小切口白内障摘出及人工晶状体植入术治疗白内障247例临床疗效分析

目的：探讨小切口白内障摘除联合人工晶状体植入术的疗效及在基层医院的应用。方法：对247例（247眼）白内障行非超声乳化的小切口摘出,植入直径为5.5～6.0mm的一体型人工晶状体。结果：术后3d,视力0.8以上者49例,占19%;0.5以上者81例,占55%;0.3以上者64例,占26%。结论：老年性白内障采用小切口非超声乳化白内障囊外摘除并人工晶体植入术,效果良好,安全性高,费用较低,易在基层医院推广,尤其适用于大批量复明手术。     

复明医疗队短期集中小切口非超声乳化白内障手术的临床分析

目的：讨论集中开展白内障摘除联合后房型人工晶状体植入术的体会，并评价手术效果。方法：于2007年8月3～10日集中实施531例小切口非超声乳化白内障摘除联合人工晶状体植入。结果：患者术后离院时裸眼视力≥0．3者占68．2％，≥0．5者占41．2％；术后1个月视力或矫正视力≥0．3者占96．6％，≥0．5者占77．2％，≥0．8者占44．3％。结论：非超声乳化白内障摘除联合人工晶状体植入有效、安全、简便、经济，适宜于白内障规模化手术。     

小切口非超声乳化人工晶状体植入术的临床观察

目的探讨小切口非超声乳化人工晶状体植入术的疗效。方法对168例(179眼)白内障患者施行小切口非超声乳化白内障囊外摘出联合人工晶状体植入术,观察其术后效果。结果术后3d视力≥0.5者占78.8%,术后1个月视力≥0.5者达91.6%。结论小切口非超声乳化人工晶状体植入术操作简便、费用低廉、手术效果满意,在临床上具有一定的应用价值。     

小切口非超声乳化联合人工晶体植入术治疗白内障的临床分析

目的:探讨小切口非超声乳化白内障囊外摘除人工晶状体植入术的难点及优点,推广该手术方式。方法:通过巩膜隧道反眉形切口行非超声乳化白内障囊外摘除人工晶状体植入术,分析手术难点及常见并发症及处理。结果:317例(373眼)术后一月视力≥0.4者有315眼(84.45%),患者对手术结果较满意。结论:小切口非超声乳化囊外摘除人工晶体植入术易于掌握,经济高效,是基层开展白内障复明手术值得推广的手术方式。     

白内障超声乳化摘除人工晶体植入术的临床观察

目的：探讨白内障超声乳化摘除人工晶体植入术的临床疗效。方法：对216例（240只眼）老年人、并发症，外伤性和先天性白内障施行超声乳化摘除及后房型人工晶体植入术。结果：白内障超声乳化术后1周裸眼视力≥0.5者占72.9%,≥1.0者占54.2%,术后3-12个月矫正视力≥0.5者占93.8%,≥1.0者占77.5%。手术并发症主要为术后角膜水肿28只眼，后发障6只眼，术中后囊膜破裂6只眼，结论：白内障超声乳化摘除人工晶体植入术，切口小、手术时间短，视力恢复快，值得临床推广普及。     

非超声乳化巩膜隧道小切口白内障摘除联合人工晶体伴植入术的疗效观察

目的 观察非超声乳化巩膜隧道小切口白内障摘除联合人工晶体植入术的疗效.方法 对250例(300眼)白内障患者施行非超声乳化巩膜隧道小切口白内障摘除联合人工晶体植入术,观察术后3d、7d裸眼视力及术中、术后并发症.术后随访3-12个月.结果 术后3d裸眼视力≥0.5者231眼(占76.85%),术后7d裸眼视力≥0.5者265眼(占88.33%).术中并发症36眼,其中上方虹膜反复脱出7眼,晶状体后囊膜破裂23眼,晶状体上方悬韧带断离6眼.术后并发症145眼,其中角膜水肿103眼,前房出血26眼,一过性高眼压16眼.结论 非超声乳化巩膜隧道小切口白内障摘除联合人工晶体植入术具有安全、有效、微创的临床特点,值得临床推广.     

