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 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 CR low dose radiography to COPD in patients with pseudo normal phenomenon.Methods 160 cases of COPD diagnosed,stratified random dividing method according to the pulmonary function test values were divided into A,B,C and D group.Each group had 32 cases,at the same time,the increase in lung function in patients with mild to moderate pulmonary emphysema in 32 cases was E group,wich was treated with normal dose as a control group,in the normal dose and low dose CR photography failed to clear the diagnosis of emphysema,causing false normalization,statistical the case number,and verify the pulmonary function classification criteria,identify false normalization of lesions in such a case,the general rule to judge the feasibility analysis and prevention.Results There was no significant chifference among 5 groups of pseudo normal comparison (x2 =4.56,P ＞0.05).Conclusion Chronic obstructive pulmonary disease with low dose CR photography on severe and extremely severe patients is deteded by emphysema detection with rate high.Moderate,mild COPD detection rate is extremely low.

Objective To analyze the effect of a new model in the nursing care ward round in the hand surgery department.Methods The implementation of nursing care ward round in the hand surgery department was retrospectively analyzed.Results The comprehensive quality of nurses were increased obviously when the new model ward round was implemented.Patients were more satisfied with the work of nursing care.The evaluation of new model ward round by nurses was higher than before.Conclusions The new model of nursing ward round showed a great help for increasing the comprehensive quality of nurses,the responsibility awareness of nurses and the nursing quality.It presented an significant application value by developing new nursing care technique and helping establish harmonious relationship between the nursing staff and patients.

Execution is one of the key factors which influence the management level of hospital libraries. The paper introduces the concept, performance and synthesis patterns of execution, and points out that execution is the main means to enhance performance of li-brary, then puts forward concrete strategies to enhance execution of library from two levels: individuals and libraries.

Bilingual teaching is a hot issue in the current medical education reform.This paper discussed the practice of bilingual teaching in ophthalmology education and explored the improvement of teaching materials,enhancement of teaching staff training and promotion of multimedia-based,web-based and PBL-based bilingual teaching in order to provide references for improving the quality of ophthalmology teaching.

Objective To explore the application of multislice computed tomographyic ( MSCT) perfusion imaging in the assessment of acute cerebral infarction. Methods 50 patients who initially diagnosed as acute cerebral infarction in 6 hours after their outbreak of infarction were selected. The Siemens semsation 4 MSCT was used to scan the patients and form time versus concentration curve analysis, including the comparision of region cerebral blood flow (CBF) between the necrosis region and the normal region, region cerebral blood volume (CBV), mean transit time ( MTT). Each case had to be examined by computed tomography at least once a week after infarction. Results 50 patients were found having a lower CBF and CBV in their necrosis region compared with the other side(P＜0.05) ,and had a longer MTT in their necrosis region compared with the other side( P ＜0.05) ,45 patients were observed a shrink of the size of the infarction region compared with the perfusion image in first 6 hours when they were reexamined by CT a week later(P ＜0.05) ,which proved the exist of ischemic penumbra area around the infarction center. Conclusion The multislice computed tomographyic perfusion imaging technology could define the infarction region and size at the early stage of acute cerebral infarction. It also provided clues to indicate the exist of a vascular area around the necrosis centre. It could diagnose acute cerebral infarction at hyperacute period and provide image proof for the thrombolysis in early period and treatment in individual manner.