新发病毒性传染病研究近况

1998年10月美国疾病预防控制中心阐明了21世纪的战略．即预防新发传染病（emerging infectious diseases，EID）。依据美国医学研究所1992年提出的定义．EID应包括过去20年人类中增加或可能增加的传染病．因此一般将1970年以来发现或认识的人类传染病纳入其中．EID的发现大致有3种情况．一是以前已经存在的疾病．因病原体的发现而被重新认识：二是以往的非传染性疾病．因病因的新发现而归入具有传染性的一类疾病：三是由于病原变异等多种复杂原因而新发生的传染病。3类疾病典型代表．分别是新发现的伯氏疏螺旋体引发的莱姆病、新认识的幽门螺杆菌所致的消化性溃疡和新发生的冠状病毒变异株引起的传染性非典型肺炎。至2005年末，报道EID约44种，其病原数量达58种或型之多．见表1．     

儿童病毒性脑炎74例的诊治体会

儿童病毒性脑炎７４例的诊治体会李波病毒性脑炎（以下称病毒脑）为一儿科常见病，它是病毒感染和机体免疫功能改变有关的中枢神经系统疾病，病情严重者可致死亡或造成残废及其它不同程度后遗症，包括儿童智力的发育障碍。为提高诊治水平，现将我院１９９１～１９９５年...     

病毒性心脏病的诊治进展

综述了病毒性心肌炎（VMC）及扩张型心肌病（简称扩心病,DCM）的诊断学研究和治疗新进展。病毒性心肌炎的诊断国内外尚无特异性标准,治疗了缺乏疗效十分确切的药物。中西药物联合治疗病毒性心脏病是发展方向之一。     

病毒性心肌炎临床诊治分析

目的 对多例病毒性心肌炎患者的临床诊治采取有效性措施,并根据该疗效进行有效性研究与分析。方法 50例心肌炎患者为实验对象,其中女30例,男20例。对患者的病情进行诊断时使用的方法是：心肌炎病理学理论、心电图、患者临床病征以及CT检查结果 ,同时需要采取科学有效的方法对其进行对症治疗。结果 50例病毒性心肌炎患者在经过一段时间的护理与治疗后,大多在住院14-32 d之后痊愈出院,病情均得到了有效的缓解与控制,并且在出院后的随访中并未有出现并发症、后遗症的病例。结论 对病毒性心肌炎患者采取科学有效的方法进行对症治疗,不仅有助于缩短患者的住院时间,而且大大减轻了患者的生理与心理压力,最重要的是极大的提高了治疗的痊愈率。     

小儿病毒性心肌炎的诊治进展

现今,小儿病毒性心肌炎发病日益增多,对其正确诊断和及时治疗尤为重要。现就近年来应用于病毒性心肌炎的诊断方法和治疗方法作一综述。     

小儿病毒性脑炎诊治现状

文章阐述了小儿病毒性脑炎的诊断、临床表现,以及目前治疗进展和预后相关因素,并提出小儿病毒性脑炎临床研究方向。     

30例新生儿病毒性脑炎的诊治体会

目的探讨新生儿病毒性脑炎的诊断和治疗。方法结合30例新生儿病毒性脑炎的临床表现及实验室仪器检查,对新生儿病毒性脑炎进行诊断和综合治疗。结果30例新生儿病毒性脑炎23例痊愈,5例好转,2例放弃治疗,3例留下后遗症。结论对新生儿病毒性脑炎早期诊断,早期治疗,以降低病死率和减少后遗症的发生。     

病毒性心肌炎的临床诊治特点分析

目的探讨病毒性心肌炎的临床诊治特点。方法选取2011年1月到2012年3月之间162例本院收治的病毒性心肌炎患者,对这些患者的临床诊断、治疗资料进行回顾性分析。结果经过有针对性的临床治疗,162例患者中治愈89例,占54.94%;显效51例,占31.48%;有效20例,占12.35%;无效2例,占1.23%;总有效率98.77%。治疗后各种心电图异常表现均明显减少,均具有显著性差异,P<0.05,具有统计学意义。结论对病毒性心肌炎患者进行早期的诊断和治疗,可有效提高治疗效果。     

