KANGGANRAN YAOXUE

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  • 2022 Volume 19 Issue 10
    Published: 25 October 2022
      
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  • Research Progress in Pharmacological Effects of Magnolol on Cardiovascular System
    ZHANG Ming-fa, SHEN Ya-qin
    2022, 19(10): 1395-1400. https://doi.org/10.13493/j.issn.1672-7878.2022.10-001
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    Magnolol, a hydrophobic biphenol compound, has the effects of anti-myocardial injury, dilating blood vessels, lowering blood pressure, anti-platelet aggregation, anti-atherosclerosis, etc. Its mechanism of action may be closely related to the blockage of calcium ion channels, anti-inflammation, anti-oxidation, etc. In this article, the cardiovascular protective effects of magnolol with regard to protection of heart and blood vessels, anti-platelet aggregation and anti-atherosclerosis and its mechanism are reviewed, and the related researches are analyzed.
  • Analysis of Diagnosis and Treatment of One Patient with Fulminant Epidemic Cerebrospinal Meningitis (Shock Type)*1
    ZOU Di, ZHU Feng-feng
    2022, 19(10): 1401-1405. https://doi.org/10.13493/j.issn.1672-7878.2022.10-002
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    Objective: To analyze the clinical characteristics and diagnosis and treatment process of one patient with fulminant epidemic cerebrospinal meningitis (shock type), so as to provide reference for the clinical treatment of such patients. Methods: The patient was sent to the First Affiliated Hospital of Soochow University after the onset of illness on January 5, 2021. During the period, the results of high-throughput sequencing tests of blood and cerebrospinal fluid samples showed Neisseria meningitidis, and the patient was diagnosed with fulminant epidemic cerebrospinal meningitis (shock type), then transferred to Department of Critical Care Medicine, Suzhou Fifth People's Hospital. Results: Under the active treatment of two hospitals, Neisseria meningitidis was no longer detected. However, the patient's limbs and organs were severely damaged and the breathing required the assistance of ventilator due to too rapid disease progression, so the family members disagreed to continual treatment. Conclusion: The fulminant epidemic cerebrospinal meningitis (shock type) has a rapid onset and serious disease condition, which seriously challenges the clinical identification and diagnosis as quickly as possible. The Emergency Department and ICU should pay special attention to the study and training of relevant disease knowledge, improve the clinical management ability, and ultimately increase the treatment success rate of patients.
  • Analysis of Clinical Detection and Drug Resistance Trend of Stenotrophomonas maltophilia in a Tertiary General Hospital from 2020 to 2021*1
    WANG Dong-xiao, MENG Guang-yi, WANG Ji-yi, ZHENG Xin, WANG Guang-zhao, QIU Dan-ping
    2022, 19(10): 1405-1409. https://doi.org/10.13493/j.issn.1672-7878.2022.10-003
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    Objective: To analyze the clinical detection and drug resistance trend of Stenotrophomonas maltophilia (SM) in the hospital, so as to provide reference for the treatment of clinical SM infection. Methods: A total of 26 605 strains of pathogenic bacteria detected in specimens sent by clinical departments of the hospital from January 2020 to December 2021 were selected as the research data to conduct statistics and analysis of the detection of SM in each quarter and the trend change of SM resistance to 4 common antibacterial drugs. Results: Among the 26 605 strains of pathogenic bacteria clinically detected in the hospital from 2020 to 2021, there were 779 strains (2.93%) of SM in total. The detection rate of SM from the first to third quarters of 2020 was low (less than 2.00%), while the detection rate of SM after the fourth quarter of 2020 was relatively high (greater than 3.00%). The drug susceptibility monitoring data showed that the total resistance rates of SM to ceftazidime, levofloxacin, compound sulfamethoxazole and minocycline were low (less than 20.00%). Although the resistance rates of SM to four antibacterial drugs fluctuated, they were always less than 30.00%, and the resistance rates of SM to levofloxacin, compound sulfamethoxazole and minocycline were always less than 15.00%. Conclusion: From 2020 to 2021, the detection rate of SM in the hospital remains at a low level, and its resistance rates to ceftazidime, levofloxacin, compound sulfamethoxazole and minocycline are low. It can be used as appropriate for the clinical treatment of patients with SM infection, but clinically attention should be paid to SM, a common drug-resistant bacterium in China, and the regular monitoring should be performed.
