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  • 2022 Volume 19 Issue 2
    Published: 25 February 2022
      
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  • Progress of Clinical Research in the Prevention and Treatment of Cervicitis by Matrine and Oxymatrine
    ZHANG Ming-fa, SHEN Ya-qin
    2022, 19(2): 159-163. https://doi.org/10.13493/j.issn.1672-7878.2022.02-001
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    Matrine and oxymatrine have a widespread bioactivities, including protection of organs (heart, liver, lung, kidney, brain and blood vessel), positive inotropic action, negative chronotropic action, antiarrhythmia, the effect of increasing leukocyte, antiasthma, antiulcer, anti-fibrogenesis, the central nervous pharmacological action (sedation, hypnogenesis and analgesia), antitumor, immunoregulation, anti-bacteria, anti-virus, anti-parasite and anti-inflammation. In gynecologic domain, matrine and oxymatrine have anti-gynecologic tumors effects, and could protect epithelial cells of mamma, endometrium and vagina, and antagonize inflammatory pathologic change of epithelial cells induced by various pathogenic factors. In clinic matrine and oxymatrine have been used to treat various cervicitis and vaginitis, and have been tried to treat mammary cancer, ovarian carcinoma, cervical carcinoma and endometrial carcinoma. In this paper, the clinical pharmacological effects of matrine and oxymatrine on cervicitis are reviewed and analyzed.
  • Study on Applicability of Microbial Limit Test Method for Shidujing Lotion
    SUN Xiao-peng, LIU Ju
    2022, 19(2): 164-168. https://doi.org/10.13493/j.issn.1672-7878.2022.02-002
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    Objective: To establish a microbial limit test method for Shidujing lotion. Methods: The applicability test of the microbial limit test method of the Shidujing lotion was carried out according to the methods contained in the Four general rules 1105, 1106 and 1107 of the Chinese Pharmacopoeia (2020 Edition). When the total number of aerobes, fungi or yeasts was checked, the membrane filtration method was adopted. Routine method and medium dilution method were used to control bacteria. Results: The results showed that the recovery ratios of Staphylococcus aureus, Pseudomonas aeruginosa, Bacillus subtilis, Candida albicans and Aspergillus Niger were between 0.5 and 2.0, and the positive bacteria added in the control bacteria could also be detected by streaks. Conclusion: The microbial limit test of Shidujing lotion can be examined by membrane filtration method, conventional method and medium dilution method. Staphylococcus aureus, Pseudomonas aeruginosa, Clostridium spore can be detected by conventional method, and Candida albicans can be detected by medium increment method.
  • Study on Identification of Main Components in Huaihua Granule by TLC*1
    XIN Xiao-fang, LIU Te-jin, HU Yu-liang, WANG Ying-jing
    2022, 19(2): 169-173. https://doi.org/10.13493/j.issn.1672-7878.2022.02-003
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    Objective: To study and establish the TLC method for the identification of the main components in Huaihua granule, and to provide the research basis for the formulation of the quality standard of the granule. Methods: Rutin, chlorogenic acid, luteolin, linarin, galuteolin and glycyrrhizin were used as the control substances, and ethyl acetate-water-formic acid (9:1:1), ethyl acetate-butanone-trichloromethane-formic acid-water (15:15:6:4:1) and ethyl acetate-formic acid-glacial acetic acid-water (15:1:1:2) were used as the developing agents. Sophorae Flos, Glycyrrhizae Radix et Rhizoma and Chrysanthemi Indici Flos were identified by TLC method. Results: The thin-layer chromatogram showed that the same color spots as rutin, chlorogenic acid, luteolin, linarin, galuteolin and glycyrrhizin were found in their corresponding positions, and the spots were clear. The method had good durability. Conclusion: The method is safe, simple and specific, and can be used as a thin layer identification for the main components in Sophora japonica granule.
