AIM:To examine the predictive perfor-mance of the PPK software JPKD for the steady-state concentrations of amikacin and recommend the applicable conditions under fixed daily dosage of 400 mg and 600 mg.METHODS:Inpatients using amikacin in the First Affiliated Hospital of Bengbu Medical University from July 2022 to February 2024 were enrolled,and the measured concentra-tions of amikacin were detected by LC-MS/MS;Ver-ified the predictive performance of JPKD software for peak and trough concentrations of amikacin;JP-KD software was applied to predict the steady-state concentrations of amikacin in the patients at the infusion time of 0.5,1.0,1.5,2.0,2.5,and 3.0 h,and then compared the variability of steady-state concentrations with different levels of renal function at optimal infusion time,then the C max/MIC values were measured.RESULTS:A total of 69 patients were enrolled,including 18 patients with steady state trough concentrations and 17 patients with steady state peak concentrations.It was found that JPKD had a poor predictive ability for steady state trough concentrations but a good predictive ability for peak concentrations,the WRES＜10％be-tween predictive and measured concentrations,and a strong correlation existed between them(r=0.806).With the shortening infusion time,the high-er peak concentrations.The predicted peak concen-trations at 0.5 h and 1.0 h infusion time groups were(34.81±6.87)μg/mL and(32.51±6.07)μg/mL,respectively.With the decline of the renal function,the peak concentrations showed a increasing trend.On the same level of renal function,the peak concentrations in the 600 mg group was high-er than that of the 400 mg group.When MIC ≤2 μg/mL,400 mg daily dose was chosen;when MIC=4 μg/mL,400 mg daily dose could be used for CKD3b stage patients,and 600 mg daily dose could be used for CKD1,CKD2,and CKD3a stage patients;when MIC=8 μg/mL,it was predicted that a higher dose was needed to achieve the expected target.CONCLUSION:Amikacin is preferably administered intravenously for 0.5 to 1.0 h,fixed daily doses of 400 mg and 600 mg are indicated for some pa-tients according to the target bacterial MIC and re-nal function.

AIM:To examine the predictive perfor-mance of the PPK software JPKD for the steady-state concentrations of amikacin and recommend the applicable conditions under fixed daily dosage of 400 mg and 600 mg.METHODS:Inpatients using amikacin in the First Affiliated Hospital of Bengbu Medical University from July 2022 to February 2024 were enrolled,and the measured concentra-tions of amikacin were detected by LC-MS/MS;Ver-ified the predictive performance of JPKD software for peak and trough concentrations of amikacin;JP-KD software was applied to predict the steady-state concentrations of amikacin in the patients at the infusion time of 0.5,1.0,1.5,2.0,2.5,and 3.0 h,and then compared the variability of steady-state concentrations with different levels of renal function at optimal infusion time,then the C max/MIC values were measured.RESULTS:A total of 69 patients were enrolled,including 18 patients with steady state trough concentrations and 17 patients with steady state peak concentrations.It was found that JPKD had a poor predictive ability for steady state trough concentrations but a good predictive ability for peak concentrations,the WRES＜10％be-tween predictive and measured concentrations,and a strong correlation existed between them(r=0.806).With the shortening infusion time,the high-er peak concentrations.The predicted peak concen-trations at 0.5 h and 1.0 h infusion time groups were(34.81±6.87)μg/mL and(32.51±6.07)μg/mL,respectively.With the decline of the renal function,the peak concentrations showed a increasing trend.On the same level of renal function,the peak concentrations in the 600 mg group was high-er than that of the 400 mg group.When MIC ≤2 μg/mL,400 mg daily dose was chosen;when MIC=4 μg/mL,400 mg daily dose could be used for CKD3b stage patients,and 600 mg daily dose could be used for CKD1,CKD2,and CKD3a stage patients;when MIC=8 μg/mL,it was predicted that a higher dose was needed to achieve the expected target.CONCLUSION:Amikacin is preferably administered intravenously for 0.5 to 1.0 h,fixed daily doses of 400 mg and 600 mg are indicated for some pa-tients according to the target bacterial MIC and re-nal function.

