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Background Linezolid-induced thrombocytopenia is the main factor restricting the clinical application of linezolid. Objectives To investigate the relationship between PNU-14230 concentration and linezolid-induced thrombocytopenia and further develop and validate a risk model for predicting linezolid-induced thrombocytopenia. Methods A regression model was constructed to predict the occurrence of linezolid-induced thrombocytopenia, and further externally validated. The predictive performance was evaluated by receiver operating characteristic curve and Hosmer–Lemeshow test. Linezolid C min and PNU-142300 concentrations were compared for different kidney function groups. The Kaplan–Meier method was used to estimate the difference in cumulative incidence of linezolid-induced thrombocytopenia among different kidney function patients. Results In the derivation (n = 221) and validation (n = 158) cohorts, 28.5% and 24.1% of critically ill patients developed linezolid-induced thrombocytopenia. Logistic regression analysis indicated that the independent risk factors were linezolid C min, PNU-142300 concentration, baseline platelet count, renal insufficiency (RI) and continuous venovenous haemofiltration (CVVH). The AUC for the risk model was 0.901, and the model was good (P  = 0.633). The model also showed good discrimination (AUC 0.870) and calibration (P  = 0.282) in the external validation cohort. Compared with normal kidney function patients, patients with RI and CVVH had higher linezolid C min and PNU-142300 concentrations (P < 0.001) and higher cumulative incidence of linezolid-induced thrombocytopenia (P < 0.001). Conclusions PNU142300 concentration, as well as linezolid C min, might identify patients at risk of linezolid-induced thrombocytopenia. The risk prediction model had good predictive performance for linezolid-induced thrombocytopenia development. Concentrations of linezolid and PNU-142300 accumulated in patients with RI and CVVH. [ABSTRACT FROM AUTHOR]

Dynamic changes in lipoxin A4 (LXA4) in child patients with congenital heart disease (CHD), in the perioperative period of cardiopulmonary bypass (CPB) were studied. Peripheral blood was collected from 16 child patients (CPB group) before operation (Tc), after operation (T0), at 1 day after operation (T1), at 3 days after operation (T3), and at 7 days after operation (T7); and from 17 children with no CHD (control group). The level of LXA4 in peripheral blood was detected via enzyme-linked immunosorbent assay (ELISA). Clinical data of the child patients were collected. The white blood cell (WBC) count, the proportion of neutrophils (N%) and high-sensitivity C-reactive protein (hs-CRP) levels were also detected, followed by statistical analysis. The plasma LXA4 levels in CPB group at Tc were significantly lower compared to that in the control group (P<0.01). In CPB group, the level of LXA4 showed an increasing trend at T0, WBC and hs-CRP were transiently increased at T0 and increased most significantly at T1. N% was obviously increased at T0 compared to that at Tc and was still significantly higher at T7 compared to that at Tc. The CPB time and aortic clamping time were positively correlated with the time in the Pediatric Intensive Care Unit (PICU), the application time of ventilator, and the hs-CRP level at T0. The LXA4 level at each time-point had no correlation with other indexes. In conclusion, the inflammatory response after CPB increases the synthesis of LXA4 with an anti-inflammatory effect, but LXA4 cannot be used as a sensitive index for monitoring inflammation. [ABSTRACT FROM AUTHOR]

Dynamic changes in lipoxin A 4 (LXA 4 ) in child patients with congenital heart disease (CHD), in the perioperative period of cardiopulmonary bypass (CPB) were studied. Peripheral blood was collected from 16 child patients (CPB group) before operation (Tc), after operation (T0), at 1 day after operation (T1), at 3 days after operation (T3), and at 7 days after operation (T7); and from 17 children with no CHD (control group). The level of LXA 4 in peripheral blood was detected via enzyme-linked immunosorbent assay (ELISA). Clinical data of the child patients were collected. The white blood cell (WBC) count, the proportion of neutrophils (N%) and high-sensitivity C-reactive protein (hs-CRP) levels were also detected, followed by statistical analysis. The plasma LXA 4 levels in CPB group at Tc were significantly lower compared to that in the control group (P<0.01). In CPB group, the level of LXA 4 showed an increasing trend at T0, WBC and hs-CRP were transiently increased at T0 and increased most significantly at T1. N% was obviously increased at T0 compared to that at Tc and was still significantly higher at T7 compared to that at Tc. The CPB time and aortic clamping time were positively correlated with the time in the Pediatric Intensive Care Unit (PICU), the application time of ventilator, and the hs-CRP level at T0. The LXA 4 level at each time-point had no correlation with other indexes. In conclusion, the inflammatory response after CPB increases the synthesis of LXA 4 with an anti-inflammatory effect, but LXA 4 cannot be used as a sensitive index for monitoring inflammation.