基于专业能力进阶制度的护理人员优化层级管理模式初探

目的　探讨分析基于护理专业能力进阶制度的优化层级管理模式在临床的应用效果。方法　选择重庆市大足区二级及以上5家医院共500名护士作为研究对象，随机分为干预组和对照组，每组护士各250名，对照组护士采用传统管理模式，干预组护士采用基于专业能力进阶制度护理人员优化层级管理模式，比较分析两组护士护理能力、临床工作质量和不良事件发生率。采用SPSS 23.0进行卡方检验和t检验。结果　两组护士年龄、性别、婚姻、职称、工作年限等差异没有统计学意义（P>0.05），基线资料保持一致，具有可比性。进行优化层级管理后，干预组护士护理能力得分（82.30±3.83）明显高于对照组（72.78±5.33）；干预组护士护理工作质量得分（97.53±9.71）明显高于对照组（90.17±8.18）。对两组医院不良事件发生率进行组间比较，干预组不良事件发生率（0.9%）明显低于对照组（3.9%），差异均有统计学意义（P<0.05）。结论　基于专业能力进阶制度的护理人员优化层级管理模式能够提升护理人员的专业能力和临床护理质量，降低不良事件发生率，为提升护理管理水平提供借鉴和参考。     

人体蠕形螨的生物学研究

用透明胶带法观察蠕形螨在人体面部的寄生、逸出及其在体外的存活能力。结果表明：毛囊蠕形螨（Ｄｅｍｏｄ－ｅｘｆｏｌｉｃｕｌｏｒｕｍ，Ｄ．ｆ．）主要以颚体朝向毛囊底部寄生，且常常有多条群居现象，而皮脂蠕形螨，（Ｄｅｍｏｄｅｘｂｒｅｖｉｓ，Ｄ．ｂ．）一般为单条独居生活。两种人体蠕形螨昼夜均可主动爬出毛囊口出现在皮肤表面，Ｄ．ｆ．以白天１０００～１８００为逸出高峰；Ｄ．ｂ．则以夜间２２００～２００逸出最多。此外，蠕形螨在体外有较强的活动力和存活力。透明胶带法在人体蠕形螨的流行病学调查和生物学研究方面具有较高的应用价值     

银杏叶提取物对宫内缺氧新生大鼠神经细胞凋亡的保护效应

目的 探讨银杏叶提取物(EGb)对宫内缺氧新生大鼠急性脑缺血损伤的保护作用。方法 夹闭妊娠大鼠子宫血管，制成急性脑缺血损伤新生鼠模型，治疗组给予腹腔注射EGb，在生后不同时间比较两组仔鼠脑组织含水量、NO的变化,神经型一氧化氮合酶(nNOS)的表达及神经细胞凋亡情况变化。结果 急性脑缺血后，脑组织含水量明显增加，NO的含量迅速上升，同时凋亡细胞数增加，两者成直线正相关。EGb治疗后NO含量显著低于未治疗组，同时观察到治疗组的nNOS表达明显降低，凋亡细胞数量减少。结论EGb对急性缺血引起的脑损伤有保护作用。     

常染色体显性遗传性枕叶癫癎临床与脑电图1家系6例报告

目的：报道常染色体显性遗传性枕叶癫痫一家系6例。方法：对先证者进行详尽的临床、脑电图(EEG)、录像脑电图(Video—EEG)、头MRA观察。结果：此家系祖孙三代6例，男性女性均有发病，患者大多为8～15岁起病，主要症状为发作性视幻觉、偏身麻木、头痛、呕吐。先证者EEG、Video—EEG、头颅MRA未见异常，家系中继发全面性强直阵挛发作患者EEG见枕颞区异常放电。结论：该家系患者的临床表现、EEG均符合枕叶癫痫诊断，并排除了颅内占位性及血管性病变。该家系符合常染色体显性遗传规律。     

我国科技期刊封面特点及问题建议——以中国科学院主管主办科技期刊为例

【目的】 总结中国科学院主管主办科技期刊的封面特点,以促进我国科技期刊通过期刊封面增强内容传播与品牌建设。【方法】 对中国科学院主管主办的341种科技期刊封面按期更换比例、期刊封面的演进与美学特点进行调研和分析。【结果】 按期更换封面的科技期刊比例有所提升、演进速度明显加快、美感明显提升,版式表现出学科特点。同时,按期更换封面的期刊比例仍然偏低,封面规范性、美感、网络传播能力仍需加强,相关管理规范也存在滞后性。【结论】 我国科技期刊需要进一步提升封面的规范性与美感,增强在线与多媒体衍生品的创作与传播,管理部门也要与时俱进地改进管理规范,充分发挥期刊封面在学术成果传播中的重要价值。     

86例痤疮患者血清性激素水平分析

目的 研究痤疮患者血清性激素水平与痤疮的关系。方法 对86例痤疮患者以放免法检测患者血清睾酮、卵泡刺激素（男性称精子生成素）、黄体生成素（男性称间质细胞刺激素）、孕酮和雌二醇;并对其中20例患者检测了泌乳素。结果 男性寻常痤疮、男和女聚合性痤疮和痤疮伴四肢或乳晕多毛（女性）63．89％患者血清睾酮增高,75％患者雌二醇增高;男性疮疮90．91％患者精子生成素低于正常。结论 血清性激素水平与痤疮类型有关,在痤疮的发生、发展和持续状态中起重要作用。     

