调节状态下眼内接触镜在眼内位移的临床观察

目的 研究调节状态下的后房型有晶状体眼人工晶状体(P-IOL)眼内接触镜(ICL)在眼内的相对位移情况.方法 系列病例研究.连续收集2008年4月至2008年10月在首都医科大学附属北京同仁医院进行ICL植入矫正高度近视的患者41例(41只眼).检查手术前后的视力、调节力,以及术后非调节状态和毛果芸香碱药物诱导调节下的ICL和自身晶状体的位移及相对位置.对等效球镜度数、散光度数、调节力、人工晶状体移动度等数据采用t检验进行统计学分析.结果 术后3个月患者裸眼矫止远、近视力均达到或高于术前最佳矫正视力.术前平均调节力(2.12±1.06)D,术后3个月平均调节力(4.46±2.11)D,较术前明显提高(t=2.312,P=0.022).ICL后表面至自身晶状体前囊的距离在非调节状态下为(0.48±0.27)mm,在药物诱导调节状态下为(0.34±0.19)mm,两者差异有统计学意义(t=2.104,P=0.038).角膜内皮至ICL前表面的距离在两种状态下差异无统计学意义(t=1.165,P=0.149).角膜内皮至自身晶状体前囊的距离在两种状态下差异虽无统计学意义(t=1.821,P=0.071),但可以见到自身晶状体的前极发生了比较明显的前移位的现象.超声活体显微镜(UBM)检查可见,部分手术眼在调节和非调节状态下ICI 的襻部与晶状体赤道部均存在接触.结论 虽然在药物诱导调节的过程中,伴随的缩瞳现象使得ICL与自身晶状体之问的距离明显缩小,但在中央区两者之间的距离对于避免前囊下白内障的形成仍然是足够的.两者在周边部的接触可能是引起晶状体周边囊膜下混浊的原因之一,但其对于中央部囊膜下混浊发生的影响还需要进一步研究.     

视功能生存质量问卷调查中问卷员的质量控制

为了研究人群视功能生存质量测量中的问卷员的挑选、训练中的质量控制方法,本研究使用视功能和生存质量问卷,根据严格条件选定５名问卷员,通过重测一致性检验和组间一致性检验,以重Ｋａｐｐｐａｗ值作为指标,完成为其个月的培训和预谋试验评价。ＶＦ和ＱＯＬ问卷的２５个问题的重测一致性检验中,问卷员的Ｋ值绝大部分在０．４以上。在组间一致性检验中,Ｋ值在约叁部分问题中高于０．４,心理指标的问题一致性较低,显示在以问     

Surgical and Oncologic Outcomes of Radical Abdominal Trachelectomy Versus Hysterectomy for Stage IA2-IB1 Cervical Cancer

Study Objective: To compare the surgical and oncologic outcomes between abdominal radical trachelectomy (ART) and radical hysterectomy (RH) for stage IA2-IB1 cervical cancer.Design: A retrospective cohort study (Canadian Task Force classification II-2).Setting: Shandong Cancer Hospital, Shandong, China.Patients: Three hundred twenty-nine patients with IA2-IB1 cervical cancer.Interventions: All patients underwent ART or RH.Measurements and Main Results: All patients were divided into ART (n?=?143) and RH (n?=?186) groups according to the surgical approach. Additionally, oncologic and fertility outcomes were compared for different tumor pathologies and sizes in ART patients. The ART group had similar case characteristics as the RH group, except that the ART group had a longer surgical time. During a similar follow-up period, there were 4 (2.9%) recurrences and 3 (2.2%) patients who died from recurrence in the ART group compared with 8 (4.6%) recurrences and 4 (2.3%) patients who died from recurrence in the RH group (p?=?.444 and p?=?.999, respectively). In the ART group, squamous cell carcinoma (SCC) patients had a 5-year overall survival and pregnancy rate similar to those of non-SCC patients (98.1% vs 96.8%, p?=?.999; 33.3% vs 26.7%, p?=?.873), and patients with tumors ≤2 cm and 2 to 4 cm experienced a similar 5-year overall survival rate (97.0% vs 98.6%, p?=?.999), except patients with tumors ≤2 cm had a higher pregnancy rate (45.2% vs 17.2%, p?=?.020).Conclusion: ART seems to have similar surgical and oncologic outcomes to RH, except ART has a longer surgical time. Both non-SCC patients and stage IA2-IB1 patients with 2- to 4-cm tumors can undergo ART safely. Patients with tumors ≤2 cm have a higher pregnancy rate than patients with 2- to 4-cm tumors.     

