Effects of antibiotics on prevention of infection, white blood cell counts, and C-reactive protein levels at different times in the perioperative period of cesarean section
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OBJECTIVE: To evaluate the effects of antibiotics on prevention of infection, white blood cell (WBC) counts and C-reactive protein (CRP) levels at different times in the perioperative period of cesarean section. MATERIALS AND METHODS: A total of 486 women undergoing cesarean section were randomly divided into groups A, B, and C (n = 162). Group A was intravenously infused with 250 mL of 0.9% normal saline containing 2 g cefuroxime sodium 30 minutes before surgery within 30 - 45 minutes. Group B was given cefuroxime 30 minutes before surgery and 3 days after surgery, respectively. Group C was given cefuroxime only after returning to ward, once daily for 3 consecutive days. The surgical time, intraoperative blood loss, postoperative hospital-stay length, hospitalization expenditure, maximum body temperature, WBC count and CRP level 3 days after surgery, grade A healing rate of incision at discharge, and incidence of infection were compared. RESULTS: Group A had the shortest postoperative hospital-stay length and lowest hospitalization expenditure (p < 0.05). The maximum body temperature, WBC count and CRP level of group A 3 days after surgery were lowest (p < 0.05). The three groups had similar grade A healing rates of incision (p > 0.05). The postoperative infection rates of groups A and B were similar (p > 0.05), both being significantly lower than that of group C (p < 0.05). CONCLUSION: Single prophylactic use of antibiotics 30 minutes before surgery effectively prevented infection after cesarean section and shortened the hospital-stay length. This method is worthy of clinical promotion due to short duration of antibiotic use and low hospitalization expenditure.

Pharmacokinetics and pharmacodynamics of cinacalcet in patients with renal failure receiving hemodialysis and hemodiafiltration therapy
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OBJECTIVE: Few studies have focused on the effects of dialysis on cinacalcet. In addition, there is no data available on hemodiafiltration (HDF) all over the world. Therefore, we studied the pharmacokinetics (PK) and pharmacodynamics (PD) of cinacalcet in patients undergoing hemodialysis (HD) or HDF to provide more guiding information on its use in these patients, especially in China. MATERIALS AND METHODS: In this open-label, single-dose, single-center study of 7 patients with renal failure who underwent dialysis, patients were randomly allocated to two groups consisting of 4 and 3 patients who received low-flux HD and HDF treatments, respectively. All participants underwent dialysis for 4 hours immediately after receiving single oral doses of a 25 mg cinacalcet tablet. High-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) and electrochemical luminescence (EI) were used to determine the cinacalcet plasma concentrations and intact parathyroid hormone (iPTH) serum levels, respectively. RESULTS: Peak concentration (Cmax) and area under the curve (AUC) from time 0 to 24 hours (AUC0-24h) of the low-flux HD therapy group were 21.8 ± 18.6 ng/mL and 145.3 ± 91.8 ng×h/mL, respectively, which were similar to those of the HDF group (30.9 ± 7.9 ng/mL and 161.6 ± 26.5 ng×h/mL, respectively). iPTH concentrations of the HD therapy group decreased after cinacalcet administration and increased following its clearance. However, iPTH levels of subjects receiving HDF therapy did not change. CONCLUSION: Compared with healthy Chinese subjects, patients with renal failure had a higher Cmax and AUC0-24h, slightly prolonged time to Cmax (tmax) after administration of the same dose of cinacalcet. On HD treatment day, variation trends of iPTH in Chinese patients and healthy subjects were similar and significantly different from that on the HDF treatment day. Considering the high protein binding rate of cinacalcet, this may lead to the great free-drug clearance during HDF treatment.