精准化护理对睑缘炎患者蠕形螨检出率的影响

目的:探讨实施精准化护理对睑缘炎患者蠕形螨检出率的影响。方法:将2018年1月1日~7月31日在门诊行蠕形螨睑缘炎治疗的85例患者作为观察组,实施精准化睫毛取样及护理措施;将2017年6月1日~12月31日的67例作为对照组,实施肉眼取样及护理措施。比较两组蠕形螨阳性检出率,同时对护理人员的沟通能力、专业知识及患者症状改善情况进行满意度调查。结果:对照组拔取睫毛蠕形螨数目为38个、阳性检出率7.9%,观察组拔取数目为471个、阳性检出率为97.4%,两组比较差异有统计学意义(P<0.01);观察组护理满意度高于对照组(P<0.05)。结论:为睑缘炎患者提供精准化护理服务,不仅是护理人员夯实优质护理的本质需求,也是对患者关爱的一种体现,而且能提高蠕形螨的阳性检出率,有助于蠕形螨睑缘炎的临床确诊,对患者实际治疗有重要意义。     

优化强脉冲光联合妥布霉素地塞米松眼膏治疗蠕形螨睑缘炎的效果

目的 分析优化强脉冲光联合妥布霉素地塞米松眼膏治疗蠕形螨睑缘炎的临床效果。方法 选取2021年7月至2022年7月开封市中心医院诊治的74例蠕形螨睑缘炎患者为研究对象，依据随机数字表法分为两组，每组37例。对照组给予妥布霉素地塞米松眼膏治疗，观察组加用优化强脉冲光治疗，连续治疗6周。比较两组临床疗效、睫毛蠕形螨数量计数、主观症状评分、临床体征评分、不良反应。结果 观察组治疗总有效率为94.59%(35/37),高于对照组[78.38%(29/37)],差异有统计学意义(P<0.05)。治疗前，两组睫毛蠕形螨数量、主观症状与临床体征评分比较，差异未见统计学意义(P>0.05);治疗后，观察组睫毛蠕形螨数量为(1.53±0.65)个，少于对照组的(3.75±1.01)个，主观症状评分为(3.21±0.48)分，临床体征评分为(1.67±0.34)分，低于对照组[(5.31±0.69)分、(3.40±0.59)分],差异有统计学意义(P<0.05)。两组治疗期间均未发生不良反应。结论 优化强脉冲光联合妥布霉素地塞米松眼膏治疗蠕形螨睑缘炎患者效果显著，可有效减少睫毛蠕形螨数量...     

妥布霉素地塞米松眼膏联合茶树油治疗蠕形螨睑缘炎的观察

目的分析探讨妥布霉素地塞米松眼膏联合茶树油(TTO)对蠕形螨睑缘炎的临床治疗效果。方法以某院2017年1月至2018年2月所收治的100例蠕形螨睑缘炎患者作为研究对象,依照治疗方式的不同将其划分为研究组和对照组,每组50例;研究组患者给予妥布霉素地塞米松眼膏联合茶树油治疗,对照组患者给予凡士林联合茶树油治疗,然后观察并比较两组患者临床治疗效果。结果研究组治疗总有效率为94.0%,比对照组的74.0%明显偏高,对比差异具有统计学意义(P0.05);治疗后,研究组患者泪膜情况及睑板腺分泌物等指标评分比对照组明显偏低,而泪膜破裂的时间比对照组明显偏长,对比差异具有统计学意义(P0.05)。结论妥布霉素地塞米松眼膏联合茶树油对蠕形螨睑缘炎的临床治疗效果显著,有助于缓解患者症状,促进其康复。     

