2018年-2021年南阳市医院抗菌药物使用情况与常见细菌耐药性相关性分析

目的:探讨南阳市第一人民医院抗菌药物的使用情况及与常见的细菌耐药的相关性。方法:收集南阳市第一人民医院2018年1月至2021年12月临床患者送检的阳性标本,统计临床标本分离病原菌检出情况、常见抗菌药物消耗情况以及常见的革兰氏阴性杆菌、阳性球菌对抗菌药物产生的耐药率(%)与抗菌药物用药频度(Frequency of defined daily doses,DDDs)的相关性。结果:我院2018年至2021年抗菌药物DDDs较高的抗菌药物依次为美洛西林、头孢他啶、哌拉西林他唑巴坦,检出率较高的病原菌分别为大肠埃希氏菌、肺炎克雷伯菌、金黄色葡萄球菌等。大肠埃希菌产生的耐药率与哌拉西林他唑巴坦、头孢呋辛钠DDDs均有相关性(r=-0.107、0.432);肺炎克雷伯菌产生的耐药率与哌拉西林他唑巴坦、左氧氟沙星氯化钠、头孢呋辛钠DDDs呈正相关(r=0.410、0.720、0.420);铜绿假单胞菌与哌拉西林他唑巴坦、头孢哌酮舒巴坦钠DDDs呈正相关(r=0.716、0.933);金黄色葡萄球菌的耐药率与左氧氟沙星DDDs呈正相关(r=0.661);肺炎链球菌产生的耐药率与左氧氟沙星、头孢呋辛钠DDDs均存在正相关关系(r=0.416和0.482)。结论:抗菌药物的DDDs与常见细菌产生的耐药性具有一定的相关性,我院应严格控制抗菌药物的DDDs,根据感染性病种及药敏试验结果选择适当的抗菌药,加强常见病原菌的耐药监测。

Autophagy induced by glibenclamide serves as a defense against apoptosis in INS-1 rat insulinoma cells

Glibenclamide, a blocker of ATP-sensitive potassium channels, has been found to induce apoptosis in some cell types, including pancreatic beta-cells. Since autophagy plays doubleedged roles in pancreatic beta-cell survival, frequently through cross-talking with apoptosis, we investigated if glibenclamide induced autophagy in INS-1 rat insulinoma cells and the influence of autophagy on apoptosis. Mammalian target of rapamycin (mTOR) is a negative regulator of autophagy. As one of the substrates of mTOR, p70 S6 kinase (p70 S6K) is phosphorylated upon mTOR activation. Our results showed that glibenclamide induced an elevated protein level of the autophagy marker LC3-II, while decreasing phosphorylated p70 S6K, indicative of inhibition on mTOR signaling in INS-1 cells. Furthermore, inhibiting glibenclamide-induced autophagy via knocking down the autophagy essential gene Atg7 decreased cell viability and increased apoptosis in INS-1 cells. Our results indicate that glibenclamide induces autophagy in INS-1 cells, and that autophagy activation is exerting a protective activity against apoptosis.

结肠癌合并心房颤动继发下肢深静脉血栓形成患者抗凝治疗的药学实践

目的:探讨临床药师在1例结肠癌合并心房颤动(简称房颤)继发下肢深静脉血栓形成(DVT)患者抗凝治疗过程中的作用。方法:临床药师通过针对1例抗凝期间出现便血的结肠癌合并房颤继发下肢DVT患者的抗凝方案,查阅相关文献资料进行抗栓分析,根据患者的实际病情提出个体化用药建议。结果:患者下消化道出血和下肢DVT症状均得到有效控制,予以出院。结论:临床药师结合患者疾病具体进展情况,全程参与抗凝方案的制定并进行药学监护与跟踪随访,以确保临床用药的安全性和有效性。

Declined trends of chlorophyll a in the South China Sea over 2005–2019 from remote sensing reconstruction

