金喉健雾化吸入联合抗感染治疗急性支气管炎疗效观察

目的观察金喉健雾化吸人联合抗生素治疗急性支气管炎干咳疗效。方法将80例住院急性支气管炎患者随机分为治疗组40例。对照组40例。治疗组及对照组均给予常规抗生素治疗，治疗组在常规治疗基础上采用金喉健4mL加入雾化器中进行超声雾化，对照组给予常规治疗。结果治疗组显效16例（40．0％），有效23例（57．5％），无效1例（2．5％）；对照组显效8例（20．0％），有效26例（65．0％），无效6例（15．0％）；治疗组与对照组咽部干痒消失、咳嗽消失、咽部充血消失的时间分别是4．16±0．99、4．96±1．38（P〈0．05），（7．00±1．10）、（8．01±1．71）（P〈0．05），5．00±1．32、6．66±1．67（P〈0．05）。结论金喉健雾化吸入治疗急性支气管炎，可明显提高疗效，改善症状，且无明显不良反应。     

H型高血压患者脑梗死后口服叶酸片的二级预防研究

目的:随访H型高血压患者脑梗死后口服叶酸片后缺血性脑血管病的复发率,为H型高血压患者缺血性中风的二级预防提供依据。方法:选取2010-2014年本院神经内科伴有H型高血压脑梗死住院患者共598例,所有患者在脑梗死二级预防基础治疗上均加服依那普利叶酸片。随访患者2年,观察缺血性脑血管病、冠脉事件、周围血管事件、抑郁、痴呆、骨折、肿瘤的发病率及死亡率。结果:598例脑梗死患者中,失访70例,到达终点患者共528例。脑梗死复发18例,冠脉事件23例,周围血管事件15例,抑郁患者95例,痴呆患者38例。无骨折发生,无新发肿瘤患者,死亡14例。结论:服用依那普利叶酸片后脑梗死患者复发率3.41%,冠脉事件的发生率4.36%,周围血管事件发生率2.85%,抑郁的发生率8.52%,痴呆的发生率7.20%。服用依那普利叶酸片后脑梗死复发率明显降低,未增加肿瘤的发生率。     

Combination Antiretroviral Therapy Is Associated With Reduction in Liver Fibrosis Scores in HIV-1-Infected Subjects

HIV increases the risk of liver disease as do two common coinfections, hepatitis B and C viruses (HBV and HCV). However, whether combination antiretroviral therapy (cART) reverses or exacerbates hepatic fibrosis remains unclear.This was an observational retrospective study. cART-naïve HIV-infected subjects without a history of substance abuse (including alcohol) had liver disease stage determined by aspartate aminotransferase-to-platelet ratio indices (APRIs) and fibrosis-4 (FIB-4) before and 24 and 48 weeks after cART. All the data were retrieved from previously established cohorts. Values before and after cART were compared using Wilcoxon test for paired samples. Regression analyses were used to determine factors associated with moderate-to-severe liver disease.Of the 1105 HIV-infected subjects, 120 were HBV coinfected and 64 were HCV coinfected. About 20% of HIV monoinfected participants had APRI and FIB-4 scores consistent with moderate-to-significant fibrosis compared to ∼36% of HIV–HBV coinfected and 67% to 77% of HIV–HCV coinfected participants. In adjusted analyses compared with HIV monoinfection, HBV coinfection was associated with 1.18-fold higher APRI (P < 0.001) and a 1.12-fold higher FIB-4 (P = 0.007) prior to cART; while HCV coinfection was associated with 1.94-fold higher APRI (P < 0.001) and a 1.43-fold higher FIB-4 (P < 0.001). After 48 weeks of cART, both fibrosis scores decreased in all subjects; however, HCV coinfection was still associated with higher fibrosis scores at week 48 compared to HIV monoinfection.cART was associated with improvement in hepatic fibrosis scores in the majority of HIV-hepatitis coinfected and HIV-monoinfected Chinese participants.     

