多焦视网膜电图评价视网膜脱离手术后的黄斑功能

目的:探讨多焦视网膜电图(MERG)对视网膜脱离(RD)术前、术后的黄斑区客观评价意义。方法:应用Retiscan图像系统对12例RD患者的12只患眼及未网脱眼术前和术后黄斑区进行MERG检测。结果:视网膜脱离术前黄斑区域第1环MERG值与对侧眼对应区域比较P1波振幅密度和N1波振幅较对侧眼相应值均明显降低(P<0.05);术后黄斑区域第1环P1波振幅密度和N1波振幅较术前有明显提高(P<0.05);与对侧眼对应区域比较P1波振幅密度和N1波振幅明显降低(P<0.01)。结论:多焦ERG能客观定量评价RD术前、术后黄斑区的视功能;视网膜解剖复位后黄斑区视功能不能完全恢复;P1波和N1波潜伏期无明显改变。     

兔眼孔源性视网膜脱离手术复位后视功能以及超微结构的变化

目的对比研究兔眼视网膜脱离后选择不同时期手术复位视功能的变化情况,为临床手术时机的选择及预测术后视功能的恢复情况提供理论与实验依据。方法利用家兔制备孔源性视网膜脱离模型,成模后1 d、7 d1、4 d时经手术达解剖复位,采用多焦视网膜电流图检测复位后视网膜的功能,数据处理应用SPSS软件。制备组织病理学切片。结果多焦视网膜电流图显示1 d、7 d、14 d的RRD手术复位后P1波平均象限反应密度(QAP1,nV/deg2),P1波幅值(AP1,μV),N1波幅值(AN1,μV),P1波潜伏期(TP1,ms),N1波潜伏期(TN1,ms)各项数值差异有显著性(P<0.05)。光镜电镜显示视网膜脱离复位后组织病理学改变。结论视网膜脱离手术复位后视网膜细胞功能的恢复与脱离时间有明显的负相关性;多焦视网膜电流图对于局部视网膜功能的评价有重要意义;组织病理学研究提供了解释视功能变化的重要依据。     

Comparison of pre-and post-operational multifocal electroretinograms of retinal detachment

目的　探讨视网膜脱离术前和术后多焦视网膜电图 (multifocalelectroretinogram ,mfERG)的改变及评价其临床应用价值。方法　 2 3例 ( 2 3只眼 )患裂孔源性视网膜脱离患者手术前后分别进行了mfERG检查。于脱离区 ,非脱离区 ,中心凹及整个测试区 ,对手术前和手术后mfERG的N1波和P1波的潜伏期和平均反应密度进行比较。结果　手术前脱离区的N1波和P1波的平均反应密度明显小于非脱离 ,差异有显著性意义 (t=3 68,t4 2 6,P <0 .0 1 ) ,脱离区的N1波和P1波潜伏期时明显比非脱离区延长 ,差异有显著性意义 (t=3 .0 7,t=3 .89,P <0 .0 1 )。手术后于脱离区 ,中心凹和整个测试区的N1波和P1波平均反应密度较术前明显增大 (P <0 .0 5) ,但N1波和P1波的潜伏期则无明显变化 (P >0 .0 5)。结论　mfERG是评价术后视网膜功能恢复的有用工具 ,对视网膜功能测试反应密度较潜伏期为更敏感的指标。     

视网膜颞上分支静脉阻塞光学相干断层扫描与多焦视网膜电图的观察

目的：观察视网膜颞上分支静脉阻塞的光学相干断层扫描和多焦视网膜电图各参数的特征及相关性。方法：随机选择视网膜颞上支静脉阻塞患者30例（30只眼）,对侧眼作为正常对照组,分别行光学相干断层扫描（OCT）及多焦视网膜电图（mfERG）检查,OCT用来观察黄斑区视网膜厚度,mfERG分析其一阶反应的P1、N1波各成分特征。结果：OCT显示患眼各个分区的视网膜厚度与对侧眼比较差异有统计学意义（P〈0．05）;mfERG显示患眼1环、颞上象限、上半侧区域P1波振幅密度,颞上象限、上半侧区域N1波潜伏期与对侧眼比较差异有统计学意义（P〈0．05）;患眼CSF视网膜厚度与2环的P1波振幅密度呈显著负相关关系（r=-0．691,P=-0．02）;直径5mm中心凹周围视网膜平均厚度与3环P1波振幅密度呈显著负相关关系（r=-0．636,P=0．03）。结论：OCT与mfERG相结合能更全面反映视网膜分支静脉阻塞眼功能、厚度及微结构变化。     

视觉电生理检查在眼球挫伤中的应用研究

目的研究眼球挫伤的多焦视网膜电图(mutilfocal electroretinogram,MERG)改变,探讨多焦电生理检查在眼球挫伤中的应用价值。方法选择眼球挫伤44例47眼,应用国特GT 2000NV电生理仪器进行MERG检查,对不同程度受伤眼及正常眼的总体参数、各环的波振幅、潜伏期进行比较。结果受伤眼的矫正视力与黄斑中心凹区一环的b波振幅密度之间具有线性正相关关系;受伤眼与正常眼之间多焦视网膜电图的a波、b波的潜伏期及一环b波振幅密度值具有显著性差异。结论国产多焦电生理系统国特GT2000NV电生理仪能够客观反映挫伤眼球的视功能损害程度,是评价眼球挫伤患者视功能的客观有效工具。     

