青光眼术后白内障超声乳化术

目的探讨青光眼术后白内障超声乳化手术适应症、时机、手术方法和并发症。方法回顾性分析2002年1月至2004年2月青光眼术后白内障患者44例,其中预防性虹膜周边切除术8例,滤过性手术36例。对39例术前眼压控制在正常范围或仅局部药物能控制正常的病例做上方透明角膜内切口或颞侧角膜缘巩膜隧道切口,避开功能滤过区行白内障超声乳化术;对3例术前眼压须全身药物才能控制的病人,控制眼压后避开原手术区行白内障超声乳化联合小梁切除术。随访半年。结果视力均有不同程度提高结论,0.5以上33例,视觉电生理检查视功能损害与术前有明显差别,眼压均在正常范围。结论超声乳化手术是治疗青光眼术后白内障的有效方法。     

The association between paired basic amino acid cleaving enzyme 4 gene haplotype and diastolic blood pressure

Background In a previously identified locus linked to hypertension on chromosome 15q, we identified three blood pressure candidate genes: insulin-like growth factor 1 receptor gene (IGF1R), myocyte specific enhancer factor 2A gene (MEF2A), and paired basic amino acid cleaving enzyme 4 gene (PACE4). In this study, we tested their associations with hypertension using haplotype analysis.Methods A total of 288 unrelated individuals, including 163 high diastolic blood pressure (DBP) subjects and 125 normal DBP subjects were enrolled in this case-control study. Twenty single nucleotide polymorphisms (SNPs) in the three genes were genotyped using polymerase chain reaction followed by restriction enzyme digestion. Haplotype analysis was accomplished in the following stages: (1) pair-wise linkage disequilibrium test among SNPs on the same gene was performed to explore blocks in which recombination is very unlikely to happen; (2) Estimation-Maximization algorithm was applied to estimate haplotype frequencies in each block; (3) the chi-square test was used to examine the specific haplotype difference, and a permutation test was used to examine the overall haplotype profile difference between cases and controls in each block.Results An estimated haplotype “CCCCG” frequency in the haplotype block on the PACE4 gene was significantly higher in high DBP cases than in controls (P<0.01). The overall estimated haplotype profile in this block was also significantly different between the cases and the controls (P<0.001). This association indicates. Conclusions This study for the first time demonstrated that PACE4 gene may play an important role in the regulation of DBP. This association indicates that variations influencing DBP resides in or near this genomic region.     

子宫肉瘤研究进展

子宫肉瘤是发生于女性生殖器官的恶性肿瘤，其发病率低、预后差，主要有异常阴道出血、腹痛、腹部包块等临床表现。血清乳酸脱氢酶、血清中性粒细胞与淋巴细胞比值（NLR）等血清学指标及超声和磁共振成像等影像学检查可协助子宫肉瘤的术前诊断，但目前其诊断仍主要依靠术后病理结果。子宫肉瘤主要有子宫平滑肌肉瘤、子宫内膜间质肉瘤及子宫腺肉瘤3种病理类型。全子宫及双附件切除是标准手术方式，术后可根据不同病理类型及手术分期选择辅助治疗方式。通过查阅国内外文献，综述子宫肉瘤的临床表现、辅助检查、病理特征、治疗及预后等。     

A novel mutation in the tRNAIle gene (MTTI) affecting the variable loop in a patient with chronic progressive external ophthalmoplegia (CPEO)

We describe a 62-year-old woman with chronic progressive external ophthalmoplegia (CPEO), multiple lipomas, diabetes mellitus, and a novel mitochondrial DNA (mtDNA) mutation at nucleotide 4302 (4302A>G) of the tRNA^Ile gene (MTTI). This is the first mutation at position 44 in the variable loop (V loop) of any mitochondrial tRNA.The muscle biopsy revealed 10% ragged-red/ragged-blue fibers and 25% cytochrome c oxidase (COX)-deficient fibers.No deletions or duplications were detected by Southern blot analysis. The 4302A>G transition was present only in the patient’s muscle and single-fiber analysis revealed significantly higher levels of the mutation in COX-deficient than in normal fibers. Like tRNA^Leu(UUR), tRNA^Ile appears to be a “hot spot” for mtDNA mutations causing CPEO.     

