微创小梁切除术联合微创晶状体超声乳化吸出术治疗新生血管性青光眼

目的方法结果结论探讨微创小梁切除术联合微创晶状体超声乳化吸出术治疗新生血管性青光眼的临床效果。2007年12月至2009年1月于我院住院治疗的新生血管性青光眼16例16眼,手术方法为先通过两个0.7毫米的透明角膜穿刺口完成微创晶状体超声乳化吸出术,再于上方结膜切口下切除2m中层角巩膜条带,周边虹膜切除及前房成形后球结膜连续缝合。观察记录手术前后眼压、前房、视力变化及滤过泡情况。随访时间6-12个月,术眼手术后眼压均低于21mmHg,滤过泡形成良好,虹膜新生血管大多消褪,全部眼球得以保留,其中11例视力保持不变,5例不同程度提高。微创小梁切除术联合微创晶状体超声乳化吸出术是治疗新生血管性青光眼的一种有效方法mm×2.5m。     

儿童急性淋巴细胞白血病雌激素受体α与β的表达及临床意义

[摘要] 目的：研究雌激素受体（ER）α与β在儿童急性淋巴细胞白血病（ALL）中的表达水平及与临床疗效的关系。方法：先采用白细胞免疫标记技术APAAP法对30例儿童急性淋巴细胞白血病（ALL）患儿进行免疫学分型,然后采用免疫组织化学SP法检测30例儿童急性淋巴细胞白血病患儿骨髓单个核细胞ERα与ERβ的表达;对照组为15例非恶性血液病患儿。结果：30例初诊组中ERα、ERβ阳性表达率分别为65.7%和70.7%,明显高于对照组（P<0.05）;ERα阳性表达者与阴性表达者之间缓解率无显著差异（P>0.05）,ERβ阳性表达者缓解率明显高于ERβ阴性表达者,两者比较有显著差异（P<0.05）;在缓解组与未缓解组之间ERα阳性表达率无显著差异（P>0.05）,在缓解组与未缓解组之间ERβ阳性表达率有显著差异（P<0.05）。在ALL-B和ALL-T中ERα、ERβ表达均无统计学意义。结论：儿童急性淋巴细胞白血病可能有一定的激素依赖性,ERβ在儿童急性淋巴细胞白血病发生、发展、预后评估上发挥重要角色。     

Pusher curving technique for preventing tilt of femoral Günther Tulip inferior vena cava filter: in vitro study

Objective To determine whether the adjustment of the pusher of GTF was useful to decrease the degree of tilting of the femoral Ginther Tulip filter (GTF) in an in vitro caval model. Methods The caval model was constructed by placement of a 25 mm × 100 mm and two 10 mm ×200 mm Dacron graft inside a transparent bifurcate glass tube. The study consisted of two groups: left straight group (GLS) (n =100) and left curved group (GLC) (n = 100). In the GLC, a 10° to 20° angle was curved on the introducer.The distance (DCH) between the caval right wall and the hook was measured. The degree of tilting (DT) was classified into 5 grades and recorded. Before and after the GTF being released, the angle (ACM1, 2)between the axis of IVC and the metal mount, the distance (DCM1) between the caval right wall and the metal mount, the angle (ACF) between the axis of IVC and the axis of the filter and the diameter of IVC (DIVC) were measured. The data were analyzed with Chi-Square test, t test, rank sum test and Pearson correlation test. Results The degree of GTF tilting in each group revealed a divergent tendency. In group LC, the apex of the filter tended to be grade Ⅲ compared in group LS (x2 value 37. 491 ,P ＜0.01).The differences of most variables between GLS and GLC were considered as statistical significance(16. 60° vs.3.05°, 20.60° vs. 3.50°, -3.90°vs. -0.40°, 2.98 mm vs. 10.40 mm, - 10.95° vs. -0.485°,13. 17 mm vs. 10.06 mm, - 1.70° vs. 0.70°, t or Z values - 12. 187, - 12. 188, -8.545, -51.834,-11. 395,9. 562, -3. 596, P ＜ 0. 01). There exist significant positive correlation between ACM1 and ACF,ACM1 - ACM2 and DCH1 - DCH2 in each group, respectively(r values 0. 978,0. 344,0. 879,0. 627 ,P ＜0. 01),while significant negative associations are detected between DCH1 and ACF in each group , ACP and ACF in group LC(r values -0.974, -0.322, -0.702,P＜0.01). Conclusion The technique of adjusting the orientation of filter pusher had minimized the incidence and extent of GTF filter tilting in vitro.     

