翼状胬肉手术前后屈光状态的改变

目的研究翼状胬肉侵入角膜内不同程度对屈光状态的影响及手术前后眼屈光状态的改变。方法初发翼状胬肉病人74例(80眼),均行翼状胬肉切除联合自体角膜缘干细胞移植术,检查术眼手术前后裸眼视力、最佳矫正视力及散光度,并按胬肉侵入角膜内程度分为≤2.5 mm组、2.6~4.0 mm组、>4.0 mm组,比较术前翼状胬肉侵入角膜内不同程度对屈光状态的影响及手术前后屈光状态的改变。结果术前3组平均裸眼视力、平均最佳矫正视力及平均散光度比较,差异有显著性(F=72.994~322.304,q=7.463~35.450,P<0.01)。翼状胬肉侵入角膜内程度与角膜散光度呈正相关(r=0.833,P<0.01)。3组术前、术后平均裸眼视力、平均最佳矫正视力、平均散光度比较,差异均有显著性(t=2.024~19.068,P<0.05、0.01)。结论翼状胬肉侵入角膜内越多对角膜屈光状态的影响越大,手术治疗可使角膜散光得以改善,提高视力。     

自体结膜瓣转位移植术治疗翼状胬肉的临床观察

目的 观察自体结膜瓣转位移植术治疗翼状胬肉的术后复发率以及翼状胬肉侵及角膜缘的距离与术后视力提高之间的关系,探讨胬肉手术的时机及必要性.方法 对56例60只眼分别进行术前、术后视力的检测对比,并按胬肉的大小分为2组(Ⅰ组≤2.5 mm,Ⅱ组>2.5 mm)进行对比观察,随访6～30个月,平均21个月.结果 56例60只眼中仅2例2眼复发,复发率为3.33%.Ⅱ组病例视力平均提高2行,Ⅰ组视力无明显提高,2组对比,Ⅱ组改变显著.结论 自体结膜瓣转位移植术治疗翼状胬肉术后复发率低,取材容易,费用低廉,值得基层医院推广.当其侵入角膜缘2.5 mm时,有必要进行胬肉切除,也是手术良机.     

两种不同手术方式治疗翼状胬肉的疗效对比及对屈光变化的影响

目的对比分析两种不同手术方式对翼状胬肉患者疗效及屈光变化的影响。方法以2013年10月~2015年11月接收的98例(98眼)翼状胬肉患者作为研究对象,随机分为甲、乙两组各49例(49眼),其中甲组患者采用翼状胬肉切除联合自体角膜缘干细胞移植治疗,乙组则采用翼状胬肉切除联合羊膜移植治疗。分别于术前和术后3周对患者的裸眼视力、角膜曲率和角膜散光度进行测定和比较。结果两组患者术后3周的裸眼视力、角膜曲率以及角膜散光度等三项指标与术前3周相比均有明显改善(P<0.05),且术前和术后3周这三项指标组间比较的差异均无统计学意义(P>0.05)。结论对于翼状胬肉患者的治疗,翼状胬肉切除联合羊膜移植术或联合角膜缘干细胞移植术为目前临床上较常用的两种手术方式,两种方式在翼状胬肉患者治疗中的疗效及对屈光变化的影响相近,具体手术方式可根据患者情况进行调整。     

翼状胬肉对角膜屈光力影响的研究

目的分析翼状胬肉对角膜屈光力影响的临床资料,把握翼状胬肉的切除时机。方法按照翼状胬肉的大小、生长方向、肥厚程度进行分类,并测定术眼前后视力、最佳矫正视力、角膜曲率及散瞳验光。结果62眼术前平均屈光度＋2．33D、散光为-1．35D,术后平均屈光度＋1．01D,散光度为-0．75D。按胬肉侵入角膜内程度统计屈光状态发现,胬肉侵入角膜内越多对角膜屈光度影响越大（P〈0．05）。结论翼状胬肉的大小、生长方向、肥厚程度不同对角膜屈光状态的影响也不同。手术治疗可以降低散光,提高视力。     

不同手术方式治疗翼状胬肉对角膜屈光状态的影响

目的探讨翼状胬肉切除联合自体角膜缘干细胞移植和翼状胬肉切除联合羊膜移植对角膜屈光状态的影响。方法将86例(86眼)翼状胬肉患者随机分为两组,每组43例,A组采用翼状胬肉切除联合自体角膜缘干细胞移植治疗,B组采用切除联合羊膜移植治疗,比较两组患者手术前后裸眼视力、角膜曲率和角膜散光度。结果两组患者术后裸眼视力、角膜曲率较术前提高(P<0.05),角膜散光度较术前减低(P<0.05),三项指标组间比较差异均无统计学意义(P>0.05)。结论翼状胬肉切除联合自体角膜缘干细胞移植和联合羊膜移植均为治疗翼状胬肉的有效的手术方法,临床可根据具体情况选择应用。     

