KANGGANRAN YAOXUE

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  • 2019 Volume 16 Issue 6
    Published: 25 June 2019
      
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  • Research Progress on Myocardial Injury in Children and Its Clinical Medication
    KONG Hao-jie, WANG Wen-juan, MA Jin, MAO Chen-mei
    2019, 16(6): 921-925. https://doi.org/10.13493/j.issn.1672-7878.2019.06-001
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    Myocardial injury is a widespread and vague concept derived from myocardial infarction, which can be caused by various causes of myocardial ischemia, inflammatory cell infiltration and poisoning. The myocardial structure and function of children are not yet mature, and the compensatory capacity of the myocardium is worse than that of adults, so the incidence of myocardial injury is higher. Common causes of myocardial damage include bacteria, viruses, hypoxia, Kawasaki disease, arrhythmia and so on. Myocardial injury leads to hyperemia, degeneration, and even apoptosis of cardiomyocytes, causing changes in serum level of related biomarkers. Some children will not show obvious symptoms and signs when myocardial injury occurs. Relatively speaking, biomarkers of myocardial injury are easy to detect sodium creatine phosphate, vitamin C, complex coenzyme, L-carnitine, etc. through antioxidant anti-inflammatory nutrition to protect the myocardium, some Traditional Chinese medicines such as Sophora flavescens, Salvia miltiorrhiza, Radix and other cardioprotective agents provide new choices for pediatricians to increase the treatment of myocardial injury, which is of great significance for the diagnosis and treatment efficiency of clinical myocardial injury.
  • Research Advances on Pharmacological Actions of Matrine Against Cervical Carcinoma and Endometrial Carcinoma
    ZHANG Ming-fa, SHEN Ya-qin
    2019, 16(6): 925-930. https://doi.org/10.13493/j.issn.1672-7878.2019.06-002
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    Matrine inhibits proliferation and induces apoptosis in association with dosage on cervical carcinoma HeLa cells, SiHa cells, C33A cells, U14 cells and human endometrial carcinoma Ishikawa cells. Matrine inhibits also the adhesion, invasion, and metastasis of these cancer cells. Matrine promotes the anticancerous effects of cisplatin, and decreases adverse reaction of cisplatin. Anti-inflammation, anti-bacteria, anti-virus of matrine is advantageous in the prophylaxis and treatment of cervical carcinoma and endometrial carcinoma. The literatures of the pharmacological effects of matrine against cervical cancer and endometrial cancer were reviewed and the research progress was analyzed.
  • Influence of Protocatechuic Acid on Differentiation of PC12 Cells in Induced by Basic Fibroblast Growth Factor
    WANG Li-fang, XUE Xiao-yan, XIE Ning-sheng
    2019, 16(6): 931-933. https://doi.org/10.13493/j.issn.1672-7878.2019.06-003
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    Objective: To explore the influence of protocatechuic acid on cell differentiation of PC12 cells induced by basic fibroblast growth factor（bFGF）. Methods: PC12 cells were cultured in vitro, and the bFGF induced PC12 cell differentiation was enhanced at the low-dose, medium-dose and high-dose PCA groups (16.0, 32.0 and 64.0 μmol/L). The number of progenitor cells and the average progenitor length were analyzed through the observation of cell morphology and the detection of cell vitality. The effects of different doses of PCA on the differentiation of bFGF induced PC12 cells were investigated. Results: Compared with the control group, PCA group at low, moderate and high doses (16.0, 32.0 and 64.0 mumol /L) could enhance bFGF induced PC12 cell differentiation. Conclusion: PCA can enhance bFGF's ability to induce PC12 cell differentiation.
