（来源：中国医药报） 转自：中国医药报 □ 李橙妍 横纹肌溶解综合征是一种由多种原因引起的肌肉疾病，虽不常见但却非常严重，使用某些药物是其重要 的诱发因素。了解药物诱发横纹肌溶解的机制，科学规范用药，有助于避免发生。 疾病症状 用药提醒 可引起横纹肌溶解的药物有他汀类药物、贝特类药物等。 他汀类药物可以降低血胆固醇、调节血脂，可用于治疗高脂血症，同时还可以用于预防动脉粥样硬化形 成，代表药物有阿托伐他汀、普伐他汀、瑞舒伐他汀等。该类药物通过抑制甲羟戊酸途径，减少辅酶 Q10和胆固醇合成，导致肌细胞膜稳定性下降和线粒体功能障碍，从而诱发横纹肌溶解；且横纹肌溶解 的风险随着药物使用剂量的增加而升高。另外，该类药物与环孢素、吉非罗齐、红霉素、克拉霉素、伊 曲康唑、酮康唑、泊沙康唑、伏立康唑、秋水仙碱等药物或葡萄柚汁联合服用，也会使横纹肌溶解的风 险升高。 贝特类药物也具有调节血脂的作用，可用于治疗高甘油三酯血症、高胆固醇血症等疾病，代表药物有非 诺贝特、苯扎贝特等。该类药物可能干扰肌肉细胞能量代谢，导致肌细胞膜稳定性下降，进而引起横纹 肌溶解。 除上述药物外，抗精神病药物（如氟哌啶醇、奥氮平、利培酮、喹硫平、氯氮平 ...

觉中国 （来源：上观新闻） 血脂异常是导致心血管疾病的主要危险因素之一。在心血管疾病的高发季节，控制好血脂显得格外重 要。 有关降血脂的疑问总是层出不穷，笔者总结了以下三个最常见的问题，也是患者最常见的认识误区。 图源：视 吃素为什么不能降血脂 "医生，我已经吃素一年了，蛋黄、油都不敢碰，怎么胆固醇不降反升了？"王阿姨拿着体检报告，一脸 困惑。与很多人一样，她认为胆固醇全是"吃出来"的。 其实，血液里的胆固醇就好比是一个"合资企业"的产物，"吃进去"的只是"小股东"。人体内有一座24小 时运转的精密"胆固醇工厂"，它通过两条生产线工作。 一条是外源性"采购线"，产量占总量的20%到30%。吃进去的鸡蛋、动物内脏等食物中的胆固醇，就像 从外部采购的"原材料"，控制"采购"，就能减少这部分胆固醇的产量。 二是内源性"自主生产线"，产量占总产量的70%到80%。这才是"胆固醇工厂"的"主营业务"。这条生产 线的效率和产量，很大程度上是由遗传基因决定的。 关键问题来了，有些人天生遗传了高效率的"生产图纸"，或者负责回收胆固醇成品的"物流系统"（LDL 受体）效率偏低。这就导致哪怕完全断绝了外部"采购"，吃得极其清淡， ...

Core Insights - Blood lipid management is crucial for preventing cardiovascular diseases and is a significant public health issue, requiring innovative approaches and multi-strategy collaboration [1][2][3] Group 1: Importance of Blood Lipid Management - Effective blood lipid management is essential for cardiovascular disease prevention, as poor lipid control can lead to serious conditions like myocardial infarction and stroke [2][4] - There is a low awareness, treatment, and control rate among patients with lipid abnormalities in China, indicating many are at high risk without symptoms [2][3] Group 2: Technological Integration - The integration of modern technology with healthcare is transforming traditional treatment models, making cardiovascular disease prevention more accessible [2][3] - Wearable devices and AI can enhance the monitoring and analysis of lipid levels, improving patient adherence to treatment and shifting from episodic to continuous intervention [3][4] Group 3: Collaborative Treatment Approaches - Joint treatment strategies are becoming a key focus in lipid management, supported by evidence that lower cholesterol levels reduce cardiovascular disease risk [4][5] - A combination of statins and cholesterol absorption inhibitors is recommended to achieve better lipid control while minimizing side effects associated with high doses of single medications [4][5] Group 4: Essential Medicines and Local Evidence - The basic drug list is crucial for ensuring access to essential medications, and there is a push to expand this list to include more combination therapies [6][7] - Emphasizing local evidence in clinical trials for new drugs is vital for ensuring their effectiveness and safety for the Chinese population [7][8] - A collaborative approach involving research, policy, and clinical practice is necessary to enhance the effectiveness of lipid management and ensure that innovative treatments benefit patients [7][8]

