KANGGANRAN YAOXUE

Archive

  • 2021 Volume 18 Issue 12
    Published: 25 December 2021
      
  • Select all
    |
  • Research Progress in COVID-19 Vaccines
    YAN Ling-jia, GU Jue-fen
    2021, 18(12): 1715-1723. https://doi.org/10.13493/j.issn.1672-7878.2021.12-001
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    COVID-19 pandemic still continues to ravage the world. Facing the extremely severe epidemic situation of COVID-19, there was no specific antiviral drug and prophylactic drugs to this virus. The development of a safe and effective Novel Coronavirus vaccine was urgent. This paper briefly introduced the different characteristics of SARS-CoV-2, SARS-CoV, MERS-CoV and Ebola virus, and found that SARS-CoV-2 had a very high rate of human-to-human transmission. Moreover,the latest clinical research progress and their possible mechanisms of 10 kinds of COVID-19 vaccine underwent phase III clinical trials at home and abroad were reviewed so as to provide reference for epidemic prevention and control.
  • Research Progress in Anti-fungal and Anti-viral Effects of Magnoliae Officinalis Cortex, Magnolol and Honokiol
    ZHANG Ming-fa, SHEN Ya-qin
    2021, 18(12): 1724-1728. https://doi.org/10.13493/j.issn.1672-7878.2021.12-002
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Magnoliae Officinalis Cortex and its active ingredients (magnolol and honokiol) have broad-spectrum anti-fungal effects. The mechanisms may be to induce apoptosis and necrosis of fungal cells by increasing the level of reactive oxygen species in fungal cells and destroying mitochondria (reducing mitochondrial membrane potential), and kill fungal cells by destroying the fungal cell wall and membrane to improve the permeability of cells or by inhibiting the adhesion ability of fungi and the formation and thickening of biofilm to reduce the self-protection ability of fungi. In vivo and in vitro honokiol improves the antibacterial action of fluconazole against Candida ablicans. Magnoliae Officinalis Cortex, magnolol and honokiol have broad-spectrum anti-viral effects. They produce the actions against Influenza virus, Herpes virus, Dengue virus, Norovirus and Grass carp reovirus by inhibiting virus replication in cells, and by improving immunoresponsiveness against virus and antioxidative capacity of host cells. This paper reviews the anti-fungal and anti-viral effects of Magnoliae Officinalis Cortex, magnolol and honokiol.
  • Research Progress in Nanoliposomes Targeting Liver Cells
    Xu Ming-hao, XUE Wen-jing, CHENG Jun-ping
    2021, 18(12): 1729-1732. https://doi.org/10.13493/j.issn.1672-7878.2021.12-003
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Conventional drugs used to treat liver disease can not effectively target the lesion site, giving rise to adverse reactions. Accordingly, the technology of targeted drug delivery is developing rapidly. Lipid nanoparticles have been developed for passive and active targeted delivery of drugs to the liver, active targeting is more specific in delivering drug to cells. By modifying ligands on the surface of the carrier, the target cell surface receptor can be selectively bound. This paper reviews the specific targeting effects of nanoliposomes on hepatocytes.
  • Analysis of Drug Resistance on Antiretroviral Agents and Mutant Site in HIV-1 Infected Patients in Suzhou District from 2019 to 2021*1
    XU Wei-lu, WEI Zhi-qiang, HUANG Jin-long, LIU Jin, QIAN Feng, ZHU Yue-ping
    2021, 18(12): 1733-1737. https://doi.org/10.13493/j.issn.1672-7878.2021.12-004
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To analyze the drug-resistant characteristics and mutant site in HIV-1 infected patients accepting antiretroviral therapy in Suzhou district from 2019 to 2021. Methods: A total of 157 patients with HIV admitted to author's hospital in Suzhou area from 2019 to 2021 were selected to detect the subtypes of virus strains and mutation characteristics of drug resistance genes in peripheral venous blood. Results: Pol gene region was successfully amplified in 90 of 157 HIV patients (57.32%), and the ratio of drug-resistant mutations in positive patients was compared with gender, route of transmission, baseline CD4 T cell level, hepatitis, syphilis, and the interval between diagnosis and treatment. The results were statistically significant (P<0.05). 71 HIV patients developed drug-resistant mutations, The drug resistance rates to integrase strand transfer inhibitors （INSTIs）, protease inhibitors (PIs),nucleoside reverse transcriptase inhibitors (NRTIs) and and non-nucleoside reverse transcriptase inhibitors (NNRTIs) were 1.41%, 4.22%, 78.87% and 94.37%, respectively. The main subtype of HIV-1 strain was CRF01_AE (40 cases, 56.33%), followed by subtype B (9 cases, 12.68%) and subtype A (8 cases, 11.27%). In addition, 9 other drug-resistant recombinant subtypes were found, including CRF67_01B, CRF01_AE/B and CRF07_BC. Conclusion: When HIV-1 infected patients in Suzhou are treated with ART, attention should be paid to the changes of drug resistance between nucleoside reverse transcriptase inhibitors and non-nucleoside reverse transcriptase inhibitors, and antiviral drugs should be rationally selected for treatment to ensure its efficacy.
