KANGGANRAN YAOXUE

Archive

  • 2019 Volume 16 Issue 9
    Published: 25 September 2019
      
  • Select all
    |
  • Research Advances on Pharmacological Effect of Clinical Medication of Oxymatrine in Patients with Respiratory System
    ZHANG Ming-fa, SHEN Ya-qin
    2019, 16(9): 1473-1477. https://doi.org/10.13493/j.issn.1672-7878.2019.09-001
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Oxymatrinee has the effect of antagonizing histamine-and allergy-induced asthma, and endotoxin-, oleic acid-, and ischemic reperfusion-induced acute lung injury, and silicosis-, bleomycin-, and super-oxygen-induced pulmonary fibrosis. Oxymatrine has the effect of antagonize lung cancer Lewis cells, A549 cells, SPC-1 cells and L929 cells too. These pharmacologic effects of oxymatrine is its combinative results of anti-microbe, antioxidation, anti-inflammation, antianaphylaxis, and increasing immunoregulation in respiratory system. The literatures of pharmacological effects of clinical medication of oxymatrine in patients with respiratory system were reviewed and its research progress was also analyzed.
  • Preliminary Study on Synthesis and Activity of Anti-drug Resistant Mycobacterium Tuberculosis Compounds Containing Amantadine
    XIA Yu-juan, WANG Xiao-hui, ZOU Jian-hua
    2019, 16(9): 1478-1481. https://doi.org/10.13493/j.issn.1672-7878.2019.09-002
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To design and synthesize a novel anti-drug Mycobacterium tuberculosis compound containing amantadine structure unit in order to improve lipophilicity and anti-drug mycobacterium tuberculosis activity, and to study the synthesis and activity of anti-drug mycobacterium tuberculosis compounds containing amantadine structure fragment. Methods: Based on the previous work, two new antituberculosis compounds (5a and 5b) were designed and synthesized through 4 steps using homopiperazine as starting materials, and their structures were characterized by 1H NMR and MS. Results: All two compounds (5a and 5b) showed good antituberculous activity against H37Ra (MIC=4.0 μg/mL). Conclusion: The adamantane structural unit which is added into compounds (5a and 5b), significantly improved the lipophilicity and anti-drug resistant mycobacterium tuberculosis activity of the compounds.
  • Analysis on Related Factors of Drug Resistance in 285 Patients with Drug-resistant Tuberculosis*1
    CHEN Yong-gang, CHEN Jie, HE Long-zhen, PENG Jiang-li, YU Ming-li, LUO Ji, LI Wei-xian, LI Na, HUANG Hongli
    2019, 16(9): 1482-1488. https://doi.org/10.13493/j.issn.1672-7878.2019.09-003
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To analyze the influencing factors of drug resistance in patients with drug-resistant tuberculosis and the results of drug sensitivity test and to provide a reference for guiding rational drug use in clinic. Methods: Data of 285 patients diagnosed with drug-resistant tuberculosis (with positive culture of mycobacterium tuberculosis in sputum) admitted from January 2017 to February 2018 were selected (109 cases in the initial treatment group and 176 cases in the re-treatment group). The main social behavior factors of the patients with drug-resistant tuberculosis, as well as the reasons for the positive culture of mycobacterium tuberculosis in sputum and the results of drug sensitivity test were analyzed. Results: Among 285 patients with drug-resistant tuberculosis, the rate of poor drug compliance in the treatment group (56.6%) was higher than that in the treatment group (14.5%) (χ2=24.437, P<0.05).The drug resistance rate of male patients in the re-treatment group (67.8%) was higher than that of the initial treatment group (32.2%), and that of female patients in the re-treatment group (51.4%) was higher than that of the initial treatment group (48.6%) (χ2=7.505, P<0.05). The drug resistance rate of patients aged between 45 and 59 years in the re-treatment group was higher than that in the initial treatment group, and was higher than that in the re-treatment group of other age groups (χ2=10.964, P<0.05). The combination drugs with high retreatment resistance were isoniazid (H)+rifampicin (R)+rifapentin (RFT) 15.34%, while ethambutol (E)+H+R+RFT (11.36%) and H+R+E+streptomycin (S)+RTF(11.36%). The drug resistance rate of the combination drug (H+S) with the most drug resistance in the initial treatment group was 17.43%.Among the patients in the treatment group, the top five drug resistance drugs were H, R, RFT, S and E respectively. There were 42 cases of single drug resistance, including 16 cases in the retreatment group and 26 cases in the initial treatment group. There were 55 cases with multi-drug resistance, including 23 cases in the re-treatment group and 32 cases in the initial treatment group.There were 171 cases with multidrug