  • Comparison of Distribution and Drug Resistance of Pathogenic Bacteria in Pulmonary Infection between AIDS Patients and Patients in Pneumology Department
    PAN Hong, XIANG Xu-bo, WANG Xue-xian
    2022, 19(10): 1410-1414. https://doi.org/10.13493/j.issn.1672-7878.2022.10-004
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    Objective: To analyze the distribution and drug resistance of pathogenic bacteria in pulmonary infection between AIDS (acquired immune deficiency syndrome) patients and ordinary patients in Pneumology Department, so as to provide reference for the precise prevention and treatment of AIDS patients with pulmonary infection. Methods: A total of 98 AIDS patients with pulmonary infection admitted to Department of Infectious Diseases of Wuxi No. 5 People's Hospital from January 2016 to January 2020 were selected as AIDS group, and 98 ordinary patients with pulmonary infection admitted to Pneumology Department during the same period were selected as non-AIDS group, and the distribution and drug resistance of pathogenic bacteria in the sputum specimens from two groups of patients were analyzed and compared. Results: Among the 111 strains of pathogenic bacteria detected in the sputum specimens from 98 patients in the AIDS group, there were 70 strains of Gram-negative bacteria (63.06%), 13 strains of Gram-positive bacteria (11.71%) and 28 strains of fungi (25.23%). Among the 130 strains of pathogenic bacteria detected in the sputum specimens from 98 patients in the non-AIDS group, there were 87 strains of Gram-negative bacteria (66.92%), 9 strains of Gram-positive bacteria (6.92%) and 34 strains of fungi (26.16%). The distribution of pathogenic bacteria in the sputum specimens of patients in the two groups was roughly similar (P>0.05); the drug susceptibility test results of main pathogenic bacteria in the two groups showed that the drug resistance rates of Staphylococcus aureus to vancomycin, linezolid and tigecycline were 0.00%, and its resistance rates to levofloxacin, tetracycline, gentamicin, moxifloxacin, and compound sulfamethoxazole were low (less than 30.00%); however, in the non-AIDS group, the resistance rates of Staphylococcus aureus to oxacillin and ciprofloxacin were low (less than 30.00%); the resistance rates of Klebsiella pneumoniae to amikacin, cefepime, imipenem, tobramycin, piperacillin-tazobactam sodium, cefotetan, etc. were low (less than 20.00%). Conclusion: The pathogenic bacteria of AIDS patients with pulmonary infection in the hospital are mainly Gram-negative bacteria, and the drug resistance characteristics of the main pathogenic bacteria are similar to those of ordinary patients with pulmonary infection. However, the consequences of infection may be more serious for AIDS patients due to their impaired immune functions. Therefore, clinical monitoring and management should be strengthened on such patients to ensure they get timely and effective treatment after infection.
  • Analysis of Risk Factors and Etiological Characteristics of Colorectal Cancer Patients with Postoperative Infection in a Hospital
    SONG Zhi, TAN Yun-chang, XIONG Huan, WANG Feng, SUN Sheng, LIU Lai-peng, CAO Chuan-pei
    2022, 19(10): 1458-1461. https://doi.org/10.13493/j.issn.1672-7878.2022.10-019
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    Objective: To analyze the risk factors and etiological characteristics of colorectal cancer (CRC) patients with postoperative infection in the hospital, so as to provide reference for the prevention and treatment of postoperative infection in such patients. Methods: A total of 482 CRC patients undergoing surgical treatment in Jiujiang University Affiliated Hospital from June 2017 to January 2021 were selected as research subjects, and they were divided into infection group (n=20) and non-infection group (n=462) according to the occurrence of postoperative infections. The patients' information such as age, gender, type of surgery, complicated underlying diseases, microbiological examination results were collected to analyze the risk factors and etiological characteristics of postoperative infection in CRC patients. Results: The regression analysis results showed that the occurrence of postoperative infection in CRC patients was correlated with age, type of surgery, presence or absence of combined diabetes, and time of operation (P<0.05). Among them, age greater than or equal to 60 years old, traditional surgery, combined diabetes and time of operation longer than or equal to 150 min were independent risk factors for postoperative infection (P<0.05, OR≥1). A total of 50 strains of pathogenic bacteria were detected in each specimen of 20 CRC patients with postoperative infection, including 32 strains