老年性上睑下垂提上睑肌腱膜的病理学观察

目的通过研究老年性上睑下垂提上睑肌腱膜的病理结构的改变,探讨老年性上睑下垂的发病机制。方法选自我科2011年6月至2013年6月就诊的老年性上睑下垂患者30例,根据下垂量分为轻度、中度、重度,将提上睑肌缩短手术中取得的提上睑肌腱膜组织,进行HE染色、弹性蛋白(Elastin)及基质金属蛋白酶(matrix metalloproteinase,MMP)-9免疫组织化学染色检查,并行透射电镜超微结构观察。结果术中可见患眼提上睑肌腱膜变长、变薄,有的出现裂孔,部分或全部从睑板表面断裂,有的出现脂肪样变性;HE染色可见患眼提上睑肌肌浆内出现大量脂肪样变性;免疫组织化学染色结果示Elastin含量下降,与下垂程度呈负相关(r=-2.782,P=0.002),MMP-9的含量增加,与下垂程度呈正相关(r=4.376,P=0.030);透射电镜显示成纤维细胞的细胞膜局部有缺损、外形不规则,胞质肿胀,内质网扩张、脱颗粒,胶原纤维周围可见脂滴。结论老年性上睑下垂的提上睑肌腱膜变薄或破裂,脂肪样变和肌纤维萎缩,Elastin含量下降,胶原纤维分裂,呈现退化改变。     

住院病人空间分布函数研究

目的:研究住院病人空间分布以及住院病人距离衰减系数,了解居民医疗服务获得的地理可及性现状,为区域卫生规划提供决策依据。方法:随机抽取23家医疗机构住院病人,利用地理信息系统计算病人到就诊医疗机构的距离以及相应的住院病人概率,进行多种曲线模型拟合,根据决定系数和模拟图形选择适宜的模型,得出相应的距离衰减系数。结果:指数曲线模型在二级医疗机构中拟合效果较好,乘幂曲线模型在三级医疗机构中拟合效果较好。指数曲线模型中二级综合医疗机构、二级专科医疗机构住院病人距离衰减系数均值分别为0.51、0.50。乘幂曲线模型中三级综合医疗机构、三级专科医疗机构住院病人距离衰减系数均值分别为0.84、0.53。结论:二级医疗机构住院病人概率随距离衰减的趋势快于三级医疗机构,综合医疗机构住院病人概率随距离衰减的趋势快于专科医疗机构。在区域卫生规划中计算卫生资源配置水平时,对于不同级别、类别的医疗机构应采用不同的距离衰减系数。     

MoO3−x-deposited TiO2 nanotubes for stable and high-capacitance supercapacitor electrodes

Here we report the supercapacitive properties of a novel MoO_3−x/TiO₂ nanotube composite prepared by a facile galvanostatic deposition technique and subsequently thermal treatment in an argon atmosphere between 350 °C and 550 °C. X-ray diffraction and X-ray photoelectron spectroscopy confirm the existence of MoO_3−x. The MoO_3−x/TiO₂ electrode prepared at 550 °C exhibits a high specific capacitance of 23.69 mF cm⁻² at a scan rate of 10 mV s⁻¹ and good cycling stability with capacitance retention of 86.6% after 1000 cycles in 1 M Na₂SO₄ aqueous solution. Our study reveals a feasible method for the fabrication of TiO₂ nanotubes modified with electroactive MoO_3−x as high-performance electrode materials for supercapacitors.

Here we report the supercapacitive properties of a novel MoO_3−x/TiO₂ nanotube composite prepared by a facile galvanostatic deposition technique and subsequently thermal treatment in an argon atmosphere between 350 °C and 550 °C.     

Economic Burden of Opioid-Induced Constipation Among Long-Term Opioid Users with Noncancer Pain

Background

Opioid-induced constipation (OIC) can be a debilitating side effect of opioid therapy and may result in increased medical costs. The published data on the economic burden of OIC among long-term opioid users are limited.

Objective

To assess the economic burden of OIC in patients with noncancer pain in a managed care population in the United States.

Methods

This retrospective study used 2007–2011 data from the Truven Health MarketScan Commercial and Medicare databases. The study included adults with ≥12 months of insurance enrollment before and after starting long-term (≥90 days) use of opioids. Patients were excluded if they had cancer or a diagnosis of drug abuse or drug dependence during the study period, or if they had constipation or bowel obstruction within 90 days before starting opioid therapy during the study period. OIC was identified by International Classification of Diseases, Ninth Edition codes for constipation (564.0) or bowel obstruction (560.x) within 12 months of the initiation of an opioid. Patients with OIC were identified in the nonelderly, elderly (age ≥65 years), and long-term care populations. Differences in costs and healthcare resource utilization were calculated using propensity scoring.