翼状胬肉切除术后角膜散光变化观察

目的通过对200例翼状胬肉切除术后患者角膜屈光状态变化的观察及视力恢复的情况,为翼状胬肉切除术提供较好的临床治疗方法。方法对200例患者进行术前散光度、角膜曲率检查,术后3 d、术后7 d及术后1个月复查裸眼视力、散光度、角膜曲率。结果术后3 d与术前相比散光度有显著性减少,散光度、角膜曲率虽有所改善但无统计学意义(P>0.05);术后7 d与术前相比直子午线屈光力的减小、水平子午线屈光的增加及角膜散光度减小均有统计学意义(P<0.05);术后个1月与术前比裸眼视力、散光度、角膜曲率均有显著性升高,与术后7 d相比各项指标均无统计学差异(P>0.05)。结论翼状胬肉手术切除设计(调整缝线方法 )中,优化手术,最大程度的使患者的角膜散光减少,进而提高患者的视觉质量。     

翼状胬肉手术方式对眼前节屈光状态改变的临床研究

目的探析翼状胬肉手术方式对眼前节屈光状态改变的临床影响效果。方法选取本院翼状胬肉患者65例(106眼),随机分为A组31例(50眼)与B组34例(56眼),A组患者采用翼状胬肉切除联合结膜瓣转移术,B组患者给予翼状胬肉切除联合角膜缘干细胞移植术,比较两组患者术后的眼前节屈光状态。结果两组患者术后15d与术后1个月的裸眼视力、角膜水平曲线K1、角膜垂直曲线K2以及角膜平均率均明显高于手术前,具有统计学意义(P0.05);但两组患者术后上述指标比较无统计学意义(P0.05)。结论术前有明显散光且矫正视力有提高,术前翼状胬肉进入角膜缘长度2.5mm时就可以选择手术切除,这比较之前的3.0mm,更加精准,可作为考虑手术的重要参考指标。     

翼状胬肉手术前后与角膜屈光的变化

目的:探讨翼状胬肉切除术与角膜屈光变化的关系。方法:对4 3例翼状胬肉患者,术前术后经常规视力、角膜曲率及电脑验光检查,并且测量胬肉侵入角膜缘的长度,比较手术前后屈光度的改变。结果:4 6眼角膜曲率检查平均散光,术前为4 .87±2 .81D ,术后一周及一个月分别为3.19±2 .2 3D及2 .74±2 .0 1D ,术后较术前散光减少,差异具有显著性意义(一周时t=2 .5 83,P <0 .0 5 ;一个月时t=3.4 6 ,P <0 .0 1)。胬肉所致角膜散光以顺规性远视散光为主,散光度数与胬肉侵入角膜长度呈正相关。结论:翼状胬肉可引起角膜散光,手术切除可减少散光,提高视力。     

头部撕除联合带蒂结膜瓣移植术治疗原发性翼状胬肉

目的观察翼状胬肉头部撕除联合带蒂结膜瓣转位移植术治疗原发性翼状胬肉的疗效,探讨治疗原发性翼状胬肉的手术方法以及对翼状胬肉早期进行手术的可行性。方法原发性翼状胬肉患者15例(20眼),胬肉头部侵入角膜<2mm5眼,2～3mm12眼,达瞳孔缘3眼。由同一人进行手术,均采用显微镜下胬肉头部撕除联合带蒂结膜瓣转位移植术。术后定期随访观察疗效。结果翼状胬肉20眼,术后随访中均未复发。术后胬肉头部侵入角膜<2mm的5眼角膜术区透明,2～3mm12眼中9眼及达瞳孔缘3眼裂隙灯下观察术区角膜有淡淡云翳。手术前后视力变化:胬肉头部侵入角膜<2mm的5眼术前术后视力无变化,其余头部>2mm的15只眼中有12只眼术后视力有不同程度的提高。美容效果:所有患者于裂隙灯下均不易发现曾行过翼状胬肉手术。结论该手术方式能安全地切除原发性翼状胬肉,获得良好的视力和美容效果,且操作方便实用,具有在临床推广应用的价值。对原发性翼状胬肉可尽早手术。     

翼状胬肉手术对患者眼屈光影响分析

目的:探讨原发性翼状胬肉切除术前后患者眼屈光度的变化。方法:将43例原发翼状胬肉患者进行翼状胬肉切除联合自体球结膜移植,测量角膜缘至胬肉顶点长度、手术前眼部屈光度、术后角膜上皮完全愈合后的眼屈光度,比较手术前后患者屈光度的变化。结果:患者翼状胬肉头部平均长度为(3.12±0.82)mm;愈合时间为4~14 d,平均(9.21±0.59)d;手术前后患者裸眼视力、最佳矫正视力和眼屈光不正比较差异均有统计学意义(P<0.05);本组复发率为4.2%。结论:翼状胬肉患者以远视散光为主,手术治疗可提高视力,降低散光。     

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.