KANGGANRAN YAOXUE

Archive

  • 2020 Volume 17 Issue 1
    Published: 25 January 2020
      
  • Select all
    |
  • Research Advances on Clinical Pharmacological Effects of Matrine Against Tumors of Upper Digestive System
    ZHANG Ming-fa, SHEN Ya-qin
    2020, 17(1): 1-7. https://doi.org/10.13493/j.issn.1672-7878.2020.01-001
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Matrine has the effects in prophylaxis and treatment of gastric precancerous lesion of rat, and rat primary gastric carcinoma induced by N-ethyl-N-nitro-N-nitrosoguanidine, and growth of transplantation tumor of gastric carcinoma MKN-45 cells, SGC-7901 cells, BG823 cells, and pancreatic cancer BxPC-3 cells in rat or nude mice. Matrine inhibits proliferation and induces apoptosis in association with dosage on gastric carcinoma SGC-7901 cells, MGC803 cells, BGC823 cells, MKN-45 cells, NCI-N87 cells, AGS cells, pancreatic cancer BxPC-3 cells, CFPAC-1 cells, cancer of biliary duct QBC939 cells, carcinoma of gallbladder GBC-SD cells, carcinoma of esophagus Eca109 cells, and Escl cells in vitro. Matrine can promote the effects of chemotherapeutics against gastric carcinoma SGC-7901 cells in vivo and in vitro. The literatures on clinical pharmacological effects of matrine on digestive system tumors have been reviewed and their research progress has been also analyzed.
  • Study on Biological Effects of Anti-inflammatory and Analgesic Components in Huangjinju*1
    ZHENG Lu-lu, ZHANG Gui-jun
    2020, 17(1): 8-11. https://doi.org/10.13493/j.issn.1672-7878.2020.01-002
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To study and verify the pharmacodynamic components of the anti-inflammatory analgesia in Huangjinju, and to compare the bioequivalence of the therapeutic components of the injectable and oral Huangjinju in anti-inflammatory analgesia. Methods: The bioequivalences of the anti-inflammatory and analgesic components in Perennial Huangjinju were compared between the oral group and the injection group to determine the anti-inflammatory and analgesic components of Huangjinju. Through the mouse blood vessel permeability test, xylene induced mouse ear swelling experiment, acetic acid writhing experiment and hot plate experiment. Results: In the mouse vascular permeability experiment, the content of Evan's blue in the positive group was (4.823±0.158)μg/mL, that in the oral group and the injectable group was (6.323±0.172) μg/mL and (5.959±0.134) μg/mL, respectively. In the experiment of ear margin swelling induced by xylene in mice, the swelling degree of the positive group was (0.812 5±0.548 9)mg, and that of the oral group and the injection group was (1.05±0.466)mg and (1.3±1.234)mg, respectively. In the acetic acid writhing experiment, the number of writhing times in the positive group was (33.5±2.121) times, and that in the oral group and the injection group was (35.5±3.535) times and (29±1.421) times, respectively. In the hot-plate test, the percentage increase of pain threshold in the positive group was (56.38±1.418)%, and that in the oral group and the injectable group was (64.92±2.421)% and (78.85±3.682)%, respectively. Conclusion: Baicalin, Chlorogenic acid, Orientoside and Vitex glycosides could be used as anti-inflammatory analgesic effective components of Huangjinju. The anti-inflammatory and analgesic effects of injection group and oral group were bioequivalent.
