拉米夫定对慢性乙肝患者HBV-DNA及HBeAg的阴转作用

目的：探讨拉米夫定治疗前后慢性乙肝患者血清及周围血单个核细胞（PBMCs）内HBV-DNA及HBeAg的变化。方法：用ELISA检测患者血清标志物;用荧光定量PCR检测患者血清及PBMCs内HBV-DNA的含量。拉米夫定对病人进行治疗,12周为一疗程,共4个疗程。结果：拉米夫定治疗48周后HBeAg及血清、PBMCs内HBV-DNA阴转率分别为52.31、46.15、41.82,较常规治疗组差异具有显著性（P〈0.05）。结论：拉米夫定对慢性乙肝患者HBV-DNA、HBeAg有较好的转阴率,且PBMCs内HBV-DNA的检测是鉴定拉米夫定疗效的一个重要指标,对抗病毒治疗具有明显的指导意义。     

广东六地区乡镇传染病防制工作现况与对策研究

目的：了解乡镇（街道社区）传染病防制工作现况，旨为政府决策提供科学依据。方法：采用现场访谈及问卷调查方法对广东省6个经济发达地区及欠发达地区的21个乡镇卫生院（或地段医院）进行传染病防制工作现况调查。结果：广东省部分地区乡镇从事传染病防制工作的防保人员配置平均为0．9人／万人；经济欠发达地区传染病防制工作经费缺乏或不足．且防保人员中具有大专以上学历的比例仅为5．8％；各地乡镇防保机构无学历及非卫生专业人员比例达40．0％；各地防保人员缺乏开展传染病防制工作的基础知识和技能。结论：设立专项经费、增加专业人员编制、实行人员准入机制和岗前培训、制定标准工作规范及程序是加强乡镇传染病防制工作能力建设的主要策略。     

精神分裂症患者自我效能与自理行为的相关性研究

目的了解精神分裂症患者自我效能和自理行为间关系.方法采用一般自我效能感量表和自行设计的精神分裂症患者自理行为调查表对69例缓解精神分裂症患者进行调查,应用Spearman's相关分析法确定两者之间关系.结果精神分裂症患者的自我效能与自理行为水平均不够理想,且自我效能与自理行为呈高度正相关(r=0.73).结论精神分裂症患者自我效能的高低影响其自理行为水平,提示临床护理工作者在制定和实施护理干预措施时,应将提高自我效能作为干预目标,通过提高患者的自我效能,来改善患者的自理行为.     

注射用丹参分子排阻色谱及指纹图谱差减分析

目的 探讨注射用丹参质量差异的分析方法.方法 取临床不良反应有差异的不同批号的样品进行平行比对试验,分别应用凝胶分子排阻色谱、碳十八反相液相色谱进行指纹图谱分析,通过综合差减分析揭示非小分子酚酸类成分信息.结果 注射用丹参的凝胶分子排阻色谱有显著的批间差异,非小分子酚酸类成分批间差异显著,与豚鼠急性毒性反应程度相对应.结论 非小分子酚酸类成分应作为丹参系列注射剂质量控制的重点.提出谱毒学研究是中药注射剂安全性研究的重要方向之一.     

肝细胞癌survivin mRNA表达的临床病理意义

目的　研究凋亡抑制基因survivin mRNA表达与肝细胞癌(HCC)临床病理之间的关系;探讨其在评价HCC侵袭性和癌症进展中的价值。方法　用逆转录聚合酶链反应测定31例HCC癌组织及癌旁组织中survivin mRNA 的表达。分析其临床病理学资料,研究在HCC 中survivinmRNA阳性和阴性表达与其各项临床病理学指标间的关系。结果　31 例HCC病人的肝癌标本中,survivin mRNA表达阳性的有22 例,占71%;阴性表达9 例,占29%。癌旁组织中未见survivinmRNA表达。HCC组织的survivin mRNA表达与病人性别、年龄、HBsAg、肝硬化、肿瘤的大小、包膜、单发或多发瘤无显著关系(P>0 05),而与癌栓、病理学分级和TNM分期有显著关系。SurvivinmRNA表达阳性组有癌栓占9/22(40 91%),survivin mRNA表达阴性有癌栓占0/9(0%),两组比较P<0. 05;Survivin mRNA 表达阳性组病理学分级Ⅰ、Ⅱ级有7/22 (31 82%),Ⅲ和Ⅳ级有15/22(68. 18%),survivin mRNA表达阴性组Ⅰ、Ⅱ级有7/9(77. 78%),Ⅲ和Ⅳ级有2/9(22 .22%),两组比较P<0 05,有显著差异;survivin mRNA表达阳性组TNM分期Ⅰ、Ⅱ期有7/22(31. 82%),Ⅲ和Ⅳ期有15/22 ( 68 .18%), survivin mRNA 表达阴性组Ⅰ、Ⅱ期有7/9 ( 77 78%),Ⅲ和Ⅳ期有2/9(22 22%),两组比较P<0 .05,有显著差异。结论　肝细胞癌sur     

