简介:摘要目的在治疗失代偿期乙型肝炎肝硬化的药物中,观测核苷类药物拉米夫定(LAM)、阿德福韦酯(ADV)、恩替卡韦(ETV)对这类患者的治疗效果如何。方法选取141例自愿服用核苷类药物的失代偿期乙肝后肝硬化患者,经患者知情同意后按其选择核苷类药物的不同分为A组、B组和C组,在内科综合治疗的基础上各辅以不同的药物进行治疗,A组服用拉米夫定,用量为每天100mg,B组服用阿德福韦酯,用量为每天10mg,C组服用恩替卡韦,用量为每天0.5mg,观察患者在3、6、9、12个月后的血清生化指标和病毒载量的变化。结果每组患者在通过核苷类药物的治疗后,HBVDNA载量在上述日期后得到明显的下降,但是C组患者的疗效更甚于A组和B组。结论核苷类药物对治疗乙型肝炎后肝硬化有较好的效果,但是恩替卡韦(ETV)效果更为显著。
简介:摘要目的研究急性脑梗塞3个月预后影响因素、危险因素及管理效果。方法选取我院2008年2月~2011年9月收治的急性脑梗塞患者104例,对所有患者的基本信息、生命体征、治疗状况及各项生命体征进行记录分析,针对性纠正患者不良习惯,进行不良影响因素指导教育。所有患者出院后进行3个月的随访调查,详细记录并分析患者各影响因素的控制效果。结果高血压、糖尿病得以控制的患者预后良好率与未控制良好率基本持平(P>0.05,差异无统计学意义)。吸烟习惯得以控制的患者预后良好率75%,未得到控制患者预后良好率62.5%;饮酒习惯得以控制的患者预后良好率63.64%,未控制患者预后良好率50%。对不良习惯等影响因素的控制有利于急性脑梗塞预后(P<0.05,差异有统计学意义)。结论对高血压等危险因素的干预与控制未见明显预后改善,对吸烟、饮酒等不良习惯的管理利于提高急性脑梗塞预后效果。
简介:AIM:Toevaluatetheefficacyandsafetyofcornealcollagencrosslinking(CXL)topreventtheprogressionofpost-laserinsitukeratomileusis(LASIK)cornealectasia.·METHODS:Inaprospective,nonrandomized,single-centrestudy,CXLwasperformedin20eyesof11patientswhohadLASIKformyopicastigmatismandsubsequentlydevelopedkeratectasia.Theprocedureincludedinstillationof0.1%riboflavin-20%dextranesolution30minutesbeforeUVAirradiationandevery5minutesforanadditional30minutesduringirradiation.Theeyeswereevaluatedpreoperativelyandat1-,3-,6-,and12-monthintervals.Thecompleteophthalmologicexaminationcompriseduncorrectedvisualacuity,bestspectacle-correctedvisualacuity,endothelialcellcount,ultrasoundpachymetry,cornealtopography,andinvivoconfocalmicroscopy.·RESULTS:CXLappearedtostabiliseorpartiallyreversetheprogressionofpost-LASIKcornealectasiawithoutapparentcomplicationinourcohort.UCVAandBCVAimprovementswerestatisticallysignificant(P<0.05)beyond12monthsaftersurgery(improvementof0.07and0.13logMARat1year,respectively).Meanbaselineflattestmeridiankeratometryandmeansteepestmeridiankeratometryreduction(improvementof2.00and1.50diopters(D),respectively)werestatisticallysignificant(P<0.05)at12monthspostoperatively.At1yearafterCXL,meanendothelialcellcountdidnotdeteriorate.Meanthinnestcorneapachymetryincreasedsignificantly.·CONCLUSION:Theresultsofthestudyshowedalong-termstabilityofpost-LASIKcornealectasiaaftercrosslinkingwithoutrelevantsideeffects.Itseemstobeasafeandpromisingproceduretostoptheprogressionofpost-LASIKkeratectasia,therebyavoidingordelayingkeratoplasty.
