二氧化碳冷冻法在结核性胸膜炎中的临床运用

目的观察经支气管镜代替胸腔镜二氧化碳冻切法在结核性胸膜炎中的运用价值.方法将98例结核性胸膜炎导致胸腔包裹性积液患者随机分为对照组和观察组,每组49例,对照组采用放置中心静脉导管引流充分后于胸腔内注入尿激酶10万U,隔天注射1次,观察组采用支气管镜代替胸腔镜二氧化碳冻切治疗.比较2组胸腔积液吸收情况、胸膜厚度、临床症状、肺功能等变化.结果对照组显效16例(32.6%),有效25例(51.0%),无效8例(16.4%),总有效率83.6%.观察组经治疗后患者胸腔积液吸收较快、症状明显改善,胸膜无明显增厚,肺功能改善明显,显效25例(51.0%),有效24例(49.0%),总有效率100.0%.结论经支气管镜代替胸腔镜能在直视下发现胸膜腔内纤维粘连包裹,二氧化碳冻切法可以对病变进行清除,有效减少胸膜肥厚粘连的发生.     

Preparation of Magnesium-Aluminum Hydrotalcite by Mechanochemical Method and Its Application as Heat Stabilizer in poly(vinyl chloride)

The traditional methods for preparing magnesium aluminum layered double hydrotalcite (Mg₂Al-CO₃LDHs) in industry include coprecipitation and hydrothermal methods. Both these methods have the disadvantages of high preparation cost and complicated water washing process. Using Mg(OH)₂, Al(OH)₃, and CO₂ as raw materials in this work, the Mg₂Al-CO₃ LDHs are successfully prepared by mechanochemical method, which solves the shortcomings of traditional preparation method and realizes the conversion and utilization of CO₂ resource. The prepared Mg₂Al-CO₃ LDHs are evaluated as a heat stabilizer in poly(vinyl chloride) (PVC). The result indicates that, when 2.4 phr Mg₂Al-CO₃ LDHs, 0.3 phr ZnSt₂, and 0.3 phr of zinc acetylacetonate are added to the PVC, the thermal stability time of PVC can reach 190 min, which is better than PVC containing commercial Mg₂Al-CO₃ LDHs. Meanwhile, its processing performance is basically the same as the PVC containing commercial Mg₂Al-CO₃ LDHs.     

Modelling of the Guillotine Cutting Process by Means of a Symmetrical Blade with the Defined Geometry

This paper modelled the cutting process of a bundle consisted of ultra-thin cold-rolled steel sheets using a guillotine. The geometry of a cutting tool with given dimensions was assumed. A bundle of sheets being cut was modelled as deformable, the cutting tool was rigid, and the finite element method along with computer system LS-DYNA was employed. Numerical simulations of the complex state of stress and of the corresponding complex state of strain were carried out. Cutting processes belong to fast changing physical phenomena, and therefore, highly nonlinear dynamical algorithms were applied in order to solve this particular problem. Experimental investigations were also conducted by means of the scanning electron microscopy. It was found that the fracture region consisted of two distinct zones: brittle and ductile separated from each other by the interfacial transition. Morphological features of the brittle, ductile, and the transition regions were identified. The ductile and brittle zones were separated at the depth of ca. 1/5 thickness of the cut steel sheet. Finally, the numerical results obtained by usage of the finite element method as well as experimental ones in the form of microscopic images were compared, showing quite good agreement.     

The Effects of Oxygen Functional Groups on Graphene Oxide on the Efficient Adsorption of Radioactive Iodine

Oxygen-containing functional groups tend to induce a strong interaction between solid adsorbents and iodine molecules, yet have not been systematically investigated. Herein, on the basis of a series of nitric acid-treated graphene oxide (GO) with different contents of oxygen functional groups for iodine adsorption, it was found that the iodine uptake capacity is proportionate to the oxygen content and the diversities of oxygen-containing groups. The density functional theory (DFT) calculation results also suggest that oxygen-containing groups result in strong interactions between iodine molecules and the adsorbents through a covalent bond-forming process, among which -OH groups possess a higher adsorption energy averagely. Such theoretical and experimental work deepens our understanding of the effects of oxygen functional groups on iodine adsorption and provides novel ideas for future design and synthesis of high-performance solid adsorbents for radioactive iodine.     

干血片法孕中期产前筛查Down＇s综合征的应用探讨

目的应用二联血清法与滤纸干血片法对孕中期Down’s综合征进行产前筛查,以了解其一致性。方法应用DELFIA法同时应用PE公司产前筛查血清二联法及滤纸干血片法分析AFP及Freeβ-HCG含量。结果血清与血片法以血清法为金标准,DS切值均为1/270时,其敏感度为93.22%,特异度为99.8%,准确度为99.5%。结论经筛查1479例中孕妇女血清法筛查高风险率3.99%（59/1479）,滤纸干血片法高风险率为3.92%（58/1479）,P〉0.05,χ^2=0.01,无统计学差异,显示产筛二联血清法与滤纸干血片法对于DS筛查高风险者结果一致性好,可推广应用于中孕期DS筛查。     

