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2020 Vol. 38, No. 2

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Recommendations for prevention and treatment of device-related pressure injuries during COVID-19 period
ZHANG Yunchang, SHENG Chunquan, WANG Bingkai, MA Zhiqiang, YANG Feng
2020, 38(2): 97-100, 109. doi: 10.3969/j.issn.1006-0111.202003018
Abstract(3903) HTML (1645) PDF (518KB)(44)
Abstract:
With the outbreak of COVID-19, non-stop working medical staff need to wear protective equipment for a long time, which could easily cause device-related pressure injuries to nose, cheek, forehead or the back of auricle, and might even cause facial skin swelling and ulceration. The above problems reduce work efficiency and increase the infection risk for healthcare people. This article introduces the concept of device-related pressure injuries and summarizes the progress of the treatment for device-related pressure injuries at home and abroad in recent years, aiming at providing guidance for frontline medical staff to prevent device-related pressure injuries.
Traditional Chinese medicine in the treatment and rehabilitation for Coronavirus Disease 2019
YOU Benming, WANG Zhongzhuang
2020, 38(2): 101-104. doi: 10.3969/j.issn.1006-0111.202003061
Abstract(3538) HTML (1354) PDF (452KB)(38)
Abstract:
Based on national health insurance policy, traditional Chinese medicine (TCM) clinical practice and newly revealed pathological changes in Coronavirus Disease 2019 (COVID-19), the early TCM utilization was recommended to promote blood circulation and protect respiratory system. The fermented Ophiocordyceps powder preparations (Bailing tablets or capsules) are the top choice to inhibit the cytokine storm, relieve lung fibrosis and kidney damage.
Advances in research on the impact of the plateau environmental on the drug metabolism
GAO Zizhao, WANG Rong, ZHAO Anpeng
2020, 38(2): 105-109. doi: 10.3969/j.issn.1006-0111.201912096
Abstract(2347) HTML (1155) PDF (518KB)(18)
Abstract:
Plateau environment will affect the metabolism of drugs in the body, which will cause changes in pharmacokinetic parameters, expression and function of drug metabolizing enzymes and transporters. With the rapid development of the pharmaceutical industry, therapeutic drug monitoring (TDM) has been widely paid attention to as a basis for personalized drugs. What impact does the plateau environment on monitoring drugs? In this literature review, we will summarize the types of commonly used therapeutic monitoring drugs, therapeutic windows, and blood samples, analyze the effects of plateau hypoxic environment on the metabolism of commonly used monitoring drugs, provide a reference for the clinical treatment and monitoring drugs of plateau, better ensure the rational use of drugs in the plateau population, and also provide a reference for the later research group to conduct the monitoring of plateau therapeutic drugs and the selection of research drugs.
Research on chemical components and biological activities of the iridoids in Morinda genus
SHEN Yi, ZHANG Qi, LIU Mengqin, HE Yuqiong, XIN Hailiang, QIN Luping, ZHANG Qiaoyan
2020, 38(2): 110-114, 119. doi: 10.3969/j.issn.1006-0111.201907143
Abstract(3298) HTML (1523) PDF (501KB)(19)
Abstract:
Morinda genus of Rubiaceae has been widely used in medicine at home and abroad. Many parts of Morinda tree are utilized in research, mainly including roots, stems, leaves, branches and seeds. Through the research of online databases, the chemical components and biological activities of the iridoids in Morinda genus were summarized in this paper. Up to now, more than 50 kinds of iridoids have been identified. In addition, more and more studies proved that Morinda iridoids might benefit human via such anti-inflammatory, antinociceptive, anti-oxidation, anti-tumor and bone protection. The theoretical basis was provided for the further development and utilization of the iridoids in Morinda genus.
