KANGGANRAN YAOXUE

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  • 2022 Volume 19 Issue 8
    Published: 25 August 2022
      
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  • Research Progress in the Role of Mycolic Acid in the Course of Mycobacterium Infection and the Corresponding Targets of Anti-tuberculotic Drugs*1
    AN Fang-fang, ZHENG Yong-biao, WU Yu-zhen, ZHANG Hui-min, WANG Fei-fei
    2022, 19(8): 1089-1095. https://doi.org/10.13493/j.issn.1672-7878.2022.08-001
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    As a higher branched chain fatty acid, mycolic acid is an important substance to maintain the skeleton structure of the cell wall of microorganisms such as mycobacteria, and also a main chemical factor that causes mycobacteria to infect the host. In addition, it plays an important role in the course of mycobacterial biofilm formation and immune escape in vivo. On this basis, scientists screened and developed a series of active anti-tuberculosis compounds by using the key enzymes in mycolic acid synthesis as targets. This paper reviews the research progress in the role of mycolic acid in the course of mycobacterium infection and the corresponding effect targets, to provide references for the development of new anti-tuberculosis drugs.
  • Research Progress in Clinical Treatment of Patients with Tuberculosis and Diabetes Comorbidity *1
    SHI Cui-lin, WU Mei-ying, XIAO Yu-mei, NIU Ya-yan, LU Jing, LING Yin, Zhang Yao-gang, LI Su-mei, ZENG Ling-wu
    2022, 19(8): 1096-1101. https://doi.org/10.13493/j.issn.1672-7878.2022.08-002
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    Both tuberculosis and diabetes are common clinical diseases and can affect each other. Diabetes can impair the immune functions of patients, which not only increases the risk of Mycobacterium tuberculosis infection, but also leads to failure of the antituberculous treatment, disease recurrence and even death of patients with tuberculosis. Therefore, for patients with comorbidities of tuberculosis and diabetes, a more targeted treatment regimen should be formulated according to the characteristics of different drugs, which has far-reaching significance for the outcome of the patients' disease. This article reviews and analyzes the significance of anti-tuberculosis drugs for patients with comorbidities of tuberculosis and diabetes in terms of the selection and course of treatment, blood glucose control, nutritional therapy, traditional Chinese medicine treatment, immunotherapy, etc.
  • Research Progress in the Pharmacological Effects and Mechanisms of Honokiol against Bladder Cancer, Skin Cancer and Osteosarcoma
    ZHANG Ming-fa, SHEN Ya-qin
    2022, 19(8): 1102-1106. https://doi.org/10.13493/j.issn.1672-7878.2022.08-003
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    Honokiol is one of the main active ingredients of the traditional Chinese medicine Magnolia officinalis. In addition to its pharmacological effects such as antibacterial, anti-inflammatory, anti-oxidation and central inhibition, honokiol can inhibit the growth of various tumor cells, thereby exerting its anti-tumor effects. In recent years, its studies mainly focus on bladder cancer, skin cancer and osteosarcoma. In terms of studies on mechanism, it was found that honokiol activated the sites such as transforming growth factor-β1 (TGF-β1), mitogen-activated protein kinase (MAPK) and nuclear factor-κB (NF-κB), and opened the corresponding signal pathway, thereby exerting its anti-tumor effects. This paper reviews and analyzes the pharmacological effects and related mechanisms of honokiol against bladder cancer, skin cancer and osteosarcoma, to provide references for the prevention and treatment of tumors and for related studies.