电脑网络技术在医院药学部门的应用

探讨电脑网络技术在医院药学部门的应用。分析和整理相关文献，并结合本院实际情况进行综述。结果表明，充分利用电脑网络技术能更好的开展医院药学工作。     

2008—2017年脑脊液病原菌分布和药物敏感性分析

目的：统计分析2008—2017年南京医科大学第一附属医院临床送检脑脊液培养标本中主要病原菌分布及药物敏感性情况。方法：细菌鉴定、药物敏感试验和真菌鉴定采用 VITEK?2 Compact 全自动微生物鉴定及药敏系统,链球菌药敏为纸片扩散法（K?B 法）,真菌药敏试验采用 ATB FUNGUS 3 方法,WHONET 5.6 软件进行统计分析。结果：2008—2017年南京医科大学第一附属医院脑脊液标本培养阳性率为6.0%,前5位的病原菌分别是鲍曼不动杆菌（35.8%）,凝固酶阴性葡萄球菌（11.3%）,肺炎克雷伯菌（9.3%）,铜绿假单胞菌（5.8%）,大肠埃希菌（5.1%）和新型隐球菌（5.1%）。鲍曼不动杆菌对常见抗菌药物敏感性均较低,肠杆菌科细菌对碳青霉烯类抗菌药物最敏感（>55.0%）,铜绿假单胞菌对除氨曲南之外的抗菌药物均有较好的敏感性（>46.7%）,革兰阳性球菌对万古霉素、利奈唑胺、替考拉宁敏感性较好,新型隐球菌对常见抗真菌药物均有较好的敏感性（>90.0%）。结论：2008—2017年脑脊液标本中,革兰阴性杆菌在中枢神经系统感染中占重要地位,应重点防范多重耐药菌的感染,尤其是鲍曼不动杆菌。统计并分析脑脊液常见病原菌和药物敏感性可为本地区临床医生合理用药提供理论依据。     

Partial left ventriculectomy for the treatment of end-stage dilated cardiomyopathy

OBJECTIVE: To report our initial experience of the first 5 cases of partial left ventriculectomy (PLV or Batista operation), a new surgical therapy for treatment of end-stage dilated cardiomyopathy in China. METHODS: From April to August 1998, 5 patients with idiopathic dilated cardiomyopathy received PLV at Anzhen Hospital. The mean age of the patients was 48.4 years (range: 42 to 53 years). Three patients were in New York Heart Association (NYHA) class III and 2 in class IV. All patients had mitral valve insufficiency (3 moderate and 2 severe) and 1 had severe tricuspid valve insufficiency in addition preoperatively. Cardiopulmonary bypass and cardiac arrest with cold blood cardioplegia were used in all patients. The average weight of the resected left ventricle muscle was 46.3 g. All patients underwent mitral annuloplasty and 1 plus tricuspid annuloplasty (De Vega). RESULTS: Echocardiography demonstrated a significant decrease in left ventricular diastolic diameter (8.4 +/- 1.1 cm to 5.4 +/- 0.4 cm, P < 0.01) and an increase in ejection fraction (17.78% +/- 6.26% to 34.82% +/- 3.18%, P < 0.025). One patient died of heart failure on the 6th postoperative day. The mean follow-up period of the 4 discharged patients were 4 months (from 3 to 6 months). One were in NYHA class I and 3 in class II; all had a normal life. CONCLUSION: Batista operation is a new and valuable alternative of the surgical treatment for end-stage dilated cardiomyopathy and the long-term results need further studies.     

Mn(ii)-Catalysed ortho-alkenylation of aromatic amines and its application in reproductive diseases

A Mn(ii)-catalysed ortho-alkenylation of aromatic amines and its application in reproductive diseases were developed. The use of MnCl₂ was critical for the ortho-alkenylation of aromatic amines. The general applicability of this procedure was highlighted by the synthesis of 27 vinylanilines, with good regioselectivities. The value of our approach in practical applications was investigated by studying the effects of one of the compounds 3m on 8 week-old adult male rats with azoospermia as a mammalian model. The results show that a small amount of sperm will gradually be produced in the epididymis and testes by treatment of 8 week-old adult male rats with azoospermia with 1 mg kg⁻¹3m after two weeks, while treatment with 10 mg kg⁻¹3m led to obvious sperm production. Notably, if we increase the dose to 100 mg kg⁻¹, there will be a lot of sperm production in the epididymis and testes after two weeks of treatment. The results of this study will be of great significance in research on drugs for treating azoospermia and oligospermia diseases.

