Objective To establish the pharmacokinetic model of linezolid in neonates,and to optimize the administration regimen. Methods A prospective study was conducted among 64 neonates with sepsis who received linezolid as anti-infective therapy,and liquid chromatography-tandem mass spectrometry was used to measure the plasma concentration of the drug. Clinical data were collected,and nonlinear mixed effects modeling was used to establish a population pharmacokinetic (PPK) model. Monte Carlo simulation and evaluation was performed for the optimal administration regimen of children with different features. Results The pharmacokinetic properties of linezolid in neonates could be described by a single-compartment model with primary elimination,and the population typical values for apparent volume of distribution and clearance rate were 0.79 L and 0.34 L/h,respectively. The results of goodness of fit,visualization verification,and the Bootstrap method showed that the model was robust with reliable results of parameter estimation and prediction. Monte Carlo simulation results showed that the optimal administration regimen for linezolid in neonates was as follows:6 mg/kg,q8h,at 28 weeks of gestational age (GA);8 mg/kg,q8h,at 32 weeks of GA;9 mg/kg,q8h,at 34-37 weeks of GA;11 mg/kg,q8h,at 40 weeks of GA. Conclusions The PPK model established in this study can provide a reference for individual administration of linezolid in neonates. GA and body weight at the time of administration are significant influencing factors for the clearance rate of linezolid in neonates.

Huangqi Guizhi Wuwu Decoction is a classic prescription in traditional Chinese medicine(TCM) and is known for its effects of tonifying Qi, warming the meridians, and promoting blood circulation to alleviate obstruction. It is primarily used to treat conditions characterized by Qi stagnation, Yang deficiency, and obstruction, and it exhibits pharmacological effects such as immune regulation, anti-inflammation, analgesia, protection of the cardiovascular and cerebrovascular systems, itch relief, reduction of frostbite symptoms, antioxidative stress, promotion of cell apoptosis, and kidney protection. In modern clinical practice, it is commonly used to treat acute myocardial infarction, sequelae of cerebral infarction, cervical spondylosis, frozen shoulder, lower limb arteriosclerosis, lower limb vascular disorders, peripheral neuropathy in diabetes, and lupus nephritis. Recent research has focused on the chemical components, pharmacological effects, and clinical applications of Huangqi Guizhi Wuwu Decoction. Based on the "five principles" of quality markers(Q-markers) in TCM, this study predicted and analyzed the Q-markers of Huangqi Guizhi Wuwu Decoction. It suggested that astragaloside Ⅳ, formononetin, kaempferol, quercetin, cinnamic acid, cinnamaldehyde, 6-gingerol, paeoniflorin, albiflorin, and gallic acid could serve as Q-markers for Huangqi Guizhi Wuwu Decoction. The findings of this study can provide references for quality control of Huangqi Guizhi Wuwu Decoction and the development of new Chinese medicinal formulations.
Drugs, Chinese Herbal/therapeutic use* ; Medicine, Chinese Traditional ; Astragalus propinquus ; Frostbite/drug therapy*

