AIM: To compare the difference between the actual cutting amount and the preoperative predicted amount of corneal stroma after the small incision lenticule extraction(SMILE), and evaluate the predictability and accuracy of SMILE for corneal stroma.

METHODS: Prospective study. A total of 113 myopic patients(220 eyes)who had taken SMILE in the Affiliated Hospital of Yunnan University were selected, and routine examinations were carried out before and 1,3mo after operation, including visual acuity, non-contact tonometer(NCT), spherical equivalents(SE), mean corneal curvature, spherical coefficient of anterior corneal surface and Pentacam anterior segment analysis. All the 102 eyes in the research objects were randomly selected to measure the central corneal thickness(CCT)with the A-supersonic cornea thickness gauge before and 3mo after operation. The actual cutting amount after operation is the difference between the thickness of the thinnest spot of the cornea before and after operation, and the error amount is the difference between the predicted cutting amount before operation and the actual cutting amount after operation. The cutting error amount was observed and its correlation with physiological parameters before operation was analyzed.

RESULTS: SMILE had a good performance and the corneal morphology and visual acuity were relatively stable 1 and 3mo after operation. The consistency was good between the data measured by the A-supersonic cornea thickness gauge and the data of the thinnest spot of the cornea in the Pentacam anterior segment analysis, where the difference had no statistical significance(t= -1.877, P=0.063). The difference between the predicted cutting amount before operation(101.36±18.91)μm, and the actual cutting amount 1mo after operation(88.89±18.69)μm and 3mo after operation(84.95±18.64)μm(F=334.65, P<0.01)had statistical significance; There was statistical difference between the cutting amount 1 and 3mo after operation, and the predicted errors before operation \〖(12.59±9.78)μm and(16.50±9.21)μm\〗. The cutting amount errors were only correlated with the preoperative equivalent diopter(r=0.299, P<0.01)and(r=0.305, P<0.01). The equivalent diopter at 1 and 3mo after operation was correlated with the cutting amount error at the same time(r=-0.275, P<0.01)(r= -0.306, P<0.01). With the increase of the cutting amount error, the postoperative spherical equivalent shifted to negative.

CONCLUSION: The actual cutting amount of corneal stroma after SMILE is smaller than the predicted preoperative cutting amount, and the predicted cutting amount error increases with the increase of preoperative diopter. As the cutting amount error increases, postoperative diopter gradually shifted to negative. The error, however, does not influence the target's visual acuity in the early postoperative period.

Narcotic drugs and class Ⅰ psychotropic substances have always been special management drugs in medical institutions. Although relevant policies and regulations have been introduced at the national level ，there are problems of poor policy understanding and inconsistent implementation in medical institutions in the process of policy implementation. In order to standardize the management of narcotic drugs and class Ⅰ psychotropic substances in medical institutions of Yunnan province ， based on the preliminary research and Delphi expert consultation ，this editing group finally formed the Expert Consensus on Key Links Quality Control Management of Narcotic Drugs and Class I Psychotropic Substances in Medical Institutions of Yunnan Province by focusing on the key aspects of quality control of key links for narcotic drugs and class Ⅰ psychotropic substances in medical institutions ，aiming to provide reference for the clinical use and management of narcotic drugs and class Ⅰ psychotropic substances in medical institutions of Yunnan province.

OBJECTIVE: To analyze the RHD genotype of a blood donor with Del phenotype in Yunnan. METHODS: Rh serological phenotype was identified. RHD gene was detected by PCR-SSP typing, and its 10 exons were sequenced. Exon 9 was amplified for sequencing and analysis. RHD zygosity was detected. RESULTS: The Rh phenotype of this specimen was CcD^elee. Genomic DNA exhibited a 1 003 bp deletion spanning from intron 8, across exon 9 into intron 9. The deletion breakpoints occurred between two 7-bp short tandem repeat sequences. There was no variation in the sequences of the remaining exons. The Rh hybridization box test showed that there was one RHD negative allele. CONCLUSION This specimen is Del type caused by deletion of RHD exon 9.
Humans ; Blood Donors ; Rh-Hr Blood-Group System/genetics* ; China ; Phenotype ; Exons ; Genotype ; Alleles

