Hualyzin, a symmetrical urea derivative isolated from Penicillium herquei isolate GA4

Penicillium herquei isolate GA4 was isolated from the infected Conchocelis of Porphyra yezoensis. A large-scale fermentation using yeast extract sucrose medium and repeated chromatography afforded a new symmetrical urea derivative, hualyzin (1). The structure was determined by detailed NMR spectroscopic investigations and MS fragmentation analysis.     

48例皮肤癌创面闭合临床分析

对４８例皮肤癌病灶切除不能直接缝合的创面,选择较大创缘潜行分离拉拢缝合、植皮、皮瓣等三种方式闭合创面,均取得创面愈合,且无明显并发症发生。提示拉拢缝合是一种较好的方式;对老年头皮创面,首选植皮;深部组织裸露,用皮瓣覆盖;邻近下腹部的创面选用轴型皮瓣闭合。     

心脏死亡供体原位肝移植术后胆道并发症的原因探讨和诊疗经验

目的: 探讨心脏死亡供体（donation after cardiac death,DCD）原位肝移植术后胆道并发症的发生因素、诊断要点和治疗方法。方法: 对2015年1月—2016年8月于南京医科大学第一附属医院肝移植中心实施的87例DCD供肝肝移植患者临床资料进行回顾性分析。87例中29例行经典原位肝移植,58例行改良背驮式肝移植,胆管重建方式均为胆总管端端吻合,无1例放置T管。结果: 87例肝移植患者中9例通过胆道造影确诊为肝移植术后胆道并发症, 8例治愈, 1例好转, 无死亡。胆道并发症发生率10.1%(9/87)。结论: DCD供体原位肝移植术后胆道并发症的发生与供肝缺血时间、DCD供肝质量、胆管吻合技术及供肝修剪技术等因素有关,术后胆道造影有助于及时诊断胆道并发症。介入技术是胆道并发症的主要治疗手段。     

天冬泡腾颗粒剂处方配比优化研究

目的优化天冬泡腾颗粒剂的最佳处方配比。方法以pH值、粒度及溶化时限作为评价方法,采用正交试验设计,考察天冬提取浸膏、辅料用量对泡腾颗粒剂处方的影响。结果天冬泡腾颗粒剂最佳处方配比为天冬提取浸膏5.0 g、乳糖1.5 g、糊精3.0 g、淀粉4.0 g。结论该制剂处方稳定,可用于该制剂生产。     

圆弧青霉提取物诱发人羊膜细胞程序外DNA合成及合成抑制的研究

从食管癌高发区河南省林县的粮食中,分离出5株圆弧青霉(Penicillium cyclopiumWestling)用大米做培养基,25℃培养两周,经氯仿:甲醇等连续提取后,得到棕褐色膏状提取物。用其中的4株,诱发出了人羊膜FL细胞株的程序外DNA合成(Unscheduled DNA Synthesis,UDS)与DNA合成抑制(DNA Synthesis Inhibition,DSI),与溶剂对照比较,具有显著性差异(P<0.05),并在一定程度上存在剂量效应关系;加S_9后,其生物学活性明显降低,推测此提取物中含有能引起人羊膜细胞DNA损伤的直接诱变剂。     

疼痛敏感性与腹腔镜胃肠肿瘤手术患者急性术后疼痛相关性的研究

目的 探讨疼痛敏感性与腹腔镜胃肠肿瘤患者急性术后疼痛的相关性。方法 择期全身麻醉下行腹腔镜胃肠肿瘤手术患者50例,性别不限,年龄≥18岁,ASA分级Ⅰ～Ⅱ级,根据术前疼痛敏感性调查问卷（PSQ）评分结果分为2组：高敏感性组（PSQ≥5.0分,S组）和低敏感性组（PSQ＜5.0分,C组）。采用视觉模拟评分（VAS）评估患者术后24h内急性疼痛的发生情况,记录术前PSQ评分、外周静脉置管疼痛评分（VCP)、年龄、性别、ASA分级、体重指数（BMI）、手术时长、全麻苏醒时间、拔管时间、术后清醒即刻（T0)、1h(T1)、2h(T2)、3h(T3)、4h(T4)、5h(T5)、6h(T6)、8h(T7)、10h(T8)、12h(T9)、24h(T10)的VAS评分、术后24h内镇痛泵按压次数和补救镇痛次数及恶心、呕吐、嗜睡、腹胀等术后并发症的发生情况。结果 两组患者的年龄、性别、ASA分级、BMI、手术时长、苏醒时间、拔管时间、术后24h镇痛泵按压次数、术后并发症比较无统计学差异（P＞0.05）。与C组比较,S组T0、T1、T2时间点的VAS评分较高,有统计学差异（P＜0.05）。术前PSQ评分与VCP呈正相关（r=0.693,P＜0.05）,结果有统计学意义。术前PSQ评分与T0、T1、T2时间点的VAS评分呈正相关（P＜0.05）。S组术后2h补救镇痛次数较C组增多,有统计学差异（P＜0.05）。以术前PSQ评分为检验变量,急性术后疼痛的发生为状态变量绘制ROC曲线。测得曲线下面积为0.909,提示采用PSQ问卷可显著预测腹腔镜胃肠肿瘤手术患者急性术后疼痛的发生。通过约登指数计算出腹腔镜胃肠肿瘤手术患者中PSQ≥4.85分者疼痛敏感性更高,其VCP≥2分的发生率为66.7%,而PSQ＜4.85分的患者中VCP≥2分的发生率仅为24.1%,比较有统计学差异（P＜0.05）。结论 疼痛敏感性与腹腔镜胃肠肿瘤手术患者急性术后疼痛的发生有相关性,可能成为急性术后疼痛发生的预测指标。腹腔镜胃肠肿瘤手术患者中,PSQ≥4.85分者术后发生疼痛的可能性更高。     

