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  • 2022 Volume 19 Issue 9
    Published: 25 September 2022
      
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  • Research Progress in Pharmacological Effects of Traditional Chinese Medicine Magnoliae Officinalis Cortex on Intestinal Tract and Its Mechanism
    ZHANG Ming-fa, SHEN Ya-qin
    2022, 19(9): 1243-1247. https://doi.org/10.13493/j.issn.1672-7878.2022.09-001
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    Magnoliae officinalis cortex has the function of regulating the gastrointestinal motility, especially it can significantly improve the gastrointestinal propulsion function and promote defecation in case of gastrointestinal motility disorders; therefore, it has good clinical effect on the intestinal paralysis caused by various reasons. Its mechanism may be related to promoting the secretion of motilin and gastrin and the proliferation of interstitial cells of Cajal, and increasing the rhythmic contraction of the gastrointestinal tract. Additionally, Magnoliae officinalis cortex has the function of intestinal mucosa protection and anti-diarrhea, and its mechanism may be related to anti-oxidative stress and anti-inflammatory action. In this paper, the pharmacological effects of traditional Chinese medicine Magnoliae officinalis cortex on the intestinal tract and its mechanism are reviewed, and the research progress is analyzed.
  • Virtual Screening of HIV-1 Integrase Inhibitors Based on Random Forest Model*1
    WANG Zhen-ting, LU Xi-kui, WU Xiang-ping, HUANG Ling, YU Hui-min, LI Jing-yang, XIAO Jian
    2022, 19(9): 1248-1255. https://doi.org/10.13493/j.issn.1672-7878.2022.09-002
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    Objective: To screen compounds with potential druggability and human immunodeficiency virus type 1 (HIV-1) integrase inhibitory activity based on the random forest model in computer-aided drug design technology, and to provide reference for the development of HIV-1 integrase inhibitors. Methods: The data of small molecules related to HIV-1 integrase was searched from the databases of ChEMBL and BindingDB using the keywords, and a random forest model for screening HIV-1 integrase inhibitors was constructed using the software MOE, Knime, etc. The small molecules screened from the ChemDiv database were verified for similarity, and finally the druggability analysis was performed using the ADMET lab tool. Results: A total of 5 459 small molecules with IC50 values were collected from the databases of ChEMBL and BindingDB, and 1 267 small molecules were screened out by random forest model and similarity search. Then molecular docking was performed with Dolutegravir as a ligand, to obtain 24 optimal small molecules. Afterwards, the druggability analysis was performed with the software ADMET lab. Finally, 5 small molecules with good druggability were obtained, among which 2 optimal molecules had better absorption indexes, with a high clearance rate and a low toxicity. Conclusion: Through the screening with the random forest model and the subsequent virtual verification with software tools, 5 HIV-1 integrase inhibitors with good druggability are obtained.
  • Analysis of the Clinical Use of Carbapenems and Comments on Medical Orders for Inpatients in a Hospital
    LIU Hui-chao, YU Ru-huan, YU Shou-ya
    2022, 19(9): 1259-1263. https://doi.org/10.13493/j.issn.1672-7878.2022.09-004
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    Objective: To analyze the clinical use of carbapenems and the results of comments on medical orders for inpatients in the hospital, so as to provide reference for the rational use of carbapenems in clinical practice. Methods: The medical records of 403 inpatients who had used carbapenems were selected from January to May 2020, and the use of carbapenems, infection types, etiology test and specimen types of patients were counted and analyzed. According to the relevant authoritative information, medical orders were commented and the rational use of carbapenems was analyzed. Results: The medication frequency of carbapenems in 403 patients in a descending order was biapenem (1 459), meropenem (1 186.67) and imipenem (208), and the amount of drugs in a descending order was meropenem (RMB 645 200), biapenem (RMB 597 900) and imipenem (RMB 109 600); 403 patients were mainly from General Surgery Department (111 cases, 27.54%), Hematology Department (74 cases, 18.36%) and Neurosurgery Department (74 cases, 18.36%). The infection types of patients were primarily pulmonary infection (215 cases, 53.35%) and abdominal infection (101, 25.06%). Among 403 patients, there were 332 patients (82.38%) who underwent etiological examination before using carbapenems, and 196 patients (48.63%) who underwent consultation on the use of special antibacterial drugs. The results of comments on medical orders showed that there were 46 patients with unreasonable use of carbapenems (occurrence rate of 11.41%) among 403 patients, and the main reasons included inappropriate drug combination (15 cases, 32.61%) and inappropriate dosage (12 cases, 26.09%). Conclusion: There are many unreasonable phenomena in the use of carbapenems for inpatients. The hospital management department should strengthen the use management of carbapenems, and carry out regular comments on medications to ensure the medication safety of patients.
