氨基糖苷类抗生素的发展历程

抗生素的定义，首先来自于20世纪40年代链霉素的发现。在随后的几十年中，其他氨基糖苷类抗生素家族被大量发现并广泛应用，一度成为抗革兰阴性菌感染的首选抗生素。但由于其毒副作用较大，并且细菌对其不断产生耐药性，加上其他结构类别的新型抗生素的不断发现，使其一度几乎退出历史舞台。然而随着多重耐药细菌引起的感染率急剧上升，人们开始关注氨基糖苷类抗生素作为几种重要的治疗革兰阴性病原体的方案之一，并且发掘了其在治疗感染性疾病、艾滋病和遗传性疾病的潜力，使这个“老牌”抗生素重焕生机。     

肺胀宁煎联合抗生素治疗慢性阻塞性肺疾病急性加重期临床观察

目的观察肺胀宁煎治疗慢性阻塞性肺病急性加重期的临床疗效。方法选取2018年1月-2019年1月接受诊治的慢性阻塞性肺疾病急性加重期患者共计60例,采用信封法分为2组,对照组30例,应用左氧氟沙星注射液静点配合对症治疗,试验组30例,在对照组的基础上应用肺胀宁煎,观察2组患者血常规及治疗前后肺功能变化情况。结果治疗后2组血常规情况:白细胞试验组为:(7.21±2.7)×10^9/L,对照组为:(8.25±0.29)×10^9/L,中性粒细胞百分比试验组为:(57.3±10.2)%,对照组为(64.8±11.2)%,数据比较差异具有统计学意义(P<0.05)。治疗后肺功能水平试验组:(70.1±6.5)%对照组为:(61.4±8.6),明显高于对照组,2组数据比较有统计学差异(P<0.05),结论慢性阻塞性肺疾病急性加重期患者通过应用肺胀宁煎联合抗生素及对症支持治疗,可有效降低肺内炎性表现,有效恢复患者肺功能水平,提高临床疗效,控制病情,降低耐药性,临床疗效优异,值得临床推广。     

Preoperative Prophylactic Antibiotics in Total Hip and Knee Arthroplasty: What,When, and How

Although there are numerous nonpatient-related factors that may help reduce infection risk, the proper use of prophylactic antibiotics is most responsible for reducing infection. The role of prophylactic antibiotics is to reduce early periprosthetic joint replacement, which is accomplished by having adequate antibiotic tissue levels at the time of skin incision. The goal of this section of the symposium is to review current antibiotic recommendations, how to manage patients with a self-reported penicillin allergy, review the use of dual antibiotics, discuss the use of antibiotics in the outpatient total joint setting, as well as very briefly discuss the administration of intraosseous antibiotics in knee arthroplasty.     

Intestinal microbial metabolism of phosphatidylcholine: a novel insight in the cardiovascular risk scenario

Intestinal microbiota is a “dynamic organ” influencing host metabolism, nutrition, physiology and immune system. Among its several interactions, the role of a phosphatidylcholine metabolite derived by gut flora activity, i.e., trimethylamine-N-oxide (TMAO), allows perceiving a novel insight in the cardiovascular risk scenario, being a strong predictor of this condition. Based on current reports, including the paper of Tang et al., we describe here: the possible role of intestinal microbiota in cardiovascular risk as well as potential interventions to reduce gut flora TMAO production by diet, probiotics and antibiotics. Finally, we highlight the possibility of evaluating, monitoring and modulating TMAO in order to use its serum levels as a marker of cardiovascular risk in the next future, when the need of controlled studies on large series will be satisfied.