The lungs are the most common sites of metastases from non-pulmonarymalignancies. Endobronchial metastases are rare and have no specificity in clinical manifestations,thus being prone to misdiagnosis and delayed treatment.The common tumors associated with endobronchial metastasis are renal,breast,and colorectal cancers.This article reported one case of postoperative rectal cancer with endobronchial and lung metastases,which was relieved by high-frequency electrocautery ablation via bronchoscope,chemotherapy,and targeted drugs,aiming to provide a reference for clinical diagnosis and treatment.
Humans ; Rectal Neoplasms/pathology* ; Electrocoagulation/methods* ; Bronchial Neoplasms/drug therapy* ; Bronchoscopy ; Lung Neoplasms/secondary* ; Bronchoscopes

Licorice has long been regarded as one of the most popular herbs, with a very wide clinical application range. Whether being used alone or as an ingredient in prescription, it has an important role which cannot be ignored. However, the efficacy and chemical constituents of licorice will change after honey-processing. Therefore, it is necessary to find quality markers before and after honey-processing to lay the foundation for a comprehensive evaluation of the differences between raw and processed licorice pieces. HPLC-DAD was employed to establish fingerprints of raw and processed licorice. Multivariate statistical analysis methods including principal component analysis(PCA) and orthogonal partial least squares discrimination analysis(OPLS-DA) were applied to screen out the differential components before and after processing of licorice. Based on network pharmacology, the targets and pathways corresponding to the differential components were analyzed with databases such as Swiss Target Prediction and Metascape, and the "component-target-pathway" diagram was constructed with Cytoscape 3.6.0 software to predict the potential quality markers. A total of 17 common peaks were successfully identified in the established fingerprint, and seven differential components were selected as potential quality markers(licoricesaponin G2, glycyrrhizic acid, liquiritigenin, liquiritin, isoliquiritin, liquiritin apioside and isoliquiritigenin). The HPLC fingerprint method proposed in this study was efficient and feasible. The above seven differential chemical components screened out as potential quality markers of licorice can help to improve and promote the overall quality. These researches offer more sufficient theoretical basis for scientific application of licorice and its corresponding products.
Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; Glycyrrhiza ; Glycyrrhizic Acid/analysis* ; Honey/analysis*

Objective To analyze the status of quality indicators(QI) on specimen acceptability and establish preliminary qual ity specification.Methods Web based External Quality Assessment system was used to collect data of laboratories partici pated in "Medical quality control indicators in clinical laboratory" from 2015 to 2017,including once in 2015 and 2017 and twice in 2016.Rate and sigma scales were used to evaluate incorrect sample type,incorrect sample container,incorrect fill level and anticoagulant sample clotted.The 25th percentile (P25) and 75th percentile (P75) of the distribution of each QI were employed to establish the high,medium and low specification.Results 5 346,7 593,5 950 and 6 874 laboratories sub mitted the survey results respectively.The P50 of biochemistry (except incorrect fill level),immunology and microbiology reach to 6σ.The P50 of clinical laboratory is 4 to 6σ except for incorrect sample container.There is no significant change of the continuous survey results.Based on results in 2017 to establish the quality specification,the P25 and P75 of the four QIs is 0 and 0.084 4 ％,0 and 0.047 6 ％,0 and 0.114 2 ％,0 and 0.078 4 ％,respectively.Conclusion According to the results of the survey,most laboratories had a faire performance in biochemistry,immunology and microbiology,and clinical laboratory needs to be strengthened.Laboratories should strengthen the laboratory information system construction to ensure the actual and reliable data collection,and make a long time monitoring to achieve a better quality.

Objective To evaluate in vitro synergy between palmatine and commonly used antibiotic against main clinical isolated strains in recent three years.Methods All of 118 strains isolated in recent three years and 2 standard strains were studied.Minimal inhibition concentrations (MIC) were tested by agar dilution method and combination effects were measured by checkerboard method.Results Palmatine showed moderate in vitro activity against Staphylococcus.Synergy was detected with palmatine in combination with levofloxacin against gram-positive and negative strains,though synergistic rate less than 20％.Synergy was not show between palmatine and linezolid.Additive effect was found widely between palmatine and two agents against almost all tested species.Conclusion The results of in vitro synergy tests may be different sometimes on account of various strains,methods,etc.So,more deeper understanding of action mechanism of traditional Chinese medicine and correlation between in vitro test and clinical outcomes will help medical to select antibiotic more suitablly.

