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  • 2022 Volume 19 Issue 5
    Published: 25 May 2022
      
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  • Research Progress in the Etiology of SARS-CoV-2 Omicron Variant*1
    ZHANG Jian-ping, SHI Cui-lin, SUN Gang, WU Mei-ying, XU Ming-hao, Cheng Jun-ping
    2022, 19(5): 617-621. https://doi.org/10.13493/j.issn.1672-7878.2022.05-001
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    The SARS-CoV-2 concerned variant was named as "Omicron" by WHO on November 26, 2021. The novel structural variation of the Omicron variant mainly focuses on the spike protein that is closely related to the pathogenicity and antigenicity, making such variant more infectious and with strong immune escape, leading to another round of large-scale spread of the global epidemic. In addition, the Omicron variant itself is constantly mutating to evolve into the variants such as BA.1, BA.2 and BA.3, which have the ability to immunize the existing vaccines and have expanded the scope of transmission, causing global concern. In this paper, with references to the existing literatures, the structural characteristics, transmissibility, pathogenicity, immune escape characteristics, vaccine resistance, and detection methods of the Omicron variant are reviewed, and corresponding analysis is performed.
  • Research Progress in the Protective Effect of Magnolol and Honokiol on Brain Injury and Their Mechanisms*1
    ZHANG Ming-fa, SHEN Ya-qin
    2022, 19(5): 621-626. https://doi.org/10.13493/j.issn.1672-7878.2022.05-002
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    The overall test results showed that magnolol and honokiol had protective effects on brain injury caused by hypoxia, ischemia, ischemia-reperfusion, hemorrhage, febrile heatstroke and sepsis. The in vitro experiments also confirmed that magnolol and honokiol could resist the injury of nerve cells caused by chemical hypoxia, glucose deficiency, ischemia-reperfusion, hyperthermia, hydrogen peroxide (H2O2), excitatory neurotransmitter N-methyl-D-aspartate (NMDA) and glutamic acid, and trimethyltin. This suggests that magnolol and honokiol may inhibit the expression of inflammatory cytokines by directly scavenging oxygen free radicals, indirectly scavenging oxygen free radicals through increasing the body's antioxidant enzyme activity, as well as blocking phosphatidylinositol 3-kinase (PI3K)-protein kinase B (Akt), extracellular signal-regulated kinase (ERK)-mitogen-activated protein kinase (MAPK) and Toll-like receptor (TLR)/MAPK/nuclear factor κB (NF-κB) signaling pathways, thereby producing antioxidant and anti-inflammatory effects and playing a protective role on the brain. In addition, magnolol and honokiol can counteract the damage of excitatory neurotransmitters to nerve cells by promoting the biosynthesis of the inhibitory neurotransmitter of Gamma-aminobutyric acid (GABA) and enhancing the receptor binding ability of GABA. In this paper, the protective effects of magnolol and honokiol on the brain injury and their mechanisms of actions are summarized, and the research progress is analyzed.
  • Research Progress in the Relationship Between Persistent High-Risk Human Papillomavirus Infection and Cervical Precancerous Lesions
    GAO Yan
    2022, 19(5): 626-629. https://doi.org/10.13493/j.issn.1672-7878.2022.05-003
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    Cervical cancer is a malignant tumor in women second only to breast cancer. China is one of the countries with the largest number of new cases of cervical cancer in the world, and its occurrence is tending to younger. Cervical precancerous lesions refer to abnormal cervical proliferative lesions that have not yet reached the criteria for diagnosis of cervical cancer, but are likely to turn into cervical cancer if existing for a long time. Cervical precancerous lesions are reversible, i.e. some lesions may disappear naturally, but may have developed or even become cancerous. Human papilloma virus (HPV) infection is one of the key factors leading to cervical cancer, of which, persistent high-risk HPV infection is a high risk factor for cervical precancerous lesions and cervical cancer. In this paper, the relationship between persistent high-risk HPV infection and cervical precancerous lesions is reviewed, and the research progress is analyzed.
