准分子激光上皮下角膜磨镶术矫正高度近视的临床观察

目的观察准分子激光上皮下角膜磨镶术(LASEK)矫正高度近视的疗效与安全性。方法对61例(120眼)进行LASEK手术的高度近视患者,术后随访6个月,观察术后症状、裸眼和最佳矫正视力、眼压、角膜愈合程度、视觉质量和并发症。结果LASEK术后6周裸眼视力≥0.6者占100%,裸眼视力≥1.0者占94%。平均角膜上皮愈合时间1~5d。术后3眼(2.5%)出现Haze,0.5级2眼,1.0级1眼。1例患者出现眩光。结论如何更好的保留上皮瓣的活力,减少角膜上皮下雾状浑浊(Haze)的发生,是LASEK矫正高度近视取得良好疗效的关键。     

IASEK和LASIK治疗中高度近视1年结果的对比分析

目的比较准分子激光上皮瓣下角膜磨镶术(LASEK)和准分子激光原位角膜磨镶术(LASIK)治疗中高度近视的临床效果。方法中高度近视58例115眼,分为LASEK组治疗28例55眼,LASIK组治疗30例60眼。术后1周,1、3、6和12个月随访检查视力、屈光度、角膜地形图和角膜雾状混浊(Haze)等并发症。结果术后12个月,裸眼视力≥0.5、≥1.0者,两组间无显著性差异(P>0.05);术前最大散光轴度与术后12个月的轴度比较,≤±15°者,LASEK组明显多于LASIK组(P<0.05),≥±30°者,LASEK组明显少于LASIK组(P<0.05);角膜地形图分析平均角膜中央屈光力与周边屈光力的差异,LASEK组(1.30D)明显小于LASIK组(1.63D),P<0.01);LASEK组角膜Haze明显高于LASIK组角膜层间混浊(P<0.01),但均为对视力无影响的<0.5级的混浊。结论LASEK治疗中高度近视效果好,避免了角膜瓣相关的并发症,有可能成为今后主要的屈光手术方法。     

LASEK和LASIK治疗中高度近视1年结果的对比分析

目的比较准分子激光上皮瓣下角膜磨镶术(LASEK)和准分子激光原位角膜磨镶术(LASIK)治疗中高度近视的临床效果.方法中高度近视58例115眼,分为LASEK组治疗28例55眼,LASIK组治疗30例60眼.术后1周,1、3、6和12个月随访检查视力、屈光度、角膜地形图和角膜雾状混浊(Haze)等并发症.结果术后12个月,裸眼视力≥0.5、≥1.0者,两组间无显著性差异(P＞0.05);术前最大散光轴度与术后12个月的轴度比较,≤±15°者,LASEK组明显多于LASIK组(P＜0.05),≥±30°者,LASEK组明显少于LASIK组(P＜0.05);角膜地形图分析平均角膜中央屈光力与周边屈光力的差异,LASEK组(1.30D)明显小于LASIK组(1.63D),P＜0.01);LASEK组角膜Haze明显高于LASIK组角膜层间混浊(P＜0.01),但均为对视力无影响的＜0.5级的混浊.结论LASEK治疗中高度近视效果好,避免了角膜瓣相关的并发症,有可能成为今后主要的屈光手术方法.     

准分子激光上皮下角膜磨镶术治疗中高度近视的效果观察

目的：评价准分子激光上皮下角膜磨镶术(LASEK)治疗中、高度近视的临床效果。方法：采用LASEK治疗68例(136眼)中高度近视,屈光度-3．25～-12．0D,随访6个月,观察症状、视力、屈光状态、角膜并发症等情况。结果：LASEK手术后角膜刺激症状轻微,介于PRK与LASIK之间,术后1个月裸眼视力均达0．5以上,6个月裸眼视力≥1．0者118眼,占86．8％,手术后6个月角膜Haze：0级72眼,0．5级54眼,1级10眼,无一例2级以上。结论：LASEK治疗中高度近视具有良好的安全性、预测性和有效性,手术后疼痛症状、角膜haze明显减轻,但高度近视患者易出现角膜混浊和屈光回退。     

丝裂霉素C防止高度近视LASEK术后角膜雾状混浊的临床研究

目的 探讨高度近视准分子激光上皮瓣下角膜磨镶术(LASEK)术中应用丝裂霉紊C(MMC)抑制术后角膜上皮下雾状混浊(Haze)的疗效.方法 218例436眼行LASEK术的高度近视患者随机分为两组:MMC组112例224眼及对照组106例212眼.MMC组在激光切削完毕后用浸有0.02%MMC的棉片覆于角膜切削区40～60s;对照组采用常规LASEK手术.术后早期观察眼部刺激症状及角膜上皮愈合情况;1、3、6、12个月复查视力、屈光度、角膜Haze及角膜地形图.结果 两组上皮愈合时间差异无统计学意义(P＞0.05);术后1、3、12个月,两组Haze分级≥0.5级以上发生率比较,MMC组明显低于对照组(P＜0.01),未出现2级及2级以上的Haze;术后1年两组达最佳矫正视力者差异无统计学意义(P＞0.05),但MMC组中高于及低于最佳矫正视力1行的眼数与对照组相比.差异有统计学意义(P＜0.05);MMC组术后1个月与1年的角膜曲率差异无统计学意义,而对照组差异有统计学意义(P＜0.05).结论 LASEK术中应用低浓度MMC能有效抑制高度近视LASEK术后角膜Haze的产生,防止屈光状态回退,有助于视力的提高.     

