流感病毒动物感染模型及其应用

流感病毒动物感染模型是研究流感病毒致病性、传播性和宿主抗病毒免疫机制的基础。目前已有多种动物用于流感病毒研究,主要包括小鼠、雪貂和猕猴等。本文介绍了目前已经建立的流感病毒动物感染模型及其应用,为流感病毒的防控工作提供借鉴。     

神经氨酸酶抑制剂的研究进展

流感病毒感染所致的急性呼吸道疾病(流感)是一种严重危害人类健康的传染病,在全世界范围流行,患病率和病死率均居高不下.由于流感病毒抗原变异性和特异性的疫苗研制的滞后性,常规的疫苗不能有效地预防流感暴发与流行.因此,抗病毒药物就成为了抗病毒的第一道防线.目前被批准上市的抗病毒药物有M2离子通道阻滞剂和神经氨酸酶抑制剂(neuraminidase inhibitors,NAIs)两大类.M2离子通道阻滞剂不良反应大,且只能防治甲型流感病毒,对乙型流感病毒无效;NAIs可以抑制高致病性的甲型和乙型流感病毒,已成为目前抗病毒药物研究的热点.目前已经上市的NAIs有奥司他韦、扎那米韦和帕拉米韦.本文介绍了NAIs的作用机制、药效学、药动学并着重对NAIs的临床研究进展进行综述.     

干扰素诱导的跨膜蛋白研究初探

生物机体存在多种方式减缓甚至阻止病毒复制。其机制主要通过抗病毒蛋白来介导,可因干扰素诱导而扩大。在这些干扰素刺激蛋白中,干扰素诱导的跨膜(interferon-induced transmembrane,IFITM)蛋白家族独树一帜,其通过阻止病毒透过细胞脂质双分子层而防止病毒感染。目前已知,至少有3种IFITM具有抗病毒活性:IFITM1、IFITM2以及IFITM3。这些跨膜蛋白已被证实在体外细胞培养中能阻止多种RNA病毒感染,包括登革热病毒、埃博拉病毒、甲型流感病毒、SARS冠状病毒和西尼罗病毒等。人ifitm3基因多态性与季节性流感/高致病性禽流感病情严重程度相关,但介导其抗病毒作用的具体分子机制仍不完全清楚。本文主要讨论ifitm基因、IFITM蛋白及其抗病毒作用和可能的作用机制,从而在研究病毒感染和肿瘤治疗中另辟蹊径,寻找最佳治疗方案。     

新甲型H1N1流感病毒与流感大流行防治研究进展

由于甲型流感病毒基因高度变异的特点,导致其对不同种属宿主亲和力、毒力、免疫原性、抗药性不断发生变化,全球新型流感大流行的风险时刻存在.因此,应加强流感特别是重症流感发病机制和有效干预措施研究,从疫苗研制、开发新型抗病毒药、加强综合治疗,特别是调节宿主免疫反应等多个方面着手,为应对可能爆发的流感大流行提供对策.     

流感病毒感染中炎症小体的激活和调控机制

炎症反应是宿主抗流感病毒感染的一个重要过程,它可以诱导产生抗病毒的炎症微环境以减少病毒的复制和扩散,同时参与对流感病毒的适应性免疫反应,在机体抗流感病毒感染过程中至关重要。然而,过度的炎症反应同时也是流感病毒重症感染、甚至死亡的主要因素。研究表明,炎症小体作为炎症反应的重要启动和调节分子,介导IL-1β和IL-18的成熟和分泌并诱导了细胞焦亡,在流感病毒发病机制中起着重要的调节作用,因此,针对炎症小体的激活和调控也成为流感病毒治疗的一个新策略。     

姜黄素防治流感病毒作用研究

目的 通过体内抗病毒实验研究姜黄素抗流感病毒作用.方法 以不同滴度的流感病毒滴鼻感染小鼠,观察肺指数,病毒致小鼠病死率等.结果 姜黄素25～100mg/kg剂量可减轻和改善感染鼠肺脏的病变程度,使其肺指数值下降,可明显延长2LD50感染鼠的平均生存天数,降低死亡率.结论 姜黄素对流感病毒有一定的防治作用,值得进一步开发.     

中医药对流感病毒感染所致炎性损伤的干预机制研究概况

流感病毒感染导致的急性免疫炎性损伤是流感全身症状、重症肺炎乃至死亡的主要原因,而在流感相关免疫调控网络中炙性细胞因子的过度释放是炎性损伤的基础.中医药在历来的时行感冒的防治中积累了丰富的经验.中医药通过影响流感病毒感染机体免疫调控网络中的炎性细胞因子的分泌,抑制异常增高的促炎细胞因子的释放,并升高抗炎细胞因子及抗病毒因子的释放,纠正失衡的细胞因子的分泌,调节流感病毒感染机体的免疫应答,从而抑制流感病毒感染所致炎性损伤,并促进损伤的修复.     