  • Influence of RMK-03TM Skin and Mucous Membrane Spray on Immune Regulation Mechanism in Mice with Upper Respiratory Mucosal Immune Dysfunction*1
    MAO Hao-tian, JIANG Guo-rong, LIANG Guo-qiang, LIN Lin, XU Jun-hua
    2021, 18(12): 1738-1744. https://doi.org/10.13493/j.issn.1672-7878.2021.12-005
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To explore the immunomodulation mechanism of RMK-03TM spray on upper respiratory mucosa based on immunoglobulin A (IgA MAb) blocking Spike-ACE 2 interaction of novel Coronavirus (SARS-CoV-2) in the mice experiment of the upper airway mucosal immune dysfunction (UAID) model induced by cold. Methods: 40 SPF ICR mice were divided into 4 groups, including normal group, UAID Model group, ribavirin spray group and RMK-03TM spray group, with 10 mice in each group. Ribavirin spray group and RMK-03TM spray group were given oral spray 0.1 mL/mouse q12h for 3 days. On day 3, other groups except normal group were used to replicate UAID model. The mice were placed in a cold environment of –20℃ for 15 min, and then acclimated to room temperature for 1 h. The mice were intraperitoneally injected with pilocarpine eye drops (0.25 mL/mouse). The expression of IgA and pIgR proteins were examined by Western blotting method. The contents of cytokines IL-4 and IL-6, IFN-γ and TNF-α were detected by ELISA method. The expression of ACE 2 and ACE were detected by immunohistochemistry. Results: The content of SIgA in saliva of mice in UAID model group was significantly lower than that in normal group (P<0.05), suggesting that the model was successfully replicated. Compared with normal group, UAID model group showed mild interstitial edema, dilatation and congestion of small vessels, and neutrophils accompanied by mild dilatation and edema of lymphatic vessels. The expression of IgA and pIgR proteins in oral and pharyngeal mucosa of mice in UAID model group, the contents of IgA-related cytokines IL-4 and IL-6, and the contents of pIgR-related cytokines IFN-γ and TNF-α were significantly lower than those in normal group(P<0.05). The mean optical density(IOD/area) of ACE and ACE 2 in the group were significantly higher than that in the normal group (P<0.05). The above main indexes of ribavirin spray group and RMK-03TM spray group were better than UAID model group to varying degrees, and the above main indexes of ribavirin spray group were better than UAID model group. Conclusions: RMK-03TM skin and mucosal care spray inhibits the active expression of ACE 2 in respiratory mucosa by regulating the content of IgA associated with low local mucosal immune barrier, and it is indirectly speculated that RMK-03TM can block the spike-ACE 2 interaction of SARS-COV-2 to provide mucosal immunity.
  • Analysis of Serum Vitamin D and T Lymphocyte Subsets Levels in Pulmonary Tuberculosis Patients*1
    LI Ming, WANG Yi, TANG Pei-jun, ZENG Ling-wu
    2021, 18(12): 1745-1748. https://doi.org/10.13493/j.issn.1672-7878.2021.12-006
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To analyze the levels of serum vitamin D and T lymphocyte subsets levels in patients with pulmonary tuberculosis so as to provide provide new ideas for pulmonary tuberculosis treatment. Methods: 152 patients with pulmonary tuberculosis admitted to The Fifth People's Hospital of Suzhou from January 2019 to December 2020 were selected. The levels of peripheral blood lymphocyte subsets were detected by flow cytometry, and the levels of 25（OH）D3 in serum were determined by automatic chemiluminescence immunoassay. The levels of vitamin D and T lymphocyte subsets in different genders, ages and types of patients were analyzed, as well as the levels of T lymphocyte subsets in patients with different vitamin D levels. Results: There were no significant differences in age, vitamin D and T cell subsets among different genders (P> 0.05). The levels of serum vitamin D and CD4/CD8 were the lowest in patients aged ≤30 years, and the highest in patients aged >30 to <60 years. With the increase of age, the levels of T lymphocytes and CD8 T cells decreased and CD4/CD8 levels increased. The CD4/CD8 ratio was the highest and CD8 level was the lowest in tuberculosis patients with vitamin D level >20 ng/mL. With the increase of vitamin D level, CD4/CD8 ratio increased (P<0.05). CD8 and CD4/CD8 levels of patients with different vitamin D levels were significantly different (P<0.05). Correlation analysis showed that vitamin D levels were negatively correlated with CD8 levels (P<0.05), but positively correlated with CD4/CD8 levels (P<0.05). Conclusion: Vitamin D may reduce CD8 T cells and increase CD4/CD8 ratio to improve cellular immune function in patients with pulmonary tuberculosis.