of Gram-negative bacteria (64.00%, mainly Escherichia coli and Pseudomonas aeruginosa), 14 strains of Gram-positive bacteria (28.00%, mainly Staphylococcus epidermidis and Staphylococcus aureus) and 4 strains of fungi (8.00%). The drug susceptibility test results showed that the resistance rates of Escherichia coli to ceftizoxime, imipenem and cefoperazone-sulbactam sodium were low (less than 30.00%), and the resistance rates of Staphylococcus epidermidis and Staphylococcus aureus to vancomycin, teicoplanin, rifampicin and oxacillin were low (less than 30.00%). Conclusion: Age, type of surgery, presence or absence of combined diabetes and time of operation are related to the occurrence of postoperative infection in CRC patients. The clinical management of high-risk patients should be strengthened to avoid the occurrence of infection as much as possible. The pathogenic bacteria of postoperative infection in patients are mainly Gram-negative bacteria, and the main pathogenic bacteria have strong drug resistance. In the clinical anti-infection treatment, antibacterial drugs should be selected rationally according to the drug susceptibility test results of pathogenic bacteria as much as possible to ensure the effect of anti-infection treatment.
  • Analysis of Clinical Characteristics of Levofloxacin-induced Rhabdomyolysis*1
    PAN Juan, ZHOU Ling-zhi, ZHONG Jing, NIE Ge, ZHANG Xu, LI Zu-yi
    2022, 19(10): 1465-1470. https://doi.org/10.13493/j.issn.1672-7878.2022.10-021
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    Objective: To analyze the clinical characteristics of levofloxacin-induced rhabdomyolysis (RM), so as to provide reference for the safety of clinical medication of levofloxacin. Methods: By using "levofloxacin", "rhabdomyolysis" and "myopathy" as keywords, the relevant literatures up to October 2021 were searched from domestic and foreign databases such as CNKI, Wanfang, Chongqing VIP, SinoMed, PubMed, Embase, Web of Science, relevant clinical data of patients with levofloxacin-induced RM were collected, and the clinical characteristics of levofloxacin-induced RM were analyzed. Results: A total of 17 literatures related to levofloxacin-induced RM were searched from domestic and foreign databases, involving 17 patients (12 males and 6 females), including 11 patients greater than or equal to 60 years old. Among the 17 patients, the main cause of medication was pulmonary infection (10 patients), the main route of administration was oral administration (10 patients), and there were 5 patients with overdose of medication. The latent period from the use of levofloxacin to the occurrence of RM was 3 hours to 19 days, including 13 patients with a latent period of less than 10 days. The clinical manifestations of RM mainly included myalgia (13 patients) and muscle weakness (11 patients), and the highest serum CK level was 451-159 450 U/L; after symptomatic treatment, 15 patients were improved or recovered. Conclusion: Levofloxacin-induced RM is more common in male and elderly patients, and the latent period is mostly within 10 days. Most patients are improved or recovered after symptomatic treatment.
  • Analysis of Clinical Characteristics and Diagnosis and Treatment of One Patient with Staphylococcus Caprae Bloodstream Infection*1
    CHEN Qian, WANG Li-hui
    2022, 19(10): 1474-1476. https://doi.org/10.13493/j.issn.1672-7878.2022.10-023
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    Objective: To analyze the clinical characteristics and successful treatment of one patient with Staphylococcus caprae bloodstream infection, so as to provide reference for the treatment of similar patients. Methods and Results: The patient had unexplained fever and infection symptoms. Considering that the patient had experiences of repeated lung infection and the use of antibacterial drugs recently, sputum and blood specimens were collected for microbial culture to identify the infection site and pathogenic bacteria. Empirical anti-infection treatment with vancomycin and imipenem was given at the same time. The subsequent report showed that Staphylococcus caprae was detected in blood specimens, which was covered by the antibacterial spectrum of vancomycin; and the drug susceptibility test results showed that it was susceptible to vancomycin. Therefore, the patient recovered quickly and was discharged from the hospital. Conclusion: Staphylococcus caprae, as a common colonization bacterium of skin and mucous membrane, rarely infects humans, but the infection is prone to occur in the populations with low immunity or frequent use of antibacterial drugs. Clinically, unexplained infections should be identified and differentiated to improve the accuracy of treatment.
