Chronic rhinosinusitis with nasal polyps causes severe symptoms and impaired quality of life. Stapokibart is a novel monoclonal antibody that targets interleukin 4Rα. To assess the efficacy and safety of stapokibart as an add-on treatment to intranasal corticosteroids in patients with severe uncontrolled chronic rhinosinusitis with nasal polyps. From August 9, 2022, to April 28, 2023, this randomized, double-blind, phase 3 clinical trial, conducted at 51 hospitals in China, enrolled adult patients with chronic rhinosinusitis with nasal polyps who had a history of systemic corticosteroid use or sinonasal surgery and a bilateral nasal polyp score of 5 or greater (on a scale of 0-8) and a weekly mean nasal congestion score of 2 or greater (on a scale of 0-3). Eosinophilic chronic rhinosinusitis with nasal polyps was defined as blood eosinophils of 6.9% or greater (without asthma) or 3.7% or greater (with asthma) or an eosinophil count of 55 per high-power field or greater or 27% or greater in nasal polyp tissue. Patient follow-up was completed on June 25, 2024. Four weeks after initiation of mometasone furoate nasal spray, 100 µg in each nostril daily, patients were randomized to receive subcutaneous stapokibart, 300 mg, or placebo (1:1) every 2 weeks for 24 weeks. Both groups then received stapokibart for 28 weeks. Co–primary end points were changes from baseline in nasal polyp score (meaningful change threshold [MCT] ≥1 point) and nasal congestion score (MCT ≥0.5 points) at week 24 in all patients and in the population with eosinophilia. Among 180 patients randomized, 179 (mean age, 45 [SD, 12.9] years; 61 [34.1%] women) received at least 1 treatment dose (n = 90 for stapokibart; n = 89 for placebo). In the overall population, the least-squares (LS) mean change in nasal polyp score from baseline to week 24 in the stapokibart vs placebo groups was −2.6 vs −0.3 points, respectively, (LS mean difference, −2.3; 95% CI, −2.6 to −1.9; P < .001); in the population with eosinophilia, the change was −3.0 vs −0.4 points, respectively (LS mean difference, −2.5; 95% CI, −2.9 to −2.1; P < .001). The LS mean change in nasal congestion score from baseline to week 24 in the stapokibart vs placebo groups was −1.2 vs −0.5 points, respectively, in the overall population (LS mean difference, −0.7; 95% CI, −0.9 to −0.5; P < .001) and −1.3 vs −0.5 points, respectively, in the population with eosinophilia (LS mean difference, −0.8; 95% CI, −1.0 to −0.6; P < .001). Serious adverse events were rare (2.2% in the stapokibart group vs 1.1% in the placebo group). Higher rates of arthralgia (7.8% vs 0%) and hyperuricemia (5.6% vs 1.1%) were reported with stapokibart vs placebo, respectively. Among patients with severe chronic rhinosinusitis with nasal polyps treated with a daily intranasal corticosteroid, stapokibart reduced polyp size and severity of nasal symptoms at 24 weeks. ClinicalTrials.gov Identifier: NCT05436275

