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  • Research Progress in Cerebral Protection Effect and Clinical Applications of Berberine
    ZHANG Ming-fa, SHEN Ya-qin
    2025, 22(5): 419-432. https://doi.org/10.13493/j.issn.1672-7878.2025.05-001
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    Berberine, a natural isoquinoline alkaloid, is clinically used primarily for the treatment of intestinal infections caused by sensitive organisms. It exhibits a wide range of pharmacological effects, including anti-inflammatory, antibacterial, antiviral, anticancer, antihypertensive, hypoglycemic, and hypolipidemic activities. With the deepening of studies, researchers have found that berberine has a cerebral protection effect. This article reviews and summarizes the protective effect, action mechanism, and clinical applications of berberine in brain injury, so as to provide a reference for the further clinical application development of berberine.
  • Research Progress in Hand Hygiene of Anesthesia Teams and Prevention and Control of Perioperative Healthcare-Associated Infections
    ZOU Lu
    2025, 22(5): 432-437. https://doi.org/10.13493/j.issn.1672-7878.2025.05-002
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    Healthcare-associated infections (HAIs) are important factors affecting patient safety and prognosis. Surgical site infections, accounting for only 20% of HAIs, cause the highest economic loss among HAIs. The anesthesia team members perform frequent procedures in the operating room, and their compliance with hand hygiene is crucial for preventing pathogen transmission. However, the actual compliance rate is generally low. This article reviews and summarizes the role of the anesthesia team in the transmission of HAIs, the current status and obstacles of hand hygiene practices, and strategies to improve hand hygiene compliance and infection prevention and control effects, so as to provide a reference for enhancing hand hygiene among anesthesiologists and reducing the incidence of perioperative HAIs.
  • Pharmaceutical Care in Anti-Infective Therapy of a Patient with Meningoencephalitis Complicated by Bilateral Pneumonia Caused by Scedosporium Apiospermum
    YOU Ming-mei, TANG Cai-lin, SUN Shui-mei, WEI Chang-xiu, QIAN Xin
    2025, 22(5): 438-443. https://doi.org/10.13493/j.issn.1672-7878.2025.05-003
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    Objective: To analyze the pharmaceutical care process in anti-infective therapy of a patient with meningoencephalitis complicated by bilateral pneumonia caused by Scedosporium apiospermum, and provide a reference for improving clinical understanding and diagnosis and treatment level of infections caused by such fungi. Methods and Results: The patient was admitted to the hospital with "recurrent headache and fever for more than 1 month after drowning". Based on admission examination results and past medical history, the clinical diagnosis was initially purulent meningitis and bilateral pneumonia, and empirical anti-infective therapy with ceftriaxone + acyclovir was administered. During further examinations, CT and MR confirmed the diagnosis of meningoencephalitis and bilateral pneumonia, but acid-fast bacillus staining and ink staining of cerebrospinal fluid (CSF), T-SPOT test, G test, and blood culture all showed negative, making it difficult to identify the pathogen. On the 5th day of admission, metagenomics next-generation sequencing of CSF suggested Scedosporium apiospermum, which was considered the probable pathogen. After consultation, clinical pharmacists recommended voriconazole treatment. After about 3 weeks of antifungal therapy, the patient's fever, headache and other symptoms disappeared, and brain and lung lesions improved significantly. The patient was allowed to be discharged and instructed to continue oral voriconazole treatment to complete the course. Conclusion: Central nervous system infections caused by Scedosporium apiospermum are relatively rare. Delayed treatment can easily lead to poor prognosis. Actively using mNGS and other examination methods to identify the pathogen promptly and carry out targeted antifungal therapy can help patients achieve good therapeutic effect.
  • Clinical Diagnosis and Treatment Analysis of a Patient with Diarrhea Caused by Clostridium Difficile Infection with Involvement of Clinical Pharmacists
    ZHANG Kai, LONG Yi, ZHOU Si-rou, HE Xing-xing
    2025, 22(5): 444-448. https://doi.org/10.13493/j.issn.1672-7878.2025.05-004
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    Objective: To analyze the diagnosis and treatment process of a patient with diarrhea caused by Clostridium difficile infection (CDI), and provide a reference for etiological diagnosis and precise treatment of clinical diarrhea patients. Methods and Results: The patient was admitted to Orthopedics Department due to "28 days after coronary artery bypass grafting, 23 days after fasciotomy for right lower extremity osteofascial compartment syndrome with muscle necrosis of right lower extremity". Before admission, the patient had long-term use of piperacillin-tazobactam sodium and proton pump inhibitors/H2 receptor antagonists. On the day of admission, right lower extremity amputation was performed, and piperacillin-tazobactam sodium and omeprazole were given postoperatively. The patient stopped taking piperacillin-tazobactam sodium after 9 days, but severe diarrhea occurred 2 weeks after discontinuation, which did not improve with multiple antidiarrheal drugs. Clinical pharmacists were consulted and considered a high possibility of CDI due to the patient's recent history of long-term use of broad-spectrum antibacterials and proton pump inhibitors, recommending CDI-related examinations. 10 days later, tests for Clostridium difficile glutamate dehydrogenase antigen, toxin A, and toxin B all showed positive, confirming the diagnosis of CDI. Clinical pharmacists were consulted again and recommended oral vancomycin treatment (125 mg, q6h, course: 10-14 days). After 5 days of vancomycin treatment, the patient's diarrhea improved significantly, with yellow formed stools. 4 days later, the patient was discharged without recurrence. Conclusion: The causes of diarrhea are complex. When empirical antidiarrheal treatment is ineffective, clinical practice should actively carry out etiological diagnosis based on the medical history and medication history of patients, identify the cause in a timely manner through various examinations, and implement precise treatment to ensure effective therapy of patients.
