Clinical pharmacists’ involvement in carbapenem antibiotics management at Wenzhou Integrated Hospital

BACKGROUND Carbapenem antibiotics are a pivotal solution for severe infections,particularly in hospital settings.The emergence of carbapenem-resistant bacteria owing to the irrational and extensive use of carbapenems underscores the need for meticulous management and rational use.Clinical pharmacists,with their specialized training and extensive knowledge,play a substantial role in ensuring the judicious use of carbapenem.This study aimed to elucidate the patterns of carbapenem use and shed light on the integral role played by clinical pharmacists in managing and promoting the rational use of carbapenem antibiotics at Wenzhou Integrated Traditional Chinese and Western Medicine Hospital.AIM To analyze carbapenem use patterns in our hospital and role of clinical pharmacists in managing and promoting their rational use.METHODS We performed a retrospective analysis of carbapenem use at our hospital between January 2019 and December 2021.Several key indicators,including the drug utilization index,defined daily doses(DDDs),proportion of antimicrobial drug costs to total hospitalization expenses,antibiotic utilization density,and utilization rates in different clinical departments were comprehensively analyzed.RESULTS Between 2019 and 2021,there was a consistent decline in the consumption and sales of imipenem-cilastatin sodium,meropenem(0.3 g),and meropenem(0.5 g).Conversely,the DDDs of imipenem-cilastatin sodium for injection increased in 2020 and 2021 vs 2019,with a B/A value of 0.67,indicating a relatively higher drug cost.The DDDs of meropenem for injection(0.3 g)exhibited an overall upward trend,indicating an increasing clinical preference.However,the B/A values for 2020 and 2021 were both>1,suggesting a relatively lower drug cost.The DDDs of meropenem for injection(0.5 g)demonstrated a progressive increase annually and consistently ranked first,indicating a high clinical preference with a B/A value of 1,signifying good alignment between economic and social benefits.CONCLUSION Carbapenem use in our hospital was generally reasonable with a downward trend in consumption and sales over time.Clinical pharmacists play a pivotal role in promoting appropriate use of carbapenems.

儿童隐匿性高度近视黄斑区视网膜厚度分析

目的:观察分析隐匿性高度近视儿童黄斑区视网膜厚度变化及其相关因素。方法:前瞻性非随机对照研究。选取2019-09/2020-09在承德医学院附属医院眼科门诊首次就诊且未进行过任何近视矫正训练的儿童56例110眼纳入研究,根据儿童近视的临床表现分为隐匿性高度近视组(27例52眼)和对照组(29例58眼,普通近视儿童)。比较两组儿童黄斑各分区视网膜厚度情况,分析隐匿性高度近视儿童黄斑中心凹平均视网膜厚度与基线资料的相关性。结果:隐匿性高度近视儿童黄斑区视网膜厚度以黄斑中心凹最薄,内环区上方最厚。隐匿性高度近视组儿童黄斑9个分区平均视网膜厚度均较对照组变薄,其中黄斑中心凹、外环区下方和颞侧处视网膜厚度有显著差异(均P<0.05)。随着隐匿性高度近视儿童屈光度的增高,黄斑各分区的平均视网膜厚度值均降低。与对照组相同屈光度儿童比较,隐匿性高度近视组除0.00D≤屈光度≤-1.00D儿童外环区颞侧、-2.00D<屈光度≤-3.00D儿童黄斑中心凹平均视网膜厚度有明显差异(均P<0.05),其余各分区平均视网膜厚度均无差异(P>0.05)。Pearson相关分析结果显示,隐匿性高度近视儿童黄斑中心凹平均视网膜厚度与性别、年龄、眼轴、眼压、角膜曲率均无相关性(P>0.05),与屈光度呈负相关性(r=-0.201,P<0.05)。结论:隐匿性高度近视儿童黄斑视网膜厚度以黄斑中心凹最薄,内环区上方最厚,黄斑各分区平均视网膜厚度较相应屈光度数近视儿童薄。隐匿性高度近视儿童黄斑中心凹平均视网膜厚度与屈光度呈负相关。

Implication of two-coupled tri-stable stochastic resonance in weak signal detection

Stochastic resonance （SR） has been proved to be an effective approach to extract weak signals overwhelmed in noise. However, the detection effect of current SR models is still unsatisfactory. Here, a coupled tri-stable stochastic resonance （CTSSR） model is proposed to further increase the output signal-to-noise ratio （SNR） and improve the detection effect of SR. The effects of parameters a, b, c, and r in the proposed resonance system on the SNR are studied, by which we determine a set of parameters that is relatively optimal to implement a comparison with other classical SR models. Numerical experiment results indicate that this proposed model performs better in weak signal detection applications than the classical ones with merits of higher output SNR and better anti-noise capability.

