KANGGANRAN YAOXUE

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  • 2023 Volume 20 Issue 5
    Published: 25 May 2023
      
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  • Research Progress in the Action Mechanism and Clinical Application of Antimicrobial Peptides*1
    MA Tian-yue, ZHU You-zhuo, YU Bing-xin, ZHENG Heng
    2023, 20(5): 447-452. https://doi.org/10.13493/j.issn.1672-7878.2023.05-001
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Increasingly severe bacterial resistance is caused by the abuse of antibacterial drugs, multidrug-resistant organisms continue to emerge, and even "super bacteria" are produced. In addition, the research and development of traditional antibacterial drugs are not as expected, new antibacterial drugs are rarely available on the market, and people are faced with a situation that no drug is available for super bacteria. The discovery of antimicrobial peptides may provide new ideas for the development of new antibacterial drugs. As a natural defense factor of organisms, they can not only directly kill microorganisms, but also eliminate pathogenic bacteria by activating the body defense mechanism. This article mainly summarizes the antibacterial mechanism, clinical application, existing problems and prospects of antimicrobial peptides, providing reference for the design and development of new antibacterial drugs based on antimicrobial peptides.
  • Research Progress in Antifungal Pharmacological Effects and Mechanism of Berberine
    ZHANG Ming-fa, SHEN Ya-qin
    2023, 20(5): 453-457. https://doi.org/10.13493/j.issn.1672-7878.2023.05-002
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    Berberine is mainly used clinically for intestinal infection, and its broad-spectrum antibacterial effect is the pharmacological basis for exerting its functions. However, berberine also has strong antifungal effects against various dermatophytes, such as Candida, Cryptococcus neoformans, Pityrosporum orbiculare, Aspergillus fumigates, Talaromyces marneffei, etc. This article summarizes the pharmacological effects and mechanism of berberine against various fungi, and provides reference for the clinical development of berberine.
  • Research Status of Main Adverse Drug Reactions of Polymyxin Antibacterial Drugs
    ZHANG Shi-jie, LIU Jing
    2023, 20(5): 458-461. https://doi.org/10.13493/j.issn.1672-7878.2023.05-003
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    Polymyxin was first discovered in bacillus polymyxin culture medium and was applied in clinical practice in the 1950s. However, it was quickly replaced by other antibacterial drugs due to significant adverse reactions such as nephrotoxicity. Nevertheless, with the increasingly severe bacterial resistance, polymyxin has returned to clinical practice, and is mainly used for severe infections caused by extended-spectrum beta-lactamase-producing Gram-negative bacteria and even carbapenem-resistant Enterobacteriaceae. Although polymyxin has been re-used in clinical practice, its adverse drug reactions still need to be carefully considered and monitored. Therefore, this article reviews the adverse drug reactions of polymyxin from pathogenesis, risk factors and countermeasures, so as to provide reference for safe and reasonable use of polymyxin in clinical practice.
  • Study on Molecular Mechanism of Xiangjuganmao Granules in Treating COVID-19 Based on Network Pharmacology and Molecular Docking Technology
    CHEN Qi, ZHANG Ya-yun, SUN Ning
    2023, 20(5): 462-469. https://doi.org/10.13493/j.issn.1672-7878.2023.05-004
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    Objective: To investigate the molecular mechanism of Xiangjuganmao Granules in treating COVID-19 based on network pharmacology and molecular docking technology. Methods: Effective components of Xiangjuganmao Granules were collected through the TCMSP analysis platform, and action targets of Xiangjuganmao Granules and treatment targets of COVID-19 were searched, screened and analyzed with databases such as UniProt, Swiss Target Prediction, PharmaMapper, DisGeNET, GeneCards, DAVID etc. Then, a "compound-target-pathway" network was established using Cytoscape software to screen key components that interacted with disease targets. Finally, molecular docking and model visualization were carried out using Vina and PyMol software. Results: A total of 411 effective components of Xiangjuganmao Granules were collected through the TCMSP platform; a total of 1 438 action targets of Xiangjuganmao Granules and 1 702 treatment targets of COVID-19 were retrieved using the databases, including 272 common targets, and 95 of them were selected as key targets for the anti-COVID-19 effect of Xiangjuganmao Granules. These 95 key targets were enriched into 237 KEGG signaling pathways, among which the first 15 signaling pathways, such as tumor necrosis factor, phosphatidylinositol kinase and nucleotide oligomeric domain, may be the core pathways of Xiangjuganmao Granules in treating COVID-19. The network construction analysis of "compound-target-pathway" showed that the first 15 core pathways involved 36 components of Xiangjuganmao Granules, among which the top 5 ranked in Degree value were quercetin, kaempferol, β-sitosterol, luteolin and isorhamnetin; these 5 components were docked with the top 5 common targets, the results showed that all 5 compounds were able to occupy the specific binding pockets of protein targets well, and the three-dimensional conformation showed a high degree of fit matching. Conclusion: Research based on network pharmacology and molecular docking technology shows that the main effective components of Xiangjuganmao Granules in treating COVID-19 may be quercetin, kaempferol, β-sitosterol, luteolin, and isorhamnetin, with action targets of tumor necrosis factor, interleukin-6, albumin, protein kinase B1 and interleukin-1B, respectively.
