SMILE联合快速角膜交联术后角膜光密度的早期临床观察

目的 观察飞秒激光小切口角膜基质透镜取出术联合快速角膜胶原交联术(SMILE Xtra)对角膜光密度的影响。 方法 收集2017年3月至2019年7月在济南明水眼科医院矫正近视及近视散光的患者78例,纳入右眼数据(78眼)进行分析,根据手术方式分为SMILE Xtra组和SMILE组,其中SMILE Xtra组39例(39眼),SMILE组39例(39眼),分别在术前和术后3个月对两组患者的角膜光密度值进行随访。应用Pentacam三维眼前节分析系统测量角膜光密度值,根据软件分析,以角膜顶点为中心,获取0~2 mm、2~6 mm及6~10 mm直径范围角膜光密度平均值,同时获取角膜前120 μm、中间基质层及后60 μm的光密度平均值。 结果 SMILE Xtra组和SMILE组在术后3个月时78眼(100%)UCVA均达到术前预期矫正视力。SMILE Xtra组术后整体角膜及角膜0~2 mm、2~6 mm直径范围的光密度值均较手术前显著增高,且变化有统计学意义(P<0.001)。逐层分析显示术后前120 μm的数值均显著高于中部及后部角膜。SMILE组术后角膜各个直径范围的光密度值与术前差异有统计学意义(P<0.05)。角膜中部角膜组织及后60 μm的光密度值在手术前后变化有统计学意义(P<0.05)。SMILE Xtra组手术后3个月角膜光密度在0~2 mm、3~6 mm、7~10 mm和前120 μm的数值均高于SMILE组,差异有统计学意义(P<0.05)。两组角膜光密度值的变化量与等效球镜度、角膜中央厚度、角膜曲率及角膜上皮厚度变化量均无明显相关性(P>0.05),与年龄呈负相关(r=-0.542, P=0.01)。 结论 SMILE Xtra组术后早期角膜光密度增加,透明度下降,但只在手术操作区域内发生变化。     

基于创新人才培养的药学专业实践教学体系的改革与探索

培养创新人才,需要强化实践教学环节,完善实践教学体系,提高学生的学习能力、实践能力和创新能力。在创新人才培养要求下,如何进行药学专业实践教学模式改革以培养学生的创新素养,是药学教育者急需探索的一个重要课题。本文从加强和改进实验教学方法,鼓励学生科研立项,开设设计性综合实验,拓展毕业专题研究,鼓励加入教师科研课题研究等方面进行了基于创新人才培养的药学专业实践教学体系的改革与探索。     

Ectopic hamartomatous thymoma: report of a case and review of literature

Ectopic hamartomatous thymoma (EHT) is an exceedingly rare lesion that usually arises in the lower neck and mainly affects adult men. We present the clinicopathological features of a case of EHT in a 28-year-old Chinese male, together with a literature review. Ultrasound imaging and a computed tomography (CT) scan of the neck demonstrated a 3.0-cm well-defined nodule of heterogeneous density located within the left sternocleidomastoid muscle. The patient underwent a gross total resection of the tumor. Grossly, the well-demarcated, encapsulated mass had a predominantly solid and gray-white appearance admixed with microcystic foci filled with serous content and yellowish regions. The lesion consisted of an irregular admixture of spindle cells, epithelium, and mature adipose tissue. Immunohistochemistry showed that both the spindle cell and epithelial components were diffuse and had intense nuclear positivity for p63 and cytoplasmic reactivity for pan-cytokeratin, CK7, and CK19. The patient was followed for 18 months without any evidence of metastasis or recurrence.     

2型糖尿病合并牙周病应用盐酸米诺环素联合替硝唑治疗的效果分析

目的探索2型糖尿病合并牙周病应用盐酸米诺环素联合替硝唑治疗的效果分析。方法在2018年12月—2019年12月选取120例2型糖尿病合并牙周病患者为研究对象,选择单双号随机分组,每组60例,对照组采用盐酸米诺环素,观察组采用盐酸米诺环素联合替硝唑治疗,随后对比两组总有效率、PD(牙周探诊深度)、SBI(龈沟出血指数)、PLI(菌斑指数)、GI(牙龈指数)。结果观察组PD(1.11±0.08)mm、SBI(1.06±0.45)分、PLI(0.41±0.59)分、GI(0.22±0.05)分优于对照组,差异有统计学意义(t=20.284、23.295、13.272、7.064,P<0.05);观察组总有效率(96.67%)高于对照组,差异有统计学意义(χ²=12.810,P<0.05);观察组HbAIc(6.96±0.54)%、餐后2 h血糖(7.15±1.66)mmol/L、空腹血糖(4.89±0.43)mmol/L低于对照组,差异有统计学意义(t=12.052、6.684、19.749,P<0.05)。结论盐酸米诺环素联合替硝唑治疗用于2型糖尿病合并牙周病患者中效果显著,可改善牙周环境,促进牙周组织再生。     

