Objective To analyze the operative methods,intraocular lens (IOL) implantation and postoperative complications in children with congenital cataract,and give the references for treating of congenital cataract.Methods From January 2008 to January 2016,children under the age of 13 years with congenital cataract were enrolled.Preoperative and posterior slit lamp microscope,fundus,intraocular pressure were examined.Children under 2 years old were treated with phacoemulsification (PHACO),posterior continuous curvilinear capsulorrhexis (PCCC),anterior-vitrectomy (AV),and ＞ 2-4 years old with PHACO + PCCC + AV + IOL implantation,＞ 4-7 years old children with PHACO + PCCC + IOL implantation,children ＞ 7 years with PHACO + IOL implantation.Results A total of 476 patients (740 eyes) were enrolled in the study,the average age were (33.59 ± 37.14) months,of which 0 ～ 6 months were 166 cases (282 eyes,38.11％).260 eyes were implanted with IOL,aged (5.59 ±2.43) years,480eyes were implanted in the second surgery,aged (4.06 ± 2.12) years.Refaction diopter (equivalent spherical) after IOL implantation in children aged ＞ 2-4 years old was (3.53 ± 0.56) D,＞ 4-6 years old was (2.36 ± 0.32) D,＞ 6-8 years old was (1.65 ±0.52)D,＞8-13 years old was (-0.25 ±0.32) D.The postoperative complications occurred in 326 eyes,of which 115 eyes (35.28％) with iridotic adhesions,97 eyes (29.75％) with posterior cataract on the visual axis,and 54 eyes (16.56％) with glaucoma.At the last follow-up,the best corrected visual acuity were (0.56 ± 0.41) LogMAR for monocular cataract surgery and (0.42 ± 0.27) LogMAR for binocular cataract surgery,the difference was statistically significant (P =0.04).Conclusion One-third of children with congenital cataract are treated with surgical treatment under 6 months old,about half of the children undergo IOL implantation at 2 ～ 3 years of age.The postoperative visual acuity in children with binocular cataract is better than children with monocular cataract.The complications in children are more complicated than adults,which should be paid more attention.

Objective To select the risk factors and focus on the pathogenesis of anterior ischemic optic neuropathy (AION) after cataract surgery.Methods A retrospective review of all patients with phacoemulsification surgery referred to the Ophthalmology Divisions,the First Affiliated Hospital,Zhengzhou University,from September 1,2010 to September 1,2016 was performed.Eligible patients were 11 206 cases(13 320 eyes),30 cases (30 eyes) were complicated with AION after cataract surgery (AION group),and 90 cases (90 eyes) were selected as control group according to the ratio of 1 ∶ 3 by random sequence.Factors of small cup disc ratios,previous surgery history,cardiac disease,diabetes,hypertension,hyperlipemia,smoking,carotid disease and intraocular pressure (IOP) were collected,x2 test,Logistic regression and t test were performed to analyze risk factors for AION.Results Small cup-disc ratios,diabetes,hypertension,hyperlipemia,carotid disease were influencing factors of AION after cataract surgery.Hyperlipemia and carotid disease were risk factors of AION after cataract surgery.There was no significant difference in preoperative intraocular pressure between two groups(all P ＞ 0.05).The intraocular pressure at postoperative 1 day and 7 days in AION group were higher than those in control group (all P ＜ 0.05).Conclusion Hyperlipemia and carotid artery disease are risk factors for AION after cataract surgery,and high intraocular pressure may be the inductive factor of AION.

Background It has been reported that murine Müller cells conditional medium can promote the survival of retinal ganglion cells (RGCs) and the regeneration of axons,and the survival rate of RGCs improve in the optic nerve axotomy eyes with cataractogenic lens injury in vitro.However,the interaction of Müller cells with pricking of lens in protecting RGCs is unclear.Objective The aim of this study was to investigate the role of Müller cells on survival of RGCs in the optic nerve axotomy with cataractogenic lens injury.Methods Forty-eight clean adult Wistar rats were randomized into sham operation group,optic nerve axotomy group and lens injury combined with optic nerve axotomy group.The optic nerve was exposed only in the rats of the sham operation group,optic nerve was completely transected at 3 mm behind the eyeball in the rats of the optic nerve axotomy group,and lens puncture and optic nerve axotomy were performed in the eyes of lens injury combined with optic nerve axotomy group.The rats were sacrificed at day 7 and day 14 after operation to prepare the retinal specimens.The RGCs were examined and counted by hematoxylin-eosin staining.Müller cells labeled by glial fibrillary acidic protein (GFAP) were counted using immunohistochemisty.Results The number of RGCs was (52.98 ± 1.90) /field and (51.81 ±3.09) /field on the 7th and 14th day in the sham operation group,without significant difference between them (t =0.910,P =0.378).The number of RGCs was significantly lower on the 14th day ([22.67±1.94] /field) than that of the 7th day ([36.61±1.69] /field) in the optic nerve axotomy group (t=15.312,P=0.000).Also,the number of RGCs was (50.76±2.77) /field and (35.69±1.80) /field on the 7th and 14th day in the lens injury combined with optic nerve axotomy group,showing a significant difference between the two timepoints (t =12.920,P =0.000).In addition,the RGCs number in the lens injury combined with optic nerve axotomy group was significantly higher than that in the optic nerve axotomy group both on 7 days and 14 days after operation (7 days:t =102.840,P =0.000; 14 days:t =164.020,P =0.000),and the number of RGCs was lower in the lens injury combined with optic nerve axotomy group than that of the sham operation group on day 14 (t =187.040,P =0.034).None of GFAP-labeled Müller cell was seen in sham operation group at both on 7 days and 14 days after operation,but a significant difference was found in the optic nerve axotomy group between the two timepoints ([29.38 ± 2.04]/field vs.[19.07 ± 2.14]/field ; t =-9.868,P=0.000).No significant difference in the number of the GFAP-labeled Müller cells was found in the lens injury combined with optic nerve axotomy group between 7 days and 14 days after operation([48.96±2.80] /field vs.[46.73±1.50]/field,t=1.987,P=0.067).In postoperative 7 days and 14 days after operation,the number of GFAP-labeled Müller cells increased in the lens injury combined with optic nerve axotomy group compared with the optic nerve axotomy group (7 days:t =-15.997,P=0.000; 14 days:t=-29.938,P=0.000).Conclusions In optic nerve axotomy with cataractogenic lens injury eye,the punctural injury of lens induce the activity of Müller cells and further promote the survival of RGCs in the cataratogenic lens injury combined with optic nerve axotomy rat eyes.