多糖类组分对大鼠肝微粒体酶CYP1A2的体外活性抑制作用

目的 建立液相色谱-串联质谱法（LC-MS/MS）测定大鼠肝微粒体中对乙酰氨基酚含量，研究人参多糖、贻贝多糖、黄原胶对大鼠肝微粒体细胞色素P450（cytochrome P450，CYP）1A2的体外抑制作用。方法 以格列齐特为内标，建立LC-MS/MS测定大鼠肝微粒体中对乙酰氨基酚含量方法。以α-萘黄酮为阳性对照药，分别将系列多糖溶液、CYP1A2酶的特异性探针底物非那西丁及大鼠肝微粒体进行孵育，LC-MS/MS测定代谢产物对乙酰氨基酚的含量，计算半数抑制浓度（IC₅₀），评价人参多糖、贻贝多糖、黄原胶对大鼠肝微粒体CYP1A2酶的抑制活性。结果 对乙酰氨基酚在10~1 000 ng·mL^-1内线性良好，精密度试验RSD均<8.24%，提取回收率为92.53%~103.23%，稳定性试验RSD均<10.77%。该试验条件下，在大鼠肝微粒体温孵体系中，人参多糖、贻贝多糖、黄原胶对CYP1A2的IC₅₀值均>100 μmol·L^-1。结论 在正常剂量下，人参多糖、贻贝多糖、黄原胶对CYP1A2酶亚型均无抑制作用，可以与其底物联合用药。     

舒适护理对门诊包皮过长环切术后效果的影响

目的探讨门诊护士对包皮环切术（使用一次性吻合环）实施舒适护理的效果。方法选择在本院门诊手术室行包皮环切术的成人患者256人,按日历单双号随机分为对照组和观察组,对照组采用常规护理,观察组在此基础上采取＂推揉手法＂、维护患者自尊以及心理支持的舒适护理干预,开创了＂推揉手法＂进行自我舒适护理。比较两组患者的疼痛度、伤口愈合情况、满意度。结果观察组拆环重度疼痛仅占9%（9/128）,对照组重度疼痛占82.03%（105/128）,两组比较P〈0.01,差异具有统计学意义;观察组伤口愈合良好率为90.63%,对照组为61.72%两组比较χ2=29.46,P〈0.001,差异具有统计学意义;观察组和对照组两组之间的满意度比较,差异有统计学意义（P〈0.05）。结论门诊护士对包皮环切术患者实施舒适护理干预,明显减轻患者的疼痛,使患者的心理、生理达到愉快舒适的状态,有效提高了患者满意度和护理质量,显著减轻了患者的疼痛度和经济负担,值得临床推广应用。     

苓桂术甘汤研究文献分析

苓桂术甘汤源于张仲景《伤寒杂病论》,为"病痰饮者,当以温药和之"的代表方剂,临床应用广泛。本文以中国知网科技学术文献总库为数据来源,利用文献计量学方法,对1963年至2011年12月间的苓桂术甘汤研究文献,分别从年代分布、期刊分布、作者分布、主题类型分布等几方面进行统计分析,探讨苓桂术甘汤方的研究现状及发展。结果统计显示本方的研究总体呈逐年上升趋势,其中以四川中医杂志载文量最多,安徽中医学院黄金玲发表的研究论文为最多,其应用常见于心血管系统、神经系统、消化系统、呼吸系统和五官科等临床各科。     

癫癎痴笑发作8例临床分析

目的总结癫癎痴笑发作（GS）的病因、临床特点和临床进展，为制定临床诊疗决策提供依据。方法：2012年1月～2013年12月，结合患者头颅MRI、PET—CT和24 h视频脑电图（V-EEG）检查结果及典型GS的临床表现，收集8例门诊诊断为GS的病例进行分析。结果：根据患者的临床表现和辅助检查综合判断，6例诊断为症状性GS，2例隐原性GS。其中3例仅有痴笑发作，5例合并有1～2种其他发作类型。所有患者均接受1～3种抗癫癎药治疗，结果3例发作得到控制，2例发作减少〉50％，3例无效。结论：通过分析病历，进一步强调了除下丘脑错构瘤为常见病因外，额、颞、顶、枕等脑叶的病变也可导致GS。对MRI正常的患者，PET—CT能更好地显示病灶。对于EEG和MRI均正常的患者，典型的临床症状和诊断性治疗更有助于早期确诊及改善预后。     

