暗环境下飞行员与正常人在不同背景下对比度视力的比较研究

目的 在暗环境下,比较空军飞行人员及正常人在亮、暗两种背景下,不同对比度的视力变化.方法 应用多功能电子视力测量仪(MFVA-100)比较20例空军飞行人员及20例正常人在亮、暗背景下不同对比度(100%、25%、10%、5%)的logMAR视力,并分析亮、暗背景下视力的相关性.结果 在亮、暗背景中,飞行员及正常人对比...     

亮环境下军事直升机飞行学员不同对比度视力的分布特征

目的观察军事直升机飞行学员在亮环境下不同对比度的视力变化情况。方法应用多功能电子视力测量仪(MFVA-100)检查86例(172眼)直升机飞行学员在亮环境中不同对比度(100%、25%、10%、5%)左右眼的log MAR视力,并分析不同对比度视力的相关性。结果在对比度100%、25%、10%、5%的log MAR视力右眼分别为-0.001±0.128、0.257±0.152、0.537±0.158、0.726±0.174;左眼分别为0.003±0.127、0.248±0.156、0.521±0.170、0.706±0.197;随对比度下降,视力呈下降趋势,高对比度组视力明显好于低对比度组(P<0.05)。左右眼在相同对比度下的视力无统计学差异(P>0.05)。100%对比度与25%、10%、5%对比度均呈正线性相关(P<0.05)。结论不同对比度是影响视力的重要因素,对比度越低,视力波动越明显。     

不同机种飞行员暗环境下对比度视力和反应时间简

目的观察不同机种飞行员在暗环境中不同对比度下的视力和反应时间。方法测量不同机型的75名男性飞行员在暗环境下的对比度视力和反应时间,年龄22-38（26．44±2．84）岁。按机种不同分为直升机组（54人108眼）、运输机组（5人10眼）、歼击机组（16人32眼）。先测量三组正常环境下的裸眼视力,再测量三组飞行员在暗环境正常背景下100％、25％、10Yoo和5％对比度下的视力和反应时间,先后测量右眼和左眼。比较各组不同对比度下的视力和裸眼视力的差别、暗环境各对比度下的视力和反应时间的差别。结果三组飞行员正常环境下的裸眼视力差异无统计学意义（P〉0．1）。直升机组100％对比度视力较裸眼视力好,差异有统计学意义（P〈0．05）,运输机组和歼击机组100％对比度视力与裸眼视力比较差异无统计学意义（P〉0．05）,其他对比度下各组的对比度视力均较正常环境下的裸眼视力差,差异有统计学意义（P〈0．05）。随对比度下降,各组对比度视力下降,反应时间延长。在各种对比度下,直升机组对比度视力较歼击机组好,差异有统计学意义（P〈0．05）;运输机组与其他两组之间差异无统计学意义（P〉0．05）;100％、25％和10％三个对比度下直升机组反应时间较歼击机组快,差异有统计学意义（P〈0．05）,运输机组和其他两组反应时间比较差异无统计学意义;在5％对比度下三组之间差异无统计学意义（P〉0．05）。结论不同机型的飞行员,虽然裸眼视力无明显差异,但在暗环境正常背景不同对比度下的视力和反应时间存在差异,直升机组较歼击机组对比度视力好,反应速度快。飞行员低对比度视力检查结果可为建立不同对比度下的视力正常值标准提供参考。     

