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  • 2020 Volume 17 Issue 8
    Published: 25 August 2020
      
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  • Research Advances in Pharmacological Effects of Matrine and Oxymatrine in Patients with Nasopharyngeal Carcinoma
    ZHANG Ming-fa, SHEN Ya-qin
    2020, 17(8): 1085-1089. https://doi.org/10.13493/j.issn.1672-7878.2020.08-001
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    Matrine inhibits proliferation and induces apoptosis in association with dosage on human nasopharyngeal carcinoma CNE1 cells, CNE1-GL cells and CNE2 cells. Matrine enhances killing ability of NK cells to drug-resistant CNE2/DDP cells, and reverse resistance of nasopharygeal carcinoma HONE1/DDP cells to cisplatin. Matrine inhibits growth of transplantation tumor of CNE2 cells in nude mice too. Oxymatrine inhibits proliferation and induces apoptosis in association with dosage on CNE1 cells, CNE2 cells, HNE-1 cells and HNE-1(200) cells. Oxymatrine enhances effects of vincristine, bleomycin, 5-fluorouracil or cisplatin against HNE-1 cells, and multidrug-resistant HNE-1（200）cells. In this paper, the Literatures of pharmacological effects of matrine and oxymatrine on nasopharyngeal carcinoma were reviewed and their research progress was analyzed. It is also suggested to use matrine and oxymatrine in the treatment of COVID-19.
  • Study on Efficacy and Mechanism of Protocatechuic Acid in Multiple Target in Mice Model with Alzheimer's Disease*1
    XUE Xiao-yan, WU Li-ping, WANG Li-fang
    2020, 17(8): 1090-1093. https://doi.org/10.13493/j.issn.1672-7878.2020.08-002
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    Objective: To study the efficacy and mechanism of protocatechuic acid (PCA) in multiple target in mice model with Alzheimer's disease (AD). Methods: AD mice model was established by D-galactose(D-gal) and aluminum chloride(AlCl3). The experiment was divided into five groups: blank control group, AD model group, the therapeutic groups were administrated PCA respectively with low, medium, and high doses (5 mg·kg–1·d–1, 15 mg·kg–1·d–1,30 mg·kg–1·d–1) through intragastric route for 5 weeks. Huperzine A (0.4 mg·kg–1·d–1) was used as a positive control drug. The test of Morris water-maze, the expression of AchE, Aβ, MAP and BDNF mRNA, immunohistochemical staining were carried out to evaluate the effects of PCA on the AD mice model. Results: Compared with AD model group, the mice administered by different doses of PCA had shorter escapelatency and longer platform-crossing times except the group treated with higt dose PCA. Furthermore, PCA downregulated the expression of AchE, Aβ and MAP mRNA, while upregulated the expression of BDNF. Conclusion: These findings provide the efficacy and mechanism of PCA in multiple target in mice model with Alzheimer's disease through shortening escapelatency and extending platform-crossing times, downregulating the expression of AchE, Aβ and MAP, while upregulating the expression of BDNF.
  • Experiment of Extracts of Coptidis Rhizoma and Forsythiae Fructus on Bacteriostasis of Methicillin-resistant Staphylococcus Aureus
    PAN Yan-rong, WANG Shuang, Chang Xiao-ping
    2020, 17(8): 1094-1096. https://doi.org/10.13493/j.issn.1672-7878.2020.08-003
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    Objective: To investigate the extracts of Coptidis Rhizoma and Forsythiae Fructus on bacteriostasis of methicillin-resistant Staphylococcus aureus (MRSA). Methods: 2 kinds of antibacterial Chinese herbal decoction pieces of Coptidis Rhizoma and Forsythiae Fructus were selected for investigation. The concentration of Coptidis Rhizoma and Forsythiae Fructus was extracted by water extraction method with a concentration of 1 g/mL. Then the minimum antibacterial concentration of Coptidis Rhizoma and Forsythiae Fructus against 100 clinical isolates was determined by dilution method, and the antibacterial effect of these 2 kinds of Chinese herbal decoction pieces on MRSA was investigated and analyzed. Results: The extracts of Coptidis Rhizoma and Forsythiae Fructus have strong bacteriostatic effect on MRSA, and the bacteriostatic effect of Coptidis Rhizoma is obviously stronger than that of Forsythiae Fructus. The inhibitory concentrations of Coptidis Rhizoma and Forsythiae Fructus on MRSA were 0.063 g/mL and 0.250 g/mL, respectively. Conclusion: Coptidis Rhizoma and Forsythiae Fructus are commonly used in clinical practice as antibacterial Chinese herbal decoction pieces, which have an ideal antibacterial effect on MRSA and are ideal Chinese herbal decoction pieces for preventing MRSA infection.
