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： 分析艾滋病合并梅毒、带状疱疹患者的临床特征与治疗情况,为临床相似病例的诊疗提供参考。方法： 临床接诊该患者后根据其既往病史情况、当前临床表现和相关检查结果,明确了其艾滋病合并梅毒、带状疱疹等诊断,其中梅毒仍处在早期,遂制定了规范的抗病毒和抗梅毒治疗方案,并追踪观察和分析患者的治疗情况。结果： 经过 2 周的规范治疗,患者皮肤部位病灶显著好转,水疱基本干涸结痂,下腹部溃疡基本愈合。结论： 艾滋病患者 T 淋巴细胞亚群免疫功能低下,易发生病毒、细菌等感染,且抗梅毒治疗效果欠佳,临床在规范治疗的同时应及早注意神经梅毒等危险情况的排查,以促进患者的康复。

目的： 分析医院化痰止咳平喘类中药饮片的临床使用特点,为科学制定采购计划提供参考。方法： 利用医院信息系统抽取 2017 年—2019 年化痰止咳平喘类中药饮片的品种、用量、销售额等数据,分析其临床使用情况。结果： 2017 年—2019 年化痰止咳平喘类中药饮片的使用量和金额均呈逐年升高之势,且增幅较大,但其使用量和金额在所有中药饮片中的占比相对较为稳定;2017 年—2019 年化痰止咳平喘类中药饮片中,清化热痰药、温化寒痰药、止咳平喘药 3 个亚类的年使用量构成比例基本稳定,而 3 个亚类下 TOP 3 品种的年使用量呈逐年升高趋势,但各品种间的构成比例保持了基本稳定;2017 年—2019 年化痰止咳平喘类中药饮片中销售金额 TOP 9 的品种分别为姜半夏、浙贝母、桔梗、竹茹、燀苦杏仁、瓜蒌、桑白皮、百部、炒芥子,这 9 个品种的销售金额与年使用量基本呈同步增加的趋势,仅浙贝母、桑白皮和炒芥子有些许不同。结论： 应根据临床需求,关注气候对疾病证型的影响,了解中药种植、采收加工、储存、供需信息对中药市场行情的影响,合理预测,科学制定化痰止咳平喘类中药饮片的采购计划,确保其临床使用。

Objective: To analyze the related factors and occurrence characteristics of adverse drug reactions(ADR) caused by Guhong injection, and to provide references for rational clinical medication of drugs. Methods: The internet was used to search PubMed, Wanfang Database, CNKI database, CQVIP database, DAYI100 Network and the National Adverse Drug Reactions Monitoring System reported by hospitals from January 2005 to February 2020 with the keywords of "Guhong Injection", "adverse reactions", "case analysis" and "influencing factors". Relevant Guhong injection reported ADRs induced by injection were collected, the basic condition of the patients with statistics, the time of the ADRs, involving system/organs and clinical characteristics, different severity of ADRs prepared by the WHO classification score method, and the grade of adverse drug reaction and its outcome were analyzed to explore the influencing factors of ADRs. Results： 32 literatures meeting the inclusion criteria were selected, involving 64 patients (including 38 males and 26 females). The incidence of ADRs in patients over 55 years old accounted for 76.57%, most of which occurred within 1 day of medication (53 patients, 82.81%). ADRs mainly involved skin and accessory injuries, respiratory system injuries and systemic allergic reactions.The recovery time was usually within 1 and 3 days after drug withdrawal or symptomatic treatment. Conclusion: The adverse reactions caused by Guhong injection involved multiple organs and might even lead to anaphylactic shock. Therefore, it is necessary to pay a close attention and closely monitor the clinical use of this drug so as to contain or reduce the occurrence of ADRs.

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.

目的: 分析医院慢性化脓性中耳炎患者耳道分泌物中病原菌的分布及其耐药情况。方法: 选取医院 2018 年 3 月—2020 年 5 月诊治的慢性化脓性中耳炎患者 159 例病历资料,统计其耳道分泌物中病原菌培养分布与药敏试验结果,分析其病原菌的分布及其对常用药物的耐药情况。结果: 159 例患者耳道分泌物标本中,检出病原菌 182 株,其中革兰阳性菌、革兰阴性菌和真菌分别占 44.50%、41.21%、14.28%;所有病原菌中占比最高的菌株分别为金黄色葡萄球菌、铜绿假单胞菌、光滑假丝酵母;药敏发现,金黄色葡萄球菌对青霉素 G 的耐药率大于 80%,铜绿假单胞菌对头孢唑林、头孢哌酮、头孢呋辛的耐药率也均大于 79%。结论: 慢性化脓性中耳炎患者的主要病原菌为金黄色葡萄球菌、表皮葡萄球菌、铜绿假单胞菌和变形杆菌,临床应当根据细菌培养及其药敏情况合理选择抗菌药物。

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.

