KANGGANRAN YAOXUE

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  • 2020 Volume 17 Issue 2
    Published: 25 February 2020
      
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  • Research Advances in Pharmacological Action of Sophocarpine on Cardiovascular System
    ZHANG Ming-fa, SHEN Ya-qin
    2020, 17(2): 156-159. https://doi.org/10.13493/j.issn.1672-7878.2020.02-002
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    Sophocarpine has the hypotensive effect, whose mechanism may relate to blocking neuroganglion and α-receptor, and improving synthesis of PGI2. Sophocarpine has positive inotropic action and negative chronotropic action on heart. Sophocarpine can decrease peripheral vascular resistance, and alleviate front and back load in heart, thus enhancing cardiac function. Sophocarpine increases flow of coronary artery, and alleviates myocardial ischemia. Sophocarpine obstructs pressure overload-induced myocardial hypertrophy and fibrosis by antioxidation and anti-inflammation, down-regulating expressions of inflammatory cytokine, matrix metalloproteinase and collagen, and improving cardiac function. Since sophocarpine has above-mentioned cardioprotection and inhibits Na+, Ca2+, and K+ currents on myocardial cells, so it can expresses antiarrhythmic action. In this paper, the literatures on pharmacological effects of Sophocarpine on cardiovascular system have been reviewed, and the research progress of Sophocarpineon on cardiovascular system has been also analyzed.
  • Study on Protective Mechanism of Resveratrol against Pyroptosis induced by Lipopolysaccharide in Human Lung Epithelial Cells
    HONG Lei, CHA Ying-jie, QIAO Shi-gang, AN Jian-zhong
    2020, 17(2): 160-164. https://doi.org/10.13493/j.issn.1672-7878.2020.02-003
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    Objective: To explore the influence of resveratrol on the proliferation, release of inflammatory cytokines and pyroptosis of human lung epithelial cells (also known as BEAS-2B) induced by LPS. Methods: The proliferation of BEAS-2B cells treated with lipopolysaccharide (LPS) or LPS combined with resveratrol was assayed by CCK-8 method; expression of inflammatory cytokines TNF-α, IL-6, IL-1β and IL-18 in cell supernatant were measured with ELISA, qPCR and Western blot were used to detect the expressions of genes related with pyroptosis NLRP3, Gasdermin D, Caspase-1, and ELAVL1; their influence on cell viability, cytokine content, expression of pyroptosis related genes and proteins in BEAS-2B cells were analyzed. Results: LPS could inhibit the proliferation of BEAS-2B cells; at the same time, the expression of Inflammatory cytokines can be promoted. The results of qPCR and Western blot showed that LPS could promote the expression of NLRP3, Gasdermin D, Caspase-1, ELAVL1. It was treated with resveratrol for 48 hours the phenomenon of inhibited cell proliferation and high expression of inflammatory factors caused by LPS can be effectively reversed. In addition, the expressions of NLRP3, Gasdermin D, Caspase-1, and ELAVL1 were also partially suppressed. Conclusion: Resveratrol can protect LPS-induced pyroptosis in BEAS-2B cells by reducing the release of inflammatory cytokines and the expression of NLRP3, Gasdermin D, Caspase-1, and ELAVL1.
  • Determination of Mangiferin in Kangbingdu Granular by HPLC
    WANG Hai-bo, LI Yang
    2020, 17(2): 165-167. https://doi.org/10.13493/j.issn.1672-7878.2020.02-004
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    Objective: To establish a method for the determination of mangiferin in Kangbingdu Granular by HPLC. Methods: The Phenomenex Lunar C18 column (250 mm×4.6 mm, 5 μm) was used, the column temperature was 30 ℃, acetonitrile-0.2% aceoic acid glacial was used as mobile phase, the detection wavelength was 258 nm, and the flow rate was 1.0 mL/min. HPLC method was used to determine the content of mangiferin in Kangbingdu Granular. Results: The concentration of mangiferin was well linear in the range of 2.50~50.08 μg/mL, and the regression equation A=42 817 ρ–45 898(r=0.999 5) was obtained. The average recovery was 99.71%, RSD was 1.45%(n=9), and the average mangiferin content was 0.258 5 mg/g. Conolusion： The method is simple, accurate and reproducible. It can be used for the determination of the content of mangiferin in Kangbingdu Granular.