蠕形螨睑缘炎患者眼表改变及功能的变化研究

目的 研究蠕形螨睑缘炎患者的眼表改变及功能的变化。方法 前瞻性选取2021年12月至2023年3月沧州市中心医院收治的70例(140只眼)蠕形螨睑缘炎患者,将其设为研究组,同时选取同一时期入院进行眼科检查的70名(140只眼)健康人群,将其设为对照组。两组研究对象均接受眼表疾病指标问卷(OSDI)调查、蠕形螨镜检,记录其OSDI得分和蠕形螨感染数量;同时接受泪液分泌试验(SIT)、泪膜破裂时间测定(BUT)、角膜荧光素钠染色(FL)检查,通过PAS加苏木素-伊红染色与结膜印迹细胞学对结膜上皮鳞状化生程度予以联合分析,比较研究组与对照组OSDI评分、SIT、BUT、鳞状化生级别。根据不同蠕形螨感染程度将研究组患者分为轻度感染组23例(46只眼),中度感染组28例(56只眼),重度感染组19例(38只眼)。同时比较不同蠕形螨感染程度患者OSDI评分、圆柱状鳞屑分级、SIT、BUT、鳞状化生级别。结果 研究组患者的OSDI得分为(45.58±7.96)分,明显高于对照组[(8.47±3.39)分],SIT平均值和BUT平均值为(8.05±2.34) mm、(6.61±2.29) s,均明显低...     

眼部蠕形螨感染与继发性免疫缺陷病相关性的研究

目的:观察继发性免疫缺陷疾病患者眼部蠕形螨的感染情况,分析眼部蠕形螨感染与继发性免疫缺陷病间的相关性。方法:选择2019年11月至2020年1月间复旦大学附属中山医院厦门医院内外科诊治的存在继发性免疫缺陷的患者192例作为研究对象,其中包括恶性肿瘤、慢性肾病、糖尿病、自身免疫病患者;另从来我院就诊的无全身性基础疾病的人群中随机选取246例作为对照者。本研究采用拔取眼部睫毛,在光学显微镜下检查蠕形螨及虫卵,确定眼部蠕形螨感染情况。结果:192例继发性免疫缺陷患者中有眼部蠕形螨感染者为162例,阳性率为84.4%;246例对照者中有眼部蠕形螨感染者为150例,阳性率为61.0%,2组间差异有统计学意义(P0.05)。眼部蠕形螨感染与继发性免疫缺陷疾病呈正相关(r=0.256,P0.001)。其中,糖尿病患者的眼部蠕形螨感染率最高,为89.7%。变量相关性分析提示,眼部蠕形螨感染与继发性免疫缺陷疾病呈正相关(r=0.256,P0.001);多因素Logistic回归分析提示,患有继发性免疫缺陷疾病患者感染眼部蠕形螨的风险是未患继发性免疫缺陷疾病的2.09倍(OR=2.09,95%CI为1.25～3.47,P=0.005)。结论:继发性免疫缺陷病可能是眼部蠕形螨感染的高危因素,糖尿病患者需注意眼部蠕形螨的检查。     

眼部蠕形螨感染对睑板腺功能障碍患者眼表功能的影响分析

正睑板腺功能障碍(MGD)是慢性的弥漫性睑板腺功能疾病,主要表现为腺体终端导管阻塞或是腺体分泌物、量的改变。蠕形螨感染是诱发睑板腺功能障碍的危险因素之一,蠕形螨是人体毛囊和皮脂腺中的一种小型寄生螨,其具有致病性,其中毛囊蠕形螨寄生在睑缘睫毛毛囊,皮脂蠕形螨寄生在眼部皮脂腺和睑板腺,而毛囊蠕形螨感染易引起睑缘炎、眼表疾病,越来越受到临床医师的关注[1]。本研究     

人体寄生虫学"蠕形螨调查实验"的设计与实施

目的 研究"蠕形螨调查实验"方案实施的可行性,以及蠕形螨校内感染情况.方法 设计蠕形螨调查实验,对658名在校学生进行蠕形螨调查研究,统计蠕形螨感染率.结果 检出蠕形螨感染者75例,蠕形螨总感染率为11.40 %,男女性别构成比无显著差异.鼻部检出率最高达92%,皮肤毛囊蠕形螨感染者68例.感染度:Ⅰ度48例、Ⅱ度19例、Ⅲ度8例.以皮肤潮红、痤疮状丘疹症状为主要症状.结论 根据蠕形螨检出特点应加强大学生的个人卫生方面的宣传,以降低医学生中蠕形螨感染率."蠕形螨调查实验" 的设计合理,效果好,值得其他院校借鉴、参考.     

