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  • 2020 Volume 17 Issue 6
    Published: 25 June 2020
      
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  • Research Advances on Pharmacokinetics of Sophoridine,Oxysophoridine and Lehmannine
    ZHANG Ming-fa, SHEN Ya-qin
    2020, 17(6): 777-781. https://doi.org/10.13493/j.issn.1672-7878.2020.06-001
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Sophoridine, oxysophpridine and lehmannine are matrine-type alkaloids. Matrine-type alkaloids have a widespread bioactivities, including protection of heart, liver, lung, kidney, brain and blood vessel, and have the effects of positive inotropism, negative chronotropism and antiarrhythmia on heart, and promoting leukocytes, anti-asthma, antiulcer,anti-fibrogenesis in liver, and central suppression of sedation, hypnogenesis, analgesia, and antitumor, immunoregulation, anti-bacteria, anti-virus and anti-inflammation. The literatures of the pharmacokinetic parameters and process in body of sophoridine, oxysophoridine and lehmannine is reviewed in the paper, and their research advances on pharmacokinetics are analyzed, which provide a reference for rational use of drugs. Sophoridine is also recommended for the treatment of COVID-19.
  • Recent Research on Clinical Application of Quinolones Antibacterials
    ZHOU Kun
    2020, 17(6): 782-785. https://doi.org/10.13493/j.issn.1672-7878.2020.06-002
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    For various infectious diseases caused by Mycoplasma, Anaerobic bacteria, Gram-positive bacteria, Gram-negative bacteria, etc., quinolones antibacterials are common therapeutic drugs, which are characterized by good oral absorption, strong antibacterial effect and wide antibacterial spectrum. In addition, the indications of such drugs are still expanding, but the incidence of adverse reactions is also on the rise. The main adverse reactions of quinolones include allergic reaction, cardiovascular system reaction, central nervous system reaction and gastrointestinal reaction. The correct and rational use of quinolones prevents the occurrence of adverse reactions and promotes the clinical medication. The literature of clinical research on quinolones was reviewed and the clinical research status was analyzed
  • Influence of 2 Determination Methods of Sulfur Dioxide Residue on Uncertainty Assessment of Testing Results in Angelicae Sinensis Radix *1
    LIU Ling, TAO Song, LIU li-min
    2020, 17(6): 788-794. https://doi.org/10.13493/j.issn.1672-7878.2020.06-004
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    Objective: To establish a method for the determination of residual sulfur dioxide in Angelicae Sinensis Radix by pararosaniline hydrochloride(PRH) and ion chromatography(IC), and to compare the influence of the two methods on uncertainty assessment. Methods: A mathematical model was established for the determination of sulfur dioxide residues in Angelicae Sinensis Radix, the sources of factors affecting the uncertainty were analyzed, each uncertainty factor was evaluated, and the synthetic uncertainty was calculated. Finally, the extended uncertainty of the sulfur dioxide residues in Angelicae Sinensis Radix under the 95% confidence interval (95% CI) were derived. The uncertainty, precision, accuracy, sensitivity, complexity and feasibility of the two methods were compared. Results: The results showed that the residue of sulfur dioxide in angelica was (972.45±48.29) g/g by PRH method, and the minimum detection limit was 2.79 mg/kg.The residue of sulfur dioxide in angelica was (1 170.53±40.5) g/g by IC method, and the minimum detection limit was 0.02 mg/kg. The latter (by IC) is more feasible than the former (by PRH).
  • Comment on Doctor's Orders for Intravenous Anti-tumor Drugs in a hospital and Its Analysis of Unreasonable Reasons*1
    CHEN Yong-gang, HU Bing
    2020, 17(6): 798-801. https://doi.org/10.13493/j.issn.1672-7878.2020.06-006
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    Objective: To explore the rationality of the clinical medication of anti-tumor drugs in the intravenous medication prescribed by doctors, and to analyze the reasons for the unreasonable use of anti-tumor drugs and the effective intervention countermeasures, so as to provide references for the rational use of anti-tumor drugs in clinic. Methods: From January 2016 to December 2019, 21 542 prescriptions of tumor patients admitted to the department of oncology of the hospital were selected, and the usage of anti-tumor drugs was statistically summarized, and the relevant factors such as the order of administration, the amount of solvent, the type of solvent and the dose of the drug were analyzed. Results: Among the 21 542 prescriptions involving anti-tumor drugs, 209 were unreasonable prescriptions, and the proportion of unreasonable prescriptions was decreasing year by year. Among those unreasonable doctor's orders, the proportion of inappropriate solvent types was the highest, followed by inappropriate solvent quantity, inappropriate dose, inappropriate order of administration, wrong input of doctor's orders and other unreasonable reasons. In the 10 drugs involved, etoposide accounted for the highest proportion, followed by epirubicin and vinorelbine. Conclusion: In the clinical medication of the anti-tumor drugs in the intravenous prescribed by the doctor, finding out the unreasonable reasons for the timely and effective intervention so as to ensure the clinical efficacy and safety of the anti-tumor drugs.
