长梗南五味子化学成分的研究

从长梗南五味子(Kadsura longepedunculata)根中分离出一个新化合物,经光谱和化学方法证明为南五内酯酸(kadsulactoneacid,I),同时还分离得到5个已知化合物:南五内酯(I)、(+)-安五脂素(II)、二氢愈疮木脂素(IV)、d-表加巴辛(V)和β-谷甾醇(VI)。     

用药包材急性全身毒性检查法替代异常毒性检查法的可行性分析

目的：比较药品包装材料（药包材）异常毒性与急性全身毒性检查法,研究用急性全身毒性检查法代替异常毒性检查法的可能性。方法：对不同国家、地区的药典、法规和标准中急性全身毒性检查法和异常毒性检查法进行分析对比。在此基础上,选择93批不同类型药包材进行急性全身毒性和异常毒性检查并进行结果分析。结果：结合各国、地区对药包材急性全身毒性和异常毒性检查的要求,以及两者方法学之间的对比分析结果,急性全身毒性检查法具有更加广泛的适用性。结论：针对药包材急性毒性风险,特别是不断涌现的新型药包材产品,从生物学风险控制的角度出发,使用急性全身毒性检查法可以更加科学、合理地控制风险,用急性全身毒性检查法替代异常毒性检查法具有实际可行性。     

肝癌术后早期下床活动方案的构建及应用

目的制订肝癌术后早期下床活动方案,探讨实施效果。方法按照入院时间将93例肝癌行肝切除术患者分为对照组45例和观察组48例。对照组实施术后常规活动护理;观察组实施早期下床活动循证实践方案,通过检索数据库获取最佳证据及整合证据,制定肝癌术后早期下床活动实践方案及流程。结果观察组术后24 h内下床活动率、首次下床时间及术后活动量指标显著优于对照组,术后排气排便时间、胃管留置时间显著短于对照组,术后24 h疼痛评分、疼痛控制满意度显著优于对照组(P0.05,P0.01);两组早期活动不良事件发生率比较,差异无统计学意义(P0.05)。结论肝癌术后早期下床活动最佳实践方案的实施,可加快肝癌患者术后康复,促进患者安全(并不增加患者安全事件)。     

内镜超声引导下经胃壁置入蕈型金属支架治疗儿童胰腺周围包裹性坏死一例

内镜超声引导下经消化管壁造瘘置入支架内引流已成为成人胰周积液的一线治疗方案,但用于患儿的治疗难度和风险比成人大。成都市第三人民医院近期收治了1例胰腺周围包裹性坏死患儿,患儿1年前因重症胰腺炎曾行外科手术治疗,术后随访过程中复查腹部超声发现胰尾低回声团伴液性暗区,近期出现腹胀等压迫症状,考虑系外科术后复发,不宜再次手术,故行内镜超声引导下经消化管壁造瘘置入支架内引流治疗,术后1个月囊液完全吸收,术后6周拔除支架,随访近1年,未见复发。     

细支气管肺泡癌的CT表现

目的：回顾性分析细支气管肺泡癌（ＢＡＣ）的ＣＴ表现：方法：４２例经病理证实的ＢＡＣ,根据ＣＴ表现分为结节型,实变型和多结节型,分别为２３,１６和３例;结合献资料分析各型肺泡癌的ＣＴ征角。结果;结节型ＢＡＣ主要表现为：肺外周（９５．７％）,分叶（６９．６％）,空泡征或细支气管气象（６５．２％）,密度不均（６５．２％）,胸膜牵引（６０．９％）和毛玻璃影（５２．２％）;     

连翘叶速溶保健茶成型工艺优选

摘 要 目的：确定连翘叶速溶保健茶的最佳成型工艺条件。方法: 以溶化性、外观、成型性为评价指标,采用单因素试验考察不同辅料与干膏粉的比例和润湿剂浓度对指标的影响,以水分为考察指标,确定干燥时间,优化最终成型工艺。结果: 最佳成型工艺：连翘叶干膏粉与乳糖的比例为1〖KG*9〗∶〖KG-*2〗1.5,混合均匀,80%乙醇为润湿剂,湿法制粒,60℃干燥1.5 h,整粒,即得。结论: 连翘叶速溶保健茶的成型工艺可行、合理,为连翘叶的综合开发利用提供参考。     

