目的 分析医院妇科患者阴道分泌物中支原体培养与药敏结果,为临床合理选用抗菌药物治疗提供参考。方法 选取 2020 年 3 月—2022 年 3 月宜黄安康医院诊治的 316 例妇科疾病患者作为研究对象,统计其阴道分泌物支原体培养与药敏试验结果,分析其支原体感染现状、支原体感染类型,以及药敏结果对抗菌药物用药的影响。结果 316 例患者阴道分泌物标本中,培养、检出支原体阳性患者 100 例,其支原体感染率为 31.65%;支原体阳性患者中,检出单纯解脲脲原体（Ureaplasma urealyticum,Uu） 58 例（占 58.00%）、单纯人型支原体（Mycoplasma hominis,Mh） 7 例（占 7.00%）和 Uu+Mh 混合阳性 35 例（占 35.00%）;药敏结果显示,Uu 对米诺环素、交沙霉素、阿奇霉素、克拉霉素、罗红霉素的敏感率较高（分别为 84.48%、79.31%、79.31%、77.59%、72.41%）,对左氧氟沙星、克林霉素、甲砜霉素的敏感率较低（分别为 13.46%、10.34%、8.62%）;Mh 对多西环素、米诺环素、左氧氟沙星、交沙霉素、加替沙星的敏感率较高（分别为 100.00%、100.00%、71.43%、71.43%、71.43%）,对阿奇霉素、克拉霉素、罗红霉素、甲砜霉素的敏感率均为 0.00%;Uu+Mh 混合感染对多西环素、米诺环素、交沙霉素的敏感率较高（分别为 77.14%、82.86%、65.71%）,对阿奇霉素、克拉霉素、克林霉素、罗红霉素、甲砜霉素的敏感率均为 0.00%,对左氧氟沙星和红霉素的敏感率均低至 5.71%。结论 医院妇科患者支原体感染率较高,以单纯 Uu 感染为主,且其对多西环素、米诺环素、交沙霉素较为敏感,临床治疗在选择用药时应按药敏结果选择敏感率高的抗菌药物,以确保其疗效。

Magnoliae officinalis cortex has the function of regulating the gastrointestinal motility, especially it can significantly improve the gastrointestinal propulsion function and promote defecation in case of gastrointestinal motility disorders; therefore, it has good clinical effect on the intestinal paralysis caused by various reasons. Its mechanism may be related to promoting the secretion of motilin and gastrin and the proliferation of interstitial cells of Cajal, and increasing the rhythmic contraction of the gastrointestinal tract. Additionally, Magnoliae officinalis cortex has the function of intestinal mucosa protection and anti-diarrhea, and its mechanism may be related to anti-oxidative stress and anti-inflammatory action. In this paper, the pharmacological effects of traditional Chinese medicine Magnoliae officinalis cortex on the intestinal tract and its mechanism are reviewed, and the research progress is analyzed.

目的: 分析医院门诊抗菌药物处方用药存在的问题与不合理的原因,为门诊患者抗菌药物合理使用提供参考。方法: 抽取 2021 年度柳州市潭中人民医院门诊抗菌药物处方 1 200 张（每月 100 张）,点评与分析处方用药的合理性和不合理的原因。结果: 1 200 张处方中,存在不合理原因用药处方 197 张（占 16.42%）,主要表现为用法用量不合理、品种选择不合理、联合用药不适宜、无指征用药、用药疗程不合理和围术期预防用药不合理。结论: 医院门诊抗菌药物的使用存在诸多不合理使用现象,医院行政部门应加强门诊医师的抗菌药物相关知识培训与学习,药师应充分发挥宣教、审方和干预等作用,以促进门诊患者抗菌药物使用的合理性、安全性。

Lonicerae japonicae flos is a common traditional Chinese medicine with multiple pharmacological activities such as antiviral, antibacterial, anti-inflammatory and immune-enhancing activities. Presently, a variety of antibacterial active ingredients have been isolated from lonicerae japonicae flos, mainly including organic acids, flavonoids, triterpene saponins, and volatile oils. In-depth studies of the antibacterial effects and pharmacological mechanisms of some active ingredients have been performed. In this article, the types, antibacterial effects and pharmacological mechanisms of antibacterial active ingredients in lonicerae japonicae flos are reviewed, to provide a theoretical basis for the subsequent development of these active ingredients.

Objective: To explore the drug resistance, drug proportion and therapeutic outcome of pathogenic bacteria in Acinetobacter baumannii infected patients in the internal ICU of a hospital in 2019, thus to provide reference for clinical treatment. Methods: 51 cases of patients in the internal ICU of a hospital from January to December 2019 were selected as the research subjects. Specimens (including sputum, secretions, urine, pleural effusion and cerebrospinal fluid) were collected from all patients after admission. Pathogen identification and drug sensitivity test were completed using automatic bacterial identification and drug sensitivity system. The age distribution of the patients and the source of the specimens were counted, and the drug resistance of 51 strains of Acinetobacter baumannii was analyzed, as well as the composition ratio and efficacy of antibiotics used by the patients. Results: 81 patients with Acinetobacter baumannii were isolated for the first time in the samples submitted for examination, and 30 patients with Acinetobacter baumannii isolated from contaminated or colonized specimens were excluded. 51 patients were included in the study, with the age distribution mainly concentrated in the 70 to 80 years old(49.02%). Specimens were collected from all 51 patients, and the top 2 sources of samples were sputum and alveolar lavage fluid, accounting for 70.59% and 17.65%, respectively. 51 cases of patients with Acinetobacter baumannii separation and resistance analysis results showed that Acinetobacter baumannii resistant rate to ceftazidime, levofloxacin, ciprofloxacin, cefepime, meropenem, imipenem, triamine, ticacillin-clavulanate potassium and piperacillin - tazobactam sodium were high(100.00%). Patients with confirmed Acinetobacter baumannii infection were all treated with antibacterials, and the top 2 effective drugs were imipenem + tigecycline and meropenem + tigecycline respectively, which were 100.00% and 60.00%. Conclusion: The detection rate and drug resistance rate of Acinetobacter baumannii in the ICU of a hospital are relatively high. It is necessary to strengthen the training of medical staff on infection control, and select sensitive antibacterials for treatment according to drug resistance so as to improve clinical efficacy.

