抗菌药物的合理联合使用

抗菌药物是指由微生物(如细菌、真菌、放线菌)所产生的化学物质-抗生素及人工半合成、合成的一类药物的总称。应用一种以上抗菌药物治疗感染性疾病一直是个争论的问题。本人结合临床的经验,认为抗菌药物的合理联合应用应注意以下问题。1掌握抗菌药物的合理联合应用目的抗菌药物     

微生物药物筛选研究进展

微生物药物是指具有抗微生物作用及其它生理活性的微生物次生代谢产物及其衍生物。具有抗微生物感染及抗肿瘤等作用的抗生素是人类在二十世纪取得抗感染决定性胜利的最重要的武器 ,是经典的微生物药物 ,其在临床上占有不可替代的重要地位。而近二十年来不断发现和开发成功的非抗菌性的特异性酶抑制剂、免疫调节剂和受体拮抗剂等的生理活性物质已经成为当今微生物药物研究与开发的主体。微生物药物的筛选研究符合药物筛选的一般规律 ,但又有其自身的特殊性。药物筛选是指以获得新型药物先导化合物为目标的新药发现过程。经典微生物药物———…     

抗菌药物的作用机制

抗菌药物一般是指由真菌、细菌、放线菌等微生物经培养所生产的抗生素及人工半合成或全合成的类似或相同的一类药物的总称.临床应用非常广泛,抗菌药物的合理使用,可预防药源性疾病、减少不良反应、提高疗效并用于降低医疗成本.     

抗感染化疗的药理学基础概述 Ⅲ、细菌对抗菌药物的耐药机制

1.抗菌药物耐药性现状 抗菌药物并非如其发现初期时某些人曾预料的会最终消灭细菌性疾病。相反,各类致病细菌已经通过多种途径来对抗抗菌药物的作用,即形成了耐药细菌。细菌对抗菌药物耐药性的问题已在近年来引起了社会的极大关注,如对于目前抗菌药物耐药性的严重性,一些世界知名学者提出了目前面临着“抗生素耐药性危机”或“后抗生素时代”,这些提法足以说明细菌对抗菌药物(抗生素)耐药性的严重现状。     

近期抗生素进展与趋势概述

一、抗生素化疗现状抗生素及其他抗菌药物应用于临床数十年。许多危及人类生命及健康的感染性疾病得到了一定程度的控制,心脑血管疾病和癌症转而成为威胁人类的主要疾病,但抗感染化疗仍然在临床医学中占据着重要地位。临床分离的细菌感染病原菌,总的趋势是革兰     

德用厌氧菌研制出抗菌物质

据新华社柏林电,德国莱布尼茨自然物质与传染病生物学研究所的科研人员报告说,他们利用厌氧菌制造出一种新的抗菌物质,这种化合物在抑制一些有耐药性的细菌方面很有效,有可能用于研制新型抗生素。研究人员介绍说,自从发明抗生素以来,微生物中的自然物质一直是抗生素的重要来源。然而一些病菌非常“聪明”,总能想方设法适应抗生素的作用并形成抗体,金黄色葡萄球菌就是典型例子。这种病菌的某些菌株已对常用抗生素甲氧西林产生耐药性,变成有“超级病菌”之称的耐甲氧西林金黄色葡萄球菌,可导致严重甚至致命的炎性反应。该研究所的科研人员通过在实验室中模拟“解纤维梭菌”的自然营养环境,促使这种厌氧菌合成了一种化合物。这种化合物含有很多硫原子,化学结构非常特殊。初步研究显示,这种化合物对于耐甲氧西林金黄色葡萄球菌等耐药病菌的抑制效果显著。     

放线菌的次级代谢产物及其抗菌抗肿瘤活性

如今,临床耐药菌株的迅速出现和癌症威胁的不断上升迫使人类不断寻找新的化合物来治疗顽疾.纵观新化合物的发现史,它们中的大多数来自资源微生物.其中广泛存在于自然界多种生境中的放线菌(Actinomycetes,ACT),因其次级代谢产物结构新颖、作用独特,有着广泛的抗菌、抗肿瘤活性,成为开发新型抗菌、抗肿瘤药物的宝贵资源,具有巨大的应用价值.目前临床上广泛使用的天然源抗生素有超过三分之二是放线菌产生的,其中链霉菌属放线菌作为放线菌家族的优势菌种,已经成为探索和发现新型生物活性化合物的重要宝库.放线菌可以产生多种不同类别抗生素,例如β-内酰胺类、氨基糖苷类、糖肽类、大环内酯类、四环素类、多烯类和烯二炔类等.本文重点介绍放线菌具有抗菌抗肿瘤活性的次级代谢产物及其作用机制.     

