Visual outcomes after small incision lenticule extraction and implantable collamer lens V4c for moderate myopia: 1-year results

Graefe's Archive for Clinical and Experimental Ophthalmology - To compare 1-year visual outcomes after implantable collamer lens V4c (EVO-ICL) implantation and small incision lenticule...     

多囊卵巢综合征患者腰臀比与糖脂代谢、胰岛素样生长因子-1及胰岛素抵抗的相关性

目的: 研究多囊卵巢综合征(polycystic ovary syndrome, PCOS)患者腰臀比与糖脂代谢、胰岛素样生长因子-1(insulin like growth factor-1, IGF-1)、胰岛素抵抗(insulin resistance, IR)的相关性。方法: 选择2018年1月至2021年9月南京医科大学附属江苏盛泽医院收治的PCOS患者110例作为PCOS组,另选择同期健康体检者60例作为对照组。测定两组腰臀比、糖脂代谢指标、IGF-1以及稳态模式IR指数(HOMA-IR),其中糖脂代谢指标包括空腹血糖（FPG）、餐后2 h血糖(2 h PBG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)和空腹胰岛素(FINS)。将PCOS组中腰臀比≥0.80的患者纳入腹型肥胖组,＜0.80的患者纳入非腹型肥胖组,比较两组糖脂代谢指标、IGF 1及HOMA IR。采用Pearson相关分析PCOS患者腰臀比与糖脂代谢、IGF 1及IR的相关性。采用ROC曲线分析腰臀比对PCOS患者糖脂代谢异常、IGF 1及IR的预测价值。结果: 与对照组相比,PCOS组腰臀比、2 h PBG、LDL-C、TG、FINS、IGF-1、HOMA-IR水平均明显增高,HDL-C水平明显降低(P均＜0.05),FPG、TC水平差异无统计学意义(P均＞0.05)。与非腹型肥胖组相比,腹型肥胖组2 h PBG、LDL-C、TG、FINS、IGF-1、HOMA-IR水平明显增高,HDL-C水平明显降低(P均＜0.05),FPG、TC水平差异无统计学意义(P均＞0.05)。PCOS患者腰臀比与2 h PBG、TG、IGF-1、HOMA IR呈明显正相关,与HDL-C呈明显负相关(P均＜0.05)。腰臀比对PCOS患者血糖、血脂代谢异常及IR均具有较好的预测价值(AUC分别为0.821、0.793、0.782)。结论:PCOS患者尤其是腰臀比较高的患者表现为明显的糖脂代谢紊乱、IGF-1异常增高以及IR,且腰臀比对PCOS患者糖脂代谢异常、IR具有较好的预测价值。     

中西医结合治疗卵巢早衰的临床观察

目的观察中西医结合治疗卵巢早衰的临床疗效。方法 30例卵巢早衰患者给予克龄蒙+补肾方+电针治疗3个月,记录治疗前后患者的月经情况及临床症状,并进行症状评分;对患者血清FSH和E2值进行比较。结果治疗后,大部分患者除了月经来潮外,临床症状均有不同程度的缓解。治疗后患者的症状评分与治疗前相比有显著性差异(P0.01);治疗后患者的血清FSH水平较治疗前降低(P0.05),血清E2水平较治疗前升高(P0.05)。结论激素替代疗法+补肾方+电针联合治疗卵巢早衰能明显改善患者的临床症状和血清性激素水平,促进卵巢功能的恢复。     

肺炎支原体感染与小儿支气管哮喘关系探讨

目的 研究分析肺炎支原体感染与小儿支气管哮喘的关系,为小儿支气管哮喘的预防和治疗提供科学可靠的依据.方法 将2012年4月至2013年8月住院治疗的290例呼吸道感染的患儿作为研究对象,采用被动凝集法测定其血清肺炎支原体总抗体.结果 哮喘组中MP感染阳性率为21.02％,哮喘组与非哮喘组MP阳性率比较差异有统计学意义(P=0.001);男童与女童MP阳性率比较差异无统计学意义(P=0.554),不同季节MP阳性率比较差异无统计学意义(P=0.138);小于1岁年龄段儿童与1～4岁年龄段儿童MP阳性率比较差异有统计学意义(P:0.014).结论 肺炎支原体是引起小儿支气管哮喘的重要病原体之一,MP感染引发哮喘与性别、季节无关,1～4岁年龄段儿童感染MP几率更高.     

In Vivo and In Vitro Alterations in Influenza A/H3N2 Virus M2 and Hemagglutinin Genes: Effect of Passage in MDCK-SIAT1 Cells and Conventional MDCK Cells

No mutations were detected in the hemagglutinin gene of influenza A/H3N2 virus isolates from patients undergoing short-term amantadine treatment. However, genetic changes occurred after serial passage in either MDCK or MDCK-SIAT1 cells. Our results showed that only a few mutations were observed in MDCK-SIAT1-passaged isolates in the presence of amantadine.     