  • Analysis on Monitoring Blood Concentration of Voriconazole in Patients with Severe Invasive Fungal Infection and Its Influencing Factors
    HUANG Yi-ting, WANG Li-man, JIANG Ting-ting, HUANG Xu-hui
    2020, 17(8): 1097-1101. https://doi.org/10.13493/j.issn.1672-7878.2020.08-004
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    Objective: To analyze the therapeutic drug monitoring (TDM) data of voriconazole plasma concentration in patients with severe invasive fungal infection. To investigate the factors affecting the blood concentration of voriconazole, so as to provide reference for individual administration of voriconazole. Methods: Clinical data of 50 patients with severe invasive fungal infection treated with voriconazole from January 2017 to October 2019 were collected, and the effects of gender, age, plasma albumin level (ALB) and other factors on the blood concentration of voriconazole were analyzed. Results: There was a significant correlation between the blood concentration of voriconazole used for the treatment of invasive fungal infection and ALB and the combined proton pump inhibitor (PPI) in patients with invasive fungal infection (P<0.05). Conclusion: When using voriconazole in patients with severe invasive fungal infection, anttention should be paid to the influence of ALB and combined PPI on blood drug concentration, and the blood drug concentration should be monitored to ensure the efficacy and safety of voriconazole medication.
  • Analysis on 504 Prescriptions of Outpatient Vascular Surgery Patients Comments and Reasons for Unreasonable Medication
    TANG Qiu-yue, QIN Yuan-yuan, HUANG Yu-yu, SHEN Xi-kun
    2020, 17(8): 1102-1106. https://doi.org/10.13493/j.issn.1672-7878.2020.08-005
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    Objective: To analyze the standardization of outpatient prescription and the rationality of drug use, as well as the reasons for unreasonable drug use. Methods: 504 prescriptions were drawn from the Outpatient Department of Vascular Surgery of the hospital (from October 2017 to September 2018), and the reasons for prescribing standardization as well as unreasonable prescriptions were reviewed. Results: Among the 504 outpatient prescriptions, 47 were unreasonable prescriptions accounted for 9.33%, in which 29 were inappropriate prescriptions accounted for 61.70%, followed by 9 non-standard prescriptions accounted for 19.15%. Conclusion: The age and condition of patients should be taken into consideration in clinical prescription, and the interaction between drugs and compatibility contraindication should be carefully considered in combination. The communication between clinical pharmacists, doctors and assist doctors should be strengthened to determine the indications of drug use, so as to improve the ability of clinical pharmacists to examine prescriptions and promote rational drug use.
  • Effect of Different Doses of Vancomycin on Clearance of Bacteria in Patients with MRSA Infection and Analysis of Blood Drug Concentration*1
    GONG Wei-wei, CAO Ji-ping
    2020, 17(8): 1107-1111. https://doi.org/10.13493/j.issn.1672-7878.2020.08-006
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    Objective: To investigate the effect of different doses of vancomycin on the bacterial clearance rate of patients with methicillin-resistant Staphylococcus aureus (MRSA) infection and to analyze the relationship between blood drug concentration and infected patients. Methods: Clinical data of 126 patients with MRSA infection admitted from January 2017 to December 2018 were collected. Based on the dosing, 40 patients in the low-dose group (15 mg·kg–1·time–1), 42 patients in the medium-dose group (17.5 mg·kg–1·time–1), and 44 patients in the high-dose group (20 mg/kg–1·time–1) were divided into the low-dose group (15 mg·kg–1·time–1), the medium-dose group (17.5 mg·kg–1·time–1) and the high-dose group (20 mg·kg–1·time–1). The clinical efficacy, plasma concentration, bacterial clearance rate, adverse reactions, and changes of renal function before and after treatment were compared among the three groups. Results: The total effective rate of high dose group and middle dose group was 97.73% and 97.62% respectively, which was significantly higher than that of low dose group (77.50%) (P<0.05). The bacterial clearance rate of high dose group and middle dose group was 97.73% and 95.23% respectively, which was significantly higher than that of low dose group (75.00%) (P<0.05). There was no significant difference in CysC, BUN and Scr among the three groups before treatment (P>0.05). After treatment, the levels of CysC, BUN and Scr in high dose group were significantly higher than those before treatment, and significantly higher than those in middle dose group and low dose group (P<0.05). After treatment, the average blood concentration of high dose group was significantly higher than that of middle dose group and low dose group, and the distribution of blood drug valley concentration was significantly worse than that of middle dose group and low dose group (P<0.05). The total incidence of adverse reactions in high dose group was 27.27%, which was significantly higher than 4.76% and 2.50% in middle dose group and low dose group (P<0.05). Conclusion: The use of vancomycin (17.5 mg·kg–1·time–1) in the treatment of MRSA infected patients has the following advantages: a significant effect, effectively increasing the bacterial clearance rate, low blood drug concentration, little impact on the renal function of patients, and high drug safety.
