带可调节缝线的巩膜瓣下小梁组织转位术治疗青光眼

目的评价带可调节缝线的巩膜瓣下小梁组织转位术治疗青光眼的疗效.方法选取74例(85眼)青光眼患者,随机分为治疗组(带可调节缝线的巩膜瓣下小梁组织转位术组)37例(44只眼)和对照组(传统小梁切除术组)37例(41只眼).并对两组术后疗效和并发症进行评价和比较.结果术后随访10～12个月.治疗组37例(44只眼)和对照组37例(41只眼)相比,功能性滤过泡分别为95.5%和75.6%,差异有显著性意义(x2=5.35,P＜0.05).浅前房出现率分别为6.8%和12.2%;低眼压发生率分别为2.27%和9.76%,两组差异均具有显著性意义(P＜0.05).术后12月,治疗组平均眼压为15.1±2.18 mmHg,对照组平均眼压为18.40±1.89 mmHg,两组相比,差异有极显著性意义(t=7.5,P＜0.01).两组均无滤过泡渗漏患者.所有病例手术前、后视力和视野基本保持不变,无统计学意义.结论带可调节缝线的巩膜瓣下小梁组织转位术可减少术后早期并发症,提高手术成功率,其近期疗效优于传统小梁切除术,且操作安全、简单,易于掌握.因本研究观察时间较短,其远期疗效尚需进一步观察.     

巩膜瓣下小梁组织转位联合巩膜瓣可松解缝线术治疗青光眼的临床研究

目的:探讨巩膜瓣下小梁组织转位联合巩膜瓣可松解缝线术治疗青光眼的疗效。方法:对完成追踪观察的264例(363只眼)各型青光眼随机分为观察组(巩膜瓣下小梁组织转位联合巩膜瓣松解缝线术组)132例(185只眼)和对照组(传统小梁切除术组)132例(178只眼),观察组术中扭转巩膜条带并缝合于巩膜床上,联合应用巩膜瓣调节缝线技术控制房水渗漏量。结果:术后随访5～84个月,平均34.6个月,其中≥12个月者占81.3%。术后12个月时,观察组和对照组平均眼压分别为(15.1±2.18)mmHg和(18.40±1.89)mmHg,差异有显著性意义(t=7.5,P<0.01);两组功能性滤过泡比较,观察组高于对照组,差异有显著性(χ2=26.351,P<0.01);术后并发症观察组亦低于对照组。结论:巩膜瓣下小梁组织转位联合巩膜瓣松解缝线术是治疗青光眼的安全而有效术式。     

改良巩膜瓣可拆调节缝线小梁切除术的临床研究

目的　观察改良巩膜瓣可拆调节缝线小梁切除术治疗青光眼的临床效果。方法　 2 8例 4 0只眼做改良巩膜瓣可拆调节缝线小梁切除术为治疗组 ,2 2例 32只眼做标准小梁切除术为对照组。结果　随诊 3年 ,治疗组 38只眼的眼压控制正常 ,手术成功率为 95 %,对照组 2 4只眼的眼压控制正常 ,手术成功率为 75 %。术后改善视力及并发症发生率 ,治疗组分别为 97.5 %、15 %;对照组为 78.12 5 %、4 0 .6 2 5 %,经统计学处理 ,均有显著差异 (P <0 .0 5 )。结论　改良巩膜瓣调节缝线小梁切除术组手术并发症少 ,视力提高显著 ,能有效控制术后滤过水平 ,促进早期前房形成 ,辅助长期滤过作用 ,较标准小梁切除术组有显著性优点。     

丝裂霉素C及可调节缝线在小梁切除术中的临床应用

目的评价在青光眼小梁切除术中联合应用丝裂霉素C和可调节缝线的效果。方法将115例122眼各种类型青光眼患者随机分组。实验组78眼行小梁切除术,术中应用丝裂霉素C联合巩膜瓣可调节缝线,对其术后疗效进行观察及随访;对照组44眼行常规小梁切除术。结果实验组的眼压控制有效率、功能性滤过泡均高于对照组（P〈0.01）,浅前房的发生率比对照组少,差异有统计学意义（P〈0.05）,无明显并发症。结论小梁切除术中联合应用丝裂霉素C及可调节缝线可有效地控制眼压水平,减少巩膜瓣瘢痕及主动调节房水滤过量,促进功能性滤过泡形成,减少并发症,提高手术成功率。此术操作简便,易掌握,是治疗青光眼安全有效的方法之一。     

拆线式巩膜瓣缝合及5-FU应用于小梁切除术中的临床观察

目的 探讨小梁切除术中应用巩膜瓣可拆除缝线及5-FU的临床效果.方法 小梁切除术中制作好巩膜瓣后,将浸透25 mg/ml的5-FU棉片敷贴于巩膜瓣下5 min,大量生理盐水冲洗,作小梁切除及虹膜根部切除,10-0丝线作巩膜瓣可拆除缝线.术后观察眼压、前房深度、结膜滤过泡及并发症.结果 治疗组前房形成平均时间1.2 d,功能性滤过泡形成率96.5%,远期平均眼压(15.2±1.7) mm Hg.与对照组比较差异有统计学意义(P＜0.01或P＜0.05).结论 小梁切除术中应用巩膜瓣可拆除缝线及5-FU,术后并发症少,功能性滤过泡形成率高,降眼压效果好,是一种较理想的抗青光眼手术方式.     

