OBJECTIVE To investigate the effects of individualized dosing regimen on blood trough concentration of vancomycin and renal function in critically ill patients. METHODS According to relevant guidelines and the results of Vancomycin Calculator， clinical pharmacists formulated an individualized dosing regimen of vancomycin including loading dose and maintenance dose for critically ill patients based on the two independent variables of body weight and creatinine clearance rate. Using the method of retrospective study， patients who were admitted to the department of intensive care unit （ICU） of the Second Affiliated Hospital of Guangzhou Medical University and used the regimen from July 2018 to December 2021 were selected as the trial group， and patients who were treated with vancomycin and received blood drug concentration monitoring in ICU from January 2015 to June 2018 were recruited in the control group. The difference in trough concentration distribution and the incidence of acute kidney injury （AKI） after medication were compared between the two groups， the change of serum creatinine before and after medication in the trial group was analyzed. RESULTS Totally 197 patients were included in the trial group and 144 patients were in the control group. There was no significant difference between the two groups in the clinical information （gender， age， body weight， acute physiology and chronic health evaluation Ⅱ score， the proportion of patients with renal insufficiency， etc.） （P＞0.05）. The proportions of major infection sites （including lung， urinary， abdominal， blood and central nervous system） and treatment type （target or empirical treatment） also had no significant difference between the two groups （P＞0.05）. There was no significant difference in the attainment rate of ideal trough concentration （15-20 μg/mL） and the proportion of patients with trough concentration　＞20 μg/mL between the two groups （P＞0.05）， while the attainment rate of target trough concentration （10-20 μg/mL） and the proportion of patients with trough concentration ＜10 μg/mL were significantly different between the two groups （P＜0.05）. The attainment rate of target trough concentration in patients with chronic renal insufficiency in trial group was significantly higher than that in control group （P＜0.05）. There was no significant difference in the incidence of AKI and vancomycin-associated AKI between the two groups （P＞0.05）. In the trial group with medication duration ≥7 days ， the level of serum creatinine on the 7th day of treatment was increased significantly， compared with that on the 3rd day of treatment （P＜0.05）. CONCLUSIONS This individualized dosing regimen can improve the attainment rate of target trough concentration of vancomycin in critically ill patients， especially those with chronic renal insufficiency， during the first standardized monitoring， and not increase the risk of renal injury compared with previous empirical medication.

Objective To study stress distributions of the cartilage around the hip joint in stress environment of complete gait cycle, and explore the optimal correction angle of bone block in curved periacetabular osteotomy (CPO), so as to provide theoretical references for clinical operation. Methods Based on CT scans from a healthy volunteer and a patient with development dysplasia of hip (DDH), the three-dimensional (3D) model including pelvis and proximal femur was reconstructed. The cortical bone and cancellous bone were distinguished by dividing the masks, and the material attributes were assigned to the finite element model. A total of 100 different postoperative models were obtained by simulating CPO in DDH model, by adjusting lateral center edge angle (LCEA) and anterior center edge angle (ACEA). According to hip joint stresses in complete gait cycle, the model was loaded respectively, and stress changes of normal, preoperative and postoperative acetabular cartilage were analyzed and compared. ResultsThe minimum peak contact stresses of acetabular cartilage of DDH patient at heel landing phase, start phase of single leg support, mid phase of single leg support, end phase of single leg support and double support phase after simulated CPO operation were 5.273, 6.128, 7.463, 6.347, 6.582 MPa, which were decreased by 2.159, 2.724, 2.249, 2.164, 2.119 MPa,respectively, compared with those before operation. The contact area between femoral head and acetabulum was significantly increased after operation, but it was still smaller than that of normal volunteers. Conclusions The optimal correction angle of LCEA and ACEA can be obtained by using finite element method, and the simulation of CPO surgery on different patients is of great significance to improve surgical accuracy and efficiency.

Objective In order to simulate different angles of acetabular blocks that need to be adjusted during operation, the optimal angle was determined through analyzing the contact stress and contact area of cartilage around the hip joint, so as to provide an individual scheme for acetabular osteotomy. Methods The finite element models for development dysplasia of hip (DDH) and normal pelvis were established to investigate morphological characteristics of the acetabulum and the causes of stress concentration. To simulate osteotomy for the DDH model, a total of 20 postoperative osteotomy models were obtained through the combination of different angles for anterior rotation and lateral rotation of acetabular blocks, and the differences in optimal results of the models during simulated one legged-standing were compared and analyzed. Results The maximum contact pressure of acetabular cartilage in normal model was 7.85 MPa. The maximum contact pressure of acetabular cartilage in DDH model was 13.42 MPa. The optimal contact pressure after simulated osteotomy decreased to 8.49 MPa, and the contact distribution was improved more significantly. Conclusions Changing the anterior rotation angle can significantly improve the contact pressure distribution and size, as well as stay away from the preoperative lesion area, which has a positive impact on postoperative outcomes. Personalized osteotomy plan based on actual situation of each patient before the operation is crucial for the surgical effect.

