Antibiotic adjuvants offer a promising strategy for restoring antibiotic sensitivity, expanding antibacterial spectra, and reducing required dosages. Previously, compound 15 was identified as a potential adjuvant for Polymyxin B (PB) against multidrug-resistant (MDR) Pseudomonas aeruginosa DK2; however, its clinical utility was hindered by high cytotoxicity, uncertain in vivo efficacy, and an unclear synergetic mechanism. To address these challenges, we synthesized and evaluated a series of novel benzamide derivatives, with A22 emerging as a particularly promising candidate. A22 demonstrated potent synergistic activity to PB, minimal cytotoxicity, improved water solubility, and broad-spectrum synergism of polymyxins against various clinically isolated MDR Gram-negative strains. In vivo studies using Caenorhabditis elegans and mouse models further confirmed the efficacy of A22. Moreover, A22 effectively suppressed the development of PB resistance in Pseudomonas aeruginosa DK2. Mechanistic investigations revealed that A22 enhances polymyxins activity by inducing reactive oxygen species production, reducing ATP levels, increasing NOX activity, and inhibiting biofilm formation, leading to bacterial death. These findings position A22 as a highly promising candidate for the development of polymyxin adjuvants, offering a robust approach to combating MDR Gram-negative bacterial infections.

Objective:To analyze the current preparation and usage situation of first-aid drugs in the rescue vehicles in children's medical institutions, and provide references for optimizing the list of emergency drugs.Methods:First-aid drug lists in the rescue vehicles of 12 children's medical institutions from 11 provinces and municipalities in China were collected through questionnaire surveys, and the drugs as well as their quantities were compared. The existing problems in the use of first-aid drugs in the 12 medical institutions were investigated by on-site interviews. The usage information of first-aid drugs in the rescue vehicles of the General Surgery and Cardiology Department of Shanxi Children's Hospital from May 2022 to April 2023 was collected through the hospital information center, and usage frequency and dosage per patient of the drugs were calculated. Descriptive statistical analysis was conducted on the collected data.Results:The first-aid drug lists in 12 hospitals were various, including 7 to 22 kinds of drugs and involving a total of 23 drugs. These mainly included vasoactive drugs, cardiotonic drugs, antiarrhythmic drugs, antiangina and anti-ischemic drugs for the heart, antispasmodic drugs, diuretics, dehydrating drugs, sedative-hypnotic drugs, and glucocorticoids, all of which were injections. The drugs that were included in all the lists of 12 hospitals were epinephrine, dopamine, dexamethasone, furosemide, and atropine. The drug lists of different rescue vehicles throughout the hospital were the same in 4 hospitals, while the lists varied among departments based on their specific clinical needs in the other 8 hospitals. None of the 12 hospitals had a first-aid drug usage manual. The on-site interview results showed that, the existing problems about drug preparation and use in rescue vehicles mainly involved the following 6 aspects: drug types, quantities, labels, storage, procurement, and usage. In Shanxi Children's Hospital, the types and quantities of first-aid drugs in rescue vehicles of General Surgery Department and Cardiology Department were the same. There were 6 and 9 kinds of drugs were used in the 2 departments during rescue operations, respectively. The drugs that were never used in either department included promethazine, lidocaine, diazepam, phenobarbital, raceanisodamine, sodium bicarbonate, atropine, glucose, and calcium gluconate.Conclusions:The phenomenon of unreasonable kinds and quantities of first-aid drugs in the rescue vehicles existed in the children's medical institutions, and the drugs provided did not fully match the actual clinical needs. There was an urgent need for preparation guidelines and usage manuals of first-aid drugs that were suitable for children's medical institutions to enhance the scientificity of drug supply and the correctness of usage.

