小儿沙门菌感染临床特点及耐药性分析

目的探讨儿童沙门菌感染的临床特点和耐药情况,为临床诊疗提供帮助。方法收集2013～2017年经粪便培养出沙门菌阳性的163例住院患儿的临床特征、沙门菌血清型分布情况及药敏试验结果,并进行回顾性分析。结果 163例沙门菌阳性患儿中,≤1岁患儿79例(48.5%);临床表现以发热、腹泻为主,体温>39℃达121例(74.2%),腹泻超过10次/d有52例(31.9%),且合并呼吸道感染多见,共56例(34.4%);沙门菌感染好发于夏秋季,5～10月共检出131例(80.4%)。血清分型以鼠伤寒沙门菌、肠炎沙门菌为主,分别为100例(61.3%)、15例(9.2%);不同血清型沙门菌对头孢噻肟耐药率均在20%以上,对β内酰胺酶抑制剂(阿莫西林/克拉维酸、哌拉西林/他唑巴坦)敏感性较高,尚未出现对碳青霉烯类(亚胺培南)耐药株。结论≤1岁婴儿夏秋季易感染沙门菌,常见血清型为鼠伤寒沙门菌;临床表现以发热、腹泻为主,合并呼吸道感染多见;沙门菌对三代头孢菌素类的耐药率有所增加,临床治疗应根据药敏试验结果合理使用抗菌药物。厦门市青年创新创业人才项目(2015-A-03

Risk factors of gastrointestinal bleeding with dabigatran etexilate for stroke prevention in atrial fibrillation patients and its preventive strategies

新型口服直接凝血酶抑制剂达比加群酯预防卒中疗效确切,但消化道出血风险不容小视。本文结合近5年达比加群酯用于预防心房颤动患者脑卒中时致消化道出血的临床随机试验和详细个案报道,对达比加群酯致消化道出血的可能危险因素、预防达比加群酯致消化道出血的措施等作一综述。临床医师应权衡应用达比加群酯的利弊,保证治疗的安全、有效。Dabigatran etexilate, a new direct thrombin inhibitor, has precise clinical curative effect on reducing the risk of stroke in patients with atrial fibrillation, but the risk for major gastrointestinal bleeding is significant. This paper reviewed risk factors and preventive strategies of gastrointestinal bleeding with dabigatran etexilate for stroke in atrial fibrillation patients according to randomized trials and case reports in recent five years. Clinician should balance the risk of bleeding with treatment outcome of dabigatran etexilate to ensure the effectiveness and safety of treatment

尼美舒利胶囊致体温过低1例

患者男,18岁,体重70 kg,既往体健,因“咳嗽、咽痛伴畏寒、发热4 d“为主诉于2015年1月25日就诊。既往史无特殊,无药物、食物过敏史。入院体检:T 40.2℃,P 82次/MIn,r 20次/MIn,bP 112/60 MM Hg。神志清楚,对答切题。口唇红润,伸舌居中,口腔黏膜无异常,双侧扁桃体Ⅱ度肿大,表面可见散在脓点,见白色分泌物,咽部后壁充血水肿,见淋巴滤泡,咽反射正常,余未见明显异常。血常规:WbC 14.99x109·l-1,n 76.4%,Hb 141 g·l-1,PlT 231x109·l-1;C反应

确保馆藏信息交流与转换的一致性—— 美国馆藏说明标准述评

美国馆藏说明标准历经近40年的发展，发展较为成熟且修订经验丰富，但其发展过程并非一帆风顺，历经新旧标准的更迭、 两个标准的统一、标准的多次修订及再确认这样一个复杂漫长的过程。拟以美国馆藏说明标准原始文本为基础，结合翻译过程中的扩展研究与思考，从美国馆藏说明标准的发展历史、主要内容和特点、与其他标准之间的关系及数据项和数据元四个方面进行系统的梳理与分析，以期为我国馆藏说明标准的完善提供有益参考。国家社科基金项目“中美电子资源国家标准比较研究”(项目编号:16BTQ027)研究成果之

