Analysis of Clinical Pharmacists Participating in the Warfarin Anticoagulation Treatment for 1 Double Valve Replacement Patient with Thrombocytopenia

目的探讨双瓣置换术后并发血小板减少的患者的抗凝治疗策略,为临床药师参与抗凝治疗提供参考。方法临床药师回顾性分析1例双瓣置换术后患者血小板减少的原因,结合药代动力学知识和相关文献资料,确定华法林初始剂量和目标国际标准化比值(INR),优化抗凝方案。结果患者血小板计数逐渐恢复正常;华法林抗凝治疗以5 mg为初始剂量,目标INR为1.8~2.5。经过五次剂量调整后以3.125 mg的维持剂量带药出院,出院时INR为1.5。结论临床药师参与可为患者提供更加安全、有效的治疗方案。Objective To explore the anticoagulation strategies for 1 double value replacement patient with thrombocytopenia, and to nsummarize the experience of clinical pharmacists participating in the anticoagulant therapy. Methods The clinical pharmacist retrospec-tively analyzed 1 patient with thrombocytopenia after double valve replacement. According to pharmacokinetic knowledge and related lit-eratures, the initial dose of warfarin and the target international normalize( INR) were determined and the anticoagulation regimen was optimized. Results The platelet counts gradually returned to normal; the warfarin anticoagulation was started with an initial dose of 5 mg,the target INR was 1. 8- 2. 5. After adjusting the dosage five times, the patient discharged with a maintenance dose of 3. 125 mg and an INR of 1. 5. Conclusion The participation of clinical pharmacists can provide more safe and effective treatment regimen for patients

门冬氨酸鸟氨酸致斑丘疹1例

1病例介绍患者,女,57岁。因\"腹胀、纳差、尿黄20 d\"于2016年9月1日就诊我院。体检:面色晦暗,全身皮肤、虹膜中度黄染,肝功能:血清丙氨酸氨基转移酶（ALT）1 543.4 U·L-1,天冬氨酸氨基转移酶（AST）1 247.3 U·L-1,总胆汁酸（TBA）120.59μmol·L-1,血氨55μmol·L-1。诊断:（1）重度肝损伤;（2）肝内胆汁

吸入用布地奈德混悬液联用吸入用复方异丙托溴铵溶液雾化吸入致接触性疱疹1例

吸入用布地奈德混悬液为目前唯一可雾化给药的非卤素糖皮质激素,雾化吸入即可到达全肺,局部抗炎作用强,有较强的抗炎、抗过敏和抗渗出作用,可减轻炎症渗; 出,阻止过敏介质的释放和降低介质活性,清除呼吸道炎症。吸入用复方异丙托溴铵溶液是一种由沙丁胺醇以及异丙托溴铵组成的复方制剂。异丙托溴铵为抗胆碱能; 受体药物,能降低迷走神经张力,抑制肺内活性物质释放而起支气管舒张作用;硫酸沙丁胺醇是beta_2受体激动剂,能选择性兴奋支气管平滑肌的beta_; 2受体,抑制肥大细胞和嗜酸粒细胞的介质释放,从而使支气管平滑肌舒张。两者协同舒张大、中、小气道平滑肌,促进支气管扩张。同时,还可改善支气管纤毛运; 动功能,减少黏液的分泌并促进其清除,以促使呼吸道通畅,最终改善患者的通气功能。吸入用布地奈德混悬液联用吸入用复方异丙托溴铵溶液为目前临床常用的局; 部雾化处方,文献有报道单用吸入用布地奈德混悬液致颜面与颈部潮红、咽部及后脑枕部麻木感、胸痛、疲乏等。吸入用布地奈德混悬液联用吸入用复方异丙托溴铵; 溶液可见不良反应为痉挛性呛咳、呼吸困难、发绀伴血氧饱和度下降,口咽部念珠菌感染等,但引起接触性疱疹尚未见报道,提醒临床注意

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

Study on Absorption of Cu~(2+) by Inorganic Colloid of Brown Desert Soil in Xinjiang

