复方托吡卡胺滴眼液在近视儿童散瞳验光中的应用效果

目的:探讨复方托吡卡胺滴眼液在近视儿童屈光检查中的应用效果。方法:将56例(112只眼)7~17岁近视患者分为7~12岁组和13~17岁组,在散瞳前后,由有经验的验光师对患者进行电脑验光和检影验光,应用SPSS 17.0统计软件比较每组用药前后等效球镜(SE)值的变化。结果:每组散瞳前后SE值比较差异均无统计学意义(P0.05)。结论:复方托吡卡胺滴眼液是一种睫状肌麻痹剂,但对不同年龄的儿童睫状肌麻痹作用效果有限,且散瞳前后屈光度无明显变化。     

成人近视患者睫状肌麻痹前后屈光度的差异

目的分析成人近视患者睫状肌麻痹前后屈光度差异与眼调节参数的相关性,为成人是否需要睫状肌麻痹(散瞳)验光提供依据.方法屈光不正患者58例(116眼),年龄18~40岁,首先应用电脑验光仪和全自动综合验光仪进行检查,确定最佳矫正视力的最大正镜度(correeted ametropia with most plus,CAMP)状态的验光结果.在此基础上进行调节功能检查,包括负相对性调节(NRA)/正相对性调节(PRA)、调节反应(BCC),之后应用复方托吡卡胺滴眼液散瞳,5 min/次,连用3次,间隔20 min进行2次屈光检查.对比患者散瞳前、后CAMP屈光度的变化.结果不同的NRA、BCC值下:NRA值<+1.75D、NRA值>+2.50D、BCC值<+0.25D,散瞳前后CAMP屈光度,差异有统计学意义(P<0.05);NRA值+1.75~+2.25D、BCC值>+0.25D时散瞳前后CAMP屈光度值,差异无统计学意义(P>0.05).结论综合验光仪测量眼调节参数,对决定成人近视患者的验光方法具有临床指导意义.对于符合NRA值<+1.75D、N... 更多     

学生人群屈光不正的睫状肌麻痹前后电脑验光仪与综合验光仪联合应用的对比研究

目的 :评价电脑自动验光与综合验光仪主觉验光联合应用在学生屈光不正验光检验中的应用价值及调节因素对其测定结果的影响。方法 :对 4～ 2 8岁小学、中学、大学生 2 0 0例 4 0 0眼调节麻痹前后分别电脑验光与综合验光仪主觉验光 ,对测得数据进行自身对照和分析。结果 :调节麻痹前后 ,17岁以下各年龄组球镜、柱镜值的差异均有显著意义 ,(P <0 .0 5 ) ;17～ 2 8岁组球镜、柱镜值差异无显著性意义 ,(P >0 .0 5 ) ,符合率为 89.2 % ;柱镜的轴向 ,均值差 <5° ,差异无显著性意义 ,(P >0 .0 5 ) ,符合率为 93.4 %。结论 :17岁以下儿童及学生调节麻痹前后电脑验光联合综合验光仪验光的屈光度数值差异有显著性意义 ,对于 17岁以下者睫状肌麻痹后电脑自动验光和综合验光仪联合验光是一种准确可靠的验光方法。调节麻痹前后柱镜轴位的结果 ,均值差 <5° ,差异无显著意义 ,故电脑验光联合综合验光仪主觉验光的轴位较为准确 ,可作为配镜处方。     

3种常用验光法在青少年屈光检查中的应用分析

目的：使用视力筛查仪、电脑验光仪与视网膜检影等3种常用验光方法比较分析青少年屈光不正患者散瞳前后的检测结果。方法：对78例(156只眼)53~17岁青少年分别在自然瞳孔下应用WelchAllyn Suresight手持式视力筛查仪及NIDEK ARK-510A型自动电脑验光仪进行验光。充分睫状肌麻痹散瞳后,行视力筛查仪、电脑验光仪和视网膜检影3种验光法。结果：各方法散瞳前球镜代数值均低于散瞳后,数值更偏近视(P<0.05);散瞳前视力筛查仪与散瞳后的检影验光比较,球镜值、柱镜值和散光轴位差异均无统计学意义(P>0.05),两者的一致性优于电脑验光与视网膜检影,但是所得数值偏近视倾向;散瞳前电脑验光与检影验光比较,球镜值和柱镜值差异均有统计学意义(P<0.05);散瞳后视力筛查仪与检影验光比较,球镜值差异有统计学意义(P<0.05),而散瞳后电脑验光与检影验光比较,柱镜值差异有统计学意义(P<0.05)。结论：对于青少年验光,睫状肌麻痹散瞳后检影验光必不可少。自然瞳孔下,视力筛查仪验光优于电脑验光,尤其在判断屈光不正的性质方面(球镜值更准)。但是两者都有高估近视程度的倾向。散瞳后,电脑验光准确性高于视力筛查仪,可作为试镜的参考。充分睫状肌麻痹散瞳后视网膜检影验光结合主观试镜仍是检查屈光不正最为有效的方法。     

