337例过敏性喉头水肿的文献分析

摘 要 目的:回顾性分析过敏性喉头水肿的主要诱因、临床表现及治疗措施,探讨其规律特点从而为其预防、发现及临床治疗提供参考。方法：检索1980 2014年间万方数据知识服务平台及中国知网数据库中有关过敏性喉头水肿的文献报道,建立“过敏性喉头水肿数据库”,按照诱因对其分类描述分析,并对其临床表现和治疗措施进行词频分析。结果：查重剔除后,得到符合要求的记录337条,涉及药物、食物、保健品等10种因素,不同诱因导致的表现症状不尽相同,主要伴随症状为呼吸困难、声音嘶哑、呼吸急促、胸闷、心率加快、脉搏增快、口唇发绀、血压降低、咳嗽等;主要治疗方案多以患者取卧位吸氧及注射地塞米松、肾上腺素、异丙嗪、葡萄糖酸钙等抗过敏药物。结论：过敏性喉头水肿是一种较严重的呼吸道速发型变态反应性疾病,必须引起患者及医务工作者的重视,临床需根据不同诱因及表现症状区别治疗。     

罗格列酮的不良反应机制及应用研究进展

目的 分析罗格列酮不良反应产生机制,并结合其拓展应用文献,探讨该药物用途。方法 对已报道的罗格列酮相关文献进行整理。结果 经文献调研发现，罗格列酮长期使用可导致心力衰竭、液体潴留、骨流失、睾酮分泌减少、骨髓生成减少以及肝脏毒性等不良反应，近年来也有文献报道罗格列酮与其他药物联合使用治疗糖尿病、肿瘤等相关疾病。结论 进一步认识了罗格列酮对动物或人体的作用机制，罗格列酮的安全使用范围还有待进一步拓展。     

55例鲍曼不动杆菌血流感染的临床分析

摘 要探讨鲍曼不动杆菌血流感染患者的临床特征、感染危险因素及细菌耐药性,为临床合理用药和控制医院感染提供指导。方法：回顾性分析某院2011～2014年鲍曼不动杆菌血流感染患者的临床及微生物资料,包括患者基本情况、临床特点、基础疾病、微生物学特征及抗菌药物使用情况等。结果：收集到55例鲍曼不动杆菌血流感染患者,其中老年人占47.27%;基础疾病主要为脑血管疾病19例（34.55%）,糖尿病15例（27.27%）;科室分布重症医学科最多占16.36% ,18例患者进行了中央静脉置管。所有分离菌株对第三代头孢菌素耐药率最高,头孢哌酮/舒巴坦耐药率最低。结论：鲍曼不动杆菌血流感染多发于重症患者,对怀疑有鲍曼不动杆菌血流感染的患者应及时进行血培养,可经验性选用头孢哌酮/舒巴坦。同时需重视医院感染的预防与控制。     

1例肾衰合并MRSA血流感染患者应用万古霉素的药学监护

摘 要 目的：提高耐甲氧西林金黄色葡萄球菌（MRSA）血流感染患者应用万古霉素抗菌治疗效果。 方法：临床药师与医生配合对1 例肾功能衰竭合并MRSA血流感染患者应用万古霉素抗感染治疗实施药学监护。在分析疾病和用药特点、评估患者肾功能及治疗方案,结合肾脏替代治疗方案,通过监护万古霉素的谷浓度及不良反应和相互作用等方面为临床提供药学服务。结果：药师与医生紧密配合,肾功能衰竭患者应用万古霉素抗感染治疗安全、有效。 结论：临床药师在特殊病人的个体化药物治疗过程中起到了积极作用。     

