持续皮下胰岛素输注对2型糖尿病早期胰岛功能改善作用的临床研究

目的探讨初发的2型糖尿病患者,应用持续皮下胰岛素输注(CSII)或多次胰岛素皮下注射(MSII)的治疗,对胰岛β细胞功能和血糖的影响。方法CSII组采用持续皮下胰岛素输注形式,在3天内使血糖达标;MSII组采用小剂量起步,平均2~3周逐步将血糖调整到位的方法,观察治疗前后血糖、血浆C肽(C-P)空腹、餐后1小时、2小时及HbAlc的变化。结果两组的血糖及HbAlc较治疗前明显下降(P<0.05),而CSII组下降更为明显(P<0.05),且该组C-P空腹及餐后1小时值有所升高(P<0.05),胰岛素用量也较MSII组有所减少。结论对初诊的血糖较高的2型糖尿病患者尽早应用持续皮下胰岛素输注的方式,更有助于将血糖控制在理想水平及改善胰岛功能。     

运动疗法对社区中老年膝关节骨性关节炎患者下肢功能及肌力的影响

目的:观察膝关节骨性关节炎中老年患者通过太极拳运动结合肌肉锻炼,其关节功能及肌力的变化.方法:在成都市武侯区簇锦社区中选取100例中老年膝骨关节炎患者,按照随机、对照法分为运动疗法干预组(简称:干预组)和对照组,每组50例.对照组给予健康宣教及口服塞来昔布胶囊,干预组在对照组基础上增加运动疗法,持续4周.分别于干预前、...     

肝细胞性肝癌中乙酰肝素酶与nm23-H1的表达及其临床意义

目的：探讨乙酰肝素酶（HPA）和nm23-H1在原发性肝细胞肝癌（HCC）中的相互关系,及其作为CC术后转移复发预测指标的价值。方法：选用33例HCC癌组织和癌旁组织标本,9例肝脏良性肿瘤瘤周肝组织作正常对照。用逆转录聚合酶链反应（RT－PCR）和免疫组化S－P法检测标本中HPA mRNA和nm23-H1蛋白的表达,并结合患者的临床病理指标和随访结果进行分析。结果：33例HCC中,16例HPA表达阳性,其阳性率显著高于癌旁组织和正常肝组织（P＜0．01）。HPA表达与肿块大小、包膜形成、AFP水平、HBsAg状态和有无肝硬化等无关（P＞0．05）;但高转移复发倾向组和随访转移复发组HPA表达率显著高于低转移复发倾向组（P＜0．05）和无转移复发组（P＜0．01）;此外,HPA基因表达多见于分化较差（P＜0．05）、TNM分期较晚（P＜0．05）的患者。nm23-H1蛋白在HCC癌组织中的阳性率显著低于癌旁和正常肝组织（P＜0．05）。nm23-H1与肿块大小、包膜形成、AFP水平、HBsAg状态、有无肝硬化、Edmondson分级和TNM分期均无关（P＞0．05）;但高转移复发倾向组和随访转移复发组HPA表达率明显高于低转移复发倾向组（P＝0．018）和无转移复发组（P＝0．024）。nm23-H1在HPA阳性组和阴性组表达差异无显著意义（P＝0．082）。按随访结果判断,HPA阳性预测转移复发准确率为78．6％（11／14）;nm23-H1阴性预测准确率为68．8％（11／16）;PHA阳性和nm23-H1阴性联合应用预测准确率为88．9％（8／9）。结论：HPA表达阳性和／或nm23-H1阴性患者有较高的肿瘤侵袭性和术后转移复发倾向,二者联合检测可提高预测HCC术后转移复发的准确性。     

Production of butanol from lignocellulosic biomass: recent advances,challenges, and prospects

Due to energy and environmental concerns, biobutanol is gaining increasing attention as an alternative renewable fuel owing to its desirable fuel properties. Biobutanol production from lignocellulosic biomass through acetone–butanol–ethanol (ABE) fermentation has gained much interest globally due to its sustainable supply and non-competitiveness with food, but large-scale fermentative production suffers from low product titres and poor selectivity. This review presents recent developments in lignocellulosic butanol production, including pretreatment and hydrolysis of hemicellulose and cellulose during ABE fermentation. Challenges are discussed, including low concentrations of fermentation sugars, inhibitors, detoxification, and carbon catabolite repression. Some key process improvements are also summarised to guide further research and development towards more profitable and commercially viable butanol fermentation.

