多普勒超声联合血清FE3、ACTA预测孕妇羊水过少并胎儿窘迫

选取224例羊水过少孕妇作为观察组,60例羊水正常孕妇作为对照组,探讨多普勒超声测定肾动脉(RA)、大脑中动脉(MCA)、脐动脉(UA)阻力指数,以及血清游离雌三醇(FE3)、激活素A(ACTA)水平,对孕妇羊水过少并胎儿窘迫预测价值及临床意义。结果显示,观察组RA和UA阻力指数、血清ACTA水平高于对照组,羊水量、MCA阻力指数及血清FE3水平低于对照组(P<0.05);羊水过少孕妇RA和UA阻力指数、血清ACTA水平与羊水量呈负相关,MCA阻力指数、血清FE3水平与羊水量呈正相关;上述指标联合预测胎儿窘迫的AUC最大,为0.918(P<0.05)。说明多普勒超声测定RA、MCA、UA阻力指数结合血清FE3、ACTA水平检测对羊水过少孕妇并胎儿窘迫有较高预测价值。     

产前胎儿超声心动图在先天性心脏病产前诊断中的应用价值

本研究探讨了产前胎儿超声心动图在先天性心脏病产前诊断中的应用价值,选取3000例孕妇作为研究对象,均于孕20~24周接受胎儿超声心动图和普通彩色多普勒超声检查。以妊娠结局为参照,分析了产前胎儿超声心动图检查和普通彩色多普勒超声诊断先天性心脏病的敏感性、特异性和准确度,并比较了不同检查切面对先天性心脏病的产前诊断率。结果表明,产前胎儿超声心动图诊断先天性心脏病的敏感度、特异度、准确度显著优于普通彩色多普勒超声(P<0.05);四腔心显示胎儿心脏畸形率显著高于其他切面(P<0.05)。综上所述,产前胎儿超声心动图对先天性心脏病产前的诊断效能较高,诊断结果明确,可显著减少先天性心脏病的漏诊率。     

彩超参数MCA、UA联合胎心监护预测胎儿宫内缺氧的模型分析

本文探讨了胎儿大脑中动脉(MCA)、脐动脉(UA)的彩超参数联合胎心监护对胎儿宫内缺氧的预测价值。选取孕妇400例,根据有无胎儿宫内缺氧分为病例组(72例)和对照组(328例),比较了两组的MCA与UA阻力指标比值(MCA/UA),包括阻力指数(RI)、搏动指数(PI)以及收缩期峰值流速与舒张末期血流速度比值(S/D),分析各参数对胎儿宫内缺氧的评估价值。结果显示,病例组MCA的RI、PI、S/D小于对照组,而UA的RI、PI、S/D高于对照组,且病例组MCA/UA各参数值均低于对照组(P0.05)。胎心监护提示病例组胎心异常率显著高于对照组(P0.05)。ROC曲线提示MCA/UA的RI预测胎儿宫内缺氧的曲线下面积为0.628,PI的曲线下面积为0.661,S/D的曲线下面积为0.598。胎心监护评估胎儿宫内缺氧与临床诊断的一致性Kappa检验值为0.661,彩超联合胎心监护评估的一致性Kappa检验值为0.798。将彩超参数MCA、UA与胎心监护联合用于胎儿宫内缺氧的预测,能提高评估准确性,便于尽早采取处理措施。     

