流感抗病毒药物治疗进展

流感是由正黏病毒科中的流感病毒引起的急性呼吸道传染病, 具有季节流行性和极强的传染性。在目前已知的四种类型的流感病毒中, 甲型流感病毒给人类健康带来的影响最大, 也给全球公共卫生带来了严重的威胁。迄今为止, 已有多种小分子抗流感病毒药物陆续投入临床, 为人类对抗流感病毒引起的急性呼吸道感染提供了有力的武器。然而, 流感病毒快速突变的特点使其逐渐对传统的抗病毒药物耐药, 使得现有抗流感病毒药物的有效性降低。因此, 开发更多针对流感病毒感染的治疗药物仍然迫在眉睫。本文综述近年来新提出的小分子抗流感病毒药物, 包括长效神经氨酸酶抑制剂拉尼米韦, 新型病毒聚合酶抑制剂巴洛沙韦、法匹拉韦、匹莫迪韦以及病毒核蛋白抑制剂、血凝素抑制剂等, 简要介绍药物药理作用并总结最新临床试验结果, 对未来流感治疗的研究进行展望, 为今后抗流感病毒药物研发提供参考。     

抗耐药性逆转录病毒药物研究的新进展

最近1种抗HIV-1感染疫苗的失败提示了抗逆转录病毒疗法对治疗HIV-1感染患者的重要性。迄今为止,2种病毒蛋白酶（逆转录酶和蛋白酶）的抑制剂对于HIV-1感染患者的存活有着显著影响。由于当前使用的抗逆转录病毒药物耐药性的发展,迫切需要新的能作用于病毒复制不同环节的抑制剂。本文综述了最近抗逆转录病毒药物的发现进展,并着重探讨了病毒进入、病毒DNA与宿主细胞基因组整合和病毒颗粒成熟等病毒复制阶段新抑制剂的发展。     

抗埃博拉病毒治疗性抗体研究进展

埃博拉病毒(EBOV)是一种烈性病毒,能够引起人类和灵长类动物发生埃博拉病毒病,死亡率高达50%~90%。它的生物安全等级为4级,高于艾滋病和严重急性呼吸综合征(SARS),后二者均为3级。2014年以来,EBOV在西非蔓延,已经夺去了数千人的生命。目前,在研的针对EBOV的防治药物包括疫苗、小分子药物和抗体等,其中抗体药物以其相对安全、靶向特异、副作用小等特点而倍受关注。国际上已经报道了16F6、KZ52等多株单抗,以及MB-003、ZMAb和ZMapp等在体内展现出优于单一抗体疗效的"鸡尾酒抗体组合"。实验性抗体ZMapp在应急条件下用于EBOV感染者的治疗,疗效显著;在中国,类似的抗体组合MIL77也完成应急储备,可在应急条件下用于患者治疗。本文将简述抗EBOV治疗性抗体的研究进展。     

HIV-1侵入抑制剂的研究进展

靶向于人类免疫缺陷病毒-1型（HIV-1）粘附、辅助受体衔接和融合等过程的抗病毒剂，均可作为侵入抑制剂，是新出现的颇具前景的治疗HIV-1感染的治疗药物。病毒的进化和耐药株的出现，在任何HIV-1新疗法的研发过程中仍将是需要重点考虑的问题。侵入抑制剂的研发面临的唯一挑战就是HIV-1包膜蛋白（Env）较高的变异性和柔性。本文主要介绍了处于临床前研究、临床试验或临床应用早期阶段的各种侵入抑制剂及其临床应用情况，以及影响其抗HIV-1效能的可能性因素。     

埃博拉病毒病治疗策略和新技术研究进展

埃博拉病毒(EBOV)能够引起人类高致死性埃博拉出血热,目前尚无安全有效的治疗策略和药物,但已经提出了一些对EBOV感染有显著疗效的候选治疗方法,包括混合单克隆抗体鸡尾酒疗法、多酶抑制剂和脂质纳米颗粒/小干扰RNA等。本文总结了在非人灵长类等动物模型上针对EBOV感染的治疗新策略和技术研究进展。     