小切口非超声乳化白内障摘除人工晶体植入的手术治疗体会

目的探讨小切口非超声乳化白内障摘除人工晶体植入的手术治疗效果。方法210例白内障施行巩膜隧道式小切口非超声乳化白内障摘除人工晶体植入术。结果术后视力均有不同程度的提高。术后第1天裸视≥0.5者为52%,术后第7天裸视≥0.5者为75.5%,术后1个月裸视≥0.5者为85.5%,术后1周平均散光为1.55±0.52D,1个月平均散光为0.95±0.26D,3个月为0.55±0.18D。结论小切口非超声乳化白内障摘除人工晶体植入术是一种有效的白内障复明手术。     

白内障摘除联合人工晶状体植入术治疗糖尿病性白内障196例疗效分析

目的：分析小切口白内障摘除联合人工晶状体植入术和超声乳化白内障吸除联合人工晶状体植入术治疗糖尿病性白内障的疗效及并发症。方法：选择2002年1月～2009年10月期间不同硬度晶状体核的糖尿病性白内障患者196例（230只眼）,188只眼Ⅱ～Ⅲ级核,采用超声乳化白内障吸除后房型人工晶状体植入术;42只眼Ⅳ-Ⅴ级核,采用小切口白内障囊外摘除后房型人工晶状体植入术。结果：超声乳化白内障吸除后房型人工晶状体植入术后一月矫正视力≥0．5者79．8％,小切口白内障囊外摘除后房型人工晶状体植入术后一月矫正视力≥0．5者57．1％,两组之间的差别没有统计学意义（P〉0．05）。结论：糖尿病性白内障在做好病例选择及良好的术前准备的前提下。行小切口白内障摘除联合人工晶状体植入术和超声乳化白内障吸除联合人工晶状体植入术同样可获得满意的视力效果。     

小切口白内障手术和超声乳化白内障摘除术的临床疗效对比分析

目的探讨小切口白内障囊外摘出人工晶状体植入术与超声乳化白内障吸出硬质人工晶状体植入术两种方法的临床效果。方法分别对80只眼小切口非超声乳化白内障囊外摘出术及68只眼超声乳化硬质人工晶状体植入术的术后视力、角膜内皮丢失率,术中、术后并发症进行比较。结果小切口非乳化组1周后视力≥0.5者59只眼（73.7%）,≤0.4者21只眼（26.3%）。超声乳化组≥0.5者54只眼（79.4%）,≤0.4者14只眼（20.6%）。角膜内皮丢失率：小切口非超声乳化组13.1%,超声乳化组13.0%。术后角膜内皮水肿：小切口非乳化组6只眼（7.50%）,超声乳化组4只眼（5.88%）。结论小切口非超声乳化白内障摘出与超声乳化硬质人工晶状体植入术疗效相似,前者简便、易行、经济,适宜于广大医院开展。     

小切口白内障手术和超声乳化白内障摘除术的临床疗效对比分析

目的 探讨小切口白内障囊外摘出人工晶状体植入术与超声乳化白内障吸出硬质人工晶状体植入术两种方法的临床效果.方法 分别对80只眼小切口非超声乳化白内障囊外摘出术及68只眼超声乳化硬质人工晶状体植入术的术后视力、角膜内皮丢失率,术中、术后并发症进行比较.结果 小切口非乳化组1周后视力≥0.5者59只眼(73.7%,≤0.4者21只眼(26.3%).超声乳化组≥0.5者54只眼(79.4%,≤0.4者14只眼(20.6%).角膜内皮丢失率:小切口非超声乳化组13.1%,超声乳化组13.0%.术后角膜内皮水肿:小切口非乳化组6只眼(7.50%),超声乳化组4只眼(5.88%).结论 小切口非超声乳化白内障摘出与超声乳化硬质人工晶状体植入术疗效相似,前者简便、易行、经济,适宜于广大医院开展.     

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.