近年来，达标治疗策略在系统性红斑狼疮（SLE）治疗中取得了巨大进展。达标治疗理念认为，SLE患者治疗的主要目标是获得并保持临床缓解，如不能达到临床缓解，则以达到低疾病活动度为次要目标。达到治疗目标并维持一定时间后，则可尝试糖皮质激素逐渐减量，如有可能可以完全停用。在持续获得临床缓解的患者中，可继续尝试逐渐减停免疫抑制剂和抗疟药物。在保持低疾病活动度的患者中，则可尝试免疫抑制剂逐渐减量。达标治疗理念为SLE零激素与零用药指明了方向并提供了可能性。本文总结了SLE达标治疗的最新理念，探讨了该理念对SLE治疗中糖皮质激素、免疫抑制剂以及抗疟药减停的影响及指导意义。

玫瑰痤疮是一种慢性复发性炎症性皮肤病,随着玫瑰痤疮发病机制研究的进展,一些新的治疗方法出现并使用于临床.本文综述了近五年内玫瑰痤疮治疗新方法,包括抗微生物类药物、抗疟药、ROS抑制剂、JAK抑制剂、生物制剂等药物治疗,射频治疗、577 nm近黄光激光、ALA-PDT、超声治疗等光电疗法,肉毒素及血小板注射治疗及膳食治疗.

系统性红斑狼疮(systemic lupus erythematosus,SLE)是一种累及多个器官或系统的自身免疫性疾病,呈现迁延反复的慢性病程.采取长期有效的管理策略,有利于延缓SLE疾病进展,降低器官损害,以及改善预后.常用药物包括糖皮质激素、抗疟药、免疫抑制剂和生物制剂,合理使用这些药物并降低其不良反应至关重要.SLE的复发率很高,需要定期评估患者的疾病活动度,尽快祛除复发诱因及诱导缓解治疗.由于SLE对器官系统的损害,应当关注靶器官损害及合并感染或妊娠等特殊情况.此外,慢病管理需要重视患者的健康教育、生活方式以及心理状况.本文将从SLE的疾病活动度评估、治疗药物、合并症和并发症等方面来阐述慢病管理的目标与策略.

疟疾作为全球重大公共卫生事件之一,是以非洲撒哈拉以南地区为主的热带、亚热带地区儿童和成人患病及死亡的重要原因,严重威胁人类的健康.疟疾引发的贫血、黑尿热、脑型疟、肾损伤等并发症广为人知.传统意义上,心脏受累并没有被列为影响疟疾发病率和病死率的常见原因,这可能与漏报或诊断不足有关,但其引起的急性冠脉综合征、心力衰竭、恶性心律不齐等严重的临床危害备受关注.目前临床上,抗疟药物使用不当会增加心血管疾病风险,造成严重的后果.该文系统总结了急性心肌梗死、心律失常、高血压病、心力衰竭、心肌炎等疟疾相关心血管并发症的研究进展,从细胞黏附假说、炎症及细胞因子假说、疟原虫诱生毒素致心肌细胞凋亡假说、急性肾功能衰竭继发心脏损伤假说、血栓形成假说等总结了疟疾导致心血管疾病发生的可能机制,并整理了临床常用的喹啉类抗疟药、核蛋白合成抑制类药物、青蒿素及其衍生物对心脏结构和功能的影响.相较于喹啉类药物在抗疟治疗中表现出的心脏毒性,青蒿素类抗疟药物目前在临床应用中未见对心脏的不良影响,而且在预防和治疗心血管疾病方面具有良好的应用前景,有望在心血管基础疾病人群罹患疟疾过程中发挥优势.该文旨在为疟疾心血管并发症防治及抗疟药安全应用提供参考.

青蒿素是从中草药青蒿中分离出的一种倍半萜内酯类抗疟药物.近年来,在不同疾病条件下研究发现青蒿素类药物在感染性疾病、自身免疫性疾病和肿瘤等非疟疾疾病中具有显著疗效.本文回顾了近年来国内外相关文献,并总结了青蒿素类药物在非疟疾疾病中的临床应用及其药理作用的研究进展.相信随着药物合成技术和临床药理学的进步,青蒿素类药物会在非疟疾疾病领域发挥更大作用.