  • Analysis on Influencing Factors of QCC Activities on Improving Accuracy of Inhaled Preparations in Patients with COPD and Its Countermeasures*1
    YI Zhao-guo, ZHANG Yuan-ping, DING Hui, XU Yin, LIU Hong-yue
    2020, 17(6): 801-804. https://doi.org/10.13493/j.issn.1672-7878.2020.06-007
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    Objective: To analyze the influencing factors of QCC activities on improving accuracy of inhaled preparations in patients with COPD and Its countermeasures, and to provides reference for the correct medication of inhaled preparations in clinic. Methods: The medical records of patients with COPD who used inhaled preparations before and after QCC activities in outpatient pharmacies from September 2018 to July 2019 were extracted. A quality control circle group was set up for the correctness of the inhaled preparation. The theme of the activity was "improving the accuracy of inhaled preparations used by outpatients", and the influencing factors were found and analyzed, and the relevant measures were formulated to organize the implementation. Results: By carrying out QCC activities, the accuracy of inhaled preparations in outpatient patients was significantly improved, from 49.39% before implementation to 106.21%. Conclusion: The development of QCC activities effectively improves the correct rate of inhaled preparations in outpatient patients and to ensures the effectiveness of medication.
  • Pareto Analysis of Unreasonable Medication of 1 467 Prescriptions of Antibiotics in Outpatient and Emergency in a Hospital
    ZHAO Hua, GUO Sheng-lan, WEI Li-qin, WANG Hao-kui, FANG Jian, LUO Chong-bin
    2020, 17(6): 805-808. https://doi.org/10.13493/j.issn.1672-7878.2020.06-008
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    Objective: To analyze the reasons and characteristics of unreasonable use of antibiotics in outpatient and emergency department, and to promote the rational use of antibiotics. Methods: The TOP 50 prescriptions of antibiotics issued by doctors in the three years from 2016 to 2018 (10 prescriptions per person, 500 prescriptions per month, a total of 18,000) were selected to comment on the rationality of their use, and the reasons and countermeasures of unreasonable prescriptions were found by using Pareto Chart according to the types of irrational medication. Results: 18 000 copies of this antimicrobial prescription, 1 467 drug prescription had unreasonable factors, including the selection of drugs, dosage form, drug delivery and usage; dosage was not suitable for 71.30% (1 046), the secondary factor for sequential medicine choice was not suitable for 94 cases (6.41%), not in the absence of any special priority selection of essential medicines 76 cases (5.18%) and therapeutic use of antimicrobial agents was greater than the reasonable treatment 3 d (contain more than 3 days) 69 cases (4.70%). Conclusion: The main factors that led to unreasonable drug use were analyzed by Pareto Chart, intervention and improvement plan was effectively made, so as to improve the rationality of clinical antibiotics medication of outpatient and emergency.
