晶体囊内摘除并人工晶体缝线固定术治疗外伤性晶体脱位12例观察

目的:探讨晶体囊内摘除并人工晶体缝线固定术治疗治疗外伤性晶体脱位患者的疗效。方法:外伤性晶体脱位继发青光眼患者12例(12眼)采用晶状体囊内摘除并人工晶体缝线固定术进行治疗,随访观察4~17个月。结果:术后所有眼视力均较术前提高;10眼眼压维持21mmHg(1mmHg=0.1333 kPa)之下,1例术后眼压失控行抗青光眼手术后控制;2例晶体光学区略倾斜;3例术后发生持续1周以上的角膜水肿,但最终均恢复透明;1例术后发生玻璃体少量积血,术后6周吸收。结论:在慎重选择病例的基础上对外伤性晶体脱位于前房、嵌顿在瞳孔区或晶体向上半脱位者实施晶体囊内摘除并人工晶体缝线固定术安全有效,可恢复一定视力,对合并继发瞳孔阻滞性青光眼可有效控制眼压。     

玻璃体抽液联合白内障摘除及人工晶体植入术治疗恶性青光眼

目的　探讨恶性青光眼的手术治疗。方法　 6例 6眼恶性青光眼行玻璃体抽液、白内障摘除及后房型人工晶体植入术。结果　 5眼眼压控制在 2 2 5 5mmHg以下 ,前房恢复正常 ;视力 >0 4者 2眼 ,>0 2者 2眼 ,=0 1者 1眼 ,无效 1眼。结论　玻璃体抽液联合白内障摘除及人工晶体植入术是治疗恶性青光眼的有效方法之一。     

膨胀期白内障继发青光眼围手术期的治疗

目的 :探讨膨胀期白内障继发青光眼围手术期的治疗方案。方法 :对膨胀期白内障继发青光眼 36例、36眼进行规范的围手术期检查及治疗。 2 9例采用白内障囊外摘除虹膜周边切除联合人工晶体植入术 ;7例采用白内障囊外摘除人工晶体植入联合小梁切除术。结果 :术后随访 2年。术后矫正视力 >0 .2者 34例(94 .4 % ) ,眼压 14 .5 7～ 18.86mmHg者 34例 (94 .4 % ) ;2例 (5 .6 % )视力为光感～ 0 .0 2 ,眼压 2 2 .38～ 2 8.0 1mmHg ,眼底可见视神经萎缩。结论 :根据膨胀期白内障继发青光眼的临床特点制定规范的围手术期治疗方案 ,提高了手术安全性及术后治愈率     

外伤后继发青光眼的临床分析

目的 探讨眼外伤继发青光眼的原因和治疗.方法 对200例200眼眼外伤继发青光眼患者的临床表现和治疗方法进行分析.结果 眼外伤继发青光眼可由多种原因引起,根据本组资料可将其发病原因主要归为4种:眼内积血、前房角挫伤、晶状体源性、炎性粘连或增殖.单纯药物治疗50眼,药物联合各类手术治疗150眼(前房冲洗、白内障摘除、玻璃体切割、小梁切除、联合手术).治疗后随防2-12个月,眼压正常者(6-21mmHg)(1mmHg=0.133kPa)164眼(82%);眼压>21mmHg者28眼(14%) ;眼压<6mmHg者8眼(4%).结论 眼外伤继发青光眼的发病原因复杂,应针对病因及时治疗.     

外伤性晶状体脱位继发青光眼联合手术治疗的临床观察

[目的]探讨外伤性晶状体脱住继发青光眼作晶状体摘除术联合玻璃体切割术和／或抗青光眼手术治疗临床疗效。[方法]对25例25只眼外伤性晶状体脱位继发青光眼的患者作脱位晶状体摘除、小粱切除、玻璃体切割等多种联合手术。[结果]25例患者（25只眼）成功摘除脱位晶状体,22例患者眼压恢复正常,18例患者矫正视力提高。[结论]晶状体摘除术、小粱切除术、玻璃体切割术等多种联合手术是治疗晶状体脱位继发性青光眼的有效手段。     

