目的 评价噻托溴铵对不同表型慢性阻塞性肺疾病（COPD）患者的疗效。 方法 选取2008年10月－2010年5月COPD患者81例，根据胸部高分辨率CT上的形态表现分型，以气道病变为主型纳入A组，以肺气肿为主型纳入B组，按方案吸入噻托溴铵，在给药前后分别测定肺功能、圣?乔治呼吸问卷评分（SGRQ）及6 min步行距离。 结果 用药3个月后A组的第1秒用力肺活量（FEV1）、用力肺活量（FVC）、FEV1/FVC及FEV1占预计值（%）比B组明显提高，两组比较差异有统计学意义（P＜0.05），SGRQ评分比较B组明显下降，运动耐力（6 min步行距离）增加（P＜0.05）。 结论 噻托溴铵在COPD的治疗中，针对不同的表型，其疗效不同。
ObjectiveTo analyze the regulative rule of mRNA of vascular endothelial growth factor (VEGF) in mice with oxygen-induced retinopathy, and to elucidate the possible mechanism of occurrence of neovascularization in retinopathy of prematurity (ROP).MethodsSixty 7-day-old C57BL/6J mice were divided into oxygen-induced retinopathy group and control group. In oxygen-induced retinopathy group, 36 mice were exposed to 75% oxygen for 5 days and then to room air for 5 days; in control group, 24 mice were raised in room air. Vascular perfusion of fluorescein and retinal stretched preparation were used to observe the morphologic changes of retinal vessels. Reversal transcriptionpolymerase chain reaction (RT-PCR) was used to observe changes of VEGF mRNA in each group. ResultsIn oxygen-induced retinopathy group, the morphologic characteristics of retinal vessels were the unperfused area at the center of superficial and deepseated vessels, and the neovascularization appeared at mid-peripheral retina after 2 days in relative hypoxia condition. The results of RT-PCR showed space-time corresponding relation between expression of VEGF and neovascularization, which meant that the transcription of VEGF mRNA decreased in hyperxia conditionand increased in relative hypoxia condition. ConclusionHypoxia is the main reason of occurrence of retinal neovascularization; increased expression of VEGF caused by relative hypoxia after hyperxia might be effective in reducing the occurrence of neovascularization in ROP.(Chin J Ocul Fundus Dis, 2005,21:292-295)
Objective To evaluate the effect of vascular endothelial cell growth factor (VEGF) antisense oligodeoxynucleotides (ASODNs) on the expression of VEGF in rats with oxygen-induced retinopathy. Methods Thirty newborn Sprague-Dawley (SD) rats were randomly divided into 3 groups:normal control group, disposal group and non-disposed group, The animal models with oxygen-induced proliferative retinopathy were established by raising the rats in hyperoxic environment. Retrobulbar injection was performed with VEGF ASODNs or normal saline on the rats in 3 groups respectively. The intraocular tissues (all the tissues except the cornea, sclera, and lens) and serum were collected, and the expressions of VEGF were determined by using competitive enzyme immunoassay.Results The expressions of VEGF in intraocular tissues of rats in disposal group were significantly lower than those in non-disposed group (P＜0.05), and there was no statistical difference between the disposal and normal control group (P＞0.05). There was no significant difference of the expressions of VEGF in serum of rats between the disposal and non-disposed group (P＞0.05), which were both lower than those in the normal control group (P＜0.05). Conclusion VEGF ASODNs could significantly inhibit the expression of VEGF in intraocular tissues. (Chin J Ocul Fundus Dis，2003，19：172-174)
Objective To investigate the clinical characteristics of prepapillary and preretinal vascular loops. Methods The clinical manifestation, results of the fundus fluorescein angiography, and the prognosis of 20 cases(24 eyes) with prepapillary and preretinal vascual loops were analyzed retrospectively. Results 66.7% of prepapillary and preretinal vascular loops were involved in one eye, and 95.8% of vascular loops were located within one optic disc diameter. There were different configuration types of the vascular loops. Among 20 cases(24 eyes) of the vascular loops, 70.8%(17 eyes) were arterial, 12.5%(3 eyes) were venous, and 16.7%(4 eyes) were both arterial and venous. 62.5% of eyes with prepapillary and preretinal vascular loops were associated with other congenital and developmental anomalies of retinal vascular vessels. Conclusion Most PRVL are arterial and superior to the optic disc. The serious distortion of the vascular loops may result in disturbance of blood flow in artery and retinal hemorrhage, which cause visual loss. (Chin J Ocul Fundus Dis, 1999, 15: 9-11)
Objective To summarize the treatment experience for concomitant diseases of other abdominal organs in laparoscopic cholecystectomy （LC）. Methods The clinical data of 176 patients with LC and concomitant diseases of other abdominal organs were analyzed retrospectively， including preoperatively diagnosed cases （such as 53 with liver cyst， 15 with choledocholithiasis， 7 with chronic appendicitis， 5 with inguinal hernia， 4 with renal cyst， and 6 with ovarian cyst） and intraoperatively diagnosed cases （such as 72 with abdominal cavity adhesion， 4 with internal fistula between gallbladder and digestive tract， 3 with Mirizzi syndrome， and 7 with unsuspected gallbladder carcinoma）. Results All the operation were successfully completed in 176 patients without severe complications， including 53 cases treated with LC plus fenestration of hepatic cyst， 15 with choledocholithotomy， 7 with appendectomy， 5 with tension free hernia repair， 4 with renal cyst fenestration， 6 with oophorocystectomy， 72 with adhesiolysis， 3 with fistula resection plus intestine neoplasty， 2 with intraoperative cholangiography plus choledocholithotomy， 5 with LC plus gallbladder bed complete burning， and 4 cases treated with conversion to open surgery （1 with intestinal fistula repair， 1 with choledocholithotomy， and 2 with radical resection for gallbladder carcinoma）. Conclusions It is safe and effective to treat gallbladder diseases complicated with other concomitant diseases simultaneously with laparoscopic operation， if the principles of surgical operation are followed and the indications and applicable conditions are strictly followed. And conversion to open surgery is necessary.
The pathogenesis of polypoidal choroidal vasculopathy (PCV) is still controversial. More evidence of clinical and basic research is needed to distinguish PCV from an independent disease to a subtype of age-related macular degeneration. Not only that, there are also many puzzles in the diagnosis, treatment options and prognosis of PCV. In addition to these common problems, we also face a large population with risk factors, a large number of PCV patients with multiple and complex challenges in China. There is a long way to go to reduce the damage effects of PCV on visual function. To fulfil this goal, we need make full use of the huge resources of PCV patients and turn these challenges into opportunities, and contribute the improvement of diagnosis and better understanding of PCV pathogenesis.