Objective: To explore the immunomodulation mechanism of RMK-03^TM spray on upper respiratory mucosa based on immunoglobulin A (IgA MAb) blocking Spike-ACE 2 interaction of novel Coronavirus (SARS-CoV-2) in the mice experiment of the upper airway mucosal immune dysfunction (UAID) model induced by cold. Methods: 40 SPF ICR mice were divided into 4 groups, including normal group, UAID Model group, ribavirin spray group and RMK-03^TM spray group, with 10 mice in each group. Ribavirin spray group and RMK-03^TM spray group were given oral spray 0.1 mL/mouse q12h for 3 days. On day 3, other groups except normal group were used to replicate UAID model. The mice were placed in a cold environment of –20℃ for 15 min, and then acclimated to room temperature for 1 h. The mice were intraperitoneally injected with pilocarpine eye drops (0.25 mL/mouse). The expression of IgA and pIgR proteins were examined by Western blotting method. The contents of cytokines IL-4 and IL-6, IFN-γ and TNF-α were detected by ELISA method. The expression of ACE 2 and ACE were detected by immunohistochemistry. Results: The content of SIgA in saliva of mice in UAID model group was significantly lower than that in normal group (P<0.05), suggesting that the model was successfully replicated. Compared with normal group, UAID model group showed mild interstitial edema, dilatation and congestion of small vessels, and neutrophils accompanied by mild dilatation and edema of lymphatic vessels. The expression of IgA and pIgR proteins in oral and pharyngeal mucosa of mice in UAID model group, the contents of IgA-related cytokines IL-4 and IL-6, and the contents of pIgR-related cytokines IFN-γ and TNF-α were significantly lower than those in normal group(P<0.05). The mean optical density(IOD/area) of ACE and ACE 2 in the group were significantly higher than that in the normal group (P<0.05). The above main indexes of ribavirin spray group and RMK-03^TM spray group were better than UAID model group to varying degrees, and the above main indexes of ribavirin spray group were better than UAID model group. Conclusions: RMK-03^TM skin and mucosal care spray inhibits the active expression of ACE 2 in respiratory mucosa by regulating the content of IgA associated with low local mucosal immune barrier, and it is indirectly speculated that RMK-03^TM can block the spike-ACE 2 interaction of SARS-COV-2 to provide mucosal immunity.

目的: 开展重点品种监测工作,分析信迪利单抗注射液的临床使用和不良反应的发生情况,为构建药品重点监测新模式提供参考。方法: 遴选信迪利单抗注射液为重点监测品种,通过主动监测模式,对患者进行用药监护,收集其不良反应发生情况,分析信迪利单抗注射液的不良反应监测结果,发生不良反应患者的性别、年龄分布、不良反应累及部位、表现、处置与转归,以及严重不良反应情况。结果: 监测期内共发现 60 例不良反应,总体发生率为 17.91%,其中一般不良反应 54 例,严重不良反应 6 例,经治疗后好转,转归情况较好,临床用药的总体安全性较高。结论: 通过对免疫检查点抑制剂开展重点品种监测,提高了医护人员对肿瘤免疫治疗风险管理的重视程度,同时临床药师全程参与患者的治疗和不良反应处理过程,有利于降低不良反应的发生率和严重程度,提高临床药物治疗的水平和安全性。

Objective: To analyze the possible causes and management of coagulation dysfunction and hemocytopenia in 2 patients, and provide reference for the safe and rational use of piperacillin-tazobactam sodium in clinical treatment. Methods: The clinical pharmacist participated in the pharmacy consultation of 2 patients with coagulation dysfunction and hemocytopenia after using piperacillin-tazobactam sodium, comprehensively considered the patients' medication and pathogenetic process, analyzed the possible causes of coagulation dysfunction and hemocytopenia, and made recommendations for management. Results: After comprehensively considering the patients' medication and pathogenetic process and analyzing that coagulation dysfunction and hemocytopenia may be caused by piperacillin-tazobactam sodium, the clinical pharmacist recommended discontinuing piperacillin-tazobactam sodium and symptomatic treatment, and the patients were improved or healed quickly after the doctor accepted the recommendation of the clinical pharmacist. Conclusion: Piperacillin-tazobactam sodium has hematologic adverse reactions, so the clinical pharmacist should pay attention to relevant pharmaceutical care when carrying out clinical pharmacy practice, timely detect relevant adverse reactions, and assist the doctor in corresponding management to ensure medication safety of patients.

Increasingly severe bacterial resistance is caused by the abuse of antibacterial drugs, multidrug-resistant organisms continue to emerge, and even "super bacteria" are produced. In addition, the research and development of traditional antibacterial drugs are not as expected, new antibacterial drugs are rarely available on the market, and people are faced with a situation that no drug is available for super bacteria. The discovery of antimicrobial peptides may provide new ideas for the development of new antibacterial drugs. As a natural defense factor of organisms, they can not only directly kill microorganisms, but also eliminate pathogenic bacteria by activating the body defense mechanism. This article mainly summarizes the antibacterial mechanism, clinical application, existing problems and prospects of antimicrobial peptides, providing reference for the design and development of new antibacterial drugs based on antimicrobial peptides.

