高度近视合并白内障患者植入AcrySof IQ ReSTOR多焦点人工晶状体的临床研究

目的评估高度近视合并白内障的患者双眼植入非球面多焦点人工晶状体AcrySof IQ ReSTOR的临床效果方法随机选取26例(52眼)高度近视合并白内障患者,接受白内障超声乳化吸除联合人工晶状体植入术。实验组(MIOL组,13例26眼)双眼植入非球面多焦点人工晶状体AcrySof IQ ReSTOR,对照组(IQ组,13例26眼)双眼植入非球面人工晶状体AcrySof IQ。检测术前视力、术后3个月裸眼远视力、最佳矫正远视力、裸眼近视力、最佳矫正近视力、屈光状态,问卷调查术后视近时对眼镜的依赖程度及患者的主观视觉症状。结果术后3个月,两组裸眼远视力、最佳矫正远视力、最佳矫正近视力、整体满意度、眩光、夜间视物模糊及色觉异常,差异均无统计学意义(P0.05);而MIOL组裸眼近视力,视近距时满意度和视近距时脱镜率,MIOL组优于IQ组(P0.05),差异有统计学意义。结论与非球面人工晶状体AcrySof IQ相比,高度近视合并白内障患者应用AcrySof IQ ReSTOR具有更好的视觉效果,近距离工作脱镜率高。     

Toric人工晶体矫正老年性白内障合并角膜散光的临床效果观察

目的评价Toric人工晶体植入矫正老年性白内障合并角膜散光的临床疗效。方法选取2014年6月至2014年12月郑州大学第一附属医院收治的老年性白内障合并角膜散光50例(50眼),行"超声乳化吸除术联合Toric人工晶体植入术"。术后随访6个月,观察术前、术后6个月术眼的裸眼远视力、最佳矫正远视力、残余散光、角膜散光、IOL轴位偏离度等。结果术后6个月随访裸眼远视力≥0.8者34例(87%),裸眼远视力≥0.6者46例(92%),术后裸眼视力明显高于术前(P<0.05),术后裸眼视力与术后矫正视力相比,差异无统计学意义(P>0.05);术后6个月残余散光(0.67±0.08)D明显小于术前角膜散光(3.34±0.27)D(P<0.05);术前预计残余散光(0.72±0.09)D与术后6个月残余散光(0.67±0.08)D相比,差异无统计学意义(P>0.05);术后角膜散光(3.29±0.09)D与术前(3.34±0.12)D相比,差异无统计学意义(P>0.05);术后6个月IOL轴位平均偏离(3.12±1.29)°。结论对于老年性白内障合并有角膜散光患者行"超声乳化吸除联合Toric人工晶体植入术"是可行的,能够有效减少总和散光,提高患者术后裸眼视力及视觉质量。     

Bigbag人工晶状体在高度近视并发白内障中的应用研究

目的探讨超声乳化白内障吸出联合Bigbag人工晶状体植入在高度近视合并白内障中的临床应用效果。方法选择因高度近视合并白内障行超声乳化吸出术患者63例（94眼）,根据患者意愿,植入Bigbag人工晶状体作为观察组,32例（48眼）,植入Acrysof后房型人工晶状体作为对照组,31例（46眼）,观察并比较两组术前、术后1周、术后1、3个月患者裸眼视力、最佳矫正视力、屈光状态、眼压及术后并发症。结果观察组术后1周、术后1、3个月裸眼视力均较术前提高（t=-5.270、-5.873、-16.738,均P＜0.05),屈光度较术前降低（t=-2.415、-2.386、-16.053,P＜0.05）,眼压较术前无明显变化（t=1.195、-1.131、1.036,均P＞0.05）;对照组术后1周、术后1、3个月裸眼视力均较术前提高（t=-14.738、-14.365、-13.954,均P＜0.05）,屈光度较术前降低（t=-13.666、-13.627、-12.820,均P＜0.05）,眼压较术前差异无统计学意义（t=-1.101、-0.745、-0.786,均P＞0.05）;术后1周、术后1、3个月裸眼视力两组差异均无统计学意义（t=1.478、1.740、2.844,均P＞0.05）,术后1周、1个月最佳矫正视力观察组优于对照组（t=2.640、2.642,均P＜0.05）。观察组术后后囊膜皱褶、后发性白内障及眩光现象的发生率较对照组降低（字2=41.17、5.452、2.352,均P＜0.05）。结论对高度近视合并白内障患者行超声乳化白内障吸出联合Bigbag人工晶状体植入术可达到较理想的术后视力,是一种安全有效的治疗方法。Bigbag人工晶状体对后囊膜有稳定的支撑作用,可明显减少术后并发症的发生,特别是后囊膜皱褶和后发性白内障及眩光现象。     

