玻璃体切除联合硅油充填术对矫正视力及屈光状态的影响

目的 探讨玻璃体切除联合硅油充填术对患者矫正视力及屈光状态的影响。方法 回顾分析40例玻璃体切除联合硅油充填术的患者术前术后的验光处方，所有患者均于术后3-6个月行硅油取出，术后随访2个月～1年。结果 矫正视力明显提高的77．2％；未发生明显变化的占12．0％；矫正视力降低的占10．8％；屈光状态变化：术后眼总屈光度降低的占43．9％，眼总屈光度平均降低（＋5．95±0．005）D；眼总屈光度增加的占24．4％，眼总屈光度平均增加（44．20±0．005）D；未发生明显变化的有5眼，占12．2％；数据不详的有7眼，占19．5％。结论 玻璃体切除联合硅油充填术对提高患者矫正视力的提高有着积极的作用。相对于术前来说，玻璃体切除联合硅油充填术患者术后的眼总屈光度改变由于受诸多因素的影响而变化不一，但眼总屈光度降低的比率相对较多。     

硅油对玻璃体视网膜手术屈光状态的影响

目的：分析硅油对玻璃体视网膜手术屈光状态的影响。方法：选择2008年3月－2013年2月到本院眼底病科进行玻璃体视网膜剥离切除手术患者,在术前、玻切硅油充填术后12周、硅油取出术后12周,分别进行诊断验光和A型超声检查,进行统计分析。结果：A超检查,眼轴长度在术前和充填硅油后12周之间以及充填硅油后12周和取出硅油后12周之间有显著统计学差异（ P＜0．05）;屈光度在术前、充填硅油后12周、取出硅油后12周之间,均有明显的统计学差异（P＜0．05）。结论：硅油填充术后眼的屈光状态明显趋于远视,如果患者有视力矫正要求可短暂给予远视屈光矫正。而硅油取出后,眼的屈光状态趋于近视,平稳后可以长期给予近视屈光矫正。     

三种方法测算硅油填充状态下人工晶状体屈光度数准确性分析

目的：比较三种不同方法测算硅油填充状态下人工晶状体的屈光度数的准确性。方法选取2012年3月～2012年12月在本院施行硅油取出联合白内障超声乳化（或囊外摘除）并人工晶状体植入手术的患者42例42只眼。按术前人工晶状体设计的方法不同分成3组,A组12例,采用硅油填充术前测定人工晶状体度数的结果作为参考值;B组17例,采用硅油填充状态下健侧眼眼轴长度,硅油填充眼角膜曲率,计算出人工晶状体度数。 C组13例,采用IOL-Master测量硅油填充眼眼轴计算人工晶状体度数。分析A、B、C三组术后屈光度与预期值的差值分布情况,并比较三组之间的差异。结果术后屈光度与预期值的差值A组（2.33±1.02）D,B组（4.03±1.52）D,C组（0.46±0.38）D。三组之间有显著差异（F＝36.522,P＝0.000＜0.01）。 C组优于A组和B组,A组优于B组。结论 IOL-Master测算硅油眼并发白内障状态下人工晶状体度数的准确性高于玻璃体切割硅油填充术前测定人工晶状体度数,而根据健侧眼眼轴测算人工晶状体度数的准确性最低。     

硅油取出对术眼屈光状态影响分析

目的:分析硅油取出对术眼屈光状态影响。方法:收集硅油取出术的病例共143眼,分别对患眼行硅油填充术后3个月及硅油取出术后3个月的眼部A超测量及诊断验光结果进行统计学分析。结果:眼轴长度在硅油填充术后3个月和取出术后3个月之间有明显的统计学差异(P0.05);屈光度在二者之间也存在显著统计学差异(P0.05)。结论:硅油填充眼的屈光状态明显趋于远视,如果患者有视力矫正要求可给予远视屈光矫正,而硅油取出术后患眼屈光状态趋于近视,待眼部病情平稳可给予近视屈光矫正治疗。     

近视眼LASIK术后角膜曲率动态变化

目的分析近视眼LASIK术后角膜曲率的动态变化和屈光状态、视力变化的关系。方法近视44例（88只眼）均采用标准LASIK治疗,术后1周、1、3、6月随访,记录术前术后角膜曲率、屈光状态、视力,并进行统计学处理。结果角膜曲率和屈光状态从术后1周～3月各期回退显著（P〈0.001）,3～6个月趋于稳定（P〉0.05,P〉0.5）;术后视力1月内稳定（P〉0.5）,1～3月下降有显著性（P〈0.01）,3～6个月趋于稳定（P〉0.1）。结论近视眼LASIK术后角膜曲率3个月内回退较显著,3～6个月趋于稳定,屈光状态和视力随着角膜曲率的变化而相应变化。角膜曲率的长期稳定性需进一步观察。     

Haigis-L公式在角膜屈光手术后人工晶状体度数计算中的应用

目的 分析应用Haigis-L公式计算角膜屈光手术后人工晶状体植入度数的准确性.方法 收集角膜屈光手术后患者25 例(30只眼),按计算方法不同分为观察组和对照组,观察组(15只眼)应用Haigis-L公式进行度数计算,对照组(15只眼)应用回归公式法计算角膜曲率,修正计算应用SRKT公式进行人工晶状体度数计算,比较两组患者超声乳化白内障吸除术后1个月的屈光度数与术前的预期屈光度数差值.结果 两组患者白内障术前人工晶状体度数差异无统计学意义(P=0.696);超声乳化白内障吸除术后1个月的屈光度与术前预期目标屈光度误差差异有统计学意义(P＜0.05).结论 应用Haigis-L公式计算角膜屈光手术后行超声乳化白内障吸除术时植入人工晶状体度数的准确性相对较高.     