Summary of Key Points from the Conference Call Industry Overview - The conference call focuses on the **hyperlipidemia treatment market** in China, highlighting the significant unmet medical needs due to the low treatment rate among over **400 million** patients with dyslipidemia [1][2][14]. Core Insights and Arguments - **Current Treatment Limitations**: Existing medications, particularly statins, have efficacy limitations. PCSK9 inhibitors, while effective, are expensive and require injections, which restricts their clinical application [1][2][5][14]. - **Emerging Therapies**: The rise of **small nucleic acid technology** is notable, with new targets such as **LPA** and **APOC3** being explored. Oral PCSK9 inhibitors, like those from Merck, show promising clinical results comparable to injectables, potentially increasing patient acceptance [1][2][3][9][15]. - **Market Potential**: The sales peak for oral PCSK9 inhibitors is projected to exceed **$5 billion**. The innovative drugs targeting non-LDL pathways are expected to significantly advance the field of dyslipidemia treatment [3][9][15]. - **New Treatment Targets**: For hypertriglyceridemia, **NANGPTL3** and **APOC3** are emerging as new therapeutic targets, with clinical data showing positive results for small nucleic acid products [10][15]. Additional Important Insights - **Patient Compliance**: Oral formulations are anticipated to improve patient compliance compared to injectable therapies, which is crucial for chronic conditions like hyperlipidemia [9][14]. - **Technological Advancements**: Companies with strong R&D capabilities and technological advantages are likely to lead in the competitive landscape of the hyperlipidemia market [2][15]. - **Market Dynamics**: The market is characterized by a high barrier to entry for new technologies and targets, indicating that firms with established capabilities in these areas will have a competitive edge [15]. - **Clinical Guidelines**: Current clinical guidelines prioritize LDL-C as the primary treatment target, with other non-LDL targets being addressed subsequently [4][8]. Conclusion - The hyperlipidemia treatment market in China is poised for significant growth driven by innovative therapies and a focus on unmet clinical needs. Companies that can leverage new technologies and address these needs will likely thrive in this evolving landscape [15].

Core Insights - The article emphasizes the increasing prevalence of dyslipidemia among adults in China, with a reported rate of 35.6% in individuals aged 18 and above as of 2018, highlighting the need for early intervention in blood lipid management [6][8]. Group 1: Health Risks and Findings - Dyslipidemia often presents no early symptoms, yet it can lead to significant vascular damage over time, increasing the risk of atherosclerotic cardiovascular diseases [6]. - Recent research suggests that the prevention of atherosclerosis should begin earlier in life, particularly focusing on the dietary habits of children and adolescents [6][9]. - A study conducted by Cambridge University found that young mice exposed to intermittent high-fat diets exhibited a significantly higher risk of atherosclerosis compared to those that were only exposed in later life [8][9]. Group 2: Research Implications - The findings indicate a strong correlation between elevated cholesterol levels in early life and the severity of atherosclerotic plaques in middle age [9]. - The research identified that early cholesterol elevation alters the gene expression of macrophages, which are crucial for clearing damaged cells and cholesterol, thereby weakening their protective function [9]. - Intermittent spikes in cholesterol levels, often due to dietary fluctuations, may pose greater risks than sustained high cholesterol, as seen in patients who irregularly take statins [9][11]. Group 3: Additional Studies - A concurrent study from Paris University also confirmed that intermittent high-fat diets accelerate atherosclerosis more than continuous high-fat diets, indicating a need for consistent dietary management [11].

Core Insights - The article highlights the increasing prevalence of coronary heart disease (CHD) in China, particularly among younger individuals, driven by unhealthy lifestyle choices and societal pressures [1][2][3]. Group 1: Prevalence and Trends - Coronary heart disease patients in China have exceeded 11 million, growing at an annual rate of approximately 2.5% [1]. - There is a concerning trend of younger individuals being diagnosed with CHD, attributed to unhealthy lifestyles and various environmental and psychological factors [1][2][3]. Group 2: Lifestyle Factors - Unhealthy lifestyle choices, such as a Westernized diet high in calories, fats, and sugars, along with reduced physical activity, are significant contributors to the rising rates of CHD among the youth [2][3]. - Factors like prolonged sitting, lack of exercise, sleep deprivation, and high stress levels further exacerbate the risk of developing cardiovascular diseases [3][4]. Group 3: Prevention and Management - Emphasis is placed on preventive measures for individuals under 35, including adopting healthy habits, regular health check-ups, and maintaining a balanced diet [2][4]. - Key recommendations for prevention include low-salt and low-fat diets, regular exercise, weight management, and stress control [2][4][5]. Group 4: Treatment Approaches - Drug therapy is considered the cornerstone of CHD treatment, aimed at alleviating symptoms, slowing plaque progression, and preventing thrombosis [7][8]. - Surgical options include percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG), with the choice depending on the severity and extent of the disease [7][9]. Group 5: Advances in Treatment - New drug developments, such as PCSK9 inhibitors, show promise in significantly lowering lipid levels and improving patient outcomes compared to traditional statins [8][9]. - The integration of advanced technologies, including AI and imaging techniques, is enhancing the precision of CHD diagnosis and treatment [9].