彩色多普勒超声测量胎儿脐动脉、大脑中动脉和主动脉弓峡部血流参数诊断孕晚期胎儿生长受限

为分析孕晚期生长受限(FGR)胎儿脐动脉、大脑中动脉和主动脉弓峡部彩色多普勒超声血流参数变化及其对FGR的诊断价值,选取2018年5月～2019年3月于我院产检且确诊为FGR的孕晚期(孕周34～36周)孕妇51例作为观察组,另选取同期正常妊娠的孕晚期(孕周34～36周)孕妇47例作为对照组。采用GE voluson E8彩色多普勒超声诊断仪测量并比较两组胎儿脐动脉和大脑中动脉以及主动脉弓峡部的多个血流参数,如搏动指数(PI)、阻力指数(RI)、收缩期末流速(PSV)、收缩期末反流流速(ESRV)、舒张期末流速(EDV)和PSV/EDV(S/D)等。测量结果发现,观察组胎儿脐动脉PI、RI、S/D及主动脉弓峡部ESRV水平均高于对照组,大脑中动脉PI、RI及主动脉弓峡部PSV/ESRV水平均低于对照组,差异均有统计学意义(P0.05);两组胎儿大脑中动脉、主动脉弓峡部PSV水平比较差异均无统计学意义(P0.05)。本研究证实孕晚期FGR胎儿脐动脉、大脑中动脉和主动脉弓峡部彩色多普勒超声血流参数均发生了一定变化,其中脐动脉和大脑中动脉PI、RI、S/D及主动脉弓峡部ESRV、PSV/ESRV均可作为诊断FGR的敏感指标。     

经颅彩色多普勒超声血流参数对短暂性脑缺血发作患者颈动脉狭窄的诊断价值

为探讨经颅彩色多普勒超声(TCCS)血流参数对短暂性脑缺血发作(TIA)患者颈动脉狭窄的诊断价值,本研究选取TIA患者作为研究组,同期健康者为对照组,两组均给予DSA检查和TCCS检查,比较TCCS血流参数。以DSA检查结果为金标准,分析TCCS血流参数对颈动脉狭窄的诊断效能。结果显示,研究组颈动脉狭窄阳性侧收缩期峰值流速(PSV)、舒张末期流速(EDV)、平均流速(MFV)、搏动指数(PI)、阻力指数(RI)均高于阴性侧和对照组(P0.05)。受试者工作特征曲线(ROC)分析结果显示,TCCS血流参数诊断颈动脉轻度狭窄、中度狭窄、重度狭窄的最佳截断点分别为PSV≥110 cm/s或MFV≥65 cm/s、PSV≥145 cm/s或MFV≥85 cm/s、PSV≥190 cm/s或MFV≥115 cm/s。最佳截断点TCCS血流参数诊断颈动脉轻度狭窄、中度狭窄、重度狭窄的符合率与DSA检查结果一致性良好(Kappa=0.875,P=0.000)。因此,TCCS血流参数可有效监测TIA患者血流动力学变化,对颈动脉狭窄具有较高的诊断价值。     

高危妊娠晚期胎儿脐动脉、大脑中动脉血流多普勒参数变化与不良妊娠结局的关系

为探讨高危妊娠晚期胎儿脐动脉、大脑中动脉血流动力学多普勒参数变化及与不良妊娠结局的关系,本研究选取2018年1月～2019年1月于我院行产前检查的高危妊娠孕妇(孕周34～36周)100例,另选取同期相同孕周的正常妊娠孕妇100例作为对照组。采用GE voluson E8彩色多普勒超声诊断仪测量并比较两组胎儿脐动脉搏动指数(PI)、阻力指数(RI)、收缩期末峰值/舒张期末峰值(S/D)值,统计两组孕妇妊娠结局,分析多普勒参数变化与不良妊娠结局的关系。结果显示,高危妊娠组中妊娠结局异常率42.00%,明显高于对照组的5.00%(P0.05)。高危妊娠组胎儿脐动脉血流参数PI、RI及S/D值均明显高于对照组(P0.05);而胎儿大脑中动脉血流参数PI、RI及S/D值均明显低于对照组(P0.05)。高危妊娠结局异常组胎儿脐动脉血流参数PI、RI及S/D值均明显高于妊娠结局正常组(P0.05);而胎儿大脑中动脉血流参数PI、RI及S/D值均明显低于妊娠结局正常组(P0.05)。结果表明,高危妊娠晚期胎儿脐动脉、大脑中动脉血流多普勒参数变化对判断胎儿宫内状况、预测不良妊娠结局均具有一定的临床意义。     

超声心动图诊断胎儿先心病及危险因素分析

本研究探讨超声心动图在胎儿先心病诊断中的价值以及影响先心病发病的危险因素。采用回顾性研究方法,选取孕产妇18987例,均进行系统的彩色多普勒超声检查,同时问卷调查胎儿先心病家庭65例(病例组)及130例正常胎儿家庭(对照组)的病史等情况。结果显示,先心病发病率为0.43%,疾病类型中:以单纯性室间隔缺损、心内膜垫缺损和右心室双出口为主;Logistic回归分析结果显示:产妇年龄、孕期有致畸物接触史、产妇糖尿病、产妇结缔病、不良妊娠史、染色体异常、胎儿早期NT值、先心病家族史是先心病发生的影响因素(P<0.05)。从上述结果可知,超声心动图在胎儿先心病诊断中有较好的价值,先心病发病受产妇年龄、致畸物接触史等因素的影响。     

