剩余稀释标本涂片复检在末梢血预稀释模式三分群血常规检查中的应用价值

目的探讨剩余稀释标本涂片细胞形态学复检在新生儿、婴幼儿末梢血预稀释模式三分群血常规检查中的可靠性。方法对新生儿、婴幼儿末梢血血常规检查标本以Sysmex-kx-21三分群血细胞分析仪预稀释模式进行检测,并对筛查的结果进行手工复检;对剩余稀释标本的手工复检以离心沉淀或静置沉淀的方式进行浓缩与涂片瑞氏染色,镜检至少观察200个白细胞,同时每例检查补充末梢血直接涂片1~2张瑞氏染色镜检作为细胞形态学复检比对的金标准。结果根据复检规则对仪器法检测结果进行统计学分析,得到真阳性率为4.6%,假阳性率为20.3%,真阴性率为74.0%,假阴性率为1.1%,复检率为24.9%,仪器法测定的敏感度为18.3%,特异度为98.6%,阳性预测值为81.3%,阴性预测值为78.5%,准确性为78.6%;两种涂片方式复检结果一致(P>0.05)。结论基层单位末梢血预稀释模式三分群血常规检查简易形态复检能为新生儿、婴幼儿门诊保健和临床医疗提供安全保障。     

蒲黄调节血脂及抗动脉粥样硬化的研究进展

蒲黄可以改善循环、降低血脂、阻止高脂血症所致的血管内皮损伤,防治动粥样硬化,临床常用于治疗冠心病。本研究就蒲黄调节血脂及抗动脉粥样硬化的研究进展做一综述。     

地佐辛对宫颈癌手术患者全麻恢复期BIS及苏醒质量影响的研究

目的:研究地佐辛对宫颈癌手术患者全麻恢复期脑电双频指数(BIS)和苏醒质量的影响.方法:将本院收治的80例行宫颈癌手术的患者随机分为A组与B组,每组40例;A组为对照组,在手术前20min给予生理盐水5 mL,B组为实验组,给予地佐辛0.1 mg/kg.记录A、B两组术前(T0)、气管插管时(T1)、气管拔管后1 min(T2)、5 min(T3)、10 min(T4)的BIS、MAP、HR和SpO2值,以及睁眼时间、定向力恢复时间、芬太尼用量、VAS评分以及躁动情况.结果:两组在各时间点的BIS、SpO2比较,差异均无统计学意义(P＞0.05);与T0时刻相比,两组BIS其它各时刻均明显降低;A组各时刻与T0时刻相比,MAP值明显升高,HR明显加快,差异具有统计学意义(P＜0.05);B组与A组相比较,各时刻与T0时刻相比,MAP值明显降低,HR明显减慢,差异具有统计学意义(P＜0.05);A组睁眼时间、定向力恢复时间较B组长、A组VAS评分较B组高,差异具有统计学意义(P＜0.05);两组躁动情况比较,差异无统计学意义(P＞0.05).结论:宫颈癌手术中使用0.1 mg/kg的地佐辛对手术患者全麻恢复期BIS无影响,且提高苏醒质量.     

表里经配穴法对脑缺血再灌注损伤大鼠海马细胞凋亡及JNK信号通路的影响

【目的】观察表里经配穴法对脑缺血再灌注损伤大鼠海马细胞凋亡及c－jun氨基末端激酶（JNK）信号通路的影响,探讨其对脑缺血再灌注损伤保护作用的可能机制。【方法】将120只SD大鼠随机分为假手术组、模型组、表里经配穴电针组、抑制剂组;参照Longa法复制局灶脑缺血再灌注模型,表里经配穴电针组取表里经配穴的足三里、三阴交和尺泽、合谷行电针治疗,每日1次。采用神经行为学评定各组大鼠不同时段神经行为, TUNEL法检测海马细胞凋亡指数,免疫组织化学法检测p－JNK表达。【结果】表里经配穴电针组、抑制剂组神经功能缺损评分均显著低于模型组（P＜0．05）;模型组凋亡指数显著高于假手术组（P＜0．01）,表里经配穴电针组和抑制剂组凋亡指数均显著低于模型组（P＜0．05）;模型组各时段p－JNK表达较假手术组显著增加（P＜0．01）,表里经配穴电针组、抑制剂组p－JNK表达较模型组显著降低（P＜0．05）。【结论】表里经配穴法可不同程度地减轻缺血再灌注后大鼠的神经功能缺损,减少细胞凋亡,其机制可能与抑制JNK信号通路有关。     

Plasma Exchange for Neuromyelitis Optica Spectrum Disorders in Chinese Patients and Factors Predictive of Short-term Outcome

Purpose

The purposes of this article were to evaluate the short-term outcome of plasma exchange (PLEX) for neuromyelitis optica spectrum disorders (NMOSDs) in Chinese patients and to identify the factors predictive of a favorable response to therapy.