Establishment of mouse myocardial infarction model and early electrocardio- gram assessment
HU Wenjun, WANG Pin, ZHENG Sili, WANG Dongsheng, MIAO Chaoyu
2020, 38(2): 115-119. doi: 10.3969/j.issn.1006-0111.202001011
Abstract(4971) HTML (3576) PDF (643KB)(72)
Abstract:
  Objective  To establish and optimize a mouse myocardial infarction (MI) model, and to use twice limb lead ECGs immediately after coronary ligation and 4 h after surgery to evaluate the occurrence of myocardial infarction.  Methods  Twenty-nine male C57BL/6J mice were anesthetized with isoflurane. then a myocardial infarction model was established by ligating the left anterior descending (LAD) coronary artery through the third/fourth intercostal space of left anterior chest. Immediate and 4 h postoperative limb lead ECGs were performed. Twenty-four hours after surgery, the chest was opened and the occurrence of myocardial infarction was evaluated. The heart samples were taken for TTC staining to determine the infarct area and calculate the infarct area.  Results  During the mice underwent coronary artery ligation the intraoperative mortality was 6.8% (2/29), and the early postoperative (<4 h) mortality was 10.3% (3/29). The 24 h survival rate was 82.8% (24/29). 24 hours after TTC staining confirmed the occurrence of infarction, the myocardial infarction model was established. The success rate of the model was 79.3% (23/29), and the average infarct size (infarcted myocardial weight / whole ventricular weight) was (28 ± 6)%; The mice successfully established by the model showed obvious ST-T changes in the ECG at 4 hours after surgery, suggesting that a myocardial infarction has occurred.  Conclusions  The mouse myocardial infarction model was successfully established. The combined use of ECG immediately after surgery and 4 h after surgery could be used as a rapid and non-invasive evaluation method for mouse myocardial infarction.
Microdialysis recovery of cefradine in vitro
YANG Xianmi, XU Xiaojian, WANG Xuebin, WANG Zhuo, Wang Tongsheng
2020, 38(2): 120-123, 128. doi: 10.3969/j.issn.1006-0111.201910044
Abstract(2989) HTML (1338) PDF (783KB)(17)
Abstract:
  Objective  To determine the in vitro recovery rate and influencing factors of cefradine microdialysis.  Methods  Two different methods (loss method, gain method) of microdialysis concentration and LC-MS/MS were used to determine the in vitro recovery rate of cefradine. The effect of flow rate and concentration of the perfusate on the recovery rate were investigated. To explore the feasibility of microdialysis technology for pharmacokinetic studies in cefradine.  Results  The LC-MS/MS analysis method was linear in the required range and the method was sensitive and reliable. There was no significant difference in the recovery rate measured by gain or loss method. Under the same conditions, the in vitro recovery of the probe decreased with increasing flow rate, independent of the drug concentration around the probe.  Conclusion  Microdialysis technique could be used to study the pharmacokinetics of cefradine, and loss method could be used to determine the in vivo recovery rate and pharmacokinetics of cefradine on microdialysis.
Determination of the content of Gd3+ in gadoteric acid meglumine salt injection by ICP-MS method
WANG Qirong, CHEN Jieyi, SUN Miao, CHEN Yuping, YANG Feng
2020, 38(2): 124-128. doi: 10.3969/j.issn.1006-0111.201908132
Abstract(2603) HTML (926) PDF (578KB)(32)
Abstract:
  Objective  To establish a method for determining the content of Gd3+ in gadoteric acid meglumine salt injection.  Methods  ICP-MS was used. The separation column was a metal chelate column (1-ml Chelating Sepharose column), column temperature was normal temperature. Flow rate was 1 ml/min. Injection volume was 500 μl. Atoms were measured by ICP-MS with a molecular weight of 157 (The molecular weight of Gd was 157). The carrier gas was argon.  Results  The linear range of Gd3+ mass concentration was 0-500 ng/ml (r=1.000); The precision, stability and repeatability of the sample recovery test were all in accordance with the requirements.  Conclusion  The method was simple in operation, accurate in results and good in repeatability, which could be used to determine the content of Gd3+ in gadoteric acid meglumine salt injection.
