无晶状体眼二期前房型人工晶状体植入后的临床观察

目的　探讨无晶状体眼二期植入弹性开放襻一体式前房型人工晶状体的有效性和安全性。方法　 37例 37眼白内障术后无晶状体眼在表面麻醉下经巩膜隧道式切口二期植入新型弹性开放襻一体式前房型人工晶状体 ,并联合周边虹膜切除术。术后随访 5～ 2 8个月 ,平均 18.4个月。结果　 37只无晶状体眼均顺利植入新型弹性开放襻一体式前房型人工晶状体。术前矫正视力为 0 .1～ 0 .6 ,术后 3个月达 0 .2～ 0 .8,2 7眼≥ 0 .5(73.0 % ) ,35眼 (94 .6 % )达到术前最佳矫正视力以上。术前角膜内皮细胞计数平均为 (194 7± 5 81)个 /mm2 ,术后 3个月平均为 (1871± 4 6 2 )个 /mm2 ,手术前、后的差异无显著性 (P >0 .0 5 )。术后常见并发症为角膜水肿、葡萄膜炎、一过性高眼压。结论　无晶状体眼二期植入新型弹性开放襻一体式前房型人工晶状体是一种简便、安全、有效的手术方法     

有晶体眼后房型人工晶状体植入矫正高度近视的临床研究

目的 观察和探讨有晶体眼后房型人工晶体植入术治疗高度近视的临床效果和安全性.方法 对屈光度为-7.1～-22.40 D的30例(52眼)高度近视的患者行有晶状体后房型人工晶状体植入术.观察手术前后患者的视力、屈光度数、角膜内皮细胞计数及眼压等,术后随访6个月.结果 52例眼均成功植入人工晶状体.术后3个月,所有患者达到或超过术前最佳矫正视力.术后屈光度为0.25～1.50 D之间,平均值为0.531±0.394 D.92.6%患者术后屈光度在预期1.0 D以内,有3例6眼术后早期眼压升高,经过积极治疗,3～5 d恢复正常.结论 有晶状体眼后房型人工晶状体植入术矫正高度近视具有较好的临床效果和安全性,是高度近视患者的理想治疗方法.     

有晶状体眼前房人工晶状体植入矫正超高度近视18眼

目的 :观察有晶状体眼前房人工晶状体植入矫正超高度近视的临床效果。方法 :近视度数 - 11～ - 30 D(平均 2 1.2 5 D)的超高度近视 11例 (18眼 ) ,前房内植入 Phakic6 H12 5型人工晶状体 ,随访 6～ 12个月 (平均 9.7个月 )。结果 18眼术后裸眼视力均优于术前矫正视力 ,两者比较差异有显著性 (P<0 .0 5 )。术后散光明显减轻 ,与术前比较差异有显著性 (P<0 .0 5 )。手术前后眼压比较差异无显著性 (P>0 .0 5 )。 3眼轻微瞳孔变形 ,1例 (2眼 )出现眩光感。结论 :有晶状体眼前房人工晶状体植入矫正超高度近视是一种颇具前途的矫正超高度近视的手术方法。     

有晶状体眼后房型人工晶体植入术治疗高度近视31眼临床观察

目的:探讨有晶状体眼后房型人工晶体植入术治疗高度近视手术方法有效性、安全性、可行性。方法:对16例31眼高度近视眼患者采用有晶状体眼后房型人工晶体植入手术。局部麻醉,11点位透明角膜隧道切口,于虹膜与晶状体之间植入后房型人工晶体(ICL)。结果:31眼术前裸眼视力及最佳校正视力分别为0.04～0.1,0.2～0.4,术后分别提高至0.6～1.2,0.8～1.2。术前屈光度平均为-11.0～-20.0D,术后1月内平均为-0.75±0.25D。术前平均角膜内皮计数3105.5±336.1/mm2,术后1月3019.5±321.1/mm2,丢失率4.3%。术前眼压平均14.7±1.5mmHg,术后第1天3眼眼压增高至26mmHg,增高率23.1%,对症处理后眼压恢复正常。1眼因术中穿刺刀刺破晶状体前囊膜,未进行ICL植入,术后第3天行晶状体超声乳化摘除联合人工晶体植入术,术后视力0.8。结论:有晶状体眼后房型人工晶体植入术治疗高度近视视力恢复好、损伤小,保留了晶状体生理调节功能,是一种有效的屈光矫正方法,但手术的安全性还需更长时间临床观察。     

高度近视白内障手法碎核及后房型人工晶状体植入术

目的评价手法碎核及后房型人工晶状体植入术治疗眼轴极长(>30mm)的高度近视白内障的临床疗效。方法对31例(54只眼)轴性高度近视白内障施行巩膜隧道切口手法碎核,植入后房型人工晶状体。平均眼轴长(31.35±1.20)mm(30.04~35.12mm),平均人工晶状体屈光度(4.03±2.92)D(-4~+8D)。结果术后最佳视力(含矫正):术后1d≥0.3者占35.2%,术后1周、1个月及3个月分别为48.1%、59.3%及64.8%;其中术后第1天≥0.5者占13.0%,术后1周、1个月及3个月分别为31.5%、42.6%及46.3%。结论通过小切口行手法碎核及后房型人工晶状体植入术治疗眼轴极长的高度近视白内障,具有术后视力恢复快、屈光状态稳定等优点。     

