社区获得性肺炎两种治疗方案的成本-效果分析

目的评价两种治疗方案对治疗社区获得性肺炎的药物经济学效果,指导合理用药。方法对两种治疗方案运用成本-效果分析法进行分析。结果两种治疗方案中,单用莫西沙星（A组）总成本为4 092.75元,联合使用阿奇霉素和头孢呋辛（B组）总成本为3 306.83元;有效率分别为88.89%和85.71%;单位效果的增量成本分别为46.04元和38.58元。结论联合使用阿奇霉素和头孢呋辛治疗社区获得性肺炎更为经济合理。     

低潮气量单肺通气复合呼气末正压对肺癌手术患者肺部炎症反应的影响

目的：对比低潮气量单肺通气复合呼气末正压（PEEP）与正常潮气量单肺通气对肺癌手术患者肺部炎症反应的影响。方法40例择期肺癌手术患者随机分为低潮气量单肺通气复合PEEP组（L组）和正常潮气量单肺通气组（N组）,每组20例。两组患者分别在麻醉诱导后双肺通气时（T1）、单肺通气60 min时（T2）、单肺通气90 min时（T3）、术毕双肺通气60 min时（T4）、术后1 d（T5）采取外周静脉血,采用放射酶联免疫吸附法（ELISA）测量肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、白细胞介素-8（IL-8）及白细胞介素-10（IL-10）水平。结果与T1比较,两组各时点血浆TNF-α, IL-6, IL-8及IL-10水平均持续升高（P〈0.05）;L组TNF-α, IL-6, IL-8在T2、T3、T4、T5时间点均明显低于N组（P〈0.05）;L组血浆IL-10在T2、T3、T4、T5时间点明显高于N 组（P〈0.05）。结论与正常潮气量单肺通气相比,采用低潮气量单肺通气复合呼气末正压可明显减轻肺部的炎症反应,从而减轻肺部损伤。     

高血压患者微量白蛋白尿与颈动脉内中膜厚度及脉搏波传导速度的相关性

目的 探讨高血压患者微量白蛋白尿（MAU）与颈动脉内中膜厚度（IMT）及脉搏波传导速度的相关性及其意义.方法 选择2012年2月至2013年3月在我院体检中心进行健康体检的高血压患者850例,依据高血压分级、尿微量白蛋白/肌酐比值（UACR）、IMT增厚程度、颈-股动脉脉搏波传导速度（cfPWV）分组,收集相关临床资料和实验室指标进行分析.结果 不同高血压分级组UACR水平及MAU检出率、IMT及cfPWV差异均有统计学意义（均P＜0.05）.颈动脉斑块组、IMT增厚组和无增厚组UACR水平[32.15（11.64,38.94）mg/g、28.68（10.42,37.58）mg/g、21.59（9.24,24.41）mg/g]及MAU检出率[44.9%（40/89）、30.2%（71/235）、12.7%（67/526）]差异均有统计学意义（均P＜0.05）.cfPWVⅠ、Ⅱ、Ⅲ、Ⅳ组UACR水平[分别为：22.04（9.66,27.98）mg/g、24.89（9.24,28.62）mg/g、29.41（12.98,38.94）mg/g、33.85（15.64,38.52）mg/g]及MAU检出率[10.6%（30/284）、17.2%（38/221）、27.7%（54/195）、37.3%（56/150）]差异均有统计学意义（均P＜0.05）.高血压患者IMT与cfPWV呈正相关（r=0.431,P＜0.05）.Logistic回归分析显示,校正年龄、性别比、体重指数、三酰甘油、低密度脂蛋白胆固醇、同型半胱氨酸（Hcy）及糖尿病后,MAU与IMT有相关性（OR=3.121,P＜0.05）;校正高血压分级的影响后,二者无明显相关性（OR=1.548,P〉0.05）;校正cfPWV的影响后,二者有相关性（OR=2.685,P＜0.05）.校正年龄、性别比、体重指数、三酰甘油、低密度脂蛋白胆固醇、Hcy及糖尿病后,MAU与cfPWV有相关性（OR=6.245,P＜0.05）;校正高血压分级的影响后,二者依然有相关性（OR=4.268,P＜0.05）;校正IMT的影响后,二者仍有相关性（OR=4.859,P＜0.05）.结论 MAU与高血压患者动脉僵硬度增加和大动脉病变发生有关,MAU与脉搏波传导速度关系更为明显,结合IMI及脉搏波传导速度检测可预测高血压患者血管病变程度.     

