光明工程联合房角分离术治疗慢性闭角型青光眼合并白内障的临床分析

目的:观察光明工程(小切口白内障囊外摘除+人工晶体植入术)联合房角分离术治疗慢性闭角型青光眼合并白内障的临床疗效.方法:将慢性闭角型青光眼伴白内障的12例(18眼)患者行光明工程(小切口白内障囊外摘除+人工晶体植入术)联合房角分离术,观察手术前后的房角,前房深度,眼压及视力变化,术后随诊1～12月.结果:术后所有术眼眼压平均为(15.97±0.45)mmHg,比术前用药后平均眼压(24.36±2.36)mmHg明显降低,两者差异有统计学意义(P<0.05),前房中央深度(CACD)眼球彩超检查明显加深,CACD由术前(1.39±0.24)mm,增加到术后的(2.50±0.24)mm,两者差异有统计学意义(P<0.05).前房角镜检查房角均增宽,术后视力有不同程度增加.结论:光明工程联合房角分离术可有效治疗慢性闭角型青光眼合并白内障.     

小切口白内障囊外摘除治疗急性闭角型青光眼

目的 探讨小切口白内障囊外摘除手术治疗急性闭角型青光眼的疗效.方法 前房角关闭粘连范围＜ 180°的急性闭角型青光眼合并有白内障患者42例(42只眼),采用小切口白内障囊外摘除联合后房型人工晶状体植入术,观察分析术前和术后矫正视力、眼压、前房角及前房深度的变化,术后随访6 ～18个月.结果 所有患者术中、术后均没有出现严重的并发症,术后视力均较术前提高,40眼术后眼压至正常,2眼加用噻吗洛尔及布林佐胺滴眼液控制正常,术后平均眼压(14.57±3.50) mmHg,与术前眼压(26.56±11.20) mmHg相比,差异有统计学意义(P＜0.05),术后平均前房深度(2.55±0.69)mm,与术前(1.32±0.61)mm相比,差异有统计学意义(P＜0.05),术后部分开放增宽视野无进行性损害,所有病例前房角均重新开放.结论 前房角关闭粘连范围＜ 180°的急性闭角型青光眼合并白内障患者行小切口白内障囊外摘除联合人工晶状体植入手术治疗是安全、经济、有效的.     

小切口非超声乳化白内障摘除联合房角分离治疗急性闭角型青光眼合并白内障的疗效观察

目的观察小切口非超声乳化白内障摘除联合房角分离治疗急性闭角型青光眼合并白内障的疗效。方法选取40例(44眼)急性闭角型青光眼合并白内障患者,于2016年3月至2017年3月期间接受手术治疗,均予以小切口非超声乳化白内障摘除联合房角分离治疗,术后观察视力恢复情况,术后3个月的眼压,术前及术后3个月时采用A超声仪检查中央前房深度变化,并进行前房角镜检查,同时观察患者术后并发症发生情况。结果术后患者视力水平明显改善,与术前比较差异有统计学意义(P<0.001);术后3个月时,术眼眼压显著降低,前房深度显著加深,与术前比较差异有统计学意义(P<0.001);前房角镜检查显示,术后前房角显著增宽,与术前比较差异有统计学意义(P<0.001),术后3个月时,有31例(33眼)房角开放,7例(9眼)粘连范围在90°以内,仅2例(2眼)粘连范围在90°～180°之间;术中有4眼在进行房角分离时出现前房积血,对手术无较大影响,术后1 d出血消失。术后有5眼角膜出现不同程度水肿,经对症治疗后均恢复,未见其他并发症。结论急性闭角型青光眼合并白内障采取小切口非超声乳化白内障摘除联合房角分离治疗,能有效提高视力,降低眼压和开放房角,减少术后并发症,具有临床推广价值。     

白内障超声乳化吸除联合房角分离术治疗急性闭角型青光眼合并白内障78例疗效观察

目的:观察白内障超声乳化吸除联合房角分离术治疗急性闭角型青光眼合并白内障的疗效。方法:选择132例共156眼急性闭角型青光眼合并白内障患者进行研究。随机分为观察组与对照组,每组78眼。观察组患者采用白内障超声乳化吸除联合房角分离术,而对照组采用青光眼与白内障联合手术。比较两组患者的治疗效果与并发症情况。结果:治疗后,观察组的视力高于对照组的视力,两者相比有统计学差异(t=4.9533,P<0.0001);观察组的眼压低于对照组(t=7.5908,P<0.0001);观察组的眼角开放度及中央前房深均高于对照组(P<0.05)。结论:白内障超声乳化吸除联合房角分离术治疗急性闭角型青光眼合并白内障的疗效优于采用青光眼与白内障联合手术,值得临床推广。     