心脏彩超对AECOPD并发肺栓塞的评估价值

本文探讨心脏彩超评估慢性阻塞性肺疾病急性加重(AECOPD)合并急性肺栓塞的价值。选取AECOPD合并急性肺栓塞患者65例作为观察组,同时选取单纯AECOPD患者130例作为对照组。结果显示,观察组肺动脉内径(PA)、右室内径(RV)、右房内径(RA)和舒张晚期峰值速度(Am)明显高于对照组(P<0.05),而肺动脉瓣口流速(PV)、舒张早期峰值速度(Em)明显低于对照组(P<0.05);观察组预后不良患者PA、RV、RA明显高于预后良好患者(P<0.05),而PV明显低于预后良好患者(P<0.05);PA、RV、RA和PV预测预后不良的ROC曲线下面积较优。心血管参数与AECOPD并发肺栓塞患者病情程度、预后有关,在预测预后方面有一定价值。     

彩色多普勒超声联合Fibroscan评分系统在慢性乙肝纤维化诊断中的应用研究

本研究探讨了彩色多普勒超声联合Fibroscan评分系统在慢性乙肝纤维化诊断中的应用价值。选取行超声引导下肝穿刺活检的慢性乙肝患者300例,其中235例有肝纤维化(观察组)和65例无肝纤维化(对照组),统计分析了这两组患者和不同肝纤维化分期患者的彩色多普勒超声参数[门静脉主干内径(mPVD)、脾静脉内径(SVD)、门静脉血流量(mPBF)、门静脉主干平均血流速度(mPVm)、门静脉淤血指数(CI)、脾静脉平均血流速度(sVm)、脾静脉血流量(sVBF)]和肝脏硬度值(LSM)。结果显示,各参数联合诊断CHB肝纤维化的AUC最高,为0.876(P<0.05);SVD、mPVD、CI、LSM与肝纤维化分期呈正相关,mPVm与肝纤维化分期呈负相关(P<0.05);LSM诊断肝纤维化分期的AUC最大(P<0.05)。可见采用彩色多普勒超声与FibroScan定向瞬时弹性成像系统检测SVD、mPVD、CI、mPVm、LSM参数可诊断CHB肝纤维化,且各参数均与肝纤维化程度密切相关,有望成为评估肝纤维化及严重程度的无创性检测方法。     

彩色多普勒超声在浅表软组织肿块诊断中的应用分析

本研究探讨彩色多普勒超声在浅表软组织肿块诊断中的应用价值。选取浅表组织肿块患者210例,其中良性病变患者172例,恶性病变患者38例,给予彩色多普勒超声检查。结果显示,恶性病变形态不规则、内部不均匀低回声、边界模糊、内部血流丰富比例明显高于良性病变(P<0.05);恶性病变病灶收缩期峰值流速(Vmax)和阻力指数(RI)明显高于良性病变(P<0.05),病灶最大长径/最大短径(L/S)明显低于良性病变(P<0.05);年龄、形态、内部回声、边界、内部血流、Vmax和RI建立Logistic回归方程,其诊断恶性病变的ROC曲线下面积为0.910(P<0.05),灵敏性和特异性达到84.00%和96.00%。可见彩色多普勒超声在浅表软组织肿块良恶性诊断中有较好的应用价值。     

