目的 观察改良睑板腺管针刺疏通法治疗早期急性睑板腺炎的效果.设计 前瞻性比较性病例系列.研究对象 2015年3月至2017年8月福建医科大学附属第二医院105例早期急性睑板腺炎患者.方法 按就诊单双日随机分为针刺组(56例)和对照组(49例).每组根据症状轻重和有无扩散分为重组和轻组.针刺组中重组31例、轻组25例;对照组中重组28例、轻组21例.针刺组采用改良睑板腺管针刺疏通法治疗,即梅花针从化脓的睑板腺(通常1～3个)腺管开口垂直缓慢刺入3～4 mm排脓.轻组配合改良睑板腺压榨法挤压,重组只轻轻按摩挤压,疏通开放睑板腺开口.对照组采用常规的保守治疗.平均随访时间(6.50±3.84)天.主要指标 治愈率.结果 针刺组总治愈率(92.86％)明显高于对照组(67.35％)(P=0.000).轻组治愈率针刺组(96.00％)高于对照组(80.95％)(P=0.04);重组治愈率针刺组(90.32％)高于对照组(57.14％)(P=0.000).针刺组病程(5.0±2.98)天,优于对照组的(8.4±3.86)天.针刺组的手术率(轻组4.00％、重组9.68％)均低于对照组(轻组23.81％、重组42.86％)(P均＜0.05).结论 采用改良睑板腺管针刺疏通法对早期急性化脓性睑腺炎能有效地对睑板腺腺管进行疏通排脓,缩短病程,减少手术切开率.

Demodex is a slender and chronic parasitic mite. Ocular demodex, which resides mainly in the follicles, meibomian gland and sebaceous gland, can cause foreign body sensations, eye itching, dry eye and other symptoms. In recent years, more and more literature has reported that demodex can cause a variety of eye diseases, such as blepharitis, meibomian gland dysfunction, chalazion, conjunctivitis, keratitis and pterygium. In addition, demodex is associated with the occurrence of basal cell carcinoma of the eyelid. As a pathogenic factor, demodex has attracted more and more attention from ophthalmologists. This review discusses the status of research on demodex-related eye diseases, in order to raise the awareness and attention of ophthalmologists.

Objective: To observe the clinical efficacy of oral azithromycin in patients with moderate to severe meibomian gland dysfunction (MGD), and the structural changes in meibomian glands. Methods: This was a prospective clinical study. Forty-nine patients (98 eyes) who had moderate to severe MGD were recruited in the Second Affiliated Hospital, Fujian Medical University, from April 2016 to January 2017. All patients underwent comprehensive ocular surface examination and slit lamp examination and were divided into two groups: 26 patients in the observation group and 23 patients in the control group. The observation group was given artificial tears and oral azithromycin 500 mg once daily for 3 days, then stopped for 7 days. There were 10 days in a treatment cycle with a total of three cycles for the treatment.The control group received only artificial tear treatment. All patients underwent modified meibomian gland compression during the first visit and for each follow-up, all of which were combined with eyelid hot compress and blepharospasm cleaning. Then an ocular check-up was performed, including the following aspects: Ocular surface disease index (OSDI), noninvasive first break-up time (NIF-BUT), noninvasive average break-up time (NIAvg-BUT), tear meniscus height (TMH), R-scan, loss rate of the meibomian gland, assessment of meibomian gland orifices, meibum quality score, meibum expression score, fluorescein stain test (FL), and SchirmerⅠtest (SⅠT) between pre-therapy and post-treatment. Data were analyzed by an independent samples t test, Mann-Whitney U test, paired t test and Wilcoxon paired rank sum test. Results: After treatment, the assessment of meibomian gland orifices (Z=-3.093), meibum quality score (Z=-2.501), meibum expression score (Z=-3.175) as well as FL (Z=-2.602) of the control group were improved compared with those before treatment, with statistically significant differences (P<0.05). However, there were no statistically significant differences in other indexes in the control group. After treatment, the OSDI (t=6.174), loss rate of the meibomian gland (t=2.402), assessment of meibomian gland orifices (Z=-5.192), meibum quality score (Z=-5.073), meibum expression score (Z=-4.807), and FL (Z=-3.587) of the observation group were improved compared with those before treatment, with statistically significant differences (P<0.05). There were no statistically significant differences in other indexes in the observation group. Statistically significant differences were observed in OSDI (t=-3.778), NIAvg-BUT (Z=-2.043), loss rate of the meibomian gland (t=-2.123), assessment of meibomian gland orifices (Z=-6.318), meibum quality score (Z=-5.852), meibum expression score (Z=-3.951) and SⅠT (Z=-2.462) between the two groups after treatment (P<0.05) and the observation group improved more obviously, but no statistically significant differences in other indexes after treatment. Conclusions: Oral azithromycin can be used to treat patients with moderate to severe MGD, relieve symptoms and partially regain the function of the meibomian gland.

