miRNA-193b-5p抑制转录调节因子CITED2表达对黑素合成的影响

目的初步探讨miRNA(miR)-193b-5p对黑素合成的影响及可能机制。方法从健康男性包皮环切术后废弃的正常包皮组织中分离培养人原代黑素细胞。分别转染miR-NC模拟物(miR-NC mimics组)和miR-193b-5p模拟物(miR-193b-5p mimics组)至人原代黑素细胞及人黑素瘤MNT1细胞, 转染48 h时实时定量PCR(RT-qPCR)检测miR-193b-5p的过表达效率, 转染72 h时Western印迹检测黑素合成相关蛋白酪氨酸酶和小眼畸形相关转录因子的表达, 转染1周时采用氢氧化钠法测定细胞中黑素含量。通过TargetScan网站预测miR-193b-5p的靶基因并采用双荧光素酶报告实验验证, RT-qPCR及Western印迹检测miR-193b-5p过表达后该靶基因mRNA和蛋白表达水平的变化。两组间比较采用两独立样本t检验。结果人原代黑素细胞及人黑素瘤MNT1细胞中, miR-193b-5p mimics组miR-193b-5p的表达水平均显著高于miR-NC mimics组, t值分别为65.57、22.49, 均P < 0.001, 且...     

金元保汤加减治疗AECOPD患者血栓前状态的临床疗效观察

目的 探讨金元保汤加减对慢性阻塞性肺疾病急性加重(AECOPD)患者血栓前状态(PTS)的影响及其临床意义。方法 选取2021年1月1日～6月31日住院的AECOPD患者100例,采用随机数字表法分为治疗组和对照组,各50例。两组均予以西医常规治疗方案,治疗组加用金元保汤加减。比较两组临床疗效,中医证候积分,肺功能,血气分析及血管性血友病因子(vWF)、白介素-32(IL-32)、纤维蛋白原(FIB)水平。结果 治疗组中医治疗有效率显著优于对照组(P<0.05)。两组治疗后中医证候积分,血浆vWF、IL-32水平与治疗前比较显著降低,第1秒用力呼气容积(FEV₁)、第1秒用力呼气容积占预计值百分比(FEV₁%pred)、1秒率(FEV₁/FVC)、血氧饱和度(SaO₂)、动脉血氧分压(PaO₂)水平与治疗前比较显著升高(P<0.05),治疗组均优于对照组(P<0.05)。结论 金元保汤治疗慢性阻塞性肺疾病急性加重患者疗效确切且安全,能够有效缓解患者临床症状并改...     

程丑夫教授运用黄连温胆汤经验举隅

黄连温胆汤以《备急千金要方》中的温胆汤为基础方加黄连,其主要功效是清热燥湿,理气化痰,和胃利胆,为临床治疗痰热证的经典方.程丑夫教授认为痰热病邪致病广泛,痰火扰心,心神不安则见心烦失眠;痰热中阻,清阳不升,则见眩晕耳鸣;情志不遂,痰热郁积,则见郁病;痰热中阻脾胃,升降逆乱则见胃痛.众疾病虽病名和临床表现不同,但其病理机制总归为痰热内扰.本文旨在通过验案举隅总结探讨程教授运用黄连温胆汤的临床经验.     

应用综合护理措施对经股动脉冠脉介入术后患者腰背酸痛的临床效果观察

总结了综合护理措施对经股动脉介入术后患者腰背酸痛的应用效果。主要包括腰背痛的现况、原因及综合护理措施,认为经股动脉冠状动脉介入术后应用综合护理措施能有效改善患者腰背痛症状,值得推广应用。     

