目的 探讨谷氨酰胺联合乌司他丁、亚胺培南对急性重症胰腺炎患者肠黏膜屏障功能和营养状态的影响.方法 选取2015年3月至2018年3月收治的急性重症胰腺炎患者80例,随机分为对照组和治疗组,每组40例.对照组给予乌司他丁、亚胺培南治疗,治疗组在对照组基础上给予谷氨酰胺治疗,疗程均为2周.观察2组血清D-乳酸、二胺氧化酶(DAO)、尿乳果糖/甘露醇(L/M)、血浆内皮素(ET)、一氧化氮(NO)、血栓素B2(TXB2)和6-酮-前列腺素F1a(6-keto-PGF1a)、丙二醛(MDA)、超氧化物歧化酶(SOD)、白蛋白(ALB)、转铁蛋白(TF)水平变化.结果 治疗前2组血清D-乳酸、DAO、尿L/M、血浆ET、NO、TXB2、6-keto-PGF1a、MDA、SOD、ALB、TF比较差异无统计学意义(P>0.05).治疗后2组血清D-乳酸、DAO、尿L/M、血浆ET、NO、TXB2、MDA均显著降低,血浆6-keto-PGF1a、SOD、ALB、TF均显著升高,差异有统计学意义(P<0.05);且治疗组D-乳酸、DAO、L/M、ET、NO、TXB2、MDA低于对照组,6-keto-PGF1a、SOD、ALB、TF高于对照组,差异有统计学意义(P<0.05).结论 谷氨酰胺联合乌司他丁、亚胺培南治疗急性重症胰腺炎疗效确切,能够保护肠黏膜屏障功能,改善微循环及营养状态.

目的 观察谷氨酰胺联合乌司他丁、亚胺培南对急性重症胰腺炎患者免疫功能和炎性反应的影响.方法 选取2015年3月至2018年3月收治的急性重症胰腺炎患者80例,随机分为对照组和治疗组,每组40例.对照组给予乌司他丁、亚胺培南治疗,治疗组在对照组基础上给予谷氨酰胺治疗.疗程均为2周.观察2组外周血T淋巴细胞亚群(CD+3、CD+4、CD+8、CD+4/CD+8)、免疫球蛋白(IgM、IgA、IgG)、血白细胞计数、血浆内毒素、血清炎性因子(IL-6、IL-8、TNF-α、hs-CRP)水平变化.结果 治疗前2组外周血CD+3、CD+4、CD+8、CD+4/CD+8、IgM、IgA、IgG、血白细胞计数、血浆内毒素、血清白介素-6(IL-6)、IL-8、肿瘤坏死因子-α(TNF-α)、超敏C-反应蛋白(hs-CRP)比较差异无统计学意义(P>0.05).治疗后2组外周血CD+3、CD+4、CD+4/CD+8、IgM、IgA、IgG均显著升高,CD+8、血白细胞计数、血浆内毒素、血清IL-6、IL-8、TNF-α、hs-CRP均显著降低,差异有统计学意义(P<0.05),且治疗组CD+3、CD+4、CD+4/CD+8、IgM、IgA、IgG高于对照组,CD+8、血白细胞计数、血浆内毒素、血清IL-6、IL-8、TNF-α、hs-CRP低于对照组(P<0.05).结论 谷氨酰胺联合乌司他丁、亚胺培南治疗急性重症胰腺炎疗效确切,能够有效抑制全身炎性反应,增强机体免疫功能,从而维持内环境稳定.

