目的 分析耶氏肺孢子菌肺炎的临床特征和实验室检测结果,为临床早期诊断和治疗提供依据.方法 回顾性分析2017年1月至2020年5月深圳某综合医院耶氏肺孢子菌的检出和临床分布情况、影像学特征、生化指标,以及六铵银染色检查的注意事项.结果 共检出6例耶氏肺孢子菌感染,患者年龄14～59岁,来源于ICU、血液内科、儿科等科室,主要临床诊断为白血病或肾炎.血清(I-3)-β-D-葡聚糖和乳酸脱氢酶均升高.染色温度和时间对六镀银染色的结果影响较大.影像学表现以胸部CT均发现磨玻璃密度影为主,患者经过复方新诺明和糖皮质激素联合治疗,症状有不同程度改善.结论 患有不明原因肺炎的白血病或肾炎患者,常规治疗无效的,应考虑耶氏肺孢子菌感染;六铵银染色法是一种检测耶氏肺孢子菌快速、简便的方法,应注意控制染色温度和时间.

目的:分析卡氏肺孢子菌感染患者临床诊治及病原体的检测,探讨实验室卡氏肺孢子菌对六胺银染色法检测的影响因素及其镜下的特征.方法:抽取医院微生物室2017年9月-2018年3月间采用六胺银染色法检测的15例标本,分析其中1例急性淋巴细胞白血病患儿伴有肺孢子菌感染引起呼吸衰竭病例的诊治过程检测结果及肺孢子菌镜下的特征.结果:15例卡氏肺孢子菌六胺银染色标本中,其中阳性标本为6例;此6例病例均为免疫力低下的非艾滋病患者,由于检测病原体的及时和准确性,无死亡病例发生,其中2例转外院治疗,4例治愈后康复出院.结论:对于免疫力低下的肺炎患者,常规治疗无效的,应考虑可能是卡氏肺孢子菌感染.

目的 探讨miR-135b在卵巢癌组织中的表达及意义.方法 选取2015年1月～2017年12月在解放军第一七四医院和南方医科大学深圳医院接受手术的卵巢病变患者的卵巢组织,包括28例卵巢癌组织和10例卵巢良性肿瘤组织,所有的组织均经过病理确认.运用荧光定量PCR(RT-PCR)的方法检测28例卵巢癌及10例卵巢良性肿瘤组织中miR-135b的表达水平,并分析其与卵巢癌患者年龄、组织学类型、分化程度、临床分期及淋巴结转移的关系.结果 ①28例卵巢癌组织中miR-135b的表达量(1.90±0.53)与10例卵巢良性肿瘤组织中miR-135b表达量(1.45±0.45)比较,差异有统计学意义(t=2.03,P＜0.05);②19例≥50岁卵巢癌患者组织中miR-135b的表达量(1.97±0.51)和20例浆液性囊腺癌组织中miR-135b的表达量(1.96±0.50)分别与9例＜50岁卵巢癌患者组织中miR-135b的表达量(1.77±0.57)和8例黏液性腺癌组织中miR-135b的表达量(1.77±0.61)比较,差异均无统计学意义(t=0.743～0.846,均P＜0.05).20例中低分化组织中miR-135b的表达量(2.05±0.54),17例临床分期Ⅲ～Ⅳ期组织中miR-135b的表达量(2.10±0.46)和15例有淋巴结转移的组织中miR-135b的表达量(2.10±0.53)均分别高于8例高分化组织中miR-135b的表达量(1.55±0.25),11例临床分期Ⅰ～Ⅱ组织中miR-135b的表达量(1.60±0.49)和13例无淋巴结转移的组织中miR-135b的表达量(1.68±0.44)比较,差异均有统计学意义(t=5.036～7.517,均P＜0.05).结论 miR-135b在卵巢癌组织中高表达,miR-135b的表达水平与卵巢癌的分化程度、临床分期和淋巴结转移有关.

