【摘要】 目的 探讨在藏区白内障术前人工晶体度数的测定的必要性。方法 回顾性分析2009年8月—12月在拉萨光明眼科康复诊疗院进行白内障手术的170例患者,其中85例术前行人工晶体度数的测定,85例未行晶体度数的测定,比较两组术后3 d的视力。结果 测定组:术后视力≥0.3为51例,占60％；0.1lt;视力lt;0.3为24例,占28.24%;视力lt;0.1为10例,占11.76％。未测定组:术后视力≥0.3为48例,占56.47％；0.1lt;视力lt;0.3为17例,占20%;视力lt;0.1为20例,占23.53％。两组术后3 d最佳视力的比较有统计学意义(P＜0.05)。结论 术前测定人工晶体度数有助于改善白内障患者术后视力,在藏区有必要行白内障术前人工晶体度数的测定。
ObjectiveTo compare the indirect calorimetry (IC) measured resting energy expenditure (MREE) with adjusted Harris-Benedict formula calculating resting energy expenditure (CREE) in the mechanically ventilated surgical critically ill patients and to evaluate the relationship between the resting energy expenditure (REE) with the severity of illness. MethodsTwenty-one patients undergonging mechanical ventilation for critical illness in the intensive care unit of general surgery between August 2008 and February 2010 were included in this study. Data during the study period of nutrition support were collected for computation of the severity of critical illness by acute physiology and chronic health evaluation Ⅱ scores (APACHE Ⅱ scores) and organ dysfunction scores (Marshall scores). MREE was measured by using IC of the MedGraphics CCM/D System within the first 7 d after nutrition therapy. CREE was calculated by using the HarrisBenedict formula adjusted with correction factors for illness at the same time. According to APACHE Ⅱ scores on admission, the enrolled patients were divided into two groups: APACHEⅡ score ≥20 scores group (n=8) and APACHE Ⅱ score lt;20 scores group (n=13), and the differences between MREE and CREE of patients in two groups were determined. ResultsThe reduction of variation tendency in CREE other than MREE in the enrolled patients within the first week of nutritional support was statistical significance (Plt;0.001). The CREE of patients 〔(1 984.49±461.83) kcal/d〕 was significantly higher than the MREE 〔(1 563.88±496.93) kcal/d〕 during the first week of nutritional support (Plt;0.001). The MREE on the 0, 1, 2, and 4 d after nutrition therapy were statistically significant lower than CREE at the same time interval in these patients (Plt;0.01), and the differences at the other time points were not significant (Pgt;0.05). There was a trend towards a reduction in APACHE Ⅱ and Marshall scores within the first week of nutrition therapy that reached statistical significance (Plt;0.001). During the first week of nutrition therapy, APACHEⅡ and Marshall scores of patients in ≥20 scores group were significantly higher than those in lt;20 scores group, respectively (Plt;0.05 or Plt;0.01), and the reductions of APACHE Ⅱ scores and Marshall scores were significant in patients of two groups (Plt;0.001). A significant positive correlation was found between CREE with APACHE Ⅱ scores (r=0.656, Plt;0.001) and Marshall scores (r=0.608，Plt;0.001) in patients within the first week after nutrition support. Although no statistically significant correlation was observed between MREE and APACHEⅡ scores (r=-0.045， P=0.563), a significant positive correlation was observed between MREE and Marshall scores (r=0.263, P=0.001) within the first week after nutrition therapy. There was no correlation between MREE and CREE (r=0.064, P=0.408) in patients at the same time interval. The reduction of MREE of patients in ≥20 scores group other than in lt;20 scores group was statistically significant within the first week after nutrition therapy (P=0.034). In addition, the MREE of patients in ≥20 scores group were not significantly different from those in lt;20 scores group (Pgt;0.05), and the mean CREE was not different in two groups patients within the first week of nutritional therapy 〔(1 999.55±372.73) kcal/d vs. (1 918.39±375.27) kcal/d, P=0.887〕. CREE was significantly higher than MREE of patients in ≥20 scores group within the first week except the 3 d and 5 d after nutrition therapy (Plt;0.05), while in lt;20 scores group CREE was significantly higher than MREE in patients only within the first 3 d after nutrition therapy (Plt;0.05 or Plt;0.01). MREE and CREE of patients in ≥20 scores group were not different from those in lt;20 scores group, respectively (Pgt;0.05).
