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1.
目的:探讨干眼患者角膜荧光素染色后泪膜破裂动态变化和泪膜脂质层动态变化的图像特征及其对干眼的诊断价值。

方法:前瞻性研究。选取我院2019-09/2020-12收治的干眼患者66例132眼,根据荧光素染色后泪膜破裂形态的不同分为片状破裂组(17例28眼)、类圆形破裂组(20例27眼)、线状破裂组(25例28眼)、点状破裂组(21例24眼)和不规则破裂组(20例25眼),比较各组患者泪膜破裂动态变化图像特征、泪膜脂质层动态变化图像特征及泪膜首次破裂时间(NIBUTf)、泪膜平均破裂时间(NIBUTav)、泪河高度(TMH)、角膜荧光素染色(FL)评分的差异。

结果:各组患者NIBUTf有差异(P<0.001),除点状破裂组和不规则破裂组间无差异(7.56±1.54s vs 8.02±1.86s,P=0.881),其余各组两两比较均有差异(P<0.05)。各组间NIBUTav有差异(P<0.001),除点状破裂组和不规则破裂组间无差异(9.54±2.12s vs 9.73±1.94s,P=0.997),其余各组两两比较均有差异(P<0.05)。各组间TMH比较有差异(P<0.001),除类圆形破裂组和线状破裂组间无差异(0.16±0.03mm vs 0.17±0.03mm,P=0.986)、点状破裂组和不规则破裂组间无差异(0.22±0.03mm vs 0.21±0.05mm,P=0.993),其余各组两两比较均有差异(P<0.05)。各组患者FL评分和泪膜脂质层分级均有差异(P<0.001)。

结论:通过分析荧光素染色泪膜破裂的动态图像和脂质层扩散的动态图像特征,并结合其他泪膜静态检查参数,发现不同荧光素染色泪膜破裂形态可以直观反映干眼患者泪膜各层结构的变化,有助于临床医生识别干眼亚型,这对于干眼的诊断和分类具有潜在的临床价值。  相似文献   

2.
变应性鼻炎(AR)对患者生活质量造成影响,干扰正常的工作、学习并加重经济负担,目前已成为全球性健康问题。目前认为AR是基因与环境相互作用的结果,由于运动所处的环境及运动模式的不同,对AR产生的影响也不同。耐力型室外陆地运动可增加人群AR的患病率,而游泳和室内陆地运动并不会增加人群AR的患病率,此外,耐力型室外陆地运动、速度与力量型室外陆地运动和冷空气环境中运动明确会加重AR患者的症状。而国内AR指南并未给出明确的运动指导。本文旨在介绍不同运动模式对AR症状及患病率的影响及其作用机制,进而对AR患者及健康人群提供运动指导。  相似文献   
3.
《Pancreatology》2022,22(6):782-788
BackgroundThe different oncological outcomes of invasive intraductal papillary mucinous neoplasm (I-IPMN) and pancreatic ductal adenocarcinoma (PDAC) are debated. This study aimed to compare disease recurrence patterns and histopathological characteristics in patients with resected I-IPMN and PDAC.MethodsConsecutive patients undergoing surgical resection for stage I-III I-IPMN or PDAC between 2010 and 2016 were retrospectively analyzed. Patients treated with neoadjuvant therapy or resected for Tis neoplasia were excluded. All surgical specimens were re-staged according to AJCC-8th-edition.ResultsA total of 330 patients were included, of whom 43 had I-IPMN and 287 had PDAC. Median follow-up time was 26.7 (1.3–92.3) months and estimated median disease-free survival (DFS) was 60.3 months (47.2–73.4) for I-IPMN and 23.8 (19.3–28.2) months for PDAC (p < 0.001). During follow-up, 32.6% of I-IPMN and 67.9% of PDAC patients experienced recurrence (p < 0.001). The sites of first recurrence were the lungs (38.5% vs 13.1%, p = 0.027), liver (28.6% vs 45.0%, p = 0.180) and local (15.4% vs 36.6%, p = 0.101) for I-IPMN and PDAC, respectively. At multivariate analysis, I-IPMN histology remained an independent predictive factor for longer DFS (OR 0.528, CI 95% 0.278–1.000, p = 0.050), regardless of stage or adjuvant chemotherapy. I-IPMN and PDAC differed in rates of neuroinvasion (51.2% vs 97.2%) and positive lymph node status (N+) (46.5% vs 82.7%), especially in patients with lower T status.ConclusionI-IPMN showed a different recurrence pattern compared to PDAC, with a higher lung tropism, and longer DFS. This different biological behavior is associated with lower rates of neuroinvasion and nodal involvement, especially in early-stage disease.  相似文献   
4.
