Simple Trends in NMR Spectra of Vinyl Polymers: The 1H NMR Spectrum of Poly(propylene)

Summary: The tacticity spreading of chemical shifts in the proton NMR spectrum of poly(propylene) in solution has been analyzed first qualitatively, taking advantage of known trends in both proton chemical shift and conformational statistics of vinyl polymers as summarized in the telephone rule, and then quantitatively using ab initio computations, empirical additivity schemes of proton chemical shifts, and conformational averages according to models of different rotational isomeric states. The very good results obtained, both qualitatively and quantitatively, stem from the relatively easy parametrization of proton chemical shift and establish a successful application of the telephone rule, also for proton NMR spectra.

Anti and syn labeling of methylene hydrogens in m and r diads.     

A diagnostic decision rule for management of children with meningeal signs

In a previous study we devised a diagnostic decision rule to improve management of children with meningeal signs, suspected of having bacterial meningitis. The decision rule aimed to guide decisions on (1) whether a lumbar puncture is necessary in children with meningeal signs, and (2) which children need hospitalisation and empirical antibiotic treatment for bacterial meningitis. In this study we assessed the validity of this rule in an external population of four (paediatric) hospitals in The Netherlands. The decision rule included two scoring algorithms using symptoms, signs and quickly available blood and cerebrospinal fluid (CSF) laboratory tests. To evaluate the discriminative value of both algorithms, the absolute numbers of correctly diagnosed patients and the area under the receiver operator characteristic curve were estimated, and compared with the results from the original population (n = 360). In a 18 month period, we included 226 children, median age 2.2 years, who visited the emergency department with meningeal signs. Bacterial meningitis was present in 25 (11%). Using the scoring algorithms patients could be categorised in groups of increasing risk of bacterial meningitis. The discriminative values of the clinical and CSF algorithm in this new population were similar to those in the original population. In the total population of 586 children with meningeal signs, the rule selected 205 children (35%) who did not need a lumbar puncture and 366 children who did not need empirical treatment (62%). In conclusion, this diagnostic rule performed well in a new population of children with meningeal signs. This diagnostic decision rule is a valuable tool for the clinician when deciding to treat these children for bacterial meningitis and thus improving their management.     

Shape of the left ventricle and its computer modelling

A simple computer program was made to draw different left ventricle shapes in order to support the theory of elongation and to get a visual presentation of the shape of the left ventricle. Experimental data, obtained from echocardiography and Simpson's rule, were used for this program. The results yielded different shapes under different physiological circumstances, indicating the sensitivity of the method. It was concluded that these figures (shapes) support the use of elongation as a shape index.     

生活垃圾管理法治化的内涵

探讨了生活垃圾管理法治化的基本原则,强调了依法管理垃圾所必须坚持的主要原则和制度,并指出目前实现生活垃圾管理法治化急需加强执法队伍建设.     

北京地区近10年高血压病中医用药规律分析

通过对近10年来北京地区中医药治疗高血压病临床研究方面文献资料的回顾性总结,从中医药治疗高血压病总体用药规律、组方用药规律和辨证用药规律等3个方面加以分析。结果显示：①总体用药规律：用药类别由高到低依次为补虚药、平肝息风药、清热药、活血祛瘀药、利水渗湿药；常用中药依次为钩藤、牛膝、天麻、茯苓、白药、泽泻、川芎等。②组方用药规律：用药类别前6位同总体用药；常用中药依次为钩藤、牛膝、茯苓、天麻、川芎、白芍、泽泻等。③常见中医证型和药物依次是：肝阳上亢证为钩藤、牛膝、白芍、天麻、川芎、菊花等,肝肾阴虚证为枸杞子、牛膝、山茱萸、熟地黄、茯苓、牡丹皮等,肝火炽盛证为黄芩、夏枯草、钩藤、栀子、龙胆草、菊花等,痰浊上扰证为茯苓、半夏、橘皮、白术、天麻、甘草等,肝风内动证为天麻、钩藤、白芍、石决明、半夏等,瘀阻脑络证为川芎、赤芍、红花、桃仁、丹参、三七等,阴阳两虚证为山茱萸、熟地黄、茯苓、肉桂、附子、牛膝等。     

糖尿病肾病中医治疗用药规律分析

[目的]探讨糖尿病肾病(DN)中医治疗用药规律.[方法]通过以"糖尿病肾"中药治疗"、"中医治疗"为副主题词,检索"中国期刊网全文数据库"2002-2007年的医学数据,最终经筛选实际进行分析文献129篇,对其进行用药规律的初步归纳和一般统计方法进行分析.[结果]发现129篇中医药治疗的文献报道中,共用中药274味,使用频次前10位的药物分别为黄芪、茯苓、山药、丹参、山茱萸、白术、泽泻、当归、大黄、制附子.[结论J糖尿病肾病用药是以补益、健脾药和活血、清利药为主,兼及其他,在具体用药上又各具特点.     

尿液分析自动审核方法的建立与评价

目的建立合适的尿常规自动审核预警规则。方法根据尿常规项目临床意义、检测结果间的逻辑关系及历史回顾等在实验室信息系统(PRD)中建立自动审核规则,对自动审核规则进行评估通过后启用自动批准,并评价使用自动审核系统前后样本周转时间(TAT)的变化。结果依据5种自动预警规则模板,建立了64条自动预警规则;尿常规平均触发规则率为96.7%,自动审核发放报告通过率达63.0%,人机一致性达98.7%,且通过的报告正确率为100%,样本周转时间TAT有明显的缩短。结论本自动审核系统的建立可缩短尿液分析报告单的TAT,提升工作效率。     

论法治视野中的卫生管理法制化建设

依法治医势在必行但应该缓行，法制化建设需要基本法治条件：1．树立法律权威意识，崇尚法治精神；2．树立法治意识，严格依法办事；3．树立创新意识，不断发展法治。结合当前法治目标环境对医疗卫生事业良性发展的基本要求，着眼于卫生管理法制化的体系建设，在卫生立法、卫生执法、卫生守法和卫生监督等方面提出了相应的对策、建议。