Background: Linezolid is classed as oxazolidinone antibiotics which can be used to treat severe infections caused by vancomycinresistant Enterococcus faecium, hospital-acquired pneumonia caused by Staphylococcus aureus, complicated skin, and uncomplicated skin structure infections (SSSIs) caused by methicillin-susceptible S. aureus or Streptococcus pyogenes, and community-acquired pneumonia caused by Streptococcus pneumoniae. However, many studies have suggested it can also cause thrombocytopenia and pancytopenia. Patients and Methods: We report on three patients with linezolid-pancytopenia. Patients in cases 1 and 2 were diagnosed with heart failure with preserved ejection fraction (HFpEF) and were both administered with dapagliflozin, one of the sodium-dependent glucose transporters 2 inhibitors (SHLT-2i). Results: Two patients were diagnosed with type 2 diabetes, pneumonia, and hyponatremia. Severe myelosuppression occurred in both patients, with a severe decrease in leukocytes and platelets and a moderate decrease in hemoglobin, who eventually passed away despite the discontinuation of linezolid and adopting appropriate treatment measures. The patient in case 3 was diagnosed with pneumonia, type 2 diabetes, and sequelae of cerebral thrombosis. After twelve days of treatment, the patient developed moderate thrombocytopenia and anemia. She recovered without any additional treatment after the discontinuation of linezolid. Conclusion:In this case series, two patients with irreversible myelosuppression were treated with both linezolid and SGLT-2i, and one diabetic patient with single linezolid use presented with reversible pancytopenia, suggesting that SGLT-2i may exacerbate myelosuppression of linezolid. Linezolid should be used with caution in infectious patients with a history of SGLT-2i. We will conduct relevant animal experiments to clarify the interaction between the two drugs.
The concept of a life force energy called "Qi" is a fundamental concept in Traditional Chinese Medicine (TCM), despite the fact that it cannot be measured using modern technology. For this study, we selected three different forms of potential sources of Qi to study the effect of Qi on cellular and organ level using telomeres as an indicator of aging. The three types of sources of Qi are as follows: The external Qi from a Qigong master, internal Qi generated by ingesting the Qi-invigorating Chinese herb, Astragali Radix, and from a Rotating Poynting Vector (RPV) device which generates an RPV-field which is reported to have similar property as Qi [1]. The results showed that for cells, the expression of TERT gene was up regulated and the telomere length was prolonged after the treatment of different Qi, but the change of telomerase activity was not significant, with only a slight increase at 4 hours after the treatment of Qigong external Qi. For animal organs, Qi from Astragali Radix was found to prolong telomere length in the heart, liver, spleen and lung tissue, but not in the kidney, brain or skeletal muscle of mice. We preliminarily conclude that the three different sources of Qi showed some similarity at the cellular level to improve the status of aging and that Qi-invigorating herbs can delay the shortening of telomere for selected organs of mice. More research needs to be conducted to better understand the effect of Qi on aging as well as its biochemical mechanisms.
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