[Periconceptional maternal homocysteine and birth weight outcomes in offspring: a prospective cohort study].

Objective: To quantify the associations between periconceptional maternal homocysteine (HCY) and offspring's birth weight and risk of small for gestational age (SGA) infant. Methods: The 19 984 mother-child pairs in this prospective cohort study were recruited from the Shanghai preconception cohort; the infants were delivered from 1st September 2016 to 11th November 2022. A standardized questionnaire was used to collect the mothers' demographic information, medical history, dietary supplement use, and maternal complications during pregnancy, and their serum samples were collected. Serum HCY, folate, and vitamin B12 were measured using chemiluminescent microparticle immunoassay based on serum sample drawn at enrollment. Birth weight data were obtained from medical records. Multiple imputation methods were applied to handle missing data in key variables. Multivariable linear regression and Poisson regression models were used to analyze the relationship between maternal HCY concentration during the periconceptional period and the birth weight and SGA risk of the offspring. Results: A total of 9 452 pairs were enrolled preconceptionally and the remaining 10 532 pairs were enrolled in early pregnancy. The proportion of mothers whose pregnancy age was greater than 35 years was 9.2% (1 832/19 984), the proportion of primiparous women was 76.5% (15 283/19 984), the proportion of pre-pregnancy overweight and obesity was 14.0% (2 804/19 984), the proportion of using folic acid supplements before pregnancy was 21.4% (4 272/19 984), and the proportion of those who supplemented with folic acid during early pregnancy was 85.2% (8 976/10 532); gestational diabetes mellitus was in 6.2% (1 245/19 984), gestational hypertensive syndrome in 3.6% (711/19 984). The birth weight of the offspring was (3 297±468) g, and there were 1 962 SGA children (9.8%). The HCY concentration in the overall population in appropriate for gestational age during the periconceptional period was (7.9±3.2) µmol/L, with (8.3±3.7) µmol/L in the preconception subgroup and (7.3±2.4) µmol/L in the early pregnancy subgroup. After adjustment for the covariates of perinatal demographic information, adverse pregnancy outcomes, serum folate and vitamin B12, increased maternal periconceptional HCY was significantly associated with lower offspring birth weight (ß=-2.30, 95%CI -4.43--0.16, P=0.035). Only the early pregnancy subgroup was significantly associated with lower offspring birth weight (ß=-7.39, 95%CI-11.50--3.21, P<0.001). No association was found between peripregnancy HCY and offspring SGA risk. However, elevated HCY in early pregnancy was associated with an increased risk of SGA in the offspring (RR=1.05, 95%CI 1.01-1.08, P=0.002). Periconceptional vitamin B12 was a mediator of the association between HCY and offspring birth weight, accounting for 16.5%, 41.2% and 5.4% of its total effect in the overall periconceptional population, the pre-pregnancy subgroup and the early pregnancy subgroup, respectively. Conclusions: Maternal periconceptional HCY level is associated with lower birth weight in offspring, but not with the risk of SGA. Elevated maternal HCY in early pregnancy subgroup may be associated with increased risk of SGA in offspring.

Supplementation with N-carbamoylglutamate during the transition period improves the function of neutrophils and reduces inflammation and oxidative stress in dairy cows.