  • Influence of Different Pharmacopoeias' Determination Methods on Drug Content in Edaravone Injection and Its Improvement Measures to Existing Problems
    LIANG Yu-xi
    2021, 18(12): 1749-1752. https://doi.org/10.13493/j.issn.1672-7878.2021.12-007
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To analyze the influence of different pharmacopoeias' determination methods on drug content in edaravone injection and provide the improvement measures to the existing problems. Methods: Japanese edaravone injection (batch numbers: B083, C084 and C085) and domestic edaravone injection (batch numbers: 1712200, 1804023, 180115 and 180212) were selected as the study subjects. Japanese Pharmacopoeia 17th edition (abbreviated as "JP 17") method and the Chinese Pharmacopoeia: 2015 edition (abbreviated as "ChP 2015") method were used to determine and compare the drug content in edaravone injection from the above different sources, and existing problems and improvement measures based on the content determination results were analyzed. Results: According to "JP 17" method, the contents of Japanese the original product edaravone injection and domestic edaravone injection were 98.50%, 98.49%, 98.42% and 98.60%, 98.44%, 98.41%, 98.39% respectively. According to the method of "ChP 2015", the contents of edaravone injection were 99.20%, 101.05%, 99.13% and 101.44%, 99.14%, 99.37%, 100.60%, respectively. The average content of edaravone injection (batch number: B083) was 98.44% and RSD was 0.09% according to "JP 17" method, which was significantly lower than that of "ChP 2015" method (99.90% and RSD 1.03%). After improving the prescription process separately. According to the method of "JP 17", the contents of the original Japanese product (batch no. B083, C084, C085) and the domestic product (batch No. 1712200, 1804023, 180115 and 180212) were 99.93%, 99.90% and 100.02%, 100.01%, 99.94%, 99.92%, 99.95% respectively. Conclusion: The precision of edaravone injection measured by "JP 17" method is good, but the overall determination results are low. The accuracy of the determination results of edaravone injection can be improved effectively by improving the prescription process of test products, and the occurrence of systematic error can be avoided.
  • Analysis of Clinical Distribution and Drug Resistance of Carbapenem-Resistant Klebsiella Pneumoniae Detected in Hospitals of Luohe District from 2017 to 2020*1
    CAO Hu-shan, JI Shou-peng, LIU Xin-zheng
    2021, 18(12): 1753-1756. https://doi.org/10.13493/j.issn.1672-7878.2021.12-008
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To investigate the distribution characteristics and drug resistance of carbapenem-resistant Klebsiella pneumoniae (CRKP) in hospitals of Luohe district from 2017 to 2020. Methods: The detection data of 4 652 strains of Klebsiella pneumoniae (KP) isolated from Luohe Regional Hospital from January 2017 to December 2020 were collected, and the clinical detection rate of CRKP, specimen source, department distribution and drug resistance characteristics of CRKP in KP strains during the 4 years were analyzed. Results: In 4 652 strains of KP, the detection rate of CRKP was 9.42%. In 2017, 1 053 strains of KP were isolated, and 86 strains of CRKP were detected, accounting for 8.17%. In 1 079 strains of KP isolated in 2018, 102 strains of CRKP were detected, accounting for 9.45%. In 2019, 1 126 strains of KP were isolated, and 110 strains of CRKP were detected, accounting for 9.77%. In 2020, 1 394 strains of KP were isolated, and 140 strains of CRKP were detected, accounting for 10.04%. The samples were mainly from respiratory secretions (36.53%), followed by urine (24.20%), blood (16.21%), sputum (13.70%), wound secretions (7.31%) and others (2.05%). CRKP was detected mainly in ICU (36.76%), followed by emergency department and respiratory department (14.16%),geriatrics department (11.87%), urology department (10.50%), liver surgery department (6.16%), pediatrics department (5.48%) and cardiology department (0.91%). Drug sensitivity results showed that the drug resistance rates of CRKP to ceftriaxone, tigecycline and polymyxin B were relatively low (46.58%,47.95% and 15.07%,respectively), while the drug resistance rates of CRKP to aztreonam, levofloxacin, ciprofloxacin, ceftazidime and cefepime were all more than 80.00%. The drug resistance rates to ampicillin, piperacillin-tazobactam and imipenem were 100.00%. Conclusion: The detection rate of CRKP in hospitals in Luohe district increased year by year, mainly distributed in ICU, and the main specimens were from respiratory secretions. In addition, CRKP is highly resistant to commonly used antibacterials, so clinical monitoring of bacterial resistance should be strengthened, and antibiotics with high sensitivity rate should be selected based on drug sensitivity results to ensure the effectiveness of treatment for patients.
