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。

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。

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.

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.

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.

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.

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.

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 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.

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.

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.

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.

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。

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.

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。

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.

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.

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。

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.

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.

Objective: To analyze the pharmaceutical care process of hemoptysis treatment in a pulmonary tuberculosis patient complicated with coronary heart disease, so as to provide reference for the treatment of such diseases. Methods: A patient with pulmonary tuberculosis was admitted for treatment due to "intermittent coughing and hemoptysis for more than 6 hours". The patient has received relatively regular anti-tuberculosis treatment, and underwent coronary stent implantation due to coronary heart disease two months ago. After the surgery, drugs such as aspirin, atorvastatin calcium, ticagrelor, and metoprolol succinate were taken regularly. In addition, the patient also had concomitant bronchiectasis. Results: Through reviewing relevant information and combining the patient's actual situation, the clinical pharmacist believed that the patient's hemoptysis may be related to the use of antiplatelet drugs and bronchiectasis, and after consultation with the doctor, aspirin and ticagrelor were discontinued, and clopidogrel was used instead. After treatment, the patient's hemoptysis symptoms improved significantly. Conclusion: Clinical pharmacists provide pharmaceutical services, optimize drug treatment regimens for patients, and improve the effectiveness and safety of medication.

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.

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。

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。

Cephalosporins are a class of β-lactam antibacterial drugs formed by linking different side chains with 7-amino-cephalosporanic acid as the mother nucleus. Through continuous iterative research and development, cephalosporins have been continuously optimized in terms of antibacterial spectrum, antibacterial effect and drug safety, etc. However, cephalosporins may induce anaphylactic response and other adverse drug reactions (ADRs) in clinical use. For a long time, ADRs are predicted by skin test in China, but relevant studies have questioned the predictive and application value of skin tests. For this purpose, the relevant studies have been reviewed in terms of the molecular mechanisms and influencing factors of anaphylactic responses caused by β-lactam drugs, the economic value of skin tests, and the current status of skin tests of cephalosporins carried out at home and abroad, etc., so as to provide reference for clinical assessment of the predictive value and application prospects of skin tests for anaphylactic responses of cephalosporins.

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.

Conventional drugs used to treat liver disease can not effectively target the lesion site, giving rise to adverse reactions. Accordingly, the technology of targeted drug delivery is developing rapidly. Lipid nanoparticles have been developed for passive and active targeted delivery of drugs to the liver, active targeting is more specific in delivering drug to cells. By modifying ligands on the surface of the carrier, the target cell surface receptor can be selectively bound. This paper reviews the specific targeting effects of nanoliposomes on hepatocytes.

目的: 探究医院骨科 Ⅰ 类切口手术患者抗菌药物的预防用药情况,为临床加强抗菌药物预防性使用管理提供依据。方法: 选取 2021 年 1 月—2022 年 12 月抚州市东乡区人民医院骨科 785 例 Ⅰ 类切口手术患者作为研究对象,采集患者的用药品种、给药时机、用药疗程等信息,并对其进行合理用药评价,分析手术患者预防用抗菌药物的用药情况。结果: 785 例骨科 Ⅰ 类切口手术患者中,441 例预防性使用抗菌药物,抗菌药物的预防性使用率为 56.18%,抗菌药物预防性使用率较高的手术类型为髋关节置换术和膝关节置换术（均达 100.00%）;441 例骨科 Ⅰ 类切口手术患者预防性使用抗菌药物品种数为 4 种,主要为头孢菌素类（占 90.48%）、林可霉素类（占 12.24%）等;预防性给药时机主要为术前 30~60 min 435 例（占 98.64%）,联合用药情况主要为单一用药 423 例（占 95.92%）,患者的用药疗程主要为<24 h 为 414 例（占 93.88%）;441 例骨科 Ⅰ 类切口手术预防性使用抗菌药物患者中,不合理使用 62 例（占 14.06%）,同一患者可能有≥2 种不合理用药情况,主要为用药疗程>24 h、无指征联合用药等。结论: 骨科 Ⅰ 类切口手术预防性使用抗菌药物的总体合理率较高,但仍有用药疗程过长、无指征联合用药等情况,临床需强化抗菌药物的管理,以进一步提升抗菌药物预防性使用合理性。

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.