The aim of this study was to investigate the effects of N-carbamoylglutamate (NCG) supplementation during the transition period on the functions of blood polymorphonuclear neutrophils (PMN), inflammation, and oxidative stress in dairy cows. Thirty multiparous Chinese Holstein dairy cows at wk 4 before parturition were blocked into 2 groups by parity, body weight, and milk yield of previous lactation, and randomly allocated to 2 dietary treatments of basal diet supplemented without (control, n = 15) or with 20 g/d per cow of NCG (NCG, n = 15). The supplementation was carried out from d -21 to 21 relative to calving. Health incidents (mastitis, retained placenta, and lameness) were recorded, and blood samples were collected at d -21, -7, 0 (the calving date), 7, and 21 relative to parturition and analyzed for variables related to inflammation and oxidative stress. In addition, whole blood was collected at d 7 to isolate PMN and used for analysis of the expression of functional genes and from d -21 to 21 for determination of weekly hematological parameters. The number of lymphocytes was greater at d 7 in the blood of NCG cows. The plasma level of malondialdehyde was lower in the NCG group, and blood reactive oxygen species were lower at d 7, whereas total antioxidant capacity tended to be greater in the NCG group and glutathione peroxidase tended to be higher at d 21 in cows fed NCG, suggesting that NCG supplementation improved antioxidation in cows. In addition, the concentration of serum amyloid A was lower in NCG-fed animals during the postpartum stage. Blood concentrations of IL6 and tumor necrosis factor-α were lower and tended to be lower in NCG-fed animals at d 7, respectively. Meanwhile, the concentrations of IL6 tended to be lower in NCG-fed animals at d 21. Furthermore, the expression of S100A9 and MMP9 in the PMN was lower and tended to be lower, respectively, whereas the expression of ITGB2, XBP1 tended to be higher and expression of CLEC6A was higher in NCG-fed cows. Overall, our results indicated that supplementation with NCG during the transition period showed the beneficial effects on animal health, by improving PMN functions and alleviating inflammation status and oxidative stress in dairy cows.

Effect of chromium methionine supplementation on lactation performance, hepatic respiratory rate and anti-oxidative capacity in early-lactating dairy cows.

Chromium may regulate dairy cow metabolism; a chelated formation of chromium methionine (Cr-Met) is available to the feed industry. The objective of this study was to investigate the effect of Cr-Met supplementation on lactation performance, hepatic respiratory rate and anti-oxidative capacity in early-lactating Holstein dairy cows. 64 multiparous cows were assigned to 16 blocks based on parity and milk yield and then the four cows in a block were randomly allocated to four treatment groups with 0, 4, 8 or 16 g/d of Cr-Met per cow supplemented to a basal diet. Cows were moved from an open dry lot to a naturally ventilated tie stall barn 2 weeks before treatment to adapt to this facility, fed and milked at 0630, 1400, and 1930 h every day. The experiment lasted for 12 weeks. Milk yield and composition were recorded weekly. Dry matter intake was measured every 2 weeks for a total of six times throughout the trial. The plasma variables were measured in weeks 4, 8 and 12 of the experiment. Supplementation of Cr-Met did not affect DM intake of cows. As the supplementation of Cr-Met increased, yields of milk, fat, energy corrected milk (P < 0.01) and lactose (P = 0.01) increased in a linear manner. In terms of plasma variables, insulin concentration decreased in a linear manner with Cr-Met supplementation. As for variables relating to hepatic respiration rate, concentrations of pyruvate and NAD in the plasma were increased in quadratic manners, and lactic dehydrogenase activity was linearly increased as Cr-Met feeding levels increased. Moreover, plasma glutathione peroxidase and superoxide dismutase activity were increased in a linear manner. In conclusion, our study suggested that Cr-Met supplementation improved lactation performance of early-lactating dairy cows through enhancing antioxidant capacity and hepatic cellular respiration.

Short communication: Effects of dietary N-carbamoylglutamate supplementation on the milk amino acid profile and mozzarella cheese quality in mid-lactating dairy cows.