  • Analysis on Distribution and Resistance of Pathogenic Bacteria in Cere-brospinal Fluid of Clinical Patients in a Hospital during 2016 to 2017*1
    CHEN Xiao-yu, XIAO Liang, JIN Gui-lin, GAO Xiu-xian
    2019, 16(6): 934-938. https://doi.org/10.13493/j.issn.1672-7878.2019.06-004
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    Objective: To analyze the distribution and resistance of pathogenic bacteria in cerebrospinal fluid(CSF) of clinical patients in a hospital during 2016 to 2017, and to provide a reference for the rational selection of antimicrobial agents in clinic. Methods: The data of culture results of common pathogenic bacteria in CSF of hospitalized patients from 2016 to 2017 were extracted to analyze the distribution of isolated common pathogenic bacteria and their resistance to antimicrobial agents. Results: In the culture results of common pathogenic bacteria, 95 strains of pathogenic bacteria were isolated, and the samples were mainly from neurosurgery (90.53%), neurology (4.21%) and ICU (2.11%). Among them, 67 strains of gram-positive bacteria accounted for 70.53%, and Staphylococcus epidermidis, hemolytic Staphylococcus and Saprococcus were the TOP 3 Gram-positive cocci, accounting for 18.95%, 16.84% and 10.53% respectively. Gram-negative bacteria accounted for 29.47% of the 27 strains, while Acinetobacter baumandii was the main isolated bacteria accounting for 10.53%, Baumann-calcium acetate acinetobacter complex accounted for 8.42%, and Enterobacter cloacae accounted for 3.16%. Gram-positive bacteria were 100% sensitive to nitrofurantoin, tikoranin and vancomycin. Except Enterococcus faecalis, other cocci such as Staphylococcus epidermidis were sensitive to furodidi acid. Except Enterococcus faecalis, Staphylococcus epidermidis were all sensitive to quinuptin/dafupretin.Acinetobacter baumannii, Acinetobacter Baumannii/calcium acetate complex, Klebsiella pneumoniae subspecies, Enterobacter cloacae, maltophilia oligomonas and Sarreia were highly resistant to amoxicillin-clavulinic acid and ampicillin but highly sensitive to polycolistin. Except for the highly sensitive slime Sarreia, Enterobacter cloacae was resistant to it (66.67%), while all the other bacteria were highly resistant to it. The first-generation cefazolin was highly resistant to all drugs except Bauman/calcium acetate Acinetobacter complex. Gram-negative and positive bacteria showed high resistance to other common drugs. Conclusion: The CSF of patients and the culture and isolation of pathogenic bacteria should be monitored and the drug resistance and the causes of changes should be understood, so as to ensure the prevention of the emergence of multi-drug resistance bacteria and the rational drug use.
  • Analysis on Distribution of Pathogenic Bacteria and Drug Resistance to Antibacterial Agents in 60 Diabetic Foot Patients with Bacterial Infection
    LIU Hui-yun
    2019, 16(6): 939-942. https://doi.org/10.13493/j.issn.1672-7878.2019.06-005
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    Objective: To analyze the distribution of pathogenic bacteria in ulcer secretion of wound residue of diabetic foot (DF) patients with bacterial infection and their resistance to antimicrobial agents. Methods: The data of 60 DF patients with bacterial infection admitted in hospital from March 2018 to February 2019 were selected to analyze the distribution of pathogenic bacteria in wound residual ulcer secretion and the drug resistance rate to common antibacterial agents. Results: 71 strains of pathogenic bacteria were detected, among which 35 (49.30%) were gram-negative bacteria. The TOP 3 pathogenic bacteria detected were 13 strains of Escherichia coli (18.31%), 6 strains of Enterobacter cloacae (8.45%) and 5 strains of Proteus (7.04%). Among them, there were 33 gram-positive strains (46.48%), 16 strains of Staphylococcus aureus (22.54%), 7 strains of Enterococcus faecalis (9.86%), 6 strains of coagulase negative Staphylococcus (8.45%) and 3 strains of Fungus (4.23%). The resistance of Proteus and Escherichia coli to cefoperazone-sulbactam, piperacillin-tazobartan and imipenem was 0.00%. The resistance of Cloacae to cefotaxime was up to 83.33%. The resistance of Proteus to cefazolin was up to 80.00%. The resistance of Escherichia coli to ampicillin was as high as 92.31%. The resistance of Staphylococcus aureus, Enterococcus faecalis and coagulase negative Staphylococcus to vancomycin, quinoptin-dafotimine and linezolid was 0.00%. The resistance of coagulase-negative Staphylococcus and Staphylococcus aureus to ampicillin and penicillin was the highest. Conclusion: The pathogens associated with bacterial infection in DF patients are complex, and different pathogens have different resistance to antimicrobial agents. Therefore, it is necessary to master the types of pathogens and their resistance to antimicrobial agents before treatment, so as to provide evidence-based support for the rational selection of antimicrobial agents in clinical practice.
