单次静脉美罗培南在健康人体的药代动力学

目的 研究单剂量美罗培南静脉制剂药代动力学,为临床提供合理给药方案。方法 中国健康受试者10名随机分组交叉给药,30 min内静脉点滴美罗培南500,1 000mg,分别在给药前,给药后0.25,0.5,0.75,1,1.5,2,3,4,5,6,8 h取血,并于0~2,2-6,6～12,12—24 h留取尿样本,用高效液相色谱法测定美罗培南血药浓度及尿药浓度。结果 血药浓度数据经3P97程序分析血药浓度-时间曲线为二室模型,静脉点滴500,1 000 mg主要药代动力学参数Cmax分别为23.08±4.00,48.19±9.78 mg·L-1,AUC分别为27.47±3.80,55.56±6.72 mg·h·L-1,,tl/2B分别为1.08±0.19,1.15±0.15 h,CL分别为18.91±2.48,18.68±2.32L·h-1,Vd分别为13.48±2.94,13.93±2.40L。12 h原形药物在尿中累积排泄百分率分别为(60.11±5.20)％与(61.23±9.81)％。结论 美罗培南单次给药在中国健康人体耐受良好,药物主要经肾脏排泄。     

两种培养基分离鉴别酵母样真菌在临床上的应用

目的：探讨CHROMagar显色培养基和沙保弱培养基分离鉴别酵母样真菌的差异。方法：取临床标本263例，同时分别划线接种于两种培养基上，分离鉴别酵母样真茼。结果：CHROMagar显色培养基分离鉴别酵母样真茼快速、简便、准确，通过茸落显色易于观察、假阳性低、检测效果好。沙保弱培养基尚需改进本身质量。结论：CHROMagar显色培养基的质量在分离鉴别酵母样真苜上优于沙保弱培养基。     

乡镇企业铸钢工艺矽肺危害的调查

目的　探讨某乡镇所有铸钢工艺的企业短时期查出多例矽肺病的缘故。方法　查阅该乡镇铸钢行业所有企业的职业卫生档案 ;总结其接尘职工的体检及矽肺病的检出情况 ;分析讨论铸钢生产过程中粉尘产生的主要细节。结果　乡镇企业中铸钢工艺的生产性粉尘危害是相当严重的 ,对其应认真做好职业性卫生监督监测、防尘防护及接尘职工的体检等工作。结论　乡镇企业铸钢工艺矽肺危害严重 ,应当引起有关部门的高度重视。     

企业医院产权制度改革探索

在分析企业医院现状和存在问题的基础上,介绍了企业医院产权制度改革的做法.对企业医院建立现代医院制度,提高效益和效率,推行区域卫生规划,加快产权制度改革步伐,促进企业医院发展进行了思考.     

微创入路人工耳蜗植入术＊

目的探讨微创入路人工耳蜗植入术的手术方式及其效果。方法回顾分析197例植入MedEl Combi 40+?、Pulsar?或Sonata?的病例，统计术后皮肤切口长度，手术历时及术后并发症的发生率。结果术后皮肤切口长度平均为3.0±0.3 cm，手术时长平均为103.4±22.4分钟，在平均26.5个月的随访期内，无手术相关并发症发生。结论微创入路人工耳蜗植入术在不增加手术难度的同时有助于降低手术相关并发症的发生率，提高患者及家属的认同度。     

A METHOD FOR RAPID DIAGNOSIS OF A(H1N1) INFLUENZA VIRUS BY USING SUSPENSION CHIP

目的 建立一种可快速诊断甲型H1N1流感病毒的悬浮芯片方法,为研制快速检测H1N1流感病毒试剂盒奠定基础.方法 针对HIN1特有的NA基因、HA基因、NS基因序列设计引物,在下游引物末端用生物素标记.根据3个基因扩增区内的核酸序列设计特异性探针,探针末端修饰氨基C12,以便把特异性的核酸探针共价结合到用彩色荧光编码的微球表面.采用液态悬浮杂交方法,将微球与生物素标记的目标物进行杂交,通过结合的链霉亲和素藻红蛋白,检测目标物.结果 所设计的探针没有交叉反应,单通道检测探针灵敏度HA基因为1.6 nmol/L,NA基因、NS基因均为8.0 nmol/L;多通道检测的探针灵敏度为1.6 nmoL/L.结论 该方法准确、灵敏度高,可以用于下一步悬浮芯片检测试剂盒的研制.     

Clinicopathological features and prognostic analysis of metastatic pulmonary sarcomatoid carcinoma: a SEER analysis