resistance, including 125 cases in the retreatment group and 46 cases in the treatment group.There were 17 cases of pan-drug resistance, including 12 cases in the re-treatment group and 5 cases in the initial treatment group.The differences among the two groups were statistically significant (χ2=27.025, P<0.05). Conclusion: Patients' gender, age, medication compliance and duration of illness as well as whether or not they were combined with extrapulmonary tuberculosis were all major factors of tuberculosis drug resistance. Poor compliance was the risk factor of tuberculosis drug resistance. The prevention and control of Mycobacterium tuberculosis infection should be strengthened in diagnosis and treatment. The provision of high-quality pharmaceutical care is one of the main measures to improve the compliance and safety of patients' medication, and to reduce the emergence of drug-resistant strains.
  • Analysis on Reasons for Intervention of Unreasonable Medication with PIVAS Prescription in a Hospital in 2018
    XIA Qiao, WU Yi
    2019, 16(9): 1488-1491. https://doi.org/10.13493/j.issn.1672-7878.2019.09-004
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To analyze the types and causes of prescription intervention for unreasonable drug use in PIVAS, and to provide a reference for guiding clinical rational drug use. Methods: 3 012 197 cases of hospital PIVAS review medical orders in 2018 were selected to analyze the types of medical orders for unreasonable drug use and their reasons. Results: Among the 3 012 197 cases of doctor's orders for review, 4 632 cases of doctor's orders for unreasonable use of drugs accounted for 0.15% of doctor's orders for review, in which the main problems were the wrong choice of solvent type and the wrong use of solvent amount accounted for 61.98%, followed by the wrong choice of drug dose (13.00%) and the mistaking input of doctor's orders (11.01%). Conclusion: Through the review and intervention of the doctor's orders for unreasonable drug use, the prescription-checking pharmacists timely intercept the doctor's orders for unreasonable drug use and to ensure the safety of patients' intravenous medication.
  • A Meta Analysis on Influence of Methimazole on Index Values of Bone Metabolism in Patients with Hyperthyroidism
    ZOU Yi, WANG Chu, HU Ling
    2019, 16(9): 1492-1496. https://doi.org/10.13493/j.issn.1672-7878.2019.09-005
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To evaluate the influence of anti-thyroid drug methimazole on bone metabolic index values in patients with hyperthyroidism by Meta-analysis. Methods: Using Embase, Cochrane Library, Pubmed, cnz.com, wanfen and other databases, clinical controlled trial data on the effect of methimazole on bone metabolism indexes in patients with hyperthyroidism and thyroid hyperthyroidism were retrieved, and quality assessment was conducted after literature selection according to inclusion criteria to extract effective data. The literature retrieval time was from the establishment of database to June 2017. The languages were English and Chinese, and the effects of methimazole on bone metabolism in patients with hyperthyroidism were evaluated by RevMan 5.3 software. Results: 8 studies (309 patients with hyperthyroidism were involved) were included. Meta-analysis results showed that post-treatment methimazole had slightly lower bone metabolism indexes such as blood calcium and blood phosphorus levels in patients with hyperthyroidism, but having no statistical significance (P>0.05). The serum ALP level was observed according to the treatment period (group within 6 months and group above 6 months). The ALP level of patients in the group within 6 months was slightly lower than that in the group above 6 months after treatment, but the difference was not statistically significant (P>0.05).After treatment, ALP level was significantly lower than that before treatment (P<0.05).The level of osteocalcin (OCN) after treatment in the group within 3 months of treatment was slightly lower than that in the group above 3 months of treatment, but there was no statistical significance(P>0.05). OCN level of patients treated between 3 and 6 months was lower than that of the group treated for 3 months (P<0.05). The OCN level in patients over 6 months of treatment was significantly lower than that in the group under 3 months of treatment (P<0.05). The level of parathyroid hormone (PTH) after treatment was significantly higher than that before treatment (P<0.05). Conclusion: In patients with hyperthyroidism treated with methimazole (between 1.5 and 12 months), the serum ALP, OCN and PTH levels in bone metabolism indexes were significantly improved compared with those before treatment, and the changes were more significant with the prolonged treatment time.