液相色谱/质谱法测定人血清中特布他林及其药代动力学

目的:测定人血清中特布他林浓度,研究中国男性健康志愿者口服该药后药代动力学规律。方法:用LC-MS法测定特布他林浓度。流动相:2%冰乙酸—异丙醇(98.5∶1.5);色谱柱:Shimadzu VP-ODS;流速:0.5mL·min^-1;柱温:30℃。结果:特布他林浓度在0.2～20ng·mL^-1范围内线性关系良好(γ=0.9998)。方法的回收率高于90%,最低浓度的日内及日间精密度分别为8.2%和12.9%,最低检测限为0.05ng。10名健康志愿者单剂量口服特布他林口服液7.5mg后,药代动力学行为符合二房室模型。结论:此法灵敏度高、选择性强,符合生物样品分析要求。     

水生真菌YMF1．01029毒杀线虫活性代谢产物的研究

从云南抚仙湖水中腐木上筛选、分离得到一株能毒杀线虫的水生真菌Coelomycetes sp.YMF1.01029.从此拮抗菌株的发酵液中分离得到了5个活性成分,通过UV、IR、MS、1H-NMR、13C-NMR、DEPT、1H-1H COSY、HMQC和HMBC等波谱分析,鉴定其结构分别与preussomerin C(1)、preussomerin D(2)、preussomerin E(3)、(4RS)4,8-dihydroxy-3,4-dihydronaphthalen-1(2H)-one(4)和4,6,8-trihydroxy-3,4-dihydronaphthalen-1(2H)-one(S)相同.首次报道这5个化合物对线虫的毒杀活性.     

Mohnarin2006——2007年度报告：西北地区细菌耐药监测

目的总结西北地区10家教学医院2006~2007年度临床分离病原菌的耐药状况。方法常规方法培养分离医院内感染病原菌,并应用半自动或全自动细菌鉴定分析仪鉴定到种,药敏试验方法按CLSI规定的标准进行。监测数据按卫生部全国细菌耐药监测(Mohnarin)中心设计方案的要求定期上报。采用WHONET5.4软件进行数据统计分析。结果西北地区10家教学医院共分离病原菌株14608株,其中革兰阴性菌10098株占分离菌的69.13%,革兰阳性菌4091株占分离菌的28.01%,真菌396株占分离菌的2.71%。大肠埃希菌超广谱β-内酰胺酶的产酶率为(1380/2021)68.28%,肺炎克雷伯菌产酶率为(455/1008)45.14%,大肠埃希菌对左氧氟沙星和环丙沙性的耐药率为63.00%~87.50%,铜绿假单胞菌、鲍曼不动杆菌为32.90%~68.40%。革兰阳性球菌中耐甲氧西林的金葡菌的发生率为43.82%,耐甲氧西林的表葡菌的发生率为60.97%。未发现耐万古霉素的葡萄球菌。粪肠球菌对替考拉宁和万古霉素耐药率分别为3.20%、1.50%,屎肠球菌对替考拉宁和万古霉素耐药率分别为5.7%、3.2%。结论碳青霉烯类、哌拉西林/三唑巴坦、阿米卡星和头孢吡肟对医院内感染分离的肠杆菌仍有较好的抗菌活性,大肠杆菌对氟喹诺酮类药物的耐药性越来越高,值得临床重视,应限制该类药物的临床应用范围。非发酵菌对临床常用抗菌药物普遍敏感性降低。耐甲氧西林葡萄球菌和耐万古霉素的屎肠球菌感染是抗菌药物治疗中的难点。临床微生物实验室应加强对产酶菌和多重耐药菌的监测,为临床正确合理使用抗菌药物提供依据。     