强骨饮联合益生菌对大鼠骨质疏松性骨折的愈合作用

目的 研究强骨饮联合益生菌对大鼠骨质疏松性骨折的愈合作用。方法 将♂SD大鼠50只随机分成5组：一般骨折对照组、骨质疏松性骨折模型组、强骨饮组、益生菌组、强骨饮联合益生菌组,每组10只。骨质疏松性骨折模型组和所有治疗组均摘除双侧卵巢制备骨质疏松模型。6周后,每组制备右侧股骨干中段横行骨折模型。造模成功后即给予强骨饮组生药灌胃量102 g·kg^-1,益生菌组灌胃量12.5 g·kg^-1,未给药组灌胃等量生理盐水,每日1次,连续6周。骨密度扫描仪测定骨密度,Micro-CT扫描股骨相关参数,酶联免疫法测定大鼠血清骨源性碱性磷酸酶（bone alkalinephosphatase,BALP）、骨钙素（osteocalcin,OC）、I型胶原C端肽（type I procollagen carboxy-terminal propeptide,CTX-I）,生化仪测定钙浓度（Ca）。HE观察骨折骨痂组织病理变化。结果 与骨质疏松性骨折组比较,强骨饮组或益生菌组均可促进骨折愈合（增加骨小梁数量和骨密度）,增加骨形成参数（BALP和OC）和降低吸收参数（CTX-I）,而强骨饮联合益生菌组作用更明显。结论 益生菌和强骨饮均有促进骨质疏松性骨折愈合的治疗作用,联合用药效果更佳。     

环烯醚萜类化合物治疗氧化应激诱发疾病的研究进展

目的：综述环烯醚萜类化合物对氧化应激诱发的相关疾病可能的治疗机理。方法：查阅、总结国内外发表的氧化应激诱导的相关疾病的成因和环烯醚萜化合物调节相关疾病的可能机理的报道。结果：氧化应激可以引起广泛的细胞内损伤,从而诱发神经系统疾病、肿瘤和糖尿病等相关疾病。环烯醚萜类化合物可通过调节机体抗氧化应激的能力,预防和减缓相关疾病的发生和发展。结论：环烯醚萜类化合物降低机体氧化应激水平,对于开发此类化合物的新药具有广泛前景。     

肠道菌群相关的抗抑郁治疗研究进展

目的 介绍肠道菌群与抑郁症的病理机制以及相关治疗的研究进展,为后续以肠道菌为靶点的抗抑郁药物的研发提供帮助。方法 查阅近年来肠道菌群与抑郁症方面的33篇中英文文献进行分类总结,从肠道菌群的门、科、属水平的角度探讨了抑郁状态下肠道菌群多样性的变化,从分子水平上阐述了肠道菌与抑郁症发病机制之间的关系,总结现有相关研究,进一步探索以肠道菌群为靶点进行药物研发治疗的可行性。结果 肠道菌紊乱与抑郁症之间相互作用,现有益生菌等生物制剂可通过改善肠道菌群病理状态下的紊乱对抑郁症治疗起到缓解作用。结论 肠道菌群失调与抑郁的发生密切相关,以肠道菌为靶点的相关药物研发治疗,可能成为治疗抑郁症的新途径。     

GLP体系下对实验动物供应商审核的要求

目的：规范实验动物供应商管理。方法：依据《药物非临床研究质量管理规范》（GLP）等相关法规要求,对实验动物供应商审核相关流程和要求进行了论述。结果与结论：实验动物在药物安全性评价中占有极其重要的地位。通过规范实验动物供应商审核流程,加强动物来源控制,可以有效地提高药物非临床原始资料的有效性和真实性,充分发挥GLP体系下实验动物供应商审核的优越性,保证非临床研究水平。     

基于网络药理学和分子对接探究苍耳子散治疗过敏性鼻炎的作用机制

目的 基于网络药理学和分子对接探究苍耳子散治疗过敏性鼻炎的作用机制。方法 利用TCMSP、GeneCards、OMIM数据库筛选出苍耳子散治疗过敏性鼻炎的潜在作用靶点;运用Cytoscape 3.7.1软件构建苍耳子散-活性成分-靶点网络,并筛选出苍耳子散治疗过敏性鼻炎的核心成分;将苍耳子散治疗过敏性鼻炎的潜在作用靶点导入STRING平台,通过通过Cytoscape 3.7.1软件构建蛋白相互作用(PPI)网络,并筛选出核心靶点。使用DAVID数据库对苍耳子散治疗过敏性鼻炎的潜在作用靶点进行基因本体论(GO)功能富集分析和京都基因与基因组百科全书(KEGG)通路富集分析。利用AutoDock Vina 1.1.2软件对关键成分与关键靶点进行分子对接。结果 共收集苍耳子散的活性成分62个,苍耳子散与过敏性鼻炎的共同靶点214个,其中丝裂原活化蛋白激酶3(MAPK3)、信号传导与转录激活因子3(STAT3)、苏氨酸蛋白激酶(AKT1)等可能为治疗过敏性鼻炎的关键靶点。通过GO富集分析得到苍耳子散治疗过敏性鼻炎的作用基因靶点参与622个生物学过程、62个细胞成分、152个分子功能;KEGG分析得到162条通路,主要与免疫反应、细胞调控和受体等相关通路有关。分子对接证实核心靶点STAT3、MAPK3能自发地与关键成分芫花素、亚油酸乙酯等结合。结论 苍耳子散主要通过芫花素、亚油酸乙酯等与STAT3、MAPK3的结合来参与免疫、炎症相关信号通路和生物细胞过程的调节,最终起到治疗过敏性鼻炎的作用。     

