氪激光治疗视网膜黄斑分支静脉阻塞激光的临床观察

目的 观察氪激光光凝术治疗视网膜黄斑分支静脉阻塞的临床疗效。方法 用氪激光光凝术治疗视网膜黄斑分支静脉阻塞45例46眼，治疗前后做视力、眼底及荧光素眼底血管造影（FFA）检查，术后随访1年。结果 45例患者中视力增高38例，不变者8例，无视力下降。38眼激光治疗后黄斑区出血、水肿完全吸收且FFA显示荧光渗漏消失。结论 氪激光光凝术治疗视网膜黄斑分支静脉阻塞疗效显著，及时光凝有利于患者视力早日恢复。     

老年特发性黄斑部视网膜前膜眼底荧光血管造影10例体会

目的 探讨老年特发性黄斑视网膜前膜患者眼底荧光血管造影（FFA）的特点。方法 收集老年特发性黄斑前膜患者10例（12只眼），对其进行FFA图像分级及分析。结果 10例患者（12只眼）中0级1只眼，Ⅰ级9只眼，Ⅱ级2只眼。结论 FFA可提示黄斑区血管渗漏和黄斑水肿、黄斑裂孔，并用于指导临床进行激光治疗。此外，FFA红外眼底相（IR）可清晰地显示视网膜前膜范围、黄斑水肿和黄斑裂孔的形态，便于了解患者黄斑视网膜前膜病变程度。     

曲安萘德玻璃体腔注射治疗黄斑水肿的临床观察

目的观察玻璃体腔注射曲安萘德（TA）治疗黄斑水肿（DME）的疗效及并发症。方法对34例38眼黄斑水肿（其中8例12眼为糖尿病视网膜病变,26例26眼为视网膜静脉阻塞）患者行玻璃体腔注射TA 4 mg,对其视力、眼压、眼底、眼底行荧光血管造影（FFA）、光学相干断层扫描（OCT）进行检查,定期随访6个月。结果治疗后1、3、6个月平均视力分别与治疗前比较差异有统计学意义（P〈0.05）。黄斑区视网膜厚度与治疗前比较,差异有统计学意义（P〈0.05）。眼底血管FFA显示治疗后黄斑区渗漏消失或减轻。结论玻璃体腔内注射TA治疗糖尿病视网膜病变及视网膜静脉阻塞引起的DME,简单安全易操作,短期内能有效提高视力,降低视网膜黄斑厚度,减轻黄斑区的水肿及渗漏,值得在基层医院推广。     

OCT3和FFA结合对诊断钝挫伤性黄斑水肿的分析研究

目的对钝挫伤引起的黄斑水肿患者进行OCT3、FFA检查，对图像、数据进行分析研究，以期早期发现黄斑水肿。方法对40例50眼正常对照组以及钝挫伤患者45例67眼分别进行直、间接眼底镜，三面镜及眼底荧光造影．三代光学相干断层扫描，通过黄斑中心凹的水平或垂直方向线性扫描，测量黄斑中心凹的厚度，对比分析两组受检者的中心凹厚度值。结果对所有眼进行直、间接眼底镜及三面镜检查，肯定有黄斑水肿者42眼（占62。7％），怀疑有水肿者13眼（占19．4％），肯定无水肿者12眼（占17．9％）；FFA确定有水肿者50眼（占74．6％），未发现水肿者17眼（占25.4％），其中黄斑局限性水肿30眼（占60．0％），弥漫性水肿20眼（占40.0％），用三代OCT，检查正常对照组黄斑中心凹6mm区域内视网膜平均厚度为（152±10）μm，在钝挫伤患者组同样区域内OcT3检查无黄斑网膜增厚者8眼（占11。9％），有黄斑增厚者59眼（占88．1％）。经比较，OCT3检查的敏感性大大高于直、间接眼底镜；FFA检查无黄斑水肿组中有9眼经与OCT检查与正常对照组相比较，有显著性差异（P〈0．05）。结论对于钝挫伤引起的黄斑水肿，OCT3检查其敏感性大大高于直、间接眼底镜及三面镜检查，并随着病程的延长，黄斑水肿加重，视网膜厚度及形态改变明显，黄斑中心凹厚度越厚，视力越差。OCT3与FFA检查相互配合，才能较准确地评估黄斑水肿的发生及发展。     

激光光凝治疗黄斑水肿疗效观察

目的观察激光光凝治疗视网膜血管性疾病所致黄斑水肿的疗效。方法对我院63例69只眼视网膜血管性疾病所致黄斑水肿病例，参照眼底荧光血管造影(FFA)结果。根据黄斑水肿的来源及范围，采用532激光分别进行局部光凝法，象限光凝法和“C”形光凝法。激光光凝后3个月～半年，复查FFA，分析视力及黄斑水肿变化。结果69只眼中，光凝后视力提高41只眼(59．4％)；视力无变化17只眼(24．6％)；视力下降11只眼(16．0％)。黄斑水肿减轻51只眼(73．9％)。结论激光光凝治疗视网膜血管性疾病所致黄斑水肿疗效肯定，早期治疗效果更好。     

