2018年 · 第57卷第11期

AIDS is an important public health problem that threatens human health. Although the introduction of highly active antiretroviral therapy (HAART) has greatly reduced the morbidity and mortality of patients with human immunodeficiency virus (HIV) infection, AIDS is incurable and patients need lifelong medication. Therefore, the safety and efficacy of long-term medication still face important challenges. The commonly used free antiviral drugs in my country are domestic generic drugs. These generic drugs lack pharmacokinetic (PK) and pharmacodynamic (PD) studies in AIDS patients in China. Their compatibility regimen, dosage and timing of starting treatment are all referred to foreign experiences. In order to confirm the efficacy of domestic antiviral drugs, Professor Li Taisheng's team from the Department of Infectious Diseases of Peking Union Medical College Hospital conducted a series of studies on optimizing anti-HIV treatment based on PK/PD, and put forward a treatment plan suitable for national conditions with "excellent efficacy, low price and low toxicity", which was promoted nationwide, providing technical support for the scientific prevention and control of AIDS. Professors Du Xiaoli and Li Taisheng were specially invited to write a monograph "Optimizing the 'Chinese Regimen' of Anti-Human Immunodeficiency Virus Treatment by Using Pharmacokinetics/Pharmacodynamics" for clinicians to provide reference in deciding treatment options.

AIDS is an important public health problem that threatens human health. Although the introduction of highly active antiretroviral therapy (HAART) has greatly reduced the morbidity and mortality of patients with human immunodeficiency virus (HIV) infection, AIDS is incurable and patients need lifelong medication. Therefore, the safety and efficacy of long-term medication remains an important challenge for us.

Endoscopic retrograde cholangiopancreatography (ERCP) was reported for the first time in 1970s. Since then, ERCP has become an indispensable procedure in the diagnosis and management of a variety of biliary and pancreatic disorders. The main purpose of Chinese ERCP guideline is to precisely define the clinical indications of ERCP. In this guideline, all recommendations were based on reviewed studies and graded on the strength of supporting evidence by GRADE criteria. ERCP is particularly appropriate in the management of patients with biliary obstruction caused by choledocholithiasis and other benign or malignant disorders. Meanwhile, a variety of benign or pancreatic disorders can be diagnosed and treated with ERCP. Plastic or metal biliary and pancreatic stents are primarily used to establish patency of an obstructed bile or pancreatic duct. Last but not least, it is very important to fully understand the potential complications of ERCP. Early recognition and immediate management of adverse events are critical to reduce procedure related morbidity and mortality.

Since the publication of China expert consensus on rehabilitation and secondary prevention of coronary heart disease in 2012, cardiac rehabilitation therapy has been developed rapidly in China. In 2015, Committee of Cardiac Rehabilitation and Prevention of Chinese Association of Rehabilitation Medicine published guidelines for rehabilitation/secondary prevention of cardiovascular diseases in China (2015 edition). The present guidelines, Guidelines for Cardiovascular Rehabilitation and Secondary Prevention in China 2018 simplified edition, were revised based on the 2015 edition and with referring to the latest updates in the relevant international guidelines published in 2017 and 2018.

May 2018HIV MedicineA multicenter study led by Professor Li Taisheng of Department of Infectious Medicine, Peking Union Medical College Hospital-"Prospective Evaluation of Efavirenz Concentration in Chinese Patients with Human Immunodeficiency Virus Infection" was published online "[Guo F, Cheng X, Hsieh E, et al. Prospective plasma efavirenz concentration assessment in Chinese HIV-infected adults enrolled in a large multicentre study. HIV Medicine, 2018, 19 (7): 440-451.] 。 With the support of the 12th Five-Year Plan National Science and Technology Project (2012ZX10001003-001), the 13th Five-Year Plan National Science and Technology Project (2017ZX10202101) and the Medical and Health Science and Technology Innovation Project of the Chinese Academy of Medical Sciences (2017-12M-1-014), this research is the first in the world to report the characteristics of efavirenz blood concentration in HIV-infected patients in China when treated with efavirenz (600 mg once daily).

1. What is the principle of uric acid-lowering therapy?

Listeria monocytogenes (Listeria monocytogenes, hereinafter referred to as Listeria) is a gram-positive, facultative intracellular parasitic bacterium that is widely present in nature and is mainly transmitted to humans through food to cause listeriosis^[1]。 When eating food contaminated with Listeria can lead to diarrhea, abdominal pain and other digestive symptoms; When invasive infection occurs, bacteria can pass through intestinal epithelial cells into the blood, leading to bacteremia, meningitis, etc. Infection in pregnant women can lead to serious complications such as miscarriage, premature delivery and neonatal infection. The elderly, pregnant women and those with low immunity are at high risk of Listeria infection^[2]。 Listeriosis accounts for 19 percent of food-borne diseases in the United States, and the average annual medical expenses and economic losses for listeriosis reach $2.8 billion^[3]。

Recent studies have shown that the number of colonic bacteria in humans is estimated to be about 3.8×10 based on the bacterial content in feces and the volume of colon¹³Individuals^[1]。 The composition of the intestinal flora remains relatively stable after the host reaches adulthood, and changes during infection, pregnancy, administration of antimicrobial drugs, and long-term changes in the original lifestyle. Intestinal flora plays an important role in the establishment of host innate and acquired immunity, and the interaction between host and microorganism is also necessary for host immune tolerance. More and more studies have proved that intestinal flora disorders may be involved in the development of many diseases, including various autoimmune diseases^[2]。 This review illustrates the interaction between intestinal flora and host immune system, the alteration of intestinal flora in three autoimmune diseases: rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), ankylosing spondylitis (AS), and the adjuvant treatment of autoimmune diseases by regulating intestinal flora.

At present, commonly used clinical blood glucose monitoring methods include self-monitoring of blood glucose (SMBG), determination of glycated hemoglobin A1c (HbA1c), glycated albumin (GA) and continuous glucose monitoring (CGM). Different from traditional monitoring methods, CGM is a monitoring technology that reflects the blood glucose level by monitoring the glucose concentration of subcutaneous intertissue fluid through glucose sensor, which can comprehensively and continuously reflect the blood glucose information of patients in a certain period of time. Approved for marketing by the US Food and Drug Administration (FDA) since 1999^[1]So far, the CGM system has been in clinical application for nearly 20 years. With the continuous improvement and improvement of technology, its accuracy and stability have been continuously improved, and its cost has been reduced, which has gradually been recognized by everyone.

Osteoarthritis is a chronic bone and joint disease with high incidence and disability rate, but its specific pathogenesis has not been fully elucidated, and no targeted drugs to effectively cure this disease have been found in clinic. Chondrocytes are the only kind of cells in adult articular cartilage. With the change of external conditions such as age, the ability of chondrocytes to synthesize new cartilage matrix decreases, and the accumulation of harmful substances in joints causes the death of chondrocytes, which makes the articular cartilage unable to be repaired, finally leading to the occurrence of osteoarthritis. extracellular vesicles (extracellular vesicles) and autophagy (autophagy) are the hot research topics at present. Studies have shown that extracellular vesicles participate in the pathogenesis of osteoarthritis on the one hand, and their synthesis and release are closely related to chondrocyte autophagy on the other hand. The decrease of chondrocyte autophagy level can lead to cartilage degeneration and promote the occurrence of osteoarthritis. Therefore, the intrinsic relationship between extracellular vesicles, autophagy and osteoarthritis, as well as the potential clinical application prospects, are summarized below.