  • Literature Review of Efficacy and Safety of Tigecycline in Pediatric Patients*1
    HAN Mei-ling, WANG Yan, Zhong Wen, Zhou Mi
    2021, 18(12): 1757-1763. https://doi.org/10.13493/j.issn.1672-7878.2021.12-009
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To evaluate and analyze the efficacy and safety of tigecycline in pediatric patients. Methods: The Cochrane Library, Ovid, Pubmed/Medline, Web of Science, CNKI, VIP and Wanfang databases were used to search 30 articles related to tigecycline and pediatric patients (327 cases). The year of publication, type of study, number of cases, dose and duration of tigecycline, pathogen isolation from specimens, clinical outcomes, and adverse reactions were evaluated. Results: A total of 30 articles (25 in English, 4 in Chinese, and 1 in Spanish) were included, involving 327 children (0 to 18 years old) receiving tigecycline, with a total clinical response rate of 77.70%. The main pathogens were Acinetobacter baumannii, Klebsiella pneumoniae, Escherichia coli, Enterobacter cloacae and methicillin-resistant Staphylococcus aureus. Among them, 36 patients (11.01%) experienced adverse drug reactions during treatment with tigecycline. The common adverse drug reactions were abnormal liver function, gastrointestinal reaction, anemia, abnormal coagulation function, yellow teeth, etc., and the serious adverse reactions were acute pancreatitis. Conclusion: Tigecycline has high efficacy and safety in the treatment of severe infection especially multiple drug resistant organism (MDROs) infection in children.
  • Analysis of Streptococcus Agalactiae Infection and Its Genotyping and Drug Resistance in 236 Third Trimester Pregnant Women of A Hospital
    LIAO Ping-ying
    2021, 18(12): 1764-1766. https://doi.org/10.13493/j.issn.1672-7878.2021.12-010
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To investigate the genotyping and drug resistance of Streptococcus agalactiae (SA) strains in the third trimester pregnant women. Methods: The medical records of 236 late-pregnancy parturients admitted to the hospital from November 2019 to November 2020 were selected as the research objects, and the bacterial culture and drug sensitivity test results of rectal and vaginal secretion samples were collected, and the genotyping and drug resistance characteristics of their pathogens were analyzed. Results: 89 strains of SA were isolated and the SA infection rate was 37.71%. Multilocus sequence typing (MLST) showed that one of the 89 strains of SA failed to be typed, and 12 genotypes were isolated from the remaining 88 strains of SA. The TOP 3 types were ST19 (34.83%), ST17 (28.09%) and ST12 (14.61%). The results of drug sensitivity showed that the SA strain with TOP 3 MLST had higher drug resistance to tetracycline, clindamycin and erythromycin, and higher drug sensitivity to vancomycin, ceftriaxone, oxacillin, penicillin, ciprofloxacin, ampicillin and cefotaxime. Conclusion: MLST accounted for TOP 3 SA strains have high drug resistance rates to tetracycline, clindamycin and erythromycin. Clinical detection and drug sensitivity test of rectal and vaginal SA infection in late-pregnancy women should be conducted as soon as possible, and targeted treatment plan should be made so as to ensure its therapeutic effect and avoid influence on newborn.
