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Polymyxin B, which is a last-line antibiotic for extensively drug-resistant Gram-negative bacterial infections, became available in China in Dec. 2017. As dose adjustments are based solely on clinical experience of risk toxicity, treatment failure, and emergence of resistance, there is an urgent clinical need to perform therapeutic drug monitoring (TDM) to optimize the use of polymyxin B. It is thus necessary to standardize operating procedures to ensure the accuracy of TDM and provide evidence for their rational use. We report a consensus on TDM guidelines for polymyxin B, as endorsed by the Infection and Chemotherapy Committee of the Shanghai Medical Association and the Therapeutic Drug Monitoring Committee of the Chinese Pharmacological Society. The consensus panel was composed of clinicians, pharmacists, and microbiologists from different provinces in China and Australia who made recommendations regarding target concentrations, sample collection, reporting, and explanation of TDM results. The guidelines provide the first-ever consensus on conducting TDM of polymyxin B, and are intended to guide optimal clinical use.

Endothelial progenitor cells (EPCs) are a kind of progenitor cells with high potential of proliferation, which exist in the bone marrow, umbilical cord blood, and peripheral blood. Under certain conditions, EPCs can differentiate into mature vascular endothelial cells. Many studies have shown that EPCs could delay the onset and development of atherosclerosis by promoting the repair of the endothelium and neovascularization. EPCs have also been considered to be a biological marker for cardiovascular diseases. Recent investigations demonstrate that EPCs can mediate the effect of some anti-atherosclerosis drugs. This paper reviews the role of EPCs in atherosclerosis and the influence of drugs on EPC function. The feasibility and the problem of using EPCs as a treatment strategy are also discussed.

CD40/CD40L is a pair of complementary transmembrane glycoproteins, expressed on immune cells, endothelial cells, smooth muscle cells, platelets and other cells involved in regulation of immunity, inflammation, coagulation and other pathophysiologic states. A large number of researches have demonstrated that, when atherosclerosis occurs, CD40L ligates CD40; subsequently CD40 is activated and stimulates downstream signaling pathways, including nuclear factor-kappaB, with consequent up-regulation of proinflammatory and proatherogenic genes. Thus it plays an important role in the occurrence, development and plaque-rupture of atherosclerosis. CD40/CD40L is a bridge between immunity, inflammation, and a hypercoagulable state, and may be an important target for prevention and treatment of cardiovascular disease.