Chlorophyll a concentration(CHL)is an important proxy of the marine ecological environment and phytoplankton production.Long-term trends in CHL of the South China Sea(SCS)reflect the changes in the ecosystem’s productivity and functionality in the regional carbon cycle.In this study,we applied a previously reconstructed 15-a(2005–2019)CHL product,which has a complete coverage at 4 km and daily resolutions,to analyze the long-term trends of CHL in the SCS.Quantile regression was used to elaborate on the long-term trends of high,median,and low CHL values,as an extended method of conventional linear regression.The results showed downward trends of the SCS CHL for the 75th,50th,and 25th quantile in the past 15 a,which were−0.0040 mg/(m^(3)·a)(−1.62%per year),−0.0023 mg/(m^(3)·a)(−1.10%per year),and−0.0019 mg/(m^(3)·a)(−1.01%per year).The negative trends in winter(November to March)were more prominent than those in summer(May to September).In terms of spatial distribution,the downward trend was more significant in regions with higher CHL.These led to a reduced standard deviation of CHL over time and space.We further explored the influence of various dynamic factors on CHL trends for the entire SCS and two typical systems(winter Luzon Strait(LZ)and summer Vietnam Upwelling System(SV))with single-variate linear regression and multivariate Random Forest analysis.The multivariate analysis suggested the CHL trend pattern can be best explained by the trends of wind speed and mixed-layer depth.The divergent importance of controlling factors for LZ and SV can explain the different CHL trends for the two systems.This study expanded our understanding of the long-term changes of CHL in the SCS and provided a reference for investigating changes in the marine ecosystem.

High sintering and dielectric performance:The improved(Mg,Zn)_(3)B_(2)O_(6) ceramics with the help of the DFT calculation

With the help of the first principle calculation,the solid-state reaction experiment was conducted to investigate the alteration in the sintering and the microwave dielectric properties of Mg_(3)B_(2)O_(6)ceramic with many Zn^(2+)substitutions.These properties were characterized using the scanning electron microscopy,network analyzer,X-ray diffraction,Raman spectroscopy,energy-dispersive spectroscopy,and thermomechanical and differential-thermal analyses.The coexistence of Mg_(3)B_(2)O_(6),Mg_(2)B_(2)O_(5)and ZnO ceramics could be observed with increasing Zn^(2+)addition,and the lattice distortion occurred in the Mg_(2)B_(2)O_(5)and Mg_(3)B_(2)O_(6)ceramics due to the substitution of Mg^(2+)with Zn^(2+).The electron density and the bond property of the MgO_(6)octahedron changed,and a quantitative method was used to discuss the variation in sintering,substitution and phase formation properties.The densification window was decreased to 1100℃,and the dielectric properties improved with the formation of a three-phase borate solid solution(dielectric constant=6.73,quality factor=112,000 GHz at 16 GHz(Q=7000),temperature coefficient of resonant frequency=-61.2 ppm℃^(-1),and relative density=97.0%).

On the Mechanical Analysis and Control for the Tension System of the Cylindrical Filament Winding

The constant winding tension can make the filament arranged in order. The stress distribution between the filament balance fully gives play to the enhancement of filament, and increases the intensive workload of the composite winding material. This paper conducts the mechanical analysis for the unwinding roller and tension measuring roller of the cylindrical winding machine so that gets the mechanical model, gives error compensation formula caused by the radius change of the yarn group in the unwinding side, designs the closed-loop control system and utilizes the dynamical- integral PID control strategy to achieve the tension control during the process of the cylindrical winding.

Total synthesis of bis-(2,3-dibromo-4,5-dihydroxyphenyl)-methane as potent PTP1B inhibitor

Protein tyrosine phosphatase 1B （PTP1B） plays an important role as a negative regulator and has been proved to be an effective target for the treatment of type 2 diabetes mellitus. Bis-（2,3-dibromo-4,5-dihydroxyphenyl）-methane 7 was first reported as a natural bromophenol with significant inhibition against PTP1B which was isolated from red algae Rhodomela conrervoides. Intrigued by its astonishing activity （IC50 = 2.4 μmol/L）, compound 7 was synthesized with the overall yield of 24% and evaluated for its PTPIB inhibitory activity compared with natural compound.

Simvastatin inhibits apoptosis of endothelial cells induced by sepsis through upregulating the expression of Bcl-2 and downregulating Bax

BACKGROUND: Many studies have showed that apoptosis of endothelial cells plays a curial role in the progress of sepsis. But the role of simvastatin in apoptosis of endothelial cells induced by sepsis is not clear. The present study aimed to investigate the role of simvastatin in apoptosis of endothelial cells induced by sepsis and its mechanism.METHODS: Human umbilical vein endothelial cells(HUVECs) were randomly divided into three groups: control group, sepsis serum intervention group(sepsis group) and simvastatin+sepsis serum intervention group(simvastatin group). After 24-hour incubation with corresponding culture medium, the relative growth rate of HUVECS in different groups was detected by MTT assay; the apoptosis of HUVECs was detected by Hoechst33258 assay and fl ow cytometry; and the expression of the Bcl-2 and Bax genes of HUVECs was detected by PCR.RESULTS: Compared with the sepsis group, HUVECs in the simvastatin group had a higher relative growth rate. Apoptotic HUVECs decreased significantly in the simvastatin group in comparison with the sepsis group. Expression of the Bcl-2 gene in HUVECs decreased obviously, but the expression of the Bax gene increased obviously after 24-hour incubation with sepsis serum; however, the expression of the Bcl-2 and Bax genes was just the opposite in the simvastatin group.CONCLUSIONS: Our study suggests that simvastatin can inhibit apoptosis of endothelial cells induced by sepsis through upregulating the expression of Bcl-2 and downregulating Bax. It may be one of the mechanisms for simvastatin to treat sepsis.