N-Carbamoylglutamate (NCG) is an enhancer of Arg, which is a functional AA and could prevent cardiovascular disease and improve immunity. The present study was conducted to investigate the effects of supplementing NCG in diets of lactating cattle on the NCG concentration and AA composition of raw milk and on mozzarella cheese quality. Thirty multiparous cows with a mean body weight of 669 kg (standard deviation = 71) and days in milk of 176 (standard deviation = 55) were blocked based on parity and milk production and randomly assigned to 1 of 2 treatments: basal diet (CON) and basal diet supplemented with 40 g of NCG per day per cow (NCG). After 8 wk of treatment, raw milk samples were collected from the 2 groups for AA analysis and mozzarella cheese-making. Furthermore, the NCG concentration and distribution in milk and mozzarella cheese were detected. The AA concentration in milk was greater and the NCG concentration in raw milk was approximately 6 times greater in the NCG group than in the CON group. No NCG was detected in cheese from the CON group, and very little NCG (<1.0 µg/kg) of cheese was detected in the NCG group. Most of the dietary NCG was transferred into whey, stretch water, and brine during cheese production. No significant difference was found between the 2 groups on cheese texture and color except that hardness was lower in the NCG group. Overall, the results indicated that dietary supplementation of NCG could improve the NCG and AA concentrations in raw milk without affecting the quality of cheeses such as mozzarella.

Effect of hydroxyselenomethionine on lactation performance, blood profiles, and transfer efficiency in early-lactating dairy cows.

The current study investigated the effects of hydroxyselenomethionine (HMBSe), a novel organic selenium (Se) additive, on lactation performance, blood profiles, antioxidative status, and transfer efficiency of Se in early-lactation dairy cows. Sixty multiparous early-lactating dairy cows with similar days in milk (57 d; standard deviation = 9.9) and milk yield (36.5 kg/d; standard deviation = 1.42) were fed a basal diet containing 0.04 mg of Se/kg (dry matter basis). These cows were assigned to 1 of 4 groups following a randomized complete block design as follows: control (basal diet) or HMBSe addition (0.1, 0.3, or 0.5 mg of Se/kg of dry matter). The experiment lasted for 13 wk, with the first week as adaptation. The results showed that milk yields (raw, protein, and lactose) and feed efficiency were improved in a quadratic manner following increased dietary HMBSe addition, whereas energy-corrected milk, 4% fat-corrected milk, and total solid yields tended to be enhanced quadratically. In terms of whole-blood variables, red blood cell and white blood cell levels were increased quadratically, whereas hemoglobin concentration increased linearly with increased HMBSe addition. Plasma nonesterified fatty acid concentrations tended to increase linearly along with HMBSe addition. Plasma superoxide dismutase activity increased quadratically with increased HMBSe addition. The total antioxidant capacity in plasma tended to improve quadratically when cows were fed more HMBSe. Moreover, plasma malondialdehyde concentrations of dairy cows tended to decrease in a quadratic manner when dietary HMBSe increased. The Se concentrations in milk, plasma, and milk/plasma ratio increased linearly following increased HMBSe addition. In conclusion, HMBSe improved lactation performance, health status, and milk Se concentrations in early-lactating dairy cows.

Effect of N-acetyl-l-methionine supplementation on lactation performance and plasma variables in mid-lactating dairy cows.

The objective of current study was to investigate the effect of N-acetyl-l-methionine (NALM) supplementation on lactation performance and plasma variables in mid-lactating dairy cows. Forty-eight multiparous cows were blocked into 12 groups based on parity, days in milk, and milk production and were randomly assigned to 1 of the 4 treatments: 0, 15, 30, or 60 g/d of NALM per cow to supplement the basal diet. The experiment was conducted over a 13-wk period, with the first week as adaptation. The yields of milk, fat-corrected milk, and milk lactose were increased quadratically, and energy-corrected milk yield tended to increase with increased NALM supplementation in a quadratic manner. The dry matter intake, milk protein yield, milk fat yield, contents of milk composition (protein, fat, lactose, total solids, and milk urea nitrogen), feed efficiency, and body weight change were not affected by NALM supplementation. In addition, plasma methionine concentration was increased quadratically, and proline, total nonessential AA, and total AA concentrations were significantly higher in the 30 g/d group compared with that of the control group. However, other AA and total essential AA concentrations were not affected with supplementation of NALM. Adding NALM increased concentrations of total protein and globulin in plasma, but decreased plasma urea nitrogen concentration in a quadratic manner. Meanwhile, plasma malonaldehyde concentration decreased linearly as doses of NALM addition increased. Our results suggested that the supplementation of NALM improved milk yield and protein synthesis in the liver, and lowered lipid peroxidation in mid-lactating dairy cows.