多波长氪激光治疗糖尿病视网膜病变

目的：探讨多波长氪激光治疗糖尿病视网膜病变的临床疗效。方法：对118例220眼糖尿病性视网膜病变Ⅲ-Ⅳ期患者用多波长氪激光行全视网膜光凝治疗及158眼行黄斑格珊样光凝，根椐病变的性质、部位和屈光情况选择不同波长激光进行光凝，术前进行视力、裂隙灯、眼底和眼底血管荧光造影检查，治疗后3个月作第1次检查，并检查视力、眼底情况，随诊6-12个月。结果：治疗后视力提高108眼（49．1％），不变92眼（41．8％），下降20眼（9．1％），黄斑水肿完全消退75眼（47．5％），部分消退69眼（43．7％）总有效率为91．2％。结论：多波长氪激光治疗糖尿病视网膜病变是一种有效的治疗方法，早期治疗效果较好。     

氟羟氢化泼尼松玻璃体腔注射治疗视网膜静脉阻塞继发性黄斑水肿的临床观察

目的：评价玻璃体腔注射氟羟氢化泼尼松（triamcinolone acetonide,TA,曲安奈德）治疗视网膜静脉阻塞（retinal vein occlusion,RVO）继发性黄斑水肿的疗效及安全性。方法：对经间接检眼镜、荧光素眼底血管造影（FFA）、光学相干断层扫描（OCT）检查确诊的RVO继发黄斑水肿患者42例（42眼）行玻璃体腔注射TA0.1ml（4mg）,治疗后随访6个月,观察术前及术后不同时期视力、眼压、眼底、FFA表现,观察OCT显示黄斑水肿高度。结果：中央视网膜静脉阻塞（CRVO）25眼（缺血型17眼,非缺血性8眼）,分支静脉阻塞（BRVO）17眼（缺血型11眼,非缺血性6眼）。最终随访视力提高30眼,比术前降低5眼,不变7眼。OCT形态恢复正常16眼,改善23眼,无改善3眼。11例术后出现一过性眼压升高,1例术后出现晶体后囊TA药物颗粒贴附,1个月后逐渐吸收。结论：玻璃体腔注射TA是一种安全有效的治疗视网膜静脉阻塞继发黄斑水肿的方法。     

Vogt-小柳-原田氏病13例荧光素眼底血管造影与治疗分析

目的探讨Vogt-小柳原田病的眼底荧光血管遣影特征和糖皮质激素治疗效果。方法回顾性分析13例（25眼）Vogt-小柳原田病的临床表现．眼底荧光血管造影的特点和糖皮质激素治疗的效果。结果所有Vogt-小柳原田病的患者均表现为：视盘充血,边界不清,黄斑呈囊样水肿,静脉迂曲扩张,动脉变细,后极部视网膜弥漫性水肿。FFA主要表现为：FFA表现为特征性后极部早期多发性荧光渗漏点,晚期视同膜呈多囊样视网膜下荧光素积存。复发1例眼底呈晚霞状,无赤光下可见赤道部Dalen—Fuchs结节,糖皮质激素治疗后25只眼底炎症基本得到控制,显效者17只眼（66．7％）,好转者8只眼（33．3％）。所有病例出院时视力均高于0．5（P〈0．05）。结论眼底荧光血管造影检查和糖皮质激素的早期合理应用对Vogt-小柳原田病的诊断及预后具有很重要的作用。     

后Tenon’s注射曲安奈德治疗视网膜静脉阻塞黄斑水肿

目的评价后Tenon’s注射曲安奈德治疗视网膜静脉阻塞（retinl vein occlusion,BVO）黄斑水肿（macular edema,ME）的疗效和安全性。方法对23例（28眼）BVO所致ME患者行后注射曲安奈德40mg,于术前和术后不同时间检查视力、眼压、眼底、眼底荧光血管造影（funds fluorescein angiography,FFA）等检查。结果术后5只眼（1786％）视力改善,14只眼（50％）视力无变化,和术前相比差异有显著性。治疗后19只眼（82．1％）患者黄斑水肿明显减轻。术后2月平均眼压升高,和术前相比差异有显著性。所有患者除眼压升高外,无其他并发症发生。结论后Tenon’s注射曲安奈德是一种治疗视网膜静脉阻塞所致黄斑水肿的有效、安全手段。     

曲安奈德联合经瞳孔温热治疗渗出型老年性黄斑变性的疗效观察

目的探讨曲安奈德联合经瞳孔温热治疗渗出型老年性黄斑变性的疗效。方法回顾性分析2011年1月～2012年1月在我院就诊的80例（90眼）渗出型老年性黄斑变性患者,随访术后1个月、2个月及6个月患者矫正视力、眼压、检查眼底,经眼底荧光血管造影（FFA）。黄斑中心凹视网膜厚度及多焦视网膜电图（mfERG）反应密度的变化。根据治疗前后两者的变化进行比较。结果曲安奈德联合经瞳孔温热治疗后6个月：视力≤0．02有5眼,0．04有4眼,0．06有6眼,0．08有8眼,0．1～0．15有28眼,0．2有17眼,0.25有15眼,0．4有7眼。77眼水肿明显消退,10眼水肿无明显改善,3眼水肿加重;69眼视网膜出血吸收,12眼出血无明显改变,9眼出血增加。较治疗前视力改善显著,不良反应较轻。治疗后患者的黄斑中心凹视网膜厚度降低,明显使多焦视网膜电图反应密度升高,与治疗前比较,差异有统计学意义（P〈0．05）。结论曲安奈德联合经瞳孔温热治疗渗出型老年性黄斑变性的疗效显著,能改善患者视力,值得临床推广应用。     

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.