KANGGANRAN YAOXUE

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  • 2021 Volume 18 Issue 1
    Published: 25 January 2021
      
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  • Research Advances in Pharmacological Actions of Sophoridine on Heart
    ZHANG Ming-fa, SHEN Ya-qin
    2021, 18(1): 1-6. https://doi.org/10.13493/j.issn.1672-7878.2021.01-001
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  • Study on Determination of Clarithromycin in Clarithromycin Sustained Release Tablets by RP-HPLC
    XU Xin-wen
    2021, 18(1): 7-10. https://doi.org/10.13493/j.issn.1672-7878.2021.01-002
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    Objective: To establish a method for determination of clarithromycin in clarithromycin sustained release tablets by reversed-phase high performance liquid chromatography (RP-HPLC) and to investigate the practicability of its methodology. Methods: Hypersil BDS C18 column (200 mm×4.6 mm, 5 μm) was used as the stationary phase and mobile phase was acetonitrile-0.067 mol/L potassium dihydrogen phosphate (40:60). The flow rate was 1.0 mL/min. The detection wavelength was 210 nm and the column temperature was 25 ℃. The content of clarithromycin in sustained-release tablets was determined by RP-HPLC. Results: Clarithromycin concentration showed a good linear relationship between 0.17 and 0.65 mg/mL (r=0.999 8), and the average RSD was 0.89%, and the recovery was 99.50%. The average content of 4 batches of clarithromycin sustained-release tablets was 96.87%. Conclusion: In the quality control of clarithromycin sustained release tablets, RP-HPLC is used to determine the content of clarithromycin. The operation is rapid and simple, and it is suitable for determination of clarithromycin sustained release tablets.
  • Analysis on Usage and Safety of Glucocorticoids in Pediatric Out-patient Transfusion Room*1
    YAN Ying-hui, GUI Huan, HUANG Yan, WANG Feng-jiao
    2021, 18(1): 11-15. https://doi.org/10.13493/j.issn.1672-7878.2021.01-003
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    Objective: To analyze the usage and safety of intravenous glucocorticoids (sodium methylprednisolone succinate for injection and sodium hydrocortisone succinate for injection) in the out-patient department of pediatric infusion in hospital, and to provide reference for rational drug use in children. Methods: By retrospective investigation, 18 029 intravenous glucocorticoids infusion prescriptions for 30 days were extracted from the out-patient department of a hospital to analyze the clinical diagnosis of intravenous glucocorticoid drug use, the correlation of patient information to indications and the rationality of drug use. Results: 18,029 prescriptions of 30-day intravenous glucocorticoids were extracted, accounting for 55.11% of the total monthly infusion prescriptions (32,714), of which more than 80% were drugs for respiratory diseases. The variety selection, dose and route of intravenous glucocorticoids are basically consistent with the principles of treatment, but there is still a lack of evidence-based evidence to support the use of corticosteroids, especially the use of hydrocortisone solely for the purpose of antipyretic in upper respiratory diseases and infectious diseases. Conclusion: The usage of glucocorticoids for intravenous infusion in out-patient department of pediatrics is still not standardized. The use of hormone drugs to reduce fever is relatively common, and the occurrence of adverse drug reactions such as rash should be warned when using in the short period.
  • Analysis on Bacterial Culture Results and Drug Resistance of Pharyngeal Swab in 150 Children with Upper Respiratory Tract Infection
    LIU Dao-yan, LIU Jie, GONG Pei-yao, JIANG Xin-hua
    2021, 18(1): 16-19. https://doi.org/10.13493/j.issn.1672-7878.2021.01-004
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  • Influence of Closed-loop Management of Anti-microbial Drug Information on Decreasing Occurrence and Detection of Drug-resistant Bacteria in Hospital
    WANG Xiang-yang, LIU Hong-yue, MA Hong-chao
    2021, 18(1): 20-23. https://doi.org/10.13493/j.issn.1672-7878.2021.01-005
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    Objective: To analyze the influence of closed-loop management of anti-microbial drug information on decreasing the occurrence and detection of drug-resistant bacteria in hospitals. Methods: The medical records of 120 patients admitted to the orthopedic surgery department of the hospital from July to December 2019 (after the closed-loop management of antimicrobial agents informatization) were extracted, and the medical records of 120 patients admitted to the orthopedic surgery department of the hospital from January to June 2019 (before the closed-loop management of antimicrobial agents informatization) were extracted. The infection rate of drug-resistant bacteria in hospital infection, the distribution of pathogenic bacteria infected sites and the detection results of pathogenic bacteria before and after the closed loop management of antimicrobial agents were compared and analyzed. Results: The drug-resistant bacteria detected after closed-loop management were mainly carbapenem-resistant Pseudomonas aeruginosa（CRPA）, carbapenem-resistant Acinetobacter baumannii (CRAB),carbapenem-resistant Klebsiella pneumoniae (CRKP) and methicillin-resistant Staphylococcus aureus (MRSA). The total infection rate was lower than that before closed-loop management (4.80% vs 18.33%, P<0.05). Closed-loop management of drug-resistant bacteria before and after the most susceptible part of the respiratory system, implementing informatization closed-loop management, blood and urinary system, and various breathing after catheter drug-resistant bacteria infection rates were significantly lower than those of the closed management (P<0.05). The drug resistance rates of CRAB, CRKP, MRSA were also significantly reduced (P<0.05). Conclusion: The main pathogenic bacteria of drug-resistant bacterial infection were CRAB and CRKP. The infection sites were mostly wound and respiratory system. The implementation of antimicrobial information closed loop management can effectively decrease the incidence of drug-resistant bacteria infection in hospitals.
