玻璃体内注射辅酶Q10对NaIO3诱导的AMD模型小鼠的保护作用

目的　探讨玻璃体内注射水溶性CoQ10对NaIO₃诱导的年龄相关性黄斑变性（age-related macular degeneration，AMD）的保护作用。方法　66只昆明小鼠分为3组:对照组、NaIO₃诱导组（小鼠尾静脉注射NaIO₃）和CoQ10修复组，小鼠尾静脉注射NaIO₃后玻璃体内分别注射高浓度（2.0 g·L^-1）和低浓度（0.1 g·L^-1）的CoQ10，注射平衡液做假处理组。在建模后第7天取材，行常规组织切片、HE染色、GFAP染色、Iba1染色，检测NaIO₃诱导的视网膜病变和CoQ10对该种病变的修复效果。结果　注射NaIO₃ 7 d后，HE染色结果显示，NaIO₃诱导组小鼠视网膜外核层每10 μm 长度的细胞数由正常水平（29.13±3.97）个减少至（17.50±4.03）个，差异有统计学意义（P<0.01）；GFAP染色结果显示，Müller细胞发生反应性胶质化，与对照组相比每250 μm×250 μm面积的细胞数由（21.17±4.26）个增加至（28.67±2.80）个，差异有统计学意义（P<0.01）；Iba1染色结果显示，小胶质细胞呈现出“阿米巴状”的激活形态，每250 μm×250 μm面积的细胞数由（6.71±2.29）个增加至（22.14±3.76）个，差异有统计学意义（P<0.01）。分别对NaIO₃诱导组小鼠玻璃体内注射高、低浓度的CoQ10（2.0 g·L^-1和0.1 g·L^-1）后，与假处理组相比，其中注射高浓度CoQ10（2.0 g·L^-1）组外核层细胞数目显著增加（P<0.05），而低浓度CoQ10（0.1 g·L^-1）组没有显著差异（P>0.05）。并且，Müller细胞反应性胶质化程度减弱，GFAP阳性细胞数恢复至（23.83±3.87）个；小胶质细胞分枝增多，Iba1阳性细胞数恢复至（16.86±3.29）个，与NaIO₃诱导组相比，差异均有统计学意义（均为P<0.05）。结论　玻璃体内注射CoQ10可通过减轻Müller细胞的反应性胶质化和抑制小胶质细胞的激活而减缓视网膜感光细胞退化，对AMD起到保护作用。     

内镜经鼻蝶窦入路手术治疗Rathke囊肿

目的探讨内镜经鼻蝶窦入路切除Rathke囊肿的手术技术。方法回顾性分析2004年12月~2010年12月治疗的Rathke囊肿患者18例,术前行头部MRI及内分泌学检查,患者均接受内镜经鼻蝶窦入路手术,术中清除囊肿内容物,部分切除囊肿壁。结果该组患者无手术死亡,术后随访12~24个月,患者症状均有所改善,复查MRI未发现囊肿复发。结论内镜经鼻蝶窦入路手术是治疗Rathke囊肿微创、安全的方法。     

腹腔镜与开腹手术治疗结直肠癌的近期疗效分析

目的：对比分析腹腔镜与开腹手术治疗结直肠癌的近期疗效。方法收集本院2011年1月~2012年4月我院收治的结直肠癌患者118例,分为研究组和对照组各59例,研究组患者实施腹腔镜手术,对照组实施开腹手术,比较两组的临床疗效。结果研究组术中出血量少于对照组,肠道功能恢复时间、住院时间均短于对照组,手术时间长于对照组,两组差异有统计学意义(P<0.05)。研究组手术前期、手术后期及总的淋巴结清扫数、3年生存率与对照组比较差异无统计学意义(P>0.05)。研究组术后并发症发生率、肿瘤复发率均低于对照组,两组差异有统计学意义(P<0.05)。结论腹腔镜手术治疗结直肠癌疗效确切,在肿瘤淋巴结清扫效果方面与开腹手术相近,腹腔镜手术可降低出血量,术后快速恢复,并发症发生率及肿瘤复发率均较低,值得临床推广应用。     

Myositis-specific autoantibodies and their clinical associations in idiopathic inflammatory myopathies: results from a cohort from China

Clinical Rheumatology - The purpose of this study was to determine the incidence of myositis-specific autoantibodies (MSAs) in a cohort of Chinese patients with idiopathic inflammatory myopathies...     

