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  • 2023 Volume 20 Issue 9
    Published: 25 September 2023
      
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  • Research Progress in Antiviral Effects of Targeted Anti-Influenza Virus Drugs*1
    ZHENG Xi, ZHANG Chen-yang, WANG Jun-lin, SU Fu-xiang
    2023, 20(9): 893-898. https://doi.org/10.13493/j.issn.1672-7878.2023.09-001
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Influenza is an acute respiratory infectious disease caused by influenza viruses. Influenza A and B viruses spread seasonally every year, and influenza A virus can cause global pandemics. Presently, anti-influenza virus drugs are often used clinically to treat influenza, which mainly exert their effects by preventing the entry, replication and release of influenza viruses. However, influenza viruses can escape recognition and clearance by the immune system through mutation and disguise, which has accelerated the research and development of targeted anti-influenza virus drugs. This article mainly reviews and analyzes the antiviral effects of the anti-influenza virus drugs targeting the sites of hemagglutinin, M2 ion channel protein, RNA dependent RNA polymerase, Cap-dependent endonuclease, neuraminidase and non-structural protein 1, etc., so as to provide theoretical support for the clinical prevention and treatment of influenza and the research and development of new drugs.
  • Research Progress in Pharmacological Effects and Mechanisms of Berberine against Leukemia
    ZHANG Ming-fa, SHEN Ya-qin
    2023, 20(9): 899-903. https://doi.org/10.13493/j.issn.1672-7878.2023.09-002
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    Berberine has a wide range of pharmacological effects such as anti-inflammatory, antibacterial, antiviral, antitumor, antihypertensive, and hypoglycemic effects. Previous studies on berberine's anti-tumor effects mainly focused on anti-hepatoma, anti-tumors of urinary system, and anti-gynecological tumors, etc. The anti-leukemia effects and pharmacological mechanisms of berberine are rarely studied. In this article, by focusing on the pharmacological effects and mechanisms of berberine on K562 cells, HL-60 cells, Jurkat cells, Molt-4 cells, U937 cells and THP-1 cells, the anti-leukemia effects and mechanisms of berberine are reviewed and analyzed.
  • Pharmaceutical Care of One Patient with Mental Disorder Caused by Elevated Plasma Concentration of Voriconazole *1
    OU Ru-jing, LUO Qian, ZHU Li-na, ZENG Jie, WANG Li, LIANG Zhi-ming, JIANG Hui-zhen
    2023, 20(9): 904-907. https://doi.org/10.13493/j.issn.1672-7878.2023.09-003
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    Objective: To analyze the pharmaceutical care process of one patient with mental disorder caused by elevated plasma concentration of voriconazole and provide a reference for clinical medication safety of voriconazole. Methodsand Results: The patient was admitted to the hospital due to "dull pain in the left lower abdomen accompanied by petechiae on both lower extremities" and was later diagnosed with acute lymphoblastic leukemia. During the treatment, the patient developed jock itch and was treated with voriconazole. However, on the 14th day of treatment with voriconazole, the patient developed severe psychotic symptoms. During the period, on the 7th and 14th days of treatment with voriconazole, the plasma trough concentrations were monitored; the results were 3.08 μg/mL and 8.57 μg/mL respectively, and the latter of which was far higher than the upper limit (5 μg/mL) recommended by the guideline. Through consultation, the clinical pharmacist believed that the mental disorder was possibly caused by elevated plasma concentration of voriconazole, which was possibly related to the patient's hypoalbuminemia and concomitant use of dexamethasone and omeprazole. So it was recommended to discontinue voriconazole and switch to caspofungin. Since then, the patient did not experience any psychiatric symptoms again. Conclusion: Clinical pharmacists should actively carry out pharmaceutical care for the drugs that require therapeutic drug monitoring by making full use of their professional expertise in the process of carrying out pharmaceutical practice, so as to ensure medication safety for patients.