晶状体玻璃体切除治疗外伤性晶状体脱位继发青光眼的临床观察

目的:观察晶状体玻璃体切除治疗外伤性晶状体脱位继发青光眼的临床效果.方法:对48例(49只眼)外伤性晶状体脱位继发青光眼患者进行晶状体、玻璃体切除手术治疗,并对术眼致伤原因、术前、后视力、眼压及术后并发症进行分析.结果:术后44例患者(45只眼)眼压＜21mmHg(91.67％);2例患者(2只眼)眼压21～30mmHg(4.16％);2例患者(2只眼)眼压＞30mmHg(4.16％).35例患者术后矫正视力提高;12例患者术后矫正视力无提高;1例患者术后矫正视力较术前差.2例患者术后视网膜脱离,3例患者出现葡萄膜炎,2例患者术后眼压仍大于30mmHg,1例患者术后出现黄斑水肿.结论:继发性青光眼是外伤性晶状体脱位的最常见并发症,其发生机制与玻璃体产生的阻滞有关,晶状体玻璃体切除手术是治疗此类青光眼的一种安全有效的方法.     

晶状体半脱位继发闭角型青光眼的临床分析

目的 回顾性分析晶状体半脱位继发青光眼的临床特点与治疗。方法 对13例（13只眼）晶状体半脱位继发闭角型青光眼患者，分别行YAG激光虹膜周边切除，小梁切除术，小梁切除术＋晶状体摘除＋玻璃体切割术（或＋人工晶体植入术），睫状体冷冻术，总结其临床表现特点与治疗效果。结果 晶状体半脱位继发闭角型青光眼临床表现类似急性闭角型青光眼；术后84．6％眼压控制正常范围；术后61．5％最佳矫正视力提高。结论晶体半脱位继发闭角型青光眼表现与急性闭角型青光眼相似，前房浅并深浅不均，眼压高，视力影响大是其特点；可根据患者前房、晶体及视力情况选择不同的治疗方案。     

白内障超声乳化及人工晶状体植入联合小梁切除术疗效观察

目的探讨白内障超声乳化摘除、人工晶体植入联合小梁切除术的疗效。方法对72例（72眼）青光眼合并白内障患者，行白内障超声乳化摘除、人工晶体植入联合巩膜隧道内小梁切除术治疗，术后观察眼压、视力、滤过泡等情况，术后随访2～16个月。结果平均眼压由术前46．42±14．80mmHg降至术后16．52±2．50mmHg；术后矫正视力数指2眼，0．1～0．6者52眼。0．8～1．2者18眼。结论白内障超声乳化摘除、人工晶体植入联合巩膜隧道内小梁切除术可良好控制眼压，显著提高视力。     

手术治疗外伤性晶体脱位继发青光眼24例观察

目的:观察白内障超声乳化联合玻璃体切割治疗外伤性晶体脱位继发青光眼的疗效。方法:回顾分析24例外伤性晶体脱位继发青光眼患者,行白内障超声乳化与玻璃体切割手术,观察术前术后视力,眼压的情况变化与术后并发症。结果:患者的视力均有不同程度的提高,眼压大部分控制在正常范围,没有明显的并发症。结论:超声乳化联合玻璃体切割,是治疗外伤性晶体脱位继发青光眼安全有效的手术方式。     

晶体囊外摘除联合人工晶体植入术治疗闭角型青光眼

目的 探讨治疗晶体膨胀期伴有房角窄而致眼压高的白内障继发青光眼的方法.方法 采用大切口晶状体囊外 人工晶体植入或小切口晶体囊外摘除联合人工晶体植入手术治疗25例29眼急性闭角型青光眼合并白内障患者,对其结果进行分析.结果 术前平均眼压39.56 mmHg,术后随访最终平均眼压降至(14±4.8) mmHg.最终矫正视力范围为4.3～5.0,其中4.7以上者5眼(占17.2%).术后早期有并发症,角膜水肿11眼(37.9%),术后第2天丁达氏征( ～ )6眼,人工晶体表面形成纤维膜3眼,经活动瞳孔、激素治疗5～10天缓解.结论 采用晶体摘除联合人工晶体植入术治疗晶体膨胀期伴有房角窄而致眼压高的白内障继发青光眼,是一种有效、便捷、可重复、并发症少的治疗急性闭角型青光眼的手术方式.     

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.