儿童眼外伤综合分析

近年来,儿童眼外伤由于患者所在地区不同,来院就诊时机也不同。现将我院1978年1月-2007年12月2398例儿童眼外伤患者发病特点、治疗及预防等方面作一初步分析。1临床资料 1．1一般资料本组2395例儿童眼外伤中男1823例（76．02％）,女575例（23．98％）。学龄前（0～7岁）951例（39．66％）,学龄儿童（〉7岁）1447例（60．34％）。     

机械性眼外伤135例治疗体会

机械性眼外伤是眼科急诊中的常见病，常伴有复合性损伤，有时治疗比较困难是现在致盲的主要原因之一。我院近十年来共收治机械性眼外伤135例。共138只眼治疗及体会如下：1资料与方法1.1一股资料135例中男性113例．女性22例．男女之比为5．1比1。年龄最小的4周岁．最大的65周岁。右眼81例，占58.70％．左眼57例，占41．3％．双眼3例占135例中的2．2％。1.2致伤原因以工作中意外为最多．其次是斗殴、玩耍时不慎所致．其中工人78例,占57.8％:一般职业（包括农民）38例占28.1％：学生15例．占11．1％：儿童4例,占3．0％。1.3就诊时间受伤后24小…     

湘西地区儿童眼外伤的临床分析

目的：探讨湘西地区儿童眼外伤致盲的影响因素。方法：将194例（201眼）儿童眼外伤的临床资料进行回顾性统计分析。结果：湘西地区儿童眼外伤具有以下特点：3—12岁患儿占77．32％,男女比例3．73：1,致伤物种类多;农村患儿占73．71％,留守儿童占62．24％,以寒暑假为高峰;就诊较晚,24小时内就诊占49．48％,5天以上就诊占28．35％;眼穿通伤占55．22％。⑤眼并发症及后遗症多且复杂;轻损伤感染致盲多。结论：儿童眼外伤后早期及时正确的诊治是减少感染机会和并发症,抢救残存视力,降低致盲率的重要环节,更要注重预防。     

昆明市儿童医院眼科门诊患者构成分析与思考

2003年1月至2007年12月间，昆明市儿童医院眼科门诊就诊患者110239例，按照疾病分类对患者资料进行统计学分析。男61613例，女48626例，平均7．35岁，7岁以下73286人（66．48％）。其中正常15237例（13．82％），屈光不正45999例（41．73％），眼睑和结膜有炎性疾病29981例（27．20％），先天性泪道阻塞8333例（7．56％），斜、弱视4428例（4．01％），倒睫967例（0．88％），上睑下垂388例（0．35％），角膜疾病297例（0．27％），白内障158例（0．14％），先天性青光眼54例（0．05％），眼外伤737例（0．67％），其他疾病3660例（3．32％）。寒暑假就诊人数占就诊总数的42．98％，非昆明本市就诊者占62．21％。     

太原市103例眼外伤临床分析

目的通过对眼外伤各相关因素的分析,探讨太原市眼外伤防治方法。方法收集2011年2月-2013年8月在眼科住院的病例,进行回顾性研究。结果103例眼外伤住院病例中,男女之比为4．15：1,男性显著高于女性（P〈0．01）,发病年龄以青壮年（21～41岁）居多,职业主要以工人和农民为主,眼外伤常见的致伤原因主要为拳击及钝器伤、摔伤、车祸。眼外伤并发症中以前房积血、眼睑复杂裂伤、眶壁骨折多见,治疗后致盲率为25％。结论眼外伤是单眼致盲的主要原因之一,并发症多,积极预防和正确的救治是降低致盲率的关键。     

玻璃体视网膜手术联合超声乳化吸出治疗严重眼外伤

目的探讨玻璃体视网膜手术联合超声乳化吸出治疗严重眼外伤的疗效。方法回顾性分析我院2003年1月至2004年2月期间共收治的36例（36眼）严重眼外伤行玻璃体视网膜手术＋超声乳化吸出术的临床资料。结果随访1-2年，大部分病例保持了眼球外形和一定的视力，其中视力〈0．013眼（占8％），0．01～0．047眼（占19％），0．04～0．115眼（占42％），0．1～0．36眼（占17％），0．3—0.52例2眼（占5％）：4例（占11％）术后无光感。结论严重眼外伤病情复杂危急，对视功能损伤大，及时对症的玻璃体视网膜手术及超声乳化吸出术是保存患眼。挽救视力的重要治疗手段。     

儿童外伤性白内障临床分析

外伤性白内障是眼外伤的主要并发症，多发生于儿童及青壮年，直接影响患者视力。如何选择适当的手术，提高复明效果，形成双眼单视，一直是我们眼科工作者努力的方向。现将我科1994-1997年收治的29例（29眼）儿童外伤性白内障报告如下：，l资料和方法1.l一般资料1994-1997年我科收治的儿童外伤性白内障29例（29眼），均为男性，年龄4-14岁。其中刀、剪刺伤Ic例，木棍戳伤9例，弹弓击伤2例，石子击伤2例，炮炸伤4例，猫头鹰啄伤1例，绳子击伤1例。1.2手术方法手术采用局麻或全麻，均在同光袖手术显微镜下进行。根据晶体后囊及眼后段的情况，…     

疣状胃炎41例临床分析

为了解疣状胃炎（VG）的临床特点，现将我院1995年1月～1998年5月经纤维胃镜检查确诊的VG41例分析报告如下。II＆床资料互！一般资料41例中，男22例，女19例，男：女为1．16：1．年龄17～65岁，平均43．7岁。职业：农民19例（46．34％），工人13例（31．71％），无业人员5例（12．19％），干部3例（7．32％），教师1例（2．44％）。l·2病史与临床表现本组病例均因上消化道症状接受检查。发病季节：l～3月13例（31，17％），4～6月17例（41．46％）．7～9月9例（ZI．95％），10～12月2例（4．88％）。病程：最短1个月，最长】0年，平均2…     

儿童与成人眼外伤临床分析

目的：比较分析儿童、成人眼外伤的危险因素．受伤状况、愈后，并提出预防措施．方法：对392例成人(18岁以上)和儿童（14岁以下)眼外伤住院病例进行回顾性分析．结果：眼外伤对眼球具有严重的破坏性，致盲率高，入院时儿童致盲率61％，成人为64．1％，其中儿童严重眼外伤发生率高，治疗后儿童致盲率达47．6％明显高于成人(30．3％)．结论：儿童眼外伤损伤严重。并发症多．治疗后致盲率比成人高．     

髋关节脱位伴髋臼骨折38例的诊治体会

目的总结髋关节脱住伴髋臼骨折的诊断经验。方法对38例髋关节脱位伴髋臼骨折的患者,先行急诊Allis法或Bige-low法整复,整复后若复住不良、移位大者,再行开放性手术治疗,或根据病情及合并症情况,选择髓内钉固定或人工关节置换术;所有病例术后随访1～7年,以评价髋关节功能恢复情况。结果本组38例中获1～7年随访结果者34例（89．47％）,综合疗效评定结果：优27例（79．41％）,良3例（8．82％）,可2例（5．88％）,差2例（5．88％）,优良率为88．23％。结论髋关节脱位伴髋臼骨折力求早期诊断,早期治疗;治疗时,既要处理好髋关节脱位及髋臼骨折,又要处理、治疗合并伤,方可有利促进髋关节功能的恢复和提高优良率。     

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.