Objective To evaluate the safety to perform 23G vitrectomy with scleral incisions at 5.0 mm behind the limbus.Methods This is a prospective uncontrolled case study.The data of 140 consecutive primary 23G vitrectomy patients (145 eyes) were enrolled in this study.There were 56 males (59 eyes) and 84 females (86 eyes),with the mean age of (56.34 ± 9.98) years and axial length of (23.99± 2.57) mm.There were 139 phakic eye and 6 aphakic eyes.All the eyes received 23G pars plana vitrectomy with scleral incisions at 5.0 mm behind the limbus.To measure the normal Chinese adult parameters of anteroposterior axis of the eyeball,lens thickness and scleral distances from the limbus to the plane passing through the lens posterior apex,the head CT scans of 105 patients without eye diseases in our hospital were studied during the same period of time for these vitrectomy surgeries.Pearson correlation analysis was used to analyze the relationship between age,anteroposterior axis of eyeball,lens thickness and scleral distances from the limbus to the plane passing through the lens posterior apex.Results Surgical related complications included retinal tears close to the scleral incision sites (3/145 eyes,2.1％) and lens injury (3/121 eyes,2.5％).No other surgical complications occurred,such as retinal hemorrhage,supra-choroidal expulsive hemorrhage and iatrogenic retinal detachment.Based on CT images,the average scleral distance from limbus to the plane passing through the lens posterior apex,anteroposterior axis of eyeball and lens thickness was (6.72± 0.81),(24.39± 0.97),(4.22 ± 0.47) mm,respectively.The results of Pearson correlation analysis showed that age and lens thickness had statistically significant correlation (r=0.328 9,P=0.000 6).Conclusion Primary 23G pars plana vitrectomy with incisions at 5.0 mm posterior to the limbus is safe.

OBJECTIVE:To explore the clinical related factors of leucopenia induced by azathioprine in the treatment of inflam-matory bowel disease (IBD). METHODS:Clinical information of 114 IBD patients were collected from our hospital during Jan. 2013-Mar. 2015. Steady concentration of AZA metabolite 6-thioguanine(6-TGNs)in red blood cell was determined by HPLC. The correlation of patient’s gender,age,diseases,AZA daily dose and blood concentration of 6-TGNs with leucopenia induced by AZA were investigated. The optimal critical value of leucopenia could be predicted with ROC curves. RESULTS:Among 114 IBD patients,40 patients suffered from leucopenia(35.1%). There was no statistical significance in the proportion of leucopenia among patients with different age,gender,diseases and AZA daily dose(P>0.05). There was statistical significance in the proportion of leucopenia among patients with different concentrations of 6-TGNs(P<0.05). Mean blood concentration of 6-TGNs in leukopenia patients [(407.82±262.88)pmol/(8×108)RBC] was higher than patients with normal leukocyte level [(275.85±118.37)pmol/(8× 108)RBC],with statistical significance(P<0.05). ROC curve predicted that the optimal critical value of leucopenia was blood con-centration of 6-TGNs>291.04 pmol/(8 × 108)RBC. CONCLUSIONS:AZA induced leucopenia may be related to the concentration of 6-TGNs in red blood cell of IBD patients,and high concentration of 6-TGNs is risk factors of leucopenia. Clinicians can provide AZA individual treatment for IBD patient to reduce the occurrence of leucopenia according to routine blood test and the concentra-tion of 6-TGNs.

Objective To develop an HPLC method for the determination of mycophenolic acid(MPA), mycophenolic acid glucuronide(MPAG) in plasma.Methods The samples were precipitated with zinc sulphate-methanol solution before injection.Carbamazepine was selected as internal standard,ZORBAX XDB C18 (4.6 mm ×250 mm,5 μm) column was used and the flow rate was 1 mL/min.The mobile phase consisted of methanol-acetonitrile-potassium dihydrogen phosphate buffer solution(gradient elution) .The column temperature was 30℃ and the detective wave length was 254 nm.And then the MPA,MPAG concentration of 32 patients in 7-14 days after renal transplantion were determined.Results The assay was linear within 0.2-50μg/mL for MPA, 2.5-500 μg/mL for MPAG(r>0.999).Absolute recovery rates of MPA,MPAG were more than 80%, the recoveries were between 90%-110%.The intra-day and inter-day RSDs were both lower than 10%.Totally 32 cases of renal transplantion patiens were with mycophenolate mofetil at the dose of 1-1.5 g/d,and MPA in plasma was within the range of 0.32-6.19μg/mL,MPAG in plasma was within the range of 9.52-149.25μg/mL.Conclusion The method is accurate, convenient and rapid, which could be used in the quantitative determination of plasma concentration of MPA,MPAG in renal transplantion patients.