  • Epidemiological Analysis of 117 Patients with ADRs Caused by Levofloxacin in a Hospital
    GUI Lai, ZHANG Gui-fen, WANG Jian
    2023, 20(9): 908-913. https://doi.org/10.13493/j.issn.1672-7878.2023.09-004
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    Objective: To analyze the epidemiological characteristics of adverse drug reactions (ADRs) caused by levofloxacin in a hospital and provide a reference for clinical medication safety of levofloxacin. Methods: The ADR reports of 117 patients caused by levofloxacin reported by Changshu No. 1 People's Hospital from January 2018 to December 2022 were selected as the research data, and the information of the patients such as age, sex, disease, specifications, usage and dosage and route of administration of levofloxacin, as well as organs involved, clinical manifestations and final outcomes of ADRs was collected to analyze the epidemiological characteristics of ADRs caused by levofloxacin. Results: In the ADR reports of 117 patients, there were more females than males (78 vs 39); the patients mainly suffered from the lower respiratory tract infections (33 cases, 28.21%), digestive system infections (23 cases, 19.66%), female pelvic infections and its adnexal infections (22 cases, 18.80%) and urinary tract infections (17 cases, 14.53%). According to the ADR reports of 117 patients, 7 specifications (4 injections, 3 tablets) of levofloxacin were involved; the injections were involved in 110 patients (94.02%), and tablets were involved in 7 patients (5.98%). The dosage regimens of levofloxacin were mainly "0.5 g, q24h, intravenous drip" (74 cases, 63.25%) and "0.2 g, q12h, intravenous drip" (27 cases, 23.08%). The ADRs caused by levofloxacin mainly involved the patients' skin and accessory organs (66 cases, 56.41%) as well as vascular systems (18 cases, 15.38%); 8 patients had serious clinical manifestations, specifically anaphylactic shock (6 cases). After symptomatic treatment, all patients became improved (38 cases, 32.48%) or were cured (79 cases, 67.52%). Conclusion: ADRs caused by levofloxacin are more common in women and mostly occur during intravenous drips. In addition, most of the clinical manifestations are not serious, but clinically attention should be paid to the medication monitoring to ensure medication safety for patients.
  • Impact of Installation of China Hospital Pharmacovigilance System on Reporting Adverse Drug Reactions in Hospitals
    CHEN Rong, WENG Feng, ZHANG Hui-ling, HUANG Yun-ling, CAI Hua-jing
    2023, 20(9): 914-917. https://doi.org/10.13493/j.issn.1672-7878.2023.09-005
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    Objective: To evaluate the impact of China Hospital Pharmacovigilance System (CHPS) on reporting adverse drug reactions (ADRs) in hospitals. Methods: ADRs reported by Fuzhou Children's Hospital of Fujian Province from January to December 2019 (56 cases before installing CHPS), January to December 2020 (70 cases during the installation transition period), and January to December 2021 (161 cases after installing CHPS) were selected as the research data to compare the quantity and quality of ADR reports of the hospital before and after installing CHPS. Results: After installing CHPS, the number of ADRs reported by the hospital significantly increased compared to that before installing CHPS (161 cases vs 56 cases), with an increase of 187.50%. Among them, the number of new or severe ADRs reported also increased significantly (25 cases vs 9 cases). The total quality score of ADR reports of the hospital after installing CHPS also significantly improved compared to that before installing CHPS (85.88±8.572 vs 68.73±12.075, P<0.05). The number of ADR cases reported after installing CHPS increased compared with that before installing CHPS (5 cases vs 20 cases), but the proportion was not statistically significant (8.93% vs 12.42%, P>0.05). Conclusion: Due to installation of the CHPS, the missed reporting and underreporting of hospital ADRs are effectively reduced, and the reporting quality of ADRs is effectively improved.