Objective:To observe the effects of 0.01% atropine eye drops on ocular biometrics in myopic adolescents.Methods:A prospective cohort study was conducted.Two hundred and nineteen myopic adolescents who visited the First Affiliated Hospital of Zhengzhou University from June 2016 to June 2017 and completed the 1-year follow-up on time were enrolled.The 219 adolescents were divided into a 0.01% atropine+ single-vision spectacles (SV) group (119 cases) wearing single-vision spectacles with one drop of atropine eye drop applied to both eyes once nightly, and a simple SV group (100 cases) wearing SV only.Axial length (AL), corneal power and anterior chamber depth were measured with the IOLMaster.Lens power was calculated using the Bennett-Rabbetts formula.Intraocular pressure was measured by non-contact tonometry.Spherical equivalent (SE) was examined by cycloplegic autorefraction.Total astigmatism and corneal astigmatism were calculated by vector decomposition.The right eye data were analyzed to compare the ocular biometrics changes between the two groups, and multiple linear regression analysis was used to evaluate the influencing factors.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of First Affiliated Hospital of Zhengzhou University (No.2016-35). Written informed consent was obtained from guardians before any medical examination.Results:The SE change and AL elongation 12 months after treatment in 0.01% atropine+ SV group were (-0.47±0.45) D and (0.37±0.22) mm, respectively, which were significantly lower than (-0.70±0.60)D and (0.46±0.35)mm in simple SV group ( t=5.523, 9.651; both at P<0.001). There were significant differences in SE and AL between before and after treatment in both groups (SE: Fgroup=1.556, P=0.015; Ftime=12.538, P=0.002; AL: Fgroup=3.425, P=0.021; Ftime=18.235, P=0.008). The SE and AL at 4, 8 and 12 months after treatment were all increased in comparison with before treatment in both groups, showing statistically significant differences (all at P<0.001). The SE and AL at 8 and 12 months after treatment in 0.01% atropine+ SV group were smaller than in simple SV group, and the differences were statistically significant (all at P<0.001). At 8 and 12 months after treatment, total astigmatism and the anterior chamber depth were increased and the lens power was decreased in comparison with before treatment in both groups, and the differences were statistically significant (all at P<0.05). There was no significant difference in corneal astigmatism, corneal power and intraocular pressure at different time points before and after treatment between the two groups (all at P>0.05). In the multiple linear regression analysis, an equation of Δmyopic SE=-0.012-2.685×ΔAL-1.002×Δcorneal astigmatism-0.656×Δlens power+ 0.477×Δtotal astigmatism+ 0.363×Δanterior chamber depth-0.060×age+ 0.011×sex was used, showing the change of SE was mainly caused by the change of AL ( β=-2.685), then corneal power, lens power, total astigmatism and anterior chamber depth. Conclusions:In adolescents, 0.01% atropine eye drops can effectively retard myopia progression and axial elongation, showing no effect on astigmatism, corneal power, lens power, anterior chamber depth and intraocular pressure.The controlling effect of 0.01% atropine eye drops in the development of myopia is mainly achieved by reducing axial elongation.

目的 探讨腹腔镜下射频消融术(LRFA)联合静脉化疗在肝癌患者中的应用效果.方法 82例肝癌患者随机分为两组各41例,对照组予以静脉化疗,观察组予以LRFA联合静脉化疗,比较两组的血清肿瘤标志物、肝功能、并发症.结果 治疗后,观察组的血清肿瘤标志物[肝癌高表达基因10(PEG10)、甲胎蛋白(AFP)、糖蛋白抗原19(CA19)]以及肝功能指标[谷草转氨酶(AST)、丙氨酸氨基转移酶(ALT)]水平均低于对照组(P<0.05).两组的并发症发生率比较,差异无统计学意义(P>0.05).结论 LRFA联合静脉化疗治疗肝癌患者的效果确切,可消除癌细胞,恢复肝功能,且并发症较少.

This study aims to evaluate the efficacy of 0.01

目的 分析全程护理管理模式对胆管结石患者术后自我护理管理及心理健康水平的影响.方法 选取郑州人民医院2020年10月至2021年10月收治的80例行手术治疗的胆管结石患者为研究对象,利用随机数字表法分为两组,各 40 例.对照组实施常规护理模式,观察组实施全程护理管理模式,比较两组患者自我护理管理评分、焦虑评分、抑郁评分、感染发生率差异.结果 护理前,两组患者的自我护理管理评分、焦虑评分、抑郁评分比较,差异无统计学意义(P＞0.05);护理后,自我护理管理评分高于护理前,焦虑评分、抑郁评分低于护理前,且观察组的自我护理管理评分高于对照组,焦虑评分、抑郁评分低于对照组,差异有统计学意义(P＜0.05).观察组的感染发生率(2.50％)低于对照组(10.00％),差异有统计学意义(P＜0.05).结论 全程护理管理模式能够提升胆管结石患者术后自我护理管理能力,改善其心理健康水平,降低感染发生率.

