滤过术后浅前房相关因素分析

目的 探讨青光眼滤过术后浅前房与术前眼压及术后并发症的关系。方法 回顾性总结各类型青光眼行抗青光眼手术183例，228眼术后发生浅前房49眼的情况。结果①spaeth分类：发生浅前房49眼（21．49％）。②术前眼压：≤21mmHg者160眼，浅前房26眼；眼压22-35mmHg者45眼，浅前房13眼；眼压〉35mmHg者23眼，浅前房10眼。③术后并发症有结膜渗漏、滤过过强和脉络膜脱离。结论 青光眼滤过术后浅前房与多种因素有关。①与术前眼压密切相关。控制正常者，发生率低。②与术后并发症密切相关，而且以滤过过强性和原因不明者多见。     

青光眼术后浅前房原因及治疗

目的探讨青光眼小梁切除术后浅前房形成的原因与处理方法,分析浅前房形成与术后结膜伤口渗漏、滤过过强及脉络膜脱离的关系。方法回顾性分析行青光眼小梁切除术后136例（142眼）发生浅前房的情况。结果发生浅前房36眼（25．35％）,其中,术后滤过过强25眼（69．44％）,结膜瓣渗漏6眼（16．67％）,脉络膜脱离4眼（11．11％）,恶性青光眼1眼（2．78％）。结论青光眼小梁切除术后浅前房与多种因素有关,以滤过过强者为最主要的原因。     

青光眼术后浅前房26例临床分析

目的：探讨青光眼术后浅前房发病机理及处理方法。方法：回顾性总结137只眼行各类青光眼术后浅前房发病率及处理方法。结果：浅前房发生26只眼，占手术人数19％，其中行双瓣下咬切术67只眼，发生浅前房15只眼，占22．3％，行小梁切除术46只眼，发生浅前房8只眼，占17．4％。所有浅前房均发生在闭角型青光眼中，滤过过强导致浅前房形成18只眼，占69．2％，色素膜炎导致浅前房形成8只眼，占30．8％；对浅前房处理均采用药物保守治疗痊愈。结论：滤过过强和色素膜炎是浅前房发生的主要原因。恰当的保守治疗是处理浅前房的主要方法。     

小梁切除术后浅前房原因分析及处理

目的探讨青光眼小梁切除术后发生浅前房的常见原因及处理方法。方法分析安阳市眼科医院2006年1月～2006年12月期间住院治疗进行常规小粱切除术的202例（271眼）青光眼患者，观察术后浅前房的情况及处理方法。结果37例（39眼）术后发生浅前房，发生率为14．4％。浅前房程度按Spaeth分级法分级：Ⅰ级18眼，Ⅱ级20眼，Ⅲ级1眼。浅前房发生原因有：房水滤过过强37眼（94．9％），脉络膜脱离2眼（5．1％）。需手术恢复前房1眼（2．6％），其余均通过非手术方法即恢复前房。浅前房发生时间在术后1～7d。结论浅前房是青光眼小梁切除术后的常见并发症，其常见原因是房水滤过过强，多数可通过非手术方法恢复前房。     

青光眼滤过术的浅前房临床探讨

目的：探讨青光眼滤过性手术后浅前房发生的原因、治疗及其预防。方法：回顾本院2001年1月-2007年10月收治青光眼患者182例共229只眼滤过性手术后发生浅前房情况，统计分析其发生原因、治疗结果。结果：182例229只眼中浅前房者62例66只眼，发生率为28．82％（66／229）。最常见原因是滤过过强（69．70％，46／66），其它依次为结膜瓣渗漏（12．12％，8／66），外力作用于术眼（10．60％，7／66），脉络膜脱离（7．58％，5／66）。浅前房66只眼中，61只眼（92．42％，61／66）经保守治疗形成前房，其它5只眼需手术治疗。结论：青光眼滤过术后浅前房发生率较高，滤过过强为主要发生原因，应重视其术前、中、后的每一环节，减少其发生率。浅前房多数可通过保守治疗而恢复。     