结合药物发放信息化的药物临床试验质量控制模式的建立及应用

目的:以试验药物发放作为质量控制时间点,建立结合信息化管理系统药物临床试验质量控制模式,研究其作用。方法:应用效果分析、对比的方法,对结合药物发放的信息化药物临床试验质量控制模式的应用进行可行性研究。结果:从药物临床试验药品管理风险出发,以试验药物发放为节点"固定"质控频次,运用药物临床试验管理系统进行"定期"质量控制,与以往质量控制模式比较,报告漏判、不良事件(AE)漏知、合并用药漏知发现率分别提高58.43%、10.19%、27.24%,加强了试验数据审核的及时性,减少了漏查、漏判、漏知的风险,增加了试验药物领用的方案符合性。结论:结合药物发放信息化的药物临床试验质量控制模式不仅保障了试验数据真实性、完整性、规范性,而且在新型冠状病毒疫情常态化下保障质控频次的同时减小了质控风险,全面提升了医院药物临床试验质量及管理水平。

Applying the disciplinary relation matrix to multidisciplinary design optimization modeling and solving

A new efficient coupling relationship description method has been developed to provide an automated and visualized way to multidisciplinary design optimization (MDO) modeling and solving. The disciplinary relation matrix (DRM) is proposed to describe the coupling relationship according to disciplinary input/output variables, and the MDO definition has been reformulated to adopt the new interfaces. Based on these, a universal MDO solving procedure is proposed to establish an automated and efficient way for MDO modeling and solving. Through a simple and convenient initial configuration, MDO problems can be solved using any of available MDO architectures with no further effort. Several examples are used to verify the proposed MDO modeling and solving process. Result shows that the DRM method has the ability to simplify and automate the MDO procedure, and the related MDO framework can evaluate the MDO problem automatically and efficiently.

Impact and risk factors of post-stroke bone fracture

Bone fracture occurs in stroke patients at different times during the recovery phase, prolonging recovery time and increasing medical costs. In this review, we discuss the potential risk factors for post-stroke bone fracture and preventive methods. Most post-stroke bone fractures occur in the lower extremities, indicating fragile bones are a risk factor. Motor changes, including posture, mobility, and balance post-stroke contribute to bone loss and thus increase risk of bone fracture. Bone mineral density is a useful indicator for bone resorption, useful to identify patients at risk of post-stroke bone fracture. Calcium supplementation was previously regarded as a useful treatment during physical rehabilitation. However, recent data suggests calcium supplementation has a negative impact on atherosclerotic conditions. Vitamin D intake may prevent osteoporosis and fractures in patients with stroke. Although drugs such as teriparatide show some benefits in preventing osteoporosis, additional clinical trials are needed to determine the most effective conditions for post-stroke applications.

前房内注射头孢呋辛预防超声乳化术后眼内炎的临床观察

目的:探讨前房内注射头孢呋辛对预防超声乳化术后眼内炎的临床效果。方法:回顾性研究2015-01/2018-06在我院接受超声乳化白内障手术患者3112例4210眼的临床资料,以2015-01/2017-04诊治的1810例2250眼患者为对照组,以2017-05/2018-07诊治的1302例1960眼患者为试验组。两组患者均行超声乳化联合Ⅰ期人工晶状体植入术。试验组术毕前房内注射头孢呋辛1mg/0. 1mL,对照组前房内未注射抗生素。术后随访1～8mo,观察两组患者的视力和感染性眼内炎发生情况。结果:对照组术后6mo内最佳矫正视力>1. 0者1 344眼,0. 5～0. 9者696眼,0. 1～0. 4者151眼,<0. 1者59眼;而试验组术后6mo内最佳矫正视力>1. 0者1 136眼,0. 5～0. 9者624眼,0. 1～0. 4者146眼,<0. 1者54眼。试验组术后6mo内未见眼内炎发生,对照组3例3眼(0. 13%)术后发生眼内炎,两组比较差异无统计学意义(P=0. 15)。对照组3例3眼眼内炎患者经全身联合眼局部治疗后治愈。试验组前房注药后均未见角膜内皮失代偿、视网膜毒性等药物相关毒性和过敏反应。结论:前房内注射头孢呋辛能有效预防超声乳化术后眼内炎的发生,安全有效。

