青光眼的手术治疗

手术治疗青光眼的主要目的是解决经药物或其他治疗后，仍然不能降低的高眼压状态，从而阻止视神经进一步受损。常用的抗青光眼手术大致有以下3大类：     

青光眼患者您用对眼药了吗?(上)

降低眼压和视神经保护是治疗青光眼的主要目标,其中药物治疗是青光眼治疗的最重要手段之一。临床上有多种治疗青光眼的药物,为使广大患者对抗青光眼药物有一个初步的了解和认识,本文将目前临床上常用的抗青光眼药物作一个简单的归类并着重介绍各种药物的用药指征、方法及副作用,以期对广大青光眼患友在防治青光眼方面有比较确实的帮助。     

小梁切除术后早期结膜下应用5-氟尿嘧啶疗效观察

抗青光眼滤过性手术仍是治疗各种类型青光眼的有效方法之一 ,导致其手术失败的最主要原因之一为滤过通道瘢痕形成。 5-氟尿嘧啶 (5-ｆｌｕｏｒｏｕｒａｃｉｌ,5-Ｆｕ)作为青光眼滤过性术中抗瘢痕形成药物 ,可提高手术成功率的实用价值 ,已为国内外的眼科临床医生所公认。我科采用术后球结膜下注射小剂量 5-Ｆｕ辅助治疗以提高抗青光眼滤过手术成功率取得一定疗效。现报告如下。1　材料与方法1·1　材料　本文选择 1995年 11月～ 1998年 3月本院收治各种类型青光眼 4 8例 (52只眼 ) ,男性 2 5例(2 7只眼 ) ,女性 2 3例 (2 5只眼 )。年龄 14～…     

抗青光眼将有新药

前不久，一种对眼的刺激性很小、降低眼压作用很强的抗青光眼新药拉坦前列腺素在国外已完成了三期临床试验。据有关专家称，这是自１９７８年噻吗心安用于青光眼治疗之后的又一重大突破，这种药在下一世纪极有可能成为青光眼治疗的首选药物。多年以前科学家们就发现，普通前列腺素有降低眼压的作用，但因它对眼睛的刺激性强而未能应用于临床。而拉坦前列腺素不仅对眼睛的刺激作用很小，而且还具有作用持续时间长等特点。另外，其降低机制主要是增加房水经巩膜外流，使房水从睫状肌间隙至脉络膜上腔吸收。排除，这和多数传统的抗青光眼药物不…     

青光眼用药 牢记三原则

青光眼治疗的目的是防止视神经的进一步损害。保持视野稳定的关犍手段是要控制眼压。控制眼压的方法包括药物（滴眼液）、激光和手术治疗。其中最常用的是药物治疗，很多患者要终身使用滴眼液来控制青光眼。长期使用药物也会产生副作用，患者应了解一些药物使用的基本知识，遵循“一不、二要、三定期”的原则：     

青光眼用药 牢记三原则

青光眼治疗的目的是防止视神经的进一步损害。保持视野稳定的关犍手段是要控制眼压。控制眼压的方法包括药物（滴眼液）、激光和手术治疗。其中最常用的是药物治疗，很多患者要终身使用滴眼液来控制青光眼。长期使用药物也会产生副作用，患者应了解一些药物使用的基本知识，遵循“一不、二要、三定期”的原则：     

抗高血压治疗对肾功能的保护作用

现有资料说明终末期肾衰竭的发病率仍在增高,终末期肾衰竭对病人的预后、存活和生活质量均有负性作用。因此预防终末期肾衰竭是临床治疗的重要目标。此种治疗基于一种策略,即肾损害的初期预防和减轻或停止肾衰竭发展的二期预防。为了达到这些治疗目标,通常使用抗高血压药物。笔者简述了高血压药物肾保护作用的机制和对糖尿病与非糖尿病肾病肾保护作用的临床试验证据。1肾保护作用的机制抗高血压药物可通过两个主要机制发挥肾保护作用。首先是降低血压,这也是现有抗高血压药物的共同作用机制,其次是肾内作用,因抗高血压药物的种类不同而异。1…     