结晶型硫化镍诱发细胞恶性转化过程中基因组总体DNA甲基化的改变

Objective To observe the effect of crystalline NiS on genome DNA methylation profile in in vitro cultured cells.Methods 16HBE Cells were treated with crystalline NiS at 0.25,0.50,1.00 and 2.00 μg/cm2 for 24 h and three times at total.DAC treatment was given at 3 μmol/L for 72 h.5-mC immunofluorescence and SssI emthyltrasferase assay methods were applied to investigate if the hypomethylation of genome DNA involved.Results The results of 5-mC immunofluorescence showed that the fluorescence intensity of NiS-treated cells were decreased in some degree, and transformed cells were decreased dramatically.By the SssI methylase assay, an average of (81.9 ± 7.3 )% methylated CpG were found in negative control cells.By contrast, ( 77.9 ± 6.2) %, ( 75.3 ± 6.8 ) %, ( 59.5 ± 4.9 ) %, ( 67.4 ±5.1 ) % methylated CpG were observed in cells treated with NiS for three times at dosage of 0.25,0.50,1.00and 2.00 μg/cm2 which were abbreviated as NiS0.25, NiS0.50, NiS1.00, NiS2.00 respectively.The ANOVA analysis results showed that there was a significant difference in the 5 groups above ( F = 124.95,P ＜0.01 ).The results of Dunnett-t test showed that the methylated CpG of both group NiS1.00 and NiS2.00were significantly decreased compared with the negative control group(t values were 7.64,4.89 respectively,P ＜0.01 ).For methylated CpG, (46.2 ±4.1 ) % and (43.6% ±4.3)% were observed in NiS-transformed cells (NSTC1 and NSTC2) which were dramatically decreased compared with the negative control group(t values were 12.79,13.56 respectively, P ＜ 0.01 ).Conclusion Genomic DNA methylation levels were decreased during NiS induced malignant transformation.     

Ⅰ期临床试验生物样本管理的差错分析及应对措施探讨

目的 提高Ⅰ期临床试验的生物样本管理质量.方法 根据原国家食品药品监督管理总局《药物临床试验数据现场核查要点》和医院体系文件,收集医院2017年1月至2020年12月的Ⅰ期临床试验的质控检查和现场核查报告中的样本管理差错,分析各类差错类型的典型案例,并提出相应纠正措施.结果 共纳入253份Ⅰ期临床试验报告.其中,发生样...     

有/无填充物微创玻璃体切割术治疗增生性糖尿病视网膜病变合并牵拉性视网膜脱离的疗效比较

目的　比较有／无填充物的微创玻璃体切割术治疗增生性糖尿病视网膜病变（ｐｒｏｌｉｆｅｒａｔｉｖｅｄｉａｂｅｔｉｃｒｅｔｉｎｏｐａｔｈｙ,ＰＤＲ）合并牵拉性视网膜脱离的疗效。方法　回顾性分析２０１０年１月至２０１３年１月我院收治的ＰＤＲ合并牵拉性视网膜脱离患者的临床资料,所有患者均采用微创玻璃体切割术治疗,根据术中是否进行玻璃体填充分为无填充物组（Ａ组）和有填充物组（Ｂ组）。术后随访３个月以上,比较两组患者的一般资料（包括性别、年龄、血糖、糖尿病病程等）、手术前后眼压、视力以及术后并发症等。结果　本研究共入组８０例（８０眼）患者,其中Ａ组患者４２例,Ｂ组患者３８例。２组患者术前、术后７ｄ、术后１个月的眼压比较,差异均无统计学意义（均为Ｐ＞０．０５）。２组患者术前、术后３个月的视力比较,差异均无统计学意义（均为Ｐ＞０. ０５）,而Ａ组术后１个月时的视力高于Ｂ组,差异有统计学意义（Ｐ＜０．０５）。术后Ａ组２例患者出现低眼压,１例出现玻璃体积血;Ｂ组２例患者出现玻璃体积血,２例出现晶状体混浊,１例出现低眼压;２组患者术后并发症发生率差异无统计学意义（χ２ ＝０．８０２,Ｐ＝０．３７）。结论　ＰＤＲ合并牵拉性视网膜脱离患者采用微创玻璃体手术治疗可取得较好的疗效,且无填充物患者术后视力恢复更快。     

应用OCT研究高度近视视网膜神经纤维层厚度及影响因素

目的 研究高度近视患者视网膜视神经纤维层(RNFL)变异情况及其与屈光度、年龄、性别和眼别的关系。 方法 选择高度近视172眼,应用光学相干断层成像术(OCT)检测全周和各象限RNFL的厚度,使用多元线性回归分析全周及4个象限的平均厚度与屈光度、年龄、性别和眼别的。 结果 高度近视172只眼RNFL平均厚度分别为全周(112.523±12.053)μm、上方(134.942±21.016)μm、下方(135.488±25.058)μm、颞侧(112.198±27.145)μm,鼻侧(68.3895±17.554)μm;高度近视RNFL全周平均厚度与屈光度的偏相关系数为-1.225,与性别的偏相关系数为5.415,与年龄的偏相关系数为-0.117。RNFL上方平均厚度与年龄的偏相关系数为-0.623,与眼别的偏相关系数为4.780。RNFL下方平均厚度与性别的偏相关系数为6.632。RNFL颞侧平均厚度与性别的偏相关系数为10.048,与屈光度的偏相关系数为4.264。RNFL鼻侧平均厚度与眼别的偏相关系数为-6.905。 结论 年龄、性别、屈光度是高度近视患者RNFL平均厚度的影响因素,眼别是RNFL上方和颞方平均厚度的影响因素,RNFL厚度影响因素的研究为高度近视合并青光眼的早期诊断和随诊提供依据,对加强高度近视患者病情进展的监测和健康宣教有重要意义。     