  • Methodological Study on the Assay of Effective Components in Fukangning Capsules Based on HPLC-DAD
    CHEN Tu-zhen
    2023, 20(5): 470-474. https://doi.org/10.13493/j.issn.1672-7878.2023.05-005
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    Objective: To establish a method for the assay of effective components in Fukangning Capsules based on high performance liquid chromatography-diode array detection (HPLC-DAD), and provide a basis for the quality evaluation of Fukangning Capsules. Methods: The HPLC-DAD was adopted, Agilent C18 column (250 mm×4.6 mm, 5 μm) was used as a chromatographic column, the mobile phase was acetonitrile (A)-0.1% phosphoric acid solution (B), the detection wavelength was switched for gradient elution, the flow rate was 0.8 mL/min, and the column temperature was 30℃. The contents of five effective components in Fukangning Capsules, including baicalin, scutellarin, heterophyllin B, desacetyl asperuloside acid and asperuloside, were determined. Results: The analysis results showed that the regression equations for baicalin, scutellarin, heterophyllin B, desacetyl asperuloside acid and asperuloside were y=6.983 5×105x+268.7 (R=0.999 9), y=6.113 7×105x+412.6 (R=0.999 8), y=5.345 6×105x–318.9 (R=0.999 7), y=8.974 2×105x–374.4 (R=0.999 6) and y=1.102 8×106x–439.8 (R=0.999 7), respectively, and the specificity, precision, stability, repeatability and recovery rate of the five effective components were all very good. The assay results showed that the contents of baicalin, scutellarin, heterophyllin B, desacetyl asperuloside acid and asperuloside in Fukangning Capsules were 19.878-20.371 mg/g, 10.788-11.122 mg/g, 1.782-2.013 mg/g, 0.762-0.812 mg/g and 1.087-1.234 mg/g, respectively. Conclusion: HPLC-DAD for the assay of baicalin, scutellarin, heterophyllin B, desacetyl asperuloside acid and asperuloside in Fukangning Capsules has good specificity, precision, stability, repeatability and recovery rate. This assay method is fast, simple and accurate, and is a good quality control method for Fukangning Capsules.
  • Analysis of Clinical Characteristics and Pharmaceutical Care of 240 Patients Infected with SARS-CoV-2 Omicron in Southern Jiangxi*1
    WU Qing-rong, SONG Xiao-bing, GONG Xiang-wen, ZHANG Li-hua, ZHANG Yu, LIU Jian-ping
    2023, 20(5): 475-481. https://doi.org/10.13493/j.issn.1672-7878.2023.05-006
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    Objective: To analyze the clinical characteristics and pharmaceutical care of patients infected with SARS-CoV-2 Omicron in southern Jiangxi, and provide reference for the treatment of such patients. Methods: 240 patients infected with SARS-CoV-2 Omicron and admitted to the Fifth People's Hospital of Ganzhou City from September to October 2022 were selected as the research subjects. Information such as age, gender, vaccination, drug use, medication intervention and adverse drug reactions of the patients was collected, and the epidemiological characteristics of the patients were analyzed. Results: The 240 patients infected with SARS-CoV-2 Omicron were mainly at the age of 18 to 60 (156 cases, 65.00%), and the clinical classification was mainly mild (205 cases, 85.42%) and asymptomatic (24 cases, 10.00%). A total of 228 of the 240 patients were vaccinated (with a vaccination rate of 95.00%), of which 162 were fully vaccinated throughout the entire process. Analysis of medication status showed that all 240 patients had used antiviral drugs, with the most commonly used being Azvudine tablets (192 cases, 85.71%), with a medication course of (13.55±2.87) d. Only 62 cases used antibacterial drugs, with a usage rate of 25.83%. 240 cases (100.00%) used traditional Chinese patent medicines and simple preparations, of which Lianhua Qingwen Granules (231 cases, 96.25%) and Feilike Mixture (127 cases, 52.92%) were the most used. For the 240 patients, clinical pharmacists had reviewed a total of 9 676 medical orders, of which 24 were unreasonable (with an unreasonable rate of 0.25%), and clinical pharmacists had proposed medication suggestions, while 21 were adopted (with an adoption rate of 87.50%). During the medication period, 5 cases of adverse drug reactions were reported, but none were severe. Conclusion: The SARS-CoV-2 Omicron infections in southern Jiangxi this time are mainly asymptomatic and mild. With the support and assistance of clinical pharmacists, the patients have reasonable medication during hospitalization, with fewer adverse drug reactions.