The effects of medical sodium hyaluronate gel on the tumor proliferation and metastasis
CAI Tongkai, YANG Wensheng, CAO Yongbing, HAN Hua, YAN Lan
2020, 38(2): 129-134. doi: 10.3969/j.issn.1006-0111.201911108
Abstract(3643) HTML (1722) PDF (923KB)(15)
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  Objective  To investigate the effect of medical sodium hyaluronate gel (HA) on the growth and metastasis of abdominal and pelvic tumor cells in vitro and in nude mice.  Methods  Three tumor cells, Hela, CT26 and HCT116, were used to investigate the effects of different HA concentrations on the growth and migration of tumor cells in vitro by MTT assay and Transwell assay. An orthotopic transplantation model of colonic tumor in nude mice was established to investigate the effect on the proliferation of cell HCT116 by comparing the tumor volume and tumor mass 4 weeks after inoculation. The effects on the metastasis of cell CT26 were investigated by comparing the tumor metastasis rate and the number of metastatic lesions of lung and liver in nude mice among the different experimental groups 3 weeks after inoculation.  Results  HA did not promote the growth and metastasis of Hela, CT26 and HCT116 cells in vitro at different concentrations. Actually, HA exhibited a certain inhibitory activity at the concentration of 5 mg/ml. In the orthotopic transplantation model of colonic tumor-HCT116, HA did not promote the growth of cell HCT116. In the orthotopic transplantation model of colonic tumor-CT26, HA inhibited CT26 tumor metastasis.  Conclusion  Under the experimental conditions, HA did not promote the growth, migration or metastasis of abdominal and pelvic related tumor cells including Hela, CT26 and HCT116 in vitro and in vivo.
Effects of hawthorn and melanoidins on the in-vitro growth of Bifidobacterium and E.coli
WANG Yun, LU Min, LIANG Jie, SUN Hua, ZHANG Mengqi, LAN Zelun, WAN Jun, ZHOU Xia
2020, 38(2): 135-137, 165. doi: 10.3969/j.issn.1006-0111.201904129
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  Objective  Effect of hawthorn and melanoidins on the in-vitro growth of Bifidobacterium and E.coli.  Methods  According to methods of the Chinese pharmacopoeia (2015),the charred hawthorn was prepared. The melanoidins in charred hawthorn were separated and purified by the macroporous resin extraction process. Ultraviolet spectrophotometry was used to detect melanoidins. The gas chromatography was used to detect the effects of hawthorn, charred hawthorn and melanoidins on the content of the acetic acid in Bifidobacterium and E.coli during growth, stable and decay period.  Results  In the early stage, the effects of hawthorn and charred hawthorn on bacteria were greater than melanoidins. In the middle and late stage, melanoidins inhibited the growth and metabolism of E.coli by changing the generation of acetic acid, and contributed to that of Bifidobacterium and also promoted the generation of acetic acid and regulate the intestinal flora.  Conclusion  Hawthorn, charred hawthorn and melanoidins all promote digestion by promoting the growth and metabolism of intestinal flora. Among them, charred hawthorn has a better effect on intestinal flora.
Identification of chemical constituents of Xiakucao Xiaoliu mixture by HPLC-TOF/MS
DAI Yuanyuan, WANG Xiaohe, MA Minghua, JI Qiangguo, GU Xiaoyan, WU Tiejun, NIAN Hua
2020, 38(2): 138-142, 155. doi: 10.3969/j.issn.1006-0111.201907116
Abstract(2954) HTML (1106) PDF (659KB)(18)
Abstract:
  Objective  To identify the chemical constituents of Xiakucao Xiaoliu mixture by high performance liquid chromatography-high resolution time-of-flight mass spectrometry (HPLC-TOF/MS).  Methods  The chromatographic separation ACE (3.0mm×150 mm) column was used. The mobile phase was methanol (A) and 0.1% formic acid (B). The gradient elution was: 0-5 min, 5% A; 5-10 min, 5%-15% A; 10-30 min, 15%-45%A; 30-40 min, 45%-70%B; 40-50 min, 70%-90%B. The injection volume was 2 μl. The flow rate was 0.4 ml/min. The column temperature was 25°C. The mass spectrometry was characterized by time-of-flight mass spectrometry, using ESI ion source. The common monitoring was in positive and negative ion mode. The reference ion was m/z 121.9856, 1033.9881. The scanning range was m/z 100-1200.  Results  A total of 37 chemical constituents were identified in the Xiakucao Xiaoliu mixture, 8 in the positive ion mode fragment voltage of 160 V, 28 in the negative ion mode fragment voltage of 160 V, and 19 in the fragment voltage of 260 V. Both positive and negative ions had 4 responses. The negative ion mode has 16 responses under both fragment voltages. And the ingredients were medicinal.  Conclusion  An effective method for the identification of the chemical constituents of Prunella vulgaris L. by HPLC-TOF/MS was established, which laid a foundation for its quality control and in-depth study in vivo.