  • Analysis of Blood Drug Level of Intravenous Vancomycin and Its Influencing Factors in Pediatric Patients
    WANG Feng-jiao, WANG Wen-juan, GUI Huan, YAN Ying-hui, YAO Hua
    2022, 19(2): 174-177. https://doi.org/10.13493/j.issn.1672-7878.2022.02-004
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  • Analysis of "Medication Warning" of Chinese Patent Medicine Orders in Inpatients of Geriatrics Department of a Hospital*1
    DUN Wen-liang, GUO Jian-ping, ZHAO Chen, MENG Si-si
    2022, 19(2): 178-181. https://doi.org/10.13493/j.issn.1672-7878.2022.02-005
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    Objective: To analyze the "medication warning" of Chinese patent medicine orders in inpatients of geriatrics department of a hospital to promote the rational use of Chinese patent medicine. Methods: The "medication warning" information of Chinese patent medicine orders in inpatients of geriatrics department of Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine from July 2020 to June 2021 were collected to analyze the current irrational use of Chinese patent medicine. Results: The main causes of "medication warning" were irrational route of administration, indication, usage and dosage and incompatibility. The "medication warning" orders were issued for 97 kinds of Chinese patent medicines in 14 categories. The ratio of the number of monthly "medication warning" to the number of monthly cases showed a downward trend, from 64.47% to 33.65%. Conclusion: Through the use of the automatic prescription review system by clinical pharmacists, the irrational prescriptions of Chinese patent medicine are reduced in the geriatrics department.
  • Analysis of Pathogen Distribution and Drug Resistance in Sputum Specimens of Patients with Pulmonary Tuberculosis Complicated with Pulmonary Infection
    ZHU Jing-fang, ZHANG Yu-kui, PAN Lin-jia
    2022, 19(2): 182-185. https://doi.org/10.13493/j.issn.1672-7878.2022.02-006
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    Objective: To analyze the distribution and drug resistance of pathogenic bacteria in sputum samples of patients with pulmonary tuberculosis complicated with pulmonary infection so as to provide reference for rational use of antibacterial in clinic. Methods: A total of 1 906 patients with pulmonary tuberculosis complicated with pulmonary infection admitted to Zhumadian Central Hospital from August 2018 to August 2021 were selected. The distribution and drug resistance of pathogenic bacteria in sputum samples, and the relationship between different types of pulmonary tuberculosis and the number of pathogenic bacteria were analyzed. Results: A total of 2 880 strains of pathogenic bacteria were isolated from sputum samples of 1 906 patients, including 1 542 strains of Gram-negative bacteria (53.54%), 152 strains of Gram-positive bacteria (5.28%) and 1 186 strains of fungi (41.18%). Pseudomonas aeruginosa and Klebsiella pneumoniae had high sensitivity to most antibacterial drugs (greater than 70.00%), while Escherichia coli only had higher sensitivity to imipenem, piperacillin-tazobactam sodium and amikacin (greater than 70.00%), and Acinetobacter baumannii was only highly sensitive to imipenem, ticacillin-clavulanate and amikacin (greater than 70.00%). Staphylococcus aureus and Staphylococcus haemolyticus had high sensitivity to linezolid, vancomycin, dalfopristin and chloramphenicol (greater than 70.00%). Candida albicans had high sensitivity to 5-fluorocytosine, amphotericin B, fluconazole, itraconazole and voriconazole (greater than 80.00%). Patients with different types of tuberculosis were mainly infected with less than two pathogens, accounting for 89.82%. Conclusion: The main pathogens are fungi and Gram-negative bacteria in patients with pulmonary tuberculosis complicated with pulmonary infection. Different pathogens have different drug resistance, so clinicians should rationally select antibacterial agents according to their respective drug resistance characteristics to ensure effective treatment.