选用采自新疆阿克苏地区典型的棕漠土壤,用模拟吸附方法研究棕漠土无机胶体在不同阴阳离子作用下对Cu2+的吸附特征,得出:棕漠土无机胶体对铜的等温吸附曲线可以用Langmuir等温方程式拟合,解吸后,铜在胶体内的残余量与加入溶液的浓度呈很好的一次函数关系;随着加入支持电解质浓度的增加,胶体对铜的吸附量逐渐减少;不同电解质溶液对土壤无机胶体吸附铜的影响不一样,在Cl-存在下,对铜竞争吸附的影响K+>NH4+>Na+;当支持电解质阳离子浓度相同时,阴离子对胶体吸附铜的影响都为SO42->Cl-This paper chose typical brown desert soil from Aksu,Xinjiang,studied the absorption of Cu2+ by inorganic colloid,the results as follows: Isothermal adsorption curve of copper absorbed by brown desert soil can match with Langmuir equation well,after desorption the relationships between original Cu2+ concentration and remainder Cu2+content in colloid was a linear function.With the increasing of electrolyte strength,the absorption quantity of Cu2+ by colloid decreases gradually;Different compounded negative ion and positive ion have different influence on copper absorbed by colloid.When negative ion is Cl-only in solution,the order of the influence on copper absorption is K+>NH4+ >Na+.SO42-on copper absorption is higher than that of Cl-

Detection of Hantavirus Genome by New Pairs of Hantavirus Universal Primers in HFRS Patients Serum

目的:提高汉坦病毒(HV)的检出率。方法:设计了两对新的汉坦病毒(HV)通用引物,建立新的RT-PCR方法,对流行于湖北省不同地区的肾综合征出血热(HFRS)患者血清进行了检测。结果:在对166份血清中HV RNA的检测显示HTN型阳性率为80.1%(133/166),SEO型为19.9%(33/166);对不同浓度的HV RNA检测结果显示,本法最低可检测出血清中72 pg病毒基因组。结论:说明本法用于检测HFRS患者血清中HV RNA的特异性和敏感性均很高,且我国中部地区HFRS流行以HTN为优势型,这一结果不仅为HFRS的诊断提供了新的手段,也为HFRS的防治提供了新的依据。 【英文摘要】 Objective: To improve the detection rate of Hantavirus.Methods: Two new pairs of Hantavirus universal primers was designed to detect the Hantavirus genome RNA in hemorrhagic fever with renal syndrome(HFRS) patient s serum in Hubei Province by RT-PCR.Results: In the 166 serum,80.1%(133/166) were detected to be HTN and 19.9%(33/166) were SEO in serology typing.At the same time,even a low level of Hantavirus genome RNA(≥72 pg) could be detected by this method.Conclusion: It is an excellent method to detect Han...国家“863”计划(编号:2007AA02Z465);; 国家自然科学基金资助项目(编号:30770096

人民币套息交易:市场基础和收益风险特征

在全球经济金融虚拟化背景下,利率与汇率的波动性增强。以跨国公司为代表的经济主体为实现利润最大化目标,在全球进行资源优化配置,频繁进出利率与汇率市场,进行套息交易。相应交易的长期性和广泛性表明,利率平价理论提出的利率与汇率间的平价均衡关系并不成立,套息交易对金融系统安全性具有负面影响。在资本账户未完全放开的条件下,关于人民币套息交易机理机制的实证研究表明,人民币套息交易有多种途径,大宗商品交易是较突出的渠道。因此,在人民币国际化过程中须健全金融监管,协调好资本账户开放的步骤与速度,防范套息交易危害实体经济发展。国家自然科学基金项目“资金流、交易者异质性与股市波动”(71373225)阶段性成