中西医治疗婴幼儿腹泻病47例疗效观察

目的：观察婴幼儿腹泻病中西医结合治疗的临床疗效。方法我院2011年1月—2012年12月收治98例腹泻病患儿,随机分为西医组和中西结合2组,均以液体疗法为基础,西医组配合止泻、抗病毒、助消化药物治疗,中西结合组配以推拿捏脊、艾灸神阙穴、中药穴位外敷治疗,对2组的治疗结果进行对比分析。结果患儿住院3 d~8 d,平均4.5 d,均痊愈出院。2组治疗48 h内的总有效率比较差异有统计学意义（P<0.05）。结论以液体疗法为基础,配以推拿捏脊、艾灸神阙穴、中药穴位外敷治疗婴幼儿腹泻,疗效优于西药治疗。     

Synthesis of trifluoromethyl-containing isoindolinones from tertiary enamides via a cascade radical addition and cyclization process

A radical trifluoromethylation reaction of tertiary enamides was investigated and trifluoromethyl-containing isoindolinones were prepared under mild conditions. Using TMSCF₃ as a radical source, PhI(OAc)₂ as an oxidant and KHF₂ as an additive, tertiary enamides were converted to isoindolinones via a cascade addition and cyclization process in moderate to good yields.

Radical trifluoromethylation and cyclization of tertiary enamides was developed and trifluoromethyl-containing isoindolinones were obtained in moderate to good yields.

In recent years, trifluoromethyl-containing azaheterocycles have attracted much attention for their potential application in the fields of pharmaceutical and agricultural chemistry.¹ Thus, lots of efforts have been devoted to the synthesis of trifluoromethyl azaheterocycles,² and among these developed methods, radical cascade addition and cyclization has emerged as a remarkable strategy due to its unique properties such as economy and high efficiency. Unsaturated amides are commonly used substrates for this type of transformation, which could be attacked by a CF₃ radical followed by intramolecular C–O, C–N, or C–C bond formation to give different kinds of trifluoromethyl azaheterocycles. Fu reported a metal-free trifluoromethylation of N-allyamides with CF₃SO₂Na for the synthesis of trifluoromethyl-containing oxazolines via oxytrifluoromethylation.³ In the presence of copper salts, N-acyl-2-allylaniline could be converted to trifluoromethylated indolines in moderate to good yields via aminotrifluoromethylation process.⁴ With Togni''s reagent,⁵ TMSCF₃,⁶ CF₃SO₂Na,⁷ CF₃SO₂Cl⁸ and other reagents⁹ as the CF₃ source, α, β-unsaturated amides, tosyl amides, or imides underwent a tandem conversion to give trifluoromethyl-containing oxindoles or isoquinoline-1,3-diones by trifluoromethylation/arylation reaction. On the other hand, as a special type of unsaturated amide containing an active double bond, enamide also exhibited excellent reactivity in radical reactions.¹⁰ In fact, trifluoromethylation of enamides has already been investigated, and in most cases trifluoromethylated alkenes were obtained as the main products.¹¹ To the best of our knowledge, the radical trifluoromethylation and cyclization of enamide still remains undeveloped.Isoindolinones are important N-heterocyclic compounds necessary in organic and pharmaceutical chemistry, and these compounds are used widely as anticoagulants and tranquilizers such as aristolactam, pagoclone, and zopiclone.¹² To introduce a CF₃ group into isoindolinones, Wang and co-workers explored a convenient way to the synthesis of trifluoromethyl-containing isoindolinones by radical aminotrifluoromethylation (Scheme 1a),¹³ but this transformation only occurred for N-methoxylbenzamides, and in case of N-alkylbenzamides trifluoromethylated alkenes were obtained as the major products. 1,1-disubstituted terminal alkenes were also not suitable substrates because of the competition between O-trapping and N-trapping process. Thus, development a new method for the synthesis of trifluoromethyl-containing isoindolinones is still in demand. Here in, as a continuation of our efforts on the radical modification of amide derivatives,¹⁴ we wish to present our work on the synthesis of trifluoromethyl-containing isoindolinones using enamides as the start materials by radical carbon trifluoromethylation (Scheme 1b).Open in a separate windowScheme 1Synthesis of trifluoromethyl-containing isoindolinones.Initially, N-n-butyl-N-(2-propenyl) benzamide 1a was chosen as the model substrate to optimize the reaction conditions of this radical carbontrifluoromethylation process. As shown in