  • Resistance Surveillance of Major Gram-negative Bacilli Isolated from a Hospital of Guangxi from 2016 to 2020*1
    LI Tai-jie, JIN Jing, JIANG Cheng-chuan, LIN Qing, LIN Hui-zhen, WANG Bo-lian, LIAO Yu, PAN Hui-ying
    2022, 19(2): 186-190. https://doi.org/10.13493/j.issn.1672-7878.2022.02-007
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    Objective: To analyze the drug resistance and its trend of major Gram-negative bacilli isolated from a hospital so as to provide reference for rational use of antibacterials in clinic. Methods: The data of microbial culture from 2016 to 2020 were collected to analyze the drug resistance and its trend of major Gram-negative bacilli. Results: A total of 10 456 strains of Gram-negative bacilli were detected from 2016 to 2020, among which the top 5 were Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii and Enterobacter cloacae. The results of drug susceptible test showed that Escherichia coli, Klebsiella pneumoniae and Enterobacter cloacae were highly sensitive to imipenem, meropenem, piperacillin-tazobactam and amikacin. The resistance rates of Pseudomonas aeruginosa to polymyxins B and E were 0.00%, and the resistance rates to imipenem and meropenem were low but showed a increasing trend. Acinetobacter baumannii was only highly sensitive to polymyxins B and E. Conclusion: The resistance rates of Gram-negative bacilli to antibacterials are stable, but the resistance rates of Pseudomonas aeruginosa and Acinetobacter baumannii to imipenem and meropenem show an increasing trend. Etiological examination and resistance surveillance should be strengthened to promote rational use of antibacterials and reduce the development of drug resistance strains.
  • Analysis of Distribution and Drug Resistance of Pathogenic Bacteria in Blood Culture Specimens of Inpatients in a Hospital
    GUO Tian-tian, ZHANG Lin, ZHANG Zi-xia
    2022, 19(2): 191-193. https://doi.org/10.13493/j.issn.1672-7878.2022.02-008
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    Objective: To analyze the distribution and drug resistance of pathogenic bacteria in blood culture specimens of inpatients in a hospital. Methods: The data of 1 000 blood culture specimens submitted for clinical examination from January 2019 to June 2020 were collected to analyze the distribution and drug resistance characteristics of pathogenic bacteria. Results: A total of 1 000 blood culture specimens were collected mainly from ICU and general surgery department. Among them, 467 strains of pathogenic bacteria (positive rate 46.70%) were isolated, including 245 strains of Gram-negative bacteria (52.46%), 204 strains of Gram-positive bacteria (43.68%), 6 strains of fungi (1.28%) and 12 strains of other pathogenic bacteria (2.57%). Escherichia coli had low drug resistance rates to imipenem and furantoin (less than 5.00%), while Klebsiella pneumoniae had low drug resistance rates to imipenem, tobramycin and aztreonam (less than 5.00%). The drug resistance rates of coagulase negative Staphylococcus and Staphylococcus aureus to linezolid and vancomycin were 0.00%. Conclusion: The proportion of Gram-positive bacteria and Gram-negative bacteria in blood culture specimens of inpatients in hospital is similar, so clinicians should choose antibacterial agents reasonably according to the types of pathogenic bacteria and their resistance characteristics.
  • Analysis of Distribution and Drug Resistance of Pathogenic Bacteria in Sputum Specimens of Patients with Acute Stroke-associated Pneumonia
    GUO Xu-dong, LI Yan-hong, SUN Shi-Bin
    2022, 19(2): 194-197. https://doi.org/10.13493/j.issn.1672-7878.2022.02-009
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    Objective: To analyze the distribution and drug resistance of pathogenic bacteria in sputum specimens of patients with acute stroke-associated pneumonia (SAP). Methods: A total of 108 cases of acute SAP patients admitted to the First Affiliated Hospital of Henan University from February 2019 to February 2021 were selected. Sputum samples were collected for microbiological culture and drug susceptible test to analyze the distribution and drug resistance characteristics of pathogenic bacteria. Results: A total of 99 case of 108 patients with acute SAP were positive in microbiological culture, with a positive rate of 91.67%. A total of 116 strains of pathogenic bacteria were detected, including 78 Gram-negative strains (67.24%, dominated by Acinetobacter baumannii, Klebsiella pneumoniae and Pseudomonas aeruginosa), 30 Gram-positive strains (25.86%, dominated by Staphylococcus aureus and Enterococcus faecalis) and 8 strains of fungi (6.90%). The drug resistance rates of Acinetobacter baumannii to all antibacterials were high (greater than 45.00%), the drug resistance rates of Klebsiella pneumoniae and Pseudomonas aeruginosa to only amikacin were low (less than 10.00%), and the drug resistance rates of Pseudomonas aeruginosa to ampicillin-sulbactam, piperacillin-tazobactam and piperacillin were relatively low (all 15.38%). The resistance rates of Staphylococcus aureus and Enterococcus faecalis to vancomycin and teicoplanin were 0.00%. Conclusion: The pathogenic bacteria in sputum samples of acute SAP patients are mainly Gram-negative bacteria, among which the main pathogenic bacteria have prominent multi-drug resistance. Therefore, antibacterial drugs should be rationally selected according to the results of drug sensitivity test in clinical practice.