  • Analysis of Unreasonable Causes of Medical Orders Medication in Pharmacy Intravenous Admixture Services of a Hospital and Its Improvement Measures
    DING Pan-pan, HAN Li-li, MA Shu-li
    2021, 18(1): 24-27. https://doi.org/10.13493/j.issn.1672-7878.2021.01-006
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    Objective: To analyze the unreasonable causes of medical orders medication in pharmacy intravenous admixture services (PIVAS) of a hospital and its improvement measures. Methods: In the first 3 Quarters of 2016, 344 952, 339 478 and 319 756 medical orders were collected respectively, and then the unreasonable causes of medical orders medication recorded in each quarter were counted and analyzed. Through Quality-Control Circle by the way of “5W1H”, the relative improvement measures were proposed. Results: In the first, second and third quarters of 2016, there were 137, 136 and 79 unreasonable medical orders, respectively, mainly due to improper solvent selection, inputting error, improper drug concentration and dosage. The corresponding improvement measures were adopted mainly to strengthen the key drugs, off-label drugs, finished product review process, standardizing the process management and reward and punishment system, and improving the intervention of the automatic audit system. By taking effective measures, unreasonable medical orders were decreased from 14.25 to 3.25 per week. Conclusion: The effectiveness and safety of intravenous medication in patients were improved through the effective intervention of unreasonable medical orders.
  • Analysis on Clinical Characteristics of Klebsiella Pneumoniae Bloodstream Infection and Its Sensitivity to Antimicrobials in 102 Patients Undergoing Thoracic Surgery
    HE Xing-long
    2021, 18(1): 28-31. https://doi.org/10.13493/j.issn.1672-7878.2021.01-007
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    Objective: To analyze the clinical characteristics of Klebsiella pneumoniae (KP) bloodstream infection and its sensitivity to antimicrobial agents in 102 patients undergoing thoracic surgery, and to provide reference for the rational usage of antimicrobial agents in patients with KP bloodstream infection after thoracic surgery. Methods: The data of 102 patients complicated with KP blood flow infection after surgical treatment admitted to the department of thoracic Surgery from January 2015 to January 2018 were extracted to analyze the clinical characteristics of KP blood flow infection and the results of antimicrobial susceptibility test. Results: 102 strains of KP were detected in 102 patients with bloodstream infection. In different thoracic surgeries, the blood flow rate of KP was 33.33%, 21.57% and 16.67% respectively in radical gastrectomy, tracheotomy and pleural puncture. Blood flow infection occurred mainly in 61.76% of male patients, 60.78% of whom were aged in greater than or equal to 60 years old, 36.27% of patients with radiation/chemotherapy history, 30.39% of patients with minimally invasive surgery, 69.61% of patients with open-heart surgery, 23.53% and 29.41% of patients with diabetes and hypertension, respectively. The drug sensitivity test results showed that the drug resistance rate of KP to ampicillin was 100.00%, while the drug resistance rate of KP to furantoin, cefazolin, amoxicillin, compound sulfamethoxazole and other antibacterial drugs were all higher, but the drug resistance to other antibacterial drugs was relatively weak. It was sensitive to amikacin, meropenem and imipenem, while sensitive to gentamicin, cefepime, piperacillin, cefoperazone, ceftriaxone, levofloxacin, cefoxitin, tigecycline and ciprofloxacin were all higher than 80.00%. Conclusion: The incidence of KP infection after radical gastrectomy, tracheotomy, and pleural puncture is relatively high, especially in men who are older than 60 years old, have a history of radiotherapy or chemotherapy, accompanied by diabetes or hypertension, and the incidence of KP blood flow infection is relatively high, the cure rate is low, and the fatality rate is higher than 10.00%. In order to ensure the effectiveness of the treatment of KP blood flow infection, antimicrobial agents with high sensitivity rate should be selected reasonably based on the drug sensitivity results.
