倍频532nm激光治疗不同分期糖尿病视网膜病变

目的 探讨倍频532 nm 激光光凝术治疗不同分期糖尿病视网膜病变(DR)患者的临床疗效.方法 70例140眼DR患者,其中非增生期(NPDR)组58眼,增生前期(PPDR)组32眼,早期增生期(早期PDR)组29眼,高危增生期(高危PDR)组21眼,NPDR组行次全视网膜光凝术,PPDR及早期PDR组行标准全视网膜光凝术,高危PDR组行超全视网膜光凝术.术后随访观察光凝术后患者的视力、眼视网膜疗效等的变化.结果 NPDR组、PPDR组、早期PDR组激光光凝后平均视力均有明显提高,视力有效率分别为79.3%、75%和75.8%,3组比较差异无统计学意义(P>0.05);高危PDR组平均视力有不同程度的提高,视力有效率为33.3%,与其他3组比较差异有统计学意义(P<0.05).视网膜病变激光光凝治疗有效率NPDR组、PPDR组、早期PDR组分别为82.8%、81.2%和75.9%,3组比较差异无统计学意义(P>0.05);高危PDR组治疗有效率为47.6%,与其他3组比较差异有统计学意义(P<0.05).结论 倍频532 nm 激光光凝能有效地治疗不同分期DR,NPDR、PPDR、早期PRD的患者疗效明显优于高危PDR的患者.     

倍频532nm激光光凝治疗糖尿病视网膜病变的疗效观察

目的:评价倍频532 nm激光光凝术治疗糖尿病视网膜病变(DR)的安全性和有效性,并探讨其治疗时机。方法:根据DRPS制定的治疗技术规定,应用倍频532 nm激光对57例(109眼)分别为增殖前期糖尿病视网膜病变(PPDR)、早期增殖性糖尿病视网膜病变(早期PDR)、高危增殖性糖尿病视网膜病变(高危PDR)及糖尿病性黄斑水肿(DME)患者行次全视网膜光凝(S-PRP)、标准全视网膜光凝(S-PRP)、超全视网膜光凝(E-PRP)及局限性或格栅样光凝,术后1、3、6 mo行眼底彩色照相和眼底荧光血管造影(FFA)检查,对有新生血管(NV)、无灌注区(NP)及视网膜水肿未消失者酌情追加光凝,并记录视力变化和视网膜病变进展情况。结果:视力变化情况:PPDR组有效率为88.9%,早期PDR组有效率为78.1%,高危PDR组有效率为57.1%,PPDR组明显高于PDR组(P<0.05);视网膜病变进展情况:PPDR组有效率为92.1%,早期PDR组有效率为81.3%,高危PDR组有效率为64.3%,PPDR组明显高于PDR组(P<0.05)。结论:倍频532 nm激光治疗DR安全、有效,增殖前期进行激光光凝效果更佳。     

氩激光凝固法对糖尿病性视网膜病变的疗效观察

目的观察糖尿病性视网膜病变(DR)不同分期者接受氩激光治疗的临床效果。方法采用科以人2000型氩激光组合激光机对170例263只患眼分别做如下处理:(1)对非增殖期糖尿病视网膜病变(NPDR) 30眼行局部氩激光凝固术(光凝);(2)对增殖前期糖尿病视网膜病变(PPDR) 156眼行次全视网膜光凝;(3)对增殖期糖尿病视网膜病变(PDR ) 77眼行全视网膜光凝,对合并黄斑局限或弥漫性水肿者给予局灶性光凝或格栅样光凝。于光凝后3个月检查,进行视力、眼底、视网膜荧光血管造影,并与治疗前各项结果对比。结果视力提高92眼(35%)、无变化144眼(55%)、下降27眼(10%)。眼底检查、荧光血管造影复查示:NPDR、PPDR眼视网膜微血管瘤、水肿、渗出消退,荧光渗漏消退占89%,其余11%需补充光凝。PDR眼视网膜、视盘新生血管消退占67%,33%为部分消退需补充光凝。黄斑水肿完全或部分消退占91%,光凝后出现视网膜前灶性出血占8%,玻璃体积血为1%。结论氩激光对不同分期DR均有效。NPDR、PPDR效果好于PDR眼,后者光凝后荧光血管造影复查以及补充光凝对提高疗效非常必要。     