  • Analysis of Clinical Distribution and Drug Resistance of Carbapenem-resistant Klebsiella Pneumoniae in Hospitalized Patients of a Hospital
    WANG Jing, WANG yuan-yuan, MU Yan-li
    2022, 19(2): 198-200. https://doi.org/10.13493/j.issn.1672-7878.2022.02-010
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    Objective: To analyze the clinical distribution and drug resistance characteristics of carbapenems-resistant Klebsiella pneumoniae (CRKP) in hospitalized patients. Methods: A total of 146 patients with CRKP infection admitted to Luoyang Hospital of Traditional Chinese Medicine from June 2020 to June 2021 were selected to analyze the clinical distribution characteristics and drug resistance of CRKP. Results: The 146 patients with CRKP infection were mainly from respiratory ICU (44.52%), followed by department of hepatobiliary surgery (21.23%) and ICU (13.01%). The main specimens were sputum (43.15%), followed by blood and drainage fluid (23.29% and 13.01%, respectively). The results of drug susceptible test showed that CRKP only had low drug resistance rates to tigecycline, compound sulfamethoxazole, amikacin and gentamicin. Conclusion: CRKP infection is most common in respiratory ICU patients, and CRKP is mostly isolated from sputum. CRKP has a low resistance rate to only a few antibacterial agents, so the rational use of antibacterials and resistance surveillance of CRKP should be strengthened to reduce the occurrence of CRKP.
  • Risk Factors for Postoperative Intracranial Infection in Patients with Type Ⅰ Incision in Neurosurgery Department and Their Prevention and Treatment Measures*1
    ZHAN Guan-jun, LU Jin, LIU Zhong-qiu, CAO Lu-lu, MA Jing, XUE Yao
    2022, 19(2): 264-268. https://doi.org/10.13493/j.issn.1672-7878.2022.02-032
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    Objective: To explore and analyze the risk factors of postoperative intracranial infection in patients undergoing type Ⅰ incision surgery in neurosurgery by multivariate Logistic regression analysis so as to provide reference for reducing the occurrence of postoperative intracranial infection. Methods: The medical records of 574 patients undergoing type Ⅰ incision surgery admitted to the neurosurgery department of Zhongda Hospital Affiliated to Southeast University from January 2018 to June 2019 were collected, and the risk factors related to postoperative intracranial infection were analyzed by multivariate Logistic regression analysis. Results: Among the 574 patients, 37 cases had intracranial infection, with an infection rate of 6.45%. Multivariate Logistic regression analysis showed that blood transfusion, hospitalization duration ≥30 d and time of indwelling drainage tube ≥2 d were correlated with postoperative intracranial infection, which constituted the independent risk factors (P<0.05). Conclusion: Medical staff should fully understand the risk factors of postoperative intracranial infection in patients undergoing type Ⅰ incision surgery in neurosurgery, and optimize various controllable factors as far as possible during the perioperative period so as to minimize the incidence of intracranial infection.