Objective:To analyze the current preparation and usage situation of first-aid drugs in the rescue vehicles in children's medical institutions, and provide references for optimizing the list of emergency drugs.Methods:First-aid drug lists in the rescue vehicles of 12 children's medical institutions from 11 provinces and municipalities in China were collected through questionnaire surveys, and the drugs as well as their quantities were compared. The existing problems in the use of first-aid drugs in the 12 medical institutions were investigated by on-site interviews. The usage information of first-aid drugs in the rescue vehicles of the General Surgery and Cardiology Department of Shanxi Children's Hospital from May 2022 to April 2023 was collected through the hospital information center, and usage frequency and dosage per patient of the drugs were calculated. Descriptive statistical analysis was conducted on the collected data.Results:The first-aid drug lists in 12 hospitals were various, including 7 to 22 kinds of drugs and involving a total of 23 drugs. These mainly included vasoactive drugs, cardiotonic drugs, antiarrhythmic drugs, antiangina and anti-ischemic drugs for the heart, antispasmodic drugs, diuretics, dehydrating drugs, sedative-hypnotic drugs, and glucocorticoids, all of which were injections. The drugs that were included in all the lists of 12 hospitals were epinephrine, dopamine, dexamethasone, furosemide, and atropine. The drug lists of different rescue vehicles throughout the hospital were the same in 4 hospitals, while the lists varied among departments based on their specific clinical needs in the other 8 hospitals. None of the 12 hospitals had a first-aid drug usage manual. The on-site interview results showed that, the existing problems about drug preparation and use in rescue vehicles mainly involved the following 6 aspects: drug types, quantities, labels, storage, procurement, and usage. In Shanxi Children's Hospital, the types and quantities of first-aid drugs in rescue vehicles of General Surgery Department and Cardiology Department were the same. There were 6 and 9 kinds of drugs were used in the 2 departments during rescue operations, respectively. The drugs that were never used in either department included promethazine, lidocaine, diazepam, phenobarbital, raceanisodamine, sodium bicarbonate, atropine, glucose, and calcium gluconate.Conclusions:The phenomenon of unreasonable kinds and quantities of first-aid drugs in the rescue vehicles existed in the children's medical institutions, and the drugs provided did not fully match the actual clinical needs. There was an urgent need for preparation guidelines and usage manuals of first-aid drugs that were suitable for children's medical institutions to enhance the scientificity of drug supply and the correctness of usage.

Objective To investigate the clinical value of serum interleukin-6 (IL-6) and interleukin-8 (IL-8) levels in combination with pulmonary function indicators in identifying severe Mycoplasma pneumoniae pneumonia (MPP) in children. Methods A total of 102 children with severe MPP were selected as the study subjects (severe group), and another 102 children with mild MPP treated during the same period were selected as the mild group. The serum levels of IL-6, IL-8 as well as forced vital capacity (FVC), forced expiratory volume in one second (FEV₁), FEV₁ percentage of predicted (FEV₁%pred) and the ratio of FEV₁ to FVC at the time of admission of children in each group were compared. Results The serum levels of IL-6 and IL-8 in the severe group were significantly higher than those in the mild group, while the FVC, FEV₁%pred, and FEV₁/FVC% were significantly lower than those in the mild group (P < 0.05). The serum levels of IL-6 and IL-8 were negatively correlated with FVC, FEV₁%pred and FEV₁/FVC% (P < 0.05). The area under the curve (AUC) for assessing the severity of MPP for IL-6, IL-8, FVC, FEV₁%pred and FEV₁/FVC% was 0.894 (0.849 to 0.939), 0.842 (0.787 to 0.897), 0.896 (0.851 to 0.942), 0.787 (0.725 to 0.849) and 0.744 (0.676 to 0.812), respectively. The AUC for the combined assessment of the above five parameters was 0.985 (0.973 to 0.997). Conclusion Serum IL-6, IL-8 and pulmonary function indicators can reflect the severity of MPP in children. Their combined detection can be used to differentiate between mild and severe MPP in children early and timely.

Rats ; Animals ; Sciatic Neuropathy ; Muscle, Skeletal ; Sciatic Nerve/physiology* ; Sequence Analysis, RNA ; Nerve Regeneration/physiology*

Objective:To conduct visual analysis of relevant literature on the nursing of patients with nasopharyngeal carcinoma radiotherapy, so as to provide a reference for the nursing of patients with nasopharyngeal carcinoma radiotherapy.Methods:The relevant research in China National Knowledge Infrastructure (CNKI) and Wanfang Data was searched, and the search time limit was from the establishment of the database to June 30, 2021. The volume of publications, authors, institutions, keywords and hot words were visualized in bibliometric analysis with the CiteSpace and Prism software.Results:A total of 450 relevant articles were screened out, and the total number of publications was on the rise. Research institutions in Guangxi was in an advantageous position in research, and there was still a lack of cooperation among different institutions. Current research hotspots in nursing care of patients with nasopharyngeal carcinoma undergoing radiotherapy revolved around formulating standardized nursing service procedures, nursing care for complications after radiotherapy, and providing complete comprehensive nursing interventions.Conclusions:Nursing care of patients undergoing radiotherapy for nasopharyngeal carcinoma has received continuous attention, and more and more innovative nursing methods and advanced nursing models have been applied to clinical practice. It is necessary to strengthen the construction of team collaboration network and conduct in-depth research on the comprehensive nursing management model.