  • Analysis of Irrational Use of Key Drug and The Effectiveness of Prescription Review*1
    DONG Yan, WANG Hai-yan, MIN Chun-yan, WANG Ze-rong
    2021, 18(12): 1767-1772. https://doi.org/10.13493/j.issn.1672-7878.2021.12-011
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To analyze the irrational use of key drug and the effectiveness of prescription review so as to provide reference for effectively promoting rational usage of key drugs. Methods: Based on the evaluation standard of the key drug monitoring and early warning system of The Fifth People's Hospital of Suzhou, the key drug prescriptions in the ward from July to November from 2017 to 2019 were reviewed, and the irrational rate of key drugs was counted by ward, drug category and month, and the irrationality situation and reasons were analyzed. Results: The irrationality rates of obstetrics and gynecology department ranked 1st from July to November in 2017 and 2018, the irrationality rates of surgery department ranked 2nd from July to November in 2017 and dropped to 5th in the same period in 2018. The irrational rate of ICU/ emergency department from July to November 2017 decreased from the 3rd to the 6th; the irrational rate of occupational disease department from July to November 2017 ranked the 4th, and no irrational drug usage was found in July to November 2018 and the same period in 2019. From July to November 2017, the top 3 drugs in the irrational rate were cardiovascular system drugs, anti-tumor and immunomodulatory drugs, and vitamin and electrolyte supplements. The irrationality rates of the latter two types of drugs decreased significantly from July to November in 2019. From July to November of 2017 to 2019, the irrationality rates of most categories (except neurologic drugs) decreased with different amplitude. From July to November in 2017 to 2019, the most unreasonable reason changed from unstandard course record to long course of treatment, the excess indications (increasing first and then decreasing) ranked the 2nd place, and the only reason for the increase of unreasonable reason was the long course of treatment, which rose from the 5th, 3rd place to the 1st place. From July to November in 2017, the monthly rate of unconscionability of key drugs in a hospital showed an upward-downward-upward-down trend; from July to November in 2018, the monthly rate of unconscionability of key drugs in a hospital showed an upward-downward-up trend; from July to November in 2019, the monthly rate of unconscionability of key drugs in a hospital showed an overall downward trend. The irrational rate of key drugs in a hospital from August to October in 2018 and 2019 was lower than the same period in 2017, and the irrational rates in November 2019 are lower than those in 2018. Conclusions: Using prescription comment to control key drugs could effectively reduce the irrational utilization rate of key drugs and promote rational clinical drug usage. Based on the review, control results and clinical treatment needs of diseases, adjusting the list of key drugs in hospitals and improving control measures could guarantee the effectiveness and economy of drug usage for patients better.
  • Analysis of Narcotic Drug Use in Patients with Cancer Pain in Outpatient and Emergency Department of a Hospital from 2018 to 2020*1
    LAN Guang-yu, DING Le-yun, HE Xing-li, DING Xin-yuan, CHEN Su-qin
    2021, 18(12): 1773-1777. https://doi.org/10.13493/j.issn.1672-7878.2021.12-012
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To analyze the narcotic drug use in patients with cancer pain in outpatient and emergency department of a hospital from 2018 to 2020 so as to provide reference in promoting rational usage of narcotic drugs in outpatient and emergency patients with cancer pain. Methods: 4 485 narcotic drugs prescriptions were collected from cancer pain patients in emergency department of a hospital from 2018 to 2020. DDDs, DDDc and B/A equivalents were calculated and analyzed using the defined daily dose (DDD) recommended by WHO. Results: There were 7 kinds of narcotic drugs (10 specifications) for the treatment of cancer pain, and the top two were morphine hydrochloride tablets (5 mg) and oxycodone hydrochloride sustained-release tablets (10 mg). The DDDs values of oxycodone hydrochloride sustained release tablets (40 mg) were the highest, followed by oxycodone hydrochloride sustained release tablets (10 mg) and fentanyl transdermal patch (4.2 mg), while the DDDs values of morphine hydrochloride tablets remained in the top 5. DDDc values of all narcotic drugs were basically unchanged, and the drugs with B/A values equal to 1 in recent 3 years were oxycodone hydrochloride sustained-release tablets (10 mg and 40 mg). Conclusion: The use of narcotic drugs such as morphine or oxycodone hydrochloride oral preparation for patients with cancer pain in outpatient and emergency of the hospital is basically reasonable.
