不同来源甘草药材成分含量及其保肝降酶作用比较

目的:研究不同来源甘草药材的成分含量及其保肝降酶作用.方法:采用HPLC同时测定甘草成分含量;用醋氨酚复制肝损伤模型,灌胃不同来源甘草的相同提取物,测定血清丙氨酸转氨酶(ALT)和谷氨酸转氨酶(AST)活力.结果:不同来源甘草组的ALT,AST活力与模型组比较具有显著性差异(P＜0.01);S1与S8甘草组之间的ALT,AST活力没有显著性差异,保护率分别为97.9％,95.8％,98.1％,94％,但前者甘草酸、甘草苷、异甘草素的含量却明显高于后者,分别为2.219％,2.86％,0.023％和0.767％,0.557％,0.013％;S4和S6甘草的保肝能力最差,保护率分别为67.4％,65.6％和70.1％,64.5％,而甘草酸、甘草苷含量却明显高于其他产地三年栽培甘草.结论:不同来源甘草对肝损伤小鼠的肝功能都有不同程度的保护作用,并存在一定的质量差异,但与甘草酸、甘草苷的含量没有呈现正相关性,提示甘草保肝降酶作用可能是甘草药材中多种成分相互作用的结果.     

儿童哮喘缓解期维持临床控制的干预研究

目的探讨哮喘缓解期儿童伴发急性上呼吸道感染（AURI）时维持临床控制的干预措施。方法选取100例达到临床控制的哮喘儿童,随机分为观察组和对照组,均以最低剂量吸入性糖皮质激素和长效β2受体激动剂复合制剂（ICS/LABA）每晚吸入维持临床治疗。伴发AURI时均予常规处理;观察组除常规处理外同时给予早期短期升级治疗,即在维持治疗基础上每日早晨加吸等量ICS/LABA复合制剂,维持升级治疗7~10 d。两组急性发作时均根据其病情严重程度按哮喘指南诊治。治疗3、6、9、12个月后观察两组哮喘控制水平、哮喘急性发作严重程度、肺功能指标变化和不良事件发生情况等。结果治疗3、6、9、12个月各随访时间点,观察组哮喘控制率均在90%以上,对照组为80%左右,两组控制率比较差异有统计学意义（P < 0.05）。各随访时间点观察组哮喘急性发作严重程度明显低于对照组（P < 0.05）。与对照组相比,观察组肺功能大、小气道指标均明显改善（P < 0.05）。与对照组相比,观察组吸入糖皮质激素量以及对家庭生活的影响均明显减少（P < 0.05）。结论哮喘缓解期儿童伴发AURI时早期短期升级治疗可预防哮喘急性发作,提高哮喘控制率,改善肺功能。     

Late response to radiochemotherapy in pediatric glioblastoma: report on two patients treated according to HIT-GBM protocols

High-grade gliomas in children are rare and the best treatment is undetermined. The German language group study HIT-GBM compares various induction protocols for subsequent patient cohorts. Currently, cisplatinum, etoposide, ifosfamide, and vincristine are given simultaneously with extended-field radiotherapy. Imaging is done 3 weeks after to define treatment response, followed by 6-weekly controls during consolidation with lomustine, vincristine, and prednisone. The authors report on 2 patients with incompletely resected glioblastoma multiforme in which response was lacking 3 weeks after radiochemotherapy but became evident 12 weeks later. This suggests that later time points are required to assess induction protocol response.     

Birth outcomes of patients with isolated anorectal malformations: A population‐based case‐control study

In most patients affected by isolated anorectal malformation (IARM) the etiology is largely unknown. Thus, the aim of our project was to analyze possible risk factors for IARM. In the first step, birth outcomes of cases with IARM were analyzed on the basis of maternal socio‐demographic variables, and these data are presented in this paper. Gestational age at delivery, birthweight, preterm birth, low birthweight and small for gestational age of cases with IARM were evaluated in the function of maternal age, birth/pregnancy order, marital and employment status of mothers in the population‐based large dataset of the Hungarian Case‐Control Surveillance of Congenital Abnormalities, 1980–1996. The study samples included 231 live‐born cases with IARM, 361 matched and 38 151 population controls without any defect. IARMs are more frequent in males, twins and newborn infants with low birthweight and small‐for‐gestational‐age, the latter being the consequence of intrauterine growth restriction. In addition, mothers of cases were younger but with higher birth order, and had lower socio‐economic status. These maternal variables are characteristic for the gypsy population in Hungary. The higher proportion of gypsy women among the mothers of cases with IARM was confirmed during the home visits of the study. Male sex and intrauterine growth restriction of cases, in addition to low socioeconomic status and gypsy origin of mothers may have a role in the risk of IARMs.     