传染病总论

返魂草提取物及其有效成分抗病毒机制的研究——李丽静等(吉林长春中医学院附属医院新药研究中心1．30021)；《陕西中医学院学报》，2004，27(6)：65-66[目的：为了研究返魂草提取物及其有效成分抗病毒机制。方法：检测药物对流感病毒感染的MDCK细胞中病毒的神经氨酸酶活性及对流感病毒增殖的影响，并观察了药物对新城鸡瘟病毒(NDV)诱生人全血细胞干扰素的影响。     

小儿哮咳喘颗粒对感染流感病毒小鼠保护作用的观察

目的 观察小儿哮咳喘颗粒对感染流感病毒小鼠的影响及体外抑菌和抗病毒作用. 方法 昆明小鼠灌胃不同浓度的小儿哮喘溶液1次/d,连续7 d,末次给药后4 h经鼻滴入流感病毒,观察7 d,记录小鼠死亡率,试验设病毒灵对照和空白对照;常规方法做体外抑菌试验;以Hep-2传代细胞进行传代培养,观察小儿哮咳喘颗粒最大无毒剂量 (TD0)、细胞半数感染量(TCID50)以及不同剂量受试药物对感染病毒细胞的保护作用. 结果 小儿哮咳喘颗粒组感染病毒动物死亡率为100%,阴性对照组死亡率为0.在体外试验显示,小儿哮咳喘颗粒对肺炎双球菌和流感杆菌等多种细菌有明显的抑制作用,对流感病毒和柯萨奇病毒所致的细胞病变均明显减轻. 结论 小儿哮咳喘颗粒具有抑菌和抗病毒作用,对感染流感病毒小鼠有明显的保护作用.     

拉米夫定抗乙型肝炎病毒治疗的耐药问题

抗病毒治疗是慢性乙型肝炎(CHB)的根本治疗方法.目前全世界公认有效的抗病毒药物主要是干扰素和以拉米夫定(lamivudine LAM)为代表的核苷(酸)类似物.LAM是首个被批准用于CHB抗病毒治疗的核苷类药物,自1999年在我国上市以来,已有上百万人服用此药,它解决了α-干扰素抗病毒治疗需皮下注射、价格较高、不良反应较多(流感样症候群、骨髓抑制、精神异常等)等的不足.然而在其长期治疗过程中病毒多聚酶基因的变异,导致乙型肝炎病毒(HBV)耐药性的发生,影响了药物疗效.本文就LAM在抗HBV治疗过程中耐药的产生机制、耐药率及耐药检测的方法等方面作综述.     

中风后言语不利的中医研究治疗进展

论述中风后言语不利的发病机制，总结中风后言语不利的辩证治疗。包括中药的辨证治疗、外灸的辨证治疗、针药结合的辨证治疗．指出了中医研究治疗中风后言语不利存在的问题，并对该研究治疗进行了展望。     

Theory of traditional Chinese medicine and therapeutic method of diseases

Traditional Chinese medicine, including herbal medicine and acupuncture, as one of the most important parts in complementary and alternative medicine (CAM), plays the key role in the formation of integrative medicine. Why do not the modern drugs targeting the specificity of diseases produce theoretical effects in clinical observation? Why does not the traditional Chinese medicine targeting the Zheng (syndrome) produce theoretical effects in clinic? There should have some reasons to combine Western medicine with Chinese herbal medicine so as to form the integrative medicine. During the integration, how to clarify the impact of CAM theory on Western medicine has become an emergent topic. This paper focuses on the exploration of the impact of theory of traditional Chinese medicine on the therapy of diseases in Western medicine.     