The preparation of a novel amphiphilic dietary fiber LDL adsorbent with sulfonic group and laurylamine group was studied. The effects of reaction time and reaction temperature on the adsorption rate were studied. The results show that the adsorption rates for the removal of Total cholesterol (TC), Low-density lipoprotein cholesterol (LDL-C) and High-density lipoprotein cholesterol (HDL-C) are 40.8%, 50.8% and 23.6%, respectively. The amphiphilic adsorbent has better selectivity in removing LDL-C.
Adsorption ; Binding, Competitive ; Cholesterol ; blood ; isolation & purification ; Dietary Fiber ; pharmacology ; Lipoproteins, LDL ; blood ; isolation & purification

Objective To investigate the cognition and attitude about human papillomavirus (HPV) and HPV vaccines among nurses, so as to provide a certain basis for the popularization of HPV vaccine. Methods A self-designed questionnaire was used to survey the cognition and attitude about HPV and its vaccine among nurses in Zhejiang Cancer Hospital by a professional platform named "Wenjuanxing" from August to September 2017. A total of 206 questionnaires were collected.Results Among 206 nurses, 98.5％ of the nurses had heard of HPV, only 14.1％ knew HPV could spread through touching and 41.3％ knew that HPV infection can be self subsided. 90.3％ of the nurses had heard of HPV vaccine. 78.6％ of the nurses would like to take HPV vaccine, and 70.2％ of the nurses agreed their daughters to take HPV vaccine. Over 60％ nurses worried about the safety and efficacy of HPV vaccine.Conclusions Nurses have some knowledge about HPV and HPV vaccine, but it is not comprehensive enough. The government should strengthen the publicity of knowledge about HPV and HPV vaccine.

Objective By measuring the nursing staffs′psychology of work adaptability and engagement before and after the utilization of hemodialysis information system, multidimensional comparative analysis was used to compare the differences of nursing staffs′ psychology between before and after the utilization of hemodialysis information system. Methods To select nursing staffs working in the Sixth People′s Hospital Affiliated Shanghai Jiaotong University, the nursing staffs were investigated by work attitude scale ( WA) and Utrecht work engagement scale ( UWES) before the implementation of hemodialysis information system. The collected data was statistically analyzed by SPSS 19. 0. Results Before the implementation of hemodialysis information system, score of WA was (20. 79 ± 3. 39), and the differences of nursing staffs in different age group had statistical significance (P <0. 01); the differences were statistically significant in WA scores of nursing staffs with different educational background after 4, 6 and 10 weeks implementation of hemodialysis information system (P<0. 05); the differences were no statistically significant in different work experiences between before and after implementation of the system (P>0. 05). The score of UWES was (48. 53 ± 9. 02) before usage of the system;when staffs had different age, education background and length of work experience, the differences had statistical significance (P >0. 05). Conclusions Hemodialysis information system can reduce obstacles of nursing staffs′ work adaptability working in Hemodialysis Room, enhance work engagement and achieve digital, scientific and modernized nursing service, so as to provide a safe and comprehensive quality nursing service for hemodialysis patients.

Objective: To investigate the relationship of stigma, coping style and psychosocial adjustment in young patients with breast cancer after operation, and the mediating effect of different coping style between stigma and psychosocial adjustment. Methods: The general information questionnaire, Social Impact Scale (SIS), Medical Coping Style Questionnaire (MCMQ) and psychosocial adjustment questionnaire for breast cancer were used to investigate the stigma, coping style and psychosocial adjustment of 292 young patients with breast cancer after operation in the affiliated hospital of Qingdao University. Results: There was a negative correlation between stigma and confrontation coping, psychosocial adjustment(r=-0.687--0.519, all P<0.01), but a positive correlation with yield coping and avoidance coping (r=0.426-0.500, all P<0.01).There was a positive correlation between psychosocial adjustment and confrontation coping(r=0.594, P<0.01), and was a negative correlation between psychosocial adjustment and avoidance copying, yield copying(r=-0.643--0.519, all P<0.05). The mediating effects of confrontation coping and avoidance coping were 32.86% and 18.81% respectively. Conclusions The stigma and coping style of young patients with breast cancer after operation were closely related to psychosocial adjustment. Nursing staff should guide the patients to adopt positive coping style, reduce the stigma, promote the psychosocial adjustment, and help the patients to return to normal life as soon as possible.

