Résumé
Objective:To investigate the causes of secondary glaucoma after vitrectomy for familial vitreous amyloidosis associated with transthyretin (TTR) gene Gly83Arg mutation.Methods:A retrospective case study. From January 2008 to January 2020, 13 cases (23 eyes) with hereditary vitreous amyloidosis and treated by vitrectomy in the Affiliated Hospital of Zunyi Medical University were collected. Among them, there were 7 males with 12 eyes and 6 females with 11 eyes. The average age was 43.0±4.8 years. All the affected eyes underwent standard three-channel vitrectomy through the flat part of the ciliary body. According to whether complete vitreous detachment (PVD) was formed during the operation, it was divided into complete PVD group and incomplete PVD group; according to the occurrence time of secondary glaucoma and vitreous amyloidosis after surgery, it was divided into 1-12 months group and 13-36 months group, >37 months group. The average follow-up time after surgery was 36.7±6.0 months. The incidence of secondary glaucoma and the recurrence rate of vitreous amyloidosis between groups were compared by χ2 test; the correlation between recurrence of vitreous amyloidosis and secondary glaucoma after surgery was analyzed by Spearman rank correlation analysis. Results:Among the 23 eyes, there were 8 eyes in the complete PVD group and 15 eyes in the incomplete PVD group, respectively. Vitreous amyloidosis recurred in 15 eyes (65.22%, 15/23) after surgery. There were 14 (93.30%, 14/15) and 1 (6.70%, 1/15) eyes in the incomplete PVD group and the complete PVD group, respectively; the comparison of the recurrence rate of vitreous amyloidosis between the two groups was statistically significant ( χ2=11.676, P<0.01). 1-12 months group, 13-36 months group, >37 months group included 1 (4.35%, 1/23), 12 (52.17%, 12/23), 2 (8.70%, 2/23) Only eye. The recurrence rate in the 13-36 months group was significantly higher than that in the 1-12 months group and >37 month group. Secondary glaucoma occurred in 11 eyes (47.80%, 11/23) after surgery. 1-12 months group, 13-36 months group, above 37 months group were 1 (4.35%, 1/23), 8 (34.78%, 8/23), 2 (8.70%, 2/23) eyes. The incidence of secondary glaucoma in the 13-36 months group was higher than that in the 1-12 months group and >37 months group. Among 11 eyes with secondary glaucoma, 10 eyes had recurrence of vitreous amyloidosis after surgery, and 1 eye had no recurrence. The results of Spearman rank correlation analysis showed that there was a positive correlation between the recurrence of vitreous amyloidosis and the occurrence of secondary glaucoma ( rs=0.516, P=0.012). Conclusion:The incidence of secondary glaucoma after vitrectomy in a family with vitreous amyloidosis caused by the Gly83Arg mutation of TTR gene is higher, and its occurrence is significantly positively correlated with the recurrence of vitreous amyloidosis.
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Based on the analysis of the existing problems in outpatient nursing education, this study builds an organizational framework of outpatient nursing education based on the competency model, and proposes measures such as the construction of outpatient nursing education teachers, the optimization of the education mode and training facilities and so on. The results show that there are statistical differences in the teaching ability, teaching quality, student feedback and total scores before and after constructing the organizational framework of outpatient nursing education based on the competency model, indicating that the framework guarantees the basis of the dynamic selection mechanism of nursing education teachers, ensures the quality of outpatient nursing education, and can provide a reference for the development of outpatient nursing specialty and talent training.
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An enhance matrix removal ( EMR) QuEChERS method for simultaneous determination of 22 triazine herbicide residuals such as atrazine, propazine, terbumeton, and desmetryn in corn was established and validated. The corn samples were initially extracted with acetonitrile ( MeCN ) in high-speed homogenization, and the targeted pesticides were prepared using EMR-Lipid (Enhanced matrix removal-lipid) method to clean-up and EMR-Polish to salt out, separated on a Kinetex XB-C18 with acetonitrile and 0. 1%formic acid aqueous as eluant, and then detected by UFLC-MS / MS under positive ( ESI+ ) electrospray ionization and MRM models. The average recoveries of 22 herbicides were in the range of 72% -105% at the spiked level of 5, 10 and 20 μg / kg. The relative standard deviations were less than 15% . In the method validation, correlation coefficients were higher than 0. 993 with the linear range from 1. 0 μg / L to 50 μg / L. The qualitative analysis and quantitative analysis were investigated by UFLC-MS / MS and matrix-matched calibration curves. The results showed that EMR QuEChERS combined with UFLC-MS / MS purification method was rapid, accurate and sensitive for the determination of 22 triazine herbicides residues in corn.
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OBJECTIVE: To compare the gastrointestional (GI) adverse events of glucagon-like peptide-1 (GLP-1) receptor agonists and dipeptidyl peptidase-4 (DPP-4) inhibitors by systematic review and meta-analysis to provide reference for clinicians. METHODS: The following databases were searched: Pubmed, Embase, Cochrane, ClinicalTrials, and CNKI. And the following terms were used to search head to head studies comparing the GI adverse events of GLP-1 receptor agonists and DPP-4 inhibitors: "GLP-1 receptor agonist", "DPP-4 inhibitor", "incretin-based therapy", "adverse events", and "safety". Meta-analysis was performed by Revman 5.0 software, with results expressed as odds ratio (OR) and 95% confidence interval (CI) for GI adverse events. RESULTS: A total of 1 231 articles were obtained, among which six randomized clinical trials (RCTs) which include 884 GLP-1 receptor agonists users and 798 DPP-4 inhibitors users (total number=1 682), were included for the meta-analysis. The result showed that GLP-1 receptor agonists were associated with a higher incidence of GI adverse events, the ORs of high dose GLP-1 receptor agonists versus DPP-4 inhibitors for nausea, vomiting, diarrhea, and constipation were 4.68(3.36, 6.52), 4.66(2.51, 8.65), 2.17(1.54, 3.06) and 2.39(1.35, 4.24), respectively; the ORs of low dose GLP-1 receptor agonists versus DPP-4 inhibitors for nausea, vomiting, diarrhea, and constipation were 4.09(3.06, 5.48), 3.80(2.22, 6.50), 2.06(1.46, 2.93) and 2.39(1.35, 4.24), respectively. CONCLUSION: Compared to DPP-4 inhibitors, GLP-1 receptor agonists are associated with a higher incidence of GI side effects including nausea, vomiting, diarrhea, and constipation.
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<p><b>OBJECTIVE</b>To observe the effect of tetrandrine on activity of collagenase derived from human hypertrophic scar for the sake of clarifying the mechanism as tetrandrine acting on scar.</p><p><b>METHODS</b>The experimental concentration was controlled below that of cell proliferation inhibited, SDS-PAGE electrophoresis was adopted to separate collagenase from extracellular matrix, and then activated by trypsin analyzed the activity of collagenase with density scanning apparatus. At the same time quantity of extracellular collagen was measured using improved chloraseptine T oxidizing assay, moreover analyzed correlation between activity of collagenase and quantity of extracellular collagen.</p><p><b>RESULTS</b>In the concentration below the lever of inhibiting fibroblast proliferation, the total activity of collagenase could be significantly increased by tetrandrine with dosage-dependence associated with quantity of extracellular collagen reduced, which was much greater than that of triamcinolone.</p><p><b>CONCLUSION</b>Increasing activity of collagenase on degradation of collagen even in a lower concentration was one of the mechanisms of tetrandrine treating hypertrophic scar.</p>