白内障超声乳化吸除术后泪膜的变化及影响因素

目的探讨白内障超声乳化联合人工晶体植入术后泪膜的变化及影响因素。方法选择老年性白内障患者60例(70只眼),均行白内障超声乳化吸除联合人工晶体植入,观察分析术前,术后1 d、1周、2周、1个月的主观干燥异物感,通过角膜荧光素试验(FSC)、基础泪液分泌试验(SIT)、泪膜破裂时间(BUT)测定泪膜功能,检测角膜知觉情况。结果与术前相比,术后1 d、1周、2周术眼干燥异物感、角膜荧光素染色、SIT程度明显增加,BUT变短,比较差异均有统计学意义(P<0.05);术后1个月时干燥异物感、角膜荧光素染色、SIT及BUT程度恢复至术前水平,与术前比较差异无统计学意义(P>0.05);术后1个月角膜知觉恢复至术前水平。结论白内障超声乳化联合人工晶体植入术可在短期内影响患者泪膜功能,导致部分患者发生干眼症;泪膜稳定性与角膜知觉呈正相关性。     

白内障超声乳化联合人工晶状体植入术后泪膜功能变化

目的:探讨白内障超声乳化联合人工晶体植入术对泪膜的影响。方法:选择2009年1~12月间在我院住院行白内障超声乳化联合人工晶体植入术的老年性白内障患者60例(80只眼),观察分析术前、术后1 d、1周、1个月、3个月的主观干燥异物感、角结膜荧光素试验、基础泪液分泌试验(Schirmer I test,SIT)、泪膜破裂时间(tear breaup time,BUT)情况。结果:与术前相比,术后1 d、1周、1个月术眼干燥异物感、角膜荧光素染色、SIT程度明显增加、BUT缩短,比较差异均有统计学意义(P<0.05);术后3个月时干燥异物感、角膜荧光素染色、SIT程度及BUT恢复至术前水平,与术前比较差异无统计学意义(P>0.05)。结论:白内障超声乳化联合人工晶体植入术可在短期内影响患者泪膜功能,导致部分患者发生干眼症,但3个月时可基本恢复正常。     

白内障超声乳化联合人工晶体植入手术后泪膜的变化

目的 观察白内障超声乳化联合人工晶体植入手术对泪膜的影响.方法 对48例(60只眼)白内障患者行超声乳化联合人工晶体植入术,观察术前3 d,术后1 d、1周、1个月、3个月的主观干燥异物感,角结膜荧光素染色试验,基础泪液分泌试验(Schirmer I test,SIT),泪膜破裂时间(breaking up time,BUT)情况.结果 术后1 d、1周、1个月术眼角膜荧光素染色积分、SIT、BUT与术前相比,差异均有统计学意义(P＜0.05);术后3个月仅有3例患者仍有明显的干燥感、烧灼感、异物感,与术前相比,各指标差异均无统计学意义(P＞0.05).结论 白内障超声乳化联合人工晶体植入术可在短期内影响患者泪膜功能,导致部分患者出现明显的干眼症状和体征.     

不同术式白内障联合人工晶体植入术后干眼症的临床观察

目的 探讨不同术式白内障联合人工晶体植入术后干眼症的发病情况.方法 选择62例62眼行白内障吸除合并人工晶状体植入术的患者,随机分为两组:A组32例(32眼)行透明角膜切口白内障超声乳化联合人工晶体植入术,B组30例(30眼)行巩膜隧道切口白内障超声乳化联合人工晶体植入术.观察术前、术后1 d、1周、1个月、3个月的干眼症状(干涩感、异物感、烧灼感),泪膜破裂时间(BuT)、基础泪液分泌试验(Schinner I试验)、角膜荧光素染色,并对数据进行统计学分析.结果 两组术后1 d、1周、1个月干眼症状明显,术眼角膜荧光素染色明显增加、SIT程度下降、BUT缩短,两组比较差异有显著性(P<0.05);术后3个月时角膜荧光素染色、SIT及BUT程度差异无显著性(P>O.05).结论 相对于巩膜隧道切口,透明角膜切口的白内障超声乳化联合人工晶体植入术术后短期干眼症的发生率较高.     

白内障超声乳化联合人工晶体植入术后泪膜的变化

目的：探讨白内障超声乳化联合人工晶体植入术后泪膜的变化。方法：选择单纯老年性白内障患者60例60眼,行白内障超声乳化联合人工晶状体植入术。观察分析术前、术后1天,7天,30天,90天的所有患者的基础泪液分泌试验（SIt）、泪膜破裂时间（BUT）及角膜荧光素染色评分情况。结果：SchirmerI试验结果表明术后1d泪液分泌量增多,与术前比较差异有显著意义（P〈0．05）;术后7天、30天、90天恢复至术前水平,差异均无显著意义（P〉0．05）。BUT结果表明术后1天,7天BUT均较术前明显缩短,差异均有显著意义（P〈0．05）。30天、90天与术前比较,差异均无显著意义（P〉0．05）。角膜荧光素染色结果表明术后1天和7天术眼角膜荧光素着色点较术前明显增多,差异有显著意义（P〈0．05）,术后30天、90天与术前比较,差异均无显著意义（P〉0．05）。结论：白内障超声乳化联合人工晶体植入术可在短期内影响泪膜功能。     

