应用单眼瞳距验光配镜的意义

目的:分析单眼瞳距差异的量在人群中的分布。方法:对1410例验光配镜患者应用雄博PD--6瞳距仪测量单眼瞳距,统计学方法分析单眼瞳距差异的量在人群中的比例。结果89.01%的人单眼瞳距有差异,其中94.18%的人单眼瞳距差异量集中分布在0.5～2.5mm之间。结论:通过大样本调查,接近90%单眼瞳距不等,配镜时选用单眼瞳距更科学,患者满意度更高。     

分析瞳距尺与视线距方法测量瞳距

目的:比较和分析视线距方法和瞳距尺方法测量瞳距值的差别及其影响。方法:分别用视线距方法和瞳距尺方法对200例患者进行瞳距的测量。结果:根据比较和分析,外隐斜的瞳距用视线距方法比瞳距尺方法小0.66mm。内隐斜的患者视线距方法比瞳距尺方法大0.38mm。正位眼的患者视线距方法比瞳距尺方法大0.01 mm。结论:棱镜度为:根据公式P=FS可得出,在F一定的情况下,S越大,P值就越大;在S一定的情况下,F值越大,P值就越大。两种方法测出的瞳距结果存在差别,长时间配戴不合适的眼镜会引起视疲劳,更严重者引起头晕、头痛等,无法正常工作学习。建议广泛推广和采用视线距方法测量瞳距。     

视力正常眼的瞳距与近视眼瞳距的差异

对600名大、中、小学生进行了瞳距测量。对照了视力正常者与近视眼者之间的差别。检测分三个年龄组进行,各随机抽样100名,经P值测定表明,两者具有显著性差异。近视眼的总的平均瞳距大于视力正常者。     

青岛与呼和浩特地区4971例儿童少年瞳距测量

目的 :调查青岛与呼和浩特两地区儿童少年瞳距发育情况 ,研究儿童少年瞳距生长发育规律。方法 :对青岛和呼和浩特地区 4 971例 5～ 17岁儿童少年进行横断面调查 ,用游标卡尺测瞳距并对结果进行分析。结果 :青岛地区 5～ 17岁儿童少年瞳距从 5 2 .0 7mm增至 6 0 .19mm ,呼和浩特市的儿童少年瞳距从 5 0 .4 7mm增至 5 9.39mm ,两地区男性瞳孔距离均大于女性 (P <0 .0 1) ,青岛地区瞳距均数为 5 7.0 3mm ,大于呼和浩特地区 5 6 .2 8mm(P <0 .0 1)。结论 :两地区儿童和青少年瞳距的生长发育经历了 6～ 9岁及 10～ 15岁 2个高峰 ,男性 16岁 ,女性 14岁的瞳孔距离已达成人水平     

呼和浩特市青少年瞳距发育情况调查分析

目的:调查呼市地区青少年瞳距发育情况,以探讨其是否具有民族差异性,及其在配镜中的应用价值。方法:对呼和浩特市1308名15~19岁青少年(在校学生)进行调查,用瞳距尺测量瞳距并将其结果进行统计学分析。结果:呼市地区青少年瞳距发育没有民族差异性,准确测量瞳距值在配镜中具有重要意义。     

散瞳与小瞳电脑验光在LASIK手术的应用分析

目的探讨患者散瞳与小瞳电脑验光屈光状态的变化及其临床应用。方法先散瞳电脑验光及综合验光仪检查,然后再小瞳电脑验光及综合仪检查。观察其结果的变化情况并进行统计学分析。结果小瞳电脑验光比散瞳电脑验光近视球镜度高-0.36D±0.31D,差异有非常显著意义(P<0.01),散光度无显著差异(P=0.39),轴向相差3°(中位数)。结论小瞳电脑验光比散瞳电脑验光近视球镜度偏高,散光度及轴向无明显改变,电脑验光可用于LASIK手术前屈光状态检查。     

贝宁6-17岁儿童青少年瞳距、外眦距离、内眦距离正常值及发育规律

目的　了解贝宁儿童青少年瞳距、外眦距离、内眦距离的发育规律,获得西非贝宁地区儿童青少年眼外形相关数据。方法　对贝宁洛克萨市6 - 17岁儿童青少年采取随机整群抽样进行调查,每两岁为一年龄组,每组男女各抽样10 0例。利用钢板尺,对其瞳距、外眦距离、内眦距离进行活体测量。结果　瞳距男性为(6 2 .97±4 .5 9)mm ,女性为(6 2 .0 4±4 .18)mm。外眦距离男性(91.4 3±5 .4 1)mm ,女性为(89.97±5 .6 5 )mm。内眦距离男性(31.6 8±3.17)mm ,女性为(31.39±3.0 8)mm。瞳距、外眦距离各年龄组的平均值男性大于女性。瞳距、外眦内眦距离随年龄的增长而增大,增大趋势呈阶段性。结论　西非贝宁地区儿童青少年的瞳距、外眦内眦距离发育在12岁前有一个生长突增期,其生长规律符合神经系统的生长发育模式。     

