典必殊眼膏注入泪小管治疗泪小管炎的临床体会

目的：探讨改善临床治疗泪小管炎疗效的新方法。方法：针对我科门诊就诊的泪小管炎病例,先用生理盐水尽量冲洗泪道分泌物和泪道内结石,然后用庆大霉素冲洗,再用典必殊眼膏泪小管内注入保留。结果：所有5例泪小管炎病例均病情恢复迅速,15天至1月内均获得治愈,随访半年以上无复发表现。结论：采用冲洗后再加入典必殊眼膏泪小管内注入的新方法疗效确切,且起效迅速,操作简单,为临床治疗慢性泪小管炎提供了一条新途径。     

改良泪囊鼻腔吻合术治疗慢性泪囊炎的治疗体会

慢性泪囊炎为眼科常见眼病之一,长期流泪、流脓,给患者带来极大痛苦.临床上多继发于鼻泪管狭窄或阻塞后而导致的,其治疗原则是重新建立鼻内引流通道,解除阻塞,消除感染[1].传统术式经鼻外内眦部行泪囊鼻腔吻合的创伤大.我院采用改良泪囊鼻腔吻合术治疗慢性泪囊炎149例（192眼）,效果较好,现报告如下.     

典必殊眼膏加艾灸治疗中老年睑板腺功能障碍的临床观察

目的:观察糖皮质激素典必殊联合中药艾灸在治疗睑板腺功能障碍性的临床疗效。方法:对本院门诊就诊的睑板腺功能障碍的患者72例144只眼,进行眼科一般常规检查后,再做泪液分泌实验和泪膜破裂时间测定等检查,确定为睑板腺功能障碍后分成两组,一组给予典必殊加艾灸治疗;另一组给予常规治疗(热敷、氧氟沙星滴眼液、普拉洛芬滴眼液点眼等),观察记录治疗效果,进行统计学处理。结果,4到5周后,实验组治疗效果明显高于对照组的效果。实验组总有效率94.4%,对照组总有效率86.1%%。结论:睑板腺功能障碍用典必殊眼膏加艾灸治疗疗效显著,长期疗效优于其它疗法,经临床观察且无局部和全身的不良反应。     

先天性泪囊炎的治疗及护理

目的探讨先天性泪囊炎的治疗及护理措施。方法对386例(407眼)先天性泪囊炎患儿采用泪囊按摩、泪道冲洗、探通、再冲洗的治疗方法及护理措施。结果泪囊区按摩法一次治疗成功率1.47%,泪道冲洗+探通+再冲洗一次治疗成功率94.34%,二次治疗成功率2.70%,三次治疗成功率1.47%。结论先天性泪囊炎患儿采取泪道冲洗+探通+再冲洗并配合临床护理可显著提高治疗效果。     

不同泪道硅胶引流管留置时间对慢性泪囊炎患者视力、生活质量及复发率的影响

目的:探讨不同泪道硅胶引流管留置时间对慢性泪囊炎患者的生活质量、视力及复发率的影响.方法:回顾性选取2018年1月～2019年12月期间于我院就诊的慢性泪囊炎患者91例(128眼),根据术后泪道硅胶引流管留置时间分为A、B两组,其中A组泪道硅胶引流管留置时间6周,44例(61眼),B组泪道硅胶引流管留置时间12周,47...     

