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

China ; Electrocardiography ; trends

Luminal B breast cancer is a main subtype of breast cancer.Disease free survival and overall survival rate of patients with Luminal B subtype are lower than those of patients with Luminal A subtype.Luminal B breast cancer is often treated with chemotherapy and endocrine therapy,and anti-Her-2 therapy is also essential for Luminal B/Her-2 positive breast cancer,but the prognosis is still poor.With the increasing understanding of Luminal B breast cancer,new targets are developed and used for improving treatment effect.This review will describe the clinical and pathological features,factors affecting prognostic,common treatments and new therapeutic targets for Luminal B breast cancer.

Objective To compare the prevention effect of atrial fibrillation recurrence in hypertensive patients by telmisartan versus nifedipine.Methods Ninety-eight cases of hypertensive with paroxysmal atrial fibrillation patients were enrolled and divided into telmisartan group and nifedipine group with 49 cases each by random digits table method.Telmisartan group was given telmisartan 80 mg/d,nifedipine group was given nifedipine 30 mg/d.Dose of the drug needed to be adjusted according to individual condition until achieving the target.Followed-up for 18 months.Observed two groups of recurrence of atrial fibrillation and the recurrence time for the first time,recorded before and after the treatment of cardiac parameters:including left atrial diameter (LAD),left ventricular end diastolic diameter(LVDD),left ventricular posterior wall thickness (LVPWT),interventricular septum thickness (IVST),left atrial volume index(LAVI) and left ventricular mass index(LVMI).Results The blood pressure after treatment in two groups was lower than that before treatment,there was statistically significant difference (P＜ 0.05),but there was no statistically significant difference between two groups (P ＞ 0.05).After treatment,the recurrence of atrial fibrillation,atrial fibrillation recurrence time for the first time in two groups had no statistical significance (P ＞ 0.05).But the incidence of persistent atrial fibrillation in telmisartan group was significantly lower than that in nifedipine group [4.1％ (2/49) vs.16.3％ (8/49)],there was statistically significant difference (P =0.045).The cardiac parameters between two groups before treatment had no significant difference (P ＞ 0.05).After treatment,the cardiac parameters in two groups were signifcantly reduced,there were statistically significant differences (P ＜ 0.05).Moreover,the LAD,LVPWT,LAVI and LVMI in telmisartan group after treatment were significantly lower than those in nifedipine group [(37.6 ± 2.9) mm vs.(38.9 ± 2.4) mm,(11.6 ± 1.0) mm vs.(12.0 ± 0.9) mm,(22.0 ± 3.6) ml/m2 vs.(23.9 ± 4.2)ml/m2,(120.4 ± 18.2) g/m2 vs.(129.5 ± 19.2) g/m2],there were statistically significant differences (P ＜ 0.05).Conclusions Nifedipine and telmisartan can effectively lower the blood pressure.But telmisartan is superior to preventing atrial fibrillation recurrences and developing in hypertensive with paroxysmal atrial fibrillation patients,promoting cardiac parameters and postponing myocardial remodeling.

Objective To explore the relationships between antithrombinⅢ(AT-Ⅲ) and D-dimer (DD) level with pediat-ric critical illness score (PCIS) in children with sepsis, and to evaluate the values in assessing the severity of illness. Methods Sixty-one children with sepsis were included in this study. Within 24 hours after admission, blood samples were tested for the ac-tivity of AT-Ⅲ and DD level. The PCIS was calculated. According to PCIS, the patients were divided into extremely critical group (<70), critical group (71-80) and non-critical group (80-100). According to the prognosis, the patients were divided into survival and death groups. The differences of the activity of AT-Ⅲand DD were compared and the relationship with PCIS were analyzed. Results The activity of AT-Ⅲ was lower and DD level was higher in critical group than in non-critical group (P<0.01) and the changes in extremely critical group were more evident than those in critical group. The activity of AT-Ⅲand PCIS were positively correlated (r=0.548, P<0.01).The DD level and PCIS was negatively correlated (r=-0.657, P<0.01). Compared with survival group, the level of DD was significantly higher in death group (P<0.01), and PCIS and the activity of AT-Ⅲwere significantly lower in death group (P<0.05). Conclusions The patients with sepsis have dysfunctions of coagulation. The activity of AT-Ⅲ, DD level are correlated with illness severity, and can be useful for assessing the severity of sepsis.

