调整Kappa角及光学切削直径对准分子激光原位角膜磨镶术后的影响

目的　评价调整光学切削直径及Kappa角后对准分子激光原位角膜磨镶术（laser in situ keratomileusis，LASIK）后效果的影响。方法　选取2017年1月至12月在我院行LASIK手术的高度近视患者313例（626眼），根据切削直径分成两组，试验组157例314眼，切削直径设定为6.0 mm，对照组156例312眼，切削直径设定为6.5 mm。试验组患者激光切削前修正Kappa角，对照组不做修正。患者术前进行裸眼视力、主视眼确定、验光、眼压、暗室下瞳孔直径、泪液分泌试验、裂隙灯、散瞳验光、眼底检查、pentacam测量角膜厚度、角膜地形图测量角膜前后表面及Kappa角等检查。术后1 d、1周、1个月随访，并检查裸眼视力、角膜厚度、波前像差及夜间视力、光晕、眩光等情况。比较两组患者角膜厚度变化、手术所用时间以及两组患者术后的高阶像差的差异。结果　试验组与对照组患者年龄分别为18～44（24.19±5.33）岁、18～42（25.08±4.91）岁，屈光度分别为（-7.47±1.04）D、（-7.61±1.12）D。两组年龄、屈光度比较差异均无统计学意义（均为P>0.05）。试验组与对照组患者术前Kappa角分别为，X轴:（210±40）μm、（200±30）μm，Y轴:（190±30）μm、（220±40）μm，差异无统计学意义（P=0.210）。两组手术前后的角膜厚度及术后角膜基质床的厚度差异均无统计学意义（均为P>0.05）。试验组与对照组的手术时间分别为（15.56±1.89）s和（20.83±3.03）s，差异有统计学意义（P=0.000）。试验组的总高阶像差和垂直慧差的变化均明显低于对照组（均为 P<0.01），但两组间的水平慧差差异无统计学意义（P>0.05），对照组的球差低于试验组（P<0.01）。结论　LASIK手术中科学合理地调整Kappa角可有助于提高患者术后的视觉质量。     

小梁切除术联合自体巩膜植入术治疗青光眼的临床研究

目的观察小梁切除术联合自体巩膜植入术治疗青光眼的临床疗效。方法对12例(12眼)青光眼患者施行小梁切除术联合自体巩膜植入术。术后观察眼压、视力、滤过泡形态、并发症等,并做超声生物显微镜(UBM)观察。结果经3～18mo的随访,术后视力11眼(92%)维持不变或提高。眼压由术前平均(36.15±11.39)mmHg降至术后1a平均(13.21±4.98)mmHg,有非常显著性差异(P<0.01),末次随访眼压≤21mmHg者11眼(92%),其中9眼形成弥散性滤过泡,术后前房轻度变浅4眼,术后3～7dUBM检查睫状体脱离2眼,无其它并发症发生。结论小梁切除术联合自体巩膜植入术,能有效降低眼压,经济安全术后视力稳定,值得临床应用推广。     

Improvement of Oral Bioavailability and Anti-Tumor Effect of Zingerone Self-Microemulsion Drug Delivery System

This study sought to prepare a self-microemulsion drug delivery system containing zingerone (Z-SMEDDS) to improve the low oral bioavailability of zingerone and anti-tumor effect. Z-SMEDDS was characterized by particle size, zeta potential and encapsulation efficiency, while its pharmacokinetics and anti-tumor effects were also evaluated. Z-SMEDDS had stable physicochemical properties, including average particle size of 17.29 ± 0.07 nm, the zeta potential of -22.81 ± 0.29 mV, and the encapsulation efficiency of 97.96% ± 0.02%. In vitro release studies have shown the release of zingerone released by Z-SMEDDS was significantly higher than free zingerone in different release media. The relative oral bioavailability of Z-SMEDDS was 7.63 times compared with free drug. Meanwhile, the half inhibitory concentration （IC50）of Z-SMEDDS and free zingerone was 8.45 μg/mL and 13.30 μg/mL, respectively on HepG2. This study may provide a preliminary basis for further clinical research and application of Z-SMEDDS.     

The efficacy and safety of gemcitabine-based induction chemotherapy for locally advanced nasopharyngeal carcinoma treated with concurrent chemoradiation: A meta-analysis

