高度近视薄角膜患者LASIK术后3a疗效观察

目的:通过研究角膜相对较薄的高度近视患者LASIK术后的远期效果,进一步探讨LASIK术中保留角膜基质床厚度与术后疗效的关系,以及可能影响术后屈光回退的因素.方法:选2001-01/2002-10在我院行LASIK手术的高度近视相对薄角膜患者21例39眼,查术后3a的视力、眼压、屈光状态、角膜曲率及中央角膜厚度,并与术前及术后早期数据进行统计学比较分析.结果:术后3a无1例出现继发圆锥角膜改变,术后视力0.8以上25眼,占64%,术后视力与术前最佳矫正视力间呈低度正相关.术后3a与早期视力无显著性差异,但屈光与角膜曲率有明显增加.术后3a屈光回退量≥1.00D30眼,占77%,屈光回退量与术前屈光度呈负相关,与患者年龄、术后角膜曲率的改变和实际角膜厚度与预留角膜厚度的差值呈正相关.结论:高度近视薄角膜患者LASIK术后的远期稳定性较低,可预测性较差,术后屈光回退可能与术前屈光、年龄、角膜厚度和曲率的改变有关.本组患者今后是否会继发圆锥角膜的改变仍需进一步观察研究.     

肝尔舒微丸的流化床制备工艺优选

目的:优选肝尔舒微丸的成型工艺.方法:以微丸得率、圆整度、堆密度、脆碎度等为指标,采用流化床侧喷制丸法,考察影响肝尔舒微丸成型过程中的处方、工艺因素.结果:优选的微丸成型处方及工艺参数为药液相对密度1.12 ～1.167g·mL-1,6％滑石粉为抗黏剂,泵速4 r·min-1,雾化压力300 kPa,转盘高度5 mm,转盘速度300 r·min-1,进风温度75℃,风机频率25～35 Hz.采用流化床侧喷制备的肝尔舒微丸外观光滑,圆整度高;粒径在600 ～ 900μm的微丸得率为86.7％.结论:优选的微丸成型工艺合理、稳定.     

住院患者跌倒/坠床管理流程的建立和应用

目的：建立住院患者跌倒/坠床管理流程,降低患者跌倒/坠床发生率。方法：于2011年建立并实施高危患者跌倒/坠床风险评估及干预—跌倒/坠床风险评估申报—住院安全告知讲解签字—每周动态评估的管理流程。结果：住院患者跌倒发生率明显降低（P〈0.05）,护患关系更融洽。结论：住院患者跌倒/坠床管理流程的实施,能有效降低住院患者跌倒/坠床发生率。     

Subungual squamous cell carcinoma presenting with minimal nail changes: A factor in delayed diagnosis?

Squamous cell carcinoma of the nail bed is a relatively uncommon tumour that may be diagnosed only after considerable delay. The first case presented is a 79-year-old man with a history of discomfort and discoloration affecting the right thumbnail of 3 years duration. The second case is a 70-year-old man who presented with a recurrent, offensive discharge from beneath the left thumbnail of 40 years duration. Clinical examination of the affected digits revealed minor nail abnormalities. The presence of tumour was fully apparent only after removal of the nail plate and inspection and biopsy of the nail bed. The cases demonstrate that subungual squamous cell carcinoma may present with prolonged symptoms and a deceptively benign appearance. The importance of consideration of the possibility of malignancy, removal of the nail plate for inspection of the nail bed and appropriate biopsy is emphasized.     

子痫前期产妇血清MMP2、MMP9含量检测及胎盘床血流动力学异常情况评估

目的:研究子痫前期产妇血清基质金属蛋白酶2、9(MMP2、MMP9)含量及胎盘床血流动力学异常情况.方法:将2011年3月～2013年8月期间在我院确诊的子痫前期产妇50例纳入研究的观察组,同期在我院进行产前检查和分娩的正常妊娠产妇50例纳入研究的对照组,采用酶联免疫吸附法检测血清中MMPs的蛋白含量,采用Western-blot的方法检测胎盘组织中MMPs的蛋白含量;采用彩色多普勒超声检测胎盘床的血流动力学.结果:两组产妇血清中和胎盘组织中MMP1、MMP3的蛋白含量无差异;观察组产妇血清中和胎盘组织中MMP2、MMP9的蛋白含量均低于对照组(P＜0.05);观察组产妇胎盘床血管的搏动指数(PI)、阻力指数(RI)、收缩期最大速度与舒张末期速度比值(S/D)高于对照组,时间平均流速(TAV)低于对照组(P＜0.05).结论:子痫前期产妇胎盘组织和血清中MMP2、MMP9含量异常降低,胎盘床血流阻力增大、灌注量减少.     