  • Optimization of Drug Dispensing Mode in Outpatient Pharmacy and Its Countermeasures to Existing Problems
    LIN Kang-shui, ZENG Chun-tao, LIU Xue-ming
    2019, 16(9): 1497-1499. https://doi.org/10.13493/j.issn.1672-7878.2019.09-006
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To analyze the optimization of drug dispensing mode in outpatient pharmacy and its countermeasures to existing problems. Methods: The personnel business training was strengthened, dividing outpatient pharmacy and pediatric pharmacy; the drug placement and distribution routes were Optimized; the queuing and calling system, disposable sterilizing paper plastic drug bag, automatic printing of electronic prescription, drug usage and dosage label, etc. were introduced. Results: The process links were reduced and the waiting time for drugs was shortened, so that the efficiency of dispensing drugs by pharmacists is improved, and the crowding and long queues at the dispensing window was improved. Conclusions: By optimizing and improving the dispensing mode of outpatient pharmacy, the work efficiency was improved, the errors of dispensing are reduced, the safety of drug delivery quality is ensured, and the level of hospital pharmaceutical care was improved.
  • Analysis on Efficacy of PDCA Cycle Management in Reducing Clinical Unreasonable Usage of Proton Pump Inhibitors and Its Countermeasures*1
    WANG Hua-jun, ZHAO Rong, TAN Cai-hong
    2019, 16(9): 1500-1503. https://doi.org/10.13493/j.issn.1672-7878.2019.09-007
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To analyze the efficacy of PDCA cycle management on reducing the clinical unreasonable usage of proton pump inhibitors (PPIs) and its countermeasures, and to provide a reference for standardizing the clinical rational usage of PPIs. Methods: 50 pieces of medical orders of inpatients using PPIs in the fourth quarter of 2017 were selected as the PDCA management pre-intervention group. In addition, 200 inpatients who used PPIs in the first, second, third and fourth quarters of 2018 were selected as the post-PDCA management intervention group, and the special comments on the rational use of PPIs in their medical orders were analyzed, and the differences in the rational use rate before and after the intervention were compared. The types and reasons of unreasonable use were analyzed. Results: After PDCA cycle management intervention, the unreasonable utilization rate of PPIs decreased from 28% to 16%, and its reasonable utilization rate continued to rise. Conclusion: PDCA cycle management intervention is beneficial to improving the quality of hospital pharmaceutical management and pharmaceutical care level, and also promoting the rational use of proton pump inhibitors in clinical practice.