  • Determination of Metoprolol Drug Concentration in Human Serum by LC-MS/MS Method*1
    YANG Juan-juan, ZHAO Heng-yi, CHEN Yong-gang
    2022, 19(5): 630-634. https://doi.org/10.13493/j.issn.1672-7878.2022.05-004
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    Objective: To establish the LC-MS/MS method for the determination of metoprolol drug concentration in human serum. Methods: The Acquity UPLC BEH C18 (2.1 mm×50 mm, 1.7 μm) column was used, taking 0.1% formic acid solution (solution A) as mobile phase-A, methanol-water (95:5) solution (containing 0.1% formic acid, 2 mmol/L ammonium formate) (solution B) as mobile phase-B; the gradient elution conditions were 20% solution B at 0~0.2 min, 20%~60% solution B at 0.2~2.5 min, 60%~20% solution B at 2.5~2.8 min, 20% solution B at 2.8~3 min, with a flow rate of 0.3 mL/min and column temperature of 40 ℃. The analyte and internal standard (esmolol) were extracted from 20 μL serum samples by the method of protein precipitation with methanol; the electrospray ionization (ESI) was running in the positive ion mode of multiple reaction monitoring (MRM), to detect the drug concentration of metoprolol in serum. Results: The standard curve equation of metoprolol was A = 0.173 064ρ–0.182 573. The drug concentration exhibited a good linear relationship in the range of 0.45~180 ng/mL (r=0.999 6), the lower limit of quantification was 0.45 ng/mL, the RSDs of intra-day and inter-day precision were less than 15% and the extraction recovery rate ranged from 88.36% to 93.57%. Conclusion: The LC-MS/MS method for the determination of the drug concentration of metoprolol in serum has strong specificity, with low serum consumption. It is easy to operate, accurate and fast, and can be clinically used for the routine drug concentration monitoring of metoprolol.
  • Analysis of Comments on Prescription of Anti-Cold Drugs in Outpatient and Emergency Departments of a Hospital
    LU Yun-xia, LI Teng-yun
    2022, 19(5): 635-639. https://doi.org/10.13493/j.issn.1672-7878.2022.05-005
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    Objective: To analyze the prescription comments results of anti-cold drugs in the Outpatient and Emergency Departments of a hospital, and provide reference for the standardized and rational use of anti-cold drugs. Methods: A total of 800 prescriptions of anti-cold drugs were randomly selected from the Outpatient and Emergency Departments of Jiangsu Shengze Hospital from January 2018 to December 2019 according to the standard of 50 prescriptions per quarter. The prescriptions were commented according to the relevant guidelines, and the drug categories of the prescriptions, the distribution of departments and types of reasons for irrational prescriptions were analyzed. Results: The drugs involved in the 800 anti-cold drug prescriptions were mainly oral antipyretics and analgesics (436), Chinese patent medicines (405), compound anti-infective preparations (370) and antibacterials (367), but there were also injections (218). Among the 800 prescriptions, there were 36 unreasonable prescriptions, mainly from the outpatient of respiratory medicine (16), emergency internal medicine (9) and emergency pediatrics (5). The main reasons of unreasonable prescriptions were inappropriate usage and dosage (15), inappropriate combination medication (8), and no indication medication (5). Conclusion: The use of anti-cold drugs in Outpatient and Emergency Departments of the hospital is generally reasonable, but there are still some problems. The hospital should strengthen the use management and publicity and education of anti-cold drugs, improve the level of clinical rational drug use, and reduce unnecessary drug therapy.