脂肝康药效学研究

目的：观察脂肝康对动物实验性脂肪肝的治疗作用。方法：采用乙硫氨酸、高脂饲料复制动物脂肪肝模型,iv高分子右旋糖苷复制大鼠“血瘀”模型,观察脂肝康的作用。结果：脂肝康能明显降低实验性脂肪肝动物肝脏、血液中的总胆固醇（TC）、三酰甘油（TG）的量;明显抑制“血瘀”大鼠全血粘度的升高。结论：脂肝康对脂肪肝大鼠有明显的治疗作用。     

部分发达国家药师在社区传染病防治方面作用的分析与思考

目的：加强对部分发达国家药师在承担传染病防治方面所发挥作用的认识,吸取经验,进而提升我国药师的职业潜能。方法：通过在PubMed及中国知网上检索药师在传染性疾病防治中发挥作用的相关文献,通过文献综述,就国内外情况进行归纳、总结,从而得到启示,提出相关建议。结果：我国药师在重大传染病事件等方面都做出了一定的贡献,但与部分发达国家药师相比,我国药师在承担传染病防治的作用上还没有充分地发掘并发挥出来。结论：增强我国药师在传染病防治中所发挥的作用,不仅需要国家在政策上给予扶持,肯定药师的专业价值并赋予药师充分的权利来承担相应的传染病防治工作,同时也需要高等药学教育的改革完善及药师自身建设的加强。     

Olopatadine: a drug for allergic conjunctivitis targeting the mast cell

Importance of the field: Ocular allergic diseases are characterized by specific activation of conjunctival mast cells with subsequent release of preformed and newly formed mediators. Mast cells are thus the first therapeutic target of ocular anti-allergic treatments.

Areas covered in this review: In this review, a Medline literature search was conducted on conjunctival mast cells, their role in ocular allergy and mast cell stabilization by ocular anti-allergic compounds.

What the reader will gain: Olopatadine hydrochloride, a mast cell stabilizer and histamine receptor antagonist, has been shown to inhibit mast cell activation in an in vitro model of human mast cell culture, reducing histamine and TNF-α release and upregulating proinflammatory mediators in conjunctival epithelial cells. In the in vivo conjunctival allergen challenge (CAC) model in allergic subjects, combined with objective evaluations of tear mediators and cytology, olopatadine reduced histamine tear levels and all aspects of allergic inflammation, confirming the positive clinical effects observed in active allergic patients.

Take home message: Mast cells play a central role in the pathogenesis of ocular allergy. The CAC model is ideal for assessing the mast cell stabilizing effects of anti-allergic compounds. This review of clinical studies demonstrates the superiority of olopatadine compared with other topical allergic drugs.     

The role of probiotics on each component of the metabolic syndrome and other cardiovascular risks

Introduction: Probiotics are defined as live microorganisms that when administered in adequate amounts confer health benefits to the host. The consumption of probiotics has gained increasing recognition from the scientific community due to the promising effects on metabolic health through gut microbiota modulation.

Areas covered: This article presents a review of scientific studies investigating probiotic species and their effects on different risk factors of the metabolic syndrome (MetS). This article also presents a summary of the major mechanisms involved with gut microbiota and the components of the MetS and raises the key issues to be considered by scientists in search of probiotics species for treatment of patients suffering from this metabolic disorder.

Expert opinion: Probiotics may confer numerous health benefits to the host through positive gut microbiota modulation. The strain selection is the most important factor for determining health effects. Further studies may consider gut microbiota as a novel target for prevention and management of MetS components and other cardiovascular risks.     

