Changes in the Consumption of Antibiotics and Resistance Rate of Escherichia coli after Special Rectification as Well as Their Correlation Analysis in Inpaitents of Our Hospital / 中国药房

OBJECTIVE:To provide reference for rational use of antibiotics in clinic.METHODS:The quarterly information about the consumption of antibiotics in inpatients of our hospital during Jan.2012-Dec.2016 were collected from Center for Antibacterial Surveillance.DDDs of various antibiotics and Escherichia coli were analyzed statistically;the detection of E.coli,producing ESBLs and drug resistance during the same period were also analyzed statistically.The correlation between DDDs of antibiotics and resistance rate was investigated by Pearson test.RESULTS:During 2012-2016,DDDs of cephalosporins was the highest in inpatients of our hospital,followed by cephamicins and macrolides.Total DDDs of antibiotics showed a decreasing trend and a slight rebound in 2016.After 2013,DDDs of most antibiotics were basically same to the change of total DDDs.However,DDDs of compound preparations of penicillin and β-lactamase inhibitors,cephalomycm,carbapenems and glycopeptides showed an upward trend.In 2012,DDDs of second-generation cephalosporin was the highest among cephalosporins;since 2013,DDDs of first-generation cephalosporin was the highest in this category.Anti-E.coli drugs included piperacillin sodium and tazobactam sodium,ceftazidime,ceftriaxone,cefepime,cefoxitin,aztreonam,meropenem,gentamicin,levofloxacin.Among anti-E.coli drugs,DDDs of cefatriaxone was the highest in 2012,while that of cefoxitin was the highest in 2016;the consumption of aztreonam decreased most obviously.During 2012-2016,110,132,104,131,243 strains of E.coli were detected in our hospital respectively.The rate of producing ESBLs decreased to 56.6％,57.0％,50.6％,48.4％,45.0％.E.coli was highly resistant to ampicillin,cefazolin,ceftriaxone and compound sulfamethoxazole,while poorly resistant to piperacillin sodium and tazobactam sodium,cefoxitin,imipenem and amikacin.Resistance rate of piperacillin sodium and tazobactam sodium was positively correlated with DDDs of ceftriaxone,aztreonam,gentamicin,levofloxacin,cephalosporins (fast-,third-generation cephalosporins),tetracyclines,quinolones and total DDDs (r were 0.880 to 0.929,P＜0.05).Resistance rate of ceftazidime was positively correlated with DDDs of ceftriaxone,aztreonam,gentamicin,levofloxacin,cephalosporins (fast-,second-,third-generation cephalosporins),tetracyclines,quinolones and total DDDs (r were 0.888 to 0.991,P＜0.05).Resistance rate of cefepime was positively correlated with DDDs of aminoglycosides(r was 0.901,P＜0.05).Resistance rate of gentamicin was negatively correlated with DDDs of compound preparations of penicillin and β-lactamase inhibitors,cefepime (r were-0.914,-0.921,P＜0.05).Resistance rate of imipenem was negatively correlated with DDDs of ceftriaxone,aztreonam,gentamicin,levofloxacin,cephalosporins (fast-,second-,third-generation cephalosporins),aminoglycosides,tetracyclines,quinolones and total DDDs (r were-0.994 to-0.878,P＜0.05).Resistance rates of anti-E.coli drugs were all independent from their DDDs (P＞0.05).The rate of E.coli producing enzyme was positively correlated with resistance rate of gentamicin(r was 0.955,P＜0.05),while was independent from resistance rate or DDDs of other drugs (P＞0.05).CONCLUSIONS:After antibiotics special rectification,total consumption of antibiotics in inpatients of our hospital show a downward trend,and the varieties also change greatly.Although drug resistance is serious,the rate of producing enzyme is decreasing.Antibiotics should be selected carefully according to the monitoring data of bacterial resistance,drug sensitivity test results,the correlation between the consumption of antibiotics and resistance rate so as to reduce the occurrence of bacterial resistance.

Correlation of Pinellia ternata agglutinin and Pinellia ternata raphides' toxicity / 中国中药杂志

<p><b>OBJECTIVE</b>To study the correlation of Pinellia ternata agglutinin (PTA) and toxicity of P. ternata raphides and to find out the toxic mechanism of P. ternata.</p><p><b>METHOD</b>PTA has obvious effect of pro-inflammation. The model of rats peritonitis was used to study the dose-toxicity and time-toxicity relationship of the effect by detecting the releases of inflammatory mediators PGE2 in the exudates. The model of Draize rabbit eye test was applied to determine the correlation of PTA and toxicity of raphides by pathological examination.</p><p><b>RESULT</b>PTA enhanced the content of PGE2 and protein in rats peritoneal cavities concentration dependently. With PTA concentration increased, PTA enhanced the inflammation induced by raphides to rabbit eyes, but PTA alone had no toxicity response.</p><p><b>CONCLUSION</b>PTA had obvious effect of pro-inflammation. The toxic mechanism of P. ternata was PTA induced inflammation only when the raphides pierce into the organization.</p>

Study on new toxicity-reducing methods of pinellia rhizoma prepared by ethanol (I)-new methods and technology / 中国中药杂志

<p><b>OBJECTIVE</b>To explore new toxicity-reducing methods of Pinellia Rhizoma prepared by ethanol and the latest technical parameters.</p><p><b>METHOD</b>Pinellia Rhizoma is prepared with ethanol. The orthogonal experimental design was adopted for investigating amount of ethanol, preparing time, ethanol concentration and preparing temperature. The optimal technology was determined by the comprehensive score of toxicological indicators of PGE2 content of rat celiac percolate, with the rabbit conjunctival irritation test as the intuitive validation on toxicology reduction. The pharmacodynamics validation was used to determine the reasonability of the preparation process.</p><p><b>RESULT</b>The optimal technology was that Pinellia Rhizoma was prepared by 75% ethanol at the temperature of 60 degrees C by 4 days, and then dried. The effect of relieving cough, reducing sputum and anti-inflammatory of Pinellia Rhizoma is not reduced after prepared by ethanol.</p><p><b>CONCLUSION</b>The optimal technology of Pinellia Rhizoma prepared by ethanol is simple and reasonable that it can be used as the new method to reduce toxicity and keep efficacy of Pinellia Rhizoma.</p>

Comparative study on toxicity of Euphorbia before and after being prepared by vinegar / 中国中药杂志

<p><b>OBJECTIVE</b>To study and compare the changes of toxicity of Euphorbia pekinensis, E. kansui and E. ebracteolata before and after being prepared by vinegar.</p><p><b>METHOD</b>Small intestinal accentuation of mice and peritoneal macrophage NO release experiments were assessed to investigate the changes of toxicity of the three Chinese Medicines of Euphorbia before and after being prepared.</p><p><b>RESULT</b>E. pekinensis, E. kansui and E. ebracteolata and vinegar can obviously promot small intestinal accentuation and peritoneal macrophage NO release with the intensity of toxicity in the order of E. kansui > E. pekinensis > E. ebracteolata. After being prepared with vinegar, the toxicity of the three medicines decreased obviously compared to crude one.</p><p><b>CONCLUSION</b>E. pekinensis, E. kansui and E. ebracteolata can induce inflammation and accelerate enterokinesis. After being prepared with vinegar, the irritation on Euphorbia decreased obviously.</p>