高度近视人群眼底病变发生的临床研究

目的探讨高度近视病人眼底病变的发生与屈光度、眼轴长度、年龄和性别的关系。方法对57例(108眼)高度近视病人进行普通验光、眼轴长度测定和眼底的检查。根据屈光度、眼轴长度、年龄和性别分别分组,比较各组眼底病变发生的差异。结果各组间眼底病变发生率比较差异均有显著性(2χ=6.064~31.866,P<0.01)。眼轴长度与屈光度数、年龄呈正相关(r=0.501、0.305,P<0.05)。男性眼轴长度与女性比较差异有显著性(t=4.429,P<0.01),而男女屈光度均值比较差异无显著性(t=0.762,P>0.05)。结论屈光度、眼轴、年龄和性别均与高度近视病人眼底病变的发生有关。预防眼底病变发生要定期详查眼底,尤其是屈光度高及眼轴长的高龄男性病人。     

无症状高度近视眼后极部和周边部视网膜病变特征

目的评价无症状高度近视眼眼底病变的特征和影响因素。方法387例无症状高度近视眼（≤-6．00D）（387眼）纳入本研究。所有患者均经睫状肌麻痹验光和散瞳检查眼底。比较有眼底病变组和无眼底病变组之间年龄及屈光度的差异。结果387例患者中,男105例,占27．1％;女282例,占72．9％。平均年龄37．9岁,平均屈光度-10．15D。52眼检测到后极部有眼底病变,占13．44％,与元病变组比较,年龄及屈光度差异均有统计学意义（t=3．341．5．183;P〈0．05）。239眼检测到周边部有视网膜病变,占61．76％,与无病变组比较,屈光度差异有统计学意义（t=3．860,P〈0．05）,年龄差异无统计学意义（t=1．283;P〉0．05）。结论无症状高度近视眼后极部及周边部病变发生率均较高,高度近视眼患者即使无症状,也应定期检查眼底。     

准分子激光原位角膜磨镶术治疗高度近视疗效分析

目的观察高度近视性眼底病变对LASIK手术疗效的影响,探讨其安全有效性。方法对162例（318只眼）屈光度在-6.00D以上的高度近视患者进行散瞳眼底检查,对其中38例（76只眼）进行了FFA和ICGA,并就患者高度近视程度、眼底病变程度与患者手术后视力、眼底并发症等进行比较分析。结果①所有患者（318只眼）都接受了LASIK手术治疗。手术前检查发现有13只眼（4.09%）周边视网膜变性及微小裂孔,有21只眼（6.60%）脉络膜新生血管,其中5只眼（1.57%）FFA检查阴性而ICGA检查阳性。都先进行了眼底激光治疗;手术后1年内有2只眼（0.63%）出现新生血管,有36只眼（11.32%）出现了黄斑水肿,有9只眼（2.83%）出现了眼底出血,有2只眼（0.63%）出现了视网膜脱离,经对症治疗后痊愈。②手术后超高度近视组的矫正视力低于普通高度近视组,差异具有显著性意义（t=3.68,P〈0.05）。③手术前及手术后较严重眼底病变组的矫正视力均低于普通眼底病变组,差异具有显著性意义（t手术前=2.28,t手术后=2.46,P〈0.05）。④手术后1年内较严重眼底病变组出现的眼底并发症多于普通眼底病变组,差异具有显著性意义（χ2=7.78,P〈0.01）。结论对高度近视眼行LASIK手术是安全有效的,但其高度近视程度和眼底病变程度会影响手术疗效,手术前应做详尽的眼底检查及相应的预防性治疗,必要时可行FFA和ICGA检查及预防性光凝治疗。     

高度近视全阈值静态中心视野改变的相关研究

目的探讨高度近视全阈值静态中心视野损害与屈光度、眼轴、年龄及后极部眼底病变间的关系。方法应用DICON TKS-5000型自动视野分析仪对36例(70眼)高度近视患者进行全阈值静态中心300视野检查并观察其眼底后极部改变,同时以低中度近视作为对照。结果高度近视眼呈现各种形态的视野改变,70眼中61眼(87.1%)视野异常,其中42眼(60%)生理盲点扩大,黄斑中心相对暗点40眼(57.1%),弥漫性损害18眼(25.7%),视野损害以颞侧明显。视野改变的形态、程度与眼底后极部改变的形态不完全对应。高度近视眼黄斑中心相对暗点出现早于眼底镜下黄斑部病变。结论高度近视中心视野损害与屈光度、眼轴、年龄及后极部眼底改变有关,高度近视视野改变早于眼底镜下眼底改变。全阈值静态中心视野检查对高度近视的诊断及全面评价具有指导意义。     

近视屈光度和视野的相关性研究

目的探讨近视屈光度与中心静态视野改变间的相关程度．方法应用Humphrey全自动视野分析仪对60例（120只眼）近视患者进行定量视野测定，并分析其与屈光度的关系．结果静态中心视野平均光敏感度，平均缺失敏感度，标准缺失敏感度三者在高度和中低度近视组间有显著性差异（P〈0．01），高度和正常时照组间有非常显著性差异（P〈0．001）。但正常和中低度组间无显著性差异．结论近视屈光度与中心静态视野的分析有助于早期判断近视性屈光不正的病变程度及有无合并其他眼底病变．     