超声心动图结合心电图在鉴别扩张性和缺血性心肌病中的应用

本文对超声心动图（UCG）结合心电图（ECG）在鉴别扩张性心肌病（DCM）和缺血性心肌病（ICM）中的应用价值进行了分析。研究对象为回顾性选取2015年12月~2018年12月本院DCM组和ICM组患者各80例,两组均给予UCG和ECG检查并分析比较其表现。结果显示,DCM组室壁节段性运动障碍、左室心尖圆而薄、左室圆拱门形、室壁矛盾运动发生率明显低于ICM组,DCM组弥漫性室壁运动障碍、左室球形发生率明显高于ICM组,差异有统计学意义（P<0.05）;DCM组左心房内径、左心室舒张期内径、左心室收缩期内径、右心室内径、二尖瓣E点至室间隔间距、E/A、RV6、RV6/RMAX明显高于ICM组,DCM组主动脉、左心室射血分数、每搏量明显低于ICM组,差异有统计学意义（P<0.05）;DCM组主动脉瓣、二尖瓣、三尖瓣反流程度明显高于ICM组,差异有统计学意义（P<0.05）;四格表法结果显示,UCG结合ECG鉴别DCM和ICM的敏感度、特异度、准确度为97.50%、96.25%和96.88%,与实际结果基本相同,差异无统计学意义（P>0.05）。本文证实了UCG结合ECG监测可为鉴别DCM和ICM提供重要的参考依据,可作为鉴别DCM和ICM的重要手段。     

Simultaneous determination of magnesium lithospermate B, rosmarinic acid, and lithospermic acid in beagle dog serum by liquid chromatography/tandem mass spectrometry

A rapid, sensitive and specific isocratic liquid chromatography/tandem mass spectrometry (LC/MS/MS) method was developed for the simultaneous quantitative determination of magnesium lithospermate B (MLB), rosmarinic acid (RA), and lithospermic acid (LA) in beagle dog serum, with silibinin as internal standard. The serum samples were treated by liquid-liquid extraction and analyzed using LC/MS/MS with a TurboIonSpray source. A short run-time (3 min) fulfilled the need for monitoring serum levels of MLB, RA, and LA in large-scale studies. The calibration curves for MLB, RA, and LA were linear over the ranges 8-2048, 4-1024, and 4-1024 ng/mL, respectively, with coefficients of correlation >0.999. The intra- and inter-day precision (CV) of analysis was <10%, and accuracy ranged from 90-104%. This quantitation method was successfully applied to a pharmacokinetic study of salvianolate administrated by intravenous infusion with dosage of 6 mg/kg in beagle dogs.     

Introducing Mutations to Modify the C13/C9 Ratio in Linoleic Acid Oxygenations Catalyzed by Rabbit 15‐Lipoxygenase: A QM/MM and MD Study

Lipoxygenases (LOs) are a family of nonheme iron‐containing enzymes that catalyze the hydroperoxidation of several polyunsaturated fatty acids with a huge regio‐ and stereospecificity. Mammalian 15‐LO‐1 yields almost exclusively oxygenation at the C13 position of the linoleic acid (LA), its preferred substrate. This is very important because metabolites derived from oxidation in distinct positions produce opposite physiological effects. We have combined here quantum mechanics/molecular mechanics calculations with molecular dynamics simulations to show how a suitable mutation of the rabbit 15‐LO‐1 enzyme can produce a significant amount of products derived from oxygenation at the C9 position of LA. In effect, the Leu597Val or Leu597Ala mutants are predicted to lead to a diminution of the oxygenation C13/C9 ratio in LA as huge as five orders of magnitude. This shows that the conserved residue Leu597 actually drives the regiospecific hydroperoxidation of LA catalyzed by 15‐LO‐1 enzyme.     

Electron spin resonance studies of dipalmitoylphosphatidylcholine liposomes containing soybean-derived sterylglucoside

The effects of soybean-derived sterylglucoside (SG) on the fluidity of liposomal membrane composed of dipalmitoylphosphatidylcholine (DPPC) were investigated compared with those of soybean-derived sterol (SS) and cholesterol (Ch) using an electron spin resonance spectrometer. Three kinds of liposomes were prepared in the molar ratio of DPPC/X=7/4, where X is SS, Ch or SG. The fluidity close to the polar head groups increased with an increase of temperature in the DPPC membrane containing SS, Ch and SG in the range 35 to 45 degrees C. Those near the hydrophobic end changed with an increase in temperature in liposomes containing SS, Ch and SG, which had a fluidizing effect on the DPPC membrane below the transition temperature (Tm, 41.9 degrees C) and a condensing effect over the Tm. The fluidizing effects of these compounds around 37 degrees C near the polar head group and the hydrophobic end increased in the following order: Ch < SG < or = SS and SS < Ch < SG, respectively. SG increased the fluidity of liposomal membrane dramatically above the Tm (35.4 degrees C). These results suggest that the high fluidity close to the hydrophobic end of the liposomal membranes around 37 degrees C, the decrease of Tm, and the sigmoidal nature of fluidity vs. temperature are important factors in the effectiveness of liposomes containing SG as a carrier of drugs.     

