原发性青光眼患者屈光状态的研究

目的:探讨原发性青光眼患者的屈光状态对其发病机制的影响.方法:对原发性青光眼患者50例(100眼),分别进行裸眼视力、矫正视力、主觉和他觉验光检查,以及眼轴的测量.结果:原发性青光眼患者50例(100眼)中,屈光不正患病率为71.00%.原发性开角型青光眼患者的近视率为76.09%,平均屈光度为-3.61D;原发性闭角型青光眼患者的远视率为50.00%,平均屈光度为 0.57D(P＜0.01).原发性开角型和闭角型青光眼平均眼轴长度为24.81 mm和22.30 mm(P＜0.01).结论:原发性青光眼的发病与患者的屈光状态存在一定内在联系,原发性开角型青光眼以近视性屈光不正为主,原发性闭角型青光眼以远视性屈光不正为主.     

儿童眼轴与角膜曲率在单纯性近视初期的变化

目的探讨青春期前儿童的正视眼与初期单纯性近视眼之间,眼轴长度、角膜曲率及其相关关系的变化.方法随机选取我科屈光门诊的轻度近视患儿30例(60眼),散瞳验光,测量眼轴长度、角膜曲率与角膜屈光力,并与同期随机选取的30例(60眼)健康正视眼儿童相比较.结果近视眼组平均眼轴长度为(24.02±0.77)mm,正视眼组为(22.99±0.72)mm,两组眼轴差异非常显著(P<0.01).两组角膜曲率、角膜屈光力之间差异无显著性.以水平向角膜曲率测得眼轴长度与角膜曲率的比值(AL/CR),近视眼组为3.032±0.058,正视眼组为2.899±0.095,差异非常显著(P<0.01).结论青春期前,儿童在由正视眼转化为轻度近视眼的过程中,以眼轴增长为主,表现为轴性近视.AL/CR超过3是近视发生的高危指标.     

Nd：YAG激光周边虹膜切除术的临床观察

目的：探讨Nd：YAG激光周边虹膜切除术前术后的视力、眼压、周边前房深度、屈光状态、眼轴长度之间的相关性。方法：采用国产YJZ-1A型Nd：YAG激光机对45例62眼患者进行周边虹膜切除术,观察术前术后的视力、眼压、周边前房深度、屈光状态、眼轴长度的变化。结果：45例62眼进行周边虹膜切除术的患者术前术后的视力（t=-11.72,P〈0.01）、眼压（t=16.90,P〈0.01）、周边前房深度,屈光状态都有显著差异（t=13.60,P〈0.01）,眼轴长度没有变化（t=-0.92,P〉0.05）。结论：眼内压的变化对原发性闭角型青光眼眼轴没有影响,前房深度的变化对屈光状态有明显的影响;激光治疗原发性闭角型青光眼是一种操作简单、安全有效、损伤小、并发症少的实用方法。     

儿童眼轴与角膜曲率在单纯性近视初期的变化

目的探讨青春期前儿童的正视眼与初期单纯性近视眼之间,眼轴长度、角膜曲率及其相关关系的变化。 方法随机选取我科屈光门诊的轻度近视患儿30例(60眼),散瞳验光,测量眼轴长度、角膜曲率与角膜屈光力,并与同期随机选取的30例(60眼)健康正视眼儿童相比较。 结果近视眼组平均眼轴长度为(24.02±0.77)mm,正视眼组为(22.99±0.72)mm,两组眼轴差异非常显著(P<0.01)。两组角膜曲率、角膜屈光力之间差异无显著性。以水平向角膜曲率测得眼轴长度与角膜曲率的比值(AL/CR),近视眼组为3.032±0.058,正视眼组为2.899±0.095,差异非常显著(P<0.01)。 结论青春期前,儿童在由正视跟转化为轻度近视跟的过程中,以眼轴增长为主,表现为轴性近视。AL/CR超过3是近视发生的高危指标。     

单纯性近视眼眼轴的相关因素分析

目的:探讨影响单纯性近视眼眼轴生长的相关因素.方法:对来我院行准分子激光治疗的363例近视患者进行眼部检查,分析影响眼轴生长的相关因素.结果:363例(726眼)近视眼患者的平均眼轴长度为(24.90±1.06)mm,其中眼轴长度≥24.00 mm的占82.37%;同一患者左右眼之间眼轴长度无显著性差异;男性眼轴长于女性;不同屈光度之间眼轴差异显著,随屈光度的增加,眼轴长度也相应增长;眼轴长度与年龄、眼内压无关,而与屈光度和前房深度呈正相关关系(r1=0.500;r2=0.038 4);眼轴(Y)与屈光度(|X1|)和前房深度(X2)的回归方程为Y=19.308 0.299 |X1| 1.266 X2.结论:单纯性近视眼的屈光度和前房深度与眼轴密切相关,且眼轴延长可能是单纯性近视眼形成的主要因素.     