  • Analysis of Current Status of Latent Mycobacterium Tuberculosis Infection in Senior High School Freshmen of A City and Its Prevention and Treatment Strategy
    LIU Cui-yu, XING Hui, MA Tong-hui, YU Guang-jing, ZHAO Ai-di, CAO Hong-tao, ZHANG Xiao-meng
    2021, 18(12): 1809-1812. https://doi.org/10.13493/j.issn.1672-7878.2021.12-023
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To analyze the current status of latent Mycobacterium tuberculosis infection in senior high school freshmen of Jiamusi City and its prevention and treatment strategy so as to provide the reference for schools to draw up management systems for freshmen. Methods: The data of tuberculin-purified protein derivative (TB-PPD) detection for freshmen were collected in 8 senior high school of Jiamusi City, and then the difference of the incidence of strong positive, moderate positive and weak positive among freshmen between ordinary high school and vocational high school were analyzed and compared. Results: Among 3 563 freshmen from 8 senior high schools,the negative rate of TB-PPD screening was 46.65%,the normal positive rate was 29.41%, the moderate positive rate was 18.72%,and the strong positive rate was 5.22%. The strong positive rate in girls was higher than that in boys (χ2=4.658, P<0.05), and the strong positive rate in greater than 15 age group was higher than that in above or equal to 15 age group (χ2=4.156,P<0.05). Conclusion: Tuberculosis screening for freshmen is an important means to control tuberculosis epidemic in schools. Schools should establish a long-term mechanism of tuberculosis screening for freshmen. Health education, preventive medicine and follow-up monitoring and management should be carried out for those who are strongly positive for TB-PPD screening so as to reduce the prevalence of tuberculosis among students.
  • Etiological Analysis of a Rare Case with Anaphylactic Shock Caused by Succinylated Gelatin Injection in Surgery and Its Treatment Strategy
    JIANG Ying-feng, Shi Xiang-kui, ZHANG Jing
    2021, 18(12): 1816-1818. https://doi.org/10.13493/j.issn.1672-7878.2021.12-025
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To analyze the pathogenesis of a rare case with anaphylactic shock caused by succinylated gelatin injection in surgery and its treatment strategy. Methods: Through analyzing the conditions of patients with anaphylactic shock after using succinylated gelatin injection in surgery and searching related literature, the pathogenesis and its treatment strategy was explored. Results: Intraoperative anaphylactic shock was a rare and serious adverse drug reaction caused by succinylated gelatin injection. It was recommended to stop succinylated gelatin injection in time and the patient gradually recovered and improved after rescue treatment to complete the operation. Conclusion: Through the active participation of clinical pharmacists in the analysis and treatment of intraoperative adverse drug reactions, the operation is successfully completed and more serious consequences are avoided.
  • Clinical Characteristics of Bloodstream Infection in a Pregnant Woman with Acute Pancreatitis and Its Pharmaceutical Care*1
    SUN Li-yun, ZHONG Han, SHAO Bei-bei
    2021, 18(12): 1822-1825. https://doi.org/10.13493/j.issn.1672-7878.2021.12-027
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To analyze the clinical characteristics of bloodstream infection in a pregnant woman with acute pancreatitis and its pharmaceutical care so as to provide reference for the treatment of similar cases. Methods: The clinical pharmacist participated in a 30-year-old pregnant woman diagnosed as acute pancreatitis at 34 weeks of gestation due to the aggravation of abdominal pain after eating, and assisted in the clinical formulation of treatment plan (fasting, piperacillin-tazobactam and vancomycin anti-infection, somatostatin enzyme inhibition, omeprazole acid inhibition, fluid rehydration, etc.). The causes of amylase increase and treatment were analyzed, and pharmaceutical care was carried out. Results: After the clinical pharmacists participated in the clinical treatment, the pregnant woman who underwent cesarean section delivered a live girl baby. After the operation, she was transferred to ICU, and after treatment, her condition was effectively improved and she was referred back to the obstetrics department for further treatment. Conclusion: That clinical pharmacists assist in making therapeutic schedules and implement pharmaceutical care improve the rational use of lipid-lowering and anti-infection drugs and avoid the occurrence of adverse reactions.
  • Analysis of Pharmaceutical Care and Medication of Continuous Intravenous Administration of Vancomycin in Patients with Renal Insufficiency Treated by CRRT*1
    TANG Lian, CHEN Fang, ZHUANG Zhi-wei, LU Jian, XU Xiao-wen, YU Yan-xia, SUN Jiantong, ZHOU Qin
    2021, 18(12): 1826-1830. https://doi.org/10.13493/j.issn.1672-7878.2021.12-028
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To analyze the pharmaceutical care and medication of continuous intravenous administration of vancomycin in patients with renal insufficiency treated by continuous renal replacement therapy (CRRT). Methods: Patients with Gram-positive bacteria bloodstream infection during CRRT were selected. Case 1 was given vancomycin for "0.5 g, q24h" after loading dose of 1.0 g, with trough concentration of 6.2 mg/L after administration, and intermittent administration of vancomycin for "1.0 g, q24h". Case 2 was administered vancomycin intravenously at an individualized daily dose, i.e. 1.0 g of loading dose followed by 1.0 g of continuous intravenous administration. Blood concentrations of 17.97 mg/L, 18.69 mg/L and 22.50 mg/L were determined at 24h, 48h and 72h, respectively. Results: Case 1 had poor curative effect and poor prognosis. The blood culture result of case 2 turned negative after anti-infection treatment, and the anti-infection effect was good without related adverse reactions. Conclusion: Based on CVVH treatment dose, clinical pharmacists could quickly reach the standard of vancomycin concentration and give full play to its anti-infection effect by individualized daily and continuous intravenous administration of vancomycin.