目的 研究谷氨酰胺联合乌司他丁、亚胺培南治疗急性重症胰腺炎的临床疗效.方法 急性重症胰腺炎患者80例随机分为对照组和治疗组,每组40例,对照组给予乌司他丁、亚胺培南治疗,治疗组在对照组基础上给予谷氨酰胺治疗.疗程均为2周.观察2组临床疗效、症状改善程度、生化指标、血清降钙素原(PCT)、尿中胰蛋白酶原激活肽(TAP)、APACHEⅡ评分、CT评分、并发症发生情况、中转手术及死亡情况.结果 治疗组总有效率较对照组明显提高,差异有统计学意义(P<0.05).治疗组首次排便时间、腹痛缓解时间、腹胀缓解时间、肠鸣音恢复时间较对照组明显缩短,差异有统计学意义(P<0.05).与治疗前比较,2组治疗后血淀粉酶、血肌酐、尿淀粉酶、尿素氮、PCT、TAP水平、APACHEⅡ评分、CT评分均显著低于治疗前,且治疗组各指标低于对照组(P<0.05).治疗组并发症发生率、中转手术率、病死率较对照组明显降低,差异有统计学意义(P<0.05).结论 谷氨酰胺联合乌司他丁、亚胺培南治疗急性重症胰腺炎疗效确切,能够有效促进胃肠功能恢复,降低并发症发生率,改善患者预后,值得临床推广应用.

目的 探讨血红素氧合酶(HO)-1在糖尿病大鼠视网膜中的表达及意义.方法 30只大鼠根据随机数字法分为对照组(正常大鼠)、糖尿病组(糖尿病模型)、氯高铁血红素(hemin)组(糖尿病模型+hemin治疗).免疫荧光染色观察视网膜HO-1、核因子相关因子(Nrf)2、磷酸化细胞外调节蛋白激酶(pERK)表达,RT-PCR检测大鼠视网膜HO-1、Nrf2、pERK mRNA表达,Western印迹测定各组大鼠视网膜HO-1、Nrf2、pERK蛋白表达.结果 免疫荧光染色显示:HO-1为绿色荧光,Nrf2、pERK为红色荧光,对照组大鼠只检测到极少量的HO-1、Nrf2、pERK阳性表达.糖尿病组大鼠HO-1、Nrf2、pERK阳性表达均增加,hemin组大鼠视网膜HO-1、Nrf2、pERK阳性表达明显增加.糖尿病组、hemin组大鼠视网膜HO-1 mRNA和HO-1蛋白相对表达量均显著高于对照组(P<0.05),hemin组大鼠视网膜HO-1 mRNA和HO-1蛋白显著高于糖尿病组(P<0.05).糖尿病组、hemin组大鼠视网膜Nrf2 mRNA和Nrf2蛋白相对表达量均显著高于对照组(P<0.05),hemin组大鼠视网膜Nrf2 mRNA和Nrf2蛋白显著高于糖尿病组(P<0.05).糖尿病组、hemin组大鼠视网膜pERK mRNA和pERK蛋白相对表达量均显著高于对照组(P<0.05),hemin组大鼠视网膜pERK mRNA和pERK蛋白显著高于糖尿病组(P<0.05).结论 糖尿病大鼠视网膜HO-1水平升高,HO-1水平升高可能通过Nrf2/ERK信号通路对糖尿病视网膜发挥保护作用.

AIM:To study the effect of Qijudihuang pills assisting sodium hyaluronate on visual function and tear film stability in patients with dry eye. METHODS:Seventy-eight patients(156 eyes)with dry eye from October 2013 to July 2015 were chosen for this study and randomly divided into observation group and control group, 39 patients(78 eyes)in each group. The patients in observation group received Qijudihuang pills combined with sodium hyaluronate. The patients in control group received sodium hyaluronate only. The visual function, tear film stability, Chinese and Western medicine clinical integration and clinical curative effect were compared between the two groups. RESULTS:Clinical curative effect:effective rate of observation group was 92% and was significantly higher than that of the control group as 74%(χ2=4.532, P<0.05). Visual function:the contrast sensitivity of observation group at 12, 18, 24 c/d was significantly higher than those of the control group(P<0.05). Tear film stability:the SIt and BUT of observation group were significantly higher than those of the control group(P<0.05). Symptoms integral:Chinese medicine clinical integral and western medicine clinical integral of observation group were significantly lower than those of the control group(P<0.05). CONCLUSION:Qijudihuang pills combined with sodium hyaluronate can improve visual function, tear film stability and Chinese and Western medical clinic symptoms, then improve the efficacy.