Objective: To evaluate the success rate of His-Purkinje system pacing (HPSP) in patients with various sites of atrioventricular block (AVB) and provide clinical evidence for the selection of HPSP in patients with AVB. Methods: This is a retrospective case analysis. 637 patients with AVB who underwent permanent cardiac pacemaker implantation and requiring high proportion of ventricular pacing from March 2016 to September 2021 in the Department of Cardiology, General Hospital of Northern Theater Command were enrolled. The site of AVB was determined by electrophysiological examination. His bundle pacing (HBP) was performed in the first 130 patients (20.4%) who were classified as the HBP group and HPSP included HBP and/or left bundle branch pacing (LBBP) was performed in later 507 patients (79.6%) and these patients were classified as the HPSP group. The basic clinical information such as age and sex of the two groups was compared, and the success rates of HBP or HPSP in patients with different sites of AVB and QRS intervals were analyzed. Results: The age of HBP group was (66.4±15.9) years with 75 males (57.7%). The age of HPSP group was (66.8±13.6) years with 288 (56.8%) males. Among 637 patients, 63.0% (401/637) had atrioventricular node block; 22.9% (146/637) had intra-His block; 14.1% (90/637) had distal or inferior His bundle block. Totally, the success rate of HPSP was higher than that of HBP [93.9% (476/507) vs. 86.9% (113/130), P<0.05]. In each group of patients with various AVB sites, the success rate of HPSP was higher than that of HBP respectively and both success rates of HBP and HPSP showed a declining trend with the distant AVB site. The success rate of HBP in patients with atrioventricular node block and intra-His block was higher than that in patients with distal or inferior His bundle block [95.2% (79/83) vs. 47.1% (8/17), P<0.001; 86.7% (26/30) vs. 47.1% (8/17), P=0.010]. The success rate of HPSP was higher than that of HBP in patients with distal or inferior His bundle block [87.7% (64/73) vs 47.1% (8/17), P=0.001]. In patients with QRS<120 ms, 94.9% (520/548) of AVB sites were in atrioventricular node or intra-His, and HBP had a similar high success rate with HPSP [95.6% (109/114) vs. 96.3% (418/434), P=0.943] in these patients. In patients with QRS ≥ 120 ms, 69.7% (62/89) of AVB sites were at distal or inferior His bundle, and the success rate of HBP was only 25.0% (4/16), while the success rate of HPSP was as high as 79.5% (58/73), P<0.001. Conclusions: In patients with QRS<120 ms and atrioventricular node block or intra-His block, success rates of HBP and HPSP are similarly high and HBP might be considered as the first choice. In patients with QRS ≥ 120 ms and AVB site at distal or inferior His bundle, the success rate of HPSP is higher than that of HBP, suggesting LBBP should be considered as the first-line treatment option.
Aged ; Aged, 80 and over ; Atrioventricular Block/therapy* ; Bundle of His/physiology* ; Cardiac Pacing, Artificial ; Electrocardiography ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

Objective:To analyze the satisfaction degree and influencing factors of basic public health services in urban and rural areas in Hubei province,and to provide the evidence for further improvement of the quality of basic public health services. Methods:A total of 12 primary health institutions (6 urban community health service centers and 6 rural township hospitals) were selected from Wuhan,Huanggang,Jingzhou of Hubei Province. A questionnaire survey was conducted on the satisfaction,accessibility,comfort,safety and effectiveness of basic public health services among 719 residents. Results:The overall urban and rural residents'satisfaction score of basic public health service was 71.62 points,and the total satisfaction rate was 73.44%. The urban residents overall satisfaction score was 74.67 points,and the overall satisfaction rate was 75. 34%. The rural residents overall satisfaction score was 67.64 points,and the overall satisfaction rate was 71.52%. Among the specific indicators,the most satisfactory items were the convenience of visits (83.03%),privacy protection (80.25%),and indicators least satisfactory were medical technology(61.61%)and equipment facilities(64.53%). Logistics regression analy-sis showed that accessibility,comfort and safety of basic public health services had a greater impact on community residents' satisfaction;and gender and annual medical expenditure had a certain impact on residents'satisfaction. Conclusions:The over-all satisfaction of basic public health services in urban and rural residents of Hubei province is at a general level and still to be promoted. Urban residents'satisfaction is higher than that of the rural area. The basic public health services should further strengthen the quality improvement to further promote the equalization of basic public health services in rural as in urban areas.