Group 1 - Cholesterol is an essential substance for the human body, playing a critical role in synthesizing hormones and vitamin D, and forming cell membranes [3][4] - Cholesterol levels can be influenced by both internal factors (genetics, diseases) and external factors (lifestyle habits such as diet and exercise) [4] - There are two types of cholesterol: high-density lipoprotein (HDL-C) known as "good cholesterol" and low-density lipoprotein (LDL-C) known as "bad cholesterol" [5][6] Group 2 - High levels of LDL-C can lead to serious health issues such as coronary heart disease and stroke, while HDL-C helps to remove excess cholesterol from the bloodstream [6][7] - It is important to assess cholesterol health through a comprehensive analysis of various blood lipid indicators, not just total cholesterol [8][10] - Individual cholesterol levels can vary based on personal health history, age, and lifestyle, making it essential to consider these factors when evaluating cholesterol [7][8] Group 3 - Dietary recommendations for lowering cholesterol include increasing intake of whole grains and high-quality fats while avoiding saturated and trans fats [10][12][14] - Regular physical activity is advised, with recommendations for at least 150 minutes of moderate-intensity aerobic exercise per week [22] - If lifestyle changes are insufficient, medication may be necessary, with common options including statins and cholesterol absorption inhibitors [24][25]

Group 1: Core Insights - The Taizhou Bay Economic and Technological Development Zone's pharmaceutical park is a national pilot for pollution reduction and carbon emission control, implementing 20 green low-carbon technology transformation projects and achieving a carbon reduction of approximately 12,500 tons [1] - The park has established a complete industrial chain from intermediates to active pharmaceutical ingredients (APIs) and formulations, aiming to become a globally influential pharmaceutical innovation hub [2] - The transition from "pharmaceutical chemistry" to "pharmaceutical health" is a key path for industrial upgrading, with a focus on traditional pharmaceutical industries transforming into new materials and high-end formulations [2] Group 2: Technological Innovations - Huahai Pharmaceutical's Sichuan branch has achieved a 40% reduction in carbon emissions per unit output from 0.91 tons per 10,000 yuan in 2020 to 0.54 tons per 10,000 yuan in 2024, alongside significant waste reduction and economic benefits [3] - The company has implemented advanced solvent recovery technologies to improve energy efficiency and reduce steam and electricity consumption by 30% and 17% respectively [3] - A unique evaluation index for pollution reduction and carbon emission control in the pharmaceutical industry has been established, reflecting the levels of "pollution reduction," "carbon reduction," and "efficiency increase" [3] Group 3: Digital Empowerment - The Taizhou Bay Economic and Technological Development Zone has invested 100 million yuan in a "smart park" regulatory platform, integrating AI and big data for environmental management [4] - The park has developed a comprehensive ecological monitoring network that covers environmental quality, pollution sources, and ecological conditions [5] - The park has been recognized as a national pilot for innovative collaborative pollution reduction and carbon emission control, and has achieved the status of a "zero direct discharge" industrial park in Zhejiang Province [5]

Core Viewpoint - The importance of curiosity and exploration in scientific research is emphasized as essential for contributing to societal development and maintaining passion in work [5]. Group 1: Scientific Research and Innovation - The need for scientists to have a sense of national pride, academic ethics, and a spirit of dedication is highlighted as part of the "scientific spirit" [3]. - Originality, innovation, leadership, and usefulness are crucial for success in scientific research, and perseverance is necessary despite challenges [5]. - The government is encouraged to change management models to allow scientists to focus deeply on their research, with examples of funding initiatives that provide long-term support [5]. Group 2: Catalysis Research and Pharmaceutical Industry - Catalysts play a significant role in reducing pharmaceutical costs, as higher catalytic efficiency leads to better conversion rates of raw materials into drugs [8]. - Breakthroughs in catalyst research have significantly lowered the costs of various drugs, including weight loss medications and statins, with prices dropping from thousands of dollars to hundreds [9]. - The reluctance of pharmaceutical companies to invest in original new drugs due to perceived risks is noted, suggesting a need for increased government investment in innovative drug development [10]. Group 3: Impact of Artificial Intelligence - Artificial intelligence is expected to enhance research efficiency in catalysis by analyzing data to identify patterns and guiding catalyst design and synthesis [7].

Group 1 - The importance of a supportive policy environment for scientists to focus on research is emphasized, with some departments already making changes to facilitate this [2][3] - The spirit of a scientist is defined by patriotism, academic integrity, a spirit of dedication, and mentorship for younger researchers [2][3] - Maintaining curiosity and a sense of responsibility is crucial for young researchers to contribute to societal development [3] Group 2 - The process of achieving breakthroughs in catalyst research can take several years, and persistence is key during challenging times [4] - Engaging in discussions with students and colleagues is vital for identifying challenges and potential breakthroughs in research [4] Group 3 - Artificial intelligence is expected to significantly enhance efficiency in catalyst research by analyzing data to identify patterns and guiding catalyst design [5] - The efficiency of catalysts directly impacts pharmaceutical production costs, with higher efficiency leading to better conversion rates and reduced waste [6] Group 4 - Recent advancements in catalyst technology have led to substantial cost reductions in various medications, including weight loss drugs and statins [7] - There is a noted lack of sufficient investment in innovative drug development in China, with a call for increased government support for original new drugs [8]