  • Analysis of Microbial Culture and Drug Resistance Changes of Inpatients in the Emergency Department of a Hospital
    LIANG Jing, LIU Shan-shan, JI Yan-ping
    2022, 19(5): 639-643. https://doi.org/10.13493/j.issn.1672-7878.2022.05-006
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    Objective: To analyze the microbial culture and drug resistance changes of inpatients in the Emergency Department of a hospital, and provide reference for the rational use of antibacterials. Methods: The medical records of 2 051 patients who were admitted to the Emergency Department of Dongli District Hospital of Traditional Chinese Medicine and underwent the microbial culture from 2015 to 2019 were collected, and the statistics and analysis of the distribution of pathogenic bacteria and drug resistance changes of major pathogenic bacteria in the inpatients of the Emergency Department over the years, as well as the clinical features of patients with Klebsiella pneumoniae infection were conducted. Results: A total of 3 387 strains of pathogenic bacteria were isolated from the specimens of 2 051 inpatients in the Emergency Department, including 1 805 strains of Gram-negative bacteria (53.29%), 1 141 strains of Gram-positive bacteria (33.69%) and 441 strains of fungi (13.02%); the top 5 bacteria were Acinetobacter baumannii (660 strains), Staphylococcus aureus (436 strains), Klebsiella pneumoniae (347 strains), Pseudomonas aeruginosa (338 strains) and Escherichia coli (237 strains); the drug susceptibility test results showed that, from 2015 to 2019, the drug resistance rate of Klebsiella pneumoniae to cefoperazone-sulbactam sodium, imipenem, amikacin and ciprofloxacin increased dramatically, and the drug resistance rates of Acinetobacter baumannii, Pseudomonas aeruginosa and Escherichia coli to cefoperazone-sulbactam sodium increased dramatically, but the drug resistance rates of Acinetobacter baumannii, Klebsiella pneumoniae and Escherichia coli to minocycline decreased dramatically; over the 5 years, the drug resistance rate of Staphylococcus aureus to vancomycin, linezolid, and tigecycline was always low (less than 5.00%), and the drug resistance rate of Staphylococcus aureus to levofloxacin and tetracycline decreased dramatically, but still relatively high (greater than 40.00%); the incidence of Klebsiella pneumoniae infection was higher (greater than 65.00%) in patients at or above 60 years old with deep venous catheters or indwelling catheters. Conclusion: Acinetobacter baumannii, Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa and Escherichia coli are the main bacteria detected in the inpatients of the Emergency Department of the hospital, and these 5 bacteria show strong drug resistance. Of which, the drug resistance of Klebsiella pneumoniae shows an obvious increasing trend in the past 5 years. The hospital should strengthen the detection of pathogenic bacteria and their drug resistance monitoring, so as to develop more scientific and reasonable anti-infective therapy regimens for clinical practices.
  • Analysis of Distribution and Drug Resistance Characteristics of Pathogenic Bacteria and the Use of Antibacterials among Inpatients in the Endocrinology Department of a Hospital from 2019 to 2021
    TANG Li-ping, ZHU Li, LIU Na, WANG Sai-fang
    2022, 19(5): 644-648. https://doi.org/10.13493/j.issn.1672-7878.2022.05-007
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    Objective: To investigate the distribution and drug resistance characteristics of pathogenic bacteria and the use of antibacterials among inpatients in the Endocrinology Department of a hospital. Methods: A total of 100 inpatients with concurrent infection who were admitted to the Endocrinology Department of Anyuan District People's Hospital of Pingxiang City from January 2019 to December 2021 were selected as the subjects, and the statistics and analysis of the patients' infection types, distribution and drug resistance characteristics of pathogenic bacteria, as well as the use of antibacterials in the patients were conducted. Results: The types of concurrent infections in the 100 patients were mainly urinary tract infection (50 cases, accounting for 50.00%) and pulmonary infection (27 cases, accounting for 27.00%). A total of 110 strains of pathogenic bacteria were detected from the specimens of the 100 patients, including 62 strains of Gram-negative bacteria (56.36%, mainly Escherichia coli, Klebsiella pneumoniae and Acinetobacter baumannii), 38 strains of Gram-positive bacteria (34.55%, mainly Staphylococcus hemolyticus and Staphylococcus aureus) and 10 strains of fungi (9.09%). The drug susceptibility test results showed that Staphylococcus hemolyticus had a low resistance rate (less than 20.00%) to rifampicin, compound sulfamethoxazole and tigecycline; the resistance rate of Staphylococcus aureus to tigecycline was 0.00%; Escherichia coli, Klebsiella pneumoniae and Acinetobacter baumannii had a low resistance rates (less than or equal to 30.00%) to imipenem, tigecycline and piperacillin-tazobactam sodium; among the 100 patients, the most frequent and expensive antibiotic was amoxicillin-clavulanate potassium for injection, while the least frequent drug was Ciprofloxacin for injection; the patients mainly used single agent (75 cases, accounting for 75.00%), and the combined use of 3 or more drugs was less (7 cases, accounting for 7.00%). Conclusion: Urinary tract infection and pulmonary infection are the main infections in the inpatients in the Endocrinology Department of the hospital. The pathogenic bacteria are mainly Gram-negative bacteria, and the main pathogenic bacteria have strong resistance to antibacterials. Clinically, it is necessary to strengthen the drug resistance monitoring of pathogenic bacteria and improve the accuracy of anti-infective therapy.
