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Objective:To explore the structure and diversity of intestinal flora in patients with community acquired pneumonia (CAP) before and after treatment with cefotaxime combined with levofloxacin.Methods:From October to December 2018, 6 patients with CAP in the Department of Infection, Zhejiang Provincial Hospital of Tongde, were treated with cefotaxime injection 2.0 g (once/8 h) combined with 0.5 g levofloxacin injection (once a day). A total of 12 fecal samples were collected before and after 7 days of treatment. The stool samples before and after treatment were analyzed by 16S rRNA sequencing.Results:⑴ The structure of intestinal flora before and after treatment : at the phylum level: Firmicutes 59.2% vs 40.8%, Proteobacteria 18.6% vs 35.5%, Bacteroidetes 14.8% vs 20.8%, Actinobacteria 5.6% vs 1.2%; At the family level: Ruminococcaceae 34.5% vs 13.0%, Lachnospiraceae 15.9% vs 9.7%, Veillonellaceae 1.8% vs 3.3%, Lactobacillaceae 0.3% vs 8.0%, Streptococcaceae 2.9% vs 1.1%, Enterococcaceae 0.02% vs 5.2%, Enterobacteriaceae 16.4% vs 34.6%, Bacteroidaceae 13.3% vs 16.8%, Porphyromonadaceae 0.3% vs 3.4%, Adlercreutzia 4.4% vs 0.5%. There was no significant difference in the composition and structure of intestinal flora before and after treatment ( P>0.05). ⑵ The diversity of intestinal flora before and after treatment: operational taxonomic units (OTU) mean (150.5±59.0) vs (93.2±34.1), t=2.72, P=0.04; Chao1 index (169.25±49.61) vs (117.92±35.06), t=3.22, P=0.02; shannon index (3.61±0.83) vs (2.31±0.73), t=4.54, P=0.01; simpson index (0.80±0.10) vs (0.61±0.20), t=2.76, P=0.04. There were significant differences in the diversity of intestinal flora before and after treatment ( P<0.05). ⑶ There was significant difference in desulfovibrio between the two groups before and after treatment (LDA=2.03, P=0.02). Conclusions:After intravenous infusion of cefotaxime combined with levofloxacin for one week , the diversity of intestinal flora was significantly reduced after treatment. Desulfovibrio was the flora with statistical differences between before and after treatment.
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Background Flap necrosis is frequently observed in flap transfer operations. Salidroside has been reported to reduce cell apoptosis by alleviating inflammation and oxidative stress. We investigated the effects of salidroside on the survival of random skin flaps. Materials and Methods The McFarlane flap model was established in 80 rats that were divided into two groups and administered salidroside or saline solution intraperitoneally over 7 days. The area of necrosis and the extent of tissue edema were measured. Angiogenesis was assessed via lead oxide-gelatin angiography, immunohistochemistry for CD34, and VEGF expression. Cell apoptosis was evaluated by expression of cleaved caspase 3, caspase 3, Bax, and Bcl-2. The inflammatory response was evaluated using an ELISA kit for TNF-α and IL-6 in serum. Oxidative stress was assessed by measuring the activity of superoxide dismutase (SOD) and the level of malondialdehyde (MDA). Results Compared with controls, salidroside-treated flaps featured a greater area of surviving tissue and less edema. It also promoted the expression of VEGF and increased skin flap angiogenesis. Cell apoptosis, inflammation reaction, and oxidative stress were significantly attenuated in the salidroside group. Conclusion Salidroside has a positive effect on improving random skin flap survival.