师范生与非师范生艾滋病知识和态度调查

目的了解黄冈市师范生与非师范生对艾滋病(获得性免疫缺陷综合征,AIDS)知识的了解及相关行为和态度,为制定黄冈市大学生AIDS知识健康教育策略提供依据。方法采用随机抽样的方法,抽取黄冈师范学院师范类在校大学生220例和非师范类在校大学生250例作为调查对象,分别对其进行问卷调查,并比较两类大学生的调查结果。结果师范生对AIDS一般知识的了解和对待AIDS患者的态度方面,平均得分率分别为77.61%、87.35%,非师范生分别为69.15%、79.14%,两者比较,差异均有统计学意义（分别u=2.03,P＜0.05;u=2.34,P＜0.05）;师范生对AIDS传播途径的了解和对待AIDS的态度方面,平均得分率分别为 82.80%、92.99%,非师范生分别为76.50%、89.84%,两者比较,差异均无统计学意义（均P＞0.05）。结论在大学生中开展AIDS健康教育非常必要,特别是师范生,对他们全面普及AIDS知识,不仅其本人可受益,而且也可为今后对其学生开展健康教育活动奠定基础。     

复杂胸部肿瘤切除胸壁重建术患者的康复护理

目的总结复杂胸部肿瘤切除胸壁重建患者的围手术期营养与康复护理经验。方法对10例复杂胸部肿瘤胸壁重建患者,实施饮食指导、康复锻炼、皮瓣观察、疼痛管理等围术期护理。结果 10例患者均顺利康复出院,术后出现胸腔积液3例,皮瓣危象、上肢淋巴水肿、自发性气胸、胸壁软化、心律失常各1例,经及时处理后均好转,伤口I期愈合。术后平均住院时间14.6d。结论胸壁重建是胸壁肿瘤尤其是复杂胸壁缺损的重要手术方法,围术期康复护理能促进患者术后恢复进程,改善预后。     

Acquired MET D1228N Mutations Mediate Crizotinib Resistance in Lung Adenocarcinoma with ROS1 Fusion: A Case Report

Patients with non‐small cell lung cancer (NSCLC) containing ROS1 fusions can have a marked response to the ROS1‐targeted tyrosine kinase inhibitors (TKIs), such as crizotinib. Common resistance mechanisms of ROS1‐fusion targeted therapy are acquired mutations in ROS1. Along with the use of next‐generation sequencing in the clinical management of patients with NSCLC during sequential targeted therapy, many mechanisms of acquired resistance have been discovered in patients with activated tyrosine kinase receptors. Besides acquired resistance mutations, bypass mechanisms of resistance to epidermal growth factor receptor (EGFR)‐TKI treatment are common in patients with EGFR mutations. Here we describe a patient with metastatic lung adenocarcinoma with CD74‐ROS1 fusion who initially responded to crizotinib and then developed resistance by the acquired mutation of D1228N in the MET kinase domain, which showed short‐term disease control for cabozantinib.Key Points

• The D1228N point mutation of MET is an acquired mutation for crizotinib resistance.
• The patient obtained short‐term clinical benefit from cabozantinib therapy after resistance to crizotinib.
• The clinical use of next‐generation sequencing could maximize the benefits of precision medicine in patients with cancer.

     

Central nervous system diseases related to pathological microglial phagocytosis

Microglia are important phagocytes of the central nervous system (CNS). They play an important role in protecting the CNS by clearing necrotic tissue and apoptotic cells in many CNS diseases. However, recent studies have found that microglia can phagocytose parts of neurons excessively, such as the neuronal cell body, synapse, or myelin sheaths, before or after the onset of CNS diseases, leading to aggravated injury and impaired tissue repair. Meanwhile, reduced phagocytosis of synapses and myelin results in abnormal circuit connections and inhibition of remyelination, respectively. Previous studies focused primarily on the positive effects of microglia phagocytosis, whereas only a few studies have focused on the negative effects. In this review, we use the term "pathological microglial phagocytosis" to refer to excessive or reduced phagocytosis by microglia that leads to structural or functional abnormalities in target cells and brain tissue. The classification of pathological microglial phagocytosis, the composition, and activation of related signaling pathways, as well as the process of pathological phagocytosis in various kinds of CNS diseases, are described in this review. We hypothesize that pathological microglial phagocytosis leads to aggravation of tissue damage and negative functional outcome. For example, excessive microglial phagocytosis of synapses can be observed in Alzheimer's disease and schizophrenia, leading to significant synapse loss and memory impairment. In Parkinson's disease, ischemic stroke, and traumatic brain injury, excessive microglial phagocytosis of neuronal cell bodies causes impaired gray matter recovery and sensory dysfunction. We therefore believe that more studies should focus on the mechanism of pathological microglial phagocytosis and activation to uncover potential targets of therapeutic intervention.