KANGGANRAN YAOXUE

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  • 2019 Volume 16 Issue 3
    Published: 25 March 2019
      
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  • Research Progress of Clinical Anti-infection Treatment Strategy in Patients with Biliary Tract Infection*1
    ZHENG Wen-can, HUANG Xing-fu, FA Yan-mei, PENG Hong-yan, GUO Jian-wei, ZHANG Lian-qing, QIAN Yao-xin
    2019, 16(3): 369-371. https://doi.org/10.13493/j.issn.1672-7878.2019.03-001
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    Objective: To explore the clinical anti-infection treatment strategy for biliary tract infection, combining common pathogenic bacteria and their characteristics of resistance to antimicrobial agents, pharmacodynamics and pharmacokinetics of antimicrobial agents, and the severity of infection of patients. The recent domestic and foreign "guidelines" for its diagnosis and treatment and related literatures were reviewed, and the research progress of clinical anti-infection treatment for biliary tract infection was analyzed.
  • Evaluation on Clinical Efficacy of Matrine in Patients with Hepatic Fibrosis
    ZHANG Ming-fa, SHEN Ya-qin
    2019, 16(3): 371-375. https://doi.org/10.13493/j.issn.1672-7878.2019.03-002
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    Matrine has clinical efficacy for the treatment of viral and non-viral liver injuries. Clinical efficacy of matrine on viral hepatitis was superior to Kuhuang injection and Yinzhihuang injection; and was also superior or slightly superior to diammonium glycyrrhizinate; it corresponds to interferon, lamivudine, and adefovir dipivoxil. Clinical efficacy of matrine on hepatic fibrosis excels Yinzhihuang injection, diammonium glycyrrhizinate, lamivudine. Matrine improves anti-fibrotic effect of interferon or reduced glutathione. Recovery rate of TBil of matrine on liver injuries patients is higher than Kuhuang injection, Yinzhihuang injection and diammonium glycyrrhizinate, and matrine promotes recovery rate of TBil of glycyrrhizic adcid-type compounds, adefovir dipivoxil and reduced glutathione.
  • Study on Preparation of Hematoporphyrin Monomethyl Ether-loaded Liposomes and Its Phototriggering Release Performance in Vitro
    JIANG Dan, WU Lin, MIAO Xu
    2019, 16(3): 376-379. https://doi.org/10.13493/j.issn.1672-7878.2019.03-003
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    Objective:To study the preparation and the effects on cytotoxicity of hematoporphyrin monomethyl ether(HMME) liposomes （Lipo-HMME） and its phototriggered release in vitro, and to evaluate the photodynamic antitumor effect in vitro. Methods: The Lipo-HMME loaded photosensitizer is prepared by reverse evaporation method.In addition, lipo-HMME is characterized by laser particle size analyzer and other means to investigate its in vitro light-triggered release performance and the effect of liposomes on dark toxicity and cell uptake of HMME. Results: The prepared liposomes have uniform particle size distribution and obvious light-triggered release performance. The 1h release rates ware 67.36% and 21.3%, respectively, under light and non-light conditions. Lipo-HMME can effectively reduce the dark toxicity of HMME and improve its photodynamic therapy effect. Conclusion: Lipo-HMME has good light-triggered release function and photodynamic therapeutic effect, which can be used as a carrier for specific treatment of tumor patients.
  • Study on Stability of Reduning Injection Combined with Cefdizine Sodium*1
    SHI Xiang-kui, JI Dong-chen, MA Xin
    2019, 16(3): 379-382. https://doi.org/10.13493/j.issn.1672-7878.2019.03-004
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    Objective: To investigate and study the stability of Reduning injection combined with 5% Glucose injection (GS) and cefdizine sodium. Methods: The pH value, insoluble particles and spectral absorption of the compatible solution were determined by the relevant methods in Chinese pharmacopoeia(Edition 2015). Results: When Reduning injection was diluted with 5% GS or combined with cefdizine sodium, the number of insoluble particles increased with time. The spectral absorption curves of the compatibility solution of Reduning injection and cefdizine sodium were changed, and the active component (chlorogenic acid) was decomposed. Conclusion: Reduning injection should be diluted with 5% GS and injected intravenously. If it is combined with cefdiazine sodium, 5% GS should be injected intravenously.
