激光泪囊鼻腔造孔术治疗慢性泪囊炎的临床观察

目的：观察激光泪囊鼻腔造孔术治疗慢性泪囊炎的疗效。方法采用鼻内镜下激光泪囊鼻腔造孔术治疗24例慢性泪囊炎,术前泪囊碘油造影检查及鼻腔疾病排查,术后药物治疗,泪道冲洗、拔管,及鼻腔处理。观察6～12个月术后溢泪、流脓等情况。结果治愈19眼,好转3眼,无效2眼,总有效率87.5%,无并发症发生。结论鼻内镜下激光泪囊鼻腔造孔术治疗慢性泪囊炎具有手术成功率高、损伤小、并发症少的优点,可作为慢性泪囊炎治疗的新方法。     

鼻内镜下钬激光泪囊鼻腔造孔术治疗慢性泪囊炎的疗效随访

目的 观察鼻内镜下钬激光泪囊鼻腔造孔术治疗慢性泪囊炎的疗效,并探讨其影响因素.方法 应用钬激光于鼻内镜下治疗慢性泪囊炎47例(47只眼),术中造孔后置入扩张的硅胶条,术后随访行泪道冲洗和鼻内镜检查处理.结果 术后随访3～6个月,治愈率87.2%,好转率6.4%,总有效率(治愈率+好转率)为93.6%.结论 鼻内镜下钬激光泪囊鼻腔造孔术后,患者面部无瘢痕,鼻部组织损伤小,手术时间短,出血少,泪液的导流系统不受影响,是传统的泪囊鼻腔吻合手术失败后的良好补救方法 .     

鼻内镜下钬激光泪囊鼻腔造孔术治疗慢性泪囊炎的疗效随访

目的 观察鼻内镜下钬激光泪囊鼻腔造孔术治疗慢性泪囊炎的疗效,并探讨其影响因素。 方法 应用钬激光于鼻内镜下治疗慢性泪囊炎47例（47只眼）,术中造孔后置入扩张的硅胶条,术后随访行泪道冲洗和鼻内镜检查处理。 结果 术后随访3～6个月,治愈率87.2%,好转率6.4%,总有效率（治愈率＋好转率）为93.6%。 结论 鼻内镜下钬激光泪囊鼻腔造孔术后,患者面部无瘢痕,鼻部组织损伤小,手术时间短,出血少,泪液的导流系统不受影响,是传统的泪囊鼻腔吻合手术失败后的良好补救方法。     

鼻内镜下泪囊鼻腔造孔术疗效观察

目的 鼻内镜下泪囊鼻腔造孔术治疗慢性泪囊炎鼻泪管阻塞疗效观察.方法 采用鼻内窥镜对82例126眼慢性泪囊炎鼻泪管阻塞患者进行手术,随访1年.结果 术后3个月症状消失,泪道冲洗通畅112眼(占89%),稍泪溢,无脓性分泌物.泪道冲洗通畅9眼(占7%).泪溢伴脓性分泌物5眼(占4%).其中术后稍泪溢,无脓性分物的患者未做特殊处理,泪溢伴脓性分泌物的患者进行二次手术后症状消失,泪道冲洗通畅.结论 鼻内镜下泪囊鼻腔造孔术对慢性泪囊炎鼻泪管阻塞病人疗效可靠,手术安全性大,操做简单,值得推广.     

鼻内镜下鼻腔泪囊激光造口术治疗慢性泪囊炎52例

目的 分析鼻内窥镜下鼻腔泪囊激光造口术的临床效果.方法 对52例52眼长期溢泪经泪道冲洗等治疗无效的患者应用鼻内窥镜行鼻腔泪囊激光造口术,并进行术后随访6～12个月以上.结果 52例患者在随访期间,49例患者无溢泪,泪道冲洗通畅,鼻内窥镜下可见泪囊造口形成良好,占94.23%;3例患者偶有溢泪,鼻内窥镜下未见泪囊造口形成,但冲洗泪道可见原造口处有液体流出,泪小管有少许反流现象,占5.77%.无不良并发症.结论 鼻内窥镜下行鼻腔泪囊激光造口术是治疗慢性泪囊炎有效简单的方法.     