  • Analysis of Perioperative Prophylactic Use of Antibacterials in Patients Undergoing Neurosurgical Procedures in a Hospital*1
    LUO Min, SU Mu, LI Mei-yan, CHEN Huan, WANG Yuan-min
    2022, 19(8): 1110-1115. https://doi.org/10.13493/j.issn.1672-7878.2022.08-005
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    Objective: To analyze the perioperative prophylactic use of antibacterials in patients undergoing neurosurgical procedures in the hospital and the results on medical orders, so as to provide reference for promoting rational use of drugs in clinical practice. Methods: A total of 1 062 surgical patients with type I-Ⅲ incisions, who were admitted to the Department of Neurosurgery of the First People's Hospital of Zunyi from August 1, 2019 to August 1, 2020 and received prophylactic use of antibacterials during the perioperative period, were selected as study subjects, of which, the number of patients undergoing the surgery with type I-Ⅲ incisions was 931, 109 and 22, respectively. The information such as age, type of incisions, use of antibacterials was collected for all patients, the medical orders for antibacterials were reviewed, and the patients' age, type of incisions, the selection of antibacterials for prophylactic use, the timing of administration, the maintenance time and rational use of drugs, etc. were analyzed. Results: The age of patients who underwent neurosurgical procedures in the hospital were mainly in the range of 18 to 65 years old (723 cases, 68.08%), and their type of incisions was mainly type I incisions (931 cases, 87.66%); in terms of selection of drug varieties, the antibacterial for patients with type I and type II incisions was mainly cefuroxime (75.40% and 72.48%, respectively), and the antibacterial for patients with type Ⅲ incisions was mainly ceftriaxone (81.82%). The time of administration of antibacterials for prophylactic use for patients who received the surgery with types I-Ⅲ incisions was 0.5-1 h before operation, accounting for 67.56%, 84.40% and 72.73%, respectively; in terms of medication maintenance time, there were only 382 cases (41.03%) with maintenance time less than 24 h for patients with type I incision, and there were 85 cases (77.98%) with maintenance time less than 48 h for patients with type II incision, and the maintenance time of all patients with type Ⅲ incision were more than 48 h. The results of medical order review showed that, the main reasons for irrational prophylactic use of antibacterials in the perioperative period included too long medication maintenance time (594 cases, 55.93%), irrational timing of administration (325 cases, 30.60%) and irrational selection of drug varieties (306 cases, 28.81%). Conclusion: The prophylactic use of antibacterials for patients who underwent neurosurgical procedures in the perioperative period has serious irrationality, mainly including too long medication maintenance time, irrational timing of administration and irrational selection of drug varieties. The hospital should strengthen the promotion and training on rational use of antibacterials for clinicians, and perform periodic assessment to improve the level of clinical medical treatment.
  • Analysis of Review Results of Long-term Medical Orders and Experience of Pharmacists on Reviewing Prescriptions in PIVAS of a Hospital
    YI Dan-dan, YU Cong-yun, SONG De-ling
    2022, 19(8): 1115-1119. https://doi.org/10.13493/j.issn.1672-7878.2022.08-006
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    Objective: To analyze the review results of long-term medical orders of the pharmacy intravenous admixture service (PIVAS) of the hospital, and identify the main reasons for irrationality, so as to provide reference for the rational use of drugs in PIVAS of the hospital. Methods: A total of 272 050 long-term medical orders reviewed by pharmacists in the hospital PIVAS from December 2020 to June 2022 were selected as the study data, and the types of reasons and typical cases of unreasonable medical orders were analyzed. Results: After review by pharmacists, there were 1 325 (0.49%) unreasonable medical orders among 272 050 long-term medical orders in PIVAS, and the main reasons for unreasonableness included inappropriate solvent (515, 38.87%), inappropriate drug concentration (298, 22.49%), inappropriate frequency of medication (171, 12.90%) and inappropriate dosage (142, 10.72%). Conclusion: The long-term medication prescribed by the medical orders in PIVAS of the hospital is generally reasonable, but there is still some irrational use of drugs, mainly manifested in the solvent selection, drug concentration, medication frequency and dosage, etc. Pharmacists should continue to improve their professional ability to ensure the patients' medication safety.
  • Analysis of Distribution and Drug Resistance of Pathogenic Bacteria in Pulmonary Infection in Patients with APLC Undergoing Chemotherapy in a Hospital
    GUO Xin-lei
    2022, 19(8): 1120-1124. https://doi.org/10.13493/j.issn.1672-7878.2022.08-007
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    Objective: To investigate the distribution and drug resistance of pathogenic bacteria in pulmonary infection in patients with advanced primary liver cancer (APLC) undergoing chemotherapy, so as to provide reference for the rational use of antibacterials in such patients. Methods: A total of 148 APLC patients who were admitted to Jiyuan Cancer Hospital from June 2019 to June 2021 and concurrently developed nosocomial pulmonary infection during the period of chemotherapy were selected as study subjects. The patients' sputum was collected for pathogenic bacteria culture and drug susceptibility test, and the distribution and drug resistance of pathogenic bacteria in the specimens were analyzed. Results: A total of 172 strains of pathogenic bacteria were isolated from the sputum specimens of 148 patients with APLC, including 46 strains of Gram-positive bacteria (26.74%, mainly Staphylococcus aureus and Streptococcus pneumoniae), 107 strains of Gram-negative bacteria (62.21%, mainly Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii) and 19 strains of fungi (11.05%). The drug susceptibility test showed that the resistance rates of Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii to piperacillin-sulbactam sodium and meropenem were low (less than 30.00%), and their resistance rates to cefazolin, ceftriaxone, ampicillin and gentamicin were high (greater than 65.00%); the resistance rates of Staphylococcus aureus and Streptococcus pneumoniae to vancomycin and linezolid were low (less than 5.00%), and their resistance rates to penicillin G, erythromycin, amikacin and trimethoprim sulfamethoxazole were high (greater than or equal to 70.00%); the resistance rates of Candida albicans, Candida tropicalis and Candida glabrata to ketoconazole were low (less than 5.00%), and their resistance rates to fluconazole, amphotericin B and 5-fluorocytosine were high (greater than or equal to 50.00%). Conclusion: The main pathogenic bacteria of nosocomial pulmonary infection in patients with APLC undergoing chemotherapy are Gram-negative bacteria. The main pathogenic bacteria have a high resistance rate to most antibacterials. Clinically, the antibacterials with high sensitivity rate should be selected according to the results of drug susceptibility test to effectively control the pulmonary infection.
