玻璃体切割术后（水眼）继发青光眼的手术治疗效果观察

目的：分析玻璃体切割术后（水眼）继发青光眼的手术治疗效果。方法：回顾性分析30例（30眼）玻璃体切割术后（水眼）继发青光眼患者的临床资料,所有患者均采取小梁切除术治疗,并持续门诊随访1周～12个月,分析患者的视力、眼压、术后并发症发生情况及治疗有效率。结果：本组30例（30眼）玻璃体切割术后（水眼）继发青光眼患者均顺利完成小梁切除术治疗,治疗有效率为93．33％,均未出现严重的并发症,并发症发生率为20．00％,其中眼压偏低4眼、脉络膜脱离2眼,经对症治疗后,显著缓解;末次随访视力较术前显著提高,眼压较术前显著降低,经T检验,差异具有统计学意义（P＜0．05）。结论：小梁切除术治疗玻璃体切割术后（水眼）继发青光眼的治疗效果显著,对于提高视力,降低眼压均具有积极作用,安全性高。     

超声乳化联合小梁切除治疗青光眼合并白内障

目的观察超声乳化联合小梁切除术治疗青光眼合并白内障的临床疗效及并发症。方法对100例（112眼）青光眼合并白内障患者进行小梁切除联合超声乳化人工晶体植入,术后测量眼压,检查视力,观察并发症。结果术后1周矫正视力为0．04～1o,较术前提高者106眼（94．6％）,其中最佳矫正视力〉0．3者91眼（81．2％）。术后1周眼压1．89±0．73kPa,较术前3．26±（I．65kPa明显下降p〈0．01）。术后并发症主要是虹膜反应、角膜水肿及术后大瞳孔。结论超声乳化联合小梁切除术治疗青光眼合并白内障损伤小、视力恢复快、降低眼压、并发症少。     

超声乳化白内障吸除联合小梁切除术的疗效观察

目的 探讨超声乳化白内障吸除联合小梁切除手术治疗合并白内障的闭角型青光眼的疗效。方法 回顾性分析1998年11月－2001年6月，收住本院同时患者闭角型青光眼和白内障的病人86例（86只眼），原发性急性闭角型青光眼54例，原发性慢性闭角型青光眼32例，患者均有不同程度的晶体混浊。患者入院后元首地巩膜隧道切口超声乳化白内障吸除人工晶体植入联合小梁切除术。随访时间0．5－3年，平均14．60个月。结果 术后随访平均眼为1．64kPa(12.30mmHg)，比术前用药后平均眼压4.15kPa(31.23mmHg)有明显降低。术后83只眼（96．5％）最佳矫正视力均不同程度提高。结论 超声乳化白内障吸附联合小梁切除手术能够有效治疗合并白内障的闭角型青光眼。     

小梁切除联合白内障摘除术在青光眼治疗中的应用

目的：探讨青光眼－白内障联合手术治疗青光眼合并白内障的效果。方法：应用小梁切除联合白内障囊外摘除或白内障超声乳化术进行手术治疗。结果：术前眼压平均40.35mmHg,术后眼压平均17.79mmGg,术前视力0.05以下53眼,0.06-0.2,14眼,0.3以上7眼。术后1周视力0．05以下31眼,0．06－0．2,24眼;0．3以上9眼。术中并发症为晶体后囊破裂,术后并发症的角膜水肿。结论：小梁切除联合晶体摘除是治疗青光眼合并白内障的有效方法。     

玻璃体切割＋青光眼引流阀植入治疗难治性青光眼2例体会

目的：探讨玻璃体切割 青光眼引流阀植入治疗难治性青先眼的手术治疗方法及其疗效。方法：通过一例视网膜静脉周围炎继发玻璃体积血合并新生血管性青先眼，经药物治疗无效，行玻璃体切割 晶体切除联合青先眼引流阀植入术；另一例因眼球穿通伤行眼球穿通伤清创缝合术，术后玻璃体积血行“玻璃体切割 C3F8填充术”，术后又因房角粘连致继发性青先眼，经药物治疗无效，再次手术行青光眼引流阀植入术；两例均为难治性“青光眼”，为无晶体眼，玻璃体腔与前、后房交通；将青光眼网引流管植入玻璃体腔内。结果：玻璃体痰病合并难治性青先眼行玻璃体切割联合青光眼引流阀植入手术治疗，术后眼压控纠正常，视力稳定或改善。结论：玻璃体疾病合并难治性青光眼行玻璃体切割联合青光眼引流阀植入手术是目前治疗玻璃体疾病合并难治性青光眼手术方式之一，但由于原来的严重疾病和术后并发症，视力结果仍可能是不良的。     

