Correlation between intraocular pressure, central corneal thickness, stage of glaucoma, and demographic patient data: prospective analysis of biophysical parameters in tertiary glaucoma practice populations

PURPOSE: To determine the correlation of central corneal thickness (CCT) to Goldmann applanation tonometry (GAT) and dynamic contour tonometry (DCT, PASCAL), and to glaucoma stage as assessed by cup-to-disc ratio (CDR). DESIGN: Prospective, cross-sectional tricenter observation study. PATIENTS AND METHODS: From three glaucoma specialty practices a sample of 406 independent eyes was included. After ultrasound pachymetry, intraocular pressure was measured using PASCAL and Goldmann applanation tonometry and cup-to-disc ration was reassessed. Demographic data were included in the multivariate analysis. RESULTS: Mean corneal thickness was 540 microm. African Americans and normal-tension glaucoma patients showed the lowest values (518 microm and 522 microm, respectively). These values were significantly thinner than the central corneal thickness of Caucasians (549 microm) and ocular hypertensives (564 microm). Intraocular pressure assessed by Goldmann applanation tonometry shows a significant correlation with central corneal thickness (r = 0.068, P < 0.001), whereas PASCAL is not significantly associated with central corneal thickness (r < 0.001, P = 0.997). Increased IOP is significantly correlated with large ocular pulse amplitudes (r = 0.13, P < 0.001), which is predominantly seen in ocular hypertensives. A significant negative correlation was detected between cup-to-disc ratio and central corneal thickness (r = 0.102, P < 0.001). CONCLUSION: Glaucoma patients with thin central corneal thickness are more likely to be found at an advanced stage of the disease and among those with normal-tension glaucoma and black African ancestry. Underestimation of intraocular pressure by Goldmann applanation tonometry could be one causative factor.     

早孕期血绒毛膜促性腺激素值对辅助生殖治疗妊娠结局的预测价值

目的：探讨辅助生殖技术治疗后早孕期血β绒毛膜促性腺激素（β－HCG）值的单次及动态测定对预测妊娠结局的临床意义。方法：对在本中心采用辅助生殖技术治疗受孕的不孕症患者监测排卵后16天的血β－HCG值及其上升情况，追踪妊娠结局，按妊娠是否超过孕12周分为继续妊娠组及不良妊娠组。结果：血β－HCG水平与妊娠结局明显相关，排卵后16天首次血β－HCG值在继续妊娠组显著高于不良妊娠组（P＜0．01），血β－HCG＜100IU／L者87．5％有不良妊娠结局，而血β－HCG＞400IU／L，则97．3％的患者妊娠超过12周。首次验血后48小时血β－HCG的上升幅度在继续妊娠组和不良妊娠组间差异无显著性（P＞0．05）。结论：辅助生殖技术中排卵后16天单次血β－HCG值是一项有意义的预测妊娠结局的指标。     

SARS-CoV-2及其他β-冠状病毒相关呼吸系统疾病治疗措施的安全性系统评价与Meta分析

目的评估指南推荐疗法治疗严重急性呼吸综合征冠状病毒2(SARS-CoV-2)和其他β冠状病毒相关呼吸道疾病的安全性。方法系统检索PubMed、Embase、Web of Science、Cochrane library、SinoMed、中国知网、万方数据库2003—2020年6月公开发表的关于β-冠状病毒治疗措施的随机对照试验(RCT)、类试验和队列研究。双人独立筛选文献、提取资料,并对符合入选标准的文献采用Cochrane偏倚评价工具进行质量评价后,使用Stata 14.0版软件进行Meta分析。结果最终纳入59项研究,共计9598例。其中49项研究关于SARS-CoV-2,包括27项RCT,19项队列和3项类试验,9项研究关于SARS-CoV,1项队列关于中东呼吸综合征冠状病毒(MERS-CoV)。所有研究中显著性结果如下:在SARS-CoV-2患者中,两项关于洛匹那韦/利托那韦的队列和一项关于大剂量羟氯喹或氯喹的RCT比标准治疗有更多的整体不良反应事件发生[RR=2.68,95%CI(1.48,4.85),I²=34.3%,采用建议分级评估、开发和评价准则(GRADE)评级为:低;RR=3.43,95%CI(1.55,7.58),GRADE评级:中]。而在一项RCT和一项非随机对照试验中,应用洛匹那韦/利托那韦和皮质类固醇激素相比标准治疗发生急性呼吸窘迫综合征的发生率更低[RR=0.46,95%CI(0.25,0.86),GRADE评级:低;RR=0.65,95%CI(0.44,0.98),GRADE评级:极低]。两项应用瑞德昔韦治疗10 d的RCT[RR=0.94,95%CI(0.80,1.11),I²=28.8%,GRADE评级:中]和11项应用中药治疗的RCT[RR=0.77,95%CI(0.53,1.10),I²=0.0%,GRADE评级:低]的安全性与标准治疗相比差异无统计学意义。在SARS-CoV患者中,6项应用中药治疗的RCT相比标准治疗的总体不良反应发生率更低[RR=0.38,95%CI(0.21,0.71),I²=0.0%,GRADE评级:低]。结论洛匹那韦/利托那韦和大剂量羟基氯喹或氯喹治疗SARS-CoV-2的总体不良反应发生率更高,而瑞德西韦和中药相对安全。     