原发性先天性青光眼患者术后生活质量的评价

Objective To evaluate the 23-item scale of Quality of Life (QOL) for patients with primary congenital glaucoma (PCG). Methods It was a cross-sectional study. The QOL scale specific for patients with PCG was firstly evaluated on 51 patients with PCG following antiglaucomat surgery at last follow-up visit (7.80 years±2.93 years with a median at 7 years) and 50 participants with normal visual acuity (VA) as control. All participants were aged 5-20 years old. The QOL of PCG was evaluated with type of disease, severity, surgical outcome, postoperative VA, age, gender and personality by using single-factor correlation analysis and multiple-factor stepwise regression analysis. Results The PCG-QOL scale achieved good reliability, validity and responsibility for PCG and 23-item were all qualified for QOL evaluation of PCG. The total scores of QOL in patients with PCG were significantly lower than those of normal individuals (PCG 60.22±10.02,normal individuals 71.41±10.11;t=5.682, P=0.000). Single-factor correlation analysis showed that the total scores of QOL were associated significantly with the severity of glaucoma (F=24.026, P=0.000), surgical outcome (t=2.638, P=0.009) and postoperative VA (F=11.248, P=0.000) ; The visual function scores were associated significantly with the severity (F=12.677, P=0. 000) and postoperative VA (F=10.369, P=0.000) ; The self-care ability scores were associated significantly with the severity (F=11.064, P=0.000) and surgical outcome (t=2.297, P=0.042) ; The social and mental scores were all correlated significantly with the severity (F=6.869, P=0.020; F=5.721, P=0.019) and personality (t=4.352, P=0.009 ; t=2.297, P=0.042). Multiple-factor stepwise regression analysis showed that there were significant correlations between total scores and the severity (β=-6.985, P=0.001 ), postoperative VA (β=-4.978, P=0.003 ) and personality (β=-5.201, P=0.020). Conclusions The PCG-QOL scale could be used for evaluating the QOL of PCG patients aged 5-20 years. The main factors that influence on the QOL of patients with PCG are severity of the disease, postoperative VA and personality. Preventing progression of glaucoma, improving VA and giving right psychological guidance may improve the QOL of patients with PCG.     

闭合性眼外伤致黄斑裂孔的光相干断层扫描图像分析

Objective To observe the features of the images of optical coherence tomograpy (OCT) in patients with traumatic macular hole (TMH), and detect the clinical significance of OCT. Methods Consecutive 74 patients (74 eyes) diagnosed with TMH by examinations of visual acuity, slit lamp, and direct or indirect ophthalmoscopy underwent optical coherence tomography (OCT), The analysis software of OCT was used to make the quantitative measurements of TMH. And the TMH were classified according to the morphological characteristics of the images of OCT. 50°color fundus photography was performed on the patients after OCT. The relationship of TMH with the average visual acuity, disease duration, average neuroepithelial thickness on the margin of hole, and the base diameter and the apex diameter of macular hole were retrospectively analyzed. Results The characterisctics of the images of 74 cases (74 eyes) of TMH were classified into 5 types: macular holes with symmetric edema of the neurosensory retina at the margin in 27 eyes (36.5%), macular holes with asymmetric edema of the neurosensory retina at the margin in 12 eyes (16.2%), macular hole with full-thickness defect of neurosensory retina without edema or detachment at the margin in 14 eyes (18.9 %), macular hole with localized detachment of the neurosensory retina at the margin without edema in 17 eyes (23.0 %), and macular hole with thinning neurosensory retina in 4 eyes (5. 4 %).There was no significant difference of visual acuity among different types of TMH (F=1. 574, P=0. 191).The visual acuity was positively related with the marginal retinal thickness (r=0. 342, P=0. 003), but not related to age, diameter of macular hole or the disease duration(r value was from-0. 022 to-0. 134, P value was from 0. 863 to 0. 261). The disease duration of Type IV TMH was shorter than that of other TMH types. In the patients with the disease duration over 90 days, Type I TMH was predominant. The average retinal thicknesses at the margin of the hole showed significant differences among different TMH types (F= 13.921, P= 0.000). Conclusions TMH could be divided into 5 types according to the characteristics of images of OCT; the clinical characteristics of different types of TMH varies.     

