图形视觉诱发电位在儿童弱视诊断中的应用

目的研究P-VEP在儿童弱视诊断中的临床应用价值,以早期治疗弱视,恢复正常的双眼视觉。方法对本市幼儿园中、小班3～5岁儿童进行图形视觉诱发电位检测,对100名单眼弱视及弱视对侧健眼和100名正常儿童进行检测,并将各组测得的P-100波幅、峰潜时值平均参数进行对比、分析、统计学处理。结果弱视眼的P-100波幅明显下降,峰潜时延长(P<0.001)不同视力其P-VEP波幅下降不同,与弱视程度有密切关系,与正常儿童相比有显著性差异(P<0.001)。弱视对侧健眼的P-VEP波幅、峰潜时与正常儿童相比也有差异性(P<0.001)。结论弱视是一种视觉功能性障碍,P-VEP检测它是双眼视觉的神经功能受到损害所致,证实了弱视对侧健眼"隐性弱视"和"亚临床性弱视"的观点,因此认为P-VEP可以作为儿童弱视早期诊断中的一项客观的重要检测手段。     

左旋多巴对形觉剥夺性弱视幼猫图形视觉诱发电位的影响

目的观察左旋多巴对形觉剥夺弱视幼猫图形视觉诱发电位的影响.方法 40只4周龄幼猫分为正常组、单眼剥夺组、对照组、左旋多巴组,每组10只,通过单眼眼睑缝合制备形觉剥夺的弱视模型,观察不同干预条件下各组图形视觉诱发电位（PVEP）的P100波的峰时及振幅的变化.结果剥夺组、对照组剥夺眼P100波峰时值延长,振幅降低,与正常组及对侧眼比较,差异有统计学意义（P〈0.05）,左旋多巴组双眼P-VEP各项指标与正常组比较,差异均无统计学意义（P〉0.05）.结论左旋多巴能缩短弱视眼的P100波峰时及提高P100波的振幅,能促进弱视眼传导和感觉功能的改善.     

弱视儿童治疗前后立体视觉及P-VEP的变化

目的：本文意在研究弱视儿童在治疗前后的立体视觉以及图形视觉诱发电位（ P-VEP ）的变化情况。方法：选取2012年1月至2013年8月在我院眼科收治的临床资料较完整的弱视儿患者43例（71眼），对比治疗前后患儿的视力变化情况、立体视觉变化情况和P-VEP 的变化情况。结果：治疗后的患儿裸眼视力、矫正视力、屈光参差度差异对比治疗前差异均显著（ P＝0．00、P＝0．00、P＝0．00）；从治疗后6个月开始，患儿的立体视觉开始与术前比有显著差异；弱视治疗后P-VEP 的P 100波改变情况为波幅增加和峰时值缩短，差异具有统计学意义（ P＜0．05）。结论：弱视儿童经过治疗后，立体视觉恢复明显，P-VEP 指标显示患儿的视神经恢复状况较好，P100波的波幅增大，潜伏期缩短。     

弱视治愈儿童图形视觉诱发电位的观察分析

目的: 通过观察比较已治愈弱视患儿与正常视力儿童的图形视觉诱发电位(pattern visual evoked potential, P-VEP), 寻求一种客观评价儿童视功能及预测弱视疗效的手段, 并且进一步观察影响P-VEP的相关因素, 为进一步探讨弱视的发病机制提供临床依据。方法: 将60例 8~12岁经正规弱视治疗后弱视治愈儿童分为单眼弱视治愈组(40人, 弱视治愈眼40只, 而另眼为相对正常眼40只)及双眼弱视治愈组(20人40只眼)。20例视力正常的同龄儿童为正常对照组。比较3组P-VEP的潜伏期和振幅, 并通过线性回归分析影响P-VEP的相关因素。结果: 3组双眼矫正视力比较差异均无统计学意义(P>0.05)。单眼弱视治愈组及双眼弱视治愈组的弱视眼P100 波较正常组潜伏期延长、振幅降低;其中单眼弱视治愈组弱视眼明显低于双眼弱视治愈组。单眼弱视治愈组的相对正常眼P100 波较正常组潜伏期延长、振幅降低, 而与双眼弱视治愈组比较差异无统计学意义(P>0.05), 与自身弱视眼比较P100 波潜伏期缩短、振幅增加(P<0.05)。线性回归分析结果显示影响弱视眼P100 潜伏期的主要相关因素是初治矫正视力、初治年龄及屈光度。结论: 通过弱视治疗, 虽然患儿视力恢复正常, 但弱视眼及相对正常眼的视功能仍未恢复正常;初治矫正视力、初治年龄及屈光度对患儿视力及视功能恢复均有重要影响;仅针对增加视力的传统弱视治疗对于提高双眼视功能仍有不足。     

单眼弱视儿童的图形视觉诱发电位

[目的]观察单眼弱视儿童的弱视眼和健侧眼的图形视觉诱发电位．[方法]检测单眼弱视儿童49人98只眼和正常儿童28人56只眼图形视觉诱发电位P100波振幅和潜伏期，并进行统计分析．[结果]单眼弱视儿童弱视眼的图形视觉诱发电位P100波振幅明显下降，潜伏期明显延长；其健测眼的P100波亦有病理性改变，主要表现在振幅的下降．[结论]单眼弱视儿童不仅弱视眼有明显异常，而且健侧眼亦表现为不正常．     