Objectives:To assess the efficacy and toxicity of gemcitabine-based induction chemotherapy followed by concurrent chemoradiotherapy (CCRT) in locally advanced nasopharyngeal carcinoma (LA-NPC).Methods:Both observational studies (OBS) and randomized controlled trials (RCT) were included in the meta-analysis. Systematic online searches were conducted in Web of Sciences, PubMed, Embase, meeting proceedings and ClinicalTrials.gov from the inception to May 25, 2020. The primary endpoint of interest was overall survival.Results:five OBSs and 2 RCTs including 1680 patients were incorporated in the analysis. The evidence from the RCTs showed that adding gemcitabine-based induction chemotherapy to CCRT significantly improved progression free survival (hazard ratio (HR): 0.60, 95% confidence interval (CI): 0.40–0.88; P = .010; chi square P = .25; I² = 24%) and overall survival (HR: 0.47; 95% CI: 0.28–0.80; P = 0.005; chi square P = .49, I² = 0%) and was related to a higher risk of hematological toxicities. Furthermore, based on the data of OBSs, overall survival (HR: 0.52; 95% CI: 0.31–0.88; P = .02; chi square P = .37, I² = 6%) was significantly improved in patients treated with gemcitabine-based induction chemotherapy compared to those treated with taxane-based induction chemotherapy. However, the progression free survival (HR: 0.67; 95% CI: 0.45–1.01; P = .06; chi square P = .74; I² = 0%) showed no significant difference.Conclusions:For LA-NPC patients, adding gemcitabine-based induction chemotherapy to CCRT significantly improved overall survival and progression free survival with a higher risk of hematological toxicities when compared to CCRT alone. Also, gemcitabine-based regimen could be used as an alternative induction chemotherapy regimen to taxane-based regimen in the treatment of LA-NPC.     

骨髓间充质干细胞应用于角膜疾病的研究进展

随着干细胞科学的飞速发展,近年间充质干细胞(MSCs)的研究已成为热点。骨髓间充质干细胞(BMSCs)是来源于骨髓中的MSCs,具有免疫原性低、有多向分化潜能、促进损伤修复、性能稳定等生物学优点。研究发现,BMSCs是医学领域中极具前景的一种特殊细胞,几乎在各系统疾病的治疗方面都有广泛应用。眼科学者的研究也发现,BMSCs已经成为角膜疾病中一种兼具科研价值和临床价值的种子细胞,为角膜盲患者的康复带来了一线希望。本文就BMSCs对角膜损伤与角膜移植排斥反应治疗方面的研究做一综述。     

Impact of Environmental Factors on Efficacy of Glucocorticoids in Chinese Population with Systemic Lupus Erythematosus

Although glucocorticoids (GCs) are effective in inducing remission in systemic lupus erythematosus (SLE) patients, there is a significant variation in response to therapeutic GCs, and some patients do not achieve full remission. The aim of this study was to explore the impact of environmental factors on the efficacy of GCs in a Chinese population with SLE. This was a prospective cohort study, and a total of 260 SLE patients treated with GCs (prednisone) were followed up for 12 weeks. The efficacy of GCs was measured with the scores on SLE disease activity index. Environmental factors were collected using a questionnaire. Single-variable analysis and multivariate logistic regression analysis were used to discriminate the impact of environmental factors on the efficacy of GCs. Two hundred forty-seven patients (95.00 %) completed the 12-week follow-up. Among these patients, 131 (53.04 %) were classified into sensitive group and 116 (46.96 %) were classified into insensitive group. Results from logistic analysis showed that the following environmental factors were significantly associated with decreased efficacy of GCs: high salt intake (OR?=?3.464, 95%CI?=?1.481–8.102, P?=?0.004), introverted personality (OR?=?3.550, 95%CI?=?1.901–6.628, P?<?0.0001), experience with negative life events (OR?=?5.526, 95%CI?=?1.612–18.946, P?=?0.007), and history of allergy (OR?=?2.966, 95%CI?=?1.312–6.704, P?=?0.009). These results indicate that environmental factors, including salt intake, personality, experience with negative life events, and history of allergy, may play an important role in the efficacy of GCs in the Chinese population with SLE.     

组织蛋白酶D和嗜铬颗粒素A在人原发性肝细胞癌的表达意义

目的探讨组织蛋白酶D和嗜铬颗粒素A在人原发性肝细胞癌(HCC)的表达及其意义.方法免疫荧光双标记染色技术结合激光扫描共聚焦显微镜观察HCC 85例.结果组织蛋白酶D在正常肝细胞有弱表达,但在HCC组织,组织蛋白酶D的表达显著增强,而且癌细胞荧光染色强度存在区域性差别,通常临床恶性程度越高、肿瘤分化越差,荧光染色较强的癌细胞越多. HCC的组织学分级越高,组织蛋白酶D的表达越多. 85例HCC中有71例癌细胞呈组织蛋白酶D强阳性,阳性率83.5%. 在组织学分级为3～4级的28例中,组织蛋白酶D阳性的占26例(阳性率92.9%);组织学分级为2级的53例中,有46例阳性(阳性率86.8%);而组织学分级为1级的4例中,仅有1例阳性(阳性率25.0%). 组织蛋白酶D阳性细胞的分布,在组织学分级不同的HCC中有明显差别(P＜0.01). 我们还发现组织蛋白酶D的表达与患者年龄无明显关系. 有组织蛋白酶D表达的患者平均年龄为51.2岁±2.8岁(32岁～68岁),无组织蛋白酶D表达的患者平均年龄为51.2岁±4.5岁(28岁～71岁)(P＞0.05). 组织学分级为1级的HCC CgA阳性率为75.0%(3/4),2级的阳性率71.7%(38/53),3～4级的阳性率为71.4%(20/28). 经统计学分析表明,CgA阳性细胞的分布,在组织学分级不同的HCC没有明显差别(P＞0.05). 免疫荧光双标记显示,在大部分癌组织中,二者同时表达. 结果提示HCC的癌细胞对组织蛋白酶D的加工出现障碍,因此组织蛋白酶D在细胞中积聚. 由于组织蛋白酶D的蛋白水解酶活性和自分泌性丝裂原活性,因此组织蛋白酶D的表达增加可能在肿瘤的浸润和转移中有一定作用. 这些发现表明组织蛋白酶D对HCC有预后诊断价值.结论组织蛋白酶D和CgA在绝大部分HCC都可同时表达. 也提示肝癌细胞中组织蛋白酶D可能与CgA的加工有关. 因为其潜在的临床应用价值,组织蛋白酶D在HCC表达显然是值得进一步研究的课题.     

