蓝-黄视野计与标准的白-白视野计对早期原发性开角型青光眼视野的对比研究

目的　评价蓝 -黄视野计 (blue- on- yellow perim etry,B/ Y)又称短波长视野计 (short- wavelength auto-mated perim etry,SWAP)与标准的白色视野计 (white- on- white perimetry,W/ W)在早期青光眼视野损害诊断中的意义。方法　利用 Hum phrey- - 75 0型全自动视野计 C- 30 - 2全阈值检测程序对 2 0例 (4 0只眼 )正常人、2 0例 (36只眼 )可疑青光眼、18例 (32只眼 )确诊的早期原发性开角型青光眼 (primary open- angle glaucoma,POAG)分别进行 W/ W与 B/ Y的视野检查。结果　正常人、可疑青光眼、早期青光眼 B/ Y检测的全视网膜光敏感度均值 (MS)低于 W/ W检测的结果 ,两者有显著性意义 (t=11.6 8,P <0 .0 1;t=14 .0 1,P <0 .0 1;t=14 .6 8,P <0 .0 1)。B/ Y检测光敏感度缺损均值 (MD)与 W/ W检测的结果 ,正常人组无显著性意义 (t=1.0 4 ,P <0 .0 1) ,其它两组有显著性意义 (t=4 .88,P <0 .0 1;t=3.378,P <0 .0 1)。W/ W检查正常人组与可疑性青光眼的 MS差别无显著意义 (t=2 .5 4 ,P >0 .0 1) ,B/ Y有显著意义 (t=5 .5 7,P <0 .0 1)。两组的 MD差别均有显著意义 (t=3.16 ,P <0 .0 1,t=6 .2 6 ,P <0 .0 1) ;W/ W与 B/ Y检查正常人组与早期青光眼组的 MS差别有显著意义 (t=6 .4 7,P <0 .0 ;t=10 .19,P     

眼部血管平滑肌瘤与平滑肌瘤

报告眼部血管平滑肌瘤１２例，平滑肌瘤２例，并作临床病理分析。本病临床特点是：①ＣＴ显示为圆或椭圆形边界清楚包块，部分病例有钙化斑存在。②手术时所见为一个圆或椭圆形、有包膜、紫红色肿块，与周围组织粘连及易出血。按组织病理学分类，血管平滑肌瘤可分为三个类型（海绵状型、静脉型、实体型），在部分病例标本中，三种类型可同时存在。     

A technique for periorbital syringomas: intralesional radiofrequency ablation

AIM: To evaluate the efficacy of intralesional radiofrequency ablation in the treatment of periorbital syringomas. METHODS: We tried the intralesional radiofrequency ablation for 64 patients with periorbital syringomas from 2007 to 2011. The operation was performed under 2.5 loupe magnifications. The handpiece was assembled with a needle electrode and connected to the radiofrequency ablation apparatus. The electrode was then inserted into the target lesions in dermis and delivering injury to the base of these tumors. Results were assessed clinically by comparing pre- and post-treatment photographs and patient satisfaction rates. RESULTS: Clinical improvement increased with each subsequent treatment session. The percent of patients whose clinic improvement grade were≥3 after each session was respectively 71.9%(Session1), 83.3%(Session2), and 100%(Session3). The statistical results indicated the concordance of the clinical assessment and the satisfaction level of patients (kappa=0.78 of the session1; kappa=0.82 of the session2). The majority of patients had good or excellent cosmetic results. Postoperatively, there were no permanent side effects or recurrences. CONCLUSION: As a new technique of minimally invasion, the intralesional radiofrequency ablation was found to be an effective, inexpensive, highly precise and safe way of treating periorbital syringomas.     

Changes of TGF-β2, MMP-2, and TIMP-2 levels in the vitreous of patients with high myopia

Purpose

To investigate the concentrations of transforming growth factor (TGF)-β2, matrix metalloproteinase (MMP)-2, and tissue inhibitor of metalloproteinase (TIMP)-2 in the vitreous of patients with high myopia.

Methods

Twenty-six patients with high myopia (HM) who received vitrectomy for macular retinoschisis or macular hole were enrolled in this prospective study. Twenty-six patients with idiopathic macular hole or macular epiretinal membrane were chosen as a control group. Vitreous samples were obtained during the vitrectomy surgery. The levels of TGF-β2、MMP-2、TIMP-2 in the vitreous samples were measured by enzyme-linked immunosorbent assay. The MMP activity was determined by a fluorometric assay.