Objective To explore the accuracy and practicability of bone age assessment for the diagnosis of idiopathic precocious puberty (IPP). Methods According to the “Gold Standard”, we selected 55 girls with IPP for the study group, and 83 normal girls for the control group. We retrospectively analyzed the first left hand-wrist radiographs at the first visit. Bone ages were assessed by using a single-blind method according to the RUS (Radius Ulna and Short bones), carpale and 20 bones method (TW2). Each had 5 decision thresholds (gt;97th percentile, gt;90th percentile, gt;75th percentile, gt;50th percentile and ≤50th percentile). The diagnostic values from RUS, carpale and 20 bones methods assessing bone age were analyzed to identify the best decision threshold. Results ① Both sensitivity and specificity of the four decision thresholds were relatively higher, including gt;90th percentile of RUS (sensitivity 0.836, specificity 0.916), gt;90th percentile of carpale (sensitivity 0.746, specificity 0.916), gt;90th and gt;75th percentile of 20 bone (sensitivity 0.746, specificity 0.964 and sensitivity 0.982, specificity 0.783, respectively). ② Area under receiver operator characteristic curve (AUR): AUR of RUS 0.939 ± 0.019 (95%CI 0.902 to 0.977), AUR of carpale 0.899 ± 0.028 (95%CI 0.845 to 0.954), AUR of 20 bone 0.958 ± 0.014 (95%CI 0.930 to 0.986). No significant difference was found (F=2.03, P=0.13). ③ Agreement assessment within-observer reliability was 89.28%, and between-observer reliability was 80.3% (Kappa 0.68, u=6.87, P＜0.01). Conclusions RUS and 20 bones methods have high accuracy for the diagnosis of idiopathic precocious puberty. Considering sensitivity and specificity, we think that ＞90th percentile of RUS is the best decision threshold.
ObjectiveTo observe the concentration of plasma endothelin (ET-1) in patients with nonarteritic anterior ischemic optic neuropathy(NAION) and investigate the relationship between ET-1 and NAION.MethodsThe plasma levels of ET-1 in 41 patients with NAION and 15 age-matched normal control subjects were measured by radioimmuoassay (RIA). The patients with NAION were divided into high papilloedema group, light papilloedema group, and recovery group according to the degree of papilloedema; and were divided into group1 (within 14 days), 2 (within 15-30 days), 3 (within 31-60 days), and 4 (within 61-180 days) according to the disease course. The plasma levels of ET-1 in different groups were detected and compared.ResultsThe plasma level of ET-1 in patients with NAION was significantly higher than that in the normal subjects (t=5.02，P＜0.05）and there was no obvious difference in NAION patients with different genders.There were significant differences of the plasma level among the groups with different degree of papilloedema（F=4.65，P＜0.05）. ET-1 plasma level gradually decreased as the disease course increased, and there were significant differences among the groups with different disease course（F=4.29，P＜0.05）. The difference of plasma level of ET-1 between Group 13 with corresponding disease courses and the control group was significant respectively(t1=5.92，t2=3.47，t3=2.18， P1lt;0.01, P2lt;0.05, P3lt;0.05)ConclusionThe plasma level of ET-1 in patients with NAION may be related to the degree of papilloedema lesion and disease courses. (Chin J Ocul Fundus Dis, 2005,21:156-158)
目的:探讨简化生长激素药物激发实验的可行性。方法:对单独应用可乐定药物激发实验的结果和联合应用可乐定与精氨酸药物激发实验结果进行对照研究。GH峰值gt;10ng/mL,正常;GH峰值lt;5ng/ml,为GH完全缺乏;GH峰值在5 -10ng/ml之间,为GH部分缺乏。结果:简化药物激发实验与经典药物激发实验结果评估无显著性差异。结论:单独使用可乐定进行生长激素激发实验的结果与可乐定联合精氨酸进行生长激素激发实验结果评价无显著性差别。