  • Analysis of Distribution and Drug Resistance of Pathogenic Bacteria in Sputum Specimens of 349 Elderly Patients with Pulmonary Infection after Lung Cancer Surgery
    XU Hong-yan, LU Kui-bin, QU Zhan, WANG Qing-feng, DONG Xian-ming
    2022, 19(5): 648-655. https://doi.org/10.13493/j.issn.1672-7878.2022.05-008
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    Objective: To analyze the distribution and drug resistance of pathogenic bacteria in sputum specimens 134. of elderly patients with pulmonary infection after lung cancer surgery in the hospital, and provide reference for the clinically rational use of antibacterials. Methods: A total of 349 elderly patients with postoperative pulmonary infection complicated by lung cancer who were admitted to the Department of Respiratory Medicine, Affiliated Hospital of Henan Medical College from April 2019 to April 2021 were selected as subjects, to analyze the distribution of pathogenic bacteria and drug resistance characteristics of major pathogenic bacteria in sputum specimens of the patients. Results: A total of 412 strains of pathogenic bacteria were detected in sputum specimens from 349 patients with concurrent pulmonary infection, including 247 strains of Gram-negative bacteria (59.95%, mainly Staphylococcus aureus, Staphylococcus hemolyticus and Staphylococcus epidermidis), 124 strains of Gram-positive bacteria (30.10%, mainly Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa) and 41 strains of fungi (9.95%). The drug susceptibility test results showed that the drug resistance rates of Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa to cefoperazone, cefepime and imipenem were low (less than 30.00%), and their drug resistance rates to cefazolin, ampicillin and compound sulfamethoxazole were high (greater than 60.00%). The drug resistance rates of Staphylococcus aureus, Staphylococcus hemolyticus and Staphylococcus epidermidis to vancomycin were low (less than 10.00%), and their drug resistance rates to penicillin, erythromycin, gentamicin, clindamycin and compound sulfamethoxazole were high (greater than 50.00%). Conclusion: The pathogenic bacteria in patients with concurrent pulmonary infection after lung cancer surgery are mainly Gram-negative bacteria, and the drug resistance of main pathogenic bacteria is generally strong. When formulating the treatment regimen clinically, it is necessary to give full consideration to the pathogenic bacteria that cause infection and their drug resistance characteristics, to improve the curative effect of anti-infective therapy.
  • Analysis of Clinical Features of Patients with Multiple Myeloma and Distribution and Drug Resistance of Pathogenic Bacteria in Patients with Pulmonary Infection
    LYU Gen-sheng
    2022, 19(5): 656-659. https://doi.org/10.13493/j.issn.1672-7878.2022.05-010
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    Objective: To analyze the clinical features of patients with multiple myeloma (MM), as well as the distribution and drug resistance of pathogenic bacteria in those with pulmonary infection, and provide reference for the anti-infective therapy of such patients. Methods: The case data of 94 MM patients admitted to Zhongmu County People's Hospital from April 2020 to April 2021 were selected, including 63 patients with pulmonary infection and 31 patients without pulmonary infection. The statistics and analysis of the clinical features of patients, as well as the distribution of pathogenic bacteria and drug resistance characteristics of major pathogenic bacteria in the sputum specimens of patients with concurrent pulmonary infection were conducted. Results: The incidences of agranulocytosis, fever, stage Ⅲ myeloma and comorbidities in MM patients with pulmonary infection were significantly higher than those without pulmonary infection (P<0.05); a total of 63 strains of pathogenic bacteria were detected in the sputum specimens of 63 patients with pulmonary infection, including 42 strains of Gram-negative bacteria (61.76%, mainly Klebsiella pneumoniae and Pseudomonas aeruginosa), 24 strains of Gram-positive bacteria (35.29%, mainly Staphylococcus aureus and Staphylococcus epidermidis) and 2 strains of fungi (2.94%). The drug susceptibility test results showed that the drug resistance rates of Klebsiella pneumoniae and Pseudomonas aeruginosa to imipenem and meropenem were low (less than 10.00 %), and their drug resistance rates to cefazolin, amoxicillin and ceftriaxone were high (greater than 80.00%); the drug resistance rates of Staphylococcus aureus and Staphylococcus epidermidis to vancomycin, rifampicin and linezolid were low (less than 10.00%), and their drug resistance rates to ampicillin, penicillin, tetracycline and erythromycin were high (greater than 70.00%). Conclusion: Agranulocytosis, fever, stage Ⅲ myeloma and comorbidities are more likely to occur in MM patients with pulmonary infection, and the pathogenic bacteria are mainly Gram-negative bacteria. Clinically, the antibacterials should be chosen rationally according to the microbial culture and drug susceptibility test results, in order to improve the accuracy of anti-infective therapy.