Treatment of child amblyopia with tap therapy of electric plum-blossom needle

目的 探讨电梅花针治疗儿童弱视的临床疗效以及对图形视觉诱发电位(P-VEP)的影响.方法 选择4～12岁弱视患儿共38例(69眼),在配镜矫正屈光不正的基础上,随机分为实验组和对照组,实验组采用西医综合治疗联合电梅花针叩刺治疗,对照组给予西医综合治疗.两组患儿治疗前、后分别进行P-VEP及矫正视力的检查；实验组患儿电梅花针1次叩刺治疗前后分别进行P-VEP检查.结果 P-VEP:实验组电梅花针叩剌即刻效应,P100波峰潜时明显缩短,P＜0.05,而振幅无显著差异；与对照组相比,实验组治疗1疗程后与治疗前比较,P100波峰潜时明显缩短,P＜0.05,而振幅无显著性差异.视力:实验组36眼经治疗视力提高2行或2行以上者32眼(88.9％)；对照组33眼视力提高2行或2行以上者24眼(72.7％).根据弱视患儿年龄、弱视程度、弱视类型与疗效的分析显示试验组总有效率高于对照组.结论 电梅花针叩刺治疗可使弱视儿童P-VEP的P100波峰潜时缩短,该治疗可明显提高患儿视力,具有较好的临床应用前景.     

应用视觉诱发电位检测早期视神经挫伤

目的：探讨视觉诱发电位（VEP）在外伤性视神经挫伤中的诊断价值。方法：对169例临床诊断为外伤性视神经挫伤的患者行VEP检测，并与自体健侧眼和正常对照组对比。结果：169例患者（单眼155例，双眼14例）共183只眼，VEP检查结果均有不同程度异常。其中5例7眼VEP波幅明显降低（4％），125例133眼单纯波幅降低（73%），潜伏期延长者49例54眼（28％）。受伤眼均与自体健侧眼和正常对照组比较，P100波幅差异有显著意义（P〈0．01），49例P100峰潜伏期略延长，与正常值对比无明显差异（P〉0．05）。结论：VEP对外伤后视神经挫伤的检出敏感性较高，因此对外伤性视神经挫伤的早期诊断、预后评估有重要价值。     

电梅花针叩刺疗法治疗儿童弱视的临床观察

目的探讨电梅花针治疗儿童弱视的临床疗效以及对图形视觉诱发电位(P-VEP)的影响。方法选择4～12岁弱视患儿共38例(69眼),在配镜矫正屈光不正的基础上,随机分为实验组和对照组,实验组采用西医综合治疗联合电梅花针叩刺治疗,对照组给予西医综合治疗。两组患儿治疗前、后分别进行P-VEP及矫正视力的检查;实验组患儿电梅花针1次叩刺治疗前后分别进行P-VEP检查。结果 P-VEP:实验组电梅花针叩刺即刻效应,P100波峰潜时明显缩短,P<0.05,而振幅无显著差异;与对照组相比,实验组治疗1疗程后与治疗前比较,P100波峰潜时明显缩短,P<0.05,而振幅无显著性差异。视力:实验组36眼经治疗视力提高2行或2行以上者32眼(88.9%);对照组33眼视力提高2行或2行以上者24眼(72.7%)。根据弱视患儿年龄、弱视程度、弱视类型与疗效的分析显示试验组总有效率高于对照组。结论电梅花针叩刺治疗可使弱视儿童P-VEP的P100波峰潜时缩短,该治疗可明显提高患儿视力,具有较好的临床应用前景。     

视觉诱发电位在视神经挫伤诊断及预后中的应用

目的探讨视觉诱发电位（VEP）的异常率对视神经挫伤诊断及预后估计。方法对69例（69眼）单倒眼挫伤组进行视力检查及VEP检查,以自体健侧眼为对照组。分析两组间VEPP100波幅值及P100峰潜时值,记录单侧眼挫伤患者的伤眼、对侧眼及治疗后伤眼的VEP。结果挫伤眼VEPP100波幅明显降低,P100峰潜时明显延长,挫伤眼各视力组VEP异常率明显高于对照组,挫伤眼矫正视力〈0．1者VEP异常更明显且预后差。结论VEP是一种客观、定量、定位评定视神经功能的方法,是目前视神经病变最敏感、早期诊断、判断预后的客观检查方法,对视觉功能评价有重要的临床价值。     

早期视觉诱发电位对眼外伤性视神经挫伤的诊治价值

目的:探讨视觉诱发电位(visual evoked potential,VEP)在眼外伤性视神经挫伤中的诊治应用价值。方法:对36例临床诊断为外伤性视神经挫伤患者进行VEP测定,并与自身健侧眼或正常对照组进行对照。结果:36例中单眼挫伤32例,双眼挫伤4例,共40眼,VEP检查结果均有不同程度的异常,其中有1例2眼VEP波幅明显降低,单纯波幅异常降低者28例30眼,波幅降低伴有峰潜伏期延长者7例8眼。所有外伤性视神经挫伤与自身健侧眼和正常对照比较,P100波幅差异均有统计学意义(P<0.001和P<0.01);而P100峰潜伏期仅有7例稍有延长,与健侧眼差异有统计学意义(P<0.001),而与正常对照组比较差异无统计学意义(P>0.05)。结论:VEP对眼球钝挫伤后视神经损伤的检出有较高的敏感性,因此对于眼外伤性视神经挫伤中的早期诊断、疗效观察、预后评估有着重要价值。     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.