屈光参差性弱视与斜视性弱视的电生理研究

目的 分析屈光参差性弱视和斜视性弱视的视觉诱发电位（VEP）与对比敏感度（CS）的特征性变化，并探讨2 种弱视不同的致病机制。方法 采用德国罗兰公司RETI scan 3.15 系统对20 例屈光参差性弱视、9 例斜视性弱视和18 例非弱视性儿童的双眼行VEP 和CS 检查，进行弱视眼、对侧眼及非弱视眼之间的对比研究。结果 与对侧眼或非弱视眼相比，屈光参差性弱视眼在高空间频率条件下潜时延长，而斜视性弱视眼在全空间频率条件下潜时延长。2 种弱视眼的振幅在低频时均下降。屈光参差性弱视对侧眼与非弱视眼比较差异无统计学意义（p >0.05），而斜视性弱视对侧眼的潜时在低频下较非弱视眼延长，差异有统计学意义（p <0.05）。屈光参差性弱视眼和对侧眼的CS 与非弱视眼比较差异无统计学意义（p >0.05）。斜视性弱视眼表现为全空间频率上的CS 下降，差异有统计学意义（p <0.05），其对侧眼的CS 则优于非弱视眼。结论 本研究结果支持斜视性弱视与屈光参差性弱视拥有不同神经机制的观点。斜视性弱视的对侧眼并非“健眼”。VEP 与CS 检查对弱视诊断具有临床意义。     

弱视治愈儿童多导视觉诱发电位地形图研究

目的：研究弱视基本治愈儿童多导视觉诱发电位地形图的变化特征。方法：选取13．7′、27．5′及55′共3种空间频率对正常儿童及弱视基本治愈儿童进行多导视觉诱发电位地形图的研究，分析13个导联位的P1潜时及N1P1振幅，并对每一例地形图进行观察。结果：(1)仅在13．7′及27．5′方格，弱视眼的P1潜时同正常组相比显著延迟，而在55′方格两组间P1潜时差异无统计学意义；3种空间频率N1P1振幅在两组间的差异无统计学意义。(2)N1P1振幅的分布同正常组改变。(3)地形图：枕区高电位活动无类似半视野刺激现象。结论：弱视基本治愈儿童视力恢复正常，但视皮层的功能仅有部分恢复．另外振幅及潜时的恢复不平行，前者的改变早于后者，弱视的视觉中枢具有一定程度的可塑性。     

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．     

屈光参差性弱视和斜视性弱视患儿非弱视眼对比敏感度比较研究

目的：探讨屈光参差性弱视和斜视性弱视患儿非弱视眼敏感度对比。方法：选取我院收取的40例屈光参差性弱视患儿、45例斜视性弱视患者和35例正常儿童进行灵敏度对比分析。结果：屈光参差性弱视组和斜视性弱视组在各个空间频率敏感性均低于对照组,比较有统计学意义（P＜0．05）;屈光参差性弱视组在各个空间频率敏感性均低斜视性弱视组,两组比较有统计学意义（P ＜0．05）。结论：弱视患儿弱视眼较非弱视眼灵敏度均下降,屈光参差性弱视患儿灵敏度较斜视性弱视患儿低。     

共同性内斜视的多导视觉诱发电位研究

目的：研究伴及不伴弱视的内斜视患者的多导视觉诱发电位（VEPs)特征，探讨伴及不伴弱视的内斜视的发病机制并为临床斜视弱视的诊断提供一种客观的检查方法。方法：采用多导视觉诱发电位地形图采集处理系统记录正常对照组（40例），伴弱视的内斜视组（69例）及不伴弱视的内斜视组（66例）的单、双眼全视野刺激及左、右眼鼻颞侧半视野刺激的多导VEPs.结果：（1）伴弱视的内斜视弱视眼与正常对照组非主导眼相比，潜伏期（LP1）延长（P＜0．01），振幅（AN1P1），且随着弱视程度的加重而加剧。（2）伴弱视的内斜视非弱视眼（主导眼）与正常对照组的主导眼相比较，LP1延长（P＜0．05），AN1P1下降（P＜0．05），不伴弱视的内斜视的主导眼及非主导眼与正常对照组相比，LP1也延长（P＜0．05），AN1P1下降（P＜0．05），但程度较弱视眼轻。（3）伴及不伴弱视的内斜视全视野刺激所记录的双眼与单眼VEPs的LP1，AN1P1比较，差异无显著性（P＞0．05），此结果与正常对照组不同。（4）内斜视单眼半视野刺激所记录的VEPs，内斜视弱视眼鼻颞侧视网膜间受刺激VEPs的LP1，AN1P1比较，差异有显著性（P＜0．05），鼻侧视网膜的LP1延长，AN1P1下降，而弱视眼的对侧眼及不伴弱视的内斜视组鼻颞侧视网膜VEPs的LP1，AN1P1比较，差异无显著性（P＞0．05），（5）内斜视弱视眼全视野刺激VEPs的多导地形图分布呈非对称状，其结果与颞侧视网膜刺激结果相似，而对侧眼及不伴弱视的内斜视组也存在类似现象，但程度较轻。结论：（1）内斜视性弱视眼的视觉通道受到损害，且随弱视程度的加重损害呈加剧趋势；（2）内斜视弱视眼的对侧眼及不伴弱视的内斜视眼尽管视力下，其VEPs有不同程度的改变；（3）共同性内斜视的双眼视功能异常，在不伴弱视的情况下，内斜视仍是影响双眼视功能的重要因素，VEPs双眼总的能够客观反映双眼视功能；（4）内斜视性弱视眼在单眼半视野刺激条件下，存在半视野刺激差异，颞侧视网膜受刺激的反应大于鼻侧，而在不伴弱视的内斜视者无此现象，说明鼻侧视网膜受刺激的VEPs受到抑制的现象存在于斜视伴弱视的患者中。（5）内斜视弱视眼的多导VEPs地形图在头皮的分布呈非对称状，高电位活动向颞侧视网膜投射方向的视皮质侧偏移，在对侧眼及不伴弱视的内斜视也存在类似现象，但程度较轻。     

