氩激光治疗中心性浆液性视网膜脉络膜病变的临床研究

目的 分析氩激光治疗中心性浆液性视网膜脉络膜病变(中浆)的临床效果。方法 选择经眼底荧光血管造影显示有明确渗漏点，其渗漏点距黄斑中心凹500μm以外的中浆患者102例102眼，采用氩绿激光行渗漏点直接光凝封闭，激光参数：光斑直径106—200μn，爆光时间0．2s，能量80-150mW。激光光凝1次或2次补充完成。结果 激光光凝后视力迅速提高-行以上者95眼，视力无变化7眼；眼前黑影、视物变形症状消失的87眼；两周内视网膜神经上皮盘状脱离消失，中心凹反光出现的80眼；首次光凝未完全封闭渗漏点需2次补充光凝的4眼；治疗过程中无1例因光凝损伤黄斑中心凹；全部患者激光光凝后随访6个月至5年，未发现远期光凝并发症，同时无1例复发。结论 氩激光治疗中浆可较快提高视力、缩短病程、减少复发率，把握光凝条件是杜绝光凝并发症的关键。     

氩激光治疗CSC病变106例临床研究

目的观察氩激光治疗中心性浆液性视网膜脉络膜病变的临床疗效。方法选择经眼底荧光血管造影显示确定有明显渗漏点，采用氩激光光凝直接封闭渗漏点。结果氩激光光凝后，97例（106眼）中1次治愈99眼，2次治愈7眼；治疗过程中无1例因光凝损伤黄斑中心凹；全部患者激光光凝后随访6个月-4年，未发现远期光凝并发症，仅1例复发。结论氩激光治疗中心性浆液性视网膜脉络膜病变可明显缩短疗程、提高视力、无并发症，把握光凝条件是札绝并发症发生的关键。     

Nd:YAG倍频激光治疗中心性浆液性脉络膜视网膜病变疗效观察

目的　评价掺钕钇铝石榴石倍频激光 (Nd :YAG倍频激光 )治疗中心性浆液性视网膜脉络膜病变 (中浆 )的临床疗效。方法　确诊为中浆且渗漏点位于黄斑中心凹 2 5 0 μm以外的患者。应用Nd :YAG倍频激光治疗的光凝组 62例 65眼。单纯行药物治疗的对照组 47例 48眼。追踪观察视力、眼底、患者自觉视野中心暗影是否消失。结果　达视力改善光凝组平均 2 .3周 ,对照组 6.8周 ;停止渗漏光凝组平均 2 .8周 ,对照组 10 .3周 ;患者自觉视野中心暗影完全消失光凝组平均 4.9周 ,对照组 15 .3周。两组间差异均具有显著性 (P <0 .0 1)。结论　Nd :YAG倍频激光治疗中心性浆液性视网膜脉络膜病变效果肯定。成功的光凝治疗可缩短病程 ,迅速恢复视功能。     

氩激光治疗中心性浆液性视网膜脉络膜病变56例临床分析

①目的 观察氩激光治疗中心性浆液性脉络膜视网膜病变的疗效。②方法 根据视网膜血管荧光造影确诊，确定渗漏点的位置，采用氩激光直接封闭渗漏点。③结果 56例（56眼）中，光凝1次治愈49眼，2次治愈7眼。其中1周治愈7眼，2周治愈14眼，3周治愈12眼，4周治愈10眼。〉4周～2月以上治愈13眼。6眼复发，再次激光治疗治愈。④结论 氩激光治疗中心性浆液性视网膜病变可明显缩短疗程，视力提高，无并发症发生。     

氩激光联合羟苯磺酸钙治疗中心性浆液性脉络膜视网膜病变临床体会

目的观察氩激光联合羟苯磺酸钙治疗中心性浆液性脉络膜视网膜病变（CSC）的疗效。方法将80例91眼渗漏点距黄斑中心凹200μm以外的中心性浆液性脉络膜视网膜病变患者,随机分为两组,治疗组40例46眼,采用氩激光光凝联合口服羟苯磺酸钙治疗;对照组40例45眼,仅采用氩激光光凝渗漏点,观察比较治疗后患者的眼底、视力、疗效及复发率的不同。结果治疗组疗效优于对照组（治疗组和对照组的总有效率分别为82.22%、63.04%）,差异有统计学意义（P〈0.05）;治疗组复发率低于对照组（治疗组和对照组复发率分别为2.22%、15.22%）,差异有统计学意义（P〈0.05）。结论氩激光联合羟苯磺酸钙是治疗渗漏点距黄斑中心凹200μm以外中心性浆液性脉络膜视网膜病变的有效方法,值得推广。     

倍频YAG激光治疗中心性浆液性视网膜脉络膜病变87例临床分析

目的:观察倍频YAG激光治疗中心性浆液性视网膜脉络膜病变(中浆)的疗效.方法:根据视网膜荧光血管造影确诊的中浆患者,对渗漏点位于黄斑中心凹250μm以外的85例(87眼)采用倍频YAG激光直接封闭渗漏点治疗.结果:经光凝治疗1次治愈83眼,2次治愈4眼,术后观察6个月均治愈,未见严重并发症发生.结论:倍频YAG激光治疗...     

