超声乳化白内障吸出术中后囊浑浊的处理

目的：探讨超声乳化白内障吸出术中后囊浑浊的处理方法及临床疗效。方法：对68眼手术中发现后囊浑浊的白内障患者,按常规完成晶状体超声乳化吸出术后,在后囊膜旁中央区刺小口,自此口向后囊膜与玻璃体前界膜间注入黏弹剂,用撕囊镊做直径3～4mm的连续环形撕囊。再将人工晶体植入囊袋内。结果：白内障超声乳化术中,发现后囊浑浊行后囊环形撕囊的68眼,对其中12眼儿童白内障和3眼术中玻璃体脱出者,予以前段玻璃体切除术。人工晶状体均成功植入囊袋内。术后视轴区清晰,无黄斑囊样水肿或视网膜脱离等并发症。结论：口囊连续环形撕囊术是治疗白内障后囊浑浊的安全有效地方法。     

晶体囊张力环在晶体半脱位超声乳化术中的应用

目的探讨晶体囊张力环（Capseular tension ring，CTR）植入晶体半脱位的囊袋内进行超声乳化白内障吸出术的安全性。方法对我院2001～2007年间10例晶状体半脱住患者实施白内障超声乳化摘除术，术中采用连续环形撕囊后植入晶体囊张力环，然后常规超声乳化摘除白内障，植入后房型人工晶体。结果9例术后人工晶体位置良好，无偏住。1例明显偏位。矫正视力术后2周〉0．8者2眼，0．5～0．8者5眼，0．1～0．4者2眼。并发症1眼高眼压，2例玻璃体脱出。1例人工晶体取出，植入前房型人工晶体。结论晶状体囊张力环是超声乳化白内障吸除术治疗白内障合并晶状体半脱位患者的新型辅助工具，它在提高手术安全性，防止人工晶体偏位，减少手术并发症方面具有重要意义。     

囊袋张力环在晶状体半脱位白内障术中应用的疗效观察

目的 评价囊袋张力环在晶状体半脱位白内障术中应用的安全性和疗效.方法 对21例23眼晶状体半脱位患者行白内障手术,术中连续环形撕囊后植入囊袋张力环,而后行超声乳化及后房型折叠人工晶体囊袋内植入手术.结果 所有植入的人工晶体均正位,术后3个月矫正视力0.2者2眼,0.3～0.4者11眼,0.5～0.8者9眼,1.0者1眼,未见由囊袋张力环引起的并发症.结论 囊袋张力环可提高晶状体半脱位超声乳化手术的安全性,防止术后人工晶体偏位,降低后发障.     

囊袋张力环在晶状体半脱位白内障超声乳化手术中的应用

目的评价晶状体囊袋张力环（CTR）在白内障合并晶状体半脱位行超声乳化白内障吸除术中的应用价值。方法对11例12眼白内障合并晶状体半脱位患者行超声乳化白内障吸除术，术中连续环行撕囊后植入CTR，超声乳化摘除白内障，囊袋内植入后房型人工晶体，若晶状体半脱位〉1／2需植入固定孔型CTR，将CTR固定孔上的聚丙烯线固定于悬韧带离断一侧板层巩膜壁上。结果所有植入的人工晶体均位于正位。术后随诊3～9个月，矫正视力0、1～0．4者4眼，0、5～0．8者5眼，〉0．8者3眼。结论在白内障合并晶状体半脱位患者行超声乳化白内障吸除术中植入囊袋张力环是安全有效的方法，有利于保持囊袋的完整，便于后房型人工晶体植入，防止人工晶体的偏位，减少手术并发症，术后视力恢复快。     

连续环形撕囊技术在小切口非超乳IOLP术中的应用

目的：探讨连续环形撕囊技术（CCC）与小切口非超声乳化白内障摘除人工晶体植入手术质量的关系。方法：将268例老年性白内障患者随机分成连续环形撕囊组（CCC）和经典信封式截囊组（EC），施行小切口无缝线非超声乳化白内障摘除联合人工晶体植入术。结果：在减少后囊破裂、晶体悬韧带部分离断、玻璃体溢出方面，CCC组明显优于EC组（P＜0．01），而在人工晶体植入率、术后视力、角膜混浊方面两组无显著差异（P＞0．05）。结论：连续环形撕囊技术在减少术中并发症方面有明显优越性，对提高白内障手术质量有一定帮助。     

