MIBS

  • 文章类型: Journal Article
    目的:探讨假性剥脱性青光眼(PXG)的治疗效果是否对XEN-45凝胶支架植入术的影响。方法:回顾性分析,在三级中心接受XEN-45凝胶支架的30例PXG患者和55例假晶状体患者的比较队列研究。主要结果指标是两年成功率,定义为眼内压(IOP)降低≥20%,目标IOP为6-21mmHg。无论是否使用抗青光眼药物,成功都是完整且合格的。除针刺以外的其他青光眼手术被认为是失败的。次要结果指标包括眼压变化,翻修率和并发症发生率。结果:有晶状体组和假晶状体组的两年完全成功率分别为70%和59%,分别(p=0.75,对数秩检验),合格率分别为80%和72%,分别(p=0.89)。眼压从基线降低的中位数为54%,假晶状体眼占46%。虽然针刺率相似,有晶状体眼的早期切口出血翻修的发生率明显较高(13%vs.3个月内为0%;p=0.0098,卡方)。一年后增加,明显更多的假晶状体眼由于继发性青光眼手术而失败(16%vs.0%;p=0.0191)。结论:XEN-45凝胶支架为有晶状体和假晶状体患者提供同样有效的IOP控制。然而,两组间气泡修正的开始和继发性青光眼手术的必要性存在显著差异.
    Objectives: To investigate whether phakia affects the outcome of XEN-45 gel stent implantation in the treatment of pseudoexfoliative glaucoma (PXG). Methods: A retrospective, comparative cohort study of 30 phakic and 55 pseudophakic PXG patients who received the XEN-45 gel stent at a tertiary centre. The primary outcome measure was two-year success defined as a ≥20% lowering of intraocular pressure (IOP) and a target IOP of 6-21 mmHg. Success was complete without and qualified irrespective of antiglaucoma medication use. Further glaucoma surgery other than needling was regarded as a failure. The secondary outcome measures included changes in IOP, revision and complication rates. Results: The complete two-year success rates were 70% and 59% in the phakic and pseudophakic groups, respectively (p = 0.75, log-rank test), and the qualified rates were 80% and 72%, respectively (p = 0.89). The median IOP reduction from baseline was 54% in phakic, and 46% in pseudophakic eyes. While needling rates were similar, the incidence of early incisional bleb revisions was significantly higher in the phakic eyes (13% vs. 0% within 3 months; p = 0.0098, chi-square). Increasing after a year, significantly more pseudophakic eyes failed due to secondary glaucoma surgery (16% vs. 0%; p = 0.0191). Conclusions: The XEN-45 gel stent offers equally effective IOP control for both phakic and pseudophakic patients. However, the onset of bleb revisions and the necessity for secondary glaucoma surgery differed significantly between the groups.
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  • 文章类型: Journal Article
    背景:使用XEN-45凝胶支架的微创气泡手术尚未建立用于治疗正常眼压性青光眼(NTG)。这项研究的主要目的是评估XEN-45在非受控NTG眼中的长期治疗效果和安全性。
    方法:回顾性分析2016年至2021年在Tuebingen大学医院接受XEN-45凝胶支架植入术的NTG患者。主要结果指标是手术成功三年后定义为眼内压(IOP)降低≥20%,目标IOP在6和15mmHg之间。无论使用局部抗青光眼药物,成功都是完全的,并且是合格的。需要进一步的青光眼手术,除了针刺,被视为失败。次要结果指标包括平均IOP的变化,抗青光眼药物的数量,针刺和并发症的发生率。
    结果:23例患者的28只眼纳入最终分析。三年后,完全和合格的成功率分别为56.5%和75%,分别。术后平均眼压±标准差在三年后从基线时的19.3±2.0mmHg显著下降至13.7±4.2mmHg(n=22;p<0.0001)。抗青光眼药物的中位数量在三年后从2(范围0-4)降至0(范围0-3;p<0.0001)。16只眼睛(57%)需要中位数为1(范围1-3)的针刺程序。一只眼睛需要进一步的青光眼手术。未观察到危及视力的并发症。
    结论:XEN-45支架对于NTG的长期治疗是有效和安全的。然而,经常需要针刺来改善结果.