  • Analysis on Reasons for Unreasonableness of 1 236 Cases of Medication Prescribed by Doctors in PIVAS of a hospital in 2019 and Its Measures
    XU Li-wei, QIN Yuan-yuan, TANG Qiu-yue, ZHAO Fei-yan
    2021, 18(1): 32-36. https://doi.org/10.13493/j.issn.1672-7878.2021.01-008
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    Objective: To analyze the unreasonable reasons of 1 236 cases of medication prescribed by doctors in PIVAS of a hospital in 2019. Methods: 107 541 intravenous drug orders received by PIVAS in 2019 were extracted, and the rationality of drug use was analyzed with Excel 2003 statistical software, and the unreasonable reasons were found out and timely solutions were taken. Results: Among the 107 541 medical orders, 1 236 unreasonable orders were verified, and the unreasonable rate of drug use was 1.15%. The main departments involved in unreasonable drug usage included general surgery, rheumatology and oncology, and the reasons included interval solution, dose, frequency of drug administration, solvent selection and compatibility contraindications. In them, 1 042 medical orders were modified, and the modification rate of medical orders was 84.30%. Conclusion: By reviewing the medical orders submitted by each clinical ward, PIVAS pharmacists can timely find out the irrationality of medical orders and timely communicate with relevant clinical personnel, effectively decreasing the irrationality rate of inpatients' intravenous drug orders, reflecting the significance of prescription pre-review, and ensuring the safety and rationality of drug usage for patients.
  • Analysis on Current Situation and Causes of Unreasonable Medication of Hp Infection in Out-patients of Gastroenterology in a Hospital
    LIU Xiu-ping, ZHANG Qian
    2021, 18(1): 37-41. https://doi.org/10.13493/j.issn.1672-7878.2021.01-009
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    Objective: To analyze the current situation of Helicobacter pylori (Hp) infection in out-patients of gastroenterology and their drug utilization of the prescriptions, so as to provide reference for clinical rational drug use. Methods: A total of 3 595 prescriptions were collected from out-patients in the Department of Gastroenterology during October 2019 to analyze the rationality of the age, gender and drug regimen in patients with Hp infection. Results: Of the 3 595 out-patient prescriptions in the department of Gastroenterology, 127 prescriptions (3.53%) were taken for 94 patients diagnosed with Hp infection. Patients with Hp infection mainly ranged from 30 to 50 years old (48 cases, accounted for 51.06%). The gender distribution was mostly female (65 cases, accounted for 69.15%). 88 patients (93.62%) received anti-Hp infection treatment, and adopted the "quadruple" therapeutic regimen, with the highest utilization rate of rabeprazole, bismuth potassium citrate, amoxicillin and clarithromycin (48.86%). Conclusion: The use of anti-Hp drugs in out-patients of our hospital basically conformed to the consensus of Hp infection management, but there were existing some unreasonable drug use phenomena.
  • Analysis on Correlation between Antimicrobials Medication and Production of Multi-drug Resistant Organisms in ICU Patients of a Hospital
    CAO Shu-jun
    2021, 18(1): 42-44. https://doi.org/10.13493/j.issn.1672-7878.2021.01-010
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    Objective: To analyze the correlation between antimicrobials medication and production of multi-drug resistant organisms (MDRO) in ICU Patients of a Hospital. Methods: The clinical data of 113 critically illness patients admitted to ICU from July 2019 to June 2020 were extracted to analyze their antimicrobials medication (route of administration, drug frequency, drug utilization index and combined drug use), and the correlation between their usage and the generation of MDRO was analyzed using Logistic regression method. Results: Among 113 patients with severe disease, intravenous administration was the main route, and cefazolin had the highest drug frequency and drug utilization index. The combined utilization rate of more than 3 antibacterial drugs was higher than that of single drug and combined drug (P<0.05). The incidence of MDRO infection was 35.40%. The Logistic regression analysis showed that more than two drug types and long-term drug use were the influencing factors for the production of multi-drug resistant bacteria (OR>1, P<0.05). Conclusion: With the increase of the types of antibacterials combination and long-term drug use, there is a correlation between the drug combination and the production of MDRO, which is also an influencing factor for the production of MDRO. It is necessary to decrease the combined drug use and shorten the duration of drug use in order to delay the production of MDRO, which is beneficial to the rehabilitation of patients.
