康柏西普和雷珠单抗治疗渗出性年龄相关性黄斑变性的疗效分析

目的:观察康柏西普与雷珠单抗治疗渗出性年龄相关性黄斑变性(AMD)的临床疗效.方法:渗出性年龄相关性黄斑变性患者40例(40只眼),随机分为康柏西普组(康组)和雷珠单抗组(雷组),分别给予玻璃体腔注射0.5 mg/0.05 mL,每月1次,连续3次,注射前、注射1周、1个月、3个月后检测2组最佳矫正视力(BCVA),及光学相干断层(OCT)检测黄斑中心凹厚度(CMT),注射1、3个月后眼底荧光血管造影(FFA)检测脉络膜新生血管(CNV)变化情况进行比较.结果:康柏西普治疗后1周、1个月、3个月BCVA提高,OCT在相同时间点黄斑中心凹1 mm范围内视网膜厚度(CMT)降低;1个月、3个月后,眼底荧光血管造影显示脉络膜新生血管渗漏治疗有效,差异均有统计学意义(P<0.05).2组治疗后视力相等,差异无统计学意义(P>0.05),注射1个月,3个月后,2组CNV渗漏治疗均有效,有效率比较差异无统计学意义(P>0.05);2组不良反应发生率差异无统计学意义(P>0.05).结论:与雷珠单抗比较,康柏西普玻璃体腔注射同样能有效控制渗出性老年性黄斑变性的渗漏,可提高视力及减轻黄斑中心凹视网膜厚度.     

眼内注射康柏西普与雷珠单抗对湿性年龄相关性黄斑变性的疗效

目的:探究眼内注射康柏西普与雷珠单抗对湿性年龄相关性黄斑变性(nAMD)疗效.方法:根据患者自行选择药物的意愿,将104例湿性年龄相关性黄斑变性患者分为康柏西普组和雷珠单抗组,每组各52例.比较两组患者治疗总有效率、治疗前后黄斑部外层视网膜管状结构(ORT)发生率、最佳矫正视力(BCVA)、黄斑中心凹厚度(CMT)、黄斑中心凹厚度及中心凹浅层血管密度、黄斑容积、血清C反应蛋白(CRP)及血管内皮生长因子(VEGF)水平;统计两组患者治疗后脉络膜新生血管(CNV)渗漏情况、眼内异物感、一次性眼压过高等并发症发生情况.结果:康柏西普组的治疗总有效率高于雷珠单抗组(P<0.05);治疗后1个月,康柏西普组BCVA值大于雷珠单抗组,CMT及黄斑容积、黄斑中心凹浅层血管密度、ORT发生率、血清CRP及VEGF水平低于雷珠单抗组(P<0.05);两组CNV减少率,3个月后的BCVA、CMT及黄斑中心凹浅层血管密度、黄斑容积及并发症发生率比较,差异均无统计学意义(P>0.05).结论:康柏西普治疗nAMD的近期疗效高于雷珠单抗,且能提高视力,减少黄斑中心凹视网膜厚度,但随着时间的延长,两者疗效相当.     

康柏西普与雷珠单抗对湿性年龄相关性黄斑变性患者视力及黄斑中心凹视网膜厚度的影响

目的：探讨康柏西普与雷珠单抗对湿性年龄相关性黄斑变性患者视力及黄斑中心凹视网膜厚度的影响。方法：选取2019年4月-2020年11月新余市人民医院收治的80例湿性年龄相关性黄斑变性患者,按照随机数字表法将患者分为康柏西普组(40只眼)给予康柏西普治疗和雷珠单抗组(40只眼)给予雷珠单抗治疗。比较两组裸眼视力、黄斑中心凹视网膜厚度、脉络膜新生血管面积及并发症情况。结果：治疗1周和治疗1、3个月后,两组黄斑中心凹视网膜厚度和脉络膜新生血管面积均低于治疗前,差异均有统计学意义(P<0.05)。治疗1周和治疗1、3个月后,两组黄斑中心凹视网膜厚度和脉络膜新生血管面积比较,差异均无统计学意义(P>0.05)。治疗1周和治疗1、3个月后,两组裸眼视力均优于治疗前,且雷珠单抗组均优于康柏西普组,差异均有统计学意义(P<0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。结论：湿性年龄相关性黄斑变性患者应用康柏西普和雷珠单抗治疗可以显著改善裸眼视力和黄斑中心凹视网膜厚度,减少脉络膜新生血管面积,且具有较高安全性。     

