This paper mainly introduces the origin and development of the slit-lamp microscope, the basic structure, working principle and test methods, focuses on diffuse illumination, direct focal illumination, indirect illumination, retro illumination, zone of specular reflection and slit-lamp filter used in the optical inspection, to provide the reference for clinical general optometry practitioners and using slit-lamp microscope widely and standardized.
Lighting ; instrumentation ; Ophthalmology ; instrumentation

Objective To observe plasma albumin,total bilirubin and serum inflammatory factors,gonadal hormone levels in men with bipolar disorder,and to provide evidence for the diagnosis of the disease.Methods 48 men with bipolar disorder were selected as disease group,and 42 cases of male physical examination were selected as control group.Plasma albumin,total bilirubin and serum inflammatory factors,gonadal hormone levels of the two groups were detected.Results The levels of serum albumin and total bilirubin of the disease group were (43.4 ± 3.9)g/L and (9.4 ±1.9)μmol/L,which were lower than those of the control group[(49.6 ±3.0)g/L and (11.8 ± 2.1)μmol/L],the differences were statistically significant (t =8.361,5.692,all P <0.05).The levels of serum inflammatory factors IL -1 and IL -4 of the disease group were (4.2 ±2.2)ng/L and (3.3 ±1.8)ng/L,which were higher than those of the control group[(1.3 ±1.0)ng/L and (1.6 ±0.9)ng/L],the differences were statistically significant (t =7.858,5.542,all P <0.05).There were no significant differences in the levels of serum LH,PRL, FSH and PRG between the two groups(all P >0.05).The serum level of E2 of the disease group was (23.2 ± 16.1)pg/mL,which was lower than (35.9 ±18.0)pg/mL of the control group,the serum T level of the disease group was (10.8 ±4.9)ng/mL,which was higher than (4.2 ±1.6)ng/mL of the control group,the differences were statistically significant(t =3.533,8.344,all P <0.05).Conclusion Plasma albumin,total bilirubin and serum IL -1β,IL -4 levels can be used as references for clinical diagnosis of bipolar disorder,and serum E2 and T levels can be used as risk factors for bipolar disorder.

Acute respiratory distress syndrome is a serious disease and has a high mortality rate.Protective ventilation strategy and conservative fluid management is the mainstay of treatment and there is no effective pharmacological treatment yet.Recent studies found that beta-2 adrenergic receptor agonists in the treatment of acute respiratory distress syndrome could inhibit the inflammatory response,protect the functions of alveolar capillary barrier,improve pulmonary edema fluid removal,promote the secretion of surfactant and enhance the impaired lung repair,and so on.This review aimed for the pathogenesis,mechanism of action and treatment mechanism of the recent studies.

Prevalence rates of paediatric allergic diseases have been gradually increasing worldwide,which cannot be ignored.The theory of atopic march of paediatric allergic diseases has been verified as early in 1985.The atopic march refers to that allergic symptoms in infancy or early childhood often predate development of other allergic diseases later in life.A number of longitudinal epidemiological studies support this theory,mainly from Europe and North America.However,there are some challenges to this theory.Allergic disease in children is influenced by various factors such as early wheezing,gender and a parental history of allergic diseases.This article reviews the latest progress on the atopic march of paediatric allergic diseases,which may provide clues to the early recognition and management of children at high risk of these diseases.

The relationship between immuno-suppression and poor prognosis of sepsis causes widely concern.Immuno-modulatory therapy is one of the research hotspots in critical medical care.Some studies have shown that to enhance the function of lymphocyte might improve the prognosis of septic patients.This paper will review the immune dysfunction and explore the value of immuno-modulatory therapy in process of sepsis.

Objective To investigate the state of self-perceived burden (SPB) and depression and to explore the relationship between them for patients with chronic respiratory diseases.Methods 95 patients with chronic respiratory diseases were investigated by the Self-Perceived Burden Scale (SPBS) and Self-Rating Depression Scale (SDS).Results The average score of SPBS was (33.64±10.23) points,which was at the middle level,90.5％ of patients showed different levels of burden,and 34.7％ of patients were at the high level.The average score of SDS was (50.23±11.93),the index was 0.63,which was at the middle to high level,74.7％ of patients showed different levels of depression,and 33.7％ of patients were at the high level.There was a positive conrelation between SPB and depression.Conclusions Patients with chronic respiratory diseases had obvious SPB and depression,and there was a close relationship between them.With chronic respiratory diseases breaking out repeatedly and more severe year by year,most patients have high level of burden and negative emotions.Nurses should take proper measures and psychological interventions to help patients face to the diseases optimistically,and to improve patients' emotion state and enhance their physical and mental health.

Objective To investigate the effect of butylphthalide combined with nimodipine in the treatment of vascular cognitive impairment.Methods 160 patients with vascular cognitive impairment were divided into the control group and the observation group according to treatment methods,80 cases in each group.The control group was treated with nimodipine,and the observation group was given butylphthalide combined with nimodipine treatment.The therapeutic effect and cognitive function were compared.Results The obvious effective rate of the observation group was 58.75 ％ (47/80),which was significantly higher than that of control group 45 ％ (36/80) (P =0.03).After treatment,MoCA score of the observation group was (24.83 ± 9.48),which was significantly higher than that of the control group(21.64 ±9.52) (P =0.04).ADL score of the observation group was(58.31 ± 11.27),which was significantly higher than(53.28 ± 10.32) of the control group (P =0.04).After treatment,directional force,visual spatial and executive function,delayed memory and attention of the observation group were higher than those of the control group (P =0.03,0.02,0.04,0.02).Conclusion Butylphthalide combined with nimodipine in the treatment of patients with vascular cognitive impairment has good effect.

