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  • Research Progress in Pharmacological Effects and Mechanisms of Berberine against Esophageal Cancer and Sarcoma
    ZHANG Ming-fa, SHEN Ya-qin
    2024, 21(8): 775-779. https://doi.org/10.13493/j.issn.1672-7878.2024.08-001
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    Berberine is a bioactive substance with a wide range of pharmacological effects. In addition to anti-inflammatory, antibacterial, antiviral, antidiarrheal, antihypertensive, antihypoxic, hypoglycemic and hypolipidemic effects, berberine also has antitumor effects. There have been reports on the effects of berberine against gastric cancer, colorectal cancer, skin cancer, pancreatic cancer, etc. The pharmacological effects and mechanisms of berberine against esophageal cancer and sarcoma are reviewed, and relevant comments and analyses are made in this article.
  • Research on Optimization of Extraction Process of Qinggan Mixture Based on Orthogonal Experimental Design*1
    WANG Yu
    2024, 21(8): 780-784. https://doi.org/10.13493/j.issn.1672-7878.2024.08-002
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    Objective: To optimize the extraction process of Qinggan Mixture through orthogonal experimental design, and provide a reference for the production and quality control of Qinggan Mixture. Methods: The orthogonal experimental design was used to investigate the frequency of decoctions, decoction time and water addition in the extraction process of Qinggan Mixture; the dry extract yield, baicalin transfer rate and comprehensive cost of process were used as evaluation indicators to select and validate the optimal process route. Results: The orthogonal experimental design showed that the optimal route for the extraction process of Qinggan Mixture was as follows: 3 times of decoctions, 1 hour of decoction time, and 8 times of water addition. Under the optimal route, the dry extract yield (33.56%), baicalin transfer rate (80.05%) and comprehensive cost of process were ideal, and the process stability and repeatability were good. Conclusion: The extraction process route of Qinggan Mixture selected by the orthogonal experimental design has good stability and reproducibility, and can be used for the production of Qinggan Mixture.
  • Pharmaceutical Care for Anti-infective Treatment of Secondary Pulmonary Infection Caused by Extensively Drug-resistant Enterobacteriaceae in Patients with Intracranial Infection Caused by Enterococci*1
    GU Rong-rong, LUO Jia, FAN Xiao-fei, WANG Jin-li, CHEN Bo-hua
    2024, 21(8): 785-788. https://doi.org/10.13493/j.issn.1672-7878.2024.08-003
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    Objective: To analyze the anti-infective treatment process of a patient with intracranial infection caused by enterococci and secondary pulmonary infection caused by extensively drug-resistant Enterobacteriaceae and provide a reference for the anti-infective treatment of similar patients in clinical practice. Methods and Results: The patient was admitted to the hospital for treatment because of headache and dizziness caused by a fall for more than one month without improvement. Considering that the patient had fever for nearly 2 weeks and the protein and chloride in cerebrospinal fluid were abnormal, it was believed to be intracranial infection; so moxifloxacin was given empirically for anti-infective treatment. Later, MRI examination prompted that the patient might have subdural abscess, and the high-throughput gene testing of PMseq-DNA pathogens indicated Enterococcus casselifavus and Enterococcus faecium, so subdural abscess drainage and decompressive craniectomy were performed. During the operation, a large amount of yellow-white pus and extensive pus mosses covering the surface of the cerebral cortex were seen, so the anti-infective treatment regimen was adjusted to linezolid plus meropenem. After 10 days of anti-infective treatment, the patient's body temperature dropped significantly, and the results of cerebrospinal fluid culture were negative for many times. But one week later, the patient's chest CT scan showed that the exudative changes in both lungs had progressed compared with before, and the sputum culture had detected extensively drug-resistant Klebsiella pneumoniae and Pseudomonas aeruginosa. Therefore, meropenem was discontinued and replaced with ceftazidime-avibactam sodium + ornidazole. After 7 days of treatment, the patient's infection indicators were significantly improved, and meropenem was downgraded to use, but the infusion time was extended to consolidate the anti-infection effect. Conclusion: Many patients with severe infections such as intracranial infection are prone to secondary pulmonary infection. Clinical pharmacists should actively work with doctors to strength the relevant monitoring and adjust anti-infective treatment regimens in a timely manner, so as to promote the improvement of patients' prognosis.