  • Pharmaceutical Care of Anti-infection Treatment for Patients with Osteomyelitis Caused by Methicillin-resistant Staphylococcus Aureus and Its Experience
    LI Xiao-lan, YU Li
    2021, 18(12): 1831-1834. https://doi.org/10.13493/j.issn.1672-7878.2021.12-029
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To analyze the pharmaceutical care process of medications in patients osteomyelitis caused by methicillin-resistant Staphylococcus aureus (MRSA) so as to provide reference for clinical rational drug of usage. Methods: Clinical pharmacists participated in the clinical consultation and treatment of patients with clinical MRSA osteomyelitis, elaborated the clinical thinking of pharmacists participating in treatment, and analyzed the pharmaceutical care entry point. Results: Pharmacists gave full play to their specialty in pharmacy, put forward optimized drug administration plan and participated in the monitoring of adverse drug reactions. Patients' bloodstream infection was controlled, blood bacteria culture was negative, and their condition was stable and discharged. Conclusion: The therapeutic schedules optimized by clinical pharmacists could improve the efficacy of patients with MRSA osteomyelitis and avoid the occurrence of the related adverse reactions.
  • Effectiveness Analysis of Anticoagulant Management on Patients with Atrial Fibrillation and Over-anticoagulation with Warfarin*1
    WANG Yan, SHENG Yu-qing, LU Qiu-hong
    2021, 18(12): 1835-1838. https://doi.org/10.13493/j.issn.1672-7878.2021.12-030
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To analyze the possible causes of over-anticoagulation with warfarin in patients with atrial fibrillation and actively carry out anticoagulation management so as to provide reference for rational usage of warfarin. Methods: Data of excessive anticoagulant treatment of warfarin in patients with atrial fibrillation (AF) admitted to our hospital from January 2017 to July 2020 were selected to analyze the influence of anticoagulant management mode with clinical pharmacists' participation on warfarin anticoagulant treatment in patients with AF. Results: Excessive anticoagulation of warfarin in patients with AF might be related to drug interactions, complication, dose adjustment, non-standard international normalized ratio (INR) monitoring, etc. Clinical pharmacists participated in warfarin anticoagulant treatment and implemented pharmaceutical care played a positive role. Conclusion: Clinical pharmacists participate in clinical anticoagulant management of patients with AF, which is helpful to improve the patients' compliance and safety of anticoagulant therapy.
  • Innovative Practice of TCM Diagnosis and Treatment in Suzhou Area during the Phase of Normalized Prevention and Control of COVID-19*1
    LU Jing, SHI Cui-lin, ZENG Ling-wu, XIAO Yu-mei, ZHANG Wen-yong, LIU Yi-an, ZHANG Jian-ping
    2021, 18(12): 1852-1854. https://doi.org/10.13493/j.issn.1672-7878.2021.12-035
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To summarize the innovative practice of TCM diagnosis and treatment in Suzhou area during the phase of normalized prevention and control of COVID-19 so as to provide reference for pandemic prevention and control. Methods: We looked back on the working mode of traditional Chinese physicians in treating COVID-19 patients in Suzhou and the whole process of the exploration, establishment and optimization of TCM consultation mode, and analyzed the important role of TCM in the prevention and treatment of COVID-19 pandemic. Results and Conclusions: TCM colleagues in Suzhou have innovatively established a relatively perfect TCM consultation mode during the pandemic prevention and control and developed many TCM prescriptions with the characteristics of Wumen Chinese medicine, which has played an important role in the prevention and treatment of COVID-19 pandemic.