Chinese herbal medicine for mild cognitive impairment using mini-mental state examination: A systematic review and meta-analysis

Introduction:The prevalence of mild cognitive impairment (MCI) in the elderly population aged 60 to 84 years ranges from 6.7% to 25.2%, and the effective prevention and reversal of MCI progression to Alzheimer disease (AD) is crucial. The mini mental state examination (MMSE) is the most commonly used screening tool in Chinese outpatient clinics, with sufficient sensitivity and specificity to allow useful stratification from average to abnormal with adequate consideration of age and education.Objective:To investigate the clinical significance of Chinese herbs on MMSE scores in MCI patients and discuss the effectiveness of Chinese herbs through pharmacology.Methods:Three English databases and 4 Chinese databases we have searched, and the risk of bias was assessed according to the Cochrane tool. Statistics will be used for heterogeneity assessment, sensitivity analysis, data synthesis, funnel plot generation and subgroup analysis. If sufficiently homogeneous studies are found, a Meta-analysis will be performed, with subgroups describing any differences.Results:A total of 21 studies were included, 4 studies were placebo-controlled, 14 Chinese Herbal Medicines (CHMs) were compared with other cognitive improvements, 3 CHMs were combined with other medications, and the results of 17 studies favored the herbal group.Conclusion:The results indicate that herbal medicine can improve MMSE scores, and herbal medicine combined with other drugs that can improve cognition can significantly improve MMSE scores, but there are methodological flaws in the study. Experimental studies have found a basis for the ability of herbs to improve cognition and memory impairment, and herbal medicine has great potential to improve MCI cognition. Keywords mild cognitive impairment, herbal medicine, MMSE, systematic evaluation, meta-analysis. PROSPERO international prospective register of systematic reviews protocol registration number: CRD42020202368     

急性重症药物性肝损伤患者发病状况的回顾性研究

目的回顾性研究急性重症药物性肝损伤患者的发病状况,以期对临床用药起到指导作用。方法回顾性研究2003年5月-2013年5月广西梧州中医医院收治的急性重症药物性肝损伤的患者82例,对急性重症药物性肝损伤患者的住院诊治情况和可能导致急性重症肝损伤的药物和致死药物进行分析。结果患者的治疗方式包括行人工肝治疗和单纯药物治疗,比例分别为34.15%和65.85%。在患者治疗的过程中死亡31例(37.80%),病情恶化30例(36.59%),病情好转13例(15.85%),治愈8例(9.76%);引起肝损伤的前3类药物分别是中草药、抗结核药物和抗菌药物,致病率分别为28.05%、24.39%和14.63%,在住院期间死亡的31例患者中,也是使用中草药(35.48%)和抗结核药物(19.35%)的患者比例居多。结论急性重症药物性肝损伤致死率较高,其中,中草药和抗结核药物是导致肝损伤以及致死的主要病因,对这两种药物的临床监测需要引起重视。     

Anti‐HBV effect of individual traditional Chinese herbal medicine in vitro and in vivo: an analytic review

Traditional Chinese herbal medicine (TCHM) has been widely used in the treatment of chronic hepatitis B (CHB) in China. The systematic analysis of clinical research of TCHM against CHB revealed its potential but not confirmed its therapeutic effect. To understand the detailed antiviral effect of TCHM against HBV infection, we systematically analysed the anti‐HBV effect of individual Chinese herbs on the basis of the research on individual TCHM in vitro and in vivo, which were published from 1995 to 2012. Among 171 herbal components isolated from 76 Chinese herbs, we found 13 compounds and 9 extracts isolated from 18 Chinese herbs showing strong inhibitory effect on HBV DNA, HBeAg or HBsAg release with low cytotoxicity in HepG2.2.15 cells, and agents from 12 Chinese herbs showing the highest inhibition rates of plasma DHBV DNA of more than 50% in DHBV‐infected ducks. In addition, the two compounds chrysophanol 8‐O‐beta‐D‐glucoside isolated from Rheum palmatum and wogonin isolated from Scutellaria baicalensis were found to display strong anti‐HBV activity. Interestingly, compounds isolated from 5 of these effective anti‐HBV Chinese herbs were found to show strong antibacterial or antifungal activity also. This review summarizes and analyses the studies on the anti‐HBV effect of individual TCHM in cell and animal models, providing potential perspective in the understanding of TCHM in the treatment of hepatitis B and the development of new anti‐HBV drugs from TCHM.     

医药结合,助力药物性肝损伤精准防控

当今药物性肝损伤(DILI)不仅是国际肝病领域关注的热点,也是全球安全用药关注的热点问题。由于缺少特异性检测指标,DILI误诊率高,也容易造成用药安全的误导,中草药所致DILI成因更复杂,临床诊断更棘手,防控难度更大。为此,呼吁临床专家与药学专家携手合作,医药结合,临床科研结合,构建DILI客观辨识策略和方法,科学厘清DILI与药物之间的因果关系,实现DILI精准诊断;科学阐明DILI成因和机制,从易感人群、易感物质和合理使用等方面实现DILI精准防控。同时建议,要进一步重视和加强中草药肝损伤研究,保证中药临床用药安全,促进中医药事业健康发展。     