    BACKGROUND: Minimally invasive bleb surgery using the XEN-45 gel stent has not been established for the treatment of normal-tension glaucoma (NTG). The main objective of this study was to evaluate the long-term treatment efficacy and safety of XEN-45 in eyes with uncontrolled NTG.
    METHODS: A retrospective analysis of patients with NTG who underwent XEN-45 gel stent implantation at university hospital Tuebingen between 2016 and 2021. The primary outcome measure was surgical success after three years defined as lowering of intraocular pressure (IOP) of ≥ 20%, with target IOP between 6 and 15 mmHg. Success was complete without and qualified irrespective of topical antiglaucoma medication use. The need for further glaucoma surgery, except for needling, was regarded as a failure. The secondary outcome measures included changes in mean IOP, number of antiglaucoma medications, and needling and complication rates.
    RESULTS: Twenty-eight eyes from 23 patients were included in the final analysis. Complete and qualified success rates were 56.5% and 75% after three years, respectively. Mean postoperative IOP ± standard deviation decreased significantly after three years from 19.3 ± 2.0 mmHg at baseline to 13.7 ± 4.2 mmHg (n = 22; p < 0.0001). The median number of antiglaucoma medications decreased from 2 (range 0-4) to 0 after three years (range 0-3; p < 0.0001). Sixteen eyes (57%) required a median of 1 (range 1-3) needling procedures. One eye required further glaucoma surgery. No sight-threatening complications were observed.
    CONCLUSIONS: The XEN-45 stent is effective and safe for the long-term treatment of NTG. However, needling was frequently required to improve outcomes.
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  • 文章类型: Journal Article
    传统上,小梁切除术一直被认为是青光眼手术的金标准,但是最近的进步,包括PRESERFLO®MicroShunt,引入了侵入性较小的技术来减轻并发症并降低眼内压(IOP)。滤过手术后的气泡形态检查对于调节伤口愈合和确保长期成功至关重要。虽然先前对PRESERFLO产生的气泡的评估依赖于小梁切除术气泡的数据,PRESERFLO和小梁切除术中使用的不同手术技术提示了大泡形态的潜在变化.这项研究对PRESERFLO和小梁切除术产生的气泡进行了比较分析。使用JenaerBleb分级系统进行回顾性描述性评估,以及使用前节OCT的八维参数进行定量评估。我们包括93只眼睛(57只在PRESERFLO之后,小梁切除术后36)。在描述性评估中,PRESERFLO产生的气泡显示结膜囊肿较少(3.5%vs.22.2%,p=0.007)和海绵状变化(10.5%与30.5%,p=0.021)与小梁切除术相比。定量地,总体气泡尺寸相当(最大气泡高度,宽度,和长度,全部p>0.05)。然而,PRESERFLO气泡显示较浅(0.52±0.24vs.0.67±0.3mm,p=0.017)但更长(4.12±1.54vs.3.23±1.64mm,p=0.024)上巩膜湖。较厚的气泡壁(1.52±0.46vs.1.10±0.37mm,p<0.001)以及更多位于后部的气泡(到角膜缘的距离=6.16±1.36vs.4.87±1.34mm,在PRESERF2O之后观察到p<0.001)。这项研究阐明了PRESERFLO和小梁切除术气泡之间细微的形态学差异。理解这些区别至关重要,使临床医生能够做出明智的术后决定,并避免对泡形态的误解。
    Trabeculectomy has traditionally been upheld as the gold standard in glaucoma surgery, but recent advancements, including the PRESERFLO® MicroShunt, have introduced less invasive techniques to mitigate complications and reduce intraocular pressure (IOP). The examination of bleb morphology post-filtering surgery is critical for modulating wound healing and ensuring long-term success. While previous evaluations of PRESERFLO-generated blebs have relied on data from trabeculectomy blebs, the differing surgical techniques used in PRESERFLO and trabeculectomy surgeries suggest potential variations in bleb morphologies. This study conducted a comparative analysis of blebs resulting from PRESERFLO and trabeculectomy procedures. Retrospective descriptive assessments using the Jenaer Bleb Grading System were performed, along with quantitative evaluation using eight-dimensional parameters utilizing anterior segment OCT. We included 93 eyes (57 following PRESERFLO, 36 following trabeculectomy). In the descriptive assessment, PRESERFLO-generated blebs exhibited fewer conjunctival cysts (3.5% vs. 22.2%, p = 0.007) and cavernous changes (10.5% vs. 30.5%, p = 0.021) compared to trabeculectomy. Quantitatively, overall bleb dimensions were comparable (maximal bleb height, width, and length, p > 0.05 for all). However, PRESERFLO blebs displayed a shallower (0.52 ± 0.24 vs. 0.67 ± 0.3 mm, p = 0.017) yet longer (4.12 ± 1.54 vs. 3.23 ± 1.64 mm, p = 0.024) episcleral lake. A thicker bleb wall (1.52 ± 0.46 vs. 1.10 ± 0.37 mm, p < 0.001) along with more posteriorly positioned blebs (distance to limbus = 6.16 ± 1.36 vs. 4.87 ± 1.34 mm, p < 0.001) were observed following PRESERFLO. This study illuminates the nuanced morphological differences between PRESERFLO and trabeculectomy blebs. Understanding these distinctions is vital, empowering clinicians to make informed postoperative decisions and avoid misinterpretation of bleb morphology.