Objective:To explore the clinical features of tacrolimus-associated posterior reversible encephalopathy syndrome (PRES) in patients after kidney transplantation.Methods:Relevant databases at home and abroad were searched as of August 2020, and case reports of tacrolimus-associated PRES after kidney transplantation were collected. Clinical information including patient′s basic characteristics, tacrolimus application (such as route of administration, dose, blood concentration, drug combination regimen, etc.), and the occurrence time, clinical manifestation, imaging characteristics, intervention measures, and outcomes of PRES were extracted and analyzed by descriptive statistical method.Results:A total of 16 patients were enrolled in the study, including 7 males and 9 females, aged from 7 to 54 years with a median age of 26 years. Of them, 6 patients were <18 years old and 10 patients were ≥18 years old. Among the 16 patients, 8 received intravenous administration and 8 oral administration. Thirteen patients had records of drug combination regimen and 1, 2, and 3 immunosuppressants were combined in 3, 8, and 2 patients, respectively. PRES occurred from 3 days to 3 months after renal transplantation and 10 patients (62.5%) occurred within 1 month after operation. Eleven of 13 patients who underwent tacrolimus plasma concentrations testing did not exceed the upper limit of the treatment window when PRES occurred. The main symptoms of PRES included convulsions/seizures-like seizures (in 11 patients), visual abnormalities (in 7 patients), persistent headache (in 6 patients), and coma or disturbance of consciousness (in 6 patients). CT and/or magnetic resonance imaging were performed in all 16 patients. Imaging features of cerebral edema or vasogenic cerebral edema were found in 15 patients and the lesions located mainly in occipital lobe (13 patients), parietal lobe (12 patients), and the frontal lobe (8 patients). After discontinuation or reduction of the tacrolimus dose and/or giving symptomatic and supportive treatments for 2-44 days (the median time of 9 days), symptoms subsided in all 16 patients and imaging examination showed cerebral edema, vasogenic cerebral edema, and other lesions subsided in 15 patients.Conclusions:Tacrolimus-associated PRES mostly occurred within 3 months after renal transplantation, which was not related to the route of administration or blood concentration of tacrolimus. The clinical manifestations of tacrolimus-associated PRES were similar to those caused by other factors. After discontinuation of tacrolimus, reduction of drug dose and/or administration of symptomatic treatment, most of the symptoms disappeared quickly and the imaging changes returned to normal.

Objective:To explore the clinical features of tacrolimus-associated posterior reversible encephalopathy syndrome (PRES) in patients after kidney transplantation.Methods:Relevant databases at home and abroad were searched as of August 2020, and case reports of tacrolimus-associated PRES after kidney transplantation were collected. Clinical information including patient′s basic characteristics, tacrolimus application (such as route of administration, dose, blood concentration, drug combination regimen, etc.), and the occurrence time, clinical manifestation, imaging characteristics, intervention measures, and outcomes of PRES were extracted and analyzed by descriptive statistical method.Results:A total of 16 patients were enrolled in the study, including 7 males and 9 females, aged from 7 to 54 years with a median age of 26 years. Of them, 6 patients were <18 years old and 10 patients were ≥18 years old. Among the 16 patients, 8 received intravenous administration and 8 oral administration. Thirteen patients had records of drug combination regimen and 1, 2, and 3 immunosuppressants were combined in 3, 8, and 2 patients, respectively. PRES occurred from 3 days to 3 months after renal transplantation and 10 patients (62.5%) occurred within 1 month after operation. Eleven of 13 patients who underwent tacrolimus plasma concentrations testing did not exceed the upper limit of the treatment window when PRES occurred. The main symptoms of PRES included convulsions/seizures-like seizures (in 11 patients), visual abnormalities (in 7 patients), persistent headache (in 6 patients), and coma or disturbance of consciousness (in 6 patients). CT and/or magnetic resonance imaging were performed in all 16 patients. Imaging features of cerebral edema or vasogenic cerebral edema were found in 15 patients and the lesions located mainly in occipital lobe (13 patients), parietal lobe (12 patients), and the frontal lobe (8 patients). After discontinuation or reduction of the tacrolimus dose and/or giving symptomatic and supportive treatments for 2-44 days (the median time of 9 days), symptoms subsided in all 16 patients and imaging examination showed cerebral edema, vasogenic cerebral edema, and other lesions subsided in 15 patients.Conclusions:Tacrolimus-associated PRES mostly occurred within 3 months after renal transplantation, which was not related to the route of administration or blood concentration of tacrolimus. The clinical manifestations of tacrolimus-associated PRES were similar to those caused by other factors. After discontinuation of tacrolimus, reduction of drug dose and/or administration of symptomatic treatment, most of the symptoms disappeared quickly and the imaging changes returned to normal.