多焦点人工晶状体和单焦点非球面人工晶状体植入术后患者视功能及生存质量比较

目的　比较植入多焦点人工晶状体（ｉｎｔｒａｏｃｕｌａｒｌｅｎｓ,ＩＯＬ）和单焦点非球面ＩＯＬ对单纯白内障患者术后视功能及生存质量的影响。方法　采用前瞻性和回顾性调查研究,共纳入７２例（１４４眼）老年性白内障患者,均行超声乳化联合ＩＯＬ植入术,其中２０例植入折叠式多焦点ＩＯＬ（多焦点ＩＯＬ组）,５２例植入折叠式单焦点非球面ＩＯＬ（单焦点ＩＯＬ组）,问卷调查并比较患者术前和术后６个月的视功能及生存质量。结果　术后两组患者总体视功能及生存质量之间的差异均无统计学意义（均为Ｐ＞０．０５）,但较术前均有提高,差异均有统计学意义（均为Ｐ＜０．０５）。在活动能力、社会交际能力和心理健康方面,单焦点非球面ＩＯＬ植入后却表现出较为明显的优势,差异均有统计学意义（均为Ｐ＜０．０５）;多焦点ＩＯＬ的术后脱镜率明显高于单焦点非球面ＩＯＬ（Ｐ＜０．０５）;而在术后视功能、生存质量的其他具体方面（与视力有关的日常活动限制、周边视野、感觉适应、立体觉和自理能力）,两组之间的差异均无统计学意义（均为Ｐ＞０．０５）。结论　单焦点ＩＯＬ和多焦点ＩＯＬ在改变视功能和生存质量方面总体效果相同,但多焦点ＩＯＬ在患者脱镜方面有明显优势,而单焦晶状体在价格上表现出比较明显的优势。     

可调节人工晶状体植入术后视觉质量评价

近年来,随着人们生活条件的改善及对生活质量的要求增加,白内障患者术眼植入人工晶状体后的视觉质量日益受到重视,逐渐成为研究的热点,相关文献报道很多。本文着重就可调节性人工晶状体植入术后的视觉质量研究进展作一综述。     

夜戴型角膜塑形镜矫治儿童屈光参差疗效分析

目的:观察和评价夜戴型角膜塑形镜矫治儿童屈光参差的临床效果。方法:对屈光参差患儿38例给予角膜塑形镜进行矫正。戴镜后1d;1wk;1,3,6mo;1,2,3a进行随诊,观察裸眼视力、角膜曲率、眼轴长度、裂隙灯检查有无并发症的发生。结果:戴镜后1d裸眼视力有大幅提高,在1wk后稳定。个别病例有轻微的结膜炎及点状角膜上皮剥脱,经治疗后均可恢复;角膜曲率变平,配戴角膜塑形镜前平均角膜曲率为43.42±1.17D,戴镜1wk后,平均角膜曲率为41.65±1.56D,与配戴前比降低,有统计学意义(P<0.01);戴镜1,3,6mo;1,2,3a后无明显变化,无统计学意义(P>0.05);戴镜1,2和3a后眼轴较前增长为0.18±0.13,0.22±0.11和0.25±0.10mm,与戴镜前比无明显统计学意义(P>0.05)。结论:角膜塑形镜是青少年屈光参差的首选治疗方法,它可以充分矫治屈光参差,达到双眼平衡,并且可以有效地控制近视发展,进而减小屈光参差的度数差距。     

黄斑孔患者手术后生活质量变化

目的评价黄斑孔手术对患者生活质量的影响。方法黄斑孔患者25例（25眼）行常规玻璃体切除术并注入C3F8。手术前和手术后5月完成中文版低视力者生活质量量表。结果1次手术黄斑孔解剖闭合率为84．00％（21／25）。手术眼视力及双眼并用视力在手术前和手术后5月差异无统计学意义（分别是P=0.206，P=0.283）。远视力、移动和光感以及读和精细工作2个指标和生活质量总分在手术前后差异有统计学意义（分别为P=0．043，P=0．034，P=0．035）。结论 黄斑孔手术能改善患者的生活质量。生活质量量表的应用结合传统的临床检查能较全面地反映手术干预后患者健康状况的变化。