Isolation and characterization of 31 polymorphic microsatellite markers in Siniperca obscura Nichols

We report for the first time a set of microsatellite markers for Siniperca obscura. Among 50 pairs of primers, 31 loci were polymorphic in 28 S. obscura individuals with the number of alleles per locus ranging from 2 to 10. Observed and expected heterozygosity ranged from 0.1149 to 0.7506 and from 0.0000 to 0.9643, respectively. Significant deviation from Hardy–Weinberg equilibrium was found at one locus, after applying Bonferroni’s correction. These new markers can be useful for the studies on population genetic structure, genetic diversity and conservation genetics in this species.     

Eating Behavior and Glucagon-Like Peptide-1-Producing Cells in Interposed Ileum and Pancreatic Islets in Rats Subjected to Ileal Interposition Associated with Sleeve Gastrectomy

Background

Ileal interposition–sleeve gastrectomy (II–SG) has been developed as a metabolic surgery based on the hindgut hypothesis. The aim of the present study was to test this hypothesis by studying the eating behavior, metabolic changes, and glucagon-like peptide-1 (GLP-1)-producing cells in rat models.

Methods

Male Sprague–Dawley rats were subjected to laparotomy, II, SG, or II–SG. Eating behavior and metabolic parameters were monitored by an open-circuit indirect calorimeter designed for a comprehensive laboratory animal monitoring system. GLP-1-producing cells were examined by quantitative immunohistochemistry.

Results

After II alone, satiety ratio, i.e., intermeal interval/meal size, was reduced, while calorie intake was increased at 2 and 6 weeks postoperatively. Respiratory exchange ratio, VCO₂/VO₂, was increased to above 1.0 (i.e., carbohydrate metabolism) during both daytime and nighttime at 2 weeks postoperatively. After SG alone, GLP-1-producing cells were increased in the pancreatic islets (in terms of volume density), but not in the ileum (number/mm). After II–SG, the rate of eating was reduced, while meal duration (min) was increased during both daytime and nighttime at 2 weeks postoperatively. GLP-1-producing cells were increased by about 2.5-fold in the interposed ileum and also increased to the same extent in the pancreatic islets as seen after SG alone. The increased GLP-1-producing cells in the pancreatic islets after SG or II–SG were located around the insulin-producing β cells.

Conclusions

The present study provides evidence supporting the hindgut hypothesis. II–SG increased GLP-1 production both in the interposed ileum and in the pancreatic islets, leading to metabolic beneficial effects and altered eating behavior.     

后巩膜加固术在超长眼轴黄斑裂孔性视网膜脱离手术中的应用

目的：评价后巩膜加固术(PSR)辅助超长眼轴黄斑裂孔性视网膜脱离患者玻璃体切除手术(PPV)的临床效果。

方法：采用临床随机对照研究。纳入眼轴≥29mm的超长眼轴黄斑裂孔性视网膜脱离患者46例46眼,随机分为两组：A组采用PSR+PPV+硅油填充,B组采用单纯PPV +硅油填充。随访1a,分析各组术后BCVA、黄斑裂孔愈合情况、视网膜脱离复位率、再手术率等指标。

结果：两组治疗后平均BCVA(LogMAR视力)均较术前改善,A组由1.61±0.02提升为0.85±0.22(t=10.36,P<0.01),B组由1.59±0.04提升为1.08±0.16(t=7.92,P<0.01),其中A组改善幅度大于B组(t=-2.38,P=0.03)。两组术前术后眼轴均无明显改变(P>0.05)。A组一次手术黄斑裂孔愈合率为91%(21/23),取油前再手术率4%(1/23),取油后无再脱离患者,1a随访期内所有术眼完成了硅油取出。B组一次手术黄斑裂孔愈合率为65%(15/23),取油前再手术率35%(8/23),取油后再脱离比例26%(6/23),1a随访期取出硅油比例74%(17/23)。

结论：后巩膜加固术有助于提高病理性近视黄斑裂孔性视网膜脱离的手术成功率,减少复发及再手术的几率。