Quality control and evaluation of Shengmai injection based on anti-oxidant and anti-inflammatory biological effects
YU Yue, LU Juan, CHAI Ruiping, LYU Xinkai, DENG Minghui, CHEN Xi
2020, 38(2): 143-147. doi: 10.3969/j.issn.1006-0111.201906029
Abstract(3420) HTML (1230) PDF (649KB)(16)
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  Objective  To establish a quality evaluation method for Shengmai injection with antioxidant and anti-inflammatory effects as indicators.  Methods  Using water-soluble vitamin E (Trolox) and N-nitro-L-arginine methyl ester (L-NAME) as control drugs, using trinitrophenyl-hydrazine (DPPH) method and nitric oxide (NO) detection kit, the anti-oxidation effect and the inhibition ability of lipopolysaccharide (LPS)-induced NO release from mononuclear macrophage RAW264.7 were measured. The sample was converted into the corresponding concentration of the control drug to control and evaluate its methodological and biological effects.  Results  Each batch of samples had good anti-inflammatory and anti-oxidation effects with high precision and good repeatability. There was no significant difference in the anti-inflammation capacity among batches of. Samples 2 and 8 were significant differences from other samples in anti-inflammatory ability.  Conclusion  The established method can accurately evaluate the anti-oxidant and anti- inflammatory effects of Shengmai injection.
Cisatracurium assay in human plasma by LC-MS
XIN Bo, WAN Lili, WANG Jing, LIU Jinbian, HUO Yan, GUO Cheng
2020, 38(2): 148-151. doi: 10.3969/j.issn.1006-0111.201909001
Abstract(3519) HTML (1082) PDF (1490KB)(34)
Abstract:
  Objective  To establish a LC-MS method of cisatracurium assay in human plasma for clinical therapeutic drug monitoring.  Method  Propafenone Hydrochloride was used as the internal standard. The plasma samples were treated with 2% formic acid aqueous solution and acetonitrile containing the internal standard to precipitate protein. Agilent SB-C18 column was used for gradient elution with the mobile phase of 0.1% formic acid-water and 0.1% formic acid-acetonitrile solution at 35 ℃ and 0.3 ml/min flow rate. The degradation products of cisatracurium m/z 464.6-358.4 and propafenone hydrochloride m/z 342.2-116.2 were identified by ESI positive-ion detection.  Results  There was a linear rage of cisatracurium in 2-500 ng/ml (r=0.996 5) with a detection limit of 2 ng/ml. The intra-day coefficients of variation (CVs) were less than 16.00%, and the inter-day CVs were less than 6.00%. The mean recoveries were in the range of 97.63%-111.93%. The plasma samples were stable for 4 hours at room temperature, 14 days at -80 ℃ and 24 hours after pretreated.  Conclusion  This method was simple, accurate, fast and repeatable for the cisatracurium assay in human plasma.
Comparative study on volatile oil in Rhizoma chuanxiong by steam distillation and supercritical fluid extraction
DENG Peng, WEI Feixue, WEN Yi, WANG Baoyi, CHEN Shan
2020, 38(2): 152-155. doi: 10.3969/j.issn.1006-0111.201907022
Abstract(2759) HTML (1914) PDF (651KB)(33)
Abstract:
  Objective  To clarify the influence of the extraction process on its active ingredients by comparing the volatile oils of Rhizoma Chuanxiong obtained under different processes.  Methods  The volatile oil of Rhizoma Chuanxiong was extracted by supercritical CO2 extraction (SFE) and steam distillation. The main chemical components and relative contents were identified by gas chromatography-mass spectrometry (GC-MS).  Results  A total of 18 common components were identified in the volatile oil samples of Chuanxiong from the two methods. In steam distillation samples, main components included phthalides (61%), monoterpenoids (25%) and sesquiterpenes (10%). In SFE samples, phthalides (97%) were major components, followed by monoterpenoids (1%),sesquiterpenes (0.4%) and other minor components.  Conclusion  The steam distillation retains highly volatile components in Rhizoma chuanxiong such as monoterpenoids and sesquiterpenes. For SFE approach, the phthalides were extracted more efficiently compared with other components. The effect of the extraction process on the active ingredients should be fully considered in obtained products of Rhizoma chuanxiong since the difference in constituents may result in varied effects.