鼻腔结构异常与慢性泪囊炎的关系及对手术预后的影响

摘要 目的：研究鼻腔结构异常与慢性泪囊炎（CD）的关系及对手术预后的影响。方法：将从2017年2月～2019年2月青岛大学附属青岛市市立医院收治的200例CD患者纳入研究,分析其鼻腔结构异常发生情况。将患者按照是否发生鼻腔结构异常分成异常组（n=132）及无异常组（n=68）,比较两组各项基线资料,并分析CD患者鼻腔结构异常发生的影响因素。将所有患者按照术后疗效的差异分成治愈组（n=152）及未治愈组（n=48）,并以多因素Logistic回归分析CD患者预后的影响因素。结果：200例患者共检出鼻腔结构异常132例,占比66.00%。异常组年龄＜60岁、职业状态为待业以及有吸烟史人数占比均高于无异常组（均P＜0.05）。经多因素Logistic回归分析发现：年龄＜60岁、职业状态为待业以及有吸烟史均是CD患者鼻腔结构异常的危险因素（均P＜0.05）。经单因素分析可得：年龄、鼻泪管引流管拔除时间以及鼻腔结构异常均和CD患者预后有关（均P＜0.05）。经多因素Logistic回归分析发现：年龄≥60岁、鼻泪管引流管拔除时间＞术后3个月以及鼻腔结构异常均是CD患者预后的危险因素（均P＜0.05）。结论：鼻腔结构异常与CD发生、发展密切相关,且多见于年龄＜60岁,有吸烟史以及待业人群中。此外,年龄≥60岁、鼻泪管引流管拔除时间在术后3个月以上以及鼻腔结构异常均是CD患者手术预后的独立危险因素,应予以重点关注。     

同期与分期鼻内镜手术治疗慢性泪囊炎合并慢性鼻-鼻窦炎的疗效对比研究

摘要 目的：探讨同期与分期鼻内镜手术治疗慢性泪囊炎合并慢性鼻-鼻窦炎的临床疗效。方法：回顾性分析本院2017年1月至2019年10月期间收治的76例慢性泪囊炎合并慢性鼻-鼻窦炎患者的临床资料,根据手术方式分为A组和B组,各38例。A组行分期手术（鼻腔鼻窦病变处理控制鼻腔鼻窦炎症后再行鼻内镜下泪囊鼻腔造孔术）。B组行同期手术（处理鼻腔鼻窦病变后立即行鼻内镜下泪囊鼻腔造孔术）,比较两组围术期指标、临床疗效、术后并发症发生情况,采用慢性泪囊炎生活质量量表（DQOLS）评价患者术前和术后6个月时的生活质量。结果：B组总有效率为94.74 %（36/38）,A组总有效率为92.11 %（35/38）,两组总有效率比较无明显差异（P>0.05）;B组术后并发症总发生率为13.16 %（5/38）,与A组的10.53 %（4/38）比较无明显差异（P>0.05）。两组患者术后6个月时的DQOLS各维度评分和总分均较术前升高（P<0.05）,但组间比较差异均无统计学意义（P>0.05）。B组患者住院总费用少于A组,住院时间、手术时间均短于A组（P<0.05）,两组术中出血量比较无明显差异（P>0.05）。结论：同期手术与分期手术治疗慢性泪囊炎合并慢性鼻-鼻窦炎患者具有相当的临床疗效和安全性,且对患者生活质量的改善程度亦无明显差异,但前者能够缩短手术时间、住院时间及减少住院费用。     

优必清软膏治疗尖锐湿疣的临床疗效观察

目的:中药复方制剂抗人乳头瘤病毒软膏(优必清软膏)对尖锐湿疣(Condyloma acuminatum,CA)脱疣的疗效、复发和安全性的评价.方法:采用随机、双盲、平行对照、临床观察,共150例.尖锐湿疣优必清软膏组(试验组)60例,尖锐湿疣足叶草脂液(别名鬼臼根树脂、疣必治、鬼臼素酯,其活性成分为足叶草酯毒素)组(对照组)60例.作为参考选取外阴假疣优必清软膏组30例与尖锐湿疣优必清软膏组60例平行对照.局部外涂覆盖疣体,隔日一次,疗程1-4周,随访3-6个月.CA脱疣疗效、复发率作为观察指标.不良事件发生情况作为安全评价.结果:试验组和对照组脱疣的有效率为95％和86.67％,两组的复发率为5％和23.33％,试验组脱疣疗效高于对照组、复发率低于对照组.结论:优必清软膏治疗CA,疗效显著,复发率低,临床用药安全.优必清软膏无明显副作用.     