Quantitation of escitalopram and its metabolites by liquid chromatography‐tandem mass spectrometry in psychiatric patients: New metabolic ratio establishment

Therapeutic drug monitoring (TDM) is used to determine the concentration of drug in plasma/serum to adjust the dose of the therapeutic drug. Selective and sensitive analytical methods are used to determine drug and metabolite levels for the successful application of TDM. The aim of the study was to develop and validate using LC‐MS/MS to analyse quantitative assay of escitalopram (S‐CT) and metabolites in human plasma samples. In order to provide a convenient and safe treatment dose, it was aimed to determine the levels of S‐CT and its metabolites in the patients’ plasma. A new method with short sample preparation and analysis time was developed and validated using LC‐MS/MS to analyse quantitative assay of S‐CT and its metabolites in plasma. Also, plasma samples of 30 patients using 20 mg S‐CT between the ages of 18 and 65 years were analysed by the validated method. The mean values of S‐CT, demethyl escitalopram and didemethyl escitalopram in plasma of patients were 27.59, 85.52 and 44.30 ng/mL, respectively. At the end of the analysis, the metabolic ratio of S‐CT and metabolites was calculated. It is considered that the method for the quantitative analysis of S‐CT and its metabolites in human plasma samples may contribute to the literature on account of its sensitive and easy application. Additionally, the use of our data by physicians will contribute to the effective drug treatment for their patients who take S‐CT.     

Management of Helicobacter pylori infection in Latin America: A Delphi technique-based consensus

AIM: To optimize diagnosis and treatment guidelines for this geographic region, a panel of gastroenterologists, epidemiologists, and basic scientists carried out a structured evaluation of available literature.METHODS: Relevant questions were distributed among the experts, who generated draft statements for consideration by the entire panel. A modified three-round Delphi technique method was used to reach consensus. Critical input was also obtained from representatives of the concerned medical community. The quality of the evidence and level of recommendation supporting each statement was graded according to United States Preventive Services Task Force criteria.RESULTS: A group of ten experts was established. The survey included 15 open-ended questions that were distributed among the experts, who assessed the articles associated with each question. The levels of agreement achieved by the panel were 50% in the first round, 73.3% in the second round and 100% in the third round. Main consensus recommendations included: (1) when available, urea breath and stool antigen test (HpSA) should be used for non-invasive diagnosis; (2) detect and eradicate Helicobacter pylori (H. pylori) in all gastroscopy patients to decrease risk of peptic ulcer disease, prevent o retard progression in patients with preneoplastic lesions, and to prevent recurrence in patients treated for gastric cancer; (3) further investigate implementation issues and health outcomes of H. pylori eradication for primary prevention of gastric cancer in high-risk populations; (4) prescribe standard 14-d triple therapy or sequential therapy for first-line treatment; (5) routinely assess eradication success post-treatment in clinical settings; and (6) select second- and third-line therapies according to antibiotic susceptibility testing.CONCLUSION: These achievable steps toward better region-specific management can be expected to improve clinical health outcomes.     

《黄帝内经》脉时相关理论与应用

[目的]探究《内经》脉时合参思想和经验,以期更全面地学习中医学脉学理论,提高临床疗效。[方法]撷选《内经》相关原文,对脉诊理论中的时间因素做简要分析,探讨昼夜、月相、季节等时间因素对脉象的影响,总结《内经》脉时合参思辨方法。[结果]昼夜、月相、季节等时间因素与脉象关系密切,自然界的阴阳消长等具有明显的时间性,人体脉象与其相适应。脉时合参不仅可以知晓脉象随昼夜、月相、季节等的生理变化,还可根据脉、脏、时的关联准确判定病位,通过脉逆四时与否细测病情轻重,依据脉象随病情发展的阶段性规律预判病势预后,以及因时制宜指导临床治疗。[结论]《内经》脉时合参思想,内容丰富,在临床中运用广泛,蕴涵着天人一体的整体观和中医学哲学思辨方法,值得深入挖掘和学习。     

基于模拟炮制法研究黄芩炒炭前后苷类成分的变化

目的:通过模拟炮制法探讨不同炒炭程度对黄芩饮片中苷类成分变化的影响。方法:采用Diamonsil C18(250 mm×4.6 mm,5μm)色谱柱;柱温箱温度25℃;进样量10μL;检测波长277 nm;流动相A为甲醇,B为0.4%磷酸,C为乙腈,使用梯度洗脱的方式,流速1 mL/min。通过模拟炮制的方法对黄芩苷与黄芩素、汉黄芩苷与汉黄芩素在炒炭温度下的转化进行初步研究。结果:黄芩炒炭后,黄芩苷以及汉黄芩苷的含量下降,而黄芩素以及汉黄芩素的含量均呈现先上升后下降的趋势。另外,在黄芩苷模拟样品中检出黄芩素,在汉黄芩苷模拟炮制品种检出汉黄芩素。结论:不同炒炭程度对黄芩中黄芩苷、汉黄芩苷、黄芩素、汉黄芩素含量有显著影响,模拟炮制法可较为真实地反映黄芩苷类成分在炒炭过程中的变化情况。