复合型抗菌药联合阿奇霉素对大叶性肺炎炎性指标的影响

目的:头孢哌酮钠舒巴坦钠与阿奇霉素联合应用对大叶性肺炎病人体内TNF-α、IL-6及HMGB1的变化影响及其临床疗效研究。方法:收集2012年11月至2015年3月期间到笔者所在医院就诊并诊断患有大叶性肺炎的病人随机平分成两组,其中A组与B组成员分别使用头孢哌酮钠舒巴坦钠+阿奇霉素和仅使用阿奇霉素进行大叶性肺炎对症治疗。通过炎性指标变化情况及对肺功能、不良反应的观察,分析两种药物联合应用对大叶性肺炎病人体内TNF-α、IL-6及HMGB1的变化影响和临床应用价值。结果:A组经联合用药治疗后相关炎症指标改善情况普遍优于B组;A组大叶性肺炎病人咳嗽、啰音及相关体征表现恢复速度快于B组,且A组病人在联合药物治疗后FEF和FEF50指标上的改善情况更为突出;而A组病人不良反应发生种类及例数、比率与B组却相差不大(P0.05)。结论:头孢哌酮钠舒巴坦钠与阿奇霉素的联合应用可有效降低病人体内TNF-α、IL-6及HMGB1浓度水平,且其治疗效果较为突出,具有一定的应用价值。     

Ribosomal crystallography: a flexible nucleotide anchoring tRNA translocation, facilitates peptide-bond formation, chirality discrimination and antibiotics synergism

The linkage between internal ribosomal symmetry and transfer RNA (tRNA) positioning confirmed positional catalysis of amino-acid polymerization. Peptide bonds are formed concurrently with tRNA-3' end rotatory motion, in conjunction with the overall messenger RNA (mRNA)/tRNA translocation. Accurate substrate alignment, mandatory for the processivity of protein biosynthesis, is governed by remote interactions. Inherent flexibility of a conserved nucleotide, anchoring the rotatory motion, facilitates chirality discrimination and antibiotics synergism. Potential tRNA interactions explain the universality of the tRNA CCA-end and P-site preference of initial tRNA. The interactions of protein L2 tail with the symmetry-related region periphery explain its conservation and its contributions to nascent chain elongation.     

阿奇霉素序贯治疗联合麻杏石甘汤加味对痰热闭肺型肺炎支原体肺炎患儿Th17/Treg细胞因子和NLRP3炎症小体通路的影响

摘要 目的：观察阿奇霉素序贯治疗联合麻杏石甘汤加味对痰热闭肺型肺炎支原体肺炎（MPP）患儿辅助性T细胞17（Th17）/调节性T细胞（Treg）细胞因子和NOD样受体蛋白3（NLRP3）炎症小体通路的影响。方法：选择山东省中医院2019年4月~2021年5月期间收治的痰热闭肺型MPP患儿106例,根据随机数字表法分为对照组和研究组,各为53例,对照组患儿接受阿奇霉素序贯治疗,研究组患儿接受阿奇霉素序贯治疗联合麻杏石甘汤加味治疗,对比两组疗效、中医证候积分、Th17/Treg细胞因子和NLRP3炎症小体通路相关指标,记录两组不良反应发生情况。结果：与对照组相比,研究组的临床总有效率明显更高（P<0.05）。两组治疗后次证积分、主证积分、总积分均较治疗前下降,且研究组低于对照组（P<0.05）。两组治疗后白介素-17A（IL-17A）、白介素-25（IL-25）水平均较治疗前下降,白介素-10（IL-10）、白介素-35（IL-35）水平均较治疗前升高,且研究组的变化程度大于对照组（P<0.05）。两组治疗后NLRP3 mRNA、接头蛋白凋亡相关斑点样蛋白（ASC）mRNA、半胱天冬酶1（caspase-1） mRNA均较治疗前下降,且研究组的下降程度大于对照组（P<0.05）。两组在治疗期间均未曾出现明显不良反应。结论：阿奇霉素序贯治疗联合麻杏石甘汤加味治疗痰热闭肺型MPP患儿疗效显著,可促进症状改善,作用机制可能与调节Th17/Treg细胞因子和NLRP3炎症小体通路有关。     

