飞秒激光辅助的SMILE因其微创、准确性、安全性、可预测性、稳定性好的特点越来越受患者和术者的欢迎,随着大家对手术的期望值增加,视觉质量成为反应手术效果极其重要的因素之一,而高阶像差又是评定视觉质量尤为重要的指标。本文对飞秒激光SMILE的眼高阶像差及其影响因素进行综述。

Femtosecond laser-assisted SMILE is more and more popular with patients and the operators because of the minimal invasion, efficacy, safety, predictability and stability. But with the increase of people's expectations of the surgery, visual quality become one of the important factors which reacts operation effect extremely, and higher-order aberration is an especially important index when evaluate the visual quality. In this paper, the higher-order aberration and its influence factors of femtosecond laser-assisted SMILE were summarized.

目的 观察比较术中及术前化疗干预对进展期胃恶性肿瘤手术患者p53、ki-67表达及预后的影响,为临床化疗时间的选择提供理论依据。方法 自2014年8月—2015年5月,我院共收入胃恶性肿瘤患者40例,将40例患者随机分为两组,每组各20例,保证两组患者在性别、年龄、胃癌分期等方面可比,无统计学差异(P＞0.05),标记为Ⅰ组和Ⅱ组。Ⅰ组20例患者于术前进行化疗干预,Ⅱ组在术中给予化疗干预。观察比较两组患者p53、ki-67表达状况及预后。结果 Ⅰ组及Ⅱ组治疗后p53及ki-67均比治疗前升高,差异有统计学意义(P<0.05)。但是治疗后,Ⅰ组和Ⅱ组的p53表达状况组间差异不明显,无统计学意义(P>0.05)。治疗前后,AI差异有统计学意义(P<0.05)。Ⅰ组效果明显好于Ⅱ组,两者差异有统计学意义(P <0.05)。术后六个月、一年随访时发现两组复发率、死亡率差别不大,无统计学意义(P>0.05),术后两年随访发现Ⅱ组复发率、死亡率明显低于Ⅰ组,差异有统计学意义(P<0.05)。结论 术中化疗的疗效优于术前化疗,患者预后较术前化疗好。

Objective To observe the effect of intraoperative and preoperative chemotherapy on the expression of p53, Ki-67 and prognosis in patients with advanced gastric cancer. Methods 40 cases of advanced gastric cancer in our hospital from Aug 2014 to May 2015 were enrolled in the study, and were divide into 2 groups randomly. In group I, 20 patients received chemotherapy intervention befoerer operation, and the other group received chemotherapy intervention during operation. The expressions and prognosis of p53 and Ki-67 were observed and compared between the two groups. Results Group Ⅰ and group Ⅱ after treatment, p53 and Ki-67 were higher than that before treatment, with statistical significance(P<0.05). However, there was no significant difference in the expression of p53 between group Ⅰ and group Ⅱ after treatment, and there was no significant difference(P>0.05). Before and after treatment, the difference of AI was significant, with statistical significance (P<0.05). The effect of group Ⅰ was obviously better than that of group Ⅱ, the difference was statistically significant(P<0.05). Six monthse after the operation and one year follow-up found two groups of recurrence rate and mortality rate had no significant difference(P>0.05). After two years follow-up found the group Ⅱ recurrence rate, mortality was lower than in group Ⅰ (P<0.05). Conclusion The effect of intraoperative chemotherapy is better than that of preoperative chemotherapy, and the prognosis is better than that of preoperative chemotherapy.

自奥津一郎于1987年首次报道内镜辅助下行腕管松解术以来,腕管综合征的内镜治疗术式得到大量创新、改良。现本文就各种内镜术式优劣势做一概述。

肺动脉高压是一类发病率低,但常引起右心衰竭等最终导致患者死亡的严重肺血管疾病,其形成的主要病理改变是肺血管重构和肺血管收缩,多种细胞因子异常作用参与发病,对该作用机制的研究成为了治疗疾病,改善疾病预后的关键。

Pulmonary hypertension is a kind of low incidence, but it is often caused by right heart failure and other serious pulmonary vascular disease. The main pathological changes of pulmonary vascular include remodeling and pulmonary vascular contraction, and many kinds of cytokines are involved in the pathogenesis of disease, which is the key to improve the prognosis of the disease.