急性病毒性心肌炎的诊治体会

目的探讨急性病毒性心肌炎的临床治疗方法。方法对16例心肌炎患者经过治疗观察其疗效及转归。结果16例患者11例痊愈。1例经激素治疗7d后恢复窦律3d,再次发生Ⅰ度房室传导阻滞,考虑可能是激素应用不足;1例为缓慢性心律失常;1例经临时起搏、激素治疗后度过急性期恢复窦律;1例在临时起搏器植入后2d发生室颤死亡;1例经激素、抗病毒及改善心肌代谢治疗后无好转行永久起搏器治疗,1例于入院10h后出现阿-斯综合征死亡。结论急性病毒性心肌炎经积极、正确、及时的治疗可降低死亡率及并发症的发生。     

儿童重症病毒性脑炎46例诊治分析

目的 探讨儿童重症病毒性脑炎诊断及治疗方法.方法 对我科收治的46例儿童重症病毒性脑炎的病例资料进行回顾性分析.结果 经综合治疗后完全治愈16例(34.8%),好转出院29例(63.0%),1例(2.2%)放弃治疗后死亡;3个月后复查继发癫痫12例(26.1%),智力倒退16例(34.8%),一侧肢体瘫痪1例(2.2%).结论 早期检查、早期诊断,采取正确的综合治疗方法可以提高儿童重症病毒性脑炎治愈率,降低病死率和致残率.     

Prion diseases and emerging prion diseases

Transmissible spongiform encephalopathies (TSEs), also called prion diseases, are fatal neurodegenerative disorders. An abnormal isoform of the prion protein (PrP(Sc)) generated by post-translational modification of the cellular prion protein (PrP(C)) is believed to be the main component of this infectious agent. PrP(Sc) is relatively resistant to proteinase K (PK) digestion. This characteristic has been widely accepted as the physicochemical basis for distinguishing between PrP(C) and PrP(Sc). PrP(C) is a glycoprotein that contains 2 Asn-linked glycosylation sites; it is present in the cells in 3 different glycoforms, including an unglycosylated form. Hence, for different prion strains, PrP(Sc) exhibits different glycoform patterns with different ratios of the 3 forms by western blot. Recently, phenotypes of TSEs have emerged that exhibit PrP(Sc) with different glycoform patterns and/or mild PK resistance in comparison with previously described typical cases. Regarding sheep scrapie, atypical scrapie cases that are represented by Nor98 have been reported among sheep previously presumed to be genetically scrapie-resistant. Moreover, atypical bovine spongiform encephalopathy (BSE) cases have been reported. These are classified into 2 phenotypes (H-type and L-type) based on the molecular weight of unglycosylated band of PK-digested PrP(Sc). The origin of these emerging prion diseases is obscure, conformational differences of PrP(Sc) may cause the different biological and biochemical characteristics of prion strains.     

Intravenous immunoglobulin: an emerging treatment for immune-mediated skin diseases

Intravenous immunoglobulins (IVIgs) exert a variety of immunomodulating activities and are therefore increasingly being used for the treatment of immune-mediated as well as autoimmune diseases. Although the exact mode of action is still poorly understood, the efficacy of IVIg in several diseases, such as thrombocytopenic pupura and Kawasaki disease, has been proven in clinical trials. According to some uncontrolled clinical studies and many case reports there is evidence for a high efficacy of IVIg in the treatment of skin diseases such as autoimmune blistering diseases, lupus erythematosus, dermatomyositis, scleroderma, toxic epidermal necrolysis, atopic dermatitis, chronic autoimmune urticaria and others. In contrast to other commonly used immunomodulating therapeutic strategies, the safety profile of IVIg treatment is significantly better. This update aims to give a current view on the efficacy and safety of IVIg treatment for dermatological diseases.     