  • Analysis of Risk Factors and Etiological Characteristics of Complicated Biliary Tract Infection in Patients with Cholelithiasis
    ZHOU Hua-rong, SHI De-quan
    2022, 19(8): 1189-1193. https://doi.org/10.13493/j.issn.1672-7878.2022.08-027
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    Objective: To investigate the risk factors and etiological characteristics of complicated biliary tract infection (BTI) in patients with cholelithiasis, so as to provide reference for the prevention and treatment of BTI in patients with cholelithiasis. Methods: A total of 268 patients with cholelithiasis, admitted to the Maternal and Child Health Hospital of Linchuan District, Fuzhou City from August 2017 to July 2020 were selected as study subjects, and they were divided into BTI group (n=134) and non-BTI group (n=134) according to whether BTI occurred. The data of patients such as age, gender, body mass index, underlying disease conditions, duration of surgery, stone count, prophylactic use of antibacterials and etiological examination results were collected to analyze the risk factors and etiological characteristics of complicated BTI in patients with cholelithiasis. Results: A total of 179 strains of pathogenic bacteria were detected in the bile specimens of 134 patients with BTI, including 123 strains of Gram-negative bacteria (68.72%, mainly Escherichia coli and Klebsiella pneumoniae), 51 strains of Gram-positive bacteria (28.49%, mainly Enterococcus) and 5 strains of fungi (2.79%); the drug susceptibility test showed that the resistance rates of Escherichia coli and Klebsiella pneumoniae to amikacin, gentamicin, meropenem and imipenem were low (less than 30.00%), and their resistance rates to piperacillin and ciprofloxacin were high (greater than 40.00%); the resistance rate of Enterococcus to gentamicin, levofloxacin, amikacin, linezolid and vancomycin was low (less than 15.00%), and its resistance rate to erythromycin was high (greater than 80.00%). The regression analysis results showed that age, body mass index, history of biliary tract surgery, stone count and duration of surgery were associated with the complicated BTI in patients with cholelithiasis (P<0.05), of which, the age greater than 60 years old, body mass index greater than 25, history of biliary tract surgery, stone count greater than 2 and duration of surgery longer than 70 min were independent risk factors for complicated BTI in patients with cholelithiasis (P<0.05). Conclusion: Escherichia coli, Klebsiella pneumoniae and other Gram-negative bacteria are the main pathogenic bacteria in patients with cholelithiasis complicated by BTI, and appropriate drugs should be selected according to the drug resistance characteristics of pathogenic bacteria in clinical antibacterial therapy; in addition, the occurrence of biliary tract infection is correlated with age, body mass index, history of biliary tract surgery, stone count and duration of surgery. Clinically, the protection of patients should be strengthened to reduce the risk of infections.