Road Dust Loading and Chemical Composition at Major Cities in Fujian Province

采集并分析了福建省重点城市厦门、漳州、泉州和莆田城区具有代表性的57个地面扬尘和16个土壤样品的26种无机元素、8种水溶性离子和碳成分等组成.不同城市粒径≤100μM的路面尘负荷平均值在6.99 g.M-2与10.11 g.M-2之间,而粒径≤2.5μM的路面尘(PM2.5)负荷平均值在4.0 Mg.M-2和12.5 Mg.M-2之间.不同城市土壤尘和路面尘PM2.5中浓度最高的元素都是SI、CA、Al、fE和k,路面尘中CA元素明显富集,而主要人为来源的重金属元素如Cu、Pb、zn、Cr在路面尘PM2.5中的浓度显著高于土壤尘.漳州城区路面尘PM2.5中二次离子nH4+、nO3-和SO24-的含量明显高于其它地区,厦门、漳州和泉州城区路面尘PM2.5中Mg2+和CA2+之间都存在显著的正相关关系.四城市路面尘中有机碳(OC)的含量均高于济南、石家庄以及北京地面扬尘OC的含量,元素碳(EC)的含量均低于北京地区路面扬尘EC的含量.泉州和莆田两地OC和EC的相关性较好,说明路面尘中OC和EC有相同或相似的来源.质量平衡结果显示泉州和莆田路面尘PM2.5中含量最高的是土壤尘,其次为有机物.按化学组成特征对路面尘PM2.5进行聚类解析,得到受大气沉降影响、受土壤尘影响、受大气沉降和土壤尘共同作用以及受土壤尘和建筑尘共同作用4类样品.A total of 57 road dust and 16 urban soil samples were collected from four cities,Xiamen,Zhangzhou,Quanzhou and Putian in Fujian Province,China.Twenty-six elements,eight water soluble ions,organic carbon and elemental carbon in the fraction of particulate diameter less than 2.5 μm(PM2.5) derived through a suspension chamber were analyzed.The average loading of road dust with diameter less than 100 μm in the four cities ranged from 6.99 g·m-2 to 10.11 g·m-2,while the loading of PM2.5 ranged from 4.0 mg·m-2 to 12.5 mg·m-2.Both the soil and road dust samples were characterized with much higher concentrations of Si,Ca,Al,Fe and K.But for the anthropogenic elements such as Cu,Pb,Zn,Cr and Ti,much lower levels were found in the soil PM2.5 than those in the road dust PM2.5.Significantly higher levels of NH+4,NO-3 and SO2-4 were found in the road dust PM2.5 from Zhangzhou in comparison with those from other cities in this study.The calcium ion(Ca2+) content was significantly positively correlated with the Mg2+ content in the road dust PM2.5 from Xiamen,Zhangzhou and Quanzhou.The levels of organic carbon(OC) in the road dust PM2.5 in these four cities were higher than those reported in Ji'nan,Shijiazhuang and Beijing while the levels of elemental carbon(EC) were all lower than those in the urban road dust from Beijing,Significant positive correlation between EC and OC was found in samples from Quanzhou and Putian,suggesting the same and/or similar sources.The result of mass balance indicated that higher percentage compositions were soil and OM in both Quanzhou and Putian.Based on the cluster analysis,the 57 road dust samples were divided into four types: influenced by atmospheric deposition,influenced by soil dust,influenced by atmospheric deposition and soil dust,and influenced by soil and construction dust.国家自然科学基金项目(40971257;41171365); 环境保护公益性行业科研专项(201009004); 福建省自然科学基金计划项目(2009J05106

