患者对预检分诊服务满意度理论框架的扎根理论研究

目的 通过扎根理论研究构建患者视角的预检分诊服务满意度理论框架,为评估和量化患者对预检分诊服务的满意度提供参考。方法 采用目的抽样和理论抽样的方法,选择27例接受过预检分诊服务的患者进行半结构式深度访谈;运用程序化扎根理论的研究方法,采用NVIVO12.0软件辅助对原始数据进行开放式编码、主轴编码及选择性编码,并进行理论饱和度检验。结果 析出患者期望、服务质量、信息供给、人本关怀、持续改进5个主范畴。结论 5个主范畴分别构成预检分诊服务满意度的主体因素、核心因素、关键因素、基本因素和保障因素。该理论框架可为改善预检分诊服务、评估患者满意度提供参考。     

Preparation of rigid polyurethane foam from lignopolyol obtained through mild oxypropylation

Lignin, one of the main components of lignocellulose, can be used as an alternative to chemical polyols in the production of polyurethane because of its abundant phenolic and alcohol hydroxyls. Traditionally, lignin is directly applied in the preparation of polyurethane; however, modified lignin has been proved to be superior, especially that obtained by the oxypropylation reaction. Therefore, lignopolyol obtained by mild and efficient oxypropylation was utilized in the production of rigid polyurethane foam in this study. Specifically, the effects of the content of lignopolyol on the chemical structure, morphological structure, mechanical properties and thermal stability of the lignin-based rigid polyurethane foam were investigated. It was found that the compressive strength of the rigid polyurethane foam was significantly improved with the addition of lignopolyol compared with that of the pure polyurethane foam, which was attributed to the fact that oxypropylation made lignin into highly branched and functionalized polyols by transforming all phenolic hydroxyls into aliphatic hydroxyls. Moreover, when the molal weight of lignopolyol accounted for 40% of the added polyols, the generated foam showed optimal uniformity and regularity, and the compressive strength reached 0.18 MPa, meeting the requirements of industrial application, below which, the amount of undesired reactions is bound to increase. As a consequence, the added amount of lignopolyol was increased as much as possible on the basis of guaranteeing the desired properties, which was more conducive to realizing the green degradation and economic synthesis of rigid polyurethane foam.

Lignin-based polyurethane foam with excellent performance could be produced with the lignopolyol prepared by mild and efficient oxypropylation.     

Selenium substituted axitinib reduces axitinib side effects and maintains its anti-renal tumor activity

Axitinib is a potent vascular endothelial growth factor receptor (VEGFR) inhibitor, which has a strong inhibitory effect on the three isoforms of VEGFR 1–3. Having strong therapeutic efficacy, its broad use is limited by its side effects such as hypertension, proteinuria, cardiovascular damage, and liver and kidney dysfunction. Selenium compounds are broadly reported to have a good protective effect on cardiovascular disease, inflammation, infection, and immune function. In this study, a selenium substitute of axitinib was synthesized, and its anti-renal cell carcinoma activity and side effects were investigated. The results of the study indicated that Se-axitinib had potent antitumor activity on renal cell carcinoma (RCC), alleviated vascular hyperpermeability, and also alleviated axitinib-related side effects including hypertension, liver dysfunction and kidney dysfunction significantly. Therefore, we suggest that Se-axitinib could be a solution to the severe side effects of VEGFR inhibitors and provide evidence to improve the outcome of RCC treatment.

Se-axitinib is a selenium substitution of sulfur in axitinib, which reduced the side effect of VEGFR inhibitors and maintained the potent anticancer activity of the original drug.     

西宁地区常见蝇种季节消长规律及其影响因素分析

目的:分析西宁地区常见蝇种季节消长规律、蝇种构成及影响因素.方法:臭豆腐诱饵法.结果:西宁地区的优势蝇种为厩腐蝇、新陆原腐蝇、常齿股蝇、红头丽蝇、大头金蝇、丝光绿蝇、舍蝇、尾黑麻蝇等,蝇密度高峰期在6、7、8月份.结论:滋生环境的改变和综合治理措施的运用,会改变城市的优势蝇种构成,持续的暖冬是导致蝇种消长规律变化的主要原因.     

抗HIV药物研究进展及发展趋势

本文分类总结了近年来抗HIV药物的研究进展以及以后的发展趋势,着重介绍了抗HIV的新的作用靶点和天然活性产物在抗HIV方面的应用。     

微卡胸膜腔注入治疗恶性胸腔积液的临床观察 5839

目的观察微卡胸膜腔内注入治疗恶性胸腔积液的效果和不良反应。方法2005年8月至2006年12月病理确诊的原发性支气管肺癌并恶性胸腔积液患者52例,胸膜腔内置入细管并接负压瓶,引流完胸腔积液后,随机分为两组,一组共27例胸腔内注入微卡225ug(微卡组);另一组共25例注入高聚生4000单位(高聚金组),观察对比两组的效果和不良反应。结果微卡组治疗效果CR6例、PR15例、NC4例、PD2例,有效率77.8%;高聚金组CR4例、PR16例、NC5例,有效率80.0%,两组的有效率无差异显著性(P>0.05)。微卡组患者80.0%(16/20),高聚金组81.2%(13/16)治疗后气促胸闷症状均有不同程度的改善甚至消失,两组比较无差异显著性(Fisher′s精确检验,P=1.00)。两组kamofsky评分治疗后比治疗前提高,微卡组平均提高(17.8±7.5)分;高聚金组(20.8±8.6)分,两组比较无差异显著性(t=1.35,P=0.183),两组均无严重不良反应事件,微卡组发热发生率33.3%,高聚生组48.0%,以低、中度发热为主,持续1～3d,经对症处理可缓解。结论微卡用于治疗恶性胸腔积液效果较好,不良反应轻微。     