Due to energy and environmental concerns, biobutanol is gaining increasing attention as an alternative renewable fuel owing to its desirable fuel properties.     

抗preS1分子高效单克隆抗体的制备及其在血清LHBs检测中的应用

目的 制备可用于血清LHBs检测的针对preS1高效单克隆抗体并进行初步临床应用研究.方法 对乙肝preS1区段基因(B基因型,adr血清亚型)全长序列(1～119 aa)进行密码子偏嗜性改造后,克隆入质粒pET32a构建原核表达重组质粒并转化入大肠杆菌BL21 (DE3),采用离子交换、HIS亲和层析柱以及肠激酶(E...     

呼吸机相关性肺炎与血清降钙素原水平

目的 通过测定血清降钙素原(PCT)水平,探讨PCT在诊断治疗呼吸机相关性肺炎(VAP)中的价值.方法 对30例VAP患者于确诊48 h内行PCT、血沉(ESR)及外周血白细胞(WBC)计数、中性粒细胞(N)比例及体温(T)测定.同时设20例非VAP组及10例健康对照组行相关指标检查.结果 VAP组PCT高于非VAP组...     

云南省边境地区症状监测预警系统的开发与实践

目的 利用信息化技术,在云南省边境地区建立持续动态症状监测预警系统,并探讨其有效性和及时性,以提升边境地区传染病防控能力。方法 选择3个边境县,以全覆盖的方式,于2016年1月至2018年2月持续监测医疗机构14个症状及6个症候群,收集小学每天学生缺勤信息和边境口岸入境人员发热信息,构建基于手机和电脑平台的症状监测预警系统。结果 采用EARS-3C和Kulldorff时空扫描的预警模型,发现皮疹、流感样症状和小学缺勤等多个监测信号源对手足口病、流感和水痘等常见传染病预警有较高的灵敏度和特异度（可提前1~5 d预警）。系统简便易用,安全性和可行性较强,以交互式图表及可视化地图的方式展示,相关人员能够随时掌握监测数据情况和预警信号的变化,及时采取处置措施。结论 该系统科学有效、操作方便,能实时发现边境地区常见传染病的暴发或聚集事件,实现及时采取有效干预措施,减少本地及跨境传染病暴发的风险,具有实际应用价值。     

Synthesis of trifluoromethyl-containing isoindolinones from tertiary enamides via a cascade radical addition and cyclization process

A radical trifluoromethylation reaction of tertiary enamides was investigated and trifluoromethyl-containing isoindolinones were prepared under mild conditions. Using TMSCF₃ as a radical source, PhI(OAc)₂ as an oxidant and KHF₂ as an additive, tertiary enamides were converted to isoindolinones via a cascade addition and cyclization process in moderate to good yields.

Radical trifluoromethylation and cyclization of tertiary enamides was developed and trifluoromethyl-containing isoindolinones were obtained in moderate to good yields.

