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  • 2019 Volume 16 Issue 8
    Published: 25 August 2019
      
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  • Research Advances in Early Screening and Clinical Prevention and Treatment of Cervical Cancer and Its Prospects
    CHEN Yuan
    2019, 16(8): 1289-1292. https://doi.org/10.13493/j.issn.1672-7878.2019.08-001
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    Cervical cancer is one of the most common tumors in women. Its incident rate is only next to breast cancer in women. In recent years, the incidence age of cervical cancer has become younger, which not only has a serious impact on women's psychology, but also threatens the life of woman. The incidence of cervical cancer is high-risk human papillomavirus (HR-HPV); excessive sexual partners and premature sexual life(<16 years old), nutritional and health conditions, smoking, education level, economic status and the number of health service resources are also playing a synergistic role in the pathogenesis of cervical cancer. In China, cervical cancer has different incidence rates among different populations. It is generally believed that the rural incidence rate of cervical cancer is higher than that of urban areas, and the mountainous areas are higher than the plains. The incidence of women aged were between 40 and 50 in the highest of all age groups. Sustained infection of HR-HPV is a major factor in the pathogenesis of cervical cancer in women. So this article reviews recent studies on the early screening of cervical cancer by HR-HPV, aiming to provide strategies and methods for the prevention and treatment of cervical cancer.
  • Evaluation on Synergistic Efficacy of Oxymatrine on Clinical Therapeutic Agents in Patients with Hepatitis B
    ZHANG Ming-fa, SHEN Ya-qin
    2019, 16(8): 1292-1298. https://doi.org/10.13493/j.issn.1672-7878.2019.08-002
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    Oxymatrine (such as intravenous drip, intramuscular injection or oral administration) improves the clinical efficacy of lamivudine, interferon, or glycyrrhizic acid-type compounds for the treatment of hepatitis B, and inhibits occurrence YMDD mutation of hepatitis B virus, to keep up a steady efficacy. Oxymatrine depends on many-sided mechanisms of self-generating effects of anti-virus, anti-inflammation, hepatoprotection, and promoting immunoregulation of body, and increases clinical efficacy of various drugs for the treatment of hepatitis B, and decreases the occurrence of adverse reaction. The literatures on the synergistic efficacy of oxymatrine on hepatitis B patients were reviewed, and Its synergistic efficacy was analyzed.
  • Study on Preparation of Liver Injury Model and Its Mechanism of Experimental Animal Induced by Anti-tuberculous Drugs*1
    LING Mei, DING Liang, WU Qian-hu, SHENG Jian-hui, ZHANG Jian-jun, HUANG Chun-fan
    2019, 16(8): 1299-1303. https://doi.org/10.13493/j.issn.1672-7878.2019.08-003
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    Objective: To study the preparation of liver injury model and its mechanism of experimental animal induced by anti-tuberculous drugs. Methods: Forty-eight mice were selected as blank control group, model-1 group, and model-2 group (16 in each group).The blank group was given 0.9% saline, and the model-1 group was given 100 mg/(kg·d) isoniazid + 400 mg/(kg·d) rifampicin; model-2 group was given 500 mg/(kg·d) acetaminophen for 4 weeks of continuous ig administration. The mice were sacrificed 24 h after the last administration, the blood and liver tissue samples of the mice were collected for serum biochemical indicators, and the pathological changes of liver injury in mice were observed. Results: Continuous administration of rifampicin and isoniazid for 2 weeks can cause obvious liver damage in mice. Pathological sections mainly showed hepatic steatosis and intracellular inflammatory cell infiltration. Administration of acetaminophen resulted in focal necrosis of the liver, between punctate and fragmented necrosis. Among them, rifampicin and isoniazid damages the liver of mice in a concentration-dependent manner, but the mechanism needs further study. Conclusion: Using 100 mg/(kg·d) isoniazid and 400 mg/(kg·d) rifampicin combined for 2 weeks, a more suitable model of liver injury induced by anti-tuberculosis drugs could be prepared.