Objective: To explore the clinical treatment and pharmaceutical care of one patient with cryptococcal meningitis (CM) with the participation of clinical pharmacists, so as to provide reference for the clinical treatment of such patients. Methods and Results: On the 2nd day after admission, the patient developed symptoms of central nervous system (CNS) infection such as confusion, restlessness and disturbance of consciousness, and the cerebrospinal fluid ink smear showed fungal spore growth, which was suspected to be CM. After the consultation with the clinical pharmacists, it was recommended to give anti-infection therapy with amphotericin B, fluconazole, piperacillin-tazobactam sodium and mannitol to reduce the intracranial pressure, and carry out the pharmaceutical care. During the period, according to the patient's symptoms and the examination results and in combination with the relevant literature, clinical pharmacists recommended the physicians to adjust the usage and dosage of amphotericin B, fluconazole and mannitol in real time. On the 5th day, the metagenomic next-generation sequencing results of cerebrospinal fluid showed positive for Cryptococcus gattii, and CM was diagnosed. Soon after the patient improved. Conclusion: CM is difficult to be diagnosed rapidly as a serious CNS infectious disease, and the treatment regimen should be adjusted in real time according to the patient's condition during the treatment period. The participated clinical pharmacists can give full play to their professional characteristics of pharmacy and assist clinicians to formulate personalized treatment regimen to facilitate the recovery of patients.

目的: 分析儿童呼吸道肺炎支原体（Mycoplasma pneumoniae,MP）感染的流行病学特征及其耐药性,为临床防治呼吸道疾病提供参考。方法: 选取 2020 年—2022 年上饶市广信区人民医院儿科收治的 500 例呼吸道感染患儿作为研究对象,汇总其肺炎支原体抗体（MP-IgM）阳性患儿不同年份的流行病学特点,分析患儿不同年龄段、不同性别、不同季节中 MP-IgM 阳性率的现状,并对比分析 MP 对红霉素（erythromycin,ERY）、阿奇霉素（azithromycin,AZI）、乙酰螺旋素（acetylspiramycin,ACE）、克拉霉素（clarithromycin,CLA）、罗红霉素（roxithromycin,ROX）的耐药特点。结果: 500 例呼吸道感染患儿中,MP-IgM 阳性患儿 210 例（占 42.00%）;2020 年—2022 年患儿 MP-IgM 阳性率分别为 47.47%、40.19% 和 38.28%,呈现逐年下降趋势,但 3 年间 MP-IgM 阳性率经比较其差异无统计学意义（χ²=2.955,P>0.05）;女性患儿 MP-IgM 阳性率高于男性患儿（50.93% vs 35.31%,χ²=12.260,P<0.05）;年龄段为≤1 岁、>1~3 岁、>3~6 岁、>6~14 岁患儿的 MP-IgM 阳性率分别为 51.28%、40.48%、42.37% 和 29.00%,其中≤1 岁患儿 MP-IgM阳性率为最高,>6~14 岁患儿 MP-IgM 阳性率为最低,不同年龄段 MP-IgM 阳性率经比较其差异具有统计学意义（P<0.05）;2020 年—2022 年间 MP-IgM 阳性率以冬季为最高（3 年分别为 64.00%、54.29% 和 50.00%）;MP 对上述5 种抗菌药物的耐药率间经比较其差异具有统计学意义（χ²=35.23,P<0.05）,其耐药率从低到高依序为 AZI>CLA>ACE>ERY>ROX。结论: 呼吸道感染患儿中 MP 感染率较高,且与患儿性别、年龄、季节等因素有关,MP 对 ERY、ROX 耐药率较高,对 AZI 的耐药率最低,临床可根据 MP 感染患儿症状合理选用抗菌药物治疗。

Tuberculosis is a chronic infectious disease caused by mycobacterium tuberculosis infection, which can invade various organs of the human body. Pulmonary tuberculosis is the most common disease and is one of the main causes of death worldwide. With the abuse of antibiotics and non-standardized use of anti-tuberculosis drugs, drug-resistant tuberculosis continues to emerge, and the treatment regimens for drug-resistant tuberculosis are complex, with the problems of long medication courses and many adverse drug reactions, etc., which brings great challenge to the clinical work. Therefore, there is an urgent clinical need for new drugs that are effective against mycobacterium tuberculosis infections, especially infections caused by drug-resistant strains. This article first describes the effectiveness and safety data of marketed drugs, and then elaborates the new drugs that are currently in the clinical research stage based on the main effect targets of the drugs (the cell wall of mycobacterium tuberculosis, protein synthesis, energy metabolism, DNA synthesis, etc.).

Berberine has a wide range of antimicrobial effects. It has a strong inhibitory effect on Helicobacter pylori (Hp) in vivo and in vitro in addition to cocci, viruses and fungi. Moreover, berberine mainly inhibits and kills Hp in the stable phase. When berberine is used in combination with anti-Hp drugs that mainly inhibit and kill Hp in the logarithmic growth phase, a synergistic bactericidal effect can be produced. This article summarizes the antibacterial effects of berberine on Hp in vivo and in vitro, in animals and humans, and the clinical practice of combination with other anti-Hp drugs, providing reference for the subsequent clinical development of berberine.

Linezolid is the core drug for the treatment of multidrug-resistant tuberculosis. In 2018, Chinese Society for Tuberculosis, Chinese Medical Association (CSTB) issued a "consensus on linezolid in the treatment of tuberculosis". With the wider use of it in clinic, the improved understanding and the progress in research, CSTB organized experts to update this consensus and formed "consensus on linezolid in the treatment of tuberculosis(2022 update)", with a view to play a guiding role for clinicians. The consensus included the molecular structure and mechanism of action, pharmacodynamics, pharmacokinetics, clinical application, indications, contraindications and relative contraindications, dosage, usage and formulation of chemotherapy regimen, adverse reactions and clinical application. In this edition, we updated the drug resistance mechanism of linezolid, and the medical evidence was rated and recommended according to the grading of recommendations assessment, development and evaluation (GRADE) method.