Objective To evaluate the in vivo antibacterial effect of cefathiamidinein against mouse septicemia.Methods Experimental model of mouse septicemia was established by intraperitoneally injection with 0.5 mL minimum lethal dose (MLD) bacteria.The 0.2 mL different concentrations of drugs were injected through caudal vein.Cefathiamidine,cefazolin and ampicillin adopted two methods of dose regimen,which are single-dose and two-dose;while,both ceftriaxone and levofloxacin adopted single-dose.The survival time of the infected mouse was monitored for 1-7 d.The 50％,95％ effective doses(ED50,ED95) were determined by the Bi-level integrated system synthesis (BLISS) method.The antibacterial activities between cefiazine and control drugs were compared.In vivo protection experiments were carned out on 3 standard strains and 7 pathogenic strains isolated through single dose.Results The cefathiamidine had good antibacterial activity in vivo against Streptococcus pneumonia and Enterococcus faecalis.The ED50 of single-dose was between 1.43-1.71 mg · kg-1,which was significantly superior to cefazolin and was similar to levofloxacin.According to the results of two -dose regimen,the ED50 values of cefathiamidine against Sreptococcus pneumonia,Staphylococcus aureus and Haemophilus influenza significantly declined,which were between 0.78-14.78 mg · kg-1.However,with regard to Enterococcus faecalis,the ED50 value of two-dose increased compared to that of single-dose,which could be related to the fact that low plasma concentration affected protective effects in vivo.Conclusion Cefathiamidine had a better antibacteria effect in vivo against gram-positive bacteria,especially Streptococcus pneumonia and Enterococcus faecalis.Through the comparison between single-dose and two-dose,it is more reasonable to adopt two-dose or multiple-dose of cefathiamidine with regard to most strains.

Oxazolidinones are a potent class of synthetic antimicrobial agents with activity mainly against Gram-positive strains.In this review,we summarize the mechanism of action and resistance,as well as the safety from clinical experience of oxazolidinones.The structural modifications and structure-activity relationships of oxazolidinones derivatives will also be presented.

Objective To evaluate the minimum inhibitory concentration (MIC) and influence factors of cefathiamidine against clinical isolates from recent years in China.Methods MIC were tested by two fold agar dilution method.The effect of various experimental conditions (such as inoculation quantity,pH value of medium,percentage of serum)on MIC of cefathiamidine was evaluated.Results A total of 794 clinical strains were tested and cefathiamidine had showed excellent antibacterial activity against gram-positive bacterial.The MIC90 of cefathiamidine against methicillin-susceptible S.aureus (MSSA) and S.epidermidis (MSSE)were 0.50,0.12 mg · L-1,respectively.The MIC90 values of cefathiami-dine had against penicillin-susceptible S.pneumoniae (PSSP) and peni-cillin-nonsusceptible S.pneumoniae(PNSSP) were 0.12 mg· L-1 and not more than 1 mg · L-1,respectively.Against S.pyogenes,the MIC90 was 8 μg · L-1.The MIC90 of cefathiamidine against ampicillin-susceptible E.faecalis and E.faecium were 1,16 mg · L-1,respectively.The MIC90 of cefathiamidine against ampicillin-susceptible Haemophilus spp.and Moraxella catarrhalis were not more than 4 mg L-1 Cefathiamidine also had some antibacterial activity against gram-positive anaerobia.The factors including inoculation quantity,pH value of medium and percentage of serum had no effect on MIC values.Conclusion Cefathiamidine exhibited good activity against gram-positive bacterial including Enterococcus spp..

