飞秒LASIK术后早期前房参数的变化研究

目的：探讨飞秒LASIK术后早期前房参数的变化情况。

方法：收集2014-01/06在我院就诊符合常规手术适应证并接受飞秒LASIK手术的患者共90例90眼,其中男47例47眼,女43例43眼,年龄18～33(平均22.38±3.96)岁。根据屈光度分为三组：A组：轻度近视组,30例30眼,≤3D; B组：中度近视组,30例30眼,>3～6D; C组：高度近视组,30例30眼,>6D。分别于术前、术后1,3mo行Pentacam检查测量前房相关参数,包括前房深度(ACD)、前房容积(ACV)、前房角(ACA)变化值。

结果：所有手术顺利,无并发症。A,B,C组术前与术后1,3mo时ACD和ACV比较,差异均有统计学意义(P<0.05),而A组术后1,3mo时ACD和ACV值比较差异有统计学意义(P<0.05),B组和C组术后1,3mo时ACD和ACV值比较差异无统计学意义(P>0.05); 无论A组和B组还是C组,ACA值差异均无统计学意义(P>0.05)。屈光度与ACD,ACV,ACA变化值无明显相关性。

结论：飞秒LASIK术后早期引起前房参数变化,包括ACD变浅,ACV变小,但对周边前房角无明显影响,对屈光手术后行内眼手术患者有进一步指导作用。     

飞秒 LASlK 术后早期前房参数的变化研究

目的：探讨飞秒LASIK术后早期前房参数的变化情况。
　　方法：收集2014－01／06在我院就诊符合常规手术适应证并接受飞秒LASIK手术的患者共90例90眼,其中男47例47眼,女43例43眼,年龄18～33（平均22．38±3．96）岁。根据屈光度分为三组：A组：轻度近视组,30例30眼,≤3 D;B组：中度近视组,30例30眼,＞3～6 D;C组：高度近视组,30例30眼,＞6D。分别于术前、术后1,3mo 行Pentacam检查测量前房相关参数,包括前房深度（ ACD）、前房容积（ ACV）、前房角（ ACA）变化值。
　　结果：所有手术顺利,无并发症。 A,B,C组术前与术后1,3 mo时 ACD 和 ACV 比较,差异均有统计学意义（ P＜0．05）,而A组术后1,3 mo时ACD和ACV值比较差异有统计学意义（ P＜0．05）,B组和C组术后1,3 mo时ACD和ACV值比较差异无统计学意义（ P＞0．05）;无论A组和B组还是C组,ACA值差异均无统计学意义（P＞0．05）。屈光度与ACD,ACV,ACA变化值无明显相关性。
　　结论：飞秒LASIK术后早期引起前房参数变化,包括ACD变浅,ACV变小,但对周边前房角无明显影响,对屈光手术后行内眼手术患者有进一步指导作用。     

三种不同方法测量年龄相关性白内障患者前房深度的比较

目的：：比较光学生物学测量仪( IOL Master )、接触式和浸润式A超对前房深度( anterior chamber depth,ACD)的测量结果,分析三种测量方法是否存在差异及其一致性。方法：选取2013-07/10于我院诊断为年龄相关性白内障患者58例98眼术前分别进行IOL Master、接触式A超和浸润式A超的ACD测量,应用方差分析对三种方法的测量结果差异进行比较,应用Blant-Altman分析法比较其一致性。结果：IOL Master 测量 ACD 为2.31~3.90(平均3.03±0.38) mm;接触式 A 超测量 ACD 为1.51~4.06(平均2.88±0.56)mm;浸润式A超测量ACD为1.99~4.17(平均3.17±0.38)mm。 IOL Master和接触式A超的ACD测量值差异有统计学意义( P=0.022<0.05)。 IOL Master和浸润式A超ACD测量值差异有统计学意义( P=0.031<0.05)。接触式A超与浸润式A超ACD测量值差异有统计学意义(P=0.000<0.05)。三种方法相互间一致性均较差。结论：三种方法测量白内障患者ACD时,浸润式A超测得结果最大,IOL Master次之,接触式A超测得结果最小,三者相互间一致性均较差,临床不建议相互替代。     

子宫内膜异位症致盆腔疼痛与病灶特点的相关性

目的 探讨子宫内膜异位症患者盆腔疼痛与病灶部位、粘连程度、浸润深度间的关系.方法 对湖州市菱湖人民医院2010年1月至2014年5月间妇科住院部确诊为子宫内膜异位症且经手术治疗的168例患者进行临床研究,观察痛经、排便痛、肛门坠痛、性交痛及慢性盆腔痛与病灶部位、粘连程度、浸润深度间的关系.结果 子宫内膜异位症发生部位在子宫骶韧带、子宫直肠凹部的肛门坠痛、排便痛、痛经、性交痛及慢性盆腔痛发生率均明显高于其它部位(子宫韧带:x2值分别为23.60、65.83、65.58、37.00、25.63,均P＜0.01;子宫直肠凹;x2值分别为17.98、56.41、54.49、27.93、40.90,均P＜0.01).术中见131例患者存在粘连,且多为复合粘连,卵巢粘连发生率明显高于其它部位(x2=115.43,P＜0.01),病灶浸润深度在≥5mm者,肛门坠痛、排便痛、痛经、性交痛及慢性盆腔疼痛患者发生率均明显高于＜5mm患者(x2值分别为6.62、11.83、10.62、10.66、7.29,均P＜0.05).结论 子宫内膜异位症患者盆腔疼痛与病灶部位、浸润深度及粘连程度为正相关性.     