人体蠕形螨病原学检查方法及相关因素对检出率的影响

目的探讨和分析不同病原学检查方法对蠕形螨的检出效果及相关因素对检出率的影响,寻求既操作简便、质量可靠、检出率高,又能适用于蠕形螨的诊断及流行病学调查的检查方法。方法在同一人群中,采用挤压刮取涂片法、透明胶纸粘贴法、刮脂法、眼睫毛检查法在不同部位、不同时间等进行蠕形螨检查。结果挤压刮取涂片法检出率明显高于其他3种检查法,差异有统计学意义(χ2=257.11,P0.01);女性检出率高于男性,差异有统计学意义(χ2=33.52、10.36、4.79和11.00,P0.01或P0.05);感染部位以鼻唇沟感染率最高,其次为鼻尖。结论挤压刮取涂片法检出率高于透明胶纸粘贴法、刮脂法及眼睫毛检查法;不同检查部位、检查次数和检查时间均可影响蠕形螨的检出效果。     

循环肿瘤细胞检测在非小细胞肺癌患者中的临床意义

选取2013年7月~2015年2月间于我院就诊的非小细胞肺癌患者78例,支气管肺炎患者56例以及42例健康志愿者分别归为肺癌组、肺炎组和健康组。采集各组人士的外周血,采用磁珠富集及免疫染色的方法检测外周血中的CTCs,比较CTCs的阳性检出率与非小细胞肺癌及其肿瘤分期的关系。结果肺癌组患者外周血CTCs阳性检出率明显高于其他两组(P<0.05)。非小细胞肺癌患者临床分期越晚,CTCs检出率越高,IV期患者的检出率达到88.89%,显著高于其他分期(P<0.05)。CTCs阳性检出率在非小细胞肺癌患者中较高,且与患者的临床分期有关。CTCs检测能够用于评估非小细胞肺癌患者的病情、判断预后,值得临床上进一步推广。     

皮肤毛囊炎患者病原菌分离鉴定结果分析

目的 了解毛囊炎致病因子,并进行病原菌分离鉴定,为临床治疗依据.方法 蠕形螨采用镜检法,其他病原菌用培养法,根据菌落形态和生化特点进行菌种鉴定.结果 791例毛囊炎患者共检出病原菌720株,检出率为91.02%,其中马拉色菌、痤疮丙酸杆菌、蠕形螨、金黄色葡萄球菌、表皮葡萄球菌检出率分别为68.39%、14.54%、3.92%、3.16%、1.01%.结论 引起皮肤毛囊炎的致病菌有多种,马拉色菌是毛囊炎的主要致病菌.     

对护生干眼状况的调查分析

目的通过评估护理学校学生干眼状况,了解其眼表健康情况。方法采用便利抽样法,选取2018年3月在首都医科大学护理学院学习的90名护生作为研究对象。采用OCULUS Jenvis-OSDI干眼问卷及OCULUS眼表综合分析仪对护生的眼表健康状况进行主、客观分析。结果OSDI干眼问卷调查显示,轻度干眼21名(23.3%),中度干眼42名(46.7%),重度干眼21名(23.3%)。干眼的主要症状是异物感,占53.3%;次要症状是畏光、视力模糊,分别占46.7%与40.0%。OCULUS眼表综合分析仪显示,双眼泪液分泌量正常;平均泪膜破裂时间分级干眼中,临界干眼占60%左右,干眼占10%左右。眼红分析显示,充血分数>2.0分者9名(10%),为炎症所致干眼。结论护校学生干眼症发病率较高,主观症状明显,提示学生用眼过度,不注意用眼卫生,带教老师有责任对学生进行健康宣教,普及科学合理用眼知识,重视眼表健康。     