小针刀配合中药治疗肱骨外上髁炎的临床观察

肱骨外上髁炎是临床常见病,是一种由前臂伸肌起点,特别是桡侧屈腕短肌的慢性撕裂性病变.2003年以来,我们运用针刀配合中药治疗30例肱骨外上髁炎患者,并与针灸药物、局部封团治疗的患者作对照观察,现报告如下.     

血必净注射液对重症急性胰腺炎患者肾功能、炎性因子和外周血单核细胞TLR4/NF-κB信号通路的影响

摘要 目的：探讨血必净注射液对重症急性胰腺炎（SAP）患者肾功能、炎性因子和外周血单核细胞Toll 样受体4（TLR4）/NF-κB信号通路的影响。方法：采用随机数字表法,将南京医科大学附属宿迁第一人民医院于2019年4月~2021年12月期间收治的重症SAP患者108例分为对照组（常规治疗,n=54）和观察组（n=54,对照组基础上结合血必净注射液）。对比两组肾功能、炎性因子和外周血单核细胞TLR4/NF-κB信号通路相关指标的变化情况。同时观察两组疗效、临床症状改善情况和不良反应发生情况。结果：观察组临床总有效率较对照组高（P<0.05）。两组不良反应率比较无差异（P>0.05）。与对照组比较,观察组腹胀腹痛缓解时间、体温恢复正常时间、恶心呕吐消失时间、住院时间更短（P<0.05）。两组治疗7 d后尿素氮（BUN）、血肌酐（Scr）下降（P<0.05）,观察组治疗7 d后BUN、Scr低于对照组（P<0.05）。两组治疗7 d后白介素-6（IL-6）、白介素-1（IL-1）、肿瘤坏死因子-α（TNF-α）下降（P<0.05）,治疗7 d后观察组IL-6、TNF-α、IL-1较对照组低（P<0.05）。两组治疗7 d后TLR4、NF-κB下降（P<0.05）,观察组治疗7 d后TLR4、NF-κB低于对照组（P<0.05）。结论：血必净注射液可有效控制重症SAP患者炎性因子水平,减轻肾功能损伤,可能与调节外周血单核细胞TLR4/NF-κB信号通路有关。     

Monoacylglycerol acyltransferase activity in the rat liver plasmalemma fractions

Bile canalicular membranes and plasma membranes free of bile canalicular membranes were prepared from rat livers and their lipolytic activities were measured. Both preparations catalyzed hydrolysis and transacylation when monoacylglycerol and phosphatidylethanolamine were used as substrates. The specific enzymatic activity in the plasmalemma free of bile canalicular membranes was slightly higher than that in bile canalicular membranes. Neither preparation attacked the triacylglycerol of chylomicra, which indicates the lack of a lipoprotein lipase. Heparin and CaCl₂ stimulated the activities in both preparations. On the basis of these data, we suggest that monoacylglycerol acyltransferase can serve two distinct roles in the liver cell, depending upon the mumbrane fraction of association.     

Isolated hepatocyte couplets and bile duct units - Novel preparations for the in vitro study of bile secretory function

Studies of the mechanisms of bile formation have been facilitated by the development of in-vitro models that enable the transport functions of hepatocytes and bile duct epithelial cells to be analyzed in isolation. Isolated hepatocyte couplets represent a primary bile secretory unit that retain secretory polarity. Isolated bile duct units are intact polarized segments of interlobular bile duct segments. Both preparations can be maintained in short term culture, respond appropriately to choleretic agonists and facilitate a variety of functional applications.     

Stability and optimization of canalicular function in hepatocyte couplets

An enriched preparation of rat hepatocyte couplets was obtaied by collagense perfusion and subsequent elutriation (> 85 per cent couplets and triplets; viability of over 95 per cent). Canalicular secretory activity (the ability to accumulate cholyl-lysyl-fluorescein, CLF) was first apparent after 2 h of culture at 37°C and was present in over 80 per cent of the total population after 5–6 h. This remained almost constant for at least 4 h in both elutriated and directly plated cells. Initial storage of freshly prepared couplets at 4°C for up to 6 h prior to incubation had no adverse effect upon secretory function. Reduction of canalicular secretory activity occurred at a concentration of the hepatotoxic agent menadione (IC₅₀ 17 μM) that was lower than that required to induce mild plasma-membrane blebbing (IC₅₀ 43 μM). This study has optimized and characterized the canalicular secretory effectiveness and stability of an enriched preparation of hepatocyte couplets, and established the feasibility of studies of toxic agents on hepatobiliary function in a heterogeneous population of hepatocytes. In this preparation other biochemical parameters can be assessed, thus complementing previous techniques using individual couplets.     