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。

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.

目的: 探究尿真菌培养与 1,3-β-D-葡聚糖检测（G 试验）的检测结果对泌尿系侵袭性真菌感染（invasive fungal infection, IFI）患者诊断效能的影响及其治疗对策。方法: 选取医院 2019 年 3 月—2020 年 5 月收治的泌尿系 IFI 患者 48 例作为观察组,另采用随机配对法选取同期 48 例非泌尿系 IFI 患者作为对照组;统计 2 组患者 G 试验、尿真菌培养鉴定结果,比较单一 G 试验、尿真菌培养结果与联合诊断检测结果对泌尿系 IFI 敏感度、特异度和准确度的差异。结果: 2 组检测方法结果中病原菌均以白假丝酵母为主,其次为热带假丝酵母、光滑假丝酵母;但 2 组的真菌鉴定结果经比较其差异无统计学意义（P>0.05）;观察组中 G 试验检出阳性率为 72.91%,尿真菌培养检出阳性率 为 75.00%,二者联合检出阳性率为 97.92%;而对照组中 G 试验检出阳性率为 20.83%,尿真菌培养检出阳性率22.92%,二者联合检出阳性率 22.92%;G 试验与尿真菌培养联合诊断泌尿系 IFI 的敏感度（97.92%）、准确度（87.50%）均高于二者的单一诊断（P<0.05）。结论: 泌尿系 IFI 患者真菌感染以白假丝酵母为主,采用 G 试验和尿真菌培养诊断对泌尿系 IFI 的诊断均具有一定价值,若采用联合检测可有效提高诊断效能。

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。

Matrine and oxymatrine have a widespread bioactivities, including protection of organs(heart, liver, lung, kidney, brain and blood vessel), positive inotropic action, negative chronotropic action, antiarrhythmia, the effect of increasing leukocyte, antiasthma, antiulcer, anti-fibrogenesis, the central nervous pharmacological action(sedation, hypnogenesis and analgesia), antitumor, immunoregulation, anti-bacteria, anti-virus, anti-parasite and anti-inflammation. In gynecologic domain, matrine and oxymatrine have the effects of anit-gynecologic tumors, and could protect epithelial cells of mamma, endometrium and vagina, and antagonize inflammatory pathologic change of epithelial cells induced by various pathogenic factors. Clinically, they have been used in the treatment of various cervicitis and vaginitis, and have also been tried in the treatment of breast, ovarian, cervical and endometrial cancer. In this paper, the pharmacological effects of matrine and oxymatrine in clinical treatment of mycotic and trichomonas vaginitis have been reviewed, and their research progress have been analyzed.

