图形翻转视觉诱发电位检查对白内障术后视力评估的价值

目的:探讨图形翻转视觉诱发电位(pattern reversal visual evoked potential,PRVEP)检查对白内障术后视力评估的价值。方法:回顾性分析2012-10/2013-05在同济医院眼科住院,并在白内障超声乳化术及人工晶状体植入手术前后接受PRVEP检查的的成年白内障患者72例114眼的病例资料,其中76眼为老年性白内障,38眼为并发性白内障。根据晶状体混浊程度及晶状体核硬度将数据分为两组:核硬度Ⅰ,Ⅱ,Ⅲ级为A组,核硬度Ⅳ,Ⅴ级为B组,应用统计学方法进行数据间的相关性分析。结果:A组:(1)术前:视力平均值为0.344,PRVEP检查P100波的潜伏期平均值为107ms,N75-P100波的振幅平均值为4.633μV;术后:视力平均值为0.672,PRVEP检查P100波的潜伏期平均值为104.37ms,N75-P100波的振幅平均值为4.400μV。(2)手术前后视力与P100波的潜伏期呈显著负相关(P<0.01);手术前后视力与N75-P100波的振幅呈显著正相关(术前P<0.01,术后P<0.05)。(3)手术前后视力改善行数与P100波的潜伏期变化值无相关性。B组:(1)术前:视力平均值为0.116,P100波的潜伏期平均值为118.905ms,N75-P100波的振幅值为1.650μV;术后:视力平均值为0.576,P100波的潜伏期平均值为108.429ms,N75-P100波的振幅值5.132μV。(2)术前视力与P100波的潜伏期呈现显著负相关(P<0.05),而术后视力与P100波的潜伏期没有相关性;手术前后视力与N75-P100波的振幅没有相关性。(3)手术前后视力改善行数与P100波的潜伏期变化值没有相关性。结论:由白内障手术前后两组视力与PRVEP的P100波的潜伏期及N75-P100波的振幅的相关性可知,PRVEP受患者术前视力(即屈光间质混浊程度)影响较大,PRVEP检查不能作为白内障术后视力预后的判断指标,白内障手术前的PRVEP检查没有临床意义。     

Research Article: Binding of Cordycepin Monophosphate to AMP-Activated Protein Kinase and its Effect on AMP-Activated Protein Kinase Activation

It had been reported that cordycepin could activate AMP-activated protein kinase. One possible mechanism is that cordycepin mediated AMP-activated protein kinase activation by conversion into cordycepin monophosphate, which acts as an AMP analog to activate AMP-activated protein kinase. To confirm the aforementioned hypothesis, we investigate the binding of cordycepin monophosphate to AMP-activated protein kinase using molecular docking. The modeling results indicate that cordycepin monophosphate binds to AMP-activated protein kinase with high affinity. The hydrogen bonds provide attractive forces between molecules. Our results further identify the key residues contributing to the interaction. Also, the modeling results predict that cordycepin monophosphate and AMP would have similar binding modes with AMP-activated protein kinase. Further investigation of AMP-activated protein kinase activation in vitro provides the evidence that cordycepin monophosphate functioned as an AMP mimic to activate AMP-activated protein kinase.     

视网膜中央静脉阻塞性黄斑水肿的OCT与ERG的对比分析

目的：观察视网膜中央静脉阻塞性黄斑水肿的黄斑区视网膜厚度与视网膜电图( electroretinogram, ERG )各项参数(Cone-a,Cone-b和30Hz)变化的关系。
　　方法：随机选择视网膜中央静脉阻塞患者25例25眼及25只对侧眼分别行明视闪光视网膜电图及光学相干断层扫描( optical coherence tomography,OCT)检查,明视闪光视网膜电图检查测各项参数的振幅和潜伏期, OCT测量黄斑区九部分的视网膜厚度,分析黄斑区形态参数与明视闪光视网膜电图各参数变化之间的关系。
　　结果：黄斑区除颞侧外七个部位视网膜厚度与 ERG 的Cone-b和30 Hz潜伏期相关。
　　结论：研究发现视网膜中央静脉阻塞患者的黄斑区视网膜厚度与内层视网膜功能密切相关。     

门冬氨酸鸟氨酸治疗肝性脑病的临床观察

目的探讨门冬氨酸鸟氨酸治疗肝性脑病的临床效果。方法我院2011年7月-2012年3月收治肝性脑病60例,随机分为治疗组和对照组,每组各30例。治疗组予门冬氨酸鸟氨酸注射液治疗,对照组予谷氨酸钾注射液、谷氨酸钠注射液治疗,并按肝性脑病Child分级比较疗效。结果治疗组总有效率为90％,对照组为50％,差异有统计学意义（χ^2=11．429,P=0．001）;治疗组不同Child分级患者治疗后血氨、肝功能均显著好转,与对照组比较差异均有统计学意义（P=0．000,P〈0．05）。肝性脑病不同分级治疗效果比较：Ⅰ级、Ⅳ级两组治疗效果比较差异无统计学意义（P〉0．05）;Ⅱ级及Ⅲ级治疗组明显优于对照组,差异有统计学意义（P〈0.05）。结论门冬氨酸鸟氨酸治疗肝性脑病安全,且治疗效果优于谷氨酸钾、谷氨酸钠。     