抗青光眼药物对青光眼患者的治疗作用及相关指标研究

目的:探讨抗青光眼药物对青光眼患者的治疗作用及相关指标。方法:选择我院100例2017年1月-2018年1月青光眼患者。随机分组,对照组采取噻吗洛尔滴眼液抗青光眼治疗,观察组则采取拉坦前列腺素滴眼液抗青光眼治疗。比较两组青光眼控制率;自觉症状改善的时间、住院的时间;治疗前后患者眼压测量数据;不良反应。结果:观察组青光眼控制率、自觉症状改善的时间、住院的时间、眼压测量数据相比较对照组更好,P0.05。观察组和对照组不良反应相似,P0.05。结论:拉坦前列腺素滴眼液抗青光眼治疗青光眼效果好。     

高血压患者合理用药之二抗高血压药物的分类和临床评价

近年来治疗高血压的药物飞速发展,用于临床的抗高血压药物已有百余种。根据药物作用方式和机理,目前常用的抗高血压药物可分六大类。 β受体阻滞剂 β肾上腺素受体阻滞剂(β受体阻滞剂)具有降低血压、减慢心率、减少心肌耗氧量的作用,还可治疗心律紊乱、心绞痛,降低眼压,治疗青光眼。如果高血压病人并发心绞痛、心律失常及青光眼,应当首选β受体阻     

青光眼患者腹痛不能乱用药

对闭角型青光眼患者来说．一旦发生”肚子痛”“胃痛”等，不能草率使用山莨菪碱等抗胆碱药物。因为，虽然抗胆碱药物具有强大的解痉止痛作用．但是它能诱发闭角型青光眼的急性发作。     

Hepatitis B and C virus infections among patients with gingivitis and adult periodontitis: seroprevalence and public health importance

The aim of the present case control study was to identify seroprevalence of hepatitis B and C virus (HBV and HCV) infections among one hundred cases with periodontal disease (71% gingivitis and 29% adult periodontitis) and one hundred controls with healthy gingiva matdhed for age and sex. Moreover, it aimed to detect hepatitis markers in saliva samples corresponding to the positive sera. Different risk factors associated with hepatitis infection and detectability rate of hepatitis markers were also studied. METHODOLOGY: enzyme linked immunosorbent assay (ELISA) technique was used to detect the presence of hepatitis B surface antigen (HBsAg), antibody to hepatitis B core antigen (anti HBc), e antigen (eAg) and antibody to hepatitis C virus (anti HCV) both in serum and saliva samples. HCV RNA was detected by polymerase chain reaction (PCR) technique. Oral examination was performed for assessment of simplified Oral Hygiene Index (OHI-S), Papillary Bleeding Index (PBI), probing pocket depth and loss of fibre attachment. RESULTS: cases with periodontal disease showed higher percentages of hepatitis exposure (hepex; anti HCV and/or anti HBc) and significantly higher anti HCV seropositivity than the controls (26% and 13% versus 22% and 8%, respectively). No difference in HBsAg carrier rate nor in anti HBc seropositivity was elicited. Furthermore, cases with periodontal disease showed higher detectability rate of HBsAg, anti HBc, anti HCV or both anti HCV and/or anti HBc in whole unstimulated saliva than the controls (100% vs 66.7%, 50% vs 23.5%, 23.1% vs 0.0% and 42.3% vs 18.2%, respectively). Stepwise logistic regression delineated two significant factors associated with the risk of hepatitis exposure, the first predictor was the rural residence and the second one was the history of blood transfusion (OR=3.10, 2.94, respectively). Periodontal disease, severity of bleeding and bad oral hygiene were associated with the risk of hepatitis infection and with the detectability of hepatitis markers in the whole saliva.     

