Effect of Muscle Relaxants on Short-term Results of Exotropia Surgery: A Focus on Resection Procedures

Purpose

We investigated the effect of muscle relaxants (atracurium) on the outcomes of intermittent exotropia surgery under general anesthesia, with a focus on resection procedures.

Methods

Thirty four patients who underwent recession and resection (R&R) were divided into two groups: atracurium usage (group A, n=18) and no atracurium usage (group B, n=16). Patients were divided into two subgroups according to the amount of resection of the medial rectus (MR): less than 5 mm (group 1, n=13) or 5 mm and greater (group 2, n=21). Deviation angles were compared between groups and subgroups. Surgical outcome was defined as successful if distant deviation angles were equal to or less than 10 prism diopters.

Results

The overall postoperative deviation angles did not show statistically significant differences between groups A and B. However, in patients with larger MR resections (≥ 5 mm), the 1 week postoperative distant deviation was significantly larger in group A (1.8±2.6 PD) than in group B (-1.6±4.6 PD, p=0.048 by t-test). The overall undercorrection rate at 3 months postoperatively for group A was 16.7%, which was higher than that of group B (6.3%), and the difference was even larger in subgroups with larger MR resections (≥ 5 mm): 18.2% in group A and 0% in group B.

Conclusions

Patients who underwent R&R procedures under general anesthesia with a muscle relaxant tended to be less corrected than those without muscle relaxant, especially in the early postoperative period and with a larger MR resection equal to or greater than 5 mm. However, there was no significant difference in the later postoperative period.     

Changes of TGF-β2, MMP-2, and TIMP-2 levels in the vitreous of patients with high myopia

Purpose

To investigate the concentrations of transforming growth factor (TGF)-β2, matrix metalloproteinase (MMP)-2, and tissue inhibitor of metalloproteinase (TIMP)-2 in the vitreous of patients with high myopia.

Methods

Twenty-six patients with high myopia (HM) who received vitrectomy for macular retinoschisis or macular hole were enrolled in this prospective study. Twenty-six patients with idiopathic macular hole or macular epiretinal membrane were chosen as a control group. Vitreous samples were obtained during the vitrectomy surgery. The levels of TGF-β2、MMP-2、TIMP-2 in the vitreous samples were measured by enzyme-linked immunosorbent assay. The MMP activity was determined by a fluorometric assay.

Results

There was no significant difference in the vitreous level of TGF-β2 between HM (1.64?±?0.38 ng/ml) and the control group (1.56?±?0.32 ng/ml, p?=?0.56). The vitreous levels of MMP-2 in HM (32.40?±?14.90 ng/ml) were significantly higher than in the control group (21.42?±?6.74 ng/ml, p?MMP-2/TIMP-2 was significantly elevated in the vitreous samples from HM (0.61?±?0.19), compared to the control group (0.48?±?0.11, p?p?Conclusions The elevated MMP/TIMP ratio and MMP activity may play a role in the pathogenesis of human high myopia. Large prospective studies are needed to further investigate the effect of MMPs in the pathogenesis of human high myopia.     

我院306例药品不良反应报告分析

摘 要 目的： 了解我院药品不良反应（ADR）发生的特点及规律。 方法: 回顾性分析我院2013年收集的306例药品不良反应报告,对患者性别、年龄、给药途径、药物类别、ADR累及系统/器官和临床表现、分类情况、因果关系评价以及报告人员构成比等进行统计分析。结果:306例ADR报告中,51～60岁患者发生ADR例数构成比最高（20.26%）;给药途径以静脉滴注引起的ADR例数构成比最高（65.58%）;药品类别以抗菌药引起的ADR例数构成比最高（20.78%）;ADR累及系统以消化系统为主,占23.91%;医师报告的数量最多,占97.71%。结论: 我院应加强对ADR的监测和报告,促进临床合理用药,降低ADR风险,保障患者用药安全。     

肝细胞癌术前红细胞分布宽度的预后价值

目的:探讨肝细胞癌术前红细胞分布宽度（RDW）的预后价值。方法:采用回顾性队列研究方法。收集2002年4月至2017年8月国内3家医疗中心收治的1 025例（西安交通大学第一附属医院586例、西安交通大学第二附属医院248例、青海大学附属医院191例）肝细胞癌病人的临床病理资料;男 809例,女216例;年龄为（54±...     

亲代谢型谷氨酸受体对基底神经节多巴胺和谷氨酸释放的调节

亲代谢型谷氨酸受体 (metabotropicglutamaterecep tors,mGluRs)是一类与G蛋白偶联的调节离子通道和第二信使生成酶的新型谷氨酸受体 ,在基底神经节 (basalganglia ,BG)分布非常广泛。分布于BG的各亚型mGluRs受体能够调节多巴胺 (dopamine ,DA)和谷氨酸 (glutamate,Glu)的释放 ,其调节效应与脑区、受体亚型以及药物浓度等相关。mGluRs多样性的发现及其在调节BG神经传递中的作用为治疗PD提供了有益的靶标     