Objective:To observe the safety and efficacy of 0.01% atropine eye drops in the prevention of myopia onset in schoolchildren.Methods:A randomized double-blind controlled study was conducted.Sixty Chinese Han children (60 eyes) with binocular spherical equivalent (SE) between + 0.50 D and -0.75 D (pre-myopia) by cycloplegic autorefraction treated in The First Affiliated Hospital of Zhengzhou University were enrolled from July to October 2020.Aged 6-12 years old, the children were divided into 0.01% atropine group and control group according to a random number table, with 30 cases (30 eyes) in each group.The children were given one drop of 0.01% atropine or placebo eye drops in both eyes once a night.The SE, axial length (AL), accommodative amplitude and pupil diameter were compared before and after 3-month, 6-month of treatment between the two groups.Discomforts were recorded.This study adhered to the Declaration of Helsinki.The study protocol was approved by an Ethics Committee of The First Affiliated Hospital of Zhengzhou University (No.2020-KY-286). Written informed consent was obtained from guardian of each subject.Results:After treatment, 26 and 25 subjects completed the 6-month follow-up in 0.01% atropine group and control group, respectively, among which 3 subjects in 0.01% atropine group accounting for 11.5% and 9 in control group accounting for 36.0% developed myopia, showing a statistically significant difference ( χ2=4.238, P=0.040). There were significant differences in the overall comparison of SE and AL at different time points between before and after treatment ( Ftime=10.981, 81.854; both at P<0.001). At 3 and 6 months after treatment, there were significant increases in the SE and AL of control group and AL of 0.01% atropine group compared with respective baseline values (all at P<0.05). There was no significant difference in SE at 3 and 6 months after treatment compared with baseline SE in 0.01% atropine group (both at P>0.05). At 6 months after treatment, the change in SE in 0.01% atropine group was (-0.15±0.26)D, which was significantly less than (-0.34±0.35)D in control group, and the change in AL in 0.01% atropine group was (0.17±0.11)mm, Which was significantly shorter than (0.28±0.14)mm in control group, with significant differences between them ( t=2.207, P=0.032; t=3.127, P=0.003). There were significant differences in pupil diameter at different time points between before and after treatment ( Ftime=2.263, P=0.032). At 3 and 6 months after treatment, the pupil diameter was increased in comparison with baseline in 0.01% atropine group (both at P<0.05). There were significant differences in accommodative amplitude at different time points between before and after treatment in the two groups ( Fgroup=0.882, P=0.042; Ftime=0.337, P=0.033). The accommodative amplitude at 3 and 6 months after treatment were decreased in comparison with baseline in 0.01% atropine group and control group at corresponding time points (all at P<0.05). Within a month after treatment, photophobia in bright sunlight occurred in 5 cases in 0.01% atropine group, accounting for 16.7%(5/30), and 2 cases in control group, accounting for 6.7%(2/30), showing no significant difference ( χ2=0.647, P=0.421). No near-vision blur and other uncomfortable symptoms was found in the two groups. Conclusions:After 6-month application of 0.01% atropine eye drops, the prevalence of myopia in pre-myopia schoolchildren decreases and the changing rate of SE and AL slows down.The accommodative amplitude is slightly reduced and pupil diameter is slightly increased, with no obvious effects on study and life.

AIM:To evaluate the safety and efficacy of 0.005% atropine eye drops on myopia control in children with low myopia. METHODS: Prospective one-year controlled study. One hundred and sixteen children with low myopia were divided into two groups(0.005% atropine group and control group)according to the requirements of children and their guardians. The children(n=58)in the 0.005% atropine group wore single-vision(SV)spectacles, with one drop of 0.005% atropine eye drop applied to both eyes once nightly. The children(n=58)in the control group only wore SV spectacles. Repeated measurements of spherical equivalent refractive errors(SERs), axial length(AL), pupil diameter and accommodative amplitude were performed at baseline, and 4, 8 and 12mo after treatment. The discomfort symptoms were also observed.RESULTS: There were no significant increase shown in change in SERs and AL from baseline to 12mo in the 0.005% atropine group and control group(P<0.05). There were differences in the change in SERs and AL between two groups, but either the change in SERs or change in AL failed to reach statistical significance(P>0.05). Statistically significant differences were all found in pupil diameter increase and accommodative amplitude decrease between two groups( P<0.01). Six eyes(10.3%)were mild photophobic in the early stage in the 0.005% atropine group. Photophobia disappeared in 4 and 2 eyes after using 0.005% eye drops 2 and 4wk, respectively. No children showed any other discomfort symptoms such as blurred vision or allergy in the two groups.CONCLUSION: Compared to wear SV spectacles alone, regular application of 0.005% atropine could somewhat control the progression of myopia in children with low myopia. However, its clinical effect was not obvious.

