急性脑梗死患者血清抵抗素水平与胰岛素抵抗的关系

目的 探讨急性脑梗死患者血清抵抗素水平与胰岛素抵抗的关系.方法 选择68例急性脑梗死患者和40例健康体检者(对照组),采用ELISA检测血清抵抗素、空腹胰岛素等指标,并分析血清抵抗素水平与胰岛素抵抗指数及其他检测指标的相关性.结果 与对照组比较,急性脑梗死组血清抵抗素水平、胰岛素水平、胰岛素抵抗指数明显升高(P＜0.01),胰岛素敏感性指数、高密度脂蛋白胆固醇水平明显低于对照组(P＜0.05);急性脑梗死组抵抗素水平与体质指数、空腹胰岛素、胰岛素抵抗指数呈正相关,与高密度脂蛋白胆固醇、胰岛素敏感性指数呈负相关(P＜0.05).对脑梗死的危险因素行多因素Logistic回归分析显示,抵抗素、胰岛素抵抗指数、胰岛素敏感性指数、血压控制情况和年龄进入回归方程(OR分别为3.505、2.222、-0.589、5.367及2.481).结论 脑梗死患者可能存在胰岛素抵抗,血清抵抗素水平可能与胰岛素抵抗密切相关.     

A new approach for evaluating the resectability of pancreatic and periampullary neoplasms

ObjectiveTo establish a new standard for assessing the resectability of pancreatic and periampullary tumors by the Medical Image Three-Dimensional Visualization System (MI-3DVS).MethodsEighty cases of pancreatic and periampullary tumors were examined. The 64-slice multidetector CT (64-MDCT) images and patient data were processed by MI-3DVS. The main elements examined by MI-3DVS included tumor shape, size, and location; distribution of related vessels; luminal morphology of large vessels; distribution and morphology of the small peripancreatic veins; morphology, degree of dilation, and obstructive sites of bile and pancreatic ducts. Based on vascular characteristics of MI-3DVS findings, the cases were classified into five types. Type I and II were resectable, type III were potentially resectable or resectable with combined vascular resection and reconstruction, and type IV and V were unresectable. The outcome was then compared with corresponding CT angiography (CTA) analysis and actual surgical observations.ResultsAmong the 80 cases, MI-3DVS indicated that 60 were resectable and the remaining 20 were not. In contrast, CTA indicated 50 resectable cases and 30 unresectable cases. For 57 cases of pancreatic ductal carcinomas and all 80 cases periampullary tumors, MI-3DVS assessment yielded a positive predictive value of 100%, negative predictive value of 100%, a sensitivity of 100%, a specificity of 100%, and an accuracy of 100%. While CTA generated corresponding values of 96%, 60%, 80%, 90%, 82.5%. The overall differences between the two methods were significant (P < 0.05).ConclusionThe new classification system is able to reliably assess the resectability of pancreatic and periampullary tumors.     

A longitudinal study of the effect of ocular biometrics measures on myopia onset

Graefe's Archive for Clinical and Experimental Ophthalmology - To investigate the relationship between ocular biometrics (OB) and myopia onset. OB data from students in 4 grades (aged from 6 to...     

光学相干断层扫描血管造影对DR诊断价值的Meta分析

目的：应用光学相干断层血管造影(OCTA)评估糖尿病视网膜病变(DR)患者中心凹无血管区(FAZ)和血管密度(VD)的变化。

方法：对OCTA在DR诊断中的应用文献进行系统回顾。搜索Medline、Embase、Web of Science、PubMed、中国知网数据库、万方数据库以查找相关研究,检索时间从建库截止到2020-09-20。仅检索中英文文献。两名研究者分别独立提取文献资料,包括浅层视网膜毛细血管层血管线性密度(VD_SCP)、深层视网膜毛细血管层血管线性密度(VD_DCP)、浅层FAZ面积和周长。绘制森林图、漏斗图,并采用Begg检验和敏感性分析,确保结果的准确性。

结果：共检索得24篇文献,纳入2 305眼。结果显示,糖尿病患者与健康对照组各指标均有差异(VD_SCP：WMD=-5.78,95% CI：-7.67～-3.88,P<0.05; VD_DCP：WMD=-5.08,95% CI：-6.49～-3.67,P<0.05; FAZ周长：WMD=0.57,95% CI：0.36～0.78,P<0.05; FAZ面积：WMD=0.08,95% CI：0.06～0.10,P<0.05)。

结论：DR患者FAZ面积更大,周长更长,与DR患者对比,对照组FAZ的VD较高。虽然目前OCTA的实际适用性仍然存在问题,但随着技术的不断发展和改进,OCTA在DR中的诊断价值可能会变得明显。     

Coalition of DNA polymorphisms of ApoB and ApoAI genes is related with coronary artery disease in Kazaks

Objective To explore the relationship between polymorphisms of XbaI and MspI loci of apolipoprotein B (ApoB) gene and -75 bp, +83 bp loci of apolipoprotein AI (ApoAI) gene and coronary heart disease (CHD) in Kazaks of Xinjiang Uyghur Autonomous Region, China. Methods These loci were analyzed by PCR-restriction fragment length polymorphism (PCR-PFLP). Two hundred and five patients with CHD and two hundred and thirty six controls were involved. Results There were significant distinctions among low-density lipoprotein cholesterol (LDL-C), triglyceride (TG) and the ApoAI/ApoB ratio between the two groups, but no significant distinction among the polymorphism frequencies of the four sites between the two groups. The polymorphism coalition frequency of X--/Ms++/M1+-/M2++ (named Coalition 11) was significantly higher in CHD compared to the control group (14.6% vs. 7.2%, P < 0.05). The level of total cholesterol (TC) in Coalition 11 was significantly higher and the level of the ApoAI/ApoB ratio in Coalition 11 was significantly lower than Coalition 1~10 in CHD patients. The level of the ApoAI/ApoB ratio of Coalition 11 was significantly lower than the Coalition 1~10 in control group. The levels of ApoAI/ApoB ratio of Coalition 3 were significantly higher compared to Coalition 11 in the two groups, respectively. The level of LDL-C of Coalition 3 was significantly lower than in the Coalition 11 in control group. The level of TC of Coalition 5 was significantly higher than Coalition 3 in the CHD group. The level of the ApoAI/ApoB ratio of Coalition 5 was significantly lower than in Coalition 3 or Coalition 1~10 of the two groups, respectively. The level of LDL-C of Coalition 5 was significantly higher than in Coalition 3 in control group. The ratio of ApoAI/ApoB was negatively related to TC, LDL-C and was positively related to HDL-C, both in CHD and control groups. Conclusion Coalition 11 of the 4 loci polymorphisms of the ApoB and ApoAI genes was correlated with CHD in Kazaks, and perhaps the ratio of ApoAI/ApoB was the most diagnostic parameter related with CHD among all lipid parameters. CHD may also be associated with Coalition 5, and, perhaps, Coalition 3 may have been confirmed as a protection factor against CHD, if more samples were enrolled.