  • Evaluation and Analysis on Prescription Medication and Rationality in Out-patient of Pediatrics in a Hospital from January to June 2018
    CAO Fei
    2020, 17(2): 168-171. https://doi.org/10.13493/j.issn.1672-7878.2020.02-005
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    Objective: To analyze the medication situation in out-patient of pediatrics from January to June 2018,and to provide a references for rational clinical medication of pediatric patients. Methods: 1 243 prescriptions were randomly selected from the out-patient of pediatrics in the hospital from January to June 2018; the information of the patients, the number of drugs, the use of antibiotics, injections, intravenous infusion and essential drugs were collected. The rationality and reason of the unreasonable prescription medication were analyzed. Results: Among the 1 243 prescriptions in the pediatric outpatient department, the average number of drugs used in each prescription was 3.05±0.69,the average number of essential drugs used in each prescription was 1.35±0.45, and the utilization rate of essential drugs was 45.21%. The usage rate of antibiotics was 46.74%. Conclusion: In order to ensure the safety and effectiveness of pediatric drug use, it is necessary to strengthen hardware construction, provide basic equipment for rational drug use, and strengthen the standard management of rational drug use.
  • Analysis on Clinical Medication of Special Comments and Rationality of of TCM Injection in a Hospital from 2016 to 2018
    HU Fang, HUANG Yu-yu, QIN Yuan-yuan, SONG Ru-jun
    2020, 17(2): 172-176. https://doi.org/10.13493/j.issn.1672-7878.2020.02-006
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    Objective: To analyze the clinical medication and rationality of Traditional Chinese Medicine(TCM) injections in a hospital during the past 3 years, and to provide a references for rational clinical use. Methods: Data such as the drug kinds, consumption sum, DDDs, DDC etc.of TCM injections in the 3 years from 2016 to 2018 were extracted to analyze the regularity of drug use and the rationality of clinical use. Results: The amount of money used for TCM injection in our hospital has decreased greatly in the past 3 years, which is related to the adjustment of the price of TCM injection, in which anticancer drugs, blood-regulating agents and tumor-assisted TCM injections rank the top three in clinical use. DDDs of antipyretic and antipyretic agents Xingnaojing injection and Reduning injection DDDs ranked top for 3 consecutive years. Conclusion: The unreasonable usage of intravenous drugs in TCM injections has been significantly improved, and the incidence of unreasonable medical advice has been decreasing year by year, effectively preventing the occurrence of unreasonable usage of TCM injections.
  • Influence of Administrative Intervention on Quality of Pediatric Doctor's Advice Evaluation and Analysis on Unreasonable Medication
    WENG Feng, WU Kai-fu, CAI Hua-jing, DENG Ben-yong
    2020, 17(2): 180-182. https://doi.org/10.13493/j.issn.1672-7878.2020.02-008
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    Objective: To explore the implementation effect of inpatients' medical advice omment, and to analyze the influence on administrative intervention in the improvement of unreasonable drug use. Methods: 377 inpatient orders were collected from October 2016 to September 2017, and the unreasonable medication was collected. At the same time, it was divided into 189 cases before administrative intervention and 188 cases after administrative intervention according to the evaluation results, the causes of unreasonable medical orders were compared and analyzed. Results: Among the 377 doctor's orders, 67 were 35.45% for unreasonable medication before intervention, and 45 were 23.94% for unreasonable medication after intervention. The TOP 3 unreasonable drug use types were off-label drug use, unreasonable use of antibacterial drugs and unreasonable use frequency. The unreasonable utilization rate after intervention was significantly lower than before intervention (23.94% vs 35.45%). The difference was statistically significant (P<0.05). Conclusion: Off-label medication and unreasonable usage of antibacterial drugs are the main types of unreasonable usage of medical orders for inpatients in hospitals. The use of comments on medical orders and administrative intervention measures can help to reduce the unreasonable rate of medication ordered by inpatients and to ensure the rationality and safety of medication for patients.
  • Analysis on Bacterial Culture Results and Resistance of Main Pathogenic Bacteria in Stool Samples of 126 Patients with Acute Diarrhea
    LIU Zhen-hua
    2020, 17(2): 183-186. https://doi.org/10.13493/j.issn.1672-7878.2020.02-009
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    Objective: To analyze the results of bacterial culture in stool samples of patients with acute diarrhea and the resistance of main pathogenic bacteria to antibiotics. Methods: The data of 126 patients with acute diarrhea diagnosed and treated in the hospital from December 2018 to November 2019 were selected, and the results of bacterial culture and drug susceptibility test in the fecal samples of the patients were collected to analyze the distribution and drug resistance of pathogenic bacteria. Results: In the feces samples of 126 patients with acute diarrhea, 99 strains of pathogenic bacteria were detected, and the detection rate was 78.57%, among which 37 strains of Enterococcus accounted for 29.37% and 26 strains of Shigella accounted for 20.63%. Enterococcus strains showed low resistance to vancomycin and linezolid, while Shigella, Klebsiella and Salmonella strains showed high resistance to ampicillin. Conclusion: Enterococcus and Shigella were the main pathogenic bacteria in fecal samples of patients with acute diarrhea, which have high resistance to some antibiotics. Therefore, the types of pathogens and their resistance should be identified before treatment to ensure the effectiveness of antimicrobial treatment.