不同职业入伍的新兵社会状况及心理素质的研究

目的 研究不同职业入伍新兵的社会状况和心理素质特点.方法 整群抽取某部2630名集训新兵进行社会状况分析,并应用症状自评量表(SCL-90)、艾森克成人个性问卷(EPQ)、自我和谐量表(SCCS)、简易应对方式问卷(CSQ)、社会支持量表(SSRS)进行心理调查.结果 收回有效问卷2599份,城镇入伍、双亲家庭、高中以上文化、主动入伍、要求进步的新兵中入伍前职业是学生者较多;农村入伍、单亲家庭、初中以下文化、被动入伍的新兵中其他职业入伍者较多(P<0.05).SCL-90:学生新兵强迫、人际关系敏感、抑郁、焦虑、敌对、精神病性因子得分低于其他职业新兵(P<0.05,P<0.01);EPQ:学生新兵内外向因子得分高于其他职业新兵,而神经质和精神质得分低于其他职业新兵(P<0.01);SCCS:学生新兵自我不和谐、自我刻板性因子得分低于其他职业新兵,而自我灵活性得分高于其他职业新兵(P<0.01);CSQ:学生新兵积极应对得分高于其他职业新兵(P<0.01);学生新兵SSRS各因子得分均高于其他职业新兵(P<0.01).结论 学生新兵心理素质较好,可塑性强,入伍前职业是影响新兵心理素质的重要因素之一;新兵入伍后应结合入伍动机、目的、家庭状况,从自我和谐、积极应对、主动寻求支持等方面加强新兵的个性塑造.     

临床药师对1例喘息性支气管肺炎患儿用药方案分析及药学监护

目的：通过分析1例喘息性支气管肺炎患儿的药物治疗过程,探讨临床药师开展临床药学的主要方法。方法：从一般病史、用药史、疗效观察、不良反应观察、用药教育等方面分析1例喘息性支气管肺炎患儿的用药方案。结果：从病史及用药史采集、观察疗效、观察不良反应、抗感染药物应用、专科药物的应用等方面分析得出该患儿用药方案基本合理,但用药仍有值得改进之处。结论：从疗效、不良反应、专科药物应用等方面分析用药方案,是临床药师开展临床药学监护的基本工作内容;深入研究抗感染用药、专科用药、益生菌等药物的使用是实施儿童支气管肺炎药学监护的亮点。临床药师可以通过分析现状、临床实践、分析解决问题的持续改进这一循环方式推动临床药学发展。     

芦丁稀土配合物的合成及药效学初步研究

目的　探索芦丁与稀土元素配位前后药效学的变化。方法　采用小鼠扭体法和耳壳肿胀法对芦丁与稀土元素配位前后镇痛与抗炎作用进行比较。结果　与NS组比较,芦丁及其配合物可明显减少醋酸所致小鼠扭体次数( P <0 0 5或P <0 0 1);与芦丁组比较,其各配合物组的镇痛作用更强(P <0 0 1)。同样,与NS组比较,芦丁及其配合物对二甲苯引起的小鼠耳壳肿胀有明显的抗炎作用(P <0 0 5或P <0 0 1);而各配合物的抗炎作用又强于芦丁组(P <0 0 5或P <0 0 1)。结论　芦丁稀土配合物较芦丁的镇痛、抗炎作用明显增强。     

