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Huang-Qin Decoction (HQD) is a classic prescription for diarrhea in Chinese medicine treatment. Recent studies have demonstrated that HQD and its modified formulation PHY906 could ameliorate irinotecan (CPT-11) induced gastrointestinal (GI) toxicity and enhance its anticancer therapeutic efficacy. Nevertheless, which constituents in HQD are effective is still unclear so far. The study aims to screen out the key bioactive components combination from HQD that could enhance the anticancer effect of CPT-11. First, the potential bioactive constituents were obtained through system pharmacology strategy. Then the bioactivity of each constituent was investigated synthetically from the aspects of NCM460 cell migration, TNF-α release of THP-1-derived macrophage and MTT assay in HCT116 cell. The contribution of each constituent in HQD was evaluated using the bioactive index E
ABSTRACT
<p><b>OBJECTIVE</b>To study the clinical features and hospital costs of neonatal sepsis caused by Gram-positive (G(+)) bacteria, Gram-negative (G(-)) bacteria, and fungi.</p><p><b>METHODS</b>The clinical data of 236 neonates with sepsis were analyzed retrospectively. Among these neonates, 110 had sepsis caused by G(+) bacteria, 68 had sepsis caused by G(-) bacteria, and 58 had sepsis caused by fungi.</p><p><b>RESULTS</b>Full-term infants accounted for 62% and 38%, respectively, in the G(+) bacteria and G(-) bacteria groups, and preterm infants accounted for 86% in the fungi group. The neonates in the fungi group had significantly lower gestational ages and birth weights than those in the G(+) and G(-) bacteria groups (P<0.05). Compared with the G(+) bacteria group, the G(-) bacteria and fungi groups had significantly higher rates of multiple births (P<0.0125). Compared with the G(+) bacteria and fungi groups, the rates of premature rupture of membranes >18 hours, grade III amniotic fluid contamination, and early-onset sepsis in the G(-) bacteria group were significantly higher (P<0.0125). Compared with the G(-) bacteria and fungi groups, the G(+) bacteria group showed significantly higher rates of abnormal body temperature, omphalitis or herpes as the symptom suggesting the onset of such disease (P<0.0125). The fungi group had significantly higher incidence rates of apnea and low platelet count than the G(+) and G(-) bacteria groups (P<0.0125). The comparison of length of hospital stay and total hospital costs between any two groups showed that the fungi group had a significantly longer hospital stay and significantly higher total hospital costs than the G(+) and G(-) bacteria groups (P<0.05).</p><p><b>CONCLUSIONS</b>Sepsis caused by G(+) bacteria mainly occurs in full-term infants, and most cases of sepsis caused by G(-) bacteria belong to the early-onset type. Sepsis caused by fungi is more common in preterm infants and low birth weight infants, and has high incidence rates of apnea and low platelet count, as well as a longer hospital stay and higher hospital costs than sepsis caused by bacteria.</p>
Subject(s)
Female , Humans , Infant, Newborn , Male , Bacteremia , Economics , Fungemia , Economics , Hospital Costs , Infant, Premature , Length of StayABSTRACT
Objective To investigate the clinical features of fungal sepsis in premature infants.Methods The risk factors,clinical characteristics,laboratory findings,treatment and prognosis of 30 preterm infants with fungal sepsis in neonatal intensive care unit of the First Mfiliated Hospital of Anhui Medical University from Jan.2010 to Dec.2012 were analyzed.Results Fourteen cases (46.7％) were extremely preterm infants.The gestational ages of 20 cases(66.7％) were less than 34 weeks.The preterm infants were infected with fungal sepsis at the age of 6-42 d,and the mean age was (15.70 ± 9.02) d.The most common pathogens were Candida albicans (83.3％) and Candida glabrata(13.3％).Before infection,6 cases accepted the endotracheal intubation and mechanical ventilation,9 cases accepted Peripherally Inserted Central Catheter with the duration more than or equal to 7 days,and 5 cases accepted multi-antibiotic treatment with the duration more than or equal to 14 days,with the main clinical manifestations including poor response in 25 cases (83.3％),poor feeding in 25 cases (83.3％),and blood oxygen concentration decrease in 20 cases (66.7％).There were 27 cases(90.0％) with the increased C-reactive protein(CRP),5 preterm infants with the white blood cell count less than 5.0 × 109/L,5 patients with the white blood cell count more than 15.0 × 109/L,and 20 cases (66.7 ％) with thrombocytopenia.Among those 30 cases,2 cases (6.7 ％) abandoned therapy,4 cases (13.3％) accepted liposomal amphotericin B because of the poor efficacy to fluconazole,and 24 cases (80.0％) accepted fluconazole.Of the 28 cases,4 cases(13.3％) were improved,24 cases(80.0％) were cured and no one died.Conclusions The proportion of Candida albicans species increased during the cause of fungal sepsis in premature infants.It was probably the cause of fungal sepsis when preterm infants had poor response,poor feeding,blood oxygen concentration decrease in 2-3 weeks after birth.Possible strategies were recommended including strict aseptic manipulation,rational use of antibiotics,antifungal prophylaxis for preterm infants who have risk factors in highoccurrence season in order to decrease the morbidity and mortality of neonatal fungal sepsis.