  • Analysis on Epidemiological Characteristics of Children's Pneumonia and Resistance of Pathogenic Bacteria in Nanyang Region of He'nan
    LI Zheng-yi, WU Qiong, ZHANG Xue-song, DING Xian-chun
    2020, 17(2): 187-190. https://doi.org/10.13493/j.issn.1672-7878.2020.02-010
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    Objective: To analyze the epidemiological characteristics of children's pneumonia and the drug resistance of pathogens in nanyang region of He'nan, and to provides a reference for clinical diagnosis, treatment and rational drug use. Methods: 198 children with pneumonia admitted to our hospital from May 2016 to June 2017 were selected as the research objects. The clinical data, pathogenic bacteria composition and drug resistance of the children were analyzed. Results: 115 pathogenic bacteria were detected in 198 children with pneumonia, and the detection rate was 58.08%. A total of 155 pathogenic bacteria were detected. Among them, 40 strains of bacteria accounted for 25.81%, 48 strains of viruses accounted for 30.97%, and 67 strains of atypical pathogens accounted for 43.22%. Mycoplasma pneumoniae was the main pathogen, accounting for 67.16% of 45 strains. The TOP 3 bacterial infections were Klebsiella pneumoniae 12 strains, accounting for 30.00%; Escherichia coli 10 strains, accounting for 25.00%; Staphylococcus aureus 8 strains, accounting for 20.00%. The resistance rates of Klebsiella pneumoniae, Escherichia coli and Staphylococcus aureus to ampicillin were 58.33%, 80.00% and 87.50%, respectively, while the resistance rates of Klebsiella pneumoniae, Escherichia coli and Staphylococcus aureus to imipenem were all 0.00%. Conclusion: Mycoplasma pneumoniae infection is the most common form of pneumonia among children in Nanyang region of He'nan, followed by Klebsiella pneumoniae, Escherichia coli and Staphylococcus aureus. Therefore, appropriate drugs should be selected according to the condition of children in clinical treatment to improve the clinical therapeutic effect and prognosis of children.
  • Analysis on Clinical Usage and Its Rationality of Antimicrobial Agents in a Hospital from 2016 to 2018
    ZHU Ai-guo, ZHANG Gui-fen, ZHI Wen-yu
    2020, 17(2): 191-196. https://doi.org/10.13493/j.issn.1672-7878.2020.02-011
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    Objective: To analyze the status of clinical usage of antimicrobial agents in a hospital, and to provide a reference for the rational medication of clinical antimicrobial agents. Methods: Data on the clinical usage of antibacterial drugs in a hospital from 2016 to 2018 were extracted to analyze the sales amount, drug use frequency (defined daily doses, DDDs), average daily cost (defined daily cost, DDC), composition ratio and any annual growth. Results: During the 3 years from 2016 to 2018, the total amount of Western medicine sold in hospitals was 335.947 1 million yuan, 321.421 3 million yuan and 296.928 4 million yuan, among which the amount of antibacterial drugs was 63.853 9 million yuan, 61.115 6 million yuan and 57.779 2 million yuan, accounting for 19.15% of the total amount of western medicine on average. The amount of antibacterial drugs decreased by 4.87% annually.The first and the second in the list of the amount of antibacterial drugs were the cephalosporins of the third and second generation.The first and second positions in DDDs were macrolides and the third generation cephalosporins.The sales amount of unrestricted and restricted use grade antibiotics were 17.14% and 70.03%, respectively, and the DDDs component ratio was 59.44% and 38.44%, respectively.The sales amount and DDDs of special use antibiotics decreased obviously.The sales volume of oral and injection dosage forms of antibiotics accounted for about 20% and 80%, with 69% and 31% of DDDs, respectively. The TOP 3 sales values of a single variety were cefotiam, cefatiamidine, piperacillin sodium-tazobactam sodium and cefoperazone sodium sulbactam sodium; The TOP 3 DDDs varieties were clarithromycin, cefoxime and cefadroxil. Conclusion: The clinical usage of antimicrobial drugs in the hospitals is relatively standardized and reasonable, but the standardized management of antimicrobial drugs is a long way to go, which should be persistent and make continuous improvement.
