Nd:YAG激光治疗后发性白内障的临床观察

目的:探讨Nd:YAG激光治疗后发性白内障(以下简称后发障)的疗效。方法:应用Nd:YAG激光分别对76例白内障超声乳化人工晶体植入后发障进行后囊膜切开。结果:全部病例视力均有不同程度提高,其中矫正视力>0.5者66眼,占86.8%,未见严重并发症发生。结论:Nd:YAG激光后囊膜切开术治疗后发障操作简易、安全且疗效确切。     

Nd：YAG激光治疗后发性白内障的临床观察

20世纪80年代以来,白内障囊外摘除术和小切口超声乳化白内障吸除术成为治疗白内障的主要方法。后发性白内障是白内障手术后最常见的并发症,是导致人工晶状体眼和无晶状体眼视力下降的主要原因。成年人的发病率约15％-50％,儿童几乎高达100％。我院自2006年2月至2010年12月对56例（64眼）的后发性白内障患者行Nd：YAG激光后囊膜切开术,取得较好效果现报告如下。     

Nd：YAG激光对白内障超声乳化人工晶体植入术后后发性白内障的治疗

目的：观察Nd：YAG激光对白内障超声乳化人工晶体植入术后后发障的效果。方法：应用Nd：YAG激光分另4对186例196只眼白内障超声乳化人工晶体植入术后后发障进行后囊膜切开。结果：术后随访6-18个月，术后181只眼视力达到白内障超声乳化术后的最佳视力，但仍有15例未达到该术后最佳视力。结论：Nd：YAG激光是目前一种安全有效的治疗超声乳化人工晶体植入后发性白内障的理想方法。     

Nd:YAG激光治疗后发障的临床分析

目的:观察Nd:YAG激光治疗后发障的技术、效果及并发症。方法:应用Nd:YAG激光分别对103例112眼白内障超声乳化人工晶体植入术后后发障进行后囊膜切开。结果:术后随访3～24个月,术后105眼视力均有提高,97眼视力达到白内障超声乳化术后的最佳视力,但仍有15例未达到该术后最佳视力,7眼无变化。结论:Nd:YAG激光后囊膜切开术治疗后发障是一种操作简易、安全、并发症少、疗效确切的非手术治疗方法。     

Nd:YAG激光治疗后发性白内障的临床研究

目的 观察Nd:YAG激光治疗后发性白内障的方法、效果及并发症.方法 应用Nd:YAG激光分别对84例88眼白内障摘除联合人工晶体植入术后后发障进行后囊膜切开.结果 术后随访3～12个月,术后78眼视力有提高,有10眼无提高.结论 Nd:YAG激光后囊膜切开术治疗后发性白内障安全有效、操作简单、并发症少.     

超声乳化低度数折叠式人工晶体植入术治疗白内障合并高度近视眼

目的探讨超声乳化白内障吸除低度数折叠式人工晶体植入术治疗白内障合并高度近视眼的临床疗效。方法85例122只眼因白内障合并高度近视行超声乳化白内障吸除术低度数折叠式人工晶体植入术。记录术前眼轴长度和术后视力,屈光度数,观察手术并发症术后眼部情况。术后随访时间为6～25个月。结果术前平均眼轴长度为27．5mm。术后最佳矫正视力〉／0．2共111只眼（90．2％）,〉／0．5者共75只眼（61．5％）。术中仅1只眼晶状体后囊膜破裂;术后12只眼出现双眼干扰症状;后发性白内障7只眼,2只眼行激光晶状体后囊膜切开术;术后发现黄斑变性和眼底出血各1例,无视网膜和脉络膜脱离者,无眼压升高者。结论超声乳化白内障吸除低度数折叠式人工晶状体植入术是治疗白内障合并高度近视眼安全、有效的方法。     

先天性白内障术式及晶体材料对后囊膜混浊的影响

目的探讨青少年先天性白内障超声乳化吸除联合丙烯酸(Acrysof)折叠式人工晶体植入和现代囊外白内障摘除联合聚甲基丙烯酸甲酯(PMMA)硬性IOL植入术对术后后囊膜混浊的影响.方法对行超声乳化白内障吸除联合Acrysof折叠式IOL植入术的超声乳化组患者25例(33只眼)及行现代囊外白内障摘除联合聚甲基丙烯酸甲酯(PMMA)硬性I0L植人术组32例(40只眼)的术后囊膜混浊情况进行比较.结果超声乳化组和囊外摘除组后囊膜混浊发生率分别为6.06%和82.50%,有非常显著性差异(P＜0.01).结论超声乳化组以手术切口小,组织损伤轻,负压吸引可最大限度清除残存晶状体上皮细胞等特点及IOL材料优良的组织相容性,使术后后囊膜混浊大大减少,值得临床推广应用.     

白内障超声乳化吸除联合人工晶体植入术后视网膜脱离的相关因素

目的 探讨未经选择患者白内障超声乳化吸除联合人工晶体(IOL)植入术后视网膜脱离(RD)的发生率及发生的相关因素.方法 回顾性分析温州医学院附属眼视光医院1998年12月1日至2008年9月30日行白内障超声乳化吸除联合IOL植入术患者10 076例(13 625只眼),术后发生RD及其相关危险因素.结果 10076例白内障患者的平均年龄(67±15)岁,男4439例和女5637例的数量差异有统计学意义(χ2=142.44,P<0.01),左眼6701例和右眼6924例的数量差异无统计学意义(χ2=3.65,P0.05),其中年龄相关性白内障6641例所占比例为65.91%.白内障超声乳化吸除联合IOL植入术后共计32例32只眼发生RD,发生率为0.32%,发生的时间间隔为术后10天至74个月,风险度估计(Kaplan-Meier法)为0.47%.高度近视和眼轴延长(χ2=14.55,P<0.01)与RD的发生紧密相关.相关危险因素有高度近视、术中晶状体后囊膜破裂、术后后发性白内障行Nd:YAG激光后囊膜切开.32只眼中31只眼1次手术复位成功,2只眼手术后复发放弃手术.结论 白内障超声乳化吸除联合IOL.植入术后增加了RD的发生率;术前合并眼病、高度近视及眼轴延长,术中晶状体后囊膜破裂及术后后发性白内障行Nd:YAG激光后囊膜切开是术后RD发生的危险因素.     

Nd:YAG激光治疗后发性白内障相关问题探讨

目的:探讨Nd:YAG激光治疗后发性白内障的临床效果。方法:应用Nd:YAG激光治疗仪,对84例(98眼)后发性白内障患者行后囊膜激光切开术。结果:经一次Nd:YAG激光后囊膜切开术切开成功89眼,其中81眼(82.6%)最佳矫正视力达0.～1.0,8眼(8.2%)0.05～0.3;1周后经二次激光手术均成功9眼(9.2%),视力有不同程度提高。所有患者无严重并发症发生。结论:Nd:YAG激光是治疗后发性白内障安全、有效的方法,把握最佳治疗时机、正确操作和预防并发症的发生是治疗的关键。     

Nd：YAG激光治疗后发性白内障的疗效观察

目的：观察Nd：YAG激光治疗后发性白内障的的效果及并发症。方法：对76例（89眼）后发性白内障患者进行Nd：YAG激光后囊膜切开术,术后随访3^6个月,观察治疗前后视力变化及术后并发症。结果：89只眼均1次性击穿后囊膜,切开成功率达100％,增视率达97．8％。术后并发症主要有：前葡萄膜炎,短暂性高眼压和人工晶体损伤等。结论：Nd：YAG激光后囊膜切开术是治疗后发性白内障安全,有效的好方法。     

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.