  • Influence on Xpert MTB/RIF Technique in Accuracy of Mycobacterium TB in Sputum Specimens and Results of Rifampicin Susceptibility
    NIE Jing, WANG Xiao-chuan, WU Han-liang
    2020, 17(8): 1112-1115. https://doi.org/10.13493/j.issn.1672-7878.2020.08-007
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    Objective: To explorate the influence on Xpert MTB/RIF technique in accuracy of Mycobacterium tuberculosis (MTB) in sputum specimens and results of rifampicin susceptibility. Methods: Data of 70 cases of suspected pulmonary tuberculosis patients admitted to the hospital from November 2018 to October 2019 were selected, and the results of Xpert MTB/RIF technique in the detection of MTB in sputum were analyzed. The sensitivity, specificity and accuracy of Xpert MTB/RIF test to MTB and the consistency of Xpert MTB/RIF test results with that of the proportional test were compared and analyzed. Results: According to the results of MTB culture, 59 of the 70 suspected tuberculosis patients were diagnosed with tuberculosis. The specificity of Xpert MTB/RIF test and sputum smear were 100.00% and 90.91%, respectively. The sensitivity and accuracy of Xpert MTB/RIF were 38.98% and 48.57%, respectively. The sensitivity and accuracy of MTB were 16.95% and 28.57%. Through Kappa analysis, it was found that the consistency of rifampicin resistance in Xpert MTB/RIF detection method was better than that of proportional method (K=0.782, P<0.05). Conclusion: Xpert MTB/RIF technique has the advantage of fast and easy operation, and the drug resistance to rifampicin can be detected at the same time as the diagnosis of MTB, so the diagnosis results are objective.
  • Analysis on the Usage of Antibacterial Drugs in Inpatients in a Hospital from 2018 to 2019
    ZHU Yong-chao
    2020, 17(8): 1115-1119. https://doi.org/10.13493/j.issn.1672-7878.2020.08-008
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    Objective: To analyze the monitoring indicators of antibacterial drugs usage in hospitalized patients,and to evaluate the rationality of antimicrobial drug usage so as to standardize the clinical application of antibacterial drugs. Methods: With the help of PASS clinical pharmacy management system, the medical records of all inpatients from 2018 to 2019 were extracted for analyzing the monitoring indicators （including the usage rate and intensity of antibacterial drugs, the preventive usage rate of antibacterial drugs in type I incision surgery and the rate of microbial detection） and rational use of antibacterial drugs. Results: Among the 12 335 inpatients' medical records, the utilization rate and intensity of antibacterial drugs decreased year by year.The proportion of antibacterial drugs used for the prevention of type I incision surgery also decreased, but the rate of microbial examination of each specimen increased year by year. The review results showed that there were many reasons for the unreasonable usage of antibacterial drugs, including inappropriate usage and dosage of antibacterial drugs and inappropriate selection of antibacterial drugs, followed by a long course of preventive medication of antibacterial drugs, inappropriate timing of preventive medication, as well as inappropriate combination of antibacterial drugs. Conclusion: The hospital should strengthen the supervision of the usage of antibacterial drugs to promote the rational usage of antibiotics in clinic.