Polymyxin was first discovered in bacillus polymyxin culture medium and was applied in clinical practice in the 1950s. However, it was quickly replaced by other antibacterial drugs due to significant adverse reactions such as nephrotoxicity. Nevertheless, with the increasingly severe bacterial resistance, polymyxin has returned to clinical practice, and is mainly used for severe infections caused by extended-spectrum beta-lactamase-producing Gram-negative bacteria and even carbapenem-resistant Enterobacteriaceae. Although polymyxin has been re-used in clinical practice, its adverse drug reactions still need to be carefully considered and monitored. Therefore, this article reviews the adverse drug reactions of polymyxin from pathogenesis, risk factors and countermeasures, so as to provide reference for safe and reasonable use of polymyxin in clinical practice.

Objective: To analyze the pharmaceutical care process of anti-tuberculosis treatment for the patient with drug-induced liver injury (DILI) caused by immune checkpoint inhibitors, and provide reference for clinical anti-tuberculosis treatment of patients with DILI. Methods: One patient with lower esophageal squamous cell carcinoma after surgery showed abnormally elevated levels of alanine aminotransferase (385.47 U/L), alkaline phosphatase (456.59 U/L) and total bilirubin (156.17 μmol/L) during the second course of chemotherapy, with the manifestation of mixed type severe liver injury; during the period, the patient developed symptoms such as cough, expectoration, and fever (39°C), and acid-fast bacilli (+++) were detected in the sputum smear. Combined with the chest CT examination results, the patient was considered to have secondary pulmonary tuberculosis in both lungs. It was recommended to initiate anti-tuberculosis treatment with drugs. Results: After the patient developed liver injury, the clinical pharmacist considered that it was caused by chemotherapy drugs (the RUCAM scores of pembrolizumab, paclitaxel and carboplatin were 6, 5, and 4 respectively), but the drugs were not discontinued. The patient received hepatoprotective treatment with adenoglycine butanesulfonate, polyene phosphatidylcholine, and methylprednisolone on the basis of magnesium isoglycyrrhizinate, however, the liver injury indicators continued to worsen, so all drugs with potential risks of liver injury were discontinued; subsequently, when carrying out anti-tuberculosis treatment, taking into account the patient's current liver injury, the doctor adopted the clinical pharmacist's suggestion and used drugs with a low risk of liver injury such as ethambutol, levofloxacin, and streptomycin; during this period, the patient's liver injury indicators kept improving; and then isoniazid was added and streptomycin was changed to linezolid; one month later, the patient's liver function returned to normal. Conclusion: When patients with severe mixed DILI need to carry out anti-tuberculosis treatment, clinical pharmacists should assist doctors in successfully treating patients with DILI and carrying out anti-tuberculosis treatment based on their professional knowledge and relevant literature reports, to ensure the life health of patients.

Objective: To analyze the pharmaceutical care process of anti-infective treatment in a patient with multidrug-resistant non-tuberculous mycobacterium lung disease, so as to provide reference for the treatment of such patients. Methods: After analyzing the drug susceptibility test report of a patient with multidrug-resistant non-tuberculous mycobacterium lung disease, the clinical pharmacist suggested another drug susceptibility test according to the drug susceptibility test standards of non-tuberculous mycobacterium (NTM). Through a combination with the drug pharmacokinetic characteristics, the treatment regimen was adjusted from cefoxitin + imipenem/cilastatin sodium + ethambutol + clarithromycin to cefoxitin + imipenem/cilastatin sodium + amikacin nebulized inhalation + azithromycin + tigecycline, improving the condition of the patient after 20 days of treatment. According to the drug susceptibility test results of NTM, the anti-infective treatment regimen was adjusted to cefoxitin + amikacin + azithromycin + tigecycline + moxifloxacin based on the patient's condition, after 20 days of treatment, the patient was discharged under further improved condition and was transferred to a community hospital for further treatment. The clinical pharmacist also participated in evaluating and preventing adverse drug reactions in the treatment process, and provided medication guidance for the patient after discharge. Results: The physician followed the advice of the clinical pharmacist and adjusted the treatment regimen twice. After 3 months of treatment, the patient's condition was well controlled and no serious adverse reactions occurred. Conclusion: The clinical pharmacist has participated in the diagnosis and treatment process of a patient with multidrug-resistant non-tuberculous mycobacterium lung disease, developed personalized anti-infective treatment regimens for the patient, and achieved good effects, reflecting the professional ability and service level of the clinical pharmacist, and providing ideas for the clinical diagnosis and treatment of multidrug-resistant non-tuberculous mycobacterium lung disease.

