Performance standards for toric soft contact lenses.

PURPOSE: To simplify the clinical assessment of toric soft contact lens (TSCL) on-eye behavior by establishing a set of standard clinical evaluation techniques. The likely performance range expected among the TSCL wearing population was determined for a series of lens designs and acceptable performance standards indicated for each variable. METHODS: Four prism-ballast, two peri-ballast and one dynamic stabilization TSCL designs were each worn by groups of 20 subjects in a nondispensing study. After 20 min of lens wear, lenses were assessed, in right eyes only, for subjective comfort (100-point scale), lens mislocation (degrees deviation from vertical) and rotational recovery after deliberate 30 degrees mislocation (degrees/10 blinks). The percentage of lenses orienting within +/-10 degrees of target orientation (zero rotation) and the variability of orientation (standard deviation of mislocation) were also calculated for each lens group. RESULTS: Based on partitioning of the data distributions for each variable, performance was designated as excellent, acceptable or poor. Corresponding performance cut-offs were determined at > or =90, 89 to 80, and <80 for subjective comfort, < or =+/-6 degrees , +/-7 degrees to 10 degrees , and >+/-10 degrees for mislocation, >10 degrees /10 blinks, 10 degrees to 6 degrees /10 blinks, and <6 degrees /10 blinks for rotational recovery. For groups of wearers the appropriate cut-offs were > or =90%, 89 to 70%, and <70% of lenses orienting within +/-10 degrees of target orientation and <+/-6 degrees , +/-6 degrees to 10 degrees , and >+/-10 degrees for variability of orientation. CONCLUSION: Techniques suitable for the evaluation of TSCL clinical performance have been described and guidelines for the assessment of such lenses established. In the process, we have identified potential performance differences that may relate to variations in TSCL design.     

地黄合剂降血糖作用的实验性研究

本文通过用四氧嘧啶复制小白鼠糖尿病模型,以血清中血糖及胰岛素水平为指标,研究了地黄合剂对高糖动物的降血糖作用。结果表明,注射四氧嘧啶前小白鼠血糖为173.47±5.23mg/100ml注射后血糖升高至419.78±22.70mg/100ml(P<0.01),差异有高度显著性。实验组服用地黄合剂后,血糖值从410.25±2739mg/100ml下降至313.51±29.39mg/100ml(P<0.05)差异有显著性。因而认为地黄合剂对于四氧嘧啶性糖尿病有显著的降血糖作用。     

Acute Cellular Rejection with CD20-Positive Lymphoid Clusters in Kidney Transplant Patients Following Lymphocyte Depletion

Lymphoid clusters (LC) containing CD20-positive B cells in kidney allografts undergoing acute cellular rejection (ACR) have been identified in small studies as a prognostic factor for glucocorticoid resistance and graft loss. Allograft biopsies obtained during the first episode of ACR in 120 recipients were evaluated for LC, immunostained with CD20 antibody, and correlated with conventional histopathologic criteria, response to treatment and outcome. LC were found in 71 (59%) of the 120 biopsies. All contained CD20 positive B cells that accounted for 5-90% of the LC leukocyte content. The incidence of LC was highest in the patients who had no lymphoid depletion or had been treated with Thymoglobulin preconditioning (79% vs. 75%, respectively) compared to 37% in patients pretreated with Campath (p = 0.0001). Banff 1a/1b ACR were more frequent in the LC-positive than the LC-negative group (96% vs. 80%, respectively; p = 0.0051). With a posttransplant follow-up of 953 +/- 430 days, no significant differences were detected between LC-postitive and LC-negative groups in time to ACR, steroid resistance, serum creatinine and graft loss. CD20+LC did not portend glucocorticoid resistance or worse short to medium term outcomes. CD20+LC may represent a heterogenous collection in which there may be a small still to be fully defined unfavorable subgroup.     

血管紧张素对增生性瘢痕成纤维细胞纤维连接蛋白合成的影响

目的：探讨血管紧张素Ⅱ（AngⅡ）及其Ⅰ型、Ⅱ型受体阻断剂和钙调神经磷酸激酶（CaN）的阻滞利环胞素A（CsA）对增生性瘢痕来源的成纤维细胞纤维连接蛋白mRNA和蛋白表达的作用。方法：体外分离培养增生性瘢痕成纤维细胞，分别将一定浓度的AngⅡ（10^-9～10^-5mmol／L），和AngⅡ10^-6mmol／L加上不同阻滞剂losartan、PD123319、环胞素A（浓度均为10^-5mmol／L）加入细胞培养液中刺激48h，分别采用逆转录聚合酶链反应（RT—PCR）及Westernblot印迹方法检测增生性瘢痕成纤维细胞纤维连接蛋白（FN）的mRNA及蛋白表达。结果：体外成功地培养增生性瘢痕成纤维细胞。经AngⅡ刺激48h后，FN mRNA和蛋白表达量明显增高，增高程度与AngⅡ浓度呈正比；加入losaartan和环胞素A后，FN原mRNA和蛋白表达量较单用AngⅡ组下降，而加入PD123319后，FNmRNA和蛋白表达量较单用AngⅡ组无明显改变。结论：AngⅡ可促增生性瘢痕成纤维细胞的FN合成，可能在增生性瘢痕的发展过程中起重要作用，该作用主要通过AngⅡ的Ⅰ型受体介导完成，该作用可能与CaN信号通路有关。     

肾动脉狭窄支架植入术的临床疗效观察

目的探讨肾动脉狭窄支架植入术的临床疗效.方法1997年1月～2004年12月,我院行支架介入治疗肾动脉狭窄27例.对27例术前、术后及随访期内血压、肾功能以及生活质量进行评估,并与同期单纯药物治疗肾动脉狭窄27例进行比较.结果介入组27例植入支架40枚,手术成功24例(88.9%,24/27),失败3例(11.1%,3/27),手术并发症5例(18.5%,5/27).术后在血压下降(包括收缩压舒张压)肌酐下降,肾小球滤过率增加方面,介入组获益率明显优于药物组,两组比较差异均有显著性,术后随访6个月～8年6个月,中位数为1年9个月,介入组有19例能比较健康的生活和工作,药物组仅12例能维持生活和工作.结论支架介入治疗较单纯药物治疗肾动脉狭窄疗效显著.     