糖尿病性视网膜病变激光治疗的视力预后

目的：探讨糖尿病视网膜病变(diabetic retinopathy,DR)不同分期的患者视网膜激光治疗的视力预后。方法：根据糖尿病性视网膜病变视网膜光凝研究组(Diabetic Retinopathy Photocoagulation Study Group,DRPS)治疗技术规定,将138例（210眼）分别为非增殖期糖尿病视网膜病变(nonproliferative diabetic retinopathy,NPDR)、增殖前期糖尿病视网膜病变(preproliferative diabetic retinopathy,PPDR)、增殖期糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)的患者行视网膜激光光凝治疗,术后3～6个月监测视力变化,并行眼底荧光血管造影(fundus fluorescence angiography,FFA)检查,观察荧光素渗漏、毛细血管无灌注区、微血管瘤及新生血管等有无消退,酌情补充光凝。随访6～24个月。结果：经过激光光凝治疗后NPDR期视力提高和不变占95.83%,PPDR期视力提高和不变占91.67%,PDR期视力提高和不变占73.81%。3～6月后复查FFA显示,NPDR期有效占95.83%,PPDR期有效占78.33%,PDR期有效占60.31%。结论：DR的不同分期行视网膜激光光凝治疗后视力预后不同,因此,选择合适的时机和合理的激光参数对不同分期DR尤其是伴有黄斑水肿的DR患者进行视网膜激光光凝治疗,是挽救其视功能的关键。     

氩激光凝固法对糖尿病性视网膜病变的疗效观察

目的 观察糖尿病性视网膜病变(DR)不同分期者接受氩激光治疗的临床效果。方法 采用科以人2000型氩激光组合激光机对170例263只患眼分别做如下处理：(1)对非增殖期糖尿病视网膜病变(NPDR)30眼行局部氩激光凝固术(光凝)；(2)对增殖前期糖尿病视网膜病变(PPDR)156眼行次全视网膜光凝；(3)对增殖期糖尿病视网膜病变(PDR)77眼行全视网膜光凝，对合并黄斑局限或弥漫性水肿者给予局灶性光凝或格栅样光凝。于光凝后3个月检查。进行视力、眼底、视网膜荧光血管造影，并与治疗前各项结果对比。结果 视力提高92眼(35％)、无变化144眼(55％)、下降27眼(10％)。眼底检查、荧光血管造影复查示：NPDR、PPDR眼视网膜微血管瘤、水肿、渗出消退，荧光渗漏消退占89％。其余11％需补充光凝。PDR眼视网膜、视盘新生血管消退占67％，33％为部分消退需补充光凝。黄斑水肿完全或部分消退占91％，光凝后出现视网膜前灶性出血占8％，玻璃体积血为1％。结论 氩激光对不同分期DR均有效。NPDR、PPDR效果好于PDR眼，后者光凝后荧光血管造影复查以及补充光凝对提高疗效非常必要。     

多波长氪激光治疗不同分期糖尿病视网膜病变

目的探讨多波长氪激光治疗不同分期糖尿病视网膜病变的临床疗效。方法60例110眼糖尿病视网膜病变(DR)患者,其中增殖前期糖尿病视网膜病变(PPDR)18眼,早期增殖期糖尿病视网膜病变(PDR)58眼,高危PDR34眼,依病变程度行次全视网膜光凝术、标准全视网膜光凝术和超全视网膜光凝术。术后随访6～32个月,观察视网膜光凝后患者的视力、眼底及荧光血管造影变化。结果治疗后PPDR患者、早期PDR患者视力提高或不变者分别占88.9%、87.9%,均显著高于高危PDR患者的73.5%(P值均<0.05)。初次视网膜光凝后,PPDR患者、早期PDR患者的有效率分别为94.5%、91.3%,均显著高危PDR患者的41.1%(P值均<0.05)。结论多波长氪激光治疗不同分期糖尿病视网膜病变有效,且PPDR和早期PDR治疗效果好。     

