KANGGANRAN YAOXUE

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  • 2019 Volume 16 Issue 11
    Published: 25 November 2019
      
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  • Research Advances in Pharmacologic Effects of Oxymatrine against Hepatocellular Carcinoma and Its Mechanism
    ZHANG Ming-fa, SHEN Ya-qin
    2019, 16(11): 1841-1846. https://doi.org/10.13493/j.issn.1672-7878.2019.11-001
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    Oxymatrine has the effects in the prophylaxis and treatment of rat hepatoma induced by diethylnitrosamine or 2-acetaminofluorene, and also has the effect of the inhibiting growth of murine hepatocarcinoma cell H22 transplantation tumor in mice. Oxymatrine inhibits proliferation, and induces apoptosis in association with dosage on hepatoma HepG2 cells,SMMC-7721 cells, BEL-7702 cells, BEL-7704 cells, QGY cells, QGY-7703 cells and 97H cells. Oxymatrine induces differentiation in hepatoma HepG2 cells, BEL-7404 cells, and PLC/PRF/5 cells too. Oxymatrine also elevates immunoregulative function in tumor-bearing body. The pharmacological effects of oxymatrine on hepatocellular carcinoma and its mechanism were reviewed and its research progress was analyzed.
  • Influence of QCC Activities on Improving Quality of Pharmaceutical Care in patients with Hypertension in Pharmacists and Its Application*1
    WANG Wan-qing, XU Tao, YAO Li-jun, GU Ji-hong, BAO Jian-an, CHEN Rong
    2019, 16(11): 1850-1855. https://doi.org/10.13493/j.issn.1672-7878.2019.11-003
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    Objective: To explore the inrfluence of quality control circle (QCC) on improving the quality of pharmaceutical care provided by outpatient pharmacists in patients with hypertension. Methods: Through the establishment of QCC activities group, quality control tools were used to analyze the reasons of low quality of pharmaceutical care provided for 236 outpatients with hypertension. The countermeasures were formulated and implemented, and finally the effects were confirmed. Results: After carrying out QCC activities, the rate of higher quality of pharmaceutical care provided for 236 patients with hypertension increased from 58.89% to 83.90%. The attainment rate of compliance was 109.26%, and the rate of progress was 42.47%. The ability of all members of solving problems and their responsibilities, and other abilities were significantly improved. Conclusion: Implementation of quality control activities is conducive to improve the quality of pharmaceutical care provided by outpatient pharmacists in patients with hypertension, and reflects the "patient-centered" principle of service.
  • Analysis on Evaluation Results of Clinical Prescription in Pediatric Internal Medicine and Rationality of Medication in a Hospital
    Huang Jian-fang, WANG Fu-hai, PENG Chun-mei, HUANG Yan-fen, ZENG Yu-chao
    2019, 16(11): 1856-1859. https://doi.org/10.13493/j.issn.1672-7878.2019.11-004
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    Objective: To analyze the evaluation results of hospital pediatric outpatient prescription and the rationality and reasons of unreasonable medication, and to provide a reference for rational drug use in hospital. Methods: From August 2018 to August 2019, 1 000 prescriptions of pediatric patients were selected to analyze the rationality and reasons of their unreasonable medication. Results: Among the 1,000 prescriptions, 857 were qualified (85.70%) and 143 were unqualified (14.30%). Among the unqualified prescriptions, 89 non-standard prescriptions accounted for 62.24% of the unqualified prescriptions, and 54 inappropriate prescriptions accounted for 37.76% of the unqualified prescriptions and 653 prescriptions for antibacterial drugs accounted for 65.30% of all prescriptions;The number of children with fever after intravenous administration was 547, accounting for 54.70% of all children. The average number of medicines used by children was 2.16, and the average number of essential medicines used was 1.67. Conclusion: The hospital administrative department should attach importance to the study of professional medicine knowledge of clinicians and pharmacists so as to improve the level of rational medicine use.