超高度近视屈光性手术后主诉视觉质量下降原因分析

目的 分析超高度近视屈光性手术后视觉质量下降原因。方法 采用回顾性病例系列研究,收集2009年1月-2015年12月在首都医科大学附属北京同仁医院眼科接受晶状体摘除联合人工晶状体植入或有晶状体眼人工晶状体植入手术后主诉视觉质量较差的超高度近视患者8例（16只眼）的资料。对术后视觉质量进行问卷调查,测量患者的术前、术后的屈光度、裸眼远视力、矫正远视力、裸眼近视力及矫正近视力的情况,分析患者术后视觉质量变差的原因。结果 本组患者年龄30~60岁,平均年龄（44.88±10.32）岁,术前屈光度范围-29.0~-18.0 D,平均屈光度（-23.19±3.60） D,术后屈光度范围-3.0~1.75 D,平均屈光度（-0.73±1.31） D,术后屈光度比术前明显减小（P<0.001）。所有患者对术后裸眼远视力及矫正远视力满意,术前矫正远视力平均为0.19±0.07,术后平均矫正远视力为0.24±0.07,术后较术前明显提高（P<0.05）,但对术后裸眼近视力和30 cm矫正近视力的满意度均较差,术后裸眼近视力明显低于术前裸眼近视力,术后30 cm矫正视力亦明显低于术前裸眼近视力,术后10 cm矫正视力有改善但依然低于术前裸眼近视力（P<0.05）。结论 超高度近视患者接受屈光性手术后,主诉视觉质量下降,主要与术后裸眼近视力和术后矫正近视力下降有关。     

2种调节性晶体术后效果比较的临床分析

目的:比较Tetraflex和1-CU可调节晶状体植入术后早期的临床效果差异.方法:选择2010年6月至2011年5月在我院接受白内障超声乳化联合植入人工晶体患者,分别分组为1-CU组和Tetraflex组.分别于术后1周、1个月、3个月行眼科检查,检查裸眼远视力及最佳矫正远视力、近视力及远视力矫正后的近视力,采用主观...     

超声乳化术治疗高度近视合并白内障患者的疗效分析

目的：探讨超声乳化术治疗高度近视合并白内障患者的临床疗效.方法：选择高度近视合并白内障患者62例（76只眼）,应用超声乳化术联合人工晶状体植入术治疗并观察患者视力、屈光度、并发症等.结果：术后1周和3个月随访,患者矫正视力显著优于术前（P＜0.05）,患者视力、柱镜、球镜屈光度较术前均有明显改善.结论：超声乳化术治疗高度近视合并白内障既可以摘除白内障又可治疗高度近视,是一种安全有效的手术方法.     

阶梯渐进衍射型多焦人工晶体植入术后患者视觉质量的观察

目的 探讨阶梯渐进衍射型多焦人工晶体（ReSTOR MIOL）植入术后患者的视力质量.方法 26例（30眼）行超声乳化白内障摘除联合AcrySof ReSTOR MIOL植入,同时选择同一时间范围内25例（30眼）行超声乳化白内障摘除联合单焦人工晶体植入病例作对照组,对两组术后裸眼远视力、最佳矫正远视力、裸眼近视力及术后并发症进行观测,同时运用视力质量调查表进行比较.结果 ReSTOR组术后裸眼远、近视力优于单焦组（P〈0.05）,术后最佳矫正远视力两组问比较差异无统计学意义（P〉0.05）.结论 AcrySof ReSTOR MIOL能够为患者提供良好的远、近视力,提高患者的脱镜率,改善视觉质量.     