  • Analysis on Monitoring Results of Isoniazid Concentration in Serum in 198 Patients with Tuberculosis and Its Influencing Factors
    MA Ping-kuan, LIU Xing, NONG Shao-hua, CHEN Jie
    2019, 16(8): 1304-1308. https://doi.org/10.13493/j.issn.1672-7878.2019.08-004
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    Objective: To investigate the situation of anti-tuberculosis drug treatment in pulmonary tuberculosis patients in hospital, and to analyze the monitoring results and influencing factors of serum isoniazid (INH) concentration in pulmonary tuberculosis patients, so as to provide a reference for rational drug use in clinic. Methods: The data of 198 hospitalized patients from October 2018 to March 2019 were retrospectively analyzed. The blood concentration of INH in the anti-tuberculosis drug treatment regimen (INH 0.3 g, q24h; RFP 0.6 g, q24h; PZA 0.5 g, q8h; EMB 0.75 g, q24h), the results and its influencing factors were analyzed. Results: Among 198 patients, 93 patients took INH (300 mg/d) for 2 hours and their blood drug concentration was lower than the target concentration range accounted for 46.97%. Among them, 59.17% of male patients had low blood drug concentration, which was higher than 28.21% of female patients (P<0.05); 52.08% of patients whose body weight was more than 50 kg had low blood drug concentration in INH. 44); 33.33% of patients with body mass was less than 50 kg (P<0.05); there was a significant difference between serum albumin level and isoniazid concentration (P<0.05); 40.00% of patients with liver function injury had low serum concentration of INH was (3.18±3.02)mg/L of patients with mild injury and 4.92% of patients with moderate injury. The serum concentration of (4.92±2.81) mg/L and (8.10±5.44) mg/L in patients with severe injury was significantly different among the three groups (P<0.05). Conclusion: After taking isoniazid, the blood concentration of tuberculosis patients will be affected by sex, body weight, complications and other factors. Therefore, the monitoring of blood concentration of anti-tuberculosis drugs is helpful to the clinical treatment of individualized drugs, so as to effectively improve the therapeutic effect.
  • Expression of CD8+ T-Cells Level in Peripheral Blood of Patients with TB and Its Influence on Resistance of Mycobacterium*1
    XUE Jing, SONG Hua-feng, CHENG Hui, ZHAO Jing, XU Ping
    2019, 16(8): 1309-1312. https://doi.org/10.13493/j.issn.1672-7878.2019.08-005
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    Objective: To investigate the expression of CD8+ T cells level in peripheral blood of patients with tuberculosis(TB) and its correlation with Mycobacterium tuberculosis drug resistance. Methods: FACSCalibur flow cytometry was used to detect the expression of CD8+ T cells and their subsets level in peripheral blood of patients with drug sensitive (DS) tuberculosis, single drug resistant (SDR) tuberculosis, multidrug resistant (MDR) tuberculosis, multidrug resistants (MDRS) tuberculosis and pan-drug resistant (PDR) tuberculosis, and the corresponding statistical methods were used for comparative analysis. Results: The expression of CD8+ T cells level in SDR group was significantly higher than that in healthy group and PDR group (P<0.05), but there was no statistical significance in the comparison between other groups (P>0.05). Further analysis of CD8+ T cells subgroup level in tuberculosis patients and healthy people in the peripheral blood, CD8+CD28+ T cells in healthy group expression is significantly higher than that of the SDR and PDR group (P< 0.05). The expression of CD8+CD28+ T cells in tuberculosis patients of each group was analyzed, and it was found that the expression of CD8+CD28+ T cells in the DS group were significantly higher than those in the SDR group (P<0.05). The expression of CD8+CD28– T cells in SDR group was significantly higher than that in MDR group, MDRS group and PDR group (P<0.05). Conclusion: The expression level of CD8+ T cells in peripheral blood of patients with different drug resistance tuberculosis is different to some extent. The detection of CD8+ T cells and their subsets is helpful to further elucidate the correlation between the immune status of the body and mycobacterium tuberculosis drug resistance, thus providing an important theoretical basis for the immune intervention and immunotherapy of tuberculosis patients.