地尔硫缓释片治疗稳定性心绞痛的临床疗效

目的 :观察地尔硫缓释片治疗稳定性心绞痛的疗效和安全性。方法 :72例稳定性心绞痛病人随机分为 2组 ,地尔硫组 37例 ,男性 2 0例 ,女性 17例 ,年龄 5 6a±s13a ,病程 6a± 4a ,给予地尔硫缓释片 90mg ,po ,qd ;氨氯地平组 35例 ,男性19例 ,女性 16例 ,年龄 5 5a± 13a ,病程 6a± 4a ,给予氨氯地平 5mg ,poqd。 2组服药 2wk后如不能控制心绞痛发作可剂量加倍 ,疗程均 6wk。结果 :对心绞痛症状的疗效地尔硫组显效 5 1% ,有效4 1% ,无效 8% ,总有效率 92 % ;氨氯地平组显效5 1% ,有效 4 0 % ,无效 9% ,总有效率 91% (P >0 .0 5 )。对心电图的疗效地尔硫组显效 2 7% ,改善 2 4 % ,无改变 4 9% ,总有效率 5 1% ;氨氯地平组显效 2 6% ,改善 2 6% ,无改变 4 8% ,总有效率5 2 % (P >0 .0 5 )。未发生严重不良反应。结论 :地尔硫缓释片治疗稳定性心绞痛是安全、有效的。     

雷公藤对豚鼠哮喘模型核因子-κB表达的作用

目的　探讨雷公藤对核因子 κB(NF κB)在豚鼠哮喘模型中表达的影响。方法　豚鼠用 10 %卵白蛋白 (OA)溶液1ml腹腔注射致敏 ,2wk后用 1%OA溶液超声雾化吸入致其哮喘发作 ,每日 1次 ,共 1wk ;测定肺功能并观察气道壁嗜酸性粒细胞 (EOS)浸润情况 ;用免疫组织化学染色方法观察NF κB在豚鼠肺组织中的表达变化。结果　NF κB主要表达在气道壁内的细胞 ,对照组、模型组、雷公藤内酯醇 ( 10 0mg·kg-1ip)组的胞核阳性的细胞数占气道上皮细胞数百分比分别为 14 3 %± 2 6%、3 2 5 %± 5 8%和 19 7%±2 1%。结论　雷公藤内酯醇能显著抑制哮喘豚鼠气道壁内细胞NF κB的表达 ,可能是雷公藤治疗哮喘的作用机制之一。     

阿片类药物治疗老年中重度癌痛不良反应分析

目的探讨阿片类药物治疗老年中重度癌痛不良反应。方法采用回顾性分析的方法,分析了100例老年肿瘤患者应用阿片类药物治疗中重度疼痛的不良反应。采用面部表情疼痛分级量表和数字评定量表综合评定疼痛强度。初次使用强阿片类药物的患者从小剂量开始药物滴定,未达到满意止痛效果者,根据剂量换算确定起始剂量。每天定时记录患者疼痛强度、部位、性质和毒副反应等。结果 100例患者用药时间中位值50d,阿片类药物剂量中位值60mg。93%(93/100)以上的患者达到中度以上缓解。患者不良反应发生率为61%(61/100)。便秘为最常见的(48%)不良反应,其次为恶心/呕吐(24%),嗜睡(12%)、头晕(5%)、皮肤瘙痒(5%)、排尿困难(4%),呼吸抑制(2%)的不良反应较少见。结论阿片类药物能够有效控制老年癌痛,主要不良反应为便秘和恶心呕吐。     

颈动脉粥样硬化斑块炎性和成骨因子的表达及意义

目的：比较未钙化与钙化颈动脉粥样硬化斑块纤维帽及周边区域炎性和成骨因子的蛋白表达水平。方法：依据1995年美国心脏协会的协议将22例行颈动脉内膜切除术（carotid endarterectomy,CEA）的斑块分为未钙化和钙化组（n=11）。制作冰冻组织切片H＆E染色后定量测量各斑块颈动脉狭窄和钙化的面积,采用Western免疫印迹技术检测斑块的纤维帽和周边区域组织的炎性因子白细胞介素-8（1L-8）和单核细胞趋化因子-1（MCP-1）及成骨因子骨形成蛋白-6（BMP-6）和骨钙素（osteocalcin）的蛋白表达水平,并用ImageJ软件作定量分析。结果：未钙化斑块中炎性因子MCP-1和IL-8蛋白表达分别为钙化斑块的1．3（P〉0．05）和1．5倍（P〈0．05）。钙化斑块的成骨因子BMP-6和osteocalcin蛋白表达分别为未钙化斑块的1．3（P〉0．05）和2．1倍（P〈0．01）。结论：炎症反应更多见于未钙化的颈动脉粥样硬化斑块,而斑块的钙化与成骨过程相关,提示颈动脉粥样硬化斑块炎症的好转可能是钙化发生的开端。     

大骨节病患者踝关节软骨IGF-1、IGFBP2基因表达的特征及意义

目的:探讨大骨节病（KBD）患者踝关节软骨胰岛素样生长因子1（IGF-1）、胰岛素样生长因子结合蛋白2（IGFBP2）基因表达的特征及意义。方法:采用病例-对照研究方法,选择2010年1月至2016年12月在陕西省人民医院骨科住院的KBD患者10例为KBD组,并以同期因外伤致踝关节骨折但无距骨损伤的患者10例为对照组,...