氩激光光凝治疗糖尿病性视网膜病变黄斑水肿效果分析

目的：观察氩激光光凝对糖尿病视网膜病变黄斑水肿的治疗效果。方法：对32例(43只眼)，采用黄斑区氩激光光凝进行治疗。并从视力、黄斑区水肿消退情况观察疗效。结果：激光治疗43只眼中，保持原有视力30只眼(69.8％)；提高2行以上11只眼(25．5％)。下降2行以下有2只眼(4．70％)；32眼(74．4％)黄斑渗漏消失，水肿完全吸收；9只眼(20.9％)水肿大部分吸收，2只眼(4．7％)黄斑渗漏仍存在，原有水肿无明显吸收。结论：氩激光光凝术治疗糖尿病视网膜病变黄斑水肿效果显。     

氪黄激光格栅样光凝早期治疗视网膜中央静脉阻塞黄斑水肿

目的:评价氪黄激光早期治疗视网膜中央静脉阻塞黄斑水肿的临床疗效.方法:用氪黄激光治疗视网膜中央静脉阻塞黄斑水肿共52例(52眼),氪黄激光波长568 nm,对黄斑区水肿采用格栅样光凝,光凝距黄斑中心小凹300 μm以上,避开视盘黄斑束,功率60～200 mW,光斑直径100 μm,曝光时间0.1 s,光凝168～287点,光斑反应Ⅰ～Ⅱ级.术后随访观察疗效.结果:术前视力为0.193±0.051,术后视力为0.221±0.045,两者比较无统计学差异;术后视力提高11眼(21.2%),不变29眼(55.8%),下降12眼(23.1%).光凝后黄斑水肿完全消退41眼(78.8%),部分消退9眼(17.3%),不变2眼(3.8%).结论:早期采用氪黄激光治疗视网膜中央静脉阻塞黄斑水肿有效,但不能提高视力.     

氩激光凝固法对糖尿病性视网膜病变的疗效观察

目的观察糖尿病性视网膜病变(DR)不同分期者接受氩激光治疗的临床效果。方法采用科以人2000型氩激光组合激光机对170例263只患眼分别做如下处理:(1)对非增殖期糖尿病视网膜病变(NPDR) 30眼行局部氩激光凝固术(光凝);(2)对增殖前期糖尿病视网膜病变(PPDR) 156眼行次全视网膜光凝;(3)对增殖期糖尿病视网膜病变(PDR ) 77眼行全视网膜光凝,对合并黄斑局限或弥漫性水肿者给予局灶性光凝或格栅样光凝。于光凝后3个月检查,进行视力、眼底、视网膜荧光血管造影,并与治疗前各项结果对比。结果视力提高92眼(35%)、无变化144眼(55%)、下降27眼(10%)。眼底检查、荧光血管造影复查示:NPDR、PPDR眼视网膜微血管瘤、水肿、渗出消退,荧光渗漏消退占89%,其余11%需补充光凝。PDR眼视网膜、视盘新生血管消退占67%,33%为部分消退需补充光凝。黄斑水肿完全或部分消退占91%,光凝后出现视网膜前灶性出血占8%,玻璃体积血为1%。结论氩激光对不同分期DR均有效。NPDR、PPDR效果好于PDR眼,后者光凝后荧光血管造影复查以及补充光凝对提高疗效非常必要。     

氩绿激光治疗糖尿病性黄斑病变的临床观察

目的 探讨氩绿激光治疗糖尿病性黄斑病变的对改善视力及黄斑水肿的疗效。方法 将对糖尿病性黄斑病变患者按病程分成两组:增殖前期;增殖期。并行眼底荧光血管造影确定视网膜血管渗漏点(区)。对局部渗漏点氩激光点状光凝,弥漫性渗漏区采用格栅样光凝。随访12个月,观察比较两组光凝前后视力及黄斑水肿、渗漏的变化,并进行统计学分析。结果 氩绿激光治疗糖尿病性黄斑病变86例136眼,87.50%的眼别提高或保存现有视力,其中对增殖前期的疗效为优;87.95%的黄斑水肿完全或部分消退,增殖前期的黄斑水肿消退尤为明显。两组的视力改善和黄斑水肿消退比较均有统计学意义。结论 氩绿激光光凝是治疗糖尿病性黄斑病变的有效手段,有助于提高或保存现有视力,疗效与病变程度有关,早期治疗效果较好。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.