Poly(bis(dimethylamino-ethyl)amino/diethylene glycol monomethyl ether)phosphazene was synthesized by nucleophilic substitution reaction with bis(dimethoxy ethyl)amine and diethylene glycol monomethyl ether. The paper studied effect reaction time,temperature,the ratio of raw materials on the synthesis yield of polyphosphazene. The results show that the polyphosphazenes yield is about 38. 2%in the condition of the reaction temperature 60℃,time 16 hours,the molar ratio of polydichlorophazene and the total mole number of bis(dimethylamino-ethyl)amino and diethylene glycol monomethyl ether 1. 1:1,the product has good ther-mal stability in the range of 0～130 ℃.

利用二乙二醇单甲醚与双(二甲氧基乙基)胺通过亲核取代反应制备得到聚[二乙二醇基单甲醚/双(二甲氧基乙基)胺基]磷腈,并应用锂盐复合得到聚磷腈导电高分子材料.研究表明,Td10为255℃,材料最大分解速率出现在410℃;聚磷腈的取代基比例在1∶1和锂盐掺入量为mol Li+/repeat unit=1.5时,聚磷腈复合导电材料的电导率达到2.71×10-8S/cm.

Objective s To study the changes of cerebral hemodynamics of the patients with tortuous internal carotid artery.Methods 40 patients with unilateral carotid internal carotid artery tortuosity,41 patients with bilateral internal carotid arterial tortuosity and 40 normal patients were collected as the control group.The changes of cerebral hemodynamics were monitored and evaluated by transcranial doppler(TCD).Results There was no significant difference in cerebral hemodynamics(P>0.05) between tortuosity side and non-tortuosity side in patients with unilateral carotid internal carotid artery tortuosity.Compared with the normal control group,the systolic blood flow velocity(Vs),end diastolic velocity(EDV) and the mean velocity(Vm) of blood flow in groups of bilateral tortuosity proved to be slower,pulsation index and resistance index decreased.The difference showed statistical significance(P<0.01).Conclusion Tortuous internal carotid artery can cause changes in cerebral hemodynamics artery.In certain cases,severe tortuosity of internal carotid artery may be one of the causes related to the attack of cerebral ischemia.

Objective To investigate the distribution of the underlying mechanisms of ischemic stroke of intracranial or extracranial large artery atherosclerosis(LAA) according to the Chinese ischemic stroke subclassification(CISS) and its risk factors. Methods Patients with ischemic stroke in our hospital were collected between July 2012 and December 2012. Setting strict inclusion criteria and exclusion criteria,patients with ischemic stroke of intracranial or extracranial LAA according to the criteria of CISS was enrolled in the study. Next step the underlying mechanism was further divided into the parent artery (plaque or thrombosis) occluding penetrating artery,artery-to-artery embolism,hypoperfusion/impaired emboli clearance,and multiple mechanisms. Register each subtype patient's age,gender,history of hypertension,history of dyslipidemia,history of diabetes,smoking and hypoechoic plaques in carotid artery. Make descriptive study on the distribution of subtypes in patients and compare the differences in distribution between 4 different subtypes of various risk factors. Results Among the patients enrolled,the subtype of parent artery (plaque or thrombus) occluding penetrating accounted for the largest proportion (41 cases, 41. 4%) ,followed by the order of artery-to-artery embolism (37 cases,37. 4%) ,multiple mechanism (18 cases,18. 2%) and hypoperfusion / impaired embolism (1 cases,1. 0%) . There were no significant differences in the aging,hypertension,diabetes, dyslipidemia,smoking history and hypoechoic plaques among the underlying mechanisms(P0. 05) . Conclusion Parent artery (plaque or thrombus) occluding penetrating is the most common underlying mechanisms of ischemic Stroke of intracranial or extracranial LAA. Common risk factors and hypoechoic plaques showed no significant association with the underlying mechanisms of stroke of intracranial or extracranial LAA.

Objective To compare with the instrument method, providing a simple and economic method for the identification of Gardnerella vaginalis.Methods The Shenzhen Hospital of Hong Kong University and Shenzhen Hospital of Peking University, a total of 112 endocervical canal swab, two methods were used for bacterial identification. Results The results of disk diffusion method and instrument method fully consistent results, disk diffusion method and instrument method are made the same results in the same samples, 42 cases of Gardnerella vaginalis, 70 cases of non Gardnerella vaginalis.Conclusion Disk diffusion method is a simple and economic appraisal of Gardnerella vaginalis, can identify instrument method of Gardnerella vaginalis.

