普米克气雾剂治疗儿童哮喘疗效观察

目的　观察普米克气雾剂治疗儿童哮喘前后的最高呼气峰流速值 (PEF)及血清嗜酸细胞阳离子蛋白 (ECP)的变化。方法　对 113例儿童哮喘病人 ,使用普米克气雾剂 [(2 0 0～ 80 0 ) μg/d],3月～ 1年。采用峰流速仪监测PEF ,并用荧光免疫法 ,使用PharmaciaCAP系统 (瑞典 )测定部分病儿治疗前后的血清ECP。结果　使用普米克治疗后 ,PEF明显增高 ,3个月、6个月、1年的PEF占预计值的百分比 (PEF % )分别为 (93.6± 5 .4) ,(93.0± 4.2 ) ,(94.5± 4.5 ) ,与治疗前 (70 .4± 19.1)比较 ,差异有显著性 ,P <0 .0 1。治疗后ECP为 (7.5± 2 .7)μg/L ,比治疗前 (2 4.0± 17.1) μg/L明显下降 ,P <0 .0 1,差异有显著性。结论　普米克气雾剂治疗儿童哮喘副作用小、安全有效、方法简便 ,用于儿童哮喘的中、长期防治 ,值得推广。     

Combined laparoscopy and hysteroscopy in the treatment of tubal infertility

IntroductionInfertilityandsteffotyisoneofworldwideproblemsinmedicalscienceandsocialscience.IiialsoanhapobotgenecolwtaldiseaseandrelatetoObstetiics,Genecology,Sexology,Reproductiveendocrinology,Iryununology,FamilyPlanning,BinlogyandGeneticsetc.ThediagnoshcandtherapeuticlevelofinfechtytreatmentreflectthelevelofthehospitalareaandstatetosomeeXtant.tubalfactorsisabout209,6tO45%thecauseofinfeMity.Achievingpreunderthesecircumstancereqthedetherthemethodofmicros~orrecentlyassistedl.eproductivetecl…     

Inhibitory effect on subretinal fibrosis by anti-placental growth factor treatment in a laser-induced choroidal neovascularization model in mice

AIM:To investigate whether anti-placental growth factor(PGF) can inhibit subretinal fibrosis and whether this effect is mediated by the inhibitory effect of PGF on epithelial-mesenchymal transition(EMT) of retinal pigment epithelial(RPE) cells.METHODS:Subretinal fibrosis model was established in laser induced choroidal neovascularization(CNV) mice on day 21 after laser photocoagulation.Immunofluorescence staining(IFS) of cryosections and enzyme-linked immunosorbent assay(ELISA) were used to detect the expression of PGF.IFS of whole choroidal flat-mounts was used to detect the degree of subretinal fibrosis.IFS of cryosections and ELISA were used to detect the expression of EMT related indicators in subretinal fibrosis lesions.RESULTS:The expression of PGF protein in subretinal fibrosis lesions was significantly up-regulated(P<0.05),and mainly co-stained with pan-cytokeratin labeled RPE cells.Intravitreal injection of anti-PGF neutralizing antibody reduced the area of subretinal fibrosis and the ratio of fibrotic/angiogenic area significantly at the concentrations of 0.25,0.5,1.0,and 2.0 μg/μL(all P<0.05).The expression of E-cadherin in the local RPE cells decreased,while α-SMA increased significantly in subretinal fibrosis lesions,and the application of anti-PGF neutralizing antibody could reverse these changes(P<0.05).CONCLUSION:The expression of PGF is up-regulated in the lesion site of subretinal fibrosis and mainly expressed in RPE cells.Intravitreal injection of anti-PGF neutralizing antibody can significantly inhibit the degree of subretinal fibrosis in CNV mice,and this effect may be mediated by the inhibition of PGF on EMT of RPE cells.     

糖尿病性视神经病变的OCT图像特点分析

目的：回顾分析糖尿病性视神经病变( diabetic optic neuropathy, DON )的相干光断层成像( optical coherence tomography,OCT)的特点。
　　方法：回顾性系列病例研究。选择2013-12/2015-10西安交通大学医学院第二附属医院眼科门诊和内分泌科会诊期间诊断为2型糖尿病且伴有眼底病变的患者175例350眼的临床资料,记录患者的全身检查情况和疾病史,阅读所有患者的彩色眼底照相、荧光素眼底血管造影( fluorescein fundus angiography,FFA)、OCT的影像结果,并进行分析统计。
　　结果：通过FFA 检查视乳头具有异常荧光表现,确定有DON的有49例90眼,占25.7%。 OCT结果显示DON 90眼中15眼(16.7%)表现为视神经形态大致正常;20眼(22.2%)表现为视杯凹陷变小或消失,筛板前组织肿胀,同时伴有盘周神经纤维层水肿;26眼(28.9%)表现为视杯深陷,杯盘比变大;18眼(20.0%)表现为视盘内或视盘表面组织增生;11眼(12.3%)玻璃体视乳头牵拉,视盘边缘抬高。在FFA中有相同荧光表现的DON患眼,在OCT检查可表现出不同的组织形态。
　　结论：FFA从视神经的血循环状态变化定义DON,而OCT可以发现FFA所不能显示的视神经组织形态的变化,从而更清晰视神经病变的位置和原因,为治疗提供依据。OCT无创、快捷、费用低、可重复性强等优点有利于DON患者的复查及治疗效果追踪。     