内镜超声判断早期胃癌浸润深度的准确性及影响因素研究

目的　研究内镜超声检查术（endoscopic ultrasound,EUS）判断早期胃癌浸润深度的准确性及影响因素。方法　回顾性分析2014年1月—2020年8月于北京友谊医院就诊、行EUS且EUS分期为T1的早期胃癌患者的资料。比较EUS与术后病理浸润深度的一致性,计算EUS判断早期胃癌浸润深度的准确率、灵敏度及特异度,并探究影响EUS准确性的相关因素。单因素及多因素分析均采用Logistic回归模型。结果　共纳入380处病变,EUS发现黏膜内（T1a）病变301处,黏膜下层（T1b）病变79处;术后病理实际浸润深度为T1a病变320处,T1b病变60处。EUS判断早期胃癌浸润深度的准确率为77.1%（293/380）,灵敏度为83.4%（267/320）,特异度为43.3%（26/60）。多因素分析提示,病变位于胃上1/3部（OR=2.272,95%CI：1.266~4.080,P=0.006）、病变长径≥20 mm（OR=2.013,95%CI：1.200~3.377,P=0.008）及低分化癌（OR=2.090,95%CI：1.018~4.294,P=0.045）是影响EUS分期准确性的独立危险因素。低分化癌（OR=4.046,95%CI：1.737~9.425,P=0.001）是EUS过度分期的危险因素。结论　EUS对于早期胃癌浸润深度的判断具有一定的临床应用价值,影响EUS分期准确性的因素包括病变位于胃上1/3部、病变长径≥20 mm及低分化癌,其中低分化癌是EUS过度分期的危险因素。     

Digital clubbing and pulmonary function abnormalities in children with lung disease

Digital clubbing and pulmonary function tests were measured in children, adolescents, and adults with chronic lung diseases to determine pulmonary function correlates with a quantitative measure of clubbing. The group had a mean age of 13.8 +/- 6.0 (SD) years, mean PaO2 of 81 +/- 21 mm Hg, and mean FEV1 of 60% +/- 26% predicted. Digital clubbing was diagnosed in 43 cases when the distal phalangeal depth to interphalangeal depth (DPD/IPD) ratio, measured on a finger cast, was greater than or equal to 1 (greater than 3 SD above mean from 85 controls; no history of pulmonary disease; mean age, 14.8 +/- 7.6). The PaO2 of patients with digital clubbing was 69.4 +/- 2.1 (SEM) mm Hg compared with 88.3 +/- 1.3 mm Hg in those without digital clubbing (P less than 0.0001). Digital clubbing was present in 39 of the 84 (46%) hypoxic patients (PaO2 less than or equal to 88) but only four of the 78 (5%) normoxic patients (P less than 0.0001). The DPD/IPD ratio was negatively correlated with PaO2 in subjects with cystic fibrosis and interstitial fibrosis. Weak negative correlations were seen for all other subjects except asthmatics. Overall, the DPD/IPD ratio was significantly correlated with PaO2 (r = -0.53; P less than 0.0001). The DPD/IPD ratio was correlated with other lung function abnormalities (increased RV, decreased FEV1, and FEF25%-75%) only for the subjects with cystic fibrosis. We conclude that digital clubbing is associated with hypoxemia and airway obstruction. The relation is seen most clearly in subjects with cystic fibrosis, possibly reflecting the prolonged duration of hypoxemia. Digital clubbing is rarely seen in normoxic subjects.     

