慢性肾脏病3-4期糖尿病肾脏疾病患者进展到终末期肾病的危险因素分类树模型分析

【目的】分析糖尿病肾脏疾病（DKD）患者进展到终末期肾病（ESRD）的相关危险因素,筛查进展到ESRD的高风险人群,以早期预防。【方法】收集本院231例糖尿病肾脏疾病患者的临床资料,随访3年,据是否出现ESRD分为未进展到ESRD（133例）、ESRD组（98例）。使用分类树模型分析进展到ESRD相关危险因素,通过节点增益分析筛选进展到ESRD的高风险人群。【结果】从预测变量中筛选到4个重要解释变量：载脂蛋B（ApoB）、性别、糖尿病视网膜病变、收缩压;ApoB升高是DKD进展的重要的危险因素;ApoB＞1.14mmol/L的慢性肾脏病（CKD）3～4期DKD患者,3年进展到ESRD的概率是75.0%,如合并糖尿病视网膜病变,有79.7%的概率进展到ESRD。【结论】分类树模型能有效筛选并分析进展到ESRD危险因素,并识别高风险人群特征,有利于早期防治。     

有晶状体眼后房型人工晶状体植入术对高度近视的疗效

目的：通过双通道客观视觉质量分析系统Ⅱ(OQAS Ⅱ)评价有晶状体眼后房型人工晶状体(ICL)植入术对高度近视的临床疗效。

方法：选取2017-12/2018-12安徽医科大学第一附属医院收治的高度近视患者26例52眼,所有患者均行ICL植入术。随访获取所有患者术前BCVA以及术前和术后1wk,1、3mo的UCVA、客观散射指数(OSI)、调制传递函数(MTF)、斯特列尔比(SR)和100%、20%及9%的模拟对比度视力(Predicted VA)等一系列参数。

结果：与术前BCVA相比,术后1wk,1、3mo UCVA情况均优于术前且日渐改善(P<0.01)。与术前OSI、MTF、SR和Predicted VA 100%、20%及9%相比,术后1wk,1、3mo情况均好转(P<0.01)。

结论：ICL植入术能够有效地矫正高度近视,提高裸眼视力。通过OQAS Ⅱ分析,ICL植入术后OSI比术前减小,术后的MTF、SR和Predicted VA 100%、20%及9%比术前均有提高,高度近视患者视觉质量得到良好的改善。     

Multimodal imaging in photic retinopathy

Letter to the Editor     

Responsiveness and minimal clinically important difference of the Chinese version of the Low Vision Quality of Life Questionnaire after cataract surgery

AIM: To investigate the Chinese version of the Low Vision Quality of Life Questionnaire (CLVQOL) as an instrument for obtaining clinically important changes after cataract surgery. METHODS: Patients underwent cataract surgery in Shanghai General Hospital, Shanghai Jiao Tong University, who fit the inclusion criteria were recruited. Two CLVQOLs were administered, including a preoperative CLVQOL and a CLVQOL at the end of the 3mo follow-up period, and were completed using face-to-face interviews or phone interviews conducted by trained investigators. The minimal clinically important difference (MCID) was calculated using an anchor-based method and a distribution method. In addition, the responsiveness of the questionnaire was measured. RESULTS: A total of 155 residents were enrolled. The average visual acuity (VA) preoperatively was 0.08 (SD=0.05), and it increased to 0.47 (SD=0.28) at the end of follow-up. Statistically significant positive changes in the CLVQOL scores indicated significant improvement of vision related quality of life after cataract surgery. With the larger value between the two results as the final value, the MCID values of the CLVQOL (scores of the four scales as well as the total score) were 8.94, 2.61, 4.34, 3.10 and 17.63, respectively. The CLVQOL has both good internal and external responsiveness. CONCLUSION: CLVQOL scores are appropriate instruments for obtaining clinically important changes after cataract surgery. This study is an effective exploration for establishing cataract surgery efficacy standards, which helps clinical and scientific research workers in ophthalmology to gain a more in-depth understanding when using CLVQOL.     

小鼠肾脏发育中光镜和电镜的体视学分析

目的对小鼠肾脏发育中各组成结构进行体视学测量和分析,以提供小鼠肾发育的基础数据。方法应用光镜和电子显微镜技术结合体视学分析方法对小鼠肾脏发育各阶段的肾脏大体、各部组成、皮质肾小体及集合管上皮主细胞进行了详细观察和体视学测量与分析。结果大体测量：肾脏长度和体积生后1～7d、21～28d增加非常显著（P〈0．01）。光镜测量：皮质体积胚龄18d到生后1d增加非常显著（P〈0．01）;髓质体积生后1～14d、21～28d增加显著（P〈0．05）;内髓生后21d出现,以后体积变化不明显;皮质肾小体体积从胚龄18d到生后40d大约增大30倍。电镜测量：集合管上皮主细胞侧基底细胞膜面密度生后3W内迅速增长,截面积胚龄18d到生后7d增加显著。结论小鼠肾脏各部组成从胚龄18d开始体积迅速增长,到生后28d发育接近成年水平。     

带肌蒂腓骨段转位治疗膝部肿瘤切除后骨缺损

自1993年以来，应用带同侧比目鱼肌或股二头肌蒂腓骨段转位，治疗股骨下端、胫骨上端肿瘤切除后骨缺损6例。除1例近期手术者外，其余5例随访4～29个月，中位18个月，全部骨愈合。除1例受区为灭活骨外，其余4例在术后8周均见大量骨痂生长。这种骨连接的速度与不带血供的移植骨无法比拟。本法的优点是：转位的腓骨营养丰富，操作简单，便于推广，但使用范围尚有一定限制。     

人CD80重组腺病毒感染的肺癌细胞的生物学特性

目的：研究c-myc对人端粒酶逆转录酶（htert）启动子的调节作用。方法：采用Lipofect脂质体转染法将DNA质粒分别转染至肝癌细胞HepG2、猴肾COS－7细胞和NIH3T3细胞,孵育48h后,分别检测其报告基因萤虫素酶活性。结果：与对照组相比,载有htert80bp启动子的质粒TERTLuc(800)在肿瘤细胞HepG2中活性显著增强。外源性转因子c-myc可显著上调htert启动子的表达,其激活作用与剂量呈正相关。人工突变c-myc结合位点明显降低htert启动子的活性。结论 ：c-myc可直接激活ht ert启动子的表达,是调节端粒酶活性的重要转录因子。