Objective To explore the visual quality parameters changes of different degrees of xerophthal-mia and the influence on the visual quality.Methods A total of 100 xerophthalmia patients treated in Huabei Oil Field Hospital from Apr.2013 to Apr.2015 were divided into a mild group of 43 cases,a moderate group of 37 cases and a severe group of 20 cases according to the disease condition,and another 40 cases of healthy peo-ple for heath examination were included as a control group.All subjects received visual quality analysis system by dual channel technology to detect the Strehl ratio ( SR) ,the cut-off frequency of modulation transfer function ( MTF cut off) ,the objective scatter index ( OSI ) under natural state, and the OSI dynamic changes without blinking,and the mean value of the dynamic changes of OSI( OSI means) were recorded.Results The spheri-cal degree,cylinder degree of the four groups had no significant differences (P>0.05),the BUT,Schirmer I test examination results of the mild group,moderate groupand severe group were significantly lower than the control group[(5.10 ±0.09) s,(5.07 ±0.09) s,(5.00 ±0.07) s vs (12.21 ±1.03) s,(10.04 ±0.10) mm/5 min, (9.95 ±0.07) mm/5 min,(9.93 ±0.10) mm/5 min vs (17.83 ±1.01) mm/5 min] (P<0.05),and there were no statistically significant differences between the mild group , moderate group and severe group ( P >0.05) .SR and MTF cut off of the moderate and severe group were significantly lower than the mild group and control group[(0.17 ±0.02),(0.13 ±0.01) vs (0.24 ±0.03),(0.25 ±0.05);(30.73 ±3.41) c/deg, (27.69 ±2.09) c/deg vs (39.86 ±3.75) c/deg,(40.53 ±4.71) c/deg],OSI of the mild group,moderate group and severe group was significantly higher than the control group [ ( 0.62 ±0.07 ) , ( 0.83 ±0.10 ) , (0.91 ±0.11) vs (0.43 ±0.05)](P <0.05),there was no significant difference in MTF and cut off SR between the mild group and control group( P>0.05);OSI of the moderate group and severe group was signifi-cantly higher than the mild group(P<0.05),SR MTF cut off of the severe group was significantly lower than the moderate group,OSI was significantly higher than the moderate group ( P <0.05 ) .The mean OSI in the mild group,moderate group, severe group were significantly higher than the control group [ ( 0.87 ±0.07 ) , (1.84 ±0.14),(2.13 ±0.27) vs (0.61 ±0.04)],the mean OSI in the moderate and severe groups were sig-nificantly higher than the mild group,and the severe group was significantly higher than the moderate group,and the differences waere statistically significant (P<0.05).Under the natural state in the patient of xerophthalmia OSI and SR,MTF cut off showed a negative correlation (r=-0.879,-0.709,P<0.05),and no significant correlation with age (r=-0.236,P>0.05),patients with xerophthalmia mean OSI under film dynamic state had no significant correlation with age,BUT and Schirmer I test(r =-0.227,0.031,0.053,P >0.05). Conclusion With visual quality parameters changes of the xerophthalmia patients, the visual quality also change,and with the aggravation of the disease,the visual quality is affected more;in treatment of symptoms of xerophthalmia,improving the visual quality of patients should also be considered.

Objective To explore the influence of insulin on E-selectin in vitreous and aqueous humor of dia-betic rats .Methods Sixty SD male rats were randomly divided into the following groups :normal control(group A) , diabetic rats with uncontrolled blood glucose group (group B) ,diabetic rats insulin controlled group(group C) ,re-ceived intensive insulin therapy ,20 rats in each group .Diabetes was induced in SD rats by a single intraperitoneal in-jection of Streptozotocin(STZ) .Application of ELISA method to detect E-selectin in vitreous and aqueous humor af-ter 5 months .Results The levels of E-selectin in vitreous in group B was higher than group A and group C (P<0 .05) ,The levels of E-selectin in vitreous respectively was group A (0 .503 ± 0 .013)ng/mL ,group B (0 .728 ± 0 .111)ng/mL ,group C (0 .565 ± 0 .061)ng/mL .Content of E-selectin(ng/mL) in aqueous humor respectively was group A (0 .048 ± 0 .004)ng/mL ,group B (0 .099 ± 0 .012)ng/mL ,group C (0 .063 ± 0 .007)ng/mL .Each group is statistically significant (P<0 .05) .Conclusion Insulin treatment can obviously reduce the levels of E-selectin in the vitreous and aqueous humor of diabetic rat ,reduce the incidence of diabetic retinopathy .

