玻璃体切除术取出眼内非磁性异物(附39例分析)

目的 :评价经玻璃体切除行眼内异物取出术治疗眼球后段非磁性眼内异物的效果。方法 :回顾性分析 1998年 9月至2 0 0 2年 3月经玻璃体切除行眼内异物取出术治疗 39例 39眼非磁性眼内异物的临床资料。结果 :39眼成功取出异物 ,成功率为 10 0 %。术后视力提高 2 9眼 (74 .36 % ) ;不变 7眼 (17.95 % ) ;下降 3眼 (7.6 9% )。术后 1个月视力 >0 .0 2者 32眼 (82 .0 5 % ) ,其中≥ 0 .1者 9眼 (2 3.0 8% )。术后有 8眼视网膜脱离复位 (72 .72 % )。结论 :经玻璃体切除行眼内异物取出术可有效地取出非磁性眼内异物 ,提高术后视力 ,同时可处理眼内异物存留的并发症     

玻璃体切割术治疗眼内异物

目的：评价玻璃体切割术治疗眼内异物的视力、手术结果及其并发症发生。方法：20眼眼内异物(15眼磁性异物,5眼非磁性异物),做了睫状体扁平部玻璃体切除和眼内异物摘除,3眼视网膜脱离做了充气性视网膜固定术,8眼外伤性白内障同时做了超声乳化白内障摘除和后房型人工晶体植入术。结果：20眼均一次取出异物。术后视力提高16眼(80％);不变3眼(15％);仅1眼(5％)视力减退;最佳矫正视力0．8～0．7。结论：玻璃体切割治疗眼内异物是一安全、有效的手术。在有选择的眼穿通伤合并眼内异物病例中,联合白内障I期后房型人工晶体植入术和玻璃体视网膜手术可以免做两次手术,其主要优点是可以一次手术就较快地恢复视力,减少患者的痛苦和费用。     

玻璃体切割术治疗复杂性眼内异物

目的探讨和评价玻璃体手术治疗复杂性眼内异物的效果和手术相关因素.方法对20例(20眼)眼内异物患者行玻璃体切割联合眼内异物摘除治疗,并行回顾性分析.结果 20眼中摘除异物18例,异物摘除率为90%,术后视力提高14眼(70%),视力不变4只眼(20%),视力下降2只眼(10%).并发症主要为视网膜脱离.结论玻璃体手术治疗复杂性眼内异物为一有效的治疗方法,能提高异物的摘除率,并同时治疗眼内多组织的损伤,促进视功能的恢复.     

玻璃体视网膜病变合并白内障的联合手术治疗

目的:探讨白内障超声乳化联合玻璃体手术治疗玻璃体视网膜病变合并白内障的临床效果以及常见并发症。方法:选择本院眼科2009年8月-2010年8月玻璃体视网膜病变合并白内障患者12例(15眼),行白内障超声乳化摘除联合玻璃体手术。术后随访3~12个月(平均6个月),对术后视力、术后并发症及其眼底病类型进行相关性分析。结果:15眼中13眼(86.7%)术后视力提高,1眼术后因玻璃体再次出血再次行玻璃体视网膜手术,1眼因取硅油后再次出现视网膜脱离复发。术后常见并发症为前房反应及高眼压。结论:白内障超声乳化联合玻璃体手术治疗玻璃体视网膜病变合并白内障安全有效,术中摘除混浊晶状体,有利于清楚观察眼内病变,决定手术方式,有利于玻璃体彻底切除和后段手术操作的顺利进行,有利于早期恢复患者视力,避免再次白内障手术。     

玻璃体切割术治疗眼内异物合并视网膜裂孔的临床效果

目的观察玻璃体切割术治疗眼内异物合并视网膜裂孔的临床效果。方法对24例(24眼)眼内异物合并视网膜裂孔患者行玻璃体切割术,取出异物、激光封闭视网膜裂孔、重水气液交换复位脱离视网膜,并行硅油填充。观察术后异物取出情况、视网膜脱离复位、并发症情况,以及手术前后视力变化。结果 24例患者Ⅰ期手术异物取出成功率为100%,患者术后视力较前明显提高(P0.05)。3例(3眼,12.5%)因合并黄斑裂孔,视力无提高;余21例(21眼,87.5%)均有不同程度视力提高。16例视网膜脱离者中14例(14眼,87.5%)成功复位,2例(2眼,12.5%)取油后复发视网膜脱离,再次手术后成功复位。结论玻璃体切除手术是治疗眼内异物合并视网膜裂孔的有效方法,其并发症少,视功能恢复良好。     