非小细胞肺癌患者外周血癌胚抗原、铁蛋白和神经元特异度烯醇化酶水平与肿瘤增殖、侵袭的关系

目的 分析非小细胞肺癌患者外周血癌胚抗原（carcinoembryonic antigen,CEA）、血清铁蛋白（serum ferritin,SF）和神经元特异度烯醇化酶 （neuronal specific enolase,NSE）水平与肿瘤增殖、侵袭的相关性。方法 回顾性分析医院2019年8月-2020年12月诊治的86例非小细胞肺癌患者作为研究对象,将其纳入病例组。于同期选择体检健康的受试者86例,将其纳入对照组。使用倾向性评分匹配(propensity score matching,PSM)法保证两组研究对象年龄和性别平衡后检测血清CEA、SF和NSE水平,根据患者病理结果将其分成增殖组和非增殖组,侵袭组和非侵袭组。比较病例组及对照组CEA、SF和NSE水平,分析增殖组和非增殖组,侵袭组和非侵袭组CEA、SF和NSE水平,探讨不同CEA、SF和NSE表达水平对肿瘤增殖、侵袭的影响。结果 病例组患者血清CEA、SF和NSE水平高于对照组（均P<0.05）。病例组中86例患者中34例患者发生增殖,26例患者发生肿瘤侵袭。增殖患者血清CEA、SF和NSE高于非增殖患者（P<0.05）。侵袭患者血清CEA、SF和NSE水平高于非侵袭患者（P<0.05）。血清CEA、SF和NSE高表达与肿瘤增殖及侵袭情况呈正相关（P<0.05）。CEA、SF和NSE水平越高,肿瘤增殖及侵袭风险越大。结论 非小细胞肺癌患者血清 CEA、SF和NSE水平高表达,且表达情况直接影响肿瘤增殖和侵袭。     

Predicting the presence and severity of obstructive sleep apnea based on mandibular measurements using quantitative analysis of facial profiles via three-dimensional photogrammetry

BackgroundIn obstructive sleep apnea (OSA), the upper airway is obstructed during sleep due to obesity and/or posterior collapse of the tongue root. Maxillofacial morphological abnormalities increase the risk of OSA in the Asian population. This study sought to elucidate whether three-dimensional (3D) photogrammetry measurements correlate with the severity of OSA irrespective of sex and degree of obesity.MethodsA prospective pilot study was performed, in which 37 consecutive adult patients (M/F = 28/9) underwent polysomnography and 3D photogrammetry in the supine position for the diagnosis of OSA. Measurements obtained from 3D photogrammetry included mandibular width (Mw), mandibular length (Ml), mandibular depth (Md), mandibular width–length angle (Mwla), and mandibular area (Ma). The effects of sex and body mass index (BMI) on the measurements and their association with the apnea–hypopnea index (AHI) were statistically analyzed. The inter-rater reliability of the measurements was evaluated using intraclass correlation coefficients (ICC).ResultsMwla (R = 0.73, p < 0.01), Mw (R = 0.39, p < 0.05), and Md (R = ?0.34, p < 0.05) were significantly correlated with the severity of OSA. On multivariate analysis, Mwla (p < 0.01) and Md (p < 0.05) remained independent factors for AHI after adjusting for sex, age, BMI, and neck circumference. In addition, diagnosability analysis revealed that Mwla was useful for identifying the presence of OSA (AHI ≥5) (cutoff: 78.6°, sensitivity: 0.938, specificity: 0.800, area under the curve: 0.931). The ICC was >0.9, showing high reliability.ConclusionsThis study suggests that Mwla measured using 3D photogrammetry can predict the presence of OSA and correlates with the severity of OSA, independent of obesity and sex.     

Expression of human chorionic gonadotropin, CD44v6 and CD44v4/5 in esophageal squamous cell carcinoma

AIM: To study the relationship between the expression of human chorionic gonadotropin (HCG), CD44v6, CD44v4/5 and the infiltration, metastasis of esophageal squamous cell carcinoma. METHODS: By labeled streptavidin-biotin technique, the expressions of HCG, CD44v6, and CD44v4/5 in 42 patients with esophageal squamous cell carcinoma were examined. RESULTS: The positive rate of HCG expression in patients with lymph node metastasis was 85.71% (18/21), higher than that (57.14%, 12/21) in those without lymph node metastasis (P<0.05). The positive rate of CD44v6 expression was 71.43% (15/21) in lymph node metastasis group, and 38.09% (8/21) in non-metastasis group; there was a significant difference between the two groups (P<0.05). The positive rate of CD44v4/5 expression was 76.19% (16/21) in lymph node metastasis group, and 42.86% (9/21) in non-metastasis group; there was also a significant difference between them (P<0.05). From grade Ⅰ to grade Ⅲ in differentiation, the positive rate of HCG expression was 84.62% (11/13), 70.59% (12/17) and 58.33% (7/12), respectively; there was no significant difference among them (P<0.05). The positive rate of CD44v6 expression in grades Ⅰ-Ⅲ of cancer tissues was 76.92% (10/13), 52.94% (9/17), and 33.33% (4/12) respectively; there was no significant difference among them. The positive rate of CD44v4/5 expression in grades Ⅰ-Ⅲ of cancer tissues was 69.23% (9/13), 64.71% (11/17), and 41.67% (5/12) respectively; there was no significant difference among the three groups. There was no correlation between the positive rates of HCG and CD44v6, CD44v4/5 expression. Cancer cells in carcinomatous emboli and those infiltrating into vascular wall strongly expressed HCG, CD44v6, and CD44v4/5. CONCLUSION: Expression of HCG, CD44v6, and CD44v4/5 in esophageal squamous cell carcinoma is related to its infiltration and metastasis. HCG, CD44v6, and CD44v4/5 have different effects on the infiltration and metastasis of esophageal squamous cell carcinoma.