QuEChERS法结合气相色谱-串联质谱法测定贝母类中药中53种农药残留

目的建立基于QuEChERS法结合气相色谱-串联质谱法(GC-MS/MS)对贝母类中药中53种农药残留量的快速检测方法,并应用于193批样品筛查。方法根据调研选择禁限用及常用农药作为检测指标。采用QuEChERS法对样品进行前处理,在气相色谱-串联质谱多反应监测(MRM)模式下进行测定,以3个添加水平测定样品的回收率和RSD。结果 53种农药在一定含量范围内线性关系良好,r均大于0.997 8;在1倍LOD(Limit of Detection)、2倍LOD、10倍LOD 3个添加浓度水平进行回收率试验中,86.8%的农药在60%～140%,RSD均小于15%;各农药检出限均小于0.01 mg/kg。193批贝母类中药种共检出14种农药,91批样品有检出,检出率为47.2%,仅有1批超出即将执行的《中国药典》2020年版限度规定。结论该方法检测指标具有一定针对性,且操作简便快速、灵敏可靠,适用于贝母类中药中农药残留的筛查测定。对于贝母类中药的生产种植和流通监管具有一定的参考意义。     

医学博士生延期毕业影响因素分析

目的调查“双一流”建设高校医学博士生延期毕业的影响因素，为改进医学博士生培养模式、降低延期毕业率提供指导依据。方法通过“学生个体特征”“关键培养环节”“导学互动”以及“心理建设与社会支持”4个维度，构建医学博士生延期毕业影响因素理论模型，利用二元logistic回归进行统计分析。结果选择跨学科读博的研究生更易发生延期（OR=8.80,P=0.01），以“申请考核”（OR=9.06,P<0.01）、“硕博连读”（OR=5.41,P=0.02）方式录取的博士生较以直博生方式录取的博士生发生延期毕业风险更高；关键培养环节中“论文写作培训与科研能力训练”（OR=0.33,P=0.01）、“资助程度”（OR=0.42,P=0.05）以及导学互动中“导师及科研团队的指导”（OR=0.23,P=0.03）和“科研投入”（OR=0.56,P<0.01）均对正常毕业存在负向影响关系。结论建立科学合理的生源选拔机制、形成良好的导学互动、科学系统的写作训练、充实的资助以及国内国际学术交流有益于降低医学博士生的延期风险。下一步应加强关键培养环节的质量监控，完善医学博士生分流机制，强化问题导向，实现“导师+院系联动”保证培养质量。     

Review of the pharmacological effects of astragaloside IV and its autophagic mechanism in association with inflammation

Astragalus membranaceus Bunge, known as Huangqi, has been used to treat various diseases for a long time. Astragaloside IV (AS-IV) is one of the primary active ingredients of the aqueous Huangqi extract. Many experimental models have shown that AS-IV exerts broad beneficial effects on cardiovascular disease, nervous system diseases, lung disease, diabetes, organ injury, kidney disease, and gynaecological diseases. This review demonstrates and summarizes the structure, solubility, pharmacokinetics, toxicity, pharmacological effects, and autophagic mechanism of AS-IV. The autophagic effects are associated with multiple signalling pathways in experimental models, including the PI3KI/Akt/mTOR, PI3K III/Beclin-1/Bcl-2, PI3K/Akt, AMPK/mTOR, PI3K/Akt/mTOR, SIRT1–NF-κB, PI3K/AKT/AS160, and TGF-β/Smad signalling pathways. Based on this evidence, AS-IV could be used as a replacement therapy for treating the multiple diseases referenced above.     

Predict Blood Pressure by Photoplethysmogram with the Fluid-Structure Interaction Modeling

Blood pressure (BP) has been identified as one of the main factors in cardiovascular disease and other related diseases. Then how to accurately and conveniently measure BP is important to monitor BP and to prevent hypertension. This paper proposes an efficient BP measurement model by integrating a fluid-structure interaction model with the photoplethysmogram (PPG) signal and developing a data-driven computational approach to fit two optimization parameters in the proposed model for each individual. The developed BP model has been validated on a public BP dataset and has shown that the average prediction errors among the root mean square error (RMSE), the mean absolute error (MAE), the systolic blood pressure (SBP) error, and the diastolic blood pressure (DBP) error are all below 5 mmHg for normal BP, stage I, and stage II hypertension groups, and, prediction accuracies of the SBP and the DBP are around 96% among those three groups.     

医防协同,推动社区老年人常见感染性疾病疫苗应用

感染性疾病对老年人危害严重,接种疫苗是预防感染的有效手段。但我国常见感染性疾病疫苗的整体接种率偏低,基层医务人员及居民对疫苗接种的认知存在不足。《社区老年人常见感染性疾病疫苗应用专家共识》针对流感疫苗、肺炎球菌疫苗和带状疱疹疫苗3种常见疫苗的接种给予了详细的指导,旨在提高基层医务人员对老年人群疫苗接种的重视程度,加强其对公众的疫苗接种宣传教育,医防协同,共同助力提高老年人群健康水平。     

半夏泻心汤及其类方不同配伍对正常大鼠胃液成分的影响

目的为类方的配伍研究提供可参考的试验设计方法.方法用均匀设计法对半夏泻心汤及其类方进行组方药量变化研究,以胃液分析为药理学指标,对所得的药理实验数据进行逐步回归分析.结果在半夏泻心汤、甘草泻心汤方中,各药味对胃液成分的影响其变化趋势类似,但影响程度不尽相同,生姜泻心汤与其他两方出入较大.不同药味之间存在交互作用.结论本方法对类方配伍研究有一定参考价值.     