  • Influence of Clinical Pharmacists' Intervention on Clinical Medication of Senile Cerebral Infarction Patients with Pulmonary Infection
    WEI Yan-fang, WU Qi, LIU Mei-juan
    2021, 18(1): 45-48. https://doi.org/10.13493/j.issn.1672-7878.2021.01-011
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    Objective: To investigate the influence of clinical pharmacists' intervention on the clinical anti-infective medication of senile cerebral infarction patients with pulmonary infection. Methods: The clinical data of 46 senile cerebral infarction patients with pulmonary infection admitted from January 2018 to January 2019 were selected as the pre-intervention group, and the clinical data of 46 senile cerebral infarction patients with pulmonary infection admitted from February 2019 to January 2020 were selected as the post-intervention group (with intervention medication by clinical pharmacists). The changes of clinical infection indexes (body temperature, WBC, neutrophils, CRP), the distribution of pathogenic bacteria and the medication of anti-infective drugs were analyzed in patients of cerebral infarction with pulmonary infection before and after intervention. Results: 92 patients were mainly infected by Acinetobacter baumannii (31.52%), followed by Enterobacter aerogenes and Escherichia coli (3.26%). After intervention, the clinical infection indexes (body temperature, WBC, neutrophilic granulocyte count, CRP) of the patients in the group were all lower than those in the group before intervention (P<0.05). The drug frequency (DDDs) of cefoperazone-sulbactam, etimicin and ceftazidime were 38.78, 30.75 and 23.79, respectively. The DDDs of cefoperazone-sulbactam, piperacillin-sulbactam and etimicin were 37.63, 17.45 and 13.68, respectively, in the group before intervention. Conclusion: Clinical pharmacists participated in clinical anti-infective medication for elderly patients of cerebral infarction with pulmonary infection, which effectively decreased inflammation indicators and improved the accuracy of anti-infective medication and the effectiveness of anti-infective drug therapy.
  • Analysis on Pathogen Infection in Children Patients with Viral Diarrhea in He'nan Children's Hospital and Its Intervention Measures*1
    SUN Bo, ZHOU Fang, LI Xiao-qin
    2021, 18(1): 107-110. https://doi.org/10.13493/j.issn.1672-7878.2021.01-031
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  • Analysis on Influencing Factors of Oral Fungal Infection During Treatment in 122 Patients with TB in a Chest Hospital and Its Intervention Measures*1
    Lü Ya-min, LIANG Li-li
    2021, 18(1): 110-113. https://doi.org/10.13493/j.issn.1672-7878.2021.01-032
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    Objective: To analyze the influencing factors of oral fungal infection during treatment in pulmonary tuberculosis (TB) patients in a hospital, and to explore its intervention countermeasures. Methods: The clinical data of 122 TB patients admitted to hospitals from May 2017 to May 2019 were extracted, and they were divided into infected group (n=46) and non-infected group (n=76) based on whether they had oral fungal infection. Univariate and multivariate Logistic analysis was used to analyze the risk factors of oral fungal infection during treatment in patients with TB, their correlation with the use of broad-spectrum antimicrobial agents and their intervention strategies. Results: The occurrence of oral fungal infection in TB patients was correlated with the use of broad-spectrum antibacterial drugs, the use of hormone ≥7 d, and the history of diabetes, which was also the main risk factor for oral fungal infection in TB patients. Good nutritional status and normal immune function are the protective factors to prevent oral fungal infection. Conclusion: Clinically, effective intervention measures should be taken in time for the influencing factors of oral fungal infection, in order to avoid or reduce the incidence of oral fungal infection after anti-tuberculosis drug treatment.
