金振口服液联合注射用炎琥宁治疗小儿病毒性肺炎的临床疗效及对症状体征评分、炎症因子和肺功能的影响

目的:探讨金振口服液联合注射用炎琥宁治疗小儿病毒性肺炎的临床疗效及对症状体征评分、炎症因子和肺功能的影响。方法:选取2017年3月至2020年5月东南大学附属南京同仁医院收治的病毒性肺炎患儿210例作为本研究对象,按随机数表法分为联合组与对照组(每组105例)。对照组患儿给予注射用炎琥宁治疗,联合组患儿给予注射用炎琥宁联合金振口服液治疗。观察两组患儿的临床疗效,治疗前后症状体征评分(体温、气促、咳嗽以及肺部啰音),治疗前后血清肿瘤坏死因子α(TNF-α)、超敏C反应蛋白(hs-CRP)和白细胞介素8(IL-8)等炎症因子水平,治疗前后肺功能指标水平和不良反应发生情况。结果:联合组患儿的总有效率明显高于对照组[96.19%(101/105)vs.85.71%(90/105)],差异有统计学意义(P<0.05);治疗后,两组患儿体温、气促、咳嗽以及肺部啰音评分均较治疗前明显降低,且联合组患儿体温、气促、咳嗽以及肺部啰音评分明显低于对照组,差异均有统计学意义(P<0.05)。治疗后,两组患儿血清TNF-α、hs-CRP及IL-8水平较治疗前明显降低,且联合组患儿明显低于对照组,差异均有统计学意义(P<0.05)。治疗后,两组患儿的用力肺活量(FVC)、1 s用力呼气容积(FEV₁)和FEV₁/FVC均较治疗前明显升高,且联合组患儿的FVC、FEV₁和FEV₁/FVC水平明显高于对照组,差异均有统计学意义(P<0.05)。联合组患儿的总不良反应发生率为7.62%(8/105),与对照组的5.71%(6/105)比较,差异无统计学意义(P>0.05)。结论:金振口服液联合注射用炎琥宁治疗小儿病毒性肺炎的临床疗效较佳,可有效缓解临床症状体征,降低炎症因子水平,改善肺功能,安全性较高。     

三阴性乳腺癌患者超声造影征象及其与抑癌蛋白P53、细胞角蛋白5/6的关系

目的 探讨三阴性乳腺癌（TNBC）患者超声造影征象及其与抑癌蛋白P53、细胞角蛋白5/6（CK5/6）的关系。方法 选取2014年7月—2020年6月于南京医科大学附属江宁医院和南京医科大学第一附属医院超声医学科行乳腺超声造影的98例TNBC患者（研究组）和103例其他分子分型乳腺癌患者（对照组）。患者均接受手术治疗,取TNBC患者术中切除的乳腺癌组织,采用免疫组织化学法检测P53和CK5/6的表达。分析TNBC患者二维超声以及造影征象与P53和CK5/6表达的关系。结果 研究组肿块形态规则、后方回声增强、血流Ⅱ级和Ⅲ级比例患者多于对照组,边缘模糊、有微钙化患者少于对照组（P <0.05）。两组肿块直径、纵横比比较,差异无统计学意义（P >0.05）。研究组高增强、增强后结节范围扩大不明显、有充盈缺损患者多于对照组,有均匀增强患者少于对照组（P <0.05）。两组患者有无穿支血管比较,差异无统计学意义（P >0.05）。血流分级Ⅱ级、Ⅲ级患者P53阳性率高于血流分级0级、I级患者（P <0.05）,边缘清晰患者CK5/6阳性率高于边缘模糊患者（P <0.05）。高增强患者P53阳性率低于等/低/无增强患者（P <0.05）,增强后结节范围扩大不明显患者CK5/6阳性率高于增强后结节范围扩大明显患者（P <0.05）。结论 TNBC超声造影征象与其他分子分型乳腺癌具有显著差异,P53、CK5/6表达与TNBC超声造影征象具有一定关系。     

恶性肿瘤患者的临终营养与护理

目前,恶性肿瘤已成为威胁人类健康与生命的常见病、多发病,病死率极高,每死亡3人～4人中就有1人死于恶性肿瘤[1]。临终护理是对那些已失去治愈希望的患者,在生命即将结束时所实施的一种积极的综合护理。其目的是尽最大努力减轻患者的痛苦,缓解症状,缓和面对死亡的恐惧和不安,帮助其理解生命的价值和意义,维护其人格尊严,提高尚存的生命质量,使临终患者安宁平静的度过人生最后的旅程[2]。为了探讨临终护理对提高晚期恶性肿瘤患者生活质量的作用,我科对33例晚期恶性肿瘤患者实施了系统的临终关怀护理,结果大大提高了患者尚存的生存质量。现将护理体会介绍如下。1临床资料本组33例,男19例,女14例,年龄33岁～80岁,平均年龄55岁。其中肺癌11例,肝癌9例,胃癌7例,乳腺癌2例,直肠癌2例,胰腺癌1例,前列腺癌1例。2护理措施2.1基础护理学者认为“舒适是所有癌症患者的主要需求,舒适实际上是临终患者接受所有护理措施的综合结果”。众多的临床事实证明,临终患者是否能舒适地走完人生最后的时光,很大程度上取决于基础护理的实施。2.1.1病室环境提倡按患者的意愿,尽可能满足其需要,安排单间病房,布置家庭式的环境,达到光线充足,空气新鲜,温度...     

和厚朴酚神经保护作用的研究进展

和厚朴酚作为中药厚朴的主要活性成分之一,是一种多酚类化合物,具有抗炎、抗菌、抗肿瘤、抗氧化等多种作用.近年来发现,和厚朴酚对神经系统具有明显的保护作用.和厚朴酚易于通过血脑屏障,具有发展为广谱抗神经系统疾病药物的潜力.本文主要概述了目前和厚朴酚在神经保护方面的作用及机制,以期为后续的深入研究提供参考.     

