玻切术后视网膜再脱离的原因探讨

目的：探讨玻璃体切割术后视网膜再脱离的原因。方法：回顾性分析我院近8年来的56例玻璃体切割术后视网膜脱离的特征及治疗过程。结果：玻切术后复发视网膜脱离的发生率为6.00%。56例中原始疾病包括玻璃体积血22例,增生性玻璃体视网膜病变（proliferative vitreo retinopathy,PVR）20例,眼内异物10例,眼内炎4例。75.00%于术后1周内出现视网膜再脱离,64.29%由增殖性玻璃体视网膜病变（PVR）引起。二次手术治疗包括玻璃体切割、经视网膜光凝、巩膜扣带环扎、长效气体及硅油充填术。最终81.00%视网膜复位、视力得到提高。结论：视网膜再脱离是玻璃体切割术后常见的并发症,本研究表明视网膜再脱离的最主要原因是PVR。     

玻璃体切除术联合硅油填充术治疗无视网膜脱离的儿童外伤性眼内炎

目的:探讨玻璃体切除术联合硅油填充术治疗儿童无视网膜脱离外伤性眼内炎临床疗效。方法:19例患儿19只眼应用标准三通道玻璃体切除术,或联合晶体切除、异物取出术,最终行硅油填充术治疗无视网膜脱离外伤性眼内炎。结果:随访3-12个月,19例患儿眼内炎均得到控制,保住眼球,12例(70.6%)患儿视力有不同程度的提高,4例(23.5%)不变,1例(5.9%)下降。2例术前不配合而不确定。结论:玻璃体切除术联合硅油填充术是治疗儿童不伴视网膜脱离外伤性眼内炎的有效方法。     

玻璃体切割联合眼内填充术治疗漏斗状视网膜脱离

目的 :探讨玻璃体切割联合眼内填充术治疗漏斗状视网膜脱离的效果。方法 :漏斗状视网膜脱离18例、18眼 ,行三切口闭合式玻璃体切割术 ,14眼填充硅油 ,4眼填充C3 F8。结果 :18眼中视力增进 13眼 ,占72 .2 % ,不变 4眼 ,占 2 2 .2 % ,下降 1眼 ,占 5 .6 %。硅油填充 14眼 ,C3 F8填充 3眼视网膜均一次复位成功。C3 F8填充 1眼术后复发网脱 ,行二次手术 ,视网膜复位。硅油填充 ,术后 4眼暂时性眼压升高。 1眼持续高眼压 ,2个月取出硅油 ,视神经萎缩。结论 :漏斗状视网膜脱离会致视功能严重损害 ,玻璃体切割联合眼内填充术可有效地提高视网膜复位率 ,挽救患者的视功能     

玻璃体切割联合硅油填充术后继发青光眼的原因分析

目的 探讨玻璃体切割联合硅油填充术后继发青光眼的发病因素.方法 对215只行玻璃体视网膜手术眼,其中硅油填充眼106只、无硅油填充眼99只进行回顾性研究.结果 硅油填充眼组12眼(11.32%),无硅油填充眼组2眼(2.02%)发生继发青光眼.两组比较x2=6.96, P<0.01.结论 继发性青光眼是玻璃体切割联合硅油填充术后常见并发症之一,硅油在眼内填充过量、硅油进入前房、硅油乳化、无晶体眼是青光眼发生的主要因素;药物和手术治疗可有效控制眼压.     

玻璃体切割术治疗眼内异物的疗效观察

目的：评价玻璃体切割术治疗眼内异物的效果。方法对新疆医科大学第一附属医院2009年5月-2012年5月48例（48眼）眼内异物患者行玻璃体切割术联合球内异物取出的临床资料进行回顾性分析。48例（48眼）行玻璃体切割、球内异物取出联合晶状体切除、视网膜脱离复位、巩膜外冷凝、巩膜环扎、视网膜激光、虹膜周切、C3F8或硅油填充术。结果48例（48眼）均一次性手术成功取出异物,术后视力较术前提高者36眼（75．0％）,视力不变者6眼（12．5％）,视力下降者6眼（12．5％）。结论玻璃体切割术能有效治疗眼内异物,异物取出成功率高,患者的视力和眼球得到了挽救。     

