Determination of tigecycline in human cerebrospinal fluid by two-dimensional liquid chromatography and its clinical application / 药学实践杂志

Objective To establish a two-dimensional high-performance liquid chromatography method for the determination of tigecycline in human cerebrospinal fluid, which can be used for the drug monitoring in patients with intracranial infection. Methods The quantification was carried out by an external standard method. The first-dimension column was a Aston SNX5 phenyl chromatographic column (50 mm×4.6 mm, 5 μm) with ammonium phosphate (pH was adjusted with ammonium hydroxide to 7.5)-methanol (45∶55, V/V) as the mobile phase and the flow rate was 1.2 ml/min. The second-dimension chromatographic column was Aston SC5 C18 (275 mm×4.6 mm, 5 μm), with ammonium phosphate (pH was adjusted with ammonium hydroxide to 7.4)-ammonium phosphate (pH was adjusted with ammonium hydroxide to 3.0)- acetonitrile (30∶50∶20, V/V/V) as the mobile phase and the flow rate was 1.0 ml/min. The detection wavelength was 340 nm. The temperature was 40 ℃ and the injection volume was 200 μl. Results The calibration curve of tigecycline showed good linearity from 64.5 to 1 290.0 ng/ml in human cerebrospinal fluid (r=0.999 8). The RSD of intra and inter-day precision were less than 5.0% with the detection accuracy of 98.80%−106.51%. Conclusion This method is simple, quick, accurate, specific and sensitive. It meets the requirements of tigecycline determination in clinical human cerebrospinal fluid, which offers the individualized therapeutic assurance for patients with intracranial infection.

Efficacy of relacin combined with sodium hypochlorite against Enterococcus faecalis biofilms.

OBJECTIVE: Relacin is a synthetic molecule that targets RelA, an essential protein in a conserved bacterial stress response system. It was shown to inhibit bacterial growth. The aims of this study were to evaluate the antimicrobial effect of relacin combined with sodium hypochlorite (NaOCl) on Enterococcus faecalis biofilms and to evaluate the cytotoxicity of relacin. MATERIAL AND METHODS: 48-h E. faecalis OG1RF biofilms were treated by various concentrations of relacin in order to determine its inhibitory concentration. Then, the 48-h biofilms were treated either with 1-min NaOCl (0.01%, 0.05%) alone, or in combination of relacin. As a means of comparison, the biofilms of ΔrelA were also treated by 1-min NaOCl (0.01%, 0.05%, 0.25%). The treatment efficacy was determined by agar plate count assays. The cytotoxicity of relacin was examined on human gingival epithelial cells Ca9-22 and murine fibroblasts NIH-3T3 by a methyl thiazolyltetrazolium (MTT) assay and a lactate dehydrogenase assay. Statistical analysis was performed by one-way or two-way analysis of variance (ANOVA) with Bonferroni's post-hoc test and an independent Student's t-test. A significance level of p<0.05 was used. RESULTS: Relacin inhibited the growth of OG1RF biofilms partially at 8 mM and fully at 14 mM. The relacin (14 mM) and NaOCl combined treatment resulted in significantly higher treatment efficacy than NaOCl treatment alone. At 0.05% NaOCl, the combined treatment resulted in 5.65 (±0.19) log reduction in biofilm viability. The ΔrelA biofilms were more susceptible to NaOCl treatment than the wild type biofilms at 0.25% NaOCl. Relacin at 14 mM was not toxic to host epithelial cells and fibroblasts. CONCLUSIONS: The combination of relacin with a low concentration of NaOCl was effective and not cytotoxic.

Efficacy of relacin combined with sodium hypochlorite against Enterococcus faecalis biofilms