Acute myeloid leukemia (AML) is a heterogeneous disease characterized by the accu-mulation of immature myeloid progenitor cells in the bone marrow,compromising of normal hematopoi-esis and ultimately resulting in bone marrow failure. Chemotherapy is the mainstay treatment for all AML patients,however,drug resistance and clinical relapse limits its efficacy.The 5-year survival rate of AML patients is only 26.6%.Survival rates are even lower among patients ages 65 to 74 years (5.3%)and 75 years or older(1.6%).Therefore,exploring novel therapeutic agents is urgent for improving the outcome of patients with AML. Saponins are amphipathic glycosides found in traditional Chinese medicines. In the present study, we isolated a panel of saponins from Paris forrestii (Takht.) H. Li, a unique plant found in Tibet and Yunnan provinces, China. By examining their activities in suppressing acute myeloid leukemia cell proliferation, total saponins from Paris forrestii (TSPf) displayed more potent activity than individual ones.TSPf induced more than 40% AML cell apoptosis within 24 h and decreased the viability of all leukemia cell lines. TSPf-induced apoptosis was confirmed by both Annexin V staining and caspase-3 activation.TSPf downregulated pro-survival proteins Mcl-1,Bcl-xL and Bcl-2,but upreg-ulated the expression of tumor suppressor proteins p53,p27,Bax and Beclin 1.The AKT/mTOR signaling pathway is frequently over activated in various AML cells,and TSPf was found to suppress the activa-tion of both AKT and mTOR,but had no effects on their total protein expression.This was further con-firmed by the inactivation of 4EBP-1 and p70S6K,two typical downstream signal molecules in the AKT/mTOR pathway. More specifically, TSPf-inactivated AKT/mTOR signaling was found to be associated with downregulated RNF6, a recently identified oncogene in AML. RNF6 activated AKT/mTOR, and consistently, knockdown of RNF6 led to inactivation of the AKT/mTOR pathway. Furthermore, TSPf suppressed the growth of AML xenografts in nude mice models. Oral administration of 100 mg·kg-1 body weight almost fully suppressed tumor growth within 14 d, without gross toxicity. This study thus demonstrated that TSPf displays potent anti-AML activity by suppressing the RNF6/AKT/mTOR pathway. Given its low toxicity,TSPf could be developed for the treatment of AML.

To know the status of Enterobius vermicularis infection in children in Jiangxi Province in 2014, so as to provide the evidence for the formulation of prevention and control measures.A survey was performed according to the scheme of the 3rd Principal Human Parasites of Jiangxi Province in 2014. Based on the ecological regions, a stratified cluster sampling method was applied by the economic and geographic situation. There were 84 survey sites from 28 counties, and the basic data were also collected in the different investigation sites, and the round-end tube adhesive cellophane anal swab was used to examine E. vermicularis eggs for the children aged 3–6 years.A total of 1 486 children aged 3-6 years were detected, the E. vermicularis infection rate was 13.73% (204/1 486), and the infection rates were 13.89% (114/821) and 13.53% (90/665) in the male and female, respectively. The infection rate in the different age groups showed a gradual rise then fall trend, the lowest infection rate was 10.05% (38/378) in the 3-year age group, and the highest infection rate was 18.24% (81/444) in the 5-year age group. The infection rates in the high, medium and low-income survey sites were 13.79% (87/631), 17.23% (51/296), and 11.81% (66/559), respectively. The E. vermicularis infection rates in the 4 ecological regions were from 12.34% to 17.74%, but there was no significant difference among the different ecological regions (P > 0.05).The status of E. vermicularis infection in children in Jiangxi Province is relatively serious, and therefore, the parasitic disease control sectors should continue to strengthen the monitoring and control work of E. vermicularis infection in children.

OBJECTIVE: To determine the relationship between intravoxel incoherent motion (IVIM) imaging derived quantitative metrics and serum soluble CD40 ligand (sCD40L) level in an embolic canine stroke model. MATERIALS AND METHODS: A middle cerebral artery occlusion model was established in 24 beagle dogs. Experimental dogs were divided into low- and high-sCD40L group according to serum sCD40L level at 4.5 hours after establishing the model. IVIM imaging was scanned at 4.5 hours after model establishment using 10 b values ranging from 0 to 900 s/mm². Quantitative metrics diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (f) of ischemic lesions were calculated. Quantitative metrics of ischemic lesions were normalized by contralateral hemisphere using the following formula: normalized D = D(stroke) / D(contralateral). Differences in IVIM metrics between the low- and high-sCD40L groups were compared using t test. Pearson's correlation analyses were performed to determine the relationship between IVIM metrics and serum sCD40L level. RESULTS: The high-sCD40L group showed significantly lower f and normalized f values than the low-sCD40L group (f, p < 0.001; normalized f, p < 0.001). There was no significant difference in D*, normalized D*, D, or normalized D value between the two groups (All p > 0.05). Both f and normalized f values were negatively correlated with serum sCD40L level (f, r = −0.789, p < 0.001; normalized f, r = −0.823, p < 0.001). However, serum sCD40L level had no significant correlation with D*, normalized D*, D, or normalized D (All p > 0.05). CONCLUSION: The f value derived from IVIM imaging was negatively correlated with serum sCD40L level. f value might serve as a potential imaging biomarker to assess the formation of microvascular thrombosis in hyperacute period of ischemic stroke.
Animals ; CD40 Ligand* ; Diffusion ; Dogs ; Infarction, Middle Cerebral Artery ; Magnetic Resonance Imaging* ; Perfusion ; Stroke* ; Thrombosis

OBJECTIVETo investigate the clinical application of superior or inferior gluteal artery perforator flaps for the gluteal sores.