  • Analysis on Antibiotic Resistance of Pseudomonas Aeruginosa Infection in Elderly Patients and Its Detection of Metalloenzyme Phenotype*1
    ZHANG Dan, LUO Shi-rong, ZHOU Shi-juan, YU Jin-sheng
    2019, 16(11): 1860-1862. https://doi.org/10.13493/j.issn.1672-7878.2019.11-005
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    Objective: To analyze the antimicrobial resistance of Pseudomonas aeruginosa infection in elderly patients in hospital and to detect the metalloenzyme phenotype. Methods: The data of bacterial identification and drug susceptibility test were extracted from various clinical specimens of elderly inpatients admitted to the hospital from March 2017 to March 2019 (isolated and identified by BD phoenix 100 bacterial identification system of the United States).The phenotype of the strain resistant to imipenem and its resistance to metalloenzyme were analyzed. Results: The 215 isolates of Pseudomonas aeruginosa were all sensitive to polymyxins, but showed low drug resistance to amikacin (drug resistance rate was 4.19%). The drug resistance rates of ciprofloxacin and levofloxacin were 39.53% and 36.74%, respectively, and the drug resistance rates of imipenem and meropenem were 16.74% and 12.56%, respectively. In addition, one of 36 imipenem-resistant Pseudomonas aeruginosa strains was screened out by the combined paper method. Conclusion: In view of the different degrees of resistance of pseudomonas aeruginosa to antimicrobial agents in elderly patients in hospital, clinicians should follow the treatment principle of anti-pseudomonas aeruginosa, select appropriate antimicrobial agents for treatment, and standandize the control of high-risk infectious factors. In addition, the trend of drug resistance of pseudomonas aeruginosa should be monitored, especially carbapenems, so as to take effective measures to control the development of drug resistance of pseudomonas aeruginosa.
  • Analysis on Effectiveness of Special Prescription Comment on Vidarabine Monophosphate for Injection
    ZHONG Wen, HUANG Yan, ZHOU Feng
    2019, 16(11): 1863-1866. https://doi.org/10.13493/j.issn.1672-7878.2019.11-006
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    Objective: To analyze and establish a prescription evaluation model of vidarabine monophosphate, to strengthen the management of rational use, and to provide a reference for safe and rational drug use in clinical children. Methods: A total sample of outpatient prescriptions containing vidarabine monophosphate were selected from June to October 2016. According to the requirements of "Prescription Management Measures"and "Hospital Prescription Review Management Standards"(trial implementation), pharmacists made a retrospective review of the prescriptions and submitted the results to the Hospital Prescription Review Expert Group. After discussion, the final result will be handed over to the Medical Department for publicity and punishment. Results: After 4 months of prescription evaluation and public announcement combined with hospital administrative treatment, the number of single prescription of vidarabine monophosphate decreased from 546 before treatment to 230 after treatment, and the qualified rate of vidarabine monophosphate prescription use increased from 1.10% before treatment to 24.34% after treatment. The rationality of the drug use was improved significantly. Conclusion: The special prescription evaluation model based on expert group and the effective reward and punishment system improved the prescription rational rate, but at present we still had to focus on post-comment. It is necessary to improve the hospital informatization and focus on the pre-prescription auditing so as to ensure the safety and effectiveness of the patient medication.
  • Influence of Statistics Management and Information Control on Economic Income of TCM Hospitals after Medical Reform
    SHENG Yiliang, WU Yan, ZHU Xing-yu, ZHANG Jing
    2019, 16(11): 1867-1870. https://doi.org/10.13493/j.issn.1672-7878.2019.11-007
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    Objective: To discuss the influence of statistical management and information technique control on hospital income after medical reform. Methods: through the statistical management and performance evaluation of drug proportion varieties. Information management to control drug use was used. Clinical pharmacists comment on the prescriptions and medical orders of disqualified departments, and took effective measures to control drug use. Results: Medicine proportion of western medicine and proprietary Chinese medicine declined to 3.31% compared with the same period of last year. Medicine proportion of Chinese traditional medicine increased to 1.29% compared with the same period of last year.The net income of drugs increased 9.64%. Conclusion: The control of drug share and related measures may increase the net income of drugs and alleviate the economic pressure of the hospital.
  • Analysis and Comment on Factors Related to Clinical Medication of Special Grade Antibacterial Drugs in Neurosurgery Patients in a Hospital
    HU Bo-lin, LIANG Ye-fei, BU Ziqing
    2019, 16(11): 1870-1874. https://doi.org/10.13493/j.issn.1672-7878.2019.11-008
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    Objective: To analyze the use of special grade antibiotics in neurosurgery patients, and to provide a reference for the rational use of antibacterial drugs. Methods: The data of varieties, utilization rate, indications, usage and dosage of antibiotics of special grade were collected from inpatients admitted to the department of neurosurgery from January to December 2018. The rationality and unreasonable reasons of the special grade antibacterial drugs in clinical use were analyzed. Results: 88 patients were treated with special grade antibiotics; among them, the rate of meropenem was 77.36%, followed by vancomycin 14.15%.98 medical records (89.77%) were examined for etiology before the use of special grade antibiotics (sputum was the main sample). Among the 41 cases of unreasonable medication, 12 cases of irregular usage and dosage accounted for 29.27%, 15 cases of irregular usage and dosage, 15 cases of no consultation record of expert group members accounted for 36.59%, and 2 cases of improper medication and indications accounted for 4.88%. Conclusion: In this department, the application rate of special grade antibacterial drugs was well controlled in etiology, but there were some problems, such as unreasonable usage and dosage, non-standard application procedure, inappropriate indications, etc.. It is suggested that the hospital should strengthen the management of clinical use of special grade antibacterial drugs, so as to ensure the rationality of patients' medication.
