Altereporenes A–E,five epoxy octa-hydronaphthalene polyketides produced by an endophytic fungus Alternaria sp. YUD20002

Five previously undescribed epoxy octa-hydronaphthalene polyketides, altereporenes A–E (1–5) were isolated from rice culture of the endophytic fungus Alternaria sp. YUD20002 derived from the tubers of Solanum tuberosum. Their structures were determined on the basis of comprehensive spectroscopic analyses, while the absolute configurations were elucidated by the comparison of experimental and calculated specific rotations. Meanwhile, the antimicrobial, cytotoxic, anti-inflammatory and acetylcholinesterase inhibitory activities of compounds 1–5 were also investigated.

Five previously undescribed epoxy octa-hydronaphthalene polyketides, altereporenes A–E (1–5) were isolated from rice culture of the endophytic fungus Alternaria sp. YUD20002 derived from the tubers of Solanum tuberosum.     

ZTA和Al2O3正畸托槽的研究

目的 分别评价ZTA(ZrO2增韧Al2O3)和Al2O3陶瓷的性能,探索一种适合制备正畸托槽的陶瓷材料.方法 选用ZrO2(3mol%Y2O3)和α-Al2O3粉体作为原料,利用热压铸成型工艺制备陶瓷托槽,在1600 ℃下烧结.将制得样品进行各方面的性能测试.结果 采用纯Al2O3制备的托槽抗弯强度远远低于ZTA复合陶瓷.结论 牙科正畸托槽可以选用具有较高抗弯强度的ZTA复合陶瓷作为原料.     

人牙龈成纤维细胞原代培养方法的比较研究

目的：建立和评价人牙龈成纤维细胞原代培养方法,并观察其生物学特性。方法：分别用组织块法、2种改良酶消组织块法培养人牙龈成纤维细胞（HGF）,用形态学、免疫荧光鉴定细胞来源。通过活细胞观察,MTT比色实验研究细胞体外生物特性。比较3种培养方法培养HGF的效果。结果：细胞抗波形丝蛋白染色阳性,抗角蛋白染色阴性,符合人牙龈成纤维细胞的形态学特征和生物学特性。组织块法、改良酶消组织块法（翻瓶法）、改良酶消组织块法（盖玻片法）的细胞培养成功率分别为26.7%、54%、60%。组织块法和2种改良酶消组织块法间的成功率差异有显著性（P〈0.01）,2种改良酶消组织块法间的成功率差异无显著性（P〉0.05）。结论：本实验建立的细胞系为人牙龈成纤维细胞。2种改良酶消化组织块法可显著提高人牙龈成纤维细胞原代培养成功率。     

利妥昔单抗治疗难治性激素耐药型肾病综合征的疗效和安全性

目的:探讨利妥昔单抗(RTX)治疗儿童难治性激素耐药型肾病综合征(SRNS)的疗效和安全性。方法:回顾性分析2013年9月至2018年3月东部战区总医院儿科收治并接受RTX治疗的10例难治性SRNS患儿的临床资料。结果:10例患儿发病年龄(4.47±2.75)岁,男女各5例;5例(50%)肾活检为局灶节段性肾小球肾炎,...     

强化极化液治疗冠心病并心功能不全的疗效观察

目的探索强化极化液治疗冠心病并心功能不全的临床价值。方法观察17例接受强化极化液治疗的冠心病并心功能不全患者的血压、心率、心功能的变化并设对照组。结果治疗组用药前后血压、心率、心功能变化明显(P<0.05或P<0.01)。对照组用药前后血压、心率、心功能变化亦显著(P<0.01或P<0.05)。两组治疗后疗效比较差异显著(P<0.05或P<0.01)。治疗组出现疗效时间为(2.5±0.7)d,对照组(10±2.5)d,治疗组明显短于对照组(P<0.01)。结论强化极化液对冠心病并心功能不全患者有良好的临床治疗效果。     

吞咽言语治疗仪配合吞咽和进食训练治疗吞咽障碍的临床观察

目的：观察吞咽言语治疗仪配合吞咽和进食训练治疗脑卒中后吞咽障碍的疗效.方法：将脑卒中后吞咽障碍的100例患者随机分2组,治疗组：用吞咽言语治疗仪配合吞咽和进食训练给予治疗;对照组采用传统选穴针刺方法治疗.2周为一个疗程,共2个疗程.从2组治疗前后饮水测试结果比较.结论：两组均能改善吞咽障碍,但吞咽言语治疗仪配合吞咽和进食训练的疗效明显优于单纯传统选穴针刺方法（p〈0.05）.     

淡黄香茶菜地下部位化学成分

目的: 研究淡黄香茶菜Isodon flavida地下部分的主要化学成分. 方法: 采用硅胶、葡聚糖凝胶Sephadex LH-20,MCI 树脂等多种柱色谱技术进行分离纯化,运用理化性质和现代波谱技术鉴定结构. 结果: 从淡黄香茶菜地下部分的70%丙酮提取物的乙酸乙酯部位分离鉴定11个化合物,分别为角鲨烯(1),豆甾-4-烯-3-酮(2),豆甾-4-烯-3,6-二酮(3),8(17),13-ent-labdadien-15→16-lactone-19-oic acid(4),1-油酸单甘油酯(5),2α-羟基-乌索酸(6),山楂酸(7),2α,3α,23-三羟基乌苏-12,20(30)-二烯-28-酸(8),豆甾醇(9),7α-羟基谷甾醇(10),β-谷甾醇(11). 结论: 除化合物7外均为首次从该植物中分离得到.本研究对于深入了解认识香茶菜属植物地下部分的化学品质具有一定的帮助.     