Short communication: Effects of dietary addition of N-carbamoylglutamate on milk composition in mid-lactating dairy cows.

The present study was conducted to investigate the effect of N-carbamoylglutamate (NCG) on milk production and composition in mid-lactating Holstein dairy cows. Sixty multiparous cows with a mean body weight of 669 kg (standard deviation = 71) and 176 days in milk (standard deviation = 55) were blocked based on parity and milk production and randomly assigned into 4 treatments, a basal diet supplemented with 0, 10, 20, or 40 g of NCG/d per cow. Milk yield and composition were recorded weekly, whereas dry matter intake and plasma variables were determined every 2 wk. The results showed that the addition of NCG had no effect on the dry matter intake and milk yield of the cows. Milk fat content and yield increased linearly with NCG addition. The contents of milk protein and total solid also increased linearly in the cows fed NCG, whereas the yield of protein was not affected by the treatments. Conversely, dietary addition of NCG increased the plasma nitric oxide content in a quadratic manner. Moreover, addition of NCG linearly increased the plasma Arg content. Overall, the results indicate that dietary NCG addition increased the milk protein and fat contents, which improved the milk quality of lactating dairy cows.

Effect of dietary supplements of biotin, intramuscular injections of vitamin B12, or both on postpartum lactation performance in multiparous dairy cows.

The current study was conducted to investigate the effects of dietary supplementation of biotin, intramuscular injections of vitamin B12 (VB12), or both beginning at the prepartum period on feed intake and lactation performance in postpartum dairy cows. Forty-eight dairy cows were allocated into 12 blocks, based on parity and milk yield of the previous lactation cycle, and randomly assigned to 1 of 4 treatments. Supplementation of VB12 (weekly intramuscular injections of 0 or 10 mg) and biotin (dietary supplements of 0 or 30 mg/d) were used in a 2 × 2 factorial arrangement in a randomized complete block design of 12 blocks with repeated measures. The study started at 3 wk before the expected calving date and ended at 8 wk after calving. Feed intake and lactation performance (milk yield and composition) were recorded weekly after calving. Blood variables were measured on d -10, 0, 8, 15, 29, 43, and 57 relative to calving. When VB12 was given, the cows had greater feed intake, better lactation performance and lower body weight loss in the postpartum period compared with animals without injection of VB12. The VB12-injected cows had lower plasma nonesterified fatty acids and ß-hydroxybutyrate concentrations but higher plasma superoxide dismutase activity compared with cows without VB12. Cows fed a biotin supplement had higher milk protein yield (6 and 8 wk) and lactose yield (6-8 wk), compared with animals without biotin. However, under the present experimental conditions, we found no additive effect of a combined supplement of biotin and vitamin B12 on lactation performance of dairy cows.

Short communication: Effects of dietary 5,6-dimethylbenzimidazole supplementation on vitamin B12 supply, lactation performance, and energy balance in dairy cows during the transition period and early lactation.

The current study was conducted to investigate the effects of 5,6-dimethylbenzimidazole (DMB) supplementation to the feed during the transition period and early lactation on the vitamin B12 supply, lactation performance, and energy balance in postpartum cows. Twenty-four prepartum Holstein dairy cows were divided into 12 blocks based on their parity and milk yield at the last lactation and were then randomly allocated to 1 of 2 treatments: a basal diet without DMB (control) or a treatment diet that contained 1.5 g of DMB/d per cow. The study started at wk 3 before the expected calving day and ended at wk 8 postpartum. The feed intake and the lactation performance were measured weekly after calving. Blood parameters were measured on d -10, 0, 8, 15, 29, 43, and 57 relative to the calving day. Body weight was measured on the calving day and on d 57 after calving. The yields of milk, protein, and lactose in cows fed DMB were higher than in the control throughout the whole postpartum stage. On wk 8 postpartum, the vitamin B12 content in the milk and sera was greater in cows fed DMB than in the control. The overall body weight loss from wk 1 to 8 postpartum was less in cows fed DMB than in the control. The plasma content of nonesterified fatty acids and ß-hydroxybutyric acid was significantly lower in cows fed DMB than in the control throughout the whole experimental stage. In conclusion, dietary DMB fed during the transition period and early lactation improved the vitamin B12 supply, milk production, and energy balance of postpartum dairy cows.