目的 探讨S100B蛋白水平与进展性脑梗塞病情的相关性,分析不同 S100B 蛋白含量的患者预后情况。方法 选取2011年10月—2012年9月在我院接受治疗的急性进展性脑梗死患者80例为研究对象。比较不同脑损害程度,进展性脑梗塞患者S100B蛋白含量及NIHSS评分动态变化。结果 急性进展性脑梗死患者血清S100B蛋白含量在治疗后第1、3、7天均升高(P＜0.05),且第3天达最高,最高值随着脑梗死面积的增大而增加,第14天下降至最低,与对照组相比,差异有统计学意义(P<0.05)。急性进展性脑梗死患者NIHSS评分与治疗前相比,在治疗后第1、3、7天均升高(P＜0.05),且第3天达最高,最高值随着脑梗死面积的增大而增加,第14天下降至最低,与对照组相比,差异有统计学意义(P<0.05)。采用Pearson对患者血清S100B蛋白含量和NIHSS评分进行相关性分析,得出相关系数为0.583,P<0.05,即血清SI00B蛋白水平与NIHSS评分呈正相关。结论 急性进展性脑梗塞患者血清S100B蛋白水平与脑梗死损坏程度及神经功能正相关,可用来判定该类患者病情及预后情况。

急性肾损伤(acute kidney injury,AKI)是由各种因素导致的临床综合征,尽管科学在发展,发病率、死亡率一直居高不下,并且严重影响患者的预后,这主要是由于对肾脏损伤的早期诊断缺乏敏感的、特异性的指标,使得患者错过了最佳的治疗窗口。研究发现在AKI的早期给予干预,能够明显提高患者的预后,达到满意的治疗效果。所以AKI的早期诊断是提高患者的生活质量的关键措施,期间出现了一系列AKI 的早期分子标志物,包括NGAL、IL-18、miRNA、KIM-1、NAG、L-FABP、TIMP-1、IGFBP-7、TFF-3、GST-π、MYL12B等。本文就这些AKI分子标志物进行总结,阐述这些分子标志物在AKI 诊断及预后预测中的价值,以便于及早制定有针对性的 AKI 治疗及护理策略,使早期诊断、早期干预 AKI 成为可能。

心肌梗死模型在心肌梗死病理发生机制、新药研发研究中占有重要地位。目前冠状动脉结扎法制作大鼠心肌梗死模型,模型稳定,操作简单,造价便宜,效果可靠,为最主要的心肌梗死造模方法,制作方法及具体操作中存在各自的优势和不足,影响着模型的进一步推广,有待继续进行改进和深入研究。

近年来的研究已经报道证实了白细胞介素-33(IL-33)及其受体ST2可以保护心衰病人因机械应力过度牵拉所导致的心肌细胞肥大、心肌纤维化的发生以及可溶性ST2受体可作为潜在的心脏机械超负荷生物标志物。而对IL-33与受体ST2在动脉粥样硬化过程中发挥的作用少有涉及。本文主要探讨的是IL-33和ST2对抑制Th1/Th2漂移从而影响到动脉粥样硬化的进展以及血浆中可溶性ST2受体蛋白升高的意义。

Recent study has reported that interleukin-33(IL-33) and its receptor ST2 could prevent cardiomyocyte hypertrophy and exaggerated interstitial fibrosis which is because of the over harmful biomechanical force in patients with heart failure and soluble ST2 receptors is the potential biomarker of cardiac biomechanical overload. But few studies mentioned the sort of IL-33/ST2 complex plays a role in atherosclerosis. The purpose of this article is to explore the IL-33 and ST2 could reduce a Th1/Th2 shift. Consequently, it may improve the development of atherosclerosis and significance of soluble ST2 receptor increased in plasma.

目的 研究进展性脑梗塞与超敏 C-反应蛋白(hs-CRP)、纤维蛋白原(FIB)、血清胱抑素C(CysC)的相关性。方法 选择82例脑梗塞患者作为观察组,根据患者临床表现分为进展性脑梗塞组和非进展性脑梗塞组,另选择70例非脑血管病患者作为对照组;分别检测血清hs-CRP和FIB、CysC水平。结果 观察组患者血清hs-CRP和FIB、CysC含量较对照组升高(P<0.01);进展性脑梗塞组血清hs-CRP和FIB、CysC含量高于非进展性脑梗塞组(P<0.05)。经Spearman 相关分析发现,进展性脑梗塞组的血清hs-CRP、FIB、CysC水平与美国国立卫生研究院卒中量表(NIHSS)评定的神经功能缺损评分呈正相关。结论 血清hs-CRP、FIB、CysC水平检测有助于进展性脑梗塞患者的早期诊断,对预后有评估作用。