双目间接检眼镜下孔源性视网膜脱离手术

目的：探讨双目间接检眼镜在孔源性视网膜脱离检查及手术中的应用价值。方法：分析20例(21眼)孔源性视网膜脱离在双目间接检眼镜直视下手术治疗的临床效果,裂孔定位,冷凝,硅海绵外加压及环扎带。玻璃体腔内注入消毒空气或C3F8。结果：术后视网膜裂孔封闭,视网膜一次性复位19眼(占90.5％),未复位2眼(占9.5％),经二次手术复位,术后视力均提高。结论：双目间接检眼镜下行孔源性视网膜脱离手术,具有较高的照明度,较宽较清晰的立体视野,直视下进行裂孔冷凝封闭,提高了裂孔检查及手术的成功率,手术效果良好。     

显微镜直视下巩膜外冷凝在视网膜脱离手术中的临床观察

目的：对孔源性视网膜脱离行巩膜外加压术应用显微镜直视下巩膜外冷凝的临床观察。方法：采用巩膜外加压术排出视网膜下液，显微镜直视下冷凝所有赤道部前后的裂孔和变性区治疗21例孔源性视网膜脱离。结果：术后随访3—12mon，裂孔完全封闭20例(95.3％)，视网膜复位良好19例(90.4％)。结论：应用手术显微镜直视下冷凝操作简便，疗效可靠，有着重要的临床实用价值。     

直接检眼镜直视下行视网膜脱离手术

目的 介绍直接检眼镜直视下行视网膜脱离手术的优点及操作要点。方法 １５例孔源性视网膜脱离病人接受手术，均在直接检眼镜直视下裂孔定位后，经巩膜ＣＯ２冷凝或放视网膜下液，硅胶外加压或环扎。结果 术后随访平均０．５ａ，视网膜复侠率９４．９％。结论直视下进行网膜脱离手术，可准确地封闭裂孔。手术成功率高，并发症少，值得在临床上推广。     

显微镜直视下视网膜裂孔冷凝的临床观察

目的探讨显微镜直视下巩膜外冷凝在孔源性视网膜脱离手术的应用和效果。方法对39眼简单型孔源性视网膜脱离患者，在显微镜直视下行巩膜外冷凝裂孔，硅胶海绵局部垫压，随访6个月-18个月。结果视网膜一次解剖复位36眼，巩膜预置缝线时穿透巩膜1例，给予局部冷凝，所有病例均未出现过度冷凝现象。结论应用手术显微镜直视下巩膜外冷凝裂孔定位操作简单且疗效可靠，冷凝及垫压准确无误。     

光纤照明显微镜直视下孔源性视网膜脱离外路手术的临床研究

目的:探讨光纤照明显微镜直视下孔源性视网膜脱离外路手术的临床价值.方法:对孔源性视网膜脱离45例45只眼,在手术显微镜直视下放视网膜下积液、光纤照明下视网膜裂孔定位及冷凝、标记、巩膜外加压术和(或)环扎术,术后观察视力恢复和网膜复位情况.结果:视网膜完全复位44眼.1眼因玻璃体出血改为玻璃体切割复位,视力提高39眼,不变4眼,下降2眼,矫正视力在0.3以上42眼,放液无并发症.结果:光纤照明显微镜直视下孔源性网膜脱离手术是一种简便、安全、疗效确切的方法.     

直接检眼镜直视下冷凝外路治疗视网膜脱离复位术

目的:探讨直接检眼镜直视下冷凝外路治疗视网膜脱离的手术方法与效果。方法:收集了2009年1月至2010年12月间,入住我院眼科行直接检眼镜直视下冷凝外路视网膜脱离术的资料完整的78例患者,具体描述了手术过程,并对手术的效果进行了分析。结果:所有患者经直接检眼镜直视下定位视网膜裂孔并实施冷凝,结合环扎、外加压治疗,视网膜复位率高。结论:在不具备双目间接检眼镜设备及技术的条件下,直接检眼镜直视下冷凝外路治疗视网膜脱离有直视下冷凝封闭视网膜裂孔的优势,这一手术方式对广大的基层医院有一定的借鉴作用。     

孔源性视网膜脱离的显微镜直视下手术治疗

目的:探讨孔源性视网膜脱离的显微镜直视下手术治疗的方法和效果.方法:对872例(882只眼)孔源性视网膜脱离病例在显微镜直视下行巩膜外环扎、硅压、放液、冷凝术,使视网膜复位.结果:视网膜裂孔封闭,包含复位837只眼(94.9%),再次手术后视网膜复位36只眼(4.1%),9只眼(1.0%),因患者拒绝再次手术,视网膜未能复位.结论:在手术显微镜直视下行孔源性视网膜脱离复位手术,双手操作准确而迅速,视网膜裂孔和变性区能清楚观察,显微镜直视下放液及作视网膜冷凝,同时核实硅胶填压的位置是否合适,且助手能同时观察和配合操作,缩短了手术时间,提高了手术成功率.     

双目间接检眼镜下巩膜扣带术138例临床分析

尽管玻璃体手术的开展为复杂性视网膜脱离患者的治疗拓宽了治疗手段；但巩膜扣带术仍是孔源性视网膜脱离最常用的治疗方法。而应用双目问接检眼镜在直视下冷凝，使巩膜扣带术的成功率明显提高，并发症降低。我院在双目间接检眼镜下对138例（138眼）孔源性视网膜脱离患者实行巩膜扣带术，较以往直接检眼镜下手术时间缩短，疗效提高，现报     

双目间接检眼镜直视下冷凝治疗孔源性视网膜脱离

目的: 探讨在双目间接检眼镜直视下冷凝治疗孔源性视网膜脱离的疗效。方法: 对86例(91眼)孔源性视网膜脱离患者,在双目间接检眼镜下查找裂孔并进行冷凝,外加压,根据视网膜脱离的具体情况决定环扎、放液或注入C₃F₈、SF₆气体。结果: 一次性手术后视网膜复位84眼,4眼二次手术后复位成功,另3眼需行玻璃体切割术。术后视力较术前明显提高(P<0.01)。结论: 间接立体检眼镜下冷凝治疗孔源性视网膜脱离,创伤小,效果好,值得推广应用。     

显微镜直视下最小量手术方法治疗裂孔源性视网膜脱离56例临床观察

目的 探讨显微镜直视下最小量外路视网膜脱离手术的可行性及治疗效果.方法 对56例（56眼）非复杂性孔源性视网膜脱离患者在显微镜直视下行前房放液、视网膜裂孔定位、冷凝、巩膜外加压、顶压硅胶加压块检查裂孔是否封闭,观察患者术中术后并发症、术后眼压、术后视力及视网膜复位情况,术后随访3～ 12个月.结果 51例一次手术视网膜完全复位（91.1％）,术中出现前房少量出血1例,术后出现裂孔形成鱼嘴状3例,行二次单纯加压块调位固定后均复位,2例因发生增殖性玻璃体视网膜病变造成裂孔开放做了玻璃体切割手术后复位.术后出现暂时性高眼压2例.术后视力提高48眼（85.7％）.结论 显微镜直视下行最小量裂孔源性视网膜脱离手术具有视野清晰、损伤小、裂孔冷凝定位可靠、手术操作简单、容易掌握、术后效果好的优点,值得临床推广应用.     

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.