改良留置导尿管相关尿路感染病原菌及感染危险因素研究

目的 研究改良留置导尿管相关尿路感染患者病原菌的分布情况,分析改良留置导尿管患者尿路感染的危险因素。方法 纳入2018年3月至2020年3月邯郸市第一医院收治的168例改良留置导尿管患者作为研究对象,观察所有患者尿路感染和病原菌分布情况。将发生尿路感染和未发生尿路感染的患者收集资料并进行对比,差异有统计学意义项目代入Logistic回归方程计算,分析改良留置导尿管患者发生尿路感染的危险因素。结果 168例改良留置导尿管患者中有49例患者发生尿路感染,发生率为29.17%。共检出病原菌84株。其中革兰阴性杆菌50株（59.52%）,革兰阳性球菌24株（28.57%）,真菌10株（11.90%）。发生尿路感染和未发生尿路感染患者在年龄、住院时间、留置导尿管时间、糖尿病、肾结石、低蛋白血症以及抗菌药物使用种类上对比差异均有统计学意义（P<0.05）。将上述项目代入Logistic回归方程计算发现,年龄≥60岁、住院时间≥21 d、留置导尿管时间≥13 d、合并糖尿病、合并肾结石、合并低蛋白血症以及尿路感染前抗菌药物使用种类≥3种均是改良留置导尿管患者发生尿路感染的危险因素。结论 改良留...     

Application of the assay of urine FSH β-subunit in patients with pubertal disorders

Objective: To evaluate the diagnostic predictive value in the identification of puberty disorders by means of ELISA of β-FSH subunit levels in successively collected urine samples compared to RIA of intact FSH in serum obtained from the normal control subjects and patients with puberty disorders, respectively.Subjects and Methods: Five male and four female volunteers were recruited as controls. Four patients with the hypogonadotropic hypogonadism, five patients with hypergonadotropic hypogonadism, four patients with the central precocious puberty and one patient with isosexual peripheral precocious puberty collected successively their early-morning urine samples for 30 to 32 days.The urine β-FSH subunit was assayed with the method of ELISA, then adjusted by creatinine (Cr) concentration.Results:Comparing with their cotemporary groups, patients with the hypogonadotropic hypogonadism had lower levels of urine β-FSH, and patients with idiopathic hypergonadism had higher levels with irregular fluctuation. Meanwhile, patients with the central precocious puberty had much higher levels of urine β-FSH with irregular peaks, and patients with isosexual peripheral precocious puberty had almost normal levels. The patterns were coincident with the clinical characteristics and serum FSH levels.Conclusion: The ELISA of urine β-FSH subunit possesses a number of advantages over the RIA of serum FSH level, such as low cost, simplicity and reliability in the clinical practice. It can be used for the diagnoses of puberty disorders. In addition, it is possible and much easier, comparing with blood samples, to collect successively urine samples for research of pathophysiological dynamics of FSH secretion in puberty disorders and other reproductive dysfunction.     

结核分枝杆菌Rv1009基因蛋白的克隆和表达

目的克隆表达结核分枝杆菌促Rv1009基因,序列测定正确后进行融合、表达。方法采用热启动聚合酶链反应(Polymerase Chain Reaction,PCR)从结核分枝杆菌H37Rv基因组中扩增出Rv1009编码基因,用限制性内切酶消化后插入pGEX 4T-2载体中,将重组质粒转化大肠杆菌BL21 (DE3),目的基因经IPTG诱导,表达Rv1009基因蛋白。结果经PCR扩增在1300bp处发现一条目的片段,获得了结核分枝杆菌H37Rv株Rv1009基因蛋白,经诱导后高效表达分子量为64KD的外源蛋白,与预期分子量大小一致,凝胶自动扫描分析,在A600值为0．6,IPTG终浓度为0．3 mmol／L,诱导表达3 h时融合蛋白表达量即达峰值,占菌体总蛋白的22．8％。结论构建了结核分枝杆菌Rv1009基因重组表达载体,获得了RPF样融合蛋白的高效表达,为今后深入研究奠定了基础。     

Fe/Co/N–C/graphene derived from Fe/ZIF-67/graphene oxide three dimensional frameworks as a remarkably efficient and stable catalyst for the oxygen reduction reaction

The development of non-noble metal catalysts with high-performance, long stability and low-cost is of great importance for fuel cells, to promote the oxygen reduction reaction (ORR). Herein, Fe/Co/N–C/graphene composites were easily prepared by using Fe/ZIF-67 loaded on graphene oxide (GO). The Fe/Co/porous carbon nanoparticles were uniformly dispersed on graphene with high specific surface area and large porosity, which endow high nitrogen doping and many more active sites with better ORR performance than the commercial 20 wt% Pt/C. Therefore, Fe/Co/N–C/graphene composites exhibited excellent ORR activity in alkaline media, with higher initial potential (0.91 V) and four electron process. They also showed remarkable long-term catalytic stability with 96.5% current retention after 12 000 s, and outstanding methanol resistance, compared with that of 20 wt% Pt/C catalysts. This work provides an effective strategy for the preparation of non-noble metal-based catalysts, which could have significant potential applications, such as in lithium–air batteries and water-splitting devices.

Fe/Co/N–C/graphene was facilely and successfully prepared by a calcination process, which has remarkable electrocatalytic ORR activity in alkali solutions and also displays an exceptional stability for the ORR and methanol tolerance.     