改良显微小梁切除术治疗葡萄膜炎继发性青光眼

Objective To investigate the effect of trabeculectomy combined with segmental iridectomy, mitomycin C (MMC) and viscoelastic agents usage on the treatment of glaucoma secondary in uveitis. Methods According to the age, degree of inflammation and the condition of Tenon capsule of patients, differ-ent concentration of MMC (0.25-0.33 mg/ml) was used during the operation, with separation of the anterior and posterior synechia, resection of pupillary organization membrane using viscoelastic agents. Segmental iridec-tomy and releasable sutures were also performed on the patients. The visual acuity of preoperation and postoper-ation, intraocular pressure, inflammation and the complication were record. Results Forty-two eyes of 38 cases with glaucoma secondary in uveitis were studied, the mean follow-up time was (12.01±3.56) months. The postoperative visual acuity improved in 14 eyes, didn't change in 28 eyes. The postoperative inflammation of anterior chamber disappeared in 35 eyes, relieved in 7 eyes. And the average postoperative intraocular pres-sure (15.20± 4.64) mmHg was significantly lower than the preoperative intraocular pressure (38.37±12.93) mmHg (t = 8.255, P = 0.000). The total success rate was 92.9%. There were no severe complication. Conclusion Trabeculeetomy combined with MMC, viscoelastic agents usage, separation of anterior and poste-rior syneehia, segmental iridectomy and releasable suture could increase the success rate of operation on pa tients with glaucoma secondary in uveitis, decrease the complication and inflammation reaction of operation, and the recurrence of uveitis.     

羊膜在小梁切除术中应用的临床研究

[目的]探讨羊膜在青光眼滤过手术中应用的降压效果及安全性.[方法]将各类型青光眼38例44只眼分为3组,A组为巩膜瓣下羊膜移植术(AMT)组(20只眼);B组为巩膜瓣下联合应用丝裂霉素组(12只眼);C组为对照组(12只眼),行单纯小梁切除术.观察手术前、术后第1、2、3、7、14、21天、第1、3、6个月各组的视力、眼压、滤过泡类型和充血程度、前房深度、眼底情况及并发症,用前房激光蛋白细胞检测仪(LFCM)测量术前和术后第1、3、7天和1个月的前房蛋白含量,进行统计学分析.[结果]3组术后平均眼压均控制在21 mmHg以下,术后7～14 d眼压最低;3组各观察点之间比较P值均大于0.05,差异无显著性.44只眼中40只眼为Ⅱ型滤过泡,4只眼为包裹性囊状滤过泡.羊膜组滤过泡术后2 d较扁平,第3天起隆起呈弥散的Ⅱ型泡;羊膜组早期滤过泡充血较轻,与其它两组比较差异有显著性(P＜0.05).羊膜组前房蛋白含量术前、术后第1天、第30天均高于其他两组,差异有显著性(P＜0.05).[结论]羊膜运用于青光眼滤过手术中可以有效地降低眼压,减轻炎症反应,并发症较少.羊膜移植术后前房房水蛋白含量增加,可能与羊膜本身蛋白溶解有关.     

包裹囊状滤过泡的发生机制及治疗进展

包裹囊状滤过泡(包裹泡)是青光眼滤过手术后出现的一种并不少见的滤过泡类型,对患者滤过术后的眼压控制以及滤过手术远期成功率有显著影响,因此自1982年正式报道以来[1],人们一直试图明确它的发生机制、了解与发生有关的危险因素以及探寻有效的治疗方法,并取得了一定进展。本文就上述各方面进行综述,为临床处理包裹泡提供参考依据。一、包裹囊状滤过泡的定义、发生机制1982年,Van Buskirk[1]对8例青光眼滤过手术后形成的一种特殊类型的圆顶状、较坚实的滤过泡并伴随眼压升高的病症进行了描述,将其命名为包裹性囊状滤过泡,这是对包裹泡的首…