柴胡-白芍药对抗抑郁作用的实验研究

目的:研究不同剂量柴胡-白芍药对及单用柴胡、白芍的抗抑郁作用。方法:雄性ICR小鼠按体重随机分为空白对照组、阳性药对照组(盐酸氟西汀0.015 g·kg-1)及柴胡-白芍(1∶1)药对高、中、低剂量组(32,16,8 g·kg-1),柴胡高、中、低剂量组(32,16,8 g·kg-1),白芍高、中、低剂量组(32,16,8 g·kg-1)共计11组。各组小鼠灌胃给药7 d后采用小鼠开场实验(OFT)排除假阳性结果,并通过小鼠悬尾实验(TST)、小鼠强迫游泳实验(FST)研究各药的抗抑郁作用。结果:在OFT中,各组小鼠实验结果无显著差异。在TST和FST中,各给药组小鼠的不动时间均显著减少,其中以柴胡-白芍药对高剂量组对小鼠不动时间的影响较为明显,在TST中不动时间为(51.3±31.7)s,在FST中不动时间为(86.3±25.9)s,分别与空白组比较均有显著性差异(P<0.01),并且TST和FST的结果具有一致性。结论:不同剂量的柴胡-白芍药对及单用柴胡、白芍均具有明显的抗抑郁作用,但它们抗抑郁作用强度存在差异。     

Gut-derived lipopolysaccharide promotes alcoholic hepatosteatosis and subsequent hepatocellular carcinoma by stimulating neutrophil extracellular traps through toll-like receptor 4

Background/AimsBinge drinking leads to many disorders, including alcoholic hepatosteatosis, which is characterized by intrahepatic neutrophil infiltration and increases the risk of hepatocellular carcinoma (HCC). Molecular mechanisms may involve the migration of bacterial metabolites from the gut to the liver and the activation of neutrophil extracellular traps (NETs).MethodsSerum samples from both binge drinking and alcohol-avoiding patients were analyzed. Mouse models of chronic plus binge alcohol-induced hepatosteatosis and HCC models were used.ResultsA marker of NETs formation, lipopolysaccharide (LPS), was significantly higher in alcoholic hepatosteatosis and HCC patients and mice than in controls. Intrahepatic inflammation markers and HCC-related cytokines were decreased in mice with reduced NET formation due to neutrophil elastase (NE) deletion, and liver-related symptoms of alcohol were also alleviated in NE knockout mice. Removal of intestinal bacteria with antibiotics led to decreases in markers of NETs formation and inflammatory cytokines upon chronic alcohol consumption, and development of alcoholic hepatosteatosis and HCC was also attenuated. These functions were restored upon supplementation with the bacterial product LPS. When mice lacking toll-like receptor 4 (TLR4) received chronic alcohol feeding, intrahepatic markers of NETs formation decreased, and hepatosteatosis and HCC were alleviated.ConclusionsFormation of NETs following LPS stimulation of TLR4 upon chronic alcohol use leads to increased alcoholic steatosis and subsequent HCC.     

有氧运动对大学生相关指标的影响

目的:通过测定排球、篮球及足球等有氧运动对大学生身长、体质量、握力等的作用,阐明有氧运动对大学生相关指标的影响.方法:共有938名大学1年级新生参与该研究.受试者分为两组,即运动组和对照组,每组各469名,运动组每周1,3,5各进行1次球类有氧运动,分别测定受试者入学和大学2年级结束时的身长、体质量、肺活量、握力、台阶实验和50 m成绩,比较两组之间的差异.结果:(1)与入学时相比,大学2年级结束时,对照组各项指标无统计学变化(P＞0.05);(2)运动组大学2年级结束时与入学时相比,其体质量减轻,台阶实验、肺活量和握力成绩提高(P＜0.05);(3)与对照组相比,运动组在大学2年级结束时,其体质量减轻,台阶实验、肺活量和握力成绩有提高(P＜0.05).结论:长期有氧运动可以减轻大学生的体质量,增强其肺活量、握力,从而提高心肺功能,增强体质.