OCTA对青少年近视人群视网膜微血管密度的观察

目的：基于光学相干断层扫描血管成像（OCTA）技术探讨青少年儿童近视与视网膜表层微血管密度 及视网膜厚度的相关性。方法：横断面研究。共纳入2018年5─11月于四川大学华西医院眼科门 诊就诊的7～14岁青少年近视患者105例（193眼）。对所有受检者进行光学相干断层扫描（OCT）和 OCTA检查，量化分析黄斑中心凹视网膜厚度和各部位视网膜表层微血管密度。单因素方差分析比 较低、中、高度近视组各部位视网膜微血管密度及视网膜厚度的差异。采用Pearson相关系数探讨视 网膜厚度与各部位视网膜表层微血管密度的相关性。Spearman相关系数用于探讨等效球镜与中心凹、 旁中心凹视网膜表层微血管密度以及视网膜厚度的关系；分段多项式函数分析等效球镜度与外环及 直径6 mm完整视网膜表层微血管密度的关系。结果：旁中心凹、外环、直径6 mm完整区域视网膜 表层微血管密度在低、中、高度近视组间比较差异均具有统计学意义（F=11.651、14.499、14.232， 均P<0.001）。年龄与中心凹视网膜厚度之间有较弱正相关关系（r=0.187，P=0.011），与各部位微血管 密度均无相关性。等效球镜度与旁中心凹视网膜微血管密度有相关性（r=-0.301，P<0.001），与外环、 直径6 mm完整区域视网膜表层微血管密度呈曲线相关（r=-0.319，P<0.001；r=-0.307，P<0.001）。 但与中心凹视网膜表层微血管密度及视网膜厚度无显著相关性。此外，中心凹处视网膜厚度与微血 管密度呈正相关（r=0.691，P<0.001），与其余部位微血管密度无相关性。结论：青少年近视程度数 与旁中心凹、外环及直径6 mm完整区域视网膜表层微血管密度呈负相关；中心凹处视网膜厚度与年 龄、微血管密度呈正相关。     

Dying is the Most Grown-Up Thing We Ever Do: But Do Health Care Professionals Prevent Us from Taking It Seriously?

This paper takes a somewhat slant perspective on flourishing and care in the context of suffering, death and dying, arguing that care in this context consists principally of ‘acts of work and courage that enable flourishing’. Starting with the perception that individuals, society and health care professionals have become dulled to death and the process of dying in Western advanced health systems, it suggests that for flourishing to occur, both of these aspects of life need to be faced more directly. The last days of life need to be ‘undulled’. Reflections upon the experiences of the author as carer and daughter in the face of her mother’s experience of death are used as basis for making suggestions about how care systems and professionals might better assist people in dealing with ‘the most grown up thing’ humans ever do, which is to die.     

急性肺血栓栓塞的急诊诊疗研究进展

急性肺血栓栓塞(APTE)是内科的危急重症之一,是以肺部功能障碍及右心室功能不全为主要特征的心血管疾病。其临床表现复杂,但又缺乏特异性表现,因而易与其他疾病相混淆,造成误诊、漏诊。近年来,APTE的发病率以及致死率呈逐年上升的趋势,使患者的生命健康受到严重威胁。该文系统总结了APTE的诱发因素以及病理学特点,详细介绍了实验室检查以及常用的影像学检查等先进手段,并针对APTE的紧急处理以及当前主要的溶栓和抗凝治疗方法进行概述。     

Nanomedicines: From Bench to Bedside and Beyond

Advancing nanomedicines from concept to clinic requires integration of new science with traditional pharmaceutical development. The medical and commercial success of nanomedicines is greatly facilitated when those charged with developing nanomedicines are cognizant of the unique opportunities and technical challenges that these products present. These individuals must also be knowledgeable about the processes of clinical and product development, including regulatory considerations, to maximize the odds for successful product registration. This article outlines these topics with a goal to accelerate the combination of academic innovation with collaborative industrial scientists who understand pharmaceutical development and regulatory approval requirements—only together can they realize the full potential of nanomedicines for patients.     

Reciprocal Peer Support for Post-partum Patients with Diabetes: A Needs Assessment for the Diabetes Buddy Program

While peer support has been investigated in multiple clinical contexts, its application to the postpartum setting is unknown. The aim was to assess acceptability of a postpartum peer support program for women with diabetes. Observational survey-based needs assessment of forty low-income women with diabetes, receiving care at a major medical institution. Mean age and gravidity were 30.7 years and 3.15 ± 1.67 respectively. 45 % expressed interest in a “buddy.” There was no significant difference between groups desiring and not desiring this program. A majority of respondents desired telephone, text messaging, and in-person contacts (79.2, 72.1, 83.8 %), with 72.5 % of patients desiring diabetes-related activities during clinic waiting time. Many women desire a postpartum diabetes reciprocal peer program for support outside of clinician visits. Patients are receptive to educational services during their wait and outside of clinic time, a potentially valuable opportunity to share important health information.     

理气中药组方对糖尿病大鼠胃排空延迟的作用

目的:观察理气中药经验组方对糖尿病大鼠胃排空延迟的干预作用。方法:雌雄各半成年SD大鼠110只,随机分为正常组(A组)、糖尿病中药组(B组)、糖尿病胃复安组(C组)、糖尿病组(D组)。A组、D组1次/d按10 mL/只予0.9%生理盐水灌胃,B组1次/d按8 mL/只予中药煎剂灌胃,C组1次/d按0.5 mg/只予胃复安片灌胃。喂养12周后,行13C胃排空实验及甲基橙水溶液胃排空实验,观察各组大鼠胃排空情况。结果:糖尿病大鼠胃排空较正常大鼠明显延迟(P0.01),糖尿病大鼠胃排空延迟模型制作成功。糖尿病中药组和糖尿病胃复安组大鼠胃排空较糖尿病组快(P0.01);糖尿病中药组大鼠胃排空较糖尿病胃复安组大鼠快(P0.05)。结论:常规喂养12周后糖尿病大鼠出现胃排空延迟。理气中药陈皮、枳实、木香、香附组方煎剂和胃复安均能促进糖尿病大鼠胃排空,理气中药组方煎剂的效果优于胃复安。