眼高压症患者角膜中央厚度对非接触眼压计测量值的影响

目的 :探讨高眼压症患者角膜中央厚度 (CCT)对非接触眼压计 (NCT)眼压 (IOP)测量值的影响及临床意义。方法 :测量 4 2例 84眼高眼压症患者与 5 0例、10 0眼屈光状态相近的正常人角膜中央厚度及眼内压 ,比较2组角膜中央厚度的差异及高眼压症患者眼内压与角膜中央厚度的相关关系。结果 :高眼压症组的角膜中央厚度平均值为 5 86 .3± 30 .7μm明显高于正常对照组的 5 31.5± 2 9.2 μm(P <0 .0 1) ,将高眼压患者角膜中央厚度与非接触眼压计眼压测量值进行线性相关分析 ,角膜中央厚度与眼压测量值呈明显正相关 (r =0 .6 346 ,P <0 .0 1) ,即角膜中央厚度每增加 5 0 μm眼内压可升高约 2mmHg。 结论 :角膜中央厚度与眼压测量值呈正相关 ,高眼压患者眼压测量值偏高的真正原因是角膜中央厚度高于正常范围所致。测量角膜中央厚度可作为高眼压症和原发性开角型青光眼诊断与鉴别诊断的重要依据 ,角膜中央厚度测量可作为排除青光眼的常规检查方法     

近视眼的屈光度、眼轴、角膜屈光力的相关性探讨

目的：探讨近视眼的屈光度、眼轴、角膜屈光力之间的相关关系以及近视的成因。方法：将204例(348只眼)近视患者分为三组：低度近视组62眼(屈光度＜-3．0D）；中度近视组159眼(屈光度-3．0D～-6．0D)；高度近视组127眼(屈光度＞-6．0D)。测量患者眼的屈光度、角膜屈光力及眼轴，与近视程度、角膜屈光力、眼轴的关系。结果：在低度近视组，62只眼屈光度与眼轴长度无显著相关性，而屈光度与角膜水平径、垂直径屈光力呈正相关(P＜0．05)，相关具有显著性；在中度近视组和高度近视组屈光度与眼轴长呈正相关(P＜0．05)，相关具有显著性，且随近视度数的增加，与眼轴长的相关系数呈递增趋势，而中、高度组患者眼屈光度与角膜水平径及垂直径屈光力无显著相关性。结论：在近视性屈光不正的影响因素中，低度近视眼患者受角膜屈光力的影响相对较大，而眼轴的作用甚微；在中、高度近视眼患者中，眼轴长是影响近视程度的主要因素，而角膜屈光力几乎不起作用。     

眼挫伤与近视

目的 观察眼球挫伤后近视性屈光改变及并发症的发病率。方法 对362例眼挫伤患者进行观察,进行视力、裂隙灯、眼底和验光检查。结果 362例眼挫伤后均有不同程度近视度数增加(-0。5D ～ -5。00D)。原有近视眼组30。60％发生眼内并发症;而原来正常眼组仅15。64％出现并发症,差异有显著性(P＜0。05)。正常眼组...     

眼屈光要素对青少年屈光度的影响

目的 :通过对青少年及儿童眼球的屈光要素 (角膜曲率、眼轴、前房深度、晶体厚度 )的测定 ,了解其对青少年屈光度的影响。方法 :以 3～ 19岁作为研究对象用散瞳验光、A超测量仪及角膜曲率计检测出 395例远视、近视屈光程度和屈光各要素的测量值进行分析。结果 :12岁前远视 2 74眼 (6 4 .0 % ) ;角膜水平径线的总平均值为 (4 2 .80± 1.5 0 )D,垂直径线总平均值为 (4 3.75± 1.6 7) D,顺规性散光 4 33眼 (91.2 % ) ,逆规性散光 1眼 (0 .2 % ) ,斜散光 4 1眼 (8.6 % )。近视程度与眼轴长度呈正相关 ,远视程度与眼轴长度呈负相关 ,前房深度、晶体厚度与度数无明显相关。中低度近视、远视与平均眼轴长度之间差异无显著性 (P>0 .0 5 )。高度近视、远视与平均眼轴长度差异有极显著性 (P<0 .0 1)。结论 :儿童青少年屈光变化是由远视到正视 ,再由正视转变为近视 ,在屈光程度上起主要作用的屈光要素是眼轴和角膜曲率     

人视网膜神经纤维层厚度与近视屈光度的相关性研究

目的　研究人视网膜神经纤维层厚度 (retinalnervefiberlayerthickness,RNFLT)与近视屈光度的关系。方法　应用视网膜厚度分析仪 (retinalthicknessanalyzer,RTA)检测 116例 (116只眼 )志愿者RNFLT、屈光状态和眼轴长度并进行统计分析。结果　RNFLT与近视眼屈光度成负相关关系 (r =- 0 6 4 6 9,P <0 0 0 1) ;RNFLT与眼轴长度也成负相关关系 (r=- 0 6 971,P <0 0 0 1)。结论　人视网膜神经纤维层厚度随眼轴长度增加而减少     

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.     

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.