川芎嗪抗缺氧致脑细胞损伤作用的实验研究

目的:观察川芎嗪对缺氧状态下离体大脑皮层细胞脂质过氧化物(LRO)含量及超氧化物歧化酶(SOD)活性的影响。方法:将4～5日龄 Wistar 大鼠大脑皮层分离并制成细胞悬液(5×10~6个细胞/ml),在 CO_2培养箱内孵育2h 之后观测单纯缺氧1h(细胞悬液通以95％N_2加5％CO_2),以及预先向细胞悬液加入磷酸川芎嗪(分10~(-5)、10~(-4)和10~(-3)mol/L3个剂量组),再缺氧1h 细胞 LPO 含量与 SOD 活性的改变。结果:缺氧可使 LPO 显著增加、SOD 活性明显降低;预先加入川芎嗪能有效防止缺氧所致的 LPO 升高和 SOD 活性降低。结论:川芎嗪对缺氧致细胞脂质过氧化损伤具有保护作用,其机制可能是通过增强内源性 SOD 活性、清除氧自由基,进而降低了细胞脂质过氧化程度。     

First-line nivolumab plus chemotherapy vs chemotherapy in patients with advanced gastric,gastroesophageal junction and esophageal adenocarcinoma: CheckMate 649 Chinese subgroup analysis

First-line chemotherapy for advanced/metastatic human epidermal growth factor receptor 2 (HER2)-negative gastric/gastroesophageal junction cancer (GC/GEJC) has poor median overall survival (OS; <1 year). We report efficacy and safety results from Chinese patients in the phase III global CheckMate 649 study of nivolumab plus chemotherapy vs chemotherapy for the first-line treatment of GC/GEJC/esophageal adenocarcinoma (EAC). Chinese patients with previously untreated advanced or metastatic GC/GEJC/EAC were randomized to receive nivolumab (360 mg Q3W or 240 mg Q2W) plus chemotherapy (XELOX [capecitabine and oxaliplatin] Q3W or FOLFOX [oxaliplatin, leucovorin and 5-fluorouracil] Q2W), nivolumab plus ipilimumab (not reported) or chemotherapy alone. OS, blinded independent central review-assessed progression-free survival (PFS), objective response rate (ORR), duration of response (DOR) and safety are reported. Of 1581 patients enrolled and randomized, 208 were Chinese. In these patients, nivolumab plus chemotherapy resulted in clinically meaningful improvement in median OS (14.3 vs 10.2 months; HR 0.61 [95% CI: 0.44-0.85]), median PFS (8.3 vs 5.6 months; HR 0.57 [95% CI: 0.40-0.80]), ORR (66% vs 45%) and median DOR (12.2 vs 5.6 months) vs chemotherapy, respectively. The safety profile was acceptable, with no new safety signals observed. Consistent with results from the global primary analysis of CheckMate 649, nivolumab plus chemotherapy demonstrated a clinically meaningful improvement in OS and PFS and higher response rate vs chemotherapy and an acceptable safety profile in Chinese patients. Nivolumab plus chemotherapy represents a new standard first-line treatment for Chinese patients with non-HER2-positive advanced GC/GEJC/EAC.     

The Combination of Glycolytic Inhibitor 2-Deoxyglucose and Microbubbles Increases the Effect of 5-Aminolevulinic Acid-Sonodynamic Therapy in Liver Cancer Cells

Sonodynamic therapy (SDT) overcomes the shortcoming of photodynamic therapy in the treatment of cancer. Previous studies indicated that the glycolysis inhibitor 2-deoxyglucose (2-DG) potentiated photodynamic therapy induced tumor cell death and microbubbles (MBs) improved the SDT performance. We hypothesized that the combination of 2-DG and MBs will increase the effect of 5-aminolevulinic acid (ALA)-SDT in HepG2 liver cancer cells. When cells were treated with 5-min ALA-SDT and 2-mmol/L 2-DG, the cell survival rate decreased to 73.0 ± 7.1% and 75.2 ± 7.9%, respectively. Furthermore, 2 mmol/L 2-DG increased 5-min ALA-SDT induced growth inhibition and augmented ALA-SDT induced cell apoptotic rate from 9.8 ± 0.7% to 17.4 ± 2.2%. In the combination group (2-DG and ALA-SDT group), HepG2 cells possessed typical apoptotic characters. 2-DG also increased ALA-SDT associated intracellular reactive oxygen species generation and loss of mitochondrial membrane potential. Moreover, SonoVue MBs had stimulatory function on cell viability inhibition, apoptosis, reactive oxygen species production and mitochondrial membrane potential loss for combination treatment. This study suggests a promising therapeutic strategy using a combination of 2-DG, MBs and ALA-SDT for treating liver cancer.     

DNA Duplexes with Hydrophobic Modifications Inhibit Fusion between HIV-1 and Cell Membranes

Discovery of new drugs for the treatment of AIDS typically possessing unique structures associated with novel mechanisms of action has been of great importance due to the quick drug-resistant mutations of HIV-1 strains. The work presented in this report describes a novel class of DNA duplex-based HIV-1 fusion inhibitors. Hydrophobic groups were introduced into a DNA duplex skeleton either at one end, at both ends, or in the middle. These modified DNA duplexes inhibited fusion between HIV-1 and human cell membranes at micro- or submicromolar concentrations. Respective inhibitors adopted an aptamer pattern instead of a base-pairing interaction pattern. Structure-activity relationship studies of the respective DNA duplexes showed that the rigid and negatively charged DNA skeletons, in addition to the presence of hydrophobic groups, were crucial to the anti-HIV-1 activity of these compounds. A fluorescent resonance energy transfer (FRET)-based inhibitory assay showed that these duplex inhibitors interacted with the primary pocket in the gp41 N-terminal heptad repeat (NHR) instead of interacting with the lipid bilayers.