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  • 文章类型: English Abstract
    近年来,随着称为MIGS(微创青光眼手术)的新手术技术的出现,青光眼的手术管理得到了丰富。这些新技术的目的是降低眼内压(IOP),同时限制常规滤过手术并发症的风险并允许更快的视觉恢复。根据用于促进房水流出的途径,MIGS可以分为三大类:小梁途径,脉络膜上途径和结膜下途径。使用结膜下途径的MIGS也称为微创性泡手术(MIBS)。这些新技术不能取代传统的过滤手术,这仍然是黄金标准技术,但现在为青光眼患者的手术管理提供了新的替代方案,联合白内障手术或作为独立手术。
    The surgical management of glaucoma has been enriched in recent years by the arrival of new surgical techniques as a group known as MIGS (minimally invasive glaucoma surgery). The objective of these new techniques is to reduce intraocular pressure (IOP) while limiting the risk of complications of conventional filtering surgery and allowing faster visual recovery. MIGS can be classified into three main categories depending on the route used to promote the outflow of aqueous humor: the trabecular route, the suprachoroidal route and the subconjunctival route. MIGS using the subconjunctival route are also called minimally invasive bleb surgery (MIBS). These new techniques do not replace conventional filtering surgery, which remains the gold standard technique, but now offer new alternatives for the surgical management of glaucoma patients in combination with cataract surgery or as stand-alone procedures.
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  • 文章类型: Journal Article
    电化学储能(EES)系统的快速增长需要使用创新、高性能电极材料。在各种EES设备中,可再充电电池(RB)具有高能量密度和延长寿命等潜在特征,非常适合满足快速增长的能源需求。层状过渡金属二硫属化合物(TMDs),典型的二维(2D)纳米材料,由于它们的层状结构和大的比表面积(SSA)有利于快速离子运输,因此被认为是RB的吉祥材料。这篇综述总结并强调了TMD的最新进展,这些TMD具有各种RB的改进性能。通过用于高性能RB的新型工程和功能化,我们简要讨论了属性,表征,和TMD的电化学现象。我们总结了采用多种技术的工程,像用于TMD的纳米复合材料受到特别关注。总之,讨论了开发基于TMD的RB电极的最新问题和有希望的研究机会。
    The fast growth of electrochemical energy storage (EES) systems necessitates using innovative, high-performance electrode materials. Among the various EES devices, rechargeable batteries (RBs) with potential features like high energy density and extensive lifetime are well suited to meet rapidly increasing energy demands. Layered transition metal dichalcogenides (TMDs), typical two dimensional (2D) nanomaterial, are considered auspicious materials for RBs because of their layered structures and large specific surface areas (SSA) that benefit quick ion transportation. This review summarizes and highlights recent advances in TMDs with improved performance for various RBs. Through novel engineering and functionalization used for high-performance RBs, we briefly discuss the properties, characterizations, and electrochemistry phenomena of TMDs. We summarised that engineering with multiple techniques, like nanocomposites used for TMDs receives special attention. In conclusion, the recent issues and promising upcoming research openings for developing TMDs-based electrodes for RBs are discussed.