  • Analysis of Distribution and Drug Resistance of Pathogenic Bacteria in Respiratory Specimens of Children with Severe Bacterial Pneumonia
    XUE Tian-tian, QU Hua-bian
    2022, 19(9): 1264-1267. https://doi.org/10.13493/j.issn.1672-7878.2022.09-005
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    Objective: To analyze the distribution and drug resistance of pathogenic bacteria in respiratory specimens of children with severe bacterial pneumonia, and provide reference for the treatment of such diseases. Methods: A total of 436 children with severe bacterial pneumonia admitted to the First Affiliated Hospital of Henan University of Science and Technology from January 2018 to January 2021 were selected as study subjects, and the distribution of pathogenic bacteria in respiratory specimens and the drug resistance of main pathogenic bacteria were analyzed. Results: A total of 562 strains of pathogenic bacteria were detected in the respiratory specimens of 436 children, including 294 strains of Gram-negative bacteria (72.06%, primarily Acinetobacter baumannii, Escherichia coli and Klebsiella pneumoniae), 114 strains of Gram-positive bacteria (27.94%, primarily Staphylococcus aureus and Streptococcus pneumoniae). The results of drug susceptibility test showed that the resistance rates of Acinetobacter baumannii, Escherichia coli and Klebsiella pneumoniae to cefotaxime, piperacillin, aztreonam and imipenem were low (less than 25.00%), and their resistance rates to amikacin, cefazolin, cefoperazone-sulbactam sodium, tobramycin and meropenem were high (greater than 60.00%); the resistance rates of Staphylococcus aureus and Streptococcus pneumoniae to linezolid and vancomycin were low (less than 10.00%), and their resistance rates to erythromycin, lincomycin and levofloxacin were high (greater than 65.00%). Conclusion: The main pathogenic bacteria of severe bacterial pneumonia in children are Gram-negative bacteria which have strong drug resistance. In clinical treatment, appropriate antibacterial drugs should be selected according to the culture results of pathogenic bacteria and their drug resistance characteristics as far as possible to ensure the therapeutic effect.
  • Analysis of Occurrence and Etiological Characteristics of Nosocomial Infection among Orthopedic Patients in a Hospital from 2018 to 2020
    GUO Dan, YAO Jin-lin, CAI Jian-li, CHEN Pei-sheng, ZHENG Hao-qu, LIU Chen
    2022, 19(9): 1268-1271. https://doi.org/10.13493/j.issn.1672-7878.2022.09-006
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    Objective: To analyze the occurrence and etiological characteristics of nosocomial infection among orthopedic patients in the hospital, and provide reference for the diagnosis and treatment of nosocomial infection in orthopedic patients. Methods: A total of 6 732 patients admitted to Department of Orthopedics of Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine from January 2018 to December 2020 were selected as study subjects, and the occurrence and etiological characteristics of nosocomial infection in patients were counted and analyzed. Results: Among 6 732 orthopedic patients, 63 patients had nosocomial infection (infection rate of 0.94%), and the infection sites were primarily urinary tract (21 patients, 33.33%) and superficial incision (18 patients, 28.57%); 80 strains of pathogenic bacteria were isolated from the specimens of 63 infected patients, including 30 strains of Gram-positive bacteria (37.50%, primarily Staphylococcus aureus), 48 strains of Gram-negative bacteria (60.00%, primarily Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli and Enterobacter cloacae) and 2 strains of fungi (2.50%). The results of drug susceptibility test showed that the resistance rate of Staphylococcus aureus to compound sulfamethoxazole, nitrofurantoin, linezolid, quinupristin-dalfopristin, rifampicin and vancomycin was low (less than 5.00%), and the resistance rates of Staphylococcus aureus to penicillin, cefoxitin, clindamycin, erythromycin, oxacillin was high (greater than 65.00%). The resistance rate of Pseudomonas aeruginosa to piperacillin-tazobactam sodium, ciprofloxacin, levofloxacin, meropenem, ceftazidime, and gentamicin was low (less than 30.00%), the resistance rates of Klebsiella pneumoniae to piperacillin-tazobactam sodium, levofloxacin, meropenem and gentamicin was low (less than 30.00%), the resistance rate of Escherichia coli to piperacillin-tazobactam sodium, meropenem, ceftazidime was low (less than 30.00%), and the resistance rate of Enterobacter cloacae to other investigational drugs except amoxicillin-clavulanate potassium and cefazolin was low (less than 30.00%). Conclusion: The occurrence rate of nosocomial infection in orthopedic patients is low in the hospital. Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli and Enterobacter cloacae are the main pathogenic bacteria, and their drug resistance is not very strong at present. However, in clinical anti-infection treatment, antibacterial drugs should be selected rationally according to the drug susceptibility test results as far as possible to improve the accuracy of treatment.