康柏西普、雷珠单抗单次玻璃体注射治疗渗出型年龄相关性黄斑变性疗效比较

为比较康柏西普、雷珠单抗单次注射治疗渗出型年龄相关性黄斑变性的效果,本文将渗出型年龄相关性黄斑变性患者48例(50眼)分为康柏西普组(24例25眼)和雷珠单抗组(24例25眼),分别采用单次康柏西普眼用注射液和雷珠单抗玻璃体腔注射治疗。观察比较了两组治疗前后的裸眼视力、眼压、中心视网膜厚度(CRT)、脉络膜新生血管(CNV)面积以及生活质量评分、术后并发症发生率等。结果发现康柏西普、雷珠单抗单次注射治疗渗出型年龄相关性黄斑变性均可有效改善近远期视力、眼压和生活质量,其中康柏西普效果更佳,术后并发症发生率未见增加,安全性良好。     

康柏西普玻璃体腔注射治疗湿性老年性黄斑变性临床观察

目的:探讨玻璃体腔注射康柏西普治疗湿性老年性黄斑变性的临床效果。方法:选取50例(50眼)湿性老年性黄斑变性患者,通过随机数字表法分为观察组(n=25)和对照组(n=25),对照组患者采用玻璃体腔注射曲安奈德治疗,观察组患者给予玻璃体腔注射康柏西普治疗,分析治疗效果。结果:治疗后观察组患者最佳矫正视力(BCVA)高于对照组,黄斑中心凹视网膜厚度低于对照组,观察组患者并发症发生率4.00%,较对照组的12.00%明显降低(P<0.05)。结论:玻璃体腔注射康柏西普治疗湿性老年性黄斑变性患者,可减轻黄斑水肿,提高视力,改善生活质量。     

玻璃体腔注射康柏西普和雷珠单抗治疗息肉状脉络膜血管病变的疗效对比

目的比较玻璃体腔注射康柏西普和雷珠单抗治疗息肉状脉络膜血管病变的疗效。方法选取本院被确诊为PCV的患者65例(65眼)并分为两组,病灶均累及黄斑中心凹,分别为玻璃体腔注射康柏西普组32例(32眼)和雷珠单抗组33例(33眼),两组均行玻璃体腔注药每月1次,连续注射3个月,后根据需要再次注药(3+PRN)。结果相较于治疗前,两组治疗后3个月及6个月的BCVA显著提升,CRT明显降低,差异有统计学意义(P0.05)。结论基于3+PRN的治疗策略,玻璃体腔注射康柏西普或雷珠单抗都能够在短期内改善PCV患者的视力并能降低中央视网膜厚度,且疗效相当,而且选择康柏西普不能减少注药次数。     

雷珠单抗与康柏西普眼内注射治疗渗出型老年性黄斑变性的效果对比

目的对比雷珠单抗与康柏西普眼内注射治疗渗出型老年性黄斑变性的临床效果。方法选取2016年6月至2017年3月解放军第91中心医院收治的60例渗出型老年性黄斑变性患者为研究对象,依据建档顺序分为对照组和研究组,各30例。对照组患者接受康柏西普治疗,观察组患者采用雷珠单抗治疗。每个月注射1次,共治疗3次。观察两组患者治疗前、治疗后1周、1个月及3个月裸眼视力及治疗后3个月脉络膜新生血管(CNV)渗漏情况。结果两组患者治疗前和治疗后3个月裸眼视力相比,差异无统计学意义(均P>0.05);治疗后1周、1个月,观察组患者裸眼视力均高于对照组,差异有统计学意义(均P<0.05)。两组患者治疗3个月后CNV渗漏情况相比,差异无统计学意义(P>0.05)。结论雷珠单抗与康柏西普眼内注射治疗渗出型老年性黄斑变性效果相当,雷珠单抗在视力改善方面起效更快。     

