黄蜡果植物鉴定、化学成分与药理作用研究进展

黄蜡果（Stauntonia brachyanthera Hand.-Mazz.）是木通科野木瓜属植物,在侗医药中具有多种药用价值,其全草均可入药。藤茎具有清热利尿、通经活络、镇痛排脓、通乳等作用,与木通功效相似,民间有将黄蜡果藤茎代替木通入药的用法。该植物主要从黄蜡果的果、花、叶和藤茎进行鉴定。经过查阅文献对黄蜡果的化学成分进行分类,主要含有三萜、黄酮、苯乙醇苷、苯丙素类等成分。目前对黄蜡果的药理活性主要集中在镇痛、抗炎、抗痛风、抗氧化、保肝、利尿等方面进行了研究。     

老年原发性高血压患者并发阵发性心房颤动的预测研究

目的 探讨老年原发性高血压患者并发阵发性心房颤动的预测因子。方法 87例老年原发性高血压患者分为两组。A组：并发阵发性心房颤动（PAF）的老年原发性高血压患者41例，B组：无PAF的老年原发性高血压患者46例；全部病例均进行同步12导联心电图、彩色多普勒超声心动图检查覆24h动态血压监测。结果 A组P波离散度（Pd）、P波最大时限（Pmax）、左心宣心肌重量指数（LVMI）、24h平均收缩压（24hSBP）、夜间平均收缩压（nSBP）均显著大于B组（均为P〈0．05）。Logistic逐步回归分析结果显示Pd、LVMI、nSBP均为老年原发性高血压患者并发PAF的独立预测因子（P〈0．05）。结论 Pd、LVMI、nSBP可以作为老年原发性高血压患者并发PAF的独立预测因子。     

Structure-Based Discovery of N-Sulfonylpiperidine-3-Carboxamides as Novel Capsid Assembly Modulators for Potent Inhibition of HBV Replication

As a key element during HBV replication, a nucleocapsid is considered a promising target for the treatment of chronic hepatitis B. The present study aimed to identify small molecules as novel capsid assembly modulators with antiviral activity. Structure-based virtual screening of an integrated compound library led to the identification of several types of HBV inhibitors. Among these inhibitors, N-sulfonylpiperidine-3-carboxamides (SPCs) potently reduced the amount of secreted HBV DNA. Through structure–activity relationship studies, we identified an SPC derivative, namely, C-39, which exhibited the highest antiviral activity without causing cytotoxicity. Mechanism studies showed that C-39 dose-dependently inhibited the formation of HBV capsid, synthesis of cccDNA, e antigen (HBeAg), viral pregenomic RNA (pgRNA), and HBV DNA levels, thereby restraining HBV replication. In summary, SPCs represent a new class of capsid assembly modulators. Further optimization of SPCs is expected to obtain new antiviral drugs against HBV infection.     

住院医师规范化培训中中医病案内涵缺失问题及对策

目的 通过补充中医病案内涵,提高住院医师规范化培训质量.方法 随机抽取80份由中医标准化培训医师撰写的中医档案,参照中医病历书写的基本规则,逐项进行检查和分析.结果 住院中医病案普遍存在的问题是中医病案内涵不完整、不完善,主要表现在四诊记录、辨证依据、三级查房记录等方面.结论 通过调查,实施一系列提高住院医师规范化培训...     

Enhanced Photo-Fenton Activity of SnO2/α-Fe2O3 Composites Prepared by a Two-Step Solvothermal Method

The x-SnO₂/α-Fe₂O₃ (x = 0.04, 0.07, and 0.1) heterogeneous composites were successfully prepared via a two-step solvothermal method. These composites were systematically characterized by the X-ray diffraction technique, field emission scanning electron microscopy, an energy dispersive spectrometer, X-ray photoelectron spectroscopy and a UV–visible spectrometer. It was found that SnO₂ nanoparticles were uniformly decorated on the surface of α-Fe₂O₃ particles in these heterogeneous composites. A comparative study of methylene blue (MB) photodegradation by α-Fe₂O₃ and x-SnO₂/α-Fe₂O₃ composites was carried out. All x-SnO₂/α-Fe₂O₃ composites showed higher MB photodegradation efficiency than α-Fe₂O₃. When x = 0.07, the MB photodegradation efficiency can reach 97% in 60 min. Meanwhile, the first-order kinetic studies demonstrated that the optimal rate constant of 0.07-SnO₂/α-Fe₂O₃ composite was 0.0537 min⁻¹, while that of pure α-Fe₂O₃ was only 0.0191 min⁻¹. The catalytic mechanism of MB photodegradation by SnO₂/α-Fe₂O₃ was examined. The SnO₂ can act as a sink and help the effective transfer of photo-generated electrons for decomposing hydrogen peroxide (H₂O₂) into active radicals. This work can provide a new insight into the catalytic mechanism of the photo-Fenton process.     

宫颈微偏腺癌六例伴五例卵巢转移的临床病理学分析

目的:探讨宫颈微偏腺癌（minimal deviation adenocarcinoma of cervix,MDA）伴卵巢转移临床病理特征。方法:收集四川省肿瘤医院2014年1月至2019年12月确诊MDA 6例伴卵巢转移5例,总结其临床病理特点及HER2表达状况,并结合文献复习。结果:6例患者年龄33~71岁,中位...     

