加替沙星和左氧氟沙星治疗细菌性结膜炎的疗效对比研究

Objective To evaluate the different efficacy and safety to the treatment of baeterial conjunctivitis between the fluoroquinolone antibiotics gatifloxacin and levofloxacin.Methods A multicentre,random,double-blind and control trial was performed in six centers including Eye Ear Nose and Throar Hospital of Fudan University,Henan Eye Institute,Eye Hospital Affiliated to Wenzhou Medieal College,the First Affiliated Hospital Of Nanjing Medical University,Xijing Hospital Affiliated to the Fourth Military Medical University,the Second Affiliated Hospital of Xi'an Jiaotong University between August 2006 and October 2007. The levofloxacin was set as the efficient control. Two hundred and thirty-five patients (235 eyes ) that diagnosed as bacterial conjunctivitis were randomly divided into two groups by the method of randomized blocks, the test group (gatifloxacin) had 118 eyes and the control (levofloxacin) group had 117eyes. The drug delivery into conjunctival sac was performed at a 7-day period ( two drops per time, eight times per day at the first two days and two drops per time, four times per day at the following 5 days). All participants were given the conjunetival sac germ culture and drug sensitive test before and after the study.The combination score of signs and symptoms and evaluation of safety were conducted at the pre-dilivery day,the (4 ± 1 ) and (7 ± 1 ) dilivery day. The statistic analysis was conducted by CMH X2 test, Pearson X2 test and Fisher's exact probabilities test. Results The efficacy of the two groups was 94. 0% ( 110/117 eyes)in gatifloxacin group and 93.8% ( 106/113 eyes) in levofloxacin group with no significant difference( X2 =0.052,P = 0.8201 ). There was also no difference in the bacteria clearance between the two groups [ gatifloxacin versus levofloxacin, 94.1% (80/85 eyes) versus 92. 5% (74/80 eyes) ,P =0. 3470]. The decrease of combination score of signs and symptoms at the (4 ± 1 ) delivery day was 4. 436 +2. 310 in the gatifloxacin group and 3. 814 ± 1. 962 in the levofloxacin group, the difference of which was significant ( F =7.280,P = 0. 0075 ) . This trend was also proved at the ( 7 ± 1 ) delivery day ( gatifloxacin versus levofloxacin, 7. 487 ± 2. 821 versus 6. 912 ± 2. 911, F = 4. 060, P = 0. 0452 ). The visual acuity and the tolerance after local application of the eye drops between the two groups had no diffenrence ( the visual acuity F = 1.04, P = 0. 3080; the tolarence after local admission X2 = 0. 1372, P = 0. 7111 ). According to the result of the germ culture, the major pathogenic bacteria were Gram-positive bacteria ( totally 20 kinds of Grampositive bacteria and 8 kinds of Gram-negetive bacteria). The MIC and drug resistence of gatifloxacin to the Gram-positive bacteria was lower than that of the levofloxaxin ( Staphylococcus Epidermidis, Staphylococcus Aureus, coagulase negative Staphylococcus, α-hemolytic Streptococcus). Conclusions The gatifloxacin eye drop has a good therapeutic effect to the bacterial conjunctivitis, It can effectively clear the pathogen with fast and strong effect. Moreover, it has a low MIC in vitro, advance a prospect in drug resistance, safety and ocular tolerance.     

新型化合物FTZ抑制血管性痴呆模型大鼠脑内低氧诱导因子过表达

目的 研究FLZ对暂时性大脑中动脉阻断（tMCAO）局部脑缺血再灌注致血管性痴呆模型大鼠学习记忆能力的作用,及对低氧诱导因子（HIF-1α）表达的影响。方法 用tMCAO缺血2 h再灌致痴呆模型大鼠,30天后用Morris水迷宫实验检测学习记忆能力。用TTC染色检测脑梗塞体积;HE染色检测皮层、海马病理学改变。此外,大鼠tMCAO缺血2 h再灌24 h后用Western blot法检测HIF-1α表达。结果 FLZ明显缩短tMCAO大鼠在Morris水迷宫中的逃避潜伏期,显著减小脑梗塞体积和减轻皮层、海马的病理学改变。FLZ显著抑制缺血2 h时HIF-1α过度表达。结论 FLZ可以显著改善tMCAO诱导的大鼠学习记忆功能障碍,抑制皮层HIF-1α过度表达和神经保护作用可能是其作用机制之一。     

单角子宫合并功能性残角子宫

单角子宫合并的"残角子宫"和先天性无阴道综合征(MRKH综合征)中的残迹子宫本质是相同的,当发生非妊娠期梗阻性隐经和腹痛症状时,也要想到单角子宫的可能。而阴道斜隔综合征与之鉴别诊断的要点在于双侧对称的宫体以及单侧阴道斜隔和隔后腔积液。单侧肾缺如是非对称型生殖道畸形的常见伴发情况,并非某一特定缺陷的特异条件,鉴别诊断中务必开拓眼界和思维。     