康柏西普注射剂治疗视网膜静脉阻塞并发黄斑水肿的临床分析

目的探讨对于视网膜静脉阻塞并发黄斑水肿患者应用玻璃体腔注射康柏西普进行治疗的效果。方法选取2017年1月至12月本院收治的视网膜静脉阻塞合并黄斑水肿的患者60例60眼,行康柏西普注射剂玻璃体腔内注射,每月1次,治疗3个月,后期随诊6个月,比较患者术后矫正视力,黄斑中心凹厚度,黄斑水肿消退率及眼底荧光血管造影中渗漏情况。结果经过3次玻璃体腔注射康柏西普,患者视力均有所提升,经比较,差异有显著的统计学意义(P0.05);黄斑中心凹厚度显著降低,差异有统计学意义(P0.05)。结论对于视网膜静脉阻塞继发的黄斑水肿患者应用玻璃体腔内注射康柏西普的方法治疗,能够明显提高患者视力水平,取得了理想治疗效果。     

玻璃体腔注射康柏西普治疗视网膜分支静脉阻塞的疗效观察

目的：研究视网膜分支静脉阻塞采用玻璃体腔注射康柏西普的治疗效果。方法：将2018年6月-2020年6月宁夏回族自治区人民医院收治的60例视网膜分支静脉阻塞患者作为研究对象,所有患者的治疗方案均为玻璃体腔注射康柏西普。比较患者治疗前后的视力水平、视网膜黄斑中心凹厚度,分析临床疗效。结果：与治疗前比较,治疗1个月后视力改善不明显,差异无统计学意义(P>0.05),治疗3、6个月后,患者的视力水平有所上升,差异有统计学意义(P<0.05);与治疗前比较,治疗1个月后视网膜黄斑中心凹厚度改善不明显,差异无统计学意义(P>0.05),治疗3、6个月后视网膜黄斑中心凹厚度改善明显,差异有统计学意义(P<0.05)。所有患者均未出现严重的并发症。结论：玻璃体腔注射康柏西普疗法,用于视网膜分支静脉阻塞眼科疾病中,对患者视力、视网膜黄斑中心凹厚度改善效果显著。     

玻璃体腔注射康柏西普治疗湿性老年性黄斑变性的临床观察

目的观察玻璃体腔注射康柏西普注射液治疗湿性老年性黄斑变性的临床疗效。方法选取平顶山市第一人民医院收治的40例(40眼)湿性老年性黄斑变性患者为研究对象,给予玻璃体腔注射康柏西普注射液治疗,比较治疗前后,患者裸眼视力变化情况、OCT检查与荧光素血管造影(FFA)检查结果。结果治疗后,视力提高超过2行患者19例(47.5%),视力稳定患者17例(56.7%),视力下降患者4例(13.3%);治疗后患者视网膜平均厚度与治疗前比较,差异无统计学意义(P>0.05);在对所有患者随访3个月后,患者经FFA检查,黄斑区渗漏完全消失31例(77.5%),黄斑区有渗漏现象但明显减轻9例(22.5%);随访半年后,经FFA检查,黄斑区渗漏完全消失35例(87.5%),黄斑区有渗漏现象但明显减轻5例(12.5%)。结论玻璃体腔注射康柏西普注射液治疗湿性老年性黄斑变性的临床疗效显著,可有效提高患者裸眼视力,值得临床进一步推广。     

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.     

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.