有晶状体眼前房型人工晶状体植入术治疗高度近视30例疗效观察

目的探讨有晶状体眼前房型人工晶状体植入术矫正高度近视的有效性和安全性。方法高度近视30例43只眼进行有晶状体眼前房型人工晶状体植入术,球面等量光度-7.00~-20.00D,术前检查散瞳前后的屈光度、视力、眼压、角膜内皮计数、房角、眼压以及裂隙灯下观察角膜、前房、瞳孔、晶状体的情况,检眼镜查看眼底。术后随访1~6个月。结果43眼均成功植入人工晶状体,术后视力明显改善,迅速达到或超过最佳矫正视力。术后屈光度明显降低,随访期内眼压、角膜内皮计数与术后无明显差异。手术无明显并发症。结论有晶状体眼前房型人工晶状体植入治疗高度近视,视力恢复迅速,预测性好,无屈光回退,无严重并发症,不失为一种治疗近视的高度近视的有效方法。     

超声乳化人工晶状体植入术效果分析

目的 :探讨超声乳化白内障摘出人工晶状体植入术 (phaco +Iol)的疗效。方法 :通过对 4 98例(5 18眼 )白内障超声乳化摘出人工晶状体植入术进行分析。结果 :术后 1日视力≥ 0 5者占 6 7 2 4 % ,术后 1周≥ 0 5者占 84 % ,1个月占 95 % ,3个月占 97 3%。术后平均散光 1周为 1 2± 0 70D ,1个月为 0 70±0 5 0D ,3个月为 0 5 0± 0 4D。术中、术后主要并发症有 :后囊破裂 8例 ,角膜水肿 4 0例。结论 :超声乳化人工晶状体植入术损伤小 ,并发症少 ,角膜散光小 ,术后视力恢复快     

高度近视白内障超声乳化吸除人工晶状体植入术

目的 :评价高度近视白内障超声乳化吸除人工晶状体植入术临床疗效。方法 :对高度近视白内障 48例 ( 5 6眼 )行超声乳化吸除人工晶状体植入术 ,本组眼轴为 2 6.5 0mm～ 3 2 .80mm ,平均 2 9.2mm。观察术中、术后并发症 ,术后视力 ,随防 6mon～ 2 6mon ,平均 17.6mon。结果 :术后 5 5只眼视力有不同程度提高 ,视力≥ 0 .3者 46眼 ( 82 .14% )。以视力≥ 0 .5为标准 ,眼轴 2 6.5mm～ 3 0mm组有 13眼 ( 40 .0 6% ) ,>3 0mm组有 4眼 ( 16.67% ) ,差异有显著性 ( χ2 =5 .3 6,P <0 .0 5 )本组术中无并发症发生 ,术后早期有轻度角膜水肿 13眼 ( 2 3 .2 % ) ,前房纤维素性渗出 2眼 ( 3 .5 7% ) ,急性迟发性葡萄膜炎 1眼 ( 1.78% )。随访期内 2 6眼 ( 46.43 % )发生后囊混浊 ,仅 2眼 ( 7.69% )需行Nd :YAG激光切开术 ,无视网膜脱离、黄斑囊样水肿发生。结论 :高度近视白内障超声乳化吸除人工晶状体植入术安全、有效 ,但眼轴 >3 0mm者术后视力恢复程度较差     

白内障超声乳化人工晶状体植入后的房角和眼压改变

目的 :随访观察透明角膜切口白内障超声乳化后房型折叠人工晶状体植入后的房角和眼压改变。　方法 :4 6例 5 0只老年性白内障眼行透明角膜切口超声乳化后房型折叠人工晶状体植入 ,比较术前与术后 6个月的眼压与房角改变。　结果 :术前平均眼压 13.76mmHg ,术后 6个月平均眼压 12 .81mmHg ,二者差异无显著性意义 (P>0 .0 5 )。术后普遍的房角改变为虹膜隔后移引起的房角增宽 ,未发现虹膜前粘连。　结论 :透明角膜切口白内障超声乳化后房型折叠人工晶状体植入术对单纯老年性白内障患者的远期眼压未产生有意义的影响 ,术后的房角较术前增宽     

三联术和分步手术治疗青光眼合并白内障的临床观察

目的　评估采用三联术 (小梁切除联合白内障囊外摘除及人工晶状体植入术 )和分步手术 (先行抗青光眼手术 ,经过一段时间再行白内障囊外摘除及人工晶状体植入术 )治疗青光眼合并白内障患眼的效果和并发症。方法　采用三联术治疗 19例青光眼合并白内障患眼 ,分步手术治疗 2 1眼。术后平均随访时间分别为 (17.6 1±14 .93)个月 (1～ 76月 )和 (2 5 .10± 16 .78)个月 (2～ 6 2个月 )。结果　三联术组平均眼压由术前 (2 1.76± 5 .0 1)mm Hg(1mmHg=0 .133kPa)降到术后 (16 .74± 2 .19)mmHg(P <0 .0 5 ) ,平均视力为 0 .2± 0 .10。分步手术组 :抗青光眼术前平均眼压为 (2 9.2 8± 6 .4 0 )mmHg ,术后即白内障术前平均眼压为 (18.2 8± 2 .38)mmHg ,两者差异有显著性 (P<0 .0 5 ) ;白内障术后为 (18.90± 2 .6 8)mmHg,两者差异无显著性 (P >0 .0 5 ) ;两次手术平均间隔 (7.98± 2 .4 6 )个月(3～ 13个月 )。白内障术后平均视力为 0 .31± 0 .16。并发症 :两组都有角膜水肿、前房渗出、一过性高眼压及前房出血 ,但差异无显著性。结论　 2组术后视力均有改善 ,三联术组长期眼压控制好于分步手术组 ,术后并发症除角膜水肿外 ,一过性高眼压、前房渗出的发生率三联术组稍高于分步手术组 ,但差异无显著性 ,且经治     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

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.