  • Efficacy of Benzathine Penicillin Combined with Ceftriaxone on Elderly Patients with Recessive Syphilis and Its Influence on T Cell Function*1
    YE Wen-feng
    2019, 16(6): 943-946. https://doi.org/10.13493/j.issn.1672-7878.2019.06-006
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    Objective: To evaluate the efficacy of benzathine penicillin combined with ceftriaxone on elderly patients with recessive syphilis and its influence on T cell immunologic function. Methods: The data of 60 cases of elderly patients with latent syphilis infection admitted from January 2016 to January 2017 were selected. According to different treatment methods, they were randomly divided into control group and combination group, with 30 cases in each group. The control group was treated with benzathine penicillin, while the combined group was treated with ceftriaxone on TOP of the control group. The changes of T lymphocyte (CD3, CD4, CD8 and CD4/CD8) levels in peripheral blood before and after treatment were compared between the two groups, and the differences of syphilis drop degree of rapid plasma reactivity test for syphilis (RPR) conversion rate and total effective rate in different time periods after 24 months of follow-up were also compared. Results: After treatment, serum CD3, CD4 and CD4/CD8 levels in the two groups were all higher than those before treatment (P<0.05), while CD8 levels were lower than those before treatment (P<0.05). After treatment, serum levels of CD3, CD4 and CD4/CD8 in the combined treatment group were higher than those in the control group (P<0.05), and CD8 levels were lower than those in the control group (P<0.05). The negative conversion rate of RPR 24 months after treatment was higher than that of 6 months and 12 months after treatment (P<0.05). The RPR negative conversion rate of patients in the combined treatment group was higher than that of the control group (P<0.05), and the total effective rate was higher than that of the control group (P<0.05). Conclusion: The combination of benzathine penicillin and ceftriaxone in the treatment of elderly patients with recessive syphilis has should a relatively definite efficacy, effectively improving the level of peripheral blood T lymphocytes, as well as improving the rate of RPR negative transformation.
  • Compatibility Analysis on Azithromycin Injection with Common Drugs and Its Countermeasures
    LI Qin, WANG Jun-lan, LEI Zhao-bao
    2019, 16(6): 946-950. https://doi.org/10.13493/j.issn.1672-7878.2019.06-007
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    Objective: To analyze the compatibility of azithromycin injection with common drugs and its countermeasures and to provides a reference for nurses to prepare and inject azithromycin injection to ensure the safety of patients. Methods: The domestic medical database was searched and the related literatures about the compatibility of azithromycin with other drugs were downloaded, read and carefully analyzed, putting forward the list of the incompatibility of azithromycin injection. A list of contraindications of azithromycin injection were edited. Results: Azithromycin can be used together with 5% glucose injection, 0.9% sodium chloride injection, 5% glucose and 0.9% sodium chloride injection, compound sodium chloride injection and other commonly used clinical infusion solution. It can also be used in combination with vitamin C injection, vitamin B6 injection, ribavirin injection and anisodamine injection. However, compatibility with Traditional Chinese Medicine injections (Yanhuning injection, Tanreqing injection, etc.), cephalosporin antibiotics (cefopiamide, cefonicil, etc.), ambroxol, ganciclovir and fursamide is contraindicated. Conclusion: In order to ensure the safety of drug use, Unnecessary drug waste and safety danger of medication should be avoided; it is suggested that azithromycin injection should be injected by intravenous drip alone. Clinical nurses should pay attention to the contraindication of the compatibility of azithromycin injection with other drugs.