  • Meta-analysis on Efficacy and Safety of Methylprednisolone Combined with Azithromycin in Children with Refractory Mycoplasma Pneumonia
    SHI Rong-hua, HAN Yao-yao, LUO Qiu-qiong, CHENG Guo-hua, WANG Xiao-lin
    2019, 16(3): 382-388. https://doi.org/10.13493/j.issn.1672-7878.2019.03-005
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    Objective: To analyze the clinical efficacy and safety of methylprednisolone combined with azithromycin in patients with refractory mycoplasma pneumonia. Methods: Methylprednisolone, azithromycin, mycoplasma pneumonia, refractory mycoplasma pneumonia, children, RMPP, randomized and clinical trial were searched and selected as key-words by using seven Chinese and English databases, including CNKI, WANFANG DATA, VIP, PubMed, The Cochrane Library, Web of science and EMbase. Randomized controlled trials of methylprednisolone combined with azithromycin for the treatment of refractory mycoplasma pneumonia in children were screened according to inclusion criteria and exclusion criteria. Time limits were retrieved from building the database to January 29, 2018, and the meta-analysis software was RevMan 5.3 software. Results: A total of 19 studies involving 1 886 patients were included. According to the inclusion criteria, exclusion criteria and effective data information extraction, 77 literatures were excluded and 19 literatures were included in the meta-analysis. Conclusion: Methylprednisolone combined with azithromycin in patients with refractory mycoplasma pneumonia in children is more effective and safer than azithromycin alone. However, limited by the number and quality of samples included in the study, further more high-quality studies will be needed for validation.
  • Analysis on Distribution and Their Antimicrobial Resistance of 1 058 Strains of Gram-negative Bacteria in a Hospital from 2015 to 2018
    ZHANG Shi-zhong, CHEN Xiao-li, TAO Guang-li
    2019, 16(3): 389-393. https://doi.org/10.13493/j.issn.1672-7878.2019.03-006
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    Objective: To analyze the distribution of gram-negative bacteria and their resistance to antimicrobial agents in hospitals from 2015 to 2018, and to provide a reference for clinical rational drug use. Methods: From August 2015 to August 2018, the bacterial culture data isolated from various specimens in the bacteria room of the laboratory department of the hospital were collected, and the clinical isolation of the bacteria, the distribution of the specimens, the detection rates of ESBLs and AmpC of enterobacteriaceae bacteria, and the MIC and bacterial susceptibility rates of antimicrobial agents against enterobacteriaceae bacteria as well as non-fermenting bacteria were analyzed. Results: 1 441 strains of bacteria were isolated, including 384 strains of Gram-negative bacillus and 1 058 strains of Gram-negative bacillus. Among them 219 strains of E. coli, 215 strains of Pseudomonas aeruginosa, 192 strains of Acinetobacter genera, 190 strains of Pneumonia klebsiella bacteria, 95 strains of Sewer enterobacter, 35 for deformation of bacterial strains, 32 strains of the Genus serratia, 28 strains of Eosinophilic malt oligotrophic, bacterium 22 strains for Citric acid bacillus and other 30 strains of bacteria, such as 9 strains of flu bloodthirsty bacteria, 6 strains producing gas e. coli, 4 strains of shigella, 6 strains of Pseudomonas other genera and 5 other strains of E. coli. Gram-negative bacilli were distributed in the specimens, including 589 strains in respiratory tract, 256 strains in urine, 74 strains in wound secretions, 47 strains in feces, 42 strains in blood, 44 strains in body fluids and 6 strains in other parts, accounting for 55.67%, 24.20%, 6.99%, 4.44%, 3.97%, 4.16% and 0.57%, respectively. The ESBLs and AmpC detection rates of escherichia coli were 19.63% and 0.91%, respectively, and the ESBLs and AmpC detection rates of Klebsiella pneumoniae were 23.6% and 0.00%, respectively.The detection rates of ESBLs and AmpC were 10.53% and 17.87%, respectively.The enzyme detection rates of ESBLs and AmpC were 46.88% and 0.00% respectively. Gatifloxacin, paracilin-tazobactam and cefoperazone-sulbactam showed broad antibacterial spectra and a good antibacterial activity against non-fermentative negative bacilli. Conclusion: Gram-negative bacilli are widely distributed in clinic, so we should monitor them and do some drug sensitivity tests to ensure the effectiveness of clinical treatment.