A Mn(ii)-catalysed ortho-alkenylation of aromatic amines and its application in reproductive diseases were developed.

Alkenyl arylamines are very important intermediates for the synthesis of drug molecules, such as carbamazepine,¹ opipramol,² and indopan³ (Scheme 1). O-Alkenyl arylamines have attracted much attention because of their widespread presence in a variety of heterocycles including indoles, quinolines and cinnolines, which are key structural units for many biologically important compounds.⁴ Moreover, they have also been used as synthetic intermediates in several total synthetic methods.⁵ Therefore, it is of great significance to carry out the ortho-alkenylation reaction of aromatic amines. But it is not an easily accessible process under normal Friedel–Crafts conditions due to the coordination of the Lewis acid with the nitrogen atom of amino group, which leads to the deactivation of the aromatic ring.⁶ To overcome this challenge, chemists began to try other methods to achieve ortho-alkenylation of aromatic amines. Subsequently, several related ortho-alkenylation of aromatic amines with phenylacetylene was reported in the literature.^4a,7 However, the ortho-alkenylation of aromatic amines catalyzed by base metals has not yet been developed, especially manganese. Therefore, it is still very important to develop a Mn-catalyzed ortho-alkenylation reaction of aromatic amines. Notably, there have been more C–H bond functionalization reactions catalyzed by monovalent manganese in recent years, but few of them were catalyzed by divalent manganese.⁸ Ackermann''s research group reported several Mn(ii)-catalyzed ortho-functionalization reactions of arylamides.⁹ In addition, a Mn(ii)-catalysed dehydrogenative annulation of N-aryl anilines with alkenes or alkynes was reported by our group last year.¹⁰Open in a separate windowScheme 1Drug molecules containing alkenyl arylamine skeleton.Herein, we report an example of Mn(ii)-catalysed ortho-alkenylation of aromatic amines and its application in reproductive diseases (Scheme 2). In our previous work, divalent manganese is easily oxidized to tetravalent manganese by K₂S₂O₈.¹⁰ This work, we hypothesis the ortho-alkenylation product of aromatic amine will be generated after the oxidant was removed in the system. Based on this hypothesis, we tried a series of manganese catalysts.Open in a separate windowScheme 2Proposed strategy.We began by treating N-benzylaniline and phenylacetylene with toluene as a solvent. Initially, we attempted using various Mn(ii) catalysts to catalyse the ortho-alkenylation of aromatic amines at 120 °C, i.e., MnO, MnSO₄, Mn(OAc)₂, and Mn(acac)₂, as detected by GC analysis, while 73% and 61% yields were observed when MnBr₂ and MnI₂ were used as catalysts (Table 1, entries 1–7). Fortunately, a 80% yield of N-benzyl-2-(1-phenylvinyl)aniline was obtained when using MnCl₂. To improve the reaction efficiency, different solvents, including N,N-dimethylformamide (DMF), dimethyl sulfoxide (DMSO), acetonitrile (CH₃CN), 1,4-dioxane, tetrahydrofuran (THF), 1,2-dichloroethane (DCE), p-xylene, mesitylene and n-hexane were tested (Table 1, entries 8–16). The optimal reaction solvent was found to be toluene. To increase conversion to the N-benzyl-2-(1-phenylvinyl) aniline, we examined a wide range of reaction temperatures (Table 1, entries 17–22). The results show that 120 °C was the optimum temperature, and the corresponding N-benzyl-2-(1-phenylvinyl)aniline was obtained the best yield. It is worth noting that more cyclization products were formed when the temperature is raised to 130 °C. Therefore, temperature is another key factor that drives the reaction forward. Notably, the addition of oxidant will terminate this reaction (see the ESI Table 1^† for details). These results therefore support our initial hypothesis that the ortho-alkenylation product of aromatic amine will be generated after the oxidant was removed.Effects of catalyst, temperature, and solvent. N-Benzylaniline (0.2 mmol), phenylacetylene (0.4 mmol), catalyst (0.04 mmol), solvent (2.0 mL), at 120 °C for 24 h

758例体检者“上火”体验的回顾性调查

目的:初步探讨"上火"的症状特征及相关因素。方法:采用回顾性问卷调查的方法,对758名志愿者的上火的原因、症状、应对措施等进行调查。结果:91%的人有过上火的经历,在调查中的发生率为4.2%。女性比男性更容易上火,尤其是老年女性,上火后持续的时间也比较长。不同性别者的上火症状亦有差异。结论:中国人日常所说的上火是一种具有燥象和热象特征的亚健康状态。不良的生活习惯是促使其发生的重要原因,症状的差异与性别、年龄相关。纠正不良的行为生活方式是预防和缓解上火的重要举措。