3种B族链球菌筛查方法在孕晚期筛查中的应用

目的比较3种B族链球菌(GBS)的筛查方法在孕晚期孕妇GBS筛查中的临床应用价值。方法收集2017年9月至12月在厦门市妇幼保健院产科门诊产检的35～37孕周孕妇阴道/直肠拭子样本1 027例,用GBS运送增菌...厦门市第二批青年创新创业人才项目(2015-A-03

我国高校涉密学位论文的管理现状与思考

随着高校科研创新能力的增强,涉密学位论文的数量有日渐增长的趋势。然而我国目前部分高校对涉密学位论文重视不够,尚未形成系统的管理细则,具体管理也不甚规范,这些都为高校知识产权问题埋下了隐患。因此,科学界定涉密学位论文的范围、完善涉密学位论文的提交、评审和答辩流程,加强对涉密学位论文保存的管理,是高校在知识产权时代的必然选择

口服非甾体类抗炎药的使用分析

目的了解医院口服非甾体类抗炎药（NSAIDs）的使用情况及用药趋势,为临床合理用药提供一定的参考依据。方法对2011-2015年解放军第175医院口服NSAIDs的主要品种、销售金额、用药频度（DDDs）以及药品的销售金额和用药频度的排序比值（B/A）等情况进行统计分析。结果 5年来,该院口服NSAIDs的销售金额与用药频度逐年呈上升趋势,塞来昔布在单药销售金额排序最高;阿司匹林肠溶片在DDDs排序中居于首位;且B/A平均值最高,5年来均大于2。结论该院口服NSAIDs的用药现状及倾向基本符合我国当前药物消耗总趋势,对阿司匹林、塞来昔布、洛索洛芬钠片的选择倾向大。解放军第175医院青年苗圃基金课题（15Y008

Variations of River N_2O Saturations and Emission Factors in Relation to Nitrogen Levels in China

通过选择我国3个不同流域的河流,研究了河流n2O饱和度与释放量的时空变化及其与河流氮水平的关系,并评估了IPCC关于河流n2O的释放系数。结果显示,河流硝态氮和氨氮的浓度变化范围分别为0.023~5.24(均值1.29±0.822)Mg n.l-1和0.020~40.3(均值2.54±5.47)Mg n·l-1;相应地,河流n2O饱和度和释放量的变化范围分别为90%~8213%(均值407%±1010%)及0.250~1960(均值58.3±221)μg n.M-2·H-1。不同河流n2O饱和度均呈现明显的季节变化特征,n2O饱和度几乎持续处于过饱和状态,表明河流n2O是大气n2O的源。不同类型的河流,其氮浓度水平、n2O饱和度与释放量均有显著差异,城市纳污型河流——南淝河,其氨氮浓度、n2O饱和度和释放量显著高于其他河流,均值分别达(12.5±6.10)Mg n·l-1、1760%±2620%及(363±548)μg n M-2·H-1。研究发现,除南淝河外,所有径流主导型的河流,其n2O饱和度与nO3-含量存在显著线性正相关关系,说明高nO3-含量的河流能增加n2O的表观产量。除南淝河以外的河流n2O释放系数变化范围为0.05%~0.87%,均值为0.20%,较为接近IPCC的参考值0.25%。但我们的研究建议采用修正后的河流n2O释放系数(均值为0.10%),该系数更能体现河流释放n2O的实际情况。Nitrous oxide(N2O)is a potent greenhouse gas that contributes the climate changes and stratospheric ozone depletion.An increase of active nitrogen(N)loading resulting from human activities to watersheds makes river systems a potentially important source of N2O.Here,we present the results of spatial and temporal variations of river N2O saturations and emissions in relation to N levels from rivers among three watersheds with multiple land uses in China,and we also assess the emission factors based on the Intergovernmental Panel on Climate Changes(IPCC)guidelines.The results showed that nitrate and ammonium concentrations ranged from 0.023 to 5.24(average 1.29±0.822) mg.L-1and from 0.020 to 40.3(average 2.54±5.47)mg N.L-1,respectively;Correspondingly,N2O saturations and emissions ranged from 90% to 8213%(average 407%±1010%)and from 0.250 to 1960(average 58.3±221)μg N.m-2.h-1,respectively among the rivers.Our study demonstrated all the rivers were sources of N2O to the atmosphere.There existed significant differences of ammonium concentrations,N2O saturations and emissions for rivers in these watersheds,and the highest mean values of ammonium concentrations,N2O saturations and emissions were(12.5±6.10)mg N.L-1,1760%±2620% and(363±548)μg N.m-2.h-1,respectively,which were observed in Nanfei River receiving urban wastewaters.We found N2O saturations from study rivers(except for the Nanfei River)were positively related to nitrate concentrations,demonstrating that rivers with increased nitrate levels can results in more N2O production.On the basis of the IPCC definition of "emission factor",the measured emission factor ranged from 0.05% to 0.87%,with an average of 0.2%,very close to IPCC given value of 0.25%.However,our study suggests that the revised "actual" emission factor with an average value of 0.1% is more appropriate instead of IPCC value.国家自然科学基金(20777073);国家自然科学基金(41076042);中国科学院地理科学与资源研究所前沿探索项目(2012QY001