乳腺实体性乳头状癌6例并文献复习

目的 探讨乳腺实体乳头状癌的临床病理特征并对国内外相关文献进行复习,以提高对乳腺实体乳头状癌的认识和病理诊断水平.方法 归纳6例乳腺实体性乳头状癌患者的临床资料,分析其组织学特征和免疫表型,并结合国内外相关文献进行总结.结果 6例实体乳头状癌发病年龄49～72岁;组织学主要表现为终末导管小叶单位呈膨胀性生长,充填整个导管腔,形成实性片状结构.实性生长区域中有纤细的纤维血管轴心形成,轴心周围细胞呈栅栏状排列或围绕纤维血管轴心形成假菊形团样结构;免疫组织化学显示肿瘤细胞神经内分泌标记出现不同程度阳性表达,ER、PR均呈阳性表达,CK5/6肿瘤细胞阴性,仅呈巢团周围肌上皮和纤维血管轴心肌上皮散在阳性表达,Ki-67呈低表达,c-erbB-2呈阴性表达.结论 乳腺实性乳头状癌是一种比较少见的病理类型,好发于老年女性,具有特征性的组织学和免疫组织化学特点,预后较好.     

Interlaminar Fracture Behavior of Carbon Fiber/Polyimide Composites Toughened by Interleaving Thermoplastic Polyimide Fiber Veils

Carbon fiber reinforced thermosetting polyimide (CF/TSPI) composites were interleaved with thermally stable thermoplastic polyimide (TPPI) fiber veils in order to improve the interlaminar fracture toughness without sacrificing the heat resistance. Both of the mode I and mode II interlaminar fracture toughness (G_IC and G_IIC) for the untoughened laminate and TPPI fiber veils interleaved laminates were characterized by the double cantilever beam (DCB) test and end notch flexure (ENF) test, respectively. It is found that the TPPI fiber veils interleaved laminates exhibit extremely increased fracture toughness than the untoughened one. Moreover, the areal density of TPPI greatly affected the fracture toughness of laminates. A maximum improvement up to 179% and 132% on G_IC and G_IIC is obtained for 15 gsm fiber veils interleaved laminate, which contributes to the existence of bicontinuous TPPI/TSPI structure in the interlayer according to the fractography analysis. The interlaminar fracture behavior at elevated temperatures for 15 gsm fiber veils interleaved laminate were also investigated. The results indicated that the introduction of thermally stable TPPI fiber veils could enhance the fracture toughness of CF/TSPI composites by exceeding 200% as compared to the untoughened one even as tested at 250 °C.     

A simple and highly selective 1,2,4,5-tetrazine-based colorimetric probe for HSO3− ion recognition in food

A series of 3,6-bis-substituted-1,2,4,5-tetrazine-based colorimetric probes has been developed in good yields that exhibits highly selective and sensitive colorimetric recognition of HSO₃⁻ in aqueous solution. The color of the solution containing colorimetric probes changed markedly from orange to colorless, upon the addition of HSO₃⁻. Quantification of the absorption titration analysis shows that the detection limit of 3,6-bis(2-aminoethylamino)-1,2,4,5-tetrazine (2a) for HSO₃⁻ was 3.8 μM. It was noted that 3,6-bis-substituted-1,2,4,5-tetrazine-based colorimetric probes have a specific response toward HSO₃⁻ without interference from other 17 different anions and 16 common cations. A plausible mechanism was proposed by high-resolution mass spectroscopy analysis and NMR spectrometry analysis, involving the nucleophilic reaction of a bisulfite anion with the tetrazine ring and free radical rearrangement of ·SO₃H. Moreover, probes 2a–2c possessed applicability for sensing bisulfite in actual food samples. Therefore, the present work established a novel strategy for investigating bisulfite in food or other products.