Objective To invosfigate the state of the nursin workforce and supply the evidences for nursing workforce optimization.Methods With questionnaires to survey 25 hospitals in Wuhan,stratified sampling and convenience sampling were used.Results Naming workforce allocation was shortage in Wuhan at present,the age,professional rifle and education background structurewas reasonable. Conclusions We should innovate the mind.pay more attention to nursing,enforce the management on nurse's career planning,provide educational training for nurses continuously,make good plan on nurs human resource,avoid nursing resource waste in order to keep on the hospital's development continually,healthily and harmoniously.

Objective To explore the method and effect of continuous quality improvement ( CQI) on the criterion for the treatment of diabetic patients with hypoglycemia in nurses .Methods The treatment process of diabetic patients with hypoglycemia was carried out the quality control and improvement in department of endocrinology using the FOCUS-PDCA process of CQI .The records of nursing including 187 cases before the implementation and 197 cases after the implementation were consulted .The effect of the criterion for the treatment of diabetic patients with hypoglycemia was compared before and after the implementation of the CQI . Results The compliance rate of instructing the patients with hypoglycemia to eat in nurses according to the standard was increased from 15.5%to 77.6%, and the compliance rate of the time of measuring the fingertip blood sugar again was increased from 2.1%to 39.8%, and the compliance rate of recording the simultaneous phenomenon of hypoglycemia was increased from 13 .9%to 77 .6%, and the degree of mastering the knowledge of hypoglycemia in nurses was increased from 43.7% to 100.0%, and the differences were statistically significant (χ2 =1.449,79.63,1.529,3.742, respectively;P<0.01).Conclusions CQI can standardize the method of the treatment of diabetic patients with hypoglycemia in nurses , and improve the knowledge of hypoglycemia in nurses , and provide the security for the treatment in diabetic patients .

The rehabilitation compliance of stroke patients is generally low.Evaluating the rehabilitation motivation of patients is helpful to promote the rehabilitation management of patients,enhance the rehabilitation enthusiasm and compliance of patients,and improve the rehabilitation outcome.This paper reviews the existing stroke patients rehabilitation motivation assessment tools,and expounds the main contents,application status,characteristics and limitations of stroke patients rehabilitation motivation assessment tools,in order to provide references for the appropriate selection of clinical assessment tools,the rehabilitation management of stroke patients and the development of domestic localized stroke rehabilitation motivation assessment tools.

Objective To examine the prospective associations between airflow obstruction (AFO) and risks of major chronic diseases morbidity in Chinese adults.Methods Samples of this study were from the China Kadoorie Biobank.A total of 486 996 participants aged 30 to 79 years (mean 51.5 years) at the baseline study,were included after excluding those who self-reported of having heart disease,stroke and cancer at baseline.AFO was defined under the Global Initiative on Obstructive Lung Disease (GOLD) criteria and forced expiratory volume per one second in percentage of the expected one (FEV1％P).Cox regression models were used to investigate the associations of AFO with incidence rates of ischemic heart disease,cerebrovascular disease and lung cancer after adjusted for potential confounders.Results Over a period of 7 years through the follow-up program,the incident cases of ischemic heart disease,cerebrovascular disease and lung cancer appeared as 24 644,36 336 and 3 218,respectively.Compared with people without AFO,the HR (95％CI) of GOLD-1 to GOLD-4 were 0.89 (0.78-1.01),1.05 (0.98-1.12),1.29 (1.18-1.40) and 1.65 (1.42-1.91) respectively for ischemic heart disease.The HR (95％ CI) of GOLD-1 to GOLD-4 were 0.96 (0.70-1.26),1.12 (0.96-1.31),1.38 (1.14-1.65) and 1.48 (1.05-2.02) respectively for lung cancer.No statistically significant differences in the associations between GOLD level and cerebrovascular disease morbidity were found.However,each 10％ decrease in FEV1％P was associated with 7.2％ (95％CI:6.4％-8.0％),3.6％ (95％CI:3.0％-4.3％) and 10.5％ (95％CI:8.4％-12.6％) increased the risks of ischemic heart disease,cerebrovascular disease and lung cancer respectively.The results were persistant when stratified by smoking status.Conclusion Higher degree of AFO seemed to be associated with the risks of ischemic heart disease,cerebrovascular disease and lung cancer morbidity among the Chinese adults.