目的： 评价莫西沙星配合四联抗结核药物治疗方案对结核性胸膜炎患者的疗效与炎症因子及免疫功能改善的影响。方法： 选取 2019 年 8 月—2021 年 6 月苏州市第五人民医院收治的 76 例结核性胸膜炎患者作为研究对象,将其分为对照组和观察组（每组 38 例）;对照组患者给予常规四联抗结核药物方案治疗,观察组患者在对照组基础上加用莫西沙星治疗,比较 2 组患者持续用药 12 周后的临床疗效,以及炎症因子和免疫功能各指标测得值的变化情况。结果： 观察组患者用药治疗后的临床总有效率高于对照组（89.47% vs 63.16%,P<0.05）;治疗后观察组患者炎症因子即血清白介素-2（interleukin-2,IL-2）、白介素-4（interleukin-4,IL-4）测定值均低于对照组（P<0.05）,免疫功能各指标（CD3、CD4 和 CD4/CD8）测得值高于对照组（P<0.05）。结论： 采用莫西沙星配合四联抗结核药物方案治疗结核性胸膜炎患者的疗效显著优于常规抗结核药物治疗,有效改善了其炎症因子水平,提高了机体的免疫功能。

Objective: To investigate the distribution and drug resistance of pathogenic bacteria in sputum samples from children with bronchopneumonia in the hospital, so as to provide reference for the rational use of antibacterial drugs in such patients in the clinic. Methods: A total of 1 265 children with bronchopneumonia admitted to the Department of Pediatrics of the People's Liberation Army No. 989 Hospital from August 2016 to August 2021 were chosen as the subjects. Their sputum samples were collected for pathogen culture and antimicrobial susceptibility testing to analyze the etiological characteristics of infection in children. Results: Among the sputum samples of 1 265 children with bronchopneumonia, 1 598 strains of pathogenic bacteria were detected, including 937 strains of Gram-negative bacteria (58.64%, mainly Escherichia coli, Klebsiella pneumoniae and Haemophilus influenzae), 647 strains of Gram-positive bacteria (40.49%, mainly Streptococcus pneumoniae, Staphylococcus aureus and Streptococcus pyogenes) and 14 strains of fungi (0.88%); the detected number of Escherichia coli and Klebsiella pneumoniae in spring, summer, autumn and winter was relatively stable, while the detected number of Staphylococcus aureus and Streptococcus pneumoniae was more in winter and spring, and less in summer and autumn. The antimicrobial susceptibility testing showed that, the resistance rates of Staphylococcus aureus, Streptococcus pneumoniae and Streptococcus pyogenes to vancomycin and linezolid were 0.00%, and their resistance rates to ceftriaxone and cefotaxime were relatively low (less than 10.00%), while their resistance rates to erythromycin, clarithromycin and clindamycin were high (more than 60.00%); the resistance rate of Haemophilus influenzae to all tested antibacterial drugs was low (less than 15.00%). The resistance rates of Escherichia coli and Klebsiella pneumoniae to imipenem, meropenem, cefoperazone-sulbactam sodium, piperacillin-tazobactam sodium, ceftazidime and cefoxitin were low (less than 30.00%). Conclusion: The pathogenic bacteria in children with bronchopneumonia in the hospital mainly include Escherichia coli, Klebsiella pneumoniae, Haemophilus influenzae, Streptococcus pneumoniae, Staphylococcus aureus and Streptococcus pyogenes. The characteristics of their resistance to antibacterial drugs are different. Before formulating clinical treatment regimens, the pathogen culture and antimicrobial susceptibility testing should be carried out as much as possible, to guide clinicians to choose antibacterial drugs rationally and ensure the effect of anti-infection treatment.

Objective: To establish a method for simultaneous and rapid determination of imipenem, meropenem, vancomycin and teicoplanin in human serum based on liquid chromatography-tandem mass spectrometry (LC-MS/MS), and provide reference for the therapeutic drug monitoring in clinically infected patients. Methods: By using Agilent 1260 series liquid chromatograph and API 4000 triple tandem quadrupole mass spectrometer, Phenomenex KINETEX XB-C18 (2.6 μm, 3×50 mm) as the chromatographic column, 0.1% formic acid-water and pure acetonitrile as the mobile phase, electrospray ionization (ESI), multiple reaction monitoring (MRM) combined with positive ion mode as the mass spectrometry conditions, a method for simultaneous and rapid determination of 4 antibacterial drugs (imipenem, meropenem, vancomycin and teicoplanin) in human serum was established. Results: The determination results showed that there were no interference peaks at the retention time of 4 antibacterial drugs and 2 internal standard substances; 4 antibacterial drugs had good linear relationships within their respective concentration ranges, and their correlation coefficients (r²) were all greater than 0.99, and the S/N of the lowest limit of quantification were all greater than 10; the precision and accuracy test results showed that the inter-day and intra-day relative standard deviations (RSDs) of determination results of 4 antibacterial drugs were all less than 10.00%, and their relative errors (REs) were all within ±10.00%; the recovery rates of determination results of 4 antibacterial drugs were all between 85.00% and 115.00%; the review of stability showed that the REs of determination results of 4 antibacterial drugs were all within ±10.00% at different temperatures and storage times. Conclusion: LC-MS/MS can determine the contents of 4 antibacterial drugs (imipenem, meropenem, vancomycin and teicoplanin) in serum simultaneously and rapidly, and has high precision and accuracy and strong stability; therefore, it can provide better support for clinical therapeutic drug monitoring.

目的: 评价复方聚乙二醇电解质散与二甲硅油联用在电子肠镜检查中对患者肠道清洁度的影响。方法: 选取 2020 年 5 月—9 月间医院内镜中心行肠镜检查的 104 例患者临床资料,按用药的不同将其分为观察组和对照组,每组 52 例;对照组患者给予复方聚乙二醇电解质散冲服,而观察组患者在对照组基础上加用二甲硅油乳化剂混合冲服,比较和评价两组患者肠道检查中肠道清洁程度、疾病检出率、不良反应发生情况以及对肠镜检查的满意度。结果: 用药后,观察组患者肠道清洁程度、疾病检出率均优于对照组（P<0.05）,其对肠镜检查的满意度高于对照组（P<0.05）;两组患者用药后均未出现不良反应。结论: 复方聚乙二醇电解质散与二甲硅油乳化剂联用混合口服后,明显改善了内镜下黏膜的视野清晰度,提高了肠道疾病的检出率,患者对检查的满意度也随之提高。

Standardized anti-tuberculosis treatment is the key to the successful cure of tuberculosis. However, anti-tuberculosis treatment usually requires many drugs and has a long course of treatment; so adverse drug reactions are more common. The main clinical manifestations include liver damage, gastrointestinal reactions, ototoxicity and renal toxicity, allergic reactions, hematological damage, nervous system damage, etc. In this article, the clinical manifestations of adverse drug reactions caused by anti-tuberculosis drugs and management measures are reviewed and analyzed, so that clinicians can better understand and master the characteristics of adverse drug reactions of anti-tuberculosis drugs, thereby reducing or avoiding the occurrence of such adverse drug reactions.