Targeting the Notch signaling pathway in autoimmune diseases

Importance of the field: The Notch signaling pathway regulates a variety of processes and has been linked to diverse effects. Aberrant Notch function is important in several disorders. Pre-clinical studies have suggested that inhibition of Notch is an attractive approach to treat hematologic and solid malignancies. Many patients with refractory autoimmune diseases respond poorly to therapy and have significant morbidity and the treatment is highly toxic, so more effective therapies for autoimmune diseases are being examined.

Areas covered in this review: The role of the Notch pathway and therapeutic strategies targeting it in many illnesses, especially autoimmune diseases.

What the reader will gain: The Notch pathway has unique and attractive advantages for targeting. Targeting it has already been trialed in many experiments, which may show better efficacy and fewer side effects compared with classical drugs for the treatment. Targeting Notch might provide etiological rather than symptomatic treatment.

Take home message: Various methods targeting the Notch pathway have been under investigation. Rational targeting of the Notch signaling pathway in cancer and some autoimmune diseases has proven to be successful. Classical drugs for the treatment of autoimmune diseases are inefficient and toxic to some extent, and targeting the Notch pathway is a promising therapeutic concept. However, there are still many questions about targeting Notch in autoimmune diseases, and further investigation will be needed.     

Pharmacokinetics,pharmacodynamics and clinical efficacy of omalizumab for the treatment of asthma

Introduction: Omalizumab is a subcutaneously administrated monoclonal anti-IgE antibody indicated in adults, adolescents and children 6 years of age and older with moderate to severe allergic asthma uncontrolled by conventional pharmacological treatments and sensitization to at least one perennial allergen.

Area covered: This drug evaluation summarizes published data on pharmacokinetic and pharmacodynamic properties of omalizumab, on clinical efficacy and safety, including real-world evidence, and provides a medico-economic evaluation of the drug.

Expert opinion: Omalizumab represents an efficient therapeutic option for the management of patients with uncontrolled moderate/severe allergic asthma. It provides a significant reduction in the asthma exacerbation rate with a steroid-sparing effect, an improvement in quality of life in adults and adolescents, despite a lack of evidence about its efficacy specifically in severe allergic asthma. Clinical trials have demonstrated its efficacy in the pediatric population but further real-life evidence is expected to better characterize long-term effects in this population. There is still some debate about the optimal treatment duration but, to date, it is recommended not to stop the treatment as cessation has resulted in symptom recurrence. Omalizumab is an expensive treatment, but a key therapeutic option when used for uncontrolled severe allergic asthma.     

The use of terpenes and derivatives as a new perspective for cardiovascular disease treatment: a patent review (2008–2018)

Introduction: Terpenes are a class of secondary metabolites that can be found in a variety of animal and plants species. They are considered the most structurally diversified and abundant of all natural compounds. Several studies have shown the application of terpenes, such as carvacrol, linalool, and limonene in many pharmaceutical and medicinal fields, including cardiovascular disorders, the leading cause of death worldwide. Areas covered: In this review, the authors outlined patents from the last 10 years relating to the therapeutic application of terpenes for the treatment and/or prevention of cardiovascular diseases found in different databases, emphasizing the possibility of these compounds becoming new drugs that may help to decrease the burden of these disorders. Expert opinion: There has been a growing awareness over recent years of the therapeutic use of terpenes and their derivatives as new pharmaceutical products. Patents involving the use of terpenes have been especially important in the technological development of new strategies for the treatment of cardiovascular diseases by bringing new scientific knowledge into the pharmaceutical industry. Therefore, the development of biotechnologies using natural products should be encouraged in order to increase the variety of drugs available for the treatment of cardiovascular diseases.     

Novel prevention strategies for bacterial infections in cirrhosis

Introduction: Bacterial infections are a serious complication of cirrhosis, as they can lead to decompensation, multiple organ failure, and/or death. Preventing infections is therefore very relevant. Because gut bacterial translocation is their main pathogenic mechanism, prevention of infections is mostly based on the use of orally administered poorly absorbed antibiotics such as norfloxacin (selective intestinal decontamination). However, antibiotic prophylaxis leads to antibiotic resistance, limiting therapy and increasing morbidity and mortality. Prevention of bacterial infections in cirrhosis should therefore move away from antibiotics.