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。

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。

Objective: To analyze the clinical use of sacubitril valsartan sodium in patients with chronic heart failure (CHF) in the hospital, and provide reference for the safe and rational use of sacubitril valsartan sodium in clinical practice. Methods: By using the hospital information system, 190 CHF patients treated with sacubitril valsartan sodium in Cardiovascular Medicine Department of Changshu No. 2 People's Hospital from January to December 2020 were selected as the research subjects. The information such as left ventricular ejection fraction (LVEF), past medication history, and information on usage and dosage, treatment course, efficacy, and adverse drug reactions of sacubitril valsartan sodium was collected to analyze the clinical use of Sacubitril Valsartan Sodium in patients. Results: 190 CHF patients all met the indications for use of Sacubitril Valsartan Sodium. Among them, 183 patients had LVEF less than or equal to 40% before treatment, while the remaining 7 patients had LVEF more than 40% before treatment but had CHF symptoms that needed to be controlled; the initial regimen of sacubitril valsartan sodium was mainly "25mg, q12h" (88 cases, 46.32%) and "50mg, q12h" (97 cases, 51.05%), with only 5 cases of "100mg, q12h", while the maintenance treatment regimen was mainly "50mg, q12h" (83 cases, 43.68%) and "25mg, q12h" (62 cases, 32.63%), with a total of 123 patients (64.74%) not adjusting the treatment regimen; among 190 patients, 101 (53.16%) had previously been taking angiotensin converting enzyme inhibitors or vascular receptor blockers, but 8 patients who used angiotensin converting enzyme inhibitors had a drug conversion interval of less than 36 hours when changing the treatment regimen; in terms of medication course, 68 cases (35.79%) had a treatment course greater than 1 year, and 17 cases (8.95%) had a treatment course greater than 6 months to 1 year; during the treatment process, 22 patients (11.58%) achieved the target dose treatment target, with 2 patients receiving a maintenance regimen of "200mg, q12h" and the remaining 20 patients receiving the highest tolerated dose maintenance; among 85 patients with a treatment course more than 6 months, there were 49 cases that sacubitril valsartan sodium was significantly effective, 26 cases that the medicine was effective, and 10 cases that the medicine was basically ineffective; 28 (14.74%) out of 190 patients experienced adverse drug reactions during the medication process, including 22 cases of hypotension, 4 cases of renal function damage, and 2 cases of hyperkalemia. However, all patients improved after treatment. Conclusion: The hospital generally has reasonable clinical management of indications and medication conversion for sacubitril valsartan sodiume, but there is still a lack of compliance with target doses, which is an important indicator affecting the medication efficacy of patients. In clinical practice, management in the whole treatment course of patients should be strengthened to ensure the medication safety and effectiveness of patients.

Objective: To analyze the drug taste and channel distribution of prescription for the prevention and treatment of COVID-19 in Suzhou Wumen Medical School by retrospective method, and to provide reference for more effective drug prescription. Methods: 108 TCM prescriptions of adult patients diagnosed with COVID-19 from February 1 to February 23, 2020 were screened out from the department of pharmacy of Suzhou TCM hospital affiliated to Nanjing University of Chinese Medicine, and a database was established to analyze the drug property distribution of TCM prescriptions. Results: The efficacy distribution of 108 TCM prescriptions for the treatment of COVID-19 was mainly for clearing heat and detoxifying, the four qi were mainly cold, warm and flat, and the five tastes were mainly sweet, bitter and hot. The main channels are lung meridian, stomach meridian and spleen meridian. Conclusions: Based on the analysis of 108 prescriptions for the prevention and treatment of COVID-19 in Suzhou Wumen Medical School, it is speculated that the distribution of four qi is related to the geographical and climatic characteristics of Jiangnan, which are prone to damp and heat. The distribution of five flavors was consistent with the pathogenesis of "dampness, heat and poison". The distribution of recurrent channels reflects the pathogenesis of lung - spleen and stomach.

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.

Mycobacterium tuberculosis can resist immune damage of the host through an immune escape pathway and cause a low immune function of the host, suggesting that tuberculosis patients have impaired immune functions to varying degrees. The immunotherapy can improve the patients' immune functions with good safety; when it is combined with anti-tuberculosis chemotherapy drugs, positive clinical benefits can be achieved. Among them, thymosin α1, as a classic immunomodulator, has been used in tuberculosis patients in China. This article reviews the research progress of thymosin α1 in tuberculosis immunotherapy.

Presently, the global situation of tuberculosis prevention and treatment is not optimistic, with high morbidity and mortality. China is still one of the countries with a high burden of tuberculosis in the world. In recent years, as a representative of oxazolidinone drugs, linezolid has been widely used in the treatment of drug-resistant and severe tuberculosis, and its clinical status has been continuously improved due to its outstanding antibacterial effect. However, because of problems such as myelosuppression, neurotoxicity, lactic acidosis, potential drug-drug interactions, and narrow therapeutic windows, etc., the shortcomings of linezolid in long-term anti-tuberculosis treatment have become increasingly prominent. Contezolid, a new generation of oxazolidinone drug, has the antibacterial activity equivalent to or even stronger than linezolid, and has lower risks of myelosuppressive toxicity, neurotoxicity, and lactic acidosis, a unique metabolic pathway, and good pharmacokinetic profiles, so it has gradually attracted attention of clinical professionals. This article reviews the current situation of tuberculosis prevention and treatment, the status and challenges of linezolid in tuberculosis treatment, as well as the pharmaceutical characteristics of contezolid and experimental research and clinical exploration in anti-tuberculosis, so as to provide reference for the subsequent further studies of contezolid in drug-resistant tuberculosis and severe tuberculosis.

