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01 October 2013, Volume 33 Issue 10 Previous Issue    Next Issue

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Strengthening good clinical practice of glucocorticoids:background and of guidelines for clinical applications of glucocorticoids and its significance. NING Guang. 2013, 33(10): 753-755.  Abstract ( )   PDF (925KB) ( )   Abstract：Glucocorticoids have been widely used in a variety of diseases because of its potent anti-inflammatory，immunosuppressive，anti-toxicity and anti-shock activities.However，its indications are not strictly followed and glucocorticoids have been excessively prescribed.Moreover，glucocorticoids have great diversity of generics，formulas，routes of admiration and dosage options.Its adverse effects and complications have been one of the challenges for both clinician and patients.Therefore，in 2011，National Health Ministry released the Guidelines for Clinical Applications of Glucocorticoids.

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Basic principles for the clinical application of glucocorticoids. NING Guang. 2013, 33(10): 756-759.  Abstract ( )   PDF (940KB) ( )   Abstract：Natural and synthetic glucocorticoids have been widely used in both endocrine and nonendocrine disorders.A number of factors affect both the therapeutic and side effects of glucocorticoids，including the pharmacokinetic of the glucocorticoids，daily dose，timing of doses during the day，individual differences in steroid metabolism，and the duration of treatment.Despite its efficacy，steroid-induced side effects generally require tapering of the drug as soon as the disease being treated is under control.Tapering must be done carefully to avoid both relapse of the disease and possible cortisol deficiency resulting from hypothalamic-pituitary-adrenal axis suppression.

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Application of glucocorticoids in endocrine diseases. WANG Wei-qing. 2013, 33(10): 760-763.  Abstract ( )   PDF (931KB) ( )   Abstract：Glucocorticoids can maintain glucose homeostasis and sodium balance and have the anti-inflammatory activity.It is used in the management of adrenocortical insufficiency，congenital adrenal cortical hyperplasia，thyroid-associated ophthalmopathy and the diagnosis and differential diagnosis of Cushing syndrome.Different glucocorticoids have different effects on glucose，sodium or immune system.Physicians should prescribe the suitable glucocorticoids to manage different clinical situations.

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Application of glucocorticoids to respiratory diseases. HU Hong，LIU You-ning. 2013, 33(10): 764-767.  Abstract ( )   PDF (994KB) ( )   Abstract：Since glucocorticoids have anti-inflammatory，anti-allergic，anti-toxins，anti-shock and immunosuppressive effects，they have been widely used in the treatment of respiratory diseases.Based on the guidelines for the clinical application of glucocorticoids developed by the Ministry of Health in 2011，with reference to the recent guidelines home and aboard，this paper focused on the treatment principle and treatment method of glucocorticoid in bronchial asthma，idiopathic interstitial pneumonia，allergic bronchopulmonary aspergillosis，sarcoidosis，chronic obstructive pulmonary disease and eosinophilic bronchitis and other respiratory diseases in the hope of regulating reasonable clinical application of glucocorticoid in respiratory diseases and reducing adverse reactions.

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Application of glucocorticoid in common digestive diseases. XIE Peng-yan. 2013, 33(10): 768-770.  Abstract ( )   PDF (926KB) ( )   Abstract：Glucocorticoid plays an important role in the treatment of digestive system diseases.The article introduces the glucocorticoid in inflammatory bowel disease (Crohn’s disease and ulcerative colitis)，eosinophilic esophagitis，eosinophilic gastroenteritis，severe acute pancreatitis，autoimmune pancreatitis，alcoholic liver disease，autoimmune hepatitis and tuberculous peritonitis，application principles of disease treatment and precautions.

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Use of glucocorticoids in the treatment of kidney diseases. CAI Guang-yan. 2013, 33(10): 771-774.  Abstract ( )   PDF (938KB) ( )   Abstract：The initiation and progression of many renal diseases are associated with abnormal immune and inflammatory reactions.Glucocorticoids have powerful anti-inflammatory and immunosuppressive effects，which plays an important role in the treatment of immune-mediated kidney diseases，including nephrotic syndrome，progressive glomerulonephritis or disorders with active pathological lesions.Treatment of kidney diseases with glucocorticoids generally starts at high doses and maintain for a long course.Improper use can cause serious adverse reactions.Therefore，renal physicians should prescribe medication based on the latest clinical guidelines to perform standard use with definite indications.Doctors should be familiar with treatment efficacy，its affecting factors，and hormone-induced side effects.Individualized treatment is advocated to avoid the excessive use of glucocorticoids.Clinical remission of renal diseases should be achieved with less adverse reactions during treatment with glucocorticoids.

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Glucocorticoid treatment in rheumatic diseases. XU Dong，SHI Qun，ZHANG Xuan. 2013, 33(10): 775-778.  Abstract ( )   PDF (933KB) ( )   Abstract：The glucocorticoid has become the anchor drug for the treatment of rheumatic diseases because of its potent anti-inflammatory and immunosuppressive effect.Glucocorticoid treatment could result in numerous side effects，so effective and appropriate treatment with glucocorticoid is very important in clinical practice.Middle-effect glucocorticoid was the most common type used in rheumatic disease，and glucocorticoid treatment should be individualized in each patient.Initial dosage，tapering method，and maintenance dosage depends on the types of rheumatic diseases，degree of disease activity，risk of side effect，and patient response to treatment.

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Use of glucocorticoids in the treatment of hematological disorders. YANG Ren-chi. 2013, 33(10): 779-781.  Abstract ( )   PDF (927KB) ( )   Abstract：Glucocorticoids are widely used in hematological disorders，including autoimmune blood diseases，such as autoimmune hemolytic anemia and idiopathic thrombocytopenic purpura，and malignant blood diseases.In malignant blood diseases，glucocorticoids are used alone or in combination with other agents，via its lymphocytolytic effects in the treatment of acute lymphocytic leukemia，lymphoma and multiple myeloma.Long-term use of glucocorticoids can cause a series of side effects，which are dose and time dependent.As doctors specialized in blood diseases，we should weigh the benefits and side effects of glucocorticoids.

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Application of glucocorticoids to infectious diseases. CHEN Zhi-hai. 2013, 33(10): 782-784.  Abstract ( )   PDF (982KB) ( )   Abstract：The application of glucocorticoids is a double-edged sword in the treatment of infectious diseases.Glucocorticoid shouldn’t be used in general or mild infections in principle.For shock，multiple system organ failure caused by serious infections，or for a particular target，the use of glucocorticoids may improve the prognosis and reduce certain impairments.Glucocorticoids are commonly used in severe hand foot and mouth disease(HFMD)，severe viral pneumonia，certain types of tuberculosis，orchitis complicated with brucellosis or mumps，shock caused by a variety of severe infections and so on.The timing of medication，dosage，course of treatment and side effects should be paid attention to.