Objective To study the relation of the variations of serum neuron-specific enolase (NSE) level and brain damage in asphyxia neonatorum.Methods The serum NSE level were detected in 75 asphyxia neonatorum(asphyxia group) and 20 normal neonatorum(control group) by the method of ELISA after parturition 1,3 and 7 d.The relation of serum NSE level and brain damage was analyzed.Results After parturition 1,3 and 7 d,the serum NSE level in mild asphyxia group and severe asphyxia group was higher than that in control group [(29.85 ±8.53),(59.26 ± 15.75) μg/L vs.(15.59 ±6.25) μg/L; (23.69 ± 6.54),(47.28 ±12.46) μg/L vs.(15.38 ±5.84) μg/L; (18.95 ±5.37),(62.57 ±19.62) μg/L vs.(13.92 ±5.37) μg/L],and the serum NSE level in sever asphyxia group was higher than that in mild asphyxia group,there had significantly difference (P＜ 0.05).After parturition 1,3 and 7 d,the serum NSE level in brain damage neonatorum (25 cases) was increased and in CT normal neonatorum (50 cases) was decreased,the serum NSE level in brain damage neonatorum was higher than that in CT normal neonatorum [(37.48 ± 12.09) μg/L vs.(30.95 ± 11.86) μg/L,(51.84 ± 14.21) μg/L vs.(21.73 ±6.15) μg/L,(68.25 ± 18.69) μ g/L vs.(15.62 ± 5.94) μ g/L],there had significantly difference (P ＜ 0.05).Conclusion The variations of serum NSE level can be the important indicator to monitor brain damage in asphyxia neonatorum.

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 applying the evidence-based nursing in elderly hypertensive cerebral hemorrhage patients with minimally invasive therapy.Methods 78 cases of hypertensive cerebral hemorrhage patients with minimally invasive treatment were recruited from May 2010 to May 2011.According to the conventional method of random numbers,they were divided into the evidencebased group and the conventional group with 39 cases in each group.The evidence-based group received evidence-based nursing,while the conventional group received conventional clinical nursing.The nursing effect of the two groups was observed.Results The satisfaction degree of the evidence-based group and conventional nursing group was respectively 94.9％ and 79.5 ％.There was statistically significant differences.The score of SDS,SAS and BI before treatment between two groups showed no significant difference,while it showed statistically significant differences after treatment between two groups.The complication rate of the evidence-based group and the conventional nursing group was respectively 10.2％ and 35.9％.There was statistically significant differences.Conclusions It is feasible to implement evidence-based nursing in the elderly hypertensive cerebral hemorrhage patients with minimally invasive therapy.It can effectively improve the patients' negative emotions,enhance daily living and quality of life.It is simple and can effectively reduce the incidence of complications.Thus,it is worthy of clinical application.

Objective To investigate the expression and significance of ERα (estrogen receptorα),ERβ(estrogen receptorβ),PR,and Bcl-2 of endometrial polyps.Methods 50 cases of endometrial polyp patients were studied.And 45 cases of endometrial normal subjects were selected as the control group.The enzyme-linked immunosorbent assay was used to detected the FSH,LH,E2,P,T and PRL six levels of the two groups.And endometrial ERα two groups of patients,ERβ,PR and Bcl-2 expression was studied.Results The FSH,LH,E2,P,T and PRL six levels of the two groups were no significant difference(P ＞0.05).Polyps in patients with proliferative phase of ERα,ERβ expression levels of the normal group had no significant difference (P ＞ 0.05),the expression level of PR(0.47 ± 0.02) point was significantly lower than that of the normal group(0.53 ± 0.02) point (t =10.383,P =0.000),Bcl-2 expression levels(0.53 ± 0.04) point was significantly higher than that of the normal group (0.49 ± 0.02) point (t =4.322,P =0.000).Polyps in patients with secretory phase of ERα,Bcl-2 expression levels (0.46 ± 0.07;0.43 ±0.04)point were significantly higher than that of the normal group (0.37 ± 0.05 ;0.39 ± 0.03) point (t =5.007,P =0.000; t =3.834,P =0.000),the expression level of PR (0.42 ± 0.02) point was significantly lower than that of the normal group (0.46 ± 0.01)point(t =8.486,P =0.000),there was no significant difference in expression levels between the two groups ERβ(P ＞0.05).Between the two groups displayed,ERα,PR proliferative phase of the normal group and the polyp group,the expression levels of Bcl-2 were significantly higher than that of the secretory phase (P ＜ 0.05).Conclusion The increase of the ERα,Bcl-2 expression levels,and the reduction of the level of PR expression in patients with endometrial polyps are closely related.

Objective To explore the relationships of traumatic brain injury ( TBI ) and recognition and empathy.Methods 120 cases with moderate to-severe TBI and 120 healthy controls with age and gender-matched were chose.Participants were evaluated for facial and vocal affect recognition;and affective and cognitive empathy (empathic concern and perspective-taking,respectively) were detected.Results Participants with TBI had signifi-cantly poorer facial and vocal affect recognition.Facial and vocal affect recognition variances (14.28 ±3.87) points and DANVA2-Voice (14.12 ±3.14) points were significantly lower than those of the control group ( t=-3.927, 4.183,all P<0.05);the empathic concern score (19.58 ±4.87) points and perspective taking(14.46 ±5.34) points were significantly lower than those of the control group too (t=-3.015,-3.935,all P<0.05).Conclusion TBI patients have a tendency to avoid thinking about emotions and more likely to have problems recognizing others′emotions and assuming others′points of view.