ObjectiveTo observe the difference of retinal vessel oxygen saturation in glaucoma and normal eyes. MethodsA cross sectional study design was performed. Fifty eyes of 30 glaucoma patients (glaucoma group) and 41 eyes of 27 age-and sex-matched healthy subjects (control group) were included. Retinal vessel oxygen saturation was measured with a spectrophotometric retinal oximeter in darkness and visual fields were obtained by Humphrey filed analyzer. The glaucoma eyes were divided into two groups: mean defect (MD)<6 dB (28 eyes) and MD≥6 dB (22 eyes) according to mean defect of visual field. ResultsRetinal arteriolar oxygen saturation values in glaucoma group and control group were (94.52±6.51)% and (93.47±6.30)% respectively. No statistical difference was found in retinal oxygen saturation in arterioles (H=-0.949, P=0.343). Retinal venous oxygen saturation values in glaucoma group and control group were (57.57±7.96)% and (52.60±7.70)% respectively. The retinal venous oxygen saturation values in glaucoma group was higher than that in control group (H=-3.318,P=0.001). The retinal arteriovenous difference in glaucoma group and control group were (36.59±4.69)% and (42.41±6.73)% respectively. The retinal arteriovenous difference in glaucoma group was lower than that in control group (H=-4.148,P<0.01). The retinal arteriolar oxygen saturation values in glaucoma eyes with MD<6 dB and MD≥6 dB were (93.38±6.33)% and (95.71±6.54)% respectively, with no statistical difference (H=-1.857,P=0.063). Retinal venous oxygen saturation values in glaucoma eyes with MD<6 dB and MD≥6 dB were (54.83±6.10)% and (61.07±8.79)% respectively. The retinal venous oxygen saturation values in MD≥6 dB glaucoma eyes was higher than that in MD<6 dB glaucoma eyes (H=-2.599, P=0.009). The retinal arteriovenous difference in glaucoma eyes with MD<6 dB and MD≥6 dB were (38.12±4.34)% and (34.64±4.49)% respectively. The retinal arteriovenous difference in MD≥6 dB glaucoma eyes was lower than that in MD<6 dB glaucoma eyes (H=-2.463,P<0.05). ConclusionsCompared with healthy eyes, there is no change in the retinal arteriolar oxygen saturation, but the retinal venous oxygen saturation is higher and the retinal arteriovenous difference is lower. This feature is more obvious in MD≥6 dB glaucoma eyes.
0bjective To evaluate the efficacy of FEV6 and FEV1／FEV6 as surrogates for FVC and FEV1／FVC in the spirometric diagnosis of airway obstruction，and to determine the fixed cut-off point of FEV1／FEV6 which can be used as an alternative for FEV1／FVC lt; 70％.Methods Spirometry measurements were perform ed in 128 participants．FEV1，FEV6，FVC，FEV1％pred，FVC％pred，FEV1／FVC and FEV1／FEV6 were measured and analyzed.FEV1／FVClt;70％ was used as the“gold standard”。Severity of obstruction was based on FEV ％ pred．From ROC curve analysis，the FEV1／FEV6 ratio，which corresponded to optimal combination of sensitivity and specificity，was determined．Correlation between FEV1／FVC and FEV1／FEV6 was studied．Results Of 128 participants，there were 65(51％)with FEV1／FVC ≥70％ ．Of the 63 participants with FEV1／FVC lt;70％ ，there were 5 with FEV1／FEV6 between 70.09％ to 71％。There was no significant difference between the mean value of FVC and that of FEV ．Lifear correlation was revealed between FEV1／FVC and FEV1／FEV6 with the value close to 1(r=0.9979，Plt;0.0001)．From ROC curve analysis，the FEV1／FEV6lt;71.14％ was the best cut-off point coresponding to FEV1／FVC lt;70％ ．Conclusion These results suggest that FEV1／FEV6 is a valid alternative to FEV1／FVC for spirometric diagnosis of airw ay obstruction．There is a b corelation between FEV1／FEV6 and FEV1／FVC．
Transit time flow measurement (TTFM),which is independent of vessel size and shape, has been considered to be an easy, reproducible and non-invasive method to assess the hemodynamic characteristics. Moreover, current studies have shown that TTFM has clinical application in identifying the function of grafted vessel and prognosis. Researchers have proved some reliable indicators for the function of grafted vessel as follows: mean graft flow (MGF) > 15 ml/min, diastolic flow (DF) >50% and pulsatility index (PI)<3 or 5. This article focuses on the review of clinical application and research progress of TTFM in CABG.