膀胱癌盆腔淋巴结转移的规律及影响因素分析

目的通过分析膀胱尿路上皮癌淋巴结转移的规律及其相关影响因素,结合盆腔淋巴清扫的研究进展,探讨盆腔淋巴清扫策略。 方法收集我院2008年至2016年由同一术者完成腹腔镜根治性膀胱切除和盆腔淋巴清扫的膀胱尿路上皮癌患者的资料,回顾性分析淋巴结转移的规律及其相关影响因素。 结果共收集患者285例,69例（24.2%）发生淋巴结转移。最常见的淋巴结转移部位为髂内/闭孔淋巴结（57/69,82.6%）,其次是髂外淋巴结（37/69,53.6%）;真骨盆外淋巴结转移均伴随髂内/闭孔或髂外淋巴结转移;单侧壁膀胱癌可以向对侧盆腔淋巴结转移。T1组淋巴结转移率4.6%（4/87）,T2组18.0%（18/100）;T3组50.8%（30/59）;T4组68.0%（17/25）。多因素回归分析显示淋巴结转移与肿瘤分期呈正相关,与分级、年龄、性别、体质量指数、吸烟等因素无关。 结论髂内/闭孔和髂外淋巴结是膀胱癌最主要的淋巴结转移部位,肿瘤高分期是影响膀胱癌淋巴结转移的主要因素。根治性膀胱切除术应行至少包括双侧髂内、闭孔、髂外淋巴结的标准淋巴清扫。     

Long-term Outcomes of Domestic Hunan Aqueous Drainage Implantation in Refractory Glaucoma

 Purpose:To evaluate the long-term outcomes of a non-valved, Chinese-made Hunan aqueous drainage device (HAD) in patients with refractory glaucoma, compared to trabeculectomy. Methods:This was a retrospective observational case series, including 27 patients with refractory glaucoma who either underwent HAD implantation (n=11) or trabeculectomy (n=16). The mean follow-up was 27.9±13.5 (mean±SD) months. Intraocular pressure (IOP), visual acuity and postoperative complications were measured. Results:IOP was significantly lower at the last follow-up in both two groups compared with the baseline IOP (HAD: 58.4 to 10.0 mmHg, P>0.001; trabeculectomy:58.4 to 23.7 mmHg, P<0.001). One week,1 month and 1 year after the operation, the average IOP of the HAD group was significantly lower than that of trabeculectomy group (P<0.05 at all time points). However, , the IOP did not differ significantly between the two groups at the time of last follow-up. Conclusion:HAD implantation serves as a good option to control IOP in refractory glaucoma.     

房水流出通道形态及功能在体评估进展

青光眼病理性高眼压的常见原因是房水流出受阻,因此房水流出通道的形态观察和功能研究是青光眼防治的重点。研究房水流出通道的形态及功能对研究青光眼发病机制、选择手术方式和开发靶向药物均有重要意义。房水流出成像方式中眼前段相干光断层扫描及血管成像、超声生物显微镜活体显像,可对房水流出通道进行结构性评估;而静态和实时房水血管造影为功能性评估。目前尚缺乏房水结构流出特征与功能流量值之间的精确关系研究。使用房水血管造影术可研究与评价青光眼的药物疗效。房水血管造影术有助于引导小梁网靶向的微创青光眼手术以获得更好的降眼压效果。但房水血管造影术有创,目前只能在手术室使用。未来尚需进一步改进评估房水流出通道的方法,以期在临床上通过结构和功能评估相结合,更好地了解房水流出通道和眼前段结构,提高青光眼诊治水平。（国际眼科纵览,2020, 45：397-403）     

调整腺嘌呤饮食磷含量制作慢性肾病高磷血症的小鼠模型

目的：通过调整腺嘌呤饮食中的磷水平,建立慢性肾脏病伴高磷血症的小鼠模型。方法：将雄性C57BL/6小鼠分为腺嘌呤饮食组（腺嘌呤0.2%,钙1.0%,磷0.6%）及其对照组（钙1.0%,磷0.6%）、腺嘌呤联合高磷饮食组（腺嘌呤0.2%,钙0.6%,磷1.0%）及其对照组（钙0.8%,磷0.6%）,每组各7只。于造模前、造模4周记录体重,测血尿素氮（BUN）、钙（Ca）、磷（P）水平,4周后取肾脏组织,RT?PCR检测肾纤维化指标包括Ⅰ型胶原蛋白（CollagenⅠ）、纤连蛋白（fibronectin,FN）、纤溶酶原激活物抑制剂?1（plasminogen activator inhibitor?1,PAI?1）以及炎症指标肿瘤坏死因子?α（tumor necrosis factor α,TNF?α）、白细胞介素?1β（interleukin?1β,IL?1β）、细胞间黏附分子?1（intercellular adhesion molecule?1,ICAM?1）等的表达情况。结果：与相应的对照组比,腺嘌呤饮食组4周时体重降低,血BUN明显升高,为（41.15 ± 4.59）mmol/L;Ca、P轻度升高,分别为（2.62 ± 0.16）mmol/L、（2.22 ± 0.26）mmol/L（P < 0.05）。腺嘌呤联合高磷饮食组造模4周时血BUN［（14.68 ± 3.57）mmol/L］轻度升高、P［（2.97 ± 0.29）mmol/L］明显升高（P < 0.05）,血Ca水平无明显差异。RT?PCR显示腺嘌呤饮食组和腺漂呤联合高磷饮食组小鼠肾脏组织中CollagenⅠ、FN、PAI?1、TNF?α、IL?1β、ICAM?1表达水平均较相应对照组升高。结论：腺嘌呤联合高磷饮食饲喂C57BL/6小鼠4周即可建立高磷血症模型,同时伴有轻度肾功能下降、肾脏纤维化,是制备慢性肾脏病伴高磷血症小鼠模型的可行方法。     

肌萎缩侧索硬化生物标志物的研究进展

肌萎缩侧索硬化(amyotrophic lateral sclerosis, ALS)是一种进行性发展的神经退行性疾病,由于缺乏有效的生物标志物,疾病的早期诊断、进展监测及预后评估均受到影响。近年来基于ALS患者体液的生物标志物研究取得了重要进展,为该病的早期诊断和进展监测提供了一定的理论基础及实践的可行性,同时也为研...     

