白内障超声乳化吸出及囊袋内人工晶体植入术

为观察和评价超声乳化白内障吸出术的临床效果、特点、并发病及防治措施，对４１　眼白内障施行超声乳化吸出术及小切口（６ｍｍ）囊袋内人工晶体植入术，并以同期的白内障患者４１眼行现代囊外摘除及后房型人工晶体植入做对照。结果：术后６个月，视力≥１．０者占４３．９％＞０．８者占７０．７≥０．５者占９２．７％，均明显高于对照组（Ｐ＜０．００１），术后平均散光为１．０４±０．８１，１，低于对照组（Ｐ＜０．０１）。白内障超声乳化吸出并囊袋内人工晶体植入术的复明效果优于囊外摘除并后房型人工晶体植入术。     

非超声乳化小切口白内障摘除人工晶体植入术35例疗效观察

采用小切口非超声乳化摘除白内障３５例３５眼,常规囊外白内障摘除术５２例５２眼。结果,小切口组术后３个月视力达１．０者２８眼（８０％）,≥０．５者３４眼（９７％）,术后角膜散光〈１．０Ｄ占９７％。术中及术后未见明显并发症。常规手术组视力达到１．０者１３眼（２５％）,≥０．５者（５６％）,术后角膜散光〈１．０Ｄ占４６％。两组相比,差异显著（Ｐ〈０．０１）,认为小切口非超声乳化治疗白内障效果明显优于常规     

超声乳化设备与操作技术在白内障手术中的应用

目的：比较现代白内障囊外摘除术与超声乳化手术2种手术方式，评价超声乳化设备与操作技术在白内障手术中的应用。方法：191例（208眼）白内障分别采用现代白内障囊外摘除术和超声乳化手术，比较术后2组患者的视力、角膜内皮的数量以厦比较手术前后角膜散光变化。结果：超声乳化设备和超声乳化技术的正确应用，缩短手术时间，减少患者痛苦，术后视力恢复非常迅速，术后1周裸眼或球镜矫正视力≥0．6者占80．8％，角膜损伤数量明显少于白内障囊外摘除术组，并且术后几乎不引起散光。     

白内障超声乳化吸出术联合人工晶体植入术的初步报告

目的：评价白内障超声乳化吸出术联合人工晶体植入术的临床效果。方法：对２６例（２９只眼）老年性白内障患者施行白内障超声乳化吸出和后房型人工晶体植入术。结果：术后１周及３个月时,裸眼或球镜矫正视力≥０．５者２４只眼（８２．８％）,术后３个月视力≥１．０者１４只眼（４８．３％）。平均散光在术后１周和３个月时分别为（１．２５±０．５０）ｍ１和（０．７５±０．２５）ｍ１。明显低于对照组（Ｐ＜０．０１）。主要并发症有虹膜咬伤、后囊膜破裂、角膜明显水肿及后发障。结论：白内障超声乳化吸出术在术后散光控制和尽快恢复视力等方面明显优于囊外摘除术     

白内障超声乳化与现代囊外摘除术对照研究

目的：对比研究白内障超声乳化术和现代囊外摘除术后患者的临床疗效。方法：选择628例（668眼）白内障患者分为两组，分别行超声乳化联合人工晶体植入术（PHACO组，326例352眼）和现代囊外摘除联合人工晶体植入术（ECCE组，302例316眼）。术后1～6个月对并发症的发生率、症状、体征等项目进行检查和评分比较。结果：两组间在症状、体征、干眼诊断性试验等各项指标评分上差异均有显著性，ECCE组评分明显高于PHACO组，ECCE组干眼症发病率（23．73％）也高于PHACO组（4．54％）。结论：白内障现代囊外摘除术较超声乳化术在术后短期内更易使泪膜稳定性受到破坏而产生干眼症。     