目的 探讨经皮经肝胆囊穿刺引流术(PTGBD)联合早期腹腔镜胆囊切除术(LC)治疗高危急性胆囊炎的短期疗效.方法 选取本院2019年10月至2021年10月经手术治疗的高危急性胆囊炎患者90例,按随机数表法分为观察组(45例)和对照组(45例).对照组采取早期LC手术治疗,观察组行PTGBD联合早期LC手术治疗,比较两组围术期指标;比较两组术前、术后24 g时炎症指标[C反应蛋白(CRP)、白细胞介素(IL)-6、肿瘤坏死因子(TNF)-α];术后住院期间,比较两组并发症发生率.结果 两组患者的手术时间比较差异无统计学意义(P＞0.05);观察组术中出血量少于对照组,差异有统计学意义(P＜0.05),术后进食时间、住院时间均低于对照组,差异有统计学意义(P＜0.05).与术前相比,术后24h,两组患者的血清CRP、IL-6、TNF-α水平升高,差异有统计学意义(P＜0.05),观察组上述炎症指标均低于对照组,差异有统计学意义(P＜0.05).观察组与对照组的术后并发症总发生率比较差异无统计学意义(P＞0.05).结论 PTGBD联合早期LC治疗高危急性胆囊炎可减少术中出血量,缩短术后康复时间,且不会增加术后炎症反应,利于改善康复质量.

Objective:To compare the clinical efficacy and safety of 0.01% and 0.02% atropine eye drops on myopia development in adolescents.Methods:A randomized controlled double-blind study was carried out.Two hundred and eighty myopic adolescents (280 eyes) with spherical equivalent (SE) from -1.25 to -6.0 D were enrolled in The First Affiliated Hospital of Zhengzhou University from June 2016 to June 2017.All the subjects wore full-correction single vision spectacle lenses before topical administration of atropine eye drops.The subjects were randomly divided into 0.01% atropine group (142 eyes) and 0.02% atropine group (138 eyes) according to the random number table method.Atropine 0.01% or 0.02% eye drops was topically used in the test eye once per night according to grouping, and the related parameters of the right eyes were collected for data analysis.The subjects were followed up at the 1st, 4th, 8th and 12th month following administration.The SE was measured with an autorefractor to evaluate the refractive change.The anterior chamber depth, corneal curvature and axial length (AL) were measured with an IOLMaster.The adverse responses of atropine eye drops were investigated via a questionnaire.This study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of The First Affiliated Hospital of Zhengzhou University (No.2016-35). Written informed consent was obtained from subjects and their guardian prior to entering the cohort.Results:The follow-up rate of 0.01% atropine group was 83.8%, and the follow-up rate of 0.02% atropine group was 84.8% at the end of following-up.SE and AL increased by (-0.47±0.32)D and (0.37±0.20)mm in 0.01% atropine group, and (-0.38±0.35)D and (0.30±0.17)mm in 0.02% atropine groups during the following-up, respectively, showing statistically significant differences between two groups ( P=0.040, 0.004). After adjusting age, body mass index and baseline SE, the analysis by generalized additive mixed model showed that the increase rate of SE was -0.039 D/month and -0.032 D/month in 0.01% and 0.02% atropine group, respectively ( Pinteraction=0.041). After adjusting age, body mass index and baseline AL, the analysis of mixed effect model showed that the increase rate of AL was 0.031 mm/month and 0.025 mm/month in 0.01% and 0.02% atropine group, respectively ( Pinteraction=0.032). In 0.01% and 0.02% atropine groups, 32 cases (26.9%) and 33 cases (28.2%) occurred photophobia from 1st to 4th week during administration, and 7 cases (5.9%) and 7 cases (6.0%) appeared near-vision blur from 2nd to 4th week.Allergic response occurred in 0.01% atropine group at 1 month of treatment, and the symptom disappeared after interruption of the medication for two days. Conclusions:The incidence of adverse resoponses of 0.01% and 0.02% atropine eye drops is similar.Atropine 0.02% eye drops is more effective in controlling myopia progression.