  • Risk Factors for Nosocomial Infection in Breast Cancer Patients Undergoing Postoperative Chemotherapy and Their Countermeasures
    WAN Hong
    2022, 19(2): 269-272. https://doi.org/10.13493/j.issn.1672-7878.2022.02-033
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    Objective: To explore and analyze the risk factors for nosocomial infection in breast cancer patients undergoing postoperative chemotherapy and their countermeasures. Methods: The medical records of 220 breast cancer patients admitted to Ganzhou Municipal Hospital from January 2016 to December 2020 were collected to explore the incidence of nosocomial infection and the distribution of pathogenic bacteria, and the risk factors of nosocomial infection were analyzed by regression analysis. Results: Among 220 breast cancer patients, 36 cases had nosocomial infection occurred with infection rate of 16.36%, and the microbiological culture showed that the Gram-negative bacteria were the main pathogen bacteria. Regression analysis showed that age ≥55 years old, combined with underlying diseases, drainage time ≥30 d, length of hospital stay ≥14 d and white blood cell count ≤1.0×109/L were independent risk factors for nosocomial infection in breast cancer patients undergoing postoperative chemotherapy (P<0.05). Conclusion: The incidence of nosocomial infection in breast cancer patients undergoing postoperative chemotherapy is high, and age, combined underlying diseases, postoperative drainage time, length of hospital stay and white blood cell count are all important risk factors for infection. In these regards, clinicians should take corresponding preventive measures to reduce or even avoid the occurrence of nosocomial infection.
  • Pharmaceutical Care of Personalized Anti-infection Therapy for Orthopedic Patients Participated by Clinical Pharmacists
    XU Tian-tian, TU Ying-qiu, YAO Yao
    2022, 19(2): 277-279. https://doi.org/10.13493/j.issn.1672-7878.2022.02-035
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    Objective: To explore and analyze the entry point of pharmaceutical care for clinical pharmacists to participate in the personalized anti-infection therapy of orthopedic patients. Methods: According to the infection characteristics of orthopedic patients, clinical pharmacists analyzed typical cases and shared their experience of participation in the formulation of individualized anti-infection therapy and the implementation of pharmaceutical care for orthopedic patients. Results and Conclusion: Clinical pharmacists carry out pharmaceutical care, including inquiry, ward rounds and consultation, and assist physicians to develop personalized treatment plan, which has achieved remarkable results and promoted rational use of drug in clinic.
  • Analysis of Adverse Drug Reactions Caused by TCM Injections in Diagnosis and Treatment Protocol for COVID-19 (Trial Version 8) *1
    ZHANG Deng-yu, QIN Yuan-yuan, HUANG Yu-yu, TANG Liang, ZHAO Fei-yan
    2022, 19(2): 283-290. https://doi.org/10.13493/j.issn.1672-7878.2022.02-037
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    Objective: To summarize and analyze the adverse drug reactions of 8 kinds of TCM injections included in the Diagnosis and Treatment Protocol for COVID-19 (Trial Version 8) so as to provide reference for the safe and rational use of TCM injections during clinical diagnosis and treatment. Methods: The literatures published in CNKI, Wanfang Database and CQVIP database from January 2010 to December 2019 were searched and analyzed with the names of 8 TCM injections and "adverse reaction" as the subject keywords. Results: A total of 168 cases of adverse reactions of TCM injections were searched, among which 39.88% patients had chronic underlying diseases, 13.69% had allergic history, 53.57% had combined intravenous medication, and only 4.44% patients recorded standard flushing operation. ADR mainly affected the whole body, respiratory system, cardiovascular system, skin and skin accessories, and nervous system, of which 85.12% were allergic or anaphylactic reactions. Conclusion: The compositions of TCM injections are complex, so it is necessary to be alert to the occurrence of ADR, standardize infusion therapy and pay attention to medication monitoring during the diagnosis and treatment of COVID-19 so as to ensure the safety of medication for patients.