老年原发性青光眼低对比度视力与HRT-Ⅱ视盘参数的相关性

目的 研究老年原发性青光眼低对比度视力的变化特点及与海德堡视网膜断层成像仪Ⅱ型(HRT Ⅱ)颞侧盘沿参数的相关性。方法 选择老年原发性青光眼患者45例(83眼),根据视野结果分为早期组21例(40眼)和中晚期组24例(43眼);正常对照组23例(40眼)。对3组受试者行屈光矫正后,采用多功能视力测量仪测得100％、25％、10%和5％4个对比度视力,分析比较各组低对比度视力有无统计学差异及青光眼组各低对比度视力与HRT-Ⅱ测得的颞侧盘沿面积(RA)、盘沿容积(RV)有无相关性。结果 3组间25％、10%及5％对比度视力总体比较差异有统计学意义(P<0.05);早期组与正常对照组各低对比度视力比较差异无统计学意义(P＞0.05);中晚期组各低对比度视力较正常对照组和早期组均下降(P<0.05),10％、5％低对比度视力与颞侧RA呈负相关(r=-0.361;r=-0.318,P均<0.05)、与颞侧RV呈负相关(r=-0.303;r=-0.377,P均<0.05)。结论 老年原发性青光眼病情进展导致低对比度视力下降,中晚期患者10％、5％低对比度视力与颞侧盘沿参数RA、RV有相关性,对比度视力检查可以对老年中晚期青光眼中心视功能的病情评估和监测提供依据。     

白内障术后早期对比度视力的恢复

目的 评估白内障患者术后早期视觉功能的恢复.方法 年龄相关性白内障42例(60眼),在术前和术后1周、1月分别测量最佳矫正视力,并应用多功能电子视力测量仪(MFVA-100)测量明亮(85cd/m2)、高亮(260cd/m2)背景下不同对比度(100％、25％、10％)的视力,用1og MAR值表示,观察手术后矫正视力和对比度视力的改变,分析不同情况下对比度视力相关性.结果 手术前明亮背景下100％的对比度视力高于高亮背景下(t=-2.901,P＜0.05);明亮背景下,术后1月100％的对比度视力高于术后1周(t=-2.398,P＜0.05);术后1周,明亮背景下各对比度视力均高于高亮背景(t=3.480、2.256、2.287,P＜0.05);术后1月,明亮背景下100％的对比度视力高于高亮背景(t=2.647,P＜0.01).结论 白内障手术可显著改善患者的各对比度下视力.手术后随着时间进展,高对比度视力可进一步改善,低对比度下眩光造成的视觉障碍逐渐降低.     

蓝光滤过型非球面人工晶体眼对比度视力、色觉的研究

目的比较蓝光滤过型非球面人工晶体眼和球面人工晶体眼在不同背景下不同对比度视力及色觉。方法对52例（52眼）老年性白内障患者行超声乳化白内障手术，以随机双盲的方式分别植入蓝光滤过型非球面人工晶体或球面人工晶体，术后3个月在暗背景（25cd／m^2）、高亮背景（255cd／m^2）、蓝色背景下检查患者不同对比度的视力及色觉。结果白色背景暗环境低对比度下（10％和5％对比度）蓝光滤过型非球面人工晶体组患者较球面人工晶体组患者视力佳，差异有统计学意义（P〈0．05）；术前、术后色觉检查未发现异常。结论暗环境低对比度下蓝光滤过型人工晶体较球面人工晶体更能提高患者的视力。     

不同飞行光环境对飞行人员对比度视力的影响

目的研究不同模拟飞行光环境下,不同视力受试者对比度视力的差异,为保障飞行安全提供试验依据。方法通过测量双眼视力,24名受试者分为1.0/1.0组、0.8/0.8组、0.6/0.6组和0.4/0.4组（均为小数视力）,每组6人,分别在模拟日光、迎光、背光、曙暮光和云上光环境下检测100%、80%、60%、40%、20%和10%对比度的视力。运用具有2个重复测量因素的三因素设计方差分析,比较不同光环境对不同视力者对比度视力的影响。结果光环境、视力和对比度3个因素间存在交互作用（P＜0.05）。进一步行两因素交互作用检验,光环境和对比度与视力间均存在交互作用（P均＜0.01）,而光环境和对比度间不存在交互作用（P＞0.05）。在相同对比度下,与日光环境相比,各视力组在曙暮光和云上光的对比度视力下降（P＜0.05）;对于80%、60%、40%对比度,0.6/0.6和0.4/0.4组在迎光环境下的对比度视力低于日光（P＜0.05）;对于20%、10%对比度,各视力组在迎光环境下的对比度视力低于日光（P＜0.05）。在相同对比度下,与1.0/1.0组相比,0.6/0.6、0.4/0.4组在5种光环境下的对比度视力均下降（P＜0.05）;对于20%、10%对比度,0.8/0.8组在日光、迎光、曙暮光、云上光环境下的对比度视力低于1.0/1.0组（P＜0.05）;在相同的光环境和对比度下,0.4/0.4组的对比度视力低于其余视力组（P＜0.05）。结论光环境、对比度和视力水平对对比度视力的作用相互影响。近视飞行人员在不利光环境（如迎光、云上光和曙暮光）下观察低对比度目标时对比度视力严重下降,对飞行安全构成潜在的威胁,故应重视近视飞行人员的对比度视力检查。     