简介:AIM:Toexaminetheexpressionofsurvivinandvascularendothelialgrowthfactor(VEGF)duringthedevelopmentofretinalneovascularization(NV)inamousemodel.·METHODS:Awell-characterizedmurinemodelofretinalNVwasusedtostudytheexpressionofsurvivinandVEGF.NVoftheretinawasinducedinmicebyexposureto75%O2frompostnataldayP7toP12,followedbyreturntoroomairfromP12toP17.ExpressionofsurvivinandVEGFproteinwasanalyzedbyImmunohistochemistry.Inaddition,mousemodelofproliferativeretinopathywasanalyzedbyretinalfluoresceinangiographyandquantificationanalysis.·RESULTS:Thenormalmicehadbothsuperfiekalanddeepvascularlayersthatextendedfromtheopticnervetotheperiphery.Inintraocularpressure(IOP)micewerecharacterizedbyrepresentatypicalpatternofpathologicalretinalNV.Therearelessorlittlenucleiofnewvesselsvascularendothelialcellbreakingthroughtheinnerretinalthaninretinopathyofprematurity(ROP)mice,largeclustersofbloodvesselswereadherenttotheinternallimitingmembrane(ILM)(0.27±0.20vs23.38±1.027,t=9.454,P<0.001).DuringtheangiogenicperiodfromP13toP17,survivinandVEGFproteinexpressionincreasedinexperimentalretinascomparedwithcontrolsamples(2.56±0.46vs3.34±0.40,t=17.43,P<0.01:2.18±0.75vs4.34±0.25,t=19.61,P<0.01).ProteinlevelsofVEGFandsurvivnhassignificantlypositivecorrelation(P<0.05,r=0.411).·CONCLUSION:CorrelationwasmadeattheproteinlevelsofsurvivinexpressioncomparedwiththatofVEGFinamurinemodelofretinalNV,whichsuggestsatemporalroleforsurvivinandVEGFinnewvesselformationinresponsetohypoxicstimulation.
简介:目的使用指南研究与评价工具Ⅱ(AGREEⅡ)评价儿童青少年维生素D(VD)临床实践指南(VD指南),反映目前儿童青少年补充VD的基本共识和存在的争议.方法制定VD指南的纳入标准和检索策略,检索PubMed、WebofScience、中国期刊全文数据库、万方数据库、维普中文科技期刊数据库、美国国立指南文库(NGC)、指南国际网络(G-I-N)等相关指南数据库,按纳入标准纳入有关儿童青少年VD指南,提取和描述VD指南AGREEⅡ评价信息,使用AGREEⅡ评价纳入指南质量,使用组内相关系数(ICC)进行评价员间一致性检验.分析比较不同VD指南推荐内容的共识和差异.结果共纳入9篇VD指南,分别来自美国、中国、加拿大、法国、波兰和澳大利亚/新西兰.发表年度从2006至2012年.3篇为循证指南,其中2篇采用GRADE证据分级系统,1篇采用AHRQ证据分级系统;其余6篇为非循证指南.①指南质量经AGREEⅡ评分显示:6大领域的评分中,范围和目的、清晰性和应用性的总体平均得分均〉50%,指南制定的参与人员、制定的严谨性和编辑的独立性有待加强(平均得分分别为48%、42%和28%);循证指南在指南的参与人员、制定的严谨性、编辑的独立性方面优于非循证指南.②总体归纳不同VD指南之间在推荐内容上有5个方面的主要差异.VD预防建议:各指南基本认同的是0~1岁婴儿400IU·d-1的VD缺乏预防量是安全的;VD治疗建议:美国(ES)指南推荐2000IU·d-1(1~18岁),维持6周;阳光照射:美国和澳大利亚/新西兰的指南持不同推荐意见;VD2或VD3:不同指南推荐意见不同;25羟维生素D(25OHD)水平:各指南基本认同25OHD水平〈30nmol·L-1时,佝偻病的患病率增加;孕妇及哺乳期妇女:各指南推荐这一人群要注意及时补充VD,或维持适宜的25OHD水平.结论①纳入VD指南整体质量仍有待提高.循证指南质量在指南的参与人员�
简介:摘要介绍了PB中数据窗口的汇总带数据的提取,把提取的数据利用DDE的方法与EXCEL相连写入EXCEL中,还介绍了SQLSELECT在pb中的使用。
简介:摘要目的探讨短效口服复方左炔诺孕酮片与妈富隆的优、缺点。二者的避孕效果。方法采用整群抽样方法,选择本县13个乡(镇)在2010年1月至2011年1月口服短效复方左炔诺酮片、口服妈富隆的所有已婚育龄妇女,随访1年,观察两种短效口服避孕药的使用效果及副反应发生情况。结果口服复方左炔诺孕酮804例中,口服满1年的妊娠率,因不良症状严重停用率,总终止率和续用率分别为每百育龄妇女为0.25,0.5,3.73,96.27;而服用妈富隆的203例中,口服满一年的妊娠率,因不良症状严重停用率和总终止率和续用率分别为每百育龄妇女为0,0.49,1.47,98.53;妈富隆口服避孕药妊娠率,不良反应症状严重总终止率,明显低于口服复方左炔诺孕酮片,差异均有统计学意义(P<0.05,P<0.01)。结论两种口服避孕药避孕效果可靠,但妈富隆不良反应症状及副作用情况发生明显低于复方左炔诺孕酮片。
