智能脉冲技术辅助的经上皮准分子激光角膜切削术（Trans-PRK）矫正中低度近视

目的　研究智能脉冲技术（smart pulse technology,SPT）辅助的经上皮准分子激光角膜切削术（transepithelial photorefractive keratectomy,Trans-PRK）矫正中低度近视的效果。方法　回顾性分析2017年6月至11月在我院使用1050 Hz切削频率和SPT辅助的Trans-PRK手术的中低度近视患者39例(75眼)的临床资料,应用Sirius眼前节分析仪测量6 mm瞳孔直径下角膜波前像差。随访6个月,手术前后数据采用重复测量方差分析检验。结果　术后6个月的最佳矫正视力与术前比较,无一例下降超过一行,46.67％(35/75)的患眼无变化,37.33％(28/75) 的患眼提高一行,16.00％(12/75) 的患眼提高两行。术后6个月的裸眼视力,100.00％(75/75) 的患眼达到20/20或更好,88.00％(66/75) 的患眼达到20/16或更好,60.00％(45/75) 的患眼达到20/13或更好,8.00％(6/75) 的患眼达到20/10。术后6个月,6 mm瞳孔直径下角膜球差、高阶像差、彗差分别为（0.25±0.14）μm、（0.45±0.15）μm和（0.23±0.11）μm,均较术前（0.19±0.07）μm、（0.33±0.07）μm和（0.19±0.09）μm增加（均为P<0.05）。结论　SPT辅助的Trans-PRK矫正中低度近视是安全、有效的,术后角膜高阶像差、球差和彗差均有一定程度增加。     

Infliximab monotherapy for Chinese patients with moderate to severe plaque psoriasis: a randomized, double-blind, placebo-controlled multicenter trial

Background  Tumor necrosis factor-α is a key mediator in the pathogenesis of psoriasis. Infliximab is a monoclonal antibody that specifically binds to tumor necrosis factor-α. The purpose of this study was to validate the efficacy and safety of 5 mg/kg infliximab therapy in Chinese patients with moderate to severe plaque psoriasis.

Methods  In this multicenter, double-blind, placebo-controlled trial, 129 patients with moderate-to-severe psoriasis were randomized to the induction therapy (weeks 0, 2 and 6) with infliximab 5 mg/kg (n=84) or placebo (n=45), followed with infliximab 5 mg/kg scheduled at week 14 and week 22 in the infliximab group, and infliximab 5 mg/kg scheduled at weeks 10, 12 and 16 in the placebo group. The primary end point was the proportion of patients who achieved at least 75% improvement in Psoriasis Area and Severity Index (PASI 75 response rate) from baseline at week 10.

Results  At week 10, 81.0% of patients treated with infliximab (5 mg/kg) achieved a 75% or greater improvement compared with 2.2% of patients treated with placebo (P <0.001). A significant improvement in PASI, Physician’s Global Assessment (PGA) and Dermatology Life Quality Index (DLQI), was seen from week 6 through week 14 in the infliximab group compared with the placebo group. Through week 22, PASI, PGA, DLQI were well maintained. The incidence of adverse events for the infliximab treatment group was slightly higher in comparison to the placebo treatment group during the first 10 weeks without statistical significance. However, there were 3 cases of tuberculosis that developed during the 26 weeks treatment with infliximal.

Conclusions  Infliximab treatment was effective as induction and maintenance treatments for Chinese patients with moderate to severe plaque psoriasis. Most drug-induced adverse events were mild to moderate, and well tolerated. Screening for tuberculosis is essential and prophylactic treatment should be given if necessary.