Study on the relationship between soil and quality of Astragalus membranaceus in Minle, Gansu
ZHANG Bo, BAN Xiaojun, YU Zheyuan, LI Xiaofang, WANG Xiaoxia
2020, 38(2): 156-160. doi: 10.3969/j.issn.1006-0111.201906077
Abstract(2923) HTML (1190) PDF (425KB)(16)
Abstract:
  Objective  To study the relationship between the quality of Astragalus membranaceus and soil in Gansu Minle.  Methods  we sampled the medicinal materials and soils of Astragalus membranaceus in Minle County, and determined the medicinal quality, soil factors and heavy metal elements by high performance liquid chromatography, ultraviolet spectrophotometry, atomic absorption spectrophotometry, and etc.  Results  The quality of Minle Astragalus meets the requirements of the Pharmacopoeia standards and is low on the risk of heavy metal pollution. There was a significant negative correlation between the extract and the available potassium. There was a significant positive correlation between the astragaloside IV and the available potassium. There was a highly significant positive correlation between calycosin-7-glucoside and soluble salt. There was a significant positive correlation with available potassium, and a significant negative correlation with pH. Among them, soil pH value is the most important factor affecting the content of astragalus extract, astragaloside IV and verrucous glucoside, followed by total phosphorus, organic matter and total nitrogen.  Conclusion  The results revealed that the soil factors is the main influencing factor of the quality of Astragalus membranaceus in Minle County, which can provide a theoretical basis for the standardized cultivation of Astragalus membranaceus in Minle County.
Determination of total polysaccharide content and analysis of monosaccharide components in the caulis polygoni multiflori mixture
YE Caifa, CAI Yuehui, ZENG Qiping, CAO Yixiang, CHEN Jinshan
2020, 38(2): 161-165. doi: 10.3969/j.issn.1006-0111.201908021
Abstract(2803) HTML (1464) PDF (630KB)(30)
Abstract:
  Objective  To establish a method for analyzing total polysaccharide content and its monosaccharide composition in the caulis polygoni multiflori mixture.  Methods  The polysaccharides of the caulis polygoni multiflori mixture were extracted by water-extraction and alcohol-precipitation. After the treatment with phenol-sulfuric acid, the content of total polysaccharides in the preparation was determined by ultraviolet spectrophotometry. In addition, after the polysaccharide was hydrolyzed into monosaccharides wtih trifluoroacetic acid, the hyrolysate was derivatized with PMP, and then the PMP derivates of monosaccharides were analyzed by HPLC method. Yilite krosmasil C18(4.6 mm×250 mm, 5 μm) was used at 30 ℃. Acetonitrile-0.1% NaH2PO4 (pH=6.8) (16:84) was the moblie phase with a flow rate of 1.0 ml/min. The detecting wavelength was at 250 nm. The injection volume was 20 μl.  Results  concentration of D-anhydrous glucose in the range of 21 ~ 105 μg/ml had a good linear relationship with the absorbance. The linear regression equation was A= 0.007x+0.0105, r=0.9982. The average recovery rate was (100.45±1.57)% (n=6). The average contents of total polysaccharides in four batches of samples were 14.24, 21.09, 17.85 and 18.17 mg/ml. The polysaccharide of the caulis polygoni multiflori mixture mainly consisted of D-mannose, D-glucosamine D-hydrochloride, D-Galacturonic acid, D-glucose, galactose, L-arabinose. The monosaccharides peak area ratios were about 9.10:0.26:1.00:3.02:4.14:2.12.  Conclusion  The method is accurate and reliable, and can be used for the determination of total content of polysaccharides and the analysis of monosaccharide composition in the preparation.
