益生菌对妊娠期糖尿病的影响及相关机制

妊娠期糖尿病(gestational diabetes mellitus, GDM)可对母体及其后代产生近期和远期的不良影响,GDM患者的肠道菌群与正常孕妇存在差异,肠道菌群结构及功能的改变影响了其发生发展。近年来,国外研究发现,益生菌可不同程度地影响GDM患者糖脂代谢,但具体机制不甚明确,短链脂肪酸、过氧化物酶体增殖...     

Vitamin D Enhances Neutrophil Generation and Function in Zebrafish (Danio rerio)

Vitamin D (VD) is a major regulator of calcium metabolism in many living organisms. In addition, VD plays a key role in regulating innate and adaptive immunity in vertebrates. Neutrophils constitute an important part of the first line of defense against invading microbes; however, the potential effect of VD on neutrophils remains elusive. Thus, in this study zebrafish in different developmental stages were utilized to identify the potential role of VD in the basal homeostasis and functions of neutrophils. Our results showed that addition of exogenous VD₃ promoted granulopoiesis in zebrafish larvae. Reciprocally, neutrophil abundance in the intestine of adult zebrafish with a cyp2r1 mutant, lacking the capacity to 25-hydroxylate VD, was reduced. Moreover, VD-mediated granulopoiesis was still observed in gnotobiotic zebrafish larvae, indicating that VD regulates neutrophil generation independent of the microbiota during early development. In contrast, VD was incapable to influence granulopoiesis in adult zebrafish when the commensal bacteria were depleted by antibiotic treatment, suggesting that VD might modulate neutrophil activity via different mechanisms depending on the developmental stage. In addition, we found that VD₃ augmented the expression of il-8 and neutrophil recruitment to the site of caudal fin amputation. Finally, VD₃ treatment significantly decreased bacterial counts and mortality in zebrafish infected with Edwardsiella tarda (E. tarda) in a neutrophil-dependent manner. Combined, these findings demonstrate that VD regulates granulopoiesis and neutrophil function in zebrafish immunity.     

Effectiveness,nephrotoxicity, and therapeutic drug monitoring of polymyxin B in nosocomial pneumonia among critically ill patients

ObjectivesWe aimed to assess the effectiveness and nephrotoxicity of polymyxin B in critically ill patients with nosocomial pneumonia and to evaluate the utility of its therapeutic drug monitoring (TDM).MethodsWe retrospectively analyzed patients who received polymyxin B treatment for ≥48 h since the establishment of polymyxin B TDM in a 26‐bed tertiary referral intensive care unit. Univariate and multivariate analyses were conducted to assess the variables associated with polymyxin B effectiveness and nephrotoxicity.ResultsA total of 62 patients were enrolled. Most (56.5%) of the patients performed TDM, 54.3% of them reached the therapeutic target of area under curve across 24 h at steady state (AUC_ss,24h) of 50–100 mg h L⁻¹, and 10 patients had an AUC_ss,24h value of <50 mg h L⁻¹. Thirty‐six (58.1) and 31 (50.0%) patients had favorable clinical and microbiological responses, respectively. Reaching the therapeutic target of AUC_ss,24h (odds ratio [OR] = 13.15, p = 0.015), a favorable microbiological response (OR = 40.80, p = 0.00), and complicated with septic shock (OR = 0.12, p = 0.021) were independently associated with favorable clinical outcomes of polymyxin B treatment. The incidence of acute kidney injury (AKI) was 45.2%. A lower creatinine clearance (OR = 0.96, p = 0.008) and concomitant treatment with loop diuretics (OR = 5.93, p = 0.046) were predictive of nephrotoxicity.ConclusionOur findings show that TDM of polymyxin B is a valuable intervention, and the achievement of its optimal pharmacodynamic target can improve treatment outcome. Renal insufficiency and concomitant treatment with loop diuretics were found to be associated with the risk of nephrotoxicity.     

中药配方颗粒发展现状与临床推广应用面临的主要问题分析

通过文献研究和市场调查,阐明中药配方颗粒国内外市场获得了较好发展,产业的规模和效益都在提高,产品逐步得到医生和患者接受,在医院诊疗中占据了越来越重要的地位.与国外市场相比,国内市场的发展相对缓慢,原因主要包括对中药配方颗粒与饮片是否等效的质疑和价格比较高等问题,进而提出加强临床应用研究以检验其疗效、加快推行电子调配方式...     