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.

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。

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.

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.).

WHO recommended treatment regimens in 6 to 12 months for drug-susceptible tuberculosis (DS-TB) in children in 2010 and 2014 respectively. In recent years, with the widespread implementation of the treatment regimens, it has been found in clinical practice that poor compliance caused by a long treatment course of the treatment regimen is an important factor affecting children to complete the entire treatment process. With the completion of a phase III clinical trial on the short-course treatment regimen and the research on chemotherapeutic regimens for children and adolescents with susceptible tuberculosis in different countries, the evidence-based basis has gradually increased. In 2022, WHO issued a new version of the Guidelines on Management of Tuberculosis in Children and Adolescents, integrating the latest recommendations with 2014 Guidelines and replacing 2014 Guidelines. The Guidelines expound the treatment regimens for drug-susceptible tuberculosis and extrapulmonary tuberculosis, and severe and non-severe tuberculosis in children in details, and recommend for the first time the 6-month tuberculous meningitis intensification plan and the 4-month non-severe tuberculosis treatment regimen with a shorter course of treatment. By combining the new WHO Guidelines, this article gives in-depth interpretation of treatment on DS-TB in children, which facilitates pediatric clinicians to effectively manage tuberculosis in children.

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.

Anti-tuberculosis drugs are essential for prevention and treatment of tuberculosis, but medication is complex in anti-tuberculosis treatment, resulting in adverse drug reactions from time to time. However, adverse drug reactions are not only disturb the anti-tuberculosis treatment for patients, but may even endanger their lives in severe cases. This article reports the clinical treatment process of two patients with severe thrombocytopenia caused by anti-tuberculosis drugs, and reviews relevant literature at home and abroad, making a detailed analysis of clinical characteristics, treatment methods, and prognosis of the patients, so as to provide reference for the prevention and treatment in similar situations.

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。

Objective: Meta-analysis was performed to systematically evaluate the efficacy and safety of miglilol in the treatment of type 2 diabetes mellitus patients with acarbose, so as to provide evidence-based references for clinical treatment. Methods: The Cochrane Library, EMBASE, PubMed, Chinese journal full-text database, wanfang database and Wipp database were retrieved by computer. Keywords are miglitol, acarbose and type 2 diabetes mellitus, etc. Miglilol, acarbose and type 2 diabetes were used as key words. A randomized controlled study (RCT) literature on the use of miglilol in the treatment of patients with type 2 diabetes mellitus (acarbose) was searched, the literature was screened, the data were extracted, and the risk of bias in the included study was evaluated. Meta-analysis was performed using RevMan 5.3 software. Results: 12 RCT literatures were included, with a total of 973 patients. The results of Meta-analysis showed that (1) the improvement value of glycosylated hemoglobin (MD=–0.59, 95% Cl(–0.94,–0.24), P<0.01) in the miglilol group was significantly higher than that in the acarbose group; (2) the incidence of adverse reactions in the miglilol group (RR=0.40, 95% Cl (0.27, 0 60), P<0.01) was significantly lower than that in the acarbose group; (3) there was no significant difference in fasting blood glucose, postprandial blood glucose and body mass index between the miglilol group and the acarbose group (P>0.05). Conclusion: The efficacy and safety of miglilol in the treatment of type 2 diabetes mellitus patients are better than those of acarbose. However, limited by the number and quality of samples included in the study, more high-quality studies are needed for verification.