干细胞经脑脊液移植后在损伤脊髓的早期变化观察

目的观察神经干细胞经脑室注射后在损伤脊髓的早期动态变化。方法取转录有绿色荧光蛋白（GFP）基因的孕16天SD鼠胚脑海马组织，培养成神经干细胞球，注射到损伤脊髓鼠第四脑室（实验组），观察其在脊髓的存活、分化状况。结果移植细胞在脊髓表面形成细胞团。分布于损伤区头侧。细胞团的面积背侧小于腹侧；数目背侧多于腹侧。这种分布和增殖形式见于损伤脊髓正常部分和无损伤脊髓（对照组）。1周时细胞侵入损伤区，GFAP表达呈阳性。2～3周时与宿主细胞良好整合。结论移植细胞通过脑脊液能广泛分布于脊髓表面。保持黏附、增殖和分化能力。并可迁移、整合到损伤脊髓组织中。     

经肝动脉As2O3碘化油化疗栓塞 对兔肝移植瘤生长及转移的影响

目的观察As2O3与碘油联合经肝动脉化疗栓塞术后对兔VX2肝移植瘤生长及转移的作用.方法 40只家兔肝内肿瘤种植后2周,随机分为5组,经肝动脉插管分别给予不同处理,实验设生理盐水灌注组、As2O3灌注组、单纯碘油栓塞组、阿霉素碘油栓塞及As2O3碘油栓塞组,As2O3的用量为2 mg/kg.肿瘤种植后5周,测量动物体重,所有动物均处死,取出肝脏及双肺标本,测定肝脏的重量,计算肝移植瘤的体积、坏死面积,观察肝内、双肺及其他器官肿瘤转移的发生率.结果肿瘤植入后5周,各处理组动物体重均有明显的下降,肝脏重量增加,计算的肝指数各组分别为9.8±2.2、9.7±2.1、8.5±2.0、8.4±2.1、6.4±1.2;肿瘤体积分别为(35.5±7.6) cm3、(32.2±9.7) cm3、(21.2±8.5) cm3、(20.9±11.3) cm3、(11.8±4.0) cm3,栓塞治疗组与非栓塞治疗组间差异有统计学意义,As2O3碘油栓塞治疗组与其他组相比差异有统计学意义.平均坏死率各组间差异无明显的统计学意义.双肺转移结节的数目各组分别为52.4±32.2、51.8±26.3、54.8±29.2、53.5±30.7、19.6±17.0;转移结节的直径各组分别为(3.8±1.2) mm、(3.6±1.1) mm、(3.9±1.3) mm、(3.5±1.6) mm、(2.2±0.7) mm.As2O3碘油栓塞治疗组与其他各组相比差异有统计学意义(P<0.05).结论 As2O3与碘油联合经肝动脉栓塞治疗,可抑制肝移植瘤的生长及肺转移.     

肾病综合征患者腺苷脱氨酶活性的变化及意义

通过检测对激素不同反应、不同病情的肾病综合征（NS）患者的血清及淋巴细胞内腺苷脱氨酶（ADA）的活性变化，观察ADA活性与临床疗效的关系。     

Remote-controlled catheter ablation of accessory pathways: results from the magnetic laboratory.

AIMS: This study evaluates feasibility, safety, and efficacy of magnetic remote-controlled accessory pathway (AP) ablation. METHODS AND RESULTS: The novel magnetic navigation system (MNS) (Niobe, Stereotaxis) creates a steerable magnetic field (0.08 T) controlling the distal magnetic tip of an ablation catheter. In conjunction with a catheter advancer system (Cardiodrive, Stereotaxis) remote catheter ablation is enabled. Conventional electrophysiology study identified AP conduction in 59 patients (37 males, 36+/-14 years, 60 APs). First generation 1-magnet tip (1-M) (group I, n=18), second generation bipolar 3-magnet tip (3-M) (group II, n=27), and third generation quadripolar 3-magnet tip catheters (3-M quad.) (group III, n=14) were used for magnetic remote-controlled ablation. Successful AP ablation was achieved in 67% (group I), 85% (group II), and 92% (group III). A significant decrease of median [IQR: Q1-Q3] fluoroscopy time and dosage was observed: 21.2 [12.1-33.8] min, 1110 [395-3234] microGym2 (group I); 6.5 [4.4-15.4] min, 290 [129-489] microGym2 (group II), and 4.9 [3.4-8.0] min, 129 [74-270] microGym2 (group III). Mean procedure time (217+/-67 min; 182+/-68 min, and 172+/-90 min) significantly decreased in group III. Median number [Q1-Q3] of radiofrequency current applications in groups I, II, and III was 4 [2-9], 4 [2-6], and 2 [2-4], respectively. No complications occurred. CONCLUSION: Remote AP ablation is safe and feasible using the novel MNS. Introduction of the 3-magnet quadripolar ablation catheter significantly improved the efficacy of the procedure.