BackgroundPulmonary sarcomatoid carcinoma (PSC) is a rare type of non-small cell lung cancer (NSCLC). Metastases are often detected at the first diagnosis. Despite high rates of distant metastasis, there is insufficient data describing the characteristics of PSC metastasis.MethodsWe performed a Surveillance, Epidemiology, and End Results (SEER) database-based analysis of clinicopathological features and prognosis of distant metastasis in PSC patients. Data queried for this analysis included PSC patients in the database between 2010 and 2016.ResultsA total of 934 patients met the criteria for inclusion in the analysis and included, at the time of diagnosis, 512 (54.8%) patients with metastasis, including bone (n=152; 16.3%), brain (n=108; 11.6%), liver (n=70; 7.5%), lung (n=142; 15.2%) metastases. Binary logistic regression showed that patients with giant cell carcinoma [odds ratio (OR) 4.023, 95% confidence interval (CI): 2.113–7.661, P<0.001] and spindle cell carcinoma (OR 3.151, 95% CI: 1.699–5.843, P<0.001) were associated with metastasis. Log-rank test and Kaplan-Meier plots indicated poor prognosis in metastatic patients [the 1-, 3-, and 5-year overall survival (OS) rates were 14.1%, 5.5%, and 4.8%, respectively]. Multivariable analysis showed younger and chemotherapy as improved prognostic factors of PSC patients with single metastasis site.ConclusionsThe SEER database-based analysis revealed the clinical features of distant metastasis of PSC and showed that different histological types posed distinct metastasis potential. Besides, age and chemotherapy were the independent prognostic factors of PSC patients with single metastasis site.     

Expression and clinical significance of B cell translocation gene 2 in esophageal squamous cell carcinoma

Esophageal squamous cell carcinoma (ESCC) is widely known as a highly fatal cancer, and thus it is important to identify tumor-specific and radiosensitivity-specific markers in ESCC. B cell translocation gene 2 (BTG2) has been considered a novel tumor suppressor gene or radiotherapy sensitivity-associated gene. However, the relationship between BTG2 and ESCC development and radiotherapy sensitivity is uncertain. The present study aims to explore the expression and clinical significance of B cell translocation gene 2 (BTG2) in ESCC by analyzing the RNAseq data from the TCGA and immunohistochemical staining of ESCC samples. We found that the level of BTG2 mRNA was significantly decreased in ESCC patients, and further decreased significantly in radiotherapy resistant patients compared to sensitive patients. The positive expression rate of BTG2 protein was 56.0% (103/184) in 184 ESCC tissue samples and 84.0% (42/50) in normal esophageal mucosal samples, respectively. The positive ratios of BTG2 expression in radiotherapy-sensitive group and radiotherapy resistant group were 57.9% (22/38) and 23.5% (4/17), respectively. Furthermore, the analysis indicates that the expression level of BTG2 significantly correlated with lymph node metastasis and clinical staging in ESCC patients. A multivariate analysis with Cox regression model showed that BTG2 level was an independent risk factor affecting the prognosis of ESCC patients. Above all, the downregulation of BTG2 may be used as a molecular marker to identify and predict ESCC progression and radiosensitivity.     

Characteristic Echocardiographic Manifestations of Behçet's Disease

The objective of this study was to determine the characteristic echocardiographic manifestations of Behçet's disease. Ninety-seven Behçet's patients admitted to our hospital from January 2002 to December 2016 were retrospectively analyzed. There were 63 patients (64.9%) with cardiac involvement; these included 47 men (74.6%) and 16 women (25.4%). Of these 63 patients, most (74.6%) exhibited valvular lesions, especially aortic regurgitation. The primary characteristic manifestations of valves were cusp prolapse with aneurysmal changes, vegetation-like lesions and echo-free spaces within the annulus. Second (30.0%) were aortic lesions, including aortic dilation or aneurysm formation, aortic pseudoaneurysm and coronary sinus aneurysm. Other manifestations, such as cardiac thrombosis, coronary arterial pseudoaneurysm, pulmonary aneurysm and pericardial effusion, were rare. Cardiac involvement is not uncommon in Behçet's patients, especially in males, and it is characterized by valvular disease, especially aortic regurgitation. The diagnosis of Behçet's disease should be considered when evaluating patients with these characteristic echocardiographic manifestations.     

Microcystin-LR degradation utilizing a novel effective indigenous bacterial community YFMCD1 from Lake Taihu

Microcystins (MC) produced by species of cyanobacteria including Microcystis, Anabaena, and Aphanizomenon are a group of monocyclic hepatotoxins posing serious threat to public health. Microcystin-LR (MC-LR) is the most toxic and frequently encountered microcystin variant in the environment, and thus removal of this toxin using bacteria was shown to be a reliable, efficient, and cost-effective method that avoids utilization of chemicals that may produce potentially harmful by-products. The aim of this study was to determine whether a novel indigenous bacterial community designated YFMCD1 was effective in destroying MC. In addition, the influence of environmental factors such as temperature, MC concentration, and pH was examined on the effectiveness of YFMCD1 to degrade MC-LR. MC-degradation products were identified by high performance liquid chromatography coupled with an ultra-high resolution LTQ Orbitrap Velos Pro ETD mass spectrometry equipped with electrospray ionization interface (HPLC-ESI-MS). MC-LR underwent maximal degradation at rate of 0.5 µg/ml/hr with YFMCD1 containing Klebsiella sp. termed YFMCD1-1 or Stenotrophomonas sp. termed YFMCD1-2. Moreover, Adda (3-amino-9-methoxy-2, 6, 8-trimethyl-10-phenyldeca-4, 6-dienoic acid) is a constituent within the MC-LR molecule found to be responsible for biological activity expression and critical for MC-induced toxicity, which is also degraded by YFMCD1. The results showed that YFMCD1 effectively degraded MC-LR. The degradation rate was significantly affected by temperature, pH, and MC-LR concentrations. Data indicate that this bacterial community may prove beneficial in bioremediation of lakes containing MC.