眼眶骨折后眼球内陷的外科治疗

目的探讨眶骨骨折后眼球内陷的手术治疗。方法治疗眼眶骨折后眼球内陷畸形17例，术前常规行眶部轴面及冠状位CT扫描，了解眶骨骨折及眶内容物移位嵌顿情况。术中首先将移位的骨折块复位、小夹板坚强内固定，重建正常的眶缘，然后用人工材料植入，同时修复眶壁。结果所有患者眼球内陷畸形均获明显改善或矫正。结论眶骨骨折所致后期眼球内陷畸形可通过骨复位及植骨的手段重建眶缘，修复眶骨各壁的缺损，缩小扩大的眶腔而得以有效矫正。     

自体下颌骨外板在眶底重建及眼球内陷矫正中的应用

目的探讨自体下颌骨外板在外伤后眶底缺损重建及继发眼球内陷矫正中的应用。方法 16例外伤后眶壁缺损合并眼球内陷患者应用自体下颌骨外板行眶底重建,眼球内陷矫正。术前常规行眼眶轴位冠状位扫描及三维重建,了解颌面部骨折、眶壁缺损及眼球周围组织移位情况。睑缘下切口,暴露眶底缺损,回纳疝出的球周组织,充分分离松解眼外肌。口内入路采取下颌骨外板,修整塑形后植入眶底修复缺损,钛板固定于眶下缘,同时下颌骨外板眶内充填矫正眼球内陷。结果术后随访6～18个月,16例患者中,13例眼球内陷得到明显改善,3例矫正不足。10例术前眼球运动受限者术后8例眼球运动正常9,例复视者术后6例明显改善,供区无并发症出现。结论自体下颌骨外板取材方便,供区生理功能损害小,痕迹隐蔽,配合小钛板坚强内固定可有效重建眶底缺损,矫正眼球内陷,是一种理想的自体骨移植材料。     

预成形钛网在眼眶骨折眶壁修复中的应用

目的评价预成形钛网在眼眶骨折眶壁修复重建中的应用效果。方法 2012年1月1日～7月30日在解放军总医院眼科就诊并接受治疗的眼眶骨折病例27例,该组病例术前均存在眼球内陷、眶壁缺损、骨性眶腔扩大和眶内软组织疝出。术前常规行眼眶水平、冠状位及三维CT检查,应用预成形钛网行眶壁修复重建,术后继续CT检查,以评价眼眶骨折后眶壁重建的准确性和眼球突出度恢复情况。结果术后3月随访,所有病例都成功地实施了眼眶壁的重建,术中术后均未发生严重并发症,85.2%(23/27)的患者眼球内陷矫正在3 mm内。结论应用预成形钛网可比较精确地修复眶壁骨折。     

预成形钛网在眼眶骨折眶壁修复中的应用

目的评价预成形钛网在眼眶骨折眶壁修复重建中的应用效果。方法2012年1月1日~7月30日在解放军总医院眼科就
诊并接受治疗的眼眶骨折病例27例,该组病例术前均存在眼球内陷、眶壁缺损、骨性眶腔扩大和眶内软组织疝出。术前常规行
眼眶水平、冠状位及三维CT检查,应用预成形钛网行眶壁修复重建,术后继续CT检查,以评价眼眶骨折后眶壁重建的准确性和
眼球突出度恢复情况。结果术后3月随访,所有病例都成功地实施了眼眶壁的重建,术中术后均未发生严重并发症,85.2%（23/
27）的患者眼球内陷矫正在3 mm内。结论应用预成形钛网可比较精确地修复眶壁骨折。
     

内联多孔羟基磷灰石在眶内骨折治疗中的应用

目的　探讨国产珊瑚多孔羟基磷灰石 (coralporoushydroxyapatite ,CHA)进行眶骨膜下植入矫正外伤性眼球内陷的治疗效果。方法　患者麻醉后按Allen报道方法进行眶内骨折眼球内陷矫正。结果　 18例(18只眼 )因外伤造成眶内骨折眼球内陷患者均获满意效果 ,经随访未见植入物脱出 ,亦无并发症发生。结论　CHA为一种良好的骨代替材料 ,明显优于自体组织和其它人工合成材料     

眶底骨折的手术治疗

目的 评价眶底骨折患者眼球内陷手术治疗的矫治效果。方法36例眶底骨折的患者进行眶壁复位固定，以羟基磷灰石人造骨重建眶底，术后进行眼球运动训练。观察指标为眼球内陷和复视的矫治情况，并记录相关的并发症。结果手术后观察时间最短7个月，最长为19个月。术前眼球内陷双侧相差大于2mm者为29例，术后双侧相差大于3mm者1例，2～3mm者5例，其余均小于2mm，无1例过矫。结论面中部骨折时通常合并有眶底骨折，造成眼球内陷，需要进行眶底重建。羟基磷灰石人造骨作为眶底植入材料具有足够的支撑能力，能够修复较大面积的眶底缺损。     