Simultaneously detect three illegal additive components in Yinhuang soft capsule by TLC-SERS
SONG Weiguo, LU Yonghui, ZHANG Zhonghu, ZHANG Huimin
2020, 38(2): 166-169. doi: 10.3969/j.issn.1006-0111.201908092
Abstract(3435) HTML (1029) PDF (683KB)(20)
Abstract:
  Objective  To establish a simultaneous detection of diclofenac sodium, fenbufen and rotundine hydrochloride illegally added in Yinhuang soft capsules by TLC-SERS.  Methods  The samples to be measured were placed on the silica gel plate, and the thin layer was developed with petroleum ether-ethyl acetate (3:5). Location detection was carried out under 254 nm ultraviolet lamp. Nano-silver colloidal solution was sprayed at each spot of separation according to the optimum conditions, and then qualitative identification was done by TLC-SERS.  Results  A method for simultaneous determination of diclofenac sodium, fenbufen and rotundine hydrochloride illegally added in Yinhuang soft capsule by TLC-SERS was established. And the minimum detection limits of three chemical constituents were determined.  Conclusion  TLC-SERS was a rapid, accurate and sensitive method for the simultaneous and rapid detection of diclofenac sodium, fenbufen and rotundine hydrochloride illegally added into Yinhuang soft capsule.
Clinical efficacy of TCM syndrome differentiation combined with entecavir in chronic hepatitis B patients
SHEN Qigang, HAN Zongru, MIN Xiaochun, YAO Qin, MA Weina
2020, 38(2): 170-173. doi: 10.3969/j.issn.1006-0111.201904148
Abstract(2942) HTML (1475) PDF (439KB)(15)
Abstract:
  Objective  To investigate the clinical effect of traditional Chinese medicine syndrome differentiation-based treatment combined with entecavir in the treatment of chronic hepatitis B.  Methods  A total of 80 outpatients with chronic hepatitis B were randomly divided into the observation group (n=40) and control group (n=40).The patients in the control group were treated with entecavir tablets. The patients in the observation group were given TCM syndrome differentiation-based treatment in addition to the treatment received by the control group. Clinical symptoms relief, improvement of liver function indexes, serological conversion and HBV-DNA negative rate were compared between the two groups after 48 weeks of treatment.  Results  The clinical symptoms of abdominal distension, fatigue, pain and anorexia were relieved better in observation group than in control groups. The difference was significant between the two groups (P<0.05). The observation group had significant therapeutic advantages over the ALT recurrence rate compared to the control group, especially 24 weeks ago (P<0.05). There was no statistically significant difference between the combined group and the control group after 12, 24, 48 weeks after treatment, and the HBV-DNA (both greater than 0.05) were clinically modified.  Conclusion  TCM syndrome differentiation-based treatment combined with entecavir had significant therapeutic advantages in the treatment of chronic hepatitis B, which could relieve clinical symptoms, improve liver function indexes, and converse serological changes and be worthy of clinical popularization.
Analysis of adverse reactions in 312 cases of gemcitabine
YAO Nannan, LIN Lili, HUANG Shan, FU Wenqian, SONG Hongtao
2020, 38(2): 174-178. doi: 10.3969/j.issn.1006-0111.201905052
Abstract(3541) HTML (1527) PDF (463KB)(29)
Abstract:
  Objective  Based on the data of gemcitabine adverse reactions (ADR), the characteristics and patterns of ADR occurrence were analyzed. The guidance for the rational clinical use of gemcitabine was provided.  Methods  From our information system, the patients treated by gemcitabine chemotherapy from September 2008 to September 2018 were selected and their related ADRs were summarized and statistically analyzed by using SPSS 18.0.  Results  Among the 750 cases, there were 312 ADRs related to gemcitabine treatment, of which the incidence of ADR was higher in female patients than in male patients (48.68% vs 36.77%) and the highest incidence in the age group of 50-69 years (44.14%). The patients with lower status (KPS) scores were more sensitive to chemotherapeutic drugs, and more likely to develop ADR. During the combination therapy, gemcitabine+paclitaxel chemotherapy had the highest incidence of ADR (61.54%) and the highest incidence of ADR in thymic carcinoma (62.50%), followed by hematological and reproductive system tumors (58.62% and 57.14%, respectively); ADR involvement in organs/systems is mainly caused by hematological toxicity. The bone marrow suppression is common, followed by digestive system damage. The major clinical symptoms were nausea and vomit.  Conclusion  Gemcitabine-related ADR has a large individualized difference and is affected by many factors. Chemotherapy should be used according to individual conditions to improve clinical safety and rational use of drugs.