结缔组织病患者结膜印迹细胞凋亡研究

目的探讨结膜印迹细胞的流式细胞术凋亡检测在干眼发病机制研究与结缔组织病患者干眼诊断中的应用价值。方法对结缔组织病患者60例（120眼）进行眼科病史询问、泪液分泌实验Ⅰ（S-I-T）、泪膜破裂时间（BUT）及荧光素染色计分（FL）检查,根据检查结果和有无Sjogren综合征分为非干燥综合征无干眼（NSS1）组、非干燥综合征干眼（NSS2）组、干燥综合征无干眼（SS1）组和干燥综合征干眼（SS2）组。并对其行结膜印迹细胞流式细胞术凋亡检测。结果结膜上皮细胞凋亡百分比除NSS1组与SS1组间差异无统计学意义（P=0.998）外,其余各组差异均有统计学意义（P〈0.001）。且细胞凋亡百分比与FL成正相关（r=0.926,P〈0.001）,与S-I-T、BUT结果成负相关（r=–0.712,r=–0.818,P〈0.001）。有无干眼和有无干燥均影响结膜上皮细胞凋亡量,且干眼与干燥有交互作用。结论细胞凋亡可能是造成干眼眼表损害的重要因素,凋亡检测有助于结缔组织病患者干眼的诊断。干眼和干燥均可使结膜上皮细胞凋亡增加。印迹细胞流式细胞凋亡检测是一项微创、有效的眼表凋亡检测方法。     

Dry eye, blepharitis and chronic eye irritation: divide and conquer

Dry eye and posterior blepharitis are the two most common causes for chronic eye irritation. Dry eye is caused by loss of water from the tear film resulting from either decreased tear production or increased tear film evaporation. The resultant increase in tear film osmolarity causes the changes on the eye surface responsible for the symptoms of dry eye. Posterior blepharitis causes eye irritation from inflammation, and leads to the development of meibomian gland dysfunction. The patient history is a powerful tool in narrowing the differential diagnosis of chronic eye irritation or even establishing the diagnosis. The exam adds power to the history, and sorts out the mechanisms causing dry eye symptoms. The primary goal of dry eye treatment is to lower elevated tear film osmolarity. This can be achieved with TheraTears treatment, either with or without punctal plugs. The primary goal of meibomitis treatment is to reduce inflammation. This can be achieved by hot compresses and lid massage and, when necessary, systemic treatment with low dose doxycycline. By determining the cause or causes of chronic eye irritation, effective treatments can be employed.     

炎症在伴有干眼的翼状胬肉发生发展中的作用及临床意义

目的 阐明翼状胬肉伴发干眼时,炎性因子的表达情况及其临床意义。方法 采用横断面研究设计,纳入103例原发性翼状胬肉（76例胬肉伴干眼组、27例单纯胬肉组）为实验组,30例干眼者为干眼对照组以及30名正常人为正常对照组。收集所有实验对象的基础分泌泪液10 μl、采用液相芯片测量泪液中6种细胞因子[（IL-6、IL-8、基质金属蛋白酶-1（MMP-1）、MMP-9、血管内皮生长因子（VEGF）和碱性成纤维细胞生长因子（bFGF）]表达量。结果 VEGF在胬肉伴干眼组升高,泪液中IL-6、IL-8、MMP-1、MMP-9在胬肉伴干眼组、单纯胬肉组中较正常人组表达升高,bFGF在胬肉伴干眼和单纯胬肉组较两个对照组均升高（P均< 0.05/6）。泪液IL-6表达量与干眼严重度呈正相关,泪液VEGF、bFGF、MMP-1和MMP-9浓度与胬肉活动性呈正相关（P均< 0.05）。讨论 干眼与翼状胬肉的致病性细胞因子具有高度的一致性,可能是导致两者具有共同高发病率的原因和重要病理机制;及时控制眼表炎症可提高2种疾病的疗效。     

Prevalence of dry eye syndrome at patients with diabetus melitus tip 2, one year retrospective study May 2011-June 2012