  • Analysis of Diagnosis and Treatment of One Patient with Pericarditis Caused by Staphylococcus Caprae
    LONG Jiang-hua, WU Yue-ting, XIAO Juan, QIAN Xin
    2024, 21(8): 789-792. https://doi.org/10.13493/j.issn.1672-7878.2024.08-004
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    Objective: To analyze the clinical diagnosis and treatment process of one patient with pericarditis caused by Staphylococcus caprae and provide ideas for the diagnosis and treatment of similar patients in clinical practice. Methods and Results: The patient was admitted to the hospital due to chest tightness and shortness of breath after repeated activities for more than 3 years. After admission, cardiac color ultrasound showed the presence of a large amount of pericardial effusion. On the 3rd day, levofloxacin was given for empirical anti-infective treatment. The microbial culture results of the patient's pericardial effusion were always negative, but the results of the metagenomic next-generation sequencing reported Staphylococcus caprae twice. As the patient has a history of drinking camel milk, the clinical pharmacist considered that pericarditis was more probably caused by staphylococcus caprae, so the anti-infective treatment regimen was adjusted to linezolid (0.6 g, q12h, intravenous drip); 5 days later, the patient's symptoms were obviously improved, so linezolid was changed to the oral sequential therapy; the follow-up visit showed that the patient recovered well and had no admission record any longer in the recent one year. Conclusion: Staphylococcus caprae has rarely been reported as a pathogen causing pericarditis in the past. For this, the existing detection techniques should be fully used and the patients' symptoms and past history should be comprehensively considered in clinical practice. Once the disease is definitely diagnosed, targeted treatment should be carried out in a timely and active manner to ensure that the patients recover as soon as possible.
  • Analysis of Clinical Diagnosis and Treatment of Liver Injury and Diarrhea Caused by Crizotinib in One Patient with Non-small Cell Lung Cancer
    ZHENG Shuang, TANG Jie
    2024, 21(8): 793-797. https://doi.org/10.13493/j.issn.1672-7878.2024.08-005
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    Objective: To analyze the clinical diagnosis and treatment process of liver injury and diarrhea caused by crizotinib in one patient with non-small cell lung cancer (NSCLC), and provide a reference for the clinically safe medication of crizotinib. Methods and Results: The patient received chemotherapy for NSCLC. During the chemotherapy, the patient developed symptoms such as fatigue and nausea 15 days after taking crizotinib, and the liver function test results showed significant abnormalities in alanine aminotransferase and aspartate aminotransferase. After investigating the patient's medical history and medication history, the clinical pharmacist believed that the liver injury was possibly related to crizotinib, and suggested doctors to discontinue crizotinib and provide liver protection therapy and the doctors accepted the suggestion. One week later, the patient's liver function basically returned to normal; afterwards, the patient used crizotinib again on the basis of liver protection therapy. Although there was no abnormal liver function, diarrhea symptoms occurred 2 months later. The clinical pharmacist believed that it was still possibly related to crizotinib, and suggested using lorlatinib instead. The doctors accepted the suggestion; 3 days later, the patient's diarrhea symptoms were completely relieved. Conclusion: For patients using anti-tumor drugs such as crizotinib that may induce more adverse reactions, clinicians and pharmacists should strength the relevant monitoring and give instructions for safe medication, so as to detect and handle them early and guarantee the medication safety for patients.
  • Analysis of Clinical Characteristics of Acute Kidney Injury Caused by Intravenous Voriconazole*1
    WANG Shu-bo1, DONG Hong-liang, JIAO Ting-ting
    2024, 21(8): 797-801. https://doi.org/10.13493/j.issn.1672-7878.2024.08-006
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    Objective: To analyze the epidemiological characteristics of acute kidney injury (AKI) caused by intravenous voriconazole in patients, and provide a reference for the clinically safe medication of voriconazole. Methods: A total of 87 adverse drug reaction reports of AKI caused by intravenous voriconazole reported by Jiaozuo People's Hospital from 2020 to 2022 were selected as research data. The data of patients such as age, sex, diagnosis, usage and dosage of voriconazole, and drug combination, as well as the occurrence time, severity and outcome of AKI were collected to analyze the clinical characteristics of AKI caused by voriconazole. Results: Among the 87 patients with AKI caused by voriconazole, the number of males was significantly higher than that of females (59 cases vs 28 cases), and the majority of patients were the elderly over and equal to 60 years old (66 cases, 75.86%); most patients were diagnosed with pulmonary infection (64 cases, 73.56%), and the rest were mostly with mixed infections based on pulmonary infection (22 cases, 25.29%). In terms of the usage and dosage of voriconazole, most patients (52 cases, 59.77%) doubled the first dose, and the maintenance dose was mainly "0.2 g, q12h" (64 cases, 73.56%). In addition, the vast majority (84 cases, 96.55%) of patients had combined use of other drugs. According to the KGIGO staging, most patients belonged to AKI stage 1 (62 cases, 71.26%). The AKI occurred within 7 days after use of voriconazole for most patients (67 cases, 77.01%); and in 34 patients (39.08%), the AKI occurred within 3 days after administration. Among the 87 patients with AKI, the drugs were discontinued immediately in 45 cases, while the drugs were not discontinued in the remaining 42 cases; finally 18 cases died. Conclusion: AKI caused by intravenous voriconazole mostly occurs in male and elderly patients. In addition, AKI has a high mortality rate. Clinical education and monitoring should be strengthened to ensure the medication safety for patients.