Objective To understand the dynamic changes of the pathogen spectrum of viral diarrhea in Southwest China, and to provide a scientific basis for formulating prevention and control measures. Methods A total of 2 262 fecal samples of diarrhea cases were collected from the diarrhea monitoring sites in Yunnan, Sichuan, and Chongqing from January 2017 to December 2019. The detection of rotavirus, norovirus, adenovirus, astrovirus, and sapovirus was performed by real-time PCR, and their epidemiological data were collected. Results The ratio of male to female patients was 1.30:1. The majority of patients were 3 years old and younger, accounting for 52.21%% of all cases. Children living at home accounted for 49.38% of all cases. The detection rate of rotavirus was 10.70%, followed by norovirus at 10.43% and adenovirus at 4.60%. The detection rate of rotavirus was the highest in Yunnan and Chongqing, which were 20.18% and 16.96%, respectively, while the detection rate of norovirus was the highest in Sichuan, which was 13.54%. Conclusion Rotavirus was still the main diarrheal pathogen in Southwest China. High incidence of diarrhea occurred in autumn and winter, with children living at home being the main patients. Measures should be taken to prevent outbreaks caused by norovirus and adenovirus.

AIM: To investigate the prevalence and risk factors of pterygium in Zhuang and Miao nationality adults aged 40 and over in Wenshan prefecture, Yunnan Province.METHODS: An epidemiological survey of Zhuang and Miao nationality in Yunnan Province was conducted by using the portable slit-lamp and Keratograph-D eye surface analyzer. The Logistic regression analysis was operated to determine the impact of gender, age, occupation, outdoor activities and nationality on pterygium.RESULTS: Totally 1 239 participants were included from March to November 2019, 437 people had pterygium in one or both eyes, and the total prevalence was 35.27%. Pterygium of both eyes accounted for 59.27% while pterygium of single eye accounted for 40.73%. The prevalence of pterygium was 34.84%(224 people)in Zhuang population and 35.74%(213 people)in Miao population, there was no significant difference between the two groups(P=0.740). According to the result of Logistic regression analysis, opening of meibomian is the influencing factor of pterygium(P=0.019), with OR=1.348. Gender, age, education, outdoor activities, hypertension and eating habits were not the influencing factors of pterygium. Logistic regression was used to analyze the invasion degree of pterygium. The results showed that the height of lacrimal river was the influencing factor of pterygium(P=0.048). The lower the lacrimal river height, the greater the degree of invasion.CONCLUSION: The prevalence of pterygium in Zhuang and Miao nationality aged 40 and over in Wenshan prefecture, Yunnan Province is high, with no significant difference between the two nationalities. The function of meibomian gland, the quality and quantity of tears are related to pterygium.

AIM: To identify pathogenic mutations of CYP4V2 gene in two Chinese families with Bietti crystalline corneoretinal dystrophy(BCD)by Sanger sequencing.

METHODS: The relevant clinical examination of BCD patients were collected. Peripheral blood of patients and their family members was collected. Then DNA was extracted from peripheral blood, and Sanger sequencing was used to identify mutation sites.

RESULTS: Two probands of BCD from different families were collected. All the probands showed progressive decrease of visual acuity and typical crystal-like material deposition could be seen in the fundus. Sanger sequencing showed that proband 1 and her brother and sister all had homozygous mutation of c.802-8_810del17insGC in CYP4V2 gene. On the other hand, proband 2 had a compound heterozygous mutation of c.219T>A(p.F73L)and c.802-8_810del17insGC in CYP4V2 gene.

CONCLUSION: The most common mutation was c.802-8_810del17insGC in Chinese BCD patients. The homozygous c.802-8_810del17insGC mutation was the cause of BCD in the proband 1 family. On the other hand, proband 2 had c.802-8_810del17insGC heterozygous mutation and c. 219T>A(p.F73L)heterozygous missence mutation, all of which affected the normal coding of CYP4V2 gene and led to disease.