目的 比较吲哚菁绿(indocyanine green,ICG)荧光定位腔镜下甲状旁腺全切术与开放甲状旁腺全切术对慢性肾功能衰竭继发甲状旁腺功能亢进(hyperparathyroidism,HPT)患者术后心功能影响的差异.方法 2019年4月～2020年6月我院25例慢性肾功能衰竭继发性HPT接受ICG荧光定位腔镜下甲状旁腺全切术作为腔镜组,24例慢性肾功能衰竭继发性HPT接受开放甲状旁腺全切术作为开放组,比较2组患者手术前后血钙、血磷、甲状旁腺素(parathyroid hormone,PTH)、血红蛋白、N末端B型钠尿肽前体(N-terminal pro-B-type natriuretic peptide,NT-pro-BNP),以及心脏超声重要参数.结果 术后3个月2组比较PTH、血钙、血磷差异有显著性(P<0.05),血红蛋白差异无显著性(P>0.05).与术前比较,腔镜组术后3个月血磷、PTH、血红蛋白、血钙均明显改善(P<0.05),开放组血磷、PTH、血红蛋白明显改善(均P=0.000).与术前比较,术后3个月2组NT-pro-BNP均显著下降(P<0.05),腔镜组下降更为显著.术后3个月2组比较左心室舒张末内径(left ventricular end diastolic diameter,LVEdD)、左心室收缩末内径(left ventricular end systolic diameter,LVEsD)、射血分数(ejection fraction,EF)、左心室短轴收缩率(fraction shortening,FS)差异均有显著性(P<0.05).腔镜组术前与术后3个月LVEdD、LVEsD、EF、左心室FS差异均有显著性(P<0.05);开放组术前与术后3个月LVEdD、EF、左心室FS差异有显著性(P<0.05),LVEsD差异无显著性(P>0.05).结论 甲状旁腺全切术能显著改善继发性HPT患者心功能及心脏内径、收缩功能变化,且ICG荧光定位腔镜下手术较常规开放手术获益更大.

目的 分析显微夹闭手术时机对脑动脉瘤破裂出血的疗效影响.方法 选取2018年1月至2020年1月期间接收的脑动脉瘤破裂出血患者86例进行回顾性分析研究,所有患者均行脑动脉瘤显微夹闭手术治疗,其中于动脉瘤破裂出血<72 h予以手术治疗的44例患者作为<72 h组,于动脉瘤破裂出血≥72 h进行手术治疗42例患者作为≥72 h组,术后对纳入病例随访3个月,依据GOS预后结局评估量表评估预后.比较两组的手术耗时、手术中失血量、住院时长、术后并发症发生状况以及术后3个月的预后状况.结果 两组手术时长、手术失血量、住院时长相比较,差异无统计学意义(P>0.05);<72 h组并发症发生率显著低于≥72 h组(P<0.05);<72 h组预后状况优于≥72 h组(P<0.05).结论 与脑动脉瘤出血≥72 h行显微夹闭术相比,在脑动脉瘤出血<72 h行显微夹闭术治疗的脑动脉瘤破裂出血患者,可明显改善预后,降低术后并发症的发生风险.

Objective:To prepare vorinostat encapsulated hydroxypropyl-β-cyclodextrin (SAHA-CD) eye drops and investigate its inhibitory effect on corneal neovascularization (CNV) induced by alkali burns in mouse.Methods:The SAHA-CD eye drops at concentrations of 0.1%, 0.2%and 0.4%were prepared by inclusion technology with hydroxypropyl-β-cyclodextrin, and the content was assayed by high performance liquid chromatography.Seventy-five SPF mice with alkali burn-induced CNV were randomized into 0.1%SAHA-CD group, 0.2%SAHA-CD group, 0.4%SAHA-CD group, dexamethasone group and normal control group according to a random number table, 15 for each group, among which the SAHA-CD groups and dexamethasone group were treated with corresponding drugs, and model control group was treated with normal saline immediately after modeling, four times a day and five microliters each time, lasting for six days.The healing of corneal epithelium was examined with a slit lamp microscope after fluorescein sodium staining, and the areas of cornea epithelial defects were calculated using Eyestudio software.The corneal flat mount was prepared, and the length and areas of CNV were calculated with ImageJ software.The histology of mouse corneas was observed through hematoxylin and eosin staining.The expression level of vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF) and matrix metalloproteinase-9 (MMP-9) in cornea were measured with enzyme linked immunosorbent assay (ELISA) kits.The use and care of animals complied with the ARVO statement and this study protocol was approved by the Experimental Animal Ethics Committee of Henan Eye Institute (No.HNEECA-2020-01).Results:The actual drug contents of the 0.1%, 0.2% and 0.4%SAHA-CD eye drops were 97.62%, 98.33%and 98.14%of the labeled amount.The cornea showed edema and opacification after modeling.On the sixth day after treatment, significant differences were found in the length and areas of CNV among various groups ( F=7.655, 8.802; both at P<0.01).The areas of CNV in 0.2%SAHA-CD, 0.4%SAHA-CD and dexamethasone groups were significantly smaller than model control group, and the length of CNV in 0.1%SAHA-CD, 0.2%SAHA-CD and dexamethasone groups were significantly smaller than model control group (all at P<0.05).On the third and sixth day following modeling, significant differences in the expression levels of VEGF, bFGF and MMP-9 were found among the five groups (third day: F=6.345, 7.149, 18.650; all at P<0.01; sixth day: F=6.749, 5.105, 5.023; all at P<0.01), and the expression levels of VEGF, bFGF and MMP-9 in 0.2%SAHA-CD group were significantly lower than those in 0.1%SAHA-CD group, 0.4%SAHA-CD group and model control group (all at P<0.05). Conclusions:SAHA-CD eye drops can inhibit alkali burn-induced CNV in mouse.