  • Pharmaceutical Care of One Patient with Mycobacterium Tuberculosis Septic Shock with Participation of Clinical Pharmacists
    LIU Zhen-yu, LI Fei, HE Ren-xian, XIE Li-xia
    2023, 20(5): 482-485. https://doi.org/10.13493/j.issn.1672-7878.2023.05-007
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    Objective: To analyze the pharmaceutical care process of one patient with Mycobacterium tuberculosis septic shock, and provide reference for the treatment of this rare case. Methods: One patient was admitted for treatment due to unexplained fear of cold and fever. After admission, empirical anti-infection treatment was given, but no pathogenic bacteria were found. On the 9th day, the patient developed symptoms of septic shock, so a multidisciplinary consultation was organized to decide to upgrade the anti-infection treatment plan. The results of subsequent high-throughput examination and ascites and alveolar lavage fluid culture showed Mycobacterium tuberculosis, considered as Mycobacterium tuberculosis sepsis. Therefore, a multidisciplinary consultation was organized again with clinical pharmacists invited. Results: Clinical pharmacists consulted relevant literature and suggested adjusting the treatment of anti-infection to rifampicin+isoniazid+ethambutol+moxifloxacin. Considering that the patient was undergoing renal replacement therapy, the interval between the administration of ethambutol should be extended to 48-72 h, while monitoring the liver and kidney function of the patient. Soon, the clinical symptoms of the patient improved significantly. Conclusion: Clinical pharmacists not only assist doctors in formulating a more reasonable treatment plan and accelerating the patient recovery, but also accumulate practical experience for this rare case by participating in the consultation of the patient with Mycobacterium tuberculosis septic shock and implementing pharmaceutical care.
  • Epidemiological Analysis of Adverse Drug Reactions Caused by Chinese Herbal Pieces in Dongguan*1
    WEI Mei-xian, LIU Ying, LUO Wei, LI Xiu-ping, TANG Yuan-liang, WANG Yan-hong
    2023, 20(5): 486-489. https://doi.org/10.13493/j.issn.1672-7878.2023.05-008
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    Objective: To analyze the epidemiological characteristics of adverse drug reactions (ADRs) caused by Chinese herbal pieces in Dongguan, and provide reference for the safe and rational use of Chinese herbal pieces. Methods: The ADR reports of Chinese herbal pieces in 211 cases collected from Dongguan Center for Adverse Drug Reaction Monitoring from January 2017 to December 2020 were selected, the information of patients with ADRs, such as age, gender, drugs involved, organs involved and their clinical manifestations, final outcomes, etc., was collected, and the rules and characteristics of the occurrence of ADRs caused by Chinese herbal pieces were analyzed. Results: Among the 211 patients with ADRs, the number of female patients was significantly more than that of male patients (142 cases vs 69 cases), those at the age of over 20-30 years old were slightly more (47 cases, 22.27%), and the distribution of other age groups was relatively uniform. After treatment, 174 cases (82.46%) were cured, and the rest (37 cases, 17.54%) were also alleviated; 211 cases of ADRs mainly involved the gastrointestinal system (134 cases, 63.51%), with the clinical manifestations of borborygmus, abnormal stool, nausea, vomiting, etc., followed by skin or mucous membranes (44 cases, 20.85%). The drugs mainly involved in the 211 cases of ADRs were mainly drugs for tonifying deficiency (62 cases, 29.38%), drugs for relieving exterior syndromes (27 cases, 12.80%), drugs for activating blood circulation to dissipate stasis (22 cases, 10.43%) and drugs for clearing heat (20 cases, 9.48%). Conclusion: Although Chinese herbal pieces are relatively safe drugs in clinical practice, there is still a risk of ADRs. Clinicians should repeatedly advise the matters needing attention for medications and basic principles of handling when prescribing Chinese herbal pieces to ensure the safety of medication for patients.