  • Analysis of Medication and Pharmaceutical Care of 17 Patients with COVID-19 in a Region*1
    ZHANG Xing, MI Jia-li, ZHAO Chuan, YANG Si-yun
    2022, 19(5): 733-737. https://doi.org/10.13493/j.issn.1672-7878.2022.05-036
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    Objective: To investigate the drug therapy and pharmaceutical care of patients with COVID-19 and provide reference for the clinical treatment of COVID-19. Methods: A total of 17 patients confirmed with COVID-19 in Suining City before March 10, 2020 were selected as subjects, to analyze the medication and monitoring of adverse drug reactions of the patients and their outcomes. Results: A total of 17 patients with COVID-19 were cured and discharged after treatment in designated hospitals, but the length of hospital stay of severe patients was significantly longer than that of ordinary and mild patients; in terms of drug therapy, all patients received the treatment with antiviral drugs and Chinese patent medicines, and 16 patients also received treatment with antibacterials due to concurrent infection symptoms; during the treatment, 15 patients developed adverse drug reactions with symptoms such as hyperlipidemia, diarrhea, nausea, etc. By considering the relationship between the occurrence of adverse reactions and medication time, it was suspected that these adverse reactions were probably caused by lopinavir-ritonavir, but most of them disappeared or improved after symptomatic treatment. Conclusion: All the patients with COVID-19 are cured and discharged under the active treatment by medical staff in the designated hospitals, but many patients were found to have different degrees of adverse drug reactions during the medication process. Clinically, it is necessary to optimize the selection of drugs and strengthen the pharmaceutical care of therapeutic drugs, to reduce or avoid the occurrence of adverse drug reactions.
  • Treatment Process and Pharmaceutical Care of One Patient with Abnormal Coagulation Function Caused by Cefoperazone-Sulbactam Sodium
    GUO Jiang-ping, LI Yan-chao
    2022, 19(5): 738-741. https://doi.org/10.13493/j.issn.1672-7878.2022.05-037
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    Objective: To analyze the treatment process and pharmaceutical care of the patient with abnormal coagulation function caused by cefoperazone-sulbactam sodium, and provide reference for the medication safety and adverse reaction response of cefoperazone-sulbactam sodium. Methods: The patient developed unexplained abnormal coagulation function during clinical treatment. Clinical pharmacists assisted doctors in developing targeted treatment regimens and implemented pharmaceutical care by analyzing the patient's medication history and combining the pharmaceutical characteristics of related drugs. Results: By investigating the drug use of the patient and combining with relevant literature, it was basically determined that the abnormal coagulation function of the patient was caused by cefoperazone-sulbactam sodium; then the drug was discontinued immediately and symptomatic treatment was carried out. Finally, the coagulation function of the patient recovered quickly. Conclusion: Abnormal coagulation function is a common adverse reaction of cefoperazone-sulbactam sodium. Clinical pharmacists should actively pay attention to the coagulation function of related patients after medication during the pharmaceutical ward rounds, so as to assist doctors in responding to adverse drug reactions and ensure the medication safety of patients.