超声乳化与现代囊外摘除治疗自内障的疗效观察

目的探讨超声乳化与现代囊外摘除手术治疗白内障的临床疗效。方法选择2006年9月～2008年11月期间我院收治的白内障患者100例（118眼）,随机将患者分为超声乳化组和现代囊外摘除组,每组59眼。两组患者经明确诊断后,超声乳化组患者行超声乳化吸除术治疗,而现代囊外摘除组患者行现代囊外摘除术治疗,并对术后视力和散光情况及并发症发生情况等临床指标进行对比分析。结果与现代囊外摘除组比,超声乳化组患者术后视力≥4．5和散光≤1．5的比率均明显提高,差别均具有统计学意义（P〈0．05）;与此同时,超声乳化组患者后发生后囊破裂和虹膜损伤以及前方出血的比率均有所降低,但未表现出显著性差异（P〉0．05）。结论在白内障治疗方面,超声乳化术较现代囊外摘除术更具较低的角膜散光值和获得较好的视功能,并在一定程度上减少了并发症的发生,是白内障患者较为理想的治疗方法。     

三种手术方法治疗白内障的临床分析

目的探讨三种白内障摘除联合人工晶体植入术治疗白内障的优缺点及产生的并发症情况。方法回顾性分析分别行小切口自内障摘除术联合人工晶体植入术、超声乳化白内障吸除术联合人工晶体植入术及囊外摘除联合人工晶状体植入术治疗310例（346眼）白内障患者的病例资料。结果超声乳化术联合人工晶体植入术效果最好、并发症最少，仅6眼（占2．54％）；小切口白内障摘除联合人工晶体植入术次之，并发症为50眼（占21．19％）；囊外摘除术联合人工晶体植入术（常规术式）效果最差、并发症最多为180眼（占76．27％）。术中并发症以后囊破裂为主，为29眼（占65．91％），术后并发症主要为散光，为156眼（占81．25％）。结论三种方法中以白内障超声乳化联合人工晶体植入术效果为最好，临床医生要充分了解其术中术中及术后并发症的发生原因，以便于指导临床工作。     

不同白内障术式对术后角膜屈光状态和视力的影响

目的探讨超声乳化白内障吸除及可折叠晶体植入、超声乳化及非折叠晶体和白内障囊外摘除（ＥＣＣＥ）三种不同术式对术后角膜屈光状态和视力功能恢复的影响。方法对三组１６９例老年性白内障分别采用３．５ｍｍ、６．５ｍｍ巩膜隧道和１０ｍｍ角巩缘切口，施行白内障超声乳化摘除及折叠式人工晶体植入术、超声乳化摘除及一体型人工晶体植入术、囊外摘除及一体型人工晶体植入术。结果术后第３天的平均裸眼视力分别为１．０２、０．５２和０．４６。达到正常视力的比例分别为６６．２５％、１２．３０％和８．６６％，超声乳化和囊外摘除术相比较，差异均有显著性（ｔ检验，Ｐ＜０．０５）。结论手术切口小，操作轻，术后早期获得良好的裸眼视力，角膜散光轻微，减少了缝合所需时间及消除缝线的不良反应。     

糖尿病患者白内障手术的疗效分析

目的分析白内障现代囊外摘除人工晶体植入术和超声乳化白内障吸除人工晶体植入术治疗糖尿病性白内障的疗效及并发症。方法选择2001年1月．2006年1月期间确诊为糖尿病白内障患者55例（68眼），51眼Ⅱ．Ⅲ级核，采用超声乳化白内障吸除后房型人工晶体植入术；17眼Ⅳ．Ⅴ级核，采用现代白内障囊外摘除后房型人工晶体植入术。结果55例（68眼）糖尿病患者白内障术后视力均有不同程度的提高，其中58眼（85．29％）术后1wk裸眼视力≥0．4。术中术后主要并发症经处理对术后视力无影响。结论对糖尿病性白内障患者采取恰当的术式,施行白内障现代囊外摘除人工晶体植入术或超声乳化白内障吸除人工晶体植入术疗效肯定。     

超乳三联手术方法治疗青光眼合并白内联的临床疗效评估

为评价小梁切除联合白内障超声乳化工晶体植入术超乳三联手术的疗效,对３２例（３５只眼）青光眼合并白内障的患施行该手术方法治疗。结果：术后１年矫正视力〈０．１３％,０．１～０．４２０％,≥０．５７７％。术后６个月眼压１０．４～１８．６ｍｍＨｇ,１例需药物控制（２．８％）;术后１年眼压９．９～１７．７％ｍｍＨｇ,３例需药物控制（８．５％）。术中无严重并发症。表明小梁切除联合白内障超声乳化人工晶体     

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.