小光斑飞点扫描准分子激光角膜内磨镶术护理

1临床资料我院眼科准分子近视矫正中心2000-09/2004-06共完成LASIK手术5678(男2841,女2837)例11350眼.年龄18～49(平均25.8±6.3)岁.术前行角膜、晶状体、玻璃体和眼底检查,排除有无角膜炎症、晶体混浊、玻璃体混浊等眼科疾病.     

In vitro aspirin resistance detected by PFA-100 closure time: pivotal role of plasma von Willebrand factor

The in vitro closure time (CT), determined by the Platelet Function Analyzer (PFA-100), is used to monitor patients treated with aspirin. A relatively high percentage of in vitro aspirin resistance was reported despite an adequate inhibition of platelet response to arachidonic acid and we investigated whether high plasma levels of von Willebrand factor ristocetin cofactor activity (vWF:RCo) may contribute to this profile. Platelet aggregation test, CT [collagen adrenaline (CEPI-CT) and collagen adenosine 5'-diphosphate (ADP) (CADP-CT)], and vWF:RCo levels were evaluated in 55 consecutive patients receiving aspirin (75-250 mg/d) versus 32 untreated control subjects. All the aspirin-treated patients showed platelet aggregation responses that reflected the aspirin intake. However, CT data analysis enabled aspirin good-responder (GR) and aspirin bad-responder (BR) patients to be identified. All GR group subjects (n = 27), had a CEPI-CT and a CADP-CT longer than 300 s and 96 s respectively. The BR group (n = 28) had CEPI-CT values below 200 s and all CADP-CT were in the normal range (77 +/- 19 s). Interestingly, the BR plasma vWF:RCo levels were significantly higher (159 +/- 43%) than those of the GR group (121 +/- 34%) (P < 0.01), which were similar to control values (114 +/- 31%). A negative correlation between vWF:RCo and CT values was established. We demonstrate that in vitro aspirin-resistance, revealed by PFA-100 CT prolongation failure, is correlated to increased plasmatic vWF:RCo levels, reinforcing its particular importance in PFA-100 cartridges performance.     

臭梧桐中海常素的波谱分析

臭梧桐又名海州常山(Clerodendron trichotomum Thunb.)系马鞭草科(Verbenaceae)植物,其叶有降血压作用,为一常用中药。1963年曾广方等从其叶中分得一新黄酮甙     

Genotypic diversity and antifungal susceptibility of Cryptococcus neoformans isolates from paediatric patients in China

Cryptococcosis is a life‐threatening mycosis primarily occurring in adult patients particularly those with immunosuppression such as HIV infection/AIDS. The number of reported cases of paediatric cryptococcosis has increased in the last decade around the world, including China. However, current information on the characteristics of cryptococcosis in children, particularly the genotypic diversity and antifungal susceptibility of the isolates, is limited. In the present study, a total of 25 paediatric isolates of Cryptococcus neoformans were genotyped using the ISHAM‐MLST scheme. In vitro susceptibility to antifungal agents of the 22 isolates was tested using the CLSI M27‐A3 method. Our analyses revealed that the genotypic diversity of C. neoformans isolates from Chinese paediatric patients was low, with ST 5 (80%) and ST 31 (12%) being the two major sequence types. Reduced susceptibility to fluconazole (FLU), 5‐flucytosine (5‐FC) and itraconazole (ITR) was observed among C. neoformans isolates from Chinese paediatric patients, particularly among the ST5 isolates, which was similar to observations made on C. neoformans isolates from Chinese adult patients. In addition, the majority of isolates (3/4, 75%) obtained from deceased patients showed decreased antifungal susceptibility, which indicates that further monitoring of antifungal susceptibility of Cryptococcus isolates is warranted in management of paediatric cryptococcosis.     