间充质细胞外泌体促进小鼠胰岛内皮细胞血管生成的研究

目的探讨间充质细胞（MSC）外泌体对低氧条件下胰岛内皮细胞（MS-1）血管生成的影响。方法 MSC无血清低氧条件培养48 h,超滤离心法富集条件培养基中的外泌体,采用电镜和Western Blot的方法进行鉴定;通过血管形成试验比较分析不同条件下:常氧培养组（NOR组,21%O2、5%CO2）、低浓度氧培养组（HYP组,2%O2、5%CO2）、外泌体+低浓度氧共培养组（HYP+EXO组,2%O2、5%CO2）,MS-1细胞的血管形成能力;image J软件分析血管形成长度;PCR、Q-PCR检测血管内皮生长因子（VEGF） RNA水平的表达,Western Blot检测VEGF、HIF1α蛋白水平表达以及mTOR信号通路激活情况。采用单因素方差分析和SNK-q检验统计学分析。结果超滤离心法富集的MSC条件培养基中的外泌体,大小为30～100 nm,表达CD9,CD63,CD81等外泌体表面标志物;血管形成试验结果显示,低氧促进MS-1血管生成,HYP+EXO组形成明显的血管网状结构;HYP+EXO组血管形成相对长度（2386.0±137.7）像素与NOR组（393.3±174.2）像素和HYP组（1467.0±230.0）像素相比增强,差异有统计学意义（t=12.30,P=0.0065;t=15.74,P=0.0040）; PCR结果显示,HYP+EXO组VEGF相对表达量（20.26±9.972）较常氧对照组（1.000）和低氧组（6.521±3.501）均增强,差异有统计学意义（t=5.462,P=0.0009;t=4.238,P=0.0038）;同时,Western Blot结果显示VEGF蛋白水平表达升高,HIF1-α表达上调,mTOR发生磷酸化。结论 MSC外泌体可促进低氧条件下的小鼠胰岛内皮细胞血管生成。MSC外泌体可能通过上调HIF1-α,调节VEGF表达,激活mTOR信号通路,促进胰岛内皮细胞血管生成。国家自然科学基金青年项目(81601618);;福建省自然科学基金面上项目(2016J01582、2016J01580、2018J01349);;福建省科技创新联合资金重大项目(2017Y9127

Establishment of air pollutant emission inventory in the West Coast of Taiwan Strait

以2009年为基准年,结合污染源普查数据、统计年鉴及工业活动、居民生活等多个方面对海峡西岸经济区包括SO2、nOX、PM2.5、VOCS和nH3在内的大气污染物的排放量进行了估算,建立了海西区大气污染物排放清单.结果发现,上述5类污染物基准年的排放量分别为40.67x104、55.84x104、50.57x104、152.26x104和26.18x104T.其中,SO2、nOX及PM2.5的排放主要来自电厂,占排放总量的比例分别为25.58%、34.89%和38.75%;VOCS和nH3的主要排放源分别来自植被排放和养殖业,其贡献量分别为49.12%和47.07%.采用gIS对排放清单进行网格化处理,得出SO2、nOX及PM2.5的高排放强度区域与固定源的空间分布较为一致.此外,结合国家和地方“十二五“发展规划,采用情景分析方法估算了2015年海西区大气污染物的排放清单.与基准年相比,SO2、nOX和nH3的排放量呈下降趋势,PM2.5和VOCS的排放量呈大幅度增加.基准年排放清单的不确定性分析显示,VOCS排放估算的不确定度最大,为225%.The emission inventories of SO2,NOx,PM2.5,VOCsand NH3 in the Western Taiwan Straits Economic Zone in the base year of 2009 were established based on the pollution source census,statistical yearbooks,industrial activities and residential activities.The total emissions of SO2,NOx,PM2.5,VOCs and NH3 were estimated to be 40.67×104,55.84×104,50.57×104,152.26×104and 26.18×104t,respectively.The power plants were the most important source and contributed to 25.58%,34.89% and 38.75% of the total emissions of SO2,NOxand PM2.5,respectively.However,the major source of VOCs and NH3 was vegetation and livestock breeding,which contributed to 49.12% and 47.07% of the total,respectively.The relative high emission areas of SO2,NOxand PM2.5were consistent with the locations of stationary sources based on GIS gridding techniques.In addition,the emission inventories in the year of 2015 were calculated using scenario analysis method based on the national and regional 12thFive-Year Plans.The emissions of SO2,NOx,and NH3 showed a slight decrease while the emissions of PM2.5and VOCs increase significantly(around 24.18% and 74.42%,respectively) in 2015,as compared to those in 2009.The estimate of VOCs had the highest uncertainty of around 225%.环境保护公益性行业科研专项(No.201009004); 厦门大学山海基金(No.2013SH011)~