Honokiol, as one of main active ingredients of the traditional Chinese medicine Magnoliae Officinalis Cortex, has a wide range of pharmacological effects. In addition to antibacterial, anti-inflammatory, and anti-oxidative effects, it also has good pharmacological activity against glioma, nasopharyngeal carcinoma, tongue cancer, laryngeal cancer, etc. In this article, the pharmacological effects and mechanism of honokiol on glioma, nasopharyngeal carcinoma, tongue cancer, laryngeal cancer and other head-neck tumors are reviewed, and the related researches are analyzed.

目的: 分析医院儿科门诊患者中成药处方的临床使用现状与其潜在用药风险,为儿科中成药的使用、用药风险的规避提供参考。方法: 抽取 2020 年 7 月—12 月上海市松江区中心医院儿科门急诊患者中成药处方 2 040 张,按《中国药典（2015 年版）》《医院处方点评管理规范》《医疗机构处方审核规范》《中成药临床应用指导原则》等相关要求,对中成药处方用药不合理的潜在用药风险进行点评与分析。结果: 2 040 张中成药处方中,存在不合理用药现象处方 960 张（占 47.06%）;不合理用药主要表现为用法用量不适宜（占 41.67%）、重复用药（占 37.50%）、联合用药不适宜（占 34.38%）等,其中用法用量不适宜主要表现为剂量过大或过少,重复用药主要是清热解毒中成药之间的联用,联合用药不适宜主要表现在中成药之间的联合用药和中成药与西药的联合用药。结论: 通过对医院儿科门诊中成药使用情况的点评与分析,临床医师对具有潜在用药风险的中成药的使用合理性明显提高,确保了儿童用药的安全性。

Magnolol and honokiol are important active ingredients of the traditional Chinese medicine Magnoliae Officinalis Cortex. In addition to the antibacterial, antiviral, antitumor, hypoglycemic, hypolipidemic and other pharmacological effects, they can resist the liver injury and liver fibrosis caused by allergy, ischemia-reperfusion, transforming growth factor-β, high glucose, high fat, carbon tetrachloride (CCl₄), acetaminophen, thioacetamide, phosphatidylethanolamine, D-galactosamine/lipopolysaccharide, H₂O₂ and tert-butyl hydroperoxide, and resist the kidney injury and renal fibrosis caused by ischemia-reperfusion, ureteral ligation, angiotensin II, high glucose, lipopolysaccharide and H₂O₂. The protective effects of magnolol and honokiol on the liver and kidney may be achieved through their anti-inflammatory and antioxidant effects. In this article, the protective effects of magnolol and honokiol on the liver and kidney are reviewed, and the related research is analyzed.

目的: 分析心血管内科患者药物治疗的药学监护重点,提升临床药师的药学服务水平以促进临床的合理用药。方法: 从药物相互作用、药物不良反应,以及抗菌药物和中药注射剂的规范使用等方面出发,结合患者实际病情,针对性、个体化地对患者开展药学监护,协助临床共同分析患者用药方案的利弊,并提出合理化建议。结果与结论: 通过药学监护的开展,临床药师协助临床医生或优化了药物治疗方案,或纠正了不合理的用药情况,不仅提升了临床医生的安全、合理用药意识,也促进了患者的康复,真正体现了临床药师的能力和价值。

随着医改政策的调整和医药科技的迅猛发展,大型综合性医院的药学部门的科学研究的重要性日益凸显,这对新时代下药学人员提出了更高的要求,但目前兼备科研能力的药学人员仍没有准确的定位。笔者针对这类人群提出了科研型临床药师（scientific clinical pharmacist,SCP）的概念并阐述了其作用和发展需求,以期鼓励各大医院打造更专业的科研药学服务团队,为患者的健康保驾护航。

Tumors pose serious threats to human life and health. Global medical experts are actively exploring novel anti-tumor drugs and have made remarkable achievements. Among them, novel monoclonal antibody anti-tumor drugs (hereinafter referred to as "McAb anti-tumor drugs") are the most representative drugs, and have the advantages of high specificity and definite therapeutic effect, showing obvious advantages and a broad prospect in the anti-tumor field. By reviewing relevant literature on new McAb anti-tumor drugs approved for marketing by the U.S. Food and Drug Administration (FDA) since 2018, we summarized their targets and mechanisms of actions, and described how clinical pharmacists carry out pharmaceutical care for patients in terms of efficacy, hypersensitivity and adverse drug reaction monitoring, providing reference for safer and more effective medications for tumor patients.

