光学药物压抑联合综合疗法治疗成年人弱视的对比观察

目的 探讨成年人弱视的治疗方法及效果，认识人的视觉系统可塑性。方法选择年龄、弱视程度、弱视性质无显著性差异的成年人病例93例，治疗前均行视力、注视性质、眼位检查。综合疗法组采用准确配戴眼镜、遮盖法、增视训练、精细作业治疗；光学药物压抑联合综合疗法组配戴使用过矫或欠矫眼镜、阿托品散瞳的远或近距离压抑疗法，并联合使用综合疗法。随访1-5年。结果 综合疗法组治愈12眼（24．00％），有效率为62．00％；光学药物压抑联合综合疗法组治愈17眼（29．82％），有效率为80．70％，2组有显著性差异（P〈0．05）。2组治疗后视力比较有极显著性差异（P〈0．01）。结论 人的视觉系统可塑性可能长期存在，传统治疗儿童弱视的综合疗法、光学药物压抑疗法用来治疗成年人弱视，其疗效是肯定的，且其疗法与患者的依从性有关，光学药物压抑联合综合疗法达到进一步提高疗效、缩短治疗时间的目的。     

综合疗法治疗儿童弱视的疗效观察

目的探讨综合疗法治疗儿童弱视的的效果。方法对有完整资料的弱视儿童（109例186眼）进行随访观察，根据弱视患儿不同情况采用遮盖疗法、压抑疗法、红光及光刷训练、精细目力训练等。结果总有效率91．40％。屈光不正性弱视的疗效明显优于屈光参差性和斜视性弱视，它与其他两组间比较差异有统计学意义（P〈0．05）；弱视程度越轻．治疗效果越好．重度弱视与轻、中度弱视比较差异均有统计学意义（P〈0．05；P〈0．05）。年龄越小，治疗效果越好，3～7岁组弱视治疗效果最好．与男外两组比较差异有统计学意义（P〈0.05；P〈0.01）。结论综合疗法治疗弱视效果好，但是疗效与弱视类型、程度、检出并进行治疗的年龄密切相关。定期随访是防止复发的关键。     

光学药物压抑法与遮盖法治疗儿童单眼弱视疗效比较

目的 探讨光学压抑法与遮盖法对儿童单眼弱视疗效差异.方法 将163例单眼弱视儿童随机分为光学压抑组(78例)和遮盖治疗组(85例).光学压抑组初始3d每晚涂1次阿托品眼膏,以后每周1次,遮盖组每天遮盖至少8h.比较两组治疗效果、治愈时间和依从性.结果 两组总有效率分别为88.5％、85.9％,差异无统计学意义(P＞0.05),治愈时间分别为(13.8±1.5)月、(13.6±1.2)月,差异无统计学意义(P＞0.05).依从性光学压抑组明显优于遮盖组,差异有统计学意义(P＜0.05).结论 光学压抑法和遮盖法治疗弱视,疗效相近,光学压抑法依从性较好.     

光学药物压抑疗法和遮盖疗法治疗儿童单眼屈光参差性弱视的效果比较

目的:比较光学药物压抑疗法和遮盖疗法治疗儿童单眼屈光参差性弱视的效果。方法:选取118例单眼屈光参差性弱视患儿作为研究对象,依据随机数字表法将其分为研究组和对照组各59例,研究组给予光学药物压抑疗法,对照组给予遮盖疗法。比较两组临床疗效、立体视重建效果、治疗依从性、临床治疗效果以及并发症发生率。结果:研究组的治疗有效率为86.44%(51/59),明显高于对照组的71.19%(42/59),差异有统计学意义(P<0.05);研究组的立体视重建有效率为72.88%(43/59),明显高于对照组的54.24%(32/59),差异有统计学意义(P<0.05);研究组治疗依从率为93.22%(55/59),明显高于对照组的79.66%(47/59),差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:与遮盖疗法相比,光学药物压抑疗法治疗儿童单眼屈光参差性弱视患儿的效果优于遮盖疗法治疗效果。     

综合疗法治疗儿童弱视的疗效观察

目的 探讨综合疗法治疗儿童弱视的的效果.方法 对有完整资料的弱视儿童(109例186眼)进行随访观察,根据弱视患儿不同情况采用遮盖疗法、压抑疗法、红光及光刷训练、精细目力训练等.结果 总有效率91.40%,屈光不正性弱视的疗效明显优于屈光参差性和斜视性弱视,它与其他两组间比较差异有统计学意义(P<0.05),弱视程度越轻,治疗效果越好,重度弱视与轻、中度弱视比较差异均有统计学意义(P<0.05,P<0.05);年龄越小,治疗效果越好,3～7岁组弱视治疗效果最好,与另外两组比较差异有统计学意义(P<0.05,P<0.01).结论 综合疗法治疗弱视效果好,但是疗效与弱视类型,程度、检出并进行治疗的年龄密切相关.定期随访是防止复发的关键.     