ObjectiveTo prescribe and analyze the correlation of Dry Eye and Diabetes Mellitus Tip II, at Polyclinic of Specialties Nr. 2 Ophthalmology service, between May 2011 and June 2012.MethodsA total number of 223 patients diagnosed with Diabetes Mellitus Tip II underwent ocular examinations. 120 male and 103 female, aged from 24–73 years old. To confirm the presence of diabetes among these patients fasting blood glucose level was performed (normal limit < 110 mg/dL). History of disease, duration of diabetes, age, sex was obtained by reviewing the medical records and direct patient interview. Also the patients complains: tearing photophobia, red eye, itching, foreign body sensation, blurred vision was recorded. From the study were excluded all conditions which affects the tear film stability and contact lens wearer.Results118 patients were diagnosed with Dry Eye Syndrome of varying degrees. 58 male/61 female. The diagnosis was made by heaving two or more positive tests performed as mentioned above, and referring to patients complains. Fourteen patients represent pinpoint corneal dye with fluorosceini, forty-six patients was positive to cotton swab test diminution of corneal sensitivity, eighty-nine patients was positive to Schirmmer test less than 10 mm, positive TBUT test less than 9 s was found to be the amount of seventy-one patients. Positive tear meniscus at inferior lid margin was found at fifty-six patients. Dry eye is a disorder of tear film because of tear deficiency or excessive tear evaporation which causes damage to the inter palpaberal ocular surface and is associated with symptoms of ocular discomfort. This ocular disorder is very common among general population with 28% of the adults having dry eye syndrome. Early diagnosis and timely treatment, complications as secondary microbial infection and corneal ulceration could be avoided.ConclusionsIn our study the Dry Eye Syndrome showed to have a high correlation with Diabetes Mellitus Tip II (about 52.9%). Prevalence of Dry Eye was significantly higher at patients with longer duration of diabetes. Dry Eye seems to be an important contributing factor related to corneal abnormalities. Age and sex not seem to play any important role in this condition. Good glycemic control is important for prevention and control of Dry Eye Syndrome.     

Dysgonic fermenter-2: a clinico-epidemiologic review

In the literature to date, there have been 44 confirmed cases of infection with the Dysgonic Fermenter-2 (DF-2) bacterium. DF-2 infections appear to demonstrate a strong association with dog bites (or recent exposure to dogs) and have a predilection for patients with defective host defenses although immunocompetent individuals are also susceptible. Recently, the first two cases of documented DF-2 infection following cat bite have been reported. Of the cases reported, 42 of the 44 blood cultures grew DF-2. In one of the two cases where blood culture failed to grow DF-2, the bacterium was isolated at the time of operation from an infected myxoma of the tricuspid valve. In the other case, the organism was isolated from the eyelid margin of a case of angular blepharitis. Peripheral blood smears also afford an effective and practical clinical tool for early diagnosis; 9 of 10 patients for whom smears were done tested positive. This paper reviews the epidemiologic, microbiological, and clinical features of this relatively new illness and also offers general guidelines to physicians for clinical management. Health professionals, especially those providing care for high risk groups, should be alerted to this potentially fatal infection.     

Comparison of tobramycin 0.3%/dexamethasone 0.1% and tobramycin 0.3%/loteprednol 0.5% in the management of blepharo-keratoconjunctivitis

In this clinical trial, investigators compared the effectiveness of 2 commercially formulated antibiotic/steroid combinations - tobramycin 0.3%/dexamethasone 0.1% (Tobradex; Alcon, Fort Worth, Tex) and tobramycin 0.3%/loteprednol 0.5% (Zylet; Bausch & Lomb Inc., Rochester, NY) - for rapidly controlling inflammation in patients with blepharo-keratoconjunctivitis. Investigators in this randomized, parallel-group, double-masked study examined 40 eyes of 40 patients with blepharo-keratoconjunctivitis. Patients received tobramycin 0.3%/dexamethasone 0.1% or tobramycin 0.3%/loteprednol 0.5% twice daily in the test eye, according to the randomization schedule. At baseline, the ocular surface was graded on a scale of 3 (extensive) to 0 (minimum) for 4 components: blepharitis, conjunctivitis, ocular discharge, and corneal punctate epithelial keratopathy (PEK). Only those patients with moderate to extensive inflammation (cumulative score >6) were included in the study. At follow-up 3 to 5 d later, the ocular surface was regraded so that treatment response could be evaluated. No statistically significant difference was noted between groups in pretreatment scores for blepharitis (P=.31), discharge (P=.62), conjunctivitis (P=1.0), and PEK (P=.57), or for total ocular inflammation (P=.87). Mean posttreatment scores were as follows: total ocular surface scores, 1.8 and 3.4 (P=.002); blepharitis scores, 0.9 and 1.35 (P=.017); discharge scores, 0.2 and 0.6 (P=.025); and conjunctivitis scores, 0.15 and 0.6 (P=.013) for tobramycin/dexamethasone and tobramycin/loteprednol, respectively. Corneal PEK scores were not significantly different between treatments. Tobramycin 0.3%/dexamethasone 0.1% significantly decreased clinical signs of ocular inflammation (ie, blepharitis, discharge, conjunctivitis) and total ocular inflammation scores when compared with tobramycin 0.3%/loteprednol 0.5% in patients with moderate to severe blepharo-keratoconjunctivitis. The 2 regimens also provided comparably rapid decreases in corneal PEK.     