Antimicrobial and antifouling efficacy of urinary catheters impregnated with a combination of macrolide and fluoroquinolone antibiotics against Pseudomonas aeruginosa

The incidence of catheter associated urinary tract infections (CAUTIs) is increasing worldwide. This study was designed to modify a biomaterial by impregnating a silicone urinary catheter with combination of a macrolide, azithromycin (AZM) and a fluoroquinolone, ciprofloxacin (CIP). Drug release profiles showed slow yet continuous release of antibiotics from catheters for one month. In vitro efficacy testing showed that group B catheters [3% (w v^?1) CIP + 6% (w v^?1) AZM] outperformed group A catheters [2% (w v^?1) CIP + 5% (w v^?1) AZM] by (1) showing larger zones of inhibition (>31 mm) compared to group A (<28 mm) for up to 30 days against Pseudomonas aeruginosa PAO1; (2) killing adhered bacteria in 24 h compared to 24–48 h in group A; (3) showing longer antimicrobial durability for four weeks; and (4) exhibiting a stable real-time shelf life of one year, suggesting that these catheters can be explored in clinical settings, especially in long-term CAUTI.     

阿奇霉素口服治疗小儿呼吸道肺炎支原体感染的临床研究

目的:探讨阿奇霉素口服治疗小儿呼吸道肺炎支原体感染的临床效果及安全性。方法:选取2012年5月至2013年10月在我院就诊的144例呼吸道肺炎支原体感染患儿,随机分为观察组和对照组,每组各72例。对照组加用注射用乳糖酸红霉素静滴治疗,观察组加用阿奇霉素口服治疗。对比两组患者的治疗效果及不良反应的发生情况。结果:观察组的总有效率为94.45%,明显高于对照组的83.33%;观察组患儿各临床症状及体征的消失时间均明显短于对照组;观察组患儿不良反应的总发生率为6.95%,显著低于对照组的16.67%,差异均有统计学意义(P0.05)。结论:相比于注射用乳糖酸红霉素静滴治疗,阿奇霉素口服治疗小儿呼吸道肺炎支原体感染疗效更佳,且具有不良反应小,用药安全,患儿的配合度高的优势。     

Comparison of Neisseria gonorrhoeae MICs obtained by Etest and agar dilution for ceftriaxone,cefpodoxime, cefixime and azithromycin

We evaluated Neisseria gonorrhoeae Etest minimum inhibitory concentrations (MICs) relative to agar dilution MICs for 664 urethral isolates for ceftriaxone (CRO) and azithromycin (AZM), 351 isolates for cefpodoxime (CPD) and 315 isolates for cefixime (CFM). Etest accurately determined CPD, CFM and AZM MICs, but resulted in higher CRO MICs.     

Design,synthesis and biological evaluation of azithromycin glycosyl derivatives as potential antibacterial agents

A series of 11,12-cyclic carbonate azithromycin-4″-O-carbamoyl glycosyl derivatives were designed, synthesized, and evaluated as antibacterial agents to search for target compounds with excellent activity. The results of preliminary antibacterial tests against eight strains in vitro revealed that all of the title compounds exhibited improved activities with broad spectrum compared with the parent compound. The glycosylated side chains may be the pharmacophores responsible for the improved activity.     

