角膜塑形镜对不同屈光度青少年近视患者的疗效分析

目的 探索夜戴型角膜塑形镜（orthokeratology,OK镜）对不同屈光度青少年近视患者的临床效果及安全性。方法 收集眼科视光门诊162例（其中单眼佩戴患者23例,共301只眼）,按等效球镜度数分为3组,分别为A组（98眼,-0.50～-2.00D）、B组（155眼,-2.25～-4.00D）及C组（48眼,-4.25～-6.00D）。观察患者每晚配戴7.5～10h OK镜后临床效果,记录、分析戴镜前及戴镜6、12个月后3组裸眼视力、眼轴、角膜曲率、角膜中央厚度、角膜内皮细胞密度变化及裂隙灯检查眼部情况。结果 3组患者戴镜6、12个月后,裸眼视力均较戴镜前显著提高（P<0.001）。戴镜12个月后,3组间视力增加值差异有统计学意义（P<0.001）;戴镜后6、12个月后,各组中央角膜曲率平K值（flat kerotometry, FK）、陡K值(steep kerotometry, SK)较戴镜前差异均有统计学意义（P<0.001）。戴镜12个月后,A组中央角膜FK、SK值与B组及C组相比,差异有统计学意义（P<0.001）,而B组与C组间FK、SK值差异无统计学意义（P>0.05）;戴镜6、12个月后,A组眼轴与戴镜前比较,差异有统计学意义（P<0.001）,而B与C组眼轴与戴镜前比较,差异无统计学意义（P>0.05）。戴镜12个月后,B、C组眼轴增长值与A组差异均有统计学意义（P<0.001）,而B组与C组差异无统计学意义（P>0.05）。戴镜6、12个月后,3组患者角膜中央厚度、内皮细胞密度较戴镜前无明显变化（P>0.05）;A、B、C组轻度角膜点状着染分别为3例（3.06%）、21例（13.46%）、10例（20.83%）。结论 OK镜控制青少年近视发展是有效且安全的,对屈光度在-2D以上青少年患者近视发展控制效果较好。     

夜戴型角膜塑形镜矫正青少年近视的安全性及有效性观察

目的 评价夜戴型角膜塑形镜矫正青少年近视的安全性和有效性.方法 37例（74眼）适合配戴夜戴型角膜塑形镜的青少年近视患者被纳入为期6个月的前瞻性研究.对纳入研究者戴镜后1天、1周、1个月、2个月、3个月、6个月的裸眼视力和屈光状态进行观察评估.结果 36例（72眼）患者完成了本次研究.戴镜后1周裸眼视力明显提高（P〈0.01）,戴镜后6个月裸眼视力达1.04±0.12.戴镜前患者屈光度的均值为（-3.16±0.75） D,戴镜后不同时间随访屈光度明显降低（P〈0.01）,戴镜后1周,屈光度降低最为明显,为（＋0.12±0.47）D.末次随访共有24眼（33.3%）角膜上皮有轻至中度着染,随访期间未发生不可逆转的并发症.结论 夜戴型角膜塑形镜矫正轻度至中度青少年近视是安全和有效的.     

不同屈光度对角膜塑形镜控制近视进展的影响

目的 探讨不同近视屈光度对夜戴型角膜塑形镜(orthokeratology,OK镜)控制近视进展疗效的影响.方法 回顾性分析2016年1月至2019年12月于四川大学华西第四医院眼科行角膜塑形镜治疗的青少年儿童29例(58眼)的临床资料,按照等效球镜度数分为低度近视组(n=14,28眼)(等效球镜度≤3.00 D)和中度近视组(n=15,30眼)(3.00 D<等效球镜度≤6.00 D),记录两组戴镜前的裸眼视力、眼轴长度、平均角膜屈光度(AveK)、角膜厚度、角膜内皮,戴镜1年后的裸眼视力及眼轴长度,比较两组戴镜1年后裸眼视力的变化及眼轴的增长值.结果 戴镜1年后,两组裸眼视力均显著高于戴镜前,差异有统计学意义(P<0.05);戴镜1年后,中度近视组眼轴的增长值低于低度近视组,差异有统计学意义(P<0.05).结论 角膜塑形镜能显著提升患儿的裸眼视力,其控制眼轴增长的疗效在近视度数较高者中效果较好.     