泪道激光鼻内镜下治疗复发性泪囊炎临床研究

目的:探讨泪道激光鼻内镜下泪囊鼻腔造孔术对复发性泪囊炎的临床疗效.方法:对15例经皮鼻腔泪囊吻合术后复发的慢性泪囊炎患者,行Nd:YAG泪道激光鼻内镜下鼻腔泪囊造孔术,术中祛除瘢痕、肉芽组织及鼻科疾病等复发因素,术后用庆大霉素冲洗,观察疗效.结果:术后3个月～3年随访,治愈15眼,有效率为100%.结论:鼻内镜下泪道激光泪囊鼻腔造孔术治疗复发性泪囊炎,损伤小,不良反应少,疗效满意.     

鼻内镜下鼻腔泪囊激光造口术治疗慢性泪囊炎52例

目的分析鼻内窥镜下鼻腔泪囊激光造口术的临床效果。方法对52例52眼长期溢泪经泪道冲洗等治疗无效的患者应用鼻内窥镜行鼻腔泪囊激光造口术,并进行术后随访6-12个月以上。结果52例患者在随访期间,49例患者无溢泪,泪道冲洗通畅,鼻内窥镜下可见泪囊造口形成良好,占94.23%;3例患者偶有溢泪,鼻内窥镜下未见泪囊造口形成,但冲洗泪道可见原造口处有液体流出,泪小管有少许反流现象,占5.77%。无不良并发症。结论鼻内窥镜下行鼻腔泪囊激光造口术是治疗慢性泪囊炎有效简单的方法。     

鼻腔泪囊造孔术联合置管治疗复发性泪囊炎疗效观察

目的探讨经鼻内镜下鼻腔泪囊造孔术联合置管治疗复发性泪囊炎的疗效。方法我院收治经皮鼻腔泪囊吻合术后复发的26例（26眼）患者,经鼻内镜下行鼻腔泪囊造孔术治疗,术后留置硅胶管2个月～3个月。结果全部26例（26眼）患者术后随访6个月~10个月,鼻腔外侧壁鼻腔造孔形成、上皮化,流泪、流脓症状消失,其中治愈24例,好转2例。手术有效率100％。结论经鼻内镜下鼻腔泪囊造孔术具有视野清晰、手术操作简单,术中出血少、时间短,损伤小,并发症少,疗效满意,是治疗复发性泪囊炎的有效选择。     

鼻内镜下钬激光泪囊鼻腔造口术的护理

目的 :探讨鼻内镜下钬激光 (Ho -YAG)泪囊鼻腔造口术的护理。方法 :对 30例 (36只眼 )慢性泪囊炎患者进行针对性的心理护理和充分的术前准备 ,术后不予鼻腔填塞 ,用典必殊眼液滴眼及伯克钠喷鼻 ,间日鼻腔换药 ,泪道冲洗 2次 (术后 4天、7天 )。结果 :本组术后无泪溢及溢脓 ,泪道冲洗通畅 ,手术效果满意。结论 :手术前后周到细致的护理是手术成功的重要保证     

经鼻内镜泪囊鼻腔造口术的临床分析

目的:探讨经鼻内镜泪囊鼻腔造口术治疗慢性泪囊炎的手术方法和治疗效果。方法:对我科2011年10月~2013年10月采用经鼻内镜泪囊鼻腔造口术治疗的慢性泪囊炎37例患者(共46眼)的临床资料进行回顾性分析,分析手术成功与失败的原因,总结手术方法及手术疗效。结果:本组37例(46眼)中,43眼治愈,3眼无效,总治愈率为93.5%。术后随访3~12个月,43眼均没有溢泪、按压泪囊区溢脓等症状,泪道冲洗通畅,3眼术后溢泪、溢脓等症状无缓解,冲洗泪道不通畅,泪囊鼻腔造口完全堵塞闭锁。结论:鼻内镜下泪囊鼻腔造口术具有手术创伤小,恢复快,面部无瘢痕,术中术后并发症少,成功率高等优点,是慢性泪囊炎较为理想的治疗方法。     

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.