小儿哮喘缓解期治疗思路

小儿哮喘缓解期辨证应以培土生金、扶正治本为主,临床采用内外治相结合的综合疗法。通过缓解期的长期规范化治疗,可以有效地控制哮喘发作。同时加强患儿的饮食调适,体质调理,从而提高患儿的抗病能力,降低发病率,达到长期控制哮喘发作的目的。     

解放军总医院智慧医院建设初探

智慧地球战略已经给很多行业的信息化建设带来巨大影响。在医疗信息化领域,数字化医院也势必会逐步向智慧医院发展。解放军总医院已经开始着眼于未来,逐步调整信息化发展战略,向智慧医院迈进。     

Subchronic toxicity study of yttrium nitrate by 90-day repeated oral exposure in rats

Concerns regarding the adverse effects of long-term exposure to low levels of rare earth elements (REEs) from foods on human health have arisen in recent years. Nevertheless, no official acceptable daily intake (ADI) has yet been proposed for either total REEs or individual REE. In accordance with the Organization for Economic Co-operation and Development (OECD) testing guideline, the present study was undertaken to evaluate the subchronic toxicity of yttrium, a representative heavy REE with higher contaminated level in foods in China, to achieve a no observed adverse effect level (NOAEL) which is a critical basis for the establishment of an ADI. Yttrium nitrate was orally administered to rats at doses of 0, 10, 30 and 90 mg/kg/day for 90 days followed by a recovery period of 4 weeks. The following toxicity indices were measured: mortality, clinical signs, daily food consumption and weekly body weight; urinalysis, hematology, blood coagulation, clinical biochemistry and histopathology at the end of administration and recovery periods. No toxicologically significant changes were found in any yttrium-treated group as compared to the concurrent control group. Under the present experimental condition, the NOAEL in rats was thus set at 90 mg/kg for yttrium nitrate, i.e. 29.1 mg/kg for yttrium.     

从“土克水”角度认识“骨痿”

原发性骨质疏松症(primary osteoporosis,POP)是一种以骨量低下、骨微结构破坏,导致骨脆性增加、易发生骨折为特征的全身性骨病,在现代中医学中属于"骨痿"范畴,肾水亏虚是本病基础,并与肝木、脾土相关,除了补肾壮骨之外,黄帝内经创造性地提出了"治痿独取阳明"治疗大法,本文将通过五行"土克水"的角度重新梳理"骨痿"的病因病机,并在主流治疗方案之外创新性地提出了独特的治法治则,兹可作为现代中医治疗"骨痿"的一个重要补充。     

Structures of dolomite at ultrahigh pressure and their influence on the deep carbon cycle

Carbon-bearing solids, fluids, and melts in the Earth''s deep interior may play an important role in the long-term carbon cycle. Here we apply synchrotron X-ray single crystal micro-diffraction techniques to identify and characterize the high-pressure polymorphs of dolomite. Dolomite-II, observed above 17 GPa, is triclinic, and its structure is topologically related to CaCO₃-II. It transforms above 35 GPa to dolomite-III, also triclinic, which features carbon in [3 + 1] coordination at the highest pressures investigated (60 GPa). The structure is therefore representative of an intermediate between the low-pressure carbonates and the predicted ultra-high pressure carbonates, with carbon in tetrahedral coordination. Dolomite-III does not decompose up to the melting point (2,600 K at 43 GPa) and its thermodynamic stability demonstrates that this complex phase can transport carbon to depths of at least up to 1,700 km. Dolomite-III, therefore, is a likely occurring phase in areas containing recycled crustal slabs, which are more oxidized and Ca-enriched than the primitive lower mantle. Indeed, these phases may play an important role as carbon carriers in the whole mantle carbon cycling. As such, they are expected to participate in the fundamental petrological processes which, through carbon-bearing fluids and carbonate melts, will return carbon back to the Earth’s surface.     

扶土抑木推拿法在儿科疾病中的临床应用

目的 分析探讨在《保婴神术》的理论指导下,扶土抑木推拿法在儿科疾病中临床应用;方法 临床病案分析及文献研究;结果 扶土抑木推拿法能补脾疏肝,对因肝脾失调引起的儿科疾病如咳嗽、黄疸、夜啼、贫血具有良好的治疗效果;结论 扶土抑木推拿法治疗儿科疾病疗效显著。     

水杨羟肟酸功能化聚苯乙烯的制备及其与Tb(Ⅲ)离子配合物的荧光发射特性初探

凭借氯甲基化的聚苯乙烯（CMPS）与水杨羟肟酸（SHA）之间的Friedel-Crafts烷基化反应,使SHA键合在聚苯乙烯( PS) 的侧链上,制备了改性聚苯乙烯(SHA/PS)。再使SHA/PS 与Tb(Ⅲ) 离子配位,制得高分子-稀土配合物Tb(Ⅲ)-SHA/PS。采用红外光谱对其结构进行了表征,考察了影响SHA与CMPS之间Friedel-Crafts 烷基化反应的主要因素。结果表明,当催化剂SnCl4用量为0.06 mL,35 ℃反应18 h时,SHA/PS上SHA的键合率高达33.1%。Tb(Ⅲ)-SHA/PS配合物不仅具有与Tb(Ⅲ)离子相似的荧光光谱,而且SHA/PS配体对Tb(Ⅲ)离子产生了显著的Antenna效应,使其荧光强度大幅增强。     