  • Characteristics and Distribution of Bacteria in Patients with APN and Influence of Drug Susceptibility Results on Rational Usage of Antibiotics
    LIU Hui-xia, XIONG Feng, LAI Fa-cai
    2020, 17(1): 12-16. https://doi.org/10.13493/j.issn.1672-7878.2020.01-003
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To explore the characteristics and distribution of pathogenic bacteria in patients with acute pyelonephritis (APN) and the influence of drug susceptibility test results on rational medication of antibiotics. Methods: The data of 200 APN patients admitted to the hospital from January 2012 to February 2019 were selected as the research objects. Summarizing the use of antibiotics and the results of susceptibility test of pathogenic bacteria, the types and distribution of pathogenic bacteria in the patients were analyzed. Logistic regression model was used to analyze the factors influencing the rationality of APN patients. Results: Among the 200 APN patients, 122 strains were detected, among which 40 strains of Escherichia coli accounted for 32.78% and 26 strains of Klebsiella accounted for 21.31%. The drug resistance rate of ESBLs to cefazolin, cefotaxime, ampicillin, ceftriaxone and cefuroxime were 100.00%. The drug resistance rates of Enterococcus to erythromycin and ciprofloxacin were 100.00% and 96.00%, significantly higher than that of other drugs. The DUI of levofloxacin, cefdiazine and aztronam in injection were all greater than one. The type of pathogen infection, ESBL-producing bacteria used according to drug susceptibility results and the type of drugs used in APN patients were independent influencing factors for the rationality of drug use in APN patients (P<0.05). Conclusions: The main pathogenic bacteria of APN patients are gram-negative bacteria. Therefore, antibiotics should be rationally selected according to the results of drug susceptibility test in clinical treatment to ensure the effectiveness and safety of drug use for patients.
  • Analysis on 1 665 Prescriptions of Unreasonable Causes for Out-patient and Emergency Medications in a Hospital and Its Countermeasures
    ZHANG Ling, DING Zeng-lin, YU Li
    2020, 17(1): 17-20. https://doi.org/10.13493/j.issn.1672-7878.2020.01-004
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To analyze the quality problems of outpatient and emergency prescriptions and the causes of unqualified prescriptions and its countermeasures. Methods: 14 400 prescriptions of outpatient and emergency from June 2017 to May 2019 were selected for review, the distribution of unqualified prescription departments and the distribution of unqualified medication types were analyzed, the existing problems in outpatient and emergency prescription review were summarized, and methods to improve the quality of outpatient and emergency prescription were found. Results: Among the 14 400 unqualified prescriptions, 1 665 prescriptions were unqualified (accounting for 11.56%), and the unqualified rates of prescriptions in pediatrics, endocrinology and oncology departments were 22.60%, 20.72% and 16.74%, respectively. There were 238 non-standard prescriptions (14.29%), 1 412 inappropriate prescriptions (84.80%) and 15 abnormal prescriptions (0.90%). Underdosing (43.36%) was the main problem. Conclusion: Outpatient and emergency prescription comments were an effective method to improve the quality of outpatient and emergency prescription, and to promote the rational use of clinical medicine and the safety of patients' medication were ensured. Through prescription comments, the quality management of outpatient and emergency medical treatment in hospitals were strengthened (the prescription acceptance rate reached 88.44%) and rational drug use was promoted.
  • Development and Its Effectiveness Analysis of Pharmaceutical Care for Out-patients with Tuberculosis in a Hospital
    LU Zhi-jun, YANG Jin, RUAN Huan-ting, CHEN Yu-hua
    2020, 17(1): 21-24. https://doi.org/10.13493/j.issn.1672-7878.2020.01-005
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To analyze the influence of outpatient pharmaceutical care (referred to as "pharmaceutical clinic") on rational drug use, and to explore a new model of individualized pharmaceutical care for tuberculosis（TB） patients. Methods: By carrying out half-day pharmaceutical care in TB outpatient service, after providing the patient with drug counseling, health and medication education, pharmaceutical care and other contents; data of 940 TB patients who visited outpatient clinics from January 2018 to April 2019 were collected to analyze the impact of pharmaceutical care on rational drug use and its effectiveness. Results: Among the 940 patients, there were 473 cases of drug counseling, 253 cases of drug education and 214 cases of pharmaceutical care. It effectively solved the problems related to the medication of patients and improved the medication compliance of patients; the adverse drug reactions during medication were timely intervened. Its prognosis has been improved and the satisfactions of patients to treatment are improved. Conclusion: The development of the new mode of pharmaceutical care in the outpatient department of tuberculosis, effectively improves the rationality, effectiveness and compliance of drug use for tuberculosis patients, and the professional expertise of clinical pharmacists is brought into full play.
