目的:探讨健脾祛湿方敷脐联合脊柱推拿对小儿腹泻(脾虚湿盛证)肠黏膜屏障功能、肠道菌群和促炎因子的影响.方法:将2019年1月至2020年6月于解放军总医院第八医学中心住院治疗的小儿腹泻(脾虚湿盛证)患者106例纳为研究对象,分为对照组和中医联合组,分组方法采用随机数字表法.对照组患儿进行调整饮食方案、口服补液盐和脊柱推拿等基础对症治疗,中医联合组患儿在对照组的基础上进行健脾祛湿方敷脐治疗.两组患儿均连续治疗7d.观察两组患儿的临床疗效,治疗前后中医症状积分、肠黏膜屏障功能、肠道菌群变化情况和促炎因子含量变化情况.结果:治疗后,两组患儿各项中医症状积分均降低,且中医联合组明显低于对照组,差异均有统计学意义(P<0.05).中医联合组患儿的总有效率为94.34％(50/53),明显高于对照组(81.13％,43/53),差异有统计学意义(P<0.05).治疗后,两组患儿血清D-乳酸和二胺氧化酶(DAO)含量均明显低于治疗前,肠道菌群中各菌群含量均明显高于治疗前,白细胞介素6(IL-6)、白细胞介素8(IL-8)和肿瘤坏死因子α(TNF-α)含量均明显低于治疗前;且中医联合组患儿血清D-乳酸和DAO含量明显低于对照组,各菌群含量明显高于对照组,IL-6、IL-8和TNF-α含量明显低于对照组,上述差异均有统计学意义(P<0.05).结论:健脾祛湿方敷脐联合脊柱推拿对小儿腹泻的疗效较好,可有效增强患儿的肠黏膜屏障功能,调节肠道菌群平衡,抑制促炎因子分泌,促进患儿康复.

目的 观察超声乳化白内障吸出术联合房角分离术治疗青光眼合并白内障对术后眼表的影响.方法 青光眼合并白内障患者44例,均为单眼发病.将手术眼设为观察组,对侧非手术眼设为对照组.观察两组术前和超声乳化白内障吸出术联合房角分离术后(3d和1、3个月)眼表疾病指数评分、泪膜破裂时间、角膜荧光素染色评分及结膜充血评分.结果 观察组术后3d和1个月眼表疾病指数评分和角膜荧光素染色评分,以及术后3d泪膜破裂时间与术前比较均有统计学差异(P＜0.05).与对照组比较,观察组术后3d和1个月眼表疾病指数评分增高、泪膜破裂时间缩短和角膜荧光素染色评分增高,术后3d结膜充血评分增高(P＜0.05).结论 超声乳化白内障吸出术联合房角分离术治疗青光眼合并白内障对术后眼表有一定程度影响,临床应采取有效措施预防和治疗.

目的 研究了甘精胰岛素联合二甲双胍治疗二型糖尿病的临床效果.方法 选取我院2016年5月～2016年11月收治的二型糖尿病患者共计48例,按照抛硬币的方式随机划分到研究组和对照组,其中,研究组患者25例,采用甘精胰岛素联合二甲双胍进行治疗;对照组患者共计23例,仅口服二甲双胍,对两组患者治疗效果进行对比.结果 治疗后,研究组患者夜间低血糖发生概率、血糖达标时间等指标均优于对照组,差异具备统计学意义(P＜0.05).结论 通过甘精胰岛素联合二甲双胍对二型糖尿病进行治疗,临床实践效果尤为显著,患者满意度高,具有较强的推广价值.

AIM:To study the effects of long-term wearing monocular orthokeratology on ocular surface.METHODS: A retrospective study was conducted in patients with unilateral myopia(The contralateral eye of each patient was emmetropic.)who used orthokeratology lens for more than half a year. The patients were recruited from January 2013 to December 2015, in ophthalmological clinic, 101 Hospital of PLA, Wuxi. The tear break-up time(BUT), basal tear secretion, central corneal thickness, corneal endothelial cell density, conjunctival congestion and corneal epithelium fluorescein staining were observed before wearing orthokeratology and at different time points during wearing orthokeratology.RESULTS: Fifty-three young patients(53 eyes)with long-term wearing a monocular orthokeratology lens were observed, whose ages were 10.43±1.70 years old and their spherical equivalents(SEs)were -3.37±1.50D. For the myopic eyes, after 1-week treatment of monocular orthokeratology, the BUT was shortened, but there was no significant difference compared with those after 1-month, 3-month, 6-month treatment of monocular orthokeratology(P>0.05). For the emmetropic eyes, there was no significant difference in changing the BUT at above different time points(P>0.05). There was no significant difference in the value of basal tear secretion at those time points between two different kinds of eyes(The myopic eyes with orthokeratology and the emmetropic eyes without orthokeratology)(P>0.05). Compared with before wearing orthokeratology lens, there was no significant difference in both corneal center thickness and corneal endothelial cell density at those time points after wearing orthokeratology lens(P>0.05). After wearing orthokeratology lens, the corneal epithelial stain was mostly Ⅰ dyed. After 1wk, 1, 3 and 6mo respectively, the Ⅰ dyed amounts were 10 eyes(19%), 6 eyes(11%), 8 eyes(15%), 6 eyes(11%),the Ⅱ dyed amounts were 1 eye(2%), 0, 0, 1 eye(2%). The conjunctival congestion(score 1)showed up on 10 patients after wearing the orthokeratology lens. After all the 10 cases stopping wearing orthokeratology lens, but taking some antibiotics and corneal repair agents, the corneal epithelium stain disappeared and the conjunctival congestion faded away. For the emmetropic eyes, no obvious conjunctival congestion was observed during the observation period, and the corneal epithelial stain was 0.CONCLUSION: Continuous wearing orthokeratology can cause the decrease of the stability of tear film. And it also affects the conjunctiva and corneal epithelium by degrees. But it has no significant effect on tear secretion, corneal thickness and corneal endothelial cells. There will be no apparent ocular surface damage on non-wearing eyes.