“御敌于国门之外”——病毒入侵抑制剂的研究进展

 25年前,我们在国际上开辟了研发人类免疫缺陷病毒(human immunodeficiency virus,HIV)融合/入侵抑制剂和抗HIV多肽药物的全新领域。近6年来,我们在HIV、中东呼吸综合征冠状病毒(Middle East respiratory syndrome coronavirus,MERS-CoV)、埃博拉病毒(Ebola virus,EBOV)和寨卡病毒(Zika virus,ZIKV)入侵抑制剂的研发工作中取得了一系列重要研究成果。本文概要性地综述了相关高致病性病毒入侵抑制剂的研究进展。     

埃博拉病毒病之病原学

埃博拉病毒病(Ebola virus disease,EVD),以往称埃博拉出血热(Ebola haemorrhagic fever,EHF),是迄今发现的凶猛烈性传染病之一。自1976年发现于非洲的扎伊尔和苏丹后,至今已有8次较大规模的人群流行,均发生在非洲,平均病死率高达67.98%。EVD的病原体埃博拉病毒(Ebola virus,EBOV)是一种人兽共患病原体,虽然其自然储存宿主尚不完全清楚,但EBOV能造成非人灵长类动物(如黑猩猩、猴等)感染,并具有致死性。EBOV在分类上属于丝状病毒科(Filoviridae)的埃博拉病毒属(Ebolavirus),属内有5个种。各种间的毒力存在差异,以扎伊尔埃博拉病毒(Zaire-EBOV)致病性最强,也是引起2014年西非大规模流行的元凶。EBOV呈丝状,形态多样,以长丝分枝状为常见;病毒体由核心、核衣壳和包膜3部分构成,病毒基因组为单股负链RNA,可编码7种结构蛋白,在病毒复制、感染和致病中发挥重要作用。EBOV主要通过接触传播,目前对其致病机制尚不完全清楚。EBOV为生物危害度最高的4级病原体,与活病毒相关的检验和实验必须在生物安全4级(BSL-4)实验室中进行,其感染的临床诊断以检测血清中抗体、抗原和核酸为主,实时荧光定量反转录PCR检测阳性可作出诊断。EVD尚无特效治疗方法,疫苗尚在研制之中,临床上以辅助性支持疗法为主。     

抗登革病毒化合物及作用机制研究进展

登革病毒感染引起登革热,是一种蚊媒传播病毒,给人类的生命健康造成了严重的威胁。目前尚无有效的抗登革病毒药物和疫苗用于临床治疗和预防。因此,研究对病毒生命周期中起关键作用的蛋白及宿主受体,设计出抗登革病毒靶标的抑制剂,从而选择性地抑制病毒的感染复制具有重要意义。本文就目前在研的抗登革病毒化合物及作用机制进行综述。     

抗埃博拉病毒疫苗和核酸类药物研究进展

埃博拉病毒（EBOV）致病性和传染性强,死亡率高,常在西非热带地区暴发流行。目前相应的抗病毒药物和疫苗正加紧研发。 EBOV疫苗依据抗原递送方式主要可分为3类,包括基于非复制性病毒载体的疫苗、基于复制性病毒载体的疫苗和基于病毒蛋白抗原的疫苗。ChAd3-ZEBOV和VSV-EBOV是最具潜力的抗埃博拉疫苗。随着埃博拉病毒感染分子基础研究的深入,抗埃博拉病毒的核酸和核苷类似物药物也成为研究热点。     

浅析埃博拉病毒致病机制

埃博拉病毒（Ebola virus,EBOV）属于丝状病毒科的单股负链RNA病毒,人体感染后可导致致命的埃博拉病毒病（Ebola viral disease,EVD）。当前EBOV广泛流行于非洲大陆,传染性强、致死率高、曾造成多次大暴发,严重威胁着疫区人们的健康和生命。然而目前EBOV的致病机制尚不明确,本文仅就EHF发病机制的最新进展做一综述,供广大同行参考。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…