  • Impact of Clinical Pathway on Perioperative Prophylactic Use of Antibacterial Drugs in Pediatric Neurosurgery Patients Undergoing Class I Incision Surgery
    HUANG Hui-yun, YUAN Hai-ping
    2023, 20(9): 918-921. https://doi.org/10.13493/j.issn.1672-7878.2023.09-006
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    Objective: To evaluate the impact of a clinical pathway on the perioperative prophylactic use of antibacterial drugs in pediatric neurosurgery patients undergoing Class I incision surgery, and provide a reference for the rational use of antibacterial drugs in clinical surgical patients. Methods: 96 patients undergoing Class I incision surgery admitted to the pediatric neurosurgery department of the hospital from August 2020 to July 2021 (48 cases before implementing the clinical pathway) and from August 2021 to July 2022 (48 cases after implementing the clinical pathway) were selected as the research subjects. The variety, medication timing, and medication duration of perioperative prophylactic antibacterial drugs used by the patients before and after implementing the clinical pathway were compared and analyzed, and the rational use of the antibacterial drugs was evaluated and analyzed. Results: After the implementation of the clinical pathway for surgical patients, there was a slight decrease in the prophylactic use of antibacterial drugs compared to that before implementation (32 cases vs 36 cases), but the varieties of antibacterial drugs were greatly different (P<0.05). In terms of medication timing, there were also significant differences before and after implementing the clinical pathway (P<0.05), and the number of cases with medication timing of 30-60 minutes before surgery after implementing the clinical pathway increased significantly compared to that before implementation (26 cases vs 8 cases, P<0.05). In terms of medication duration, there were also significant differences before and after implementing the clinical pathway (P<0.05). Among them, the number of cases with a treatment period of not more than 24 hours after implementing the clinical pathway increased significantly compared to that before (27 cases vs 15 cases, P<0.05), while the number of cases with a treatment period of more than 24 hours decreased significantly compared to that before (3 cases vs 16 cases, P<0.05). After implementing the clinical pathway, the irrational use of drugs by patients in terms of varieties, medication timing, medication duration, and expected intraoperative addition but failed in addition was significantly reduced compared to that before (P<0.05). Conclusion: The clinical pathway has indeed effectively reduced irrational prophylactic use of antibacterial drugs during the perioperative period in pediatric neurosurgery patients undergoing Class I incision surgery, thereby enhancing the hospital's level of rational use of antibacterial drugs and ensuring the medication safety for patients.
  • Analysis of Clinical Characteristics of Irrational Antibacterial Drug Prescriptions in the Outpatient Department of a Hospital
    SHI Mei-ling
    2023, 20(9): 922-925. https://doi.org/10.13493/j.issn.1672-7878.2023.09-007
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To analyze the clinical characteristics of irrational antibacterial drug prescriptions in the outpatient department of the hospital, and provide parameters for the rational use of antibacterial drugs in clinical practice. Methods: A total of 2 798 outpatient antibacterial drug prescriptions from Xinfeng County People's Hospital from August 2020 to August 2022 were selected as the research data. Based on relevant guidelines, consensus, and package inserts, among other authoritative information, the rational use of drugs was evaluated. Subsequently, the clinical characteristics of irrational antibacterial drug prescriptions in terms of reasons for irrational drug use, drug varieties, drug combinations, and department distribution were statistically analyzed. Results: According to the evaluation of rational drug use, 351 out of 2 798 antibacterial drug prescriptions were found to be irrational (with an irrational rate of 12.54%). The main reasons for irrational drug use were inappropriate usage and dosage (102 prescriptions, 29.06%), inappropriate route of administration (96 prescriptions, 27.35%), and inappropriate drug combination (78 prescriptions, 22.22%). Among the 351 irrational prescriptions, the main types of antibacterial drugs involved were cephalosporins (128 prescriptions, 34.50%), quinolones (106 prescriptions, 30.20%), and macrolides (115 prescriptions, 32.76%). In terms of drug combination, single drugs (223 prescriptions, 63.53%) were still mainly used, with some cases of combination of two drugs (107 prescriptions, 30.48%) and combination of three drugs (21 prescriptions, 5.98%). The irrational prescriptions were mainly distributed in departments such as pediatrics (82 prescriptions, 23.36%), otolaryngology (73 prescriptions, 20.80%), urology (60 prescriptions, 17.09%), and respiratory (52 prescriptions, 14.81%). Conclusion: The antibacterial drugs are generally rationally used in the outpatient department of the hospital, but there are still some cases of irrational drug use. It is necessary to provide special training and education on key varieties and departments in clinical practice to improve the level of clinical rational use of antibacterial drugs and ensure the medication safety for patients.