Objective: To investigate the lens and ora serrata safety during 23G vitrectomy with sclera incisions at 5.0 mm or 4.0 mm posterior to the limbus. Methods: A prospective case-controlled study was adopted. From April 2016 to January 2018, 290 consecutive primary 23G vitrectomy patients (300 eyes) with vitreoretinal disease in Department of Ophthalmology of Subei People’s Hospital Affiliated to Yangzhou University were enrolled in this study. Among them, 146 patients (150 eyes) received 23G pars plana vitrectomy (PPV) with scleral incisions at 5.0 mm posterior to the limbus (5.0 mm group), and 144 patients(150 eyes) at 4.0 mm (4.0 mm group). No statistically significant difference was found in age, axial length(t=−1.324, 0.867; P=0.186, 0.387) and in gender, right/left eyes, proportion of indications (χ²=1.366, 2.615, 10.195; P=0.242, 0.106, 0.070) between the two groups. The incidence rate of complications between the two groups were comparatively observed, such as lens injury, retinal tears close to the scleral incision, retinal hemorrhage, supra-choroidal expulsive hemorrhage and iatrogenic retinal detachment. Independent sample t test and χ² test were performed for comparison between the two groups. Results: Lens injury was observed in 4 eyes(2.67%) and 14 eyes (9.33%) respectively in the 5.0 mm and 4.0 mm group during surgery (χ²=5.910, P=0.015). Retinal tears close to the scleral incision sites were observed in 5 eyes (3.33%) and 6 eyes (4.00%) respectively in the 5.0 mm and 4.0 mm group during surgery (χ²=0.094, P=0.759). The mean time of removing the vitreous base was 6.17±2.76 min and 10.03±5.56 min respectively in the 5.0 mm and 4.0 mm group (t=7.599, P <0.01). No other surgical complications occurred in any group, such as retinal hemorrhage, supra-choroidal expulsive hemorrhage and iatrogenic retinal detachment, etc. Conclusion In primary 23G PPV, the safety of ora serrata with incisions at 5.0 mm posterior to limbus is similar to that at 4.0 mm, but the safety of lens and the efficiency of vitreous resection is higher with incisions at 5.0 mm.

Objective:To develop a risk prediction model for postoperative catheter-associated urinary tract infection (CAUTI) in patients with gynecologic malignancies, so as to provide a reference for the prevention of CAUTI.Methods:From January to June 2020, convenience sampling was adopted to select postoperative 800 patients with gynecologic malignancies and indwelling urinary catheters in Zhejiang Cancer Hospital as the research object. The patients were divided into derivation samples (derivation group) and validation samples (validation group) according to the ratio of 3∶1 by random number table method. In the derivation group of 600 cases, the predictive factors were analyzed by binomial Logistic regression analysis and the risk prediction model was developed. In the validation group of 200 cases, the receiver operating characteristic curve was used to evaluate the prediction performance of the model.Results:Binomial Logistic regression analysis showed that age ≥ 60 years old, intraoperative urinary tract injury, postoperative bladder irrigation, and indwelling catheter for more than 7 days were risk factors for CAUTI, and the difference was statistical ( P<0.05) . Model evaluation showed that the area under the receiver operating characteristic curve of the validation group was 0.79 with a statistical difference [95% CI (0.72, 0.87) , P<0.01], and the sensitivity, specificity and Youden index were 71.8%, 78.3% and 50.1% respectively. Conclusions:The prediction performance of the model is good, which helps medical and nursing staff to monitor high-risk patients and reduce the occurrence of CAUTI.

OBJECTIVE： To study the relationship of CYP3A4， CYP2C8 and CYP3A5 gene polymorphism with ADR/blood concentration of hydroxychloroquine in patients with autoimmune disease （AID）， and to provide reference for individual medication of hydroxychloroquine. METHODS： Totally 77 AID patients，who were treated with hydroxychloroquine （daily dose of 200 mg to 400 mg） for a long-term （＞6 months）， were selected from the department of rheumatology and immunology， the First Affiliated Hospital of Anhui Medical University during Jul. 2017 to Aug. 2018. The information， blood sample and ADR of them were collected. Those patients were divided into normal liver function group， abnormal liver function group， normal renal function group， abnormal renal function group， normal eye group and abnormal eye group according to the site of ADR. The concentration of hydroxychloroquine was determined by HPLC. Genotype of CYP3A4， CYP2C8 and CYP3A5 were detected by MassARRAY microarray system. The differences of hydroxychloroquine-induced ADR in different genotypes were analyzed by χ2 test. The blood concentration difference of hydroxychloroquine in different genotypes were analyzed by independent sample t-test and one-way ANOVA. RESULTS： There was statistical significance in the distribution of CYP3A5 rs4646453 locus between normal renal function group and abnormal renal function group（P＜0.05）. The incidence of CC genotype was higher than that of AA+AC genotype in abnormal renal function group. There was statistical significance in the distribution of CYP2C8 rs10882526 locus between normal liver function group and abnormal liver function group（P＜0.05）. The incidence of allele G was higher than that of allele A in abnormal liver function group， and the incidence of AG genotype was higher than that of AA genotype. There was no significant correlation of the gene polymorphisms of CYP3A4， CYP2C8 and CYP3A5 with blood concentration among 77 AID patients. In subgroup analysis， blood concentration of GT， GG and TT genotypes of CYP2C8 rs10882521 in 58 patients with systemic lupus erythematosus （SLE） were 514.1，735.3 and 785.9 ng/mL， respectively； GG and TT genotypes were significantly higher than GT genotype （P＜0.05）. CONCLUSIONS： AID patients with CYP3A5 rs4646453 CC genotype have a higher incidence of renal dysfunction due to taking hydroxychloroquine； patients with CYP2C8 rs10882526 locus allele G and AG have a relatively high incidence of renal dysfunction due to taking hydroxychloroquine. When SLE patients taking the same dose of hydroxychloroquine， the blood concentration of hydroxychloroquine in patients carrying CYP2C8 rs10882521 GT genotype is lower than other genotypes.