  • Analysis on Anti-infective Medication in 1 Patient with Severe Legionella Pneumophila Pneumonia*1
    CHEN Qian, YANG Ting, ZHANG Xiu-hong, DONG Liang, YAN Jie
    2021, 18(1): 120-123. https://doi.org/10.13493/j.issn.1672-7878.2021.01-035
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  • Pharmaceutical Care on Clinical Medication in 3 Cases of Overlap Syndrome Patients with AIH-PBC*1
    XU Lu, SHAO Jin-min, XU Li-ming, JIANG Ya-ping
    2021, 18(1): 124-126. https://doi.org/10.13493/j.issn.1672-7878.2021.01-036
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  • Analysis on Efficacy of SAN'AO Tablet Combined with Salmeterol/Fluticasone Propionate in Patients with CVA and Its Influence on Immune Function and Lung Function*1
    QIAO Jin, ZHU Li-cheng, ZHAO Yan
    2021, 18(1): 127-131. https://doi.org/10.13493/j.issn.1672-7878.2021.01-037
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    Objective: To analyze on efficacy of SAN'AO tablets combined with salmeterol/fluticasone propionate in patients with cough variant asthma (CVA) and its influence on immune function, lung function and inflammatory factors on improvement. Methods: Clinical data of 86 CVA patients in the Department of Respiratory Medicine from January 2018 to June 2019 were selected and divided into observation group and control group based on different therapeutic drugs, with 43 patients in each group. Patients in the observation group were given oral administration of SAN'AO tablet and salmeterol/fluticasone propionate, while patients in the control group were given salmeterol/fluticasone propionate only. The differences in clinical efficacy, incidence of adverse drug reactions and recurrence rate, and the changes in cough symptom scores, lung function (FEV1, FVC and FEVl/FVC), immune function (CD3, CD4 and CD4/CD8), serum inflammatory factors (IgE, TNF-alpha, IL-4 and IL-6) before and after 4 weeks of treatment were compared between the two groups. Results: After 4 weeks, the total effective rate in the observation group was higher than that in the control group (97.67% vs 74.42%, P<0.05). Compared with that before treatment, the scores of cough symptoms in both groups were significantly lower after treatment (P<0.05), but the scores of cough symptoms in the observation group were significantly lower than those in the control group (P<0.05). After treatment, the levels of lung function (FEV1, FVC and FEVl/FVC) in the observation group were significantly higher than those in the control group (P<0.05), and the levels of immune function (CD3, CD4 and CD4/CD8) were significantly higher than those in the control group (P<0.05). After treatment, serum levels of inflammatory factors (IgE, TNF-alpha, IL-4 and IL-6) were all lower than those before treatment, but the observation group was significantly lower than the control group (P<0.05). After 4 weeks of treatment, the recurrence rate of patients in the observation group was significantly lower than that in the control group (11.63% vs 30.23%, P<0.05). There was no statistically significant difference in the incidence of adverse drug reactions between the two groups (P>0.05). Conclusion: Patients with CVA were treated using inhalation of San'ao tablet and salmeterol/fluticasone propionate can effectively improve symptoms of cough, immune function and lung function in patients with CVA, reduce the serum IgE, TNF-alpha, IL-6 and IL-4 levels, its curative effect is better than that of salmeterol/ fluticasone propionate alone medication, effectively improve the clinical efficacy, and the safety of medication is higher.
  • Efficacy of Cefuroxime Sodium in Injecting Eye Anterior Chamber on Prevention and Treatment of Postoperative Endophthalmitis in Patients with Cataract
    ZHOU Yuan, ZHANG Wen, CHEN Yun
    2021, 18(1): 132-134. https://doi.org/10.13493/j.issn.1672-7878.2021.01-038
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    Objective: To analyze the clinical efficacy of anterior chamber injection of cefuroxime sodium on prevention and treatment of postoperative endophthalmitis in patients with cataract. Methods: The clinical data of 2 645 cataract patients undergoing phacoemulsification and intraocular lens implantation in outpatient ophthalmic diagnosis and treatment from January 2017 to December 2019 were selected. Among them, 1 575 patients underwent cataract surgery from January 2017 to December 2018 were in the control group (conventional treatment was used). In addition, 1 070 patients undergoing cataract surgery from January to December 2019 were selected as the observation group (cefuroxime sodium was injected into the anterior chamber at 1 mg/0.1 mL). The infection of endophthalmitis for 4 weeks after operation was compared between the two groups. Results: In the control group, 759 patients had optimal corrected visual acuity greater than 1.0, 787 patients had visual acuity between 0.5 and 0.9, and only 29 patients had visual acuity less than 0.1 within 4 weeks after the treatment. In the observation group, the best corrected visual acuity was greater than 1.0 in 579 patients, 482 patients were between 0.5 and 0.9, and 9 patients with visual acuity less than 0.1 within 4 weeks after the treatment. No endophthalmitis was observed in patients in the observation group within 4 weeks after surgery, while 2 patients in the control group had endophthalmitis after surgery, and the difference between the two groups was not statistically significant (P0.150>0.05). The 2 patients with endophthalmitis in the control group were cured after treatment, while no drug-related toxicity and allergic reactions such as corneal endothelium decompensation, retinal toxicity and other drugs were observed after cefuroxime sodium was injected into the anterior chamber of the eye in the observation group. Conclusion: Cefuroxime sodium injection in the anterior chamber can effectively prevent postoperative intraocular infection and avoid postoperative intraocular infection.