  • Influence of Clinical Pathway Management on Medical Quality Management and Control of Tuberculosis and Its Countermeasures
    HU Zhi-jie, LIU Jia
    2019, 16(9): 1536-1539. https://doi.org/10.13493/j.issn.1672-7878.2019.09-020
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To evaluate the influence of clinical pathway management on medical quality management and control of tuberculosis and its countermeasures. Methods: The data of pulmonary tuberculosis patients diagnosed and treated before clinical pathway management in tuberculosis department from January 2013 to December 2015 were selected as the pre-management group. In addition, the data of pulmonary tuberculosis patients diagnosed and treated after clinical pathway management in tuberculosis department from January 2016 to December 2018 were selected as the post-management group. The control rate of medical quality (bacterial negative primary pulmonary tuberculosis, bacterial positive primary pulmonary tuberculosis, retreated pulmonary tuberculosis and tuberculosis pleurisy) in the two groups before and after management, and the changes of the average hospitalization days, the total cost of hospitalization, the proportion of drugs and the satisfaction of patients with treatment were summarized and analized. Results: After the implementation of clinical pathway management, the medical quality of tuberculosis in hospital has been significantly improved, and the number of hospitalization days decreased from 27.89 days before management to 17.29 days in 2018, the hospitalization expenses and the proportion of drugs decreased significantly, and patients' satisfaction with treatment was also improved. Conclusion: Through the implementation of clinical pathway management, which standardizes the diagnosis and treatment behavior of medical staff, and satisfaction with quality of service continues to improve, promoting the standardization, refinement and informatization of medical service management.
  • Study on Influence of Comprehensive Quantitative Score in Improving Hand Hygiene Compliance of Medical Staffs*1
    YAN Hai-bin, ZHANG Li, YUAN Chun, WANG Meng-hua, HU Yun
    2019, 16(9): 1539-1543. https://doi.org/10.13493/j.issn.1672-7878.2019.09-021
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To explore the influence of comprehensive quantitative score on medical staff's compliance with hand hygiene. Methods: A comprehensive quantitative scoring method was used to analyze the hand hygiene compliance of medical staff in a maternal and child health care hospital of " Third Level A Degree". The differences of hand hygiene compliance rate, pass rate of hand hygiene knowledge and skill examination and hand hygiene product consumption were compared per bed and day between the medical staffs before the intervention (from October 2018 to December 2018) and after the intervention (from January 2019 to June 2019). Results: The hand hygiene compliance rate of medical staff after intervention (77.93%) was higher than that before intervention (44.65%), and the efficiency was improved by 33.28% compared with that before intervention. The compliance rate of hand hygiene time of medical staff in different posts after intervention was higher than that before intervention (all P<0.05), and the pass rate of examination of hand hygiene knowledge and skills of medical staff in departments was higher than that before intervention (all P<0.05). The consumption of hand hygiene products after intervention was 7.00 mL/(bed·day), 2.82 mL/(bed·day) more than that before intervention. Conclusion: Comprehensive quantitative scoring combined with continuous monitoring, evaluation and feedback is also a simple and effective hand hygiene management method. The medical staff awareness and compliance with hand hygiene were effectively improved. The occurrence of nosocomial infection was curbed and the safety of patients during treatment was ensured.
  • Analysis on Influencing Factors in 26 Patients with Adverse Drug Reactions Caused by Cefmezole
    LU Jue
    2019, 16(9): 1555-1558. https://doi.org/10.13493/j.issn.1672-7878.2019.09-026
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To analyze The characteristics and influencing factors of ADRs induced by cefmezole, and to provide a reference for clinical rational drug use. Methods: 26 cases of ADRs of patients caused by cefmezole in hospitals from February 2016 to February 2019 were selected. The occurrence characteristics and influencing factors of ADRs were analyzed by case control study, and the influencing factors and countermeasures were evaluated by Logistic regression analysis. Results: The results of single-factor analysis showed that there was no correlation in patients' age, gender, allergic history, bottle infusion or not, and the rate of drop (P>0.05). However, the results of multivariate Logistic regression analysis showed that the number, frequency and course of treatment of combined drugs were independent risk factors for ADRs caused by cefmezole (P<0.05), and their OR values were 6.715, 35.417 and 0.178, respectively. Conclusion: The clinical symptoms of ADRs induced by cefmezole were mild, but the risk factors of ADRs such as the number, frequency and course of administration of combined drugs should be prevented to reduce the risk of ADRs.