  • Analysis of Pathogenic Bacteria Distribution and Risk Factors of Postoperative Infection in Patients of Breast Surgery in a Hospital
    WANG Xian-bin
    2022, 19(8): 1194-1197. https://doi.org/10.13493/j.issn.1672-7878.2022.08-028
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    Objective: To investigate the distribution of pathogenic bacteria and risk factors of postoperative infection in patients of breast surgery in the hospital, so as to provide reference for the precise prevention and treatment of postoperative infection for such patients. Methods: A total of 96 patients of breast surgery admitted to Chongyi County People's Hospital from January 2019 to December 2021 were selected as study subjects, and they were divided into infection group (n=21) and non-infection group (n=75) according to whether postoperative infection occurred. The data of patients such as etiological examination results, age, underlying diseases and surgical conditions were collected to analyze the distribution of pathogenic bacteria and risk factors of postoperative infections in the patients. Results: A total of 35 strains of pathogenic bacteria were detected in the specimens of 21 patients with postoperative infection, including 17 strains of Gram-negative bacteria (48.75%, mainly Klebsiella pneumoniae and Escherichia coli), 15 strains of Gram-positive bacteria (42.86%, mainly Staphylococcus aureus and Staphylococcus epidermidis) and 3 strains of fungi (8.57%); the regression analysis results showed that postoperative infection in patients of breast surgery was related to age, diabetes mellitus, nutritional status and duration of surgery (P<0.05), of which, the age greater than 60 years old, diabetes mellitus, poor nutrition and duration of surgery longer than 60 min were independent risk factors of postoperative infection (P<0.05). Conclusion: The pathogenic bacteria associated with postoperative infection in patients of breast surgery mainly include Staphylococcus aureus, Staphylococcus epidermidis, Klebsiella pneumoniae and Escherichia coli. The occurrence of infection is closely related to the age, diabetes mellitus, nutritional status and duration of surgery. Clinical management should be strengthened for patients with high risk to reduce the occurrence of infection; the etiological examination and drug susceptibility test should be actively carried out clinically to improve the accuracy of treatment.
  • Medication Analysis and Pharmaceutical Care of Anti-Infection Therapy in One Patient with Pulmonary Infection and Septic Shock
    SUN Li, ZHANG Shuang, WANG Jin-yuan, WANG Yong-mei
    2022, 19(8): 1205-1209. https://doi.org/10.13493/j.issn.1672-7878.2022.08-031
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    Objective: To investigate the anti-infection treatment process of one patient with pulmonary infection and septic shock, so as to provide reference for the treatment of patients with septic shock. Methods: During the hospitalization of the patient with septic shock in the ICU, clinical pharmacists traced the whole process and understood the patient's conditions in real time. By searching relevant literatures and data, clinical pharmacists assisted the physicians in developing an individualized anti-infection treatment regimen, carried out pharmaceutical care, and made timely adjustments in case of any change in disease conditions. Results: According to various evidences, the infection site of this patient with septic shock was considered to be lungs. Meropenem was selected as the initial empiric drug to cover most possible pathogenic bacteria. The results of multiple sputum cultures reported Acinetobacter baumannii (carbapenem-resistant), which was considered to be the main pathogenic bacteria. So the treatment regimen was adjusted in time, and finally the patient's infection was effectively controlled. Conclusion: For critically ill patients with septic shock, the clinical pharmacists can give full play to their professional knowledge and skills in the pharmacy, assist physicians in developing more targeted anti-infection treatment regimen, and carry out pharmaceutical care to ensure the precise effectiveness and safety of drug therapy.
  • A Comparative Study of "Training Program for Clinical Pharmacists Specialized in Anti-infective Drugs (2017)" and "Clinical Pharmacist Training Guide (2008)" Based on Game Theory
    YIN Zhao-jun, NIU Li-ying, WU Dian-bin, GUO Hui
    2022, 19(8): 1210-1216. https://doi.org/10.13493/j.issn.1672-7878.2022.08-032
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    Objective: To compare and analyze the differences between the "Training Program for Clinical Pharmacists Specialized in Anti-infective Drugs (2017)" (referred to as Program (2017)) and "Clinical Pharmacist Training Guide (2008)" (referred to Guide (2018)) in terms of the training objectives, training methods and training contents of clinical pharmacists specialized in anti-infective drugs, so as to provide references for the cultivation of excellent clinical pharmacists in the future. Methods: Based on the principle of game theory, the differences between the Program (2017) and Guide (2008) on the cultivation of clinical pharmacists specialized in anti-infective drugs were compared and analyzed in terms of training objectives, training methods and training contents, and personal comments and suggestions were proposed. Results and conclusion: The comparison showed that, compared with the Guide (2008), there were many beneficial improvements in the training objectives, training methods and training contents of clinical pharmacists specialized in anti-infective drugs in the Program (2017), but there were still deficiencies in some aspects, especially professional theoretical knowledge, practical skills training and the examination and assessment. The authors analyzed them one by one and proposed suggestions and comments, which should be adopted in the training program in the future to improve the quality and level of clinical pharmacist training.