[Analysis of infection and drug-resistance in 6 107 cases of extrapulmonary tuberculosis in Chengdu area].

Objective: To analyze the infection and drug resistance of extrapulmonary tuberculosis, in order to provide useful references for prevention and treatment of tuberculosis (TB). Methods: A total of 6 107 suspected cases of extrapulmonary tuberculosis, including lymph node, pleural, peritoneal, meningeal, urinary tract, and bone tuberculosis, were collected retrospectively from January 2013 to December 2015 in Public Health Clinical Center of Chengdu. There were 4 033 male and 2 074 female patients, and the average age was 37 years.The epidemiological data, infection and drug resistance were analyzed statistically. Results: There were 21 036 cases of mycobacterial culture from January 2013 to December 2015, of which 7 119 were positive(33.8%). Extrapulmonary tuberculosis was found in 6 107 cases, of which 896 were positive, accounting for 12.6% of the positive cases(896/7 119). Culture-positive cases of extra-pulmonary tuberculosis showed a rising trend from 2013 to 2015 (n=174, 310, 421, respectively), and the annual average increasing rate was over 50%.Cases were distributed at younger ages (21-40 years), with an average age of 34 years.There were more male patients, with a male to female ratio of 2.1∶1. The most common site of extrapulmonary tuberculosis was the bone(62/243, 25.5%), followed by lymph node(283/1 297, 21.8%), pleural(289/1 840, 15.7%), urinary tract(63/452, 13.9%), peritoneum(41/303, 13.5%), meningeal(156/1 915, 8.1%)and other types of tuberculosis(2/57, 3.5%). Drug sensitivity test of 896 extrapulmonary tuberculosis strains showed that the resistance rate (from high to low) was in the order of isoniazid, rifampicin, streptomycin, ofloxacin, ciprofloxacin, amikacin, capreomycin and ethambutol. Multidrug-resistant(MDR)and extremely-drug resistant (XDR) rate was 9.7 %(87/896)and 2.0%(17/896)respectively. Conclusions: Cases of extrapulmonary tuberculosis sent for bacterial culture and the positive rate showed a rising trend by years in Chengdu area.The drug resistance level was higher than that reported both in China and abroad.The prevention and treatment of extrapulmonary tuberculosis should be strengthened in this area.

Effects of γ-aminobutyric acid on feed intake, growth performance and expression of related genes in growing lambs.

This study was conducted to investigate the effects of rumen-protected γ-aminobutyric acid (GABA) on feed intake, growth performance and expression of related genes in growing lambs. A total of 24 lambs weaned at age of 50 days were divided into four block of six based on their BW, six lambs within a block were allocated to three pairs, which were then assigned randomly to three treatments with addition of rumen-protected GABA at levels of 0, 70 or 140 mg/day for 6 weeks. Dry matter intake was recorded weekly in three consecutive days, and BW was recorded every two weeks. At the end of the trial, four lambs from each group were slaughtered, and duodenum and ileum mucosa were obtained for measurement of mRNA abundance of GABA receptor and cholecystokinin receptor. Dry matter intake was higher (P<0.01) in the lambs fed 140 mg/day GABA than that in the control or 70 mg GABA-fed lambs. Average daily gain and nutrients digestibility were not different (P>0.05) among treatments. Lambs fed 140 mg/day GABA had higher mRNA abundance of GABA-B receptor (P<0.01) and lower mRNA abundance of cholecystokinin-2 receptor (P<0.01) in duodenum mucosa. Serum CCK content was lower (P<0.01) in lambs fed 140 mg/day GABA than that in control. It is indicated that GABA may enhance feed intake by regulating GABA- and cholecystokinin-related genes.