  • Analysis on Reasons for Unreasonable Medication of Carbapenems in a Hospital
    YANG Zhong-hui, QIAN Miao-jin
    2019, 16(6): 951-954. https://doi.org/10.13493/j.issn.1672-7878.2019.06-008
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    Objective: To analyze the causes of unreasonable medication of carbapenems in clinic, and to provide a reference for clinical rational drug use. Methods: Data of 623 inpatients treated with carbapenems in hospitals from January to December 2018 were extracted, and the rationality of their use of pathogenic microorganisms was judged from the aspects of the detection rate, indications of drug selection, usage and dosage and combination of drugs. Results: Among the 623 cases of clinical use of carbapenems in clinic, the rates of pathogenic microorganisms were 95.83% and 135 cases of unreasonable medication were 21.67%.Among them, the TOP 3 reasons of unreasonable drug use were improper drug selection, improper cultivation of pathogenic microorganisms not sent for testing and improper combined drug use in 91 cases, accounting for 67.41% of all unreasonable drug use. Conclusion: Clinical medication of carbapenems in hospitals needs to be further strengthened in intervention management to improve the level of rational use.
  • Analysis on Relevant Factors of Anti-diabetic Drugs Medication in a Hospital during 2016 to 2018
    LIU Xin-yan, TIAN Jing-lin, ZHU Hong, LU Ji-guang
    2019, 16(6): 954-957. https://doi.org/10.13493/j.issn.1672-7878.2019.06-009
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    Objective: To analyze the relevant factors of anti-diabetic drugs medication in a hospital during 2016 to 2018, and to provide a reference for clinical rational drug use. Methods: The data on the use of antidiabetic drugs from January 2016 to December 2018 were extracted, and statistical software Excel 2007 was used to analyze the sales volume, composition ratio, medication frequency and daily drug cost of antidiabetic drugs. Results: During 2016 to 2018, the sale amount of anti-diabetes drugs in the hospital was increased year by year. Besides insulin drugs, other hypoglycemic drugs accounted for more than 60%. The total sales amount and medication frequency of metformin tablets, acarbose tablets and siglitine tablets were in the TOP 3, which were commonly used drugs for patients with diabetes. Conclusion: In the past 3 years, the use of antidiabetic drugs was relatively reasonable, and biguanides, alpha-glycosidase inhibitors and DDP-4 inhibitors accounted for a relatively large market share. Therapeutic means for clinical diabetes patients was provided..
  • Correlation between High Risk of 21-Trisomy and Fetus Antenatal Ultrasonography in Pregnant Woman of Middle Gestational Period
    HANG Gui-fang, XU Hao-qin, YU Ling, GAO Ya-qing
    2019, 16(6): 991-994. https://doi.org/10.13493/j.issn.1672-7878.2019.06-022
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    Objective: To explore the correlation between the high risk of 21-trisomy (also known as Down's syndrome) and fetus antenatal ultrasonography results including abnormal soft indexes and structural malformation during the middle gestational period. Methods: The data of 289 cases of 21-trisomy high-risk pregnant women with Down's syndrome during the middle pregnancy admitted between January 2016 and December 2017 were selected as the observation group. In addition, the data of 289 cases of low-risk pregnant women with 21-trisomy were selected as the control group. The results of 21-trisomy ultrasound screening and the ultrasonographic characteristics of fetuses in the middle pregnancy of two groups were compared and analyzed. Results: Among the pregnant women in the observation group, the incidence of 21-trisomy high risk and fetal ultrasound soft index and structural malformation were 44.64% (129/289) and 1.73% (5/298), respectively. In the control group, the incidence of 21-trisomy low risk and fetal ultrasound soft index and structural malformation were 7.96% (23/289) and 0.69% (2/289), respectively. In the control group, the incidence of ultrasound soft index was significantly lower than that of the observation group (P<0.05), and the incidence of structural malformation was slightly lower than that of the observation group, but the difference was statistically significant (P<0.05). Conclusion: The incidence of abnormality of fetal ultrasonography in pregnant women with high risk of 21-trisomy was significantly higher than that in pregnant women with low risk of 21-trisomy, and there was a correlation between the high risk of trisomy 21-trisomy and fetal ultrasonography.