超声乳化术联合房角粘连分离术治疗闭角型青光眼合并白内障的效果观察

目的:观察超声乳化术联合房角粘连分离术治疗闭角型青光眼合并白内障的效果。方法:选取闭角型青光眼合并白内障患者64例(64眼)为研究对象,采用随机数字表法将其分为对照组和观察组各32例(各32眼)。对照组行小梁切除术,观察组行超声乳化术联合房角粘连分离术。对比两组手术前后的视力、眼压、房角分级和前房深度及并发症发生率。结果:术后1个月观察组视力、房角分级情况均明显优于对照组,前房深度明显高于对照组,差异有统计学意义(P<0.05);术后3 d、1个月,观察组眼压明显低于对照组,差异有统计学意义(P<0.05);观察组术后并发症发生率为6.25%(2/32),明显低于对照组的25.00%(8/32),差异有统计学意义(P<0.05)。结论:超声乳化术联合房角粘连分离术治疗闭角型青光眼合并白内障患者的效果优于小梁切除术的治疗效果。     

白内障超声乳化联合房角分离治疗原发闭角型青光眼的效果观察

目的:分析超声乳化吸除联合房角分离术治疗原发性闭角型青光眼合并白内障患者的临床效果。方法:选取120例原发性闭角型青光眼合并白内障患者,随机分为实验组和对照组,每组60例。对照组采用青光眼白内障联合手术治疗,而对照组采用白内障超声乳化吸除联合房角分离术进行治疗。比较两种不同治疗方式治疗后患者视力及眼压、房角恢复情况。结果:两组患者视力均有不同程度提高。实验组患者的房角开放程度和眼压分别为(69.7±8.45)和(15.6±2.46)mmHg,明显小于对照组的(81.2±6.11)和(19.6±3.46)mmHg,差异均有统计学意义(P<0.05);实验组患者的中央前房深为(3.36±0.11)mm,显著高于对照组的(3.04±0.28)mm(P<0.05)。结论:采用白内障超声乳化吸除联合房角分离术治疗房角粘连范围不超过180°的原发性闭角型青光眼合并白内障患者效果显著,值得临床推广使用。     

双切口联合手术治疗闭角型青光眼合并白内障临床效果观察

目的观察分析双切口联合手术治疗闭角型青光眼合并白内障的临床效果及安全性评价。方法选取2016年3—8月泌阳县人民医院行手术治疗的闭角型青光眼合并白内障患者70例,按随机数表法将其分为对照组(行单切口联合手术治疗)和观察组(行双切口联合手术治疗),各35例。统计比较两组患者术前和术后3个月的裸眼视力、最佳矫正视力、眼压、前房深度及术后并发症发生情况。结果治疗前,两组患者裸眼视力、最佳矫正视力、眼压、前房深度比较,差异均无统计学意义(P>0.05);治疗后,观察组患者裸眼视力、最佳矫正视力、前房深度均优于对照组,眼压低于对照组,差异均有统计学意义(P<0.05)。观察组患者并发症发生率8.57%低于对照组28.57%,差异有统计学意义(P<0.05)。结论双切口联合手术治疗闭角型青光眼合并白内障效果显著,可改善患者视力,安全性高,值得临床推广应用。     