临床拟诊机化性肺炎31例诊疗的回顾性分析

目的 探讨临床拟诊机化性肺炎的诊断与治疗.方法 回顾性分析31例临床拟诊为机化性肺炎患者的临床资料、影像资料和治疗方法.结果 31例经抗生素治疗无效的患者,通过支气管镜肺活检病理或经皮肺穿刺病理除外结核、真菌、化脓性炎、肺癌而拟诊机化性肺炎24例,无病理检查结果而经激素治疗有效拟诊7例.21例患者具有典型机化性肺炎CT表现,所有病例均经短期（6～14d）激素治疗后影像学结果明显改善.随访6～25个月,复发6例,均发生在激素减量过快或停药患者中.结论 临床上经抗生素治疗无效、结合临床影像学特点、病理检查除外其他疾病是拟诊机化性肺炎的重要指标;对于无病理检查患者短期激素治疗有效有助于诊断.过早激素减量容易导致复发.     

Incidence and risk of hypertension with lenvatinib in treatment of solid tumors: An updated systematic review and meta‐analysis

This meta‐analysis was performed to assess the relationship between Lenvatinib use for malignancy and hypertension (HTN). A total of 2483 patients met inclusion criteria. The relative risk (RR) for all‐grade and high‐grade (≧3) HTN were 2.61 (p ≦ .001) and 3.35 (p≦ .001), respectively, for Lenvatinib compared with other multitarget tyrosine kinase inhibitors or placebo. The cumulative incidence of all‐grade and high‐grade HTN was 70% and 34%, respectively. The studies with median treatment duration (TD) longer than 7.4 months demonstrated a higher incidence of high‐grade HTN than studies with shorter TD (34% vs 28%). The incidence of all levels of HTN increased with TD (68% vs 49%). Trials with median progression‐free survival (PFS) longer than nine months had a higher incidence of both all‐grade (37% vs 28%) and high‐grade (71% vs 48%) HTN. Lenvatinib, a drug commonly used in cancer treatment, is a risk factor for the development of HTN. A longer duration of Lenvatinib treatment was associated with higher frequency of HTN. Further investigation for Lenvatinib of the association between the occurrence of HTN and prognosis will be warranted.     

Analysis on the difference of skin surface lipids during blue light therapy for acne by lipidomics

Acne is a chronic inflammatory skin disease of the sebaceous glands of the hair follicles, caused by a variety of factors and tends to recur, causing skin damage and psychological stress to patients. Blue light (415nm) is a popular physical therapy for acne, however, studies on the effects of blue light on skin surface lipids (SSL) have not been exhaustively reported. So, we want to investigate the difference in SSL before and after acne treatment with blue light and to reveal the potential mechanism of acne treatment with blue light from the lipid level. SSL samples were collected and physiological indicators (moisture content, transepidermal water loss (TEWL), sebum content and pH) were measured. By using ultra performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry (UPLC-QTOF-MS) with multivariate data analysis methods to obtain specific information on the lipid composition. Analysis of the physiological index data showed a significant increase in moisture content (p = 0.042), pH (p = 0.000) and a significant decrease in sebum content(p = 0.008) in the after treatment area (AT group), while there was no significant change in TEWL values. A total of 2398 lipids were detected by lipidomics analysis and 25 differential lipids were screened. Triradylglycerols (TGs), isoprenoids and hopanoids being the potential differential lipids. Among the lipids associated with the skin barrier, only monounsaturated fatty acids (MUFA) (p = 0.045) were significantly increased. This study revealed significant changes in SSL after blue light treatment for acne, suggesting that blue light exposure may cause changes in the relative lipid content and redistribution of lipid components, and that whether it damages the skin barrier requires further study.