负度数人工晶体植入的临床分析

目的分析超高度近视合并白内障患者超声乳化后负度数人工晶状体植入的临床疗效。方法回顾性分析34例（43眼）行白内障超声乳化联合负度数人工晶体植入术的患者。记录术前眼轴长度、术前视力,观察术中、术后并发症及术后视力,随访6个月。结果术后屈光度数与预留屈光值接近,平均绝对屈光误差≤±1D;裸眼视力≥0．3者占72．09％,有46．51％术眼裸眼视力≥O．5。随访中无视网膜脱离等致盲性并发症。结论通过术前精确测量眼轴长度和角膜屈率,超声乳化＋负度数人工晶体植入治疗超高度近视合并白内障安全性高,预测性较好,能使患者获得良好的视力。     

两种新型人工晶状体在近视人群中的应用比较

目的 观察近视白内障患者植入两种新型人工晶状体(多焦点人工晶状体和可调节人工晶状体)的临床疗效.方法 对近视白内障患者38例42眼,分别在超声乳化术后植入多焦点人工晶状体和可调节人工晶状体,观察术后1个月裸眼远视力,裸眼近视力,最佳矫正远视力,最佳矫正近视力,术后3个月裸眼远视力,裸眼近视力,最佳矫正远视力,最佳矫正近视力,最佳视远度数矫正时的近视力及拟调节力,对比敏感度和眩光敏感度. 结果 术后1个月裸眼远视力,最佳矫正远视力,最佳矫正近视力,术后3个月裸眼远视力,最佳矫正远视力,最佳矫正近视力,6.3度和0.7度对比敏感度和眩光敏感度无统计学差异(P>0.05).术后1个月裸眼近视力,术后3个月裸眼近视力,最佳视远度数矫正时的近视力,拟调节力,4.0度、2.5度、1.6度和1.0度对比敏感度和眩光敏感度具有显著统计学差异(P<0.05).结论 2种IOL在视远时均能达到较为满意的效果,视近时多焦点人工晶状体要优于可调节人工晶状体,但反映功能性视力的对比敏感度和眩光敏感度方面可调节人工晶状体要优于多焦点人工晶状体.     

多焦点人工晶状体ACRYSOF ReSTOR的临床应用

目的 探讨多焦点人工晶状体ACRYSOF ReSTOR的临床应用价值.方法 对28例(30眼)白内障患者实施超声乳化并植入ACRYSOF ReSTOR人工晶状体(MIOL),对照组26例(30眼)植入ACRYSOF Natural单焦点人工晶状体(SIOL).术后3个月检查患者的裸眼远、近视力、矫正远、近视力及最佳远视矫正状态下的近视力,对比敏感度,并发症,并调查两组患者不同距离下的视物舒适与否、是否存在眩光等视觉症状及是否需要依赖眼镜.结果 两组患者裸眼远视力、最佳矫正远视力、最佳矫正近视力无明显差异(P>0.05);裸眼近视力及最佳矫正视远度数的近视力,MIOL组明显优于SIOL组(P<0.05);两组患者的对比敏感度在各空间频率段差异均无显著性(P>0.05).仅1例(3.33%)单眼植入MIOL患者诉头晕、眩光等症状,其他患者均无明显不适,满意程度较高.MIOL组术后脱镜率为86.67%,SIOL组所有患者需配戴眼镜,两组有显著差异(P<0.05).MIOL组2例(6.67%)、SIOL组3例(10%)发生后发性白内障,两组比较差异无显著性(P>0.05).结论 ACRYSOF ReSTOR 多焦点人工晶状体能同时提供良好的远、中、近视力,提高白内障患者术后的生活质量.     

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.     

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.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.