小切口白内障手术治疗白内障合并青光眼临床疗效观察

目的：比较观察小切口白内障摘除联合后房型人工晶体植入术治疗白内障合并不同房角关闭程度的闭角型青光眼患者的临床疗效。方法：41例（43眼）白内障合并闭角型青光眼患者,根据房角关闭程度分为A、B两组：A组（房角关闭粘连≤180°）25眼,B组（房角关闭粘连〉180°）18眼。均施行小切口白内障摘除联合人工晶体植入手术。观察二组手术前后视力、眼压、前房深度、房角变化情况并进行统计分析处理。结果：41例（43眼）白内障合并闭角型青光眼患者术后视力均有提高,房角加深。房角镜检查：A组25眼房角完全开放12眼,房角关闭粘连≤90°者8眼（80%）,房角关闭粘连90°～180°者5眼。B组（房角关闭粘连（180°）18眼中房角关闭粘连≤90°者4眼,房角关闭粘连（180°14眼（78%）。A组优于B组,二者差异有统计学意义（P〈0.05）。眼压：术前A组（44.36±4.27）mmHg,B组（47.01±4.35）。术后一周：A组眼压控制在（15.96±3.97）mmHg,B组眼压控制在（16.20±5.56）mmHg;B组术后6月：6眼需加用降眼压药物,5眼青光眼发作行抗青光眼滤过手术。A组优于B组,二者差异有统计学意义（P〈0.05）。结论：白内障合并闭角型青光眼患者,单纯小切口白内障摘除联合人工晶体植入手术,可有效治疗房角关闭粘连≤180°患者。而对于房角关闭粘连〉180°患者,单纯小切口白内障摘除联合人工晶体植入手术效果不佳,可考虑行青白联合手术,或需降眼压药物治疗。     

白内障和青光眼联合手术治疗的方法及疗效观察

目的分析白内障和青光眼联合手术治疗的方法及疗效。方法将2017年1月至2018年1月我院接治的250例白内障合并青光眼患者随机分为治疗组和对照组,分别行联合手术、传统分期手术治疗。分析两组疗效以及患者的视力、眼压、前房角的变化。结果治疗组的总有效率为94.4%,治疗后的视力为(0.68±0.31),眼压为(13.05±3.92)mm Hg,前房角为(3.77±1.41)mm,相比于对照组,差异均具统计学意义(P0.05)。结论白内障和青光眼联合手术治疗的疗效显著,值得推广应用。     

隧道式小切口联合小梁切除术治疗白内障合并青光眼26例

目的 观察隧道式小切口非超声乳化白内障摘除人工晶体植入联合小梁切除术治疗白内障合并青光眼的疗效.方法 应用隧道式小切口非超声乳化白内障摘除人工晶体植入联合小梁切除术,对26例27眼白内障合并青光眼患者进行手术治疗.术后观察视力、眼压、滤过泡及并发症情况.结果 术后视力＞0.5者15眼(55.6%),0.2～0.5者10眼(37.0%),2眼为眼前指数(7.4%),术后视力均有不同的提高,术前术后视力差异有统计学意义(P＜0.05).术后随访4～24个月,平均眼压为(14.4±2.2)mm Hg(1 mm Hg=0.133 kPa),较术前平均眼压(23.2±4.3)mm Hg明显下降.术前术后眼压差异有统计学意义(P＜0.05).结论 隧道式小切口白内障青光眼联合手术是治疗白内障合并青光眼的一种损伤小、安全有效的手术方法.     

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.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

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.     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.     

Possible Spread of adenovirus type 3 from poultry to humans ：indirect evidence from an outbreak in China

Objective:To explore the epidemiology and etiology for an outbreak of acute respiratory tract infection that occurred in one county of Jiangsu Province, China 2004. Methods: Only cases meeting the case definition were included in the study. We reviewed the medical records of the cases who were admitted to the local hospitals, interviewed cases by a standard questionnaire, and then described the epidemiotogic features and analyzed risk factors by means of a case-control study. We collected pharyngeal swab specimens and sent them to different laboratories for isolation and culture. The laboratory used different detection methods such as DIP, PCR, electron microscope examination and microneutralization assay, to identify and then type the positive specimens. Results:A total of 871 cases were reported during the period from April 18 to July 4,2004. The distribution of onset times presented two peaks, one in late May and another in middle June. The epidemic occurred mainly in the elementary and junior high schools in ten townships of one county, and the mean age of the cases was 12 years (range 7 months to 18 years). The course of the disease was acute, and was characterized by fever accompanied with sore throat and tonsillitis. The WBC count of cases was normal or elevated. The mean duration of illness was 5 days (range 2 to 12 days). No fatalities from illness were reported. A case-control study indicated that the possible risk factors were close contact with a case and/or poultry before onset and sharing of towels among members of the family. The typical CPE was observed through inoculating pharyngeal swab specimens into the HEP-2 cell cultures in different laboratories. An infection of adenovirus type 3 was verified by detecting positive specimens in different methods. Conclusion:This investigation demonstrated that the acute respiratory infection in cases was caused by adenovirus type 3. Cases occurred in over 70 schools in ten townships in 2004, and the route of transmission was possibly close contact with cases or droplet transmission.