硬性透气性接触镜停戴后角膜前表面像差变化分析

Objective The present study used a corneal topographic device to record aberrations on the anterior surface of the cornea at different time-points prior to wearing and following discontinued use of rigid gas permeable (RGP) contact lenses. The effect of wearing RGPCL on the anterior surface of the cornea was discussed to provide guidance for clinical refractive error correction. Methods The study objects were 60 eyes from 30 patients. All patients underwent identical examination procedures prior to lens use, as well as afterwards, including slit-lamp examination, non-contact tonometer measurement, computer optometry & corneal curvature measurement, subjective refraction test, and corneal topography analysis. The patients wore contact lenses every day for 1 month and then discontinued. Corneal topographies were recorded at certain time points of 30 min, 1 day, 3 days, 1 week, and 2 weeks following use. Results Total corneal aberration at each time point following discontinued use of RGP contact lenses was less than the time point prior to use. Detailed results are as follows; root mean square (RMS) (pre) = (1.438 ±0.328), RMS (30 min) = (1.076 ± 0.355), RMS (1 day) = (1.362 ± 0.402) , RMS (3 day) =(1.373 ± 0.398), RMS (7 day) = (1.387 ± 0.415), and RMS (14 day) = (1.448 ± 0.423) .Results showed that at 30 minutes after discontinued use of RGP contact lenses, almost all 2nd-and 3rd-order aberrations were altered. Quadrafoil Z10 and spherical Z12 of the 4th-order were also changed. Alterations to Z5, Z6, and Z12 at 1 day after discontinued use were significant compared with the time period prior to RGP use: Z5 and Z6 decreased, and Z12 increased slightly( F =2. 869 ～5. 549 ,P =0. 001 ～0. 042). Z5 and Z6remained decreased at 3 days after discontinued use, but Z9 and Z10 continued to increase and Z12 returned to levels prior to RGP use ( P ＞ 0. 05 ). At 2 weeks after discontinued use, all aberrations were not significantly different from the values prior to use ( P ＞ 0. 05). Conclusions The use RGP contact lenses greatly reduced total aberration of the anterior surface of the cornea. Changes to 2nd- and 3rd-order aberrations ( including Z3, Z4, Z5, Z6, Z7, and Z8 ) were more significant. Following discontinued use of RGP contact lenses, the majority of lower order aberrations returned to original levels in a short period of time. During this process, a transient higher order aberration appeared, but all changes disappeared within 2 weeks after discontinued use of RGP contact lenses.     

基于网络药理学和分子对接法探讨安神补心六味丸治疗冠心病的作用机制

摘要：目的:采用网络药理学和分子对接法探讨蒙药安神补心六味丸治疗冠心病（CHD）的分子作用机制。方法:通过文献挖掘、多个数据库检索收集整理并筛选安神补心六味丸的活性成分以及治疗CHD的相关靶点,运用Cytoscape 3.6.0构建"中药-活性成分-靶基因"网络,使用String数据库并结合Cytoscape 3.6.0筛选出关键靶点;通过DAVID数据库对潜在靶点进行功能及信号通路富集分析,利用Auto Dock Vina对成分和靶基因网络分析结果进行分子对接验证。结果:从安神补心六味丸中筛选得到52个活性成分,涉及CHD作用靶点141个,网络拓扑分析筛选出24个关键靶点,基因本体（GO）功能富集分析得到GO条目263个,京都基因与基因组百科全书（KEGG）通路富集分析筛选得到29条信号通路,主要涉及亚油酸代谢、花生四烯酸代谢和Ras信号通路等。通过分子对接得到结合能≤-5 kcal·mol-1的活性成分20个,与排名前6的关键靶点均有较好的亲和力。结论:安神补心六味丸中的活性成分鞣花酸、异鼠李素及柚皮苷等能作用于多个靶点和调控多条通路,对CHD可能具有治疗作用。     