  • Analysis on Use and ITs Effectiveness of Quality Control Circle Activities in Reducing PIVAS Missed Unreasonable Medical Orders
    ZHAO Xue-feng, FANG Li-zong
    2020, 17(1): 25-27. https://doi.org/10.13493/j.issn.1672-7878.2020.01-006
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To explore the application and its effectiveness of quality control circle activity (QCC) in reducing the occurrence of unreasonable doctor's orders missed in Pharmacy Intravenous Admixture Services(PIVAS). Methods: From January 2017 to January 2018, 3 000 medical orders of hospital PIVAS were selected as the pre-management group, and other 3 000 medical orders were selected as the post-management group after the QCC were carried out from February 2018 to February 2019, the causes of unreasonable medical orders were analyzed. The differences of the causes and incidence of unreasonable medical orders were compared between the two groups. And the difference of personal ability score of PIVAS staff before and after QCC was carried out in the two groups were compared. Results: Among the 3 000 medical orders in the pre-management group, 563 of them contained unreasonable drug use, including unreasonable frequency of drug administration, unreasonable choice of solvent, unreasonable dosage, unreasonable concentration, etc., with an unreasonable incidence of 18.77%. Among the 3000 medical orders in the post-management group, only 67 of them had unreasonable drug use, and the incidence of unreasonable medical orders decreased significantly, with the incidence of only 2.23%.The post-management group was significantly lower than the pre-management group (P<0.05). The scores of responsibility, communication ability, creativity, enthusiasm and team spirit of PIVAS staff in the post-management group were all higher than those in the pre-management group (P<0.05). Conclusion: QCC plays an important role in reducing the occurrence of unreasonable medical orders in PIVAS missed, improving the drug safety of patients, and giving full play to the team responsibility and working ability of PIVAS staff.
  • Analysis on Irrational Medication of 186 Prescription of Traditional Chinese Medicine Injections in PIVAS Hospital and Its Countermeasure
    BAI Shun-min, FAN Zhe
    2020, 17(1): 28-32. https://doi.org/10.13493/j.issn.1672-7878.2020.01-007
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To analyze the reasons and its countermeasures of unreasonable medication of Traditional Chinese Medicine (TCM) injections in doctor's advice, and to provide a reference for the rational medication of TCM injections in clinic. Methods: 186 unreasonable prescriptions for TCM injections were collected in Pharmacy Intravenous Admixture Services (PIVAS) from July to December 2018 to analyze the causes of unreasonable prescriptions for TCM injections and to propose solutions. Results: Among the 186 TCM injections prescribed by doctors, the main Irrational reasons were choice of solvent, dosage of solvent, usage and dosage, extra-course medication, combination of drugs, compatibility, etc.. Conclusion: For the unreasonable medication of TCM injections in the doctor's advice, pharmacists should strictly review the system and strengthen the intervention, so as to further standardize the rational medication of TCM injections and to ensure the safety of clinical medication.
  • Analysis on Postoperative Infection Site with Pathogenic Bacteria and Drug Susceptibility Test Results in 324 Patients with Acute Appendicitis
    WANG Ya-lei
    2020, 17(1): 33-36. https://doi.org/10.13493/j.issn.1672-7878.2020.01-008
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To analyze the distribution of pathogenic bacteria in acute appendicitis and their resistance to antibiotics. Methods: The Data of 324 patients with acute appendicitis admitted for surgical treatment from June 2014 to June 2018 were extracted, and the results of bacterial culture in the secretion samples of the surgical incision site were collected, and the distribution of pathogenic bacteria and their drug resistance were analyzed. Results: Among 324 patients undergoing acute appendicitis surgery, 360 pathogenic bacteria were detected in the infected secretions from the incision, among which 237 Gram-negative bacteria accounted for 65.83%, 88 Gram-positive bacteria accounted for 24.45% and 35 fungi accounted for 9.72%. Among the Gram-negative bacteria, Escherichia coli (97 strains, 26.94%), Acinetobacter baumannii (44 strains, 12.22%), Pseudomonas aeruginosa (27 strains, 7.50%) and Klebsiella pneumoniae (30 strains, 8.33%) accounted for the largest proportion. Staphylococcus aureus (55 strains, 15.58%) and Enterococcus faecalis (18 strains, 5.00%) were the major Gram-positive strains. Among the fungi, Candida albicans (17 strains, 4.72%) and Trichoderma (13 strains, 3.61%) were the most important strains. The results of drug susceptibility test showed that (1) the sensitivity of Escherichia coli in Gram-negative bacteria to piperacillin, ciprofloxacin, aztreonam and levofloxacin was higher, 82.47%, 77.32%, 85.56% and 71.13%, respectively, while the resistance of Acinetobacter bauman to cefoperazone and aztreonam was 97.73% and 86.36%, respectively. Klebsiella pneumoniae had a higher sensitivity to aztreonam (86.67%), while Pseudomonas aeruginosa had a higher sensitivity to piperacillin, ciprofloxacin and aztreonam (96.3%, 81.48% and 92.59%, respectively). (2) among Gram-positive bacteria, Staphylococcus aureus had higher sensitivity to vancomycin, imipenem, linezolid and cefoxitin, while Enterococcus faecalis had higher sensitivity to imipenem, linezolid and cefoxitin. Conclusion: Based on the results of drug susceptibility test for postoperative wound infection, rational treatment should be made with aztreonam (infection caused by Gram-negative bacteria) or imipenem, linezolid, cefoxetine and other drugs (infection caused by Gram-positive bacteria) to ensure the effectiveness of medication.