Abstract Objective Relacin is a synthetic molecule that targets RelA, an essential protein in a conserved bacterial stress response system. It was shown to inhibit bacterial growth. The aims of this study were to evaluate the antimicrobial effect of relacin combined with sodium hypochlorite (NaOCl) on Enterococcus faecalis biofilms and to evaluate the cytotoxicity of relacin. Material and Methods 48-h E. faecalis OG1RF biofilms were treated by various concentrations of relacin in order to determine its inhibitory concentration. Then, the 48-h biofilms were treated either with 1-min NaOCl (0.01%, 0.05%) alone, or in combination of relacin. As a means of comparison, the biofilms of ΔrelA were also treated by 1-min NaOCl (0.01%, 0.05%, 0.25%). The treatment efficacy was determined by agar plate count assays. The cytotoxicity of relacin was examined on human gingival epithelial cells Ca9-22 and murine fibroblasts NIH-3T3 by a methyl thiazolyltetrazolium (MTT) assay and a lactate dehydrogenase assay. Statistical analysis was performed by one-way or two-way analysis of variance (ANOVA) with Bonferroni's post-hoc test and an independent Student's t-test. A significance level of p<0.05 was used. Results Relacin inhibited the growth of OG1RF biofilms partially at 8 mM and fully at 14 mM. The relacin (14 mM) and NaOCl combined treatment resulted in significantly higher treatment efficacy than NaOCl treatment alone. At 0.05% NaOCl, the combined treatment resulted in 5.65 (±0.19) log reduction in biofilm viability. The ΔrelA biofilms were more susceptible to NaOCl treatment than the wild type biofilms at 0.25% NaOCl. Relacin at 14 mM was not toxic to host epithelial cells and fibroblasts. Conclusions The combination of relacin with a low concentration of NaOCl was effective and not cytotoxic.

Practice of Clinical Pharmacists Participating in Drug Treatment for a Leukemia Child with Neutrophil De-ficiency Complicated with Fever / 中国药房

OBJECTIVE:To explore the role of clinical pharmacists in the process of drug treatment for leukemia children with neutrophil deficiency complicated with fever (NDCF). METHODS:Clinical pharmacists participated in the treatment for a leuke-mia child with NDCF. Considering about continuous decrease of platelet accompanied by epistaxis,combined with age,clinical symptom,lab indexes and related guidelines,clinical pharmacists thought it was possibly associated with bone marrow induced by chemotherapy drugs and drug-induced hemorrhage induced by cefoperazone sodium and sulbactam sodium. It was suggested to stop using cefoperazone sodium and sulbactam sodium;use Meropenem for injection 1.0 g,ivgtt,q8 h instead for anti-infection;addi-tionally use Recombinant human thrombopoietin injection 15000 U,sc,qd for elevating platelet. During treatment,taking into ac-count the low levels of neutrophils(0.17×109 L-1)and platelets(11×109 L-1)in this child,it was recommended to continue anti-in-fection and elevating platelet treatment,and continue to use Lienal polypeptide injection to auxiliarily enhance hematopoietic func-tion. When the child's condition was stable and neutrophils returned to normal,it was successively recommended to stop elevating platelet and anti-infection treatment;at the same time,conduct pharmaceutical care as body temperature examination,related indi-cator examination (such as routine blood test) and ADR monitoring,etc. RESULTS:Physicians adopted the clinical pharmacist's suggestions. The body temperature of the child was decreased,the hemogram recovered gradually,no infection occurred,and the next round of chemotherapy was successfully carried out. CONCLUSIONS:The clinical pharmacists participate in drug treatment for leukemia children with NDCF,pay attention to the prevention,diagnosis and treatment of drug-induced disease,and make com-prehensive analysis by using their own professional advantage,taking the possible effects of drugs on blood system,pharmacody-namics and pharmacokinetic characteristics as the breakthrough point,combing with the specific situation of children's age and ill-ness;assist physicians to formulate and optimize drug therapy plan so as to guarantee safe and effective drug use.

Clinical effect of endoscopic implantation of accurate and slow-release particles for advanced esophageal carcinoma / 中国内镜杂志

Objective To observe the clinical effects by endoscopic implantation of accurate and slow-release particles for advanced esophageal carcinoma. Methods Under endoscopy, we dividing the whole focus into several layers by each 1.0 cm and implanting one slow-release particles (about 10 mg) in each point whose interval is 1.0 cm. One course of treatment includes three-time implantation and each treatment needs four weeks, by the way the details depend on the state of illness. In this research, all of patients complete the treatment smoothly. By comparing the patients’ situation before treatment, three-month treatment and six-month treatment, which include the remission of clinical symptom, the changing of focus area, the improvement of swallow function, untoward effect and life quality, et al. Results The results show several test indexes changed a lot. When treated for 3 months and 6 months, the levels of focus area and swallow difficulty classification were decreased significantly (P 0.05), by the way there isn’t individual difference appearing because of a little short of testing time and a few of samples. In addition, the WBC had a significant statistical difference between before treatment and three-month treatment (P < 0.05), and the ratio of complication didn’t have a significant change. Conclusions Endoscopic implantation of 5-Fu slow-release particles for the treatment of advanced esophageal carcinoma is a safety, high efficacy, low toxic and good tolerant palliative treatment.