目的 探讨腹腔镜下钬激光碎石术对肝内外胆管结石患者应激反应及术后并发症的影响.方法 回顾性分析我院普外科2017年12月～2019年12月收治的80例肝内外胆管结石患者的临床资料,将采用腹腔镜下网篮取石术治疗的患者归为对照组(38例),将采用腹腔镜下钬激光碎石术治疗的患者归为观察组(42例).对比两组患者围术期指标与术前、术后7d应激指标,以及术后并发症发生率.结果 与对照组相比,观察组手术用时、住院时间明显缩短,手术总出血量明显减少,差异有统计学意义(P<0.05).与术前比较,两组患者术后7d的β-内啡肽水平明显下降,生长激素水平明显上升(P<0.05);并且,观察组患者术后7d的β-内啡肽水平明显低于对照组,生长激素水平明显高于对照组,差异有统计学意义(P<0.05).与对照组相比,观察组术后并发症(胆管损伤、胆漏、胆管出血、结石残余)发生率明显降低,差异有统计学意义(P<0.05).结论 腹腔镜下钬激光碎石术在有效治疗肝内外胆管结石的同时,可有效缓解患者围术期应激反应,降低术后并发症发生率,促进患者康复,值得临床推广使用.

Objective:To compare the clinical effect of 0.02% atropine eye drops once every two days and 0.01% atropine eye drops once every day in myopia control and adverse reactions in children.Methods:A randomized controlled study was performed.The 231 Han nationality myopic children wearing full-corrected single-vision spectacle lenses enrolled from June 2016 to June 2017 in The First Affiliated Hospital of Zhengzhou University and Henan Eye Hospital were divided into two groups by random number table, with 110 children in the 0.02% atropine group and 121 children in the 0.01% atropine group.The subjects were treated with 0.02% atropine eye drops once every two days or 0.01% atropine eye drops once every day to each eye before bedtime for one year.Ninety-two cases and 101 cases were followed up for one year in the 0.02% and 0.01% atropine group, respectively.The right eyes were selected as experimental eyes, and the spherical equivalent refraction (SER), axial length (AL), amplitude of accommodation (AMP), pupil diameter (PD), anterior chamber depth (ACD), and corneal curvature were recorded at baseline and 12 months after treatment.Discomfort symptoms were also observed during the 1-year follow-up.The study protocol was approved by an Ethics Committee of The First Affiliated Hospital of Zhengzhou University (No.2016-35). Written informed consent was obtained from guardians prior to any treatment.Results:After 1 year of treatment, the mean SER change was (-0.46±0.49)D and (-0.48±0.46)D, and the mean AL change was (0.38±0.21)mm and (0.39±0.19)mm, and the mean AMP change was (-1.49±0.29)D and (-1.61±0.26)D, and the mean PD change was (0.72±0.44)mm and (0.70±0.40)mm in the 0.02% atropine group and 0.01% atropine group, respectively.There was no significant difference in the change of SER, AL, AMP, PD between the two groups (all at P>0.05). There were 21 cases (19.1%) in the 0.02% atropine group and 25 cases (20.7%) in the 0.01% atropine group that represented mild photophobia in bright sunlight, which disappeared in 12 and 13 cases during 1-6 months respectively.The photophobia symptoms of the remaining children were alleviated.There existed 5 cases (4.5%) and 6 cases (5.0%) in the two groups that developed mild near blurred vision that lasted no more than 1 month. Conclusions:Compared with 0.01% atropine eye drops once a day, 0.02% atropine once every two days has the same efficacy on controlling myopia progression in children with no more adverse reactions.