  • Analysis on Efficacy of Clinical Medication of Antibiotics for Pharma-ceutical Intervention and Optimization of Working Mode of Pharmacy*1
    GUAN Zhi-tao, HUANG Jian-tong, TAN Bin, CHENG Shu-lai
    2020, 17(1): 37-39. https://doi.org/10.13493/j.issn.1672-7878.2020.01-009
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To analyze the efficacy and intensity of pharmaceutical intervention by clinical pharmacists on reducing the unreasonable utilization rate of antibiotics, to standardize the rational medication of antibiotics and to explore the working mode of establishing cooperation between clinical pharmacists and clinical departments. Methods: The clinical use data of antibacterial drugs among inpatients in each department of the hospital from January 2015 to March 2018 were collected as the pre-pharmaceutical intervention group, and the unreasonable use of antibacterial drugs was statistically analyzed. In addition, the data of antimicrobial use in all departments of the hospital from April 2018 to June 2019 after the application of PDCA cycle management were extracted for the pharmaceutical intervention group. The intensity of antimicrobial use in two groups in different quarters were compared and analyzed, that is, the difference of DDDs/(100 persons·d). And for unreasonable drug use departments to develop the corresponding special rectification plan and the rational use of antibacterial drugs were standardized, reduce the intensity of the use of antibacterial drugs, so as to reduce the intensity of antimicrobial use. Results: After using of PDCA cycle management, the clinical medication of antibiotics in hospitals was standardized, and the intensity of antibiotics was reduced to less than 40 DDDs/(100 persons·d). Conclusion: Through pharmaceutical intervention in the rational use of antimicrobial drugs, clinical pharmacists have strengthened and established the working mode of clinical pharmacy knowledge education and training, ward rounds consultation and medical record review, and the rational medication of antimicrobial drugs was standardized.
  • Analysis on Risk factors related Influencing Incision Infection after Cesarean Section in Elderly Parturients
    XU Ting
    2020, 17(1): 67-69. https://doi.org/10.13493/j.issn.1672-7878.2020.01-020
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To analyze the risk factors associated with wound infection after cesarean section in elderly women and its countermeasures. Methods: Clinical data of 225 elderly women admitted to the hospital for cesarean section from March 2016 to February 2018 were selected. Among them, 47 elderly women with postoperative incision infection were selected as the infection group, while 178 patients without incision infection were selected as the uninfected group. The factors influencing incision infection and their countermeasures were compared and analyzed. Results: In the infection group, there was a correlation between incision infection and maternal infection factors (obesity, premature rupture of membranes, operation time, intraoperative blood loss, proportion of cases with diabetes and hypertension) (P<0.05). Logistic regression analysis showed that obesity, premature rupture of membranes, operation time (Greater than 1 hour), combined diabetes, hypertension and blood loss (more than 300 mL) were all risk factors for postoperative incision infection. Conclusion: Maternal obesity, premature rupture of membranes, operation time, intraoperative blood loss and high blood pressure are affecting women with diabetes mellitus the related in risk factors of infection of incision cesarean section. There are many factors that need to be targeted for prevention and control. corresponding prevention and control measures should be adopted, so as to curb or reduce the incidence of incision infection after cesarean section. There are many factors, so specific prevention and control measures should be adopted to prevent or reduce the incidence of incision infection after cesarean section.