Results

A total of 13,808 nonelderly (age, 48.6 ± 10.4 years; female, 50%) and 2958 elderly patients (age, 78.7 ± 8.1 years; female, 70%) met the study inclusion criteria. Of 401 nonelderly and 194 elderly patients with OIC, 85 patients initiated opioid therapy in a long-term care facility (age, 80.7 ± 11.6 years; female, 77%). After matching by key covariates, patients with OIC had significantly more hospital admissions than patients without OIC (nonelderly, 33% vs 22%, respectively; P <.001; elderly, 51% vs 31%, respectively; P <.001) and longer inpatient stays (nonelderly, 3.0 ± 8.4 days vs 1.0 ± 3.0 days, respectively; P <.001; elderly, 5.2 ± 12.2 days vs 2.1 ± 4.0 days, respectively; P <.001). The group with OIC had significantly higher total healthcare costs than the group without OIC in all 3 study cohorts (nonelderly, $23,631 ± $67,209 vs $12,652 ± $19,717, respectively; elderly, $16,923 ± $38,191 vs $11,117 ± $19,525, respectively; long-term care, $16,000 ± $22,897 vs $14,437 ± $25,690, respectively; all P <.05).

Conclusion

To the best of our knowledge, this is the first study to analyze the economic impact of long-term use of opioids among patients with OIC, using real-world data. The findings underscore the significant economic burden associated with long-term opioid use for noncancer pain in a managed care population. Effective therapies for OIC may reduce the associated economic burden and improve quality of life for long-term opioid users.     

Comparison of electroretinographic responses between two different age groups of adult Dark Agouti rats

AIM: To describe and compare the differences in electroretinographic responses between two different age groups of adult Dark Agouti (DA) rats and to better understand the effect of age on retinal histology and function.METHODS: The electroretinographic responses of two different age groups of adult DA rats were compared. Animals were divided into younger adult DA rats 10-12wk (n=8) and older adult DA rats 17-19wk (n=8). Full field electroretinography (ERG) was recorded simultaneously from both eyes after dark adaption and light adaption and parameters including the positive scotopic threshold response (pSTR), negative scotopic threshold response (nSTR), scotopic a-wave, b-wave, photopic a-wave, b-wave and photopic negative response (PhNR) were compared between groups.RESULTS: The older adult rats displayed lower stimulation thresholds of the STRs (pSTR and nSTR) and higher amplitudes of pSTR, scotopic a-wave and b-wave, photopic b-wave and PhNR amplitudes, with shorter implicit times. Photopic a-wave amplitudes were however higher in the younger adult rats.CONCLUSION:In summary, for the rod system, photoreceptor, bipolar cell and RGC activity was enhanced in the older adult rats. For the cone system, RGC and bipolar cell activity was enhanced, while photoreceptor activity was depressed in the older adult rats. Such age-related selective modification of retinal cell function needs to be considered when conducting ophthalmic research in adult rats.     

Extraction (DSX) from Erigeron breviscapus modulates outward potassium currents in rat retinal ganglion cells

AIM: To investigate the effect of DSX, an active component extracted from Erigeron breviscapus, on the voltage-gated outward K+ channel currents in rat retinal ganglion cells (RGCs) by using electrophysiological method, and to explore the possible mechanisms of DSX on optic nerve protection. METHODS: Outward K+ currents were recorded by using whole-cell patch-clamp techniques on acutely isolated rat RGCs. Outward K+ currents were induced by a series of depolarizing voltage pulses from a holding potential of -70 mV to +20 mV in an increment of 10 mV. RESULTS: Extracellular application of DSX voltage-dependently suppressed both the steady-state and peak current amplitudes of outward K+ currents in rat RGCs. Furthermore, DSX reversibly and dose-dependently inhibited the amplitudes of outward K+ currents of the cells. At +20 mV membrane potential DSX at the concentrations of 0.02 g/L and 0.05 g/L showed no significant effects on the currents. In contrast, DSX at higher concentrations (0.1 g/L, 0.2 g/L and 0.5 g/L) significantly suppressed the current amplitudes. CONCLUSION: These results suggest that DSX reversibly and dose-dependently suppress outward K+ channel currents in rat RGCs, which may be one of the possible mechanisms underlying Erigeron breviscapus prevents vision loss and RGC damage caused by glaucoma.     

分析方法转移内容介绍

有关药品分析方法转移的相关指导原则和技术文件目前国内尚属鲜见,很多药品监管机构、实验室质量控制人员,甚至药品检验人员对方法转移的概念理解不清,方法转移的具体内容和适用范围不明,给分析检测及管理工作带来不便。本文在系统调研国际上有关分析方法转移标准规范内容的基础上,结合中国药品检验工作的实际情况需要,梳理药品检验相关方法转移的概念,介绍日常药品检验工作中的方法转移内容和步骤,为相关工作提供参考。