人工泪液对患者玻璃体切除术后泪膜功能的影响

观察玻璃体切除手术后泪膜的变化和应用人工泪液后对泪膜恢复的影响。方法:60例(60眼)行玻璃体切除手术的患者随机分为两组,A组行玻手术后单用妥布霉素地塞米松眼液和眼膏,B组手术后联合应用妥布霉素地塞米松眼液、眼膏和人工泪液Dextran 70 Eye Drops。分别于术前1d,术后3d、7d、14d及30d详细询问患者是否存在干眼症状,并行泪膜破裂时间(Break-Up Time,BUT)、基础泪液分泌试验(Schirmer I test,SIt)、角膜荧光素染色(Cornea Fluorescein Staining,CFS)检查。对结果进行统计学分析。结果:(1)手术前A组和B组的干眼评分、泪膜破裂时间、角膜荧光染色评分、基础泪液分泌试验检查4个项目的检查值经统计学分析无明显差异;(2)术后各个时间点,B组的BUT检查值较A组均增加且差异显著;(3)术后7d和14d,B组的干眼评分和CFS评分较A组减少且差异显著。结论:玻璃体切除术后早期泪膜稳定性明显下降,加用人工泪液后可明显提高术后泪膜稳定性,提示玻璃体切除术后早期使用人工泪液有利于泪膜恢复。     

Effect of lacrimal plugs combined with deproteinized calf blood extract eye gel for filamentary keratitis

This study aims to investigate the efficacy of lacrimal plugs combined with deproteinized calf blood extract eye gel on the treatment of dry-eye-associated filamentary keratitis. Lacrimal plugs were inserted into both the upper and lower puncta of 15 patients (28 eyes). Deproteinized calf blood cxtract eye gel was applied in two patients who were not cured after this operation. All patients were asked to complete three questionnaires 1 day before the surgery and at 1 week and 1 month after the surgery. Ophthalmologic examinations were carried out and repeated at 1 day and at 1 week and 1 month after plug insertion, which include fluorescein staining, tear break-up time (BUT), Schirmer test I (STI), corneal confocal microscope (HRT-III), and impression cytology (IC). Symptoms were relieved in all patients 1 month after the application of lacrimal plugs. Deproteinized calf blood extract eye gel was applied to two patients whose symptoms remained after lacrimal plug implantation for 1 week. At 3 weeks later, the symptoms disappeared and cornea fluorescein stain was hardly identified. The lacrimal river in all patients became broader after the surgery, 11 of whom reached 0.3 mm. Cornea filamentary disappeared in all patients. The average of BUT and ST were increased to 7.50 ± 1.897 s (p < 0.001) and 8.12 ± 1.996 mm at 1 week after the operation and 7.94 s and 9.00 ± 1.897 mm at 1 month later, respectively. Photography from HRT-III suggested that the state of corneal epithelium was markedly improved, including the squamous metaplasia of the epithelial layer of the cornea and the bend of nerve fibers under the corneal epithelium. IC also suggested that the squamous metaplasia of epithelial layer of conjunctiva in these patients was improved. The symptoms of patients suffering from severe filamentary keratitis were remarkably relieved by using lacrimal plugs, which could increase the tear volume of the ocular surface, improve the condition of tear film, and promote the recovery of corneal diseases. For patients with more severe symptoms, additional usage of deproteinized calf blood extract eye gel could assist the treatment. Therefore, lacrimal plugs combined with deproteinized calf blood extract eye gel are suggested to be an effective method to treat severe filamentary keratitis.