Well-being and Its Influencing Factors of Junior High School Students from County Town and Rural Areas

目的 了解县城乡镇初中生幸福感水平及其影响因素.方法 采用Rosenberg自尊问卷、一般自我效能感量表和中学生应对方式问卷等对706名初中生进行调查.结果 觉得“很幸福”或“幸福”的学生占70.4％；女生的幸福感水平显著高于男生(x2=9.714,P＜0.01)；家庭经济状况较好的学生,幸福感水平较高(x2=58.184,P＜0.001)；幸福感水平年级间无显著差异(x2=0.471,P＞0.05)；自尊、自我效能感、问题解决、寻求社会支持、积极的合理化解释得分幸福组显著高于非幸福组(t1=9.257,t2=3.988,t3=4.245,t4=4.150,t5=5.184,P5＜0.001).忍耐、“幻想、否认”、逃避得分幸福组显著低于非幸福组(t1=-3.090,t2=-3.073,Ps＜0.01;t3=-3.830,P＜0.001).家庭经济状况、自尊、寻求社会支持、逃避应对方式能显著预测县城乡镇初中生的幸福感(x2=136.165,P＜0.001).结论 县城乡镇初中生总体上是幸福的,性别、家庭经济状况、自尊、自我效能感和应对方式等因素会影响其幸福感水平,并且家庭经济状况、自尊、寻求社会支持及逃避应对方式能有效预测其幸福感水平.     

“120”出诊中急性左心衰的救治体会

目的探讨“120”出诊中急性左心衰竭的救治措施。方法回顾分析34例急性左心衰竭的出诊病例，均经过了病情快速判断、心理安抚、吸氧、辅助端坐体位、心电监护、急救药物治疗、正确转运等处理，少部分患者进行了电除颤、心肺复苏治疗。结果34例患者经过急救处理后病情均不同程度的得到了缓解，安全到达医院者31例，急救有效率91．18％。结论急性左心衰竭是常见的危急重症。提高急救意识、熟练抢救方法、医护担架工积极配合、完善的抢救设备是提高抢救有效率的保证。另外，与患者及家属的积极有效沟通也至关重要，可有效减少医患纠纷。     

Discovery of Hydroxyamidine Derivatives as Highly Potent,Selective Indoleamine-2,3-dioxygenase 1 Inhibitors

In this study, a series of novel hydroxyamidine derivatives were identified as potent and selective IDO1 inhibitors by structure-based drug design. Among them, compounds 13–15 and 18 exhibited favorable enzymatic and cellular activities. Compound 18 showed improved bioavailability in mouse, rat, and dog (F% = 44%, 58.8%, 102.1%, respectively). With reasonable in vivo pharmacokinetic properties, compound 18 was further evaluated in a transgenic MC38 xenograft mouse model. The combination of compound 18 with PD-1 monoclonal antibody showed a synergistic antitumor effect. These data indicated that compound 18 as a potential cancer immunotherapy agent should warrant further investigation.     

对围绝经期妇女激素补充治疗的认知度调查

目的探讨医护人员和妇女主任对激素补充治疗(HRT)的知晓率及培训需求情况。方法采用自行设计的调查问卷,对桐乡市医护人员和妇女主任进行问卷调查,调查表的主要内容分为一般情况、对HRT的利弊认知度、推荐与否、培训需求等方面。结果共调查医护人员430人、妇女主任206人,两组人员在平均年龄、工作年限、文化程度等基本特征方面无统计学差异。68.9%的妇女主任认为围绝经期妇女有必要应用HRT,明显高于医护人员。只有8.6%的医护人员表示一定会推荐患者使用HRT,明显低于妇女主任。医护人员不推荐使用HRT的原因主要是对副作用的担心。医务人员组更倾向于从相关书籍、期刊获得信息,而妇女主任组更倾向于从医生及媒体获得相关信息。结论桐乡市部分医护人员对HRT的相关知识了解不够,担心HRT发生不良反应,HRT的推荐率低。医护人员和妇女主任在HRT的认知上存在差异。针对不同人群,开展形式多样的HRT知识宣教及培养妇女主任成为HRT知识的传播者是提高HRT应用的关键措施。     

