异甘草酸镁与多烯磷脂酰胆碱治疗脂肪肝的疗效

目的 对比异甘草酸镁与多烯磷脂酰胆碱治疗脂肪肝患者的临床疗效.方法 依照数字分表法将本院2018年12月—2021年4月纳入的60例脂肪肝患者分为两组,每组患者30例,其中实行多烯磷脂酰胆碱治疗的为参照组,实行异甘草酸镁治疗的为观察组,比较治疗效果.结果 对比参照组,观察组血脂水平显著低,差异有统计学意义(P<0.05...     

异甘草酸镁治疗抗结核药物性肝损伤疗效

目的 探讨异甘草酸镁(MgIG)治疗对抗结核药物引起肝损伤患者的疗效及细胞因子(IFN-γ, IL-10, TNF-α)的影响。方法 选取2016年2月至2019年12月昆明医科大学第六附属医院感染科就诊的符合抗结核药物性肝损伤诊断标准的轻度肝细胞损伤型患者,随机分为观察组使用MgIG治疗(n=25)和对照组使用多烯磷脂酰胆碱治疗(n=25)。比较两组患者治疗前后肝功能(ALT, AST, TBIL)和细胞因子水平(IFN-γ, IL-10, TNF-α)变化。结果 观察组患者治疗总有效率显著高于对照组患者(100% vs 76.0%, P<0.01)。两组患者IFN-γ、IL-10、TNF-α均较治疗前降低(P均<0.05);观察组IFN-γ, IL-10, TNF-α均低于对照组(P均<0.05)。Pearson相关分析显示,两组治疗前、治疗后的所有细胞因子水平与ALT呈正相关关系。结论 在轻度的抗结核药物性肝损伤中,MgIG快速改善肝功能可能与其降低炎症细胞因子相关。     

清肝祛湿活血方治疗非酒精性脂肪肝的疗效评价

目的:观察清肝祛湿活血方治疗非酒精性脂肪肝患者的临床疗效,并探讨其作用机制。方法:将112例非酒精性脂肪肝患者采用随机数字表法分为对照组(57例)和治疗组(55例)。对照组给予多烯磷脂酰胆碱胶囊;治疗组给予清肝祛湿活血方。治疗2个月,观察治疗前后两组患者消化系统彩超、肝功能、血脂水平、胰岛素抵抗指数(HOMA-IR)、体重指数(BMI)、腰围和证候积分。结果:治疗组总有效率优于对照组(P0.05);与治疗前比较,治疗后两组患者的谷丙转氨酶(ALT),谷草转氨酶(AST),总胆固醇(TC),甘油三酯(TG),低密度脂蛋白胆固醇(LDL-C),HOMA-IR,BMI及腰围均明显下降(P0.05,P0.01),且治疗组优于对照组(P0.05)。结论:清肝祛湿活血方能够显著改善非酒精性脂肪肝患者临床症状,降低体重指数、腰围,改善肝功能、胰岛素抵抗,调节血脂代谢。     

Drug development challenges and strategies to address emerging and resistant fungal pathogens

Introduction: Invasive fungal infections represent an expanding threat to public health. The recent emergence of Candida auris, which is often resistant to existing antifungal agents and is associated with a high mortality rate, underscores the urgent need for novel drug development strategies.

Areas covered: In this paper, we examine both challenges and opportunities associated with antifungal drug development and explore potential avenues to accelerate the development pipeline, including data sharing, surrogate endpoints, and the role of historical controls in clinical trials.

Expert commentary: We review important lessons learned from the study of other rare diseases, including mitochondrial storage diseases and certain forms of cancer that may inform strategies to develop new antifungal agents while highlighting promising new compounds such as SCY-078 for the treatment of invasive fungal infections.     

