使用甲醛制作猪眼白内障模型用于超声乳化手术培训

白内障超声乳化手术需要一个特定的学习曲线。初学者一般都要经过动物眼手术阶段才能过渡到人眼操作。绝大多数动物眼球都是透明晶状体,与实际白内障手术的感觉不一样。本文介绍了使用甲醛制作猪眼白内障模型的具体方法,探讨了此方法制作的白内障模型的特点与注意事项。使用甲醛制作的猪眼白内障模型可以大致模拟出不同硬度白内障核的情况,使初学者有较为真实的手术体验及对不同硬度核的认识,并且可以训练刻槽、分割核与劈核等许多重要技术。这种方法简单实用、效果逼真,可以在超声乳化手术培训中加以应用以提高培训效果。     

单人操作白内障摘出术的介绍(附122眼手术分析)

本文着重介绍了单人操作白内障摘出术的手术方法,指出单人操作与双人操作的不同点和注意点。通过122只眼白内障摘出术的效果表明,其手术复明率为96.7%,并对术中主要并发症作了比较。     

屈光性白内障手术研究进展

以简单复明为目的的传统白内障手术逐渐被个性化屈光性白内障手术所取代。通过不断更新手术设备、提高手术技巧、改良人工晶状体(IOL)等措施实现更加完美的视觉效果。伴随超声乳化技术的发展和可折叠IOL的成功研制,手术方式也由大切口变为小切口,并在向微切口发展。IOL的快速发展也为临床不同类型病例提供了更多、更个性化的选择。视光学与现代白内障手术的有机结合,是今后研究发展的方向。     

青光眼白内障联合手术的探讨

报道我院几年来共施行的青光眼白内障联合手术10例(10只眼),其中9例术后视力提高,眼压正常,成功率达90%,故认为联合手术在青光眼白内障同时存在时是可以同时施行的。讨论了联合手术的适应证和手术操作的体会等。     

人工晶体植入术的护理进展

全世界致盲原因中白内障占46.0%,我国约有500万双眼视力低于0.3的白内障患者[1].一般认为白内障不能预防,但可通过手术治疗将大多数盲人视力恢复到接近正常的视力范围.临床上手术治疗白内障取得了满意的效果,除手术操作因素外,护理工作在整个治疗过程中也起到了很重要的作用.人工晶体植入术是高科技电子技术介入眼科领域的产物,是目前矫正白内障术后屈光不正的首选方法,其手术精细、操作复杂,对术后提出比传统手术更高的要求,因此手术的效果如何与护理密切相关.……     

双手微切口白内障超声乳化术

随着白内障超声乳化手术技术的提高，手术设备的更新，超乳医生对手术完美性的追求，白内障超声乳化新技术一双手微切口超声乳化，以它安全、快速、有效、简便的特点，为我们提供了更加完美的手术效果。该术式将以缩小切口，提高能量应用效率和减少眼组织损伤等众多优点进一步改善白内障超声乳化术的疗效，引领白内障手术治疗进入“冷超声乳化”的新时代。     

基于流动医院的白内障超声乳化手术培训模式的探索

基于流动医院的白内障复明手术给无数白内障患者带来了光明,同时也培养了一批合格的白内障手术医师。在实施复明手术的过程中,北京大学人民医院眼科中心探索了2种新的白内障手术培训模式,取得了良好的手术培训效果。通过2种模式的有机结合,显著提高了受训眼科医师的白内障手术独立完成率,并降低了手术并发症的发生率。     

人工晶体植入术的护理进展

全世界致盲原因中白内障占 46 .0 % ,我国约有 5 0 0万双眼视力低于 0 .3的白内障患者 [1 ] 。一般认为白内障不能预防 ,但可通过手术治疗将大多数盲人视力恢复到接近正常的视力范围。临床上手术治疗白内障取得了满意的效果 ,除手术操作因素外 ,护理工作在整个治疗过程中也起到了很重要的作用。人工晶体植入术是高科技电子技术介入眼科领域的产物 ,是目前矫正白内障术后屈光不正的首选方法 ,其手术精细、操作复杂 ,对术后提出比传统手术更高的要求 ,因此手术的效果如何与护理密切相关。1　护　理1.1　术前准备1.1.1　心理护理　病人术前均有…     

对糖尿病患者白内障术后视力影响因素的护理探讨

目的探讨糖尿病白内障患者术后视力影响因素。方法通过加强术前护理,减少了糖尿病患者白内障手术的并发症。结果尽管糖尿病患者的白内障手术存在诸多不利因素,但是通过加强护理措施,提高了糖尿病患者的白内障手术的成功率。针对患者的各种心理状态,做好心理护理,指导患者对疾病树立正确的认识。从而减少了糖尿病患者白内障手术的并发症,不同程度地提高了患者的视力,提高了糖尿病合并白内障患者的生活质量。结论术前教育、术后密切观察护理与术后指导正确用药是提高手术成功率和减轻人工晶体异物反应的关键,值得临床推广与应用。     

老年性白内障手术心电监护的临床观察

白内障是老年人致盲的第一原因,眼科手术虽然创伤小,但精神恐惧、麻醉操作及手术引起的眼心反射,均可增加并存心血管疾病、糖尿病等老年白内障病人的术中危险性。因此,术中行心电监护对提高手术的安全性十分重要。我们对122例老年性白内障病人进行术中心电监护,现将结果报告如下。     

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.