改良小梁切除治疗青光眼的远期疗效观察

目的 提出小梁切除的一种改良术式并进行疗效观察。方法 采用垂直于角膜缘的坚向条形小梁切除术，治疗不同类型青光眼65例（72眼）。结果 经6－30个月随访，手术成功率为94．4％。术后不同时期平均眼压：出院时2．01kPa；1年时眼压2．31kPa；2年时眼压2．35kPa；3年时眼压2．39kPa。功能性滤过泡在1年时为94．4％；2年时为86．0％；3年时为53．0％。本组滤过泡消失28眼中，仅有2眼眼压失控。结论 本手术有结膜下和脉络膜下腔引流的双重作用，降压作用稳定，远期疗效好。     

人工晶体植入术联合小梁切除术的临床观察

目的：探讨行小梁切除术联合人工晶体植入术治疗白内障合并青光眼的疗效。方法：对28例白内障合并青光眼的患者行小梁切除联合人工晶体植入术,并对其术后视力,眼压及并发症进行了分析和手术方法探讨,结果：28眼中术后轿正视力≥0．5有15例,占54％,0．1－0．4有11例,0．1以下2例,眼压控制在2．74kPa以下的25例,占89％,3例眼压偏高,但不超过3．54kPa,联合术无严重不良反应,结论：小梁切除术联合人工晶体植入术对白内障合并青光眼是一种较好的手术治疗方法。     

86例眼外伤致迟发性青光眼的临床观察

目的：探讨眼外伤迟发性青光眼不同类型的治疗。方法：86例（86眼）眼外伤迟发性青光眼根据不同类型分别采用复合式小梁切除术、复合式小梁切除联合玻璃体切除术、睫状体光凝进行手术治疗。结果：86例中64例眼压被控制,成功率为74．42％,61例（70．93％）的视力与术前相同或提高,25例（29．07％）视力下降。术后5例出现白内障,3例合并视神经萎缩加重,1例视网膜脱离,1例脉络膜脱离。结论：眼外伤迟发性青光眼应根据不同分型进行系统治疗,对于房角后退型和粘连增殖型及虹膜缺损型继发青光眼应选择复合式小梁切除术治疗;无晶状体型继发青光眼根据病情,选择复合式小梁切除或复合式小梁切除联合玻璃体切除术;新生血管型继发青光眼可直接进行睫状体光凝治疗。     

窦小梁切除术联合超声乳化白内障吸除术治疗急性闭角型青光眼合并白内障85例分析

目的：观察窦小梁切除术联合白内障超声乳化吸除术、人工晶体植入术（三联术）。对治疗青光眼合并白内障患者的疗效。方法：对85人85眼急性闭角型青光眼合并白内障患者进行手术治疗，采用窦小梁切除术联合白内障超声乳化吸除术、人工晶体植入术。术后随访1～12个月。结果：术前眼压16．87～37．12mmHg（1mmHg=0．133kPa），平均（23．87±3．87）mmHg，术后随访最终眼压12．45～21．48mmHg，平均眼压（14．664-2．56）mmrig，经统计学t检验，手术前后眼压差异有统计学意义（P〈0．05）。术后中央前房深度平均加深1．38倍。术后视力〈0．1者6眼，此6例患者均有眼底视神经萎缩；0．1～0．5者32眼；〉0．5者47眼。结论：改良窦小梁切除三联手术治疗青光眼合并自内障患者，具有恢复视力、稳定眼压、减少术后用药，并发症少等效果。     

无晶体性青光眼的病因和治疗

探讨引起无晶体眼眼压升高的各种原因及无晶体性青光眼的治疗方法。分析３１例（３１只眼）无晶体性青光眼的病因，根据不同致病因素分别采用药物降眼压、激光治疗及前房穿刺、小梁切除、状体剥离、玻璃体切割等手术治疗。结果：眼压均控制在下沉范围。瞳孔阻滞、周边虹膜前粘连、前房出血、晶体物质残留、炎症、玻璃体进入前房及有原发性青光眼因素存在均可引起白内障术后眼压升高，根据不同 病因采取不同的治疗方案可取得良好效果     

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.