评价血清中结核杆菌特异性蛋白抗体对诊断肺结核的应用价值

目的 评价结核分枝杆菌特异性蛋白抗体检测对肺结核诊断的应用价值.方法 对370例活动性肺结核患者、42例非结核性肺部疾病患者和30例健康献血员进行血清结核分枝杆菌特异性蛋白抗体检测,同时对全部肺结核和非结核性肺部疾病患者进行痰抗酸杆菌涂片和培养.结果 370例临床诊断的活动性肺结核患者,结核分枝杆菌特异性蛋白抗体检测阳性284例,阳性率76.8％;42例菲结核性肺部疾病患者,假阳性4例,假阳性率9.5％;30例健康献血员对照组,假阳性1例,假阳性率3.3％.检测菌阳肺结核的敏感性为81.4％,,菌阴肺结核的敏感性为72.9％;阳性检出率76.8％远高于细菌学的阳性检出率45.1％,x2=77.72,P＜0.05,具有统计学意义.结论 结核分枝杆菌特异性蛋白抗体检测对肺结核的诊断具有较好的敏感性和特异性.     

Sjogren's syndrome in chronic hepatitis C: clinical features and diagnosis

AIM: To examine clinical features of Sjogren's syndrome (SS) and morphological picture of the lesser salivary glands (LSG) in chronic hepatitis C (CHC). MATERIAL AND METHODS: The examination of 42 patients with SS and chronic HCV infection (mean age 44.3 +/- 13.7 years) has detected signs of chronic hepatitis and hepatic cirrhosis, respectively, in 31 (71.4%) and 11 (26.2%) patients. "Dry syndrome" was diagnosed by criteria of European SS Study Group. LSG biopsy of the lower lip was conducted in 23 (54.7%) of 42 patients. RESULTS: The "dry" syndrome in CHC ran subclinically in 73.8% patients. Apparent symptoms of SS were seen primarily in middle-aged and aged women with CHC history over 10 years. The first signs of SS occurred in 25 (59.5%) patients 2.9 +/- 3.1 years prior to diagnosis of hepatic disease. All the patients had xerostomy. Xerophthalmia was recorded 1.5 times less frequently. In 16 (47.1%) patients with CHC "dry eye" and in 6 (17.6%) patients dry keratoconjunctivitis were detected. Pathohistological changes of LSG were diagnosed in 21 (91.3%) of 23 patients with CHC. In the majority of cases (86.9%) the glands exhibited insignificant inflammatory infiltration and advanced fibrosis. LSG in CHC is characterized by fibrosis prevalence over cell infiltration. 83.3% CHC patients had SS and other extrahepatic lesions. SS was most evident in 28.6% CHC patients with cryoglobulinemia. CONCLUSION: Registration of SS symptoms in CHC patients depends on targeted examination of patients with chronic HCV infection. The severity of the symptoms correlates directly with the infection duration and age of the patient. LSG lesions in CHC patients with SS are characterized by fibrosis pre-domination over cell infiltration.     

Eye injury: prevalence and prognosis by setting

Although an estimated 1 million Americans suffer ocular injuries each year, the setting of injury and its prognostic implications have not been closely examined. Using data compiled by the Eye Injury Registry of Alabama (EIRA) from 514 cases of serious eye injury, we examined the demographics and prognosis of ocular injury by setting of injury. Work-related injuries accounted for only 28% of total injuries, and injuries occurring at home accounted for 27%, followed by situations related to recreation (25%), assault (11%), travel (5%), and "other" (school, unknown, etc) (4%). The poorest initial vision, poorest final vision, and highest rate of enucleation occurred in patients injured by assault, whereas the lowest rate of enucleation and loss of light perception was found in patients who had work-related injuries. Patients in the "other" category had the highest rate of return to 20/100 or better vision.