乳化劈裂技术在硬核白内障超声乳化吸除术中的应用

目的 探讨乳化劈裂技术在硬核白内障超声乳化中的应用价值。方法 对采用乳化劈裂技术实施超声乳化白内障吸除术的硬核白内障276眼，记录手术中使用的超声功率、超声乳化时间，观察术后视力和角膜内皮水肿情况。结果 使用超声功率50％～70％，平均超声乳化时间2．8min，术后1周视力≥0．3者占95．3％，未发生角膜内皮失代偿等严重并发症。结论 乳化劈裂技术在硬核白内障超声乳化中应用是安全有效的。     

外引流术后的白内障超声乳化手术

目的：探讨抗青光眼餐引流术后的白内障患眼进行超声乳化吸除术的手术入路，操作方式及临床效果。方法：避开功能性滤过泡，选择角巩膜隧道切口或透明角膜切口，瞳孔麻痹性散大时，做一个完美的直径约5mm的连续环形撕囊以补偿之；恰当处理虹膜后粘连后，在病理性小瞳孔下完成超声乳化手术；眼压失控者行青光眼白内障人工晶体植入三联术。结果：无后囊破裂，人工晶体全部囊袋内植入，术后1周视力≥0．5者20只眼（64．5％），0．1－0．4者8只眼（25．8％），＜0．1者3只眼（9．7％）。随访1－16个月，眼压均在20.55mmHg以下。结论：体外流术后的白内障患眼，超声乳化手术因其切口小，并发症少，不破坏功能性滤过泡，不损伤瞳孔，是目前各种手术方法中的最佳选择。     

角膜小切口超声乳化白内障吸除及折叠式人工晶体植入的临床疗效比较

目的 比较角膜小切口超声乳化白内障吸除及折叠式人工晶体植入与囊外摘除术及PMMA人工晶体植入术的临床疗效。方法 67例(62只眼)老年白内障患者随机分为两组：37例(50只眼)行超声乳化及折叠式人工晶体(AcrySof)植入(AcrySof组)；30例(42只眼)行囊外摘除及PMMA人工晶体植入(PMMA组)，观察术后视力，前房炎症反应和后囊膜混浊发生情况。结果 术后1d视力：≥0．5者，AcrySof组占56．6％，PMMA组占23．8％；≥1．0者两组分别为38．0％及4．7％。术后1周视力：≥0．5者，AcrySof组占64．0％，PMMA组占42．9％；≥1．0者分别为48．0％及9．5％。术后3个月的视力：≥0．5者，A~ysof’组占70．0％，PMMA组占52．4％；≥1．0者分别为62．0％及21．4％；术后l周前房炎症反应的发生率：AcrySof组为5．40％，PMMA组为26．7％。随访1年后囊膜混浊发生率：AcrySof组为8．0％，PMMA组为28．6％。结论 角膜小切口超声乳化白内障吸除及折叠式人工晶体植入术后视力恢复好，前房炎症反应及后囊膜混浊发生率显著低于囊外摘除及PMMA人工晶体植入。     

表面麻醉下白内障超声乳化术的临床观察

目的：观察表面麻醉在白内障超声乳化及人工晶状体植入术中的效果。方法：采用表面麻醉的方法对120例（148只眼）进行白内障超声乳化人工晶状体植入术。结果：120例均在表面麻醉下完成，术后1周最佳视力≥0．5者为81．5％，术后1月最佳视力≥0．5者为90．3％，主要并发症：后囊破裂12只眼（8．1％）中度角膜水肿9只眼（6％）。结论：白内障超声乳化术中表面麻醉是一种简便、安全、有效的麻醉方法。     

改良小切口手法白内障囊外摘除人工晶体植入术的研究

目的分析小切口非超声乳化白内障囊外摘除人工晶体植入术的临床效果及方法。对137例（142眼）白内障进行小切口非超声乳化白内障囊外摘除人工晶体植入术。结果术后1天，患者裸眼视力或矫正视力≥O．5者占52．8％，术后1周矫正视力≥0．5者，占60．20％，≥1．0者占21．50％。结论此手术技术操作简易，容易掌握，效果可靠，适应症广，适合基层医院开展。     