增生型糖尿病视网膜病变治疗后的多焦视网膜电图特征及其与视力的相关性

目的 观察治疗后增生型糖尿病视网膜病变（PDR）患眼的多焦视网膜电图（mfERG）特征并分析其与视力的相关性。方法 采用病例对照研究方法，将2021年12月至2022年5月安徽医科大学第一附属医院眼科确诊为PDR，并治疗后稳定3个月的患者29例（39眼）作为PDR组，同时选取年龄匹配且无明显糖尿病视网膜病变眼底表现的2型糖尿病（T2DM）患者33例（53眼）作为T2DM组纳入研究。受检者均行最佳矫正视力（BCVA）、mfERG及光学相干断层扫描（OCT）检查，观察两组对象mfERG的P1波、N1波振幅密度与潜伏期、视盘周围视网膜神经纤维层（pRNFL）厚度，分析各个指标与视力的相关性。结果 与T2DM组比较，PDR组1～6环P1波及N1波振幅密度均降低（P<0.05）, 2～6环的P1波潜伏期和5～6环N1波潜伏期均延长（P<0.05），而1环P1波及1～4环N1波潜伏期差异无统计学意义（P>0.05）。PDR组各个象限P1波振幅密度均下降以及潜伏期均延长（P<0.05），并且颞上、颞下和鼻下方的N1波潜伏期均延长（P<0.05），而各个象限N1波振幅密度...     

兔出血性视网膜脱离的视觉电生理变化

目的 :观察在一种兔出血性视网膜脱离 (hemor rhagicretinaldetachment,HRD)模型中的视功能损害 .方法 :12只健康青紫蓝兔 ,设立HRD组 (视网膜下腔注入 0 .2mL自体血 ) ,视网膜脱离 (retinaldetachment,RD)组和假注射组 .于HRD建立前 2d ,建立后 3h ,1,3,7,14 ,2 1和 2 8d行视网膜电图 (electroretinogram ,ERG)和视觉诱发电位 (visualevokedpotential,VEP)检查 .结果 :HRD建立后ERGa及b波的潜伏期均延长 ,3～ 7d升至最高点 ,后有所恢复 ,但在 2 8d仍较正常水平延长约 5 % - 30 % .其振幅于 3d降到最低点 ,7d时略有回升 ,遂进入平台期 ,直至 2 8d约相当于术前的 5 0 %(P <0 .0 5 ) .RD组相应的各波潜伏期术后略有延长 ,1d后接近术前值 .振幅在术后 1d下降到最低点 ,与假注射组有显著差异 (P <0 .0 5 ) .假注射组术后 3hERGs略有改变 ,而后恢复至正常值 .HRD组VEP的潜伏期和振幅值术后较另 2组分别延长和降低 ,3d后无明显变化 .结论 :采用视觉电生理检查客观评价此模型的视网膜功能损害 ,证实HRD损伤是涉及视网膜多层的不可逆性损伤     

44例裂孔性视网膜脱离的暗适应视网膜电图及振荡电位的观察

目的：检测裂孔性视网膜脱离患者的视网膜电图（FERG）及振荡电位（OPs),总结FERG及OPs在视网膜脱离中的变化规律。方法：随机选择1眼为裂孔性视网膜脱离,另1眼除屈光不正外无其他眼疾中44例、44眼,进行暗适应FERG及OPs的检测。与对侧眼作比较研究,主要观察指标有：FERG中的a波振幅（aA);b波振幅（bA);a波峰时（aT);b波峰时（bT),OPs中的∑O,O1,O2,O3,O4及其峰时值的变化。结果：全部病例均有病理改变,视网膜脱离眼上述指标与对侧眼差异有显著性（P＜0．05）,降低幅度与视网膜脱离面积有关。视网膜脱离眼FERG的a波振幅、b波振幅与手术效果相关,异常程度轻者手术成功率高。结论：视网膜电图检查是了解视网膜机能的有效方法之一,术前检查视网膜脱离患者的FERG及OPs,有助于了解病变严重程度及视功能损害的情况,能对手术预后做出较适合的估计。     

激光治疗后中心性浆液性脉络膜视网膜病变多焦视网膜图分析

目的观察经激光治疗后的中心性浆液性脉络膜视网膜病变(CSC)多焦视网膜电图(m fERG)特点。方法对25例研究对象进行双眼m fERG随访测定,61个六边形从中央到周边共分5个环,测定31°视野范围的一阶反应(first-order kernel),分别进行双眼比较。结果N1波、P1波潜伏期比较各环均无差异显著性(P>0.05),N1波幅值在环1、环2比较差异有非常显著意义(P<0.01),P1波幅值在环1、环2比较差异有非常显著意义(P<0.01)。双眼无差别组N1波幅值患眼与对侧眼比较各环均无差异显著性(P>0.05),P1波幅值患眼与对侧眼比较仅在环2差异有显著意义(P<0.05);双眼有差别组N1波幅值患眼与对侧眼比较在环1、环2差异有显著性(P<0.05),P1波幅值患眼与对侧眼比较在环1、环2差异有非常显著意义(P<0.01),在环3差异有显著意义(P<0.05)。结论激光治疗后的CSC患眼m fERG幅值仍低于正常对侧眼。m fERG检查能反映其黄斑区功能变化。     

视网膜电图在视网膜脱离术前后的应用研究

目的：探讨视网膜脱离术前后的视网膜电图（ERG）变化规律。方法：对30例单眼单纯性视网膜脱离的病人术前术后行ERG检查。结果：ERG振幅下降与视网膜脱离的面积正相关，与脱离时间正相关；术前ERG振幅越高，手术的成功率越高，术后机功能恢复越好；网脱手术成功者对侧眼ERG振幅与正常对照组间差异无显著性（P≥0.05），而手术未成功组与正常对照组间差异有显著性（P＜0．01），未成功组与手术成功组间ERG振幅的差异有显著性（P＜0．05）。结论:ERG检查对视网膜脱离手术治疗有重要指导意义。     

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.