Population Pharmacokinetics of Fixed Dose Combination of Ceftriaxone and Sulbactam in Healthy and Infected Subjects

Increased antibacterial resistance (ABR) and limited drug discovery warrant optimized use of available antibiotics. One option is to rationally combine two antibiotics (fixed dose combination (FDC)) that may delay or prevent emergence of ABR in notorious pathogen. Major concern with FDC is the mutual interaction of its components that might influence their pharmacokinetic (PK) profile, requiring reassessing of whole formulation (adding cost and time). The interaction can be identified by comparing PK profile of a drug present in FDC with its independent entity. An open-label, crossover, single-dose comparative PK study of FDC (ceftriaxone and sulbactam) with their individual reference formulations was performed in 24 healthy adult subjects. No mutual PK interactions between ceftriaxone and sulbactam were observed. Pharmacokinetic data was used to develop a population-PK model to understand between-subject variability (BSV). Pharmacokinetics of ceftriaxone/sulbactam was explained by one and two compartment models, respectively. The subject’s “weight” was identified as a covariate explaining BSV. Both internal and external validations (healthy/infected subjects) were done. The model-derived population-PK parameters of FDC’s active components in infected subjects were similar to literature reported values of individual components. Efficacies of various FDC dosage regimens over a range of minimum inhibitory concentrations (MICs) were assessed by Monte Carlo simulations using population-PK parameters of infected/healthy subjects. In infected subjects, 3 g FDC/24 h can treat bacteria with MIC ≤8 μg/mL, while for MIC 8–32 μg/mL, 3 g FDC/12 h is recommended. Lastly, the developed population-PK model was successfully used to predict drug exposure in pediatric population.     

窄带成像内镜、染色内镜及常规内镜模式诊断结直肠增生性病变的应用价值比较研究

目的:探讨窄带成像内镜(NBI)、染色内镜及常规内镜模式鉴别诊断非肿瘤性、肿瘤性结直肠增生性病变的应用价值。方法:选择2017年2月至2019年3月西安市中心医院消化科收治的结直肠增生性病变患者,均行NBI、染色内镜、常规内镜检查。比较三种模式图像清晰度以及鉴别诊断非肿瘤性、肿瘤性结直肠增生性病变的效能。结果:NBI、染色内镜模式图像质量评分分布优于常规内镜(P<0.05),NBI图像质量评分分布优于染色内镜模式(P<0.05)。以病理结果为准,常规内镜结直肠增生性病变检出率73.13%,NBI 91.04%,染色内镜96.26%,NBI、染色内镜结直肠增生性病变检出率高于常规内镜(P<0.05),NBI、染色内镜比较无统计学差异(P>0.05)。NBI模式下检测NBI分型与病理组织学结果一致性较好(kappa值=0.801,P<0.05)。NBI、染色内镜诊断肿瘤性结直肠增生性病变的灵敏度、特异度、阳性预测值、阴性预测值、准确度均明显高于常规内镜,染色内镜、NBI、常规内镜诊断肿瘤性结直肠增生性病变的曲线下面积(AUC)分别为0.844(95%CI:0.812~0.956)、0.921(95%CI:0.860~0.982)、0.750(95%CI:0.651~0.848)。结论:NBI、染色内镜在鉴别非肿瘤性和肿瘤性结直肠增生性病变方面效能相似,均优于常规内镜,NBI分型与病理组织学结果一致性高,更适合结直肠增生性病变的鉴别诊断。     

Fine structure of the neuromuscular system of Polyorchis penicillatus (Hydromedusae,Cnidaria)

Polyorchis penicillatus exhibits outer, inner and endodermal nerve rings. The inner ring contains a number of giant axons with infolded plasma membranes and annular gap junctions. The existence of an innervation supplying the velar radial muscle strengthens the view that the steering mechanism is under nervous control. The basal portions of the cells of the endoderm canals form a muscle band which might enable the animal to regulate the flow of materials or could perform peristalsis.     

Leishmania donovani flagellum-specific epitopes mediating host-parasite interactions

Abstract Monoclonal antibodies were developed against flagellar components of promastigotes of Leishmania donovani . The monoclonal antibody produced by clone A₁₁ (mAb A₁₁) recognised epitopes in the polypeptides with molecular weights of 86, 66 and weakly 53 kDa. These epitopes were found to be distributed along the flagellum and at the anterior end of promastigotes. The mAb A₁₁ of IgG₁ isotype strongly agglutinated the promastigotes of L. donovani . The prior treatment of promastigotes of L. donovani with mAb A₁₁ resulted in a significant ( P < 0.001) reduction in the attachment of promastigotes to cultured mouse peritoneal macrophages of line J774G8. The affinity-purified epitopes identified by mAb A₁₁ were recognised by human sera of cases of visceral leishmaniasis. The present study suggest that flagellar-specific epitopes mediate host-parasite interactions and, therefore, the role of these epitopes in the disease process is speculated.