瘦素在诱导血管内皮细胞纤溶酶原激活物抑制物-1表达中的作用

目的通过体外研究探讨瘦素对血管内皮细胞纤溶酶原激活物抑制物-1表达的影响。方法Ⅱ型胶原酶消化法分离和培养人脐静脉内皮细胞（HUVECs）,在不同时间采用不同剂量瘦素培养HUVECs,应用荧光定量PCR、Northern blot以及Western blot检测技术研究瘦素对HUVECs PAI-1 mRNA及蛋白表达的影响。结果100ng／ml瘦素作用于内皮细胞,PAI-1 mRNA表达水平随着时间延长呈升高的趋势,8h达到最高（P〈0．001）,24h后仍高于起点（P〈0．005）,而tPA的表达则无显著变化（P〉0．05）。不同浓度的瘦素作用于内皮细胞,其PAI-1 mRaNA水平呈剂量依赖性升高（P〈0．001）;tPAmRNA表达亦无显著变化（P〉O．05）。100ng）ml瘦素孵育HUVECs时间依赖性促进PAI-1蛋白表达,24h达到最高峰。结论瘦素可能通过诱导血管内皮细胞PAI-1表达促进动脉粥样硬化和血栓的形成。     

Efficacy and safety of itraconazole as empirical antifungal therapy in febrile neutropenic patients with hematologic malignancies: an open-lable, multicenter, observational trial in a Chinese cohort

Background  Invasive fungal infection (IFI) is a common and fatal complication in neutropenic patients with hematological malignancy. Empirical antifungal therapy is widely used in practice due to the difficulty of pathogens determination and illness of the hosts. The aim of this study was to evaluate the efficacy and safety of itraconazole as empirical antifungal therapy for persistent fever in neutropenic patients with hematologic malignancies.

Methods  Two hundred and seventy-four patients with hematologic malignancies who had suspected fungal infections were enrolled in 18 centers across China between April 2008 and April 2009. Empirical antifungal therapy with intravenous itraconazole 200 mg twice daily was given for the first two days, followed by 200 mg once daily for the next 12 days. Oral itraconazole solution was sequential for follow-up therapy if necessary. Five composite end points were evaluated for the response, which was more restrictive and adopted for the first time in such study in China.

Results  The intent-to-treat analysis included data from 274 patients (full analysis set, FAS), of whom 248 were included as the per-protocol population (PPS). As the composite end point of five indices was concerned, the overall response rate was 43.4%. Seperately, defervescence was achieved in 90% of patients in which 55.5% occured during neutropenia. The mean time to defervescence was 2.71 days. Absence of breakthrough IFI during drug administration or within the first 7 days after study completion was observed in 71.5% of patients. Fifty-five point five percent patients with IFI at baseline was successfully treated. Ninety point five percent patients survived for at least 7 days after completing the study. PPS analysis revealed that the duration of neutropenia ≥10 days was a statistically significant negative predictor for the response. The withdrawal rate due to drug-related toxicity or lack of efficacy was 11.0%. The incidence of adverse events was 22.6%, in which 11.6% was study drug related. The most frequent adverse events were mild to moderate liver toxicity.

Conclusion  Itraconazole shows desirable efficacy and safety as empirical antifungal therapy for febrile neutropenic patients with hematologic malignancies.

     

Efficacy and safety of pramipexole in chinese patients with restless legs syndrome: results from a multi-center, randomized, double-blind, placebo-controlled trial

Background

We performed a six-week study of pramipexole vs. a placebo in Chinese restless legs syndrome patients.

Methods

Overall, 305 enrolled patients were assigned randomly in a 2:1 ratio to the pramipexole group (N = 202) and the placebo group (N = 103).

Results

Of 287 patients in the full analysis set, the pramipexole group showed significant improvement compared with the placebo group in the change of their International Restless Legs Syndrome Study Group Rating Scale of Severity (IRLS) total score from baseline to week 6 after adjustment of centers and baseline characters (−15.87 ± 0.66 vs. −11.35 ± 0.92, p < 0.0001) and in the proportion of patients who were “much improved” and “very much improved” when measured by Clinical Global Impressions-Improvement (81.9% vs. 54.3%, p < 0.0001). At week 6, the IRLS responder rate was 73.8% (pramipexole) and 48.9% (placebo) (p < 0.0001) and the patient global impression responder rate was 68.6% (pramipexole) and 43.5% (placebo) (p < 0.0001). The proportion of adverse events was 62.9% in the pramipexole group and 43.7% in the placebo group, respectively. No deaths occurred.

Conclusion

Pramipexole was effective and well-tolerated in Chinese patients with restless legs syndrome.