KANGGANRAN YAOXUE

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  • 2022 Volume 19 Issue 12
    Published: 25 December 2022
      
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  • Research Progress in Protective Effects of Magnolol and Honokiol on the Liver and Kidney
    ZHANG Ming-fa, SHEN Ya-qin
    2022, 19(12): 1625-1631. https://doi.org/10.13493/j.issn.1672-7878.2022.12-001
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    Magnolol and honokiol are important active ingredients of the traditional Chinese medicine Magnoliae Officinalis Cortex. In addition to the antibacterial, antiviral, antitumor, hypoglycemic, hypolipidemic and other pharmacological effects, they can resist the liver injury and liver fibrosis caused by allergy, ischemia-reperfusion, transforming growth factor-β, high glucose, high fat, carbon tetrachloride (CCl4), acetaminophen, thioacetamide, phosphatidylethanolamine, D-galactosamine/lipopolysaccharide, H2O2 and tert-butyl hydroperoxide, and resist the kidney injury and renal fibrosis caused by ischemia-reperfusion, ureteral ligation, angiotensin II, high glucose, lipopolysaccharide and H2O2. The protective effects of magnolol and honokiol on the liver and kidney may be achieved through their anti-inflammatory and antioxidant effects. In this article, the protective effects of magnolol and honokiol on the liver and kidney are reviewed, and the related research is analyzed.
  • Effect of Prescription Pre-Review and Intervention on Rational Use of Antibacterial Drugs in Patients Undergoing Type I Incision Surgery*1
    HAN Lan-ping, LI Wen-bo
    2022, 19(12): 1632-1635. https://doi.org/10.13493/j.issn.1672-7878.2022.12-002
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    Objective: To evaluate the effect of prescription pre-review and intervention on rational use of antibacterial drugs in patients undergoing type I incision surgery, so as to provide reference for improving the prophylactic use of antibacterial drugs in perioperative patients. Methods: A total of 300 patients who underwent type I incision surgery in the Zhengzhou Central Hospital Affiliated to Zhengzhou University were chosen before and after the transfer between the prescription pre-review system and the hospital information system. The patients' information such as gender, age, type of surgery, selection of antibacterial drugs and the course of medication was collected. The rational use of antibacterial drugs in the patients was commented according to the authoritative materials such as package inserts of drugs and Guiding Principles for Clinical Application of Antibacterial Drugs (2015), and the effect of prescription pre-review and intervention on rational use of antibacterial drugs in patients undergoing type I incision surgery was investigated. Results: There were no significant differences in gender, age and type of surgery between the two groups of patients before and after intervention (P>0.05); the rate of prophylactic use of antibacterial drugs after intervention was lower than that before intervention (21.33% vs 29.67%, P<0.05); the reasonable rate of antibacterial drug selection in the perioperative period after intervention was higher than that before intervention (98.44% vs 88.76%, P<0.05); and the reasonable rate of the course of prophylactic medication of antibacterial drugs after intervention was higher than that before intervention (81.25% vs 51.69%, P<0.05). Conclusion: The prescription pre-review and intervention can improve the level of prophylactic use of antibacterial drugs in patients undergoing type I incision surgery in the hospital in terms of variety selection and medication course, etc.
