Gut microbiota and osteoarthritis management: An expert consensus of the European society for clinical and economic aspects of osteoporosis,osteoarthritis and musculoskeletal diseases (ESCEO)

The prevalence of osteoarthritis (OA) increases not only because of longer life expectancy but also because of the modern lifestyle, in particular physical inactivity and diets low in fiber and rich in sugar and saturated fats, which promote chronic low-grade inflammation and obesity. Adverse alterations of the gut microbiota (GMB) composition, called microbial dysbiosis, may favor metabolic syndrome and inflammaging, two important components of OA onset and evolution. Considering the burden of OA and the need to define preventive and therapeutic interventions targeting the modifiable components of OA, an expert working group was convened by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) to review the potential contribution of GMB to OA. Such a contribution is supported by observational or dietary intervention studies in animal models of OA and in humans. In addition, several well-recognized risk factors of OA interact with GMB. Lastly, GMB is a critical determinant of drug metabolism and bioavailability and may influence the response to OA medications. Further research targeting GMB or its metabolites is needed to move the field of OA from symptomatic management to individualized interventions targeting its pathogenesis.     

期刊视角的近代上海名医文化效应研究

以中国近代中医药期刊为主视角,以近代中医名家为研究主体,探讨近代上海名医文化区域特征。近代上海名医多家学渊源,国学功底深厚,以文会友,在期刊阵营中思想活跃;上海为近代中医药期刊创刊的主阵地,名医办刊办学,刊学相辅,使中医教育呈现出师承、家学、院校、函授等多种模式相结合的发展趋势。生逢乱世的近代上海名医,将中医的命运与民族命运紧密相连,注重扶持民族企业,研发自主品牌,这标志着近代中医民族品牌意识开始觉醒。近代上海名医具有传统中医的特色,深受江南地域文化影响,又注重吸收和借鉴西方医学,形成了异彩纷呈的海派特色。     

现代化管理方法应用于医院药学管理的可行性研究

目的探究现代化管理方法应用于医院药学管理的可行性。方法该院于2017年7月开始在医院药学管理中实施现代化管理措施,具体实施的管理方法有品管圈法、精益管理法以及PDCA管理法,将2017年7月—2019年1月实施管理后的工作人员资料作为观察组,于2016年5月—2017年6月未实施管理措施的工作人员作为对照组,每组15名,对比统计两组管理质量、药学工作情况以及人员工作能力。结果观察组在管理措施实施后的药品管理质量、药剂调配质量以及护理满意评分均显著比对照组高,其不合理用药、抗菌药的重复率以及处方配伍出错率等均比对照组低,数据对比差异有统计学意义(P<0.05);两组人员的工作能力对比,观察组人员的能力明显优于对照组,差异有统计学意义(P<0.05)。结论医院药学管理中有机结合现代管理措施可进一步优化药学管理质量,降低临床用药不安全事件,值得药学临床借鉴使用。     

Radiotherapy in combination with nivolumab for relapsed/refractory classical Hodgkin lymphoma: About two cases

Hodgkin lymphoma is a highly curable malignancy involving lymph nodes and the lymphatic system. Even at late stage disease, about 70% of patients will be cured with standard first line therapy. For patients who experience relapse or refractory classical Hodgkin lymphoma, the standard treatment option is high-dose chemotherapy followed by autologous stem cell rescue or transplant. However about 50% of patients will have recurrence after high-dose chemotherapy followed by autologous stem cell rescue or transplantation and have worse prognosis with median overall survival of 32% at 5 years. The anti-PD1 checkpoints inhibitors pembrolizumab and nivolumab have remarkably improved outcomes of patients with relapse of refractory classical Hodgkin lymphoma after high-dose chemotherapy followed by autologous stem cell rescue or transplantation. On the other hand, radiotherapy is an entire component of salvage therapy and its efficacy is now well established in term of local disease control in sites of relapsed or refractory Hodkin lymphoma. Defining the optimal modality and timing of radiotherapy as these new agents arrive is a challenge. An interesting approach is the combination of radiotherapy with checkpoint inhibitor and the possibility of stopping the treatment when complete response is achieved. We add to the literature two new cases of combination of radiotherapy with immunotherapy in patients who relapsed after high-dose chemotherapy followed by autologous stem cell rescue or transplantation and consolidation with brentuximab vedotin, resulting in excellent outcomes.     

浅谈现代化设备对血液成分制备工作的影响

随着近些年科学技术的不断进步,关于制备血液的设备也陆续出现,改变了以往靠人工制备血液的传统方式,不仅增加血液储备,同时也避免了血液的浪费,提升了血站的血液供应能力,可减少不良事件发生例数,使信息一体化,能够帮助血液成分制备工作顺利进行。该文将细致探讨现代化设备对血液成分制备工作的影响。     

痛风的中西医研究进展＊

随着人民生活水平的不断提高，痛风的患病率呈逐年上升趋势。痛风如果治疗不当，反复发作可逐步导致组织破坏、骨侵蚀、关节疼痛和僵硬，给患者带来巨大痛苦，影响生活质量。西医治疗痛风主要目标是终止急性发作、控制血清尿酸及避免复发，虽然在终止急性发作和控制血清尿酸方面效果良好，但是实际应用中发现血尿酸的良好控制及达标并没有很好的避免痛风的复发。而且对于尿酸盐沉积的清除这个核心问题没有有效的治疗手段。中医药在改善临床症状及控制复发等方面往往有独特的疗效，同时还可以避免血尿酸控制的过低而带来的潜在风险，但背后的现代药理作用机制尚不明确，限制了临床应用和推广。此外，中医药是否可以促进核心问题尿酸盐沉积的溶解清除，还需要深入探索研究。现就痛风的中西医研究现状加以综述。     

蒋健以芍药甘草汤为主古方新用治疗脾胃病

从以芍药甘草汤为主治疗食管裂孔疝、胃黏膜脱垂症、肠鸣、反胃、帕金森病流涎案等脾胃病的临床验案出发,探讨基于现代医学疾病发病机制、基于现代药理研究成果的辨病论治思维模式和方法的临床可行性。指出辨病论治是对辨证论治的补充;辨病论治与辨证论治相结合有助于提高疗效。