角膜塑形术对青少年近视患者眼调节参数以及立体视觉的影响

目的分析研讨角膜塑形术对青少年近视患者眼调节参数以及立体视觉的影响。方法随机选取我院2016年1月至2017年3月收治的近视患者156例,回顾分析其病历资料,依据其等效球镜度将其分三组,即低度近视组(52例,-0.50D≤屈光度-2.00D),中度近视组(52例,-2.00D≤屈光度-4.00D),高度近视组(52例,-4.00D≤屈光度-6.00D),患者均接受角膜塑形术治疗,观察其治疗效果,如立体视觉、眼调节参数等,并比较。结果患者戴镜后裸眼视力高于戴镜前,柱镜、球镜均低于戴镜前(P0.05)。比较三组患者戴镜后立体视锐度差、近视力差、远视力差值(P0.05);低度近视组远视力差值高于中度和高度近视组(P0.05);中度近视组远视力差值低于高度近视组(P0.05)。结论患者佩戴角膜塑形镜后,裸眼视力明显提高,达到正常水平,双眼视功能与立体视觉得以提高与恢复,应用推广价值高。     

不同度数青少年近视配戴OK镜两年后的近视控制效果评价

目的 通过对不同度数青少年近视验配角膜塑形镜（OK 镜）两年后的近视控制效果的比较,探讨配戴OK镜后近视控制效果与近视度数的关系。方法 采用前瞻性非随机对照研究。收集2018 年1～3 月在我院视光专科验配角膜塑形镜的青少年近视患者100 例,根据等效球镜度不同分为近视低度数组（-1.25～-2.50 D）和中度数组（-3.75～-5.00 D）。随访2 年,观察和记录两组的性别、年龄、度数、角膜曲率和眼轴以及戴镜后6、12、18、24 个月的眼轴数据。对基线数据及眼轴的变化情况进行统计学分析,并监测不良反应。结果 共94 例（177 眼）完成两年随访。其中低度数组108 眼,中度数组69 眼。两组等效球镜度（D）分别为（-2.04±0.44）D 和（-4.20±0.63）D,差异有统计学意义（t=26.936,P＜0.001）;眼轴分别为（24.33±0.71）mm 和（25.20±0.67）mm,差异有统计学意义（t=8.144,P＜0.001）,年龄、性别和角膜曲率比较,差异无统计学意义。中度数组配戴OK 镜两年后眼轴增加量为（0.27±0.11）mm,小于低度数组的（0.57±0.36）mm,差异有统计学意义（t=7.384,P＜0.001）,组内各时间点眼轴变化比较,差异有统计学意义（P＜0.001）。结论 中度数组配戴OK 镜两年后眼轴增长速度明显低于低度数组,近视控制的效果中度数组优于低度数组。相对高度数的青少年近视配戴OK 镜后近视控制的效果好,更多的周边近视性离焦能更好地抑制眼轴的增长。     

配戴角膜塑形镜治疗少年儿童近视的疗效及依从性分析

目的探讨少年儿童配戴角膜塑形(OK)镜治疗近视的疗效及安全性。方法对该院318例配戴OK镜的少年儿童近视患者的疗效、依从性及并发症进行回顾性分析。结果 318例患者试戴成功率为98.11%(312/318)。裸眼视力在戴镜后7d(0.96±0.06)较戴镜前(0.15±0.08)显著升高(P<0.01),并且在之后1～12个月裸眼视力稳定。戴镜7d角膜前表面水平曲率(HK)及垂直曲率(VK)较戴镜前均显著降低(P<0.01)。戴镜后1～12个月HK及VK仍显著低于戴镜前,并且维持稳定。坚持戴镜1年以上者193例(61.86%)。1年内并发症发生率为55.45%(173/312)。结论配戴OK镜能有效矫正少年儿童的近视,但依从性较差,并发症发生率高。     

角膜塑形镜对青少年近视矫正的长效研究

目的观察长期配戴角膜塑形镜矫正青少年近视的疗效。方法选取爱尔眼科医院就诊的青少年近视患者95例（180只眼）,年龄8-15岁,平均年龄（11.5±1.2）岁,双眼近视球镜范围为0--6.00DS,散光均为顺规散光,范围为0--1.50DC。根据矫正屈光不正的方法随机分为两组,角膜塑形镜组（A组）、普通框架眼镜组（B组）。两组患者戴镜后6个月、1.5年、3年回访,观察患者屈光度、眼轴长度以及A组的角膜曲率。结果A组病例戴镜后不同时期眼轴长度与戴镜前比较差异无统计学意义（P〉0.05）;B组病例戴镜6个月眼轴长度与戴镜前比较差异无明显统计学意义（P〉0.05）,戴镜1.5年、3年眼轴长度与戴镜前比较差异有统计学意义（P〈0.05）。两组间比较差异有统计学意义（P〈0.05）。A组病例经戴镜满1.5年者停戴3周后查近视屈光度,平均每年增加-0.20DS,B组病例戴镜满1.5年后查屈光度,平均每年近视增加-0.86DS,两组间比较差异有统计学意义（P〈0.05）。A组病例的角膜曲率在戴镜前,6个月、1.5年、3年,每一个时间与前一时间两两比较,均有统计学差异（P〈0.01）。回访时,两组患者均无不适。结论角膜塑形镜可以有效控制近视的发展,对于青少年近视矫正效果确切、安全有效。     