高频电刀使用安全与质量控制中关键因素的分析

目的：分析高频电刀质量控制中的各个关键因素,为质量控制工作提供具体参考,以保证质量控制的准确和规范。方法：从保护接地阻抗、阻容网络及测试误差等因素的定义、结构、量值及其他方面分析质量控制细节。结果：掌握高频电刀质量控制中的各个关键因素后,提高其可操作性,有效降低使用风险,提高医疗服务质量,保障患者和使用人员安全。结论：分析各个关键因素,对全面深入地做好高频电刀的质量控制工作具有重要意义。     

Ten-percent solar-to-fuel conversion with nonprecious materials

Direct solar-to-fuels conversion can be achieved by coupling a photovoltaic device with water-splitting catalysts. We demonstrate that a solar-to-fuels efficiency (SFE) > 10% can be achieved with nonprecious, low-cost, and commercially ready materials. We present a systems design of a modular photovoltaic (PV)–electrochemical device comprising a crystalline silicon PV minimodule and low-cost hydrogen-evolution reaction and oxygen-evolution reaction catalysts, without power electronics. This approach allows for facile optimization en route to addressing lower-cost devices relying on crystalline silicon at high SFEs for direct solar-to-fuels conversion.Distributed and grid-scale adoption of nondispatchable, intermittent, renewable-energy sources requires new technologies that simultaneously address energy conversion and storage challenges (1, 2). Coupling photovoltaics to drive catalytic fuel-forming reaction, such as water splitting to generate H₂, allows for direct solar-to-fuels conversion. The solar-generated H₂ can effectively be harnessed to electricity by fuel cell devices (3, 4) or converted to liquid fuels upon its combination with CO or CO₂ (5–7). For this technology to be effectively implemented, a solar-to-fuels conversion efficiency (SFE) of 10% or higher is desirable (8, 9).Direct photoelectrochemical (PEC) water splitting by a single absorber material has attracted a vast amount of attention (10, 11), and recent progress indicates improvements in the field (12, 13); but after decades of research, direct PEC faces three challenges to increase conversion efficiency: (i) Direct absorber band alignment is required to provide carriers with appropriate potential to both half reactions. Although such an alignment is difficult to achieve in a single material initially, any change in band alignment due to changing surface conditions can result in further efficiency degradation. This makes it challenging to design devices that maintain robust, high efficiencies in actual operation. (ii) The wide absorber bandgap (>1.23 eV; typically >1.6 eV) needed to drive the water-splitting reaction is not optimized for the solar spectrum, which results in a maximum SFE of only 7% (14–16). (iii) The absorbers are poor catalysts, and they are incapable of efficiently performing the four proton-coupled electron transfer chemistry (17–22) that is needed for water splitting.These deficiencies can be overcome by substituting a PEC device with a buried-junction photovoltaic (PV) device and an electrochemical catalyst (EC) system, forming a PV–EC tandem (23–27). In a buried-junction device, the electric field is generated at an internal junction within the semiconductor and is then coupled with water-splitting catalysts through ohmic contacts, which can either be conductive coatings directly deposited onto the PV or connected through wires to the electrodes. The buried junction relaxes the constraints imposed by a PEC device because it separates light absorption from catalysis, and does not require that the absorber be stable in aqueous electrolytes in which the pH regime for the absorber and best water-splitting catalyst may not be compatible. However, PV–EC devices have been viewed historically as too expensive to be economically viable, primarily because of the use of noble-metal water-splitting catalysts and expensive and/or low-efficiency PV devices. Indeed, the solar splitting of water by nonprecious materials and under simple conditions has long been identified to be a “holy grail” of solar energy conversion (28). We have pursued this goal by using a buried-junction device coated with transparent conducting oxides, overlaid with self-healing catalysts that self-assemble upon oxidation of Co²⁺ (29–36), Ni²⁺ (37–39), and Mn²⁺ (40, 41) ions in phosphate or borate electrolytes. These catalysts have shown great fidelity for interfacing with a variety of buried junctions (42–46) to deliver what is more commonly known as the artificial leaf (47). This approach is generally being adopted by others (48, 49).Efficiencies are predicted to be as high as 18% for PV–EC devices comprising series-connected single-junction PV devices and higher for multijunction PV devices (14–16). Of significant consequence to the design of PV–EC devices is the quickly changing landscape of silicon as a PV material. In the past 7 y, the price of crystalline silicon (c-Si) solar cells has decreased by 86%, and the price of PV modules has dropped 77%. In the meantime, average commercial c-Si solar-cell efficiencies have increased to 17.5% for multicrystalline silicon and 19.5% for monocrystalline silicon (50, 51). We now report an approach that leverages c-Si solar cells and our nonprecious metal catalysts to furnish a solar-to-fuels device with an efficiency of 10%. Because a single c-Si solar cell is unable to provide enough voltage to drive the water-splitting reaction, we use multiple single-junction solar cells series connected into minimodules. Although this approach does not result in a monolithic structure in which catalysts are directly deposited on the PV device in a buried-junction configuration (e.g., an artificial leaf), the equivalent circuit for both constructs is identical (52). This approach allows for modular independent optimization, after which the components could be integrated into a monolithic design. Our device bears resemblance to recently reported copper indium gallium diselenide-based devices (53), but incorporates low-cost and nonprecious crystalline silicon solar cells and oxygen-evolution and hydrogen-evolution catalysts.     

含钕聚合物的制备及荧光性质

用复分解的方法制备了辛酸钕[Nd(OCA)_3]和甲基丙烯酸钕[Nd(MAA)_3];将它们分别加入甲基丙烯酸甲酯和甲基丙烯酸的混合体系,聚合后得到交联的[含Nd(MAA)_3]和非交联的[含有Nd(OCA)_3]二种聚合物。研究了上述钕的有机酸盐和二种含钕聚合物的荧光性质。