目的: 分析 200 例儿童急性下呼吸道肺炎克雷伯菌感染相关因素与病原菌感染特点及其耐药性。方法: 回顾性选取 2018 年 6 月—2020 年 6 月横峰县中医院收治儿童急性下呼吸道感染 200 例资料,依据临床检验操作的相关标准与流程检测所有样本的病原菌分布与产、非产超广谱β-内酰胺酶（extended-spectrum β-lactamase,ESBLs）菌,采用微生物自动分析仪器及其配套药敏卡进行药敏试验,分析患儿的肺炎克雷伯菌感染情况、相关因素和病原菌耐药率,以及产、非产 ESBLs 肺炎克雷伯菌的耐药率情况。结果: 200 例急性下呼吸道感染患儿标本中,检出肺炎克雷伯菌感染 49 例,检出率为 24.50%,其中产 ESBLs 菌感染 26 例,非产 ESBLs 菌感染 23 例;经单因素分析结果显示,病程≥1 周、发热、胸片肺纹理增粗、应用抗菌药物、并发症是患儿的肺炎克雷伯菌感染相关因素（P<0.05）;患儿感染肺炎克雷伯菌对氨苄西林的耐药率最高（100.00%）,其次为呋喃妥因（81.63%）,再次为头孢唑林、复方磺胺甲噁唑、氨苄西林-舒巴坦钠,分别为 63.27%、61.22%、59.18%,最低为哌拉西林-他唑巴坦钠、阿米卡星、厄他培南、亚胺培南,均为 2.04%;产 ESBLs 肺炎克雷伯菌对复方磺胺甲噁唑、头孢唑林、氨苄西林-舒巴坦钠、头孢曲松、庆大霉素、氨曲南、妥布霉素、头孢他啶、头孢吡肟、环丙沙星、左氧氟沙星的耐药率均显著高于非产 ESBLs 肺炎克雷伯菌（P<0.05）,但二者对氨苄西林、呋喃妥因、头孢替坦、哌拉西林-他唑巴坦钠、阿米卡星、厄他培南、亚胺培南的耐药率经比较其差异无统计学意义（P>0.05）。结论: 儿童急性下呼吸道感染的肺炎克雷伯菌感染率高,其对氨苄西林的耐药率最高,对哌拉西林-他唑巴坦钠、阿米卡星、厄他培南、亚胺培南的耐药率最低;临床应据此合理选用抗菌药物治疗。

Objective: To analyze the application of PIVAS Companion software (PIVAS MATE) in (pharmacy intravenous admixture service (PIVAS) and the reasons for lossing drug to optimize PIVAS MATE software design and reduce drug loss rate in central pharmacy. Methods: The loss amount and the lossing types of drugs reported in 2017, 2018 and 2019 were counted and sorted out. PIVAS MATE software was used to analyze the reasons and treatment methods of drug reported loss, so as to standardize and optimize the work flow and work system. Results: Compared with the manual loss reporting mode, the loss rate of drugs in the central pharmacy annual report in 2017 decreased from 0.097% to 0.044% in 2019 by using PIVAS MATE digitized electronic loss reporting software, with a decrease rate of 54.64%. Conclusion: By changing the traditional manual loss reporting mode and using PIVAS MATE software, the drug loss reporting rate can be greatly reduced and the resource cost loss caused by improper drug management can be reduced.

目的: 分析注射用头孢曲松钠致慢性盆腔炎(chronic pelvic inflammation,CPI)患者血尿的不良反应发生的相关因素,并提出的防治对策。方法: 采用回顾性分析法,抽取医院 2017 年 5 月—2020 年 4 月间收治诊疗的 CPI 患者 31 例临床资料,分析其出现血尿不良反应（由注射用头孢曲松钠所致）的相关因素（年龄分布、用药天数、转归情况和生产厂家）与防治措施。结果: 31 例 CPI 患者中,发生 ADRs 最大年龄为 61 岁,最小年龄为 23 岁;30~40 岁年龄段患者占比 45.16%;其中 5 例出现镜下血尿（占 16.13%）、26 例肉眼血尿（占 83.87%）;最早出现血尿时间为用药后 15 min,最晚出现血尿时间为用药后 10 d,而血尿发生率则随着时间推移而逐渐下降;治疗后仅 1 例未好转（占 3.23%）,12 例好转（占38.71%）,18 例治愈（占 58.06%）;血尿发生率 TOP 4 的生产厂为台湾某制药厂、哈药某集团制药厂、上海某先锋药业以及山东某医药股份公司。结论: CPI 患者治疗期间,应加强对注射用头孢曲松钠的用药监测,充分认识该药物的实际危害,以避免患者血尿的发生。