  • Analysis on Results and Drug Sensitivity of Mycoplasma Culture of Cervi-cal Secretions in 78 Patients with Ectopic Cervical Columnar Epithelium
    XU Hui
    2020, 17(8): 1119-1122. https://doi.org/10.13493/j.issn.1672-7878.2020.08-009
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    Objective: To analyze the results and drug sensitivity of Mycoplasma culture of cervi-cal secretions in 78 patients with ectopic cervical columnar epithelium. Methods: Clinical data of 78 patients with ectopic cervical columnar epithelium admitted from August 2018 to August 2019 were collected to analyze the culture of Mycoplasma from their cervical secretion specimens and the results of drug sensitivity test. Results: The infection rate of single Ureaplasma urealyticum (Uu) (74.36%) was higher than that of single Mycoplasma Hominis (Mh) (10.26%) and Mh+Uu (15.38%) (P<0.05). In Uu infection, the infect rate of simple type (58.82%) was less than that of particle type (86.21%) and mastoid type （86.67%） (P<0.05). The sensitivity rates of Uu to minocycline and doxycycline were 96.55% and 98.28%, and the resistance rates of Uu to norfloxacin and ciprofloxacin were 82.76% and 75.86%, respectively. The sensitivity rate of Mh to MMC, minocycline, doxycycline and azithromycin was 100.00%, while the resistance rate to norfloxacin was 87.50%. The sensitivity rates of Mh+Uu to doxycycline and minocycline were 94.67% and 83.33%, and the drug resistance rates of Mh+Uu were 50.00% and 41.67%, respectively. Conclusion: The infection rate of Uu in the cervical secretions in patients with ectopic cervical columnar epithelium was higher, among which the lesion type is granule type and mastoid type, and the sensitivity rate to a variety of antibacterial drugs was different to some extent. Therefore, the clinical treatment plan should be formulated based on the drug sensitivity results.
  • Influence of Procedures of Cleaning and Disinfecting of Endoscope on Reducing Risk of Nosocomial Infection and Qualified Rate of Endoscopic
    CAI Zheng-ju
    2020, 17(8): 1186-1189. https://doi.org/10.13493/j.issn.1672-7878.2020.08-030
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    Objective: To analyze the influence of endoscopic cleaning and disinfection process on reducing the risk of nosocomial infection and the qualified rate of endoscopic disinfection and its countermeasures. Methods: Data of traditional endoscopic cleaning and disinfection procedures recorded from January to December 2017 (100 patients, 100 pieces of endoscopy) were selected as the routine group, and data of improved endoscopic cleaning and disinfection procedures recorded from January to December 2018 (100 patients, 100 pieces of endoscopy) were selected as the improvement group. The differences of qualified rate of endoscopic disinfection and incidence of nosocomial infection in the two groups were compared. Results: The qualified rate of endoscopic disinfection in the improved group was significantly higher than that in the routine group (P<0.05), while the incidence of nosocomial infection was significantly lower than that in the routine group (P<0.05). Conclusion: The improvement of endoscopic cleaning and disinfection process could avoid the occurrence of nosocomial infection and the qualified rate of endoscopic disinfection was effectively improved.
  • Epidemiological Analysis on Helicobacter Pylori Infection of 10 487 Healthy Persons in Pingxiang Area and and Its Medication Strategy
    REN Mei, HUANG Yong-jian, LI Feng-zhong, WANG Xiao-ming
    2020, 17(8): 1189-1193. https://doi.org/10.13493/j.issn.1672-7878.2020.08-031
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    Objective: To explore the epidemiological analysis and treatment strategies of Helicobacter pylori (Hp) infection in Pingxiang area, and to provide a theoretical basis for the prevention and treatment of Hp. Methods: The data of 10 487 healthy physical examinees who were detected by indirect solid phase immunochromatography from January 2016 to June 2019 were extracted to analyze the detection results of Hp antibody and its epidemiological characteristics. Results: Among the 10 487 healthy specimens, 5 021 were positive for Hp antibody, with a positive rate of 47.88% (59.97% for males and 40.03% for females).The prevalence of Hp infection in all age groups were less than or equal to 30 years old (38.51%), 30 to 40 years old (49.90%), 40 to 50 years old (50.55%), 50 to 60 years old (49.35%), 60 to 70 years old (52.97%), and greater than 70 years old (40.76%). The incidence of Hp infection in different seasons was as follows: in spring (47.25%), summer (50.14%), autumn (47.42%) and winter (47.15%), respectively. The difference of Hp infection in different seasons was not statistically significant (P>0.05). Conclusion: The analysis of regional Hp infection in the population can clarify the distribution characteristics of Hp and the relevant influencing factors of Hp infection, which is conducive to the development of targeted screening and prevention measures to reduce the occurrence of Hp disease.