Pentacam、IOLMaster和A型超声测量近视患者前房深度的比较

目的 对Pentacam、IOLMaster和A型超声测量仪测量前房深度(ACD)的准确性进行比较.方法 对69例(138眼)近视患者分别使用Pentacam、IOLMaster和A型超声测量仪进行ACD测量,对所得数据进行统计学处理与分析.结果 Pentacam、IOLMaster和A型超声的ACD测量值分别为(3.77±0.24)、(3.73±0.23)、(3.69±0.22) mm,3种方法测量结果差异有统计学意义(F=4.49,P=0.01).Pentacam测得的ACD值比A型超声大约(0.08±0.07) mm(t=13.25,P＜0.001).3种仪器ACD测量值相互正相关(r=0.987、0.951、0.946,P＜0.001),且变异系数很小(0.012±0.07).Bland-Altman分析结果显示,3种方法的ACD测量平均值一致性较好(Pentacam vs IOLMaster:CoA 0.04 mm,LoA 0.13～-0.05 mm;A型超声vs IOLMaster:CoA 0.04 mm,LoA 0.08～-0.17 mm;Pentacam vs A型超声:CoA 0.08 mm,LoA 0.22～-0.06 mm).结论 Pentacam、IOLMaster和A型超声测量ACD的可重复性均很好、变异小、高度相关.Pentacam测得的ACD值稍大于A型超声,但由于3组数据可重复性好,变异系数小,其差异没有重要的临床意义,临床上可相互代替使用.     

甘草苷在大鼠体内的代谢途径研究

目的研究甘草苷在大鼠体内的代谢途径。方法大鼠ig给予甘草苷300 mg/kg后,收集胆汁、尿液、粪便和血浆,应用高效液相色谱-四级杆-离子阱串联质谱(HPLC-QTRAP-MS)技术分析甘草苷在大鼠体内的代谢途径。结果共检测到除原形药物外的9个代谢产物,提示甘草苷在大鼠体内的主要代谢途径为脱葡萄糖基反应生成甘草素及甘草素的脱氢氧化以及葡糖醛酸化和硫酸化。结论甘草苷在大鼠体内经历了广泛的I相和II相代谢。应用峰面积归一化法计算主要代谢产物相对生成量百分比,甘草苷ig给药后在大鼠胆汁、尿、粪和血浆中的主要代谢产物为甘草素、甘草素的葡萄糖醛酸结合物及其硫酸结合物。     

Pentacam系统测量准分子激光角膜屈光手术前近视患者角膜厚度的临床观察

目的比较Pentacam系统与A型超声角膜测厚仪测量准分子激光手术前近视患者中央角膜最薄点厚度的差异。方法对准备行准分子激光角膜屈光手术的近视患者69例138只眼,分别采用Pentacam系统和A型超声角膜测厚仪测量角膜中央最薄点厚度,对测量结果进行统计学分析。结果 Pentacam系统、A型超声角膜测厚仪测量中央角膜最薄点厚度值分别为（548.0±28.9）μm和（538.8±29.4）μm,两者高度正相关（P〈0.05）。Pentacam系统比A型超声测得的中央角膜厚度厚（9.2±9.9）μm,差异有显著意义（P〈0.05）,该差值与A型超声测量角膜厚度值负相关（P〈0.05）,而与屈光度、年龄等无关。结论 Pentacam测量近视患者角膜厚度值略高于A型超声法,尽管二者有较好的一致性,但相互间还不能完全替代。     