玻璃体视网膜手术治疗儿童复杂性眼外伤效果分析

目的评价玻璃体视网膜手术救治儿童复杂性眼外伤的效果。方法回顾性分析玻璃体切除术及联合手术治疗2.5～12岁儿童穿孔性眼外伤36例（37眼）。包括眼内炎、玻璃体积血、眼内异物、视网膜脱离等。结果 37眼患者术后,36（97.30%）只眼一次性手术治愈,其中视力提高者31（83.78%）只眼,1眼因视网膜脱离,经二次膜剥离,气-液交换后硅油填充,视网膜仍不复位最终成为硅油依赖而失败。所有患者均随访2～6个月。其中光感～0.1者13（35.14%）眼,0.1～0.3者12（32.43%）眼,0.3以上的6（16.22%）眼,视力不变者5（13.51%）眼,1（2.70%）眼视力下降。结论经过恰当的玻璃体切除术联合相应的治疗措施,大多数儿童复杂性眼外伤视功能可得到相当程度的挽救,少部分儿童可以达到脱盲、脱残的目的。     

玻璃体切除联合硅油填充治疗无视网膜脱离感染性眼内炎13例

目的探讨玻璃体切除联合硅油填充术治疗无视网膜脱离感染性眼内炎的疗效。方法对13例13眼无视网膜脱离感染性眼内炎采用玻璃体切除联合硅油填充术治疗。结果随访3—18个月,13眼眼内感染全部控制,与术前相比,12眼视力有不同程度提高,1眼视力不变,无眼球萎缩。1眼在硅油取出后发生视网膜脱离。9眼并发前房炎性渗出,3眼术后短暂高眼压。经治疗渗出物吸收,眼压得到控制。结论玻璃体切除联合硅油填充手术是治疗无视网膜脱离感染性眼内炎的有效方法。     

玻璃体切除术联合硅油填充术治疗无视网膜脱离的儿童外伤性眼内炎的疗效观察

目的:研究玻璃体切除术联合硅油填充术治疗无视网膜脱离的儿童外伤性眼内炎的临床效果。方法:选取收治的15例(15只眼)无视网膜脱离的外伤性眼内炎患儿作为试验组,并选取同期的15例(15眼)设为对照组。试验组采用标准三通道玻璃体切除术与硅油填充术治疗,对照组采用玻璃体切除术与抗生素注入治疗,观察治疗效果。结果:试验组11例患儿视力有提高,2例不变,1例下降,1例未能确定;参照组5例视力提高,6例不变,4例下降。结论:对于无视网膜脱离的儿童外伤性眼内炎,玻璃体切除术联合硅油填充术可取得良好的效果。     

玻璃体切割联合眼内硅油填充术治疗增殖性玻璃体视网膜病变疗效观察

目的:观察玻璃体切割联合眼内硅油填充术治疗增殖性玻璃体视网膜病变疗效。方法:对增殖性玻璃体视网膜病变患者采用闭合式玻璃体切割联合眼内硅油填充手术。结果:共治疗575例(636眼),术后观察(平均1～3个月):视力提高477例(占75.0%),视力无变化113例(占17.8%),视力下降46例(占7.2%)。结论:闭合式玻璃体切割联合眼内硅油填充手术治疗增殖性玻璃体视网膜病变可有效降低术后再出血、视网膜脱离、新生血管性青光眼的发生几率。     

曲安奈德辅助玻璃体切割术治疗儿童眼内异物伤的临床研究

目的:观察和评价曲安奈德辅助玻璃体切割术治疗儿童眼内异物伤的临床效果,以指导临床治疗。方法:将2012年1月-2016年10月在本院行玻璃体切割术的80例(83眼)儿童眼内异物伤患者,根据术中是否应用曲安奈德分为两组:A组40例(42眼)行眼内异物取出联合玻璃体切割、曲安奈德注射、眼内光凝、硅油填充术;B组40例(41眼)行眼内异物取出联合玻璃体切割、眼内光凝、硅油填充术,术后随访均≥3个月。结果:80例眼内异物伤患儿均一次手术摘除异物,出院时视网膜均恢复。除2例(3眼)患者视力检查不合作外,术后视力提高53例(56眼),其中A组31例(33眼),占78.57%,B组22例(23眼),占56.10%,两组比较差异有统计学意义(字2=4.774,P=0.029)。41例(42眼)术后矫正视力0.05,其中A组25例(26眼),占61.90%,B组16例(16眼),占39.02%,两组比较差异有统计学意义(字2=4.345,P=0.037)。13例(13眼)患者术后出现视网膜脱离,其中A组2例(2眼),发生率为4.76%,B组11例(11眼),发生率为26.83%,两组比较差异有统计学意义(字2=7.648,P=0.006)。结论:玻璃体切割手术中辅助应用曲安奈德可明显改善儿童眼内异物伤患者的视力预后,并可有效预防视网膜脱离等术后严重并发症的发生,值得临床推广。     

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.