  • Epidemiological Characteristics of 40 Cases of Dengue Fever in Jiangmen From 2018 to 2019 and Its Strategies of Prevention and Control
    LIANG Shao-qun, WU Xing-liu, ZHAO Ming-cong, HE Gang, LUO Ming, WU He-ming, Chen Xiao-hua
    2020, 17(8): 1194-1197. https://doi.org/10.13493/j.issn.1672-7878.2020.08-032
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    Objective: To study the epidemiological characteristics and clinical patterns of Dengue fever patients in Jiangmen, Guangdong province from 2018 to 2019, and to provide an examination for clinical diagnosis, treatment and prevention and control of Dengue fever. Methods: Data of 40 patients with Dengue fever in Jiangmen from 2018 to 2019 were collected to analyze their history, clinical manifestations, diagnosis priorities, treatment effects and prevention and control measures, disease transmission characteristics, distribution rules, clinical diagnosis and treatment points, occurrence of complications, characteristics and management of critically ill patients, prognosis and outcome. Results: There were 40 cases of Dengue fever with an equal proportion of males and females, with 19 cases over 60 years old accounting for 47.50% and 3 cases under 14 years old accounting for 7.50%.Thrombocytopenia was found in 36 cases (90.00%) and leukopenia in 38 cases (95.00%). There were 5 cases of hypotension (12.50%), 1 case of slow heart rate (2.50%) and 32 cases of liver function damage in (80.00%). Among them, 26 cases were from Jiangmen Waihai district (65.00%) and 14 cases were from Jiangmen Xinhui district (35.00%). Conclusion: In Jiangmen area, the prevalence of Dengue fever was mainly in the form of undulation fever. Patients in Jianghai area were mostly accompanied by diarrhea, and patients in Xinhui area were mostly accompanied by vomiting. Most of patients were with severe platelet count abnormality, liver function damage and severe complications, and the results were good after treatment. Anti-mosquito work should be actively conducted as the main prevention and control measures.
  • Pharmaceutical Care for Anti-infection Medication in one Patient with Severe COVID-19*1
    SONG Xiao-bing, WANG Yan, WU Qing-rong, LIU Jian-ping
    2020, 17(8): 1209-1212. https://doi.org/10.13493/j.issn.1672-7878.2020.08-037
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    Objective: To analyze the method of clinical pharmacists taking part in the medication of patient with severe COVID-19 and conducting pharmaceutical care,through the practice of drug treatment in Patient with severe COVID-19. Methods: The clinical pharmacists used the professional knowledge of pharmacy and the latest clinical research evidence to participate into the pharmaceutical care in one Patient with severe COVID-19, assisting the clinic to adjust the treatment regimen. Results: Clinical pharmacist actively participates in the pharmacy care of patient with severe COVID-19, timely detects problems of drug use and can promote rational drug use in the clinic to achieve obvious results. Conclusion: Clinical pharmacist participated in the formulation of the drug treatment plan in the patient with severe COVID-19 and found an entry point into the clinical treatment team. Combining the theoretical knowledge and clinical practice can not only optimize the medication regimen and raise the level of clinical drug treatment, but also improve medication safety and effectiveness.
  • Study on Performance Appraisal Method of Pharmacy Staff Made in a Hospital based on Key Performance Indicator Principle
    WANG Yong, WU Hui-min, LI Yi
    2020, 17(8): 1216-1219. https://doi.org/10.13493/j.issn.1672-7878.2020.08-039
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    Objective: To study a set of scientific and reasonable performance appraisal index method based on the principle of key performance indicator method (KPI), so as to evaluate the work efficiency and quality of the staff in the central pharmacy of the hospital. Methods: Based on the main function of the central pharmacy staff, access to literature, consult experts and pharmaceutical sector leaders, and select 6 main indicators: workload, work quality, supervision function, satisfaction, drug storage management, quality control index, as the main performance evaluation standard of 40 staff members in the central pharmacy of our hospital. Collect and analyze the data of performance evaluation for 2 years and compare the changes before and after the implementation. Results: After the implementation of the performance appraisal method, the per capita quarterly score of the center pharmacy was stable at 95 points. The average personal infusion allocation increased from 61 bags/hour to 78 bags/hour, and the number of doctor's advice per capita increased from 96/hour to 158/hour. The difference between the two main errors occurring in the work was statistically significant (P<0.05). Satisfaction survey results showed that 96 percent of hospital staffs were satisfied with the work of the center pharmacy. Conclusion: The implementation of the performance appraisal system has positive effects on the work efficiency, work quality and satisfaction of the center pharmacy staff. Finally, the work efficiency was improved.