  • Analysis of Clinical Treatment of Bloodstream Infection in Pregnant Women in the Third Trimester Caused by Listeria Monocytogenes
    WANG Hong, PAN Bin, SUN Xiao-hong, SHUAI Li-hua, ZHOU Hui-xiang, OU-YANG Liang-liang
    2022, 19(5): 741-744. https://doi.org/10.13493/j.issn.1672-7878.2022.05-038
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    Objective: To analyze the clinical diagnosis and treatment process of bloodstream infection in pregnant women in the third trimester caused by Listeria monocytogenes, and provide reference for the clinical treatment of such disease. Methods: For one clinically received patient with fever pending investigation, the medical staff searched for possible pathogens by means of laboratory test and microbial culture, etc., judged the drug susceptibility characteristics of pathogenic bacteria based on the drug susceptibility test, and developed individualized treatment regimen according to the relevant literature. Results: The results of blood culture showed that Listeria monocytogenes was positive, suggesting that the patient's fever was possibly caused by the bloodstream infection due to Listeria monocytogenes. The drug susceptibility test results showed that the said bacteria were sensitive to penicillin, ampicillin, erythrocin and meropenem. After adjusting the clinical treatment regimen, the patient's fever and other infection indications disappeared quickly. Conclusion: When patients with unexplained fever are found clinically, it is necessary to actively carry out etiological screening, use various examination techniques to find out the cause of disease, and develop a targeted treatment regimen, in order to promote the recovery of patients.
  • Anti-Infective Pharmaceutical Care of 5 Patients with General Surgical Infection Participated by Clinical Pharmacists*1
    YAN Cheng, SU Yan-lei
    2022, 19(5): 745-748. https://doi.org/10.13493/j.issn.1672-7878.2022.05-039
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    Objective: To explore the method and process of anti-infective pharmaceutical care by clinical pharmacists for 5 patients with general surgical infection, and provide reference for the clinically rational drug use of such patients. Methods: Clinical pharmacists actively participated in and assisted doctors in developing individualized anti-infective therapy regimens according to the patients' infection types, laboratory test indices, microbial culture results and their drug susceptibility characteristics and with reference to the relevant consensus in the guidelines, and carried out pharmaceutical care for the treatment effect and possible adverse drug reactions. Results: With the joint efforts of doctors and clinical pharmacists, the infection indications of 5 patients disappeared or improved significantly, and the patients were discharged smoothly. Conclusion: Clinical pharmacists can give full play to their expertise in the pharmacy and assist in developing more scientific and reasonable drug therapy regimens, when carrying out the clinical work, so as to promote the recovery of patients.
  • Analysis of Clinical Features of 127 Cases of Reported Adverse Reactions of Antibacterials in 4 Tertiary General Hospitals in Xuzhou Region
    YAN Wei, TIAN Jia-qi, SUN Wei
    2022, 19(5): 749-752. https://doi.org/10.13493/j.issn.1672-7878.2022.05-040
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    Objective: To analyze the clinical features of adverse drug reactions (ADRs) caused by antibacterials reported by four tertiary general hospitals in Xuzhou Region, and provide reference for the safe and rational use of antibacterials in clinical practice. Methods: Relevant data of 127 cases of ADRs caused by antibacterials reported to the National Adverse Drug Reaction Monitoring Center from 4 tertiary general hospitals in Xuzhou Region were collected, to analyze the age and gender distribution of patients reported with ADRs, the types, dosage forms and route of administration of antibacterials, as well as the organs involved, severity and outcomes. Results: Among the 127 cases of ADRs reported, most of them were above 60 years old (43 cases, 33.86%) and female patients had a high proportion (75 cases, 59.06%); among the antibacterials involved in ADRs, the proportions of cephalosporins (51 cases, 40.16%) and fluoroquinolones (37 cases, 29.13%) were the highest, followed by penicillins, macrolides and aminoglycosides. In terms of the dosage forms, the proportion of the injection was the highest; in terms of organ involvement, 127 cases of ADRs mainly involved the skin and its appendages (76 cases) and the digestive system (36 cases); in terms of severity, 117 cases were "general", and 9 cases were "severe", and 124 cases of patients were treated as improvement or recovery. Conclusion: There is a certain risk of occurrence of ADRs in the clinical use of antibacterials. Clinicians should pay attention to and attach importance to the occurrence of ADRs of antibacterials, understand and master the occurrence characteristics of ADRs of antibacterials, and avoid or reduce the harm of ADRs as much as possible, so as to ensure the medication safety for patients.