微柱凝胶技术应用于ABO新生儿溶血病患儿输血前检验价值评价

目的：：总结性探讨分析微柱凝胶技术在ABO新生儿溶血病患儿输血前的检验价值。方法：采用228例疑似ABO新生儿溶血病患儿血标本,分别采用传统试管法和微柱凝胶技术进行放散实验、间接抗人球蛋白试验以及直接抗人球蛋白试验,分析比较检测结果。结果：所有疑似ABO新生儿溶血病患儿中检测出ABO新生儿溶血病患儿200例,微柱凝胶法的直接、间接抗人球蛋白试验以及放散试验阳性检出率分别为77%、91%、99%,传统试管法的直接、间接抗人球蛋白试验以及放散试验阳性检出率分别为60%、67%、79%,三个方面的差异都较为明显（P＜0.05）。结论：微柱凝胶技术相比于传统试管法的检测阳性率高,值得在临床工作中加大使用范围。     

汶川地震灾后卫生应急防病管理模式

“5.12”汶川大地震,摧毁了重灾区的卫生防病体系,当地卫生防疫机构处于瘫痪和半瘫痪状态。江苏赴川卫生防疫队根据灾后卫生应急防病特点和实际情况,科学制定防病阶段目标,突出灾后卫生防病特点,落实各项卫生防疫措施,采用了科学合理的灾后卫生应急防病管理模式,使卫生应急防病工作取得了显著成效。     

归国劳务人员传染病监测模式的探讨

目的 了解归国劳务人员患传染病状况，探讨其监测模式的防治对策；方法 选择某劳务工司，对归国劳务人员实施了HIV抗体、RPR抗体、HBsAg检测和胸部透视检查，根据结果作原因分析，寻找适合归国劳务人员传染病监测的途径；结果 某劳务公司1996年至2000年底派往新加坡、牙买加、毛里求斯等国归国劳务人员960名，健康检查680名，检出RPR抗体阳性3例、HBsAg阳性29例；结论 提示要加大加强对归国劳务人员的传染病监测工作，防止传染病的传入和传播，在加强出境劳务人员传染病防治知识宣传教育的同时，认真履行归国劳务人员传染病监测的法律法规，建议政府尽快制定劳务人员归国后自觉接受体检的管理办法和具体措施。     

Conjugated linoleic acid

Conjugated linoleic acid (CLA) is a collective term for metabolic by‐products resulting from the conversion of linoleic acid to oleic acid by rumen bacteria. Consequently CLA is found in foods and fats of animal origin. There is a growing body of information regarding effects of dietary CLA in health and disease, but not yet any definitive mechanisms relating to its mode(s) of action. The review paper by Professor Kritchevsky and accompanying commentary by Professor Williams summarise the recent evidence from animal studies for anti‐tumourigenic, anti‐lipogenic and anti‐atherogenic effects of CLA. These findings may open new avenues of research in several normal and disease states. Furthermore, if the health benefits suggested by animal studies can be shown to apply in human populations, the consequence of advice to reduce fat intakes, may prove to have important public health implications.     

还原型谷胱甘肽治疗恙虫病合并中毒性肝炎的临床观察

目的观察在抗感染的同时采用还原型谷胱甘肽治疗恙虫病合并中毒性肝炎的临床疗效。方法将32例恙虫病合并中毒性肝炎患者随机分为2组,治疗组17例在抗感染及给予甘草酸二铵护肝降酶基础治疗上加用还原型谷胱甘肽,对照组15例仅予抗感染及甘草酸二铵护肝降酶。2组均治疗2周。结果治疗组加用还原型谷胱甘肽可使患者临床症状消失或明显改善,总有效率为88.2%,对照组为66.7%。肝功能各指标恢复正常或下降优于对照组。结论还原型谷胱甘肽治疗恙虫病合并中毒性肝炎疗效良好,安全性高。     