小切口白内障囊外摘除联合人工晶体植入术后泪膜的改变

目的：探讨小切口白内障囊外摘除联合人工晶体植入术后泪膜的改变。方法：选择行小切口白内障囊外摘除联合人工晶体植入术的老年性白内障患者52例（52眼）,观察分析术前、术后1天、1周、1月、3月的主观感觉,基础泪液分泌试验（SchirmerⅠtest,SⅠt）,泪膜破裂时间（breaking up time,BUT）情况。结果：与术前相比,术后1天、1周、1个月术眼干燥异物感、SⅠt明显增加,BUT缩短,比较差异均有显著意义（P〈0.05）;术后3个月时干燥异物感、SⅠt及BUT程度恢复至术前水平,与术前比较差异无显著性（P〉0.05）。结论：小切口白内障囊外摘除联合人工晶体植入术可短期影响泪膜的稳定性。     

硬核性白内障超声乳化吸除术后的眼表变化临床研究

目的探讨硬核性白内障超声乳化吸除术后的眼表变化情况。方法对89例(95眼)硬核性白内障行超声乳化吸除联合人工晶体植入手术,观察患者术前、术后1d、3d、1周、1个月、3个月和半年的眼表变化,包括症状、泪膜破裂时间(BUT)、角膜荧光素染色(FL)、基础泪液分泌试验(SIT),并对所取得的数据进行统计学分析处理。结果硬核性白内障超声乳化吸除联合人工晶体植入术后第一周,患者出现明显的干眼症状,且FL较术前增多(P<0.05);术后1个月内BUT和SIT均明显缩短(P<0.05);术后3个月至半年,多数患者的FL、BUT和SIT已基本恢复或接近术前水平(P>0,05)。结论硬核性白内障患者在接受超声乳化吸除术后的一段时间内,其眼表功能会受到一定程度的影响,分析其发生的机制,提出术前、术中和术后应采取积极措施进行防护,以避免或减少因手术所造成的眼表医源性损伤。     

白内障超声乳化术后局部用药与干眼症临床分析

目的观察白内障超声乳化术后局部用药与干眼症发生情况。方法 423例（423眼）行白内障超声乳化吸除合并人工晶状体植入术的患者,术后随机分为两组：观察组211例（211眼）给予复方新霉素局部点眼4次/d,每周递减1次至停药。对照组212例（212眼）给予复方新霉素局部点眼6次/d,每周递减1次至停药。观察术后1周、1个月、3个月的干眼症状,泪膜破裂时间（BUT）、角膜荧光素染色。并对数据进行统计学分析。结果观察组术后1周、1个月和3个月发生干眼症状及角膜荧光染色评分均明显低于对照组,而泪膜破裂时间则明显长于对照组,两组比较差异有统计学意义（P〈0.05、P〈0.01）。结论白内障超声乳化联合人工晶体植入术后局部合理用药可以有效降低干眼症发生。     

糖尿病白内障患者超声乳化摘除术后泪膜的变化

[目的]观察糖尿病白内障患者超声乳化摘除术后泪膜的变化。[方法]随机选取54例(60只眼)糖尿病白内障患者行超声乳化白内障摘除术联合折叠式人工晶体植入术,术前、术后1、7、30、90d进行症状、角膜荧光素染色(FL)、泪膜破裂时间(BUT)、基础泪液分泌试验(SIt)等检查查,与术前指标进行比较。[结果]与术前比较,术后1d、7d、30d干涩、异物感、烧灼感等加重,BUT明显缩短,SIt分泌术后第1天明显增多,FL染色率术后1d、7d明显增多,差异均有统计学意义(P0.05)。[结论]糖尿病患者白内障超声乳化术后可致泪膜的稳定性下降,术前或术后及早补充人工泪液,促使泪膜功能的稳定,对糖尿病患者尤为重要。     

超声乳化手术对年龄相关性白内障患者泪膜的影响分析

目的观察白内障超声乳化手术对年龄相关性白内障患者泪膜的影响。方法选择行白内障超声乳化术的年龄相关性白内障患者75例（80只眼）。分别于术前2d和术后1、7d、1、3个月观察患者主观干眼症状、泪膜破裂时间（BUT）、角膜荧光素染色及下睑中央泪河高度的变化情况。结果与术前相比,干眼症状在术后1、7d增加,BUT在术后1、7d、1个月明显缩短,角膜荧光素染色在术后1、7d明显增高,差异均有统计学意义;术后3个月时主观干眼症状、BUT、角膜荧光素染色及下睑中央泪河高度恢复至术前水平,与术前比较差异无显著性。结论白内障超声乳化手术可在短期内影响泪膜的稳定性,应该进行积极地预防及治疗。     

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…     

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.     

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.     

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.