目的： 分析生殖道感染孕妇生殖道分泌物标本中病原菌的分布与耐药情况,为临床合理选用抗菌药物提供参考。方法： 选取 2019 年 8 月—2021 年 8 月兴国县人民医院收治的 79 例孕晚期生殖道感染孕妇作为研究对象,所有孕妇均采用无菌拭子采集生殖道分泌物,进行病原菌培养和药敏试验,统计孕妇生殖道感染的病原菌分布,并分析主要革兰阳性菌、主要革兰阴性菌的耐药情况。结果： 79 例孕妇共检出 86 株病原菌,其中革兰阳性菌占比最高（占 48.84%）,革兰阴性菌次之（占 45.35%）,真菌最低（占 5.81%）;革兰阳性菌排名前 2 位的为金黄色葡萄球菌（占 22.09%）、表皮葡萄球菌（占 12.79%）,革兰阴性菌排名前 2 位的为大肠埃希菌（占 20.93%）、肺炎克雷伯菌（占 11.63%）;金黄色葡萄球菌和粪肠球菌对万古霉素、左氧氟沙星、环丙沙星的耐药率较低（<30.00%）,表皮葡萄球菌对万古霉素、环丙沙星的耐药率较低（<30.00%）;大肠埃希菌、肺炎克雷伯菌和产期肠杆菌对亚胺培南、美罗培南、阿米卡星、环丙沙星的耐药率较低（<30.00%）。结论： 生殖道感染孕妇的病原菌以革兰阳性菌为主,革兰阴性菌次之,并伴少量真菌感染,且病原菌对常用抗菌药物耐药情况较为严重,临床需高度重视,充分结合药敏试验结果选用敏感药物治疗,以促进感染消退。

目的: 分析妇幼保健院孕妇剖宫产围手术期抗菌药物的使用情况。方法: 选取 2019 年 1 月— 12 月洛阳市妇幼保健院收治的 259 例行剖宫产手术患者的临床资料,统计和分析患者围手术期抗菌药物使用情况与合理性。结果: 259 例剖宫产患者中围手术期使用抗菌药物 299 例次,其中 208 例次使用头孢唑林（占 80.31%）,62 例次使用甲硝唑（占 23.94%）,15 例次使用头孢哌酮-舒巴坦钠（占 5.79%）,14 例次使用头孢呋辛（占 5.41%）;联合用药的有 169 例,其中头孢唑林与甲硝唑联用的有 62 例,头孢唑林与左氧氟沙星联用的有 23 例,甲硝唑与头孢孟多酯钠联用的有 17 例,氨苄西林钠与甲硝唑联用的有13 例,甲硝唑与头孢西丁钠联用的有 5 例;用药时机上,术前 0.5~2 h 给药的有 202 例,夹脐后给药的有41 例,术后给药的有 16 例。结论: 剖宫产患者围手术期使用的抗菌药物种类较多,其药品选用基本符合相关要求,但仍存在不合理用药现象,医院行政部门应加强剖宫产围术期抗菌药物的使用管理,以遏制术后感染的发生。

目的: 探究粪便钙卫蛋白（fecal calprotectin,FEC）对儿童炎症性肠病（inflammatory bowel disease,IBD）的诊断价值。方法: 选取 2020 年 7 月—2021 年 12 月在苏州大学附属儿童医院初诊为 IBD 的 91 例患儿设为 IBD 组,其中克罗恩病（Crohn's disease,CD）患儿 78 例,溃疡性结肠炎（ulcerative colitis,UC）患儿 13 例,另选取 80 例健康体检儿童设为对照组;检测所有研究对象的 FEC、白细胞（white blood cell,WBC）计数、C 反应蛋白（C reactive protein,CRP）、红细胞沉降率（erythrocyte sedimentation rate,ESR）值,采用受试者工作特征（receiver operating characteristic,ROC）曲线评价 FEC 及其他炎症指标对儿童 IBD 的诊断效能。结果: IBD 组患儿的 FEC 检测值明显高于对照组儿童（P<0.05）,IBD组内 UC 患儿的 FEC 检测值明显高于 CD 组（P<0.05）;ROC 曲线分析结果显示,FEC 诊断 IBD 的曲线下面积（area under the curve,AUC）为 0.834,敏感性为 68.57%,特异性为 97.03%,诊断效率为 85.71%,明显高于其他炎症指标。结论: FEC 对 IBD 诊断的敏感性、特异性均高于 WBC 计数、CRP 和 ESR 等炎症指标,可作为 IBD 的特异性筛查及辅助诊断指标。

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.