从“五月九毒日”谈男性房事养生

从顺时养生的角度讲,五月九毒,远离房事,有一定道理,但没有这么绝对,更没有这么可怕。主要在于提醒男性夏日房事要注意节制,以保存阳气、固守阴精,从而达到"长生久视"的养生目的。     

熟三七配方颗粒的质量分析研究

目的：进行熟三七配方颗粒的质量标准研究,建立质量评价方法,为科学评价其质量提供依据。方法：采用薄层色谱法（TLC）对熟三七配方颗粒中人参皂苷 Rh1、Rg3进行鉴别,采用高效液相色谱法（HPLC）对其三七皂苷 R1,人参皂苷 Rg1、Re、Rb1、Rd 进行含量检测分析。结果：建立了熟三七配方颗粒中人参皂苷 Rh1、Rg3的薄层鉴别方法;建立了检测熟三七配方颗粒中三七皂苷 R1,人参皂苷 Rg1、Re、Rb1、Rd 的含量测定方法。结论：该方法简单、准确、专属性好,能有效对熟三七配方颗粒的质量进行评价。     

初诊外周血淋巴细胞绝对值对儿童慢性原发性免疫性血小板减少症诊断价值的meta分析

目的 评价初诊外周血淋巴细胞绝对值（ALC）诊断儿童慢性原发性免疫性血小板减少症（ITP）的临床价值。方法 计算机检PubMed、EMbase、Cochrane Library、中国知网、中国生物医学文献数据库、维普中文期刊数据库和万方数据库上的中英文相关的文献,检索时间均为建库至2020年2月。2名研究者独立提取资料数据和评价纳入文献,并进行文献偏倚风险评价。采用Meta Disc 1.4软件进行Meta分析,计算合并灵敏度、特异度、阳性似然比、阴性似然比以及描绘综合受试者工作特征（SROC）曲线。结果 最终纳入5篇研究,包括1 301例患儿,合并灵敏度为0.70［95%CI（0.66,0.73）］、合并特异度为0.65［95%CI（0.60,0.69）］、合并阳性似然比为3.36［95%CI（1.57,7.19）］、合并阴性似然比为0.45［95%CI（0.34,0.60）］。SROC曲线下面积（AUC）为0.771, Q=0.711。回归分析显示未发现研究间异质性来源。结论 初诊ALC对预测诊断儿童慢性ITP仅具有中等灵敏度及特异度,ALC对于预测儿童ITP慢性发展的临床价值仍有待进一步研究。     

Structure and conductivity enhanced treble-shelled porous silicon as an anode for high-performance lithium-ion batteries

Silicon is regarded as the next generation anode material for lithium-ion batteries because of its high specific capacity, low intercalation potential and abundant reserves. However, huge volume changes during the lithiation and delithiation processes and low electrical conductivity obstruct the practical applications of silicon anodes. In this study, a treble-shelled porous silicon (TS-P-Si) structure was synthesized via a three-step approach. The TS-P-Si anode delivered a capacity of 858.94 mA h g⁻¹ and a capacity retention of 87.8% (753.99 mA h g⁻¹) after being subjected to 400 cycles at a current density of 400 mA g⁻¹. The good cycling performance was due to the unique structure of the inner silicon oxide layer, middle silver nano-particle layer and outer carbon layer, leading to a good conductivity and a decreased volume change of this silicon-based anode.

In this paper, a treble-shelled porous silicon structure is synthesized through three-step approach to enhance the structural stability and conductivity.     

Experimental studies on soft contact lenses for controlled ocular delivery of pirfinedone: in vitro and in vivo

Context: Pirfinedone (PFD) is a novel agent which has the potential to prevent scarring in the eyes. The 0.5% PFD eye drops exhibits poor bioavailability. Whereas, the feasibility of using contact lens as ocular drug delivery device initiated novel possibilities.

Objective: To evaluate the delivery of PFD by soft contact lens (SCL) in vivo, we screened the most suitable lens material for PFD among various commercially available SCL materials in vitro.

Material and methods: Firstly, 11 different SCLs (?1.00 diopter) were respectively soaked in 2?ml of 0.05% PFD-loading solution for 24?h to fully absorb drug, and then placed in fresh phosphate buffered saline (PBS) to release the drug. PFD concentration in PBS was determined by ultraviolet absorbance at 310?nm. Secondly, by immersing in 2?ml of 0.5% PFD eye drops for 24?h, the polymacon lens (0.00 diopter) was then placed on the cornea of New Zealand rabbits. PFD concentrations were detected by high performance liquid chromatography (HPLC) in tears, aqueous humor, conjunctiva, cornea, and sclera at different time points.

Results: PFD showed some affinity for pHEMA-based lenses and the polymacon lens more slowly released more amount of PFD than any other lens in vitro (p < 0.001). Compared with eye drops, drug-loaded SCLs greatly enhanced the retention time and concentrations of PFD in cornea and aqueous humor and consequently improved the bioavailability of PFD.

Conclusion: Polymacon-based SCL is probably a promising vehicle to be an effective ophthalmic delivery system for PFD.