目的:探讨丙戊酸类药物致急性严重肝损伤的特点、相关因素及临床转归,为临床合理用药提供依据.方法:关键词以“丙戊酸”分别搭配“肝损害”“肝损伤”“肝炎”“肝毒性”,检索CNKI期刊全文数据库和万方医学网相关文献,就药物不良反应(ADR)相关情况进行统计、分析.统计患者年龄、性别、日剂量、是否合并肝脏相关疾病、发生ADR时的用药时间、血药浓度、肝酶变化、临床表现与转归等情况.结果:共检索到丙戊酸类药物致严重肝损害的病例报告13篇,共15例.1)女性(占66.67％)患者占比较高;2)儿童(占40％)及老年人(占26.67％)是丙戊酸肝损伤的高危人群;3)丙戊酸初次用药后的前两个月是发生肝损伤的高危期;4)临床转归与肝损伤始发表现中的转氨酶水平高低无必然联系;5)肝脏相关疾病史不是丙戊酸钠导致急性肝损伤的影响因素,但肝脏疾病史与临床转归是否有必然联系尚有待临床进一步观察;6)肝损伤的发生与剂量过大、血药浓度过高无必然联系;7)多见皮肤/眼睑黄染、恶心/食欲不振等,也可见腹泻、水肿、发热、皮疹,偶见头晕头痛、皮肤红斑.结论:丙戊酸类药物可致急性肝损伤,严重时可致死.临床用药前应慎重选择用药人群,对患者既往肝脏疾病史、儿童、老人要慎重选用,使用过程中要密切监测肝功能;加强患者及家属用药教育,一旦发生疑似肝损伤症状,要及时就医,尽可能避免出现致死性结局.

OBJECTIVE To investigate the distribution and changes in drug resistance of clinical isolates of Acineto‐bacter baumannii from the neurosurgical intensive care unit (NSICU ) ,and to provide evidence for the clinical ther‐apy for infections .METHODS The distribution and results of drug sensitive test to 18 antibiotics of 106 strains of A .baumannii were analyzed .Data were collected for statistical analysis with the WHONIT 5 .6 software . RESULTS Severe cerebrovascular disease (51 cases ,48 .1% ) was the main disease among the 106 patients .Total‐ly 106 strains of A .baumannii were isolated ,mainly from sputum specimens (74 strains ,69 .8% ) .The resistant rates of the isolated strains were more than 90 .0% to cefazolin ,ampicillin ,piperacillin ,and sulfamethoxazole/tri‐methoprim and 100 .0% to polymyxin .CONCLUSION A .baumannii had multiple resistances to several antimicro‐bials .Monitoring for drug resistance of A .baumannii should be strengthened ,as well as the disinfection and man‐agement of NSICU ,hand disinfection of medical staffs should be improved ,and antimicrobial drugs should be used more rationally .

双台子构造带沙三段为典型的断陷盆地发育的湖底扇浊积体,储层为低孔、低渗的致密砂岩,油气藏类型为致密砂岩气藏.传统的叠后波阻抗反演对储层及流体的预测能力有限.本文从分析已发现油气藏的AVO属性入手,结合基于Gassmann方程的流体替代及基于Zoeppritz方程的正演模拟,对储层饱含不同流体状态时的AVO响应特征进行了解剖和总结,在此基础上,利用重新处理的保幅保真地震资料,开展AVO属性反演,得到对气层敏感的泊松比反射率属性,进而对储层的含油气性分布特征进行了预测,并建议部署探井1口,为研究区的勘探部署和储量上报提供了重要依据.

OBJECTIVE To compare the solubility and in vitro dissolution of ursolic acid(UA) solid dispersions(SD) with 4 different carriers.METHODS UA solid dispersions were prepared with solvent method by using poloxamer 188(F68),polyvinylpyrrolidone(S630),polyoxyethylene(40) stearate(S40),and hydroxypropyl methylcellulose(HPMC) as carriers,respectively.The solubility and in vitro dissolution of the pure drug and solid dispersions were determined.The existing forms of UA in solid dispersions were investigated by differential scanning calorimetry(DSC) and X-ray diffraction(XRD).RESULTS The solubility and dissolution of UA solid dispersions were significantly higher than those of the pure drug and physical mixtures.It was found that UA existed as amorphous or molecular state in solid dispersions.CONCLUSION The effects of HPMC and S40 as carriers of solid dispersions on enhancing the dissolution of UA in solid dispersions are better than F68 and S630.