Effect of dietary N-carbamoylglutamate on milk production and nitrogen utilization in high-yielding dairy cows.

The objective of the current study was to investigate the effect of N-carbamoylglutamate (NCG) supplementation on milk production and nitrogen (N) utilization in Chinese Holstein dairy cows. Sixty multiparous cows (78±17.3 d in milk, 635±61.00kg of body weight, and 41.9±7.9kg/d milk yield; mean ± SD) were blocked by parity, days in milk, and milk yield and randomly allocated to 1 of 4 groups, each of which was fed a dietary treatment containing 0 (control), 10, 20, or 30g of NCG/d. Milk yield was recorded weekly. Dry matter intake, milk composition, plasma variables, and urea N contents in plasma, urine, and milk were determined every other week. Blood samples were collected from the coccygeal vein. Rumen microbial protein synthesis was estimated based on the purine derivatives in the urine. Dry matter intake was found to be similar between the treatments. Addition of 20g of NCG/d tended to increase milk yield (40.2 vs. 38.1kg/d) and increased the content (2.83 vs. 2.74%) and yield (1.12 vs. 1.02kg/d) of milk protein compared with the control. The yield and content of milk fat were similar between the treatments, whereas the contents of lactose and total solids increased linearly with an increase in NCG. Dietary supplementation of NCG linearly increased the plasma nitric oxide level and decreased the plasma ammonia N level. Compared with the control, the plasma Arg concentration in cows fed 10, 20, and 30g of NCG/d was increased by 1.1, 10.4, and 16.0%, respectively. The urea N concentrations in the milk, plasma, and urine decreased with the addition of NCG, although the lowest urea N concentrations were observed with the addition of 20g of NCG/d. The conversion of dietary crude protein to milk protein exhibited quadratic trends of improvement by NCG supplementation, with a peak at 20g of NCG/d. The rumen microbial protein synthesis was not altered by NCG supplementation, but the metabolizable protein tended to show a quadratic increase in cows fed 20g of NCG/d. In conclusion, supplementation of 20g of NVG/d may alter the plasma metabolites, optimize the AA profile, increase the metabolizable protein utilization, and thereby improve the lactation performance and N utilization of high-yielding dairy cows.

Effects of rumen-protected γ-aminobutyric acid on feed intake, lactation performance, and antioxidative status in early lactating dairy cows.

The objective of this study was to investigate effects of rumen-protected γ-aminobutyric acid (GABA) on dry matter intake, milk performance, and serum metabolites in Chinese Holstein lactating cows. Thirty-nine multiparous cows were blocked based on days in milk (60 ± 6.3 d; mean ± SD) and milk production (30.9 ± 4.17 kg; mean ± SD), and were randomly assigned to 1 of 4 treatments, with rumen-protected GABA added at levels of 0, 0.8, 1.6, or 2.4 g/d, the actual predicted available amounts being 0, 0.30, 0.61, or 0.91 g of GABA/d, respectively. The experiment lasted for 8 wk, with the first week for adaptation. Milk yield and milk compositions were recorded weekly, and serum concentrations of GABA, neuropeptide Y, and biochemical and antioxidant variables were analyzed in the first, fourth, and seventh weeks of the study. Dry matter intake linearly increased in cows receiving added GABA compared with that for the control. Addition of 0.8 g of GABA/d was associated with higher milk yield than the other treatments, but contents of milk protein and fat did not differ across the treatments. Dietary GABA tended to quadratically enhance the serum content of GABA (23.6, 30.2, 29.8, or 28.3 mmol/L for 0, 0.8, 1.6, or 2.4 g/d, respectively), and increased neuropeptide Y, with the highest value (3.07 ng/L) for 0.8 g of GABA/d. Nonesterified fatty acid quadratically decreased with GABA addition, with the lowest value (218.1 µmol/L) for 0.8 g of GABA/d. Serum glutathione peroxidase and superoxide dismutase quadratically increased in cows fed GABA, whereas serum malondialdehyde was quadratically reduced for all GABA groups. Rumen-protected GABA quadratically improved N efficiency across all treatments, contributing to the enhanced production of milk and milk protein and reduced N emission to the environment. In conclusion, addition of rumen-protected GABA is beneficial for early lactation dairy cows in terms of feed intake, lactation performance, and animal health.