垂盆草的研究进展

通过阅读大量的垂盆草相关研究文献,本文对其化学成分、药理作用、临床应用3个方面进行概述,为垂盆草的开发和利用提供有效的科学依据。     

交叉异位融合肾并左肾区囊肿99Tcm-DTPA肾动态显像一例

笔者报道了一例交叉异位融合且左肾区囊肿患者的99Tcm-DTPA肾动态显像,该类肾畸形发病罕见,且缺乏特异性症状。通过临床症状、实验室检查、病理及影像学检查综合分析该病特点,还通过99Tcm-DTPA肾动态显像评估畸形肾的功能状态,旨在为该疾病的检出、诊断及治疗提供有力参考。     

Myeloid-Derived Suppressor Cells Protect Mouse Models from Autoimmune Arthritis via Controlling Inflammatory Response

Myeloid-derived suppressor cells (MDSCs) have been reported to participate in immune suppression and autoimmune disorders. However, its role in autoimmune arthritis remains to be determined. We explored whether adoptive transfer of MDSCs in vivo would block joint inflammation and histological damage using collagen-induced arthritis (CIA) and antigen-induced arthritis (AIA) models. CD11b⁺ Gr-1⁺ MDSCs were isolated from the single cells from the spleens of CIA mice on day 41 or AIA mice on day 35. MDSCs (2?×?10⁶) were then transferred to AIA and CIA mice via tail vein before arthritis establishment at indicated time points. Phosphate buffered saline (PBS) was injected as control. Arthritis was evaluated by severity score and histology. The levels of TNF-α, IL-6, IL-17 and IL-10 in the serum and joints were detected by enzyme-linked immunosorbent assay (ELISA). The number of Th17 cells and macrophages in draining lymph nodes and joint tissues was assessed by flow cytometric analysis. Adoptive transfer of MDSCs significantly reduced the clinical score of arthritis, alleviated joint inflammation and histological damage both in AIA and CIA models compared with PBS-treated control groups. The levels of TNF-α, IL-6, IL-17, and IL-10 in the serum and joints were down-regulated by transfer of MDSCs. In addition, adoptive transfer of MDSCs significantly reduced the number of Th17 cells and macrophages in draining lymph nodes and joint tissues. Altogether, we demonstrate that adoptive transfer of MDSCs prevented autoimmune arthritis in mouse models of RA through inhibiting Th17 cells and macrophages. These new findings provide insights into the inhibitory functions of MDSCs and MDSCs may be used as a cell-based biotherapy in RA.     

布鲁氏菌血培养阳性报警时间的分析

目的:探讨布鲁氏菌血培养阳性报警时间的特点及临床意义.方法:选择2017年1月~2018年12月124例布病患者为观察组,随机选择性别、年龄相仿的其它细菌感染者为对照组,其中葡萄球菌112例,肠杆菌科菌91例.回顾性分析各组血培养的阳性报警时间.结果:布鲁氏菌48h内未见阳性报警者,48~72h、72~96h、96~120h、120~168h的阳性报警率分别为1.6%、14.5%、45.2%、35.5%;葡萄球菌和肠杆菌科菌48h内阳性报警率分别为87.5%、94.5%,均未见超过120h阳性报警者.组血培养平均阳性报警时间分别为:布鲁氏菌117.4h(103.4h^126.8h)、葡萄球菌24h(18h^34h)、肠杆菌科菌11h(9.5h^15h).组间比较差异有统计学意义(P<0.01).结论:布鲁氏菌血培养阳性报警时间明显长于于其它病原菌,对疑似布病的患者,血培养的孵育时间至少设置为7d.综合分析血培养阳性报警时间与典型的菌落、革兰氏染色形态,对鉴定布鲁氏菌具有重要意义.     

肢体缺血后处理对大鼠慢性脑缺血后脑内LINGO-1的表达及神经功能的变化

目的:观察大鼠肢体缺血后处理后脑内LINGO-1表达的变化,研究肢体缺血后处理改善慢性脑缺血后神经损伤的分子机制。方法:采用50%三氯化铁处理双侧颈总动脉的方法建立慢性脑缺血模型,随机将大鼠分为假手术组、模型组和肢体缺血后处理组。大鼠肢体缺血后处理3周后采用三等分Y型电迷宫方法观察各组大鼠的学习记忆能力,RT-qPCR检测LINGO-1的mRNA,Western blot法测定LINGO-1的蛋白水平。结果:与模型组相比,肢体缺血后处理组大鼠学习记忆能力显著增加(P0.05)。假手术组大鼠LINGO-1的mRNA及蛋白水平有少量阳性表达。肢体缺血后处理组大鼠LINGO-1的mRNA及蛋白水平均显著下降(P0.05)。结论:慢性脑缺血大鼠脑内LINGO-1水平明显上调,肢体缺血后处理可明显降低LINGO-1的表达水平,并提高学习记忆能力,这可能是肢体缺血后处理改善慢性脑缺血神经功能的分子机制之一。