抗感染化疗的药理学基础概述——一、抗菌药物临床应用的药理学基本知识

本文简介抗菌药物的基本理论知识。阐述了抗菌药物在临床应用的重要意义,抗菌药物分类、抗生素后效应,细菌耐药性,抗菌药物应用的药动学原则,联合用药的指征、抗菌药物的毒副反应,药物剂量与疗程及预防性使用抗菌药物问题等。     

我院2012年度抗菌药物临床应用情况分析

目的：了解我院2012年度抗菌药物临床应用情况,评价抗菌药物使用的合理性.方法：以卫生部颁布的抗菌药物临床应用指标为标准,对我院门诊和住院患者2012年度每月抗菌药物使用情况进行统计分析.结果：通过抗菌药物临床应用专项整治,到2012年12月,门诊患者抗菌药物处方比例为17.38％,住院患者抗菌药物使用率53.22％,住院患者抗菌药物使用强度40.366DDD,Ⅰ类切口手术抗菌药物使用率16.79％,接受抗菌药物治疗住院患者微生物检验样本送检率达53.37％.结论：抗菌药物临床应用基本合理,极少数抗菌药物联用存在不合理现象.     

抗菌肽的制备和抗菌机制研究进展

目前,所有的常规抗生素都出现了相应的抗药性致病菌株,病原菌的抗药性问题已经日益严重地威胁着人们的健康。开发全新类型的抗生素是解决抗药性问题的一条有效途径。抗菌肽具有广谱抗菌性、抗菌活性高、种类多等优点,成为传统抗生素的理想替代药物。抗菌肽的来源非常广泛,如植物、动物、微生物等;不同抗菌肽的作用机制及其研究方法也有显著的差异。本文就抗菌肽的制备、抗菌机制和研究抗菌机制的方法做一概述。     

Pain and Effusion and Quadriceps Activation and Strength

Context:

Quadriceps dysfunction is a common consequence of knee joint injury and disease, yet its causes remain elusive.

Objective:

To determine the effects of pain on quadriceps strength and activation and to learn if simultaneous pain and knee joint effusion affect the magnitude of quadriceps dysfunction.

Design:

Crossover study.

Setting:

University research laboratory.

Patients or Other Participants:

Fourteen (8 men, 6 women; age = 23.6 ± 4.8 years, height = 170.3 ± 9.16 cm, mass = 72.9 ± 11.84 kg) healthy volunteers.

Intervention(s):

All participants were tested under 4 randomized conditions: normal knee, effused knee, painful knee, and effused and painful knee.

Main Outcome Measure(s):

Quadriceps strength (Nm/kg) and activation (central activation ratio) were assessed after each condition was induced.

Results:

Quadriceps strength and activation were highest under the normal knee condition and differed from the 3 experimental knee conditions (P < .05). No differences were noted among the 3 experimental knee conditions for either variable (P > .05).

Conclusions:

Both pain and effusion led to quadriceps dysfunction, but the interaction of the 2 stimuli did not increase the magnitude of the strength or activation deficits. Therefore, pain and effusion can be considered equally potent in eliciting quadriceps inhibition. Given that pain and effusion accompany numerous knee conditions, the prevalence of quadriceps dysfunction is likely high.Key Words: arthrogenic muscle inhibition, central activation failure, voluntary activation, muscles

Key Points

• Knee pain and effusion resulted in arthrogenic muscle inhibition and weakness of the quadriceps.
• The simultaneous presence of pain and effusion did not increase the magnitude of quadriceps dysfunction.
• To reduce arthrogenic muscle inhibition and improve muscle strength, clinicians should employ interventions that target removing both pain and effusion.

