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China Pharmacy ; (12): 364-369, 2021.
Article in Chinese | WPRIM | ID: wpr-872691


OBJECTIVE:To provide reference for the ra tional use of carbap enems in tuberculosis patients. METHODS :Totally 12 576 tuberculosis inpatients were collected from our hospital. Multi-disciplinary team (MDT) model was adopted for carbapenems management in aspects of policy intervention ,technical support and staff training. Average hospitalization duration , mortality,nosocomial infective rate ,use and drug resistance of carbapenems were compared before (Mar. 2016-Mar. 2017)and after management (Apr. 2017 to Mar. 2019). Interrupted time series (ITS)analysis was used to analyze the utilization rate of carbapenems,DDDs,the proportion of carbapenems ’DDDs in the total antibiotics ’DDDs,the proportion of carbapenems ’cost in the total antibiotics ’cost before and after management. Pearson correlation analysis was conducted for DDDs of carbapenems with medical quality indicators and detection rate of carbapenems-resistant bacteria. RESULTS :After the management ,average hospitalization stay ,the cost of antibiotics ,DDDs of carbapenems ,the proportion of carbapenems ’DDDs in the total antibiotics ’ DDDs,the proportion of carbapenems ’cost in the total antibiotics ’cost,the utilization rate of carbapenems ’,and the drug resistance rate of some bacteria to carbapenems were significantly lower than those before the management (P<0.05). ITS analysis results showed that after management ,the utilization rate of carbapenems ,DDDs,the proportion of com carbapenems’DDDs in the total antibiotics ’DDDs and the proportion of carbapenems ’cost in the total antibiotics ’cost were decrease d by 4.491% ,220.276,6.535% ,11.747% , with statistical significance (P<0.05). Co mpared with before management ,above indexes were decreased by 0.330%,17.625, 0.308%,0.304% monthly,among which the utilization rate and DDDs of carbapenems were decreased significantly (P<0.05). Before management ,drug resistance rate of Pseudomonas aeruginosa to carbapenems was 21.80%,and those of Acinetobacter baumannii to meropenem and imipenem were both 4.60%;after management ,drug resistance rate of P. aeruginosa to imipenem was 13.00%,and those of A. baumannii to meropenem and imipenem were both 16.30%,with statistical significance before and after management (P<0.05). There was no statistical significance in drug resistance rate of Enterobacteriaceae (P>0.05). Pearson correlation analysis showed that carbapenems ’DDDs was significantly positively correlated with average hospitalization duration and antibiotics ’cost(P<0.05);imipenem’s DDDs was positively correlated with drug resistance rate of P. aeruginosa (P<0.05). CONCLUSIONS: MDT management can effectively standardize the use of carbapenem in tuberculosis patients , shorten hospitalization duration ,and reduce drug cost ,DDDs and drug resistance rate of some bacteria.

China Occupational Medicine ; (6): 542-546, 2017.
Article in Chinese | WPRIM | ID: wpr-881636


OBJECTIVE: To explore the effect of arsenic on the homeobox D10( HOXD10) gene expression in peripheral blood lymphocytes and human lung adenocarcinoma cell A549. METHODS: ⅰ) A total of 59 workers exposed to arsenic from a arsenic factory were selected as the exposure group and 17 local people without arsenic exposure were chosen as controls by using judgment sampling method. Hydride generation-cold hydrazine trapping-atomic absorption spectrometry was used to detect arsenic levels in urine of these 2 groups. The expression of HOXD10 in peripheral blood lymphocytes was detected by real-time fluorescent quantitative polymerase chain reaction( qRT-PCR).ⅱ) The A549 cells were treated with arsenic trioxide( As_2O_3) with concentration of 0. 0,0. 1,0. 5,1. 0 and 2. 0 μmol/L,and the survival rate of cells was examined by colorimetric assay. The expression of HOXD10 was detected by qRT-PCR. RESULTS: ⅰ) The levels of inorganic arsenic,methylarsonic acid,dimethyl arsenate,total arsenic in the urine,and the relative expression of HOXD10 mRNA in peripheral blood lymphocyte in exposure group were higher than that of the control group( P < 0. 05).ⅱ) As_2O_3 decreased the survival rate of A549 cells in a dose-dependent manner( P < 0. 01) and lead to a dose-dependent increase of HOXD10 mRNA expression( P < 0. 01). A549 cell survival rate and relative expression of HOXD10 mRNA showed a negative correlation,the correlation coefficient was-0. 777( P < 0. 01). CONCLUSION: Arsenic can up-regulate HOXD10 expression in the peripheral blood of occupational arsenic exposure individuals. As_2O_3 can inhibit the proliferation of A549 cells,which may be related to the up-regulation of HOXD10 expression.