     

Methylation status of genes in papillary thyroid carcinoma

OBJECTIVES: To determine the methylation status of gene promoter regions using methylation-specific polymerase chain reaction in genes encoding for thyrotropin receptor (TSHR), E-cadherin (ECAD), sodium iodide symporter protein (NIS-L), ataxia telangiectasia mutated (ATM), and death-associated protein kinase (DAPK) proteins and if methylation status correlates with patient variables, tumor factors, or outcome measures among patients with papillary thyroid carcinoma. DESIGN: Database query and retrospective medical chart review for patients with well-differentiated thyroid cancer and nonmalignant thyroid conditions treated at our institutions (1996-2004). Methylation-specific polymerase chain reaction was performed, and results were compared with controls for these genes. Methylation status was then compared with patient variables, tumor factors, and outcome measures for patients with thyroid carcinoma and controls. PATIENTS: The study population comprised 32 patients with papillary thyroid carcinoma and 27 controls. RESULTS: In our patients, all 5 genes were methylated more frequently in papillary thyroid carcinoma than in controls. NIS-L trended toward a more advanced stage at presentation. NIS-L methylation in cancer cells was not associated with methylation in adjacent benign tissue, unlike the other 4 genes. Neither age nor sex affected methylation status, and methylation status did not correlate with extent of the primary tumor or presence of nodal metastasis at diagnosis. Tumors recurred less frequently in patients with TSHR methylation than in patients with unmethylated TSHR promoter regions. CONCLUSIONS: Promoter methylation may be a marker for malignancy in thyroid carcinoma. Furthermore, methylation status of tumors as determined by methylation-specific polymerase chain reaction may help in determining patient prognosis.     

原发性胆汁性胆管炎患者肝脏雌激素受体与外周血细胞因子及自身抗体的相关性分析

目的 探讨原发性胆汁性胆管炎(PBC)患者肝脏雌激素受体(ER-α)与外周血Th1、Th2细胞因子及自身抗体的相关性.方法 选择2015年12月—2017年12月南京市第二医院收治的PBC患者62例(PBC组)、自身免疫性肝炎患者60例(AIH组)及同期门诊体检健康者50例(对照组)为研究对象.酶联免疫吸附试验(ELI...     

Outcome of drug-eluting balloon angioplasty versus endarterectomy in common femoral artery occlusive disease

Objective

Common femoral artery (CFA) occlusive disease remains a debatable site for endovascular therapy, and the outcome of drug-eluting balloon (DEB) angioplasty in treating CFA occlusive disease is largely unknown. This study compared the efficacy, safety, and short-term patency rate of DEB angioplasty and femoral endarterectomy for treatment of CFA occlusive disease.

血管介入栓塞治疗肺结核并发出血39例

目的：观察血管介入栓塞治疗肺结核并发出血的临床效果。方法选择2012年6月—2013年6月南京市胸科医院结核一科收治的肺结核并发出血78例，按治疗方法分为观察组和对照组，每组39例。两组均给予常规治疗，在此基础上对照组给予垂体后叶素联合血凝酶治疗，观察组采用血管介入栓塞治疗。比较两组临床疗效及并发症发生情况。结果观察组总有效率高于对照组，并发症发生率低于对照组(P <0．05)。结论血管介入栓塞治疗肺结核并发出血效果好，并发症发生率低。     

Effect of Helicobacter pylorieradication on gastric hyperplastic polyposis in Cowden＇s disease

A 21-year-old woman with complaints of hematochezia was diagnosed as having Cowden's disease (CD), an autosomal dominant condition characterized by multiple hamartomas, since facial papules and gingival papillomas were identified. On endoscopy, multiple hyperplastic polyps were seen in the rectum and left-side colon. There were also esophageal glycogenic acanthosis and hyperplastic polyposis in the antrum accompanied by Helicobacter pylori-related gastritis. Although gastric hyperplastic polyposis had by no means regressed with unsuccessful first-line eradication therapy for H pylori, following cure of the infection with salvage therapy consisting of rabeprazole, amoxicillin and metronidazole, the polyposis lesions almost disappeared. Follow-up gastroscopy 2 and 3 years after cessation of the second-line eradication therapy revealed almost complete regression of the polyposis lesions with no evidence of H pylori infection. We recommend eradication treatment for CD patients with gastric hyperplastic polyps and the infection, as the occurrence of gastric carcinoma among hyperplastic polyps has been described.