  • Comparison of Influence of Different Surgical Methods on Post-operative Pulmonary Infection in Patients with Esophageal Carcinoma
    WANG Yi-fei, ZHU Xue-juan, DUAN Shan-zhou, YANG Wen-tao, SANG Yong-hua, CHEN Yong-bing
    2019, 16(6): 994-996. https://doi.org/10.13493/j.issn.1672-7878.2019.06-023
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    Objective: To compare the influence of different surgical methods on postoperative pulmonary infection in patients with esophageal carcinoma. Methods: The data of 128 cases of patients undergoing radical resection of esophageal cancer admitted to hospitals from January 2016 to May 2019 were selected and divided into 53 cases in the VATS group and 75 cases in the OPEN group based on different surgical methods. Patients in the VATS group were treated by thoracoscopic radical resection of esophageal carcinoma, while patients in the OPEN group were treated by thoracotomy (such as left posterolateral incision, thoracoabdominal incision and cervicothoracoabdominal incision). The differences of postoperative pulmonary infection incidence between the two groups were compared, as well as the differences of the values of variables related to different surgical methods were also compared. Results: The incidence of postoperative pulmonary infection in the VATS group was lower (1.89%) than that in the OPEN group (12.00%) (χ2=3.120, P<0.05), and all the variables were lower than those in the OPEN group (P<0.05). Conclusion: The risk of pulmonary infection after radical resection of esophageal carcinoma by thoracoscopy was lower than that after traditional thoracotomy, which significantly reduced the risk of pulmonary infection after surgery.
  • Pharmaceutical Care for Clinical Medication of 2 Liver Cirrhosis Patients with Hypertension
    WUJing, DING Liang, WU Qian-hu
    2019, 16(6): 1000-1002. https://doi.org/10.13493/j.issn.1672-7878.2019.06-025
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    Objective: To analyze the key points of pharmaceutical care for clinical medication of liver cirrhosis patients with hypertension. Methods: In combination with 2 typical cases of liver cirrhosis accompanied by hypertension in which pharmacists participated in pharmaceutical care; the clinical doctors were reminded to pay attention to observation of adverse drug reactions and drug interactions, and to put forward drug Suggestions. After evaluation, the doctors adopted the pharmacist's suggestions and achieved good clinical efficacy. Results: According to the clinical symptoms of the two patients, clinical pharmacists proposed the key points of pharmaceutical care for patients with liver cirrhosis accompanied by hypertension. When using antihypertensive drugs combined with glucocorticoids, attention should be paid to the effect of glucocorticoids on blood pressure, as well as the indirect effect of antibiotics on blood pressure. When using liver-protecting drugs, the combination with glycyrrhizin preparation should be avoided to avoid raising blood sugar value, etc. After the implementation of pharmaceutical care, the patient's blood pressure and liver function indexes returned to normal and the condition was relieved. Conclusion: In the pharmaceutical care of patients with liver cirrhosis accompanied by hypertension, the focus should be on the medication care of antihypertensive drugs and liver-protecting drugs, and the effects of various drugs on patients' blood pressure and liver function indicators after treatment should be paid close attention.
  • Clinical Efficacy of Azathioprine Combined with Prednisone in Patients with Optic Neuromyelitis Disease and Its Influence on Recurrense*1
    LIU Jia-bin, JIANG Bin, LUO Ye-ting, YANG Yun-zhu
    2019, 16(6): 1009-1012. https://doi.org/10.13493/j.issn.1672-7878.2019.06-028
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    Objective: To investigate the clinical efficacy of azathioprine combined with prednisone in patients with optic neuromyelitis disease and its influence on recurrense. Methods: Data of 94 cases of patients with optic neuromyelitis spectrum disease admitted between November 2014 and November 2017 were selected. According to different treatment methods, they were divided into treatment group and control group, with 47 cases in each group. Patients in the control group were given with prednisone alone, while patients in the treatment group were treated with azathioprine on the basis of the control group. The differences of recurrence frequency, EDSS score value and adverse reaction rate during medication between the two groups were compared. Results: The EDSS scores at 6 months after treatment were significantly lower than those in the control group (P<0.05). With the extension of time, the average recurrence frequency of patients in the two groups was increased gradually, and the average recurrence frequency in the treatment group at 3 months, 6 months and 12 months was significantly lower than that in the control group (P<0.05). The incidence of adverse drug reactions (liver function injury, thrombocytopenia, nausea vomiting, etc.) during the medication period (12.77%) was significantly lower than that of the control group (40.43%) (P<0.05). Conclusion: Azathioprine combined with prednisone showed an obvious therapeutic effect in patients with optic neuromyelitis spectrum disease, the EDSS score and recurrence frequency were effectively reduced, and had a high safety.