Objective To study effect of total hip replacement and artificial head of femur replacement in patients with failed femoral neck fracture.Methods 62 cases with failure of the conservative treatment or fixed steel femoral neck fracture were enrolled as research subjects.They were randomly divided into the two groups,the control group (n =31) and the observation group (n =31).They were operated through hemiarthroplasty in the control group,while they were operated through total hip replacement in the observation group.The operative time,blood loss,drainage,hospital stay,hip function,VAS score and quality of life changes,early complications were observed.Results The operative time,blood loss,drainage,length of hospital stay were (87.4 ± 21.3) min,(209.6 ± 34.5) mL,(174.2 ±29.4)mL and (17.8 ±5.6)d in the control group and (104.2 ±33.7)min,(229.1 ±35.1)mL,(182.2 ± 30.5) mL and (18.2 ± 6.2)d in the observation group.The operative time in the observation group was significantly longer than that of the control group (t =4.927,P ＜ 0.05).The blood loss,drainage,length of hospital stay were no significant difference between the two groups (t =0.386,0.413,0.775,all P ＞ 0.05).The excellent rate of hip function was 83.9％ (26/31) in the control group and 96.8％ (30/31) in the observation group,the observation group was significantly higher (x2 =6.92,P ＜ 0.05).Score changes of VAS and quality of life were (23.4 ± 9.2) and (36.1 ± 11.2) in the control group and (35.1 ± 10.6) and (42.8 ± 12.6) in the observation group.Score changes of VAS and quality of life in the observation group were higher (t =6.032,3.924,all P ＜ 0.05).The early complications occurred in the control group was 25.8％ (8/31),which in the observation group was 9.8％ (3/31),the early complications in the observation group was significantly lower than that in the control group (x2 =13.64,P ＜0.01).Conclusion For patients in the conservative treatment or femoral neck fracture fixation failure or steel,the use of total hip replacement surgery was complicated,but it can significantly improve hip function,reduce pain,improve quality of life and reduce early complications.

Objective To study parecoxib sodium preemptive analgesia on agitation and inflammatory factors in patients with esophageal cancer.Methods 78 patients with esophageal cancer were randomly divided into two groups,the control group(n =39 cases) and the observation group(n =39 cases).The patients in observation group received parecoxib sodium preemptive analgesia,while the patients in the control group were given NS.Then,both two groups were given conventional anesthesia.Restlessness was observed in patients with grading and Remesay sedation score.Serum concentrations of interleukin-6 (IL-6) and interleukin-10 (IL-10) were measured before anesthesia (T0),surgery (T1),6h after operation (T2),and 24h after operation (T3).Results Degree of agitation in the observation group was significandy lower than the control group (x2 =6.26,P ＜ 0.05).In the control group,irritability,sedation,sedation were 18 cases,20 cases,one case and those in the observation group were 6 cases,32 cases,one case.Higher satisfaction with sedation in the observation group(x2 =7.26,P ＜ 0.05),irritability rate in the observation group was lower than the control group (x2 =10.14,P ＜0.05).In the postoperative T1,T2,T3 moment,serum IL-6 level in the observation group was lower than the control group(t =3.172,4.001,2.702,all P ＜0.05),serum IL-10 level was higher in the observation group(t =3.112,2.624,3.092,all P ＜ 0.05).Conclusion Parecoxib sodium preemptive analgesia can decrease agitation and balance inflammatory factors in patients with esophageal cancer.

By studies of primary influencing factors in interferon ( IFN ) purification as well as affinity of IFN for different ligands, a purification system for leukocyte IFN from human umbilical cord blood was preliminarily established, and the properties of this IFN were studied.The established purification system includes two steps. The first step may be called "rough purification" using potassium thiocyanate (KCNS)-alcohol method. The second step "fine purification" using Blue Dextran-sepharose 4B(BDS) column affinity chromatography. The effects of different temperature, KCNS concentration, pH and the time(s) of salting out with KCNS on the activity, purity and recovery of the IFN were studied. Moreover, the affinity of the IFN for Blue Dextran and the chromatographic behavior of it on ConA-sepharose 4B column and BDS column were also observed.The experimental results showed that optimal conditions for precipitating the IFN from the crude IFN solution were to add KCNS to 0.5M, and then adjust pH to 4.0. The optimum pH values in separating out the IFN from acid alcohol-interferon were 5.5 to 7.2. The results between the salting out of once and twice by KCNS were not significantly different. Centrifugation with centrifuge maintaining lower temperature with cold alcohol might be used instead of refrigerated centifuge during purification. The IFN can be purified to about 106 international units per mg of protein with about 70% recovery on the first step of purification. On the second step of purification, the specific activity of IFN in the collecting fraction with maximum activity was increased up to about 107 international units per mg of protein and the recovery of activity was over 40%.Furthermore, the present findings indicated that the IFN from human umbilical cord blood was resistant to treatment with Sodium Dodeyl Sulfate(SDS), nucleolytic enzymes and pH 2.0; but sensitive to proteolytic enzymes. It was proved that the IFN had clearly species specificity. The determination of antiviral activity titer in SDS-PAGE gel slices documented that molecular weights of the IFN was about 18.3k to 24.3k. The IFN could be bound to Blue Dextran, but almost not to ConA. It indicates that IFN from human umbilical cord blood belongs in human IFN-? (Le) and is probably a glycoprotein that its carbohydrate moieties had hidden within IFN molecules.The present experiments may offer the possibility in purifying the IFN for clinical use and be helpful in revealing the essence of IFN from human umbilical cord blood. The purification method discribed in the paper will render some valuable reference to other types of IFN.