隔天配戴角膜塑形镜治疗青少年低度近视的疗效观察

目的 观察隔天夜间配戴角膜塑形镜、连续夜间配戴角膜塑形镜及框架眼镜控制青少年低度近视的临床效果.方法 收集成都医学院第一附属医院眼科门诊2014年4月至2015年6月诊治的7~16岁低度近视患者123例(246眼),随机将患者分为隔天夜间配戴角膜塑形镜组38例(76眼),连续夜间佩戴角膜塑形镜组40例(80眼),配戴框架眼镜组45例(90眼),观察戴镜前和戴镜后1周、1、3、6月和1年的裸眼视力和角膜曲率,观察1年后3组患者的屈光度及眼轴变化.结果 与戴镜前比较,戴镜1周、1、3、6月和1年的裸眼视力均明显提高,角膜曲率明显下降,差异有统计学意义(P<0.05),1年后,两组角膜塑形镜的屈光度及眼轴长均小于框架眼镜组,差异有统计学意义(P<0.05);两组角膜塑形镜之间屈光度数和眼轴长比较,差异无统计学意义(P>0.05).结论 隔天配戴角膜塑形镜治疗低度近视效果明显,可提高裸眼视力,延缓屈光度增加,减少戴镜依赖性.     

夜戴型角膜塑形镜矫治青少年近视的临床观察

目的观察青少年近视患者配戴夜戴型角膜塑形镜对角膜曲率、角膜厚度和眼轴长度影响。方法随访满1年且资料完整的患者56例（112眼）,年龄9～15岁,男性22例,女性34例,近视度数均〈-6.00D。患者夜戴Boston XO角膜塑形镜,采用博士伦公司的ORBSCANⅡZ角膜地形图检查角膜厚度和角膜曲率,采用蔡司公司的IOL Master（光学生物测量仪）测量眼轴长度。结果与戴镜前相比,戴镜3～12个月后,角膜地形图显示角膜曲率均明显变平,差异有统计学意义（P〈0.01）;角膜厚度有所变化,但差异无统计学意义（P=0.5992）;戴镜12个月后,眼轴长度有所增加,但差异无统计学意义（P=0.389 7）。结论夜戴型角膜塑形镜矫治青少年近视效果确切、安全。     

夜戴型角膜塑形镜对青少年角膜形态早期变化的影响

目的 研究高中青少年在佩戴夜戴型角膜塑形镜后对角膜形态的早期变化。 方法 选取深圳市龙岗区第五人民医院2014年9月-2015年9月符合佩戴夜戴型角膜塑形镜标准的青少年近视患者60例117眼,并根据初诊时患者的近视程度将患者分为A组(58眼,近视 ≤ -3.00 D)和B组(59眼,-3.00 D<近视 ≤ -6.00 D)。所有患者在戴镜前、戴镜后的1 d,1周,1、3、6个月;1、1.5、2年定期对裸眼视力、角膜曲率、眼轴长度、眼压等各项进行复查。 结果 2组患者在佩戴夜戴型角膜塑形镜后1 d的裸眼视力均有大幅度提高,戴镜后1周基本趋于稳定,角膜曲率均较戴镜前变平,角膜厚度也均有不同程度的变薄现象,戴镜1、3、6个月后基本趋于稳定,其中B组患者的治疗效果较A组更加显著,差异具有统计学意义(P<0.05)。2组患者虽在佩戴夜戴型角膜塑形镜后均有不同程度的干眼症状出现,但角膜的各形态变化包括眼轴长度、前房深度和眼压等各项与戴镜前相比,差异无统计学意义(P>0.05)。 结论 佩戴夜戴型角膜塑形镜能在短期时间内提高患者裸眼视力,阻止近视的发展,且控制中度近视患者的疗效较低度近视患者更加明显,是一种安全、快速、有效的治疗青少年近视的方法,值得在临床中推广。      

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.