面罩BiPAP通气治疗COPD合并呼吸衰竭的疗效观察

目的　探讨面罩 Bi PAP通气治疗 COPD合并呼吸衰竭的疗效。方法　 30例 COPD合并呼衰患者随机分为 Bi PAP通气加常规疗法组 (试验组 )和单用常规疗法组 (对照组 )各 1 5例 ,试验组设置参数 :IPAP由 8- 1 0cm H2 O开始 ,渐升至 1 4 - 2 0 cm H2 O、EPAP2 - 5 cm H2 O,氧流量 5 - 1 0 L / min。定期记录病情变化、血气、参数及治疗时间等 ,若病情及血气进行性恶化 ,予以气管插管。结果　需气管插管者 ,对照组 1 5例有 1 1例 (73% ) ,而试验组1 5例有 3例 (2 0 % )有显著减少 (P<0 .0 5 ) ;通气 1 h试验组 Pa O2 明显增高 (P<0 .0 5 ) ,心率和呼吸频率明显减少 (P<0 .0 5 ) ;通气 1 2 h试验组 Pa CO2 显著降低 ,酸中毒明显改善 (P<0 .0 5 )。结论　面罩 Bi PAP通气可作为 COPD并呼衰的一线治疗手段     

The effect of rhBMP-2 on pulmonary arterioles remodeling in endotoxin-induced acute lung injury in rats

Endotoxin is known to cause acute lung injury (ALI). Here, we investigated the effects and mechanisms of recombinant human bone morphogenetic protein-2 (rhBMP-2) on pulmonary arteriole remodeling in endotoxin-induced ALI in rats. Sixty Wistar rats were randomly divided into 3 groups (n = 20). Control group was infused with normal saline. Lipopolysaccharides (LPS) alone group was infused with LPS. LPS plus rhBMP2 group was infused with rhBMP-2 and LPS. Lung tissue was harvested. The tunica media of the pulmonary arterioles was measured. The expression levels of survivin, p21, cyclin D1, and activated caspase-3 were examined. The proliferation and apoptosis of pulmonary artery smooth muscle cells were evaluated. The tunica media of pulmonary arterioles in LPS alone group was significantly thicker than both that in control and that in LPS plus rhBMP2 groups (P < 0.01). The multiplication rate in LPS alone group was also significantly higher than both that in control and that in LPS plus rhBMP2 groups (P < 0.01). The apoptotic rate in LPS alone group was lower than that in LPS plus rhBMP2 group (P < 0.01). Compared with the control and LPS plus rhBMP2 groups, the expression levels of mRNA and proteins of survivin and cyclin D1 were increased in LPS alone group (P < 0.01), while the expression levels of p21 and activated caspase-3 were decreased (P < 0.01). RhBMP-2 inhibits the remodeling of pulmonary arterioles in endotoxin-induced ALI, which is achieved by enhancing apoptosis and inhibiting proliferation of pulmonary artery smooth muscle cells.     

不同年代首次住院精神分裂症患者诊断分型及近期结局对照研究

目的：探讨不同年代首次住院精神分裂症患者诊断分型变化及近期结局。方法整群抽取1989年、1999年及2009年度首次住院,且入院时病程＜2 a的精神分裂症或急性精神分裂症样精神病性障碍患者各128例,分别设为A组、B组和C组,对3组患者的一般资料及诊断变化进行统计分析。结果3组年龄、受教育年限、首次住院时间、预后比较差异有显著性（P＜0．05或0．01）,入院时病程比较差异无显著性（ P＞0．05）。3组患者除儿童精神分裂症、精神分裂症（型未分）诊断率比较差异有极显著性外（P＜0．01）,其他类型精神分裂症诊断率比较差异均无显著性（P＞0．05）。结论首发精神分裂症患者住院时间有明显缩短趋势,受教育年限在逐渐提高,预后有改善趋势;首诊病程尚无变化,人们对精神分裂症的认识仍不乐观。     

二级医院等级护理服务成本核算的价值规律研究

目的从价值规律角度探讨并分析湖北省二级医院等级护理服务现行定价合理性,为等级护理服务合理定价提供科学依据。方法自行设计湖北省"优质护理服务示范医院"等级护理成本核算调查表,对湖北省50所二级医院的221个优质护理服务病房护士长进行调查。结果二级医院一级护理、二级护理、三级护理实际成本分别为(96.80±25.63)元/d、(47.91±11.28)元/d和(9.09±2.06)元/d;一级护理、二级护理、三级护理人力成本分别为(48.52±16.64)元/d、(24.26±8.32)元/d和(4.00±1.37)元/d,一级护理、二级护理、三级护理不计价材料成本不一。结论湖北省二级医院等级护理服务价格与价值严重偏离,不符合价值规律,现行等级护理收费标准不合理,亟待改革。     