Pancreatic cancer currently has no subtypes that inform clinical decisions; hence, there exists an opportunity to rearrange the morphological and molecular taxonomy that guides a better understanding of tumor characteristics. Nonetheless, accumulating studies to date have revealed the large-duct type variant, a unique subtype of pancreatic ductal adenocarcinoma (PDA) with cystic features. This subtype often radiographically mimics intraductal papillary mucinous neoplasms (IPMNs) and involves multiple small cysts occasionally associated with solid masses. The “bunch-of-grapes” sign, an imaging characteristic of IPMNs, is absent in large-duct PDA. Large-duct PDA defines the mucin profile, and genetic alterations are useful in distinguishing large-duct PDA from IPMNs. Histologically, neoplastic ducts measure over 0.5 mm, forming large ductal elements. Similar to classic PDAs, this subtype is frequently accompanied by perineural invasion and abundant desmoplastic reactions, and KRAS mutations in codon 12 are nearly ubiquitous. Despite such morphological similarities with IPMNs, the prognosis of large-duct PDA is equivalent to that of classic PDA. Differential diagnosis is therefore essential.  相似文献   
5.
廖宇娇  敖明月  彭颖  胡昌江  陈志敏  许润春 《中草药》2021,52(11):3224-3233
目的建立不同炮制品组方五子衍宗丸(Wuzi Yanzong Pills,WYP)的HPLC指纹图谱,研究盐制对WYP化学成分的影响。方法采用HPLC法建立不同炮制品组方WYP的指纹图谱,并进行相似度评价,采用方差分析、聚类分析(CA)、主成分分析(PCA)与偏最小二乘法-判别分析(PLS-DA)对结果进行评价。结果 WYP全生品组、药典组、盐制组指纹图谱相似度均大于0.9,标定了18个共有峰,利用对照品指认出绿原酸(5号峰)、鞣花酸(10号峰)、金丝桃苷(11号峰)、异槲皮苷(12号峰)、毛蕊花糖苷(13号峰)、紫云英苷(14号峰)、槲皮素(15号峰)、山柰酚(17号峰)、五味子醇甲(18号峰)9个成分,归属性分析表明峰2来源于枸杞子,峰3、5、7、9、11、12、14、15、17来源于菟丝子,峰6、8、10、16来源于覆盆子,峰13来源于车前子,峰18来源于五味子,峰1是覆盆子和五味子共有成分,峰4是枸杞子和覆盆子共有成分。药物炮制后组方WYP未出现色谱峰的增加,但峰面积发生变化。通过CA将WYP全生品组、药典组、盐制组聚为3类,PCA筛选出4个主成分,PLS-DA标记出峰1、13(毛蕊花糖苷)、10(鞣花酸)、7、4、11(金丝桃苷)、12(异槲皮苷)、3、5(绿原酸)共9个差异性成分;绿原酸、鞣花酸、金丝桃苷、异槲皮苷、山柰酚、五味子醇甲及峰1、3、4、7、8共11个成分可能是不同炮制品组方WYP的差异标志物。结论建立的指纹图谱测定方法稳定、可靠,炮制后组方WYP的化学成分发生变化,结果可为WYP中如何选用药物炮制品提供一定的依据。  相似文献   
6.
7.