多焦角膜接触镜矫正老视视觉质量评估

目的 探讨配戴多焦角膜接触镜矫正老视视远和视近视觉质量的效果.方法 18例老视患者分别配戴框架眼镜和多焦角膜接触镜后,测量亮环境下不同对比度（100%、25%和5%）视远和视近的LogMar对数视力,并在亮环境下测量对比敏感度,比较两种矫正方法对视觉质量的改善情况.结果 亮环境下,对比度为100%时,框架眼镜配戴后的视远视力和多焦角膜接触镜配戴后的视力无明显差异（P ＞0.05）;而对比度为25%和10%时,多焦角膜接触镜配戴后视远视力均显著低于框架眼镜配戴后视力（P＜0.01）.多焦角膜接触镜配戴后视近视力均明显低于框架眼镜配戴后视力（P＜0.05）.在低频（1.5周/度）情况下,框架眼镜和多焦角膜接触镜配戴后对比敏感度值无明显差异（P ＞0.05）;而在其他空间频率（3、6、12、18周/度）下,框架眼镜配戴后的对比敏感度值均明显高于多焦角膜接触镜配戴后的对比敏感度值（P＜0.05）.结论 多焦角膜接触镜在高对比度和亮环境下有很好的视远和视近视觉质量,而在低对比度下视觉质量有所下降.     

1977～1990年同济医科大学新生视力状况分析

用统计学方法对14年来（1977～1990年）我校6746名新生（13492只眼）的视力状况进行分析。结果表明；新生正常视力逐年减少，视力不良率相应上升（P＜0.001）。城市学生的视力比农村学生差，男生的视力优于女生（P＜0.001）。17～19岁组的视力明显低于其他年龄组（P＜0.001）。高考分数线升高与正常视力者减少呈明显负相关；而与视力不良者增加呈正相关（P＜0.001,＜0.05）。本文认为近距离用眼持续时间过长及环境视域小等是引起视力不良的主要原因。     

老年性痴呆患者认知功能与单胺类神经递质的关系

目的:探讨老年性痴呆(SD)患者认知功能与单胺类神经递质的关系.方法:对50例SD患者和48例正常人(对照组)分别进行事件相关电位(ERP)、探究性眼动分析(EEM)和血浆单胺类神经递质(去甲肾上腺素、多巴胺和5-羟色胺)水平的测定.结果:SD组ERP异常率为96%(48/50).与对照组比较,SD组ERP中N2、P3潜伏期延长,P3波幅降低(t分别为3.453、4.972和6.544,P均＜0.001);EEM测定巾的凝视点(NEF)及反应探索评分(RSS)值减少,D值增加(t分别为8.072、6.724和7.953,P均＜0.001);血浆去甲肾上腺素、多巴胺和5-羟色胺水平降低(t分别为4.587、3.971和3.534,P均＜0.001).相关分析显示SD组P3潜伏期、D值与去甲肾上腺素、多巴胺和5-羟色胺血浆水平呈负相关(r=-0.46～-0.33,P均＜0.05),而P3波幅、NEF、RSS与其呈正相关(r=0.32～0.48,P均＜0.05).结论:SD患者认知障碍和血浆单胺类神经递质水平下降间存在相关性.     

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…     

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.     

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.