  • Analysis on Clinical Medication of Special Grade Antibiotics in a Hospital in 2018
    WENG Shun-long, YANG Jin, LU Zhi-jun
    2019, 16(8): 1312-1318. https://doi.org/10.13493/j.issn.1672-7878.2019.08-006
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    Objective: To analyze the clinical rational medicatiom of special grade antibiotics in a hospital. Methods: 157 medical records of patients with clinical use of special grade antimicrobial agents from January to December 2018 were selected and there were 194 cases involving patients, and relevant factors of clinical medication of special grade antimicrobial agents were analyzed and calculated. Results: Among the 194 cases, the first three cases were pulmonary infection, septic shock and liver failure. The TOP 3 antimicrobial agents used were imipenamine-cisstatine sodium for injection, meropenem for injection and voriconazole for injection, with an average time of 10.14 days. The detection rate of pathogenic bacteria culture was 90.72%, and the first three pathogenic bacteria were Klebsiella pneumoniae, Pseudomonas aeruginosa and Candida albicans. The main reasons for unreasonable drug use are that no drug sensitivity test was carried out after the pathogenic bacteria were cultivated and the drug usage and dosage were not appropriate.Conclusion: The clinical medicatiom of special grade antibacterial drugs in a hospital is basically reasonable, but there are still some problems. It is suggested to strengthen the drug training of relevant personnel, promote rational use of antibiotics, and reduce the resistance rate of pathogenic antibiotics.
  • Analysis on Antibacterial Drugs Used Varieties in Different Age Groups of Patients with Acute Upper Respiratory Tract Infection
    YANG Yu-ling, CHEN Zhong-dong, CHEN Yong-yan
    2019, 16(8): 1318-1324. https://doi.org/10.13493/j.issn.1672-7878.2019.08-007
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    Objective: To understand and analyze the utilization rate of different antimicrobial agents for upper respiratory tract infection in patients of different age groups, the use of antimicrobial agents in patients of different age groups in seven cities, and to provide a reference for the rational use of different antimicrobial agents. Methods: Data on the use of antimicrobial agents for upper respiratory tract infection in outpatient and emergency department of patients of different ages from January 2013 to December 2017 were selected. The utilization rates of antimicrobial agents, combination rate, usage rate of each variety of antimicrobial agents, combined use rate of different combinations of antimicrobial agents were analyzed and compared with the recommended varieties of "Guidelines for Clinical Application of Antimicrobial Drugs (2015 edition)" and "The Sandford Guide To Antimicrobial Therapy(fever)". Results: The TOP 10 varieties of clinical antibiotics for patients of different ages are basically within the recommended scope of drugs, but the varieties that are not within the recommended scope are cefoxitin and acetylmedemycin. The combination of antibacterial drugs is mainly used in two combinations, but there is still a certain proportion of three, four and five combinations. Among them, two or more beta-lactamides or other similar drugs are used in combination, and some varieties or categories in the combination scheme are not recommended drugs. The unreasonable use of quinolones and tetracycline drugs mainly occurs in the minor patients, among whom the unreasonable use of infants is the most serious. Conclusion: Based on the analysis of the prescription data, the current situation of the use of antibacterial drugs in different regions was understood, providing methodological basis for the rational use of antibacterial drugs in different diseases of patients of different ages, and providing baseline data for the annual program of special antibacterial drug control activities nationwide.
  • Analysis on Reasons of Unreasonable Medical Orders in 33 Cases of Neuronutritional Auxiliary Medication*1
    QIAO Chen, MIAO Xu, WU Lin, CHEN Xia
    2019, 16(8): 1324-1327. https://doi.org/10.13493/j.issn.1672-7878.2019.08-008
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    Objective: To analyze the reasons of unreasonable medical orders for neuronutritional auxiliary medication in hospitalized patients, and to provide a reference for improving the mechanism of auxiliary drug use and rational use of neurotrophic drugs. Methods: From May 2018 to May 2019, 240 orders of neuronutrition-assisted drugs were selected and the reasons for unreasonable drug use were analyzed. Results: Among the 240 medical orders, 29 cases of unreasonable medical orders accounted for 12.08%, and the other 4 cases accounted for 1.67%. The reasons are mainly unsuitable indications, unsuitable selection of drugs, unsuitable route of drug administration, unsuitable usage and dosage, unsuitable selection of solvent, unsuitable combination of drugs, incompatibility and repeated administration. Conclusion: Through the review and comment on the special medical advice of neuronutritive auxiliary drugs, the level of rational use of neuronutritive drugs were standardized, and the rationality and safety of the use of neuronutritive drugs were ensured in patients.