目的 探讨保胆取石术后口服牛磺熊去氧胆酸预防结石复发的疗效与价值.方法 选取2018年4月-2020年4月期间郑州人民医院普外三科收治的80例胆结石患者为研究对象,患者均行保胆取石术治疗,采用双色球抽签的方式将患者分至两组中,其中抽取红色球及绿色球的患者分别分至对照组与观察组中,每组各40例,对照组术后口服熊去氧胆酸治疗,观察组术后口服牛磺熊去氧胆酸治疗,对比两组患者术后2年胆囊壁厚度及胆囊收缩功能,记录患者不同时期结石复发率及症状复发率.结果 术前观察组胆囊厚度(3.16±0.69)mm较对照组胆囊壁厚度(3.18±0.72)mm无统计学意义(P＞0.05).术后2年两组患者的胆囊壁厚度均得以减小,观察组减小幅度(0.58±0.12) mm大于对照组减少幅度(0.14±0.05) mm,且差异具有统计学意义(P＜0.05).术后2年两组患者胆囊收缩功能对比,观察组胆囊排空指数(56.32±10.58)明显优于对照组胆囊排空指数(45.65±14.34),差异具有统计学意义(P＜0.05).随访2年观察组结石复发率(12.50％)低于对照组结石复发率(32.50％),差异具有统计学意义(P＜0.05).观察组症状复发率(7.50％)低于对照组(12.50％),差异无统计学意义(P＞0.05).结论 术后口服牛磺熊去氧胆酸能改善胆囊收缩功能,缩小胆囊壁厚度,减少保胆取石术后结石复发及症状复发的情况,具有极高的临床使用价值.

目的 探讨腔镜下吲哚菁绿荧光定位下甲状旁腺全切除术联合或不联合自体移植治疗继发性甲状旁腺功能亢进的临床效果.方法 回顾分析我院2019年1月～2020年9月42例因继发性甲状旁腺功能亢进行腔镜下吲哚菁绿荧光定位下甲状旁腺全切术联合或不联合自体移植的临床资料,根据患者有无肾移植意愿分为腔镜下甲状旁腺全切组(n=20)和腔镜下甲状旁腺全切+自体移植组(n=22),比较2组患者术后临床症状缓解情况、围手术期并发症及血钙、血磷、甲状旁腺激素(parathyroid hormone,PTH)的变化情况.结果 42例均在腔镜下完成手术,围手术期无死亡.2组患者麻醉清醒后均诉骨痛及皮肤瘙痒完全缓解.腔镜下甲状旁腺全切组手术时间明显短于腔镜下甲状旁腺全切+自体移植组[(228.2±40.3)min vs.(268.0±48.2)min,t=-2.892,P=0.006],住院时间明显长于腔镜下甲状旁腺全切+自体移植组[(18.2±1.6)min vs.(11.8±2.9)min,t=8.985,P=0.000].2组出血量、术后声音嘶哑发生率无统计学差异(P>0.05).随访期内,腔镜下甲状旁腺全切+自体移植组术后2例PTH升高超过术前水平,且再次出现骨痛及皮肤瘙痒症状,腔镜下甲状旁腺全切组未见复发.血钙组间、时间及组别与时间的交互作用均无统计学差异(P>0.05).血磷组间无统计学差异(P>0.05),不同时间点有统计学差异(P<0.05),但组别与时间无交互作用(P>0.05).PTH组别与时间无交互作用(P>0.05),但组间、时间差异有显著性(P<0.05),腔镜下甲状旁腺全切术+自体移植组PTH明显高于腔镜下甲状旁腺全切术组(P<0.05),且2组PTH术后1、6个月明显高于术后2周(P<0.05).结论 腔镜下甲状旁腺全切术联合或不联合自体移植治疗药物控制欠佳的难治性继发性甲状旁腺功能亢进安全、有效,腔镜下甲状旁腺全切术复发率更低,甲状旁腺水平更低,且手术时间更短.

目的 探讨经皮经肝胆道镜(PTCS)硬镜碎石术治疗肝内胆管结石的效果.方法 回顾性分析2014-06—2019-06郑州人民医院普外科行手术治疗的127例肝内胆管结石患者的临床资料.按照不同术式分为开腹胆管切开取石术或胆肠吻合术组(对照组,62例)和PTCS硬镜碎石术组(观察组,65例).比较2组患者的基线资料、术中情况、术后临床指标;统计2组患者术后6个月内结石复发率.结果 2组患者的基线资料差异无统计学意义(P>0.05).观察组手术时间、术中出血量和术后肛门排气时间、并发症发生率、住院时间,以及随访期间内的结石复发率等指标均优于对照组,差异均有统计学意义(P<0.05).结论 与开腹胆管切开取石术或胆肠吻合术比较,PTCS硬镜碎石术治疗肝内胆管结石,具有手术创伤小,患者术后恢复快,结石复发率低等优势.

