经外路途径行异种视网膜片移植的实验研究

目的：探讨经外路途径行视网膜下腔的全层异种视网膜移植的方法，并对移植结果进行初步观察。方法：用明胶包埋小鼠视网膜制成视网膜移植片，九只兔按外路手术方法将植片植入视网膜下腔。移植术后1-23天摘除动物眼球，石蜡包埋、切片、HE染色，光学显微镜观察。结果：明胶包埋的视网膜移植片可以被植入宿主视网膜下腔中，视网膜移植片平铺于宿主视网膜下腔中，植片外层与宿主视网膜色素上皮层相贴、存活，未见明显免疫排异反应。结论：视网膜下腔是较为理想的视网膜移植的受位；明胶包埋的异种视网膜植片可作为供体进行移植；移到视网膜下腔的异种视网膜能够存活，这一结果为今后异种视网膜移植研究奠定了基础。     

糖尿病性白内障超声乳化术和人工晶体植入术后的临床观察

随着糖尿病治疗的进展，糖尿病患者的寿命不断延长，糖尿病性白内障发病所占比例也逐渐增大［’j。为了使这部分患者提高视力，进一步治疗视网膜疾病，常需摘除白内障L‘。以往认为，糖尿病性白内障摘除及人工晶体植人术后易发生出血、感染、视网膜病变化恶化等。近年来，国内外研究表明，未合并视网膜病变或合并单纯性视网膜病变的患者，行人工晶体植人，可以改善视力，且并发症与一般患者无显著性差异D‘。1997年4月至1998年元月，我科对78例糖尿病性白内障患者实施超声乳化摘除及人工晶体植人，并随机选取同时进行手术的同年龄组的非糖…     

外层渗出性视网膜病变的临床观察

目的:评价外层渗出性视网膜病变的治疗及预后的影响、及治疗前后视力变化。方法:对外层渗出性视网膜病变患者进行激光光凝。结果:明确外层渗出性视网膜病变激光光凝后疗效观察提供可靠临床资料。结论:激光光凝在临床上对于外层渗出性视网膜病变的治疗具有非常重要应用价值。     

双开门椎管成形并羟基磷灰石人工骨植入术治疗颈椎管狭窄症

目的：观察双开门颈椎管成形并羟基磷灰石人工骨材料植骨术治疗颈椎管狭窄症的效果。方法：采用双开门法行颈椎管成形、椎管扩大及羟基磷灰石人工骨植骨术治疗12例颈椎管狭窄症，对其手术方法及治疗效果进行讨论。结果：经过5年随访，11例发育性颈椎管狭窄病，临床症状明显缓解、体征改善，l例疗效不佳。结论：双开门颈椎管成形及人工骨材料植骨术是治疗颈椎管狭窄症的一种安全有效的手术方法。羟基磷灰石载体具有良好的生物相容性及骨传导性，是理想的骨移植替代材料，在颈椎椎管成形术具有良好的应用价值。     

晚期Coats氏病的临床病理观察

本文对１８例晚期Ｃｏａｔｓ氏病（亦称外层渗出性视网膜病变）进行了临床病理观察。该病的主要病理改变是视网膜全脱离及广泛的结构破坏，视网膜血管扩张，大量的类脂质渗出。在视网膜下的渗出中典型地含有胆固醇结晶空隙和许多泡沫细胞。在临床上，晚期ｃｏａｔｓ氏病应注意与视网膜母细胞瘤的鉴别。在组织病理学方面则应与视网膜血管瘤病、糖尿病性视网膜病变等相鉴别。     

双开门椎管成形联合羟基磷灰石人工骨植入术治疗颈椎管狭窄症

目的观察双开门颈椎管成形合并羟基磷灰石人工骨材料植骨术治疗颈椎管狭窄症的效果。方法采用双开门法行颈椎管成形、椎管扩大及羟基磷灰石人工骨植骨术治疗12例颈椎管狭窄症。结果经过5年随访，11例发育性颈椎管狭窄患者临床症状明显缓解、体征改善，1例疗效不佳。结论双开门颈椎管成形及人工骨材料植骨术是治疗颈椎管狭窄症的一种安全有效的手术方法。羟基磷灰石载体具有良好的生物相容性及骨传导性，是理想的骨移植替代材料．在颈椎椎管成形术中具有良好的应用价值。     

视网膜脱离患者卧位与休息的护理研究

视网膜由神经外胚叶发育而成，按胚胎发育来源分为二层，外层为色素上皮层；内层为视网膜感觉层（神经上皮层），两层之间有潜在的腔隙。视网膜脱离（简称网脱）就是指视网膜神经上皮与色素上皮的分离。无论什么原因引起网脱，其体位和休息都是非常重要的护理内容。几年来，我们重视对视网膜脱离患者卧位与休息的护理研究，收到较好的临床效果，现将护理体会报告如下。     

脉络膜微血管内皮细胞的体外培养

脉络膜微血管内皮细胞不仅在维持眼睛局部的内环境稳定、局部散热以及营养视网膜色素上皮细胞（RPE）和外层视网膜等方面发挥重要作用，更是许多视网膜、脉络膜病变的解剖基础，包括脉络膜渗漏、炎症以及新生血管的发生等等。脉络膜新生血管的发生是一系列引起视功能障碍的脉络膜、视网膜疾病的重要病理生理学机制，尤其在渗出性老年黄斑变性、中心性渗出性视网膜炎、高度近视眼底改变等方面，脉络膜新生血管是致盲的根本原因。     

玻璃体切割治疗Coats病导致的渗出性视网膜脱离的临床观察

Coats病又称外层渗出性视网膜病变,1908年Coats首先对其进行临床和病理方面的描述,其主要特征是视网膜毛细血管及微动脉的扩张,而视网膜渗出则是继发于毛细血管扩张的病变,故也可称为视网膜毛细血管扩张症。该病因视网膜毛细血管渗出引起的视网膜脱离在临床上是一种难治性疾病,本文应用玻璃体切割手术联合眼内硅油注入术对10例(11眼)进行治疗,观察其治疗作用。     

光学相干断层扫描观察38眼病理性近视中黄斑视网膜劈裂

目的 为了解病理性近视中黄斑劈裂的发生情况及其特征。方法 对2002年6月～2003年12月间光学相干断层扫描（Optic Coherence Tomography，OCT）确诊为黄斑部视网膜劈裂的病理性近视眼进行了进一步的检查．包括最佳校正视力、超声波了解后巩膜葡萄肿和眼轴。结果 OCT确诊有36名病理性近视患者的38眼中存在黄斑部的视网膜劈裂．所有眼都完成了进一步的检查。38眼都视力低下，超声波检查都发现了后巩膜葡萄肿，平均屈光度数-10．5D，平均眼轴为29．6mm。OCT中视网膜劈裂的形态和范围差异较大，但大致分为两种类型：外层劈裂和内层劈裂；外层劈裂较常见。内层劈裂通常与外层劈裂相伴，同时常位于黄斑的周边区域；两种形式的劈裂可分别也可共同存在；劈裂常伴有局限性的视网膜脱离和其他黄斑病变。结论 黄斑劈裂在临床病理性近视眼中并不罕见，且常与其他黄斑病变相伴，OCT在其诊断和观察中有着重要的意义。     

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.     

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.     

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…     

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.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.