  • Analysis of Distribution and Drug Resistance of Pathogenic Bacteria in Sputum Samples from 1 265 Children with Bronchopneumonia in a Hospital*1
    ZHANG Hai-feng, YAN Li-na, ZHAI Lei, ZHONG Chun-yan
    2022, 19(12): 1636-1640. https://doi.org/10.13493/j.issn.1672-7878.2022.12-003
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    Objective: To investigate the distribution and drug resistance of pathogenic bacteria in sputum samples from children with bronchopneumonia in the hospital, so as to provide reference for the rational use of antibacterial drugs in such patients in the clinic. Methods: A total of 1 265 children with bronchopneumonia admitted to the Department of Pediatrics of the People's Liberation Army No. 989 Hospital from August 2016 to August 2021 were chosen as the subjects. Their sputum samples were collected for pathogen culture and antimicrobial susceptibility testing to analyze the etiological characteristics of infection in children. Results: Among the sputum samples of 1 265 children with bronchopneumonia, 1 598 strains of pathogenic bacteria were detected, including 937 strains of Gram-negative bacteria (58.64%, mainly Escherichia coli, Klebsiella pneumoniae and Haemophilus influenzae), 647 strains of Gram-positive bacteria (40.49%, mainly Streptococcus pneumoniae, Staphylococcus aureus and Streptococcus pyogenes) and 14 strains of fungi (0.88%); the detected number of Escherichia coli and Klebsiella pneumoniae in spring, summer, autumn and winter was relatively stable, while the detected number of Staphylococcus aureus and Streptococcus pneumoniae was more in winter and spring, and less in summer and autumn. The antimicrobial susceptibility testing showed that, the resistance rates of Staphylococcus aureus, Streptococcus pneumoniae and Streptococcus pyogenes to vancomycin and linezolid were 0.00%, and their resistance rates to ceftriaxone and cefotaxime were relatively low (less than 10.00%), while their resistance rates to erythromycin, clarithromycin and clindamycin were high (more than 60.00%); the resistance rate of Haemophilus influenzae to all tested antibacterial drugs was low (less than 15.00%). The resistance rates of Escherichia coli and Klebsiella pneumoniae to imipenem, meropenem, cefoperazone-sulbactam sodium, piperacillin-tazobactam sodium, ceftazidime and cefoxitin were low (less than 30.00%). Conclusion: The pathogenic bacteria in children with bronchopneumonia in the hospital mainly include Escherichia coli, Klebsiella pneumoniae, Haemophilus influenzae, Streptococcus pneumoniae, Staphylococcus aureus and Streptococcus pyogenes. The characteristics of their resistance to antibacterial drugs are different. Before formulating clinical treatment regimens, the pathogen culture and antimicrobial susceptibility testing should be carried out as much as possible, to guide clinicians to choose antibacterial drugs rationally and ensure the effect of anti-infection treatment.
  • Analysis of Etiological Characteristics and Risk Factors of Pulmonary Infection in Patients with Intracerebral Hemorrhage in the Basal Ganglia Region in a Hospital*1
    SANG Chun-sheng, FU Xi-an, XIE Tao
    2022, 19(12): 1663-1667. https://doi.org/10.13493/j.issn.1672-7878.2022.12-011
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    Objective: To investigate the etiological characteristics and risk factors of pulmonary infection in patients with intracerebral hemorrhage in the basal ganglia region in hospital, so as to provide reference for clinical prevention and treatment of patients with pulmonary infections. Methods: A total of 181 patients with intracerebral hemorrhage in the basal ganglia region admitted to Affiliated Suzhou Hospital of Nanjing Medical University from September 2016 to September 2022 were chosen as the subjects, and the patients were divided into the infection group (n=74) and non-infection group (n=107) depending on presence or absence of pulmonary infection. The statistical processing and analysis were performed on the etiological characteristics and risk factors of patients with pulmonary infections. Results: A total of 106 strains of pathogenic bacteria were isolated from the sputum samples of 74 patients with intracerebral hemorrhage in the basal ganglia region complicated with pulmonary infections, including 90 strains of Gram-negative bacteria (84.91%, mainly Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii) and 16 strains of Gram-positive bacteria (15.09%, mainly Staphylococcus aureus and Enterococcus). The antimicrobial susceptibility testing showed that, the resistance rates of Klebsiella pneumoniae and Pseudomonas aeruginosa to polymyxin, moxifloxacin and amikacin were low (less than 30.00%), and the resistance rate of Acinetobacter baumannii to polymyxin and tigecycline was low (less than 30.00% ); the resistance rates of Staphylococcus aureus and Enterococcus to linezolid, vancomycin, amikacin and ciprofloxacin were low (less than 30.00%), and their resistance rates to penicillin and cefazolin were high (more than 60.00%). The univariate analysis showed that the age, gender, smoking history, Glasgow Coma Scale (GCS) score, vomiting and aspiration, surgical conditions and tracheotomy were correlated with pulmonary infection in patients with intracerebral hemorrhage in the basal ganglia region (P<0.05). The multivariate analysis showed that age of 60 years old and more, smoking history, GCS score lower than12 points and surgery were the independent risk factors for pulmonary infection in patients with intracerebral hemorrhage in the basal ganglia region (P<0.05). Conclusion: The pathogenic bacteria of pulmonary infection in patients with intracerebral hemorrhage in the basal ganglia region in the hospital are mainly Gram-negative bacteria with a strong drug resistance. Antibacterial drugs should be selected rationally according to the results of the antimicrobial susceptibility testing during clinical treatment. In addition, there is an important relationship between age, smoking history, GCS score, surgical conditions and concurrent pulmonary infection in patients. It is necessary to strengthen the clinical management and monitoring for high-risk patients to reduce the occurrence of pulmonary infection.