  • Analysis on Clinical Distribution and Antimicrobial Resistance of 368 Strains of Common Pathogens
    CHEN Yao-sheng, WANG Juan, ZHANG Hui-zhi
    2020, 17(6): 809-812. https://doi.org/10.13493/j.issn.1672-7878.2020.06-009
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    Objective: To analyze the clinical distribution of common pathogenic bacteria and their antimicrobial resistance trend, and to monitor bacterial resistance, so as to provide theoretical basis for rational selection of antibiotics in clinic. Methods: The data of bacterial culture and drug sensitivity of 2 248 specimens of various types submitted for clinical examination by hospitalized patients in 2019 were collected, and the minimum inhibitory concentration (MIC) determined by the strip diffusion method (K-B method) and the broth microdilution method, as well as the clinical distribution and drug resistance of pathogenic bacteria were analyzed. Results: Among the 2 248 specimens collected, 368 strains of pathogenic bacteria were detected, among which the TOP 3 strains were 112 strains of Staphylococcus epidermal (30.40%), 46 strains of Klebsiella pneumoniae (12.50%) and 39 strains of Pseudomonas aeruginosa (10.60%). The TOP 3 pathogenic bacteria detected in the samples were mainly eye secretion (44.02%), sputum (19.57%) and blood (14.95%). The resistance of pathogenic bacteria varies greatly due to the different mechanisms of action of antimicrobial agents. Conclusion: Strengthening the monitoring of drug resistance of pathogenic bacteria is conducive to the rational selection of antimicrobial agents according to the results of drug sensitivity test, so as to ensure the effectiveness and safety of clinical drug use.
  • Analysis on Component and Drug Sensitivity Test Results of Pathogenic Bacteria in 80 Cirrhosis Patients with Spontaneous Bacterial Peritonitis
    DENG Zhi-shi, LEI Jin-hui, LIU Pei-pei, XU Ling
    2020, 17(6): 813-816. https://doi.org/10.13493/j.issn.1672-7878.2020.06-010
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    Objective: To analyze the pathogenic bacteria component and drug sensitivity test results of ascites in patients with cirrhosis complicated with spontaneous bacterial peritonitis. Methods: Data of 80 cirrhosis patients complicated with spontaneous bacterial peritonitis admitted from March 2014 to March 2019 were selected to summarize the bacterial culture and drug sensitivity test results of their ascites specimens, and the composition and drug resistance of pathogenic bacteria in their ascites specimens was analyzed. Results: Specimens of 80 cases of liver cirrhosis patients complicated with spontaneous bacterial peritonitis in the ascites in 44 strains detected Gram-negative bacteria (including 21 strains of Escherichia coli, 8 strains of Klebsiella pneumoniae, 4 strains of Acinetobacter baumannii, 4 strains of Pseudomonas aeruginosa, 1 strain of Acinetobacter Lwoffi, 2 strains of Enterobacter cloacae and 4 other strains), in 30 strains of Gram-positive bacteria (including 11 strains of Coagulase-negative Staphylococcus aureus, 6 strains of grass green Streptococcus, 6 strains of Enterococcus, 4 strains of Staphylococcus aureus and 3 other strains) and 6 strains of fungus (including 3 strains of Candida albicans, 2 strains of Subsmooth candida and 1 strain of dark red Candida). Among Gram-negative bacteria, Klebsiella pneumoniae had higher resistance to ampicillin, while the resistance to piperacillin-tazobactam, imipenem and amikacin was the lowest. Escherichia coli had higher resistance to ampicillin and levofloxacin, while the resistance to amikacin was the lowest. Enterococcus in Gram-positive bacteria had the lowest resistance to linezolid, grass green Streptococcus had the lowest resistance to vancomycin, and Staphylococcus had a higher resistance to penicillin G. Conclusion: The pathogenic bacteria in the ascites of patients with cirrhosis complicated with spontaneous bacterial peritonitis were mainly Klebsiella pneumoniae, Escherichia coli, Enterococcus, grass green Streptococcus and Saphylococcus. According to the results of drug sensitivity test, piperacillin-tazobactam, imipenem, amikacin, linezolid, vancomycin and other antibiotics should be selected for clinical treatment.
  • Influence of Continuous Nursing Intervention Based on "Internet +" Orientation on HSMA of Uremic Patients and Its Countermeasures
    ZHOU Xin, ZHONG Xiao-mei, QIAN Jia, WU Xiao, YIN Jian-fang, Jiang Xiao-mei
    2020, 17(6): 854-858. https://doi.org/10.13493/j.issn.1672-7878.2020.06-023
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    Objective: To analyze the Influence of continuous nursing intervention based on "internet +" orientation on hemodialysis self-management ability (HSMA) of uremic patients and its countermeasures. Methods: Data of 60 cases of hemodialysis patients with uremia admitted to the hospital from January to December 2018 were selected as the control group (by routine continuous nursing intervention). Other data of 60 cases of hemodialysis patients with uremia admitted from January to December 2019 were selected as the observation group (by "internet + "oriented continuous nursing intervention). The changes of the scores of "Self-management Scale for Hemodialysis"(SMSH) and chronic health literacy after intervention were compared between the two groups. Results: the scores of self-management in problem-solving, emotional management and self-care were significantly higher in the observation group than in the control group , and the difference was statistically significant (P<0.05). After intervention, the scores of information acquisition ability, improvement of health intention, and communication and interaction ability in the observation group were higher than those in the control group, and the difference was statistically significant (P<0.05). Conclusion: The continuous nursing intervention based on "Internet +" oriented self-management enhanced the HSMA in patients with uremia and improved their health literacy.
