基于CiteSpace的国内外抗菌药物透过血脑屏障的研究进展及可视化分析

目的 利用科学文献可视化分析软件CiteSpace对国内外抗菌药物透过血脑屏障的研究现状、研究热点和发展趋势等进行客观全面的展示与分析，为临床用药提供有用的指导与参考。方法 以Web of Science数据库、CNKI数据库为检索对象，纳入建库至今发表的与抗菌药物透过血脑屏障研究相关的文献，使用Excel对原始数据进行初步的文献计量分析，使用CiteSpace对关键词、作者、期刊、机构、国家等进行科学文献可视化分析，形成相关的可视化科学网络图谱。结果 抗菌药物透过血脑屏障的研究主要集中在血脑屏障的结构与功能、中枢神经系统感染的预防与治疗、抗菌药物的PK/PD、新型抗菌药物、抗菌药物载体等方面，研究热度不断上升。美国、欧洲、日本都在抗菌药物透过血脑屏障研究方面有着突出的贡献，但是各国、各机构之间的合作交流并不密切。国内研究相比国外研究，存在起步时间晚、研究数量少、研究质量不高的缺陷，无论是发文量还是文章质量均落后于国外，需要加强与国际的合作交流与学习。结论 目前，抗菌药物透过血脑屏障的研究日益受到人们的重视，欧美与日本对抗菌药物透过血脑屏障的研究处于世界领先水平。国内研究与国外仍存在很大差距，需要加大对抗菌药物透过血脑屏障研究的投入，促进临床合理用药。     

Current and emerging osteoporosis pharmacotherapy for women: state of the art therapies for preventing bone loss

Introduction: Pharmacological options to address the imbalance between bone resorption and accrual in osteoporosis include anti-resorptive and osteoanabolic agents. Unique biologic pathways such as the Wnt/β-catenin pathway have been targeted in the quest for new emerging therapeutic strategies.

Areas covered: This review provides an overview of existing pharmacotherapy for osteoporosis in women and explore state-of–the-art and emerging therapies to prevent bone loss, with an emphasis on the mechanism of action, indications and side effects.

Expert opinion: Bisphosphonates appear to be a reliable and cost-effective option, whereas denosumab has introduced a simpler dosing regimen and may achieve a linear increase in bone mineral density (BMD) with no plateau being observed, along with continuous anti-fracture efficacy. Abaloparatide, a parathyroid-hormone-related peptide (PTHrP)-analogue, approved by the FDA in April 2017, constitutes the first new anabolic osteoporosis drug in the US for nearly 15 years and has also proven its anti-fracture efficacy. Romosozumab, a sclerostin inhibitor, which induces bone formation and suppresses bone resorption, has also been developed and shown a significant reduction in fracture incidence; however, concerns have arisen with regard to increased cardiovascular risk.     

卡泊芬净治疗儿童血液病合并侵袭性真菌病的临床评价

目的探讨卡泊芬净治疗儿童血液病合并侵袭性真菌病(IFD)的疗效及安全性。 方法选择2013年6月至2016年6月，于中山大学孙逸仙纪念医院儿科血液肿瘤病区诊断为合并IFD，并且接受卡泊芬净治疗的57例血液病患儿为研究对象。回顾性分析其临床病例资料。采用χ²检验及t检验，对本组血液病合并不同诊断级别IFD患儿的卡泊芬净治疗有效率、各诊断级别IFD卡泊芬净一线及二线治疗的有效率及不同诊断级别IFD的血液病患儿卡泊芬净治疗后12周生存率，卡泊芬净治疗有效和无效患儿的疗程，以及不同中性粒细胞缺乏时间患儿的卡泊芬净治疗有效率，进行统计学比较，并评价卡泊芬净治疗血液病合并IFD的安全性。本研究遵循的程序符合2013年修订的《世界医学协会赫尔辛基宣言》要求，并且与所有患儿监护人均签署卡泊芬净使用知情同意书。 结果①本组血液病患儿中，91.2%(52/57)为单一部位合并IFD，以肺部最为常见(78.9%，45/57)；确诊IFD为5例(8.8%)，临床诊断IFD为38例(66.7%)，拟诊IFD为14例(24.5%)。②卡泊芬净治疗57例血液病合并IFD患儿的总有效率为86.0%(49/57)。临床诊断和拟诊IFD患儿的卡泊芬净治疗有效率为90.4%(47/52)，高于确诊IFD患儿的40.0%(2/5)，并且差异有统计学意义(χ²＝9.597，P＝0.001)。③确诊和临床诊断IFD患儿的卡泊芬净一线治疗有效率为96.7%(29/30)，显著高于二线治疗的76.9%(10/13)，并且差异有统计学意义(χ²＝4.190，P＝0.041)。拟诊IFD患儿卡泊芬净一线治疗有效率为90.0%(9/10)，亦显著高于二线治疗的25.0%(1/4)，并且差异有统计学意义(χ²＝5.915，P＝0.015)。④确诊、临床诊断及拟诊IFD的血液病患儿卡泊芬净治疗后12周的生存率比较，差异无统计学意义(P>0.05)。⑤卡泊芬净治疗有效患儿的疗程为(16±7) d，显著长于治疗无效患儿的(8±6) d，并且差异有统计学意义(t＝3.730，P＝0.032)。⑥卡泊芬净对中性粒细胞缺乏时间≥14 d患儿的治疗有效率为66.6%，显著低于中性粒细胞缺乏时间<14 d患儿的92.9%，并且差异有统计学意义(χ²＝6.284，P＝0.012)。⑦本组患儿无一例发生与使用卡泊芬净相关的不良反应。 结论卡泊芬净治疗儿童血液病合并IFD疗效确切，患儿中性粒细胞缺乏可影响其疗效。该药无明显药物不良反应，推荐应用于血液病合并IFD儿童一线抗真菌治疗，治疗疗程建议>14 d。     