  • Analysis of Risk Factors of Multidrug-resistant Organisms Infection in Long-term Bedridden Patients in a Hospital
    ZHANG Cong-ling, XU Rong, HUANG Bo, Wang Nai-qun
    2022, 19(9): 1369-1371. https://doi.org/10.13493/j.issn.1672-7878.2022.09-036
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    Objective: To analyze the related risk factors of multidrug-resistant organisms (MDROs) infection among long-term bedridden patients in the hospital, and provide reference for the prevention and treatment of clinical MDROs infection. Methods: A total of 288 long-term bedridden patients admitted to Yichun People's Hospital from June 2019 to June 2021 were selected as study subjects. Depending on the occurrence of MDROs infection or not, they were divided into MDROs infection group (36 subjects) and non-MDROs infection group (252 subjects). The related risk factors of MDROs infection in long-term bedridden patients were analyzed by regression analysis. Results: The results of univariate analysis showed that factors like age, underlying diseases such as combined diabetes or chronic obstructive pulmonary disease (COPD), bed rest time, number of antibacterial drugs used in combination, and presence or absence of traumatic operations were correlated with the occurrence of MDROs infection (P<0.05). The results of multivariate Logistic regression analysis showed that age of 70 years or above, combined diabetes, combined COPD, bed rest time of 25 days or more, use of 3 antibacterial drugs or more, and traumatic operations were independent risk factors for the occurrence of MDROs infection in long-term bedridden patients (P<0.05 and OR≥1). Conclusion: The incidence of MDROs infection is higher in long-term bedridden patients. Age, underlying diseases such as combined diabetes or COPD, bed rest time, number of antibacterial drugs used in combination and presence or absence of traumatic operations are closely related to the occurrence of MDROs infection. Therefore, high attention should be paid to patients with high risks clinically, and necessary management measures should be taken to reduce the occurrence of MDROs infection.
  • Analysis of Clinical Characteristics of 137 Patients with Adverse Reactions to Carbapenems*1
    LIN Xiao-fei, LIU Ying, LUO Wei, TANG Yuan-liang, WANG Yan-hong
    2022, 19(9): 1376-1379. https://doi.org/10.13493/j.issn.1672-7878.2022.09-038
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    Objective: To analyze the characteristics and rules of adverse drug reactions (ADRs) caused by carbapenems, and provide reference for the clinical rational use of carbapenems. Methods: A total of 137 patients with ADRs caused by carbapenems which were reported to the National Adverse Drug Reaction Monitoring System in Dongguan city from January 2016 to December 2020 were selected as study subjects, and information such as patients' age, gender, type of ADRs, organs (or systems) involvement, route of administration and outcomes was collected to analyze the characteristics and rules. Results: Among 137 patients with ADRs, the ratio of males and females was basically the same (76:61), and their ages were mainly in 3 age groups: greater than 30 to 50 years old (33 patients, 24.09%), greater than 50 to 70 years old (37 patients, 27.01%) and greater than 70 to 90 years old (35 patients, 25.54%). Among 137 patients, the type of ADRs was general in 76 patients (55.47%) and serious in 42 patients (30.66%); among 137 patients, the route of administration was mainly intravenous infusion (133 patients, 97.08%); among 137 patients, the organs (or systems) involved in ADRs were mainly skin and its appendages (71 patients, 36.41%), digestive system (40 patients, 20.51%) and nervous system (29 patients, 14.87%). After treatment, among 137 patients with ADRs, 57 patients (41.61%) were cured, 76 patients (55.47%) were improved, and 2 patients had sequelae. Conclusion: ADRs are unavoidable when patients are taking carbapenems. Although they can be cured or improved after timely treatment, the monitoring and management of ADRs should be strengthened clinically to ensure the medication safety of patients.
  • Analysis of Anti-Infective Pharmaceutical Consultations and Discussion of Typical Cases Participated by Clinical Pharmacists in a Hospital from 2020 to 2021
    JIN Hui-jing, MIAO Jie, YUAN Jing, HAN Yun
    2022, 19(9): 1380-1382. https://doi.org/10.13493/j.issn.1672-7878.2022.09-039
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    Objective: To analyze the anti-infective pharmaceutical consultations participated by clinical pharmacists in the hospital from 2020 to 2021, analyze relevant typical cases, and provide reference for clinical pharmacists to carry out pharmaceutical work in clinical departments. Methods: A total of 130 patients of anti-infective pharmaceutical consultation participated by clinical pharmacists in Suzhou Hospital of Traditional Chinese Medicine from January 2020 to December 2021 were selected as study subjects. The department distribution, purpose of consultation and adoption of consultation opinions of patients were counted and analyzed, and the typical cases were analyzed and discussed. Results: A total of 130 patients for consultation were mainly from Department of Orthopedics and Traumatology (43 patients, 33.08%) and Department of Hematology (30 patients, 23.08%). The purpose of the consultation was to seek the help of clinical pharmacists to adjust the anti-infection treatment regimens (89 patients, 68.46%). Among 130 patients, the consultation opinions for 124 patients (95.38%) were adopted, of which the consultation opinions for 113 patients (86.92%) were wholly adopted, and those for 11 patients (8.46%) were partially adopted. Among 124 patients for whom consultation opinions were adopted, 39 patients (31.45%) were cured, 73 patients (58.87%) were improved, and only 12 patients (9.68%) were invalid. Conclusion: In anti-infection treatment of patients during hospitalization, disease progression of patients and pharmaceutical properties of drugs should be considered comprehensively, and participation of clinical pharmacists can better assist doctors in developing or improving the anti-infection treatment regimens to ensure the medication effectiveness and safety of patients.