Asymmetric stochastic resonance under non-Gaussian colored noise and time-delayed feedback

Based on adiabatic approximation theory,in this paper we study the asymmetric stochastic resonance system with time-delayed feedback driven by non-Gaussian colored noise.The analytical expressions of the mean first-passage time(MFPT)and output signal-to-noise ratio(SNR)are derived by using a path integral approach,unified colored-noise approximation(UCNA),and small delay approximation.The effects of time-delayed feedback and non-Gaussian colored noise on the output SNR are analyzed.Moreover,three types of asymmetric potential function characteristics are thoroughly discussed.And they are well-depth asymmetry(DASR),well-width asymmetry(WASR),and synchronous action of welldepth and well-width asymmetry(DWASR),respectively.The conclusion of this paper is that the time-delayed feedback can suppress SR,however,the non-Gaussian noise deviation parameter has the opposite effect.Moreover,the correlation time plays a significant role in improving SNR,and the SNR of asymmetric stochastic resonance is higher than that of symmetric stochastic resonance.Our experiments demonstrate that the appropriate parameters can make the asymmetric stochastic resonance perform better to detect weak signals than the symmetric stochastic resonance,in which no matter whether these signals have low frequency or high frequency,accompanied by strong or weak noise.

Novel Woods-Saxon stochastic resonance system for weak signal detection

We propose a joint exponential function and Woods–Saxon stochastic resonance(EWSSR)model.Because change of a single parameter in the classical stochastic resonance model may cause a great change in the shape of the potential function,it is difficult to obtain the optimal output signal-to-noise ratio by adjusting one parameter.In the novel system,the influence of different parameters on the shape of the potential function has its own emphasis,making it easier for us to adjust the shape of the potential function.The system can obtain different widths of the potential well or barrier height by adjusting one of these parameters,so that the system can match different types of input signals adaptively.By adjusting the system parameters,the potential function model can be transformed between the bistable model and the monostable model.The potential function of EWSSR has richer shapes and geometric characteristics.The effects of parameters,such as the height of the barrier and the width of the potential well,on SNR are studied,and a set of relatively optimal parameters are determined.Moreover,the EWSSR model is compared with other classical stochastic resonance models.Numerical experiments show that the proposed EWSSR model has higher SNR and better noise immunity than other classical stochastic resonance models.Simultaneously,the EWSSR model is applied to the detection of actual bearing fault signals,and the detection effect is also superior to other models.

Mass Spectrometry Imaging-Based Single-Cell Lipidomics Profiles Metabolic Signatures of Heart Failure

Heart failure(HF),leading as one of the main causes of mortality,has become a serious public health issue with high prevalence around the world.Single cardiomyocyte(CM)metabolomics promises to revolutionize the understanding of HF pathogenesis since the metabolic remodeling in the human hearts plays a vital role in the disease progression.Unfortunately,current metabolic analysis is often limited by the dynamic features of metabolites and the critical needs for high-quality isolated CMs.Here,high-quality CMs were directly isolated from transgenic HF mice biopsies and further employed in the cellular metabolic analysis.The lipids landscape in individual CMs was profiled with a delayed extraction mode in time-of-flight secondary ion mass spectrometry.Specific metabolic signatures were identified to distinguish HF CMs from the control subjects,presenting as possible single-cell biomarkers.The spatial distributions of these signatures were imaged in single cells,and those were further found to be strongly associated with lipoprotein metabolism,transmembrane transport,and signal transduction.Taken together,we systematically studied the lipid metabolism of single CMs with a mass spectrometry imaging method,which directly benefited the identification of HF-associated signatures and a deeper understanding of HF-related metabolic pathways.

Synthesis and thermal properties of novel calix[4]arene derivatives containing 1,2,3-triazole moiety via K_2CO_3-catalyzed 1,3-dipolar cycloaddition reaction

Two calix[4]arene derivatives containing 1,2,3-triazole moiety were synthesized via K2CO3-catalyzed1,3-dipolar cycloaddition reaction between calix[4]arene-based azide and active methylene compounds in good yields.The structures of the two compounds synthesized herein were fully confirmed by 1HNMR,,（13）C NMR,and MS（ESI）.The thermal analysis showed that the mass losses of the synthesized compounds 4 and 5 containing 1,2,3-triazole groups are similar to each other.

Synthesis and anti-integrase evaluation of novel calix[4]arene derivatives containing the triazolyl 1,3-diketo moiety

A series of novel calix[4]arene derivatives incorporating two triazolyl 1 3-diketo subunits in alternate positions at the lower rim were synthesized and screened for HⅣ integrase inhibition activity.The chemical structures of these compounds were confirmed by means of1H NMR 13C NMR,and ESI-MS.Preliminary bioassays indicated that calix[4]arene derivatives proved to be more active than p-tertbutylcalix[4]arene derivatives.In particular,compound 4g presented the most potent integrase strand transfer inhibitory activity with an IC50value of 6.1 mmol/L.