  • Analysis on Diagnosis and Treatment of 1 Case of Pneumocystis Carinii Infection and its influence on Detection by Hexamine Silver Staining*1
    Liu Qing, Song Chun-li, Zhou Yi-wen, Zhou Lin-tao
    2019, 16(8): 1356-1359. https://doi.org/10.13493/j.issn.1672-7878.2019.08-018
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    Objective: To analyze the clinical diagnosis and treatment of Pneumocystis Carinii infection patients and the detection of pathogens, and to explore the influence factors of Pneumocystis Carinii on the detection of hexamine silver staining in laboratory and its characteristics under microscope. Methods: Samples of 15 patients tested by hexamide silver staining in the microbiology room of the hospital from September 2017 to March 2018 were extracted to analyze the diagnosis and treatment results of one patient with acute lymphocytic leukemia complicated with pneumocystis infection and respiratory failure and the characteristics of pneumocystis under the microscope. Results: Among the 15 cases of Pneumocystis Carinii, 6 were positive. All the 6 cases were non-aids patients with low immunity. Due to the timely and accurate detection of pathogens, no death occurred. Among them, 2 cases were transferred to other hospitals for treatment, and 4 cases were discharged after recovery. Conclusion: For people with immunocompromised pneumonia, since conventional CT treatment is ineffective, we should consider possibility of Pneumocystis Carinii infection and timely send the correct specimen, the laboratory should pay attention to the influencing factors in the testing process to prevent the omission.
  • Pharmaceutical Care of Anti-infection Medication of 1 Patient with Acute Obstructive Suppurative Cholangitis by Clinical Pharmacists*1
    HUANG Wei-bin, GAO Jun-wei, FAN Guo-rong, GAO An
    2019, 16(8): 1365-1369. https://doi.org/10.13493/j.issn.1672-7878.2019.08-021
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    Objective: To analyze the process of pharmaceutical care of clinical pharmacists participating in anti-infection medication of 1 patient with acute obstructive suppurative cholangitis (AOSC). Methods: Based to the grading of disease severity and epidemiology of infection, pharmacists participate in the adjustment of individual drug regimen for antimicrobial treatment, monitoring adverse reactions, monitoring drug concentration and evaluation of withdrawal indications, assisting clinicians in formulating and optimizing treatment regimen, and carrying out the whole process of pharmaceutical care. Results: Pharmacists participate in clinical treatment and the individual medication scheme proposed is reasonable and effective. Conclusion: Through the process of pharmacists' pharmaceutical care, the development of the disease is effectively curbed. It improves the safety and effectiveness of drug therapy and plays an important role in the rational use of anti-infective drugs.
  • Efficacy of Atomization Inhalation of Recombinant Human IFN-α2b in Children with HFMD and Its Influence on Inflammatory Factors Level
    YUAN Guo-zhong, HE Xiao-lin, ZHOU Shan, TANG Ling
    2019, 16(8): 1381-1384. https://doi.org/10.13493/j.issn.1672-7878.2019.08-027
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    Objective: To evaluate the clinical efficacy of recombinant human interferon alpha 2b（IFN-α2b） atomization inhalation on hand-foot-mouth disease (HFMD) in children and its influence on the improvement of inflammatory factors level. Methods: The data of 160 children with HFMD admitted from March 2017 to December 2018 were selected. According to different treatment methods, the children were divided into observation group(80 patients)and control group(80 patients). Patients in the control group were treated with Ribavirin, while patients in the observation group were treated with IFN-α2b atomization inhalation. The differences of total effective rate after treatment and the changes of measured inflammatory factor levels before and after treatment were compared between the two groups.Results: The total effective rate (93.75%) of the observation group was higher than that of the control group (82.50%) (P<0.05), and the recurrence time of clinical symptoms (body temperature, rash) was earlier than that of the control group (P<0.05). After treatment, IL-4, IL-6 and WBC levels were significantly lower than those of the control group (P<0.05). Conclusion: The clinical efficacy of IFN-α2b atomization inhalation on HFMD in children was better than that of Ribavirin intravenous infusion; it effectively improved the level of inflammatory factors and promoted the recurrence of clinical symptoms.