白内障超声乳化术后囊袋阻滞综合征临床治疗体会

目的：探讨白内障超声乳化吸除及囊袋内人工晶体植入术后囊袋阻滞综合征（CBS）的发生与连续环形撕囊（ccc）、吸出粘弹剂的关系。方法：对我院2008年10月-2012年10月白内障超声乳化及人工晶体植入术后发生囊袋阻滞综合征的6例患者予NdYAG激光前囊造孔或后囊切开术。结果：6例CBS患者经处理均获得良好视力。结论：白内障超声乳化术后囊袋阻滞综合征与连续环形撕囊的大小、囊袋内粘弹剂残留等因素有关。NdYAG激光前囊造孔或后囊切开术可获得良好效果。     

二次撕囊术在16例白内障超声乳化摘除人工晶体植入术中的应用

目的：讨论对16例（16只眼）白内障超声乳化除及人工晶体植入术行二次撕囊术（Secondary capsulorhexis)的方法 作用。方法；对6例因皮质膨胀或液化眼行计划性的二次撕囊（二阶段连续曲线撕囊术，Two-stage continuous curvilinear capsulorhexis)；3例因囊口过小难于植入囊袋内位固定人工晶体，3例因超声乳化白内障除时前囊膜切迹破裂，4例因撕囊口偏中心为防止囊膜收缩综合征发生以及遮盖孔区而行二次撕囊。结果：二次撕囊术后完成前囊膜连续曲线形撕囊14眼，16只眼均植入囊袋内位固定人工晶体。结论二次撕囊术可使因晶体皮质膨胀或液化白内障眼易于完成丧囊膜连续曲线形撕囊；避免白内障术中前囊膜切迹破裂进一步放射状撕裂，维持完整曲线形撕囊口边缘，防止发生人工晶体植入后光学部偏中心，囊襻异位；使过小撕囊口易于植入囊袋内位固定人工晶体；减少或避免过小前囊膜撕囊口或明显偏中心撕囊口发生囊膜收缩综合征。     

小切口无缝线非超声乳化人工晶体植入术的临床观察

目的：探讨小切口无缝线非超声乳化人工晶体植入术的临床效果。方法：老年性白内障65例,76眼均采用皱眉状隧道式切口,长4．5mm,连续环形撕囊,扩大内切口5．5mm,晶状体圈匙托出晶体核,囊袋内植入人工晶体,结果：老年性白内障76眼术后视力第1天≥0．5。20眼,占20％,第3天≥0．5,33眼,占43％,第5天≥0．5,37眼,占49％,第7天≥0．5,46眼,占60％,1个月≥0．5,59眼,占78％,结论：小切口无缝线非超声乳化人工晶体植入术适用于现代囊外摘除人工晶体植入术。     

原发闭角青光眼小梁切除术后白内障超声乳化吸除术的临床观察

目的原发闭角青光眼小梁切除术后白内障超声乳化吸除术的临床效果。方法对原发性闭角型青光眼小梁切除术后白内障50例患者行连续环形撕囊,充分水分离,囊袋内超声乳化,囊袋内或睫状沟内植入折叠式人工晶状体。结果所有患者术后视力比较术前均有所提高。术后视力34只眼（70％）〉0．5;6只眼（14％）视力≤0．1。结论抗青光眼滤过术后,视功能未严重损害者行白内障手术可明显改善视力。     

外引流术后的白内障超声乳化手术

目的：探讨抗青光眼餐引流术后的白内障患眼进行超声乳化吸除术的手术入路，操作方式及临床效果。方法：避开功能性滤过泡，选择角巩膜隧道切口或透明角膜切口，瞳孔麻痹性散大时，做一个完美的直径约5mm的连续环形撕囊以补偿之；恰当处理虹膜后粘连后，在病理性小瞳孔下完成超声乳化手术；眼压失控者行青光眼白内障人工晶体植入三联术。结果：无后囊破裂，人工晶体全部囊袋内植入，术后1周视力≥0．5者20只眼（64．5％），0．1－0．4者8只眼（25．8％），＜0．1者3只眼（9．7％）。随访1－16个月，眼压均在20.55mmHg以下。结论：体外流术后的白内障患眼，超声乳化手术因其切口小，并发症少，不破坏功能性滤过泡，不损伤瞳孔，是目前各种手术方法中的最佳选择。     

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.