Objective To study the effect of propofol intravenous on myocardial damage degree and cardiac function for 2 diabetes patients before and after coronary artery bypass grafting.Methods Seventy-six patients with type 2 diabetes in our hospital was selected from April 2014 to October 2015.The patients were divided into treatment group and control group,according to the method of random numbers,38 cases in each group.Patients in two groups were taken general anesthesia induction,treatment group were infused 1-2 μg · kg-1 · mL-1 propofol after anesthesia induction to maintain anesthesia,continuous intravenous infusion of 0.2-0.4 μg · kg-1 · min-1 fentanyl.Patients in control group isoflurane inhalation and intravenous 0.2-0.4 μg · kg-1 · min-1 fentanyl.Before surgery and postoperative 12 h,the level of the malondialdehyde (MDA),superoxide dismutase (SOD),ischemia modified albumin (IMA),troponin I (cardiac troponin I,cTnI) in two groups were measured by spectrophotometer.Results Before the operation,the level of MDA,SOD,IMA,cTnI in the treatment group were (3.69 ±0.43) nmol · L-1,(73.24 ±6.13) nmol · L-1,(77.29 ± 3.94)ABSU · mL-1,(0.08 ± 0.02) μg · L-1,respectively while in control group were (3.62 ± 0.37) nmol · L-1,(72.36 ±8.22)nmol · L-1,(77.61 ± 3.74) ABSU · mL-1,(0.07 ± 0.01) μg · L-1 with no significant difference (P＞0.05).After 12 h of operation,the level of MDA,IMA,cTnI in treatment group were (4.42 ±0.82) nmol · L-1,(70.52 ± 2.62) ABSU · mL-1,(3.70 ± 0.28) μg · L-1,significantly lower than control group with (7.14 ±1.01)nmol · L-1,(73.63 ±4.12) ABSU · mL-1,(4.79 ±0.29)μg · L-1.But SOD in treatment group was (68.74 ± 6.82) nmol · L-1,significantly higher than the control group with (64.O1 ± 5.88) nmol · L-1,the difference between two groups above factors had statistical significance (all P ＜ 0.05).Conclusion Patients with type 2 diabetes using CABG surgery,the use of intravenous propofol,compared with isoflurane,can effectively reduce the degree of myocardial injury and effectively protect the cardiac function in patients.

Objective To evaluate the optimal administration regimen of flomoxef for the bacterial infection based on pharmacokinetic/pharmacodynamic (PK/PD) models.Methods A literature search was conducted in PubMed to capture the pharmacokinetic data of flomoxef.Minimum inhibitory concentrations (MICs) were determined using two-fold agar dilution method.The percent time that drug concentration exceeds the minimum inhibitory concentration (％fT＞MIC) was used as the PK/PD indicator correlated with efficacy.Monte Carlo simulation was employed to determine the appropriate regimens of flomoxef based on the probability of target attainment (PTA) against the clinical isolates of strains.Results The regimens of 1 g q6 h,1 g q8 h and 1 g q12 h with 1 hour infusion at 70％ of ％ fT＞MIC achieved 93.1％,89.1％ and 66.8％ of PTA against Escherichia coli (ESBL +),respectively.For the Klebsiella pneumoniae (ESBL+),these regimens achieved 81.8％,78.7％ and 62.3％ of PTA at ％fT＞MIC =70％.The regimen of 2 g q12 h achieved the similar PTA as 1g q6 h and 1 g q8 h at 50％ and 70％ of ％fT＞MIC,but not at higher ％ fT＞MIC.Furthermore,flomoxef also showed potent bactericidal activity against Escherichia coli (ESBL-),Klebsiella pneumoniae (ESBL-),methicillin-susceptible S.aureus (MSSA),methicillin-susceptible S.Epidermidis (MSSE) and Moraxella catarrhalis,etc.with all dosing regimens according to the PK/PD analysis.Conclusion As a time-dependent antibiotic,the clinical outcome of flomoxef can be improved by shortening dosing interval,extending infusion time and/or increasing dose.The first two strategies played more significant roles.