Objective To understand the laboratory technicians’ abilities in blood slide making and reading in 10 prefectures of Yunnan Province which have passed the provincial malaria elimination evaluation, so as to provide the evidence for improving the malaria elimination surveillance and parasite examination. Methods Thirty negative blood slides were randomly sampled to evaluate coating, dyeing and clean quality and reading results, and 4 laboratory technicians were sampled to evaluate their reading abilities from each prefecture level and its 2 subordinate counties (districts) respectively, and then the results were analyzed. Results A total of 869 negative blood samples were evaluated. The coincidence rate was 100%. The proportions of good coating, dyeing and clean quality were 96.09%, 91.71% and 96.89%, respectively. Totally 576 blood slides were used to evaluate the reading ability. The number of correct reading was 505, and the correct rate was 87.67%. Among them, the Plasmodium vivax correct reading rate was 87.76%, the P. falciparum correct reading rate was 87.50%, and the correct reading rate of mixed infections was 47.62%. The laboratory technicians’ ability to the mixed infections was significantly lower than the ability to the others (χ² = 37.169, P < 0.05), however, in the laboratory technicians’ abilities, there was no significant difference among the center (s) for disease control and prevention, general hospitals and township hospitals (χ² = 2.782, P > 0.05), and the prefecture, county and township levels (χ² = 0.358, P > 0.05) . Conclusion The 10 prefectures have passed the provincial evaluation in blood slide making and microscopic examination skill indicators requested, but the medical and public health institutions at all levels still should further improve their laboratory technicians’ abilities in blood slide making and microscopic examination skills.

China ; Female ; HIV Infections ; HIV-1 ; Humans ; Incidence ; Pregnancy ; Prevalence ; Sentinel Surveillance

OBJECTIVE: To explore the mediating role of doctor-patient relationship between occupational stress and job burnout of medical staffs involved in the prevention and treatment of patients with acquired immune deficiency syndrome(AIDS) and the regulating role of personality traits. METHODS: A total of 346 medical staffs who are involved in AIDS prevention and treatment from 29 antiviral treatment sites in Yunnan Province were selected as the study subjects using convenience sampling method. The Questionnaire of Doctor-Patient Interaction, Subscale of Feeling Stress, Questionnaire of Chinese Job Burnout, and China′s Big Five Personality Questionnaire(short version) were used to investigate these subjects. The mediating-regulating model was tested with the Process program. RESULTS: The total scores of doctor-patient relationship, occupational stress, personality traits and job burnout were(43.6±9.2),(153.1±29.5),(156.2±17.9) and(67.7±16.8), respectively. The job burnout was associated with doctor-patient relationship and occupational stress(correlation coefficients were-0.31 and 0.24, respectively, all P<0.05). Occupational stress had a direct effect on job burnout(P<0.01). The doctor-patient relationship had a mediating effect between occupational stress and job burnout(P<0.05), which accounted for 13.1% of the total effect. It was regulated by open personality traits(P<0.01). CONCLUSION: The doctor-patient relationship has a mediating effect between the occupational stress and job burnout of the medical staffs engaged in AIDS prevention and treatment, and the open personality traits plays a moderating role.

AIM: To observe the medium-long-term efficacy of trabeculectomy in the treatment of pigmentary glaucoma(PG).METHODS: The clinical data of 38 patients(51 eyes)who were diagnosed with PG and received trabeculectomy at the Affiliated Hospital of Yunnan University from January 2010 to September 2022 were retrospectively analyzed. The postoperative follow-up ranged from 3 to 144mo. The intraocular pressure(IOP), visual acuity and refractive status were analyzed, complications were recorded and surgical efficacy was evaluated.RESULTS: The average preoperative use of IOP lowering drugs was 2.90±0.12, with a mean IOP of 18.89±7.40mmHg. The IOP at 3d, 1, 3, 6mo, 1a after surgery and the last follow-up visit were 14.68±5.08, 13.99±2.95, 14.25±2.50, 14.36±2.83, 14.33±2.66, 14.94±1.95mmHg, respectively, and postoperative IOP was significantly lower at all time points than that before surgery(P<0.05), while there was no significant difference at all time points after surgery(P>0.05). During the follow-up period, the visual acuity of all patients was stable, and no endophthalmitis or malignant glaucoma occurred. At the last follow-up, the complete success rate was 90%, the qualified success was 8%, and the failure rate was 2%.CONCLUSION: Trabeculectomy is a safe and effective treatment method for PG, which can effectively control the IOP, and stabilize the visual acuity and relieve the reverse pupil block.