  • Clinical Efficacy of Xeloda Combined with Oxaliplatin in Patients with Advanced Gastric Cancer and Its Influence on CEA and T Cell Levels*1
    TIAN Ya-li, CHAI Xiao-yan, ZHU Jie-bin, GU Min
    2019, 16(9): 1559-1563. https://doi.org/10.13493/j.issn.1672-7878.2019.09-027
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To explore the clinical efficacy of xeloda combined with oxaliplatin (XELOX) in the intervention of patients with advanced gastric cancer and their influence on CA19-9 and other cancer-embryo antigen (CEA) markers and T cell level improvement. Methods: The data of 132 patients with advanced gastric cancer admitted from January 2014 to December 2015 were selected. They were divided into observation group and control group according to different treatment methods, with 66 cases in each group. Patients in the observation group received XELOX regimen, while patients in the control group (66 cases) received FOLOFX regimen. The differences in total response rate and incidence of adverse reactions after treatment between the two groups as well as the changes in tumor related antigen indicators (CEA, CA125, CA19-9 and TPS) and serum T-cell subsets (CD3, CD4 and CD8) measured before and after treatment were compared. Results: There was no statistically significant difference between the two groups in the total effective rate and disease control rate after treatment (P>0.05). Three years after treatment, the recurrence rate of the observation group (57.58%) was slightly lower than that of the control group (63.64%), but there was no statistically significant difference between the two groups (χ2=0.608, P0.433>0.05). The 1-year and 3-years survival rates (93.94%, 75.76%) were slightly higher than those of the control group (90.91%, 66.67%), but there was no statistically significant difference between the two groups (P>0.05). The incidence of hand-foot syndrome in the observation group was significantly higher than that in the control group (P<0.05), while the incidence of gastrointestinal reactions, oral mucosal inflammation and leukocyte inhibition was lower than that in the control group (P>0.05). There was no statistically significant difference between the two groups in the incidence of abnormal liver function after treatment (P>0.05). After 6 weeks of treatment, the level of tumor-related antigen indicators in the observation group was lower than that in the control group (P<0.05), while the serum T-cell subsets (CD3, CD4 and CD8) were significantly higher than those in the control group (P<0.05). Conclusion: The efficacy of XELOX regimen for intervention of patients with advanced gastric cancer was better than that of FOLOFX regimen, and the incidence of adverse reactions was low, which effectively improved the survival rate and the quality of life.
  • Clinical Efficacy of Cefotaxime Sodium Combined with Albumin in Patients with Spontaneous Peritonitis and Its Influence on Liver function
    JIE Su-ping, SONG Xian-bing
    2019, 16(9): 1564-1566. https://doi.org/10.13493/j.issn.1672-7878.2019.09-028
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To explore the clinical efficacy of cefotaxime sodium combined with albumin in patients with spontaneous peritonitis and its influence on liver function as well as to provide a reference for clinical rational drug use. Methods: Data of 70 patients with spontaneous peritonitis admitted from March 2015 to May 2017 were selected and they were divided into observation group and control group according to different treatment methods, 35 cases in each group. Patients in the control group were treated with cefotaxime sodium for injection, and patients in the observation group were treated with human blood albumin injection on the basis of the control group. The differences of total effective rate, liver function (ALT, TBIL, ALB) and clinical symptom recurrence time were compared between the two groups. Results: The total effective rate (94.29%) of the observation group was higher than that of the control group (77.14%) (P<0.05), the ALB values (38.56±7.82) U/L and TBIL values (23.28±3.58) mumol /L were lower than those of the control group (P<0.05), and the ALB values (43.58±5.43) g/L were higher than those of the control group (P<0.05). After treatment, the recurrence time of clinical symptoms (body temperature, abdominal pain, ascites, abdominal tenderness, etc.) in the observation group was earlier than that in the control group (P<0.05). Conclusion: Cefotaxime sodium combined with albumin is more effective than cefotaxime sodium alone in treating patients with spontaneous peritonitis. It can effectively improve liver function, promote the recurrence of clinical symptoms and improve the clinical efficacy.