几种常见免疫抑制剂的研究进展

介绍了已在临床使用或处于临床研究的吗替麦考酚酯、他克莫司、西罗莫司、FTY720以及一些中药免疫抑制剂的作用机制、临床应用、不良反应等情况。高效、低毒仍然是研究和开发新型免疫抑制剂的方向。     

三七总苷联合葛根黄酮治疗不稳定型心绞痛的机制探讨

目的观察三七总苷联合葛根黄酮对不稳定型心绞痛的治疗效果,并进一步探讨其可能的治疗机制。方法随机将64例不稳定型心绞痛患者分为2组,分别给予常规抗不稳定型心绞痛治疗（A组）及在常规治疗基础上添加三七总苷注射液静脉滴注及口服葛酮通络胶囊（B组）,治疗2周。观察2组临床疗效以及治疗前后血浆中纤溶酶原激活物（t-PA）及抑制物（PAI）、可溶性细胞间黏附分子-1（sICAM-1）、C反应蛋白（CRP）、基质金属蛋白酶-9、氧化型低密度脂蛋白（ox-LDL）的水平及超氧化物歧化酶（SOD）的活力变化并进行对比分析。结果 B组的临床疗效显著高于A组;B组的t-PA水平治疗后明显升高、PAI水平明显降低（P均〈0.05）,而A组t-PA、PAI治疗前后均无明显变化（P均〉0.05）;2组的SICAM-1、CRP及MMP-9水平治疗后均明显降低（P均〈0.05）,B组降低的幅度较A组更显著（P均〈0.05）;A组的ox-LDL治疗前后无明显变化,而B组治疗后水平明显降低（P〈0.05）;2组的SOD活力在治疗后均升高（P均〈0.05）,B组的升高幅度较A组更显著（P〈0.05）。结论三七总苷联合葛根黄酮治疗不稳定型心绞痛临床疗效肯定,其通过调节血脂、改善纤溶活性、减轻炎症反应及抗氧化等,从而降低冠状动脉事件的再发生率。     

雷公藤减毒研究进展

雷公藤为治疗类风湿性关节炎常用中药,具有清热解毒,祛风除湿,消肿止痛,杀虫止痒的功用,现代药理研究表明其具有抗炎、镇痛、抗肿瘤及免疫调节等作用,临床主要用于治疗免疫性疾病、肾脏性疾病、皮肤性疾病等,对类风湿性关节炎的疗效尤为显著。但严重的毒副作用,尤其是肝肾毒性,限制了其临床应用,成为迫切需要解决的难题,故雷公藤的减毒研究成为近年来的研究热点。本课题组主要研究雷公藤的经皮给药对其减毒增效的作用,但目前雷公藤的应用困境仍然没有得到改善,故对2006年至2016年近10年来雷公藤减毒研究的相关文献进行检索,包括传统的炮制减毒、配伍减毒和现代的制剂减毒、结构修饰减毒、生物技术减毒以及其相互的联合应用等,分析雷公藤的减毒现状和困境,对比现存减毒方式间的差异,为雷公藤减毒增效研究提供思路,促进其合理开发和临床安全应用,也为其他有毒中药的合理应用提供参考。     

Effects of omega-3 fatty acid on major cardiovascular outcomes: A systematic review and meta-analysis

Background:The effects of omega-3 fatty acid on cardiovascular health obtained inconsistent results. A systematic review and meta-analysis were therefore conducted to assess the effects of omega-3 fatty acid supplementation for primary and secondary prevention strategies of major cardiovascular outcomes.Methods:The databases of PubMed, Embase, and the Cochrane library were systematically searched from their inception until September 2020. Relative risks (RRs) with 95% confidence intervals were used to assess effect estimates by using the random-effects model.Results:Twenty-eight randomized controlled trials involving 136,965 individuals were selected for the final meta-analysis. Omega-3 fatty acid was noted to be associated with a lower risk of major cardiovascular events (RR, 0.94; 95% CI, 0.89–1.00; P = .049) and cardiac death (RR, 0.92; 95% CI, 0.85–0.99; P = .022). However, no significant differences was noted between omega-3 fatty acid and the control for the risks of all-cause mortality (RR, 0.97; 95% CI, 0.92–1.03; P = .301), myocardial infarction (RR, 0.90; 95% CI, 0.80–1.01; P = .077), and stroke (RR, 1.02; 95% CI, 0.94–1.11; P = .694).Conclusions:Major cardiovascular events and cardiac death risks could be avoided with the use of omega-3 fatty acid. However, it has no significant effects on the risk of all-cause mortality, myocardial infarction, and stroke.     

Epidemiology of Mosquito-Borne Viruses in Egypt: A Systematic Review

There are at least five common mosquito-borne viruses (MBVs) recorded in Egypt, including dengue virus (DENV), Rift Valley fever virus (RVFV), West Nile virus (WNV), Chikungunya virus, and Sindbis virus. Unexpected outbreaks caused by MBVs reflect the deficiencies of the MBV surveillance system in Egypt. This systematic review characterized the epidemiology of MBV prevalence in Egypt. Human, animal, and vector prevalence studies on MBVs in Egypt were retrieved from Web of Science, PubMed, and Bing Scholar, and 33 eligible studies were included for further analyses. The monophyletic characterization of the RVFV and WNV strains found in Egypt, which spans about half a century, suggests that both RVFV and WNV are widely transmitted in this nation. Moreover, the seropositive rates of DENV and WNV in hosts were on the rise in recent years, and spillover events of DENV and WNV to other countries from Egypt have been recorded. The common drawback for surveillance of MBVs in Egypt is the lack of seroprevalence studies on MBVs, especially in this century. It is necessary to evaluate endemic transmission risk, establish an early warning system for MBVs, and develop a sound joint system for medical care and public health for managing MBVs in Egypt.     

政和县医疗卫生机构消毒效果监测分析

消毒效果与医院感染密切相关。为了解政和县医疗机构消毒质量状况,进一步加强消毒卫生监测管理,依据《中华人民共和国传染病防治法》和《消毒管理办法》的规定,2006年8-10月对全县各级医疗机构进行消毒质量监测,现将结果报告如下。     

EBV-IgM对川崎病患儿大剂量免疫球蛋白治疗耐药的预测价值

目的 研究川崎病(KD)患儿静脉注射大剂量免疫球蛋白(IVIG)耐药的影响因素,探讨血清EBV-IgM对KD患儿静脉注射大剂量IVIG耐药的预测价值.方法 将KD患儿分为敏感组和耐药组,分别对临床资料、实验室检查及血清EBV-IgM阳性率进行单因素分析;经多因素Logistic回归分析分析影响IVIG耐药的危险因素;建...     

西安地区伴吞咽障碍老年急性脑梗死患者的临床特征及对住院结局的影响

目的 探讨西安地区伴吞咽障碍老年急性脑梗死患者的临床特征以及吞咽障碍对院内结局的影响.方法 通过西安卒中登记研究,纳入西安市4所三级甲等医院收治的1116例老年急性脑梗死患者,根据入院24 h内洼田饮水试验评分分为吞咽良好组(1～2级)1004例和吞咽障碍组(3～5级)112例,比较分析2组的基线临床特征.采用多因素L...