Objective To evaluate the pharmacokinetics of multiple dose of antofloxacin hydroehloride tablet under fast and food state in Chinese healthy subjects.Methods A randomized,open and multiple dose study was conducted.Three dose groups with 16 subjects per group were given the dose of 200,400 and 600 mg antofloxacin hydrochloride tablet,once daily for 7 days respectively.8 subjects (4 male and 4 female) were administrated under fast state and 8 subjects (4 male and 4 female) under food state in each dose.The concentrations of antofloxacin in plasma and urine were determined by HPLC method.Results The main pharmacokinetics parameters of three dose (200,400 and 600 mg) under fast at first day were as follows:Cmax were (2.23 ±0.38),(4.59 ± 1.40),(5.03 ±0.77)mg · L-1,t1/2βwere(11.99 ±3.31),(10.97 ±5.33),(14.39 ± 1.63)h,tmax were (1.37 ±0.78),(2.04 ± 1.42),(2.90 ±2.02)h,AUC0-t were (27.61 ±6.14),(51.77 ±22.09),(73.62 ±10.14)mg · L-1 · h,AUC0-∞ were (38.28 ± 13.49),(72.28 ± 42.80),(108.91 ± 13.26) mg · L-1 · h,V/F were (92.84 ± 12.98),(91.90±14.55),(116.28±22.62)L,CL/F were (5.73 ±1.71),(7.67 ±4.65),(5.58 ±0.66)L· h-1,respectively;under food state at first day,Cmax were (2.36 ± 0.43),(4.11 ± 1.53),(5.60 ± 1.00) mg · L-1,t1/2β were (14.37 ±4.34),(11.25 ±5.39),(15.53 ±2.94) h,tmax were (2.69 ± 1.62),(2.40 ± 1.50),(2.65 ±1.29)h,AUC0-t were (33.69 ±4.00),(48.07 ±22.19),(78.01 ±17.18)mg · L-1 · h,AUC0-∞ were (50.71 ± 8.86),(67.37 ± 41.98),(121.31.66 ± 33.54) mg · L-1 · h,V/F were (81.04 ± 16.35),(106.32 ±34.33),(114.08±20.00)L,CL/Fwere (4.07 ±0.82),(8.28 ±5.29),(5.23 ±1.18)L · h-1,respectively.After 7 days,the main pharmacokinetics parameters of three dose (200,400 and 600 mg) under fast were as follows:Cmax were (3.69 ± 1.39),(7.54 ± 2.95),(8.50 ± 0.93) mg · L-1,t1/2β were (25.22 ± 3.34),(19.56 ±12.47),(15.95 ±2.85)h,tmax were (1.64±1.29),(1.31 ±0.79),(1.60±1.07)h;AUC0-twere (72.29 ± 24.00),(142.96 ± 67.20),(180.81 ± 35.33) mg · L-1 · h,AUC0-∞ were (75.90 ± 25.46),(148.26 ±69.86),(183.30±35.11)mg · L-1 · h,V/F were (184.77 ±52.51),(119.22 ±53.92),(118.91 ±30.13) L,CL/F were (5.06 ± 1.18),(4.75 ± 1.72),(5.15 ±0.72)L · h-1;under food state,Cmax were (3.53 ± 1.06),(6.54 ±1.43),(8.52 ±1.80)mg · L-1,t1/2βwere (24.08 ±6.12),(20.64 ±9.16),(18.69 ±6.49)h,tmax were (2.94 ± 1.02),(1.96 ± 1.05),(2.69 ±0.96)h,AUC0-t were (94.71 ±31.03),(142.17 ±52.46),(211.34.01 ±52.99)mg · L-1 · h,AUC0-∞were (99.32 ±33.93),(149.77 ±55.19),(213.76 ±53.00)mg· L-1 · h,V/F were (139.40±37.39),(140.24±71.11),(130.20 ±71.09)L;CL/F were (4.11 ±1.13),(4.81 ± 1.17),(4.69 ± 0.88)L · h-1.Urinary recovery rates after 7 days doses from zero to 120 h were (67.24±13.56)％,(68.62±14.45)％ and (74.31 ±12.99)％,respectively.Conclusion Food had no obvious influence on pharmacokinetics parameters after multiple oral dose of 200,400 and 600 mg antofloxacin hydrochloride tablet under fast and food state,except that tmax increased.There was no accumulation in human body.It can be considered that food had no effect in the clinical use of antofloxacin hydrochloride tablet.