Impact of follow-up visits on disease outcome in Chinese systemic lupus erythematosus

The objective of this study is to determine whether the frequency of visits would affect disease activity and disease damage in patients with systemic lupus erythematosus (SLE). We recruited 147 patients who met the 1997 American College of Rheumatology (ACR) criteria for SLE. Patients were divided into three groups based on follow-up frequency: ≤ 6 visits/year (group 1), 6–12 visits/year (group 2), and > 12 visits/year (group 3). Disease activity and organ damage were evaluated using the SLE disease activity index (SLEDAI) and Systemic Lupus International Collaborative Clinics (SLICC)/ACR criteria, respectively. Data on disease features, patient characteristics, and treatment were retrospectively reviewed. We found that the SLICC score was significantly lower in patients with > 12 visits/year (P = 0.008), while the SLEDAI score showed no significant difference. The age at symptom onset (32.68 ± 13.53) and the age at SLE diagnosis (33.32 ± 13.81) in group 3 were significantly older than those in the other two groups. In univariate regression analysis, the frequency of visits, the age at symptom onset, and the age at SLE diagnosis were found to be associated with the SLICC scores. Visit frequency has no impact on SLE disease activity, but may be associated with less disease damage, an important outcome.     

Molecular mechanisms of human thyrocyte dysfunction induced by low concentrations of polychlorinated biphenyl 118 through the Akt/FoxO3a/NIS pathway

Polychlorinated biphenyls (PCBs) are typical persistent organic pollutants that can interfere with multiple organ systems of humans. Previously, we concluded that persistent exposure to low doses of PCB118 could severely damage the thyroidal structure, dramatically decrease the concentration of serum thyroid hormones and inhibit the pivotal gene expressions such as sodium/iodide symporter (NIS) and thyroglobulin (Tg). To explore the molecular mechanisms of thyrocyte dysfunction induced by 2,3′,4,4′,5‐pentachlorobiphenyl (PCB118), monolayer cultured human thyroid epithelial cells (HTECs) were treated with PCB118 or dimethyl sulfoxide (DMSO) as a control. Our results indicated that relatively higher concentrations of PCB118 could induce a loss in the viability of HTEC. In cultures with concentrations of PCB118 from 0.025 to 25 nM, which did not affect cell viability or apoptosis, concentrations of Tg and thyroxine (T₄) were significantly decreased compared with those in the controls. In addition, mRNA and protein levels of Akt were increased significantly in the PCB118‐treated groups, whereas FoxO3a expression did not show particular variation. Furthermore, exposure to PCB118 was associated with a significant increase of the protein levels of p‐Akt and p‐FoxO3a, and these effects were blocked by LY294002. In contrast, mRNA and protein expression levels of NIS were decreased significantly, and this effect was blocked by LY294002. Unlike control cells, a cytoplasmic shift of FoxO3a was observed in the PCB118‐treated group. Our research suggests that PCB118 may induce thyrocyte dysfunction through the Akt/FoxO3a/NIS signalling pathway, which provides potential new insights for finding interventions to counteract the damage to the human body caused by PCBs. Copyright © 2015 John Wiley & Sons, Ltd.     

“医院-社区-家庭-个人”四位一体化糖尿病健康教育模式探究

目的分析目前糖尿病(diabetes mellitus,DM)健康教育工作中的优势及存在的问题,根据这些优势和问题提出一种更好的DM健康教育模式。方法通过对有关DM健康教育模式文献资料进行研究,根据不同方面,将其按照一个清晰的框架整理出来,在此基础上进行综合分析。结果目前国内DM健康教育主要是由医院、社区、家庭开展,而医院、社区、家庭和DM患者在DM健康教育中各有优势,同时也有局限,若能协调得当,可更有效、更系统地开展健康教育工作。结论 "医院-社区-家庭-个人"四位一体化健康教育模式是以医院为主导并提供优势资源,社区卫生服务机构为中心纽带,带动患者及其家庭的健康教育模式,这便于DM患者及其家庭掌握更多DM知识及其防治技能,有效地控制病情和减轻患者家庭负担。     