China is a country with a high burden of tuberculosis, that is, with a large number of tuberculosis patients, and a long period of anti-tuberculosis treatment. In the course of anti-tuberculosis treatment, various adverse drug reactions may occur due to complex and diverse combination of drugs, of which drug-induced liver injury (DILI) is the most common and most harmful one, with mild cases showing transient elevated transaminases and severe cases leading to liver failure and even life-threatening effects. Therefore, some patients have to discontinue anti-tuberculosis treatment. This article reviews the influencing factors of anti-tuberculous drug-induced liver injury (ATB-DILI) in patients from aspects such as living habits, underlying diseases, and genetic factors, providing reference for prevention and treatment of ATB-DILI in clinical practice.

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.

Both tuberculosis and diabetes are common clinical diseases and can affect each other. Diabetes can impair the immune functions of patients, which not only increases the risk of Mycobacterium tuberculosis infection, but also leads to failure of the antituberculous treatment, disease recurrence and even death of patients with tuberculosis. Therefore, for patients with comorbidities of tuberculosis and diabetes, a more targeted treatment regimen should be formulated according to the characteristics of different drugs, which has far-reaching significance for the outcome of the patients' disease. This article reviews and analyzes the significance of anti-tuberculosis drugs for patients with comorbidities of tuberculosis and diabetes in terms of the selection and course of treatment, blood glucose control, nutritional therapy, traditional Chinese medicine treatment, immunotherapy, etc.

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。

目的: 分析医院门急诊 8 864 张抗菌药物处方的处方点评结果,以及处方不合理的原因。方法: 抽取 2020 年 1 月—12 月中国人民解放军陆军第七十三集团军医院门急诊 8 864 张抗菌药物处方作为研究资料,进行处方合理用药点评,分析点评结果和不合理处方的原因。结果: 8 864 张门急诊抗菌药物处方中发现不合理处方 765 张（不合理率为 8.63%）,不合理处方的类型主要为用药不适宜处方（638 张,不合理率为7.20%）、不规范处方（91 张,不合理率为 1.03%）和超常处方（36 张,不合理率为 0.41%）;765 张不合理处方中,用药不适宜处方的原因主要为“适应证不适宜”（315 张,占 83.40%）和“用法用量不适宜”（252 张,占 32.94%）,不规范处方表现为“无特殊情况超‘急三慢七’”（91 张,占 11.90%）,而超常处方则主要体现为“无适应证用药”（34 张,占 4.44%）。结论: 医院门急诊抗菌药物的使用存在一定的问题,不合理用药情况较为严重,医院应加强抗菌药物使用的管理和处方审核力度,以减少抗菌药物不合理使用情况的发生。

Objective: To establish a method based on ultra performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS) to determine the concentration of voriconazole in human blood, and apply this method to tuberculosis patients complicated with fungal infection, so as to provide reference for the antifungal treatment of such patients. Methods: The chromatographic column was ACQUITY UPLC^® HSS T3 C18 column (2.1 mm × 50 mm, 1.8 μm). The mobile phase was acetonitrile (A)-water (containing 0.1% of formic acid) (B), the gradient elution curve was 6, the flow rate was 0.3 mL/min, gradient elution, with internal standard of gatifloxacin, electric spray ion source, multi-reaction ion monitoring mode, positive ion mode detection, voriconazole and gatifloxacin ion pair m/z as 350.138/127.08 and 376.2/332.1 respectively. This method was adopted to monitor the plasma concentration of voriconazole in tuberculosis patients of the hospital. Results: Voriconazole within the concentration range of 0.10-21.7 μg/mL was in good linear relationship with the relative peak area (r=0.993 1), and the relative standard deviation (RSD) of stability, extraction recovery rate, and matrix effect was less than 6%. Conclusion: The method based on UPLC-MS/MS can determine the concentration of voriconazole in human blood in an easy, quick and accurate manner, providing a strong basis for the safety and effectiveness of medication in patients with fungal infection.