  • Analysis of Risk Factors and Etiological Characteristics of Nosocomial Infection in Patients in the Department of Cardiovascular Medicine of a Hospital
    XIAO Feng-yan, WANG Jian-feng, JIANG Ming-yu
    2022, 19(12): 1668-1671. https://doi.org/10.13493/j.issn.1672-7878.2022.12-012
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    Objective: To investigate the risk factors and etiological characteristics of nosocomial infection in patients in the Department of Cardiovascular Medicine of the hospital, so as to provide reference for the prevention and treatment of nosocomial infection in such patients. Methods: A total of 600 patients with cardiovascular diseases admitted to the Department of Cardiovascular Medicine of Jishui People's Hospital from May 2019 to February 2021 were chosen as the subjects, and their information and data such as age, gender, underlying diseases, medication history, hospitalization history and etiological examination results were collected to analyze the risk factors and etiological characteristics of nosocomial infection in the patients. Results: Among the 600 patients with cardiovascular diseases, 169 cases had nosocomial infection, with the infection rate of 28.17%. A total of 192 strains of pathogenic bacteria were detected from the specimens of 169 patients with nosocomial infection, including 112 strains of Gram-negative bacteria (58.33%, mainly Klebsiella pneumoniae and Acinetobacter baumannii), 36 strains of Gram-positive bacteria (18.75%, mainly Staphylococcus aureus) and 44 strains of fungi (22.92%, mainly Candida albicans). The antimicrobial susceptibility testing showed that the resistance rates of Klebsiella pneumoniae and Acinetobacter baumannii to amikacin, meropenem and imipenem were low (less than 10.00%); the resistance rate of Staphylococcus aureus to vancomycin and teicoplanin was 0.00%; the resistance rate of Candida albicans to itraconazole, caspofungin and micafungin was low (less than 10.00%). The results of regression analysis showed that the patient's age, use of antacids or not, prophylactic use of antibacterial drugs or not, with or without underlying diseases, and hospitalization for many times or for a long time or not were correlated with the occurrence of nosocomial infection in patients with cardiovascular diseases (P<0.05 ). Among them, age of 60 years old and more, use of antacids, prophylactic use of antibacterial drugs, with underlying diseases and hospitalization for many times or for a long time were the independent risk factors for nosocomial infection (P<0.05). Conclusion: There is a high risk of nosocomial infection in inpatients in the Department of Cardiovascular Medicine of the hospital. Gram-negative bacteria are the main pathogens, but there are differences in the drug resistance characteristics of different pathogens. Antibacterial drugs should be selected rationally according to the results of the antimicrobial susceptibility testing in clinical practice, to improve the accuracy of treatment; in addition, the occurrence of nosocomial infection is closely correlated to the patient's age, underlying disease, medication use and hospitalization status. It is necessary to strengthen the clinical management and monitoring for high-risk patients to reduce the occurrence of nosocomial infection.
  • Analysis of Adverse Drug Reactions of a Child with Disulfiram-Like Reaction Caused by Combined Use of Sinupret Drops and Compound Cefaclor for Suspension*1
    JIN Tai-wei, GE Xiao-xia, DU Xiao-chen, NIU Wen-si, LU Ling-hong
    2022, 19(12): 1696-1697. https://doi.org/10.13493/j.issn.1672-7878.2022.12-020
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    Objective: To investigate the diagnosis and treatment process and related reasons of a child with disulfiram-like reaction caused by combined use of Sinupret Drops and Compound Cefaclor for Suspension in the hospital. Methods and Results: The hospital clinician prescribed Sinupret Drops and Compound Cefaclor for Suspension for one child diagnosed with sleep apnea syndrome and sinusitis, and the patient developed disulfiram-like reaction 10 minutes after taking the two drugs simultaneously. After inquiring about the medical history, the physician believed that the excipients of Sinupret Drops contained a relatively high content of ethanol, and suspected that the symptoms might be caused by the patient's failure to take the medicines according to the matters needing attention. Then the child stopped the Compound Cefaclor for Suspension immediately, and 30 minutes later, the child's dyspnea symptoms were relieved. Conclusion: When prescribing clinically for related patients, attention should be paid to possible drug interactions; for example, taking cephalosporins and ethanol-containing drugs simultaneously may cause disulfiram-like reaction. When combined use cannot be avoided, the physicians and pharmacists should explain the precautions for medication in detail to avoid the occurrence of adverse drug reactions.