该院高危手术前二次医患沟通12年的实践研究

高危手术的患者死亡、残疾等不良后果概率高,极易发生医患纠纷,通过在医务处二次医患沟通,强化并完善术前准备内容,充分医患沟通手术的相关内容,降低术后风险发生概率,有效防范医患纠纷的发生。     

注射剂中不溶性微粒的测定及其对微循环功能的影响

目的:考察注射剂中不溶性微粒的差异,并研究其对微循环功能的影响。方法:以盐酸氨溴索注射剂为模型药物,采用显微镜计数法和光子相关光度法检测4个厂家盐酸氨溴索注射剂中不溶性微粒的数量和分布。取大鼠复制肢体缺血再灌注(LIR)大鼠模型,实验分为模型组与正常组,每组再分为8小组,每小组10只,依次尾iv给予生理盐水、4个厂家的盐酸氨溴索注射剂和粒径为0.5、2.5、25μm的聚苯乙烯微球,给药量为250μl。正常大鼠依次记为CN、CA、CB、CC、CD、CE、CF、CG组,模型大鼠依次记为RN、RA、RB、RC、RD、RE、RF、RG组。给药后20 min检测各组大鼠肠系膜微静脉血流速度(BFVV)和微静脉管径(DV)。结果:4个厂家的盐酸氨溴索注射剂中不溶性微粒数量均符合《中国药典》规定,但0.5~2.5μm的不溶性微粒数量间差异具有统计学意义(P<0.05)。在正常状态下,与CN组比较,除CG组外其余各组大鼠BFVV明显减小,CB、CD、CE、CF组大鼠DV明显增加,差异具有统计学意义(P<0.01),其中CE、CF、CG组微循环效果与粒径大小呈负相关。在LIR状态下,与RN组比较,其余各组大鼠BFVV明显减小,RB、RD组大鼠DV明显减小,差异具有统计学意义(P<0.01)。结论:4个厂家盐酸氨溴索注射剂中不溶性微粒数量虽然均符合《中国药典》规定,但小粒径的不溶性微粒数量存在一定差异;不溶性微粒对微循环功能有不同程度的影响,且在LIR状态下影响更显著。     

首次复治肺结核患者采用短程化疗方案的疗效评价

目的 探讨采用短程化疗方案治疗首次复治肺结核的疗效、依从性及不良反应情况,为临床诊治提供依据。方法 收集2018年6月至2021年3月在安徽省胸科医院就诊的符合条件的首次复治肺结核患者101例,采用随机数字表法将患者分为两组,分别为短疗程方案组(73例,采用6个月莫西沙星、利福布汀、对氨基水杨酸异烟肼、吡嗪酰胺、乙胺丁醇)和标准方案组(28例,强化期3个月使用异烟肼、利福平、吡嗪酰胺、乙胺丁醇,巩固期6个月使用异烟肼、利福平、乙胺丁醇),比较两组患者2个月痰菌阴转率、治疗转归情况、影像学病灶吸收率及不良反应发生情况。结果 短疗程方案组2个月痰菌阴转率为69.0%(29/42),高于标准方案组[41.2%(7/17)],差异有统计学意义(χ²=3.952,P=0.047)。短疗程方案组治疗成功率为78.1%(57/73),高于标准方案组[60.7%(17/28)],差异有统计学意义(Fisher确切概率法,P=0.039)。短疗程方案组病灶吸收情况[57例治疗成功患者中,病灶全吸4例(7.0%),显吸24例(42.1%),吸收29例(50.9%),不变0例(0.0%),恶化0例(0.0%)] 明显好于标准方案组[17例治疗成功患者中,病灶全吸0例(0.0%),显吸3例(17.6%),吸收13例(76.5%),不变1例(5.9%),恶化0例(0.0%)],两组之间差异有统计学意义(Fisher确切概率法,P=0.046)。短疗程方案组不良反应发生率为11.0%(8/73),标准方案组不良反应发生率为14.3%(4/28),差异无统计学意义(χ²=0.014,P=0.905)。结论 在首次复治肺结核患者的治疗过程中,短疗程方案组患者相较于标准方案组患者具有更高的治疗依从性,且短疗程方案有助于痰菌阴转和病灶吸收,能够明显缩短治疗时间并提高疗效。