  • Analysis of the Distribution Characteristics of Virus Genotypes in Patients Infected with Hepatitis C Virus in Jiangsu Province*1
    SONG Yi-yan, YUE Xiao-dong, SONG Hua-feng, WU Min-juan, XU Jun-chi, HUANG Li-na, XU Ping
    2023, 20(9): 933-936. https://doi.org/10.13493/j.issn.1672-7878.2023.09-010
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    Objective: To analyze the distribution characteristics of virus genotypes in hepatitis C virus (HCV) infected patients in Jiangsu Province, and provide a reference for further research on the prevalence and control strategies of HCV infection. Methods: Serum samples from 924 HCV infected patients in Suzhou, Yangzhou, Zhenjiang, Xuzhou, and Lianyungang of Jiangsu Province from January 2020 to May 2021 were selected as the research data, on which HCV genotype testing was performed to analyze the distribution characteristics of HCV virus genotypes. Results: The ages of 924 HCV infected patients were mainly concentrated in three age groups, namely elder than 50-60 years old (293 cases, 31.71%), elder than 60-70 years old (211 cases, 22.74%), and elder than 40-50 years old (137 cases, 14.83%). A total of 8 genotypes were detected in serum samples from the 924 patients, with the main genotype being 1b (697, 75.43%), followed by 2a (152, 16.45%). In addition, there were significant differences (P<0.05) in the distribution of type 1b between southern Jiangsu (i.e. Suzhou) and central Jiangsu (i.e. Yangzhou + Zhenjiang), as well as between central Jiangsu and northern Jiangsu (i.e. Xuzhou + Lianyungang), while there were significant differences (P<0.05) in the distribution of type 2a among southern Jiangsu, central Jiangsu, and northern Jiangsu. Conclusion: The ages of HCV infected patients in Jiangsu Province are mainly concentrated in the age group of elder than 40 to 70 years old, and the genotype of the virus is mainly 1b, followed by 2a. Attention should be continuously paid to clinical research on the HCV infection characteristics to assist in the prevention and treatment of HCV infection.
  • Diagnosis and Treatment Analysis of One Case of Mycobacterium Abscessus Pulmonary Disease and Literature Review*1
    CHEN Mu-xing, WU Di, LIN You-fei, CHEN Xiao-hong
    2023, 20(9): 936-939. https://doi.org/10.13493/j.issn.1672-7878.2023.09-011
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    Positive acid-fast staining can be found in pulmonary tuberculosis and nontuberculous mycobacteria (NTM) diseases. NTM diseases with positive acid-fast staining are easily misdiagnosed as pulmonary tuberculosis. Intermittent fever is a less common type of fever. At present, there are no reports in the literature that the fever type of Mycobacterium abscessus pulmonary disease (MAB‐PD) is manifested as intermittent fever. This article analyzes the diagnosis and treatment process of one patient with MAB-PD who is positive for acid-fast staining and manifested as intermittent fever, and performs literature review on the cases of MAB‐PD that have been reported so far.
  • Analysis of Clinical Characteristics of Patients with Mycoplasma Hominis Bloodstream Infection
    XIANG Yu-pei, FAN Bing, GU Li
    2023, 20(9): 940-943. https://doi.org/10.13493/j.issn.1672-7878.2023.09-012
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    Objective: To analyze the clinical characteristics of patients with Mycoplasma hominis (Mh) bloodstream infection, and provide a reference for improving the clinical diagnosis and treatment level of Mh bloodstream infection. Methods: One patient with Mh bloodstream infection admitted to the hospital, as well as seven patients of full particulars with Mh bloodstream infection retrieved from domestic and foreign databases such as PubMed, CNKI, and Wanfang Database, were selected as the research subjects. The information of the patients such as age, sex, body temperature, infection indicators, blood culture, surgical situation, history of catheterization, treatment regimen, and treatment outcome was collected to analyze the clinical characteristics of patients with Mh bloodstream infection. Results: Mh bloodstream infections occurred in 8 patients (5 males and 3 females) after surgery, including 3 cases of surgery of the gynecological reproductive system, 2 cases of heart valve surgery, 2 cases of craniotomy operation, and 1 case of fracture surgery. The alarm time for patients with positive blood culture was 1.68-7 days, with a median value of 4 days. All 8 patients developed fever symptoms (including 4 cases with high fever), and infection indicators such as white blood cell count, neutrophil percentage (NEUT%), C-reactive protein, and procalcitonin showed varying degrees of abnormalities. After targeted treatment, all 8 patients became improved or were cured. Conclusion: Compared with other bloodstream infections, Mh bloodstream infection has no clinically specific indications observed yet. The relevant diagnosis mainly relies on the results of microbial culture identification. The learning and accumulation of knowledge related to Mh bloodstream infection should be continuously enhanced in clinical practice, and microbial examination techniques should be well used to help clarify the diagnosis in clinical practice.