Objective To explore the influence of different model scopes on acetabular stress distribution and optimal osteotomy result in preoperative planning of Bernese acetabular osteotomy. Methods Two patients with hip dysplasia were established according to different model ranges. Model 1 included the affected hip and femur, and Model 2 included the complete pelvis and affected femur. Compare and analyze the acetabular cartilage contact pressure, area and distribution of the two models under single-leg standing conditions, and simulate osteotomy. Results Compared with Model 1 before surgery, Model 2 had higher contact pressure, smaller contact area and closer distribution to the meniscus edge of acetabulum. Compared with 11 postoperative plans, the variation amplitude of contact pressure and the optimal osteotomy angle for Model 1 were all smaller than those of Model 2. Conclusions The preoperative analysis result of the model with affected hip bone and femur would underestimate the degree of stress concentration and misjudge the location of stress concentration, and the obtained optimal osteotomy rotation angle would be relatively small. The research findings provide certain theoretical basis for preoperative planning and modeling of osteotomy.

Objective To understand the situation of Schistosoma japonicum infections in wild animals in transmission-controlled schistosomiasis-endemic areas in Jiangxi Province, so as to provide scientific evidence for implementing precision control interventions and achieving the goal of transmission interruption and elimination of schistosomiasis. Methods Five endemic villages from Ruichang City and Pengze County that were heavily endemic for schistosomiasis in Jiangxi Province, were selected as the study villages. Wild animals like wild mice were captured, and the livers of wild animals were purchased from the snail habitats in the study villages for detection of S. japonicum infections. In the study villages, S. japonicum human infections were screened using indirect hemagglutination assay (IHA) followed by parasitological examinations with miracidial hatching test and Kato-Katz method, and the S. japonicum infection in livestock was tested using a miracidial hatching test with a plastic tube. In addition, snail survey was conducted in the study villages by means of systematic sampling combined with environmental sampling, and the S. japonicum infection in snails was detected using a loop-mediated isothermal amplification (LAMP) assay. Results A total of 240 liver specimens were sampled or purchased from 5 species of wild animals in the study villages, including wild mice, weasels, pigs, deer and rabbits. A total of 172 wild mice were captured, with a 2.91% rate of S. japonicum infection, and there was no S. japonicum infection detected in other wild animals. The prevalence of Capillaria hepatica infection was 12.21%, 1.96% and 12.50% in wild mice, deer and pigs, respectively. In addition, there was no S. japonicum infection found in either humans or livestock in the study villages, and the mean snail density varied from 0.13 to 0.80 snails/0.1 m² in the study villages. LAMP assay detected S. japonicum infection in 2 tubes in a study village. Conclusions The role of wild animals in schistosomiasis transmission and their potential risks can not be neglected in hilly schistosomiasis-endemic areas of Jiangsu Province after transmission control. Intensified surveillance and targeted control measures should be implemented to consolidate schistosomiasis control achievements.

Objective To solve the problems in medical equipment utilization,supervision,management,clinical safety and etc.Methods A centralized management and sharing system of medical equipment was developed with functional requirements analysis,C/S architecture and programming.Results The system eliminated the needs for manual accounting and allocation,enhanced medical equipment usage rate and improved equipment borrowing procedure.Conclusion The system contributes to dynamic management and efficacy evaluation of medical equipment,so as the working efficiency can be increased while the costs can be decreased for manpower and materials.

The modular,net-enabled,full-dimensional protective and highly mobile equipment of the U.S.Army medi-cal company is systematically analyzed.The roles and performance of essential equipment are outlined, and some sugges-tions are raised, providing reference for the PLA medical equipment construction.

Penicillin is a kind of β-lactam drug which has been applied in the clinical treatment firstly in the world, and it has still been widely used at present. The synthesis and regulation mechanism of Penicillium chrysogenum, which is used to produce penicillin, has been studied quite maturely, but its proteomics research started relatively late and fewer reports were published. This paper reviews the synthesis and application of penicillin, transformation of Penicillium chrysogenum, and the research progress of its proteomics. On this basis, the study highlights the advantages of proteomics in the research of protein expression.
Penicillins ; biosynthesis ; Penicillium chrysogenum ; metabolism ; Proteome ; Proteomics

Objective:To investigate the efficacy of HC-videolaryngoscopy in nasotracheal intubation for patients with predicted diffi-cult airway undergoing oral maxillofacial surgery.Methods:70 patients undergoing oral maxillofacial surgery with predicted difficult airway were enroled and randomly divided into 2 groups(n =35).Nasotacheal intubation was performed with HC-videolaryngoscopy (group VL)and Macintosh laryngoscopy(group ML)respectively.The duration and success rate of intubation,degree of glottis expo-sure,hemodynamic response as well as intubation related complications were evaluated.Results:There was higher success rate of first attempt(P <0.05),shorter intubation duration(P <0.05)and fewer frequency of multiple intubation(P <0.05)in group VL than in group ML.During intubation,the first and the best Cormack-Lehane laryngeal view was better in group VL(P <0.05)and less intuba-tion assistance was required in group VL(P <0.05).1 3 patients in group ML were intubated with VL after failure of the first attempt with ML.Conclusion:HC-videolaryngoscopy is safe and effective in the nasotracheal intubation for the patients with predicted difficult airway undergoing oral maxillofacial surgery.

This paper mainly introduces some related problems of biosafety and biosafety laboratory. It also mentions the present situation of worldwide biosafety laboratory and gives out some proposals.