网吧内发现的重症肺结核患者2例报告

临床资料 病例1 患者,男,20岁,咳嗽咳痰3月余,自觉发热未诊治。3 d前症状加重伴胸闷憋气,1 d前昏倒于网吧里,被急诊120送往附近医院。经双肺CT检查考虑肺结核转入我院。双肺CT示左肺毁损肺,右肺上、中、下野可见片状密度增高阴影。即时痰涂片抗酸杆菌4+。实验室检查:K 2.90,Na133,CL 96,CO219.5,BG3.8,Ca 1.13     

Plasmonic probing of the adhesion strength of single microbial cells

Probing the binding between a microbe and surface is critical for understanding biofilm formation processes, developing biosensors, and designing biomaterials, but it remains a challenge. Here, we demonstrate a method to measure the interfacial forces of bacteria attached to the surface. We tracked the intrinsic fluctuations of individual bacterial cells using an interferometric plasmonic imaging technique. Unlike the existing methods, this approach determined the potential energy profile and quantified the adhesion strength of single cells by analyzing the fluctuations. This method provides insights into biofilm formation and can also serve as a promising platform for investigating biological entity/surface interactions, such as pathogenicity, microbial cell capture and detection, and antimicrobial interface screening.

Microorganisms can form biofilms, which are widely distributed and present on biotic and abiotic surfaces in natural, industrial, and medical settings (1–3). Initial bacterial adhesion to surfaces is the most crucial step in biofilm formation. The transition from initial weak, reversible interactions between a bacterium and a surface to irreversible adhesion involves complex physicochemical forces, including specific receptor-ligand forces, nonspecific hydrophobic, and electrostatic forces (4). Understanding and managing bacterial adhesion, especially at single-cell level, is a cross-disciplinary challenge (5, 6).While many methods have been developed for study of bacterial adhesion, most technologies are based on ensemble analysis of a vast population of cells, which washes out heterogeneity and microscopic information of single bacterial cells, and cannot measure the forces driving cell adhesion. Several methods are now available to study bacterial adhesion at the single-cell level (7–9). For example, atomic force microscopy (AFM) measures interfacial forces by mechanically moving one cell with the AFM probe (7, 10). Optical tweezers are another force spectroscopy method with an intense laser field that uses microbeads attached to the cell (11, 12). These methods measure one single cell at one time, thus having limited throughput. Additionally, they exert external forces on the cell and interfere with the intrinsic feature of bacterial adhesion.Here, we aim to probe the interfacial forces by measuring intrinsic fluctuations of bacteria attached to the surface using plasmonic interferometric imaging technique. Unlike AFM or optical tweezers, this method enabled us to perform high-throughput tracking of many single bacterial cells, to determine the potential energy profile for each bacterial cell and obtain the elastic parameters. To probe the tiny vertical fluctuations, we imaged the interferometric pattern of bacterial cells scattering the planar plasmonic wave propagating on the surface. The plasmonic scattering intensity was extremely sensitive to the vertical distance, allowing precise tracking of the fluctuations. From the fluctuation analyses, we obtained the interfacial energy profiles and elasticity of microbial binding, which were essential properties in understanding microbial adhesion. The derived binding constant can be used to quantify bacterial adhesion strength. Thus, the knowledge obtained can help understand biofilm formation and be used in the design of artificial surfaces to minimize or maximize bacterial adhesion.     

自身免疫性心肌炎的治疗进展

心肌炎是引起儿童及青少年猝死最常见的病因之一,自身免疫反应在其发生发展中起重要作用。组织病理学证实心肌炎是由T细胞介导的免疫反应,主要表现为严重的心肌损害和炎细胞浸润。研究者从不同的角度发掘治疗自身免疫性心肌炎的方法,包括免疫调节,干扰传导通路、细胞因子等,该文就自身免疫性心肌炎治疗进展进行综述。