倍频532nm激光治疗糖尿病视网膜病变疗效评价

目的:观察倍频532 nm激光治疗糖尿病视网膜病变(DR)的疗效。方法:回顾性分析用倍频532 nm激光对78例不同分期的糖尿病视网膜病变患者(112眼)行视网膜光凝(RP)治疗。结果:视力提高者32只眼(28.6%),视力下降者34只眼(30.4%),视力无明显变化者46只眼(41.1%);FFA检查,治疗有效者88只眼(78.6%),无效者24只眼(21.4%);黄斑水肿65只眼经治疗55只眼(84.6%)水肿明显消退或消失,6只眼(9.2%)无明显变化,4只眼(6.2%)水肿加重。结论:倍频532 nm激光光凝治疗糖尿病视网膜病变安全可靠,可以有效预防患者视力丧失。     

倍频532nm激光治疗糖尿病视网膜病变75例报告

目的:观察倍频532nm激光视网膜激光光凝术治疗糖尿病视网膜病变(DR)的疗效.方法:应用倍频532nm激光对75例(123眼)Ⅲ和Ⅳ期DR患者进行视网膜光凝治疗.光凝共分4次完成.术后随访6～24个月不等.结果:治疗后64眼(52%)视力提高,49眼(39.9%)视力无变化,10眼(8.1%)视力下降.黄斑水肿70眼中,36眼(51.4%)完全消退,22眼(31.4%)部分消退,12眼(17.2%)加重.结论:倍频532nm激光视网膜激光光凝术治疗DR有效,对有激光治疗指征的患者应及时行激光治疗.     

不同分期糖尿病视网膜病变激光治疗疗效分析

目的 观察激光治疗对不同分期糖尿病视网膜病变(DR)患者的疗效及预后.方法 根据2003年DR国际临床分级标准对DR患者102例(192眼)进行分期,中度非增生性糖尿病性视网膜病变(NPDR)41眼、重度NPDR 83眼及增生性糖尿病性视网膜病变( PDR)68眼.参照早期治疗DR研究组规定,采用氪激光对中度NPDR行次全视网膜光凝,重度NPDR及PDR行标准全视网膜光凝;记录激光术前及激光治疗至少半年的最佳视力、眼底及荧光眼底造影检查变化情况.新生血管未消退和无灌注区残留追加光凝治疗,术后随访6～18个月.根据视力标准及荧光血管造影标准判定疗效,并进行视力及视网膜病变进展情况比较.结果 中度NPDR视力提高和不变37眼,占90.24％,重度NPDR视力提高和不变65眼,占78.31％,PDR视力提高和不变48眼,占70.59％,3组治疗有效率比较,差异有统计学意义(P＜0.01).视网膜病变激光光凝治疗有效率中度NPDR组为95.12％,重度NPDR组为85.54％,PDR组为77.94％,3组治疗有效率比较,差异有统计学意义(P＜0.01).结论 不同分期DR全视网膜光凝治疗后预后不同,选择合适的时机进行有效的光凝治疗是稳定视力和眼底病变的关键.     

白内障摘除联合人工晶体植入术后糖尿病视网膜病变的激光治疗

目的:探讨白内障摘除联合人工晶体植入术后糖尿病(DM)视网膜病变的激光治疗效果。方法:白内障摘除联合人工晶状体置入术后120例DM网膜病变患者(180眼)均采用经眼底荧光血管造影(FFA)确定为增殖前期DM视网膜病变(PPDR)40眼、增殖期DM视网膜病变(PDR)140眼,采用全视网膜光凝治疗,随访6～24个月。结果:患者视力、视网膜病变改善的有效率为73.9%、76.1%。3个月后复查视力、眼底、FFA及彩色眼底像,新生血管大部分萎缩,视网膜水肿消退,无灌注区残留补充激光光凝。无黄斑水肿组治疗后的视力显著优于有黄斑水肿组,P<0.05。结论:白内障摘除联合人工晶状体置入,及时合理的激光治疗是确保DR患者视力稳定,降低致盲率的关键。     

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.