广西药品经营企业实施新版GSP的思考

目的：结合广西壮族自治区新版GSP实施过程中存在的困难,提出对策建议,保障新版GSP的顺利实施。方法：基于广西壮族自治区GSP的实施现状,采用新旧版GSP认证对比分析等方法开展研究。结果与结论：新版GSP实施面临着人员、资金与成本等问题。应加强培训,强化监督,给予适当的政策扶持,确保新版GSP的实施。     

Dicarbonyl Electrophiles Mediate Inflammation-Induced Gastrointestinal Carcinogenesis

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Patients with unstable angina pectoris show an increased frequency of the Fc gamma RIIa R131 allele

Patients with Systemic Lupus Erythematosus (SLE) carry an increased risk for the development of coronary artery disease (CAD). The R131 allele of the Fc gamma receptor IIa (FcγRIIa) is associated with SLE incidence and disease severity but also with CAD. Compared to stable angina pectoris (SAP) the unstable angina (UAP), as a manifestation of destabilizing CAD, is associated with increased risk of persistent instability, myocardial infarction, and death. Identification of clinically relevant determinants for unstable angina promises reduction of UAP-associated mortality in patients with SLE. We conducted a clinical study among 553 consecutive patients with stable angina pectoris (n = 330) and unstable angina pectoris (n = 223). All patients were genotyped for a frequent functional variant at position 131 of the mature FcγRIIa. UAP, but not SAP was significantly associated with the R/R131 genotype (P < 0.001). In troponin-negative patients with angina carrying the R/R131 genotype the odds ratio for suffering from UAP was 4.02 (95% confidence interval, 2.52–6.41) compared to those with non-R/R131 genotypes. In a multivariable analysis, the R/R131 genotype independently predicted the risk for development of UAP in a model adjusted for classical atherogenic risk factors. Our data imply that risk stratification of SLE- and other high risk patients with troponin-negative angina could be significantly improved by FcγRIIa genotyping.     

Helicobacter pylori infection: A brief overview on alternative natural treatments to conventional therapy

Abstract

Helicobacter pylori is a human gastric pathogen considered as the etiologic agent of several gastric disorders, that may range from chronic gastritis to more severe outcomes, including gastric cancer. The current therapeutic scheme relies on the combination of several pharmacological substances, namely antibiotics and proton pump inhibitors. However, the cure rates obtained have been declining over the years, mostly due to bacterial resistance to antibiotics. In this context, the use of non-antibiotic substances is of the utmost importance regarding H. pylori eradication. In this review, we present different classes of compounds obtained from natural sources that have shown to present anti-H. pylori potential; we briefly highlight their possible use in the context of developing new therapeutic approaches.     

新型射频治疗女性性功能障碍的疗效分析

目的研究新型射频治疗对女性性功能障碍的治疗效果。方法回顾性分析在湖南省妇幼保健院2020年7月至2021年2月期间门诊就诊的性功能障碍女性患者35例行新型射频治疗前后的临床资料。患者平均年龄(36.0±6.7)岁,均为经产妇。性生活满意度问卷(SSQ)评价中非常不满意13例,差19例,中等3例,对患者予以新型射频治疗(每次25分钟,每14天治疗一次,5次为一个疗程),1个疗程后对患者进行随访,采用女性性功能指数评估(FSFI),阴道松弛度问卷(VLQ),外阴阴道松弛度问卷(VVLQ)及盆底肌肌力等级评价治疗疗效。结果患者治疗后FSFI评分由(12.4±2.6)分上升至(23.4±2.9)分,治疗前后差异具有统计学意义(P<0.05),74.3%患者盆底肌恢复至III级以上。结论新型射频在治疗女性患者性功能障碍方面,具有显著的临床疗效,具有推广价值。     

More than a decade after live donor nephrectomy: a prospective cohort study

Previously reported short‐term results after live kidney donation show no negative consequences for the donor. The incidence of new‐onset morbidity takes years to emerge, making it highly likely that this will be missed during short‐term follow‐up. Therefore, evidence on long‐term outcome is essential. A 10‐year follow‐up on renal function, hypertension, quality of life (QOL), fatigue, and survival was performed of a prospective cohort of 100 donors. After a median follow‐up time of 10 years, clinical data were available for 97 donors and QOL data for 74 donors. Nine donors died during follow‐up of unrelated causes to donation, and one donor was lost to follow‐up. There was a significant decrease in kidney function of 12.9 ml/min (P < 0.001) at follow‐up. QOL showed significant clinically relevant decreases of 10‐year follow‐up scores in SF‐36 dimensions of physical function (P < 0.001), bodily pain (P = 0.001), and general health (P < 0.001). MFI‐20 scores were significantly higher for general fatigue (P < 0.001), physical fatigue (P < 0.001), reduced activity (P = 0.019), and reduced motivation (P = 0.030). New‐onset hypertension was present in 25.6% of the donors. Donor outcomes are excellent 10 years post‐donation. Kidney function appears stable, and hypertension does not seem to occur more frequently compared to the general population.     

The Need for a Coagulation Assay after Initiation of New Oral Anticoagulants in Patients with Renal Dysfunction: A Case Report

Background

Dabigatran etexilate, a new oral anticoagulant, was recently approved as an efficacious alternative to warfarin for the prevention of first and recurrent stroke in patients with nonvalvular atrial fibrillation. Limited data are available for dabigatran use in patients with a creatinine clearance rate (CrCL) of 15-30 mL/min. Furthermore, current guidelines do not recommend frequent blood monitoring after dabigatran use. We report herein a patient with severe renal dysfunction who exhibited profound coagulopathy after 2 days of dabigatran use.

Case Report

An 87-year-old woman was admitted for altered mental status and left-side weakness. She was diagnosed with right middle cerebral artery infarction. The baseline assessment revealed a serum creatinine concentration of 1.29 mg/dL and a CrCL of 27.2 mL/min. Dabigatran therapy was started 5 weeks after admission at a dosage of 110 mg twice daily. After 2 days of dabigatran use, the patient developed multiple bruises and evidence of upper-gastrointestinal bleeding. Laboratory tests demonstrated a severe coagulopathy, with a prothrombin time of 85.9 sec, an international normalized ratio of 11.36, an activated partial thromboplastin time of 119.2 sec, and a thrombin time of 230.8 sec. Serial assessment of the patient''s renal function revealed substantial fluctuation of the CrCL (range, 17.9-26.5 mL/min).

Conclusions

The present case emphasizes the need for frequent checking of renal function and assessment using coagulation assays after commencing dabigatran therapy in patients with moderate-to-severe renal impairment.     

P2X7受体和肾脏疾病

P2X7受体是三磷酸腺苷(ATP)门控阳离子通道受体,是嘌呤受体P2X家族受体亚型之一。P2X7受体信号通路与IL-1β、IL-6、COX-2等多种炎症因子的生成和释放相关,在多种疾病的发病过程中起到了至关重要的作用。目前以此受体为治疗靶点的P2X7受体拮抗剂已进入临床试验阶段,表现出良好的安全性和疗效。最新研究表明P2X7受体与多种肾脏疾病有关,P2X7受体拮抗剂具有潜在的肾脏疾病治疗作用。本文综述P2X7受体在肾脏疾病中的作用及其可能的作用机制,以期为肾脏疾病治疗的新靶点和新策略提供理论依据。