弱视治疗的新进展

弱视的治疗方法主要包括遮盖疗法、压抑疗法、屈光矫正、手术治疗及药物治疗,但根据病情不同治疗的效果差别较大。重度弱视儿童每天遮盖6h和全天遮盖治疗的效果无明显差异。阿托品压抑治疗中度弱视与遮盖治疗效果相近,但依从性更高。有研究认为遮盖配合近距离活动并不能显著提高弱视的最终疗效,此结果挑战了传统的遮盖配合近距离活动的治疗方案。同时证明了单纯使用配镜治疗轻度弱视也可以得到较好的疗效。     

大龄儿童弱视134例综合治疗体会

目的：分析大龄儿童弱视治疗疗效及影响因素。方法：对134例大龄弱视儿童（12～15岁）采用屈光矫正、遮盖健眼、弱视治疗仪和压抑法等综合疗法进行治疗,观察其疗效,并对弱视不同类型、不同程度、不同注视性质与疗效的关系进行分析。结果：134例大龄儿童弱视的治愈率58.20%、进步率26.87%、无效率14.93%,总有效率85.82%。屈光参差性弱视的疗效明显优于斜视性弱视和形觉剥夺性弱视（P〈0.01）。弱视程度越轻,疗效越好,重度弱视与轻、中度弱视的有效率比较,差异具有统计学意义（P〈0.01）。结论：综合疗法治疗弱视的效果满意,值得推广。但其疗效与弱视类型、弱视程度、弱视性质密切相关。     

综合疗法治疗儿童弱视的疗效分析

目的 :评价综合疗法治疗儿童弱视的远期疗效。方法 :追踪观察治疗 3年以上的弱视患者 2 30例、36 5眼 ,在治疗过程中根据患者弱视程度、年龄及注视性质采用传统遮盖疗法 ,光学及药物压抑疗法 ,后像疗法及脉冲红光闪烁疗法等综合治疗。结果 :总治愈率为 71.78% ,其中轻度弱视治愈率为 93.85 %、中度为 82 .6 7%、重度为 34.6 9%。屈光不正性弱视 81.95 %、屈光参差性弱视 6 4.13%、斜视性弱视 4 9.4 7%。中心注视与旁中心注视之间差异有显著性 (P <0 .0 5 )。表明弱视程度越轻 ,治疗效果越好。各种类型弱视中 ,以屈光不正性弱视疗效最好。中心注视者疗效明显好于旁中心注视者。结论 :采用综合疗法治疗弱视 ,疗效显著 ,能明显缩短疗程 ,是目前治疗弱视最有效的方法。     

大龄儿童及青少年弱视治疗的临床观察

目的：观察大龄儿童及青少年弱视治疗的效果。方法患儿在佩戴矫正眼镜后采用综合治疗方法治疗8～16岁弱视患者126例（156眼）,按照初诊年龄、弱视程度、弱视类型、注视性质进行分组观察。治疗方法包括：遮盖方法、多功能弱视训练仪疗法、精细目力训练、药物压抑疗法和干预治疗。结果（1）不同年龄的治疗效果：不同年龄组的治疗效果无明显差异;（2）弱视程度与疗效：不同程度弱视治疗效果有显著差异,轻度弱视治疗效果最好,重度弱视治疗效果最差,差异有统计学意义;（3）弱视类型与疗效：结果显示屈光不正弱视治疗效果最好,斜视性弱视治疗效果最差,差异有统计学意义;（4）注视性质与疗效：结果显示中心注视弱视治疗效果明显好于非中心注视性弱视,差异有统计学意义。结论大龄儿童及青少年通过综合治疗,能获得较好的治疗效果。     

综合疗法治疗儿童弱视的疗效观察

目的探讨综合疗法治疗儿童弱视的的效果。方法对有完整资料的弱视儿童(109例186眼)进行随访观察,根据弱视患儿不同情况采用遮盖疗法、压抑疗法、红光及光刷训练、精细目力训练等。结果总有效率91.40%;屈光不正性弱视的疗效明显优于屈光参差性和斜视性弱视,它与其他两组间比较差异有统计学意义(P&lt;0.05);弱视程度越轻,治疗效果越好,重度弱视与轻、中度弱视比较差异均有统计学意义(P&lt;0.05;P&lt;0.05);年龄越小,治疗效果越好,3～7岁组弱视治疗效果最好,与另外两组比较差异有统计学意义(P&lt;0.05;P&lt;0.01)。结论综合疗法治疗弱视效果好,但是疗效与弱视类型、程度、检出并进行治疗的年龄密切相关。定期随访是防止复发的关键。     

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.