目的 探讨腔镜辅助甲状旁腺手术治疗继发性甲状旁腺功能亢进(甲旁亢)的疗效及安全性.方法 回顾性分析2018-02—2020-02郑州人民医院普外三科收治的95例继发性甲旁亢患者的临床资料.按术式不同分为对照组(46例,行开放手术)和观察组(49例,行腔镜辅助手术).比较2组患者的手术效果、并发症发生率,以及手术前后血清成纤维细胞生长因子23(FGF-23)、甲状旁腺激素(PTH)、钙、磷水平.结果 观察组手术时间长于对照组,术中失血量、术后引流量和住院时间短于对照组,差异均有统计学意义(P<0.05);2组并发症发生率差异无统计学意义(P>0.05).术后均获6～8个月随访,2组患者术后6个月时的血清FGF-23、PTH、磷水平均较术前降低,钙水平升高,差异无统计学意义(P>0.05).结论 腔镜辅助甲状旁腺手术和传统开放手术治疗继发性甲旁亢患者的效果相仿,但前者具有手术时间短、术中失血量和术后引流量少,以及住院时间短等优势,尤其因颈部无切口瘢痕,更符合部分患者的美容需求.

目的 探讨腹腔镜联合胆道镜下钬激光碎石取石术治疗肝外胆管结石的临床效果.方法 选取2017年6月至2020年6月我院收治的114例肝外胆管结石患者为研究对象,根据手术方式不同将其分为对照组(57例,腹腔镜下胆管切开取石术)和观察组(57例,腹腔镜联合胆道镜下钬激光碎石取石术).比较两组的治疗效果.结果 观察组手术时间、取石时间、胃肠功能恢复时间、住院时间均短于对照组,术中出血量少于对照组,结石清除率高于对照组(P<0.05).术后,两组TBIL、TBA、CB、UCB、ALT、AST、AKP、GGT水平均较术前降低,且观察组低于对照组(P<0.05).术后12、24 h,观察组VAS评分均低于对照组(P<0.05).观察组并发症总发生率低于对照组,治疗总有效率高于对照组(P<0.05).结论 腹腔镜联合胆道镜下钬激光碎石取石术治疗肝外胆管结石疗效显著,能有效优化手术及预后指标,降低患者血清胆汁生化指标和肝功能指标水平,减轻疼痛,降低并发症发生率,促进术后康复.

目的 探讨吲哚菁绿(indocyanine green,ICG)荧光定位在继发性甲状旁腺功能亢进患者腔镜甲状旁腺全切除术中的应用价值.方法 2019年1月～2020年1月,对20例因继发性甲状旁腺功能亢进行经胸前入路腔镜甲状旁腺全切除术中采用ICG荧光定位,将25 mg ICG溶解于10 ml灭菌注射用水,术中腔镜下发现疑似甲状旁腺后取2.5 ml于外周静脉快速推注,观察甲状旁腺显影特点,切除全部甲状旁腺,监测围手术期甲状旁腺激素、血钙的变化以判断是否完全切除腺体.结果 20例术中切除荧光显影定位疑似甲状旁腺腺体88枚,经术后病理证实为甲状旁腺组织共79枚(16例有4枚甲状旁腺,3例3枚,1例6枚),另外9枚为甲状腺组织.8枚肉眼未发现而使用荧光显影发现且经病理证实为甲状旁腺腺体.甲状旁腺从40 s开始显影,荧光显影高峰为70～100 s,持续至180 s开始消退;甲状腺从25 s开始显影,迅速达到高峰,持续至20 min后开始消退.切除甲状旁腺后20 min及术后2周甲状旁腺激素均明显低于术前水平.术后声音嘶哑2例,3个月恢复.术后均有低钙血症,积极静脉补钙、口服补钙及骨化醇后恢复.均随访半年,无复发.结论 继发性甲状旁腺功能亢进患者行腔镜甲状旁腺全切除术时,应用ICG荧光定位有助于提高甲状旁腺检出率,且安全可行.