深板层角膜移植术治疗圆锥角膜的临床探讨

目的观察深板层角膜移植术治疗圆锥角膜的手术方法及临床效果.方法总结自2008年7月至2009年12月于邢台眼科医院住院的圆锥角膜患者19例,手术均采用深板层角膜移植术,术后随访观察6～18个月,观察角膜植片的透明度及视力情况.结果 19例患者中,术后裸眼视力为0.2～0.5的16眼,≥0.6的3眼.4例术后第2天发现少许层间积液,植片基质层轻度水肿,经前房补气后层间积液吸收,角膜植片恢复透明,余角膜植片全部透明.结论深板层角膜移植术治疗圆锥角膜可以取得较好的临床效果.     

深低温保存兔角膜穿透性移植后神经再生形态的观察

观察采用深低温保存和新鲜角膜移植术后，移植角膜神经再生情况以及其形态的差异性。方法 采用深低温保存和新鲜兔角膜行同种异体穿透性移植。通过氯化金浸染技术对两种方法保存角膜移植术后１０－２４０ｄ植片内神经再生形态进行形态学观察。结果 术后３０ｄ内，植片内神经溃变，同时宿主角膜实质神经出芽再生。     

深低温保存兔角膜穿透性移植后神经再生形态的观察

①目的观察采用深低温保存和新鲜角膜移植术后，移植角膜神经再生情况以及其形态的差异性。②方法采用深低温保存和新鲜兔角膜行同种异体穿透性移植。通过氯化金浸染技术对两种方法保存角膜移植术后１０～２４０ｄ植片内神经再生形态进行形态学观察。③结果术后３０ｄ内，植片内神经溃变，同时宿主角膜实质神经出芽再生。１２０～１８０ｄ，在边缘处再生的神经形成神经纤维“瘤”样结构，并可见髓鞘再生。术后２４０ｄ，多数植片中央有再生的神经分布，但均失去了正常角膜神经分布形态。④结论在光镜下，深低温保存的角膜移植后对角膜神经再生形态无影响；角膜移植术后角膜神经表现为显著地不完全性再生。     

深板层角膜移植术治疗坏死性角膜基质炎

目的：评价深板层角膜移植治疗坏死性角膜基质炎的临床效果及影响因素。方法：采用深板层角膜移植治疗坏死性角膜基质炎21例（21眼）,临床观察3～23个月。结果：术后矫正视力≥0.3者19眼（90.48%）,发生排斥反应3眼（14.29%）,复发1例（4.76%）。植片透明21眼,透明率为100%。结论：深板层角膜移植术具有清除病灶彻底、排斥反应发生率低、无内眼手术并发症等优点,是治疗坏死性角膜基质炎的理想方法。     

123例穿通性角膜移植临床观察

目的 观察穿通性角膜移植的治疗效果,探讨影响成功率的因素,方法 采用新鲜角膜材料行穿通性角膜移植１４６例（１５８眼）,术后１２３例（１２８眼）随访观察３个月至５年（平均１．５年）。结果 植片透膜移植是治疗多种角膜疾病、恢复视力的非常有效的方法,手术成功率取决于术眼条件,供体质量,手术技术和并发症处理。     

深板层角膜移植术治疗坏死性角膜基质炎

目的：评价深板层角膜移植治疗坏死性角膜基质炎的临床效果及影响因素。方法：采用深板层角膜移植治疗坏死性角膜基质炎21例（21眼），临床观察3～23个月。结果：术后矫正视力≥0．3者19眼（90．48％），发生排斥反应3眼（14．29％），复发1例（4．76％）。植片透明21眼，透明率为100％。结论：深板层角膜移植术具有清除病灶彻底、排斥反应发生率低、无内眼手术并发症等优点，是治疗坏死性角膜基质炎的理想方法。     

自动角膜板层刀在角膜移植中的应用

目的：介绍自动角膜板层刀应用于板层角膜移植手术的治疗效果。方法：对3例3只眼用自动角膜板层刀在受体眼上根据病变厚度及直径大小做植床,然后在供体眼上做与受体相应厚度和直径的植片,再将植片放置于植床使其自然粘附,结果：经3个月随访,3例3只眼均达到了手术的目的,其中1例视力为指数／40cm,1例为0．2,另1例无明显改善;2只眼植片完全透明,1只眼半透明;1例1只眼术后第3天出现层间出血,经激光处理后植片透明,余均未出现术中及术后并发症,结论：用自动角膜板层刀行板层角膜移植术与既往板层角膜移植术相比,有明显优越性。     

深低温长期保存角膜穿透性移植治疗感染性角膜病的临床观察

目的 :观察深低温长期保存角膜穿透性移植治疗感染性角膜病的临床效果。方法 :应用深低温保存 1～ 60月的健康人尸角膜为真菌性角膜炎 10例、10眼和病毒性角膜炎 4例、4眼行穿透性角膜移植术。结果 :随诊 1～ 19月 ,13例角膜植片透明 ( 92 .85% ) ,1例半透明 ,无 1例原发病复发 ,视力均有提高。结论 :深低温长期保存的角膜是治疗急性致盲性角膜病的重要储备材料 ,有重要的临床应用价值。     

异种板层角膜移植的免疫学及组织学观察

本实验以鸡对兔异种板层角膜移植为实验模型,动态观察手术前后3个月内角膜透明度、体液免疫、细胞免疫及组织学改变。结果发现术后3～4周异种角膜移植动物发生免疫排斥致植片混浊,3个月内又渐恢复透明。作者认为,细胞及体液因素均参与免疫排斥反应;受体角膜细胞的再生修复可能是植片又复透明的原因。     

深低温长期保存角膜行穿透性角膜移植术的临床观察

目的观察深低温长期保存角膜行穿透性角膜移植术的临床效果.方法观察组25例(25只眼)采用深低温长期保存角膜行穿透性移植术.对照组23例(23只眼)采用新鲜人尸角膜行穿透性移植术.随访3～32个月.结果观察组中角膜植片透明18例(占72.0%),半透明5例,混浊1例,眼球摘除1例.对照组中角膜植片透明17例(占73.5%),半透明5例,混浊1例.两组植片透明情况无统计学意义(χ2=0.022,P＞0.05).结论深低温长期保存角膜在穿透性角膜移植术中具有重要的临床价值和推广价值.     

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.