寻常型天疱疮合并下肢深静脉栓塞1例

报告1例寻常型天疱疮伴下肢深静脉栓塞。患者,女,56岁。因全身多发松弛性水疱1年余,进行性加重1周入院。皮损免疫病理提示表皮角质形成细胞间IgG、C3网状沉积（＋＋）,IgA、IgM、C1q（-）。组织病理诊断为寻常型天疱疮。患者因右下肢胀痛,行双下肢血管彩超提示右下肢深静脉栓塞。     

新时期临床教学面临的问题与改革对策

近年来临床教学模式改革已成为社会各界广为关注的热点话题。面对临床教学模式改革过程中的诸多难题,如何找到有效解决方法迫在眉睫。本文分析了新时期临床教学现状和存在问题,并在此基础上探讨了如何改革临床教学模式,旨为提高教学质量,为管理决策层提供某些参考之处。     

2018—2019年安徽省蔬菜种植人员钩虫感染及危险因素分析

目的 了解安徽省蔬菜种植人员钩虫感染状况及危险因素,为制定人体钩虫感染防治策略提供参考依据。方法按照自然生态功能区划分,2018—2019年随机选择安徽省7个县(市)共计1 179例蔬菜种植人员进行调查。采用自制问卷收集调查对象社会人口学特征、蔬菜种植方式及施肥情况、家庭种植农作物类型、动物饲养、卫生及劳动习惯等信息;同时采集调查对象粪便标本,采用改良加藤厚涂片法(1粪2检)检查钩虫感染。采用Bayesian log-binomial回归模型分析蔬菜种植人员钩虫感染的危险因素。结果 1179例研究对象中,共检出钩虫感染者46例,钩虫总体感染率为3.90%。无业/待业者、务农者、专职菜农和其他职业者钩虫感染率分别为10.07%(15/149)、5.32%(31/583)、0(0/377)和0(0/70),不同职业研究对象钩虫感染率差异有统计学意义(χ²=36.37,P<0.01)。Bayesian log-binomial回归分析结果显示,采用人粪施肥[相对危险度(RR)=18.25,95%可信区间(CI):(4.31,77.17)]、赤脚下地劳动[RR=2....     

改良置管方式对单孔胸腔镜术后引流管口愈合及引流效果的比较

目的:比较2种不同的胸腔引流管留置方式对单孔胸腔镜肺癌根治术后引流效果及引流管口愈合、疼痛的影响。方法:收集安徽省胸科医院胸外科2019年12月至2020年5月行单孔胸腔镜肺癌根治术的患者共80例,分别采用单根24F胸引管(传统组)与24F胸引管联合8F微导管(改良组),通过2种不同的置管方式,分析术后引流管留置时间、术后住院时间、术后总引流量、术中出血量、手术时间、切口渗液、切口感染、术后疼痛评分及引流管口愈合情况。结果:与传统组相比,改良组可减少引流管留置时间、引流量、切口渗液,缩短患者平均住院时间,差异有统计学意义(P<0.05)。改良组患者术后疼痛从术后第2天开始较传统组减轻,术后第3天的差异有统计学意义(P<0.05)。结论:改良后的胸腔引流管的留置方式是可行的,有利于患者术后快速康复,可以为患者减轻疼痛、减少切口渗液及引流管口愈合不良的发生率。     

MicroRNA-590在急性心肌梗死诊断及预后评估中的价值

目的 研究microRNA-590(miR-590)在急性心肌梗死(AMI)诊断及预后评估中的价值.方法 选择2018年5月至2019年10月安徽省第二人民医院心内科收治的患者162例,根据临床诊断及冠状动脉造影结果,分为对照组(HC组,n=40)、稳定型心绞痛(SAP)组(n=50)和AMI组(n=72),收集临床资...