Myopia, a deteriorated and still unsolved eye problem in China, shows the character of early onset, rapid progress and increased proportion of high myopia. Because of the serious complication caused by high myopia, such as retinal detachment, glaucoma, cataract and macular disorders, it can even lead to the irreversible loss of vision. The prevention and effective control of myopia turn to be an urgent social problem. In this review, causes and the progress of treatment in myopia are described.

目的 研究不同方案对初诊2型糖尿病的临床治疗效果.方法 选取我院2016～2017年收治的93例2型糖尿病患者,结合治疗方案的不同划分为A组、B组和C组,各组患者均为31例,其中,对A组患者进行单纯的胰岛素治疗,对B组患者施加甘精胰岛素和二甲双胍治疗,C组患者实施格列美脲联合二甲双胍治疗,对三组患者治疗前后的效果进行对比.结果 三组患者在经过治疗之后,HbAlc、FBG等水平相较于之前均有所下降,其中,A、B两组患者的血糖达标时间要低于C组,差异具备统计学意义(P<0.05).结论 对于初诊2型糖尿病患者而言,以上三种治疗方案均具有显著疗效,糖代谢异常患者更加适合于单纯胰岛素的治疗方法.

Objective To compare the clinical curative effect between combined trabeculectomy and 810 nm laser through scleral ciliary body photocoagulation method in the treatment for glaucoma patients.Methods Selected 70 patients who were diag-nosed with glaucoma from January 2013 to June 2014 in our hospital.According to different operation, they were divided into observa-tion group and control group.47 cases of 57 eyes in the observation group received ciliary body photocoagulation and 23 cases of 31 eyes in the control group received combined trabeculectomy.Compared visual acuity, intraocular pressure before and after treatment , postoperative complications and outcome in two groups.Results The visual acuity in the two groups before and after treatment had no significant difference.1 week and 3 months after treatment, intraocular pressure in observation group was better than control group, while at the time of the last follow-up, there was no significant difference ( P>0.05 ) .Reoperation rate of observation group was 27.66%(13/47) and control group was 8.70%(2/23).There was significant differences between the two groups (P<0.01).Con-clusion Compared with trabeculectomy operation, TDCP in the treatment of glaucoma is more simple but its short-term effects is not as good as trabeculectomy and should be treated with auxiliary drug or reoperation.Long-term effects and restored vision effect has no ob-vious difference between two methods.

Objective To explore the age difference of the changes in anterior chamber angle (ACA) in the patients after cataract ultrasonic emulsification operation(CUEA) .Methods A total of 174 patients(174 eyes) with cataract was assigned into three groups of A(<60 years old ,36 cases) ,B (60‐75 years old ,75 cases) and C (> 75 years old ,63 cases) .The ACA parameters of the anterior chamber depth (ACD ) ,ACD angle (ACAA ) ,anterior chamber angle opening distance (AOD ) and trabecular iris space area(TISA) at 270 degrees and 750 μm in horizontal and vertical levels were measured by anterior segment optical coherence tomography (as‐OCT ) before and in one week ,one month ,three months and 6 months after operation .Results Compared to before ,the ACD ,ACA ,AOD and TISA were all significantly increased after CUEA(P<0 .05) ,which were more in groups of B and C than those in group A(P<0 .05) .Conclusion The increases of ACD ,ACA ,AOD and TISA after CUEA are more in cataract patients aged greater than 60 years old than in the youngers with cataract .