抗青光眼术后浅前房的形成原因及临床治疗

目的分析抗青光眼术后浅前房形成的原因,并探讨处理和预防方法。方法回顾性研究134例共151只眼行抗青光眼手术后出现浅前房45例的术前术中原因及术后临床处理和治疗。结果占总眼数的29.80％的45例术后浅前房中,滤过过强的原因占46.67％,睫状体脉络膜脱离占2448％,结膜瓣渗漏占17.78％,恶性青光眼占6.67％,其他原因的占4.45％。48只眼中的28只眼（62.22％）发生术后浅前房的时间在术后1d,10只眼（2222％）发生在术后2d,4只眼（8.89％）发生在术后3d,其他的发生在4d及4d以上。通过及时治疗均恢复前房,半年随访眼压控制良好。结论注重手术各个环节,可使术后浅前房发生率明显降低。术眼的前节变化及眼压的异常波动是预防抗青光眼术后浅前房形成的关键。     

青光眼滤过术后浅前房的治疗体会

目的讨论青光眼滤过术后浅前房形成的常见原因及处理方法。方法回顾性总结了我眼科2005年～2009年2月期间收治的青光眼患者134例,行青光眼滤过术后发生浅前房的原因、类型及治疗方法。结果共行青光眼滤过手术161只眼,其中52只眼发生浅前房,发生率为32．3％。小梁切除＋丝裂酶素为386％（35／88）。浅前房发生于术后1～7天,术后3～4天发生率最高。其中滤过过畅19只眼（36．54％）、睫状体脉络膜脱离12只眼（23．08％）、结膜瓣渗漏19只眼（36．54％）、恶性青光眼2只（3.08％）。其中需要手术治疗的有2只眼,其余56只眼均通过保守治疗恢复前房。结论青光眼滤过术后浅前房发生率较高,常见原因是房水滤过过畅、结膜瓣渗漏及睫状体脉络膜脱离。滤过术后,眼内环境的改变,促使房水分泌减少,也是浅前房发生的重要因素,因此,小梁切除术＋MMC的浅前房发生率较高。     

青光眼小梁切除术后浅前房临床分析

目的 探讨青光眼小梁切除术后浅前房的原因及发生情况。方法 回顾总结我院1997年1月至2001年12月连续92例104只眼小梁切除术后发生浅前房的程度及原因。结果 本组发生术后浅前房16眼；占15.4％，其中结膜漏1眼(6．25％)，滤过过强11眼(68．75％)，脉络膜睫状体脱离4眼(25％)。结论 青光眼小梁切除术后浅前房原因复杂，与术前眼压关系密切，与患者年龄及青光眼类型无关，最常见的原因是房水滤过过强。     

青光眼滤过手术后并发症原因分析及处理方法

目的：探讨青光眼滤过手术后发生并发症的原因及处理方法。方法：对接受滤过手术治疗的60例（60只眼）青光眼患者，术后10例（10只眼）发生浅前房，前房出血，虹膜睫状体炎的原因进行临床分析，结果：60只眼中，浅前房3只眼，发生率为5．0％，前房出血4只眼发生率为6．7％，虹膜睫状体炎3只眼发生率为5．0％，采用加压包扎、扩瞳抗炎，激素等治疗后均恢复，浅前房形成、前房出血、虹膜炎症全部吸收。结论：明确青光眼滤过手术后并发症的原因，并采用积极的治疗措施，可达到预防及治疗的目的。     

青光眼术后浅前房的原因分析及其治疗

目的 探索青光眼手术后浅前房的发生原因及其治疗。方法 回顾分析青光眼手术总者412例468眼发生浅前房的比率、发生时间、类型及处理方法，分析各类型青光眼和手术方式对术后浅前房的影响。结果 青光眼术后浅前房146眼占31．2％，闭角型青光眼术后发生率较高占36．6％，青光眼建过手术后易引起浅前房。浅前房发生在术后1—7天，房水引流过畅占80．8％，原因不明占12．3％脉络废脱离占4．1％，结膜伤口渗漏占．2．7％。3眼行结膜辫修复恢复前房，6眼行品状体囊外摘除恢复前房，其余保守治疗。结论 青光眼滤过手术后浅前房发生率最高，其最常见的原因是房水滤过过强。通过不同方法的治疗，效果满意。     

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.