目的 观察Exendin-4对2型糖尿病大鼠的空腹血糖(FBG)、糖化血清蛋白(GSP)、胃组织氧化应激、胃动力的影响.方法 雄性SD大鼠给予高脂高糖饲料加小剂量链脲佐菌素(STZ) (35 mg/kg)腹腔注射,制备2型糖尿病大鼠模型.随机分为正常对照组(NC组),正常干预组(NE组),糖尿病对照组(DC组),糖尿病干预组(DE组);NE及DE组给予Exendin-4(2μg/kg每日两次)皮下注射,50 d后四组进行核素胃排空检查,测定胃半排时间、排空速率.之后处死大鼠,取血清标本测定FBG、GSP;取胃组织制备组织匀浆,测定胃组织的一氧化氮(NO)、丙二醛(MDA)以及超氧化物歧化酶(SOD)的含量.结果 DC组与NC组相比,FBG(P ＜0.001)、GSP和MDA(P ＜0.01)水平升高,胃半排时间缩短、而排空速率加快(P＜0.05),NO及SOD(P ＜0.05)水平下降.DE组与DC组比较,FBG(P ＜0.001)、GSP和MDA(P ＜0.05)浓度降低,NO(P＜0.01)及SOD(P＜0.05)水平增加,胃半排时间加长、而排空速率减慢(P＜0.05).NC组与NE组比较无差异.多因素逐步回归分析显示与胃排空速率相关的依次为NO和FBG.结论 Exendin-4可以改善糖尿病大鼠的胃组织氧化应激、内皮损伤及胃动力异常.

Application of DLL in hydrological forecasting system can give full play to the specialty of multiple development languages.It improves the system developing efficiency and the running speed.It also enhances the system extensibility.The article analyzes how to create and test hydrological forecasting system with VB in detail.And it analyzes how to call DLL which is created by VB for hydrologic forecasting in ASP.NET.The programming and calling instances prove that it is effective to use DLL for hydrological forecasting.

The asymmetric synthesis of Danshensu borneol ester(1) was achieved.Intermediate(E)-3-(3,4-dibenzyloxyphenyl) acrylic acid(3) has been synthesized by taking 3,4-dihydroxybenzaldehyde as starting material,which was reacted with benzyl chloride and propandioic acid.Treatment of 3 with thionyl chloride and borneol to attain(E)-3-(3,4-dibenzyloxyphenyl) acrylic acid borneol ester(4) in the mild conditions.Then the asymmetric synthesis of chiral molecule 3-(3,4-dibenzyloxyphenyl)-2,3-dihydroxy propionic acid borneol ester(5) was achieved by Sharpless asymmetric dihydroxylation of 4 in excellent enantionmeric excesses.Finally,selective hydrogenation of 5 provides the desired product(1).The enantionmeric excesses(ee=97%) have been analysed by the chiral HPLC columns.The structure of products were characterized by 1H-NMR,13C-NMR and high-resolution MS techniques.The method contains the merits of easy manipulation and high enantioselectivity.

目的观察喜炎平注射液治疗毛细支气管炎的疗效。方法将124例毛细支气管炎患儿随机分为治疗组和对照组,每组62例。2组患儿均给予吸氧、止咳祛痰等常规治疗,治疗组加用喜炎平注射液静脉滴注,对照组加用利巴韦林注射液静脉滴注。观察2组患儿的症状和体征改善的时间及不良反应,比较2组疗效。结果治疗组总有效率(96.78%)明显高于对照组(77.42%),差异有统计学意义(P<0.01),且症状、体征改善时间明显缩短(Pa<0.01)。治疗组无不良反应发生,对照组1例出现白细胞减少,但停药后恢复正常。结论喜炎平注射液治疗小儿毛细支气管炎的疗效优于利巴韦林注射液。