3,6-Bis-substituted-1,2,4,5-tetrazine-based colorimetric probes, which have good water solubility, could detect bisulfate with high sensitivity and selectivity in food samples.     

1,2,3,4,6-O-五没食子酰基葡萄糖对MPP+诱导PC12细胞凋亡的保护作用

目的 考察1,2,3,4,6-O-五没食子酰基葡萄糖(1,2,3,4,6-penta-O-galloyl-β-D-glucose,β-PGG)对MPP⁺诱导的帕金森病细胞模型中PC12细胞凋亡的保护作用及其机制研究。方法 PC12细胞孵育于高糖DMEM培养基中,在药物处理前1周,将神经生长因子(NGF)加入培养基中,使培养基中NGF的终质量浓度为50 ng/mL。将细胞分为对照组、MPP⁺组以及50 μmol/L β-PGG预处理7、12、20、30 h组,观察预处理不同时间对MPP⁺中PC12细胞存活影响。采用台盼蓝染色法检测细胞死亡情况,MTT法检测细胞活力,免疫印迹法检测Bcl-2、Bax、Fas、FasL、procaspase-3、procaspase-8、procaspase-9蛋白表达情况,并检测caspase-3、caspase-8、caspase-9活力。结果 对照组PC12细胞死亡率最低,MPP⁺组PC12细胞死亡率最高,从β-PGG预处理12 h起PC12细胞死亡率较MPP⁺组均明显降低(P< 0.01)。MPP⁺组PC12细胞活力最低,50 μmol/L β-PGG预处理12 h时PC12细胞活力进一步增高,预处理20 h时细胞活力最高。β-PGG预处理5 h后即可见Bcl-2、procaspase-3、procaspase-8、procaspase-9蛋白含量增加,至15 h时增加达到高峰;与之相反的是,β-PGG预处理5 h后即可见Bax、Fas、FasL蛋白含量减少,至30 h时达最少。50 μmol/L β-PGG预处理PC12细胞15 h后caspase-3、caspase-8、caspase-9的活力分别为MPP⁺组的36.5%、40.2%、42.2%。结论 β-PGG对MPP⁺诱导PC12细胞凋亡具有保护作用,其机制是通过增强Bcl-2的表达、抑制Bax、Fas、FasL的表达以及降低caspase-3、caspase-8、caspase-9的活力实现了抑制MPP⁺引起的PC12细胞凋亡,促进PC12细胞的存活。     

In Vitro Functional Assessment of 22 Newly Identified CYP2D6 Allelic Variants in the Chinese Population

Cytochrome P450 2D6 (CYP2D6) is one of the most widely investigated CYPs related to genetic polymorphisms and is responsible for one‐quarter of the currently used clinical drugs. We previously detected 22 novel, non‐synonymous, mutated sites in the Chinese population, but nothing is known about the functional effects of these mutations in terms of specific CYP2D6 substrates. In this study, wild‐type CYP2D6, two common allelic variants and 22 newly reported CYP2D6 isoforms were transiently expressed in 293FT cells, and the enzymatic activities of these variants were systematically assessed using dextromethorphan and bufuralol as the probing substrates. Consequently, 19 and 21 allelic variants were found to exhibit significantly decreased enzymatic activities for dextromethorphan and bufuralol, respectively. Of 22 novel CYP2D6 variants, six allelic isoforms (CYP2D6.89, CYP2D6.92, CYP2D6.93, CYP2D6.96, E215K and R440C) exhibited absent or extremely reduced metabolic activities compared with those observed for the wild‐type enzyme. Our in vitro functional data can be useful for CYP2D6 phenotype prediction and provide valuable information for the study of clinical impact of these newly found CYP2D6 variants in China.     

Structure-Based Design of GNE-495, a Potent and Selective MAP4K4 Inhibitor with Efficacy in Retinal Angiogenesis

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Discovery of Quinazoline-Based Fluorescent Probes to α1-Adrenergic Receptors

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