三种佛手不同提取部位的薄层色谱分析

目的 探讨不同佛手品种的鉴别方法。方法 对3种不同产地佛手醇提取物的石油醚与醋酸乙酯提取部位进行了薄层色谱分析。结果 研究表明，在石油醚．醋酸乙酯（90：10）展开系统中，3种佛手石油醚提取部位的薄层色谱所显示的斑点不相一致，其化学组成差异较大，而醋酸乙酯提取部位在石油醚-醋酸乙酯（85：15）系统的薄层荧光图谱，也显示了三种佛手不同的化学成分。结论 两种提取部位的薄层色谱实验均提示了三种不同产地佛手显著的种间差异性。     

加强高职高专医学生公共卫生和临床医学整合教育的思考

文章讨论了由突发公共卫生事件引发的对构建现代公共卫生和临床医学整合教育模式的反思及其对策措施.透过SARS危机，暴露出我国现行医学教育体制上存在的医防分离的严重性，提示我们应借鉴21世纪医学生培养目标与要求，改革医学教育模式，促进多学科、跨专业的合作，建立以社区为目标、以问题为中心的公共卫生与临床医学整合教育的全新综合化课程体系;积极推广计算机辅助教育（CAI），加强运用现代化教学手段;建设以社区实践为主要内容的公共卫生和临床医学整合教育基地，加强高职高专医学生实践技能的培养，以构建新型高职高专医学人才培养模式，培养防治结合的新型实用型医学人才.     

清洁手术的围手术期抗菌药物预防使用分析

目的:观察术前 术后未使用抗菌药,仅术前使用抗菌药和术前 术后均使用抗菌药三组病人清洁手术的切口愈合情况.方法:将三组病人术后情况进行统计分析.结果:三组病人切口愈合情况无显著性差异.结论:清洁手术术后一般不需要应用抗菌药物预防切口感染.     

Concurrent primary carcinoid tumor arising within mature teratoma and clear cell renal cell carcinoma in the horseshoe kidney: report of a rare case and review of the literature

Primary carcinoid tumor arising in a mature teratoma of the horseshoe kidney is exceptionally rare and only 4 such cases have been reported in the world literature to date. The simultaneous occurrence of different subtypes of renal cell carcinoma (RCC) or RCC coexistence with non-RCC neoplasms from the same kidney is unusual and infrequently reported. Herein we report a case of primary carcinoid tumor arising within mature teratoma, concurrent with a clear cell RCC in the horseshoe kidney of a 37-year-old man. Histologically, both the carcinoid tumor and clear cell RCC demonstrated the characteristic morphology in their classic forms. In addition to the carcinoid tumor, the mature teratoma consisted of variably sized, large cystic spaces lined by cytologically bland mucinous columnar epithelium, pseudostratified columnar epithelium, ciliated epithelium and mature smooth muscle fibers were also identified within the cystic wall. Furthermore, foci of round, small nodules composed of mature prostatic acinus were noted in the teratoma which was confirmed by exhibiting strong immunoreactivity for prostate specific antigen. The present case serves to expand the histologic component that may be encountered in the mature terotoma of the kidney and further broadens the spectrum of primary tumors occurring in the horseshoe kidney.     

维生素D联合西格列汀对2型糖尿病肾病患者尿蛋白水平、骨密度和骨代谢的影响

目的 探讨维生素D联合西格列汀对2型糖尿病肾病患者尿蛋白水平、骨密度和骨代谢的影响。 方法 选取2016年1月—2018年1月间宁波市鄞州区第二医院收治的114例2型糖尿病肾病患者，随机分为对照组56例和实验组58例。所有患者均给予降糖等常规治疗，在此基础上，对照组给予维生素D治疗，实验组给予维生素D联合西格列汀治疗，比较治疗后2组患者的尿白蛋白排泄率(UAER)、尿β₂-微球蛋白(β₂-MG)、24小时尿白蛋白、骨密度(L₂～L₄、股骨颈、Ward三角区、股骨粗隆区、髋关节)、血钙、血磷、25羟维生素D(25-OH-D₃)、甲状旁腺素(PTH)、骨钙素(BGP)、Ⅰ型前胶原氨基末端前肽(PINP)、Ⅰ型胶原羧基端肽β特殊序列(β-CTX)。 结果 治疗后实验组患者的UAER、尿β₂-MG和24小时尿白蛋白水平均低于对照组(P<0.05)；治疗后实验组患者各检测部位的骨密度均高于对照组(P<0.05)；治疗后实验组的血钙高于对照组，血磷显著低于对照组(P<0.05)；治疗后实验组的25-OH-D₃和PINP高于对照组(P<0.05)，实验组的PTH、BGP和β-CTX低于对照组(P<0.05)；对照组和实验组患者的不良反应总发生率分别为8.93%和12.07%(P=0.585)。 结论 在治疗2型糖尿病肾病中应用维生素D联合西格列汀能有效降低患者的尿蛋白，升高患者的骨密度并改善骨代谢，且安全性较好。      

A platelet-activating factor (PAF) receptor deficiency exacerbates diet-induced obesity but PAF/PAF receptor signaling does not contribute to the development of obesity-induced chronic inflammation

Platelet-activating factor (PAF) is a well-known phospholipid that mediates acute inflammatory responses. In the present study, we investigated whether PAF/PAF receptor signaling contributed to chronic inflammation in the white adipose tissue (WAT) of PAF receptor-knockout (PAFR-KO) mice. Body and epididymal WAT weights were higher in PAFR-KO mice fed a high-fat diet (HFD) than in wild-type (WT) mice. TNF-α mRNA expression levels in epididymal WAT and the infiltration of CD11c-positive macrophages into epididymal WAT, which led to chronic inflammation, were also elevated in HFD-fed PAFR-KO mice. HFD-fed PAFR-KO mice had higher levels of fasting serum glucose than HFD-fed WT mice as well as impaired glucose tolerance. Although PAF receptor signaling up-regulated the expression of TNF-α and lipopolysaccharide induced the expression of acyl-CoA:lysophosphatidylcholine acyltransferase 2 (LPCAT2) mRNA in bone marrow-derived macrophages, no significant differences were observed in the expression of LPCAT2 mRNA and PAF levels in epididymal WAT between HFD-fed mice and normal diet-fed mice. In addition to our previous finding in which energy expenditure in PAF receptor (PAFR)-deficient mice was low due to impaired brown adipose tissue function, the present study demonstrated that PAF/PAF receptor signaling up-regulated the expression of Ucp1 mRNA, which is essential for cellular thermogenesis, in 3T3-L1 adipocytes. We concluded that the marked accumulation of abdominal fat due to HFD feeding led to more severe chronic inflammation in WAT, which is associated with glucose metabolism disorders, in PAFR-KO mice than in WT mice, and PAF/PAF receptor signaling may regulate energy expenditure and adiposity.