糖尿病患者白内障超声乳化摘除及人工晶体植入术治疗评价

目的 评价糖尿病患者白内障超声乳化摘除及人工晶体植入术后的临床效果。方法 对２４例（２７只眼）糖尿病２型患者行白内障超声乳化摘除及人工晶体植入术，术前平均血糖８．４ｍｍｏｌ／Ｌ。结果 术后随访１２～２２个月，视力０．５以上者１４只眼（５２％），０．１～０．４者１２只眼（４４％），０．１以下者１只眼（４％）。术中术、后并发症少。结论 糖尿病患者白内障，术前血糖高于正常水平，但无全身及眼部严重并发症者     

外伤性白内障人工晶体植入手术的探讨

对６２例（６２只眼）外伤性白内障施行白内障摘除及人工晶体植入手术。随访３～３８个月，术后矫正视力≥０５者占５１６％，≥１０者占２０９％。对外伤性白内障人工晶体植入的时机、手术操作、术后并发症及前房型人工晶体的植入进行了探讨。认为正确选择手术时机，处理好术中并发症，选择合适的晶体，可以减轻术后并发症，使病人恢复更好视力。     

近视并白内障的手术治疗

目的：探讨用超声乳化摘除白内障联合人工晶体植入，治疗中老年近视及并发白内障的疗效和并发症。方法：对47例(53只眼)近视并发白内障患者在表面麻醉下行超声乳化摘除白内障联合人工晶体植入手术，观察手术前、后的视力变化和手术并发症的发生情况。结果：视力0．4～0．516只[30．18％)、0．6～0．714只眼[26．14％)、≥0．815只眼(28．30％)，脱盲率占94．34％。术中并发症有7只眼后囊膜穿孔、1只眼前房出血，术后有15只眼反应重，2只眼虹膜脱出、9只眼后囊膜混浊，2只眼囊袋收缩。结论：超声乳化摘除白内障联合人工晶体植入，治疗中老年近视并发白内障，手术并发症少，安全有效。     

儿童白内障摘除联合后房型人工晶体植入术

目的：通过对儿童白内障摘除联合后房型人工晶体植入术的观察，探讨儿童人工晶体植入的时机、屈光度的选择、手术技巧、并发症的防治及疗效．方法：２岁～１２岁（平均 ７．６±３．５岁）儿童白内障 ７８眼，Ｉ期植入人工晶体６８眼（先天性白内障６０眼，外伤性白内障８眼）；Ⅱ期植入１０眼（外伤性白内障６眼，无晶体眼４眼）结果：术后矫正视力＞０．５共 ３７眼，占 ４７．４％；０．３～０．５共 ２８眼，占 ３５．９％；０．３以下 １３眼，占 １６．７％．术后葡萄膜炎及后发障较重．结论：儿童期白内障术后植入后房型人工晶体是防治弱视、恢复双眼单视功能行之有效的方法．     

糖尿病患者老年性白内障的手术治疗

目的：比较白内障超声乳化（phacoemusification,PHACO)与现代囊外除（extracapsular cataract extaction,ECCE)两种不同术式治疗糖尿病患白内障优缺点。方法：采用回顾性的分析方法，分析我院1998年至2001年糖尿病患白内障66例和76只眼，行白内障超声乳化除联合后房型人工晶体植入36例42只眼，现代囊外除联合后房型人工晶体植入30例34只眼，对两术前血糖，术后视力，角膜散光及术中术后并发症进行比较。结果：66例76只眼糖尿病患包括术前空腹血糖高于正常均安全完成手术，经统计分析，PHACO组的空腹血糖水平高于ECCE组；术后裸眼视务≥0．5PHACO组占76．2％，ECCE组占26．5％，PHACO组优于ECCE组；角膜散光PHACO组低于ECCE组。PHACO组术后并发症低于ECCE组。结论：PHACO组有较高的血糖耐受水平，把握好手术时机，采用小切口超声乳化术，多数糖尿病患可获得满意效果。     

糖尿病患者白内障围手术期处理及疗效观察

目的 探讨糖尿病患者白内障的围手术期处理方法并观察手术疗效。方法 选择2003年2月～2004年1月期间明确诊断为糖尿病的白内障患者82例（92眼），50例（54眼）为Ⅳ～Ⅴ级核，采用囊外晶体摘除术＋人工晶体植入（ECCE＋IOL）术。32例（38只眼），为Ⅱ～Ⅲ级核，采用超声乳化＋人工晶体植入（PHACO＋IOL）术。结果 术后疗效评价采用术前和术后平均裸眼视力等级资料配对秩和检验（Wilcoxon配对法）。术后裸眼视力≥0.5者占66.3%,≥0.3者占92.4%，术前和术后裸眼视力差异非常显著（P〈0.01）。结论 糖尿病白内障患者经正确的围手术期处理，将血糖控制至基本正常水平，行ECCE-IOL术及PHACO＋IOL术，疗效肯定。     

糖尿病患者白内障摘除人工晶体植入术的探讨

目的 :观察糖尿病患者白内障摘除人工晶体植入的疗效。方法 :对 17例 (2 0眼 )糖尿病患者血糖控制在安全范围后行白内障摘除人工晶体植入术 ,并将其结果与同期行此类手术随机抽取的 17例 (2 1眼 )非糖尿病患者进行比较。结果 :糖尿病患者术后矫正视力 0 5以上者 11眼 ,占 5 5 %。 0 1以上者 18眼 ,占 90 %。非糖尿病患者术后矫正视力 0 5以上者 12眼 ,占 5 7 1%。 0 1以上者 2 0眼占 95 2 %。差异无显著性 (P >0 .0 5 ) ,两组术中术后并发症的发生率差异亦无显著性 (P >0 .0 5 )。结论 :糖尿病患者血糖控制在安全范围内行白内障摘除人工晶体植入已不再为手术禁忌 ,相反 ,手术安全可靠 ,能达到预期的复明效果     

超高度近视白内障超声乳化人工晶状体植入手术治疗分析

目的探讨采用白内障超声乳化人工晶体植入对超高度近视合并白内障患者进行手术,观察患者术后的疗效。方法对43只眼超高度近视白内障患者实施白内障超声乳化摘除人工晶体植入,记录其术后效果。结果术后裸眼视力≥0.4者12眼(28%),0.1～0.4者28眼(65%)。结论白内障超声乳化摘除人工晶体植入治疗超高度近视合并白内障眼是安全有效的。     

糖尿病患者白内障手术临床观察

为了解糖尿病患者的白内障手术效果和手术并发症，观察糖尿病性白内障现代囊外摘出术３９ 例４１眼，并以４０ 例４４ 眼非糖尿病性白内障手术作对照，两组各有１０ 眼植入后房型人工晶体。最终随访矫正视力：糖尿病组６１ ％ ≥０５ ，非糖尿病组７０ ％ ≥０５ ，两组间差异无显著性（ Ｐ＞ ００５） 。视力为００６ ～０２ 的糖尿病组中的５ 只眼都有糖尿病性视网膜及黄斑病变。术后并发症， 糖尿病组明显多于对照组，差异有显著性。强调手术后密切观察和及时治疗的重要性。     

糖尿病患者白内障摘除及人工晶体植入术

目的评估糖尿病患者白内障摘除及人工晶体植人术治疗效果。方法对32例（40眼）糖尿病患者行白内障囊外摘除和后房型人工晶体植入术。结果随访3～36个月,40只眼视力均得到明显提高,矫正视力达0．5以上者占77．5％。结论白内障囊外摘除及人工晶体植入术是糖尿病白内障患者的一种较理想的手术。     

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.     

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.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

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.