目的:建立放射性损伤的小鼠血虚证模型,观察三康胶囊的药理作用.方法:选取昆明种小鼠随机分为正常对照组、模型组、阳性对照组及三康胶囊低、中、高剂量组.采用60C-γ射线照射的方法造成小鼠血虚证模型,分别观察给药后第14、21、28、60天外周血象以及骨髓细胞形态学改变,以此考察三康胶囊的疗效.结果:①低、中、高剂量三康胶囊给药后第14、21、28、60天对放射性损伤的小鼠血虚证所致的红细胞(RBC)、白细胞(WBC)、血小板(PLT)和血红蛋白(HB)降低均具有显著升高作用(P＜0.05或P＜0.01);②60天镜下观察可见:正常对照组小鼠骨髓增生极度活跃,巨核细胞、粒细胞、红细胞大小、形态正常;模型组有8例小鼠骨髓增生不良,退化细胞胞浆不完整,胞浆胞核溶解,涂片中有空泡;其余4例骨髓增生极度活跃,有大量的粒细胞(以中性杆状粒细胞、中性分叶核细胞为主),幼稚红细胞;各剂量给药组小鼠骨髓增生极度活跃,有粒细胞、晚幼粒细胞、中性杆状粒细胞、中性分叶核细胞及幼稚红细胞逐步增多;三康胶囊低、中、高剂量组分别有6、4、3例小鼠骨髓增生不良退化,细胞胞浆、胞核不完整逐步减少.阳性对照组小鼠骨髓增生极度活跃,有大量的粒细胞(以中性杆状粒细胞、中性分叶核细胞为主),幼稚红细胞;其中有3例小鼠骨髓增生不良,退化细胞胞浆、胞核不完整.结论:三康胶囊对放射性损伤的小鼠血虚证模型有一定的治疗作用.

The pump head of a super high pressure fracturing pump is selected as an object,the e-lastic finite element analysis of which is done with changing the yield strength of the material.Thus the in-herent relationships of the yield strength and bearing capacity is obtained.Then elastic-plastic finite ele-ment analysis of the autofrettaged procedure of the pump head is done.The results of finite element analy-sis are used to draw the conclusion that in order to improve autofrettage properties of the pump head,both yield strength of the material and autofrettaged inside pressure should be considered.

目的:应用放射性核素单光子发射断层显像技术胃排空测定法(SPECT)观察中药单体氢溴酸槟榔碱(ARE)对糖尿病胃轻瘫(DGP)大鼠胃动力的影响及可能的作用机制.方法:清洁级(SPF)♂ Wistar大鼠95只,随机分为正常对照组(n=20)、实验组(n=75).正常对照组以普通饲料喂养20 wk,实验组以高脂高糖饲料喂养6 wk后,小剂量链脲佐菌素(STZ)腹腔注射建立糖尿病模型,以高糖高脂饲料及饮食失节法继续诱导20 wk后,应用SPECT筛检出DGP大鼠模型,随机分为模型组、氢溴酸槟榔组(ARE)及红霉素组(ERY),而后进行药物尾静脉注射,前后再次测定胃排空.实验结束时各组大鼠空腹12 h(禁食不禁水)后采血用生物化学方法测定血脂、血糖.结果:正常对照组、DGP模型组胃半排空时间(GET1/2)分别为71.96 min±14.60 min、161.9 min±10.61 min,模型组GET1/2显著高于正常对照组,差异有统计学意义(P<0.05),ARE组大鼠治疗后GET1/2(165.8 min±18.30 min)缩短为99.6 min±16.60 min,ERY组大鼠治疗后GET1/2(164.1 min±20.71 min)缩短为133.3min±19.70 min,与本组治疗前比较均显著缩短,差异有统计学意义(P<0.05).ARE组GET1/2较ERY组缩短显著,组间比较差异有统计学意义(P<0.05),模型组治疗前后比较差异无统计学意义.实验结束时模型组大鼠空腹血糖(GLU)、三酰甘油(TC)较正常对照组明显升高,ARE组及ERY组治疗后TG较模型组下降,差异有统计学意义(P<0.05),GLU、TC、LDL-C均有下降趋势,差异无统计学意义.结论:ARE及ERY均可促进DGP大鼠的GET1/2,其中ARE的治疗效果优于ERY;给予ARE及ERY治疗后TG水平下降.

