有晶状体眼虹膜夹型人工晶状体矫治高度近视眼的3年随访观察

目的 研究有晶状体眼虹膜夹型人工晶状体(ICPIOL)矫治高度近视眼的长期安全性和有效性.方法 高度近视眼患者49例(86只眼),等效球镜度数(SE)(-15.33±3.81)D,植入ICPIOL.术后随访3年,观察手术前后的视力、屈光状态、眼压、角膜、前房、瞳孔、ICPIOL和晶状体、眼底情况,并采用单因素方差分析进行统计学比较.结果 与术前比较,术后1、2、3年的裸眼视力(UCVA)、最佳矫正视力(BCVA)和SE显著改善(F=513.68,20.88,827.65;P＜0.01).术后3年时,UCVA≥0.5有85%,≥0.8有35%;BCVA未见下降,17%比术前提高1行,59%比术前提高≥2行;81%眼的实际屈光度数稳定在预期的±1.00 D,54%稳定在预期的±0.50 D.术后1、2、3年的角膜内皮细胞累积丢失率分别为3.60%、5.78%、7.74%.除了3只眼术中在抓持虹膜固定ICPIOL时有轻度虹膜脱色素,1只眼ICPIOL脚襻脱位重新手术固定,2只眼黄斑出血外,未见其他并发症发生.结论 ICPIOL矫治高度近视术后3年内安全、有效.     

Preoperative laser reduces silicone oil use in primary diabetic vitrectomy

AIM: To identify the predictive factors and laser photocoagulation associated with the use of silicone oil as endotamponade during primary diabetic vitrectomy. METHODS: The medical and surgical records of 690 patients (798 eyes) who underwent primary diabetic vitrectomy at a tertiary eye hospital in China from January 2018 to December 2018 were reviewed in this retrospective cohort study. The patients’ baseline characteristics and preoperative treatments were recorded. The binary Logistic regression model was used to evaluate the risk factors for the use of silicone oil as endotamponade agent during primary vitrectomy for proliferative diabetic retinopathy (PDR)-related complications. RESULTS: Among 690 patients with mean age of 52.1±10.5y (range: 18-85y), 299/690 (43.3%) were female. The 31.6% of the eyes received preoperative laser treatment, and 72.4% of the eyes received preoperative anti-VEGF adjuvant therapy. Non-clearing vitreous haemorrhage (VH) alone or combined with retinal detachment was the main surgical indication (89.5%) for primary vitrectomy. Silicone oil was used as endotamponade in 313 (39.2%) eyes. Lack of preoperative laser treatment [odds ratio (OR) 0.66, 95% confidence interval (CI): 0.48-0.92; P=0.015] and older age (OR 0.96, 95%CI: 0.95-0.98; P<0.001) were predictors of silicone oil tamponade during primary vitrectomy for PDR. CONCLUSION: The lack of preoperative laser treatment is a significant predictor of silicone oil tamponade during primary vitrectomy for PDR. However, the severity of PDR relevant to silicone oil use should be further evaluated.     

应用Ripley-EA玫瑰花结试验检测K细胞

人的淋巴细胞除T和B两大类外,尚有所谓第三类淋巴细胞,由于其细胞膜具有IgGFc受体,结合IgG后能杀伤靶细胞,因此称为抗体依赖性细胞毒性细胞(antibody-dependent cytotoxic cell,ADCC)或杀伤细胞(Killer Cell,K细胞)。检查K细胞可以从数量定量检测,也可以从功能上检测。本文报道应用Ripley型血清进行玫瑰花结     

Clearance of beta- amyloid from the CSF by the choroid plexus： implications in drug development for treatment of Alzheimer＇s disease

The formation of insoluble aggregates of beta - amyloid peptide （ A ） within the brain extracellular fluid is a critical event in the etiology of Alzheimer＇s disease （AD）. In theory, an unbalanced A kinetics can be due to its over production, inadequate metabolic cleaning, or an improper balance of import or export of A or related molecules at brain barriers. We investigated the role of the choroid plexus, which forms a barrier between blood and brain cerebrospinal fluid （ CSF）, in regulating A in the CSF. A uptake from CSF was determined as its volume of distribution （ VD ） into isola- ted rat choroid plexus tissue by using [^125I] A 1-40 and along with a extracellular space marker [^14C ] sucrose. The choroid plexus exhibited a definite capacity in sequestering [^125I] A 1-40 from the surrounding CSF. Uptake of [^125I] A by the choroid plexus was saturable, time - and temperature - dependent, and not ttffected by addition of transthyretin or apolipoprotein E3. Studies with cultured monolayers of primary choroid epithelial cells indicated that A permeability across cells, corrected by [ ^14C] sucrose, was greater from the CSF -facing membrane than from the blood -facing membrane. Similarly, cellular accumulation of [ ^125 I ] A was concentrative from both directions and was greater from the CSF -facing membrane. Quantitative real- time RT- PCR, immunodetection and enzyme activity assays further revealed the presence of several key enzymes involved in A production, e. g. , amyloid precursor protein and beta - secretase, and in A metabolism and alternate processing, e. g. , insulin degrading enzyme, endothelin - converting enzyme - 1, neprilysin and alpha - secretase. Overall, these results suggest the choroid plexus selectively cleanses A from the CSF by an undetermined mechanism （s） ; moreover, it has the capacity to degrade A , suggesting a vital role of this tissue in maintaining A homeostasis. The perspectives of drug development for treatment of AD by reducing A from brain extracellular fluid as a new strategy will be discussed.     