Preparing anti-SARS-CoV-2 agent EIDD-2801 by a practical and scalable approach,and quick evaluation via machine learning

EIDD-2801 is an orally bioavailable prodrug, which will be applied for emergency use authorization from the U.S. Food and Drug Administration for the treatment of COVID-19. To investigate the optimal parameters, EIDD-2801 was optimized via a four-step synthesis with high purity of 99.9%. The hydroxylamination procedure was telescoped in a one-pot and the final step was precisely controlled on reagents, temperature and reaction time. Compared to the original route, the yield of the new route was enhanced from 17% to 58% without column chromatography. The optimized synthesis has been successfully determinated on a decagram scale: the first step at 200 g and the final step at 20 g. Besides, the relationship between yield and temperature, time, and reagents in the deprotection step was investigated via Shapley value explanation and machine learning approach-decision tree method. The results revealed that reagents have the greatest impact on yield estimation, followed by the temperature.     

Characterization of hepatitis C virus antibody positive blood donors in Japan and Thailand: a comparative study

The assay of specific antibodies to hepatitis C virus (anti-HCV) was introduced in the screening of donated blood in November 1989 in Japan and in January 1991 in Thailand. Anti-HCV-positive rates obtained using commercial second-generation kits on donated blood in both countries are similar. However we found differences in the serum alanine aminotransferase (ALT) values of anti-HCV-positive donors between the two countries: 57.0% of anti-HCV-positive Thai donors showed elevated ALT values, whereas only 23.7% of anti-HCV-positive Japanese donors did. Furthermore, different distributions of HCV genotypes were observed among anti-HCV-positive donors of the two countries. Although type 1b showed the highest prevalence among donors in both countries, type 1a showed the lowest prevalence in Japanese donors and the second-highest prevalence in Thai donors. We also examined the HCV RNA levels using a branched DNA probe assay in serum samples of Thai donors and observed no significant relationships between ALT value and HCV genotype or HCV RNA level, although HCV RNA levels in genotype 1b Japanese donors were higher than that in genotype 2a Japanese donors.     

含熟地黄血清的高效液相色谱分析

目的 :探索熟地黄滋阴药效的物质基础对含熟地黄血清进行分析。 方法 :建立中医阴虚大鼠动物模型,用高效液相色谱法,通过比较熟地黄药材、阴虚大鼠含药血清、正常大鼠血清的高效液相指纹图谱,研究熟地黄血中移行成分。 结果: 含药血清中发现了1个与熟地黄原药材相同位置的波峰。 结论: 给药血清中与熟地黄药材相同位置的波峰,为熟地黄移行入血的原形成分,可能为熟地黄滋阴药效的活性成分,对其进行深入研究,有助于阐明熟地黄功效物质基础。     

从方剂组方规律中探析哮喘病机之痰与饮

目的：研究哮喘病病机之痰与饮。方法：运用数据库软件处理1310首古今哮喘方剂,通过分析其组方配伍规律总结蕴涵于其中的病机及治法。结果：哮喘方剂组方配伍重点在化痰、利水与其它功效的组合上。结论：通过组方配伍的分析总结出饮聚痰壅为哮喘病发作的主病机,痰与饮作为不同的病机应分而论之,积饮不散遂变成痰,痰饮之寒热错纵复杂。     

Oral administration of muramyl dipeptide into mice modulates cell proliferation,immunoglobulin synthesis and cytokine mRNA levels in gut associated lymphoid tissues

Muramyl peptides (MDPs) are synthetic immunostimulants capable of potentiating a multitude of immune functions following parenteral administration into a host. The parent molecule MDP was also found to exert certain activities when applied via the oral route. Thus, we have studied the effect of oral treatment of mice with MDP on the lymphoproliferative responses, immunoglobulin secretion and cytokine induction in gutassociated lymphoid tissues (GALT) employing lymphocyte transformation test, ELISA and RT-PCR, respectively. Cells derived from Peyer's patches (PP) of mice orally primed with MDP were found to have enhanced proliferative responses to different mitogens and to secrete significantly more IgG, IgM and IgA immunoglobulins than cells from unprimed mice. These effects were not observed with cells derived from mesenteric lymph nodes (MLN) or spleens of MDP-primed mice. However, oral administration of MDP resulted in the up-regulation of interleukin-6 (IL-6) mRNA in MLN and down-regulation of IL-4 and tumour necrosis factor-α (TNF-α) mRNAs in MLN, spleens and PP. These studies suggest that selective modulations of GALT responses by orally administered MDP are achievable and imply that these agents may be useful in the therapy and prophylaxis of allergic diseases.     

内固定手术在踝关节骨折治疗中的应用效果观察

目的 分析对内固定手术在踝关节骨折临床治疗中的应用效果。方法 选取2013年11月~2017年11月本院收治的50例踝关节骨折患者,随机分为对照组和研究组,各25例,对照组采用手法整复外固定治疗,研究组采用对内固定手术治疗,比较两组踝关节功能优良率、VAS评分、AOFAS评分。结果 治疗后,研究组踝关节功能优良率为96.00%,高于对照组的72.00%,差异有统计学意义（P＜0.05）;研究组VAS评分低于对照组[（1.25±0.21）分vs（2.99±0.34）分],差异有统计学意义（P＜0.05）。研究组AOFAS评分高于对照组[（88.26±9.62）分vs（65.28±7.16）分],差异有统计学意义（P＜0.05）。结论 对内固定手术可有效改善踝关节骨折患者踝关节功能,减轻疼痛感,安全性更高,值得借鉴应用。