Results

There was no significant difference in the vitreous level of TGF-β2 between HM (1.64?±?0.38 ng/ml) and the control group (1.56?±?0.32 ng/ml, p?=?0.56). The vitreous levels of MMP-2 in HM (32.40?±?14.90 ng/ml) were significantly higher than in the control group (21.42?±?6.74 ng/ml, p?MMP-2/TIMP-2 was significantly elevated in the vitreous samples from HM (0.61?±?0.19), compared to the control group (0.48?±?0.11, p?p?Conclusions The elevated MMP/TIMP ratio and MMP activity may play a role in the pathogenesis of human high myopia. Large prospective studies are needed to further investigate the effect of MMPs in the pathogenesis of human high myopia.     

妊娠肝内胆汁淤积症患者胎儿缺氧的影响因素

目的　探讨妊娠肝内胆汁淤积症 (ICP)患者胎儿缺氧机理及其相关因素。方法　分别测定ICP患者 (30例 ,ICP组 )及正常妊娠妇女 (30例 ,对照组 )新生儿脐动脉血胆汁酸总量 (TBA)、次黄嘌呤 (HX)、内皮素 (ET)及有核红细胞 (NRBC)计数。结果　 (1)ICP组缺氧者 (10例 )脐血HX水平为(18.6 8± 15 .73) μmol/L ,明显高于ICP组无缺氧者 (2 0例 ) [(6 .87± 2 .82 ) μmol/L ]及对照组 [(6 .81±2 .83) μmol/L](P <0 .0 1) ;但NRBC[(4 .2 0± 2 .49)个 / 10 0白细胞 ,(3.40± 2 .2 6 )个 / 10 0白细胞 ,(3.5 0± 1.74)个 / 10 0白细胞 ]及ET水平 [(72 .44± 12 .2 3)ng/L ,(70 .16± 2 6 .6 1)ng/L ,(6 7.2 7± 43.5 6 )ng/L],各组相似 (P >0 .0 5 )。 (2 )ICP组缺氧者脐血TBA为 (2 3.77± 11.82 ) μmol/L ,明显高于ICP组无缺氧者 (14.86± 5 .46 ) μmol/L ,ICP组无缺氧者脐血TBA又高于对照组 [(9.2 8± 4.39) μmol/L](P <0 .0 1) ;且ICP组脐血TBA与HX水平呈正相关 (r=0 .6 89,P <0 .0 1) ;ICP组羊水胎粪污染率明显高于对照组 (5 3.3% ,13.3% ;P <0 .0 1) ,ICP组羊水胎粪污染者脐血TBA[(2 1.44± 9.92 ) μmol/L],明显高于羊水清亮者 [(13.6 9± 5 .74) μmol/L],差异有显著性 (P <0 .0 5 )。 结论　ICP时 ,     

反复自然流产绒毛生化学改变的研究

木研究对３４例反复自然流产（ＲＳＡ）、１０例１次流产及３８例正常妊娠人流绒毛组织，应用生物化学及免疫组化方法，检测绒毛组织中谷胱甘肽硫转移酶（ＧＳＴ）活性、腺苷脱氨酶（ＡＤＡ）活性和还原型谷胱甘肽（ＧＳＨ）含量及γ谷氨酸转肽酶（γ－ＧＴ）免疫组化定位进行对比性研究。结果表明，ＲＳＡ绒毛组织较正常绒毛组织中ＧＳＴ活性和ＡＤＡ活性均有明显改变（Ｐ＜０．０１）。γ－ＧＴ免疫组化定位、阳性颗粒的分布及强度也有明显的差别。自然流产３次以上较２次和１次流产的ＧＳＨ含量和ＧＳＴ活性明显降低，经统计学分析均有非常显著差别（Ｐ＜０．０１）。该结果提示绒毛组织本身某些生化功能的改变，可能是原因不明的ＲＳＡ的原因之一。     

聚丙烯酰胺等电聚焦分析兔子宫雌激素受体

本文介绍用一种简便、快速的小玻璃管聚丙烯酰胺凝胶等电聚焦来分析细胞浆液雌激素受体及血清性激素结合蛋白的方法。作者采取电泳槽周围用冰水浸泡,以及在有游离雌激素存在的条件下进行聚焦,减少了甾体-蛋白复合物的解离。所得的结果是:孕妇血清性激素结合蛋白等电点(PI)为5.2;兔子宫内膜细胞浆雌激素受体复合物有二种组份,等电点分别为6.8及5.8。在有0.4MKCl 存在的条件下,PI6.8的放射性增加,PI5.8的放射性消失,因而前者很可能是4S 形式的甾体-受体复合物,后者很可能是8S形式的甾体-受体复合物。     