In recent years, trifluoromethyl-containing azaheterocycles have attracted much attention for their potential application in the fields of pharmaceutical and agricultural chemistry.¹ Thus, lots of efforts have been devoted to the synthesis of trifluoromethyl azaheterocycles,² and among these developed methods, radical cascade addition and cyclization has emerged as a remarkable strategy due to its unique properties such as economy and high efficiency. Unsaturated amides are commonly used substrates for this type of transformation, which could be attacked by a CF₃ radical followed by intramolecular C–O, C–N, or C–C bond formation to give different kinds of trifluoromethyl azaheterocycles. Fu reported a metal-free trifluoromethylation of N-allyamides with CF₃SO₂Na for the synthesis of trifluoromethyl-containing oxazolines via oxytrifluoromethylation.³ In the presence of copper salts, N-acyl-2-allylaniline could be converted to trifluoromethylated indolines in moderate to good yields via aminotrifluoromethylation process.⁴ With Togni''s reagent,⁵ TMSCF₃,⁶ CF₃SO₂Na,⁷ CF₃SO₂Cl⁸ and other reagents⁹ as the CF₃ source, α, β-unsaturated amides, tosyl amides, or imides underwent a tandem conversion to give trifluoromethyl-containing oxindoles or isoquinoline-1,3-diones by trifluoromethylation/arylation reaction. On the other hand, as a special type of unsaturated amide containing an active double bond, enamide also exhibited excellent reactivity in radical reactions.¹⁰ In fact, trifluoromethylation of enamides has already been investigated, and in most cases trifluoromethylated alkenes were obtained as the main products.¹¹ To the best of our knowledge, the radical trifluoromethylation and cyclization of enamide still remains undeveloped.Isoindolinones are important N-heterocyclic compounds necessary in organic and pharmaceutical chemistry, and these compounds are used widely as anticoagulants and tranquilizers such as aristolactam, pagoclone, and zopiclone.¹² To introduce a CF₃ group into isoindolinones, Wang and co-workers explored a convenient way to the synthesis of trifluoromethyl-containing isoindolinones by radical aminotrifluoromethylation (Scheme 1a),¹³ but this transformation only occurred for N-methoxylbenzamides, and in case of N-alkylbenzamides trifluoromethylated alkenes were obtained as the major products. 1,1-disubstituted terminal alkenes were also not suitable substrates because of the competition between O-trapping and N-trapping process. Thus, development a new method for the synthesis of trifluoromethyl-containing isoindolinones is still in demand. Here in, as a continuation of our efforts on the radical modification of amide derivatives,¹⁴ we wish to present our work on the synthesis of trifluoromethyl-containing isoindolinones using enamides as the start materials by radical carbon trifluoromethylation (Scheme 1b).Open in a separate windowScheme 1Synthesis of trifluoromethyl-containing isoindolinones.Initially, N-n-butyl-N-(2-propenyl) benzamide 1a was chosen as the model substrate to optimize the reaction conditions of this radical carbontrifluoromethylation process. As shown in

Antibodies to varicella-zoster virus in blood donors with genetic variance in CC chemokine receptor 5

Carriers of a 32 bp deletion (Delta32) allele of the CC chemokine receptor 5 (CCR5) gene are reported to be more likely to lack antibodies to varicella-zoster virus than CCR5 wild-type individuals. To find out whether CCR5-Delta32 is associated with the seroprevalence of varicella-zoster virus infection, we tested blood donors with different CCR5-Delta32 genotypes for varicella-zoster virus IgG. Antibody to varicella-zoster virus was present in 209 (99.5%) of 210 CCR5-Delta32 carriers and exactly the same proportion of CCR5 wild-type individuals (209 of 210). We have therefore found no evidence that the CCR5-Delta32 allele is associated with decreased seroprevalence of varicella-zoster virus infection.     

诱导痰细胞分类在嗜酸细胞性支气管炎诊断和治疗中的应用

目的探索诱导痰细胞分类在嗜酸细胞性支气管炎(EB)诊断和治疗中的作用。 方法回顾性分析我院门诊239例慢性咳嗽患者,依据慢性咳嗽中诊断标准,分为非EB组和EB组,分析两组诱导痰中细胞分类情况;同时给予EB患者进行8周治疗,观察经治疗后诱导痰中各细胞分类的改变情况。 结果239例慢性咳嗽患者中,非EB患者216例,占90.7%,EB患者23例,占9.3%,两组中共有121例(50.6%)患者诱导痰中嗜酸细胞百分比升高;非EB患者组细胞总计数为(4.83±2.61)×10⁶个/g、嗜酸细胞比例为(4.56±10.07)%、中性粒细胞比例为(50.32±26.12)%、淋巴细胞比例为(5.14±7.27)%、单核巨噬细胞比例为(40.30±16.70)%,EB患者组痰中细胞总计数为(5.46±3.07)×10⁶个/g、嗜酸细胞比例为(13.85±1 2.23)、中性粒细胞比例为(46.16±16.89)、淋巴细胞比例为(4.83±2.98)、单核巨噬细胞比例为(35.91±16.35),两组间EB组嗜酸细胞比例有显著的增多(P<0.05),在性别、年龄以及其余细胞成分差异无统计学意义(P>0.05);EB患者组经治疗后,痰中细胞总计数为(4.07±3.89)×10⁶个/g、嗜酸细胞比例为(2.52±3.80)%、中性粒细胞比例为(54.18±17.97)%、淋巴细胞比例为(5.59±4.33)%、单核巨噬细胞比例为(38.32±17.23)%,嗜酸细胞较治疗前有显著减少(P<0.05),其余细胞改变无显著差异(P>0.05)。 结论诱导痰细胞分类检查是诊断EB的重要方法,在其诊断和治疗过程中有着重要的指导作用,可作为EB治疗过程的监测指标。