Background:Increased serum autoantibodies against interleukin-2 (anti-IL-2 autoantibodies) were reported in patients with systemic lupus erythematosus (SLE) and in patients receiving IL-2 therapy.This study aimed to explore the clinical relevance of serum anti-IL-2 autoantibodies and the interactions between low-dose IL-2 therapy and serum anti-IL-2 autoantibodies.Methods:Serum samples were collected from 152 SLE patients and 100 age-and gender-matched healthy controls (HCs).Among them,75 SLE patients were followed up for 10 weeks,and all of them were treated with corticosteroids,antimalarials,and/or immunosuppressants.Forty-six out of the 75 SLE patients received low-dose IL-2 therapy additionally.Clinical and laboratory parameters were collected at baseline and week 10.Serum anti-IL-2 autoantibodies were determined by enzyme-linked immunosorbent assay.Results:Compared with HCs,median levels and positive rates of serum anti-IL-2 autoantibodies were higher in SLE patients (32.58 [23.63,45.23] arbitrary unit [AU] vs.37.54 [27.88,60.74] AU,P =0.006,and 5.0％ vs.18.4％,P =0.002,respectively).Compared to those without the corresponding disorders,serum anti-IL-2 autoantibody was increased in patients with alopecia (49.79 [36.06,64.95] AU vs.35.06 [25.40,58.46] AU,P =0.033),but it was decreased in those with lupus nephritis (31.71 [22.60,43.25] AU vs.44.15 [31.43,68.52] AU,P =0.001).Moreover,serum anti-IL-2 autoantibody was positively correlated with serum IgA (r =0.229,P =0.005),total IgG (r =0.327,P ＜ 0.00 1),and total IgM (r 0.164,P =0.050).Treatment with exogenous IL-2 was not significantly associated with serum anti-IL-2 autoantibody.In addition,no significant difference was found in serum anti-IL-2 autoantibody between responders and nonresponders to low-dose IL-2 therapy.Conclusions:Serum anti-IL-2 autoantibody was increased and associated with disease severity in SLE.Exogenous low-dose IL-2 did not significantly induce anti-IL-2 autoantibody production.

Cancer is a leading cause of death globally,while malaria is the leading cause of death from parasitic diseases in Nigeria.Historically,plant remedies have been used to manage both cancer and malaria.Interestingly,the possibility of treating cancer with antimalarial remedies has long been reported,even though the two diseases appear to have little in common.However,a body of research has indicated the potential anticancer activity of both synthetic and nature-derived antimalarials.In Nigeria,over 100 plants are used for the management of malaria,but little is known for their potential role in combatting cancer.Therefore,this review is to highlight the documented anticancer activities of plants used to treat malaria in Nigeria,with the goal of supporting anticancer drug discovery.Scientific databases were used to search for antimalarial plants using selected keywords.Of over 100 plants used to treat malaria in Nigeria,56 have documented anticancer properties,containing alkaloids,flavonoids,tannins,terpenes,terpenoids,quinones,anthraquinones,saponins,steroids,sterols,organosulfur compounds and other polyphenols as the major bioactive components.The major mechanisms of anticancer activity include induction of apoptosis and autophagy,arrest of cell growth,generation of reactive oxygen species and inhibition of angiogenesis.However,mechanistic and clinical investigations of the anticancer properties of most of these plants are still lacking.Notwithstanding,the huge anticancer potential uncovered by the in vitro or in vivo studies and a few clinical studies,Nigerian antimalarial plants may provide a valuable resource,ready to be harnessed for anticancer drug development.

本文报道了广东高本底地区与对照地区除辐射以外的其它致癌和致突变因素的对比研究结果。研究内容包括：自然地理条件，民族及世居史，居民附加医疗照射，药物和农药使用量，食物种类和饮食习惯，工业 "三废" 污染，以及表层土中微量元素含量等。研究结果表明，两地这些条件比较相似，是可比的。但这些研究还是初步的，今后还要进一步的深入研究。

Having faced increased clinical treatment failures with dihydroartemisinin-piperaquine(DHA-PPQ),Cambodia swapped the first line artemisinin-based combination therapy(ACT)from DHA-PPQ to artesunate-mefloquine given that parasites resistant to piperaquine are susceptible to mefloquine.However,triple mutants have now emerged,suggesting that drug rotations may not be adequate to keep resistance at bay.There is,therefore,an urgent need for alternative treatment strategies to tackle resistance and prevent its spread.A proper understanding of all contributors to artemisinin resistance may help us identify novel strategies to keep artemisinins effective until new drugs become available for their replacement.This review highlights the role of the key players in artemisinin resistance,the current strategies to deal with it and suggests ways of protecting future antimalarial drugs from bowing to resistance as their predecessors did.