不同抗生素序贯疗法治疗小儿支原体肺炎的临床分析

目的：探讨不同抗生素组合（红霉素＋阿奇霉素,阿奇霉素＋阿奇霉素）序贯治疗小儿支原体肺炎的临床疗效及其安全性。方法：将82例诊断为小儿支原体肺炎的患者分为红霉素＋阿奇霉素组（Erythromycin＋Azithromycin,E＋A组）和阿奇霉素＋阿奇霉素组（Azithromycin＋Azithromycin,A＋A组）,E＋A组患者41例,先给予红霉素静滴治疗,后给予阿奇霉素口服治疗,A＋A组患者41例,先给予阿奇霉素静滴,后给予阿奇霉素口服治疗;治疗后观察和比较两组的l临床疗效、平均退热时间、用药疗程、住院时间及不良反应的发生率。结果：两组患者的临床疗效上比较无显著差异（P〉0．05）;但两组患者的用药时间（15．3±4．0VS17．9±5．4天）、平均退热时间（4．0±2．2VS5．2±2．4天）、平均住院时间（8．9±3．0Vs10．8±3．4天）均有显著性差异（P〈0．05）。两组不良反应的发生率比较无显著性差异（P〉0．05）。结论：红霉素静滴后给予阿奇霉素口服的序贯疗法治疗小儿支原体肺炎可显著缩短患者的疗程、退热时间和平均住院时间,值得临床推广。     

Group determination of 14-membered macrolide antibiotics and azithromycin using antibodies against common epitopes

Erythromycin (ERY), clarithromycin (CLA), roxithromycin (ROX), and azithromycin (AZI) are macrolide antibiotics widely used in livestock and human medicine. Therefore, they are frequently found as pollutants in environmental water. A method based on indirect competitive enzyme-linked immunosorbent assay (ELISA) for group determination of these macrolides in foodstuffs, human biofluids, and water was developed. Carboxymethyloxime of clarithromycin (CMO–CLA) was synthesized and conjugated to bovine serum albumin (BSA) and gelatin to prepare immunogen and coating antigen with advantageous presentation of target epitopes, l-cladinose and d-desosamine, common for these analytes. Antibodies generated in rabbits were capable of recognizing ERY, CLA, and ROX as a group (100–150%), and AZI (12%) and did not cross-react with ERY degradants, which lack antibiotic activity. Assay displayed sensitivity of determination of 14-membered macrolides (IC₅₀ = 0.13–0.2 ng/ml) and low limit of detection (LOD) that was achieved at 0.02 to 0.03 ng/ml. It allowed performing analysis of milk, muscle, eggs, bovine serum, water, human serum and urine, and avoiding matrix effect without special pretreatment using simple dilution with assay buffer. For 15-membered macrolide AZI, the corresponding characteristics were IC₅₀ = 1.6 ng/ml and LOD = 0.14 ng/ml. The recoveries of veterinary and human medicine macrolides from corresponding matrices were validated and found to be satisfactory.     

阿奇霉素联合布地奈德治疗小儿支原体肺炎的临床疗效分析

目的 探讨阿奇霉素联合布地奈德治疗小儿支原体肺炎的临床疗效。方法 选取90例支原体肺炎患者,随机分为对照组和观察组（每组45例）,两组均常规给予药物进行对症治疗,在此基础上,对照组采用阿奇霉素序贯疗法进行治疗,观察组采用阿奇霉素序贯疗法联用布地奈德混悬液雾化吸入治疗,两组均连续治疗14天,观察两组患者主要指标变化时间,临床疗效及不良反应等。结果 治疗后,观察组的临床总有效率为95.6%,显著高于对照组的80.0%;观察组的体温复常时间、咳嗽消失时间、症状好转时间及住院时间分别为（2.1±0.9）、（10.1±2.3）、（6.9±1.6）和（12.1±2.4）天,对照组分别为（4.6±1.6）、（12.3±3.1）、（8.4±2.4）和（15.8±3.7）天,两组比较,差异均有统计学意义（P＜0.05）;两组不良反应比较,差异无统计学意义（P>0.05）。结论 阿奇霉素联合布地奈德用于治疗小儿支原体肺炎,可显著缩短主要指标复常时间,提高临床疗效,且安全性较好。