A retrospective analysis of the efficacy and safety of dicycloplatin in the treatment of malignant tumor
ZHANG Shuang, CHEN Mengli, YIN Hong, XU Fenghua
2020, 38(2): 179-183. doi: 10.3969/j.issn.1006-0111.201904096
Abstract(3288) HTML (1993) PDF (629KB)(26)
Abstract:
  Objective  To observe the short-term efficacy and adverse reactions of dicycloplatin in the treatment of malignant tumors.  Methods  A retrospective analysis was performed in our hospital from January 2017 to August 2018 using dicycloplatin to treat patients with malignant tumors. The efficacy and adverse reactions were evaluated after at least 2 cycles of chemotherapy.  Results  Among the 20 patients with an average of 4 cycles of chemotherapy, 1 had complete remission (CR), 4 had partial remission (PR), 7 had stable diseases (SD), 8 had progression (PD). The total efficacy was 25%. The control rate was 60%. The KPS scores for quality of life was higher than that before treatment (P<0.05). The main adverse effects during chemotherapy were bone marrow suppression, gastro-intestinal reactions. The incidence of leukopenia, thrombocytopenia, reduced hemoglobin, nausea vomiting and liver damage was 45%, 35%, 50%, 20%, and 5%, respectively.  Conclusion  Dicycloplatin-based chemotherapy has a good curative effect on malignant tumors, and the adverse reactions are mild and tolerable, which deserves further clinical observation and application.
Medical big data analysis of the clinical off-label use of proton pump inhibitors
MAO Xufeng, YANG Zhangwei
2020, 38(2): 184-188. doi: 10.3969/j.issn.1006-0111.201909086
Abstract(2618) HTML (1410) PDF (554KB)(45)
Abstract:
  Objective  To explore the main causes of the overuse of proton pump inhibitor (PPIs) in domestic hospitalized patients.  Methods  The electronic medical records of patients in 20 general hospitals from January 1, 2015 to March 31, 2018 were analyzed. The distribution of indications of PPIs, the distribution of different uses of PPIs, the most often diseases of patients using the off-label medications, surgeries and combined medication, etc. were analyzed.  Results  The number one indication of PPIs was the prevention of NSAIDs-related ulcer, which accounted for 40.9% of the patients and 34.2% of them was off-label users. Among the off-label patients, lansoprazole was the most highly used, which accounted for 48.1%. The most often diseases, surgeries and combined medications of the patients using PPIs were the diseases of esophagus, stomach and duodenum, gallbladder and biliary surgery and mineral supplement.  Conclusion  The prevention of drug-induced ulcers and the off-label use is the main reasons for the huge amount of PPIs usage. The application of lansoprazole is not standardized; The main causes of the off-label PPIs usage are gastrointestinal discomfort, fasting, surgery and glucocorticoids.
Effects of comprehensive intervention on the application of special-use-grade antibacterial agents and on bacterial resistance in oncology department
WANG Tao, ZHOU Baozhu, YU Fang, ZHU Jie, WANG Ying
2020, 38(2): 189-192. doi: 10.3969/j.issn.1006-0111.201908070
Abstract(2511) HTML (1135) PDF (445KB)(23)
Abstract:
  Objective  To investigate the comprehensive intervention of special-use-grade antibacterial agents and their effects on bacterial resistance in oncology department, and analyze the effects of comprehensive intervention.  Methods  The medical records of 63 patients discharged from January to June 2017 were used as the control group, and the medical records of 61 patients discharged from January to June 2018 were used as the intervention group. The changes in the indicators of special-use-grade antibacterial agents before and after the intervention were compared.  Results  After comprehensive intervention, the pass rate of online consultation of special-use-grade antibacterial agents increased from 65.34% to 98.00%, with a statistical difference (P<0.05). DUI values of linezolid, amitraconam, carbophenazim and voriconazole decreased from more than 1 to less than 1. The usage rate of single use antibacterial agents was significantly increased, and the usage rate of combination of antibacterial agents was significantly decreased (P<0.05). Main pathogenic bacteria for escherichia coli, klebsiella pneumoniae, pseudomonas aeruginosa, staphylococcus aureus, white smooth candida yeast and candida, and their constituent ratio had no significant change. Except for klebsiella pneumoniae, the resistance rate of imipenem increased by 16.67%, while resistance rate of other pathogens is in a downward trend.  Conclusion  The comprehensive intervention makes the clinical application of special-use-grade antibacterial agents in oncology department increasingly reasonable.