AIM: To investigate the ratio of spontaneous regression of retinopathy of prematurity (ROP) and to explore the possible relevant predictive factors. METHODS: A retrospective review of 405 infants who were diagnosed with ROP and mother during pregnancy were collected. Stage, zone, and duration of ROP were recorded. Statistical analysis was performed on 51 possible predictive factors. RESULTS: Totally 356 infants showed spontaneous regression. The incidence was 100%, 95.3%, and 22.7% in stage 1, 2, and 3, respectively. The 13.4% of the ROP with plus disease eventually resolved spontaneously. All affected eyes of aggressive posterior retinopathy of prematurity (AP-ROP) failed to spontaneously regress. The mean duration of ROP was 7.2wk in patients with spontaneous resolution of ROP. Days of mechanical ventilation (OR=0.981, 95%CI, 0.965-0.997, P=0.021), retinal hemorrhage (OR=0.173, 95%CI, 0.064-0.470, P=0.001), delivery pattern (OR=2.750, 95%CI, 1.132-6.681, P=0.025), maternal anemia in pregnancy (OR=0.142, 95%CI, 0.036-0.563, P=0.005), the stages (at initial diagnosis OR=0.183, 95%CI, 0.041-0.816, P=0.026; at final diagnosis OR=0.031, 95%CI, 0.006-0.167, P<0.001), and with plus disease or not (OR=0.005, 95%CI, 0.001-0.031, P<0.001) were independent predictive factors of the spontaneous regression of ROP. CONCLUSION: Most mild ROP can spontaneously resolve. Active treatment is still recommended for stage 3 ROP, zone I ROP, AP-ROP, and ROP with plus disease. Prolonged mechanical ventilation and concurrent retinal hemorrhage reduce the likelihood of spontaneous ROP resolution. The pattern of delivery and the mother’s anemia during pregnancy can also affect the prognosis of ROP.  相似文献   
8.
Background: An utmost increase of breast cancer burden during the last several decades was reported in Asian countries. Findings from literature confirm that risk factors of breast cancers can be modifiable and non-modifiable in nature. Objective: The present study is designed to identify specific modifiable and non-modifiable risk factors associated with breast cancer. Methods: A matched case-control study was conducted considering 187 cases as women diagnosed with breast cancer and 187 hospital-controls as women without having breast cancer visiting the hospital. Other than standard risk factors, stress is measured using Perceived Stress Scale (PSS) and stress is measured using Pittsburgh Sleep Quality Index (PSQI). Several modifiable and non-modifiable risk factors were assessed using conditional logistic regression to find out significant association with breast cancer. Results: Regular multi-vitamin uptake (OR = 3.38; 95%CI = 1.69 – 6.77; p-value = 0.001), poor sleep (OR = 11.29; 95%CI = 4.36 – 29.25; p-value < 0.001), irregular sleep (OR = 34.11; 95%CI = 10.03 – 115.92; p-value < 0.001) and severe stress (OR = 6.74; 95%CI = 3.06 – 14.81; p-value < 0.001) were found to be the highest odds ratio among all modifiable risk factor of breast cancer. Also, age at first childbirth less than 30 years (OR = 0.44; 95%CI = 0.25 – 0.78; p-value = 0.005) was found protective against breast cancer. Conclusion: In our study, stress, sleeping pattern, and regular multi-vitamin uptake were found to be significant modifiable risk factors of breast cancer. None of the non-modifiable risk factors were found to be significantly associated with the risk of breast cancer.  相似文献   
9.
10.
《Piel》2019,34(8):464-469
IntroductionTelangiectasia macularis eruptiva perstans (TMEP) is a rare cutaneous mastocytosis, characterised by erythematous and/or brown macula in which telangiectasia are identified. The diagnosis is based on the clinical state of the lesions and on histopathology; however dermoscopy is an important diagnostic tool, revealing a very characteristic reticular vascular pattern.MethodologyA clinical examination, dermatoscopy, photographic follow-up, and histological study were performed on 5 patients with erythematous brown spots on the neck and V of the neckline, and were seen in this Centre between 2008 and 2018. A polarised light dermatoscope was used on lesion and the skin around it. All patients had a 4 mm punch biopsy of the affected skin, and the slices were stained with haematoxylin-eosin and Giemsa.ResultsThe dermatoscopy of the 5 patients showed a retiform vascular pattern with surrounding and crossing yellow spots corresponding to the follicular sebaceous glands, with few hairs. The skin around the lesion did not show any of these changes. In all patients, biopsy with haematoxylin-eosin corroborated the diagnosis of mastocytosis type TMEP. The location of the disease in the 5 patients was in the neck and V of the neckline.ConclusionsDermatoscopy helps in the diagnosis of TMEP by demonstrating that the retiform telangiectatic vascular pattern is a constant finding in all affected patients, and this is supported by the dermoscopic-histological findings. It also makes it possible to differentiate with other erythematous skin disease, and with other disorders that dermatoscopically exhibit retiform patterns.  相似文献   
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