白内障超声乳化术中后囊破裂的后房型人工晶体植入术

目的：评价白内障超声乳化术中后囊破裂的I期后房型人工晶体植入术的疗效。方法：对231例（269眼）施行的白内障超声乳化术中后囊破裂39例（40眼）行I期后房型人工晶体植入术。结果：囊袋内植入12眼，人工晶体光学部前囊固定13眼，睫状沟内植入13眼，2眼需缝线固定，随访1－37个月，裸眼视力≥0．5者33眼（82．5％），≥1．0者19眼（47．5％），矫正视力≥0．5者38眼（95％），≥1．0者25眼（62．5％），并发症主要有：人工晶体偏位3眼，瞳孔变形2眼，结论：白内障超声乳化术中后囊破裂时，控制破口的扩大，利用前，后囊作支撑，结合前段玻璃体切割术，植入后房型人工晶体仍可取得满意的效果。     

小切口无缝线白内障非超声乳化与超声乳化疗效观察

目的观察比较小切口无缝线白内障囊外摘除与超声乳化的术后视力及并发症。方法将360眼单纯性老年性白内障随机分为两组，1组行超声乳化吸出术，2组行小切口无缝线非超声乳化白内障囊外摘除术，观察术后1周的视力，术中术后并发症。结果术后1周裸眼视力：超声乳化组和小切口无缝线白内障囊外摘除组≤0．4者分别占18．3％和18．9％，0．5～0．9者占66．1％和66．6％，≥1．0者占15．6％和14．4％；术中后囊破裂两组分别为4．4％和3．3％；术后角膜内皮水肿分别为16．1％和17．2％。结论两种手术疗效相似，差异无显著性（P〉0．05）。非超声乳化白内障手术方法简便经济，适合在基层医院开展。     

白内障超声乳化术271眼临床分析

目的总结白内障超声乳化手术的疗效。方法对271眼各种类型白内障患者进行超声乳化联合人工晶体植入术。结果术后d1视力≥0．1者223眼占82．3％；≥0．3者189眼占69．7％，术后1wk视力≥0．3者235眼占86．7％，术中后囊破裂术后角膜水肿为主要并发症。结论白内障超声乳化术优点为切口小，损伤小，视力恢复快，但早期并发症较多，应注意病例选择，注意手术操作技巧，掌握并发症的预防处理措施，减少并发症的发生。     

基层医院开展白内障超声乳化手术

目的：探讨基层医院从白内障囊外摘除术转型到白内障超声乳化人工晶体植入术。方法：采用普通的手术设备,3个月内完成38眼晶状体超声乳化并人工晶体植入手术进行分析。结果：经手术后2个月随访,术后视力〉0．3者占89．5％,其中视力≥0．8者占78．9％,其中后囊膜破裂2眼,晶状体半脱位1眼。虹膜粘连引起小瞳孔1眼,超声时间28眼为0．2～0．9分钟,平均0．6分钟,超声能量20％～60％,平均38％。结论：基层医院虽设备较差,初学者并不能完全撑握超声乳化术,但只要充分准备,细心操作,完全能够开展白内障超声乳化人工晶体植入术。     

高度近视眼合并白内障低负度数人工晶体植入的临床观察

目的：评价高度近视眼合并白内障行超声乳化白内障摘除并低、度度数人工晶体植 入的疗效。方法：63例68眼高度近视眼合并白内障行反眉状隧遂道式自闭性切口行超声乳化摘除术，5．5mm切口植入人工晶体，眼轴26mm-30mm者38眼，＞30mm者30只眼，随访0．5年－2年，观察超声能量，时间，术后不同眼轴视力和并发症。结果：眼轴26mm-30mm组术后3月视力＞0．5者34只眼，占89．5％，＞30mm组术后3月视力≥0．5者15只眼，占50．0％，后囊膜破损并玻璃体溢出3只眼（4．4％）半年后发生视网膜脱离2只眼（2．9％），角膜水肿11只眼（16．1％）。术后3个月视力比较有显著性差异（P＜0．05），结论：高度近视眼合并白内障行超声乳化白内障摘除并低，负度数人工晶体植入术可提高患者视力，改善视功能，但＞30mm组效果较差。     

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…     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

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.