屈光性弱视颜色视觉诱发电位的初步研究

【目的】 评价弱视的色觉损害以及颜色视觉诱发电位对弱视早期诊断和评价弱视儿童视功能的临床价值,探讨正常儿童、屈光不正性弱视儿童、屈光参差性弱视儿童的颜色视觉诱发电位的表现和差异。【方法】 应用同亮度不同颜色棋盘格的刺激,比较正常儿童、屈光不正性弱视儿童、屈光参差性弱视儿童的颜色视觉诱发电位。【结果】 受试者分为3组,分别为正常儿童组、屈光不正性弱视儿童组、屈光参差性弱视儿童组。①三组儿童组内比较发现:除绿/灰刺激后产生的P1波潜伏期比其它颜色刺激延长之外;其它颜色刺激产生的P1潜伏期两两间的差别无统计学意义。各种颜色刺激产生的P1-N2振幅在各组内的差异无统计学意义。②正常组和屈光不正组儿童在蓝/灰(P = 0.004)和蓝/黄刺激(P = 0.01)后的P1潜伏期的差别有统计学意义,而其它颜色刺激后的P1潜伏期没有显著差别;在红/灰刺激(P = 0.007)后的P1-N2振幅有显著差别,而其它颜色刺激后的P1-N2振幅没有显著差别。③正常组和屈光参差组儿童在蓝/灰(P = 0.02)和蓝/黄刺激(P = 0.01)后的P1潜伏期有显著差别,而其它颜色刺激后的P1潜伏期没有显著差别;正常组和屈光参差组儿童在红/灰(P = 0.005)和黑/白刺激(P = 0.009)后的P1-N2振幅有显著差别,而其它颜色刺激后的P1-N2振幅没有显著差别。④屈光不正组和屈光参差组儿童在各种不同颜色刺激后,两组之间的P1潜伏期及P1-N2没有显著差异 (P值均大于0.05)。【结论】 正常眼和弱视眼的颜色视觉诱发电位存在差异,而屈光不正性弱视和屈光参差性弱视之间则不存在差异。颜色视觉诱发电位可能有助于弱视的早期诊断和视功能评价。     

多元化视功能训练在屈光参差性弱视患儿中的应用研究

目的：探究多元化视功能训练在屈光参差性弱视患儿中的应用效果。方法：选择2021年3月—2022年9月黔西南布依族苗族自治州人民医院收治的屈光参差性弱视患儿82例,按随机数字表法分为两组,各41例。两组均采取遮盖疗法,对照组进行常规训练,观察组实施多元化视功能训练,均持续训练3个月。比较两组视力、视觉诱发电位、立体视功能、对比敏感度。结果：干预前,两组视力、视觉诱发电位、立体视功能、对比敏感度比较,差异均无统计学意义（P>0.05）;干预后,观察组裸眼视力、最佳矫正视力（BCVA）均高于对照组,1°、15°空间频率潜伏期均短于对照组,振幅均高于对照组,立体视锐度小于对照组,1.5、3、6、12、18 c/d空间频率对比敏感度均高于对照组,差异均有统计学意义（P<0.05）。结论：多元化视功能训练能够有效改善屈光参差性弱视患儿视力、立体视功能,提高对比敏感度。     

弱视斜视临床与发病机理的研究

本文报告了弱视931例(1332只眼)的远期疗效,结果表明视力提高与年龄、弱视深度、弱视类型等因素有明显关系。治愈的弱视患者中有81.07％建立立体视,弱视深度与体视有关,斜视性弱视获立体视率明显低于屈光不正和屈光参差两组。体视建立随年龄增长而逐渐发育。弱视复发是治疗中的一个重要问题,随访3年以上者无1例复发。同时在国内外首次3年治愈的随访期限。用多导视诱发电位地形图的研究结果提示:(1)内斜弱视的弱视眼鼻侧视网膜呈抑制现象;(2)恒定性外斜弱视颞侧视网膜抑制;(3)间歇性外斜弱视和屈光参差弱视眼未见半侧视网膜抑制;(4)内斜弱视眼对侧眼为非“正常眼”。     

弱视儿童图形视觉诱发电位异常的发生率分析

本文对80例弱视儿童和30例同年龄正常儿童同期进行图形视觉诱发电位（P－VEP）的检测。结果表明儿童弱视眼的P－VEP有异常改变（潜时延长和振幅下降），而部分正常儿童亦会出现异常P－VEP，但是弱视眼的异常P－VEP发生率远比正常眼为高。单眼弱视患者其对侧眼异常P－VEP发生率与正常眼儿童相比无显著差异。     

P-VEP敏感空间频率刺激综合疗法治疗弱视的临床观察

目的：探讨根据图形视觉诱发电位（pattern visual evoked potential,P-VEP）检查出的敏感空间频率进行视觉刺激训练疗法对儿童弱视治疗的有效性。方法：所有患儿随机分两组,对照组110例（126只眼）,采用遮盖法和精细目力训练法治疗,实验组100例（119只眼）,采用P-VEP检查出敏感空间频率,选择该敏感空间频率进行视觉刺激训练加遮盖法的综合治疗。结果：两组总基本治愈率比较,相同年龄段、屈光不正和屈光参差的基本治愈率中比较,实验组高于对照组（P＜0.05）。结论：敏感空间频率刺激加遮盖法综合疗法对弱视治疗有较好的疗效。     

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.