植入负度数后房型人工晶状体对眼内组织稳定性的影响

背景:白内障合并超高度近视眼的患者手术摘除白内障后,多数学者丰张植入人工晶状体.目的:观察超声乳化白内障吸出联合负度数人工晶状植入治疗超高度近视合并白内障的效果.设计、时间及地点:回顾性分析,于2006-10/2007-10在潍坊医学院附属医院眼科中心完成.对象:选取本院同期收治的行超声乳化白内障吸除负度数人工晶状体植入术患者28例(50只眼),均为超高度近视眼合并白内障,术前矫正视力<0.1共45只眼,0.1～0.15共5只眼.Sensar AR40e疏水性丙烯酸酯折叠式人工晶状体为AMO公司产品.方法:术前常规检查眼轴长度、测量角膜曲率,以第3代理论公式(Sanders-Retzlaff-Kraff T,SRK-T)计算人工晶状体屈光度数,实际植入人工晶状体的屈光度数为测量度数增加 1.00～ 3.50 D.眼表面麻醉,11～12点钟方位角膜缘后1.0 mm处做宽3.0 mm的角巩膜隧道切口,直径5.0 mm连续环形撕囊,使用超声乳化仪吸除晶状体核,囊袋内植入屈光度数为-1.00～-10.00 D人工品状体.术后随访3～12个月.主要观察指标:术后最佳矫正视力、屈光度数偏差值及并发症.结果:术前平均眼轴长度为(32.19±2.31) mm.术后最佳矫正视力≥0.2共43只眼(86.0%),≥0.5共23只眼(46.0%);屈光度数偏差值<±1.00 D共25只眼(50.0%),<±2.00 D共44只眼(88.0%).术中仅1只眼晶状体后囊膜破裂.随访3个月时,1眼品状体后囊轻度浑浊,术眼无视网膜和脉络膜脱离.随访12个月时,5眼晶状体后囊轻度浑浊,术眼无视网膜和脉络膜脱离.结论:超声乳化自内障吸除后植入负度数后房型人工晶状体既可以增加眼内组织的稳定性,防止发生视网膜脱离,又可同时进行屈光矫正.     

儿童腹股沟疝快速康复临床路径的应用价值

目的：观察快速康复临床路径治疗儿童腹股沟疝的安全性及应用价值。方法回顾性分析2013年1月至2014年2月,南方医科大学附属南海医院入院的腹股沟疝患儿170例,按照是否进入快速康复临床路径分为快速康复路径组（观察组）和普通临床路径组（对照组）。观察组患儿（86例）采用快速康复临床路径,对照组患儿（84例）采用普通腹股沟疝临床路径。比较二组患儿的复苏时间、术后不良反应、并发症、住院时间、住院费用。结果二组患儿均无并发症出现。观察组复苏时间为（9±4）min,对照组复苏时间（18±9）min,二组比较差异有统计学意义（t＝－23．686,P＝0．00）;观察组术后不良反应发生率为9．3％,对照组为23．8％,二组比较差异有统计学意义（χ2＝6．501,P＝0．11）;观察组住院时间（1．2±0．2）d,对照组住院时间（2．9±0．7）d,二组比较差异有统计学意义（t＝－25．646,P＝0．00）;观察组住院费用（4864±360）元,对照组住院费用（5311±463）元,二组比较差异有统计学意义（t＝－7．340,P＝0．00）。结论快速康复临床路径应用于儿童腹股沟疝治疗是安全可行的,利于患儿的快速康复并减少住院时间,减轻患者家属的经济负担。     

Sufentanil induces delayed myocardial preconditioning mediated by HO-1

Purpose. The objective of this study was to examine whether sufentanil also confers delayed cardioprotection and whether this effect is mediated through HO-1.
Methods. Male Sprague-Dawley rats received either delayed ischemic preconditioning （DIPC） or sufentanilinduced preconditioning （SPC; with 3 μg/kg, 15 μg/kg, 30 μg/kg, 60 μg/kg, or 120 μg/kg sufentanil） or an ischemic reperfusion（CON）. After 24 h, all animals were subjected to a 30 min coronary occlusion followed by a 2 h reperfusion. In the group treated with 120 μg/kg sufentanil, the selective HO-1 inhibitor Zinc protoporphyrin IX （Znpp IX） was administered. The infarct size （IS） was determined with 2,3,5-triphenyltetrazolium chloride staining. Western blotting analysis was used to examine HO-1 expression.
Results. The IS/AAR ratios in the animals treated with DIPC （0.33±0.07） or with SPC （0.44±0.08, 0.32±0.10, 0.32±0.06, and 0.28±0.07 for the groups treated with 15 μg/kg, 30 μg/kg, 60 t~g/kg, or 120 μg/kg sufentanil, respectively） were significantly reduced compared with control （CON） group （0.54±0.06; P〈0.05）. The ED50 of sufentanil was found to be 13.83 μg/kg according to the sigmoid equation. Znpp IX abolished the effect of the 120 μg/kg sufentanil treatment （the IS/ AAR values were 0.54±0.04 for the SPC±Znpp IX group and 0.28±0.07 for the group treated with 120μg/kg SPC; P〈0.05）. The 120 μg/kg SPC treatment increased the expression of HO-1 compared with the CON group（P〈0.05）, and this effect was prevented by Znpp IX （P〈0.05）.
Conclusion. These results indicate that sufentanil produces delayed cardioprotection in anaesthetized rats and HO-1 may be involved in it.     