近视眼的屈光度、眼轴、角膜屈光力的相关性探讨

目的：探讨近视眼的屈光度、眼轴、角膜屈光力之间的相关关系以及近视的成因。方法：将204例(348只眼)近视患者分为三组：低度近视组62眼(屈光度＜-3．0D）；中度近视组159眼(屈光度-3．0D～-6．0D)；高度近视组127眼(屈光度＞-6．0D)。测量患者眼的屈光度、角膜屈光力及眼轴，与近视程度、角膜屈光力、眼轴的关系。结果：在低度近视组，62只眼屈光度与眼轴长度无显著相关性，而屈光度与角膜水平径、垂直径屈光力呈正相关(P＜0．05)，相关具有显著性；在中度近视组和高度近视组屈光度与眼轴长呈正相关(P＜0．05)，相关具有显著性，且随近视度数的增加，与眼轴长的相关系数呈递增趋势，而中、高度组患者眼屈光度与角膜水平径及垂直径屈光力无显著相关性。结论：在近视性屈光不正的影响因素中，低度近视眼患者受角膜屈光力的影响相对较大，而眼轴的作用甚微；在中、高度近视眼患者中，眼轴长是影响近视程度的主要因素，而角膜屈光力几乎不起作用。     

视网膜色素变性患者屈光不正的分析

目的：探讨视网膜色素变性与屈光不正之间的关系。方法：将一组常染色体遗传（包括显性遗传和隐性遗传）的视网膜色素变性（RP）患者（14个家系,140眼）与散发的RP患者（81人,161眼）屈光程度进行比较。结果：两组患者的屈光不正发生率分别为93％和98％,屈光度平均值分别为-2．07D和-2．13D,屈光程度统计学t检验两组无明显差别（P〉0．01）,但遗传组的高度近视发病率高于散发组,且散发组病人近视发病年龄早、度数大。结论：RP与屈光不正没有紧密联系,但应注意视网膜色素变性与高度近视的基因位点两者之间可能有紧邻关系。散发性RP患者发病早、近视度数高,但随年龄增加病情趋于稳定。     

病理性近视黄斑病变危险因素研究

目的:探讨病理性近视不同类型、不同程度黄斑部病变与年龄、眼轴、屈光度等相关危险因素之间的关系。方法:对入选的高度近视患者均进行标准对数视力表检查,诊断验光确定屈光度及最佳矫正视力,应用IOL-Master测定眼轴长度,并散瞳行眼底检查,光学相干断层扫描(OCT)检查及眼底血管造影检查(FFA)。根据OCT及FFA结果分析不同类型、不同程度的病理性近视黄斑病变与年龄、眼轴长度、屈光度等相关危险因素之间的关系。结果:根据OCT及FFA对患者眼底黄斑病变进行分型,将眼底病变分为豹纹状眼底、脉络膜新生血管、黄斑出血、局灶性脉络膜萎缩及弥漫性脉络膜萎缩。其中10～30岁年龄组豹纹状眼底所占比例61.76%,显著高于其余几种类型眼底病变,随年龄增加>50岁年龄组,脉络膜萎缩比例逐渐增多(45.45%),差异具有统计学意义(P<0.05);以眼轴长度分组,<30 mm组,以豹纹状眼底占比最高48.39%,>32 mm组,以弥漫性脉络膜萎缩占比最高(69.23%),差异具有统计学意义(P<0.05);以屈光度分组,屈光度越小,-6～-10 D组,豹纹状眼底改变占比越高(76.92%),屈光度越高,脉络膜萎缩越明显,-20 D以上屈光度弥漫性脉络膜萎缩型黄斑病变比例高达65.22%,差异具有统计学意义(P<0.05)。病理性近视呈豹纹状眼底改变者最佳矫正视力明显高于其他几种类型眼底病变,特别是弥漫性脉络膜萎缩型(P<0.05);弥漫性脉络膜萎缩黄斑中心凹厚度低于其他几种类型病变(P<0.05)。结论:眼轴越长、年龄越大、屈光度越大发生病理性近视黄斑病变的几率越高。同时不同年龄、眼轴长度以及屈光度所易发生的黄斑病变类型不尽相同。OCT及FFA检查对明确不同类型黄斑病变有重要作用。     

近视性屈光不正患者眼底检查及处理

目的 探讨眼科门诊就诊的屈光不正患者眼底并发症的发生情况和治疗方法.方法 对1698例的眼科门诊近视患者进行散瞳后详细眼底检查,确定其有无眼底并发症的发生.对发现的眼底病变,进行针对性治疗.结果 所有患者中共发现存在眼底病变166眼,包括视网膜变性、视网膜裂孔、视网膜脱离和黄斑出血等,分别给予针对性治疗后恢复良好.结论 近视性屈光不正患者发生眼底并发症并不少见,检查时不能忽视近视患者的眼底检查.     

探讨高度近视发生眼底病变的危险因素及措施

目的：研究分析高度近视导致的眼底病变危险因素和预防措施。方法：根据该院2013年1月至2014年5月的350例高度近视患者来进行研究分析,根据患者是否发生眼底病变分成两组,统计眼底病变发生几率,对发生的因素进行分析,探讨预防措施。结果：眼底病发病率是14.7%。病变组患者的男性数量、高龄数量、高屈光度患者数量以及眼轴长比例均要比无眼底病变组患者高,结果存在统计学差异性（P <0.05）。结论：高度近视患者男性较多、高屈光度较多、眼轴长情况差,用眼不合理情况普遍,这些是眼底病变的危险因素,临床中要针对高危群体提供干预措施,预防高度近视致眼底病变情况发生。     

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.