阜阳市2009～2013年性病门诊男性就诊者艾滋病哨点监测结果分析

目的了解性病门诊男性就诊者艾滋病防治知识知晓水平,掌握这一人群艾滋病、梅毒、丙型肝炎流行现状。方法依照《全国艾滋病哨点监测方案》要求,对阜阳市性病门诊男性就诊者哨点监测对象进行问卷调查并采集静脉血5ml进行HIV、HCV和梅毒抗体检测。结果 2009-2013年共调查性病门诊男性就诊者2 011人,艾滋病知识知晓率介于62.50%至81.24%之间;不同年龄组、婚姻状况和样本来源的调查对象知识知晓率差异有统计学意义（P〈0.001）,接受过有关预防艾滋病服务人群的AIDS知识知晓水平较高;接受过安全套宣传和发放/艾滋病咨询与检测（OR=5.434,P〈0.001）、自己知道HIV检测结果（OR=30.909,P=0.003）可促进艾滋病知识知晓率的提高。监测对象HIV、丙肝抗体阳性检出率均在0%-1%之间波动,梅毒抗体的阳性检出率呈逐年上升趋势。结论阜阳市性病门诊男性就诊者对艾滋病防治相关知识的知晓率较低,且梅毒检出率逐年上升,需要加强艾滋病防治知识的宣传教育。     

山东省的疟疾防治与监测

目的　总结疟疾防治工作中的经验。方法　从建国初期始 ,详细阐述了不同年代和不同发病时期所采取的相应防制措施 ,从而有效地降低了疟疾发病 ,控制其暴发流行 ,直至达到基本消灭 ,嗣后进入监测阶段。结果　基本消灭疟疾后继续采取卓有成效的监测措施 ,使疟疾疫情始终保持稳定 ,巩固了疟防成果。结论　疟疾防制工作只要领导重视 ,措施得力 ,即能降低其发病 ,疟防成果即可得到巩固和加强     

Pretreatment 25‐Hydroxyvitamin D Levels and Durability of Anti–Tumor Necrosis Factor–α Therapy in Inflammatory Bowel Diseases

Introduction: Emerging evidence supports an immunologic role for 25‐hydroxyvitamin D (25(OH)D) in inflammatory bowel disease (IBD). Here we examined if pretreatment vitamin D status influences durability of anti–tumor necrosis factor (TNF)–α therapy in patients with Crohn's disease (CD) or ulcerative colitis (UC). Methods: All IBD patients who had plasma 25(OH)D level checked <3 months prior to initiating anti–TNF‐α therapy were included in this retrospective single‐center cohort study. Our main predictor variable was insufficient plasma 25(OH)D (<30 ng/mL). Cox proportional hazards model adjusting for potential confounders was used to identify the independent effect of pretreatment vitamin D on biologic treatment cessation. Results: Our study included 101 IBD patients (74 CD; median disease duration 9 years). The median index 25(OH)D level was 27 ng/mL (interquartile range, 20–33 ng/mL). One‐third of the patients had prior exposure to anti–TNF‐α therapy. On multivariate analysis, patients with insufficient vitamin D demonstrated earlier cessation of anti–TNF‐α therapy (hazard ratio [HR], 2.13; 95% confidence interval [CI], 1.03–4.39; P = .04). This effect was significant in patients who stopped treatment for loss of response (HR, 3.49; 95% CI, 1.34–9.09) and stronger for CD (HR, 2.38; 95% CI, 0.95–5.99) than UC (P = NS). Conclusions: Our findings suggest that vitamin D levels may influence durability of anti–TNF‐α induction and maintenance therapy. Larger cohort studies and clinical trials of supplemental vitamin D use with disease activity as an end point may be warranted.     

Recurrence of focal sclerosing glomerulonephritis in the kidney graft

This is the first report on the recurrence of a glomerular disease in renal transplant in Hungary. The primary disease of the girl died at the age of 13 was focal sclerosing glomerulonephritis with slight mesangial cell proliferation. The first symptoms appeared at the age of 6.5 and they progressed rapidly. Four years later, because of the severe nephrotic syndrome and chronic renal failure, renal transplantation was performed with the synchronous removal of the patient's own kidneys. In the latter an interesting immunohistological finding has been observed: beside the usual positivities, the basement membrane of the distal tubule at the opposite side of the macula densa showed a strong reaction with anti IgM and a somewhat weaker positivity with anti C3 sera. The primary disease recurred very soon. A mesangial cell proliferation, however did not develop, in contrary to the primary disease, which contradicts the theory that the mesangioproliferative form would be a distinct clinicopathological entity.