Effect of Cefoperazone/Sulbactam on Blood Coagulation Function in Infected Emergency Department Patients and the Necessity of Vitamin K1 (VK1) Preventive Intervention: A Single-Center, Retrospective Analysis.

BACKGROUND Owing to its broad-spectrum antibacterial activity, strong antibacterial effects, and ß-lactamase stability, cefoperazone/sulbactam has been recognized as a first-line empirical drug for treating severe infections. However, its administration is also characterized by numerous adverse effects, including coagulation dysfunction. Here, we summarize past clinical treatment data to provide data support for clinical use of cefoperazone sulbactam. MATERIAL AND METHODS We retrospectively analyzed the clinical medical records of 820 patients treated with cefoperazone/sulbactam from January 2015 to December 2020. A retrospective cohort study design was used. We assessed the general data of patients, age and sex distribution, type of primary disease, and incidence and days of abnormal blood coagulation with cefoperazone sulbactam. The chi-square test and t test were used to analyze the effect of cefoperazone sulbactam on coagulation function and the effect of vitamin K intervention on prognosis. RESULTS The rate of coagulation dysfunction was 24.39% (200 patients). Among these 200 patients, 50 were treated with vitamin K1. With increasing patient age, the number of patients with cefoperazone/sulbactam-induced coagulation dysfunction increased (peak at 81-90 years). APACHE II of coagulation dysfunction (15.54±4.095) was significantly higher than that in the normal group. It occurred at days 2-19 after administration of 9.0 g/day of cefoperazone/sulbactam. Measured coagulation indices were significantly higher after treatment with cefoperazone/sulbactam than before treatment, including international normalized ratio, prothrombin time, and activated partial thrombin time (P<0.0001). CONCLUSIONS All coagulation indices decreased significantly after vitamin K1 intervention, indicating improved coagulation function, especially in patients with high APACHE II scores. Hence, regulated vitamin K1 administration can benefit patients with coagulation dysfunction in clinical treatment.

Enhanced removal of Cr(VI) using a modified environment-friendly adsorbent.

Chitosan (CS) was modified with ferric chloride hexahydrate (FeCl3·6H2O) and sodium laurylsulfonate (SLS) to prepare the compound adsorbent CS-Fe-SLS. Taking Cr(VI) as the target pollutant, the influence of different factors (solution pH, adsorption time, initial adsorption concentration and coexisting ions) were investigated. The results showed that the optimal pH value was 3.0; the adsorption equilibrium was reached at 120 min, with both physical and chemical process being involved in the adsorption process; the maximum adsorption value was 131.91 mg/g, with the adsorption being both single-layer and multi-layer adsorption; Cl-, NO3- and SO42- had little effect on adsorption, CO32- reduced it and Cu(II) increased it. The characterization results of scanning electron microscopy, Fourier transform infrared spectroscopy and X-ray diffraction showed that CS-Fe-SLS and chitosan had different morphological characteristics: in contrast with chitosan, CS-Fe-SLS had a larger volume and more flakes on the surface. CS-Fe-SLS was significantly lower in crystallinity than chitosan, and was more irregular and amorphous in shape, and the experimental results showed that CS-Fe-SLS had better adsorption capacity for Cr(VI). The adsorption Cr(VI) was related to -NH and -OH on the material. Some Cr(VI) was reduced to Cr(III) during the adsorption process.

Muscle Synergy for Hand Motions Based on Electromyography Analysis.

This study aimed to investigate the muscle synergy for hand motions of both the left and right hands based on surface electromyography (sEMG) signals. Six hand motions, including hand grasp (HG), four fingers flexion (FFF), index finger extension (IFE), thumb internal rotation (TIR), thumb opposition (TO), key pinch (KP), were examined in the experiment. The sEMG signals were recorded from brachioradialis (BRA), flexor carpi ulnaris (FCU), flexor carpi radialis (FCR), extensor digitorum communis (EDC), flexor digitorum superficialis (FDS), abductor pollicis brevis (APB), first dorsal interosseous (FDI) and abductor digiti minimi (ADM) of both the left and right hands. A co-contraction index (CI) followed by a correlation coefficients (CC) was applied to quantify the muscle synergy during the hand motions and to compare the synergistic patterns across hands. Results shown that the left and right hands had similar muscle synergy (CC (CC>0.9) for any of the motions. For both hands, there were strong correlations between the synergistic matrix of different motions (CC (CC>0.85), including the correlations between HG and FFF, between FFF and IFE, and between TO and KP. By contrast, weak correlations between the synergistic matrix for IFE and that for TIR (CC (CC<0.1), suggesting a low similarity of the muscle synergy for the two motions. This study shed light on how the muscles of the left and right hands are involved and co-contracted for the dexterous hand motions.

Cross-Recurrence Quantification Analysis for Inter-Muscular Coordination during Power Grip at Different Force Levels.

This study aimed to examine the dynamical coordination across muscles during power grip at different force levels. Twenty-four healthy volunteers (12 males, 12 females) participated in this experiment. Subjects were instructed to grip a hydraulic hand dynamometer and produce forces at 30%, 50%, 70% Maximal Voluntary Contractions (MVC) for at least 10s, respectively. Surface electromyography (sEMG) signals were simultaneously recorded from eight muscles, including brachioradialis (BR), flexor carpi ulnaris (FCU), flexor carpi radialis (FCR), extensor digitorum communis (EDC), flexor digitorum superficialis (FDS), abductor pollicis brevis (APB), first dorsal interosseous (FDI) and abductor digiti minimi (ADM). A cross-recurrence quantification analysis (CRQA) was applied to analyze the sEMG signals by both visualization and quantifications. Results showed that percentage of determinism (%DET) and percentage of entropy (%ENT) of the extrinsic muscle pairs were augmented with increased force levels and had a weak but positive correlation. For intrinsic muscle pairs, the %DET and %ENT increased with force levels but the difference is not or less statistically significant. These results showed that the intermuscular coordination would be alter with force output increased. For the right-handers, the values of intrinsic muscles couplings in right hand were lower than left hand, because less coupled intrinsic muscles contribute to finger dexterity; the reason why the values of extrinsic muscles couplings in right hand were greater than left hand was stronger couplings of extrinsic muscles produced higher synergistic force.