Interaction of age and CYP2C19 genotypes on voriconazole steady-state trough concentration in Chinese patients.

OBJECTIVES: Both age and CYP2C19 genotypes affect voriconazole plasma concentration; the interaction of age and CYP2C19 genotypes on voriconazole plasma concentration remains unknown. This study aims to investigate the combined effects of age and CYP2C19 genotypes on voriconazole plasma concentration in Chinese patients. METHODS: A total of 480 patients who received voriconazole treatment were recruited. CYP2C19*2 (rs4244285) and CYP2C19*3 (rs4986893) polymorphisms were genotyped. Patients were divided into the young and the elderly groups by age of 60 years old. Influence of CYP2C19 genotype on steady-state trough concentration (Css-min) in overall patients and in age subgroups was analyzed. RESULTS: Voriconazole Css-min correlated positively with age, and mean voriconazole Css-min was significantly higher in the elderly group (P < 0.001). CYP2C19 poor metabolizers showed significantly increased mean voriconazole Css-min in the young but not the elderly group. The percentage of patients with subtherapeutic voriconazole Css-min (<1.0 mg/l) was higher in the young group and that of supratherapeutic voriconazole Css-min (>5.5 mg/l) was higher in the elderly patients. When the average Css-min in the CYP2C19 normal metabolizer genotype was regarded as a reference, CYP2C19 genotypes showed greater impact on voriconazole Css-min in the young group, while the influence of age on voriconazole Css-min exceeded CYP2C19 genotypes in the elderly. CONCLUSION: CYP2C19 genotypes affects voriconazole exposure is age dependent. Influence of CYP2C19 poor metabolizer genotype on increased voriconazoleexposure is prominent in the young, while age is a more important determinant factor for increased voriconazole exposure in the elderly patients.

Prognostic value of multiple immune inflammatory markers in diffuse large B-cell lymphoma.

OBJECTIVE: To explore the prognostic value of multiple immune inflammatory indicators for diffuse large B-cell lymphoma (DLBCL). METHODS: The clinical data of 175 patients with DLBCL who were diagnosed and received Immunochemotherapy in The Qinzhou First People's Hospital between January 2015 and December 2021 were retrospectively analyzed for this study. Patients were classified into a death group (n = 54) and a survival group (n = 121) depending on their prognosis. The clinical data of the patients with lymphocytes-to-beads (LMR), neutrophils-to-lymphocytes (NLR), and platelets-to-lymphocytes (PLR) were collected. The receiver operator characteristic curve (ROC) was used to determine the optimal critical value of the immune index. The Kaplan-Meier was used to draw the survival curve. The Cox regression model was used to analyze the factors affecting the prognosis of DLBCL. A nomogram risk prediction model was constructed to verify its effectiveness. RESULTS: By the ROC curve analysis, the optimal cut-off value was 3.93 × 109/L for neutrophil count, 2.42 for LMR, 23.6 mg/L for C-reactive protein (CPR), 2.44 for NLR, 0.67 × 109/L for Monocyte, and 195.89 for PLR. The survival rate of patients with neutrophil number ≤ 3.93 × 109/L, LMR > 2.42, CRP ≤ 23.6 mg/L, NLR ≤ 2.44, Monocyte ≤ 0.67 × 109/L, PLR ≤ 195.89 was higher than that of patients with neutrophil number > 3.93 × 109/L, LMR ≤ 2.42, CRP > 23.6 mg/L, NLR > 2.44, and Monocyte > 0.67 × 109/L, PLR > 195.89. The nomogram was constructed based on the results of the multivariate analysis. The AUC of the nomogram was 0.962 (95% CI: 0.931-0.993) and 0.952 (95% CI: 0.883-1) in the training set and the test set, respectively. The calibration curve showed that the predicted value of the nomogram was in good agreement with the actual observed value. CONCLUSION: IPI score, neutrophil count, NLR, and PLR are risk factors impacting the prognosis of DLBCL. The combined prediction of IPI score, neutrophil count, NLR, and PLR can better reflect the prognosis of DLBCL. It can be used as a clinical index to predict the prognosis of diffuse large B-cell lymphoma, and provide clinical basis for improving the prognosis of patients.