综合疗法治疗糖尿病周围神经病变90例疗效观察

目的:观察中药通必舒霜外用为主综合治疗糖尿病周围神经病变(DPN)的疗效。方法:将120例患者随机分为2组。治疗组90例采用中药通必舒霜外用局部透皮给药联合川芎嗪注射液、丹参注射液静滴及弥可保肌注等多种途径给药,对照组30例仅用弥可保肌注治疗。3周为1疗程,共治疗2疗程。结果:总有效率治疗组与对照组分别为90.25％、57.06％.2组比较,差异有显著性意义(P<0.05);显效率治疗组与对照组分别为62.53％、34.20％,2组比较,差异有非常显著性意义(P<0.01)。而且治疗组治疗后,空腹血糖略有下降,肌电图、血液流变学均有明显改善,红细胞山梨醇浓度有明显下降(P<0.05.P<0.01)。结论:中药通必舒霜外用为主的综合疗法治疗DPN有较好的疗效。     

借助显微镜照明直视下单通道经睫状体平坦部玻璃体切割术治疗人工晶状体脱位

目的：描述一种显微镜照明直视下、经单通道睫状体平坦部行玻璃体切割术治疗人工晶状体全脱位至玻璃体腔的手术技术。

方法：收集2013年至今经超声乳化白内障摘除术后自发性人工晶状体(IOL)囊外脱位或IOL复合体脱位至玻璃体腔的病例。术后随访至6mo。本文详细描述了该手术技术,并回顾性总结了8例典型病例。

结果：共40例患者接受了该手术方法。与IOL全脱位至玻璃体腔相关的危险因素包括：玻璃体切除手术史、超声乳化术中后囊膜破裂或悬韧带断裂、既往眼部外伤史、长眼轴、Ⅱ期IOL植入、陈旧性葡萄膜炎、视网膜色素变性、或抗青光眼手术史。术中所有患者的IOL均顺利取出。随访期内未发生与手术步骤相关的术中或术后并发症。术前患者的最佳矫正视力(CDVA)位于20/133至20/25间,末次随访时(术后6mo)基本持平。眼压值均位于正常范围。

结论：显微镜照明直视下单通道玻璃体切割术是一种处理IOL脱位的相对简单、安全有效的手术方法,其能缩短手术时间,并大大减少手术相关并发症的发生。     

成人圆锥角膜急性水肿一例

患者男,43岁.1年前左眼在无明显诱因出现视力逐渐下降2008年11月20日来院就诊.全身情况良好,否认家族史、遗传病史以及过敏性疾病史.眼科检查:右眼视力:1.0,左眼视力:0.1.眼压(Canon TXF-非接触式眼压计)右眼13mmHg,左眼测不出.     

加替沙星和左氧氟沙星治疗细菌性结膜炎的疗效对比研究

Objective To evaluate the different efficacy and safety to the treatment of baeterial conjunctivitis between the fluoroquinolone antibiotics gatifloxacin and levofloxacin.Methods A multicentre,random,double-blind and control trial was performed in six centers including Eye Ear Nose and Throar Hospital of Fudan University,Henan Eye Institute,Eye Hospital Affiliated to Wenzhou Medieal College,the First Affiliated Hospital Of Nanjing Medical University,Xijing Hospital Affiliated to the Fourth Military Medical University,the Second Affiliated Hospital of Xi'an Jiaotong University between August 2006 and October 2007. The levofloxacin was set as the efficient control. Two hundred and thirty-five patients (235 eyes ) that diagnosed as bacterial conjunctivitis were randomly divided into two groups by the method of randomized blocks, the test group (gatifloxacin) had 118 eyes and the control (levofloxacin) group had 117eyes. The drug delivery into conjunctival sac was performed at a 7-day period ( two drops per time, eight times per day at the first two days and two drops per time, four times per day at the following 5 days). All participants were given the conjunetival sac germ culture and drug sensitive test before and after the study.The combination score of signs and symptoms and evaluation of safety were conducted at the pre-dilivery day,the (4 ± 1 ) and (7 ± 1 ) dilivery day. The statistic analysis was conducted by CMH X2 test, Pearson X2 test and Fisher's exact probabilities test. Results The efficacy of the two groups was 94. 0% ( 110/117 eyes)in gatifloxacin group and 93.8% ( 106/113 eyes) in levofloxacin group with no significant difference( X2 =0.052,P = 0.8201 ). There was also no difference in the bacteria clearance between the two groups [ gatifloxacin versus levofloxacin, 94.1% (80/85 eyes) versus 92. 5% (74/80 eyes) ,P =0. 3470]. The decrease of combination score of signs and symptoms at the (4 ± 1 ) delivery day was 4. 436 +2. 310 in the gatifloxacin group and 3. 814 ± 1. 962 in the levofloxacin group, the difference of which was significant ( F =7.280,P = 0. 0075 ) . This trend was also proved at the ( 7 ± 1 ) delivery day ( gatifloxacin versus levofloxacin, 7. 487 ± 2. 821 versus 6. 912 ± 2. 911, F = 4. 060, P = 0. 0452 ). The visual acuity and the tolerance after local application of the eye drops between the two groups had no diffenrence ( the visual acuity F = 1.04, P = 0. 3080; the tolarence after local admission X2 = 0. 1372, P = 0. 7111 ). According to the result of the germ culture, the major pathogenic bacteria were Gram-positive bacteria ( totally 20 kinds of Grampositive bacteria and 8 kinds of Gram-negetive bacteria). The MIC and drug resistence of gatifloxacin to the Gram-positive bacteria was lower than that of the levofloxaxin ( Staphylococcus Epidermidis, Staphylococcus Aureus, coagulase negative Staphylococcus, α-hemolytic Streptococcus). Conclusions The gatifloxacin eye drop has a good therapeutic effect to the bacterial conjunctivitis, It can effectively clear the pathogen with fast and strong effect. Moreover, it has a low MIC in vitro, advance a prospect in drug resistance, safety and ocular tolerance.     

