亲水性软性角膜接触镜治疗角膜病的可行性研究

目的 研究亲水性软性角膜接触镜治疗角膜病的可行性.方法 2015年12月—2016年12月来我院治疗的角膜病患者60例(80眼)入选本次研究,按照随机分组法将其分为对比组、研究组.对比组予以常规用药、局部包眼治疗,研究组在此基础上佩戴亲水性软性角膜接触镜.对2组患者治疗相关情况进行比较.结果 研究组无论是大泡性角膜病变患者还是丝状角膜炎患者,治疗缓解情况都明显要好于对比组,差异有统计学意义(P<0.05);2组间大泡性角膜病变创面愈合情况对比无统计学差异(P>0.05),但研究组丝状角膜炎完全愈合情况要好于对比组(P<0.05).结论 合理使用亲水性软性角膜接触镜治疗角膜病可有效缓解患者痛苦、促进角膜修复;但是对于大泡性角膜病变患者来说,应选择穿透性角膜移植这一根治方法.     

软性角膜接触镜在眼表外伤中的应用

目的:探讨治疗性亲水性软性角膜接触镜在眼表外伤中的治疗效果.方法:对本科2001-2005年间收治的26例26眼住院和门诊的眼表外伤病例,包括化学伤、热烧伤、角膜机械性损伤及角膜裂伤患者,连续配戴治疗性亲水性角膜接触镜治疗和联合抗生素滴眼液等治疗.结果:除5例Ⅳ度烧伤外,其余21例全部治愈,治愈率80.8%.结论:亲水性软性角膜接触镜在眼表外伤中是一种安全有效的辅助治疗方法.     

抗生素眼药水联合亲水性软性角膜接触镜治疗角膜病及对患者白细胞介素水平的影响

目的:研究抗生素眼药水及人工泪液联合亲水性软性角膜接触镜治疗角膜病的疗效及对白细胞介素(IL-4、IL-10、IL-13)水平的影响。方法:纳入2016年1月～2019年1月我院收治的角膜病患者68例作为研究对象,随机分成联合组及对照组。对照组予以抗生素眼药水及人工泪液治疗,联合组则在对照组的基础上增用亲水性软性角膜接触镜治疗。比较2组症状缓解情况、治疗1周后角膜创面愈合情况及治疗前后血清IL-4、IL-10、IL-13水平变化。结果:联合组大泡性角膜病变及丝状角膜炎症状缓解情况均优于对照组(均P<0.05)。联合组治疗1周后丝状角膜炎角膜创面愈合情况优于对照组(P<0.05)。联合组治疗后血清IL-4、IL-10、IL-13水平均显著低于治疗前及对照组(均P<0.05)。结论:抗生素眼药水及人工泪液联合亲水性软性角膜接触镜对角膜病患者疗效显著,且有效降低血清IL-4、IL-10、IL-13水平。     

应用软性亲水性角膜接触镜治疗药物毒性角膜炎的体会

目的探讨软性亲水性角膜接触镜在药物毒性角膜炎中的应用.方法对药物毒性反应致角膜上皮粗糙、水肿,角膜刺激症状明显伴视力下降16例(20只眼)连续配戴治疗性软性角膜接触镜联合营养角膜上皮修复药物治疗.结果连续配戴一周左右病情均好转治愈.结论连续配戴治疗性软性角膜接触镜联合营养角膜药物,治疗药物毒性反应性角膜炎,具有保护角膜上皮促进其愈合的效果.     

绷带式角膜接触镜在眼表化学伤中的临床应用

目的观察绷带式角膜接触镜在眼表化学伤治疗中的应用情况。方法选择符合纳入标准的眼表化学伤患者35例,63只眼,患者随机分为两组：治疗组（配戴绷带式角膜接触镜）21例（39眼）及对照组（无配戴绷带式角膜接触镜组）14例（24眼）。在常规抗炎促修复治疗后观察患者眼部刺激症状改善情况及角膜上皮剥脱修复情况。结果治疗组中21例（39眼）患者在配戴绷带式角膜接触镜后37眼自诉眼部刺激症状好转,有效率94.8%;对照组24眼中有21眼眼部刺激感始终存在,有效率12.5%。治疗组患者有18例（34眼）在1周复查时上皮明显修复,修复面积平均达到30%。所有患者在7~14 d时间角膜上皮完全修复。治疗组角膜修复时间（6.25±2.12）d,对照组角膜修复时间（8.04±2.38）d。治疗组患者角膜上皮修复时间明显短于对照组。结论眼表化学伤,尤其是伴有角膜上皮剥脱的患者,配戴绷带式角膜接触镜作为辅助治疗可以明显缓解患者的眼部不适症状,同时有促进角膜上皮修复的作用。     