Objective To explore the prevalence and influencing factors of poor vision among primary and secondary students,in order to provide evidence for the prevention and control myopia.Methods A structured questionnaire and computer optometry vision detection were done for 1796 students in Shijiazhuang.Results The poor vision detection rate was46.77%,and the prevalence of poor vision rate were 42.63% for boys,51.21% for girls,33.15% for elementary students,56.36% for middle school students,53.76% for urban students,and 39.24% for rural students.Logistic regression analysis indicated that watching TV or computer more than 1 hour a day(OR = 1.276),studying more than 8 hours a day(OR = 1.539),continue reading for more than 1 hour(OR = 1.311),as well as reading in bed(OR = 1.102) and family history(OR = 1.364) were the risk factors.For the correct reading and writing poses(OR = 0.774),regular eyechecking(OR = 0.647),sleeping over eight hours a day(OR = 0.752),exercising more than 1 hours a day(OR =0.693) and initiative rest after a long time learning(OR = 0.875) were the proactive factors.Conclusion The prevalence rate of poor vision among students was still high,effective interventions should be taken for students according to the influencing factors,in order to prevent poor vision effectively.

目的 了解石家庄市中小学生视力不良及预防视力不良知识、态度、行为(knowledge,attitude,behavior,KAP)现状,为防治中小学生视力不良提供科学依据.方法 采用自编结构式调查问卷对石家庄市1 796名中小学生进行预防视力不良知识、态度及行为的调查.结果 石家庄市中小学生视力不良检出率为46.77％,其中男生42.63％,女生51.21％,小学生33.15％,中学生56.36％,城市学生53.76％,农村学生39.24％.女生预防视力不良知识、态度及行为得分均高于男生(P＜0.01),中学生预防视力不良知识得分高于小学生,行为得分低于小学生(P＜0.01),农村学生预防视力不良行为得分高于城市学生(P＜0.05).结论 石家庄市中小学生视力不良检出率较高,应采取针对性的措施加强中小学生爱眼护眼的健康教育,有效预防中小学生视力不良.

目的 观察视网膜静脉阻塞患者行视网膜光凝术后睫状体的形态学改变.方法 对22例视网膜中央静脉阻塞(缺血型)患者和19例视网膜分支静脉阻塞患者行视网膜光凝治疗.分别于激光治疗术前、术后第2天、第7天行超声生物显微镜检查,观察睫状体结构的变化.结果 视网膜静脉阻塞患者视网膜光凝术前均无睫状体脱离.术后第2天21只眼(51％)发生睫状体脱离,睫状体脱离的范围与光凝范围的大小无显著性差异.术后第7天有2只眼(5％)发生睫状体脱离.结论 睫状体脱离是视网膜光凝术后常见并发症,但有自愈倾向,应注意预防.

AIM: To investigate the etiology, classification and different treatments for chestnut thorn foreign bodies in corneal. METHODS: Totally 56 cases with chestnut thorn foreign bodies in corneal were studied retrospectively, and we analyzed how long foreign bodies had been in the eyes and where they lay, the visual acuity and etc. Different operative treatments and operation effects were also analyzed. RESULTS: Males were more than females in patients. Most patients were less than 50 years old. No composite traumatic cataract was found. 82% patients were removed by the slit-lamp in outpatient department, 18% patients were removed the foreign bodies under operating microscope in inpatient department. Visual acuity after treating was better than that before treating. There are significant difference in both groups(P<0.05). CONCLUSION: Chestnut thorn foreign bodies in corneal were variable. It could to improve the therapeutic effect and reduce the cost of medical care that different foreign body types use different method.