脉络膜转移癌的荧光素和吲哚菁绿血管造影的影像分析

目的：比较脉络膜转移癌的荧光素眼底血管造影(FFA)及吲哚菁绿血管造影(ICGA)的影像特点,为该疾病的准确诊断提供依据。

方法：经临床诊断,有明确原发恶性肿瘤病灶的患者6例8眼,散瞳后行眼底照相,用海德堡眼底血管造影仪行FFA及ICGA同步造影,比较两种影像学检查的异同。

结果：FFA早期显示瘤体为低荧光,中期呈现针尖样或斑点样荧光,晚期表现为斑驳样强荧光,部分病例病灶边缘呈强荧光环带; ICGA显示的病灶表现为低荧光,整个造影过程中荧光强弱无明显变化,仅有1例病例在反转期出现中央及病灶周围的点状强荧光。

结论：FFA和ICGA对于脉络膜转移癌有较为特征性的表现,二者结合有助于脉络膜转移癌的诊断。     

吡非尼酮对内皮细胞间质转化的抑制作用及机制

目的:建立缺氧诱导内皮细胞的内皮-间质转化(EndoMT)模型,探讨吡非尼酮(PFD)在视网膜下纤维瘢痕形成过程中的抗纤维化作用及机制。方法:原代培养人脐静脉内皮细胞,鉴定后取4~7代用于实验。CoCl2诱导细胞缺氧建立纤维化模型。CCK-8法检测细胞增殖率,筛选药物浓度。将细胞分为对照组(无血清培养基培养)、CoCl2(200μmol/L)模型组、CoCl2+低浓度(0.3mg/mL)PFD组、CoCl2+高浓度(0.6mg/mL)PFD组。Western blot法检测细胞CD31、VE-cadherin、α-SMA、FSP1、p-p38和p38的蛋白表达水平。CD31/α-SMA免疫荧光双染法观察蛋白表达的变化。划痕实验观察细胞迁移能力的改变。q-PCR法检测TGF-β1、SNAI1 mRNA转录水平。结果:与CoCl2模型组相比,PFD能明显提高缺氧细胞的增殖率,抑制细胞的迁移能力(均P<0.05);PFD组细胞标志蛋白CD31、VE-cadherin表达增加,α-SMA、FSP1表达降低(均P<0.05)。免疫荧光检测显示PFD可明显抑制α-SMA和增加CD31的蛋白表达(P<0.05)。内皮细胞EndoMT过程中,p38总蛋白表达不变(P>0.05),但p-p38磷酸化蛋白表达增加、TGF-β1和SNAI mRNA转录水平增高的现象可明显被PFD抑制(均P<0.05)。高低浓度PFD组上述各现象无明显差异。结论:PFD可以抑制内皮细胞纤维化的发生,TGF-β/p38 MAPK通路可能是PFD调控EndoMT过程的机制之一,为视网膜下纤维化的治疗提供了新思路。     

Association of urinary albumin excretion with central foveal thickness and intravitreal conbercept treatment frequency in patients with diabetic macular edema

AIM: To investigate the effect of albuminuria on diabetic macular edema (DME) and the possible association between baseline urinary albumin excretion (UAE) and intravitreal conbercept (IVC) treatment frequency in DME patients. METHODS: In this hospital-based retrospective study, a total of 350 in-patients with type 2 diabetes mellitus were recruited and their clinical records were reviewed. Thereafter, 52 patients identified with severe non-proliferative diabetic retinopathy (NPDR) combined with albuminuria were divided into the microalbuminuria (UAE 30-300 mg/24h) and macroalbuminuria (UAE>300 mg/24h) groups, which were compared and analyzed by both independent sample t-test and Chi-square test. Correlations between the systemic variables and the central foveal thickness (CFT) were evaluated using Spearman’s correlation and linear regression analyses. Of the 52 patients with center-involved DME, 43 received an initial combined injection of conbercept (0.5 mg/0.05 mL) and triamcinolone acetonide (1 mg/0.05 mL), followed by an IVC injection, as needed. The relationship between baseline UAE and number of IVC injections during the first year of treatment was analyzed using Spearman’s partial correlation. RESULTS: Of 350 patients, a higher incidence of DME was observed in severe non-proliferative retinopathy (NPDR) patients than that observed in other groups. By dividing the 52 patients with severe NPDR into the micro- and macro-albuminuria subgroups, significant differences in CFT, systolic blood pressure, total cholesterol and serum creatinine levels, and UAE were revealed. Furthermore, a positive liner correlation between the UAE and CFT was found. Finally, the partial correlation coefficient adjusted for either the CFT or UAE indicated that both parameters directly correlated with the number of IVC injections administered during the 12mo of follow-up. CONCLUSION: Generally, macular edema occurred in patients with severe NPDR, for whom the UAE is an independent risk predictor of DME. The baseline UAE and CFT predicted the treatment frequency of IVC injections administered in the first year for eyes with DME.