Standard dosing regimen of liposomal amphotericin B is as effective as a high-loading dose for patients with invasive aspergillosis: AmBiLoad trial

Invasive mold infections continue to account for significant morbidity and mortality in immunocompromised patients; outcomes are dependent on both underlying host factors and appropriate therapy. The antifungal armamentarium has gradually increased during the past, with liposomal amphotericin B (L-AMB) being an important representative. Still, the question of what dose to use – a maximum tolerated or a minimum effective – has yet to be answered. On this basis, a randomized trial comparing a high-loading dose regimen with a standard dosing of L-AMB (AmBiLoad trial) for primary therapy of mold infections was initiated. No significant differences in response between the treatment groups were detected, although recipients of the 10-mg/kg daily dose experienced higher rates of nephrotoxicity and hypokalemia. Uncontrolled malignancy and allogeneic stem cell transplantation were significantly associated with poor survival. This article analyzes the study, discusses the rationale and the results and concludes that this study supports the routine application of L-AMB.     

地衣芽胞杆菌与多烯磷脂酰胆碱联合治疗非酒精性脂肪性肝炎的疗效分析

目的：分析地衣芽胞杆菌与多烯磷脂酰胆碱联合治疗非酒精性脂肪性肝炎的疗效。方法选取2012年1月～2014年1月收治的非酒精性脂肪性肝炎患者92例,随机分为对照组和研究组,分别治疗后对比两组患者临床症状评分、体重指数（ BMI）、腰臀比（ WHR）、血常规以及B超评分。结果治疗后,研究组的临床症状明显较好, BMI、WHR评分低于对照组,P＜0.05;研究组的血常规与B超评分明显低于对照组,有统计学意义（ P＜0.05）。结论地衣芽胞杆菌与多烯磷脂酰胆碱联合治疗非酒精性脂肪性肝炎的疗效比单一多烯磷脂酰胆碱治疗效果好,无不良反应,值得推广应用。     

原子吸收分光光度法测定多烯磷脂酰胆碱中砷盐含量

目的：创新性地建立测定多烯磷脂酰胆碱中砷盐含量的原子吸收分光光度法。方法样品经混合酸消解后,采用原子吸收分光光度法在砷元素的特征吸收波长（193.7 nm）处测定砷。结果砷的质量浓度在0~20 ng/mL范围内与吸光度线性关系良好,r=0.9994（ n=5）,加样回收率良好。结论该方法操作简便、准确、干扰少,可用于多烯磷脂酰胆碱中砷盐含量的测定。     

Advances in the treatment of invasive neonatal candidiasis

Introduction: Invasive candidiasis is responsible for ～ 10% of nosocomial sepsis in very-low-birth-weight infants and is associated with substantial morbidity and mortality. Over the last two decades, the antifungal armamentarium against Candida spp. has increased; however, efficacy and safety studies in this population are lacking.

Areas covered: We reviewed the medical literature and extracted information on clinical and observational studies evaluating the use of antifungal agents in neonates with invasive candidiasis.

Expert opinion: Efficacy and safety data for antifungals in neonates are lacking, and the majority of studies conducted to date have concentrated on pharmacokinetic/pharmacodynamic evaluations. Unlike other anti-infective agents, efficacy data in the setting of neonatal candidiasis cannot be extrapolated from adult studies due to differences in the pathophysiology of the disease in this population relative to older children and adults. Data for amphotericin B deoxycholate, fluconazole, and micafungin suggest that these are the current agents of choice for this disease in neonates until data for newer antifungal agents become available. For prophylaxis, data from fluconazole randomized controlled trials will be submitted to the regulatory agencies for labeling. Ultimately, the field of therapeutics for neonatal candidiasis will require multidisciplinary collaboration given the numerous challenges associated with conducting clinical trials in neonates.     

注射用多烯磷脂酰胆碱与奥硝唑存在配伍禁忌

多烯磷脂酰胆碱用于肝硬化、肝昏迷、胆汁淤积的治疗,具有促进肝组织再生,稳定胆汁的生理功能。奥硝唑为抗菌药物,用于敏感厌氧菌所引起的多种感染性疾病。在临床用药过程中,我们发现上述两种药物存在配伍禁忌,为给临床提供用药依据,现报告如下。