Insights into the gelatinization of potato starch by in situ1H NMR

The gelatinization of potato starch and the effect of NaCl on starch gelatinization were monitored successfully in situ by ¹H NMR spectroscopy. Variable temperature (VT) ¹H NMR measurement, from 316 K to 340 K, was conducted on a suspension of potato starch and deuterium water as well as a mixture of potato starch, NaCl and deuterium water. The hydration level of starch was determined with the increase of temperature. In the presence of NaCl, the initial gelatinization temperature of potato starch was decreased from 331 to 328 K. Meanwhile, in situ¹H NMR spectroscopy as a function of time was also carried out to monitor the gelatinization with a time resolution of 90 s per spectrum. Furthermore, the effect of using different processing methods during gelatinization, including varying the temperature or time duration, was investigated in detail. It was confirmed that protons from different groups of starch showed different accessibility for water during hydration of starch granules. In comparison with temperature, gelatinization time as the major factor for reaching complete gelatinization was confirmed. We expect that this research, as a continuing effort to apply NMR spectroscopy for characterizing starch, will pave a new way in the structural elucidation of starch.

The gelatinization of potato starch and the effect of NaCl on starch gelatinization were monitored successfully in situ by ¹H NMR spectroscopy.     

拉米夫定治疗乙型肝炎肝硬化临床随机对照试验国内文献的荟萃分析

目的应用荟萃分析评价拉米夫定治疗乙肝肝硬化国内文献的疗效。方法对2000年1月—2006年12月在国内生物医学期刊有关拉米夫定治疗乙肝肝硬化的临床随机对照试验进行质量评价。结果纳入8个RCT(n=578)研究拉米夫定100mg/d治疗乙肝肝硬化的疗效,纳入文献的总体方法学质量较高,4篇Jadad评分为3分以上,但在随机化方法、分配隐藏和盲法的使用方面重视不够。分析结果显示,使用拉米夫定可明显促使ALT复常,对Child-Pugh评分与对照组相比有统计学意义(P<0.05),短期内使用拉米夫定对HBVDNA转阴率与对照组相比有统计学意义(P<0.05),但长期则无统计学意义(P>0.05)。拉米夫定治疗组的HBeAg转阴率与对照组相比无统计学意义(P>0.05)。结论拉米夫定治疗乙肝肝硬化是安全的,它可使ALT复常,降低Child-Pugh评分,但对远期HBVDNA和HBeAg阴转率尚无足够证据说明。     

乐果诱导的迟发性神经病大鼠模型的实验研究

目的建立乐果诱导的迟发性神经病的大鼠模型,并观察其神经病理改变。方法随机将SD大鼠分成3组：高剂量组腹腔注射乐果乳油剂量为330mg／kg;低剂量组注射剂量为165mg／kg;对照组注射同量玉米油。观察染毒后急性中毒症状及中毒后活动、饮食等一般状况的变化;检测血清乙酰胆碱酯酶（AChE）活性变化;光镜和电镜观察周围神经的病理变化。结果实验第2周。高剂量组大鼠出现了轻微的步态不平衡;第4周时高剂量组大鼠出现了后肢肌力弱,有的后肢完全瘫痪。低剂量组在中毒后也出现了同样的症状。染毒组大鼠胫神经轴索内线粒体聚集,还可见到神经微丝排列紊乱。髓鞘普遍疏松,板层分离多见,板层间空泡化、气球样变,有的呈典型的葱管样改变,可见部分髓鞘缺失。结论用大鼠建立乐果迟发性神经病的动物模型是可行的。     

关于注射剂中可见异物研究进展

注射剂可见异物是目前注射剂产品常见的问题之一,也一直是全球监管机构和行业内激烈讨论的问题。尽管业界对可见异物的定义及判断标准有一定的共识,但在实际生产过程中,对于如何控制可见异物仍然存在不同的理解和掌握尺度。此外,企业在生产过程中对于检测人员的技能要求和设备的验证也缺乏权威的参考和依据,如可见异物的标准物质和相关技术指导文件等,这些对于国内注射剂的生产和质量控制影响都很大。本研究旨在开展关于“注射剂中可见异物”的文献调查,通过收集和整理国内外相关文献,对本领域的相关研究进展进行分析总结,为提高注射剂质量提供参考。     

天津市零售药店药学服务开展现状调查

目的：为提升零售药店执业药师药学服务水平提供参考。方法：设计调查问卷,对天津市零售药店的执业药师的药学服务开展现状进行调查,并就数据进行统计和分析。结果：共发放问卷3021份,回收有效问卷3001份,有效回收率为99.34%。被调查对象中大专及以上学历者占86.23%,（中）药学类专业人员占76.27%（47.95%+28.32%）,副高级及以上职称人员仅占1.17%。参与调研的天津市各种类型药店均开展了较为详实的药学服务事项。但是非处方药店中药品安全及安全用药相关科普教育不足,在经营处方药及非处方药的零售药店,执业药师仅开展口头用药指导,在建立药历、开展用药情况追踪方面存在欠缺。慢性病管理药店,制定药学监护计划、分级分层管理疾病,用药疗效定期随访评估难以持续。医保药店中疗效追踪和安全性随访还有不足。直接面向患者提供专业服务的药房（DTP）中欠缺完整记录,长期随访不足。接入药品网络交易第三方平台药店的执业药师忙于订单核对、调配药品,用药交代没有落到实处。执业药师工作满意度达87.67%,执业药师对中成药推荐正确率27.16%,药品不良反应、患者教育相关知识掌握不精准。结论：执业药师队伍长足发展,但专业学历结构尚待优化;零售药店已逐步开展起基础的药学服务,但服务的水平和标准化程度尚待提高;执业药师工作满意度较高,但执业能力尚有差距。故提出鼓励零售药店开展多种类型及层次的药学服务满足公众多样化的社会需要;执业药师严守服务规范底线,不断提升执业能力素质;管理机构调动社会各界力量,提升执业药师职业荣誉感,增强职业吸引力,从而优化执业药师队伍结构,并采取一定措施,有效提升零售药店执业药师药学服务水平的建议。