Strongly enhanced efficiency of polymer solar cells through unzipped SWNT hybridization in the hole transport layer

Single-walled carbon nanotubes (SWNTs) have good conductivity, but their size can''t match the heterojunction nanostructure in polymer solar cells (PSCs). To improve the photovoltaic performance of PSCs, herein, a faciley fabricated composite hole transport layer composed of unzipped single-walled carbon nanotubes (uSWNTs) and poly(3,4-ethylenedioxythiophene):polystyrene sulfonate (PEDOT:PSS) is effectively applied for PSC devices. Compared with the pure PEDOT:PSS hole transport layer (HTL) without uSWNTs, the uSWNTs/PEDOT:PSS layer shows more effective performance as the hole transportation layer. Optimizing the uSWNT concentration in PEDOT:PSS results in fabrication of the PSC devices with uSWNTs/PEDOT:PSS hole transport layers that exhibit greatly improved average power conversion efficiency (PCE), from 13.72% to 14.60%, and greatly enhanced current density and fill factor, which can be ascribed to the increased conductivity and hole transport efficiency. Our approach also supports simple solution-processing techniques and the insensitivity of the performance to thickness, which promises that the faciley fabricated uSWNTs/PEDOT:PSS layer has more potential to be applicable to the roll-to-roll process of PSC fabrication with extremely low cost.

Single-walled carbon nanotubes (SWNTs) have good conductivity, but their size can''t match the heterojunction nanostructure in polymer solar cells (PSCs).     

左氧氟沙星/PLGA亚微粒的制备、表征和体外释药考察

目的:制备左氧氟沙星/PLGA亚微粒,并进行相关表征和体外释放行为考察.方法:采用纳米共沉淀法制备左氧氟沙星/PLGA亚微粒,采用激光粒度分析仪以及扫描电镜分别进行亚微粒粒度测定和形貌分析.同时采用紫外-可见分光光度法(UV)测定其载药量与体外药物释放行为.结果:经过激光粒度分析仪测定,所制备的左氧氟沙星/PLGA亚微粒粒径为197 ～230 nm,Zeta电位为-24 mv.扫描电镜观察亚微粒呈圆形/椭圆形,分布均匀.UV法测定亚微粒的载药量为6.25％～9.38％,包封产率为12.45％ ～46.59％.体外释放结果显示相比于商品化左氧氟沙星滴眼液,所制备的左氧氟沙星/PLGA亚微粒具有良好的缓释效果.结论:通过纳米共沉淀法成功制备粒径均一,高载药量的左氧氟沙星PLGA亚微粒,同时能实现药物的缓慢释放,减少给药次数的目的.     

醋酸棉酚对人舌鳞癌Tca8113细胞生长及人类错配修复基因1甲基化水平的影响

目的 研究醋酸棉酚（ GAA）对人舌鳞癌 Tca8113细胞增殖的影响和对人类错配修复基因 1（hMLH1）甲基化水平的影响,初步探讨其抗肿瘤机理。方法 应用 MTT法检测 GAA对Tca8113细胞生长的影响;应用巢式甲基化特异性聚合酶链反应（nMSP）检测 Tca8113细胞在 GAA作用 48、72 h后hMLH1基因甲基化状态的改变情况。结果 MTT检测显示,作用 24~72 h,GAA对Tca8113细胞生长具有抑制作用;nMSP检测显示,以终浓度 30、15 μmol•L-1的GAA作用于 Tca8113细胞 48、72 h后, hMLH1基因甲基化条带的平均光度值降低,与未经药物处理组比较差异有统计学意义（P<0.05）。结论 GAA能抑制舌鳞癌细胞的生长,并能降低 hMLH1基因的甲基化水平。 GAA去甲基化作用可能是其具有抗肿瘤作用的机制之一。     

认知储备能与疾病相关认知障碍的研究进展

认知储备能可以理解为不同个体延缓认知功能障碍发病以及进展的能力,虽然不能作为一个症状或一种独立的病症,但通过认知储备能,可以帮助理解在不同的疾病发展过程中出现的认知功能下降的差异性。认知储备能在一些疾病相关认知功能及症状的发生和发展中具有一定的作用,如记忆力减退、轻度认知功能障碍、阿尔茨海默病、帕金森病、多发性硬化等;同时,也会影响丙型肝炎、肥胖、睡眠障碍和脑外伤等引起的认知功能障碍的发生和发展。中医药尤其是补益肝肾的中药,在改善各种原因引起的认知功能障碍方面,具有较好的疗效,但目前尚未被引入认知储备能的干预研究。本文对认知储备能与各种疾病相关认知功能的关联进行综述。