Objective: To evaluate and compare the clinical value of early enteral nutrition (EEN) and total parenteral nutrition (TPN) af-ter esophageal cancer surgery. Methods: We retrospectively analyzed 237 patients who underwent esophageal cancer surgery at Bei-jing Shijitan Hospital from March 2011 to March 2019. They were assigned into two groups based on the postoperative nutritional sup-port used: EEN (136 cases) and TPN (101 cases). Nutritional status, liver function, recovery of gastrointestinal function, days of hospital-ization, and postoperative complications were compared between the two groups after propensity score matching. Results: Using 1 :1 nearest neighbor matching, we successfully matched 91 pairs of patients. The prealbumin (PA) level was significantly higher in the EEN group than in the TPN group 7 days after surgery (P<0.05); however, there was no significant difference in albumin (ALB) level before surgery, 3 or 7 days after surgery. Additionally, the levels of ALT and AST in the EEN group were significantly lower than those in the TPN group 3 and 7 days after surgery (P<0.05). The incidence of acid reflux, vomiting, and diarrhea in the EEN group was higher than that in the TPN group, while the incidence of pulmonary edema and pulmonary infection was lower in the EEN group than in the TPN group (P<0.05). Conclusions: Compared with TPN, EEN is associated with a high incidence of acid reflux, vomiting, and diarrhea after esophageal cancer surgery, but it has a lower impact on liver function. EEN can promote the recovery of intestinal function, improve nutritional indicators, and shorten hospitalization time.

ObjectiveToinvestigatetheroleofimmuneinflammatoryreactionintheformationof intracranial aneurysm. Methods The intracranial aneurysms in 40 patients of craniotomy ( intracranial aneurysm group) and the vascular specimens in 20 craniotomy patients w ith traumatic brain injury (control group) w ere col ected. Fluorescence quantitative polymerase chain reaction w as used to detect the expression of interleukin (IL)-17 receptor in the arterial w al . Flow cytometry w as used to detect the Th-17 cel s in peripheral blood. Enzyme-linked immunosorbent assay w as used to measure the levels of IL-17, IL-6 in the arterial w al and tumor necrosis factor-α( TNF-α) in peripheral blood. Results There w ere no significant differences in the age (62.6 ±8.7 years vs.61.4 ±7.9 years;t=0.342;P=0.681), proportions of male (60.0%vs.65.0%; χ2 =0.246, P=0.434), hypertension ( 12.5%vs.10.0%; χ2 =0.315, P=0.492), diabetes (75.0%vs.10.0%; χ2 =0.284, P=0.482), and smoking (35.5%vs.30.0%; χ2 =0.224, P=0.413) betw een the intracranial aneurysms group and the control group. The expression of IL -17 receptor in the arterial w al (0.106 ±0.032 vs.0.264 ±0.071; t=5.115, P=0.001) and the proportion of Th17 cels in peripheral blood (2.75%±0.53%vs.7.18%±1.54%; t=8.436, P<0.001) and IL-17 level ( 7.32 ±1.82 μg/L vs.22.64 ±4.51 μg/L; t= 8.357, P< 0.001 ) in the control group w ere significantly low er than those in the intracranial aneurysm group. The levels of IL-6 (1.15 ±0.24 μg/L vs. 19.64 ±4.16 μg/L; t=9.527, P<0.001) and TNF-α(1.43 ±0.31 μg/L vs.26.17 ±4.32 μg/L; t=9.816, P<0.001) in the arterial wal in the control group were significantly lower than those in the intracranial aneurysm group. Conclusions The expression of IL-17 receptor in the arterial w al , the proportion of the Th17 cels and IL-17 level in peripheral blood were increased in patients with intracranial aneurysms. Immune inflammation may be involved in the formation of intracranial aneurysm.