  • Analysis of Clinical Characteristics and Treatment of Patients with Nocardiosis in a Hospital
    LIU Yuan, WANG Qian, Zhou An-qin, LI Qi-quan, SHAO Sheng-chun
    2023, 20(5): 490-493. https://doi.org/10.13493/j.issn.1672-7878.2023.05-009
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    Objective: To analyze the epidemiological characteristics and treatment of patients with nocardiosis in the hospital, and provide reference for the diagnosis and treatment of nocardiosis. Methods: 7 patients with nocardiosis admitted to the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University from January 2017 to December 2021 were selected as the research subjects, and the information of the 7 patients, such as age, underlying diseases, pathogenic bacteria, infection site, clinical manifestations, medications and treatment outcomes, was collected to analyze their epidemiological characteristics and rational drug use. Results: Among the 7 patients with nocardiosis, 5 cases were complicated with underlying diseases, and the pathogenic bacteria included Nocardia brasiliensis (4 cases), Nocardia asteroides (2 cases), Nocardia otitidiscaviarum (1 case), and the infection sites included skin (4 cases), lungs (2 cases), central nervous system (1 case) and disseminated (1 case); for the treatment regimens, 6 cases were treated with compound sulfamethoxazole-based combined with other antibacterial drugs, and 1 case was treated with minocycline + piperacillin-tazobactam sodium + moxifloxacin; for the treatment outcomes, all of the 7 cases finally improved. Conclusion: For nocardiosis, regardless of whether the infection site is skin, lungs or disseminated, compound sulfamethoxazole is recommended as the first option in the relevant treatment guidelines. This survey also verifies the effectiveness of this regimen, but clinically, appropriate drugs should be reasonably selected in combination with the patient's immune status, severity, specifies of pathogenic bacteria and their drug resistance results, etc.
  • Analysis of Usage of Human Serum Albumin among Inpatients in a Hospital in 2020
    ZHAO Jie-jie, MIAO Jie, HUANG Yu-yu
    2023, 20(5): 494-497. https://doi.org/10.13493/j.issn.1672-7878.2023.05-010
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    Objective: To analyze the usage of human serum albumin among inpatients in the hospital and provide reference for the rational use of human serum albumin in clinical practice. Methods: 240 inpatients (20 cases per month) admitted to Suzhou Affiliated Hospital of Nanjing University of Chinese Medicine to receive the treatment with human serum albumin from January to December 2020 were randomly selected as the research subjects, the patients' information such as age, gender, department, reasons for medication and serum albumin (ALB) levels before medication was collected, and then the rational medication evaluations were conducted according to the relevant guidelines, consensus, package inserts of drugs, etc. Results: Among the 240 inpatients treated with human serum albumin, the ratio of male to female was comparable (121 cases vs 119 cases), and their ages were mainly over 60-80 years old (128 cases, 53.33%) and over 80 years old (26.67%). For the department distribution, the top 5 departments were orthopedics (40 cases, 16.67%), hematology (32 cases, 13.33%), nephrology (31 cases, 12.92%), department of spleen and stomach diseases (30 cases, 12.50%) and ICU (22 cases, 9.17%); for the reasons for medication, the main reason was hypoalbuminemia (124 cases, 51.67%), followed by edema caused by liver and kidney diseases (38 cases, 15.83%), nutritional support (26 cases, 10.83%) and promotion of postoperative incision healing (26 cases, 10.83%); before medication, the ALB levels of patients were mainly over 25-30 g/L (107 cases, 44.50%), followed by over 20-25 g/L (70 cases, 29.17%); the results of evaluations on rational drug use showed that 171 cases (71.25%) of the 240 patients met the indications for medication, and 94 cases (39.17%) had the relevant contraindications, but there were no inappropriate conditions of dosage and administration and combined medication. Conclusion: There are many unreasonable situations in the use of human serum albumin in inpatients in the hospital at present. Experts in the hospital can be organized to establish the guidelines for the use of human serum albumin to guide the rational use of human serum albumin clinically.