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  • 文章类型: Journal Article
    未经授权:母婴关系是支持婴儿社会情感发展的重要因素。因此,每个家庭成员都应该承认这些过程,尤其是在印度尼西亚这样的大家庭中。一般研究目标是预测印尼样本中与母婴结合相关的几种社会人口统计学因素。
    UNASSIGNED:这是一项横断面研究。参与者包括168名母亲,他们有0至36个月的婴儿,并愿意通过签署知情同意书加入研究。对所有母亲都进行了印度尼西亚版的母婴联系量表和社会人口调查问卷。Logistic回归用于确定与母婴结合量表有任何关联的社会人口统计学因素。使用SPSS程序版本21forMac分析数据。
    UNASSIGNED:研究表明,13.1%的参与者被归类为中度至高度的母婴结合受损。Logistic回归分析显示,与剖宫产相比,阴道分娩或正常分娩方式表现出低水平母婴结合受损的可能性是4.07倍(95%CI[1.27,13.09])。该模型解释了母婴结合受损的差异的18.6%(NagelkerkeR2),并准确地分类了86.9%的病例。
    UNASSIGNED:这些发现支持先前在几个国家进行的研究。支持母婴结合的心理教育可能包括几个主题,如阴道分娩方式的优势和家庭支持的重要性。它可能在成年早期交付,希望,这些时期的基本知识可能有助于加强所有家庭成员对母婴二元问题的理解。
    Mother-infant bonding is an important factor that supports an infant\'s socio-emotional development. Therefore, every family member should acknowledge these processes, especially in an extended family set-up like in Indonesia. The general study objective was to predict several socio-demographic factors associated with mother-infant bonding in Indonesian samples.
    This is a cross-sectional study. The participants included 168 mothers who had infants aged 0 to 36 months and willingly joined the study by signing the informed consent form. The Indonesian version of mother-infant bonding scale and a socio-demographic questionnaire were administered to all mothers. Logistic regression was applied to identify the socio-demographic factors that had any association with the mother-infant bonding scale. The data were analyzed using the SPSS program version 21 for Mac.
    The study showed that 13.1% of the participants were categorized as having a moderate-to-high level of impaired mother-infant bonding. Logistic regression analysis showed that vaginal or normal delivery mode was 4.07 (95% CI [1.27, 13.09]) times more likely to exhibit low levels of impaired mother-infant bonding compared to a cesarean section. The model explained 18.6% (Nagelkerke R2) of the variance in impaired mother-infant bonding and accurately classified 86.9% of cases.
    The findings support prior studies that have been conducted in several countries. Psychoeducation on supporting mother-infant bonding may consist of several topics, such as the advantages of vaginal delivery mode and the importance of family support. It may be delivered in the early adulthood period and, hopefully, basic knowledge during those periods may help strengthen the understanding of mother-infant dyad issues among all family members.
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  • 文章类型: Journal Article
    目的:产后抑郁症是众所周知的危险因素,产后焦虑和产次是潜在的危险因素,母婴结合障碍。然而,很少有研究关注这些因素与母婴联系之间的关系。这项横断面研究探讨了抑郁症之间的关联,焦虑和平价,和母婴结合。
    方法:日本母亲,初产妇和多段产妇,分娩后1个月完成母婴结合量表(MIBS)和医院焦虑抑郁量表(HADS)。我们使用正向选择方法进行了逐步多元回归分析,以评估HADS焦虑和抑郁评分以及作为自变量的胎次对作为因变量的母婴结合的影响。
    结果:共有2379名日本母亲(1116例初产妇和1263例初产妇)参加了这项研究。初产妇的MIBS评分(2.89±2.68vs1.60±2.11;p<0.0001)明显高于多段产妇。初产妇的HADS焦虑(6.55±4.06vs4.63±3.41;p<0.0001)和抑郁(6.56±3.43vs5.98±3.20;p<0.0001)评分也显着高于多段产妇。使用正向选择方法进行的逐步多元回归分析显示,HADS抑郁和焦虑评分以及胎次与MIBS评分显着相关(p=0.003、0.015和0.023)。
    结论:抑郁症,焦虑和初产与分娩后1个月的母婴关系呈负相关。
    OBJECTIVE: Postpartum depression is a well-known risk factor, and postpartum anxiety and parity are potential risk factors, for mother-infant bonding disorder. However, few studies have focused on the relationships among these factors and mother-infant bonding. This cross-sectional study explored the associations between depression, anxiety and parity, and mother-infant bonding.