目的:分析标本溶血对儿科常见急诊生化检验项目的影响,并探讨相应对策.方法:随机选择2016年3月—2017年1月在本医院儿科急诊就诊并开具生化检验项目的患儿65例,将采集的生化标本分为溶血组与非溶血组,用美国雅培C1600全自动生化分析仪对各项常见急诊生化指标进行检测,对比两组结果.结果:溶血组血清的AST、ALT、LDH、CK、CKMB、GLU、K+结果均高于非溶血组(P<0.05);溶血组血清的BUN、CR、AMY与非溶血组的结果比较差异无统计学意义(P>0.05).结论:标本溶血直接影响儿科常见急诊生化检验项目的多项结果,临床操作应避免标本溶血,需分析溶血原因并采取相应措施,保证检验结果的准确性.

目的：探讨包括ANA、ds‐DNA、ENA多肽抗体谱、抗环瓜氨酸肽抗体（anti‐CCP）、类风湿因子（RF）在内的多种自身免疫抗体的联合检测在系统性红斑狼疮（SLE）、类风湿性关节炎（RA）诊断中的价值。方法：对在本院确诊为SLE的患者132例、RA患者82例、健康对照组40例，抽取静脉血分离血清后，采用 ELISA 法检测 ANA 和 ds‐DNA ，免疫印迹法检测ENA多肽抗体谱，化学发光法检测anti‐CCP、速率散射比浊法检测RF。结果：SLE患者的ANA、ds‐DNA、ENA多肽抗体谱、anti‐CCP、RF及5项联合检测的阳性率分别为88．6％、66．7％、68．9％、3．0％、6.8％、95．4％；RA患者以上项目的阳性率分别为31．7％、14．6％、24．4％、75．6％、46．3％、87．8％；健康对照组仅出现1例 ANA 阳性。结论：以上多种自身免疫抗体在SLE和 RA 患者血清中的阳性率均明显高于对照组（ P＜0.01），同时不同的自身免疫抗体在SLE和RA患者血清中的阳性率也不同，联合检测多种自身免疫抗体对SLE和RA患者的早期诊断、鉴别诊断以及监测治疗有重要的临床价值。

目的：检测临产孕妇临床生化、血常规、凝血功能指标并建立参考范围。方法：随机选取300例临产孕妇测定血常规、生化、凝血并进行统计分析。结果：临产孕妇95%参考区间：TP、ALB、BUN、CR、CA、RBC、Hb、HCT、AT-Ⅲ、PT与非孕妇女95%参考区间相比较偏低；而ALP、TG、CHOL、HDL、WBC、GR#、FIB、FDP、D-D升高；LY#的95%参考区间增大；TT、PLT、APTT95%参考区间缩小。结论：临产孕妇体内各系统发生特殊的生理变化，应根据不同仪器建立适用于临产孕妇的参考范围，为临床工作提供参考。

Objective To study the relationship between plasma P-selectin,h-CRP and diabetic nephropathy(DN).Methods 93 cases with diabetes mellitus(DM) were classified into two groups:diabetic nephropathy(DN) groups and diabetes mellitus groups.And 30 healthy individuals were as normal control.Plasma FPG,h-CRP,P-selectin were measured.Results The plasma levels of FPG,h-CRP,P-selectin in the DN group were higher than those of normal control,and plasma levels of h-CRP,P-selectin in the DN group were higher than those of DM group,with significant difference(P 0.01).Conclusion The results show that the relationship between plasma h-CRP,P-selectin and DM is intensive,which is of great clinical importance to the diagnosis,treatment and prognosis of DM.