持续佩戴软性角膜接触镜治疗角膜上皮病变23例

目的:研究持续配戴软性角膜接触镜治疗角膜上皮病变的有效性。方法:对角膜上皮病变患者23例(28眼),采用软性角膜接触镜镜片连续过夜配戴,同时局部给予1%玻璃酸钠滴眼剂及抗生素滴眼剂,定期检查疼痛缓解情况、眼部改变、镜片的配适状态、镜片沉淀物以及眼部并发症。结果:治疗观察时间5～60 d。眼部疼痛症状完全缓解16眼(57.14%),明显缓解10眼(35.72%),无效2眼(7.14%)。角膜上皮完全愈合17眼(60.7%),部分愈合5眼(17.9%),无效6眼(21.4%)。结论:持续配戴角膜接触镜对于角膜上皮病变具有促进角膜愈合和缓解疼痛刺激等作用。     

穿透性角膜移植术后持续戴角膜接触镜的临床观察

目的探讨穿透性角膜移植术（penetrating keratop lasty,PKP）后佩戴软性角膜接触镜来减轻术眼刺激症状、促进角膜上皮愈合的临床疗效。方法共201例（201只眼）PKP病例,其中术后戴软性亲水性角膜接触镜者159只眼,未戴镜者42只眼。定期观察患眼角膜知觉、角膜上皮愈合、新生血管形成、角膜内皮数量和形态。随访期6个月。结果术后4个月,戴镜组角膜知觉减退（P〈0.01）,摘除镜片后1个月角膜知觉可恢复到同不戴镜组相似;戴镜组会更易形成表层植片新生血管,摘除镜片后1个月新生血管大部分消退;戴镜组角膜上皮完整性较未戴镜组好,上皮修复迅速,不易损伤。角膜内皮细胞的形态和数量两组间无明显区别（均P〉0.05）。结论PKP术后佩戴软性角膜接触镜可减轻术后早期刺激症状、保护角膜,加快上皮愈合。     

软性角膜接触镜在角膜外伤中的应用

目的：评价软性角膜接触镜治疗角膜外伤的疗效。方法：配戴软性角膜接触镜治疗角膜外伤59例,63眼,包括角膜穿通伤未缝合9眼,缝合术后39眼,化学及热烫伤11例,15眼,伤后包扎2－3天,无菌条件下戴镜,局部用药,配合全身用药,结果：戴镜后刺激症状消除,角膜上皮修复快,伤口愈合期缩短,无并发症发生,视力均有不同程度的提高。结论：在角膜外伤治疗过程中,角膜接触镜与全身及局部合理用药,有助于促进伤口愈合,缩短疗程,减少并发症。     

持续配戴软性角膜接触镜在角膜病治疗中的应用

目的评估持续配戴软性角膜接触镜(博士伦清朗月抛型)治疗角膜病变的指征与疗效。方法非随机选用眼科门诊与住院病例,包括需要缓解疼痛与刺激症状,保护角膜和促进角膜创面愈合等病例。采用镜片连续过夜配戴的同时,根据角膜病变性质,局部适当给予抗生素或人工泪液,定期检查或询问疼痛缓解情况、眼部改变、镜片的配适状态、镜片沉淀物以及眼部并发症。结果接受观察病例共33例(46眼),镜片配戴时间3～45d,平均(23.2±5.1)d。治疗的角膜病包括大泡性角膜病变5例(5眼),丝状角膜炎6例(12眼),角膜上皮糜烂2例(2眼),复发性角膜上皮剥脱症2例(4眼),眼外伤18例(23眼)。症状完全缓解18眼(39.1%),明显缓解28眼(60.9%)。角膜创面或伤口完全愈合39眼(84.8%),部分好转5眼(10.9%),无效2眼(4.3%)。结论角膜接触镜对于多种角膜病具有角膜保护、促进角膜愈合和缓解疼痛刺激等显著疗效,没有明显的并发症。     

重组人表皮生长因子衍生物滴眼液治疗软性角膜接触镜所致的角膜上皮病变的疗效观察

目的观察因戴软性角膜接触镜引起的表层角膜上皮病变滴用重组人表皮生长因子衍生物的疗效。方法试验组用重组人表皮生长因子衍生物眼液和氧氟沙星眼液交替滴眼各每日5次。对照组用氧氟沙星眼液滴眼各每日5次。结果重组人表皮生长因子衍生物有明显促进角膜上皮缺损痊愈的作用,角膜上皮愈合时间明显短于对照组（P〈0.01）。治疗过程中无局部及全身不良反应。结论重组人表皮生长因子衍生物眼液治疗软性角膜接触镜所致角膜上皮缺损安全有效。     

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.