激光斑纹验光仪与检影法验光的对比观察

本文对299例(573眼)屈光不正用激光斑纹验光仪与检影法作对比,认为激光斑纹验光仪与检影法的准确度相似,而且对散光及其轴向较易检出,并可同时检测几个人,适用于普查性验光工作。     

激光散斑检查人眼屈光不正的研究

利用单色性很好的 He-Ne 激光,在漫射屏后产生看得见的空间散斑图样,观察者与漫射屏之间有相对运动时,观察到的斑纹影动能反映出观察者的屈光状态。根据这个道理,我们利用激光散斑,对80例屈光不正人眼进行检查研究。结果如下:1.各种不同类型的屈光不正,用激光     

波前像差与屈光矫正

0引言波前像差,作为一种光学测量方法,最早在天文学上得到应用,测量大气引起的光学像差犤1犦。1944年开始用于测量人眼的屈光误差和高阶像差犤2犦,但由于设备复杂难以普及。随着准分子激光角膜屈光手术的进展,波前像差的测量设备和方法得到了飞跃性的发展犤3犦。使我们能够跳出几何光学水平,对人眼的屈光矫正有了更新的认识,视野更为开阔。以下是我们在学习和实践中的一些体会。运用像差理论,能够更全面地解释人眼的屈光异常及验光配镜中的一些问题。1什么是波前像差光是一个行进的电磁波,波前是光波的连续性的同相表面。波前垂直于行进方向…     

角膜屈光手术前不同验光方法的差异及应用

目的探讨不同验光方法的屈光度差异及在角膜屈光手术中的应用。方法对行准分子激光角膜屈光手术的近视患者121例（242眼）,术前用自动电脑验光、主觉验光、散瞳检影验光三种不同验光方法检查近视屈光度,并根据年龄、程度分组,以散瞳检影验光的屈光数为参数,另外两种方法与其进行比较,〉0．75D为差异有统计学意义。结果自动电脑验光与散瞳检影验光差异比率是71．07％,主觉验光与散瞳检影验光差异比率是61．16％。差异受年龄、瞳孔、调节因素影响。结论不同验光方法所获得的近视屈光度是有差异的,角膜屈光手术前应避免单种验光手段所带来屈光误差,根据综合验光结果制定手术计划。     

怎样验光与配镜

屈光不正患者由于眼球屈光系统屈折的异常，致使平行光线人眼后不能在视网膜上成一清晰的像，临床上表现为视力不正常。如通过验光的方法找出共轭焦点（或联合焦点），则可在视网膜上成一清晰的像，从而矫正视力。下面简单谈谈如何验光与配镜。1验光方法分两大类，即客观验光（散瞳验光）及主观验光。1．1散瞳验光儿童及青少年时期或远视患者，因调节过强必须使用调节麻痹剂，待瞳孔散大后可以了解到：有无假性近视；真实的屈光状态及屈光度；较小的散光及球面差。1．1.1散瞳药物的使用（1）15岁以下的儿童、青少年及远视患者，最好选用力量…     

第二阶Zernike多项式与屈光不正的关系及其像差的矫正

波前像差引导的准分子激光角膜屈光手术是“个性化”切削的主要方法，与传统的矫正屈光不正方法相比，在原理和方法上有很大不同。本研究从人眼像差的概念出发，研究像差的Zernike多项式表示方法、第二阶像差与屈光不正的关系，验证波前像差引导的准分子激光角膜屈光手术的可行性和准确性，为矫正人眼低阶和高阶像差提供理论依据。采用理论研究和实验相结合，标定像差和切削量的关系。实验结果表明，第二阶像差与屈光不正存在一定的联系，从而可以标定以像差引导的切削，达到矫正人眼像差的目的。     

Suresight验光仪在儿童屈光筛查中的应用

目的探讨Suresight验光仪筛查儿童屈光不正的价值,从而达到早期防治弱视的目的。方法用Sure-sight验光仪自然状态下筛查学龄前儿童12238（24476眼）,对屈光异常者中437人（874眼）做散瞳验光。结果3-6岁儿童群体屈光筛查异常率为15.41％,437人屈光异常者散瞳验光后,47.14％确诊为弱视。自然状态下Suresight验光仪检查结果与散瞳检影结果比较：球镜度数呈正相关（r=0.560,P〈0.01）;柱镜及轴向也呈正相关（r=0.846和r=0.925,P〈0.01）。结论Suresight验光仪在婴幼儿和学龄前儿童屈光筛查中有较好的使用价值。     

屈光不正1387例医学验光与1176例常规验光的对比分析

目的　探讨屈光不正的科学检测及验配方法。方法　将屈光不正患者 2 5 63例 ,按时段分为医学验光 ( 13 87例 )和常规验光 ( 1176例 )两组。医学验光在客观和规范主觉验光的基础上 ,根据被检者眼位、调节强弱、集合功能、双眼单视及双眼调节平衡状态确定最后的验光处方 ,结合患者实际需要 ,经充分时间试戴后再确定配镜。将两种验光处方戴镜后的视力、舒适性和持久性结果 ,用统计软件SPSS11 0进行统计学分析。结果　戴镜后两组矫正视力的改善情况无显著性差异 (P >0 0 5 )。从戴镜舒适性和持久性相对改善情况 ,医学验光组优于常规验光组 (P <0 0 1)。结论　临床检测屈光不正应按照医学验光的步骤取得准确的远用屈光矫正度数 ,并结合年龄、眼位以及调节强弱等有关因素进行科学的验配 ,经充分时间试戴后方可配镜 ,决不能简单地以改善和提高视力为目的。     

远视患者去调节散瞳后两种验光方法的对比观察

目的:探讨远视性屈光不正患者在去调节散瞳后采用电脑验光仪验光与带状光检影镜验光检测结果有无差异,了解电脑验光能否取代检影镜验光。方法:随机选取2006年就诊验光的25例远视患者,在去调节散瞳后,对每只眼随机先后采用电脑验光仪和带状光检影镜分别验光检测屈光不正的度数。所获数据进行统计学分析。结果:两种验光方法检测结果差异有统计学意义(P<0.01)。结论:电脑验光的结果还不够准确,它还不能取代检影验光,因电脑验光简便、快速,可为检影验光提供参考,并可用于屈光不正的群体普查工作。     

小瞳孔电脑验光散瞳电脑验光和散瞳检影验光的对照分析

110例4～39岁屈光不正患者用日本AR-3000型自动电脑验光机进行小瞳孔电脑验光、散瞳电脑验光和散瞳检影验光、对照分析结果表明,电脑验光与检影验光两种方法相关系数很大,小瞳电脑验光与散瞳电脑验光两者对比有差距,柱镜度差距小,球镜度差距大,4～16岁者差距尤为显著,故此年龄组屈光不正患者仍以散瞳验光更为准确可靠。     

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.     

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.     

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.