准分子激光原位角膜磨镶术治疗超高度近视的疗效观察

目的:探讨评价准分子激光原位角膜磨镶术治疗超高度近视的临床疗效。方法:采用准分子激光原位角膜磨镶术治疗37例(72眼)超高度近视患者,屈光度为-10.0~-22.5D,平均为(-16.37±3.12)D,散光为-1.25~-4.25D,平均为(-1.92±0.87)D。结果:手术后视力明显提高,术后6个月时35例70眼(97.22%)视力达到或超过术前最佳矫正视力,其中24眼(33.33%)超过术前最佳矫正视力2行或以上,2例2眼视力较术前最佳矫正视力下降1行;术后6个月屈光度(1眼欠矫-1.5D)为(-0.37±0.42)D,散光为(-0.43±0.46)D。结论:准分子激光原位角膜磨镶术可以有效的治疗超高度近视,而且无明显并发症发生。     

4878例准分子激光角膜原位磨镶术治疗近视疗效观察

目的观察应用准分子激光原位角膜磨镶术治疗近视的效果。方法使用美国VISX STAR S4准分子激光仪对4878例（9718只眼）近视患者行准分子激光角膜原位磨镶术矫治。术前球镜屈光度为-1．00～-14．00DS散光0— -4．50DC，按术前屈光度分为：1．组-1．00～-6．00DS。4328眼。2．组-6．25～-10．00DS，3616眼 3组-10．25～-14．00DS，1774眼。对三组术后的裸眼视力进行比较分析及术后裸眼视力和术前最佳矫正视力进行比较分析。结果 I组49．6％视力超过1．2，16．5％术后裸眼视力低于术前最佳矫正视力。II组1．9％裸眼视力超过1．2，6．9％低于术前最佳矫正视力。Ⅲ组34．3％裸眼视力超过1．2，16．5％低于术前最佳矫正视力。结论应用准分子激光原住磨镶术治疗近视可获得良好的治疗效果，并发症少，手术预见性和稳定性好，安全性高。     

准分子激光原位角膜磨镶术治疗高度近视

目的评价准分子激光原位角膜磨镶术(excimerlaserinsitukeratomileusis,LASIK)治疗高度近视的疗效。方法23例(41眼)高度近视,平均屈光度为-14.74±3.72D,采用准分子激光原位角膜磨镶术治疗,随访观察3个月以上。结果术后第1天,裸眼视力有明显提高,裸眼视力达术前矫正视力者为39.2％。术后1个月及3个月裸眼视力达术前矫正视力者分别为58.54％、53.66％,术后3个月41.46％为正视眼,≤±1.0D为65.85％,≤±2.0D为77.27％。结论准分子激光原位角膜磨镶术治疗高度近视眼的近期疗效满意,其远期疗效有待进一步观察研究。     

准分子激光角膜屈光手术矫治RK术后近视散光

目的:探讨准分子激光原位角膜磨镶术(LASIK)和准分子激光屈光性角膜切削术(PRK)矫治角膜放射状切开术(RK)后残余近视散光的安全性和有效性.方法:对接受RK手术4～15年,近视散光稳定2年以上的患者19例(38眼)分别行PRK和LASIK手术,其中PRK组8例(16眼),术前屈光度为:球镜-1.00～-5.25D,平均-3.12±0.87D,柱镜0～-2.25D,平均-1.27±0.36D,LASIK组11例(22眼),术前屈光度:球镜-1.50～-9.50D,平均-3.54±2.79D,柱镜0～-3.0D,平均-1.58±0.69D,术后随访12个月.结果:两组患者术后3个月时视力和屈光状态趋于稳定,术后6个月屈光度均在±0.75D以内,术后1年裸眼视力33眼(86.84)≥1.0,38眼(100%)≥0.8,未有最佳矫正视力下降.结论:LASIK和PRK矫治RK术后近视散光均安全、有效,PRK安全简便,LASIK稳定性和预测性更好.     

准分子激光原位角膜磨镶术治疗远视的疗效观察

目的 :评价准分子激光原位角膜磨镶术治疗 +6 .0 0D以下远视的疗效。方法 :采用准分子激光原位角膜磨镶术治疗远视 2 1例、38眼 ,平均随访 2 4个月 ,观察裸眼视力及屈光度。结果 :术后第 1天裸眼远视力较术前最佳矫正视力有所下降 ,2～ 3周后逐渐提高 ,3个月时稳定 ;术后第 1天裸眼近视力明显改善且一直保持稳定 ;术后 3个月时 ,2 7眼达到或超过术前矫正视力 ,占 71.0 5 % ,平均屈光度为 +1.6 7± 0 .83D。结论 :准分子激光治疗 +6 .0 0D以下远视安全有效 ,但手术方案的设计还需进一步完善     