简介:AIM:Toestablishanuntransfectedhumancornealstromal(HCS)celllineandcharacterizeitsbiocompatibilitytoacellularporcinecornealstroma(aPCS).·METHODS:PrimaryculturewasinitiatedwithapurepopulationofHCScellsinDMEM/F12media(pH7.2)containing20%fetalbovineserumandvariousnecessarygrowthfactors.Theestablishedcelllinewascharacterizedbygrowthproperty,chromosomeanalysis,tumorigenicityassay,expressionofmarkerproteinsandfunctionalproteins.Furthermore,thebiocompatibilityofHCScellswithaPCSwasexaminedthroughhistologicalandimmunocytochemistryanalysesandwithlight,electronmicroscopies.·RESULTS:HCScellsproliferatedtoconfluence2weekslaterinprimarycultureandhavebeensubculturedtopassage140sofar.AcontinuousuntransfectedHCScelllinewithapopulationdoublingtimeof41.44hoursatpassage80hasbeendetermined.Resultsofchromosomeanalysis,morphology,combinedwiththeresultsofexpressionofmarkerproteinandfunctionalproteinssuggestedthatthecellsretainedHCScellproperties.Furthermore,HCScellshavenotumorigenicity,andwithexcellentbiocompatibilitytoaPCS.·CONCLUSION:Anuntransfectedandnon-tumorigenicHCScelllinehasbeenestablished,andthecellsmaintainedpositiveexpressionofmarkerproteinsandfunctionalproteins.Thecellline,withexcellentbiocompatibilitytoaPCS,mightbeusedforinvitroreconstructionoftissue-engineeredHCS.
简介:AIM:Toinvestigatethespecialtyoftranscranialsurgerythroughpterionalapproachforremovalofcranio-orbitaltumors,introducetheophthalmologicalexperiencesofenteringtheorbittoreducetheincidencerateofassociatedcomplicationsofthisoperation.·METHODS:Weperformedaretrospectiveanalysisofaseriesof37casesinvolvingpatientswhounderwenttranscranialsurgerythroughpterionalapproachfortreatmentofcranio-orbitaltumorsinourdepartmentinthepast8years.Pterionapproachcraniotomywasperformedtoallpatients.Afterremovingtumorsintheskullbytheneurosurgeon,ophthalmologistremovedtumorsinorbit.Wetookmeasuresbelowtodecreasecomplications,includinggroundingopticcanalthroughanabrasivedrillingwhennecessary,hangingvariousextraocularmusclestobeexposedforprotection,refrigeratingbyrefrigerationheadstoremovetumors,atlastsewinguporbitseptumaftersurgery.·RESULTS:Tumorswereremovedcompletelyin32cases,andincompletein5casesduetoextensiveinvasionintothecavernoussinusorsphenoidsinus.Ofallthecases,benigntumorsweredemonstratedin28cases(75.6%,28/37)andmalignantin9(24.3%,9/37).Themostcommonlesiontypewasmeningiomain11cases(29.7%,11/37).Extraocularmuscles(EOM)impairment,occurringin21cases(56.7%,21/37),wasthemostfrequentpostoperativecomplication.Themostseriousconsequencewasvisionlossoccurredin4cases(10.8%,4/37).Othercomplications,suchas11casesoftransientblepharoptosis29.7%(11/37),5casesofmydriasisin13.5%(5/7);2casesofcerebrospinalrhinorrheain5.4%(2/37).·CONCLUSION:Cranio-orbitaltumorscanberemovedcompletelyusingtranscranialapproach,andthepterionalapproachoffersexcellentexposure.Cooperationofinterdisciplinaryteamofneurosurgeonsandophthalmologistsconducestofulluseofrespectiveprofessionaladvantages.Theexperienceofophthalmicoperationtechnologycandecreaseoccurrenceofocularcomplicationsaftersurger