Surgical and Oncologic Outcomes of Radical Abdominal Trachelectomy Versus Hysterectomy for Stage IA2-IB1 Cervical Cancer

Study Objective: To compare the surgical and oncologic outcomes between abdominal radical trachelectomy (ART) and radical hysterectomy (RH) for stage IA2-IB1 cervical cancer.Design: A retrospective cohort study (Canadian Task Force classification II-2).Setting: Shandong Cancer Hospital, Shandong, China.Patients: Three hundred twenty-nine patients with IA2-IB1 cervical cancer.Interventions: All patients underwent ART or RH.Measurements and Main Results: All patients were divided into ART (n?=?143) and RH (n?=?186) groups according to the surgical approach. Additionally, oncologic and fertility outcomes were compared for different tumor pathologies and sizes in ART patients. The ART group had similar case characteristics as the RH group, except that the ART group had a longer surgical time. During a similar follow-up period, there were 4 (2.9%) recurrences and 3 (2.2%) patients who died from recurrence in the ART group compared with 8 (4.6%) recurrences and 4 (2.3%) patients who died from recurrence in the RH group (p?=?.444 and p?=?.999, respectively). In the ART group, squamous cell carcinoma (SCC) patients had a 5-year overall survival and pregnancy rate similar to those of non-SCC patients (98.1% vs 96.8%, p?=?.999; 33.3% vs 26.7%, p?=?.873), and patients with tumors ≤2 cm and 2 to 4 cm experienced a similar 5-year overall survival rate (97.0% vs 98.6%, p?=?.999), except patients with tumors ≤2 cm had a higher pregnancy rate (45.2% vs 17.2%, p?=?.020).Conclusion: ART seems to have similar surgical and oncologic outcomes to RH, except ART has a longer surgical time. Both non-SCC patients and stage IA2-IB1 patients with 2- to 4-cm tumors can undergo ART safely. Patients with tumors ≤2 cm have a higher pregnancy rate than patients with 2- to 4-cm tumors.     

不同发育天数囊胚冻融移植后妊娠结局分析

目的比较不同发育天数冻融囊胚移植后的妊娠结局。方法回顾性分析1 176例行冻融囊胚移植患者的临床资料,其中植入前遗传学诊断(preimplantation genetic diagnosis,PGD)周期135例,比较第5日单囊胚移植(single embryo transfer,SET)组、双囊胚移植(double embryo transfer,DET)组与第6日SET组和DET组的妊娠结局。结果同是优质囊胚级别的条件下,第5日DET组的生化妊娠率(56.91%)、临床妊娠率(53.25%)以及多胎妊娠率(1.20%)显著高于其他组(P0.05);第5日DET组与SET组的胚胎着床率无统计学差异(P0.05),但均显著高于第6日DET组和SET组(P0.05);同级别以及PGD周期中第5日和第6日SET组相比较,第5日组的生化妊娠率、胚胎着床率均显著高于第6日组(P0.05)。结论在同是优质囊胚的条件下,第5日SET、DET及经PGD诊断的SET妊娠结局均优于第6日。     

妇科肿瘤患者治疗前后血浆FN水平的观察及意义

目的：通过比较妇科肿瘤患者纤维连结蛋白（ＦＮ）的变化，评价ＦＮ对妇科肿瘤诊断及疗效评价的意义。方法：检测妇科良性肿瘤２６例、恶性肿瘤７１例治疗前后血浆的ＦＮ值，并与健康献血员４０例血浆ＦＮ值作对照。结果：妇科恶性肿瘤组治疗前血浆ＦＮ平均值为４．５０×１０－３±１．９０×１０－３ｍｍｏｌ／Ｌ，治疗后升至６．８１×１０－３±２．２２×１０－３ｍｍｏｌ／Ｌ，治疗前后差异有显著性（Ｐ＜０．０１）。恶性肿瘤组治疗前血浆ＦＮ值与健康献血员、良性肿瘤组治疗前血浆ＦＮ值比较差异也有显著性（Ｐ＜０．０１）。结论：妇科恶性肿瘤患者血浆ＦＮ值明显低于正常，治疗效果好的患者血浆ＦＮ值总的趋势是逐渐上升，治疗效果不好的患者血浆ＦＮ值总的趋势是逐渐下降。ＦＮ可作为妇科常见恶性肿瘤诊断、疗效观察的临床参考指标。