Nutraceuticals--an emerging era in the treatment and prevention of cardiovascular diseases

Foods and nutrients play a vital role in normal functioning of the body. They are helpful in maintaining the health of the individual and in reducing the risk of various diseases. Worldwide acceptance of this fact formed a recognition link between "nutrition" and "health" and the concept of "nutraceuticals" was evolved. Nutraceuticals are medicinal foods that play a role in maintaining well being, enhancing health, modulating immunity and thereby preventing as well as treating specific diseases. Thus the field of nutraceuticals can be envisioned as one of the missing blocks in the health benefit of an individual. More than any other disease, the etiology of cardiovascular disease reveals many risk factors that are amenable to nutraceutical intervention. The scientific literature shows that several ingredients marketed for use in dietary supplements address each of these. The ability of nutraceuticals to positively influence cardiovascular risk factors should be recognized as an enormous opportunity in the treatment of a highly prevalent disease. Nutraceuticals hold promise in clinical therapy as they have the potential to significantly reduce the risk of side effects associated with chemotherapy along with reducing the global health care cost. In this review, an attempt has been made to summarize some of the recent research findings on garlic, omega-3-fatty acids, soy products, dietary fibres, vitamins, antioxidants, plant sterols, flavonoids, prebiotics and probiotics that have beneficial effects on the heart, in order to update the practising clinician on the benefit of using nutraceuticals for the management of cardiovascular diseases.     

Midkine: an emerging target of drug development for treatment of multiple diseases

Midkine is a multifunctional factor and has anti-apoptotic, migration-promoting, angiogenic, anti-microbial and other activities. Midkine ameliorates ischemic injury in the heart and brain, enhances oocyte maturation, and is involved in neurogenesis. On the other hand, midkine is an important factor in the etiology of various diseases, especially those with inflammatory backgrounds. Furthermore, midkine is overexpressed in most malignant tumors and plays roles in their invasive phenotypes as well as in their resistance to chemotherapeutics. Therefore, midkine itself is expected to be useful for the treatment of brain and heart diseases, while midkine inhibitors are promising for the treatment of malignant tumors, multiple sclerosis, restenosis, renal diseases, hypertension and osteoporosis. Blood levels of midkine are also expected to be helpful as disease markers, especially as cancer markers.

Linked Articles

This article is part of a themed section on Midkine. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2014.171.issue-4     

Drug combination therapy for emerging viral diseases

Effective therapeutics to combat emerging viral infections are an unmet need. Historically, treatments for chronic viral infections with single drugs have not been successful, as exemplified by human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infections. Combination therapy for these diseases has led to improved clinical outcomes with dramatic reductions in viral load, morbidity, and mortality. Drug combinations can enhance therapeutic efficacy through additive, and ideally synergistic, effects for emerging and re-emerging viruses, such as influenza, severe acute respiratory syndrome-coronavirus (SARS-CoV), Middle East respiratory syndrome (MERS)-CoV, Ebola, Zika, and SARS-coronavirus 2 (CoV-2). Although novel drug development through traditional pipelines remains a priority, in the interim, effective synergistic drug candidates could be rapidly identified by drug-repurposing screens, facilitating accelerated paths to clinical testing and potential emergency use authorizations.     

Diagnosis and individual treatment of cardiovascular diseases: targeting vascular oxidative stress

Cardiovascular diseases are the leading cause of death and disability worldwide, yet we do not fully understand their underlying causes to reliably identify and treat, let alone prevent, these diseases. The majority of therapeutic approaches are symptom orientated, and current practice often follows a 'one-fits-all' approach. New strategies are needed, which harness the potential of individualized medicine with its three major pillars: in vitro diagnostics for early identification of individuals at risk and monitoring of drug efficacy; molecular imaging for disease localization and monitoring; and innovative, mechanism-based drugs. One so far untargeted mechanism of cardiovascular disease is oxidative stress, that is, the increased occurrence of reactive oxygen species in the vascular wall that leads to endothelial dysfunction. We outline why previous antioxidant supplements do not work and suggest an alternative approach targeting the enzymatic sources of oxidative stress and using emerging biomarkers of oxidative stress. These and similar approaches may be applied to fewer patients but in a much more individualized, effective and cost-saving manner.