MORIA SBK、90、110刀头切削角膜瓣的厚度变化及相关因素分析

目的探讨使用MORIA公司SBK、90、110刀头切削角膜瓣的厚度变化及相关影响因素。方法收集行准分子激光角膜原位磨镶术（LASIK）治疗的近视患者90例180眼,按术中使用刀头的不同分为SBK、90、110刀头组,每组30例60眼,均先右眼后左眼施行手术。术中测量角膜床厚度,对3组间角膜瓣厚度的差异进行比较,对角膜瓣厚度与年龄、屈光度、角膜厚度、曲率、角膜横径的相关性进行分析。结果 3组患者和手术眼的基线资料特征比较差异无统计学意义（P〉0.05）。SBK刀头组右眼和左眼的角膜瓣厚度分别为（97.50±11.39）μm和（96.73±10.45）μm,差异无统计学意义（P〉0.05）。逐步回归分析证实,SBK刀头组角膜瓣厚度与术前角膜厚度呈正相关（r=0.490,P=0.000）、与角膜横径呈负相关（r=-0.520,P=0.001）。在90刀头组中,患者右眼和左眼的角膜瓣厚度分别为（128.03±12.03）μm和（123.40±12.38）μm,差异有统计学意义（P〈0.01）。角膜瓣厚度与术前角膜厚度呈正相关（r=0.430,P=0.000）,与年龄呈负相关（r=-0.360,P=0.002）。110刀头组患者右眼和左眼的角膜瓣厚度分别为（140.53±15.14）μm和（135.23±18.03）μm,差异有统计学意义（P〈0.01）,角膜瓣厚度与术前角膜厚度呈正相关（r=0.710,P=0.000）。结论 MORIA角膜刀切削的角膜瓣厚度与术前角膜厚度有关,SBK刀头切削的角膜瓣厚度变异最小而110刀头者最大,LASIK术中用SBK刀头和90刀头能制作超薄或较薄的角膜瓣。术中应测量角膜床厚度,及时调整治疗方案,避免术后产生继发性圆锥角膜。     

消旋山莨菪碱滴眼液（信流丁）对青少年近视的临床疗效分析

目的：评价消旋山莨菪碱滴眼液（信流丁）对青少年初发性近视的临床疗效。方法：临床随访30例（60眼）10～15岁近视眼初发的患者,给予信流丁滴眼液,分别于用药前及用药1个月、3个月和6个月检测受检眼裸眼视力、等效屈光度、眼压、眼轴长度等数值变化,并记录用药后不良反应。结果：受检者用药前裸眼视力平均为0.34±0.19,用药后1个月,裸眼视力较前明显提高至0.52±0.21（P〈0.001）,等效屈光度相应降低（P〈0.001）。用药3个月视力及等效屈光度继续改善（P〈0.05）。但用药6个月与3个月之间差异无显著性（P〉0.05）。用药前后患者眼压无明显改变,用药6个月眼轴长度平均增长0.11mm,无明显不良反应。结论：信流丁滴眼液对青少年初发性近视有良好控制作用,无明显不良反应。     

飞秒LASIK与SBK术后角膜像差的对比分析

目的 比较飞秒激光FS200制瓣辅助的LASIK（FS-LASIK）和角膜板层刀制瓣的前弹力层下激光角膜磨镶术（SBK）的临床效果及角膜像差变化.方法 前瞻性病例对照研究.34例（68眼）应用FS200飞秒激光制瓣（FS组）患者和45例（90眼）M2微型角膜板层刀制瓣（SBK组）患者纳入研究.术前及术后1、3个月分别检查记录2组患者的裸眼视力、屈光度、矫正视力,并采用Pentacam-HR眼前节分析系统,对术眼进行眼前节扫描获得三维图像,通过内置分析软件获取瞳孔直径为6 mm的角膜总高阶像差（HOA）、球差（C40）、水平彗差（C31）、垂直彗差（C3-1）和水平三叶草（C33）、斜向三叶草（C3-3）数据,采用方差分析及t检验进行统计分析.结果 FS组角膜HOA、C40、C3-1手术前后比较差异均有统计学意义（F=8.511、12.356、11.843,P＜0.01）;SBK组角膜HOA、C40、C3-1、C31差异也存在统计学意义（F=46.601、38.627、10.874、11.727,P＜0.01）.术后1个月时SBK组HOA的增高幅度明显高于FS组,差异有统计学意义（t=3.063,P＜0.05）,术后3个月仍有同样趋势（t=2.998,P＜0.05）.术后1个月时2组患者角膜球差均有增高,组间差异无统计学意义（t=-1.990,P＞0.05）,而3个月时FS组有所恢复,组间差异有统计学意义（t=-2.666,P＜0.05）.2组三叶草像差（C33、C33）均较术前增加,术后1、3个月斜向三叶草（C3-3）与术前比较差异有统计学意义,但组间比较差异无统计学意义.结论 FS-LASIK和SBK均可造成角膜总高阶像差、球差、垂直彗差的增加,但FS-LASIK角膜总高阶像差和球差的增幅比SBK小,在提高视觉质量方面飞秒可发挥更大的作用.     