Lollipop supplements- nutrient-dense foods or sweets in disguise?

The consumption of dietary supplements (DSs) is rising among children. Lately the composition of such products has come under considerable criticism. Sweetening agents (SA) were identified and quantified in dietary supplements, which take the form of lollipops (lollipop supplements) using HPLC and the calorific value of the analysed products was determined using a caloric bomb. The purpose of the study was to evaluate: (i) content of SA in lollipop supplements, (ii) energetic value of the daily dose of lollipop supplement vs the average energy requirement (AR) for children aged 3–12 and (iii) potential impact that the sweetening agents, found in lollipop supplements, may have on children’s health. The analysis of the energy values of the supplements’ daily doses shows a significant impact of such dose of supplement on the energy balance of the daily diet amounting to 12.74 % of a 7-year-old female child’s AR for energy (kcal/day).     

2012-2018年北京市抗结核药物使用趋势分析

目的分析北京市2012-2018年抗结核药物的使用情况与变化趋势,为北京市进一步规范及修改结核药物的使用策略提供数据参考。方法对2012-2018年北京市46家医院J04A类抗结核药物的销售金额、用药频度(Defined daily doses,DDDs)、药品限定日费用(Defined daily cost,DDC)等指标进行统计分析与评价。采用SPSS 22.0线性回归分析,判断变化趋势。结果 2012-2018年抗结核药销售金额逐年上升,而销售量在2016年到达高峰后缓慢下降;2012年和2018年相比抗结核的药物种类构成变动不大,各类药物销售金额构成变化较大;抗结核药物以一线、口服为主,二线、注射为辅,且二线用药的销售金额、DDDs和注射用药的销售金额有上升的趋势(P均<0.05);抗生素销售单价以注射类经济负担最重,且2018年较2012年,大部分种类药物都有不同程度的价格增长。结论抗结核药物的DDDs在2012-2018年间保持平稳,但大部分种类抗结核药物的DDC均出现上升趋势,患者经济负担增大,且抗结核药物使用存在用药集中的现象,带来的耐药风险不容忽视。     

Chronic mucocutaneous anogenital herpes: series of ten cases and literature review

Anogenital herpes is one of the most prevalent sexually transmitted infections worldwide. It has several clinical manifestations, from cases of primary herpes infection to recurrent forms, among them chronic mucocutaneous herpes. This presentation is rare, characterized by a duration of more than four weeks, usually associated with immunosuppression and resistance to classic anti-herpetic treatment. The present study presents a series of ten cases of chronic mucocutaneous herpes with a discussion about its clinical, laboratory, and therapeutic aspects.     

Role of antimicrobial photodynamic therapy in the treatment of aggressive periodontitis: A systematic review

BackgroundThe aim was to assess the efficacy of antimicrobial photodynamic therapy (aPDT) in the treatment of aggressive periodontitis (AgP).MethodsThe addressed focused question was “Is aPDT effective in the treatment of AgP?” MEDLINE/PubMed, EMBASE, Scopus, ISI Web of knowledge and Google-Scholar databases were searched from 1977 till May 2015 using combinations of the following keywords: antimicrobial; photochemotherapy; photodynamic therapy; photosensitizing agents; AgP; scaling and root-planing (SRP). Reviews, case reports, commentaries, and articles published in languages other than English were excluded.ResultsSeven studies were included. In 5 studies, aPDT was performed as an adjunct to SRP. Laserwavelengths and duration of irradiation ranged between 660–690 nm and 60–120 s, respectively. Laser power output as reported in 2 studies was 75 mW. One study showed significant improvement in periodontal parameters for subjects receiving aPDT as an adjunct to SRP as compared to treatment with SRP alone at follow up. However, comparable periodontal parameters were reported when aPDT as an adjunct to SRP was compared to SRP alone in the treatment of AgP in one study. One study showed comparable outcomes when aPDT was compared to SRP in the treatment of AgP. In two studies, adjunctive antibiotic administration to SRP showed significantly better outcomes when compared to application of adjunctive use of aPDT to SRP.ConclusionaPDT is effective as an adjunct to SRP for the management of AgP, however, further randomized clinical trials with well defined control groups are needed in this regard.