  • Effect of Multidisciplinary Team on Improving The Prevention And Control of Multidrug-resistant Organisms Infection
    LI Yuan-yuan
    2021, 18(12): 1855-1857. https://doi.org/10.13493/j.issn.1672-7878.2021.12-036
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To explore the effect of multidisciplinary team (MDT) on improving the prevention and control of multidrug-resistant organisms (MDROs) infection. Methods: The clinical data of 1 946 in-patients who underwent routine management from January to December 2019 were selected as the pre-collaboration group, and the clinical data of 1 947 in-patients who underwent MDT management from January to December 2020 were selected as the post-collaboration group. The differences in the implementation effect of MDROs prevention and control and the detection rate of hospital MDROs infection before and after multidisciplinary collaboration were compared. Results: After 1 month of intervention, the implementation rates of clinical equipment disinfection, environmental disinfection and hand hygiene standards, as well as the implementation rate of patient-specific prevention and control measures in the cooperative group were higher than those in the cooperative group (P<0.05). The detection rates of MDROs infection were lower than those of the group before collaboration (P<0.05). Conclusion: MDT promotes the effective implementation of prevention and control measures, effectively improves the prevention and control effect of MDROs infection, and effectively contains MDROs infection in the hospital.
  • Evaluation on Clinical Efficacy of Intensive Insulin Control in Diabetic Patients with Pulmonary Tuberculosis
    ZOU Wen-lan
    2021, 18(12): 1862-1864. https://doi.org/10.13493/j.issn.1672-7878.2021.12-038
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To evaluate the clinical efficacy of insulin in patients with diabetes mellitus complicated with pulmonary tuberculosis. Methods: 80 patients with diabetes complicated with tuberculosis admitted to the Fifth People's Hospital of Suzhou from January 2019 to May 2021 were selected and divided into control group (40 cases, treated with conventional anti-tuberculosis regimen combined with oral hypoglycemic drugs) and observation group (40 cases, conventional anti-tuberculosis regimen combined with insulin degu and insulin aspartic for intensive hypoglycemic treatment); the changes of blood glucose before treatment and 3 months after treatment, as well as differences in absorption of tuberculosis foci, effect of cavity closure, time of blood glucose reaching standard and incidence of hypoglycemia in 2 groups were compared. Results: At 3 months of treatment,fasting blood glucose(FBG）, glycosylated hemoglobin (HbA1c） and 2h postprandial blood glucose(2h-PBG） in observation group were lower than those in the control group (P<0.05), the total effective rate of tuberculosis focal absorption and cavity closure were higher than those in the control group (P<0.05), and the time of blood glucose reaching standard was shorter than that in the control group (P<0.05). The incidence of hypoglycemia was lower than that of control group (P<0.05). Conclusion: Intensive insulin control of blood glucose could improve the efficacy of diabetes patients with pulmonary tuberculosis, so that the blood glucose could be well controlled, and the absorption rate of focus could be improved. The patients have no serious hypoglycemia events.
  • Clinical Characteristics and Therapeutic Efficacy of Glucocorticoids in 54 Patients with COVID-19
    ZOU Di, ZHU Feng-feng
    2021, 18(12): 1865-1868. https://doi.org/10.13493/j.issn.1672-7878.2021.12-039
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: To analyze the Clinical characteristics and therapeutic efficacy of glucocorticoids in 54 patients with COVID-19. Methods: A retrospective study was conducted to collect 54 patients diagnosed with COVID-19 admitted to The FifthPeople's Hospital of Suzhou from January 25 to February 20, 2020, who were divided into glucocorticoid treatment group (21 cases) and routine treatment group (34 cases), and the clinical characteristics and the effects of glucocorticoids of the two groups were analyzed. Results: There was no statistical significance of age, sex, symptom onset to hospital stay, glutamic-pyruvic transaminase (GPT), creatinine (Cr) and C reactive protein (CRP) in 2 groups (P>0.05). However, the oxygenation index (OI) in the hormone treatment group was significantly lower than that in the conventional group (P<0.05), and the proportion of patients with acute respiratory distress syndrome(ARDS) was higher than that in the conventional group (P<0.05). The lymphocyte(LYM) count in hormone group was lower than that in conventional group (P<0.05), while the white blood cell count was higher than that in conventional group (P<0.05). There was no significant difference in the time of negative swab conversion between the two groups (P>0.05), and the median time of negative swab conversion between the two groups was 12 days(W=303.5, P=0.4498), while the median time of absorption on CT was 8 days (W=391, P=0.4316). Conclusions: WBC and LYM counts and OI values are correlated with the severity of COVID-19, while glucocorticoids do not affect the negative nucleic acid conversion and imaging absorption effect of patients.