外翻肠囊法研究五味清浊散的肠吸收成分及其吸收特征

研究五味清浊散在不同肠段的吸收情况,以及其生物碱类成分胡椒碱、胡椒新碱、荜茇宁和二氢荜茇宁的吸收特征。通过构建大鼠肠外翻模型,应用UPLC-Q-TOF-MS技术测定五味清浊散在不同肠段透过的化学成分,以及采用UPLC-Q-TRAP-MS技术测定肠吸收液中胡椒碱、胡椒新碱、荜茇宁和二氢荜茇宁的含量,计算其吸收参数,并分析其在大鼠不同肠段、不同时间的吸收特征。实验结果显示,在建立的UPLC-Q-TOF-MS条件下,在空肠、回肠、十二指肠和结肠段的肠囊液中分别检测到27、27、8、6个吸收成分;且发现五味清浊散中胡椒碱、胡椒新碱、荜茇宁和二氢荜茇宁在各肠段均为线性吸收,r均达到0.9以上,各肠段的吸收量胡椒碱>胡椒新碱>二氢荜茇宁>荜茇宁,但各成分在各个肠段的吸收速率及其机制不尽相同,提示在不同肠段五味清浊散提取液各成分的吸收具有选择性,并不是简单的半透膜渗透过程。     

硬性透气性接触镜停戴后角膜前表面像差变化分析

Objective The present study used a corneal topographic device to record aberrations on the anterior surface of the cornea at different time-points prior to wearing and following discontinued use of rigid gas permeable (RGP) contact lenses. The effect of wearing RGPCL on the anterior surface of the cornea was discussed to provide guidance for clinical refractive error correction. Methods The study objects were 60 eyes from 30 patients. All patients underwent identical examination procedures prior to lens use, as well as afterwards, including slit-lamp examination, non-contact tonometer measurement, computer optometry & corneal curvature measurement, subjective refraction test, and corneal topography analysis. The patients wore contact lenses every day for 1 month and then discontinued. Corneal topographies were recorded at certain time points of 30 min, 1 day, 3 days, 1 week, and 2 weeks following use. Results Total corneal aberration at each time point following discontinued use of RGP contact lenses was less than the time point prior to use. Detailed results are as follows; root mean square (RMS) (pre) = (1.438 ±0.328), RMS (30 min) = (1.076 ± 0.355), RMS (1 day) = (1.362 ± 0.402) , RMS (3 day) =(1.373 ± 0.398), RMS (7 day) = (1.387 ± 0.415), and RMS (14 day) = (1.448 ± 0.423) .Results showed that at 30 minutes after discontinued use of RGP contact lenses, almost all 2nd-and 3rd-order aberrations were altered. Quadrafoil Z10 and spherical Z12 of the 4th-order were also changed. Alterations to Z5, Z6, and Z12 at 1 day after discontinued use were significant compared with the time period prior to RGP use: Z5 and Z6 decreased, and Z12 increased slightly( F =2. 869 ～5. 549 ,P =0. 001 ～0. 042). Z5 and Z6remained decreased at 3 days after discontinued use, but Z9 and Z10 continued to increase and Z12 returned to levels prior to RGP use ( P ＞ 0. 05 ). At 2 weeks after discontinued use, all aberrations were not significantly different from the values prior to use ( P ＞ 0. 05). Conclusions The use RGP contact lenses greatly reduced total aberration of the anterior surface of the cornea. Changes to 2nd- and 3rd-order aberrations ( including Z3, Z4, Z5, Z6, Z7, and Z8 ) were more significant. Following discontinued use of RGP contact lenses, the majority of lower order aberrations returned to original levels in a short period of time. During this process, a transient higher order aberration appeared, but all changes disappeared within 2 weeks after discontinued use of RGP contact lenses.