新生儿暂时性呼吸困难的肺部超声表现

目的 观察新生儿暂时性呼吸困难的肺部超声特点。方法 选取2018年7月至2019年6月扬州大学医学院附属淮安市妇幼保健院收治的60例暂时性呼吸困难患儿作为观察组,选取同期60例胎龄相近的健康新生儿作为对照组。观察组患儿分别在出生后6 h内和72 h后进行肺部超声检查,对照组患儿仅在出生后6 h内进行肺部超声检查,分析其肺部超声特点。结果 超声检查发现,所有患儿均无实变发生。出生后6 h内,观察组患儿胸膜线异常、A-线消失、存在B-线、肺泡间质综合征、双肺点和胸腔积液的发生率高于对照组,差异有统计学意义（P<0.05）。观察组出生后72 h后患儿胸膜线异常、A-线消失、存在B-线、肺泡间质综合征、双肺点和胸腔积液的发生率低于出生后6 h内超声检查结果,差异有统计学意义（P<0.05）。结论 暂时性呼吸困难患儿具有胸膜线异常、A-线消失、存在B-线、肺泡间质综合征、双肺点、无实变发生和胸腔积液等特点,肺部超声对新生儿暂时性呼吸困难的早期诊断和病情监测具有重要价值。     

An integrated strategy for the comprehensive profiling of the chemical constituents of Aspongopus chinensis using UPLC-QTOF-MS combined with molecular networking

ContextThe extracts of Aspongopus chinensis Dallas (Pentatomidae), an insect used in traditional Chinese medicine, have a complex chemical composition and possess multiple pharmacological activities.ObjectiveThis study comprehensively characterizes the chemical constituents of A. chinensis by an integrated targeted and untargeted strategy using UPLC-QTOF-MS combined with molecular networking.Materials and methodsThe ultra-performance liquid chromatography-tandem quadrupole time-of-flight mass spectrometry (UPLC-QTOF-MS) combined with molecular networking-based dereplication was proposed to facilitate the identification of the chemical constituents of aqueous and ethanol extracts of A. chinensis. The overall strategy was designed to avoid the inefficiency and costliness of traditional techniques. The targeted compounds discovered in the A. chinensis extracts were identified by searching a self-built database, including fragment ions, precursor ion mass, and other structural information. The untargeted compounds were identified by analyzing the relationship between different categories, fragmentation pathways, mass spectrometry data, and the structure of the same cluster of nodes within the molecular network. The untargeted strategy was verified using commercial standard samples under the same mass spectrometry conditions.ResultsThe proposed integrated targeted and untargeted strategy was successfully applied to the comprehensive profiling of the chemical constituents of aqueous and ethanol extracts of A. chinensis. A total of 124 compounds such as fatty acids, nucleosides, amino acids, and peptides, including 74 compounds that were reported for the first time, were identified in this study.ConclusionsThe integrated strategy using LC tandem HRMS combined with molecular networking could be popularised for the comprehensive profiling of chemical constituents of other traditional insect medicines.     

The role of hypoxia inducible factor-1α in the increased MMP-2 and MMP-9 production by human monocytes exposed to nickel nanoparticles

Nickel is an important economic commodity, but it can cause skin sensitization and may cause lung diseases such as lung fibrosis, pneumonitis, bronchial asthma and lung cancer. With development of nanotechnology, nano-sized nickel (Nano-Ni) and nano-sized titanium dioxide (Nano-TiO?) particles have been developed and produced for many years with new formulations and surface properties to meet novel demands. Our previous studies have shown that Nano-Ni instilled into rat lungs caused a greater inflammatory response as compared with standard-sized nickel (5 μm) at equivalent mass concentrations. Nano-Ni caused a persistent high level of inflammation in lungs even at low doses. Recently, several studies have shown that nanoparticles can translocate from the lungs to the circulatory system. To evaluate the potential systemic effects of metal nanoparticles, we compared the effects of Nano-Ni and Nano-TiO? on matrix metalloproteinases 2 and 9 (MMP-2 and MMP-9) gene expression and activity. Our results showed that exposure of human monocyte U937 to Nano-Ni caused dose- and time- dependent increase in MMP-2 and MMP-9 mRNA expression and pro-MMP-2 and pro-MMP-9 activity, but Nano-TiO? did not. Nano-Ni also caused dose- and time- related increase in tissue inhibitor of metalloproteinases 1 (TIMP-1), but Nano-TiO? did not. To determine the potential mechanisms involved, we measured the expression of hypoxia inducible factor 1α (HIF-1α) in U937 cells exposed to Nano-Ni and Nano-TiO?. Our results showed that exposure to Nano-Ni caused HIF-1α accumulation in the nucleus. Furthermore, pre-treatment of U937 cells with heat shock protein 90 (Hsp90) inhibitor, 17-(Allylamino)-17-demethoxygeldanamycin (17-AAG), prior to exposure to Nano-Ni significantly abolished Nano-Ni-induced MMP-2 and MMP-9 mRNA upregulation and increased pro-MMP-2 and pro-MMP-9 activity. Our results suggest that HIF-1α accumulation may be involved in the increased MMP-2 and MMP-9 production in U937 cells exposed to Nano-Ni.     