Tacrolimus dosing in Chinese renal transplant recipients: a population-based pharmacogenetics study

Objectives

The aims of this study were to examine the effects of genetic and clinical factors on the maintenance dose of tacrolimus in patients following renal transplantation and to develop a tacrolimus-dosing model that could be combined with associated factors.

Patients and methods

This study included 142 renal transplant recipients who received tacrolimus as immunosuppressive agent. CYP3A5, MDR1 and NR1I2 gene polymorphisms were identified based on the SNaPshot assay. The relationship between the genetic and clinical factors and tacrolimus maintenance dose as well as between dose-corrected tacrolimus concentration was examined.

Results

CYP3A5 genotype, body weight, haematocrit, haemoglobin and total bilirubin significantly influenced the maintenance tacrolimus dose. The tacrolimus-dosing model derived from linear regression model accounted for 40.5% of total variations in the tacrolimus maintenance dose.

Conclusions

A pharmacogenetics-based dosing model has been developed for the prediction of the tacrolimus maintenance dose in renal transplant recipients. This model may be useful in helping clinicians prescribe the initial tacrolimus dose with greater safety and effectiveness.     

Identification of distinct carboxyl-terminal domains mediating internalization and down-regulation of the hamster alpha(1B)- adrenergic receptor

The roles of the carboxyl-terminal tail of the alpha(1B)-adrenergic receptor in its expression, function, and regulation were investigated by site-directed mutagenesis. The receptor construct truncated after residue 363 seemed not to be properly expressed. In contrast, the receptor truncated after residue 366 and all of the longer receptor constructs were properly expressed and exhibited agonist and antagonist binding and activation of phosphoinositide hydrolysis similar to the wild-type receptor. Agonist-induced sequestration of receptors within the plasma membrane, endocytosis into intracellular vesicles, and eventual down-regulation were all absent in the receptor truncated after residue 366. A series of sequential truncations and a deletion mutation identified a critical role for residues 403 to 425, which include the previously identified sites for G protein-coupled receptor kinase phosphorylation, in agonist-induced internalization of the receptor. Similar studies identified a critical role for residues 367 to 380 in agonist-induced down-regulation. Individual point mutations converting either cysteine 367 or serine 369 to alanine selectively eliminated down-regulation, thus identifying two specific amino acid residues required for down-regulation. Importantly, several of the mutated receptors that failed to show rapid agonist-induced internalization nonetheless exhibited normal agonist-induced down-regulation. In addition to identifying specific regions and individual residues of the alpha(1B)-adrenergic receptor involved in internalization and down-regulation, these studies provide mutated receptors that internalize but do not down-regulate, that down-regulate without internalization, and that are defective in both internalization and down-regulation, all of which should be useful tools for further studies of the specific cellular compartments and molecular mechanisms involved in receptor internalization and down-regulation.     

Bacteremia tuberculosis among HIV-negative children in China

Importance: Bacteremia tuberculosis (TB) is a severe form of extrapulmonary TB. Studies assessing bacteremia TB in children are limited, especially for HIV-negative children.Objective: To explore the detailed clinical features of the bacteremia TB in children under 18 years of age.Methods: We reviewed the clinical records of the patients retrospectively and collected the strains isolated from their blood cultures. We used mycobacterial interspersed repetitive-unit-variable-number tandem-repeat (...     

鼻咽癌放疗后副鼻窦炎的临床观察及影响因素分析

背景与目的:鼻咽癌放疗后常常合并副鼻窦炎,严重影响患者生活质量。本文旨在了解鼻咽癌患者放射治疗前、后副鼻窦炎的发生情况,探讨放疗后副鼻窦炎的发生、发展规律及其影响因素。方法:收集中山大学肿瘤防治中心1998年1月至2000年7月住院治疗381例鼻咽癌患者的临床资料,阅读并比较其放疗前、后鼻咽部CT片,总结副鼻窦炎的发生情况并分析其影响因素。结果:放疗前176例患者合并有副鼻窦炎,发生率为46.2%;放疗前无副鼻窦炎的205例患者中,放疗后103例发生副鼻窦炎,副鼻窦炎发生率为50.2%;放疗后1个月、3个月、6个月及1年副鼻窦炎的发生率分别为21.0%、33.7%、41.5%及29.3%,具有统计学差异(χ2=20.92,P<0.001)。Logistic分析,T分期与放疗后副鼻窦炎发生有关。结论:鼻咽癌患者放疗后副鼻窦炎的发生率较高,以6个月时为最高峰;肿瘤的T分期与放疗后副鼻窦炎的发生有关。     

Targeted inhibition of osteoclastogenesis reveals the pathogenesis and therapeutics of bone loss under sympathetic neurostress

Sympathetic cues via the adrenergic signaling critically regulate bone homeostasis and contribute to neurostress-induced bone loss, but the mechanisms and therapeutics remain incompletely elucidated. Here, we reveal an osteoclastogenesis-centered functionally important osteopenic pathogenesis under sympatho-adrenergic activation with characterized micro RNA response and efficient therapeutics. We discovered that osteoclastic mi R-21 was tightly regulated by sympatho-adrenergic cues downstream th...     

Metformin can mitigate skeletal dysplasia caused by Pck2 deficiency

As an important enzyme for gluconeogenesis, mitochondrial phosphoenolpyruvate carboxykinase(PCK2) has further complex functions beyond regulation of glucose metabolism. Here, we report that conditional knockout of Pck2 in osteoblasts results in a pathological phenotype manifested as craniofacial malformation, long bone loss, and marrow adipocyte accumulation. Ablation of Pck2 alters the metabolic pathways of developing bone, particularly fatty acid metabolism. However, metformin treatment can mi...