METHODSBefore operation, the perforator artery was detected by Doppler flowmeter and labeled. The perforator flap was designed, including the perforator artery, but not the gluteal maximum muscle.

RESULTSFrom Aug. 2006 to May 2009, 15 cases were treated. The flap size ranged from 6 cm x 8 cm to 7 cm x 15 cm. All the flaps survived completely without hematoma, seroma or other complication.

CONCLUSIONSThe gluteal maximum muscle-reserved gluteal artery perforator flap is a good choice for gluteal sore with reliable blood supply and less morbidity in donor site.

Adult ; Buttocks ; blood supply ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Pressure Ulcer ; surgery ; Surgical Flaps ; blood supply ; Treatment Outcome

Objective To examine the relationship between hyperthyroidism and excessive iodine intake from drinking water through epidemiological studies in the iodine excess and the iodine normal villages. Methods Mengzhuang village of Pei county and Xingji village of Pizhou city in Jiangsu province, with median water iodine concentration of 1284.1 μg/L and 77.9 μ/L, respectively,were selected in 2006. Thyroid diseases of all local residents in the two villages were assessed clinically to compare the prevalence and the distribution of hyperthyroidism. Results A total of 17 471 residents were recruited from the iodine excess village, 26 of them were diagnosed with hyperthyroidism. The prevalence of hyperthyroidism was 1.49‰, 0.75‰ (7/9264) in male,2.32‰( 19/8207) in female, and the age-standardized prevalence was 1.48‰. A total of 12 765 residents were recruited from the iodine normal village, among them 27 residents were diagnosed with hyperthyroidism. The prevalence of hyperthyroidism was 2.12‰, 0.96‰(7/6823) in male, 3.26‰(20/5942) in female, and the agestandardized prevalence was 2.02‰. The prevalence and age-standardized prevalence was significantly lower in the iodine excess village than those in the iodine normal village (u = 2.88, 2.89; all P < 0.01). The prevalence of hyperthyroidism was lower among females in the iodine excess village (2.32‰) than that in the iodine normal one (3.37‰, u = 2.89, P < 0.01). Residents aged 20 - 50 years had higher prevalence of hyperthyroidism[(19.36 -38.96 )/10 000]in the two villages. The proportion of Graves diseases was 50.00% (13/26) in the iodine excessvillage, higher than that in the iodine normal village[29.41%(5/17) , χ2 = 5.853, P < 0.01]. Conclusions Chronic excessive iodine intake does not increase the chance of suffering from hyperthyroidism. On the contrary, the prevalence of hyperthyroidism in the iodine excess village decreases significantly compared with that of the iodine normal village. The prevalence is higher among females.

This study was purposed to investigate the practicality of matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF MS) for detection of single nucleotide polymorphisms (SNP) on jak2 gene in multiple myeloma (MM) cells. The DNA fragment containing 2 SNPs of jak2 (C428T and C643T) was amplified using PCR and was purified. The purified product was used as the template for primer extension (PEX). The small products of allele-specific reaction were purified, the SNPs on jak2 gene of 5 patients with MM and 5 healthy persons were detected by MALDI-TOF MS. The results showed that the distribution of genotype C428T and C643T was not different between MM patients and healthy persons, both of which are homozygous T/T. In conclusion, the method based on MALDI-TOF MS and PEX technique for detecting SNP in jak2 gene is rapid, accurate and reliable method, and can be used in clinical practice.
Case-Control Studies ; DNA Primers ; Genotype ; Humans ; Janus Kinase 2 ; genetics ; Multiple Myeloma ; genetics ; Polymorphism, Single Nucleotide ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ; methods