盆底功能康复技术对防治产后女性压力性尿失禁的作用研究

目的探究盆底功能康复技术对防治产后女性压力性尿失禁的作用。方法选取2009年2月～2010年2月在本院分娩的产妇178例,随机分为两组。其中治疗组89例采取专门的盆底功能康复技术对产妇进行治疗,时间为8周。而对照组89例采取一般措施,主要是产后健康教育,时间也是8周。产后16周对两组产妇进行随访,主要通过问卷调查的方式进行分析盆底功能康复技术对防治产后女性压力性尿失禁的作用。结果通过两组的调查对比分析,其中治疗组在产后出现压力性尿失禁的发生率明显低于对照组。结论盆底功能康复技术对防治产后女性出现压力性尿失禁有着极大的帮助,但是其长期的疗效还需要进一步的观察。     

复方丙谷胺西咪替丁片溶出度测定方法的研究

目的：确定复方丙谷胺西昧替丁片溶出度测定的方法。方法：采用转篮法，以磷酸盐缓冲液（pH7．2）为溶出介质，转速100r·min^-1，高效液相法检测。结果：45分钟的溶出量不少于70％，三种主要成分丙谷胺、西咪替丁、尿囊素分别在120～280μg／ml；58．4～136．4μg／ml；65．3～153．7μg／ml范围内呈现良好的线性关系。结论：本方法操作简单，准确可靠，能满足质量控制的要求。     

利尿剂药物治疗高血压所致51例不良反应分析

目的：为降低利尿剂药物不良反应的发生,为其临床安全用药提供参考依据。方法：汇总徐州市2014年7月至2016年7月共51例利尿剂药物的不良反应报告进行回顾性分析和总结。结果：小剂量使用利尿剂药物较为安全,当剂量过大时易引起不良反应,主要表现为头痛、头晕、腹泻、电解质紊乱和高尿酸血症等。结论：利尿剂药物应从小剂量开始服用,选择合适的利尿剂药物,加强监测,避免不良反应的发生。     

A new isoquinolinone derivative with noble vasorelaxation activity

The pharmacological effects of BDPBI (7-bromo-1,4-dihydro-2-phenyl-4,4-bis(4-pyridinylmethyl)2H-isoquinolin-3-one dihydrochloride) were tested on isolated endothelium-containing or denuded aorta of the guinea pig. BDPBI with the formula C(27)H(24)BrCl(2)N(3)O was synthesized starting with 3-isochromanone. In the endothelium-containing preparations of the aortic rings, phenylephrine (PHE; 10 micromol/l) elicited contracture and acetylcholine (ACh; 10 micromol/l) or BDPBI (0.01-10 micromol/l) elicited relaxation effects on the PHE-precontracted preparations. The BDPBI-elicited effect on the PHE-precontracted aortic rings was not altered in the presence of adrenergic blockers (propranolol or yohimbine; 1 micromol/l) or pretreated preparations with aspirin, indomethacin (10 micromol/l) or L-NAME (1 mmol/l). However, the relaxation effects of BDPBI were blocked if the preparations were pretreated with diphenhydramine (10 micromol/l) or chloropheniramine maleate (10 micromol/l). In contrast to lower concentrations of atropine (1 micromol/l), higher concentrations of atropine (30 micromol/l) did block the effects of BDPBI on the PHE-precontracted aortic rings. HTMT dimaleate (0.01-10 micromol/l), a histamine H(1) receptor agonist, also elicited relaxation effects on the PHE-precontracted preparation, and the effects were blocked if the preparations were pretreated with diphenhydramine or chloropheniramine maleate. On isolated denuded aorta of the guinea pig, BDPBI did not elicit relaxation effects on the PHE-precontracted aortic rings. These results demonstrated that the vasorelaxation effect of BDPBI on PHE-precontracted aortic rings is partly dependent on the activation of a histaminergic receptor from the vascular endothelium. We suggested that BDPBI would be an effective vasorelaxant for cardiovascular systems.     

补肾通络法治疗38例肺纤维化的临床分析

目的:探讨补肾通络法治疗肺纤维化的临床效果。方法:回顾采用补肾通络法治疗38例肺纤维化的临床资料。结果:临床症状改善明显。结论:补肾通络法是治疗肺纤维化的有效方法。     

胰头肿块型慢性胰腺炎12例诊治分析

目的分析胰头肿块型胰腺炎的诊治方法。方法回顾性分析我院1998年6月至2008年6月间收治的125例慢性胰腺炎病例,总结其中12例因胰头占位而行胰十二指肠切除术患者的病例。结果12例患者术中探查均显示肿块位于胰头,与周围组织有粘连,其中1例与门静脉有粘连,但尚能剥离,术后病理证实均为慢性胰腺炎。结论目前区分慢性胰腺炎与胰腺癌尚无特异性好和敏感性高的鉴别方法,CT结合经内镜逆行胰胆管造影对大部分病例的鉴别诊断具有较高的价值,胰头肿块型胰腺炎行胰头十二指肠切除术治疗效果良好。     

隐匿性房室旁道心电图定位的临床价值评价

目的探讨隐匿性房室旁道心电It定位的临床价值。方法以我院2010年-2013年诊断收治的隐匿性房室旁道患者48例为研究对象。结果右侧旁道13例,在V1倒置12例,平坦3例,P-R间期均〉R—P-间期,左侧旁道35例,其中21例左前区域旁道,在I、aVLP-波倒置,在III、aVFP-波直立,P-R间期均〈R—P-间期;14例左后区域旁道,12例P-波在I、aVL直立、浅倒置、平坦,各种变化较大,P-R间期〉R—P-间期,2例左后间隔旁道在III、aVFP。波深倒置。结论隐匿性房室旁道诊断中采用体表心电图通过对P-波形态以及RP间期长短的观察能形成较为准确的定位。