超声乳化术治疗糖尿病性白内障的临床观察

目的探讨糖尿病患者白内障超声乳化摘除联合人工晶体植入手术的疗效及安全性。方法对30例（30眼）糖尿病性白内障患者进行超声乳化联合人工晶体植入术,以30例（30眼）非糖尿病患者的白内障作对照组。结果术后视力〉0.4,糖尿病组23眼,占77%。非糖尿病组25眼,占83%。两者差异无显著性（P〉0.05）。两组白内障患者中出现角膜水肿,房水混浊,纤维素性渗出等眼前段手术并发症者糖尿病患者均较高。结论空腹血糖控制在8.3mmol/L以下,对糖尿病患者进行超声乳化联合人工晶体植入手术是安全的。手术不但可以提高患者视力,更重要的是有利于眼底观察,为及时治疗视网膜的病变提供了条件。糖尿病患者术后眼前节反应明显发生率高,需积极观察治疗。     

糖尿病患者白内障与老年性白内障手术疗效分析

目的观察超声乳化联合人工晶体植入术治疗糖尿病患者白内障和老年性白内障的临床效果。方法 78例(102只眼)糖尿病白内障患者(A组)和92例(106只眼)老年性白内障患者(B组)均采取超声乳化联合人工晶体植入术进行治疗,观察两组患者术后状况。结果两组患者治疗后的视力比较差异无统计学意义(P>0.05);A组患者治疗后的并发症发生率为44.1%,B组为12.3%,差异具有统计学意义(P<0.05)。结论糖尿病患者只要合理的控制好患者的血糖情况,采取白内障手术治疗是可行的。     

2型糖尿病患者白内障手术不同术式观察

目的观察2型糖尿病患者白内障超声乳化手术(PHACO)联合人工晶体植入术和现代囊外摘除术(ECCE)联合人工晶体植入术的不同。方法A组:2型糖尿病白内障患者30例35眼行PHACO,B组:2型糖尿病白内障患者行ECCE联合人工晶体植入术的患者30例32眼,比较两组术后视力及术后反应,进行分析。结果(1)术后视力:术后反应消退后视力≥0.5者A组30眼,B组19眼,两组比较差异显著意义(P<0.05);(2)术后反应:房闪()以上,瞳孔区纤维素渗出或晶体表面色素沉着,A组3眼,B组10眼。两组比较差异显著意义(P<0.05)。结论2型糖尿病白内障患者行PHCAO手术较行ECCE术后反应小,视力恢复好。     

糖尿病患者白内障超声乳化吸出联合人工晶体植入术50例疗效观察

目的:观察糖尿病(DM)患者行白内障超声乳化吸出联合人工晶体植入术的临床效果.方法:50例(55眼)糖尿病白内障患者接受白内障超声乳化吸出联合人工晶体植入术,选择随机抽取同期年龄施行白内障超声乳化吸出联合人工晶体植入手术的非糖尿病患者50例(55眼)为对照组,比较两组术后视力及并发症情况.结果:两组术后并发症、术后视力比较差异无统计学意义.结论:糖尿病白内障患者在术前空腹血糖控制良好的情况下行超声乳化吸除联合人工晶体植入术能获得较满意的疗效.     

糖尿病患者白内障超声乳化联合人工晶体植入术的临床观察

目的探讨糖尿病性白内障超声乳化联合人工晶体植入手术的临床效果。方法对46例（58眼）糖尿病性白内障与同时期抽取46例（52眼）老年性白内障行超声乳化联合人工晶体植入术进行临床分析与比较。结果糖尿病性白内障术后视力虽然在术后短时间内低于老年性白内障组,但最终视力（3个月后）与老年性组差异无统计学意义。糖尿病性白内障术后并发症高于老年性白内障组,但经术中、术后积极正确处理均能得到有效控制。结论糖尿病患者只要有效控制血糖,行白内障超声乳化联合人工晶体植入术是安全有效的。     