牡蛎中诺如病毒核酸两种提取方法比较

目的寻找简便有效的更适合长期监测的牡蛎中诺如病毒核酸提取的方法。方法通过甘氨酸聚乙二醇富集后硅胶膜离心
柱法（方法A）和蛋白酶K生物消化后顺磁性硅胶基法（方法B）两种核酸提取方法,采用实时RT-PCR检测自然状态的牡蛎和人
工染毒状态的牡蛎来进行比较。结果两种方法的阳性检出率没有差异,总体比较方法B的病毒回收率高。结论方法B优于
方法A,且方法B更快捷,故方法B更适合长期监测。
     

内科胸腔镜对不明原因胸腔积液诊断价值的前瞻性研究

评价内科胸腔镜对不明原因胸腔积液的诊断价值及安全性。方法前瞻性分析自2005年7月至2011年6月收入院不明原因的胸腔积液患者156例。按随机数字表法分为胸腔镜检查组(A组)80例,闭式胸膜活检术组(B组)76例,对比分析2组患者的诊断阳性率及术后并发症,并对不同年龄分层进行合并症比较。结果A组诊断率为95.0%(76/80),B组诊断阳性率为44.7%(34/76),2组比较,χ2=48.358,P=0.000,相对危险度(OR):24.029,95%置信区间:7.987～72.294,差异具有统计学意义。A组并发症发生率18.8%(15/80),B组并发症发生率15.8%(12/76),2组比较差异无统计学意义(P=0.625)。2组年龄<70岁及年龄≥70岁并发症比较(均P>0.05),差异均无统计学意义。结论内科胸腔镜操作简单,安全,诊断率高,并发症发生率低。     

慢性乙型肝炎及其肝硬化患者HBsAg与HBV DNA定量变化及其相关性

目的探讨慢性乙型肝炎（CHB）、乙型肝炎肝硬化（HBV-LC）患者HBsAg定量和HBVDNA定量的变化及两者的相关性。
方法采集46例CHB轻中度患者（CHB-LM组）,24例CHB重度患者（CHB-S组）和28例HBV-LC患者入院时及51例患者经核
苷（酸）类似物（NA）抗病毒治疗4.08±3.06 月时的血清标本;采用化学发光法定量检测HBsAg 水平,荧光PCR 定量检测
HBVDNA载量。多组比较采用Kruskal-Wallis,两组间比较采用Mann-Whitney U检验,治疗前后比较采用Wilcoxon检测,相关
性分析采用Spearman检验。结果HBsAg和HBVDNA定量在CHB-LM组、CHB-S组和HBV-LC组中逐渐下降（χ2=12.537和
8.381,P=0.002和0.015）;CHB-LM组和CHB-S组HBsAg和HBV DNA定量值均高于HBV-LC组（P<0.05）;CHB-LM和CHB-S
两组之间差异均无统计学意义（Z=-0.649和0.032,P>0.05）。HBeAg阳性患者HBsAg和HBVDNA定量在CHB-LM组、CHB-S
组和HBV-LC 组中呈下降趋势（χ2=6.146,P=0.046 和1.009,P>0.05）;CHB-LM组HBsAg 定量高于HBV-LC 组（Z=-2.247,P=
0.025）。HBeAg阴性患者HBsAg和HBVDNA定量在CHB-LM组、CHB-S组和HBV-LC组中逐渐下降（χ2=7.196和14.658,P<
0.05）;CHB-LM 组和CHB-S 组HBsAg 和HBV DNA 定量均高于HBV-LC 组（P<0.01）。HBsAg 与HBVDNA 定量水平在
CHB-LM 组（r=0.389,P=0.009）、HBV-LC 组（r=0.431,P=0.022）中均呈正相关性;而在CHB-S 组中无相关性（r=0.348,P=
0.104）。与NA抗病毒治疗前相比,51 例患者治疗后HBsAg水平略有下降（Z=-1.050,P=0.294）,而HBVDNA水平明显下降
（Z=-5.415,P<0.001）;治疗后HBsAg定量与HBVDNA定量无统计学相关性（r=0.241,P=0.111）;且两者治疗前后的差值也无统
计学相关性（r=0.257,P=0.085）。结论HBsAg和HBVDNA定量在CHB-LM、CHB-S和HBV-LC患者中逐渐降低,按照HBeAg
阳性和阴性分组后,这种趋势依然存在;HBsAg和HBVDNA之间呈正相关,但并非绝对平行。