IOL-Master测量硅油眼眼轴长的精确度评价

  目的 评价IOL-Master测量硅油填充眼眼轴长的精确度。方法 采用IOL-Master测定玻璃体切割联合眼内硅油填充术3-~6个月后行硅油取出术的30例眼的眼轴长度。其中18例在硅油取出同时植入人工晶体（IOL）,植入前后分别测量眼轴长。结果 硅油取出术前后的眼轴平均长度分别为（24.27±3.01 01）mm和（24.26±2.79 79）mm,两组间差异无统计学意义。IOL-Master和A超两种方法测量硅油眼的眼轴长度无显著差异超2种方法测量硅油眼的眼轴长度无显著差异。结论 IOL-Master测量硅油眼眼轴长的精确度高,可用于硅油取出联合IOL植入的IOL度数计算。     

A超测量硅油填充眼眼轴及人工晶状体度数的临床评价

目的评价A超经修正后测量硅油填充眼眼轴及人工晶状体（IOL）度数的准确性。方法应用我院现有的法国QUANTELMEDICAL公司的CompattachIIA／B超声仪采用实验的方法对超声波在纯Ox5700型硅油、患者眼中取出的硅油及平衡盐溶液中的传播速度进行测量及比较,进而对眼轴值进行修正,最终推算出准确的人工晶状体度数。选取25例行玻璃体切割伴硅油填充术的患者,应用公认0x5700型硅油的测量值对患眼进行眼轴的测量,再用我们实验所得到的测量值分别对患眼进行坐位及平卧位的眼轴测量,最后将坐位时测出的跟轴长度代入SRKⅡ公式计算拟植入的人工晶状体度数。行硅油取出术联合白内障摘除＋人工晶状体植入术。术后3个月测量患眼的眼轴、最佳矫正视力及屈光状态。对手术前后眼轴长度及最佳矫正视力进行对比,将术后屈光状态与术前预期值比较。结果纯Ox5700型硅油的比色杯宽度为（31．440±0．011）mm,患眼中取出硅油的比色杯宽度为（31．420±0．047）mm,两者间差异无统计学意义（P〉0．05）。平衡盐溶液的比色杯宽度为21．07mm。取油前,硅油填充眼的玻璃体腔的传播速度设置为990m／s时的患眼平均眼轴长度为（23．219±0．125）mm。传播速度设置为1027in／s时坐位测量患眼平均眼轴长度为（24．103±0．135）mm,平卧位患眼平均眼轴长度为（24．116±0．128）mm。取油后患眼平均眼轴长度为（24．018±0．135）mm。硅油的传播速度设置为1027m／s时坐、卧位测量的眼轴值同取油后患眼的眼轴值差异无统计学意义（P〉0．05）。传播速度设置为990m／s时的测量值与取油后眼轴长度及传播速度设置为1027m／s时测量的眼轴长度差异有统计学意义（P〈0．05）。手术后屈光度与术前预期值差值平均为（-1．50±2．00）D,差异无统计学意义（P〉0．05）。结论A超经修正后可准确测量硅油填充眼的眼轴长度,进而准确推算出硅油填充眼的IOL度数,A超测量硅油填充眼眼轴及IOL度数是相对准确、安全、方便的方式,但各医院应对自身的仪器及材料进行实验测量,进而得出更加适合本院的实验数值。     

基于对侧眼眼轴计算硅油眼人工晶体度数的准确性

目的：探讨使用对侧眼眼轴计算硅油眼患者人工晶体度数的准确性。方法：将拟行硅油取出联合白内障超声乳化吸除及人工晶体植入术的患者60例（60眼）随机分为A、B、C组。A组20例,硅油填充眼直接使用光学相干生物测量仪IOL-Master计算人工晶体度数;B组20例,使用IOL-Master测量对侧眼眼轴长度和硅油眼角膜曲率,计算人工晶体度数;C组20例,使用患眼硅油填充前IOL-Master测量的眼轴长度和硅油眼角膜曲率,计算人工晶体度数。三组均使用SRK/T公式计算人工晶体度数并植入相应度数晶体。术后1个月测量实际屈光度,并与预期屈光度比较,计算绝对屈光误差（MAE）,观察使用三种方法计算人工晶体度数的准确性。结果：角膜曲率：纳入研究患者硅油填充前、硅油填充后角膜曲率分别为（43.29±0.85）D、（43.52±1.05）D,差异无统计学意义（t=1.690,P>0.05）;A、B、C三组硅油填充眼角膜曲率分别为（43.26±0.57）D、（43.53±1.04）D、（43.78±1.39）D,差异无统计学意义（F=1.238,P>0.05）。眼轴长度：纳入患者硅油填充前、硅...     

玻璃体切除手术与角膜内皮损伤关系的研究

目的 :探讨玻璃体切除手术方式与角膜内皮细胞损伤的关系。方法 :观察 2 6只眼行玻璃体切除术 +硅油填充术 ,2 2只眼行玻璃体切除术 +晶状体摘除术 +硅油填充术 ,术前 ,术后 1周、1月、2月、3月内皮细胞动态变化。结果 :有晶体眼者行玻璃体切除术 +硅油填充术 ,手术前后角膜内皮细胞密度、六角形细胞出现率、内皮细胞丢失率差异无统计学意义。无晶体眼者行玻璃体切除术 +硅油填充术 ,手术前后角膜内皮细胞密度、六角形细胞出现率、内皮细胞丢失率差异有统计学意义。结论 :在施行玻璃体切除术时 ,晶体完整性对角膜内皮有保护作用     

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.