Optimization of beta lactam antibiotics regimens against bloodstream infection caused by Pseudomonas aeruginosa

目的制定某院beta内酰胺类在铜绿假单胞菌(PA)血流感染中的治疗方案。方法收集某院2015年至2016年血培养中铜绿假单胞菌共64株,测定; beta内酰胺类(哌拉西林/他唑巴坦,头孢他啶,头孢吡肟,亚胺培南,美罗培南)对铜绿假单胞菌的最低抑菌浓度(MIC)。用蒙特卡洛模拟计算多种治疗; 方案的达标率(PTA)和累积反应分数(CFR)。结果经验治疗时,哌拉西林/他唑巴坦4.5 g(q6 h),头孢他啶2 g(q8 h),头孢吡肟2; g(q8 h),亚胺培南1 g(q6 h),美罗培南1 g(q8 h, q6 h),共6种方案的CFR值> 90%;目标治疗时,当MIC≥16; mug·mL~(-1)时,模拟的所有方案达标概率值均 90% at; experiential therapy,when MIC≥16 mug·mL~(-1) at target therapy,PTA of; all regimens < 90%. Conclusion when the patient was PA bloodstream; infection,we suggest TZP 4.5 g (q6 h),CAZ 2 g(q8 h),FEP 2 g(q8 h),IPM 1; g(q6 h) and MEM 1 g(q8 h,q6 h) regimens at experiential therapy,and; combined with other antibiotics at target therapy when MIC≥16; mug·mL~(-1)

Optimization of β lactam antibiotics regimens against bloodstream infection caused by Pseudomonas aeruginosa

目的制定某院B内酰胺类在铜绿假单胞菌（PA）血流感染中的治疗方案。方法收集某院2015年至2016年血培养中铜绿假单胞菌共64株，测定B内酰胺类（哌拉西林／他唑巴坦，头孢他啶，头孢吡肟，亚胺培南，美罗培南）对铜绿假单胞菌的最低抑菌浓度（MIC）。用蒙特卡洛模拟计算多种治疗方案的达标率（PrA）和累积反应分数（CFR）。结果经验治疗时，哌拉西彬他唑巴坦4．5g（q6h），头孢他啶2g（q8h），头孢吡肟2g（q8h），亚胺培南1g（q6h），美罗培南1g（q8h，q6h），共6种方案的CFR值〉90％；目标治疗时，当MIC≥16μg·mL^-1时，模拟的所有方案达标概率值均（90％。结论铜绿假单胞菌血流感染经验治疗时可选哌拉西林／他唑巴坦4．5g（q6h），头孢他啶2g（q8h），头孢吡肟2g（q8h），亚胺培南1g（q6h），美罗培南1g（q8h，q6h）；目标治疗当MIC≥16μg·mL^-1时需要联合用药。Objective To develop the regimens of β lactam antibiotics against bloodstream infection caused by Pseudomonas aeruginosa （PA）. Methods A total of 64 strains of PA cultured by blood from 2015 to 2016, the minimum inhibitory concentration （MIC）of piperacillin/ tazobactam （ TZP ）, ceflazidine （ CAZ ）, cefepime （ FEP ）, imipenem （IPM）, meropenem（MEM） against PA were determined, probability of talget attainment （ PTA ） and cumulative fraction of response （CFR） were calculated by monte carlo simulation. Results CFRs of TZP4. 5 g （q6 h）, CAZ 2 g（q8 h）, FEP2 g（q8 h）, IPM 1 g（q6 h） and MEM 1 g （q8 h, q6 h） were 〉 90% at experiential therapy, when MIC ≥16 μg · mL-1 at target therapy, PTA of all regimens 〈 90%. Conclusion when the patient was PA bloodstream infection, we suggest TZP 4. 5 g （q6 h）, CAZ2 g（q8 h）, FEP2 g（q8 h）, IPM 1 g（q6 h） and MEM 1 g（q8 h, q6 h） regimens at experiential therapy, and combined with other antibiotics at target therapy when MIC ≥ 16 μg · mL-1

放射性核束首次物理实验的探测器系统

描述了用放射性核束进行首次物理实验所使用的探测器系统的构成及各类探测器的性能，同时给出了该系统用于物理实验所得到的令人满意的在线获取结果。A detector system used in the first physics experiment on RIBLL which consists of a position sensitive gas filled detector, an array of surface Si(Li) detectors and an array of neutron detectors was described. The performances of the detectors in the system were tested. A position resolution of 2 mm and energy resolutions of 0.4% for thc c α particles and 25keV for 137 Cs inner conversion electrons were obtained. A satisfactory on line experiment result was given in the paper