Is Going Beyond Rasch Analysis Necessary to Assess the Construct Validity of a Motor Function Scale?

Objective

To examine whether a Rasch analysis is sufficient to establish the construct validity of the Motor Function Measure (MFM) and discuss whether weighting the MFM item scores would improve the MFM construct validity.

A genetic model of the effects of insecticide-treated bed nets on the evolution of insecticide-resistance

Background and objectives: The evolution of insecticide-resistance in malaria vectors is emerging as a serious challenge for the control of malaria. Modelling the spread of insecticide-resistance is an essential tool to understand the evolutionary pressures and dynamics caused by the application of insecticides.Methodology: We developed a population-genetic model of the spread of insecticide-resistance in a population of Anopheles vectors in response to insecticides used either as adulticides (focussing on insecticide-treated bed nets (ITNs)) or as larvicides (either for the control of malaria or, as an inadvertent side-product, in agriculture).Results: We show that indoor use of insecticides leads to considerably less selection pressure than their use as larvicides, supporting the idea that most resistance of malaria vectors is due to the agricultural use of the insecticides that are also used for malaria control. The reasons for the relatively low selection pressure posed by adulticides are (i) that males are not affected by the ITNs and, in particular, (ii) that the insecticides are also repellents, keeping mosquitoes at bay from contacting the insecticide but also driving them to bite either people who do not use the insecticide or alternative hosts.Conclusion: We conclude by discussing the opposing public health benefits of high repellency at an epidemiological and an evolutionary timescale: whereas repellency is beneficial to delay the evolution of resistance, other models have shown that it decreases the population-level protection of the insecticide.     

Cost-Effective Isolation of a Process Impurity of Pregabalin

Cost-effective isolation methods were developed on preparative HPLC, flash LC, and simulated moving bed (SMB) to prepare the process impurity, 3-(aminomethyl)-5-methylhex-4-enoic acid (4-ene impurity), of pregabalin. By a thorough experimental study on the different isolation techniques available, it was concluded that SMB was the most cost-effective. Hence, it was a continuous chromatography that utilized the advantage of SMB so that a high quantity of the impurity was generated in a short period of time. SMB was equipped with eight reversed-phased columns and was used to separate the process impurity of pregabalin. The effects of flow rate in zone 2 (Q2) and 3 (Q3), as well as switching time, on the operating performance parameters like purity, productivity, and desorbent consumption were studied. Operating conditions leading to more than 90% purity in the raffinate outlet stream were identified, together with those achieving optimal performance. All of these developed methods are novel, cost-effective, and can be applied to the isolation of other process- and stability-related impurities of pregabalin.     

Effect of temporary school closure due to COVID-19 on musculoskeletal function in elementary school children

Objective: In 2020, coronavirus disease-2019 (COVID-19) became the cause of a pandemic. In response, the Japan Sports Agency issued warnings about secondary damage to health, such as the threat to physical and mental well-being due to the lack of exercise in this situation. In this study, we report on cross-sectional and longitudinal examinations of standing trunk flexion to evaluate how temporary long-term school closures affected musculoskeletal function in elementary school students.Patients and Methods: All children in one public elementary school in T-city during the school years 2019 and 2020 were included in this study. A digital forward flexion meter was used to measure standing trunk flexion.Results: In this study, 284 (284/289: 98.3%) and 266 (266/274: 97.1%) children in school years 2020 and 2019, respectively, were found to have valid data for cross-sectional analysis. The standing trunk flexion did not show significant differences between grades or sexes. In the longitudinal analysis, the results of the comparison of standing trunk flexion in children for two consecutive years revealed significant differences only between grades 3 and 4 (P<0.05) and between girls in grades 3 and 4 (P<0.01), but no significant differences in other grades or among boys or girls were observed.Conclusion: Initially, we expected that there would be a difference in the results of functional assessment using standing trunk flexion depending on the period of absence from school. However, the results of this study showed no significant changes in standing trunk flexion. Moreover, since children’s musculoskeletal functions may be affected by various factors during the COVID-19 pandemic, they should be carefully monitored in the future.