Bio-inspired antifogging PDMS coupled micro-pillared superhydrophobic arrays and SiO2 coatings

In this work, inspired by some typical creatures from nature with superhydrophobic surfaces, a bio-inspired antifogging PDMS is designed and fabricated successfully using UV lithography and a template method. First, we fabricated an SU-8 layer with a bio-inspired micro-pillared array (MPA) using traditional UV lithography. Then, it was used as a template to fabricate a PDMS film (PF). After that, it was chemically modified with SiO₂ coatings. It was found that the PF coupled with sprayed SiO₂ coatings and a MPA have a higher water contact angle (CA) of 158° and a lower contact angle hysteresis (CAH) of less than 2°. Water drops can be separated from this bio-inspired PDMS surface within 86.8 ms. More importantly, this film’s antifogging property is superior, with a recovery time of less than 13 s, which is significantly superior to that of the flat PF and the PF with the MPA. Afterwards, FTIR was applied to analyse the surface chemistry features and suggested that the bio-inspired PF has extremely low surface tension. So, it can be confirmed that an excellent superhydrophobic antifogging property has been achieved on the surface of the PF. Meanwhile, the microscopic and macroscopic dynamic movement behaviour of the fog drops was further observed. Then, the underlying antifogging mechanism was also revealed. These properties mainly benefit from the coupling effect of intermolecular attraction of droplets, chemical compositions (nanometre roughness SiO₂) and the physical structures (MPA). The investigations offer a promising way to handily design and fabricate multiscale hierarchical structures on polymers and other materials. More importantly, these findings suggest great potential value for specific antifogging applications in display devices, transport, agricultural greenhouses, food packaging and solar products, especially in continuous harsh fogging conditions.

Inspired by nature, a bio-inspired antifogging PDMS is designed and fabricated successfully using UV lithography and a template method. It achieves an excellent superhydrophobic antifogging property, which benefits from a coupling effect.     

Effect of inflammatory factor‐induced cyclo‐oxygenase expression on the development of reperfusion‐related no‐reflow phenomenon in acute myocardial infarction

No reflow after reperfusion therapy for myocardial infarction is a strong predictor of clinical outcome. Increased levels of inflammatory factors, including C‐reactive protein (CRP), in patients with acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PCI) may affect myocardial perfusion. However, why the no‐reflow phenomenon increases in inflammation stress after PCI is not clear. The aim of the present study was to determine the effects and molecular mechanisms underlying the effects of CRP on the expression of cyclo‐oxygenase (COX) on the development of the no‐reflow phenomenon. There was a significant increase in plasma levels of CRP and interleukin (IL)‐6 in no‐reflow patients, suggesting that inflammatory factors play an important role in the development of the no‐reflow phenomenon. The mechanisms involved were further evaluated after reperfusion in a rat model mimicking the no‐reflow phenomenon. Compared with normal reflow rats, there were significant increases in both COX‐1 and COX‐2 in cardiac tissue from no‐reflow rats. The COX inhibitor indomethacin (5 mg/kg, i.p.) significantly reduced the no‐reflow area. In another series of experiments, human coronary artery endothelial cells (HCAEC) were treated with CRP at clinically relevant concentrations (5–25 μg/mL). C‐Reactive protein significantly increased COX‐1 and COX‐2 levels in a time‐ and concentration‐dependent manner. In addition, extracellular signal‐regulated kinase (ERK) and Jun N‐terminal kinase (JNK) were activated in CRP (5, 10, 25 μg/mL)‐treated HCAEC cultures. Furthermore, the ERK inhibitor pd98059 (30 μmol/L) and the JNK inhibitor sp600125 (10 μmol/L) blocked CRP‐induced COX‐1 and COX‐2 expression for 12 h. Together, the findings of the present study suggest that CRP can promote the development of the no‐reflow phenomenon by increasing COX‐1 and COX‐2 expression, which is regulated, in part, via ERK and JNK activity.