巩膜瓣可调整缝线在小梁切除术中的应用

目的:观察巩膜瓣可调整缝线在青光眼小梁切除术中的应用.方法:对80眼青光眼患者,做常规的梯形巩膜瓣与小梁切除术.在巩膜瓣两侧做可调整缝线.术后观察眼压、前房深度、结膜滤过泡.当手术后前房形成稳定或眼压回升大于10mmHg时,拆除巩膜瓣调整缝线.结果:术后第1天全部前房形成良好,术后巩膜瓣可调整缝线2周内拆除,平均7天,缝线拆除后,结膜滤过泡明显增大.结论:巩膜瓣可调整缝线能促进青光眼小梁切除术后早期前房的形成,能有效预防术后浅前房发生,术后2周内拆线对眼压具有调节作用,提高青光眼手术的安全性.     

原发性闭角型青光眼小梁切除术中两种巩膜瓣可调整缝线的疗效比较

目的 探讨原发性闭角型青光眼小梁切除术中两种巩膜瓣可调节缝线的临床疗效。方法 选取2018 年1 月至2020 年6 月在我院眼科手术治疗的原发性闭角青光眼患者43 例（60 眼）作为研究对象,随机分为对照组与观察组,每组各30 眼,对照组采用小梁切除术联合巩膜瓣两侧缝合1 对可调整缝线,观察组采用小梁切除术联合巩膜瓣鼻侧后角及中部各缝合1 针可调整缝线。定期随访3 个月比较两组并发症发生率、术后眼压控制情况及手术成功率。结果 两组术后浅前房、脉络膜脱离的并发症总发生率比较,差异无统计学意义（P>0.05）。观察组在术后1 d、1 个月、3 个月眼压均低于对照组,差异有统计学意义（P<0.05）。观察组在术后7 d、术后2 周眼压均低于对照组,但差异无统计学意义（P>0.05）。观察组术后3 个月的手术成功率为96.67%（29/30）,高于对照组的73.33%（22/30）,差异有统计学意义（P<0.05）。结论 在原发性闭角型青光眼小梁切除术中联合利用改良巩膜瓣可调整缝线技术是安全有效的,与传统的巩膜瓣可调整缝线相比提高了术后3 个月的手术成功率。     

小梁切除术联合巩膜瓣缝线松解及丝裂霉素应用治疗青光眼

目的:探讨青光眼的治疗方法及效果. 方法:对各型青光眼40例57眼,行小梁切除术联合巩膜瓣缝线松解,术中应用丝裂霉素为治疗组,观察术后眼压及浅前房等并发症,并与16例18眼常规小梁切除术(对照组)进行比较. 结果:治疗组:术后1个月平均眼压11.98mmHg,浅前房发生率为12.3%(7/57),对照组为55.5%(10/18),两组差异有非常显著意义(χ2=14.62,P<0.01).结论:小梁切除术联合巩膜瓣缝线松解及丝裂霉素应用可提高小梁切除术的成功率和安全性.     

丝裂霉素C及可调节缝线在小梁切除中的联合应用

目的评价在青光眼小梁切除术中联合应用丝裂霉素C和可调节缝线的效果。方法将72例76眼各种类型青光眼患者随机分为实验组44眼行小梁切除术,术中应用丝裂霉素C联合巩膜瓣单条可调节缝线,对其术后疗效进行观察及随访;对照组32眼行常规小梁切除术。结果实验组的眼压控制有效率、功能性滤过泡均高于对照组（P〈0.05）,浅前房的发生率比对照组少（P〈0.05）,无明显并发症。结论小梁切除术中联合应用丝裂霉素C及可调节缝线可有效地控制眼压水平,减少巩膜瓣瘢痕及主动调节房水滤过量,促进功能性滤过泡形成,减少并发症,提高手术成功率。     

丝裂霉素C及可调整缝线在青光眼小梁切除术中的应用

目的 评价在青光眼小梁切除术中应用丝裂霉素C和可调整缝线的效果.方法 将68例71眼各种类型青光眼患者随机分组.实验组37眼行小梁切除术,术中应用丝裂霉素C(MMC)联合巩膜瓣单条可调整缝线,对其术后疗效进行观察及随访;对照组34眼行常规小梁切除术.结果 所有病例术前术后视力不变或增减一行,实验组的眼压控制有效率、功能性滤过泡比例均较对照组高(P＜0.05),浅前房的出现比例比对照组少,差异有高度显著性意义(P＜0.01),无明显并发症,眼压控制良好.结论 小梁切除术中应用MMC及可调整缝线可减少手术并发症,防止滤过道粘连阻塞,有效地控制眼压水平,提高青光眼的手术成功率.     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.