Objective: To analyze the prophylactic use of perioperative antibacterial drugs in patients undergoing Class I incision surgery in a hospital, and provide reference for the standardized and rational use of antibacterial drugs in clinical perioperative patients. Methods: 258 patients undergoing Class I incision surgery admitted to Fengxin County People's Hospital from January 2021 to October 2022 were selected as the research subjects, and the information such as patient's age, sex, clinical diagnosis, department, and selection of antimicrobial drugs, timing of administration and medication course was collected, to analyze the characteristics of perioperative medication of antimicrobial drugs, and give comments on the rational drug use according to the Guiding Principles for Clinical Application of Antibacterial Drugs and other authority data. Results: Among 258 patients undergoing Class I incision surgery, 95 (36.82%) had prophylactic use of antibacterial drugs during the perioperative period, with the highest the proportions in the orthopedics (35 cases, 35.79%) and general surgery (25 cases, 26.32%); among 95 patients, the main antibacterial drugs used were cefazolin (50 cases, 52.63%) and clindamycin (15 cases, 15.79%); the results of comments on the rational drug use showed that 7 (7.37%) of 95 patients used drugs without indications, 16 (16.84%) were administered more than 2 hours or less than 0.5 hour before surgery, and 13 (13.68%) had a medication course of more than 24 hours. Conclusion: The prophylactic use of perioperative antibacterial drugs in patients undergoing Class I incision surgery in the hospital is generally reasonable, but there are still many problems in terms of indications, variety selection, timing of administration, and medication course. The hospital administrative department should strengthen the clinical training and management to reduce the occurrence of irrational drug use and ensure the medication safety for perioperative patients.

Objective: To analyze the usage and rationality of toxic traditional Chinese medicine in out-patient prescriptions of Traditional Chinese medicine (TCM) in order to provide reference for clinical safety and rational usage of toxic traditional Chinese medicine. Methods: A total of 3 374 TCM prescriptions were collected from outpatients in our hospital from July to December 2016, and the use of toxic TCM prescriptions and its rationality were statistically analyzed. Results: In 3 374 TCM prescriptions, 1 089 prescriptions of toxic TCM prepared pieces and 22 kinds of toxic and minor toxic TCM prescriptions were involved. Department of Oncology, followed by Department of Traditional Chinese Medicine and Department of Cardiology. In the prescriptions, the single prescription containing 1 kind of toxic Chinese herbal medicine was the most, followed by the prescription containing 2 kinds of toxic Chinese herbal medicine, and then the prescription containing 3 kinds or more of toxic Chinese herbal medicine was less. Aconiti Lateralis Radix Praepapata is the most widely used traditional Chinese medicine. Conclusions: The use of toxic TCM in hospital is very common, so the administrative department of hospital should formulate "the use and management norms of toxic TCM decoction pieces" to avoid the occurrence of adverse accidents, so as to ensure the safe usage of toxic TCM decoction pieces for patients.

目的: 分析耐甲氧西林金黄色葡萄球菌(methicillin-resistant Staphylococcus aureus,MRSA)感染病例的特征以及抗感染治疗的合理性,探究临床药师参与抗感染治疗中的药学监护及其发挥的作用。方法: 临床药师通过参与 1 例 MRSA 感染患儿治疗过程,协助医师制定治疗方案,评价其抗菌药物使用的合理性;同时根据药敏试验结果结合抗菌药物 PK/PD,监测血药浓度,规避不良反应,并实施药学监护。结果: 采用万古霉素、利奈唑胺抗感染治疗后,治疗效果极为理想,病情得到显著改善。结论: 临床药师参与临床会诊和药学监护是药物治疗中的重要组成部分,得到医生认可,促进了药物治疗的合理性、有效性和安全性。

Oxazolidinones are a class of antibacterial drugs with strong antibacterial activity against gram-positive pathogens, and many of them also have good antibacterial activity against Mycobacterium tuberculosis, and linezolid, for example, has good therapeutic effect on drug-resistant or even multi-drug resistant tuberculosis. However, the myosuppressive effect of linezolid limits its wide application in anti-tuberculosis therapy to some extent, so the research and development of highly effective and low-toxicity oxazolidinones has attracted much attention. In this paper, the clinical application of linezolid in anti-tuberculosis and the clinical development status of other oxazolidinones are reviewed, so as to deepen the understanding of the anti-tuberculosis effect of oxazolidinones.

目的： 分析医院泌尿生殖道感染患者病原菌的检出情况及其耐药特点,以便于指导临床用药。方法： 选取 2019 年 2 月—2022 年 2 月宜黄县第一人民医院收治的 105 例泌尿生殖道感染患者作为研究对象,采集其泌尿生殖道分泌物标本开展病原菌培养和药敏试验,统计病原菌分布与耐药情况。结果： 105 例患者标本中共分离出病原菌 155 株,其中支原体 78 株（占 50.32%,主要为解脲脲原体和人型支原体）、细菌 61 株（占 39.35%,主要为肠杆菌科和肠球菌属细菌）、真菌 16 株（占 10.32%,白假丝酵母占比最高）;主要支原体对环丙沙星、甲砜霉素、氧氟沙星等药物的耐药率较高（>65.00%）,对交沙霉素、米诺环素、多西环素的耐药率较低（<15.00%）;肠杆菌科细菌对氨苄西林、头孢他啶、头孢唑林等药物的耐药率较高（>80.00%）,对美罗培南、亚胺培南的耐药率为 0.00%;肠球菌属对青霉素、红霉素等药物的耐药率较高（≥90.00%）,对万古霉素、替考拉宁的耐药率为 0.00%。结论： 支原体为泌尿生殖道感染的主要病原菌,其次为细菌、真菌,临床需依据药敏结果选取抗菌药物治疗,以加快感染消退,减轻患者痛苦。

Objective: To investigate the diagnosis and treatment process and related reasons of a child with disulfiram-like reaction caused by combined use of Sinupret Drops and Compound Cefaclor for Suspension in the hospital. Methods and Results: The hospital clinician prescribed Sinupret Drops and Compound Cefaclor for Suspension for one child diagnosed with sleep apnea syndrome and sinusitis, and the patient developed disulfiram-like reaction 10 minutes after taking the two drugs simultaneously. After inquiring about the medical history, the physician believed that the excipients of Sinupret Drops contained a relatively high content of ethanol, and suspected that the symptoms might be caused by the patient's failure to take the medicines according to the matters needing attention. Then the child stopped the Compound Cefaclor for Suspension immediately, and 30 minutes later, the child's dyspnea symptoms were relieved. Conclusion: When prescribing clinically for related patients, attention should be paid to possible drug interactions; for example, taking cephalosporins and ethanol-containing drugs simultaneously may cause disulfiram-like reaction. When combined use cannot be avoided, the physicians and pharmacists should explain the precautions for medication in detail to avoid the occurrence of adverse drug reactions.