Polydichlorophazene is a colloidal ivory inorganic polymer with high elastic and an important intermediate that synthetizes polyphosphazene derivatives. By means of substituting the chloridion on polydichlorophazene by nucleophilic group, new functional materials with various different performance are fromed. The paper present research progress of synthetizing polydichlor- ophazene methods which are consist of two steps: the first step is synthesis of hexachlorocyclo- triphosphazene, the second step is synthesis of polydichlorophazene.

目的 通过UF-500i 全自动尿沉渣分析仪(简称UF-500i)对中段尿中的细菌进行定量分析,指导临床合理送检中段尿培养标本,合理使用抗生素.方法 对700 例新鲜中段尿标本做细菌培养菌落计数和UF-500i 尿沉渣分析仪细菌计数进行比较.结果 122 例UF-500i 细菌计数>1 000/μl 时,细菌培养达到鉴定标准;569 例细菌计数<100/μl 时,细菌培养无菌生长或仅有几个菌落生长,培养未达到鉴定标准,判为阴性;有9 例细菌计数介于100~1 000/μl 时,细菌培养3例阳性,6 例阴性.结论 当UF-500i 检测出细菌数>1 000/μl 时可送检中段尿做细菌培养,以指导临床合理用药;UF-500i 检测出细菌数<100/μl 时无需送检中段尿培养;而当UF-500i 检测出细菌数介于100~1 000/μl 时,可根据临床和UF-500i 的另一些参数如WBC(白细胞)、NIT(硝酸盐)和尿沉渣涂片革兰染色镜检细菌来决定是否需要培养.

With yellow phosphorus slag as the raw material and nitric acid as leaching agent,SiO2 was separated from the yellow phosphorus slag in the form of amorphous hydrated silicon dioxide.The calcium was entered into lixivium in the form of calcium nitrate,which was precipitated with sulphuric acid and high quality calcium sulfate(CaSO4)product was obtained after washing and drying.The effect of the factors such as mass concentration of sulphuric acid,the volume ratio of H2SO4 to nitrleaching liquor,the reaction temperature,the reaction time on the yield of CaSO4 was studied.The characterization of CaSO4 was described by SEM and Energy Spectrum.The research result showed that the yield of CaSO4 can reach 92.52%,its purity arrives at 99.09% and looks like needles.The optimum technical conditions are H2SO4 mass fraction 20%,normal temperature,the volume ratio of H2SO4 to HNO3 lixivium 0.6,reaction time 45min.

Objective The current global antibiotics abuse is very serious,multi-drug resistant bacteria appeared in large numbers.The aim of this study is to understand the clinical distribution and drug resistance change of Pseudomonas aeruginosa(PA) and to provide reference for rational clinical use of antibacterial drugs.Methods 530 strains of Pseudomonas aeruginosa were isolated from the patients in the 5th affiliated hospital of Guangzhou medical college from 2008 to 2011.The microbial analyzer MicroScan autoSCAN4 was used for identification of bacteria and drug sensitivity test.WHONET 5.4 was used to analyze the drug resistance.Results 530 clinical isolates of Pseudomonas aeruginosa were most isolated from sputum,urine specimen and secretion samples,accounting for 42.3%,32.1% and 20.0% respectively.The drugs with low antimicrobial drug resistance on isolated strains was imipenem(6.79%),amikacin(7.92%),tobramycin(10.94%),and piperacillin / tazobactam(12.08%).Resistance rate from high to low were: ceftriaxone > cefotaxime > levofloxacin > ticarcillin/clavulanic> ciprofloxacin > aztreonam = piperacillin = ceftazidime > cefepime = gentamicin > piperacillin/tazobactam > tobramycin > amikacin > imipenem.Conclusion Pseudomonas aeruginosa is an important pathogen of nosocomial infection.Monitoring the distribution and drug resistance of common pathogenic bacteria,and to know the clinical distribution and drug sensitivity could reduce the generation of multidrug-resistant bacteria,extend the service life of antimicrobial agents,so as to provide reference for rational use of clinical antibiotics.