目的：通过对以近视首诊的青少年开角型青光眼78例检查、确诊分析，以期早期发现、早期诊断和早期治疗。方法选取2007-2012年以近视首诊的青少年开角型青光眼78例（156眼），对其性别、年龄、屈光状态、眼压、房角、眼底、视野、家族史等有关参数进行回顾性分析。结果男31例（39．7％），女47例（60．3％）。发病年龄：10～15岁23例，16～20岁33例，21～25岁13例，26～30岁9例。屈光状态：＜-3．00 D的低度近视眼58眼，-3．00～-6．00 D的中度近视眼50眼，＞-6．00 D的高度近视眼13眼，正视眼35眼。眼压：10～20 mmHg者54眼，21～25 mmHg者34眼，26～30 mmHg者42眼，31～40 mmHg者19眼，＞40 mmHg者7眼。眼底：C／D＜0．6者97眼，C／D 0．6～0．8者53眼，C／D＞0．8者6眼。眼底照相所见视网膜神经纤维层缺损（ RNFLD）：阳性者149眼，可疑者7眼。全自动视野分析仪检查：不同程度视野损害者102眼，阴性者54眼。156眼房角全部为开角未见特殊异常。有青光眼家族史者8例。结论青少年开角型青光眼发病隐匿，发病年龄较早，发现时大多为中晚期，在本病近视眼有高度的发病率，因此在临床工作中应慎重对待近视眼患者，重视全面的眼部检查，这是青少年开角型青光眼早期诊断的关键。

AIM: To integrate the individual and various items of refractive examination to one software, and made it applicated conveniently. METHODS: On the basis of every examination system, the computer software was designed and developed, the modules were established and maintained. RESULTS: The computer software could fulfill the examinations of visual acuity, strabismus (Hess screen), color vision, stereopsis. CONCLUSION: After 10 years' application, the effect is significant. It can nearly replace the items using projector of integrated refractometer, stereopsis exam and color blind exam.

目的:探讨中西医结合治疗中老年女性膝关节骨性关节炎的护理方法.方法:选取2008年2月到2011年8月收入我科的32例中老年女性膝关节骨性关节炎患者,通过中西医结合治疗、有效地护理措施及康复锻炼进行治疗.结果:取得了较满意的临床疗效.现报告如下.

目的分析首诊眼科确诊为青年高血压病患者的眼部情况。方法对45例(50眼)以视力下降为主要症状就诊的疑为青年高血压病患者,给予眼前后节检查、眼底荧光血管造影及视野检查、血压测定等。结果所有患眼中视网膜动脉阻塞18眼,视网膜静脉阻塞19眼,缺血性视神经病变13眼。45例均确诊为青年高血压病。结论因眼部并发症而首诊于眼科的青年高血压病患者缺乏高血压病的典型症状,临床应加以重视,以免延误治疗。

<正>冠脉造影是确诊冠心病的"金标准",而冠脉介入是目前治疗冠心病的一种极为有效的手段。目前主要采用经股动脉、桡动脉两种穿刺途径进行手术。2008年6月以来,我们采用经桡动脉行冠脉介入治疗204例,经精心护理,效果满意。现将护理体会报告如下。

AIM:To observe the effect and safety of orthokeratology rectifying myopia and controlling the development of myopia.METHODS:The myopia of 423 cases(789 eyes) were corrected by orthokeratology,and the changes of corneal condition,vision,dioptre were observed.At the same time,patients under the age of 15,who had worn orthoklenses for over one year were studied.RESULTS:All patients were satisfied with the effect and safety of orthokeratology.CONCLUSION:Orthokeratology as a non-traumatic way rectifying myopia can reduce dioptre and control the development of myopia effectively.

AIM:To evaluate the effect of phacoemulsification combined with goniosynechialysis for the treatment of primary angle-closure glaucoma(PACG) complicated with cataract. METHODS:Totally 45 cases (52 eyes) who were PACG complicated with cataract underwent transparent corneal incision cataract phacoemulsification and goniosynechialysis by topical anesthesia. RESULTS:Visual acuity improved significantly, central anterior chamber depth and angle all improved differently after operation. CONCLUSION:It is an effective and safe therapy for PACG complicated with cataract treated by phacoemulsification combined with goniosynechialysis. 

Objective To observe the influence of early using edaravone on mortality and serum neuron-specific enolase and C-reactive protein levels in patients with acute massive hemispheric infarction.Methods 90 patients(admitted within 48 hours after onset)with acute massive hemispheric infarction were divided into two groups randomly,treatment group and control group.Mortality and the scores of NIHSS were recorded,the levels of serum neuron-specific enolase and C-reactive protein were measured before and after treatment.Results Compared with the control group,mortality was decreased significantly in treatment group,the difference of NIHSS was not significant,serum NSE levels were decreased significantly at d7 and d14 but not at d21 after treatment,difference of serum CRP levels at d7 was significant,but not at d14 and d21.Compared with stages before treatment,the serum NSE and CRP levels in treatment group were decreased significantly at d7 or d14 or d21 after treatment,in control group at d14 or d21.Conclusion Serum NSE and CRP levels and mortality in patients with acute massive hemispheric infarction can be decreased significantly by early using edaravone.