糖尿病患者白内障不同手术方式的临床观察

目的探讨白内障超声乳化吸出术＋人工晶体植入术与白内障囊外摘除术＋人工晶体植入术治疗糖尿病患者合并白内障的临床疗效。方法观察73例（81眼）糖尿病合并白内障患者,A组37例（42眼）行白内障超声乳化吸出术＋人工晶体植入术,B组36例（39眼）行白内障囊外摘除术＋人工晶体植入术,术后分别检查1d和1周的视力。结果术后1d视力A组〈0.1、0.1-、〉0.5的眼数分别为4眼、32眼、6眼,B组分别为6眼、30眼、3眼;术后1周视力A组〈0.1、0.1-、〉0.5的眼数分别为2眼、26眼、14眼,B组分别为4眼、23眼、12眼。术后并发症发生角膜水肿、前房闪辉程度和黄斑水肿的眼数,术式A组3项并发症的发生少于术式B组。结论糖尿病者白内障用超声乳化治疗是一种疗效确切的手术,且术后并发症较白内障囊外摘除术少。     

糖尿病患者白内障超声乳化吸除联合折叠式人工晶体植入术的临床疗效分析

目的探讨对糖尿病患者白内障行超声乳化吸除联合折叠式人工晶体植入术的临床疗效。方法对56例（66眼）糖尿病性白内障患者和54例（66眼）非糖尿病性老年性白内障患者施行白内障行超声乳化吸除联合折叠式人工晶体植入术,对比观察术后视力及并发症。结果糖尿病患者行白内障术后并发症明显较非糖尿病者多,但总体预后两组并无显著差异。结论糖尿病白内障患者在空腹血糖控制良好情况下采用超声乳化吸除联合折叠式人工晶体植入术安全有效。影响术后视力主要是视网膜病变和黄斑病变。     

糖尿病患者白内障超声乳化联合人工晶体植入的临床观察

目的 探讨对糖尿病患者行白内障超声乳化人工晶体植入术的手术效果.方法 对40例糖尿病并白内障患者与40例非糖尿病白内障患者行白内障超声乳化人工晶体植入术,同时进行临床分析和比较.结果 糖尿病并白内障患者术后出现角膜内皮水肿、房水混浊等眼前段手术并发症明显高于非糖尿病白内障患者,但经正确处理后总体预后无差别.结论 糖尿病患者白内障采用白内障超声乳化人工晶体植入术治疗安全有效.     

血糖水平对白内障超声乳化联合人工晶体植入手术影响的临床研究

目的探讨血糖水平对糖尿病并发白内障患者超声乳化联合人工晶体植入手术的影响。方法对糖尿病并发白内障患者185例233眼行白内障超声乳化联合人工晶体植入术,根据患者术前血糖控制水平分为三组：血糖控制组58例、血糖未控制组63例、血糖不详组64例。所有患者术后随访3个月,于术后1d、7d、3个月复查视力、眼前节及眼底。结果三组患者术后视力均较术前明显提高（P〈0.05）,术后1d、7d、3个月视力差异无统计学意义（P〉0.05）;角膜内皮水肿7只眼（3%）,前房炎性渗出5只眼（2.1%）,晶体后囊混浊6只眼（2.6%）。结论糖尿病并发白内障患者行超声乳化联合人工晶体植入手术可以获得较好效果,其手术安全性受血糖水平影响不大,可考虑放宽术前血糖要求。     

糖尿病患者行白内障超声乳化联合人工晶体植入术的治疗效果观察

目的:探讨糖尿病患者行白内障超声乳化联合人工晶体植入术的临床疗效。方法:选取在我院行白内障超声乳化联合人工晶体植入术的患者100例,根据有无合并糖尿病分为两组,其中糖尿病组50例(71眼),非糖尿病组50例(65眼),于术后7d、1个月、3个月进行随访,比较两组术后并发症及最佳矫正视力(BCVA)改善情况。结果:与术前比较,两组患者术后BCVA明显提高,随访3个月后发现糖尿病组BCVA明显低于非糖尿病组(P<0.05);两组患者手术顺利,在并发症上糖尿病组患者术后角膜水肿和黄斑囊样水肿发生率比非糖尿病组高(P<0.05)。结论:糖尿病合并白内障患者行超声乳化白内障联合人工晶体植入术后黄斑水肿发生率明显高于非糖尿病组,是影响视力恢复的因素之一。精细手术操作、合理控制血糖是降低术后相关并发症的重要措施。     

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.     

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.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.