  • Analysis on Cause of Drug Accumulation in Body in 1 Patient Treated with Vancomycin and Its Pharmaceutical Care
    LI Qiu-mei, LI Yan-qing, TAN Jun
    2020, 17(1): 75-77. https://doi.org/10.13493/j.issn.1672-7878.2020.01-023
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To analyze the factors causing vancomycin poisoning, to collect the treatment measures after poisoning, and to provide reference for using medicine safely and poisoning a disposal. Methods: Taking a case of vancomycin accumulation in the body as an example, combined with patient medical records and literature, the experimental examination index, clinical management process and prognosis of vancomycin accumulation in the body were described. Results and Conclusion: The reason leading to the accumulation in the body of vancomycin in patients is that physicians do not fully consider the patient's age, disease and combined medications. Treatment drug monitoring（TDM） can quickly and accurately find drug accumulation in the body, and high-throughput dialysis can effectively remove vancomycin accumulation in the body. Clinical pharmacists should pay more attention to the pharmaceutical care for special patients.
  • Pharmaceutical Care of a Clinical Pharmacist Participating in Consultation for Anti-infection in a Patient with Infective Endocarditis
    ZHOU Fang, CHEN Sui-chen
    2020, 17(1): 78-80. https://doi.org/10.13493/j.issn.1672-7878.2020.01-024
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To analyze the pharmaceutical care of a clinical pharmacists participating in the clinical consultation treatment of infective endocarditis (IE) patients, and to explore the process of pharmaceutical care. Methods: By participating in the pharmaceutical care of one patient with IE, the rationality of the anti-infection medication was analyzed. Results and Conclusion: Clinical pharmacists provided personalized pharmaceutical care, which was recognized by clinicians successfully controlling the infection. The clinical pharmacist assists the clinician to choose the medicine, helping the patient to use the medicine the safely and the effectively.
  • Pharmaceutical Care of Clinical Pharmacists Participated in 1 Patient with Hemodialysis of Catheter-related Infected by Staphylococcus aureus
    ZHONG Lin
    2020, 17(1): 81-83. https://doi.org/10.13493/j.issn.1672-7878.2020.01-025
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To analyze the pharmaceutical care process of clinical pharmacist participating in clinical treatment of catheter-related infection in hemodialysis patients. Methods: A catheter-related infection occurred after femoral vein catheterization in a hemodialysis patient who was admitted to the hospital; The results of blood culture proved to be caused by staphylococcus aureus, and the clinical pharmacist participated in the medication and dose adjustment, as well as participated in the whole treatment process. Results: The clinical pharmacists conducted the process pharmaceutical care for the anti-infection treatment of the infected patients, and provided personalized pharmaceutical care for the patients based on the rationality, safety and adverse drug reactions of the dosage of the treatment drugs. Conclusion: Clinical pharmacists make use of their professional advantages to provide more accurate pharmaceutical care for patients with catheter-related infections, and to ensure the effectiveness of the patient's medication.
  • Comparation of Efficacies of Mezlocillin-Sulbactam in Patients with Respiratory and Urogenital Infections
    JIN Chun-fang
    2020, 17(1): 84-86. https://doi.org/10.13493/j.issn.1672-7878.2020.01-026
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To compare the efficacies of mezlocillin-sulbactam in patients with different respiratory and urogenital infections and its influence on clinical indicators. Methods: Clinical data of 160 patients with different respiratory and urogenital infections admitted from November 2017 to November 2018 were extracted. According to the different diseases treated with meloxicillin-sulbactam for injection, 129 patients with respiratory system infection and 31 patients with urogenital system infection were divided. The clinical efficacies of patients with different diseases and their influence on the improvement of various symptom indicators were analyzed. Results: The total effective rate of patients with respiratory system infection and patients with urogenital system infection were 92.25% and 90.32%, respectively.Compared with that before treatment, all the clinical indexes were significantly improved after treatment. The incidence of mild adverse drug reactions was only 1.88%. Conclusion: For patients with respiratory and urogenital system infection, the medication of meloxicillin-sulbactam has a good efficacy, and it also has a higher security.