青少年睫状肌麻痹前后屈光度变化的研究

目的:分析青少年屈光不正在睫状肌麻痹前后客观屈光度的变化规律以及使用睫状肌麻痹剂验光的临床意义。方法:随机选取三组患者,即远视组、轻度近视组、中高度近视组各20例,共60例,120只眼,观察各组在睫状肌麻痹前后屈光度的变化。结果:睫状肌麻痹前后,客观检影球镜度在远视组有明显变化,轻度近视组变化次之,中高度近视组略有变化或不变;柱镜度数、轴位在各组中均有轻微变化。结论:青少年睫状肌麻痹前后,球镜度数、柱镜度数、轴位均有变化,所以,对青少年进行验光时,建议使用睫状肌麻痹剂散瞳后再行客观检影验光,可排除假性近视,获得较准确屈光度。睫状肌麻痹下检影验光公认为是较准确的客观检测屈光不正的方法。     

江门市视力不良学龄前儿童屈光状态调查分析

目的 调查和了解江门市视力不良学龄前儿童的屈光状态,加强儿童视力保健.方法 采用随机抽样方法,对江门市100名(200眼)4岁至7岁学龄前视力不良儿童采用1%阿托品眼膏麻痹睫状肌后检影验光.结果 屈光状态:全体儿童不同年龄组两两比较,5岁时屈光不正患病率最高,总体以复性远视散光最多见,单纯性远视次之.而散光则以低度顺规散光为主.结论 视力不良儿童中复性远视散光患病率很高,应引起关注.     

复方托吡卡胺散瞳后学龄前远视儿童屈光检查分析

目的探讨经复方托吡卡胺散瞳后，学龄前远视儿童检影验光与电脑验光仪验光的差异。方法视力不良学龄前儿童使用复方托吡卡胺散瞳后，分别采用检影验光和电脑验光仪验光，收集双眼均为远视及单纯远视散光儿童166名（322眼）并进行分析。结果88．86％远视眼经复方托吡卡胺散瞳后，电脑验光仪验光屈光度绝对值比检影验光平均低0．542D。结论了解复方托吡卡胺散瞳后学龄前远视检影验光与电脑验光仪验光的差异，可以提高学龄前儿童远视眼的配镜质量，对不会看视力表的幼儿及弱视儿童更为重要。     

复方托吡卡胺与阿托品散瞳后屈光检查差异分析

目的探讨复方托吡卡胺与阿托品为睫状肌麻痹剂散瞳后，远视性学龄前儿童检影验光的屈光差异。方法视力不良的远视性儿童分别使用复方托吡卡胺与阿托品为睫状肌麻痹剂散瞳后，采用检影验光法作静态验光，比较两者的差异。结果80．75％的远视性儿童眼复方托吡卡胺为睫状肌麻痹剂后静态检影验光屈光度比阿托品为睫状肌麻痹剂低，低幅为0．25-1．50D，平均每眼低0．75D；7．69％的远视性儿童眼复方托吡卡胺为睫状肌麻痹剂后静态检影验光屈光度比阿托品为睫状肌麻痹剂高，高幅为0．25～0．50D，平均高0．27D；相等者占10．71％。结论学龄前远视性儿童使用复方托吡卡胺与阿托品为睫状肌麻痹剂屈光差异不大，可用复方托吡卡胺代替阿托品，减轻幼儿的种种不适，达到早发现早治疗儿童弱视的目的。     

新加坡儿童散光的发病率及进展情况

目的:调查研究在校儿童的散光发病率和进展,以及与散光变化有关的因素。方法:本研究为前瞻性队列研究,受试者种族分别为中国裔、马来裔、印度裔的7～9岁儿童,每年检测1次,使用睫状肌麻痹下的自动验光仪检测,连续检测4年。采用问卷调查表的方式来评估与散光发病率及进展有关的危险因素。结果:累计3年的散光发病率为33.6%(柱镜倍数≤0.5D)或11.5%(柱镜倍数≤1.0D),患有近视的儿童比非近视者具有较高的发病率(P<0.001)。平均每年J0变化0.012D(95%CI0.007～0.018),而J45未显示显著变化(平均每年0.001D)。中国裔儿童每年的J0进展较快(P<0.00…     

学龄前儿童电脑验光与视网膜检影验光的比较

为探讨电脑验光仪对学龄前儿童验光的准确性和实用价值 ,用电脑验光仪初测、再用视网膜检影复核比较 2 5 1例 ( 5 0 2眼 )的验光结果。两种方法所测球镜值呈现高度正相关 ,差异有显著性 ( r=0 .82 3,P<0 .0 1)。2种方法所测球柱镜值≤ 0 .5 0 D者占 82 .2 8% ,差异无显著性 ( P>0 .0 5 ) ,而所测柱镜轴轴向≥ 1.0 0 D时符合率高。因此 ,自动电脑验光仪检出屈光度不可作为学龄前儿童的配镜度     

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.