糖尿病大鼠肾脏细胞凋亡与Bax和Bcl-2基因表达

目的　观察糖尿病大鼠肾脏细胞凋亡、Bax和 Bcl- 2表达及二者的相关性。　方法　单侧肾切除大鼠腹腔注射链脲佐菌素诱发糖尿病 ,采用原位末端标记法检测肾脏细胞凋亡 ;流式细胞术和免疫组化检测肾皮质 Bax和 Bcl- 2表达水平 ;原位杂交检测 Bax和 Bcl- 2 m RNA表达 ,并观察尿蛋白、BU N、尿肌酐等反映肾功能的有关指标。　结果　在制模后 2、4、8、12周时 ,糖尿病组大鼠较对照组肾小球、肾小管凋亡细胞数明显增多 ,Bax、Bcl- 2蛋白和 m RNA的表达显著增强 (P<0 .0 5 )。随着大鼠糖尿病病程延长 ,肾功能恶化 ,肾脏凋亡细胞数逐渐增多 ,Bax表达亦逐渐增强 ,Bax/Bcl- 2比增加 ,且肾脏凋亡细胞数与 Bax及 Bax/Bcl- 2比具有相关性 (P<0 .0 5 )。　结论　肾脏凋亡细胞的不断增加可能是糖尿病肾病发生、发展的原因之一 ,Bax和 Bcl- 2可能参与肾脏细胞凋亡的调控。     

Experimental Investigations of Micro-Meso Damage Evolution for a Co/WC-Type Tool Material with Application of Digital Image Correlation and Machine Learning

Commercial Co/WC/diamond composites are hard metals and very useful as a kind of tool material, for which both ductile and quasi-brittle behaviors are possible. This work experimentally investigates their damage evolution dependence on microstructural features. The current study investigates a different type of Co/WC-type tool material which contains 90 vol.% Co instead of the usual <50 vol.%. The studied composites showed quasi-brittle behavior. An in-house-designed testing machine realizes the in-situ micro-computed tomography (μCT) under loading. This advanced equipment can record local damage in 3D during the loading. The digital image correlation technique delivers local displacement/strain maps in 2D and 3D based on tomographic images. As shown by nanoindentation tests, matrix regions near diamond particles do not possess higher hardness values than other regions. Since local positions with high stress are often coincident with those with high strain, diamonds, which aim to achieve composites with high hardnesses, contribute to the strength less than the WC phase. Samples that illustrated quasi-brittle behavior possess about 100–130 MPa higher tensile strengths than those with ductile behavior. Voids and their connections (forming mini/small cracks) dominant the detected damages, which means void initiation, growth, and coalescence should be the damage mechanisms. The void appears in the form of debonding. Still, it is uncovered that debonding between Co-diamonds plays a major role in provoking fatal fractures for composites with quasi-brittle behavior. An optimized microstructure should avoid diamond clusters and their local volume concentrations. To improve the time efficiency and the object-identification accuracy in μCT image segmentation, machine learning (ML), U-Net in the convolutional neural network (deep learning), is applied. This method takes only about 40 min to segment more than 700 images, i.e., a great improvement of the time efficiency compared to the manual work and the accuracy maintained. The results mentioned above demonstrate knowledge about the strengthening and damage mechanisms for Co/WC/diamond composites with >50 vol.% Co. The material properties for such tool materials (>50 vol.% Co) is rarely published until now. Efforts made in the ML part contribute to the realization of autonomous processing procedures in big-data-driven science applied in materials science.