The FEM(Finite Element Analysis) program ANSYS was used to study the structural strength and the vibration modal of the high-speed rotational disk.The optimal data of the size and structure of the high-speed rotational disk are solved with the theory of optimization design.Letting the disk′s the size and structure be the design variables and the maximal Von Mises stress and the first mode be state variables,the standard deviations of Von Mises stresses be the objective function.The changes of stresses achieved the least degree.

The diamond bit selection is closely related to the rock property of the drilled formation. The rock property is the basis for targeted selection of the diamond bit. Therefore, based on elasticity theory, the diamond bit type can be selected according to well logging data. The theoretical basis for diamond bit type selection according to formation rock property is discussed and the methods for the type selection are summarized in this paper. Adopting Visual Basic 6.0, the software of the diamond bit selection was developed. The software adopts a three-step optimum seeking method. The first step is to ensure the purpose of the diamond bit; the second step is to guarantee the formation where the bit will be used; the third step is to use a comprehensive formula to calculate and obtain the bit of the minimum cost.

作为一个新上市的5α-2还原酶抑制剂,相应的临床研究还很不完善,有许多问题诸如服用爱普列特与PSA水平下降的量化关系、服用爱普列特的长期疗效和安全性以及毒副作用等都需要进一步研究.总体来讲,依据目前所能获得的研究资料,我们认为爱普列特可以显著地缩小前列腺体积,改善BPH患者症状,在这些方面与非那雄胺所取得的临床效果有良好的可比性,是一种较理想的治疗BPH的药物.

With the derrick,drill string and bit as a unified system,the dynamic model of the PDC bit was established,including the models of longitudinal vibration,lateral vibration,torsional vibration and the bit-wall collision model.By using Visual C 6.0,the model in the form of computer software was obtained by means of the object-oriented programming method.The examples prove that the calculations by the simulation software are consistent with the real working conditions of the PDC bit.The software can simulate the bit under different rock conditions and with different drilling parameters,study the working performance of different schemes in the drilling process and then compare them so as to optimize a better design scheme.

目的:探讨糖尿病胃轻瘫（DGP）大鼠血浆孤啡肽（OFQ）的变化与胃轻瘫的关系及意义.研究孤啡肽对DGP胃排空的作用.方法:SPF级雄性Wistar大鼠90只随机分为正常对照组（n=15）和实验组（n=75）.正常对照组以普通饲料喂养20wk,实验组以高脂高糖饲料喂养6wk后小剂量链脲佐菌素（STZ）腹腔注射加高糖高脂饲料及饮食失节法继续诱导20wk,建立糖尿病模型.应用放射性核素胃排空法筛检出DGP及糖尿病（DM）大鼠模型.采用酶联免疫法测定空腹血浆OFQ,而后将DGP再随机分为3组,分别给予OFQ0.6,6.0,60.0nmol/kg静脉注射,每日1次,连续5d,再次测定胃排空.结果:正常对照组、DM组及DGP组胃半排空时间（GET1/2）分别为（61.9±4.6）,（66.5±2.3）,（168.9±10.6）min,DGP组GET1/2较正常对照组、DM组显著延迟,差异有统计学意义（P＜0.05）.DGP组血浆OFQ较正常对照组、DM组显著降低,差异有统计学意义[（5.30±1.70）ng/Lvs（9.83±5.70）,（8.90±3.50）ng/L,P＜0.05].相关性分析显示,血浆OFQ水平与胃轻瘫之间呈负相关关系（r=-0.6726,P=0.004）.DGP大鼠静脉注射OFQ0.6,6.0,60.0nmol/kg后胃半排时间较前有明显缩短[（136±7）vs（166±8）min,（101±12）vs（162±11）min,（112±10）vs（158±12）min,P＜0.05],治疗前后差异有统计学意义（P＜0.05）,其中6.0nmol/kg的剂量已经接近或达到最大治疗效果,增加OFQ剂量并不能相应提高其治疗效果.结论:OFQ在DGP中起着重要的调节作用,与DGP胃半排时间呈负相关.静脉注射OFQ可以明显缩短DGP大鼠的GET1/2,其中6.0nmol/kg的剂量已经接近或达到最大治疗效果.