  • Research on Potential Active Ingredients and Mechanism of Action of "Coptidis Rhizoma-Scuteliariae Radix- Phellodendri Chinensis Cortex" for the Treatment of Bacillary Dysentery Based on Network Pharmacology, Molecular Docking1,*
    ZHU Zhi-dong, CAI Yan-qu
    2024, 21(8): 806-814. https://doi.org/10.13493/j.issn.1672-7878.2024.08-008
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    Objective: To analyze the potential active ingredients and mechanism of action of "Coptidis rhizoma-Scuteliariae radix-Phellodendri chinensis cortex" for the treatment of bacillary dysentery by using network pharmacology methods and molecular docking technology, so as to provide a basis for subsequent research and development of new drugs. Methods: The active compounds and the potential targets of "Coptidis rhizoma-Scuteliariae radix-Phellodendri chinensis cortex" were acquired from Traditional Chinese Medicine Systems Pharmacology Database (TCMSP), and the disease targets of bacillary dysentery were acquired from the databases such as GeneCards, CTD, TTD and drugbank, then the potential targets of "Coptidis rhizoma-Scuteliariae radix-Phellodendri chinensis cortex" for the treatment of bacillary dysentery were identified. Subsequently, the protein-protein interaction (PPI) analysis was performed to screen the core targets, and the biological processes and related pathways of "Coptidis rhizoma-Scuteliariae radix-Phellodendri chinensis cortex" for the treatment of bacillary dysentery were screened by GO functional analysis and KEGG pathway enrichment analysis. Finally, the affinity between receptors and ligands was analyzed by molecular docking. Results: Through the TCMSP, a total of 87 key active ingredients were screened from "Coptidis rhizoma-Scuteliariae radix-Phellodendri chinensis cortex", and there were 228 corresponding targets. A total of 313 disease targets of bacillary dysentery were obtained in the relevant database, and 34 intersection targets were obtained through comparative analysis. By PPI analysis, 14 core targets were screened from the 34 intersection targets. The KEGG pathway enrichment analysis showed that there were 14 important signaling pathways for the treatment of bacillary dysentery. By using the software Cytoscape and based on the 34 intersection targets and 14 important signaling pathways, the top five active ingredients with the largest degree were screened, which were quercetin, wogonin, baicalein, β-sitosterol, and isocorypalmine in sequence. The molecular docking results showed that the tumor necrosis factor (TNF), interleukin-6 (IL-6) and cyclooxygenase 2 (PTGS2) had good affinity to quercetin, wogonin, baicalein, β-sitosterol, and isocorypalmine (binding energy less than -5 kJ/mol). Conclusion: Quercetin, wogonin, baicalein, β-sitosterol, and isocorypalmine may be the main potential active ingredients of "Coptidis rhizoma-Scuteliariae radix-Phellodendri chinensis cortex" for the treatment of bacillary dysentery, and TNF, IL-6 and PTGS2 may be the main targets.
  • Analysis of Practice of Anti-infective Pharmacy Consultation for Inpatients in a Hospital
    CAI Cai-min, XIE Gen-ying, ZENG Guo-fu, XIE Su-zhi, LI Bi-yun
    2024, 21(8): 815-821. https://doi.org/10.13493/j.issn.1672-7878.2024.08-009
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    Objective: To analyze the practice of anti-infective pharmacy consultation for inpatients in the hospital and provide a reference for the implementation of pharmacy consultation by clinical pharmacists. Methods: A total of 77 inpatients who were admitted to Xiamen Haicang Hospital from January 2022 to February 2023 and received anti-infective pharmacy consultation were selected as the research subjects. The data of the patients, such as age, sex, department, microbiological examination results, consultation opinions and their adoption, treatment outcomes, etc. were collected to analyze the clinical characteristics of patients who received anti-infective pharmacy consultation. Results: Among the 77 patients who received anti-infective pharmacy consultation, the number of males was significantly more than that of females (50 cases vs 27 cases), and the majority of patients were the elderly over 60 years old (43 cases, 55.84%). The patients were mainly from general surgery II (26 cases, 33.77%) and department of urology and pain (20 cases, 25.97%), followed by the department of cardiovascular medicine (11 cases, 14.29%) and the department of oncology and hematology (10 cases, 12.99%). Among the 77 patients, 46 cases had positive microbiological examination results, and a total of 46 strains of pathogenic bacteria were detected, including 22 strains of Gram-positive bacteria, 22 strains of Gram-negative bacteria and 2 strains of fungi. The consultation opinions proposed by clinical pharmacists mainly included "adjusting the types of antibacterial drugs" (46 cases, 59.74%) and "maintaining the current anti-infective treatment regimen" (21 cases, 27.27%). Among the 77 patients, pharmacy consultation opinions for 73 cases were adopted by doctors, of which 57 cases had the outcomes of recovery or improvement, and 16 cases had the outcomes of worsening of the condition or ineffective treatment. Conclusion: In the hospitals, clinical pharmacists carry out the pharmacy consultations and put forward personalized drug treatment suggestions, which are welcomed and accepted by clinicians and greatly promote the recovery of patients.