  • Pharmaceutical Care in Anti-Infective Therapy of a Patient with Endophthalmitis Caused by Streptococcus Agalactiae
    ZHANG Shi, MA Yi-ping
    2025, 22(5): 449-454. https://doi.org/10.13493/j.issn.1672-7878.2025.05-005
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    Objective: To analyze the pharmaceutical care process in anti-infective therapy of a patient with endophthalmitis caused by Streptococcus agalactiae, and provide a reference for anti-infective therapy of such patients in clinical practice. Methods and Results: The patient was admitted to the hospital with eye swelling and headache after left eye intraocular lens implantation + silicone oil removal. Admission examinations showed conjunctival congestion, corneal edema, aqueous humor turbidity of the left eye, with abnormal white blood cell count and neutrophil percentage. The clinical initial diagnosis was left eye endophthalmitis, and surgical treatment was given, followed by postoperative empirical systemic treatment with vancomycin + ceftazidime, intermittent vitreous cavity perfusion, and local treatment with levofloxacin eye drops. On the 6th day of admission, Streptococcus agalactiae was detected in the aqueous humor of the left eye, and drug susceptibility test results showed susceptibility to ampicillin, vancomycin and linezolid, so ceftazidime was discontinued. After about 3 weeks of vancomycin treatment, the patient's ocular inflammation was controlled, but mild conjunctival congestion and corneal edema persisted. Considering that the effect of vancomycin was less than expected, vancomycin was adjusted to linezolid. After 11 days of linezolid treatment, the aqueous humor culture of the left eye was negative. 2 days later, the patient's ocular infection symptoms improved, and the infection was basically controlled, so the patient was allowed to be discharged. Conclusion: Endophthalmitis caused by Streptococcus agalactiae is rare in clinical practice, and its treatment is challenging. Clinicians should pay more attention, and make personalized treatment adjustments in a timely manner based on the patient's condition changes and etiological results to ensure effective treatment.
  • Analysis of Adverse Drug Reaction in a Case of Delirium Induced by Levofloxacin
    LV Song, LI Chun-yu, ZHANG Li-chao, JIA Ting-ting
    2025, 22(5): 455-458. https://doi.org/10.13493/j.issn.1672-7878.2025.05-006
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    Objective: To analyze the identification and management process of adverse drug reactions (ADRs) in a case of delirium induced by levofloxacin, and provide a reference for the safe use of levofloxacin in clinical practice. Methods and Results: The patient was admitted to the hospital with symptoms such as nausea, vomiting, and diarrhea. Combined with abnormal indicators such as neutrophil percentage and C-reactive protein, the clinical diagnosis was acute gastroenteritis, and levofloxacin was given for anti-infective therapy. In the early morning of the 4th day, the patient developed mental symptoms such as restlessness, delirium, and confused speech. Experts from Department of Encephalopathy were consulted. The experts learned that the patient had no history of neuropsychiatric diseases or related family history. Combined with the current medication, they initially judged that these symptoms might be caused by levofloxacin, recommended discontinuing levofloxacin and giving symptomatic treatment. After discontinuing levofloxacin, the patient did not experience restlessness, delirium, confused speech or other symptoms again. Subsequent Naranjo Scale scoring showed that the association between levofloxacin and mental symptoms such as delirium was "probable". Conclusion: As a commonly used antibacterial drug in clinical practice, levofloxacin has the risk of causing central nervous system adverse reactions. Clinicians should strengthen medication monitoring during patient medication to ensure medication safety of patients.
  • Active Surveillance Analysis of Adverse Drug Reactions Induced by Colchicine Based on China Hospital Pharmacovigilance System*1
    HU Bo-lin, BU Zi-qing, ZHU Mei, QIU Sheng-hua
    2025, 22(5): 459-463. https://doi.org/10.13493/j.issn.1672-7878.2025.05-007
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    Objective: To explore the clinical characteristics of adverse drug reactions (ADRs) induced by colchicine using China Hospital Pharmacovigilance System (CHPS), and provide a reference for the safe use of colchicine in clinical practice. Methods: Using CHPS, patients who used colchicine in the First People's Hospital of Qinzhou from January 2021 to December 2022 were selected as the research objects. The occurrence of ADRs after colchicine use was statistically analyzed, and a correlation evaluation was conducted. Information such as patient age, gender, ADR occurrence time, clinical manifestations, and outcome was collected to analyze the clinical characteristics of colchicine-related ADRs. Results: A total of 2 008 patients who used colchicine were retrieved through CHPS, among which 133 cases were reported of ADRs, with an incidence rate of ADRs at 6.62%. According to the classification and evaluation criteria for ADR causality of WHO-UMC, the vast majority had a "probable" association with colchicine (119 cases, 89.47%). Among 133 patients with colchicine-related ADRs, males were far more than females (120 cases vs 13 cases), and middle-aged and elderly patients aged not below 45 were the main group (117 cases, 87.97%). Most of 133 colchicine-related ADRs occurred within the first five days of colchicine use (116 cases, 87.22%), with diarrhea being the most common clinical manifestation (120 cases, 90.23%), followed by abdominal pain (12 cases, 9.02%). Among 133 ADR patients, most adopted the strategies of discontinuing colchicine and using montmorillonite powder (56 cases, 42.11%) and simply discontinuing colchicine (47 cases, 35.34%). After treatment, ADRs of all patients gradually disappeared, and related indicators returned to normal. Conclusion: As a drug with a narrow therapeutic window, colchicine has a high incidence rate of ADRs, especially in middle-aged and elderly patients. Clinicians should strengthen the monitoring of medication safety in related patients, such as using CHPS, to ensure medication safety of patients.