Candida auris otomycosis in Iran and review of recent literature

Candida auris is a multidrug‐resistant yeast emerging in immunocompromised and in otherwise healthy individuals. Due to difficulties in microbiological identification of C. auris because of the lack of available laboratory technology in developing countries, the number of patients affected is most likely underestimated. We report the first case of C. auris otitis which now adds Iran as the fifth country around the Persian Gulf, in addition to Kuwait, Oman, United Arab Emirates and Saudi Arabia. Candida auris is an unknown pathogen in routine laboratories in Iran because most Candida isolates are probably misdiagnosed. Otomycosis seems to be a different clinical presentation of C. auris mainly involving isolates from the East‐Asian clade. We compared the mycological and clinical details of the Iranian patient with other cases of otitis reported since the last review of C. auris otomycosis in 2017.     

Dissociation between the phospholipases C and A2 activities in stimulated platelets and their involvement in the arachidonic acid liberation

Summary. In previous work we have demonstrated that platelets depleted from secretory phospholipase A2 (sPLA2) produced similar amounts of thromboxane (Tx)B₂ as control platelets upon stimulation by thrombin. However, since depletion of sPLA2 was not total, this sole finding only suggested the non-involvement of sPLA2 in arachidonic acid release.
In the present study we provide further evidence for the non-involvement of sPLA2 in arachidonic acid liberation during platelet activation. Thus, rabbit platelets exposed to thrombin secreted sPLA2, released free arachidonic acid and formed TxB₂ and inositol phosphates. In contrast, U46619, a stable prostaglandin (PG)H₂ analogue, activates phospholipase C (PLC) and induces release of sPLA2 without TXB₂ generation nor arachidonic acid liberation. At each concentration tested of both agonists, stimulation of sPLA2 activity paralleled the production of inositol phosphates. These data suggest that sPLA2 is dependent on phosphoinositide hydrolysis and on the release reaction and that it is not involved in the liberation of arachidonic acid from stimulated platelets. In addition, a dissociation was observed between sPLA2 and the enzyme involved in the arachidonic acid mobilization, suggesting that the liberation of this fatty acid from membrane phospholipids was mediated by cytosolic phospholipase A2 (cPLA2). Finally, PLC does not play a major role in arachidonic acid liberation, since U46619, which induced the breakdown of inositol phospholipids, failed to release arachidonic acid. In confirmation, neomycin, which inhibits PLC activity, failed to inhibit ATP, sPLA2 and arachidonic acid release upon stimulation of platelets by fluoroaluminate. These data demonstrate that sPLA2 is not involved in the arachidonic acid release by stimulated platelets and indicate that the activations of PLC, sPLA2 and cPLA2 are independent events.     

磁共振扩散张量成像评价肌萎缩侧索硬化症非锥体束的扩散特征

目的:应用磁共振扩散张量成像初步评价肌萎缩侧索硬化症非锥体束的扩散特征。方法:于2004-10/2006-10选择武汉大学人民医院神经科收治的肌萎缩侧索硬化症患者16例,为病例组。纳入标准:①符合ElEscorial诊断标准诊断和分型。②为散发性病例。③患者知情同意。排除标准:①糖尿病、原发性高血压、脑血管疾病病史。②服用神经系统活性药物史。③颅脑和颈髓MRI扫描显示有其他神经系统疾病。同期选择与病例组年龄和性别相匹配的健康体检者15例,为对照组。两组间性别、年龄比较差异无显著性意义(P>0.05)。所有受试者行轴位扩散张量成像扫描,选取左右侧非锥体束走行区各5个感兴趣区(中央后回皮质下白质、额叶白质、胼胝体压部、膝部、丘脑)测量各向异性分数和平均扩散系数。结果:所有受试者均完成实验,图像质量符合实验要求,未见明显变形。双侧感兴趣区的各向异性分数和平均扩散系数差异无显著性意义,故左右侧合并取均值分析。在中央后回皮质下白质、额叶白质、胼胝体压部、膝部、丘脑非锥体束走行区,肌萎缩侧索硬化症组和对照组均以胼胝体压部的各向异性程度最高(分别为0.825±0.021,0.833±0.023),两组间各向异性分数和平均扩散系数差异无显著性意义。结论:在病程早期,肌萎缩侧索硬化症患者非锥体束损害征象不明显,随访研究有可能阐明肌萎缩侧索硬化症患者运动系统以外部位是否受累和受累的程度。