  • Analysis on Risk Factors of Surgical Site Infection in 35 Patients with Cardiac Surgery and Its Countermeasures
    SONG Jun-hong
    2019, 16(11): 1904-1906. https://doi.org/10.13493/j.issn.1672-7878.2019.11-019
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    Objective: To explore the risk factors of surgical site infection in patients with cardiac surgery and its countermeasures. Methods: Clinical data of 218 patients admitted to cardiac surgery from August 2016 to September 2018 were collected, and the risk factors related to surgical site infection were analyzed. Results: Among the 218 patients, 35 patients had surgical site infection （accounting for 16.06%）. Using multiariable Logistic regression analysis the results showed that patients who aged 60 or higher and had a history of diabetes, Ⅱ~Ⅲ incision, duration of surgery or greater 3 h, 1 500 mL intraoperatie blood loss or greater, whose hospitalization days 20 d, 5 d or higher drainage indwelling time, preoperative use of antibiotics and associated with malignant tumors in the 2 h had heart independent risk factors for surgical site infection. Conclusion: Patients' age, history of diabetes, type of incision, etc. were the risk factors for surgical site infection in cardiac surgery patients; in order to control the occurrence of surgical site infection, clinical doctors need to take effective measures to prevent these risk factors.
  • Pharmaceutical Care based on Therapeutic Drug Monitoring of Anti-fungal Medication in 1 Patient with Severe Aspergillus Fumigatus Infection
    LI Mei-yun, HU Jian, LIU Li-hua, ZHANG Ming-xiang, LI Xin
    2019, 16(11): 1920-1923. https://doi.org/10.13493/j.issn.1672-7878.2019.11-024
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    Objective: To explore pharmaceutical care based on therapeutic drug monitoring(TDM) of anti-fungal medication in 1 patient with severe Aspergillus fumigatus infection and to provide a reference for clinical formulation to individualize drug delivery plan and medication monitoring of voriconazole. Methods: According to the monitoring results of blood drug concentration, clinical pharmacists participated in the optimization of drug regimen of voriconazole and the monitoring of adverse drug reactions and drug interactions of one patient with pulmonary Aspergillus fumigus infection. Results: After the clinical pharmacists applied the blood concentration monitoring technique to the critically ill patient with individualized medication and pharmaceutical care, the patient's pulmonary fungal infection and adverse drug reactions were controlled, the pulmonary inflammation was significantly improved and the condition was stable. Conclusion: During the treatment of critical ill patients with Aspergillus fumigus infection with voriconazole, clinical pharmacists conducted pharmaceutical care for the patients based on TDM, ensuring the safety and effectiveness of the patients' medication.
  • Pharmaceutical Care of Clinical Medication in Acute Attack Patients with Bronchial Asthma and Clinical Pharmacists Experience
    LI Xiao-lan
    2019, 16(11): 1923-1926. https://doi.org/10.13493/j.issn.1672-7878.2019.11-025
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    Objective: To explore the pharmaceutical care of Clinical medicatiom in acute attack patients with bronchial asthma and to provide a reference for clinical rational drug use. Methods: Clinical pharmacists participated in the detection and analysis of pathogenic bacteria caused by acute attack of bronchial asthma patients and the process of clinical medication monitoring. The rationality of drug therapy was evaluated. Conclusion: Clinical pharmacists based on the actual clinical treatment of bronchial asthma patients, established the targeted drug treatment programs to improve the rationality of medication and the effectiveness of clinical treatment in patients with bronchial asthma.
  • Analysis on Related Factors in Report of 535 Cases of Adverse Drug Reaction to Antibiotics in a Hospital
    MENG Xiang-yun, MENG Wang-yang, XING Hai-yan, DAI Li, JIANG Yi, WANG Xing-hui
    2019, 16(11): 1930-1934. https://doi.org/10.13493/j.issn.1672-7878.2019.11-027
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    Objective: To analyze the characteristics of adverse drug reactions (ADR) of antibiotics in a hospital and to promote rational use of antibiotics in clinic. Methods: 535 cases of ADRs reported from January 2016 to December 2018 were selected to analyze the related factors involved in ADRs. Results: Among the 535 cases of ADRs, 248 cases were male and 287 cases were female. The number of reported cases of ADRs increased year by year. The most ADRs were induced by intravenous administration (93.46%), followed by oral administration (6.16%).Cephalosporins accounted for 26.83% of the drugs involved in the report.ADRs reported general ADRs (93.27%), new ADRs (4.67%), and severe ADRs (2.06%). Conclusion: The hospital administrative department should attach importance to the reporting and monitoring of adverse reactions of antibacterial drugs, rationally use antibacterial drugs and cautiously use quinolones, so as to ensure the rationality and safety of patients' medication.