Areas Covered: This review focuses on various potentially novel methods to prevent infections in cirrhosis focusing on non-antibiotic strategies. The use of probiotics, nonselective intestinal decontamination with rifaximin, prokinetics and beta-blockers or fecal microbiota transplant as means of targeting altered gut microbiota, bile acids and FXR agonists are all potential alternatives to selective intestinal decontamination. Prokinetics and beta-blockers can improve intestinal motility, while bile acids and FXR agonists help by improving the intestinal barrier. Finally, granulocyte colony stimulating factor (G-CSF) and statins are emerging therapeutic strategies that may improve immune dysfunction in cirrhosis.

Expert Opinion: Evidence for these strategies has been restricted to animal studies and proof-of concept studies but we expect this to change in coming years.     

Treatment of bacterial vaginosis: what we have and what we miss

Introduction: The disturbing, foul-smelling discharge of bacterial vaginosis (BV) is a nuisance to women. Treatment possibilities for BV are limited and only achieve complete cure in 65 to 85% of cases. In most women, the condition relapses within weeks to months after treatment.

Areas covered: In search of new therapeutic actions to cure, prevent or delay recurrences of BV, PubMed and web of science were searched for papers with i) decent study layout, ii) proper statistics, iii) comparison group (placebo or standard treatment) and iv) language English, French, Dutch or German. The following keywords were used: bacterial vaginosis and treatment or management or therapy or prophylaxis or prevention. Results were grouped in treatment categories and were discussed.

Expert opinion: Clindamycin and metronidazole are the standard drugs for BV. As other antibiotic and acidifying treatments are progressively being studied, like tinidazole, rifaximin, nitrofuran, dequalinium chloride, vitamin C and lactic acid, more options have become available for switching therapy, combining therapies and long-term prophylactic use to prevent recurrences. Further studies are needed. Also, adjuvant therapy with probiotics may have a significant role in improving efficacy and in preventing recurrences. However, it is unlikely that probiotics will replace antibiotherapy.     

Cancer prevention and treatment using combination therapy with natural compounds

ABSTRACT

Introduction: Naturally occurring compounds play an essential role in the prevention and treatment of various cancers. There are more than 100 plant and animal based natural compounds currently in clinical use.

Areas covered: 1) The importance of natural products combinations in the prevention and treatment of cancer, 2) the need to maximize efficacy while minimizing side effects when using natural product combinations, and 3) specifics related to plant and animal derived natural products, as well as agents derived from natural products. Therapies using natural compounds that have been investigated, their rationale, mechanism of action and findings are reviewed. When the data warrant it, combined interventions that appear to increase efficacy (compared with monotherapy) while minimizing toxicity have been highlighted. Pubmed was used to search for relevant publications.

Expert opinion: Combination therapy with natural compounds has the potential to be more effective than single agent therapy. Similar to pharmacologic agents, the goal is to maximize efficacy while mimimizing potential side effects. There is an increasing research focus on the development of agents derived from natural products, with notable successes already achieved from the effort.     

儿童过敏原皮肤点刺试验213例分析

目的 了解本地区患变态反应性疾病儿童的过敏原,为预防和治疗儿童变态反应性疾病提供依据。方法 对儿科门诊2012年3月至2013年10月收治的213例5个月～14岁确诊变态反应性疾病患儿做过敏原皮肤点刺试验,变应原包括粉尘螨、户尘螨、狗毛、猫毛、蟑螂、蒿属花粉、羽毛、香烟、花生、牛奶、大豆、牛肉、扇贝、海虾、海蟹、芒果、鸡蛋清、鸡蛋黄。 结果 粉尘螨和户尘螨在支气管哮喘组阳性率最高(分别为67.8%和60.0%), 户尘螨和牛奶阳性率在荨麻疹/湿疹组较高(分别是25.7%和22.9%),支气管哮喘和变应性鼻炎吸入性变应原皮试阳性率高于食入性变应原。结论 吸入性变应原为儿童变应性疾病常见变应原,尘螨是本地区引起儿童哮喘的主要过敏原,户尘螨和牛奶是导致儿童荨麻疹/湿疹不能忽略的重要因素。