三维CT重建及微型钛板坚固内固定术在眼眶骨折整复重建中的应用

目的观察三维CT重建技术及微型钛板坚固内固定术应用于眼眶骨折整复重建手术的效果。方法30例眼眶骨折患者术前均行横断面、冠状面二维CT扫描和三维CT重建。根据三维CT重建图像,对患者进行骨折复位及眼眶骨缺损整复手术,术中均采用微型钛板坚固内固定术。结果 30例患者通过术前三维CT的诊断完成手术,手术切口隐蔽,手术时间缩短。手术中骨折及缺损处修复良好,软组织回纳充分,移植物无移位,无一例患者出现视力丧失。手术后患者无主观异物感或移动感,体表无植入体轮廓阴影或阶梯状畸形。CT扫描复查骨折对位良好,钛板无松脱移位。患者复视及眼球运动障碍改善,眼球内陷好转,患者外观满意。术后随访3月～1年,未发现微型钛板排斥反应、移位、感染及其他不良反应。结论三维CT重建及微型钛板坚固内固定术可提高眼眶骨骨折的诊断和手术的准确性。     

爆裂性眶壁骨折眼球内陷修复手术的护理

爆裂性眶壁骨折是指由钝力外伤引起的单纯眶壁骨折而不合并眶缘凹陷性骨折的一种外伤综合征。是临床上较为常见的外伤眼病,骨折造成眼球内陷,眼球运动障碍和复视,需行眼眶修复重建手术来矫正复视,改正外形。从2001~2005年我们对采取眼眶重建眼球复位术治疗的16例爆裂性眶壁骨折     

内联多孔羟基磷灰石在眶内骨折治疗中的应用

目的探讨国产珊瑚多孔羟基磷灰石(comlporous hydroxyapatite，CHA)进行眶骨膜下植入矫正外伤性眼球内陷的治疗效果。方法患者麻醉后按Allen报道方法进行眶内骨折眼球内陷矫正。结果18例(18只眼)因外伤造成眶内骨折眼球内陷患者均获满意效果，经随访未见植入物脱出，亦无并发症发生。结论CHA为一种良好的骨代替材料，明显优于自体组织和其它人工合成材料。     

计算机辅助制作个性化钛网治疗眼眶骨折继发眼球内陷

目的:应用计算机辅助技术制作个性化钛网重建眶壁,矫治眼眶骨折继发眼球内陷,并与传统方法对比,评价其治疗效果.方法:20例非单纯性眼眶骨折的患者,男性12例,女性8例.A组8例应用个性化钛网,B组12例应用传统方法.应用图形处理软件,以CT数据为基础,行眼眶三维重建,镜像翻转复制健侧眼眶替代患侧眼眶,应用快速成形技术制作复制后的患侧眼眶的三维模型,在其上成形钛网,手术植入行眶壁重建.通过临床检查和CT测量,并与传统眼眶重建方法对比,评价该方法的治疗效果.结果:术前、术后患侧眼球内陷的差值:A组平均为2.6 mm,B组平均为2.0 mm;术前、术后患侧眼眶容积扩大量的差值:A组平均为4.3 mL,B组平均为3.7 mL;术后眶下壁修复指数A组和B组均为100%;眶内壁修复指数:A组为84.7%,B组为53.3%;植入体眶内置入深度:A组平均为31.2 mm,B组平均为28.3mm;术后复视相改善情况:A组平均1.5个象限恢复,B组平均1个象限恢复.术后所有病例未出现相关并发症.结论:计算机辅助制作个性化钛网技术在重建眶壁形态、眶壁修复范围和置入深度等方面均优于自体骨、人工材料移植等传统重建方法.应用计算机辅助制作个性化钛网技术可以更加精确地重建眶壁,提高眼球内陷和复视的矫治效果.     

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.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

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.     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.     

Possible Spread of adenovirus type 3 from poultry to humans ：indirect evidence from an outbreak in China

Objective:To explore the epidemiology and etiology for an outbreak of acute respiratory tract infection that occurred in one county of Jiangsu Province, China 2004. Methods: Only cases meeting the case definition were included in the study. We reviewed the medical records of the cases who were admitted to the local hospitals, interviewed cases by a standard questionnaire, and then described the epidemiotogic features and analyzed risk factors by means of a case-control study. We collected pharyngeal swab specimens and sent them to different laboratories for isolation and culture. The laboratory used different detection methods such as DIP, PCR, electron microscope examination and microneutralization assay, to identify and then type the positive specimens. Results:A total of 871 cases were reported during the period from April 18 to July 4,2004. The distribution of onset times presented two peaks, one in late May and another in middle June. The epidemic occurred mainly in the elementary and junior high schools in ten townships of one county, and the mean age of the cases was 12 years (range 7 months to 18 years). The course of the disease was acute, and was characterized by fever accompanied with sore throat and tonsillitis. The WBC count of cases was normal or elevated. The mean duration of illness was 5 days (range 2 to 12 days). No fatalities from illness were reported. A case-control study indicated that the possible risk factors were close contact with a case and/or poultry before onset and sharing of towels among members of the family. The typical CPE was observed through inoculating pharyngeal swab specimens into the HEP-2 cell cultures in different laboratories. An infection of adenovirus type 3 was verified by detecting positive specimens in different methods. Conclusion:This investigation demonstrated that the acute respiratory infection in cases was caused by adenovirus type 3. Cases occurred in over 70 schools in ten townships in 2004, and the route of transmission was possibly close contact with cases or droplet transmission.