  • Evaluation on Rationality of Clinical Medication of Vancomycin in 90 Inpatients in a Hospital
    CAI Xiao-tie, WEI Xiu-rong, OU Meng-ting, YUAN Liu-qing, ZHUANG Xiao-xin
    2020, 17(2): 200-202. https://doi.org/10.13493/j.issn.1672-7878.2020.02-013
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    Objective: To analyze the rationality of clinical medication of vancomycin in inpatients of a hospital, in order to provide a reference for the rational use of vancomycin. Methods: The data of 90 hospitalized patients receiving vancomycin treatment from January 2018 to June 2019 were selected as the research objects, and the treatment department, clinical diagnosis and information related to vancomycin treatment were collected to analyze the rationality of vancomycin medication. Results: Most of patients were reasonable, and the reasonable conditions were as follow: indications 85 cases (94.44%), solvent selection 90 cases (100.00%), usage and dosage 84 cases (93.33%), treatment course 82 cases (92.22%), combined use of vancomycin 85 cases (94.44%), pathogenic examination 88 cases (97.78%) and timely consultation 89 cases (98.89%). Conclusion: The clinical medication of vancomycin in the hospital basically conforms to relevant regulations, but there are still a small number of unreasonable drug use. The hospital should carry out treatment drug monitoring (TDM) to ensure the rationality and safety of vancomycin medication in patients.
  • Influence of Optimizing Nosocomial Infection Control Management in PIVAS on Quality of Infusions and Reducing of Nosocomial Infection Rate
    HE Chenxi
    2020, 17(2): 223-225. https://doi.org/10.13493/j.issn.1672-7878.2020.02-021
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    Objective: To explore the influence of optimizing nosocomial infection control management in pharmacy intravenous admixture services(PIVAS) on the quality of infusion and the reduction of nosocomial infection rate. Methods: Data of 1 586 patients with PIVAS from January 2015 to December 2016 (before optimized management) were collected. In addition, data of 1 865 patients (after optimized management) from January 2017 to January 2019 were extracted. PIVAS had 25 staff before and after optimized management. The difference of intravenous infusion quality and hospital infection rate before and after optimized management were compared. Results: Compared with that before the optimized management, the satisfaction of the packaging of chemotherapy drugs, infusion preparation quality and operating platform environment after the optimized management was higher (P<0.05), and the incidence of nosocomial infection was lower than that before the optimized management (P<0.05). Conclusion: PIVAS optimized the nosocomial infection control management, the quality of intravenous infusion was effectively improved, containing the occurrence of nosocomial infection, and ensuring the safety of patient medication. The occurrence of nosocomial infection was curbed and the safety of medication was ensured.
  • Effectiveness Analysis of Process Reengineering model on Improving Multisector participation and management of MDRB Infections
    WANG Fang
    2020, 17(2): 226-229. https://doi.org/10.13493/j.issn.1672-7878.2020.02-022
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    Objective: To analyze the effectiveness of the process reengineering model on improving the management of multidrug-resistant bacterial (MDRB) infection, and to provide a reference for the guidance of multi-department collaborative management and prevention of MDRB infection in hospitals. Methods: Data of 110 patients with MDRB infection from July 2015 to June 2016 were selected as the pre-process reengineering group, and 106 patients with MDRB infection from July 2016 to June 2017 were selected as the post-process reengineering group. The MDRB infection reporting time, nosocomial infection detection rate and nosocomial infection incidence were compared and analyzed before and after the multi-disciplinary collaboration model of process reengineering, and the differences in the awareness rate of MDRB among medical staff and the compliance of prevention and control measures were compared and analyzed; the difference of medical personnel's awareness rate of MDRB and compliance of prevention and control measures. and the difference in the rate of sample submission, the utilization rate of antibiotics and DDDs were compared and analyzed too. Results: The patients of post-process reengineering group in the ward after receiving the MDRB from clinical laboratory report time obviously earlier than those of pre-process reengineering group (P<0.05), the detection rate of MDRB, nosocomial infection rate are lower than those of pre-process reengineering group (P<0.05), medical staff awareness and prevention and control measures of MDRB adherence were higher than pre-process reengineering group (P<0.05). Conclusion: The application of the process reengineering model can improves the participation of all departments and the efficiency of nosocomial infection management.