Poly-di (bis-dimethoxy-ethyl) amine phosphazene was synthesized by nucleophilic substitution reaction with bis (dimethoxy ethyl) amine and conductive polymer materials were manufactured by compositing of the lithium salt and polyphosphazene. The results show that: Td10=503K, the maximum decomposition rate was at 653K. When the mol Li+/ repeat unit was 1.5, the conductivity of polyphosphazene composite conductive material comes up to 4.21×10-8S/cm.

目的探讨合适的感染性疾病实验室诊断模式,协助医生合理使用抗菌药物。方法采用回顾性调查方法,分析300例感染性疾病患者在诊断与抗菌治疗中血常规、C反应蛋白(CRP)、细菌涂片、细菌培养等相关的实验室检查的选择与抗菌药物应用的现状及存在的问题。结果 300例感染性疾病患者全部采用了经验性抗菌治疗。在诊断与治疗中,各科较认可将血常规检查作为筛查细菌感染的实验室指标,住院期间平均检查次数大于或等于2次,除儿科外其他科室细菌涂片、细菌培养的送检次数大于或等于1次,呼吸内科及泌尿外科依据血常规、细菌涂片、细菌培养结果调整用药,儿科多以入院时CRP<10mg/L时停止经验用药,但对CPR≥10mg/L的患者继续抗菌治疗的过程中未做动态监测。其他科室对CRP作为细菌感染的实验室指标实际运用较少,只偶尔作风湿5项检查排除免疫性疾病。还存在部分医生因不能正确解读细菌药敏报告导致调整用药的失败。结论感染性疾病快速诊断与细菌培养相结合,提供经验性抗菌用药的指征与目标用药种类选择信息,加强实验室与临床间沟通,将实验室数据转化为临床有用的信息,共同促进抗菌药物的合理使用。

<正>流感嗜血杆菌(HI)是引起儿童呼吸道感染的常见病原菌,是儿童社区获得性肺炎的重要病原菌,尤其是有荚膜的b型HI(HIb)最具侵袭力[1-2]。HI属于嗜血杆菌属,是一群无动力、无芽孢、呈球杆状或多形态的革兰阴性小杆菌,在培养基中必须加入新鲜血液才能生长,因此叫嗜血杆菌。人工培养时对培养基要求较高,需要Ⅹ因子和Ⅴ因子才能生长,故一般临床实

铜绿假单胞菌为条件致病菌,是医院内感染的主要病原菌之一.多重药耐药铜绿假单胞菌在各地均有爆发和散发报道[1].患代谢性疾病、血液病和恶性肿瘤的患者,以及术后或某些治疗后的患者易感染本菌.该菌在麦康凯琼脂平板上,可形成5种不同的菌落:(1)典型型;(2)大肠菌样型;(3)粗糙型;(4)黏液型;(5)侏儒型[2].侏儒型铜绿假单胞菌因生长缓慢,菌落形态不典型,无生姜味,给临床鉴定带来了一定难度和困惑.

In the paper,according to the researche of network cells based on a most reliable path,the synthetical reliable measurement is put forword and the importance of network cells based on it is researched.The algorithm is validated by an example.

The influence of extraneous hormone with various sorts and concentration upon the rooting capability were investigated in this paper.The results showed that the suitable concentration of extraneous hormone could significantly increase rootage and pretreating the cutting with 250mg/L NAA for 5minutes which could get the hightest rootage,with rooting percentage up to 61.61%.

The triple I FMT method is a basic algorithm of fuzzy reasoning.In this paper,triple I methods with respect to FMT models under some fuzzy implication operator are discussed.

The anionic waterborne polyurethane was synthesized by the reaction of toluene di-isocyanate(TDI) with polyester glycol and dimethlolpropionic acid(DMPA) with the process ofprepolymerization step by step and self-emulsification.Studied the factors which influence the re-action.The results show that the performances of emulsion is optimum when NCO/OH ratio is 1.5~2.3 and the amount of DMPA is 3%~8%.