准分子激光角膜原位联合角膜瓣背面磨镶术治疗LASIK术后屈光回退

目的 探讨准分子激光角膜原位联合角膜瓣背面磨镶术治疗LASIK术后屈光回退的有效性和安全性.方法 对10例(15眼)LASIK术后屈光回退,剩余的角膜基质层厚度不足以矫正的患者行准分子激光角膜原位联合角膜瓣背面磨镶术治疗.结果 术后复查角膜瓣平整、复位良好.术后视力第1天、1周、3个月均值分别为0.95±0.26、0.98±0.25、1.02±0.26;术前屈光度(-2.5±1.25)DS,散光(-1.05±0.65)DC;术后3个月的屈光度(-0.37±0.50)DS,散光(-0.50±0.37)DC,术后与术前相比差异有统计学意义(F=6.250,P=0.002;F=3.086,P=0.043),术后3个月时15眼均达到或超过术前最佳矫正视力.结论 准分子激光角膜原位联合角膜瓣背面磨镶术可以安全有效地治疗LASIK术后屈光回退、术前预测角膜基质层厚度不够的近视患者,而且无明显并发症,但远期疗效还有待进一步观察.     

准分子激光原位角膜磨镶术治疗高度近视

目的观察准分子激光原位角膜磨镶术治疗高度近视的临床效果,并作出评价。方法选取我院准分子中心自2008年4月至2009年6月接诊的80例160眼高度近视患者,采取准分子激光原位角膜磨镶术进行治疗,并收集患者手术0.5～1年的相关资料加以分析。结果经过准分子激光原位角膜磨镶术治疗,患者视力状况：裸视视力在0.5以上的149眼,在0.8以上的有121眼,在1.0以上的有53眼,最佳矫正视力降低2行以上的有3眼;患者的屈光度在手术后早期呈现轻微远视,经过1～3个月得以恢复;手术并发症状况：术后视网膜脱离1眼,角膜瓣移位1眼。结论采取准分子激光原位角膜磨镶术是一种收效良好且安全的治疗高度近视的手术,在手术并发症的预防上需要引起高度重视。     

准分子激光角膜原位磨镶术治疗高度近视患者的临床效果

目的观察高度近视患者应用准分子激光角膜原位磨镶术(LASIK)治疗的临床效果。方法选入高度近视患者40例(80眼)作为研究对象,PTA≥40%,资料完整,选入时间为2018年1月至2019年1月,手术治疗方法为准分子激光角膜原位磨镶术,术前术后对裸眼视力(UCVA)、矫正视力(CDVA)、散光度数、中央角膜厚度(CCT)、等效球镜度(SE)等指标进行检查,了解术式的临床效果。结果术后复查结果显示,40例(80只眼)平均CUVA值(0.8±0.2),平均球镜度数(-0.86±0.87)D,平均散光度数(0.42±0.42)D,平均SE为(-0.76±1.06)D,平均CDVA值(1.0±0.1);术后最佳矫正视力水平相比于术前明显更优(P0.05),术后1周与术后1个月与术前单眼调节幅度值比较存在统计学意义(P0.05),而术后3个月与术前的单眼调节幅度相比无明显差异(P 0.05)。结论高度近视患者应用准分子激光角膜原位磨镶术治疗疗效显著。     

准分子激光原位角膜磨镶术治疗近视

目的 :评价准分子激光原位角膜磨镶术治疗近视的效果。方法 :用自动板层角膜刀和VISXSTARS2型准分子激光仪对 35 5例 6 93只眼行LasiK手术 ,术后随访半年以上 ,在分析屈光度变化时将患者分为三组。Ⅰ组 ( 1.0 0～ 6 .0 0D)2 6 3只眼 ,Ⅱ组 ( 6 .2 5～ 11.75D) 371只眼 ,Ⅲ组 ( 12 .0 0～ 2 6 .0 0D) 5 9只眼。结果 :6 93只眼术后 1周有 99.1%裸眼视力达到术前最佳矫正视力 ,术后 3个月及 6个月分别为 98.0 %及 96 .8%裸眼视力达到术前最佳矫正视力 ,在术后屈光度分析中可见高度及超高度近视 3个月后有回退现象。术中术后未发生严重并发症。结论 :LasiK治疗近视安全有效。     

LASEK治疗近视散光的临床疗效观察

目的探讨准分子激光上皮下角膜磨镶术（LASEK）治疗近视散光的安全性和有效性。方法对91人（182眼）近视散光患者进行LASEK手术治疗。随访12个月,观察手术后的视力,屈光度,散光及其散光轴位的变化。结果术后随访12个月,裸眼视力≥术前最佳矫正视力（BCVA）者占61．5％;所有患眼术后散光在±1．00D以内,残留散光平均为-0．24D,散光矫正74．8％,散光轴较术前偏斜23°。术前与术后结果行配对t检验,P〈0．01,二者存在显著差异。结论;隹分子激光上皮下角膜磨镶术（LASEK）治疗近视散光预测性佳,安全可靠。     

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.     

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…     

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.     

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.