Unconventional anisotropic s-wave superconducting gaps of the LiFeAs iron-pnictide superconductor.

We have performed high-resolution angle-resolved photoemission spectroscopy on Fe-based superconductor LiFeAs (T(c)=18 K). We reveal multiple nodeless superconducting (SC) gaps with 2Δ/k(B)T(c) ratios varying from 2.8 to 6.4, depending on the Fermi surface (FS). We also succeeded in directly observing a gap anisotropy along the FS with magnitude up to ~30%. The anisotropy is fourfold symmetric with an antiphase between the hole and electron FSs, suggesting complex anisotropic interactions for the SC pairing. The observed momentum dependence of the SC gap offers an excellent opportunity to investigate the underlying pairing mechanism.

Community-acquired pneumonia in Shanghai, China: microbial etiology and implications for empirical therapy in a prospective study of 389 patients.

The aim of this multicenter study was to identify the causative pathogens of community-acquired pneumonia (CAP) in Shanghai, China, and to determine their susceptibility to antimicrobial agents. Pathogens obtained from 389 patients with documented CAP during 2001-2003 were identified by multiple diagnostic tools that included bacterial culture, polymerase chain reaction (PCR), and specific immunological assays. Susceptibility of the bacterial isolates was tested by the broth microdilution method. A specific pathogen was identified in 39.8% (155/389) of the patients: Haemophilus influenzae (n=80), Klebsiella spp. (n=15), Streptococcus pneumoniae (n=12), Staphylococcus aureus (n=6), Moraxella catarrhalis (n=1), other gram-negative organisms (n=9), and atypical pathogens that comprised Mycoplasma pneumoniae (n=42), Chlamydia pneumoniae (n=17), and Legionella pneumophila (n=2). Most H. influenzae isolates were susceptible to ampicillin (88.3%), and all were susceptible to macrolides. Of the S. pneumoniae isolates, 75% (9/12) were susceptible to penicillin, while 25% (3/12) were intermediately susceptible. H. influenzae and atypical pathogens are among the most important pathogens of CAP. Ampicillin, cephalosporins, and the newer fluoroquinolones can be used as empirical therapy for CAP in the Shanghai area. The efficacy of monotherapy with newer macrolides for CAP caused by S. pneumoniae requires further evaluation.

The influence of plasticizers on the release of theophylline from microporous-controlled tablets.

The aim of present work was to investigate the influence of plasticizer on the release of theophylline from microporous-controlled tablets. Three plasticizers, acetyltributyl citrate (ATBC), castor oil, and triacetin, were included in this study. These plasticizers reduced the crystallinity of poly(epsilon-caprolactone) (PCL)/poly(ethylene glycol) (PEG)-blended films, and the most prominent change of enthalpy of fusion was the film plasticized by triacetin. This might be due to triacetin penetrating into both PCL and PEG domains. However, the lipophilic property of castor oil only allowed it to alter the crystallization of hydrophobic PCL domain. The Young's modulus and the tensile strength of films showed a decreased tendency while increasing the amount of plasticizer. The change of elongation of plasticized blended films was irregular and was dependent of the type of plasticizer. The size of micropores formed in the presence of plasticizer was larger than those micropores formed in its absence. The fatty plasticizer, castor oil, altered the thermal and mechanical performance and pore size of films via soluble in PCL domain, which resulted in the release of theophylline from castor oil plasticized-coated tablets, which in turn enhanced and closed to a constant release pattern.