allele. Together, the luciferase reporter gene vectors containing SNPs in NFKBIA gene 3'UTR were constructed successfully and rs696G > A could decrease the luciferase activity while rs8904C >T didn't have much effect on the luciferase activity.