OBJECTIVE：To provide refere nce f or the quality control and evaluation of rice-wine processed Coptidis Rhizoma decoction piece. METHODS ：Taking 17 batches of rice-wine processed Coptidis Rhizoma decoction piece from different manufacturers as samples ，HPLC method was adopted to determine the contents of 4 kinds of alkaloids as epiberberine ，coptisine， palmatine and berberine. The compound weights of epiberberine ，berberine，palmatine and berberine were calculated by the subjective and objective combination weighting method （AHP combined with variation coefficient ）. Then the quality evaluation method was used to evaluate the quality of decoction pieces combined with the appearance of decoction pieces and the contents of 4 alkaloids. The percent mass constant was calculated and the grade of rice-wine processed Coptidis Rhizoma decoction piece was classified. RESULTS ：According to the results of content determination of 4 kinds of alkaloids ，among 17 batches of samples ，a total of 13 batches of samples met the requirements of 2015 edition of Chinese Pharmacopoeia （part Ⅳ）. Mass constants of 13 batches of qualified samples were 10.03-26.96，and the percent mass constants were 37.20％-100％. If the percent mass constant ≥ 80％ of the sample was listed as the first-class product ，the sample with the percent mass constant between 50％-＜80％ was classified as the second-class product ，and the rest was listed as the third-class product ，therefore the quality constant of first-class product was ≥21.57，that of second-class product was 13.48-＜21.57，and that of third-class product was ＜13.48. According to the grading standard ，3 batches of 13 batches of qualified samples are classified as first-class products ，6 batches are classified as second-class products ，4 batches are classified as third-class products. CONCLUSIONS ：The established subjective and objective combination weighting method and quality constant method can more scientifically and reasonably classify rice-wine processed Coptidis Rhizoma decoction piece.

Objective To investigate the influence of thrombus entrance shape, suction rate and blood flow velocity on thrombus aspiration of rotary cutting and suctioned thrombectomy devices, so as to provide theoretical support for the design and optimization of such devices. Methods Three models with different thrombus entrance shapes (‘L’-style, ‘8’-style and ‘0’-style) were established to study the influence of thrombus entrance shape on the thrombectomy; different suction rates (75, 100, 125, 150 mL/min) and different blood flow velocities (0-10 cm/s, at interval of 1 cm/s) were set to discuss how the suction rate and blood flow velocity affected the thrombectomy based on ‘8’-style thrombus entrance. Results The thrombus could not be aspirated evenly in ‘L’-style model, and there was no significantly difference in aspiration between ‘8’ -style model and ‘0’-style model. But the ‘8’-style model was better than ‘0’-style model in lateral thrombus suction. The suction rate that was greater than 100 mL/min provided a limited effect on improvement of thrombectomy effect. The best suction effect was reached when blood flow velocity was less than 1 cm/s, and the effect of thrombectomy was decreasing gradually with blood flow velocity increasing. Conclusions The thrombus entrance shape, suction rate and blood flow velocity had a great impact on thrombectomy greatly. A wide and short thrombus entrance shape, an appropriate increase of suction rate and decrease of blood flow velocity would contribute significantly to the improvement of thrombectomy effect. These results can be used as guidance for the optimal design of rotary cutting and suctioned thrombectomy devices.