激光治疗白内障超声乳化术后糖尿病视网膜病变时机探讨

目的观察白内障超声乳化术后糖尿病视网膜病变（diabetic retinopathy,DR）激光光凝治疗的效果和时机。方法对45例72眼白内障超声乳化术后DR患者进行了氩激光治疗,分析不同治疗时机的疗效。结果白内障术后2-3周内行激光光凝治疗,糖尿病视网膜病变稳定,黄斑水肿消退或减轻为76.9%,不变为23.1%;视力提高或不变为80.8%,视力下降为19.2%。白内障术后1-3个月行激光光凝治疗,20眼中有16眼糖尿病视网膜病变加重,黄斑水肿消退或减轻占70.0%,不变为30.0%;视力提高或不变为75.0%,视力下降为25.0%,视力下降与黄斑水肿程度密切相关。结论白内障术后1个月内DR患者尽早进行激光光凝,对控制或延缓糖尿病视网膜病变的发展极为重要。     

白内障术后糖尿病视网膜病变的激光治疗

目的观察白内障超声乳化摘除人工晶体植入术后糖尿病视网膜病变（DR）的光凝治疗效果,探讨光凝治疗的时机及影响光凝的因素。方法对35例58眼行白内障超声乳化人工晶体植入术后的糖尿病视网膜病变患者在眼底荧光血管造影（FFA）指导下早期予以激光治疗。结果光凝治疗后随访1年,其中23眼视力提高（39.7%）,视力不变25眼（43.1%）,视力下降10眼（17.2%）,总有效率82.8%。结论白内障超声乳化摘除人工晶体植入术后及时的光凝治疗能有效的控制DR进展,稳定视力。     

激光光凝治疗糖尿病性视网膜病变

目的 观察激光光凝治疗糖尿病性视网膜病变的疗效。方法 对36例66眼糖尿病视网膜病变者用半导体激光进行全视网膜光凝，治疗后3个月做FFA检查，并检查视力、眼底情况。结果 术后视力提高13眼（19．69％），不变42眼（63．63％），下降11眼（16．66％）。结论 半导体激光治疗糖尿病性视网膜病变是安全有效的方法。     

白内障超声乳化术后糖尿病视网膜病变的激光治疗

目的:观察白内障超声乳化术后糖尿病视网膜病变(DR)氩激光治疗的时机及疗效。方法:对68例102只眼行白内障手术DR患者,在眼底荧光血管造影(FFA)指导下,早期予以视网膜激光光凝治疗。结果:平均随访1.5年。光凝治疗68例102眼,视力提高两行以上42只眼(41.2%),视力不变48只眼(47.1%),视力下降12只眼(11.8%)。3月后荧光素眼底血管(FFA)检查,新生血管大部分萎缩,视网膜水肿消退,出血部分吸收,视网膜无灌注区消失,未出现明显的并发症。结论:DR的白内障手术后早期进行视网膜激光光凝,能有效的控制疾病进展,稳定视力。     

糖尿病性白内障人工晶体植入术35例疗效观察

目的　探讨糖尿病性白内障超声乳化人工晶状体植入术的疗效。方法　对 35例35眼行白内障超声乳化人工晶体状植入术。结果　术后 2周 ,视力 1.0以上者 3只眼 (8.6 % ) ,0 .5～ 0 .9者 2 1只眼 (6 0 ..0 % ) ;0 .1～ 0 .4者 7只眼 (2 0 .0 % ) ;0 .1以下者 4只眼 (11.4 % )。术后对 12只眼有糖尿病性视网膜病变者行视网膜激光治疗。结论　糖尿病性白内障行超声乳化吸出人工晶体植入术 ,术后视力恢复满意 ,并发症少 ,并为眼底病变的诊治创造条件     

白内障术后糖尿病视网膜病变的氪激光治疗

目的观察白内障超声乳化联合人工晶状体植入术后糖尿病视网膜病变（DR）氪激光光凝治疗的时机及疗效。方法对69例94只眼行白内障超声乳化联合人工晶状体植入术,DR患者在FFA指导下,早期予以氪激光光凝。结果光凝治疗后,69例94只眼术后随访3个月-3年,其中视力提高21只眼,占22.34%;视力不变62只眼,占65.96%;视力下降11只眼,占11.7%;黄斑水肿完全消退45只眼,占47.87%;部分消退32只眼,占34.04%,不变者甚至加重17只眼,占18.08%。视网膜毛细血管广泛渗漏消退或新生血管全部萎缩显著有效65例,占69.14%;有效22例,占23.40%;无效7例,占7.45%。结论适时的白内障超声乳化联合人工晶状体植入术,术后早期进行FFA检查,氪激光光凝能有效地控制DR的发展,稳定视力,提高生活质量。     