高度近视眼行单眼LASEK术及另眼LASIK术避免双眼Haze的疗效探讨

【目的】探讨高度近视患者行单眼准分子激光角膜上皮下磨镶术（LASEK）及另眼行薄瓣准分子激光原位角膜磨镶术（LASIK）以避免双眼同时出现Haze的可行性和有效性。【方法】在同一患者的两眼分别行LASEK及超薄瓣LASIK,治疗对象为近视度高于-6.0D,角膜厚度≥450μm的43例患者。其中LASEK组近视度数-6.0— -17.75D,平均（-9.34±2.75）D;超薄瓣LASIK组近视度数-6.0— -15.25D,平均（-8.29±2.14）D。分别于术后1d、1周、2周及1、3、6、12个月随访患者裸眼视力、屈光状态及角膜上皮下雾状混浊（Haze）的情况。【结果】超薄瓣LASIK组术后反应较LASEK组轻。术后6个月UCVA≥0.8的比例为：LASEK组为93.0％;LASIK组为88.4％。等效球镜值在±0.5D以内的比例分别是：LASEK组为79.1％;LASIK组为76.7％。双眼同时视物时裸眼视力均在1.0以上。Haze情况：LASIK组无1例,LASEK组在术后的1个月时为18.6％、3个月为25.6％、6个月为20.9％、1年为16.3％,其中1例为2级,其余均为1级。【结论】在高度近视的患者,一眼行LASEK,另眼行超薄瓣LASIK,既避免双眼同时出现Haze的现象,又保证了双眼视远时良好的视力。     

早期激素冲击疗法治疗LASEK术后Haze形成的临床研究

目的研究准分子激光上皮下角膜磨镶术(LASEK)术后激素冲击疗法治疗角膜上皮下混浊(Haze)的效果。方法65例127眼分为实验组和对照组,在LASEK术后采用不同的给药方法,观察Haze形成及视力、眼压情况。结果两组术后10天均有Haze出现,术后1、3、6个月Haze发生率差异有高度显著性(P均<0.01),术后12个月差异无显著性(P>0.05)。两组术后不同时期的裸眼视力和眼压差异无显著性(P>0.05)。结论激素冲击疗法治疗LASEK术后Haze形成安全有效,可以推广应用。     

联合用药对LASEK术后Haze治疗的临床观察

目的 观察通过短期大剂量应用高浓度激素冲击疗法及配合非激素性药物减轻或消除LASEK术后角膜上皮下雾状混浊(Haze)的疗效.方法 选取LASEK术后出现Ⅱ～Ⅲ级Haze的患者10例(20眼),右眼滴用0.5%百力特眼水,普拉洛芬眼水、噻吗心安眼水(眼压升高者应用),左眼滴0.1%氟米龙眼水作为对比.结果 治疗3个月后,右眼Haze减轻或消失,视力提高明显,眼压控制好.结论 百力特联合普拉洛芬治疗Haze是安全有效的,值得临床推广.     

LASEK治疗中高度近视的效果分析

目的 评价准分子激光上皮下角膜磨镶术(LASEK)治疗中、高度近视的临床效果.方法 应用美国VISX starS4准分子激光仪行LASEK治疗80例(176眼)中高度近视,屈光度-3.25～-12.0D,随访12个月,观察症状,视力,屈光状态、角膜混浊程度情况.结果 LASEK手术后角膜刺激症状轻微,介于PRK与LASIK之间,术后1个月裸眼视力均达0.5以上,6个月裸眼视力达到甚至超过术前最佳矫正视力159眼占90.91%,手术后12个月角膜haze:0级141眼,0.5级32眼,1级3眼,无1例2级以上.结论 LASEK治疗中高度近视具有良好的安全性,预测性和有效性,操作简单,适合于角膜厚度较薄的高度近视、某些特殊职业者,其拓宽了准分子激光的适应证.手术后疼痛症状角膜haze明显减轻,但高度近视患者偶尔出现角膜混浊和屈光回退.     

准分子激光上皮下角膜磨镶术治疗超高度近视的远期疗效观察

目的 探讨准分子激光上皮下角膜磨镶术(laser subepithelial keratomileusis LASEK)治疗超高度近视(≥-10.00D)的远期效果.方法 收集2003年12月-2006年1月在本院行LASEK的超高度近视103例180只眼,观察时间14～38个月,平均(24.93±6.50)月;术前裸眼视力0.01～0.1,平均(0.062±0.047),最佳矫正视力0.5～1.2;平均(0.97±0.13),术前屈光度10.00～-14.50D,平均(-11.32±1.14)D.结果 术后14～38个月回访,裸眼视力0.2～1.5,平均(0.98±0.29),≥1.0者128眼占71.10%,≥0.6者164眼占91.10%,haze 10眼,0.5级8眼,1级2眼.结论 LASEK治疗超高度近视的远期疗效安全可靠,疗效稳定,并发症少.     

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.     

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.     

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.