  • Clinical Treatment and Pharmaceutical Care of One Patient with Cryptococcal Meningitis with the Participation of Clinical Pharmacists
    LI Min
    2022, 19(12): 1698-1701. https://doi.org/10.13493/j.issn.1672-7878.2022.12-021
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    Objective: To explore the clinical treatment and pharmaceutical care of one patient with cryptococcal meningitis (CM) with the participation of clinical pharmacists, so as to provide reference for the clinical treatment of such patients. Methods and Results: On the 2nd day after admission, the patient developed symptoms of central nervous system (CNS) infection such as confusion, restlessness and disturbance of consciousness, and the cerebrospinal fluid ink smear showed fungal spore growth, which was suspected to be CM. After the consultation with the clinical pharmacists, it was recommended to give anti-infection therapy with amphotericin B, fluconazole, piperacillin-tazobactam sodium and mannitol to reduce the intracranial pressure, and carry out the pharmaceutical care. During the period, according to the patient's symptoms and the examination results and in combination with the relevant literature, clinical pharmacists recommended the physicians to adjust the usage and dosage of amphotericin B, fluconazole and mannitol in real time. On the 5th day, the metagenomic next-generation sequencing results of cerebrospinal fluid showed positive for Cryptococcus gattii, and CM was diagnosed. Soon after the patient improved. Conclusion: CM is difficult to be diagnosed rapidly as a serious CNS infectious disease, and the treatment regimen should be adjusted in real time according to the patient's condition during the treatment period. The participated clinical pharmacists can give full play to their professional characteristics of pharmacy and assist clinicians to formulate personalized treatment regimen to facilitate the recovery of patients.
  • Cost-Effectiveness Analysis of Different Antibacterial Drug Prophylaxis Regimens for Patients Undergoing Joint Replacement in the Orthopedics Department of a Hospital*1
    ZHAO Jun-yan, QIAO Jin, SHI Yu, ZHANG Yue-yue
    2022, 19(12): 1702-1706. https://doi.org/10.13493/j.issn.1672-7878.2022.12-022
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    Objective: To analyze the cost-effectiveness of different antibacterial drugs prophylaxis regimens for patients undergoing hip and knee arthroplasty in the Orthopedics Department of the hospital, so as to provide reference for the rational use of antibacterial drugs in such patients. Methods: A total of 114 patients undergoing hip and knee arthroplasty admitted to Nantong Third Hospital Affiliated to Nantong University from January 2019 to April 2021 were chosen as the subjects, and they were divided into group A, group B and group C according to the different antibacterial drug prophylaxis regimens, with 38 cases in each group. Patients in group A were given cefazolin (2 g, q12h) 0.5-1 h before operation, and the total course of treatment was less than or equal to 48 h; the medication regimen of patients in group B was the same as that in group A, but the total course of treatment was more than 48 h. Patients in group C were given ceftriaxone (2 g, q12h) 0.5-1 hour before operation, and the total course of treatment was more than 48 h. The indicators such as the incidence of postoperative infection, maximum body temperature, time of recovery to normal body temperature after operation, hospitalization time and cost of antibacterial drugs of patients in the three groups were compared. Results: No postoperative infection occurred in the 3 groups of patients; there were no significant differences in the maximum body temperature and time of recovery to normal body temperature after operation among the 3 groups of patients (P>0.05); the hospitalization time and use of antibacterial drugs in group A were more than those in group B and more than those in group C, and there was significant difference between any two groups (P<0.05); the cost-effectiveness comparison results showed that the antibacterial drug prophylaxis regimens for patients in group A had the maximum cost-effectiveness advantage (P<0.05). Conclusion: For patients undergoing hip and knee arthroplasty, the administration of the first-generation cephalosporin cefazolin 0.5-1 h before operation according to the guiding principle and the total course of treatment equal to or less than 48 h have the maximum cost-effectiveness advantage, which can effectively prevent the occurrence of postoperative infection and minimize the economic burden of patients.