玻璃体手术治疗眼内异物128眼疗效分析

目的评价玻璃体手术治疗眼内异物的临床效果。方法对128眼眼内异物行玻璃体切除、异物摘除或联合巩膜外冷凝、视网膜光凝、玻璃体腔C3F8或硅油填充术,进行临床资料的回顾性分析。结果 128眼经玻璃体手术后,异物摘除共127眼,成功率99.22%。术前视力〈0.05者120眼（93.75%）,≥0.05者8眼（6.25%）。术后1个月视力〈0.05者46眼（35.9%）,≥0.05者82眼（64.1%）,其中最佳矫正视力1.0者8眼。伴视网膜脱离者26眼,术中视网膜全部一次性复位;术后远期（≥0.5年）发现有4眼再次出现视网膜脱离,复位率为89.47%。结论玻璃体手术可有效摘除眼内异物,异物摘除率高,术后视力绝大部分患者可提高,并可及时处理伴随的并发症。     

经睫状体扁平部玻璃体切割术摘除眼内异物

目的 分析经睫状体扁平部玻璃体切割术摘除眼内异物的疗效.方法 对眼内异物16例(16眼)行经睫状体扁平部玻璃体切割术摘除眼内异物,并进行回顾性分析.结果 16眼成功取出异物,成功率为100%.术后6个月复查时视力提高10眼(62.5%),不变5眼(31.2%),下降1眼(6.3%),术后6个月矫正视力≥0.05者12眼(75%).结论 经睫状体扁平部玻璃体切割术可有效摘除眼内异物,处理并发症,挽救伤眼的视功能.     

曲安奈德辅助玻璃体切割术治疗儿童眼内异物伤的临床研究

目的:观察和评价曲安奈德辅助玻璃体切割术治疗儿童眼内异物伤的临床效果,以指导临床治疗。方法:将2012年1月-2016年10月在本院行玻璃体切割术的80例(83眼)儿童眼内异物伤患者,根据术中是否应用曲安奈德分为两组:A组40例(42眼)行眼内异物取出联合玻璃体切割、曲安奈德注射、眼内光凝、硅油填充术;B组40例(41眼)行眼内异物取出联合玻璃体切割、眼内光凝、硅油填充术,术后随访均≥3个月。结果:80例眼内异物伤患儿均一次手术摘除异物,出院时视网膜均恢复。除2例(3眼)患者视力检查不合作外,术后视力提高53例(56眼),其中A组31例(33眼),占78.57%,B组22例(23眼),占56.10%,两组比较差异有统计学意义(字2=4.774,P=0.029)。41例(42眼)术后矫正视力0.05,其中A组25例(26眼),占61.90%,B组16例(16眼),占39.02%,两组比较差异有统计学意义(字2=4.345,P=0.037)。13例(13眼)患者术后出现视网膜脱离,其中A组2例(2眼),发生率为4.76%,B组11例(11眼),发生率为26.83%,两组比较差异有统计学意义(字2=7.648,P=0.006)。结论:玻璃体切割手术中辅助应用曲安奈德可明显改善儿童眼内异物伤患者的视力预后,并可有效预防视网膜脱离等术后严重并发症的发生,值得临床推广。     

硅油眼内填充治疗复杂性视网膜脱离

目的 观察硅油眼内填充治疗复杂性视网膜脱离的临床效果。方法 回顾性研究45例(46眼)复杂性视网膜脱离病例，视网膜脱离伴严重增殖性玻璃体视网膜病变23眼(D1级5眼，D2级6眼，D3级12眼)．其中6眼单纯巩膜扣带术后未复位，巨大裂孔4眼，伴巩膜后葡萄肿的黄斑裂孔4眼，糖尿病视网膜病变Ⅵ期6眼。眼外伤增殖性玻璃体视网膜病变致牵拉性视网膜脱离9眼。行闭合式玻璃体手术硅油眼内填充，联合巩膜扣带术治疗。结果 术后随访3～24个月，43眼获解剖复位，成功率93．5％。成功病例视力均有不同程度提高。术后并发症高眼压6眼，白内障5眼，硅油乳化1眼。结论 玻璃体手术眼内硅油填充治疗复杂性视网膜脱离可明显提高手术成功率，用5000cps以上的硅油可减少并发症发生。     

玻璃体切除眼后段异物摘除临床分析

目的：总结玻璃体切除眼后段眼内异物摘除术的临床效果。方法：本组39例（39眼）,其中非磁性异物21例,磁性异物18例,手术采用经睫状体平坦部标准三通道切口,均一次手术成功。伴有晶体混浊者,先行晶体摘除、均未植入人工晶体,有视网膜脱离等并发症,在玻璃体手术摘除眼内异物后再行视网膜复位,眼内光明、气体或硅油填充。本组1例伴有睫状体脱离,先行睫状体缝合复位。结果：39例均一次成功摘除眼内异物,术后眼压升高7例,经药物治疗恢复正常。术后视力无光感1例,0.01～0.1者20例,0.1～0.6者18例。术后观察3～6个月,无视网膜脱离、眼球萎缩、眼内炎等并发症。结论：玻璃体切除可以准确的摘除眼后段异物,去除混浊的屈光间质。具有损伤小、准确、安全、疗效好。     

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.