目的:基于药动学(pharmacokinetics,PK)/药效学(pharmacodynamics,PD)模型和蒙特卡洛模拟(Mote Carlo simulation,MCS),分析大肠埃希菌所致脓毒症休克患者抗感染治疗方案的优化过程,为临床感染患者构建合理有效的治疗方案提供参考。方法...目的:基于药动学(pharmacokinetics,PK)/药效学(pharmacodynamics,PD)模型和蒙特卡洛模拟(Mote Carlo simulation,MCS),分析大肠埃希菌所致脓毒症休克患者抗感染治疗方案的优化过程,为临床感染患者构建合理有效的治疗方案提供参考。方法:一患者因不明原因发热入院,初步诊断为尿路感染和脓毒症休克。入院后第一时间完善了相关实验室检查,随后采用PK/PD模型和MCS依据微生物培养结果及其药敏试验确定最优的抗感染治疗方案。结果:入院第3天,微生物培养检出大肠埃希菌,随后的药敏试验提示其对美罗培南、亚胺培南敏感,而对头孢哌酮-舒巴坦钠中介;采用PK/PD模型和MCS对拟定的几个抗感染治疗方案进行分析,结果发现美罗培南(1 g,q8h)和亚胺培南(0.5 g,q6h)的达标概率(probability of target attainment,PTA)均为100.00%,而头孢哌酮-舒巴坦钠(3 g,q12h)的PTA为1.14%,头孢哌酮-舒巴坦钠(3 g,q8h)的PTA为7.65%;最终,临床选择了美罗培南(1 g,q8h)治疗,1周后患者的感染指征基本消失。结论:PK/PD模型和MCS两个工具可以较好地帮助临床药师预测抗感染治疗方案的可能效果,从而更好地协助医生制定和优化治疗方案,进而最大程度保证患者的治疗效果。展开更多
Observations of PKS 1510-089 indicate the existence of a deep flux minimum with a timescale of -35 min and an interval of about 336 ± 14 d. A binary black hole system is proposed to be at the nucleus of this obje...Observations of PKS 1510-089 indicate the existence of a deep flux minimum with a timescale of -35 min and an interval of about 336 ± 14 d. A binary black hole system is proposed to be at the nucleus of this object. The secondary black hole orbits around the primary black hole. The minimum is caused by the periodic eclipse of the primary black hole by the secondary black hole. Based on the observations of PKS 1510-089, we estimate the parameters of the binary black hole system. The masses for the primary and secondary black holes are 1.37 × 10^9M⊙（M⊙ is the solar mass） and 1.37 × 10^7M⊙, and the major axis for this pair being about 0.1 parsec（pc）.展开更多
基金Project supported by State Key Development Program for Basic Research of China （Grant No 19990754）, the National Science Foundation for 0utstanding Young Scientists of China （Grant No 10125313）, the National Natural Science Foundation of China （Grant No 10573005）, and the Fund for Top Scholars of Guangdong Province, China （Grant No 02114）. Acknowledgments The authors wish to thank the referee for the comments and suggestions, and are also grateful for useful discussion to Dr Wang Hong-Guang, Liu Yi, Zhou Ji- Liang, Chen Jian-Ling and Xu Shou-Xi.
文摘Observations of PKS 1510-089 indicate the existence of a deep flux minimum with a timescale of -35 min and an interval of about 336 ± 14 d. A binary black hole system is proposed to be at the nucleus of this object. The secondary black hole orbits around the primary black hole. The minimum is caused by the periodic eclipse of the primary black hole by the secondary black hole. Based on the observations of PKS 1510-089, we estimate the parameters of the binary black hole system. The masses for the primary and secondary black holes are 1.37 × 10^9M⊙（M⊙ is the solar mass） and 1.37 × 10^7M⊙, and the major axis for this pair being about 0.1 parsec（pc）.