传统猪场应对非洲猪瘟的生物安全升级改造

非洲猪瘟是由非洲猪瘟病毒引起的一种急性、烈性、高度接触性传染病,严重危害全球养猪业的发展。我国将其列为一类动物疫病,属于烈性外来疫病,其强毒力毒株对生猪致病率高,致死率为100%。2018年8月,中国首次报告非洲猪瘟疫情,截止目前内地所有省份均受到非洲猪瘟的影响[1]。非洲猪瘟作为养猪业的头号杀手,事关国民经济平稳运行和生猪产业持续健康发展。猪场因人员、猪只、物资、饲料等频繁出入,如果生物安全防控不理想,感染风险将极高。

Two new bromoindoles from red alga Laurencia similis

二新 bromoindole 碱从红水藻 Laurencia similis 的 ethanolic 摘录被孤立。根据化学、分光镜的方法(包括的 1D 和 2D NMR 技术) ，他们的结构作为 2,2 &#x2032 被阐明了；， 5,5 &#x2032；， 6,6 &#x2032； -sixibromo-3, 3 &#x2032； -bi-1H-indole 并且 3， 5-dibromo-1-methylindole 分别地。

Amelioration of sintering and multi-frequency dielectric properties of Mg_(3)B_(2)O_(6):A mechanism study of nickel substitution using DFT calculation

With the support of density functional theory(DFT)calculation,the amelioration of sintering and dielectric properties of the Mg_(3)B_(2)O_(6)(MBO)ceramic was realized through the substitution of magnesium with nickel.The TE-mode cylindrical cavity method was used to measure the dielectric properties at different frequencies.The thermo-mechanical analysis and simultaneous thermal analysis were used to characterize the chemical and mechanical properties.The phase composition was determined through the X-ray diffraction(XRD)and Raman spectrum.The microstructure was investigated using the scanning electron microscopy(SEM).Magnesium substitution with nickel(4 mol%)could ionize the B-0 bond of BO3,modify the vibration mode,improve the order degree,densify the microstmcture,decrease the intrinsic densification temperature,and ameliorate the dielectric properties of the MBO ceramics.The maximum values were achieved for the ceramics with 4 mol%nickel and sintered at 1175℃,that is,97.2%for relative density,72,600 GHz(10 GHz),75,600 GHz(11.4 GHz),and 92,200 GHz(15 GHz)for Q×f,7.1(10 GHz),7.01(11.4 GHz),and 6.91(15 GHz)for£r,and-56.3 ppm/℃ for if.

Digitizing the thermal and hydrological parameters of land surface in subtropical China using AMSR-E brightness temperatures

Digitizing the land surface temperature(T_(s))and surface soil moisture(m _(v))is essential for developing the intelligent Digital Earth.Here,we developed a two parameter physical-based passive microwave remote sensing model for jointly retrieving T_(s) and m_(v) using the dual-polarized T_(b) of Aqua satellite advanced microwave scanning radiometer(AMSR-E)C-band(6.9 GHz)based on the simplified radiative transfer equation.Validation using in situ T_(s) and m_(v) in southern China showed the average root mean square errors(RMSE)of T s and m_(v) retrievals reach 2.42 K(R^(2)=0.61,n=351)and 0.025 g cm^(−3)(R^(2)=0.68,n=663),respectively.The results were also validated using global in situ T_(s)(n=2362)and m_(v)(n=1657)of International Soil Moisture Network.The corresponding RMSE are 3.44 k(R 2=0.86)and 0.039 g cm^(−3)(R^(2)=0.83),respectively.The monthly variations of model-derived Ts and mv are highly consistent with those of the Moderate Resolution Imaging Spectroradiometer T_(s)(R^(2)=0.57;RMSE=2.91 k)and ECV_SM m_(v)(R^(2)=0.51;RMSE=0.045 g cm^(−3)),respectively.Overall,this paper indicates an effective way to jointly modeling T_(s) and m_(v) using passive microwave remote sensing.