No clinical benefit of gender-specific total knee arthroplasty: A systematic review and meta-analysis of 6 randomized controlled trials

Background and purpose

There is no consensus regarding the clinical relevance of gender-specific prostheses in total knee arthroplasty (TKA). We summarize the current best evidence in a comparison of clinical and radiographic outcomes between gender-specific prostheses and standard unisex prostheses in female patients.

Methods

We used the PubMed, Embase, Cochrane, Science Citation Index, and Scopus databases. We included randomized controlled trials published up to January 2013 that compared gender-specific prostheses with standard unisex prostheses in female patients who underwent primary TKAs.

Results

6 trials involving 423 patients with 846 knee joints met the inclusion criteria. No statistically significant differences were observed between the 2 designs regarding pain, range of motion (ROM), knee scores, satisfaction, preference, complications, and radiographic results. The gender-specific design (Gender Solutions; Zimmer Inc, Warsaw, Indiana) reduced the prevalence of overhang. However, it had less overall coverage of the femoral condyles compared to the unisex group. In fact, the femoral prosthesis in the standard unisex group matched better than that in the gender-specific group.

Interpretation

Gender-specific prostheses do not appear to confer any benefit in terms of clinician- and patient-reported outcomes for the female knee.Women account for almost two-thirds of knee arthroplasties (Kurtz et al. 2007). Recently, a possible effect of gender on functional outcomes and implant survivorship has been identified (Vincent et al. 2006, Ritter et al. 2008, Kamath et al. 2010, Parsley et al. 2010, O’Connor 2011). Gender differences in the anatomy of the distal femur are well documented (Conley et al. 2007, Yue et al. 2011a, b, Yan et al. 2012, Zeng et al. 2012). Women tend to have a less prominent anterior condyle (Conley et al. 2007, Fehring et al. 2009), a higher quadriceps angle (Q-angle) (Hsu et al. 1990, Woodland et al. 1992), and a reduced mediolateral to anteroposterior aspect ratio (Chin et al. 2002, Chaichankul et al. 2011). Investigators have found that standard unisex knee prostheses may not equally match the native anatomy in male and female knees (Clarke and Hentz 2008, Yan et al. 2012). A positive association between the femoral component size and the amount of overhang was observed in females, and femoral component overhang (≥ 3 mm) may result in postoperative knee pain or reduced ROM (Hitt et al. 2003, Lo et al. 2003, Mahoney et al. 2010).The concept of gender-specific knee prostheses was introduced to match these 3 anatomic differences in the female population (Conley et al. 2007). It includes a narrower mediolateral diameter for a given anteroposterior dimension, to match the female knee more closely. Additionally, the anterior flange of the prothesis was modified to include a recessed patellar sulcus and reduced anterior condylar height (to ovoid “overstuffing” during knee flexion) and a lateralized patellar sulcus (to accommodate the increased Q-angle associated with a wider pelvis).Several randomized controlled trials (RCTs) have failed to establish the superiority of the gender-specific prosthesis over the unisex knee prosthesis in the female knee (Kim et al. 2010a, b, Song et al. 2012a, Thomsen et al. 2012, von Roth et al. 2013). In contrast, other studies have found higher patient satisfaction and better radiographic fit in the gender-specific TKAs than in the standard unisex TKAs (Clarke and Hentz 2008, Parratte et al. 2011, Yue et al. 2014). We therefore performed a systematic review and meta-analysis to compare the clinical and radiographic results of TKA in female patients receiving gender-specific prostheses or standard unisex prostheses.     

Skeletal muscle expression and abnormal function of beta-myosin in hypertrophic cardiomyopathy.