  • Diagnosis Influence of Non Blood Sample 1,3-beta-D-glucan Detection on Fungal Infection in Patients with Cancer after Radiotherapy
    LIANG Yong-jun
    2020, 17(2): 230-234. https://doi.org/10.13493/j.issn.1672-7878.2020.02-023
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    Objective: To explore the influence of non-blood sample 1,3-beta-D-glucan(G test) detection on the diagnosis of invasive fungal infection in patients with cancer after radiotherapy. Methods: Data of 309 patients with non-surgical cancer admitted from January 2010 to January 2016 were selected, and 134 patients with suspected fungal infection 1 week after radiation were selected. Finally, 41 patients with invasive pulmonary fungal infection were confirmed. The blood, airway secretions, and breast water G test and fungal culture, appraisal result were analyzed. The sensitivity (SE), specificity (SP), positive predicative value (PPV), negative predicative value (NPV), accuracy and Youden index in the diagnosis of invasive fungal infection by G test and fungal culture were observed, and the ROC curve was drawn. Results: Forty-seven fungal strains were detected, including 34 candida infections, 4 aspergillus infections and 3 cryptococcus infections. In the blood samples, the G test was higher than that of the fungal culture, and the specificity of the fungal culture was higher than that of the G test. The G test was more accurate in positive predictive value, negative predictive value and accuracy. In the pleural effusion samples, the G test was higher than that of the fungal culture, and the specificity of the fungal culture was higher than that of the G test.Fungal culture was more accurate in positive predictive value, negative predictive value and accuracy. Based on G test results, with 10 pg/mL as the threshold, the AUC of blood samples was 0.620 (0.517, 0.724).The AUC of airway secretions was 0.494 (0.380, 0.609).The AUC of pleural effusion was 0.385 (0.284, 0.487). Conclusion: Blood, airway secretions and pleural effusion of non-surgical lung cancer patients after radiotherapy were detected by G test. The results showed that non-blood sample G test was of high diagnostic value for fungal infection.
  • Pharmaceutical Care of Clinical Medication of 1 Patient with Pulmonary Infection during Pregnancy
    CHU Ning
    2020, 17(2): 241-243. https://doi.org/10.13493/j.issn.1672-7878.2020.02-026
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    Objective: To explore the methods of pharmaceutical care for the clinical medication of pulmonary infection during pregnancy. Methods: Clinical pharmacists were involved in the clinical medication of patients with pulmonary infection during pregnancy, and the whole course of medication monitoring and treatment was carried out. Drug adjustment and adverse drug reactions of patients with pulmonary infection during pregnancy were analyzed. Results: The effectiveness, rationality and safety of medication were ensured by pharmaceutical care for patients with pulmonary infection during pregnancy. Conclusion: For pregnant patients, clinical pharmacists should find out the main contradiction among various complicated contradictions, and based on the pharmacokinetic characteristics of drugs in pregnant women and fetuses, ensuring the life safety of pregnant women and fetuses to the maximum extent. It is necessary based on the change of the disease to adjust the treatment plan and course of treatment in time to ensure the effectiveness of the patient's medication.
  • Influence of Tanreqing Injection with Different Concentrations on Efficacy and Safety in Children with AURTI
    YIN Zhao, LU Na-jin, LI Meng-yang, LIU Jing
    2020, 17(2): 252-256. https://doi.org/10.13493/j.issn.1672-7878.2020.02-029
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    Objective: To investigate the influence of Tanreqing injection with different dilution concentrations on efficacy and safety in children with acute upper respiratory tract infection (AURTI). Methods: 108 children with AURTI who were treated with Tanreqing injection from January to December 2018 were selected. According to the different dilution concentration of Tanreqing injection, 29 patients in the high concentration group, 40 patients in the medium concentration group and 39 patients in the low concentration group were divided into the high concentration group, the meddle concentration group and the low concentration group. The differences of the dilution concentration of Tanreqing injection on the recurrence time of clinical symptoms, the total effective rate and the incidence of adverse drug reactions(ADRs) during administration were analyzed. Results: The recovery time of symptoms and signs in the high and meddle concentration group was similar (<5 d), but earlier than that in the low concentration group (<7 d). The total effective rate was 89.66% and 87.50% respectively in the high concentration group and the meddle concentration group, and the difference between the two groups was not statistically significant (P>0.05), but significantly higher than that in the low concentration group (64.10%). The incidence of ADRs during treatment was 7.50% and 5.13%, respectively, in the meddle and low concentration groups. The difference between the two groups was not statistically significant (P>0.05), but significantly lower than that in the high concentration group (31.03%). Conclusion: The efficacy and safety of Tanreqing injection in patients with AURTI were significant. Proper dilution of Tanreqing injection has not only good clinical effect but also higher safety.