Aripiprazole versus other atypical antipsychotics for schizophrenia

BACKGROUND: In most western industrialised countries, second generation (atypical) antipsychotics are recommended as first line drug treatments for people with schizophrenia. In this review we specifically examine how the efficacy and tolerability of one such agent - aripiprazole - differs from that of other comparable second generation antipsychotics. OBJECTIVES: To evaluate the effects of aripiprazole compared with other atypical antipsychotics for people with schizophrenia and schizophrenia-like psychoses. SEARCH METHODS: We searched the Cochrane Schizophrenia Group Trials Register (November 2011), inspected references of all identified studies for further trials, and contacted relevant pharmaceutical companies, drug approval agencies and authors of trials for additional information. SELECTION CRITERIA: We included all randomised clinical trials (RCTs) comparing aripiprazole (oral) with oral and parenteral forms of amisulpride, clozapine, olanzapine, quetiapine, risperidone, sertindole, ziprasidone or zotepine for people with schizophrenia or schizophrenia-like psychoses. DATA COLLECTION AND ANALYSIS: We extracted data independently. For dichotomous data we calculated risk ratios (RR) and their 95% confidence intervals (CI) on an intention-to-treat basis based on a random-effects model. Where possible, we calculated illustrative comparative risks for primary outcomes. For continuous data, we calculated mean differences (MD), again based on a random-effects model. We assessed risk of bias for each included study. MAIN RESULTS: We included 12 trials involving 6389 patients. Aripiprazole was compared to olanzapine, risperidone and ziprasidone. All trials were sponsored by an interested drug manufacturer. The overall number of participants leaving studies early was 30% to 40%, limiting validity (no differences between groups).When compared with olanzapine no differences were apparent for global state (no clinically important change: n = 703, 1 RCT, RR short-term 1.00 95% CI 0.81 to 1.22; n = 317, 1 RCT, RR medium-term 1.08 95% CI 0.95 to 1.22) but mental state tended to favour olanzapine (n = 1360, 3 RCTs, MD total Positive and Negative Syndrome Scale (PANSS) 4.68 95% CI 2.21 to 7.16). There was no significant difference in extrapyramidal symptoms (n = 529, 2 RCTs, RR 0.99 95% CI 0.62 to 1.59) but fewer in the aripiprazole group had increased cholesterol levels (n = 223, 1 RCT, RR 0.32 95% CI 0.19 to 0.54) or weight gain of 7% or more of total body weight (n = 1095, 3 RCTs, RR 0.39 95% CI 0.28 to 0.54).When compared with risperidone, aripiprazole showed no advantage in terms of global state (n = 384, 2 RCTs, RR no important improvement 1.14 95% CI 0.81 to 1.60) or mental state (n = 372, 2 RCTs, MD total PANSS 1.50 95% CI -2.96 to 5.96).One study compared aripiprazole with ziprasidone (n = 247) and both the groups reported similar change in the global state (n = 247, 1 RCT, MD average change in Clinical Global Impression-Severity (CGI-S) score -0.03 95% CI -0.28 to 0.22) and mental state (n = 247, 1 RCT, MD change PANSS -3.00 95% CI -7.29 to 1.29).When compared with any one of several new generation antipsychotic drugs the aripiprazole group showed improvement in global state in energy (n = 523, 1 RCT, RR 0.69 95% CI 0.56 to 0.84), mood (n = 523, 1 RCT, RR 0.77 95% CI 0.65 to 0.92), negative symptoms (n = 523, 1 RCT, RR 0.82 95% CI 0.68 to 0.99), somnolence (n = 523, 1 RCT, RR 0.80 95% CI 0.69 to 0.93) and weight gain (n = 523, 1 RCT, RR 0.84 95% CI 0.76 to 0.94). Significantly more people given aripiprazole reported symptoms of nausea (n = 2881, 3 RCTs, RR 3.13 95% CI 2.12 to 4.61) but weight gain (7% or more of total body weight) was less common in people allocated aripiprazole (n = 330, 1 RCT, RR 0.35 95% CI 0.19 to 0.64). Aripiprazole may have value in aggression but data are limited. This will be the focus of another review. AUTHORS' CONCLUSIONS: Information on all comparisons are of limited quality, are incomplete and problematic to apply clinically. Aripiprazole is an antipsychotic drug with a variant but not absent adverse effect profile. Long-term data are sparse and there is considerable scope for another update of this review as new data emerges from the many Chinese studies as well as from ongoing larger, independent pragmatic trials