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.     

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