基于组分中药理论的薏苡仁-知母药对治疗糖尿病患者的配伍特点

药对是源于中医传统经方或验方,依据中药配伍原则,能长期应用并指导临床实践的两味药物相对固定的配伍形式,具有协同增效或配伍减毒的作用。薏苡仁-知母为典型的清热滋阴药对,二者相辅相成,治疗阴虚热盛型糖尿病患者效果显著。其成分知母皂苷、知母多糖、芒果苷、薏苡仁多糖等对糖尿病均有较好的干预作用。现从中医理论及现代药理学研究等层面探究薏苡仁-知母药对治疗糖尿病的配伍特点,剖析主要活性成分的降糖作用和作用机制,为治疗糖尿病的新药研究提供理论基础。     

Early changes in corneal densitometry after FS-LASIK combined with accelerated corneal cross-linking for correction of high myopia

AIM: To observe the effects of femtosecond laser-assisted excimer laser in situ keratomileusis combined with accelerated corneal cross-linking (FS-LASIK Xtra) on corneal densitometry after correcting for high myopia. METHODS: In this prospectively study, 130 patients underwent FS-LASIK or FS-LASIK Xtra for high myopia. Their right eyes were selected for inclusion in the study, of which 65 cases of 65 eyes in the FS-LASIK group, 65 patients with 65 eyes in the FS-LASIK Xtra group. Patients were evaluated for corneal densitometry at 1, 3, and 6mo postoperatively using Pentacam Scheimpflug imaging. RESULTS: Preoperative differences in corneal densitometry between the FS-LASIK and FS-LASIK Xtra groups in different ranges were not statistically significant (P>0.05). Layer-by-layer analysis revealed statistically significant differences in the anterior (120 μm), central, and total layer corneal densitometry between the FS-LASIK and FS-LASIK Xtra groups at 1 and 3mo postoperatively (all P<0.05), the FS-LASIK Xtra group is higher than that of the FS-LASIK group. Analysis of different diameter ranges showed statistically significant differences between the FS-LASIK group and the FS-LASIK Xtra group at 1mo postoperatively in the ranges of 0–2, 2–6, and 6–10 mm (both P<0.05); At 3mo postoperatively, the FS-LASIK Xtra group is higher than that of the FS-LASIK group in the ranges of 0–2 and 2–6 mm (P<0.05). At 6mo postoperatively, there were no statistically significant differences in corneal densitometry between the FS-LASIK group and the FS-LASIK Xtra group in different diameter ranges (all P>0.05). CONCLUSION: There is an increase in internal corneal densitometry during the early postoperative period after FS-LASIK Xtra for correction of high myopia. However, the densitometry values decreased to the level of conventional FS-LASIK at 6mo after surgery, with the most significant changes observed in the superficial central zone.     

应用脱钙骨基质和硫酸钙颗粒治疗骨缺损的初期结果

目的探讨使用骨移植替代物脱钙骨基质（DBM）和硫酸钙颗粒（OSTEOSET）治疗骨缺损的疗效。方法对同期手术治疗的52例骨缺损患者的缺损处,分别于术后第1、4、8周及3、6、12个月进行随访并摄X线片直至骨缺损愈合。统计分析患者的临床资料、X线片辅助分析骨缺损修复程度和并发症。结果随访8-12个月,植骨术后6、12个月分别有95%和99%患者的骨缺损显示有明显的新骨形成,修复水平为60%-100%。并发症为3例（5.77%）,经换药后治愈,未发生骨缺损不愈合。结论DBM和OSTEOSET在骨愈合早期可加速骨缺损的修复,并可作为新鲜自体髂骨的替代物。     

胃肠道间质瘤21例临床分析

目的:探讨胃肠道间质瘤(GIST)的诊断和治疗方法。方法:收集21例GIST临床资料,进行回顾性分析。结果:21例平均年龄56.2岁,主要临床表现为腹部胀痛、腹部包块、黑便及贫血,2例无任何不适于查体时发现。9例经超声内镜检查确诊。21例均行根治性手术,肿瘤位于胃14例,小肠5例,肠系膜2例。21例均经术后病理检查及免疫组化确诊GIST,免疫组化表型以CD117、CD34阳性率较高。根据Miettinen等原则分类,良性5例,低度恶性10例,中等度恶性3例,高度恶性3例。结论:GIST的术前诊断有赖于纤维内镜、超声内镜、B超、CT等检查的综合应用,病理检查及免疫组化表型分析是确诊金标准,手术切除是最有效的治疗手段。