Quadriceps weakness is a common consequence of traumatic knee joint injury^1,2 and chronic degenerative knee joint conditions.^3,4 Arthrogenic muscle inhibition (AMI), a neurologic decline in muscle activation, results in quadriceps weakness and hinders rehabilitation by preventing gains in strength.⁵ The inability to reverse AMI and restore muscle function can lead to decreased physical abilities,⁶ biomechanical deficits,⁷ and possibly reinjury.⁵ Furthermore, researchers^8,9 have suggested that quadriceps weakness resulting from AMI may place patients at risk for developing osteoarthritis in the knee. In light of the substantial influence of quadriceps AMI on these clinically relevant outcomes, we need to improve our understanding of the factors that contribute to this neurologic decline in muscle activity so efforts to target and reverse it can be implemented and gains in strength can be achieved more easily.Joint injury and disease are accompanied by numerous sequelae (ie, pain, swelling, tissue damage, inflammation), so ascertaining which one ultimately leads to neurologic muscle dysfunction is difficult. Whereas a joint effusion can result in AMI,^10–12 the effects of pain are less understood despite many clinicians attributing AMI to pain. Using techniques that introduce knee pain without accompanying injury may provide insights into the role of pain in eliciting AMI.The degree of knee joint damage may play a role in the quantity of AMI that manifests. Hurley et al^13,14 demonstrated that quadriceps AMI, measured using an interpolated-twitch technique, was greater in patients with extensive traumatic knee injury (eg, fractured tibial plateau, ruptured medial collateral ligament, and medial meniscectomy) than patients with isolated joint trauma (ie, isolated anterior cruciate ligament [ACL] rupture). Similarly, patients with more knee joint symptoms (ie, greater number of symptoms and increased severity of symptoms) may present with greater magnitudes of quadriceps inhibition. Recently, investigators¹⁵ have suggested that patients with more pain display less quadriceps strength, supporting this tenet. Given that effusion and pain often present simultaneously with joint injuries and diseases, such as ACL injury and osteoarthritis, examining both the isolated and cumulative effects of these sequelae appears warranted to determine if they influence the magnitude of muscle inhibition.Experimental joint-effusion and pain models are safe and effective experimental methods that allow for the isolated examination of their effects on muscle function. The effusion model, whereby sterile saline is injected directly into the knee joint capsule,⁷ produces a clinically relevant magnitude of the joint effusion that may be present with traumatic injury. Effusion is thought to activate group II afferents responding to stretch or pressure,^16–18 which in turn may facilitate group Ib interneurons and result in quadriceps AMI.⁵ The pain model involves injecting hypertonic saline into the infrapatellar fat pad to produce anteromedial knee pain similar to that described in patients with patellofemoral pain syndrome.¹⁹ Pain is considered to initiate AMI through activation of group III and IV afferents that act as nocioceptors to signal damage or potential damage to joint structures.^16–18 The firing of these afferents then may lead to facilitation of group Ib interneurons, the flexion reflex, or the gamma loop, ultimately resulting in quadriceps inhibition.²⁰ Thus, these models allow us to create symptoms that are associated with knee injury and have the added benefit of providing a way to examine their effects in isolation.Therefore, the purpose of our study was to determine the effects of pain on quadriceps strength and activation and to learn if simultaneous pain and knee joint effusion would affect the magnitude of quadriceps dysfunction. We hypothesized that pain alone would result in quadriceps inhibition and that the magnitude of inhibition would be greater when effusion and pain were present simultaneously.     

即早基因c-fos与脑血管病及学习记忆

即早基因c-fos是广泛存在于原核细胞和真核细胞的高度保守基因.在正常情况下,c-fos基因参与细胞生长、分化、信息传递、学习和记忆等生理过程,而在病理情况下c-fos基因表达及调控变化与多种疾病的发生和发展有关.C-fos在中枢神经系统的某些部位可有基础水平的表达,但表达很低,当受到如脑缺血、脑出血、痫性发作、应激等刺激后,其在数十分钟内做出反应,在对外界刺激-转录耦联的信忠传递过程中起着核内第三信使的重要作用.     

Opportunities and challenges in the prevention and control of cancer and other chronic diseases: children's diet and nutrition and weight and physical activity

OBJECTIVE: The purpose of this article is to review the role of behavioral research in disease prevention and control, with a particular emphasis on lifestyle- and behavior-related cancer and chronic disease risk factors--specifically, relationships among diet and nutrition and weight and physical activity with adult cancer, and tracking developmental origins of these health-promoting and health-compromising behaviors from childhood into adulthood. METHOD: After reviewing the background of the field of cancer prevention and control and establishing plausibility for the role of child health behavior in adult cancer risk, studies selected from the pediatric published literature are reviewed. Articles were retrieved, selected, and summarized to illustrate that results from separate but related fields of study are combinable to yield insights into the prevention and control of cancer and other chronic diseases in adulthood through the conduct of nonintervention and intervention research with children in clinical, public health, and other contexts. RESULTS: As illustrated by the evidence presented in this review, there are numerous reasons (biological, psychological, and social), opportunities (school and community, health care, and family settings), and approaches (nonintervention and intervention) to understand and impact behavior change in children's diet and nutrition and weight and physical activity. CONCLUSIONS: Further development and evaluation of behavioral science intervention protocols conducted with children are necessary to understand the efficacy of these approaches and their public health impact on proximal and distal cancer, cancer-related, and chronic disease outcomes before diffusion. It is clear that more attention should be paid to early life and early developmental phases in cancer prevention.