Herbal Medicine in the Treatment of Ulcerative Colitis

Ulcerative colitis (UC) is a refractory, chronic, and nonspecific disease occurred usually in the rectum and the entire colon. The etiopathology is probably related to dysregulation of the mucosal immune response toward the resident bacterial flora together with genetic and environmental factors. Several types of medications are used to control the inflammation or reduce symptoms. Herbal medicine includes a wide range of practices and therapies outside the realms of conventional Western medicine. However, there are limited controlled evidences indicating the efficacy of traditional Chinese medicines, such as aloe vera gel, wheat grass juice, Boswellia serrata, and bovine colostrum enemas in the treatment of UC. Although herbal medicines are not devoid of risk, they could still be safer than synthetic drugs. The potential benefits of herbal medicine could lie in their high acceptance by patients, efficacy, relative safety, and relatively low cost. Patients worldwide seem to have adopted herbal medicine in a major way, and the efficacy of herbal medicine has been tested in hundreds of clinical trials in the management of UC. The evidences on herbal medicine are incomplete, complex, and confusing, and certainly associated with both risks and benefits. There is a need for further controlled clinical trials of the potential efficacy of herbal medicine approaches in the treatment of UC, together with enhanced legislation to maximize their quality and safety.     

Different Chinese herbal medicine therapy for idiopathic thrombocytopenic purpura: A protocol for systematic review and Bayesian network meta-analysis

Background:Idiopathic thrombocytopenic purpura (ITP) is a common immune system and blood system disease in clinical practice, and it is a hemorrhagic disease caused by immune factors causing platelet destruction and decreasing number of platelets. There is currently no effective treatment plan for ITP. At this stage, glucocorticoid and gamma globulin are mostly used in the treatment of ITP, and some patients use splenectomy to achieve therapeutic purposes, but the various treatment methods are inadequate. At this stage, a large number of randomized controlled studies have reported that Chinese herbal medicine has achieved good curative effect in the treatment of ITP. However, due to the variety of Chinese herbal medicine, there has been no evidence of the effectiveness and safety of Chinese herbal medicine in the treatment of ITP. Because of the above reasons, this study uses the network meta-analysis method based on Bayesian method to compare the clinical efficacy and safety of different kinds of Chinese herbal medicine in the treatment of ITP through direct and indirect comparison, in order to provide evidence-based medical support for the treatment of ITP with Chinese herbal medicine.Methods:This study uses the method of combining free words with theme words, and using computer to retrieve PubMed, EMbase, The Cochrane Library, WANFANG Database, CNKI, and VIP Database, etc, to collect the randomized control studies on Chinese herbal medicine in the treatment of ITP. The retrieval time is from the establishment of each database to January 2021, and the retrieval languages are Chinese and English. Two researchers independently read the title, abstract and full text of the article to determine whether it is included in the literature; In the event of a disagreement, a third researcher will join the discussion to resolve the disagreement; For the literature that lacks information, trying to contact the original author of the document to supplement it. The literature quality evaluation carried out by using the Stata 14.0 software to draw network and funnel plots, in accordance with the quality evaluation criteria of version 5.1.0 of the Cochrane System Evaluation Manual. Statistical analysis is performed by using ADDIS 1.16.8 software based on the Bayesian model.Results:This study will compare the clinical efficacy and safety of different types of Chinese herbal medicine in the treatment of idiopathic thrombocytopenic purpura through the method of network meta-analysis, and rank the different types of Chinese herbal medicine according to their effectiveness, and the results will be published in a peer-reviewed, high-quality academic journal.Conclusion:This study will find effective and safe Chinese herbal medicine for clinical treatment of ITP from the perspective of evidence-based medicine, and benefit more ITP patients.     

85例老年药物性肝炎患者临床分析

目的分析老年人药物性肝炎的临床特点、药物种类及防治原则。方法对85例老年和87例非老年药物性肝炎患者进行回顾性临床对照分析。结果在老年药物性肝炎患者,由中（成）草药引起的42例（49.4%）,抗生素28例（32.9%）,抗结核药7例（8.2%）,其他8例（9.4%）;肝细胞型38例（44.5%）,胆汁淤积型34例（40.0%）,混合型13例（15.3%）,死亡4例（4.7%）;在非老年患者,抗结核药38例（43.7%）,抗生素26例（29.9%）,中（成）草药15例（17.2%）,其他7例（8.0%）;肝细胞型58例（66.7%）,胆汁淤积型18例（20.7%）,混合型11例（12.6%）,无一例死亡。结论中草药和抗生素是引起老年人药物性肝损害的常见药物。应用中草药和抗生素的老年人应定期检测肝功能。