OBJECTIVE: To investigate the mechanism of the effects of Emodin on the gastric motility of type 2 diabetic rats. METHODS: Murine type 2 diabetes model was induced in rats by intravenous injection of a small dose of streptozotocin plus long-term high fat high caloric laboratory chow. Then the model rats were treated with Emodin(EMO), tegaserod (TEG) or domperidone(DOM) for 6 weeks, with control(NOR) and model(MOD) groups as comparison. Gastric emptying half time(GET1/2) and 90 min residual rate(RIH) were measured by single photon emission computed tomography(SPECT) be-fore sacrifice. The fasting blood glucose and serum insulin, riglycerides TG), total cholesterol(TC),high density lipoprotein-cholesterol(HDL-C) were determined by biochemical methods. Plasma and tissue levels of substance P(SP) and somatostatin(SS) were determined using radioimmunoassay. RESULTS: Gastric emptying in model group was significantly slower than in normal control group(P0.01), but were significantly sped up after treatment by Emodin, tegaserod or domperidone(P0.01 or P0.05). Plasma and intestine levels of SP were significantly increased while SS were significantly decreased after treatment by emodin, tegaserod or domperidone as compared with model group(P0.01 or P0.05). Serum TG and TC were significantly higher while HDL-C was lower in the model group and tegaserod or domperidone-treated group than those in normal group(P0.01), but serum TG, TC and HDL-C levels were regulated to normal in Emodin-treated group(P0.01). CONCLUSION: Emodin can promote the gastrointestinal motility in type 2 diabetic rats is possibly related to its ability to regulate the abnormal expression of gastrointestinal hormones.

目的 探讨早产儿脑室周围白质软化(PVL)的治疗措施.方法 PVL早产儿126例按家长意愿分为干预1组(57例)、干预2组(35例)和常规育儿组(34例).干预1组予脑细胞保护剂,接受常规育儿指导及早期干预治疗.干预2组接受常规育儿指导外,进行针灸及按摩传统中医治疗.常规育儿组只接受常规育儿指导.3组患儿均在纠正胎龄后3、9、12、24、30个月行智力检查.纠正胎龄9个月后行神经运动检查.结果 干预1组患儿智力发育及运动发育指数明显高于常规育儿组(Pa<0.05);与干预2组比较,智力发育指数明显提高(Pa<0.05),纠正胎龄9个月后运动发育指数无显著性差异(Pa0.05).3组间脑性瘫痪发病率比较均无显著差异(Pa0.05).结论 早期综合治疗早产儿PVL有一定疗效,可促进智力发育及运动发育,减少认知、行为缺陷,减轻运动障碍,但不能降低PVL脑性瘫痪发生率.

OBJECTIVE:To study the effects of modern decoction method vs. traditional decoction method on decoction rate and decoction quality. METHODS: The advantages and disadvantages were compared between the two decoction methods through analysis on the whole decoction process and the storage of the decoction before oral administration taking major components or active components as parameters. RESULTS: As compare with traditional decoction method, the modern decoction method had more advantages for in which the operation is standard, the contents of active components were high, and the quality control can be performed from many ways. CONCLUSION: The modern decoction method deserves to be popularized.

Objective To study the effect of combination of Fuzhengjiedu decoction and enteral nutrition in patients with esophageal carcinoma preoperative course. Methods 98 preoperative patients were randomly divided into two groups. 49 patients in control group were treated with enteral nutrition emulsion;the other 49 patients in treatment group were treated by combination of Fuzhengjiedu decoction and enteral nutrition emulsion. To evaluate the effect, T cell subset, the ordinary state, alimentary canal reaction of postoperation, the time of draining defecate , hospitalization expenses and time for both groups were observed. Results There were remarkable differences between two groups on CD3, CD4 and CD4/CD8 ratio at the first week of postoperation, especially at the second week (P0.01). There are some obviously improvement in ordinary state,symptoms of alimentary canal reaction of postoperation. The hospitalization expense in treatment group is lower than that in control group(P0.05). Conclusion The Enteral nutrition can significantly improve the nutritional status and immunocompetence, and reduce the occurrence of serious postoperation complication. So it is safe, effective and economical after esophageal carcinoma surgery.