“明阴阳 医道之纲也”之明其用——名老中医陈业强学术思想研究

中医学通过将阴阳学说与五行学说相结合,而提出了整体观念,并构筑了中医学的理论体系。从整体观出发,强调人生命机体要"天人合一"与"形神合一",从而达到"阴阳冲和"的最佳生命活动状态。并以此来解释复杂的生命现象,把握生命运动的变化规律,而指导生命的各种活动。并通过治病必求其本的原则,指导着中医学防治疾病,养生保健。这正是《黄帝内经》应用阴阳学说作为世界观与方法论的根本与发挥。     

发展广东中药工业的思路

通过对广东中药工业现状的分析,提出大力调整产业结构,实施“大广药”名牌战略,注重改善中药品种、技术结构和剂型结构,提高产品外向度,提升医药投资引力,进一步完善中药产业发展政策措施等发展思路。     

消水方联合顺铂治疗恶性胸腔积液的临床观察

目的:观察口服消水方联合顺铂胸腔灌注治疗恶性胸腔积液的临床疗效。方法:118例恶性胸腔积液患者随机分为两组,治疗组65例采用口服中药消水方联合顺铂胸腔灌注,对照组53例单用顺铂胸腔灌注。以恶性胸腔积液的近期疗效、生活质量评分及临床症状积分为指标进行临床观察。结果:治疗组和对照组近期有效率分别为72.3%和66.1%,两组无显著性差异,但治疗组较对照组生活质量显著改善(P<0.05),症状明显缓解(P<0.05)。结论:消水方联合顺铂胸腔灌注治疗恶性胸腔积液,近期疗效未见明显提高,但可减轻症状,提高生活质量。     

芪龙胶囊对大鼠脑缺血的保护作用

目的:研究观察中药芪龙胶囊对大鼠脑缺血的保护作用.方法:采用光化学诱导局灶性脑梗塞模型(PITCI)和三氯化铁所致大鼠单侧大脑中动脉阻塞(MCAO)模型,观察了芪龙胶囊对缺血性中风的保护作用;采用双侧颈总动脉结扎模型研究药物对脑毛细血管通透性的影响.结果:芪龙胶囊0.6g·kg-1,0.3g·kg-1,0.15g·kg-1可明显减轻光化学诱导局灶性脑梗塞模型大鼠神经症状,减少脑梗塞范围(P＜0.05,P＜0.01);0.6g·kg-1,0.3g·kg-1可明显减轻该模型大鼠脑含水量变化率(P＜0.05,P＜0.01).芪龙胶囊0.6g·kg-1,0.3g·kg-1可明显减轻MCAO大鼠神经症状,减少脑梗塞范围(P＜0.05,P＜0.01).该药还能显著降低双侧颈总动脉结扎大鼠血脑屏障毛细血管通透性,减少模型大鼠脑组织EB含量(P＜0.05,P＜0.01).结论:芪龙胶囊具有很好的脑保护作用.     

广东中药工业竞争力评价

以生产、营运、市场和发展竞争力有关的指标,对2002-2007年广东中药工业与吉林、山东、四川和江西共5省之间进行动态对比,对2006年综合竞争力的进行定量比较。结果表明,广东的平均生产规模、产销率等多数指标在6年中处于5省的中等水平,销售收入和利润增长率波动较大,部分指标在2007年增长趋势良好;广东中药产业综合竞争力指数为5省平均水平的91.93％。     

SLCO1B1突变致1例甲氨蝶呤清除延迟患儿的药学监护

目的:分析甲氨蝶呤清除延迟的影响因素,使临床更加合理地使用甲氨蝶呤( MTX)、减少不良反应的发生。方法:对1例发生MTX 排泄延迟、出现胃肠道黏膜损伤症状并继发鼠伤寒沙门菌感染的急性淋巴细胞性白血病(ALL)高危患儿的生理病理因素、合并用药情况进行分析,并通过测序法分析SLCO1B1多态性,探讨影响MTX清除延迟的相关因素。结果:根据MTX血药浓度,临床药师判断该患儿Block-1时发生了MTX早期清除延迟,Block-2时发生早期和晚期清除延迟。另结合相关文献,临床药师选择SLCO1B1的3个SNP位点进行测序分析,发现患儿为SLCO1B1c.521、c.1865+4846和c.1865+248 3个位点的突变纯合子。SLCO1B1突变和合并使用奥美拉唑可能是导致患儿发生MTX早期清除延迟的原因;腹水可能是导致其发生晚期清除延迟的原因。结论:临床医师在使用MTX治疗ALL患儿时,应综合考虑患儿的生理病理因素和遗传因素等,如有条件,可同时检测相关基因型,根据基因型和肾脏清除率等制定合适的治疗方案或采取一定的预防措施,同时尽量避免选择会导致患儿甲氨蝶呤排泄延迟的相关药物,以减少MTX不良反应的发生。