  • Meta-evaluation of the Efficacy and Safety of Esomeprazole and Pantoprazole in Patients with Helicobacter Pylori-positive Peptic Ulcer*1
    LI Guo-dong, XU Ya, ZHU Ying, WANG Wei
    2023, 20(5): 507-516. https://doi.org/10.13493/j.issn.1672-7878.2023.05-014
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    Objective: To systematically analyze the efficacy and safety of esomeprazole and pantoprazole in patients with Helicobacter pylori (Hp) positive peptic ulcer, and provide reference for rational drug use in patients with Hp positive peptic ulcer. Methods: The randomized controlled trials (RCT) and prospective observational studies (POS) of esomeprazole and pantoprazole in the treatment of Hp positive peptic ulcer were searched from the databases such as PubMed, Cochrane Library, CNKI, Wanfang database and VIP using "esomeprazole", "pantoprazole", "Helicobacter pylori" and "peptic ulcer" in Chinese and English as keywords, and the efficacy and safety of esomeprazole and pantoprazole in patients with Hp-positive peptic ulcer in the obtained documents and literatures were analyzed by meta-analysis. Results: After preliminary search, a total of 988 literatures were obtained, and 21 articles were finally included after screening (4 382 cases involved), of which 15 articles were RCT and 6 articles were POS. The efficacy evaluation results showed that esomeprazole had better efficacy than pantoprazole in patients with peptic ulcer (OR=1.77, 95% CI: 1.23-2.56, Z=3.06, P=0.002). The comparison of Hp eradication rate showed that esomeprazole was superior to pantoprazole in the eradication effect of Hp in patients with peptic ulcer (OR=1.40, 95% CI: 1.16-1.68, Z=3.76, P=0.0004). The studies on patients with extensive metabolizer (EM) and poor metabolizer (PM) CYP3C19 genotypes showed that esomeprazole was comparable to pantoprazole in the eradication rate of Hp in patients with EM or PM. The safety evaluation results showed that the incidence of adverse drug reactions between esomeprazole and pantoprazole was basically the same (OR=0.97, 95% CI: 0.72-1.30, Z=0.21, P=0.83). Conclusion: For patients with Hp positive peptic ulcer, esomeprazole-based therapy is superior to pantoprazole-based therapy in terms of efficacy and Hp eradication effect, and the drug safety of esomeprazole is not weaker than that of pantoprazole. However, since the literatures included in this study may be insufficient and incomplete, and the research methods may have deficiency, more and larger-scale studies are required for verification.
  • Analysis of Epidemiological Characteristics of Patients with Brucellosis in Dunhuang Region
    LIU Jian
    2023, 20(5): 517-526. https://doi.org/10.13493/j.issn.1672-7878.2023.05-015
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    Objective: To analyze the epidemiological characteristics of patients with brucellosis in Dunhuang region, and provide reference for early diagnosis and treatment of such patients. Methods: 171 patients with brucellosis admitted to the Hospital of Dunhuang City from January 2015 to December 2020 were selected as the research subjects, the information of the patients such as gender, age, place of residence, occupation, time of onset, history of exposure, clinical manifestations, laboratory indexes, complications and final outcomes was collected, and their epidemiological characteristics were analyzed. Results: Among the 171 patients with brucellosis, most of them were males (132 cases, 77.19%), and their ages were mainly between 40 years old and lower than 65 years old (120 cases, 70.18%); most of them lived in rural areas (152 cases, 88.89%), most of them were farmers and herdsmen (145 cases, 84.80%), and 128 cases (74.85%) had a definite history of exposure to cattle and sheep, and the staging of disease was mostly acute (157 cases, 91.81%). Among the 171 patients, the most common symptoms were fever (158 cases, 92.40%) and joint pain (120 cases, 70.18%), followed by hyperhidrosis (77 cases, 45.03%), fatigue (66 cases, 38.60%) and splenomegaly (58 cases, 33.92%), and complications were mainly arthritis (24 cases, 14.04%) and spondylitis (22 cases, 12.87%). Laboratory tests results showed that many patients had elevated transaminases (99 cases, 57.89%), elevated α-hydroxybutyrate dehydrogenase (α-HBDH) (53 cases, 30.99%), increased lymphocytes (59 cases, 34.50%), decreased eosinophils (46 cases, 23.90%), anemia (43 cases, 25.15%), etc.; the follow-up visits showed that 132 patients completed standard treatment, 27 patients failed to complete the standard treatment, and 9 patients relapsed within 6 months after treatment. Conclusion: The occurrence of brucellosis is closely related to people's living environment, occupation, and history of exposure to cattle and sheep. After the onset, the main manifestations are fever and joint pain. Clinically, the relevant conditions of patients should be understood so as to make a definite diagnosis and carry out precise treatment.