Hypertrophic cardiomyopathy is an important inherited disease. The phenotype has been linked, in some kindreds, to the beta-myosin heavy chain (beta-MHC) gene. Missense and silent mutations in the beta-MHC gene were used as markers to demonstrate the expression of mutant and normal cardiac beta-MHC gene message in skeletal muscle of hypertrophic cardiomyopathy patients. Mutant beta-myosin, also shown to be present in skeletal muscle by Western blot analysis, translocated actin filaments slower than normal controls in an in vitro motility assay. Thus, single amino acid changes in beta-myosin result in abnormal actomyosin interactions, confirming the primary role of missense mutations in beta-MHC gene in the etiology of hypertrophic cardiomyopathy.     

儿童外伤性白内障50例临床分析及护理

[目的]通过对儿童外伤性白内障围术期相关护理因素的分析,确定患儿的心理特征及健康需求。[方法]对不同年龄段患儿采用了不同的护理措施。[结果]通过对外伤性白内障患儿的护理,使之能最好的配合手术,50例儿童外伤性白内障手术前后矫正视力比较,差异具有统计学意义(χ2=32.29,P<0.05)。[结论]采用针对性的围术期护理措施,是取得良好治疗效果保障之一。     

国外药典与中国药典的无菌检查用真菌培养基的灵敏度比对

微生物培养基是微生物生长繁殖需要的一种生物营养物质。无菌试验用培养基是药品无菌检验的重要手段，中国药典无菌检查法中检查真菌用的培养基改良马丁培养基是用于检查样品是否污染真菌。而BP、EP、USP、JP等国家药典用大豆-酪蛋白消化培养基检查此项。进口药品的药品标准及厂报标准大多都参照国外药典制定，为了与国际接轨，了解大豆-酪蛋白消化培养基能否替代改良马丁培养基，我们参照中国药典培养基灵敏度检查法对中国药典改良马丁培养基与大豆-酪蛋白消化培养基进行了比对试验。现报告如下.     

系统性红斑狼疮伴肝,肾损害时血浆P选择素测定意义

为探讨粘附分子Ｐ选择素在系统性红斑狼疮（ＳＬＥ）发病中的作用，本文采用ＥＬＩＳＡ法检测ＳＬＥ患者血浆Ｐ选择素含量。结果表明３０例患者血浆Ｐ选择素平均水平较正常对照明显升高（Ｐ〈０．０１）。其中ＳＬＥ伴肝、肾损害者的血浆Ｐ选择素显著高于不伴有肝、肾损害者（Ｐ〈０．０１），后者与正常对照组相比，也有显著差异。此外，ＳＬＥ患者血浆Ｐ选择素变化与血沉（ＥＳＲ）呈正相关（ｒ＝０．４６７，Ｐ〈０．０１）；但与     

SUMOylation plays a role in gemcitabine- and bortezomib-induced cytotoxicity in human oropharyngeal carcinoma KB gemcitabine-resistant clone

Bortezomib, a novel dipeptide boronic acid proteasome inhibitor, has been shown in previous studies to be synergistic with gemcitabine; however, the molecular mechanisms are not fully understood. Because post-translational modification of proteins, such as ubiquitination and SUMOylation, plays a critical role in governing cellular homeostasis, we explored this further by treating human oropharyngeal carcinoma KB wild-type (KBwt) and gemcitabine-resistant (KBGem) cells with gemcitabine and bortezomib in a time-dependent and sequence-dependent manner. Treatment with bortezomib at 4 to 8 hours post-gemcitabine significantly induced cell death in KBwt cell lines. However, in KBGem cells, bortezomib alone was just as cytotoxic. Using reporter assays, nuclear factor-kappaB (NF-kappaB) activity was found to be 5-fold higher in KBGem cells than that in KBwt cells, and the combination treatment decreased NF-kappaB activity by 44% in KBwt cells and 28% in KBGem cells, respectively. By Western blot analyses, treatment with gemcitabine and bortezomib resulted in a cleavage of NF-kappaB in KBwt but not in KBGem cells. SUMOylation capacity was modulated by transducing KBwt and KBGem cells with lenti-SUMO-1 or the unconjugatable lenti-SUMO-1aa followed by drug treatment. The expression of cyclins A, D1, and E was differentially regulated by SUMOylation capacity in KBGem but not in KBwt cells. We report herein that the activation of NF-kappaB signaling plays a critical role in eliciting KBwt cell survival against gemcitabine, whereas the role of SUMOylation in modulating the steady-state levels of key cell cycle regulator proteins seems more significant in KBGem cells.