  • Analysis on Susceptible Factors and Bacteriology of Nosocomial Infection Patients in ICU During 2014 to 2017 in a Hospital and Its Countermeasure
    QIU Min
    2020, 17(6): 859-862. https://doi.org/10.13493/j.issn.1672-7878.2020.06-024
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    Objective: To analyze the susceptible factors and the distribution of pathogenic bacteria in hospital ICU patients and to provide reference for the development of nosocomial infection control measures. Methods: The clinical data of 20 734 ICU patients admitted from 2014 to 2017 were collected, and the distribution of susceptibility factors and pathogenic bacteria were analyzed by retrospective analysis according to "the diagnostic criteria of nosocomial infection (trial)" issued by Ministry of Health of China in 2001. Results: Among the 20 734 patients in ICU (Among them, 5 172 patients in 2014, 4 632 patients in 2015, 4 944 patients in 2016 and 5 986 patients in 2017), 944 were infected (7.27% in 2014, 4.86% in 2015, 3.98% in 2016 and 2.44% in 2017). The difference of the infection rate in ICU was statistically significant (Chi-square value was 57.345, P<0.001), and it was decreasing year by year, with an average annual infection rate of 4.55%. In the age dimension, the infection rates of inpatients of different age groups was roughly "linear upward". The TOP 3 infection sites were respiratory system, urinary system and blood system. The majority of infectious pathogens were Gram-negative bacteria (50.00%). Conclusion: Nosocomial infection in ICU is the result of multiple factors. Effectively monitoring nosocomial infection is of great importance for improving medical quality and ensuring medical safety of patients.
  • Pharmaceutical Care for Clinical Medication in 1 Patient of Granulocyte Deficiency Fever with Myelosuppression Caused by Chemotherapy Drugs
    XU Yin, YI Zhao-guo, LIU Hong-yue
    2020, 17(6): 876-879. https://doi.org/10.13493/j.issn.1672-7878.2020.06-029
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    Objective: To explore the pharmaceutical care for the clinical medication in patient of granulocyte deficiency fever with myelosuppression caused by chemotherapy drugs. Methods: Clinical pharmacists participated in monitoring of 1 breast cancer patient with severe myelosuppression and granulocytic fever after chemotherapy (cyclophosphamide, fluorouracil, epirubicin). From the evaluation of chemotherapy regimen, symptomatic treatment of myelosuppression and anti-infection medication of pharmaceutical suggestions were put forward. Results: After clinical pharmacists participate in the clinical medication and the whole process of pharmaceutical care, the patient safely passed the myelosuppression period after chemotherapy. Conclusion: The whole-process of pharmaceutical care participated by clinical pharmacists promotes the safety and efficacy of medication for patients.
  • A Study on Emergency Strategies in the Drug Storehouse of a Third Grade Class A Medical Institution During COVID-19 Epidemic Period
    SHI Fang, LUO Chon-bin, HUANG Jian-ling, SU Yi-hong, CHEN Yin-hua, XIONG Xiao-lan, LUO Min-ling, WU Kai-zhen
    2020, 17(6): 922-925. https://doi.org/10.13493/j.issn.1672-7878.2020.06-045
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    Objective: To explore the emergency strategy against novel coronavirus pneumonia (COVID-19) in the drug storehouse of our hospital, so as to ensure the supply of drugs and personnel safety during the pandemic period. Methods: This paper reviews and analyzes the measures taken by the drug storehouse in the establishment and implementation of emergency plan, the personnel training and management, the supply and guarantee of drugs, humanistic care, etc., since the outbreak of the COVID-19 pandemic, and evaluates the implementation effect of corresponding measures. Results and Conclusion: Facing the challenge of the pandemic, the emergency strategy and corresponding measures of the drug storehouse are implemented in a standardized and orderly manner and work smoothly.