不同剂量藻酸双酯钠对血脂异常的调节作用

目的;观察不同剂量藻酸双酯钠（PSS）对缺血性心脑血管病伴血脂异常患者的临床疗效。方法：将128例缺血性心脑血管病伴血脂异常的患者随机分为A、B2组,其中A组68例,PSS300mg/d,po.B组60例,PSS600mg/d,po。比较服药前及服药后4、8wk血脂变化。治疗结束,将A组未达到理想控制水平的患者加大PSS剂量至600mg/d,再服药8wk后复查血脂。结果：2组均能有效地降低胆固醇（TC）和低密度脂蛋白胆固醇（LDL－C）（P＜0．05或0．01）,B组三酰甘油（TG）也较明显降低（P＜0．01）。服药8wk后,B组降低TC、TG、LDL－C及升高HDL－C的有效率明显高于A组,疗效差异有高度统计学意义（P＜0．01）。将A组患者血脂未控制到理想水平的44例患者继续服用PSS600mg/d,8wk后又有75％患者的TC、LDL－C降到理想水平。2组用药前后血尿常规、肝肾功能等均无显著变化。结论：对伴血脂异常的缺血性心脑血管病患者,2组不同剂量的PSS均能有效降低TC和LDL－C,对伴有TG升高的患者以600mg/d为佳,并使HDL－C明显升高,PSS剂量的增加并不伴有不良反应的增加。     

Salvianolic acid A demonstrates cardioprotective effects in rat hearts and cardiomyocytes after ischemia/reperfusion injury

Salvianolic acid A (Sal A), the water-soluble component from the root of the Salvia miltiorrhiza plant, possesses antioxidant, antiproliferative, and antiplatelet properties. However, whether it plays a role in the protection against ischemia-reperfusion (I/R) injury in rat hearts has yet to be elucidated. In the present study, we tested cell viability, shortening amplitude, necrosis, apoptosis, and the expression levels of Akt, phosphorylated Akt, Bcl-2, Bax, and caspase-3 after 3-hour simulated ischemia and 2- or 6-hour simulated reperfusion in cardiomyocytes. We further observed the contractile function and infarct size in isolated hearts after they were subjected to global 30-minute ischemia and 120-minute reperfusion. Pretreatment with Sal A markedly increased cell viability and shortening amplitude while reducing evidence of necrosis and apoptosis in the cells. In addition, the expression of Bcl-2 was upregulated and Bax was downregulated, thereby increasing the Bcl-2/Bax ratio. Sal A inhibited the activation of caspase-3 as well. The results also showed that Sal A significantly increased phosphorylation of Akt and that this phosphorylation can be partially inhibited by phosphoinositide 3-kinase/Akt inhibitor. Furthermore, Sal A improved I/R-induced myocardial contractile function and reduced infarct size. In summary, our results showed that Sal A prevents I/R-induced myocardial damage by reducing necrosis and apoptosis in isolated rat hearts and cardiomyocytes.     

重组人Elafin对肝脏缺血-再灌注损伤的保护作用

目的探讨重组人Elafin在大鼠肝脏缺血-再灌注损伤中的保护作用。方法将50只大鼠随机均分为5组,即正常对照组、肝脏缺血-再灌注损伤模型组以及Elafin低、中、高剂量组。对Elafin低、中、高剂量组给予不同浓度的重组人Elafin进行治疗,然后取血液及肝脏标本,检测血清中丙氨酸氨基转移酶(ALT)、天门冬酸氨基转移酶(AST)及乳酸脱氢酶(LDH)水平,测定肝组织中髓过氧化物酶(MPO)和一氧化氮(NO)含量,并观察肝脏的病理组织学改变。结果缺血-再灌注后大鼠肝组织损害较重,血清ALT和AST以及LDH水平明显升高(P<0.001),肝组织中MPO和NO含量明显升高(P<0.001);若手术前给予大鼠一定浓度的重组人Elafin,可使ALT,AST,LDH,MPO及NO水平明显降低(P<0.05)。结论重组人Elafin对肝脏缺血-再灌注损伤有一定的保护作用。