    METHODS: Japanese mothers, both primiparas and multiparas, completed the Mother-to-Infant Bonding Scale (MIBS) and the Hospital Anxiety and Depression Scale (HADS) one month after childbirth. We performed a stepwise multiple regression analysis with the forward selection method to assess the effects of HADS anxiety and depression scores and parity as independent variables on mother-infant bonding as the dependent variable.
    RESULTS: A total of 2379 Japanese mothers (1116 primiparas and 1263 multiparas) took part in the study. MIBS score (2.89 ± 2.68 vs 1.60 ± 2.11; p < 0.0001) was significantly higher in primiparas than in multiparas. HADS anxiety (6.55 ± 4.06 vs 4.63 ± 3.41; p < 0.0001) and depression (6.56 ± 3.43 vs 5.98 ± 3.20; p < 0.0001) scores were also significantly higher in primiparas than in multiparas. A stepwise multiple regression analysis with the forward selection method revealed that HADS depression and anxiety scores and parity were significantly associated with MIBS score (p = 0.003, 0.015 and 0.023).
    CONCLUSIONS: Depression, anxiety and primiparity were negatively associated with mother-infant bonding one month after childbirth.
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  • 文章类型: Journal Article
    抗肿瘤药物耐药性仍然是癌症化疗的主要挑战。在这里,我们研究了对新型抗癌剂RH1的获得性抗性的机制,该抗癌剂RH1设计为在癌细胞中被NQO1酶激活。数据显示,在一些癌细胞中,RH1可以以不依赖NQO1的方式起作用。对RH1具有获得性抗性的乳腺癌细胞的差异蛋白质组学分析揭示了细胞能量的变化,氨基酸代谢与G2/M细胞周期转换调控。通过多重激酶抑制剂珠对磷酸蛋白质组学和蛋白激酶活性的分析表明,在RH1抗性细胞中,参与细胞周期和干性调节的蛋白激酶的活性增加,以及促凋亡激酶如JNK的下调。抑制JNK导致癌细胞对RH1的抗性增加。此外,抗性细胞增强了干细胞因子(SCF)和干细胞标志物的表达。SCF受体c-KIT的抑制导致癌症干细胞富集的减弱和肿瘤起始细胞的量减少。RH1抗性细胞也获得对常规疗法的抗性,同时保持对c-KIT靶向疗法的敏感性。数据显示,RH1可用于以NQO1非依赖性方式治疗癌症,靶向肿瘤干细胞可能是对抗RH1治疗耐药的有效方法。
    Antitumor drug resistance remains a major challenge in cancer chemotherapy. Here we investigated the mechanism of acquired resistance to a novel anticancer agent RH1 designed to be activated in cancer cells by the NQO1 enzyme. Data show that in some cancer cells RH1 may act in an NQO1-independent way. Differential proteomic analysis of breast cancer cells with acquired resistance to RH1 revealed changes in cell energy, amino acid metabolism and G2/M cell cycle transition regulation. Analysis of phosphoproteomics and protein kinase activity by multiplexed kinase inhibitor beads showed an increase in the activity of protein kinases involved in the cell cycle and stemness regulation and downregulation of proapoptotic kinases such as JNK in RH1-resistant cells. Suppression of JNK leads to the increase of cancer cell resistance to RH1. Moreover, resistant cells have enhanced expression of stem cell factor (SCF) and stem cell markers. Inhibition of SCF receptor c-KIT resulted in the attenuation of cancer stem cell enrichment and decreased amounts of tumor-initiating cells. RH1-resistant cells also acquire resistance to conventional therapeutics while remaining susceptible to c-KIT-targeted therapy. Data show that RH1 can be useful to treat cancers in the NQO1-independent way, and targeting of the cancer stem cells might be an effective approach for combating resistance to RH1 therapy.
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