Functional groups of benthic macrofauna in the 14th Yong intertidal zone of Nansha,Guangzhou

大型底栖动物根据食性可分为浮游生物食者(planktophagous,Pl)、植食者(phytophagous,Ph)、肉食者(carnivorous,C)、杂食者(omnivorous,O)和碎屑食者(detritivorous,D)五个功能群。本文根据2007–2008年度和2013–2014年度在茳芏(Cyperus malaccensis)、海桑(Sonneratia caseolaris)2种生境调查获得的各4个季度的大型底栖动物数据,分析了广州南沙十四涌潮间带大型底栖动物功能群的生境差异、季节变化和年际变化。2007–2008年度采集到26种大型底栖动物,低于2013–2014年度的36种。无论是2007–2008年度还是2013–2014年度,茳芏、海桑生境的大型底栖动物均以植食者的栖息密度和生物量最高,碎屑食者的栖息密度和生物量最低。生境比较得出,茳芏生境大型底栖动物浮游生物食者(Pl)的丰富度指数(d)、均匀度指数(J)和多样性指数(H')均高于海桑生境。年度比较得出,在茳芏和海桑生境,2013–2014年度浮游生物食者的丰富度指数、均匀度指数和多样性指数均高于2007–2008年度,这是因为2013–2014年度采集到红树蚬(Gelonia coaxans)和彩虹明樱蛤(Morerlla iridescens)等,而2007–2008年度没有采集到。Benthic macrofauna were classified into 5 functional groups,i.e.planktophagous(Pl),phytophagous(Ph),carnivorous(C),omnivorous(O) and detritivorous(D).The biotope difference,seasonal and annual variations of functional group of benthic macrofauna in the intertidal zone of the 14 th Yong of Nansha,Guangzhou were analyzed in this study according to the four seasonal data of benthic macrofauna collected in two biotopes(Cyperus malaccensis and Sonneratia caseolaris) in 2007–2008 and 2013–2014.A total of 26 species were recorded in 2007–2008,which was lower than 36 species in 2013–2014.Both in 2007–2008 and 2013–2014,phytophagous group showed the highest value while detritivorous group shared the lowest one in density and biomass.Habitat comparison showed that the abundance index(d),evenness index(J) and diversity index(H') of planktophagous group in Cyperus malaccensis habitat were all higher than those in Sonneratia caseolaris habitat.Annual comparison showed that the abundance index,evenness index and diversity index of planktophagous group in 2013–2014 were all higher than those in 2007 –2008 both in Cyperus malaccensis and Sonneratia caseolaris habitats because the planktophagous such as Gelonia coaxans and Morerlla iridescens and so on were collected in 2013–2014 but they were not found in 2007–2008.国家自然科学基金(41176089和41376113