Berberine is an isoquinoline alkaloid found in Chinese herbs Coptidis Rhizome and Phellodendron amurense. With pharmacological effects such as anti-pathogenic microorganisms, anti-inflammation, anti-tumor, lowering blood glucose, regulating blood lipid and immunosuppression, it has been used in the clinical treatment of cardiovascular diseases, digestive diseases, metabolic diseases, tumors, etc. This article summarizes the pharmacological effects of berberine on viruses such as influenza virus, herpes virus, Coxsackie virus B3, trachoma virus, porcine rotavirus, hepatitis B virus and human immunodeficiency virus, and their related mechanisms, providing reference for the clinical application and promotion of berberine.

Objective: To analyze the pharmaceutical care process of anti-infection therapy in a patient with sepsis after joint replacement, and provide reference for the clinical treatment of similar patients. Methods: One patient was admitted to the hospital due to a fall-induced intertrochanteric fracture, and then underwent artificial femoral head replacement. After the operation, the patient developed fever and wound redness and swelling, and Escherichia coli was detected in blood culture. The multidisciplinary consultation indicated "sepsis". The clinical pharmacists recommended vancomycin combined with meropenem for anti-infection therapy based on the patient's conditions, and the patient was transferred to the ICU immediately; during the treatment, since the patient had kidney disease and required dialysis treatment, the clinical pharmacists recommended adjustment of the dosage of vancomycin and meropenem with the rhythm of dialysis treatment. Results: After 2 weeks of treatment with vancomycin and meropenem, the patient's body temperature returned to normal, the blood culture result turned negative, and other symptoms and indicators returned to normal basically, so the patient was discharged from the hospital. Conclusion: Sepsis is a serious infectious disease and may endanger a patient's life. As the member of multidisciplinary consultation team, clinical pharmacists can assist clinicians in developing a scientific and reasonable anti-infection treatment plan based on their professional expertise in pharmacy, carry out pharmaceutical care to follow up the treatment process and ensure the treatment effect of patients.

目的:分析药物理化性质、血药浓度监测、用药禁忌、外科相关等方面的 4 例典型病例的药学会诊和药学监护过程和要点,为临床药师开展相关药学会诊提供参考。方法:临床药师利用自身专业优势,以药物理化性质、血药浓度监测、用药禁忌和医学相关知识为切入点,开展药学会诊实践,帮助临床制定或优化治疗方案。结果:针对 4 例典型病例,临床药师充分了解患者的病情和治疗细节,结合相关文献资料,找准问题要点,并为临床提出针对性的建议,最终 4 例患者的问题均得到解决。结论:临床药师发挥药学专业特长,并结合患者病情,协助临床医生制定或调整治疗方案,提高了临床的安全、合理用药水平,规避了医疗风险,获得临床医生、护士的认可,更是实现了临床药师的自我价值。

Berberine has a broad-spectrum antibacterial effect and has good inhibitory effects on Escherichia coli, Helicobacter pylori, cocci, etc. By acting on multiple targets, berberine can interfere with the metabolism of polysaccharides, lipids, amino acids, nucleic acids and proteins in bacteria, thereby disrupting the formation of cell membranes and walls. In addition, berberine can enhance the function of immune cells, improve the defense and killing ability of the body against bacteria. Berberine is not only less susceptible to bacterial resistance, but also can inhibit the occurrence of bacterial resistance to other antibacterial drugs. This article mainly reviews and analyzes the pharmacological effects and mechanism of berberine against Salmonella, Shigella, Vibrio, Mycobacterium, and Klebsiella pneumoniae, providing reference for further clinical research of berberine.

目的： 分析头孢他啶-阿维巴坦钠致重症肺炎患者肝细胞损伤型肝损伤的临床特点,为头孢他啶-阿维巴坦钠的临床安全使用提供参考。方法： 临床药师参与了 1 例重症肺炎患者的抗感染治疗,在药学监护中发现患者出现肝损伤情况,根据肝损伤的发生特点,结合患者的既往病史和近期的用药史,探寻可能的发生原因,并协助医生积极处置。结果： 临床药师根据患者的既往病史基本排除肝损伤由疾病引起的可能,由转氨酶和碱性磷酸酶异常水平可判定该肝损伤属肝细胞损伤型,而近期所用药物中有肝细胞损伤型肝损伤情况的仅恩他卡朋和头孢他啶-阿维巴坦钠,考虑患者既往长期服用恩他卡朋未出现过肝损伤情况,故认为肝损伤由头孢他啶-阿维巴坦钠引起的可能性更大,遂建议医生停用头孢他啶-阿维巴坦钠,结果患者的转氨酶水平呈进行性下降,并在第 11 天恢复至正常水平;此外,RUCAM 评分亦显示肝损伤与头孢他啶-阿维巴坦钠的关联度为“极可能”。结论： 头孢他啶-阿维巴坦钠作为新近上市的抗菌药物,与其相关的药物不良反应报道较少,药物性肝损伤案例更是少之又少,对此临床药师应当主动深入临床,对患者尤其是老年患者积极开展药学观察,及时识别药物不良反应,并给出处置建议,以保证患者的用药安全。