7β-(6-取代-2-喹诺酮-3-乙酰氨基)头孢菌素的合成

以6-取代-2-喹诺酮-3-乙酸为侧链,用CDI法和潘化酯法与7-ADCA,7-ACA,7-ACT,和7-ACD缩合,合成了16个新的7β-(6-取代-2-喹诺酮-3-乙酰氨基)头孢菌素类化合物,通过溶媒转提,葡聚糖凝胶(Sephadex LH-20)柱层析及离心薄层层析分离精制,得到纯品。初步体外抑菌试验表明:新化合物对革兰氏阳性及某些阴性菌具有高度敏感性。大多数化合物对所试试验菌的抗菌活性与头孢唑啉和青霉素G钠相当,有些比它们还强。     

不同结合状态硫酸软骨素多糖链对体外二维三维培养背根节神经突起生长影响研究

目的构建鸡胚背根节细胞3D生长模型,观察CSPG对不同浓度的琼脂糖水溶胶培养基对鸡胚背根节神经突起生长的影响。方法①利用多肽缩合剂1’1羰基二咪唑介导CS-B长链与琼脂糖凝胶共价结合。②分别配制0.5%、0.75%、1%、1.25%、1.5%的SeaPrep琼脂糖凝胶溶液和共价结合了CS-B多糖长链的琼脂糖凝胶溶液。取孵育9~10天后鸡胚背根节加入上述凝胶溶液加培养液培养。③培养24小时之后在24 h、48 h7、2 h、96 h进行观察拍照。观察各时间点神经突起生长情况。结果①鸡胚背根节神经突起在1.25%的琼脂糖凝胶溶液中开始呈3D生长,在小于1%的琼脂糖溶液中只能2D生长。②在同一时间点,呈2D生长的背根节突起和呈3D生长的背根节突起在突起长度方面没有统计学差异(P>0.05)。③3D生长的DRG神经突起在共价结合了CS-B的琼脂糖凝胶中生长长度明显短于普通琼脂糖水凝胶(P<0.05),并且可观察到部分突起长出短而直的成束突起。但是对于呈2D生长的DRG突起长度在两种培养基中却未见差异(P>0.05)。结论鸡胚背根节神经元周围突起生长长度在3D培养中与在2D培养中有没有明显的差异。硫酸软骨素能够有效抑制呈3D生长的神经节突起生长,并且影响到神经突起的生长方式。但是在2D培养基中,未能看到上述的抑制作用。     

Toxic Clostridioides (formerly Clostridium) difficile colitis: No longer a diarrhea associated infection

BackgroundClostridioides difficile infection (CDI) is traditionally taught to be an antibiotic associated diarrheal infection. This diagnosis is based on the presence of clinical symptoms (usually defined as more than 3 watery, loose or unformed stool within 24 h) coupled with a diagnostic test. There is now a new presentation of CDI, including progression to toxic megacolon, in patients without diarrhea.MethodsWe report a case series of 9 surgical patients from a single institution who developed CDI without preceding diarrhea.ResultAll 9 patients had CDI with positive laboratory testing for C. difficile toxin. They, however, presented with a lack of or minimal bowel movements. Six patients had rapid development of abdominal distention, 1 patient had a single episode of watery stool in 3 days, while the other 2 patients presented with constipation. Seven patients received stool softeners, suppositories and/or enemas for presumed constipation. Four patients had a mild course of infection and were successfully treated medically. The other 5 patients developed toxic megacolon, and eventually required total abdominal colectomy. Out of the 5 patients that required total colectomy, 2 expired.ConclusionCDI must be suspected in patients who rapidly develop abdominal distention, vague abdominal complaints or change in bowel function even in the absence of diarrhea, especially if coupled with multi-system organ failure.     

Hemoglobin A1c,frequency of glucose testing and social disadvantage: Metrics of racial health disparity in youth with type 1 diabetes

Introduction

Black youth with type 1 diabetes (T1D) have higher HbA1c than whites. To understand HbA1c differences, we examined the relationship of psycho-social factors and glucose testing with HbA1c.

柱前手性衍生化-反相高效液相色谱法拆分布洛芬对映异构体

目的：建立一种柱前手性衍生化-反相高效液相色谱紫外法检测布洛芬的异构体。方法：以N′N-羰基二咪唑（CDI）作为活化剂活化布洛芬的羧基基团,再以（R）-（+）-1-（1-萘基）乙胺（R-NEA）作为手性衍生化试剂进行反应。选用Kromasil C18色谱柱,流速1.0 mL·min-1,柱温30 ℃,以乙腈-0.05%磷酸（68∶32）为流动相,检测波长225 nm。结果：布洛芬的非对映异构体色谱峰的保留时间分别为25.6 min和27.9 min。结论：本方法操作简单,条件温和,衍生化产物稳定,且衍生化试剂价格便宜,更准确地实现了对布洛芬对映异构体的分离检测。     

Prevalence of Clostridium difficile infection in hospitalized patients with diarrhoea: Results of a Polish multicenter,prospective, biannual point-prevalence study

Purpose

We aimed to measure the underdiagnosis of Clostridium difficile infection across Poland and the distribution of PCR-ribotypes of C. difficile.

神经外科病人水电解质失衡病因及治疗

目的探讨神经外科病人水电解质失衡的临床特点和处理。方法回顾分析108例我科住院并伴有水电解质紊乱的病人的临床资料,治疗方法和效果。结果46例诊断为中枢性尿崩症（CDU,27例为抗利尿激素分泌不当综合征（SIADH）,20例为脑性盐耗综合征（CSWS）,15例为脑性潴盐综合征。其中101例治愈,另有3例中枢性尿崩症需要长期替代治疗,1例抗利尿激素分泌不当综合征患者死亡,3例CSWS患者需长期高钠饮食以维持正常血钠。结论108例病人中水电解质紊乱原因有：CDI,SIADH,CSWS,脑性潴盐综合征,但无论哪种水电解质紊乱在早期明确诊断后积极治疗,绝大多数患者是可以治愈的。