依那普利联合倍他乐克治疗慢性心力衰竭的临床观察

目的探讨依那普利和倍他乐克对慢性心力衰竭的临床效果。方法61例慢性心力衰竭患者随机分为治疗组和对照组，对照组常规抗心衰治疗，治疗组加服依那普利和倍他乐克治疗前和治疗6mo后观察左室结构和功能指标的变化。结果治疗组左室结构和功能有明显改善，与对照组相比左室射血分数和心输出量明显增加p〈0．05。结论在强心利尿扩血管基础上加用依那普利和倍他乐克可显著改善慢性心力衰竭患者的左心功能。     

DIAGNOSIS AND TREATMENT OF THE MALIGNANT GESTATIONAL TROPHOBLASTIC TUMOR WITH PULMONARY METASTASIS COMPLICATED WITH PULMONARY TUBERCULOSIS

Objective. To evaluate the diagnosis and treatment for malignant gestational trophoblastie tumor (MGTT) with pulmonary metastasis complicated with pulmonary tuberculosis. Methods. To analyze ten cases of MGTT with pulmonary metastasis complicated with pulmonary tu-berculosis in oar hospital from 1980 to 1997 retrospectively, Results. From the x-ray film, there are great resemblances between MGTT with pulmonary metastasis and pulmonary tuberculosis. Of 10 patients, 7 of them were examined out pulmonary tuberculosis during the ehamotherapy of MGTT. Pulmonary tuberculosis appeared six months before chemotherapy in three eases, All of the patients were treated with multiagent chemotherapy. Seven patients achieved a complete remission, 2 patients developed drug resistance and died of cerebral haemorrhage and cerebral herniation, 1woman who had achieved a complete remission from MGTT for 14 months died of miliary tubereulosis. Condu.non. It is very important to make differential diagnosis oi the MGTT with pulraonary metasta-sis complicated with pulmonary tuberculosis, Trying to avoid excessive anti tumor treatment owing to mis-take pulmonary tuberculosis for pulmonary metastasis, and avoiding missing an opportunity of anti-tuber-culosis treatment because of missed diagnosis should be emvhasized.     

孕妇双胎妊娠合并肥厚型心肌病诊治分析及文献复习

目的探讨孕妇双胎妊娠合并肥厚型心肌病(HCM)的临床诊治及特点，并进行文献复习。 方法选取2017年10月12日，因孕龄为33⁺⁵孕周时皮肤瘙痒5 d，血液生化指标异常，于四川大学华西第二医院产科入院治疗的1例双胎妊娠合并HCM孕妇为研究对象。回顾性分析其临床资料、临床特点和诊疗过程，并进行相关文献复习。设定文献检索策略为，以"肥厚型心肌病""双胎""心肌病""twin pregnancy""hypertrophic cardiomyopathy""cardiomyopathy"为关键词，在中国知网、万方数据知识服务平台、维普中文期刊服务平台、PubMed及Web of Science(WOS)数据库中检索相关文献，检索时间设定为上述数据库建库至2020年1月1日。本研究符合2013年修订的《世界医学协会赫尔辛基宣言》要求。 结果①本例患者在本院诊治结果如下。病史采集：30岁，孕龄为33⁺⁵孕周，G₂P₀⁺¹，体外受精-胚胎移植技术(IVF-ET)术后(移植冻胚2枚)，HCM史4⁺年，反复告知孕妇夫妇妊娠风险，并由多学科团队(MDT)充分评估后，孕妇在产科及心内科共同监管下定期产前检查。因胎膜早破(PROM)后临产，于胎龄34⁺¹周在全身麻醉下急诊剖宫产术分娩，手术顺利。术后立即转入重症监护病房(ICU)。患者术后出现急性心力衰竭，经呼吸支持、镇静、抗感染、减轻容量负荷、改善心功能等治疗后病情平稳，经心血管科医师评估，给予口服美托洛尔控制心室率、降低心肌氧耗治疗，术后2 d病情好转。目前随访显示母婴情况均良好。②文献复习结果：根据本研究设定的文献检索策略，未检索到相关孕妇双胎妊娠合并HCM的相关报道，遂扩大检索范围，将检索词由"双胎"改为"妊娠"，共计检索到12篇国内外相关文献，涉及260例妊娠合并HCM患者，共计284次妊娠，所有患者均为单胎妊娠。这284次妊娠中，孕产妇发生心力衰竭为28次，2例死亡，其余患者均治疗有效。其中52次妊娠数据中新生儿未报道，余232次妊娠中，胎儿早产为46例，胎儿宫内死亡为5例。 结论多数无明显症状或轻症妊娠合并HCM孕妇可耐受妊娠及分娩，并且母儿结局多良好。但是，对于多胎妊娠合并HCM患者，即使孕妇孕期未发生相关不良心血管事件，分娩后由于血容量变化，对于本身罹患心肌病者是巨大挑战。