High prevalence of amantadine-resistance influenza a (H3N2) in six prefectures, Japan, in the 2005-2006 season

Substantial increase in amantadine-resistant influenza A (H3N2) was reported in Asia and North America in 2005. In this study the frequency and genetic characteristics of amantadine-resistant influenza A, circulated in Japan in 2005-2006 season, were investigated. Isolates were tested by amantadine susceptibility test (TCID(50)/0.2 ml method), and sequencing of the M2 gene to identify mutations that confer resistance. Additionally, the hemagglutinin (HA) and neuraminidase (NA) genes of the viruses were examined. In total, 415 influenza A isolates from six prefectures were screened, and 231 (65.3%) of 354 influenza A (H3N2) were amantadine-resistant, with a serine to asparagine (S31N) change in the M2 gene. However, none of 61 A (H1N1) isolates were resistant. In addition, genetic analyses of the HA gene showed all amantadine-resistant viruses clustered in one (named clade N), possessing specific double mutations at 193, serine to phenylalanine (S193F), and at 225, asparatic acid to asparagine (D225N), and sensitive viruses belonged to another group (clade S). The clinical presentations at the clinical visit did not differ between patients shedding clade N virus and those shedding clade S virus. None of the patients had received previous treatment with amantadine. The results indicate an unusually high prevalence and wide circulation of the amantadine-resistance influenza A (H3N2) in Japan in the 2005-2006 season. These strains had the characteristic double mutations in the HA, in addition to the M2 mutation responsive for resistance. Antiviral resistance monitoring should be intensified and maintained for rapid feedback into treatment strategies, and selection of alternative therapeutic agents.     

Effects of CYP2C11 gene knockout on the pharmacokinetics and pharmacodynamics of warfarin in rats

1. CYP2C11 is the most abundant isoform of cytochrome P450s (CYPs) in male rats and is considered the main enzyme for warfarin metabolism.

2. To further access the in vivo function of CYP2C11 in warfarin metabolism and efficacy, a CYP2C11-null rat model was used to study warfarin metabolism with both in vitro and in vivo approaches. Prothrombin time (PT) of warfarin was also determined.

3. The maximum rate of metabolism (V_max) and intrinsic clearance (CL_int) of liver microsomes from CYP2C11-null males were reduced by 37 and 64%, respectively, compared to those in Sprague Dawley (S-D) rats. The K_m of liver microsomes from CYP2C11-null males was increased by 73% compared to that of S-D rats. The time to reach the maximum plasma concentration (T_max) of warfarin in CYP2C11-null males was significantly delayed compared to that in S-D males, and the CL rate was also reduced. The PT of CYP2C11-null rats was moderately longer than that of S-D rats.

4. In conclusion, the clearance rate of warfarin was mildly decreased and its anticoagulant effect was moderately increased in male rats following CYP2C11 gene knockout. CYP2C11 played a certain role in the clearance and efficacy of warfarin, while it did not seem to be essential.     

Recurrence and persistence of fever in children who developed amantadine-resistant influenza viruses after treatment

In recent years, a dramatic increase of amantadine-resistant influenza A has occurred globally, but limited data have been available on the clinical course of patients developed amantadine-resistant viruses. We compared fever reduction between patients who developed resistance or remained sensitive in a pediatric clinic in Niigata, Japan, from 2000 to 2006. A total of 2,802 clinical samples were collected from patients who visited the pediatric outpatient clinic with influenza like illness during the seven influenza epidemic seasons. Patients were divided into 4 groups and analyzed for the fever reduction after amantadine treatment: emerged amantadine-resistant (n = 15); amantadine-sensitive (n = 35); patients administered no antiviral drugs (n = 42); and oseltamivir-treated patients (n = 320), which served as references. All 4 groups showed alleviation of fever up to day 3. The amantadine-resistant group had a significant recurrence of fever on day 4 and/or 5, and as a consequence, the course of illness was prolonged. Considering the pattern of fever, recurrent and persistent patterns were found significantly at higher rates in children with emerged resistant virus compared to other groups, and the age tended to be younger in amantadine-resistant compared to amantadine-sensitive group (3.9 +/- 3.0 vs 6.7 +/- 4.1 years old, n.s.). Therefore, we concluded that younger children were prone to develop amantadine-resistance after treatment and showed a significant recurrence of fever on day 4 and/or 5, and the course of illness was consequently prolonged.     

Effectiveness of oseltamivir treatment among children with influenza A or B virus infections during four successive winters in Niigata City, Japan

Oseltamivir has been used for treatment of influenza A and B infections, but recent reports documented that it was less active against the latter. We compared the effectiveness of oseltamivir in children between laboratory confirmed influenza A and B over 4 influenza seasons from 2001 to 2005 in a pediatric clinic in Japan. Among 1,848 patients screened, 299 influenza A and 209 influenza B patients were administered oseltamivir (treated groups), and 28 influenza A and 66 influenza B patients were assigned as non-treated groups. The duration of fever, defined as period when patients had the maximum temperature higher than 37.5 degrees C in three-time measurements in a day after the clinic visit, was evaluated among the four groups. In uni-variate analysis, the duration of fever was shorter for treated group than non-treated for influenza A (1.8 +/- 0.9 days vs 2.6 +/- 1.3 days, p < 0.01), but it was not significant for influenza B (2.4 +/- 1.3 days vs 2.8 +/- 1.2 days, p = 0.9). The fever duration was longer in treated influenza B than A patients (p < 0.01). Multi-variate analysis indicated younger age (< 6 years old) and higher body temperature at the clinic visit prolonged the duration of fever. Adjusted average duration of fever indicated that oseltamivir was effective for both types, but more effective on influenza A, and the benefit increased for younger children. Our data provide evidence that oseltamivir is beneficial for influenza infections, but the effectiveness is differed by type and age.