多波长氪激光治疗糖尿病视网膜病变的临床研究

目的观察多波长氪激光在治疗糖尿病视网膜病变中的临床疗效。方法应用前瞻性研究方法对糖尿病性视网膜病变Ⅲ-Ⅳ期患者46例87眼,使用美国多波长氪激光仪进行局部光凝或全视网膜光凝治疗。结果术后随访1～3个月,糖尿病性视网膜病变Ⅲ期患者视力稳定者30眼（96．77％）,糖尿病性视网膜病变Ⅳ患者视力稳定者43眼（76．79％）。结论多波长氪激光治疗糖尿病性视网膜病变Ⅲ期患者疗效优于糖尿病性视网膜病变Ⅳ期患者,并且能降低黄斑水肿的发病率。     

糖尿病性白内障病人视网膜病变的治疗探讨

目的 探讨糖尿病性白内障病人的视网膜病变治疗时机及临床效果.方法 对120例(189只眼)糖尿病性白内障病人行散瞳眼底检查,45例(79只眼)因严重白内障眼底窥不清.65例(90只眼)接受眼底荧光造影,其中60只眼糖尿病性视网膜病变属于1～2期;30只眼属于3～5期,白内障手术前对其可见区域视网膜进行激光光凝.102例(157只眼)接受了白内障手术,植入人工晶体.白内障手术后有112只眼接受眼底荧光造影检查(包括术前曾行此检查的90只眼),对其中糖尿病性视网膜病变1～3期病人行局部视网膜光凝治疗,4～5期病人行全视网膜光凝治疗.结果 白内障术后眼底造影检查示糖尿病性视网膜病变1～2期40只眼,3期45只眼,4～5期共27只眼.10只眼放弃治疗,62只眼单纯行激光治疗.光凝治疗后随诊6～12个月,4只眼因玻璃体积血行玻璃体切除术,1只眼注入硅油.其他病眼视力稳定或提高,视网膜病变未见明显进展.26只眼发现黄斑水肿明显,玻璃体腔注射曲安奈德4 mg.结论 白内障术前及术后及时检查眼底,积极治疗,可控制视网膜病变进展.     

合并白内障的增殖性糖尿病视网膜病变联合手术效果及并发症的观察

目的探讨合并白内障的增生性糖尿病视网膜病变（proliferativediabeticretlnopathy,PDR）玻璃体切除联合超声乳化人工晶状体植入术的临床效果及并发症。方法回顾性分析2006年3月至2010年1月本院手术治疗的合并白内障的增生性糖尿病视网膜病变患者228例（236只眼）。其中男108例,女120例;年龄39—76岁,平均57岁;糖尿病史2～26年,眼病史1月至8年。结果术后平均随访时间分别为6～16个月。患者手术后视力较术前提高198眼（占86．8％）,不变15眼（占6．6％）,术后视力下降或光感消失15眼（占6．6％）;术后前房内纤维素渗出膜形成有76眼（占33．3％）,观察1W～3个月完全吸收的有65眼（占85．5％）;术后角膜水肿、上皮愈合慢有52只眼（占22．8％）,有1例经3个月的营养角膜治疗,最终恢复正常;术后发生后囊膜混浊（后发障）156眼（占68．4％）,于取油同时处理,不注油者单行YAG激光切除;术后网膜再增殖,牵引网脱,或玻璃体再积血者16例（占7．0％）,均再行玻璃体切割术联合剥膜、注油。结论玻璃体切除联合超声乳化白内障摘除人工晶状体植入术治疗增殖性糖尿病视网膜病变是安全、有效的,术后并发症少,能迅速恢复患者视力,减少患者多次手术的痛苦。     

玻璃体切割联合超声乳化人工晶体植入术治疗增生性糖尿病视网膜病变

目的探讨增生性糖尿病视网膜病变（proliferative diabetic retinopathy，PDR）合并白内障患者的玻璃体手术中，同期行白内障超声乳化摘除和后房型人工晶状体植入术的临床效果。方法回顾性分析合并不同程度白内障的增生性糖尿病视网膜病变患者36例（46只眼）实施玻璃体切割联合晶状体超声乳化人工晶体植入手术，其中气体填充15只眼，硅油填充5只眼；观察术后视力改善程度及术中术后并发症。结果术后随访3-24个月，平均6个月。术后33只眼（74％）视力有不同程度的改善，不变7只眼，下降6只眼；术后视力低下者多伴有明显的糖尿病黄斑水肿、硬性渗出或缺血。术后并发症包括虹膜后粘连17只眼（35％），视网膜脱离3只眼（7％）。晶体后囊混浊12只眼（26％），角膜上皮延期愈合12只眼（26％），玻璃体出血14只眼（30％）。结论玻璃体切割联合晶状体超声乳化人工晶体植入术治疗合并不同程度白内障的增生性糖尿病视网膜病变是安全有效的．可使大多数患者视力改善，避免玻切术后并发白内障再次手术：糖尿病黄斑病变是影响术后视力提高的主要原因。     

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.