Numerical analysis of a double interlocking padded finger seal performance based on thermo-fluid-structure coupling method

Non-contacting finger seals represent an advanced non-contacting and compliant seal in gas turbine sealing technology.This paper proposes a new structure of noncontacting finger seals with double interlocking pads.The numerical analysis model based on the thermo-fluid-structure coupling method for the new type finger seal was established.The influence of working conditions on leakage of the seal was studied and compared with the single padded non-contacting finger seal.The results show that the interface between the bottom of the finger pad and rotor surface is the main leakage path that forms the gas film with obvious variations of pressure and flow velocity.Under high temperature and high pressure operating conditions,the hydrodynamic effect of the gas film is enhanced,and lifting force is significantly improved.The deformation of fingers is composed of elastic deformation and thermal deformation.At room temperature,the deformation of fingers is mainly elastic deformation and points to the center of the rotor,which reduces the gas film clearance.The deformation of fingers at high temperature and high pressure creates a circumferentially convergent gap between the bottom of the pad and the rotor,which is beneficial to improve the loading capacity and to reduce leakage of the seal.Compared with the typical single padded noncontacting finger seal,the double interlocking padded finger seal proposed in this paper reduces the leakage factor by about 37%,which provides an advanced seal concept with the potential to improve sealing performance under high temperature and high pressure working conditions.

碳青霉烯类抗菌药物及替加环素的临床应用管理及成效分析

目的加强对南阳市第一人民医院碳青霉烯类抗菌药物及替加环素的临床应用管理,分析评价其管理成效。方法分析2016年1月1日—2018年6月30日医院对碳青霉烯类抗菌药物及替加环素使用管理前后出院患者抗菌药物使用率、患者平均住院日、人均抗菌药物费用、所占费用比例、各品种销售金额比例和微生物送检率等的变化情况。结果加强管理前后总抗菌药物使用率和碳青霉烯类药物使用率分别由54.12%,1.69%明显降至50.44%,1.30%(P<0.05);加强管理后患者人均抗菌药物费用为1 095.75元,较加强管理前的1 190.83元有明显下降(P<0.05);碳青霉烯类及替加环素费用占总药品费用和总治疗费用比例分别由加强管理前的2.09%,0.84%降至1.81%,0.66%(P<0.05);加强管理后总治疗性抗菌药物、特殊使用级抗菌药物、碳青霉烯类及替加环素微生物送检率由管理前的32.03%,81.34%和85.31%分别提高至36.17%,85.99%和92.95%(P<0.05)。结论通过对碳青霉烯类抗菌药物及替加环素使用的综合干预措施可显著降低此类药物的使用率和人均抗菌药物费用,有效提高微生物标本送检率,且平均住院日无明显变化。

2016—2018年南阳市第一人民医院特殊使用级抗菌药物的使用情况分析

目的对2016-2018年南阳市第一人民医院住院患者特殊使用级抗菌药物的使用情况进行分析,为规范科室合理使用提供管理思路。方法对南阳市第一人民医院特殊使用级抗菌药物的使用率、销售金额、用药频度(DDDs)、使用强度(AUD)和科室分布等指标进行回顾性分析。结果 2016-2018年,特殊使用级抗菌药物的平均使用率为2.73%,美罗培南的销售金额始终处于首位。DDDs和AUD排名前3位的均为美罗培南、替考拉宁、盐酸头孢吡肟,呼吸内科、儿科和呼吸重症监护科的使用数量较多。结论南阳市第一人民医院特殊使用级抗菌药物的使用频度过高,临床药师应积极参与进行针对性的管理。

Low-temperature sintering and microwave dielectric properties of CaMg1−xLi2xSi2O6(x=0−0.3)ceramics

In this study, low-temperature fired CaMg1−xLi2xSi2O6 microwave dielectric ceramics were prepared via the traditional solid-state reaction method. In this process, 0.4 wt% Li2CO3-B2O3-SiO2-CaCO3-Al2O3 (LBSCA) glass was added as a sintering aid. The results showed that ceramics consisted of CaMgSi2O6 as the main phase. The second phases were CaSiO3 always existing and Li2SiO3 occurring at substitution content x > 0.05. Li+ substitution effectively lowered sintering temperature due to 0.4 wt% LBSCA and contributed to grain densification, and the most homogeneous morphology could be observed at x = 0.05. The effects of relative density, the second phase, and ionic polarizability on dielectric constant (εr) were investigated. The quality factor (Q × f) varied with packing fraction that concerned the second phase. Moreover, the temperature coefficient of the resonant frequency (τf) was influenced by MgO6 octahedral distortion and bond valence. Excellent dielectric properties of the CaMg1−xLi2xSi2O6 ceramic was exhibited at x = 0.05 with εr = 7.44, Q × f = 41,017 GHz (f = 15.1638 GHz), and τf = −59.3 ppm/°C when sintered at 900 °C. It had a good application prospect in the field of low-temperature co-fired ceramic (LTCC) substrate and devices.