  • Influence of Vancomycin Blood Concentration Test on Rational Control of Dosage in Patients with Resistant Gram-positive Bacteria Infection
    An Yu-ying, ZHANG Feng-lin
    2019, 16(3): 394-397. https://doi.org/10.13493/j.issn.1672-7878.2019.03-007
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    Objective: To explore the influence of vancomycin blood concentration detection on rational control of drug dosage in patients with drug-resistant Gram-positive bacteria infection, and to provide a reference for the rational use of vancomycin. Methods: The data of 112 patients with drug-resistant Gram-positive bacteria infection admitted from July 2015 to January 2018 were selected, and the results of vancomycin blood concentration test during the treatment were statistically analyzed. The results of vancomycin blood concentration test and the effects of different concentrations of vancomycin on clinical efficacy and safety were analyzed. Results: The blood concentration test results of 112 patients showed that the blood concentration of 37 patients was located in the target-valley concentration distribution range(between 10 and 20 g/mL) (33.04%). According to the test results, in 44 patients was adjusted the follow-up dose; including 20 patients with the valley concentration were greater than 5 g/mL and 15 patients was increased the daily dose. In 18 cases, the daily dose was reduced by greater than 20 g/mL. In addition, there were 2 patients with dose adjustment errors, i.e., in 1 patient with valley concentration were Less than 5 g/mL was decreased daily dose and in 1 patient with valley concentration between 16 and 20 g/mL was increased daily dose.Thirty patients with symptomatic treatment were selected, and the difference in clinical effect between the vancomycin low concentration group (Less than 10 g/mL) and the high concentration group (10 g/mL) was not statistically significant (P>0.05). Adverse reactions occurred in 4 of the 30 patients (2 with nephrotoxicity, 1 with erythrosis and 1 with ototoxicity). It was mainly concentrated in patients with serum valley concentration greater than 20 g/mL. Conclusion: For patients with drug-resistant Gram-positive bacteria infection, when vancomycin is used for treatment, the blood drug concentration should be tested, which is beneficial to the rational control of dosage, so as to reduce the risk of adverse reactions.
  • Return Visit Analysis on Narcotic Analgesics in Out-patients with Cancer Pain in A Hospital
    XU Xiao-yun, CHENG Ping
    2019, 16(3): 397-400. https://doi.org/10.13493/j.issn.1672-7878.2019.03-008
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  • Analysis on Rationality of Prophylactic Usage of Antimicrobial Agents in 55 Patients with Gastro-intestinal Polyps after Mucosal Resection
    YIN Wei-qing, TANG Ye-qiu, FAN Hong-chun
    2019, 16(3): 400-404. https://doi.org/10.13493/j.issn.1672-7878.2019.03-009
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  • Analysis on Distribution and Sensitivity of Pathogenic Bacteria in Tuberculosis Patients with Lower Respiratory Tract Infection from 2015 to 2018
    LIU Yue, LIU Xiu-ying
    2019, 16(3): 404-407. https://doi.org/10.13493/j.issn.1672-7878.2019.03-010
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    Objective: To analyze the distribution and drug sensitivity of pathogenic bacteria in sputum of pulmonary tuberculosis patients with lower respiratory tract infection in Anfu area. Methods: Data of 82 patients of tuberculosis with lower respiratory tract infection admitted to anfu area from March 2015 to June 2018 were selected, and the distribution of pathogenic bacteria in sputum of the patients and their drug sensitivity results were statistically analyzed. Results: Among 82 patients of tuberculosis with lower respiratory tract infection, 95 strains of pathogenic bacteria were isolated through pathogen culture, among which 65 strains of gram-negative bacteria accounted for 68.42%, 8 strains of gram-positive bacteria accounted for 8.42% and 22 strains of fungi accounted for 23.16%. The drug resistance rates of Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa to ampicillin were as high as 100.00%, that of Acinetobacter baumannii and Pseudomonas aeruginosa to furantoin was also as high as 100.00%, and that of Staphylococcus aureus and Staphylococcus epidermidis to benzocillin was also as high as 100.00%. However vancomycin was completely sensitive to Staphylococcus aureus and Staphylococcus epidermidis (the sensitivity rate was 100.00%), and amikacin was also completely sensitive to Acinetobacter baumannii and Pseudomonas aeruginosa (the sensitivity rate was 100.00%). Conclusion: Based on the distribution of pathogenic bacteria in sputum of tuberculosis patients with lower respiratory tract infection and the drug sensitivity results, antibiotics with better efficacy can be chosen providing a basis for clinical rational and scientific use of antibiotics.