急下存阴法对脓毒症急性胃肠损伤的胃肠动力疗效研究

目的：观察急下存阴法治疗脓毒症急性胃肠损伤的胃肠动力临床疗效。方法：脓毒症急性胃肠损伤少阴三急下证患者66例随机分为对照组和试验组各33例。对照组给予常规西医治疗;试验组在对照组的治疗基础上加予急下存阴中药汤剂。测定两组患者AGI分级、GIF评分、APACHEⅡ评分、SOFA评分、中医证候积分、腹胀症状积分、便秘症状积分、口燥咽干症状积分、血清胃泌素(gastrin, GAS)、腹内压(intra-abdominal pressure, IAP)、肠鸣音分级、腹壁张力。结果：治疗前后,AGI分级、GIF评分、SOFA评分、中医证候积分、腹胀症状积分、便秘症状积分、口燥咽干症状积分、IAP、肠鸣音分级、腹壁张力测定,试验组较对照组均有所降低(P<0.05),血清GAS试验组较对照组均有所上升(P<0.05),差异有统计学意义。APACHEⅡ评分在试验组治疗后降低,但组间差异不明显,以待进一步扩大研究。结论：研究结果显示,急下存阴法治疗能够减轻脓毒症胃肠功能障碍,促进胃肠动力,改善脓毒症急性胃肠损伤的预后。     

妊娠女性药物相关肝损伤风险的识别及分析

目的 通过对妊娠女性药物相关肝损伤不良反应(ADR)特征识别与分析,警示其潜在用药风险。方法 收集中草药肝损伤云系统(hilicloud.net)中2012年1月1日—2016年12月31日妊娠女性药物相关肝损伤ADR报告进行回顾性研究,分析其主要临床特征及用药规律,并采用报告比值比(ROR)对相关药物进行相对风险分析。计量资料组间比较采用t检验。结果 妊娠女性药物相关肝损伤报告的高频药物有甲氨蝶呤、米非司酮、利托君等,主要用于终止异位妊娠及葡萄胎等疾病的治疗。药物相关肝损伤相对风险分析发现,妊娠女性使用甲氨蝶呤(ROR=37.52,95%CI:31.35～44.89)、黄体酮(ROR=7.33,95%CI:2.75～19.59)、地屈孕酮(ROR=6.58,95%CI:2.20～19.69)与肝损伤风险相关性较强,其中妊娠女性(ROR=37.52,95%CI:31.35～44.89)使用甲氨蝶呤比非妊娠女性(ROR=1.71,95%CI:1.47～4.36)使用发生肝损伤的风险相关性强。结论 应重视甲氨蝶呤、黄体酮等药物在妊娠女性人群中发生肝损伤的潜在风险,避免严重不良反应的发生。     

微探头超声内镜联合腹部彩超在结肠癌患者临床分期中的应用

目的 评价微探头超声内镜与腹部超声联合应用对提高大肠癌患者的临床分期准确性及特异性的价值.方法 应用微探头超声内镜及其与B超联合的检查方法分别对88例大肠癌患者进行术前TNM分期,并与术后病理结果进行比较.结果 微探头超声内镜术前大脑癌浸润深度的分期和是否有淋巴结转移与术后病理结果分期的总符合率分别为78.4％和72.7％,T1、T2、T3和T4的符合率分别为88.9％、73.9％、80.6％和76.0％;无淋巴结转移(N-)和有淋巴结转移(N+)的符合率分别为75.0％和71.9％.微探头超声内镜与B超联合对淋巴转移的准确度、敏感度及特异性均高于单独应用微探头超声内镜检查,但差异无统计学意义.结论 微探头超声内镜是大肠癌浸润深度分期的有效手段之一,结合其他影像学检查有助于提高TNM分期准确性.