肾功能亢进患者万古霉素血药浓度监测与临床疗效分析

目的：调查分析肾功能亢进（augmented renal clearance, ARC）患者使用万古霉素的用药剂量、谷浓度及临床疗效。方法：回顾性研究2013年7月-2017年3月在某院住院期间使用过万古霉素并进行了血药浓度监测的67例ARC患者和142例肾功能正常患者病历资料,比较2组万古霉素给药方案、谷浓度及临床疗效。结果：ARC组与肾功能正常组初始给药的日剂量分别为（2.0±0.3） g和（1.8±0.4） g,具有显著性差异（P=0.041）。ARC组初始给药方案下谷浓度均值（8.3±5.2） mg·L^-1明显低于肾功能正常组的谷浓度均值（14.3±8.4） mg·L^-1,有显著性差异（P=0.000）。ARC患者的初始给药方案谷浓度达标率为20.6%,肾功能正常组为40.1%,具有显著性差异（P=0.007）。ARC组万古霉素的临床总有效率和革兰阳性菌清除率分别为69.1%和67.6%,肾功能正常组为76.7%和81.6%,均无显著性差异（P=0.286;P=0.143）。结论：多数ARC患者初始方案万古霉素用药剂量不足,谷浓度达标率较肾功能正常患者更低。     

海洋青铜小单孢菌FIM 02-523全基因组测序及分析

青铜小单孢菌(Micromonospora chalcea, M. chalcea)FIM 02-523能够合成对乏氧肿瘤细胞、艰难梭菌等具有活性的环脂肽类化合物rakicidins。利用Illumina HiSeq高通量测序平台,本研究首次对M. chalcea FIM 02-523进行全基因组测序,得到总长约6.74Mb的序列信息。分析表明基因组GC含量为72.89%,包含了6167个蛋白编码序列。利用AntiSMASH预测基因组中存在19个生物合成基因簇。结合PKS/NRPS生物合成特征和rakicidins化学结构特点,定位到了rakicidins的生物合成基因簇,并初步推测其生物合成途径。研究为M. chalcea FIM 02-523的功能基因组学研究和代谢调控提供了理论基础。     

初始耐药肺结核调查分析

目的掌握信宜市肺结核病人初始耐药疫情,分析耐药的原因,制定预防对策。方法以胸片、痰涂片诊断为肺结核的初治患者为对象,进行结核菌培养,阳性者做链霉素（S）、异烟肼（I）、利福平（R）、乙胺丁醇（E）四种药敏试验。结果共检测188例,初始耐药62例,占32．98％。其中耐1种药物51例,占耐药总数的82．26％;耐2种以上药物11例,占耐药总数的17．74％。41—50岁为耐药最高峰,四种耐药次序为I〉R〉S〉E。结论信宜市耐药肺结核疫情相当严峻,应进一步分析耐药原因,探讨预防对策。     

Genomic characterisation of breast fibroepithelial lesions in an international cohort

Fibroepithelial lesions (FELs) are a heterogeneous group of tumours comprising fibroadenomas (FAs) and phyllodes tumours (PTs). Here we used a 16-gene panel that was previously discovered to be implicated in pathogenesis and progression, to characterise a large international cohort of FELs via targeted sequencing. The study comprised 303 (38%) FAs and 493 (62%) PTs which were contributed by the International Fibroepithelial Consortium. There were 659 (83%) Asian and 109 (14%) non-Asian FELs, while the ethnicity of the rest was unknown. Genetic aberrations were significantly associated with increasing grade of PTs, and were detected more in PTs than FAs for MED12, TERT promoter, RARA, FLNA, SETD2, TP53, RB1, EGFR, and IGF1R. Most borderline and malignant PTs possessed ≥ 2 mutations, while there were more cases of FAs with ≤ 1 mutation compared to PTs. FELs with MED12 mutations had significantly higher rates of TERT promoter, RARA, SETD2, EGFR, ERBB4, MAP3K1, and IGF1R aberrations. However, FELs with wild-type MED12 were more likely to express TP53 and PIK3CA mutations. There were no significant differences observed between the mutational profiles of recurrent FAs, FAs with a history of subsequent ipsilateral recurrence or contralateral occurrence, and FAs without a history of subsequent events. We identified recurrent mutations which were more frequent in PTs than FAs, with borderline and malignant PTs harbouring cancer driver gene and multiple mutations. This study affirms the role of a set of genes in FELs, including its potential utility in classification based on mutational profiles. © 2019 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.