  • Pharmaceutical Care of Clinical Medication in Type 2 Diabetes Mellitus Patients with Mucormycosis Pneumonia
    YANG Yong-hua
    2019, 16(3): 473-475. https://doi.org/10.13493/j.issn.1672-7878.2019.03-035
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    Objective: To analyze the pharmaceutical care of medication in type 2 diabetes mellitus patients with Mucormycosis pneumonia, and to provide reference for rational drug usage in clinic. Methods: Clinical pharmacist participated in clinical consultation, proposed individualized treatment plan, and monitored the whole course of treatment. Results: In the clinical anti-infection treatment of type 2 diabetes mellitus patient with Mucormycosis pneumonia, the individualized medication suggestions put forward by clinical pharmacist were reasonable and effective. Conclusion: The blood glucose of type 2 diabetes mellitus patients with mucormycosis pneumonia was effectively controlled through participation of clinical pharmacist in anti-infective treatment process with amphotericin B and liposomes. Discovering the unreasonable medication in time could improve the safety and effectiveness of clinc drug treatment.
  • Analysis on Related Factors of Reports of Adverse Drug Reaction Induced by Reduning Injection in 73 Children's with Bronchopneumonia
    CAO Zheng, SHI Xiang-kui, ZHANG Jing, HUANG Ting, LIU Yuan
    2019, 16(3): 476-479. https://doi.org/10.13493/j.issn.1672-7878.2019.03-036
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    Objective: To analyze the causes and characteristics of the adverse drug reactions (ADRs) caused by Reduning injection in children's bronchopneumonitis, and to provide a reference for clinical safety and rational drug use. Methods: Data of 73 patients of ADRs caused by Reduning injection in children with bronchopneumonia were collected from January 2014 to December 2018. The sex, age, dose, time of occurrence of ADRs, combination of drugs, involvement of organs/systems and clinical manifestations of ADRs, and outcome were computed. The causes and characteristics of ADRs induced by Reduning injection were analyzed. Results: Among the 73 cases of ADRs, 46 cases were male, accounting for 63.01%. All children with ADRs were Less than 4 years old, and the incidence increased with the increase of dosage. ADRs occurred within 30 minutes after administration, accounting for 82.19% which was mainly related to drug combination. The main clinical manifestations were in skin and its appendages and systemic lesions, accounting for 74.41% and 16.28%, respectively. Most of the symptoms of ADRs improved or disappeared within 1 hour after withdrawal of Reduning injection or after prompt symptomatic treatment. Conclusion: ADR in children induced by Reduning injection commonly occurred within 30 minutes after administration. To reduce the incidence of ADR, we should conduct the injection immediately after the intravenous drug configuration, and we should do flushing the infusion tube if there are drug combinations.
  • Efficacy of Cefoperazone Sulbactam in Postoperative Infection in Patients with Lung Cancer and Influence on Inflammatory Factors Level
    LONG Sheng-gen, XIAO Yu-lan
    2019, 16(3): 483-485. https://doi.org/10.13493/j.issn.1672-7878.2019.03-038
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    Objective: To compare and evaluate the effects of cefoperazone sulbactam sodium and cefuroxime on postoperative infection in patients with lung cancer and its influence on the levels of inflammatory factors. Methods: Data of 86 cases of postoperative infection of lung cancer patients admitted from January 2016 to November 2018 were selected and divided into observation group and control group according to different treatment methods, with 43 cases in each group. Observation group patients were given cefoperazone sulbactam sodium intravenous drip treatment and control group patients were given cefuroxime intravenous drip treatment. The differences in the recovery time of clinical symptoms (body temperature, bloody sputum, cough and lung rale), and changes in the levels of inflammatory cytokines (IL-1, TNF-α, PCT, CRP) after treatment were compared. Results: In observation group of patients after treatment the total effective rate was higher than that of control group (P<0.05) and clinical symptoms (body temperature, blood in phlegm and cough and lung's) recovery time were earlier than the control group (P<0.05), inflammatory cytokines (IL-1, TNF-α, PCT and CRP) levels measured values were lower than those of the control group (P<0.05), while IL-4, IL-10 levels measured values were higher than those of the control group and there was significant difference(P<0.05). Conclusion: The efficacy of cefoperazone sulbactam sodium intravenous infusion in the treatment of postoperative infection in patients with lung cancer is superior to that of cefuroxime, it effectively improves the level of serum inflammatory factors and promotes the recovery of clinical symptoms.