Research on the integrated system of case-based reasoning and Bayesian network.

With the arrival of big data era, the integration of Case-Based Reasoning (CBR) and Bayesian Network (BN) has become increasingly a promising technology in implementing the intelligence of engineering application. To further improve the efficiency of the integrated system and make it adapt to the large number of parameter under big data, Within-Cross (WC) algorithm is proposed in this paper to assigned big data to each slave node of Hadoop platform for parallel data processing. The WC algorithm can greatly reduce the time costing of parallel data processing and thus improve the efficiency of the integrated system by fully using the computation resource of Hadoop platform. To further enhance the accuracy of the integrated system, this paper proposes a new method called Weighted Super Parameters of Dirichlet Distribution (WSPDD) algorithm to perform probability learning. The WSPDD algorithm gives a weight to each super parameter of Dirichlet Distribution of all problem parameters to adjust the result of probability statistics and then improve probability learning. Therefore, the accuracy of the integrated system is greatly improved. Finally, an application domain is taken as a case study to validate the proposed method.

[Chemical constituents of petroleum ether extract of fruits of Schisandra sphenanthera].

OBJECTIVE: To study the chemical constituents in the fruits of Schisandra sphenanthera. METHOD: The constituents were isolated by their silica gel column, Sephadex LH-20 gel column, and their structures were elucidated by their chemical properties and spectroscopic analyses. RESULT: Twelve compounds were isolated and identified as (+)-anwulignan (1), deoxyschizandrin (2), interiotherin A (3), schisantherin A (4), beta-sitosterol (5), schisantherin D (6), 4-hydroxybenzaldehyde (7), 6-O-benzoylgomisin O (8), schizandronic acid (9), schisanlactone D (10), schisanlactone B (11), kadsulactone A (12). CONCLUSION: Compounds 3, 7, 10-12 were obtained from this plant for the first time.

[Microscopic authentication method of traditional Chinese medicine Gusuibu].

OBJECTIVE: To provide practical method for microscopic authentication of traditional Chinese medicine Gusuibu and its adulterants. METHOD: By means of light microscope, scanning electron microscopy and tissue section techniques, the morphology, the size of the rhizome scales and their bearing position in the original plants of Gusuibu and its adulterants, i. e. Drynaria roosii, D. delavayi, D. quercifolia and Pseudodrynaria coronans were analyzed. RESULT: There were significant differences between scales length of D. roosii, D. delavayi and P. coronans, while there was no significant difference between that of D. roosii and D. quercifolia. The scale teeth of D. delavayi were usually curved, bifid and uneven distributed at the scale fringe, which was different from that of the other three species. The base of the scales sinks in epidermis in D. roosii, D. quercifolia, and P. coronans, while it bore at the raised part of epidermis in D. delavayi. CONCLUSION: [corrected] Morphology, size and bearing position of the rhizome scales have significant differences in the several species. Therefore, these characteristics can be applied to the identification of Gusuibu and its adulterants.

Quantitative determination of four compounds and fingerprint analysis in the rhizomes of Drynaria fortunei (Kunze) J. Sm.

A rapid, sensitive, and accurate reversed-phase high-performance liquid chromatography with photodiode array detection method was developed for both quantitative determination of four compounds (caffeic acid-4-O-ß-D-glucopyranoside, 5,7-dihydroxychromone-7-O-rutinoside, neoeriocitrin and naringin) and fingerprint analysis of the rhizomes of Drynaria fortunei (Kunze) J. Sm. The chromatographic separation was accomplished on an MZ-C18 column (4.6 × 250 mm, 5 µm) using gradient elution with acetonitrile and 0.02% aqueous acetic acid, at a flow rate of 1.0 mL min(-1), an operating temperature of 25°C, and a wavelength of 260 nm. The four compounds showed good regression relationship (R (2) > 0.9990) within linear ranges, and their recoveries were in the range of 98.11-102.23%. In the chromatographic fingerprint, thirteen common peaks were found and selected as characteristic peaks to assess the consistency of ten batches of the rhizomes of D. fortunei. The results indicate that the method of multiple compounds determination in combination with chromatographic fingerprint analysis is suitable for systematic quality evaluation of D. fortunei.