  • Cost-Utility Analysis of Three First-line Helicobacter Pylori Eradication Therapies Based on a Decision Tree Model*1
    LU Xi-kui, WANG Zhen-ting, WU Xiang-ping, HUANG Ling, YU Hui-min, LI Jing-yang, XIAO Jian
    2022, 19(10): 1477-1482. https://doi.org/10.13493/j.issn.1672-7878.2022.10-024
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    Objective: To analyze the cost-utility of three first-line Helicobacter pylori (Hp) eradication therapies based on a decision tree model, so as to provide reference for clinical selection of more economical Hp eradication therapies. Methods: By using "Helicobacter pylori", "first-line eradication therapy", "second-line eradication therapy", "systematic review", "Meta analysis" as search words, the relevant literatures up to May 31, 2022 were searched from domestic and foreign databases such as PubMed, Web of Science, Embase, Cochrane Library, CNKI, Wanfang and VIP to build a decision tree model, and the cost-utility analysis method in pharmacoeconomics was used to analyze the cost-utility of different Hp eradication therapies. Results: The curative effects of vonoprazan-based triple therapy, bismuth-based quadruple therapy and dual therapy were searched from the literatures, and the cost of three therapies was calculated according to the domestic medical expenses; the cost-utility analysis results showed that the costs of bismuth-based quadruple therapy, dual therapy and vonoprazan-based triple therapy increased sequentially, respectively (680.670±35.93) yuan, (937.940±35.93) yuan and (1 174.240±35.93) yuan, but there was no statistically significant difference in the utility among the three Hp eradication therapies (P>0.05). The analysis results of cost influencing factors of three Hp eradication therapies showed that the eradication rate of the second-line therapy was the biggest factor affecting the cost. Conclusion: Compared with dual therapy and vonoprazan-based triple therapy, bismuth-based quadruple therapy has more cost-utility advantages in Hp eradication therapies, but the current studies still have certain limitations, and the relevant results may be biased, which needs further observations and studies.
  • Signal Mining and Analysis of Cephalosporins and Neurotoxic Risks Based on FAERS*1
    WU Xiang-ping, HUANG Ling, LU Xi-kui, WANG Zhen-ting, YU Hui-min, LI Jing-yang, XIAO Jian
    2022, 19(10): 1483-1486. https://doi.org/10.13493/j.issn.1672-7878.2022.10-025
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    Objective: To mine and analyze the risks of neurotoxic adverse reactions of cephalosporins based on FDA adverse event reporting system (FAERS), so as to provide reference for the clinical medication safety of cephalosporins. Methods: The relevant materials of neurotoxic adverse events from January 2015 to March 2022 were searched from the FAERS database, the correlation between neurotoxic adverse events and cephalosporins was evaluated based on the proportional imbalance measurement method and Bayesian method, and the clinical characteristics of related cases were analyzed. Results: A total of 559 cases of neurotoxic adverse events with cephalosporins as the primary suspected drug were searched from the FAERS database from January 2015 to March 2022. The correlation between the adverse events and cefepime, cephradine and ceftaroline was strongest, followed by cefozopran and cefotiam, and the correlation with ceftriaxone and cefazolin was weakest. There were no positive signals for cefotaxime, cefpodoxime, cefuroxime and ceftazidime. Among the 559 reported adverse events, the age of the main populations was elder than or equal to 65 years old (236 cases, 42.22%), elder than 45 and younger than 65 years old (181 cases, 32.38%). The reporting countries were mainly the United States (284 cases, 50.81%) and France (119 cases, 21.29%). Among the patients with adverse events, 387 patients (69.23%) were hospitalized or had prolonged hospital stay, and 135 patients (24.15%) died eventually. Conclusion: Some cephalosporins may indeed have neurotoxic adverse reactions, especially in elderly patients, and may lead to serious consequences. Clinical monitoring of relevant drugs should be strengthened during the medication, so as to provide corresponding treatment measures for patients at once.