间歇性外斜视与近视发展关系的研究

目的 探讨间歇性外斜视(IXT)与近视发展的关系.方法 将56例IXT患者分为3组,儿童组24例(3～9岁)、少年组15例(10～18岁)、成人组17例(19～39岁).应用红外自动验光仪测定在单眼视和双眼同时视状态下的等效球镜屈光度和调节反应,各年龄组进行比较,并与年龄进行相关性分析.结果 各组单眼和双眼同时视状态下屈光度比较差异均有统计学意义(P＜0.05);双眼同时视和单眼视状态下的屈光度变化(△R)在成人组[(1.31±0.38)D]较儿童组的[(0.47±0.43)D]和少年组的[(0.62±0.27)D]均明显增加,差异有统计学意义(P＜0.05).△R和年龄呈正相关(r=0.699,P=0.000);调节反应与年龄呈负相关(r=-0.407,P=0.002).调节反应量(AR)成人组[(-1.87±1.35)D]较儿童组的[(-0.78±1.00)D]和少年组的[(-0.82±1.28)D]调节超前趋势显著增加,差异有统计学意义(P=0.012).结论 IXT患者为维持双眼视轴平行做出过度的调节,表现为调节超前,可能是导致IXT患者出现调节性近视的潜在因素.儿童的相对调节与相对辐辏幅度较大,调节性近视不明显;而成人调节力和融合力下降,可能更易出现调节性近视.     

内直肌后徙术治疗分开不足型内斜视的疗效观察

  目的   研究内直肌后徙术对分开不足型内斜视的治疗效果。   方法   回顾性研究2017年12月?2020年6月于上海交通大学医学院附属新华医院行内直肌后徙术的9例分开不足型内斜视患者资料,随访至少1年,观察患者术后视近、视远斜视角及视功能。   结果   9例患者平均年龄28. 8岁（10～49岁）,其中18岁以下青少年患者有3例。9例患者术前视近斜视角为（+19.8±13.2） PD,视远斜视角为（+32.6±15.3） PD,术后1年视近斜视角为（?0.2±3.5） PD,视远斜视角为（+5.8±5.6） PD,均较术前显著改善（P=0.012,P=0.007）。 术前视近视远斜视角度差为（12.8±2.4） PD,术后1年为（6.0±2.2） PD,有明显改善（P=0.008）,回退不明显（F=0.075,P=0.900）。患者术后近立体视改善不明显（P=0.306）,视远双眼单视功能改善,差异有统计学意义（Worth4点灯P=0.017;Bagolini线状镜P=0.035）。根据患者年龄分为青少年组（≤18周岁,n=3）及成年组（>18周岁,n=6）,青少年组术前的球面屈光度平均值（右眼?1.75 D,左眼?1.92 D）较成年组（右眼?6.17 D,左眼?6.04 D）低（P=0.012）。术前调节性集合与调节的比值（AC/A）的平均值青少年组为4.33;成年组平均值为2.33,低于正常值,且较青少年组降低（P=0.12）。青少年组与成年组手术前后视近视远斜视角及其差值差异均无统计学意义。   结论   内直肌后徙术能够改善分开不足型内斜视的视近视远斜视角度差及视远双眼单视功能,视近斜视角及视远斜视角易回退,因此应加大手术量。      

电脑验光、综合验光仪验光及试戴三者度数的比较研究

目的 :比较电脑验光、综合验光仪验光及试戴三者度数之间的关系。方法 :本组选取年龄≥ 1 4岁、双眼屈光度 (等效球镜 )差 <2 .5D及排外斜弱视的屈光不正患者 1 82人 (36 4眼 ) ,分别经电脑验光、综合验光仪验光及试戴 ,比较三者度数之间的差异性 ,包括球镜度数、散光度数及散光轴向之间的比较。结果 :经SPSS统计学软件配对资料t检验及秩和检验 ,综合验光仪验光度数、试戴度数与电脑验光度数比较有显著性差异 (P <0 .0 5 ) ,综合验光仪验光度数与试戴度数之间无显著性差异 (P >0 .0 5 )。结论 :综合验光仪是一种科学的、更符合人的生理与实际的验光仪器 ,其结果更为精确 ,而电脑验光仪虽具有迅速验光的优点 ,但其结果并不能作为最终配镜处方     

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.