Physical nature of the chemical bond II. Valence atomic orbital and energy partitioning studies of linear nitriles

The valence atomic orbitals (VAO 's) of several linear nitriles are determined using non-empirical SCF –LCAO –MO wave functions expanded in a minimal (CN^?, HCN, FCN, C₂N₂), double-zeta (CN^?, HCN), or double-zeta + polarization (HCN) basis of Slater atomic orbitals (AO 's). The molecular energy of each system (except the double-zeta + polarization HCN system) is partitioned according to the procedure of Ruedenberg to obtain numerical values of nitrile C and N atomic and C?N bond components of the energy. In addition, the nitrile results are compared with minimal AO basis results obtained previously by other authors for homonuclear diatomics, diatomic hydrides and H₂O. The numerical data are used to test the internal self-consistency of the various definitions entering the partitioning method, i.e. whether or not analogous quantities assume similar values in chemically similar situations. The analysis of nitrile SCF –MO wave functions in terms of the set of VAO 's characteristic of the system under consideration is shown to be a promising approach to the problem of extracting useful information from the wave functions. In general, numerical results for the nitrile systems studied are fairly consistent with the concepts on which the partitioning method is based: promotion, quasi-classical interaction, sharing penetration, sharing interference and charge transfer. However, the VAO expansions for several energy components need to be investigated further and possibly revised.     

Selectively increasing of polyunsaturated (18:2) and monounsaturated (18:1) fatty acids in Jatropha curcas seed oil by crystallization using D-optimal design

ABSTRACT: BACKGROUND: This study was done to obtain concentrated polyunsaturated fatty acid (PUFA) linoleic acid (LA; 18:2) and monounsaturated fatty acid (MUFA) oleic acid (OA; 18:1) from Jatropha curcas seed oil by urea complexation. Urea complexation is a method used by researchers to separate fatty acids (FAs) based on their molecular structure. Effects the ratio of urea-to-FAs, crystallization temperature and crystallization time on the final products of urea complexation were examined. D-optimal Design was employed to study the significance of these factors and the optimum conditions for the technique were predicted and verified. RESULTS: Optimum conditions of the experiment to obtain maximum concentration of LA were predicted at urea-to-FAs ratio (w/w) of 5:1, crystallization temperature of 10 C and 24 h of crystallization time. Under these conditions, the final non-urea complex fraction (NUCF) was predicted to contain 92.81% of LA with the NUCF yield of 7.8%. The highest percentage of OA (56.14%) was observed for samples treated with 3:1 urea-to-FAs ratio (w/w) at 10 C for 16 h. The lowest percentage of LA (8.84%) was incorporated into urea complex fraction (UCF) with 1:1 urea-to-FAs ratio (w/w) at 10 C for 8 h. CONCLUSIONS: The separation of PUFA (LA) and MUFA (OA) described here. Experimental variables should be carefully controlled in order to recover a maximum content of PUFA and MUFA of interest with reasonable yield% with a desirable purity of fatty acid of interest.     

中心静脉导管闭式引流胸腔积液在基层医院临床应用研究

目的探讨在基层医院临床中中心静脉导管闭式引流胸腔积液的应用。方法从68例胸腔积液患者中选取55例渗出性积液患者作为研究的对象,采用计算机表法的形式将其分为28例引流组(行引流治疗)和27例常规组(行传统胸腔穿刺抽液术),对两组患者的治疗效果、住院时间以及不良反应发生情况进行指标的记录和对比。结果行引流治疗的引流组其各项指标均优于行常规治疗的27例患者,两组数据对比呈现为P0.05,表明有统计学意义。结论在基层医院中,将中心静脉置管引流胸水应用其中,具有良好的经济以及实用价值,这对于基层医院的临床研究具有重要意义。