以学生为案例望面色教学实践体会

望面色是望诊的主要内容之一,为了加强学生望面色这一诊断方法的学习效果,在征得学生同意,自愿参加的前提下,在学生中找典型面色进行真实案例教学,调动了学生学习积极性,取得了良好教学效果,实现了教学相长。     

去卵巢对大鼠泪腺中IL-17A等炎症因子表达的影响

目的建立去卵巢大鼠模型,观察性激素水平改变对泪腺中IL-17A以及IL-1β、IL-6、TNF-α等炎症因子表达的影响。方法实验研究。健康雌性SD大鼠20只随机分为2组,实验组（10只）摘除大鼠双侧卵巢,对照组（10只）为未摘除卵巢的模拟手术组。术前及术后第1个月、第2个月、第3个月时2组均行泪液分泌试验（SIT）、角膜荧光染色检查进行眼表评估。于第3个月时放射免疫分析法分别检测2组大鼠血清雌二醇、睾酮含量,HE染色观察泪腺上皮细胞形态,免疫组化染色法、Western Blot法检测2组泪腺中IL-17A、IL-1β、IL-6、TNF-α的表达。2组性激素质量浓度比较、炎症因子A值表达比较均应用独立样本t检验。2组各时间点的SIT结果比较采用重复测量资料两因素方差分析。结果实验组大鼠去卵巢后第3个月时,体内雌二醇浓度低于对照组（t=-35.37,P<0.01）,睾酮浓度低于对照组（t=-12.13,P<0.01）。2组各时期SIT检查未见泪液分泌减少、均未见角膜荧光染色。HE染色见实验组泪腺腺泡萎缩,排列紊乱,胞质内酶原颗粒明显减少。泪腺IL-17A表达量2组比较实验组高于对照组（免疫组化法：t=7.56,P<0.01;Western Blot法：t=20.90,P<0.01）。余各因子表达量实验组也均高于对照组（免疫组化法：IL-1β：t=13.71,P<0.01;IL-6：t=13.92,P<0.01;TNF-α：t=6.11,P<0.01。Western Blot法：IL-1β：t=16.93,P<0.01;IL-6：t=12.46,P<0.01;TNF-α：t=14.47,P<0.01）。结论大鼠去卵巢3个月时性激素水平降低,未见明显眼表损害。但泪腺中炎症因子IL-17A、IL-1β、IL-6、TNF-α的表达增加。     

Impact of Ocular Residual Astigmatism on Visual Outcomes of Myopic Astigmatism Correction after Small Incision Lenticule Extraction

Objective: To calculate ocular residual astigmatism (ORA) by vector analysis and to evaluate the impact of ocular residual astigmatism on refractive and visual outcomes after correction of myopic astigmatism by small incision lenticule extraction (SMILE). Methods: In this prospective case-series study, 115 eyes with myopic astigmatism were treated with SMILE from Jauary 2019 to August 2019 atRefractive Center of Ophthalmology Department, Shengjing Hospital, China Medical University. ORA was calculated by vector analysis and patients were divided into two groups according to the magnitude of ORA: high ORA group (ORA≥1.00 D) with 42 eyes and low ORA group (ORA<1.00 D) with 73 eyes. The follow-up period was 3 months after the operation. Uncorrected visual acuity (UCVA) and pythagorean length were measured and compared after the operation. The following measurements were compared: refractive outcomes, total higher order aberrations (tHOAs), vertical trefoil, vertical coma, horizontal coma, oblique trefoil, oblique quadrafoil, oblique secondary astigmatism, spherical aberration, vertical secondary astigmatism, and vertical quadrafoil. Contrast sensitivity was compared between the high and low ORA groups under either 85 cd/m2 or 3 cd/m2 illumination from 1.5 c/d to 18 c/d. The data were analyzed by an independent-samples t test and Mann-Whitney U test to compare the differences between the two groups. Results: Three months postoperatively, refractive outcomes showed that postoperative residual astigmatism in the high ORA group was significantly higher than in the low ORA group (t=3.293, P=0.001). Vector analysis showed that the error vector (EV), absolute error of angle (absolute EA) and index of success (SI) were higher in the high ORA group (t=-3.235, P=0.001; t=-2.326, P=0.020; t=-2.587, P=0.010). After SMILE，all cases had achieved a desirable visual acuity: high ORA group: -0.15±0.05, low ORA group: -0.15±0.05. There were no statistically significant differences in visual acuity, pythagorean length, tHOAs, vertical trefoil, vertical coma, horizontal coma, oblique trefoil, oblique quadrafoil, oblique secondary astigmatism, spherical aberration, vertical secondary astigmatism, or vertical quadrafoil between the two groups. An obvious difference was found in contrast sensitivity, which showed a higher contrast sensitivity at a spatial frequency of 18 c/d with 85 cd/m2 in the low ORA group than in the high ORA group (t=-2.877, P=0.005), but this tendency was not present at 3 cd/m2 . Conclusions: Ocular residual astigmatism impacts the precision of SMILE in correcting myopic astigmatism. This leads to a tendency of more residual astigmatism in refractive outcomes, and reduces contrast sensitivity at high spatial frequencies. However, it does not affect the outcome of obtaining good visual quality in both visual acuity and higher order aberrations.