  • Analysis of Adverse Drug Reactions in Children in Hemato-oncology Department of a Hospital*1
    ZHOU Mi, LI Gui-feng, ZHONG Wen, YANG Meng-jie, WANG Mei, ZHU Zeng-yan
    2022, 19(2): 291-296. https://doi.org/10.13493/j.issn.1672-7878.2022.02-038
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    Objective: To analyze the adverse drug reactions (ADRs) of 238 children in the hemato-oncology department of a hospital so as to provide reference for drug treatment of similar patients. Methods: The medical records of 238 children with ADRs reported to the National Adverse Drug Reaction Surveillance System by the hemato-oncology department of Children's Hospital of Soochow University from 2012 to 2020 were selected to analyze the occurrence regularity of ADRs from the aspects of age, gender, clinical diagnosis, route of administration, involved system and clinical outcome. Results: Among the 238 cases of ADRs, 65 cases (27.31%) were severe ADRs, and 173 cases (72.69%) were general ADRs. The suspected drugs of ADRs were mainly anti-tumor and adjuvant drugs (119 cases, 50.00%) and anti-infective drugs (66 cases, 27.73%). The main route of administration was intravenous administration, among which 173 cases (72.69%) were intravenous drip and 13 cases (5.46%) were intravenous injection. The most commonly involved part was skin and its accessories (102 cases, 42.86%), followed by systemic manifestations (70 cases, 29.41%). Among the 238 cases of ADRs, 140 cases occurred on the day when the suspicious drug was used, 200 cases were treated with withdrawal or dosage reduction after the occurrence of ADRs, 227 cases were cured or improved, and 196 cases had no significant effect on the original disease. Conclusion: ADRs is an important problem affecting the treatment of children in the hemato-oncology department. Clinical monitoring of ADRs should be strengthened, especially for drugs for the treatment of main diseases and complications.
  • Prediction of Coagulation Disorders Caused by Cefoperazone/Sulbactam with Logistic Regression Analysis Combined with Roc Curve
    TAN Hao-wen
    2022, 19(2): 300-304. https://doi.org/10.13493/j.issn.1672-7878.2022.02-040
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    Objective: To analyze the influencing factors of coagulation disorders caused by cefoperazone/sulbactam with Logistic regression analysis combined with receiver operating characteristic (ROC) curve, and establish a model to predict the risks of coagulation disorders. Methods: The medical records of 139 patients treated with cefoperazone/sulbactam in Wuzhou Red Cross Hospital from January 1, 2019 to August 31, 2021 were collected, and the influencing factors of coagulation disorders caused by cefoperazone/sulbactam were analyzed by Logistic regression analysis combined with ROC curve. The model was established to predict the coagulation disorders. Results: Among 139 patients, 62 cases (44.60%) had the coagulation disorders. Logistic regression analysis showed that daily dose of cefoperazone, patient's creatinine level and fasting status were the independent risk factors for coagulation disorders. The Logistic regression equation was established with the above independent risk factors, and the calculation formula of combined predictors was obtained after transformation, Ycombined=45.15 Xfasting+27.23 Xdaily dose+0.1 XCr. The maximum area under the ROC curve of the combined predictors was 0.760 (95% CI 0.679~0.841, P<0.05). The cut-off point was the optimal value (91.89) on the ROC curve when Youden index was 0.459. Conclusion: When patients receive cefoperazone/sulbactam treatment, the daily dose of cefoperazone, patient's creatinine value and fasting status can be substituted into the combined predictor formula to predict the risk of coagulation disorders in patients so as to ensure the safety of medication.
  • Feasibility Exploration and Prospect of Construction of Regional Prescription Review Center Based on Intelligent Pharmaceutical Care*1
    GAO Yue, YANG Lin
    2022, 19(2): 305-308. https://doi.org/10.13493/j.issn.1672-7878.2022.02-041
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    In order to further standardize the prescription behavior of physician and improve the rationality of prescription, Shanghai Songjiang District Government, using intelligent pharmaceutical care as a means, plans to build a regional prescription review center based on the pre-prescription review work of Shanghai Songjiang District Central Hospital. The center, which can complete the intelligent pre-prescription review service, will provide the same high-quality pharmaceutical care to all medical institutions in the region.